Search Results (2,344)

Background and Objectives: The COVID-19 pandemic placed substantial mental and physical burdens on healthcare workers, particularly nurses. In the post-pandemic period, sustained stress, elevated mental workload and disturbed sleep may continue to affect well-being and job performance. This study aimed to assess perceived stress levels, occupational stress, and sleep quality among Hungarian nurses, while identifying key demographic, occupational, and behavioral predictors. Materials and Methods: A cross-sectional, quantitative study was conducted from April to July 2022 among nurses employed in Hungarian general hospitals (N = 418). Data were collected via an online self-administered questionnaire. Stress and sleep quality were measured using the Perceived Stress Scale (PSS-14), Expanded Nursing Stress Scale (ENSS), and Groningen Sleep Quality Scale (GSQS). Statistical analysis included descriptive statistics, ANOVA, post hoc tests, t-tests, and Pearson’s correlation (p < 0.05). Results: The mean PSS-14 score was 27.82 (SD = 7.82), indicating moderate stress. Sleep quality was poor (mean GSQS = 7.29, SD = 4.28), with significant positive correlation with perceived stress (r = 0.442, p < 0.001). Low income, lower education, and high coffee or alcohol consumption, and multiple night shifts were significantly associated with higher stress and poorer sleep quality. Occupational stress and mental workload, as measured by ENSS, was highest in internal medicine (mean = 122.16, SD = 37.09; p = 0.033). The most burdensome ENSS subscale was “workload” (mean = 2.30, SD = 0.92), with “not enough staff to adequately cover the unit” identified as the most stressful item. Additional cognitive and emotional workload components included dealing with violent patients and a lack of emotional preparedness in supporting families. Conclusions: Post-COVID nurses in Hungary experience moderate stress and impaired sleep. Excessive workload, emotional demands, and shift patterns significantly contribute to psychological and cognitive strain. Institutional and policy-level interventions are needed to reduce occupational stress and promote workforce resilience. Full article

Background/Objectives: The adoption of artificial intelligence (AI) in healthcare, particularly in high-stakes environments such as operating rooms (ORs), is expanding rapidly. While AI has the potential to enhance patient safety and clinical efficiency, it may also trigger anxiety among healthcare professionals due to uncertainties around job displacement, ethical concerns, and system reliability. This study aimed to examine the relationship between AI-related anxiety and patient safety attitudes among OR professionals. Methods: A descriptive, cross-sectional research design was employed. The sample included 155 OR professionals from a university and a city hospital in Turkey. Data were collected using a demographic questionnaire, the Artificial Intelligence Anxiety Scale (AIAS), and the Safety Attitudes Questionnaire–Operating Room version (SAQ-OR). Statistical analyses included t-tests, ANOVA, Pearson correlation, and multiple regression. Results: The mean AIAS score was 3.25 ± 0.8, and the mean SAQ score was 43.2 ± 10.5. Higher AI anxiety was reported by males and those with postgraduate education. Participants who believed AI could improve patient safety scored significantly higher on AIAS subscales related to learning, job change, and AI configuration. No significant correlation was found between AI anxiety and safety attitudes (r = −0.064, p > 0.05). Conclusions: Although no direct association was found between AI anxiety and patient safety attitudes, belief in AI’s potential was linked to greater openness to change. These findings suggest a need for targeted training and policy support to promote safe and confident AI adoption in surgical practice. Full article

China’s healthcare expenditure tripled during 2010–2019, prompting the nationwide implementation of centralized volume-based procurement (CVBP). While effective in reducing drug prices, CVBP introduces sustainability challenges including supply chain vulnerabilities and welfare trade-offs. This study develops a pharmaceutical sector-embedded computable general equilibrium (CGE) model to quantify CVBP’s multidimensional sustainability impacts. Using China’s 2020 Social Accounting Matrix (SAM) with simulated 10–50% price reductions, key findings reveal that (1) >40% price reductions trigger sectoral output reversal; (2) GDP exhibits an inverted U-shape; (3) household income declines despite corporate/government gains; and (4) industrial contraction impairs innovation capacity and employment stability. Our analysis identifies potential sustainability risks, emphasizing the need for rigorous empirical validation prior to implementing aggressive price reduction policies, and underscores the importance of integrating supply chain considerations into procurement policy design. This approach maximizes resource allocation efficiency while advancing socioeconomic resilience in healthcare systems. Full article

Background: The COVID-19 pandemic caused lasting disruption to healthcare systems and the mental health of frontline workers. Though the acute crisis has passed, many healthcare workers (HCWs) continue to experience long-term psychological effects, including anxiety, grief, and burnout. This mixed-methods study investigates the enduring effects of the COVID-19 pandemic on the mental health of physicians in a low-resource country. Methods: Drawing on data from the ear, nose, and throat (ENT) or otolaryngology department at a tertiary care hospital in Pakistan, the study employed an explanatory mixed-methods design, combining structured surveys and semi-structured interviews. The Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Brief COPE Inventory were administered to 42 ENT specialists, trainees, and house officers, alongside semi-structured interviews with eight ENT physicians. Results: Survey results revealed moderate to high levels of anxiety, depression, and stress that persisted beyond the acute crisis phase of the pandemic. Interviews provided nuanced insights into the emotional burden experienced by physicians, including persistent concerns about contagion risk, professional isolation, and increased workload. Physicians described maladaptive responses and employed active coping strategies, such as seeking peer support and utilizing adaptive problem solving. Conclusions: The COVID-19 pandemic has had enduring effects on the mental well-being of physicians. Targeted interventions and policy reforms that address the ongoing pressures frontline physicians face in resource-constrained environments may help mitigate these burdens, support healthcare professionals more effectively, and improve their mental health. Full article

In response to contemporary challenges such as the COVID-19 pandemic, climate change, armed conflicts, and economic instability, healthcare systems worldwide are increasingly confronted with multifaceted and overlapping crises—collectively referred to as polycrisis. These interconnected threats amplify one another, placing unprecedented strain on healthcare infrastructure, governance, and equity. The COVID-19 pandemic alone led to an estimated 16.3 million missed hospitalizations in 2020 and 14.7 million in 2021, revealing systemic vulnerabilities and deepening social inequalities. Armed conflicts, such as in Syria and Gaza, have devastated healthcare access. In Gaza, by mid-2024, 85% of the population had been forcibly displaced, with only 17 of 36 hospitals partially functioning and over 885 healthcare workers killed. Climate change further exacerbates health burdens, with over 86% of urban residents globally exposed to harmful air pollution, contributing to 1.8 million deaths annually. This study introduces a novel perspective by applying social epidemiology to the analysis of polycrisis. While the existing literature often emphasizes political or economic dimensions, our approach highlights how overlapping crises affect population health, social vulnerability, and systemic resilience. By integrating sociodemographic and environmental data, social epidemiology supports crisis-resilient care models, targeted interventions, and equitable health policies. We argue for a stronger mandate to invest in data infrastructure, enhance surveillance, and embed social determinants into health system responses. Full article

Physical and mental health are intrinsically linked. However, healthcare systems, training programs, and clinical practice often operate in silos, creating structural disincentives that exacerbate morbidity, mortality, and economic burden. Integrated care models have consistently demonstrated improved outcomes, enhanced quality of life, and greater cost-effectiveness across a range of neuropsychiatric and chronic disorders. With the launch of the World Health Organization Brain Health Framework (2022) and the Swiss Brain Health Plan (2023–2033), important progress has been made toward integrating mental and brain health. However, current brain health concepts could be further strengthened by more explicitly incorporating the role of the body and physical health, including psychosomatic and social aspects, particularly in terms of their dynamic, bidirectional interactions with the brain. This article further outlines the health-related and economic benefits of integrated care, key challenges to the systematic implementation of mind–body integration within healthcare systems, and proposes strategic directions for embedding body–brain dynamics into research, education, and policy. This includes interdisciplinary teaching, harmonized conceptual models, composite clinical metrics, transferable interventions, and the removal of systemic barriers to establish integrated care pathways and reduce stigma through patient-centered empowerment. Ultimately, the “no health without brain health” ethos demands the conceptual and practical integration of dynamic, bidirectional body–brain interactions. Full article

The health technology assessment (HTA) is a multidisciplinary process utilized to determine the clinical, economic, social, and ethical value of new health technologies before they are incorporated into healthcare systems. In the case of rare diseases, such as Cystic Fibrosis (CF), challenges arise due to limited evidence and high treatment costs. Indeed, although CF transmembrane conductance regulator (CFTR) modulators are breakthrough therapies for CF, their incorporation into public health systems has been complex with considerable challenges, especially in low- and middle-income countries. This article presents a descriptive and exploratory case study of the regulatory and policy journey for CFTR modulators to be approved in Brazil. Based on a narrative review and document analysis, we highlight the importance of building lay society knowledge to shape policy decisions and promote equitable access to innovative therapies. In parallel, we critically reflect on the HTA process and highlight efforts in the training, education, and coordination required to enable meaningful public engagement and landmark achievements. Full article

The World Health Organization (WHO) declared snakebite envenoming (SBE) as a neglected tropical disease in 2017. Antivenom is the gold standard of treatment, but many healthcare barriers exist, and hence, affected populations are often unable to access it. The challenge is further perpetuated by the lack of attention from national health authorities, poor regulatory systems and policies, and mismanagement of antivenom. This study aims to map the evidence regarding snake antivenom regulations globally and identify gaps in the literature to inform future research and policy. This review was conducted using the original Arksey and O’Malley framework by three independent reviewers, and the results were reported using the Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). A search strategy was developed with assistance from a librarian, and six databases were searched: PubMed, SCOPUS, ProQuest Central, Africa Wide Web, Academic Search Output, and Web of Science. Screening was conducted independently by the reviewers, using Rayyan, and conflicts were resolved with discussions. A total of 84 articles were included for data extraction. The major themes that emerged from the included studies were regarding antivenom availability, accessibility, manufacturing, and regulations. The study revealed massive gaps in terms of policies governing antivenom management, especially in Asia and Africa. The literature does not offer sufficient evidence on management guidelines for antivenom in the endemic regions, despite identifying the challenges in supply. However, significant information from Latin America revealed self-sufficient production, involvement of national health bodies in establishing efficient regulations, effective distribution nationally and regionally, and technology sharing to reduce SBE-related mortality. Full article

Background/Objectives: The middle-income countries (MICs) in the Middle East and North Africa (MENA) region face multifaceted challenges—including fiscal constraints, conflict, and vaccine hesitancy—that impede the timely introduction of critical vaccines. This study examines the status, barriers, and facilitators to introducing three critical vaccines—human papillomavirus vaccine (HPV), pneumococcal conjugate vaccine (PCV), and rotavirus vaccine (RV)—across seven MENA MICs, to identify actionable solutions to enhance vaccine uptake and immunisation coverage. Methods: Using the READ methodology (ready materials, extract, analyse, and distil data), this review systematically analysed policy documents, reports, and the literature on the introduction of HPV, PCV, and RV vaccines in seven MENA MICs. A data extraction framework was designed to capture the status of vaccine introduction and barriers and facilitators to introduction. Findings and data gaps were validated with stakeholder consultations. Results: Of the seven study countries, progress in introducing PCV and RV has been uneven across the region (five countries have introduced PCV, four have introduced RV, and only a single country has introduced HPV at time of writing), hindered by vaccine hesitancy, fiscal challenges, and insufficient epidemiological data. Morocco is the only country to introduce all three vaccines, while Egypt has yet to introduce any. Other common barriers include the impact of conflict and displacement on healthcare infrastructure, delayed introduction due to the 2020 COVID-19 pandemic, and limited local production facilities and regional cooperation. In addition, not all countries eligible for Gavi MICs support have applied. These findings provide a roadmap for policymakers to accelerate equitable vaccine introduction in the MENA region. Conclusions: Targeted efforts, such as addressing fiscal constraints, improving local manufacturing, tackling gender barriers, and fostering public trust, paired with regional collaboration, can help bridge gaps and ensure no community is left behind in preventing vaccine-preventable diseases. Full article

Climate change is the biggest global health threat of the 21st century. However, this challenge presents an opportunity to do things differently. This paper sets out how, using a design-led and collaborative approach, one can re-imagine the delivery of healthcare itself in a way that will deliver environmental sustainability. The paper presents a series of eight projects at the intersections of design, health and wellbeing, and complex net zero challenges, with an emphasis on inclusive, equitable, and sustainable design-led interventions. This encompasses diverse interventions across and beyond conventional design boundaries such as architecture, product design, and textile design providing insights that demonstrate the impact of design thinking, making, and acting on real-world net zero issues. Addressing such a broad and complex topic requires engagement across a wide range of stakeholders. The work undertaken has been conducted as part of a UK Government-funded Green Transition Ecosystem (GTE) Hub that has allowed multiple academic disciplines, research organisations, regional and local industry, and other public sector stakeholders, to connect with policy makers. Across seven themes, the paper describes how Design HOPES (Healthy Organisations in a Place-based Ecosystem, Scotland), as a design-led GTE Hub, brings in multiple and marginalised perspectives and how its design-led projects as one part of a wider movement for transformational change can re-use, nurture and develop these interventions sustainably. The overarching ambition being, through our collaborative design-led thinking, making, and acting, to build a more equitable and sustainable health and social care system across Scotland. Full article

As cyber threats such as phishing and ransomware continue to escalate, healthcare systems are facing significant challenges in protecting sensitive data and ensuring operational continuity. This study explores how email communication practices influence cybersecurity in Saudi Arabia’s healthcare sector, particularly within the framework of rapid digitalisation under Vision 2030. The research employs a qualitative approach, with semi-structured interviews conducted with 40 healthcare professionals across various hospitals. A phenomenological analysis of the data revealed several key vulnerabilities, including inconsistent cybersecurity training, a reliance on informal messaging apps, and limited awareness of phishing tactics. The inconsistent cybersecurity training across regions emerged as a major weakness affecting overall resilience. These findings, grounded in rich qualitative data, offer a significant standalone contribution to understanding cybersecurity in healthcare settings. The findings highlight the need for mandatory training and awareness programmes and policy reforms to enhance cyber resilience within healthcare settings. Full article

Background/Objectives: Introducing new transformative surgical technology involves navigating a complex process from design to implementation, often hindered by various barriers that delay the transition into clinical practice. This review critically examines the barriers, proposes a unified guide for medical device implementation in the Australian healthcare system utilising the validated Medtech Innovation Guide, and compares regulatory frameworks in Australia, the United Kingdom, and the United States of America. Methods: We conducted a literature review using MEDLINE and EMBASE with MeSH terms or emtree terms and keywords “new OR novel” AND “surgical device OR medical device OR health technology OR surgical technology OR surgical instrument OR transformative technology OR technological innovation OR technological change” AND “implementation OR adoption OR innovation adoption” AND “surgery OR surgical” AND “Australia”. We also assessed governmental websites (gov.au) and documents as well as the Royal Australasian College of Surgeons (RACS) website, policies, and position statements. Furthermore, Australian medical technology start-up companies were asked for any published roadmaps. Results: Four key stakeholder groups were identified: medical professionals, government, hospitals, and patients/consumers. Barriers include surgeon scepticism, regulatory hurdles (e.g., Australian Register of Therapeutic Goods), hospital clearance processes, and meeting patient expectations. To address these challenges, we propose a five-phase system: surgical device development (phase one), compliance with regulatory processes (phase two), research and experimentation (phase three), finalisation for product launch (phase four), and product launch and assessment (phase five). Conclusions: By following our five-phase guide, innovators may better navigate the complexities of integrating transformative surgical technologies into Australian healthcare. Although there are limitations, this approach is based on the validated Medtech Innovation Guide and may help both experienced and inexperienced practitioners better implement innovative technology; however, real-world validation is required. Full article

This study aimed to understand, through the voices of patients, the factors that contribute to inequality and inequity in oral healthcare and their implications for patient safety. A qualitative study was performed using a Grounded Theory approach (GT) through 13 in-depth interviews with a flexible design, recorded and transcribed verbatim for study purposes. Open and axial coding and analysis categories were generated, and a conceptual and explicative framework was established. Ethical approval was obtained. The main findings highlighted how individual, social, and contextual factors significantly influence the materialization of risks and failures in oral healthcare, ultimately affecting patient safety in dental practice. These factors include individual factors, the relationship between professionals and patients, and failures in healthcare service provision. Participants’ discourses showed examples of inequities, such as gender, socioeconomic gradient, educative level, type of healthcare system, discrimination, stigmatization, and othering-otherness, and their effect on dental care and dentistry safety. Health inequities should be tackled in a preventive and proactive manner through the effective integration of intersectoral policies and strategies. This approach would enhance oral health, make patient safety a fundamental pillar of dental care, uphold human dignity, and strengthen trust in the healthcare system. Full article

In recent years, Italy has experienced a significant increase in violence against healthcare workers, mirroring a global trend. Manifesting as verbal, physical, psychological, and material aggression, this phenomenon endangers both personnel safety and the foundational principles of the National Health Service (SSN) as outlined in Article 32 of the Italian Constitution. The escalation—most acute in emergency departments, psychiatric units, inpatient wards, and community services—affects a broad spectrum of professionals, compromising care quality and institutional integrity. Data from the FNOMCeO-CENSIS Report 2023–2024 reveal over 18,000 reported incidents in 2024, with verbal assaults disproportionately affecting female nursing staff. The COVID-19 pandemic further exacerbated systemic vulnerabilities, heightening user dissatisfaction and psychological strain among healthcare providers. In response, legislative actions—such as Law No. 113/2020 and Decree-Law No. 137/2024—aim to strengthen prevention, monitoring, and penal measures. This article examines legal, institutional, and organizational responses, including on-the-ground and hospital-based strategies to mitigate violence. Adopting a multidisciplinary perspective, it analyzes recent policy developments, regional dynamics, and victim-perpetrator profiles, arguing that safeguarding healthcare environments is both a public security priority and an ethical imperative essential to preserving the dignity of care work and the resilience of the health system. Full article

Primary healthcare is vital to achieving universal health coverage, as emphasized by Sustainable Development Goal 3 (SDG 3). However, energy poverty remains a critical yet overlooked barrier to the efficiency of primary healthcare services in rural China—precisely the focus of this study. It employs panel regression models and threshold analysis methods using data from 31 Chinese provinces for the period 2014–2021, sourced from the EPSDATA data platform. Robustness checks are performed using bootstrap procedures, accompanied by detailed mechanism analyses. The empirical results demonstrate that rural energy poverty significantly reduces primary healthcare efficiency, particularly in provinces initially characterized by lower healthcare performance. The mechanism analysis identifies four critical transmission channels—off-farm employment, internet intensity, food safety, and health education—through which rural energy poverty undermines healthcare outcomes. Furthermore, threshold regressions uncover nonlinear relationships, indicating that the negative impacts of rural energy poverty intensify when household medical expenditures exceed 10.9%, the old-age dependency ratio surpasses 22.61%, and the rural energy poverty index is higher than 0.641. In theoretical terms, this study identifies rural energy poverty as a critical determinant of primary healthcare efficiency, thereby addressing an important gap in the existing literature. At the policy level, the findings emphasize the necessity for integrated measures targeting both rural energy poverty and primary healthcare inefficiencies to achieve SDG 3 and sustainably promote equitable, high-quality healthcare access in rural China. Full article