Search Results (131)

Cost control in engineering, procurement, and construction (EPC) public works is shaped by interacting drivers, nonlinear feedback, and qualitative judgments. Existing studies usually apply the three relevant method families separately: DEMATEL-ISM maps causal structure but does not propagate hesitation-aware expert judgments into cost trajectories; fuzzy systems represent uncertainty but commonly lack a verified causal hierarchy; and system dynamics (SDs) capture dynamic accumulation but often rely on crisp inputs. The resulting absence of a traceable causal screening to uncertainty to dynamic cost link is the specific gap addressed in this study. We therefore develop a transparent three-stage pipeline combining the Decision-Making Trial and Evaluation Laboratory–Interpretive Structural Modeling (DEMATEL-ISM) method, triangular intuitionistic fuzzy reasoning (TIFR), and SDs. DEMATEL-ISM identifies the causal hierarchy; TIFR represents membership, non-membership, and hesitation in design complexity and human–technology synergy judgments; and SDs evaluate stage-specific cost trajectories. Recalculation from the supplied 17 × 17 direct influence matrix produced a six-level hierarchy in which senior management decision-making capability and the level of integration occupy the two deepest driving levels. For the Urumqi Civic Center case, the baseline terminal cost absolute percentage error was 0.492%. A coordinated intervention scenario shifted the simulated terminal cost by CNY 12.1243 million (6.1%) relative to the baseline; this is a model-based scenario difference, not an observed project saving. Integration had the largest simulated effects on design and transportation costs, whereas senior management decision-making capability had the largest effects on procurement and construction costs. Security cost curves showed a complementary pattern between managerial capability and workers’ professional competence, but no statistical interaction effect is claimed. The framework is intended for within-case scenario comparison and intervention prioritization; multi-project and time-series validation remains necessary. Full article

Objective: Patient safety culture (PSC) is a critical determinant of healthcare quality. This study aimed to assess the current status of PSC among healthcare workers at Kien An Hospital, Hai Phong, Vietnam, and identify associated factors. Methods: A cross-sectional survey was conducted using the 12-dimension hospital survey on patient safety culture (HSOPSC). A total of 324 healthcare professionals (physicians, nurses, and allied staff) participated. Data were analyzed using descriptive statistics and multivariable logistic regression. Results: The positive response rate (PRR) across the 12 dimensions of patient safety culture (PSC) varied widely. The highest positive perceptions were observed in “Teamwork within units” (98.5%) and “Teamwork across units” (98.1%). Conversely, severe vulnerabilities in psychological safety were identified, with “Communication Openness” recording the absolute lowest PRR at 25.9%, closely followed by “Non-punitive response to error” at 29.0%. Comparative analysis between professional strata revealed broad alignment across 11 dimensions, with the sole significant divergence occurring in “Feedback and communication about error”, where physicians reported a significantly higher PRR than nurses & allied staff (85.8% vs. 75.2%; p = 0.04). In the multivariable logistic regression model, age emerged as the single independent predictor of overall positive PSC; compared to early-career staff (<30 years), healthcare workers aged 30–40 years (AOR = 4.17, p = 0.02) and 40–50 years (AOR = 5.03, p = 0.02) had significantly higher odds of favorable safety perceptions. Conclusions: Healthcare workers at the study hospital exhibit exceptionally strong collaborative teamwork, yet low communication openness and the fear of a punitive environment remain critical systemic barriers to safety. Because safety culture challenges are macro-institutional and disproportionately impact junior personnel, interventions should shift away from role-specific policies. Instead, hospital leadership must prioritize establishing non-punitive reporting mechanisms, enhancing open dialogue, and designing targeted safety culture onboarding initiatives tailored specifically to the needs of early-career healthcare workers to foster continuous organizational learning. Full article

Background/Objectives: Occupational burnout is a major challenge among healthcare workers. Night-shift work, insufficient sleep, and lifestyle factors may contribute to higher burnout levels. This study examined associations of night-shift work, sleep duration, and physical activity with burnout using the Burnout Assessment Tool (BAT). Methods: This cross-sectional study included 213 healthcare workers undergoing routine occupational health assessments in Bucharest, Romania, between January and April 2026. Burnout was assessed using the BAT-23 core questionnaire and BAT Secondary Symptoms module. Data on night-shift work, sleep duration, physical activity, age, sex, and professional experience were analyzed using group comparisons, correlations, and multivariable linear regression. Results: Night-shift workers had higher burnout scores than non-night-shift workers (3.36 ± 0.43 vs. 2.44 ± 0.41, p < 0.001), while physically active participants had lower scores than sedentary workers (2.46 ± 0.44 vs. 3.23 ± 0.52, p < 0.001). Burnout correlated negatively with sleep duration (r = −0.336, p < 0.001) and physical activity (r = −0.655, p < 0.001), and positively with night-shift work (r = 0.798, p < 0.001). In adjusted analysis, night-shift work (B = 0.831, 95% CI 0.637–1.024, p < 0.001), shorter sleep duration (B = −0.079, 95% CI −0.127 to −0.031, p = 0.001), and female sex (B = 0.162, 95% CI 0.029–0.295, p = 0.017; male = 0, female = 1) were associated with higher burnout; the model explained 58.6% of the variance. Conclusions: Night-shift work and shorter self-reported sleep duration were independently associated with higher burnout. Physical activity was associated with lower burnout only in unadjusted analyses. Owing to the cross-sectional design and self-reported exposures, findings should be interpreted as associations and confirmed longitudinally. Full article

Background: Scapular Dyskinesis (SD) is common in computer-based office workers, yet its short-term response to thoracopelvic exercise intervention is unknown. This quasi-experimental exploratory pre–post study examined the primary outcome of short-term change in SD grade and the secondary outcomes of static scapular position and passive glenohumeral (GH) rotational range of motion (ROM). Methods: Forty office workers with obvious SD in the dominant arm were assessed at baseline, immediately post-intervention, and at 24 h follow-up using the Scapular Dyskinesis Test (SDT), the Lateral Scapular Slide Test (LSST), and electronic goniometry for passive GH internal (IR) and external rotation (ER). Each completed a single thoracopelvic exercise intervention session targeting pelvic neutrality, thoracic orientation, and respiration-based core activation. Results: SDT grades fell on both sides at post-intervention and follow-up (dominant, p = 0.001, W = 0.766; non-dominant, p = 0.001, W = 0.250), shifting from obvious to subtle SD. LSST decreased only at position 2 (dominant, p = 0.014, ηp² = 0.101; non-dominant, p = 0.011, ηp² = 0.107). Dominant IR increased (p = 0.001, ηp² = 0.462) and ER decreased (p = 0.001, ηp² = 0.163); non-dominant ER increased (p = 0.015) while IR was unchanged (p = 0.847). The dominant SDT change correlated inversely with the IR change (ρ = −0.35, p = 0.03). Conclusions: A single thoracopelvic exercise intervention session was associated with selective short-term changes in SD grade and dominant-side passive GH ROM, whereas static scapular changes were limited. These findings represent preliminary response patterns rather than evidence of clinical effectiveness. Trial Registration: Clinical Research Information Service (CRIS), Korea KCT0011747 (registered retrospectively on 19 March 2026; study start date on 4 August 2025). Full article

Workers are exposed to pollutants generated by hair salon activities, which may pose potential health risks. This study measured volatile organic compound (VOC) concentrations in five hair salons using a high-sensitivity photoionization detector (PID) during daily work shifts. The highest VOC concentration was observed in Hair Salon III (0.87 ± 0.57 ppm), likely due to its high customer volume and the use of organic solvents during cleaning procedures. VOC concentrations were higher on weekends than on weekdays. Workers’ exposure to VOCs was elevated during the morning and evening periods, possibly due to inadequate ventilation and cleaning activities conducted at the beginning and end of business hours. The variance structure indicated that indoor VOC concentrations were primarily influenced by emission sources within the salons. Therefore, representative monitoring should prioritize a range of salon types to adequately characterize the variability in VOC exposure. Hair Salon III exhibited the highest exposure concentration (EC), hazard quotient (HQ), and hazard index (HI), with values of 0.055, 0.018, and 0.047, respectively. The health risk assessment indicated that workers in all five hair salons were not at significant risk of non-carcinogenic health effects, as all HQ values were below the acceptable threshold of 1.0. Full article

Background/Objectives: Shift work is associated with circadian disruption, sleep disturbances, and psychological distress, all of which may influence both reflux-related symptoms and temporomandibular disorder (TMD)-related complaints. However, the relationships among reflux-related symptom burden, TMD severity, oral parafunctional behaviors, and psychological distress in healthcare professionals remain insufficiently understood. To evaluate the association between reflux-related symptom burden, assessed using the Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) questionnaire, and TMD severity among healthcare professionals, and to investigate the potential roles of shift work, oral parafunctional behaviors, and psychological distress in this relationship. Methods: This cross-sectional observational study included healthcare professionals working at a tertiary hospital. Data were collected using validated questionnaires, including the GERD-HRQL, Fonseca Anamnestic Index, Oral Behavior Checklist (OBC), Depression Anxiety Stress Scale-21 (DASS-21), and Epworth Sleepiness Scale (ESS). Participants were categorized as shift workers (≥4 night shifts/month) and non-shift workers. Correlation and multivariable regression analyses were performed. Results: A total of 240 participants were included. Higher GERD-HRQL scores were positively correlated with TMD severity (r = 0.31, 95% CI: 0.19 to 0.42, p < 0.001), oral parafunctional behavior scores (r = 0.28, 95% CI: 0.16 to 0.39, p < 0.001), and DASS-21 stress scores (r = 0.35, 95% CI: 0.23 to 0.46, p < 0.001). Shift workers demonstrated significantly higher GERD-HRQL scores and TMD severity scores than non-shift workers, with small-to-moderate effect sizes. In multivariable analysis, higher TMD severity, OBC score, stress score, and shift-work exposure showed adjusted associations with higher GERD-HRQL scores. The model explained 32% of the variance in reflux-related symptom burden (R² = 0.32; adjusted R² = 0.29). Conclusions: Higher GERD-HRQL scores, reflecting reflux-related symptom burden rather than objectively confirmed GERD, showed weak to small-to-moderate associations with TMD severity, oral parafunctional behaviors, psychological distress, and shift-work exposure among healthcare professionals. These findings indicate co-occurrence of gastrointestinal, temporomandibular, behavioral, and psychosocial symptom domains within this occupational population. Longitudinal studies using objective diagnostic methods are required to clarify the directionality and clinical significance of these associations. Full article

GPS-derived floating car data (FCD) provide spatially continuous urban traffic observations without fixed-sensor infrastructure. This study develops a spatiotemporal baseline framework jointly modelling day type and precipitation for 1189 junction-level nodes in Budapest. A six-phase pipeline—GPS preprocessing, coordinate reprojection, FME (Feature Manipulation Engine, Safe Software Inc., Surrey, BC, Canada)-based map-matching, junction-level aggregation, Voronoi meteorological allocation, and dataset assembly—was applied to 44.1 million 10 s records from approximately 1100 probe vehicles (November 2024–December 2025). Public holidays form a structurally distinct traffic flow pattern compared to Sundays (r = 0.71) and to regular workdays (r = 0.42); morning peak shifts to 09:00–11:00 and pooling holidays with Sundays introduces reference errors of 15–25%. Precipitation raises morning peak volumes by 6–17% across all zones while afternoon peaks remain statistically unchanged, consistent with commuter inertia; Saturday volumes fall by 7–15%. Rainy Wednesdays reach 109–112% of the Monday dry reference in inner zones, attributed to hybrid workers advancing their office day. Pairwise junction correlations show a non-monotonic distance-decay pattern, and time-lagged cross-correlation identifies 23 anticipative junction pairs with 60–90 min lead times. The results could potentially help decision making when developing city-wide infrastructure and tuning traffic signals so that traffic can be optimised and adapt to both real-time natural and social effects. The resulting baselines map onto DATEX II (Data Exchange standard, CEN EN 16157) ElaboratedDataPublication fields, supporting metadata publication on the Hungarian National Access Point under EU Regulation 2022/670/EU. Full article

Challenging work conditions and a predominantly male workforce have intensified concerns about worker well-being in the U.S. construction industry. Although these issues are increasingly acknowledged, empirical evidence on how management perceives and addresses employees’ psychological needs remains limited. This study seeks to fill that gap by examining managerial awareness and responsiveness to workplace mental health challenges, as well as the implementation of targeted well-being interventions across construction organizations. A mixed-methods approach was employed, integrating quantitative data from a nationwide survey of construction professionals with qualitative insights from open-ended responses. Results indicate that workers experience moderate levels of psychological strain, with notable differences across demographic and occupational groups. Women, non-white professionals, and site supervisors reported higher stress and lower overall well-being, emphasizing the need for more inclusive and tailored interventions. While both senior leaders and frontline supervisors demonstrated moderate awareness of these challenges, supervisors were perceived as less consistent in taking action to address them. Among existing workplace practices, transparent compensation structures and opportunities for skill diversification were identified as the most established supports for well-being. In contrast, mentoring programs, employee recognition, and open feedback mechanisms emerged as promising yet underutilized strategies. Overall, the study contributes by shifting attention from documenting construction-related mental health stressors to understanding how leadership recognition is translated into organizational response. Therefore, the findings provide practical guidance for construction leaders seeking to strengthen workers’ well-being and build a more resilient work environment. Full article

Artisanal and small-scale gold mining (ASGM) generates complex metal mixtures, yet their biological effects remain poorly characterized in high-altitude populations, where occupational exposure occurs against a hypoxic environmental background. This study evaluated 49 occupationally exposed gold miners from the Vetas–California mining district, near the Santurbán páramo in Colombia, and 25 non-exposed individuals from a comparable high-altitude area. Hair concentrations of essential and toxic elements were quantified by ICP-MS, and serum catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH), oxidized glutathione (GSSG), and the GSH/GSSG ratio were assessed. Miners showed a distinct multielement profile, with a higher toxic-metal burden and a dominant mixture mainly characterized by Fe, Mn, As, Pb, Cd, and Hg. CAT and SOD activities did not differ markedly between groups, although SOD activity decreased along the main exposure gradient among exposed workers. In contrast, glutathione-related biomarkers showed a more consistent exposure-related pattern, with higher GSSG and a lower GSH/GSSG ratio, suggesting a shift toward a more oxidized glutathione redox status. Together with positive within-group associations between selected elements and the GSH/GSSG ratio, these results are consistent with a mixture-associated perturbation of glutathione redox homeostasis, with heterogeneous adaptive responses. Overall, this study supports the use of integrated biomonitoring strategies and highlights glutathione-related markers as potential indicators of early redox perturbation in high-altitude mining populations. Full article

Background: Despite being considered a country with a larger health workforce in Africa, the South African health workforce continues to experience shortages and a maldistribution of health workers across regions and sectors. Current projections suggest that the workforce is expected to decline further, especially among doctors, nurses and midwives, in large part, due to attrition—which could compromise the delivery of primary health and maternity services. These health workforce shortages and uneven distribution threaten the sustainability and effectiveness of health services in South Africa and drives the need to investigate the factors that may be influencing career choice and change decisions among health professionals in South Africa. Methods: A qualitative exploratory study, making use of purposive sampling and semi-structured interviews, was conducted to investigate the factors influencing career choice and change decisions among health professionals in South Africa. The participants were qualified health professionals in the fields of medicine, nutrition, pharmacy, nursing, and psychology working in the private, public, and academic sectors. Data was collected until saturation was achieved and then thematically analyzed using MAXQDA 24. Results: A total of 10 participants made up of three males and seven females were interviewed. These participants worked in different employment sectors with some having dual roles in private practice, public sector, and academia. The analysis revealed three major themes that capture the nature of and factors influencing career choice and career changes occurring in South Africa. The first theme related to factors influencing career choice (including altruism, family influence, personal experiences, financial/job security, academic achievement, career guidance, and opportunity for change). The second theme focused on career change dynamics (nature of career changes and career transitions occurring in the form of specialization, switching health professions, exiting health professions, adding non-health interests, and shifting focus areas). The third theme revealed factors influencing career change. These were categorized into personal and individual factors, workplace or job-specific factors, and administrative factors. This study has contributed to understanding the career choices and career changes taking place within the health professions in South Africa. It has also revealed a need for reforms in policy and practice for the current health professionals who have no intention of changing their careers while highlighting implications for future training of health professionals. Also, addressing the challenges of poor working conditions, lack of support, unemployment and placement delays, and other administrative barriers will help mitigate some of the issues leading to health workforce shortages and inequities in the South African context. Conclusions: The strongest motivator for choosing a career in health professions is the desire to care for others, while retention of the health workforce is challenged by personal, workplace, and administrative factors. Enhancing workplace conditions and support systems, implementing policy reforms, and minimizing administrative barriers is essential for achieving universal health coverage and sustaining a resilient health workforce in South Africa. Full article

High-altitude workers in the Los Andes Mountains, known as “the Chilean miner model,” are exposed to chronic intermittent hypobaric hypoxia (CIHH). This intermittent condition differs from other models of chronic hypoxia, mainly due to the hypoxic pattern and the cardiovascular and pulmonary effects. There are reports of cardiopulmonary dysfunction and remodeling in human and animal models. However, research on some mechanisms of vascular function and the consequences of lung remodeling induced by CIHH is still lacking. Therefore, this study aims to characterize the effects of CIHH exposure on lung structure and redox status in a rat model of the Chilean miner, involving intermittent exposure to chronic cycles of normoxia/hypobaric hypoxia (96 h/96 h) in an experimental hypoxic chamber. Our results demonstrate that CIHH acts as a primary driver of pulmonary vascular remodeling by significantly increasing the medial wall thickness of small pulmonary arteries (<100 μm) and promoting a shift toward a more muscularized phenotype in previously non-muscularized vessels. Structurally, this was characterized by a marked reduction in alveolar space and a significant increase in the thickness of the alveolar-capillary barrier, suggesting impaired gas exchange capacity. These structural changes were strongly associated with a pro-oxidant state, evidenced by increased lipid peroxidation (malondialdehyde levels) and a concomitant reduction in antioxidant enzyme activities, such as superoxide dismutase (SOD) and catalase (CAT), in lung tissue. In conclusion, the CIHH model effectively replicates the complex interplay between chronic oxidative damage and structural lung remodeling, identifying the thickening of the arterial medial wall and alveolar septa as key pathological features of probably CIHH-induced pulmonary hypertension. Full article

This study analyzes the performance of the double robust estimator to compute the treatment effect, not only at the mean but also in the tails in a Monte Carlo experiment. While previous research focused on shifting the regression component of the double robust estimator toward the tail, here we focus on the behavior of the propensity score away from the mean. Investigating the tails of the regression outcome allows for a closer look at the observations that are either highly or poorly responsive to treatment. Examining the tails of the propensity score distribution scrutinizes the observations with a higher or lower probability of being treated, which can be non-constant and even asymmetric. The goal is to assess the behavior of the double robust estimator when both components are computed away from the sample mean, in the tails of the treatment and control distributions. A case study on Italian education concludes the analysis. We find a positive double robust difference in higher education across regions, larger at the top location, due to the significant internal migration of qualified workers toward the northern regions. Women’s employment is higher for highly educated women, and gender has a significant impact: the analysis of the mismatch between probabilities and outcomes signals that women achieve higher education at rates exceeding their probabilities; they are more likely to exceed their predicted likelihood of attaining higher education. Full article

Routine-Biased Technological Change (RBTC) is viewed as reshaping labor markets, yet its implications for gender inequality in developing economies remain underexplored. This study examines these dynamics among formal wage workers in Indonesia from 2001 to 2019. Using stacked first-difference estimations and a dynamic shift-share decomposition, we document three interconnected patterns. First, routine displacement unfolds episodically rather than simultaneously—with relative contraction in routine cognitive jobs (2001–2005), routine manual jobs (2005–2010), and renewed routine cognitive pressures (2015–2019)—a sequence likely shaped by technological change alongside macroeconomic and institutional forces. Second, these adjustments are gender-asymmetric. Women experienced greater exposure to displacement but reallocated substantially toward non-routine interpersonal roles. This occupational upgrading is consistent with both task-based demand shifts associated with technological change and the entry of younger, more educated female cohorts. Third, employment reallocation exerted a narrowing influence on the gender wage gap, particularly in 2005–2010. However, this equalizing channel weakened over time as market valuation (wage exposure) became increasingly unfavorable to female-concentrated occupations, contributing to a renewed widening in 2015–2019. Ultimately, while residual within-task group dynamics dominate the gap’s magnitude, task-based employment and wage channels remain critical in structuring the timing and directional shifts of gender inequality in the formal sector. Full article

In response to the widespread adoption of hybrid work models, organizations must strategically address the challenges of knowledge transfer and organizational learning in distributed environments. We extend March’s computational model of organizational learning by initially incorporating three variables: the ratio of tacit-to-explicit knowledge, the proportion of remote workers, and structured shift arrangements. The extended model incorporates distinct subgroups for remote and on-site workers, organizational memory mechanisms for tacit knowledge exchange, and alternating work location schedules designed to foster interaction. Simulation results reveal that under non-contact scheduling, the interaction effect between learning from code/memory ($p_1$) and the proportion of tacit knowledge ($q$) is insignificant, while the coefficient of interaction effect $p_2\times q$ between learning by code/memory ($p_2$) and $q$ is twice that under partial-contact or full-contact scheduling. Moreover, under full-contact scheduling, the interaction effect between $p_1$ and the proportion of work-from-home employees ($wfh$) is insignificant ($p > 0.1$), whereas the interaction effect between $p_2$ and $wfh$ is significant ($p< 0.05$). Aligning with March’s findings that a low $p_1$ and high $p_2$ contribute to higher organizational knowledge, our simulation results indicate that non-contact scheduling preserves knowledge diversity, and full-contact scheduling promotes small-world network effects, thereby enhancing organizational knowledge equilibrium. These findings position hybrid work scheduling as a data-driven managerial decision, and the proposed model offers analytical insights for optimizing knowledge processes within business analytics contexts. Full article

The COVID-19 pandemic has placed a considerable psychological burden on healthcare workers, potentially leading to increased burnout and anxiety. This study aimed to evaluate burnout and anxiety levels among healthcare workers compared to non-healthcare professionals during the pandemic. We initially recruited 438 adults; 351 (217 HCWs and 134 non-HCWs) provided complete responses across all three survey waves and were analyzed. Burnout was assessed using the Maslach Burnout Inventory, and anxiety with the State–Trait Anxiety Inventory. Data were collected through an online self-administered survey at three different time points during the pandemic, and analyzed with non-parametric tests and effect sizes. Healthcare workers exhibited significantly higher levels of emotional exhaustion, depersonalization, overall burnout, and anxiety compared to non-healthcare workers across all three periods (p < 0.05). Of 438 consented individuals, 351 (80.1%) completed all waves, allowing within-population longitudinal comparisons. Within the healthcare worker group, women, individuals living alone, those working night shifts, and those considering a career change had notably higher burnout and anxiety scores. No significant differences were observed in personal accomplishment scores. Healthcare workers experienced greater psychological distress than non-healthcare workers during the COVID-19 pandemic. Identifying vulnerable subgroups and implementing supportive strategies are essential to protect the mental health and well-being of healthcare professionals during pandemics and similar crises. Full article