Search Results (393)

Background/Objectives: Nursing involves repeated exposure to emotionally, morally, and psychologically distressing experiences, yet the mechanisms through which low-intensity occupational stressors accumulate and contribute to psychological harm remain conceptually unclear. This scoping review examined how the nursing literature conceptualises the cumulative effects of repeated occupationally distressing experiences and identified the conceptual gap created by the absence of a unifying term such as micro-trauma. Methods: A scoping review was undertaken to map concepts used to describe cumulative occupational distress in nursing and determine whether any terminology captures the cumulative impact of repeated low-intensity exposures. Searches were conducted across CINAHL, MEDLINE, and Emcare, supplemented by citation searching, Google Scholar, targeted grey literature searching and structured generative artificial intelligence-assisted source identification. Data were extracted using a priori criteria and synthesised narratively. Consistent with Joanna Briggs Institute guidance, quality appraisal was not undertaken. Results: No included publication applied the term ‘micro-trauma’ to nursing or healthcare workers. Seven publications met the inclusion criteria following expanded searching across supplemental pathways. The literature used heterogeneous and overlapping terminology, including burnout, compassion fatigue, cumulative grief, moral distress, workplace trauma, and post-traumatic stress disorder symptomatology, to describe cumulative psychological burden, but none provided a unifying conceptual frame for repeated low-intensity exposures. Conclusions: The current literature does not yet clearly define or consistently apply micro-trauma in nursing, despite evidence that repeated occupational exposures contribute to cumulative psychological burden. This review highlights a conceptual space before end-point conditions such as burnout, compassion fatigue, or post-traumatic stress disorder symptomatology are recognised. Future research should develop and test a clearer conceptual framework for micro-trauma in nursing before it is applied as a distinct unifying concept. Full article

Background/Objectives: Healthcare students face an occupational risk of hepatitis B virus (HBV) exposure during clinical training, often many years after receiving their primary vaccination series in infancy or childhood. Progressive waning of anti-hepatitis B surface (anti-HBs) antibody titres, heterogeneous vaccination histories in international student cohorts, high rates of underreported needlestick injuries, and variable occupational health protocols across institutions raise important questions about the adequacy of pre-clinical immunization surveillance in this population. This review aimed to synthesize current evidence on hepatitis B immunization among healthcare students, focusing on occupational exposure risk, seroprotection and immunological memory, clinical management of low or absent anti-HB titres including post-exposure prophylaxis, and the specific challenges posed by multicultural academic settings. Methods: A narrative review was conducted through a systematic literature search of PubMed/MEDLINE and Scopus, covering publications from January 2000 to December 2025, supplemented by key seminal references. After the removal of duplicates and stepwise screening, 49 references were selected for final inclusion. Results: Needlestick and sharps injuries occur at measurable rates during clinical training, with medical students accounting for approximately 30% of occupational exposure events in some series, and with underreporting rates estimated at 19–80% across studies. Pooled seroprotection prevalence at clinical training entry is approximately 73.8% (95% CI 69.1–78.0%), with substantially lower rates among students vaccinated in infancy—as low as 28% at 16–20 years post-vaccination in longitudinal data—compared with adolescence immunization. The majority of students with non-protective titres retain immunological memory, with 90.9% (95% CI 87.7–93.3%) demonstrating an anamnestic response after a single booster dose. Post-exposure prophylaxis pathways depend critically on pre-existing immunological status, reinforcing the operational value of pre-clinical serological screening. International student cohorts present additional complexity due to heterogeneous vaccination schedules, documentation gaps, and variable natural immunity profiles. Conclusions: Systematic pre-clinical serological screening (anti-HBs, HBsAg, and anti-HBc), combined with evidence-based stepwise immunization management and structured educational interventions, is essential to protect healthcare students from occupational HBV exposure. The primary operational goal of screening is the identification of the approximately 5% of true non-responders who require tailored occupational health management. These findings support a proactive, integrated approach to hepatitis B immunization surveillance in healthcare education, aligned with the WHO 2030 viral hepatitis-elimination targets. Full article

The digital transformation of work has increasingly blurred the temporal, spatial, and psychological boundaries between professional and personal life. As a result, structural conditions have emerged that are associated with an elevated risk of burnout. This narrative review draws on literature identified through searches of Web of Science, Scopus and PubMed covering publications from 2004 to early 2026, which yielded 36 included studies, supplemented by further sources identified outside that search. It integrates key theoretical perspectives, including boundary theory, the Areas of Worklife model, the Job Demands-Resources framework and Conservation of Resources theory. Across diverse occupational contexts, three pathways recur: rising work-family conflict, reduced ability to psychologically detach from work during non-work time and the gradual depletion of personal resources. Structural drivers, comprising organisational availability norms, leadership behaviour, technology and platform design, workload, and economic precarity, are treated as the conditions under which exposure arises, and the review argues that responses pitched at individual coping are correspondingly limited. The public health implications extend beyond mental health, encompassing cardiovascular risk associated with long working hours, strain on healthcare systems, productivity losses and widening health inequities along gendered and socioeconomic lines. Addressing these challenges requires multilevel interventions, including organisational job redesign, leadership development, enforceable right-to-disconnect policies and greater recognition of recovery as a public health priority. At the same time, there remains a need for more longitudinal and intervention-based research, particularly in non-Western contexts. Full article

Psychosocial working conditions are important determinants of employee health, work ability, and organizational sustainability, yet existing instruments often assess job demands, job resources, psychosocial risks, or well-being outcomes separately. This study examined the structural validity of the Multidimensional Psychosocial Work Experience Scale for Employed Persons (MPWES), an instrument designed to assess a multidimensional occupational psychosocial profile comprising workplace conditions and demands, psychosocial resources, adverse exposures, health-related experiences, and subjective functioning. A cross-sectional validation study was conducted among 1631 employees from the pharmaceutical, energy, healthcare, and administrative sectors in Latvia. Confirmatory factor analysis with the robust WLSMV estimator was used to test the predefined measurement model. The refined eight-factor model demonstrated acceptable fit in the calibration subsample (N = 400; CFI = 0.930, TLI = 0.922, RMSEA = 0.066, SRMR = 0.078) and was replicated in the held-out validation subsample (N = 1231; CFI = 0.911, TLI = 0.901, RMSEA = 0.068, SRMR = 0.067). Reliability indices were acceptable for several domains, although some factors showed modest or borderline values. Discriminant validity was supported, with all HTMT values below 0.85, and measurement invariance testing supported configural, metric, scalar, and strict invariance across samples. The findings provide initial evidence of the MPWES’s structural validity and measurement stability in the present sample. However, further studies using external validity criteria, longitudinal designs, and culturally diverse samples are needed before the scale can be considered fully validated for broader occupational and public health applications. Full article

Environmental contamination by potentially toxic elements remains a public health concern in groundwater-dependent regions. This exploratory community-based cross-sectional study examined associations among a historical area-level arsenic screening classification, questionnaire-derived potential-exposure indicators, and self-reported symptom count in 275 adults from 37 standardized locality clusters in Satu Mare County, Romania. The arsenic Health Risk Index (HRI) screening classification was derived entirely from drinking-water measurements collected in a preceding regional study during 2022–2024; no water samples or exposure biomarkers were obtained in the present survey. The questionnaire-derived potential exposure index was calculated as the unweighted sum of seven binary indicators covering residential, drinking-water, occupational, dental, and dietary characteristics (theoretical range, 0–7; observed range, 0–6) and was analyzed continuously. Symptom count (theoretical range, 0–8) was analyzed primarily using negative binomial regression with locality-clustered standard errors and adjustment for age, sex, smoking, alcohol consumption, HRI classification, and self-reported comorbidity. Each one-point increase in the potential exposure index was associated with a modestly higher expected symptom count (adjusted incidence rate ratio = 1.106, 95% CI: 1.031–1.186; p = 0.005), whereas the area-level HRI classification was not statistically associated with symptom count (adjusted incidence rate ratio = 1.135, 95% CI: 0.829–1.554; p = 0.431). The association remained positive across alternative index specifications, although the drinking-water-focused estimate was smaller and less precise. These findings represent exploratory associations between reported potential-exposure characteristics and nonspecific self-reported symptoms; they do not establish individual arsenic exposure, contaminant-specific effects, or causality. Full article

The modern agricultural sector faces a multidimensional crisis, mainly consisting of an aging workforce, labor shortages, exhausting working conditions, and high rates of work-related accidents. In response, the authors carried out a systematic literature review (SLR), to explore the latest research on smart agricultural technologies, their effects on occupational safety, ergonomics, and worker health, and pinpoint obstacles to sustainable adoption. A thorough search was performed solely in the Scopus database, covering peer-reviewed publications from 2020 to 2026, strictly following the PRISMA 2020 guidelines. Based solely on Scopus, this study provides a focused synthesis, with the results suggesting that hazards such as chemical exposure and musculoskeletal strain are significantly reduced with the use of innovations such as unmanned vehicles, exoskeletons, and collaborative robots. These technologies also show great promise in cutting down resource waste, helping farmers practice sustainable agriculture. However, a recurring gap between research and real-life deployment exists, as adoption is hindered by cost considerations, reliability issues, and ergonomic problems. To achieve a sustainable technological transition in agriculture, it is necessary to simultaneously bridge three critical gaps: technological (ensuring robust field performance), ergonomic (design and testing processes based on real end-users and their needs), and socio-economic (addressing adoption barriers). Full article

Infectious diseases remain a major global public health concern, disproportionately causing morbidity and mortality in low- and middle-income countries. Sexually Transmitted Infections (STIs) heavily affect sexually active populations. Sex workers, encompassing female sex workers (FSWs), male sex workers (MSWs), and transgender/gender-diverse individuals, face heightened vulnerabilities due to occupational exposures, structural barriers, stigma, and criminalization. While substantial focus has historically centered on HIV, non-HIV STIs such as Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, and viral hepatitis present significant co-morbidity. Crucially, drug resistance across these pathogens presents distinct biological and epidemiological challenges: bacterial antimicrobial resistance (AMR) in N. gonorrhoeae and C. trachomatis, antiretroviral (ARV) resistance in HIV, and direct-acting antiviral (DAA) resistance in hepatitis B and C. This perspective article synthesizes the current epidemiological landscape, critiques the reliance on syndromic management over molecular diagnostics (e.g., NAATs, point-of-care, and genomic surveillance), highlights diagnostic stewardship, and outlines priority public health strategies aligned with the WHO 2022–2030 Global Health Sector Strategies. Full article

Peri-urban rural public spaces are increasingly involved in territorial development, rural-regeneration management, and built-environment upgrading, yet existing research often treats rural regeneration as program implementation rather than as a spatial-development and public-space management problem. This study develops a built-environment governance framework from the 2025 Hsinchu City Community Rural Regeneration Facilitation Program in Taiwan. Using a reflective document-based case-study design, the analysis integrates administrative reports, training records, plan-review materials, spatial-planning documents, built-environment case evidence, agricultural net-zero policy materials, and Taiwanese rural-regeneration literature. Four descriptive readiness ratios are used to profile the governance process: SIE (urban–rural interface exposure), PPC (training participation), RAC (review conversion), and ATR (approval-track readiness). These indicators clarify administrative and governance readiness, but they are not treated as direct measurements of spatial quality, carbon reduction, or user wellbeing. The results identify a four-dimensional management framework for peri-urban rural public-space regeneration: wellbeing-oriented public spaces, low-carbon ecological infrastructure, cultural-landscape continuity, and community-based implementation capacity. The study further proposes standardized ordinal scoring rules, a policy-to-space translation model, and a future post-occupancy and spatial-quality validation scheme. The theoretical contribution lies in reframing rural regeneration as a built-environment governance interface for territorial development, while the practical contribution lies in providing a reviewable framework for managing public-space proposals, construction priorities, maintenance readiness, and future validation in peri-urban rural areas. Full article

Staphylococcus aureus is one of the leading causes of both community- and healthcare-associated infections. Nasal colonization constitutes the primary reservoir for subsequent infection and transmission, while methicillin-resistant Staphylococcus aureus (MRSA) remains a major public health concern because of its resistance to multiple antimicrobial agents. However, data regarding community nasal colonization in rural Portuguese populations remain scarce. The BI-STAPH Project was established to address this knowledge gap through systematic surveillance of rural communities in inland Portugal. To estimate the prevalence of presumptive nasal colonization by Staphylococcus aureus and MRSA among adults living in the municipality of Fundão, Portugal, and to explore potential associations between colonization and demographic, behavioural, occupational, and environmental characteristics. A prospective community-based cross-sectional study was conducted as the second phase of the BI-STAPH Project. A total of 200 adults were recruited from different parishes of the municipality of Fundão. Bilateral nasal swabs were collected and processed using standardized microbiological methods for the presumptive identification of S. aureus. Presumptive MRSA isolates were investigated using a PBP2′ latex agglutination assay. Sociodemographic and exposure-related information was obtained through structured questionnaires. Associations between presumptive colonization and participant characteristics were evaluated using Pearson’s chi-square or Fisher’s exact tests, as appropriate. Presumptive S. aureus nasal colonization was identified in 56 of 200 participants, corresponding to a prevalence of 28.0% (95% CI: 21.8–34.2%). No presumptive MRSA-positive isolates were identified, corresponding to an observed prevalence of 0% (95% CI: 0.0–1.8%). Colonization prevalence was 29.5% among females and 26.8% among males, and ranged from 25.8% to 31.1% across age groups; neither sex nor age was significantly associated with colonization. Participants reporting daily animal contact had a colonization prevalence of 32.3%, compared with 20.5% among those without animal contact, but this difference was not statistically significant (p = 0.075). Overall, no statistically significant associations were identified between presumptive S. aureus colonization and the demographic, behavioural, occupational, or environmental variables evaluated. Presumptive S. aureus nasal colonization was common among adults living in the rural municipality of Fundão, Portugal, whereas no presumptive MRSA-positive isolates were identified in this study population. No statistically significant associations were observed between colonization and the characteristics evaluated. These findings expand the epidemiological evidence generated by the BI-STAPH Project and support continued community-based surveillance of S. aureus in rural Portugal. Future multicentre studies incorporating molecular confirmation, antimicrobial susceptibility testing, and larger populations will be important to better characterize circulating strains and transmission patterns within a One Health framework. Full article

Despite being classified as low-risk workplaces, museums involve tasks that generate demands, chemical exposure, and management-related stress that accumulate over time. This study assesses the relationship between occupational safety and health conditions in museums and task organization within operations to develop a task-based coordination approach grounded in practice. A mixed-methods design was employed in three museums, encompassing conservation, public interaction, and administrative activities. Data included 30 task observations in each museum, collected through on-site observations, posture assessment, checklist evaluation of chemical handling and ventilation practices, task-focused exchanges, and observation of leadership engagement during activities. Task configurations, defined as the combination of technical and organizational conditions under which a task is performed during routine activities, were compared through task scenarios developed as analytical models using a composite task-level safety index. Results suggested that exposure patterns varied with the technical and organizational conditions of task execution. Task configurations combining adjustable equipment, functional ventilation, coordinated task allocation, and regular leadership presence had lower frequencies of ergonomic, chemical, and organizational non-compliance. The findings indicate that occupational safety and health practice in museums depends on how technical and organizational measures operate at the task level. Full article

Background: Toxoplasmosis is a globally prevalent zoonotic infection caused by Toxoplasma gondii, with potentially severe consequences for pregnant women, foetuses, and immunocompromised individuals. Despite its public health importance, epidemiological data on T. gondii infection in Kuwait remain limited and restricted to selected population groups. This study assessed the seroprevalence of T. gondii among community-based adult participants in Kuwait and examined potentially associated risk factors. Methods: A cross-sectional study was conducted in September 2024 in Kuwait City and Jahra governorates. Serum samples from a convenience sample of 200 adults attending governmental polyclinics were screened for T. gondii IgM and IgG antibodies using VIDAS ELISAassays, with IgG-positive samples further analysed for IgG avidity. Demographic and exposure data were collected using structured questionnaires. Univariable and multivariable associations between demographic and exposure-related factors and IgG seropositivity were statistically evaluated. Results: The overall IgG seroprevalence was 11.5% (23/200), with no significant difference between governorates. All samples were IgM-negative, and all IgG-positive and equivocal samples showed high avidity. Age >40 years was associated with seropositivity in univariable analysis, but this association was not significant after adjustment (aOR = 2.21, 95% CI: 0.88–5.89; p = 0.092). No significant associations were observed with sex, nationality, educational level, travel history, cat ownership, or contact with stray cats. Conclusions: Among the participating community-based adults in Kuwait, T. gondii seroprevalence was lower than that reported in several regional studies, with serological findings consistent with past rather than recent infection. No demographic or exposure-related factor was independently associated with seropositivity. Larger population-based studies specifically powered to investigate risk factors and incorporating dietary, occupational, environmental, and migration-related exposures are needed to better characterise transmission pathways and inform targeted One Health surveillance and prevention strategies. Full article

Climate change is increasing the frequency, intensity, and duration of heatwaves, making extreme heat a recurrent public health challenge with important nutritional implications. High ambient temperatures affect human health through thermoregulatory strain, sweating, dehydration, electrolyte imbalance, cardiovascular and renal stress, impaired cognitive and physical performance, and exacerbation of chronic diseases. Diet and hydration may therefore represent modifiable, although still underinvestigated, components of heat-health prevention. This narrative review synthesizes evidence on hydration, electrolyte balance, meal composition, dietary quality, vulnerable populations, Mediterranean dietary patterns, seasonality, environmental sustainability, and public health strategies for reducing heat-related health risks. Evidence from climate-health research, physiology, nutrition science, occupational and sports medicine, geriatrics, pediatrics, and public health guidance was integrated. Particular attention was given to distinguishing direct heat-health evidence from recommendations based on indirect evidence, physiological plausibility, or expert consensus. Regular water intake, water-rich foods, avoidance of alcohol, moderation of sugar-sweetened beverages, and individualized electrolyte replacement during prolonged or intense sweating are supported by physiological rationale and public health guidance, although direct heatwave-specific intervention studies remain limited. Dietary recommendations should prioritize smaller, digestible, nutrient-dense meals that preserve nutritional adequacy while reducing unnecessary digestive and metabolic burden. However, evidence on meal size, macronutrient composition, and heat-related outcomes remains largely indirect. Vulnerable groups, including older adults, children, pregnant women, individuals with chronic diseases, outdoor workers, athletes, and socioeconomically disadvantaged populations, require tailored strategies. The Mediterranean diet may provide a useful regional model because it emphasizes seasonal plant foods, fruits and vegetables with high water content, legumes, whole grains, olive oil, culinary simplicity, and environmental sustainability; however, its specific role in heat adaptation requires further study. Integrating nutrition and hydration into heat-health action plans may improve preparedness and support climate-resilient food systems. Future studies should evaluate hydration protocols, meal patterns, Mediterranean diet adherence, biomarkers of nutritional heat resilience, and nutrition-sensitive interventions in real-world heat exposure settings. Full article

Vanilla and vanillin are the most popular flavorings added to processed foods, medications, cosmetics, and e-cigarette liquids. Vanilla owes its unique aroma to vanillin. Both vanilla and vanillin can cause hypersensitivity reactions, probably type IV. Clinically, hypersensitivity to vanilla and/or vanillin most often manifests as a limited rash (of various types) accompanied by itching and/or swelling. Long-term exposure to vanillin or its intermediates may be a factor in occupational sensitization. Although hypersensitivity to vanilla/vanillin appears to be rare, it is worth considering in the diagnostic process, especially in non-obvious situations when identifying the triggering allergen is difficult. Regardless of the likely allergic hypersensitivity to vanilla and vanillin, there are also hypotheses suggesting that vanillin and other flavorings and aromas found in e-cigarette liquids may have cytotoxic effects in people who use electronic cigarettes (vaping). Toxic reactions caused by inhaling vapors of these additives may affect the bronchial tree and other distant organs. This hypothesis, although new and relatively poorly researched, may have significant implications for public health, including for future generations, especially considering that vaping is a popular form of nicotine delivery, particularly among adolescents and young adults. Full article

Environmental exposures throughout life play a major role in shaping human health and contribute to the onset and progression of numerous chronic diseases, including neurodegenerative disorders and cancer. These effects arise from complex interactions between environmental pollutants, diet, lifestyle, occupation, genetic background, and other biological and socioeconomic factors. Although recent advances in omics technologies have substantially improved our understanding of the molecular mechanisms underlying these interactions, most studies continue to adopt reductionist approaches that fail to capture the complexity of the environment–health–disease continuum. We propose a comprehensive conceptual framework based derived from the existing literature for investigating lifelong environmental exposures through a multilevel and multidimensional strategy. Four complementary levels are defined: (i) molecular alterations characterized using ionomics, metallomics, proteomics, metabolomics, transcriptomics, genomics, and integrated multi-omics; (ii) tissue and organ alterations assessed by imaging technologies and radiomics; (iii) population-level variability investigated through epidemiological approaches (epidemiomics); and (iv) the integration and interpretation of heterogeneous datasets using artificial intelligence. Representative applications of these methodologies are discussed to illustrate their potential for identifying biomarkers, elucidating disease mechanisms, and improving exposure assessment. Particular attention is given to the integration of molecular, imaging, and epidemiological data to establish more robust causal relationships between environmental exposures and health outcomes. The proposed framework highlights the need for multidisciplinary collaboration and advanced computational tools to address the complexity of exposome research. Ultimately, this integrative approach may support early disease detection, personalized prevention strategies, and the development of evidence-based environmental, occupational, and public health policies aimed at reducing the burden of environment-related diseases. Full article

Portable sensing systems are increasingly important in biological and chemical analyses because they can provide analytical information at the point of decision-making. While traditional laboratory methods remain crucial for reference measurements, regulatory validation, and high-precision quantification, portable systems emphasize rapid response, convenience, cost-effectiveness, robustness, and relevance to decision-making. This paper views portable sensing systems as integrated analytical platforms rather than isolated sensing elements. The paper discusses recognition elements, including enzymes, antibodies, nucleic acid probes, aptamers, molecularly imprinted polymers, nanomaterials, and hybrid recognition interfaces, as well as electrochemical, optical, mass-sensitive, thermal, field-effect, and hybrid sensing technologies. Furthermore, this paper reviews platform designs, including paper-based analytical devices, chip lab systems, smartphone-assisted sensors, wearable and flexible sensors, handheld instruments, and wireless sensor networks. It explores their applications in sample handling, calibration, data processing, and field deployment. Applications of this technology include point-of-care diagnostics, pathogen detection, wearable health monitoring, agriculture, veterinary medicine, environmental monitoring, food safety, industrial process control, forensic analysis, public safety, and occupational exposure assessment. The report focuses on sample acquisition, miniaturized preparation, reagent storage, matrix interference, calibration transfer, signal conditioning, machine learning, cloud platforms, analytical validation, and decision support. Furthermore, it identifies key obstacles to translating academic prototypes into industrial products, including reproducibility, stability, manufacturability, ease of use, cybersecurity, regulatory approval, and market acceptance. Future development requires fully integrated sample-to-result systems, multimodal sensing, artificial intelligence, sustainable single-use materials, self-powered devices, and system-level validation under real-world operating conditions. Full article