Search Results (3,108)

Background: Moral harassment (mobbing) in healthcare, particularly among nurses, remains a persistent issue with detrimental effects on mental health, resilience, and quality of life. Aim: We examine the relationship between the resilience of nurses working in Emergency Departments (EDs) and how these factors influence experiences of workplace mobbing. Methods: This cross-sectional study included 90 nurses from four public hospitals in Greece’s 5th Health District. Data were collected between October 2023 and March 2024 using the WHOQOL-BREF, Workplace Psychologically Violent Behaviors (WPVB) scale and the Connor–Davidson Resilience Scale (CD-RISC). The sample consisted primarily of full-time nurses (84.3% female; mean age = 43.1 years), with 21.1% reporting chronic conditions. Most participants were married (80.0%) and had children (74.4%), typically two (56.1%). Statistical analyses—conducted using SPSS version 27.0—included descriptive statistics, Pearson and Spearman correlations, multiple linear regression, and mediation analysis, with significance set at p < 0.05. Results: Resilience was moderate (mean = 66.38%; Cronbach’s α = 0.93) and positively correlated with all WHOQOL-BREF domains—physical, psychological, social, and environmental (r = 0.30–0.40)—but not with the overall WHOQOL-BREF. The mean overall WHOQOL-BREF score was 68.4%, with the lowest scores observed in the environmental domain (mean = 53.76%). Workplace mobbing levels were low to moderate (mean WPVB score = 17.87), with subscale reliabilities ranging from α = 0.78 to 0.95. Mobbing was negatively associated with social relationships and the environmental WHOQOL-BREF (ρ = –0.23 to –0.33). Regression analysis showed that cohabitation and higher resilience significantly predicted better WHOQOL-BREF outcomes, whereas mobbing was not a significant predictor. Mediation analysis (bootstrap N = 5000) indicated no significant indirect effect of resilience in the relationship between mobbing and WHOQOL-BREF. Conclusions: Resilience was identified as a key protective factor for nurses’ quality of life in emergency care settings. Although workplace mobbing was present at low-to-moderate levels, it was negatively associated with specific WHOQOL-BREF domains. Enhancing mental resilience among nurses may serve as a valuable strategy to mitigate the psychological effects of moral harassment in healthcare environments. Full article

With the arrival of an aging society and the continuous extension of the human lifespan, the quality of life has not improved in a corresponding manner. People’s demand for happiness and health is increasing. As a result, a model emerged that integrates tourism and medical services, which is health tourism. This growing demand has prompted many service providers to see it as a business opportunity and enter the market. Tourism can help travelers release work stress and restore physical and mental balance; meanwhile, health check-ups and disease treatment can help them regain health. Consumers have long favored health and medical tourism because it helps relieve stress and promotes overall well-being. As people age, some consumers experience a gradual decline in physical functions, making it difficult for them to participate in regular travel services provided by traditional travel agencies. Therefore, this study aims to explore the service needs of health and medical tourism customers (tourists/patients) and the interrelationships among these service needs, so that health and medical tourism service providers can develop more customized and diversified services. This study identifies four key drivers of medical tourism services: medical services, medical facilities, tour planning, and hospitality facilities. This study uses the APA (attention and performance analysis) method to assess each dimension and criterion and utilizes the DEMATEL method with the NRM (network relationship map) to identify network relationships. By combining APA and NRM techniques, this study develops the APA-NRM technique to evaluate adoption strategies and identify suitable paths for health tourism services, providing tailored development strategies and recommendations for service providers to enhance the service experience. Full article

Objectives: This study investigated levels of work engagement and the occurrence of compassion fatigue among nursing professionals during the COVID-19 pandemic. Methods: A cross-sectional, descriptive, and correlational study was conducted at a Brazilian university hospital between February and April 2022. The Brazilian versions of the Utrecht Work Engagement Scale (UWES-9) and the Professional Quality of Life Scale (ProQOL-BR) were administered. Results: High levels of compassion satisfaction (44.9 points), low levels of burnout (21.0 points), and low levels of secondary traumatic stress (22.8 points) were observed. No professional demonstrated a profile consistent with compassion fatigue. Engagement levels were high for dedication (5.3) and moderate for vigor (4.9), absorption (4.5), and overall engagement (4.9). Burnout showed moderate negative correlations with vigor (r = −0.611, p = 0.005) and dedication (r = −0.599, p = 0.019). Compassion satisfaction showed moderate positive correlations with vigor (r = 0.522, p < 0.001) and dedication (r = 0.572, p < 0.001). The overall engagement score was moderately and positively correlated with compassion satisfaction (r = 0.532, p < 0.001). Conclusions: This study identified high levels of work engagement, especially regarding dedication, and low levels of compassion fatigue among nursing professionals. The data suggest that even amid the emotional and physical demands imposed by the pandemic, participants preserved their emotional well-being and maintained a positive relationship with their work. Full article

Interpreters who translate for refugees are regularly confronted with traumatic content. Listening regularly to and translating potentially traumatizing stories make interpreters vulnerable to secondary traumatization. The current study aimed to investigate secondary traumatic stress (STS) in interpreters working with refugees and to identify potential risk and protective factors. In this cross-sectional study, 64 interpreters from Austria, Germany, and Switzerland participated. STS, compassion satisfaction, burnout, and resilience were assessed using the Secondary Traumatic Stress Scale, Professional Quality of Life Scale, and Connor–Davidson Resilience Scale. Sociodemographic data were collected (e.g., experiences with translation in psychotherapy, personal backgrounds of forced displacement, and personal experiences with psychotherapy as a client). Subgroup comparisons were conducted to identify risk factors for STS. A total of 43 participants (67%) showed at least mild STS. STS was significantly associated with burnout. Personal experiences of forced displacement, gender, and working context had no impact on STS. Interpreters with personal experiences of psychotherapy showed a higher level of STS as well as higher resilience than those without personal experiences of psychotherapy. Independent of personal experiences of forced displacement, gender, and working context, interpreters who work with refugees are at high risk of STS. Regular training and supervision for interpreters who work with refugees should thus be offered as standard practice. Full article

The use of opioids for cancer-related pain is essential but poses significant challenges due to the risk of misuse and the development of opioid use disorder (OUD). This review takes a multidisciplinary perspective based on the current scientific literature to analyze the pharmacological mechanisms, classification, and therapeutic roles of opioids in oncology. Key risk factors for opioid misuse—including psychiatric comorbidities, prior substance use, and insufficient clinical monitoring—are discussed in conjunction with validated tools for pain assessment and international guidelines. The review emphasizes the importance of integrating toxicological, pharmacological, physiological, and public health perspectives to promote rational opioid use. Pharmacogenetic variability is explored as a determinant of treatment response and addiction risk, underscoring the value of personalized medicine. Evidence-based strategies such as early screening, psychosocial interventions, and the use of buprenorphine-naloxone are presented as effective measures for managing OUD in cancer patients. Ultimately, this work advocates for safe, patient-centered opioid prescribing practices that ensure effective pain relief without compromising safety or quality of life. Full article

The operational and indoor environmental quality of buildings has a significant impact on global energy consumption and human quality of life. One of the key directions for improving building performance is the optimization of building control systems. In modern buildings, the presence of numerous actuators and monitoring points makes manually designed control algorithms potentially suboptimal due to the complexity and human factors. To address this challenge, model predictive control based on artificial neural networks can be employed. The advantage of this approach lies in the model’s ability to learn and understand the dynamic behavior of the building from monitoring datasets. It should be noted that the effectiveness of such control models is directly dependent on the forecasting accuracy of the neural networks. In this study, we adapt neural network architectures such as GRU and TCN for use in the context of building model predictive control. Furthermore, we propose a novel hybrid architecture that combines the strengths of recurrent and convolutional neural networks. These architectures were compared using real monitoring data collected with a custom-developed device introduced in this work. The results indicate that, under the given experimental conditions, the proposed hybrid architecture outperforms both GRU and TCN models, particularly when processing large sequential input vectors. Full article

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

Background/Objectives: Quality of life (QOL) is a multifaceted concept involving a variety of factors which define the overall well-being of individuals. Food security, which implies a resilient food system, is one factor that is central to the calculus of the QOL status of a community considering that food is a staple of life. Advancing food security as a strategy for attaining sustained improvement in community QOL hinges on recognizing that food security is embedded in a matrix of other factors that work with it to generate the QOL the community experiences. The lived experience of the community defines the community’s QOL value matrix and the relative position of food security in that value matrix. Our thesis is that the role of food security in the lived experience of low-income communities depends on the position food security is accorded relative to other factors in the QOL value matrix of the community. Methods: This study employed a multimethod approach to define the QOL value matrix of low-income Guilford County residents, identifying the relative position of the value components and demographic segments based on priority ranking. First, an in-depth interview was conducted and then a telephone survey (280 sample) was used for collecting data. The ISAC Analysis Procedure and Best–Worst Scaling methods were used to identify and rank components of the QOL value matrix in terms of their relative impact on QOL. Results: The analysis revealed that spiritual well-being is the most important contributor to QOL, with a weight of 0.23, followed by access to health services (0.21) and economic opportunities (0.16), while food security has a moderate impact with 0.07. Conclusions: These findings emphasize the need for targeted policy interventions that consider the specific needs of different demographic segments to effectively improve QOL and inform the design of resilient food systems that reflect the lived experiences of low-income communities. Food security policies must be integrated with broader quality of life interventions, particularly for unemployed, low-educated, and single individuals, to ensure that a resilient food system effectively reduces inequities and address community-specific vulnerabilities. Full article

Background and objectives: Trismus is a frequent and debilitating complication in people with head and neck cancer (HNC) which leads to significant functional limitations and reduced quality of life. Rehabilitation interventions are commonly recommended to manage or prevent trismus. However, in many randomized controlled trials (RCTs), the theoretical justification for these interventions is poorly articulated, and the underlying biological or physiological mechanisms are not described in detail, limiting our understanding of why certain treatments may (or may not) work. This review aimed to identify and analyze how RCTs report the rationale for rehabilitation interventions and the explanations used to manage this population. Materials and Methods: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. Five databases (PubMed, PEDro, Web of Science, Scopus, and EMBASE) were searched up to May 2025 for RCTs evaluating rehabilitation interventions for the management or prevention of treatment-induced trismus in patients with HNC. Data were extracted and synthesized narratively, focusing on the type of intervention, the rationale for its use, and the proposed mechanisms of action. Results: Of 2215 records identified, 24 RCTs met the inclusion criteria. Thirteen studies focused on preventive interventions—primarily exercise therapy—while the remainder addressed established trismus using exercise, manual therapy, electrotherapy, or combined treatment modalities. The rationales provided for intervention selection were heterogeneous and often lacked depth, with most studies justifying interventions based on their potential to improve mouth opening or reduce fibrosis but rarely grounding these claims in detailed pathophysiological models. Only half of the studies provided any mechanistic explanation for the intervention’s effects, and these were typically generic or speculative. Conclusions: RCTs investigating rehabilitation interventions for treatment-induced trismus in patients with HNC frequently lack comprehensive rationales and mechanistic explanations for their interventions. This gap limits the ability to refine and optimize treatment approaches, as the underlying processes driving clinical improvements remain poorly understood. Future research should be guided by theoretical models and include objective outcomes to better elucidate the mechanisms of action of interventions to inform clinical practice. Full article

Background/Objectives: Psychosocial (PS) factors and cognitive dysfunction (CD) in patients with atrial fibrillation (AF) may negatively impact treatment compliance. The PS profile covers multiple psychological and socio-economic factors, although research is mostly limited to depression, anxiety, and work stress. This study assessed the prevalence of a broad range of PS factors in patients with AF and their relationship with cognitive decline. Methods: We retrospectively analyzed data from patients referred to a cardiovascular rehabilitation clinic between March 2017 and April 2023 who underwent standardized assessments of PS factors, cognition, and quality of life. Results: Of the 798 included patients, 230 (28.8%) had AF, with a mean age of 68.07 years (SD 9.60 years). Six of nine PS factors were present in more than half of the overall sample. Compared to non-AF patients, those with AF showed significantly higher levels of social isolation, depression, and hostility, whereas low socioeconomic status, family and work-related stress, and other mental disorders were more frequent in the non-AF group. CD was present in 67.4% of the total cohort and was more prevalent in AF patients with a higher PS burden. Patients with permanent AF reported the poorest health status. Conclusions: Integrating assessments of PS factors and cognition in cardiac rehabilitation is feasible and supports a more comprehensive, patient-centred model of care in AF. Full article

Introduction: Nurses are the largest group of healthcare workers, and healthcare managers should pay attention to the quality of work life and the health and working capacity of nurses in order to ensure a sufficient number of nurses and a stable workforce. Aim: The present study aimed to determine nurses’ quality of work life, work ability index and intention to leave the nursing profession and to examine the associations between nurses’ quality of work life, work ability index and intention to leave the nursing profession. Methods: An online cross-sectional study was conducted. A total of 498 nurses completed the instrument, consisting of demographic data, Brooks’ Quality of Nursing Work Life Survey (BQNWL), Work Ability Index Questionnaire (WAIQ) and questions on their intention to leave their current job or the nursing profession. Results: Most nurses had a moderate quality of work life (QWL) (73.7%) and a good work ability index (WAI) (43.78%). Men (p = 0.047), nurses who study (p = 0.021), nurses who do not have children (p = 0.000) and nurses who do not take care of their parents (p = 0.000) have a statistically significantly higher total WAIQ score. Most nurses (61.1%) had considered changing jobs in the last 12 months, and 36.9% had considered leaving the nursing profession. A statistically significant positive correlation was found between the total BQNWL and the total WAI. The study found no correlation between QWL, WAI and intention to change jobs or leave the profession, which was unexpected. Conclusions: To ensure the provision of necessary nursing care and a healthy working environment for nurses, it is necessary to regularly monitor QWL and WAI and take measures to ensure the highest quality of working life. Further longitudinal and mixed-methods research is needed to understand the relationship between QWL, WAI and intention to leave. Full article

Ulcerative colitis (UC), a subtype of inflammatory bowel disease (IBD), is a chronic, relapsing inflammatory condition that significantly impairs the patient’s quality of life. While biologics have transformed disease management, a substantial number of patients remain unresponsive or lose efficacy over time. Tofacitinib (TOFA), an oral Janus kinase (JAK) inhibitor, introduces a novel therapeutic class of small-molecule drugs with a unique oral administration route, offering enhanced patient convenience and broader accessibility compared to parenterally administered biologics. As the first oral treatment approved for moderate to severe UC in years, TOFA acts by modulating the JAK/STAT pathway, influencing critical inflammatory mediators such as IL-6, IL-17, and IFN-γ. However, response rates are variable and appear dose-dependent, with up to 60% of patients showing inadequate therapeutic outcomes. This review represents the first comprehensive synthesis focused specifically on biomarkers of TOFA response in UC. Drawing on multi-omics data—epigenomics, transcriptomics, proteomics, and cellular profiling, we highlight emerging predictors of responsiveness, including CpG methylation signatures (e.g., LRPAP1 and FGFR2), transcriptomic regulators (e.g., REG3A and CLDN3), immune and epithelial cell shifts, and the cationic transporter MATE1. TOFA demonstrates a dual mechanism by modulating immune responses while supporting epithelial barrier restoration. Despite being promising, TOFA’s dose-dependent efficacy and interpatient variability underscore the critical need for non-invasive, predictive biomarkers to guide personalized treatment. As the first review of its kind, this work establishes a basis for precision medicine approaches to optimize the clinical utility of TOFA in UC management. Full article

Background/Objectives: In late 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a pandemic called the ‘coronavirus disease 2019’ (COVID-19). After the acute SARS-CoV-2 infection, many individuals (up to 33%) complained of unexplained symptoms involving multiple organ systems and were diagnosed as having Long COVID-19 (LC-19). Currently, LC-19 is inadequately defined, requiring the formation of consistent diagnostic parameters to provide a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy. LC-19 represents a significant burden on multiple levels. The reduced ability of workers to return to work or compromised work efficiency has led to consequences at national, economic, and societal levels by increasing dependence on community services. On a personal scale, the isolation and helplessness caused by the disease and its subsequent impact on the patient’s mental health and quality of life are incalculable. Methods: In this paper, we used Walker and Avants’ eight-step approach to perform a concept analysis of the term “Long COVID-19” and define its impact across these parameters. Results: Using this methodology, we provide an improved definition of LC-19 by connecting the clinical symptomology with previously under-addressed factors, such as mental, psychological, economic, and social effects. This definition of LC-19 features can help improve diagnostic procedures and help plan relevant healthcare services. Conclusions: LC-19 represents a complex and pressing public health challenge with diverse symptomology, an unpredictable timeline, and complex pathophysiology. This concept analysis serves as a tool for improving LC-19 definition, but it remains a dynamic disease with evolving diagnostic and therapeutic approaches, requiring deeper investigation and understanding of its long-term effects. Full article

Endoscopic dacryocystorhinostomy (DCR) is a widely recognized and highly effective procedure. This surgical procedure is performed globally, with minimal modifications across different regions. Background/Objectives: The fundamental goal of DCR is to marsupialize the lacrimal sac into the nasal cavity, which helps eliminate epiphora (excessive tearing) and recurrent dacryocystitis (inflammation of the tear sac). With advancements in technology, new instruments are being developed to minimize risks and maximize efficacy, ultimately improving surgeon convenience, patient safety, and quality of life. One such innovation is piezosurgery, a method of bone cutting that utilizes ultrasound vibrations. Originally prevalent in oral and maxillofacial surgery, piezosurgery is now being applied in many clinical applications. Its primary advantages include the preservation of soft tissues, precise bone cutting, and the ability to work effectively in narrow spaces. Methods: This article outlines the standard technique used at our facility for performing endoscopic dacryocystorhinostomy (DCR) with a piezoelectric system. We describe the preoperative evaluation, intraoperative techniques, and postoperative care to present what we consider the standard procedure in our clinic. Results and Conclusions: Piezosurgery’s selective cutting prevents damage to surrounding soft tissues, making it theoretically advantageous in DCR by preserving tissue integrity. Additional case–control and multicenter studies are necessary to compare its outcomes with those of traditional osteotomy, particularly in relation to the potential increase in operative time. Full article

Protein degradation plays a fundamental role in maintaining protein homeostasis and ensures proper cellular function by regulating protein quality and quantity. Heat shock protein 100 (Hsp100), found in bacteria, plants, and fungi, is a unique chaperone family responsible for rescuing misfolded proteins from aggregated states in an ATP-dependent manner. To date, they are primarily known to mediate heat stress adaptation and enhance cellular survival under extreme conditions in higher plants and algae. Resting cyst formation in dinoflagellates is widely recognized as a response to adverse conditions, which offers an adaptive advantage to endure harsh environmental extremes that are unsuitable for vegetative cell growth and survival. In this study, based on a full-length cDNA sequence, we characterized an Hsp100 gene (SaHsp100) from the cosmopolitan bloom-forming dinoflagellate Scrippsiella acuminata, aiming to examine its life stage-specific expression patterns and preliminarily explore its potential functions. The qPCR results revealed that Hsp100 transcript levels were significantly elevated in newly formed resting cysts compared to vegetative cells and continued to increase during storage under simulated marine sediment conditions (darkness, low temperature, and anoxia). Parallel reaction monitoring (PRM)-based quantification further confirmed that Hsp100 protein levels were significantly higher in resting cysts than in vegetative cells and increased after three months of storage. These findings collectively highlighted the fundamental role of Hsp100 in the alteration of the life cycle and dormancy maintenance of S. acuminata, likely by enhancing stress adaptation and promoting cell survival through participation in proteostasis maintenance, particularly under natural sediment-like conditions that trigger severe abiotic stress. Our work deepens the current understanding of Hsp family members in dinoflagellates, paving the way for future investigations into their ecological relevance within this ecologically significant group. Full article