AIMS Public Health最新文献

Nurse migration from low- and middle-income countries to high-income nations is a significant global phenomenon. This study aimed to examine the opportunities and challenges faced by Albanian nurses during their work integration after migrating to Germany. A descriptive cross-sectional quantitative study was conducted using convenience sampling with a snowball recruitment technique. A total of 162 Albanian nurses working in Germany, mostly female and married, participated in the survey. The findings revealed that the overall integration process was satisfactory, particularly regarding the recognition of professional qualifications, respect from colleagues, patients, and families, career opportunities, and autonomy at work. The host institutions supported integration through mentorship programs, language training, procedural training, and education on the German healthcare system. However, nurses reported challenges in medical terminologies, telephone communication, and healthcare documentation. The participants expressed the need for more comprehensive pre-departure information to facilitate smoother transitions. The study highlights the pivotal role of managers and institutions in the integration process and in creating inclusive and equitable work environments. Germany serves as a model for implementing effective integration activities for migrant nurses. Albania must adopt stronger strategies to retain nurses within the country and enhance its human capital by improving the working conditions and providing career development opportunities. Future research is recommended to explore the integration processes of Albanian nurses across other European countries. Subsequent studies should concentrate on identifying and addressing potential barriers to integration while fostering opportunities for collaboration between the origin and destination countries. Such research can contribute to academic, political, and social frameworks that enhance the migration experience for migrant nurses.

Background: Type 2 diabetes (T2D) is a prevalent global health problem largely caused by lifestyle factors, including poor diet and physical inactivity. With the increasing incidence of T2D, effective prevention strategies are urgently needed. This review examines the role of different dietary patterns and exercise regimens in the prevention and management of T2D, focusing on their effects on glycemic control, insulin sensitivity, and cardiovascular health.

Methods: A narrative review was conducted synthesizing evidence from clinical trials, cohort studies, and meta-analyses. The review focused on the effects of low-carbohydrate diets (LCDs), Mediterranean diets (MDs), plant-based diets, high-protein diets (HPDs), and various exercise regimens, including aerobic, resistance, and high-intensity interval training (HIIT).

Results: Dietary interventions, particularly MD and plant-based diets, are associated with improved glycemic control and reduced risk of developing T2D. LCDs show short-term benefits for weight management and HbA1c reduction, although adherence remains a challenge. HPDs show mixed results, with some benefits for lipid profiles but inconsistent effects on glycemic control. Exercise programs, especially combined aerobic and resistance training, significantly improve glycemic control, insulin sensitivity, and cardiovascular risk factors. HIIT emerges as an effective option for improving metabolic health in individuals at risk for or living with T2D.

Conclusions: A combination of dietary modification and physical activity, particularly Mediterranean and plant-based diets coupled with combined aerobic and resistance exercise, appears to be the most effective strategy for the prevention and management of T2D. Future research should focus on personalized approaches that integrate both diet and exercise to tailor interventions to individual patient needs.

The salutary effects of a sense of control on health are well acknowledged; however, rigorous studies evaluating its effect on mortality remain scarce. This study aimed to study the association between a sense of control and mortality and to identify the effect of changes in this sense of control on mortality risk. This prospective cohort study included 22,793 participants over age 50 and their spouses, drawn from a nationally representative U.S. sample from 2006 to 2018. Cox proportional hazard regression analyses estimated the association between sense of control and all-cause mortality. Kaplan-Meier survival curves were compared using the log-rank test, and changes in sense of control levels associated with mortality risk were evaluated using the Cox proportional hazards model. Over the 12-year follow-up period, 5027 deaths were recorded. An increased sense of control was significantly associated with decreased mortality risk, as revealed by stratified analysis according to sex and age. Hazard ratios (HRs) for the second, third, and fourth quartiles of sense of control levels were 0.91 (95% CI, 0.84-0.98), 0.83 (95% CI, 0.77-0.92), and 0.79 (95% CI, 0.72-0.87), respectively, relative to the first quartile. Compared to individuals with stable sense of control scores from baseline to study conclusion, the HR was 0.58 (95% CI, 0.48-0.70) for those with increased scores and 1.81 (95% CI, 1.53-2.13) for those with decreased scores. High levels of sense of control were significantly associated with reduced mortality risk. These findings underscore the importance of a sense of control as a focus for public health interventions.

Introduction: Employee exposure to specific risks often increases work-related stress, negatively impacting their effectiveness and potentially leading to illnesses, mistakes, or accidents.

Objective: We aimed to determine the psychosocial risks experienced by nurses in tertiary hospitals and their association with attitudes toward safety and the occurrence of medication errors.

Methods: A cross-sectional study was conducted between September 30, 2022 and December 31, 2023 in four Greek tertiary hospitals (Evangelismos, Nikaia "Agios Panteleimon", University Hospital of Larissa, and "G. Papanikolaou"). The study involved 514 nurses aged 20-67, employed for at least 12 months, fluent in Greek, and completing questionnaires on stress, burnout, and medication errors. The questionnaire used in the study included demographic information of the nursing staff (age, gender, marital status, work experience, and education level), characteristics of the nursing unit (medical, surgical, long-term care unit, Intensive Care Unit), the COPSOQ III (Copenhagen Psychosocial Questionnaire Version III), the HSOPSC (Hospital Survey on Patient Safety Culture), and the questionnaire for Investigating Nursing Errors in Medication Administration.

Results: Nurses exposed to psychosocial risks, such as bullying and high demands, reported increased medication errors. Supportive work environments with sufficient staffing and collaborative culture significantly mitigated these risks. Factors such as "Staffing" and "Handoffs" partially mediated the relationship between demands and errors. Thus, targeted interventions to reduce bullying and enhance teamwork are essential. Continuous education emerged as crucial for improving safety and performance.

Conclusion: The study underscores the necessity of social support, job autonomy, and work-life balance as critical factors in reducing stress and improving the quality of care. Specific strategies are proposed to enhance nurses' mental health and improve working conditions.

Indoor radon exposure poses significant health risks and has prompted testing and mitigation programs in regions such as Europe, North America, Japan, and South Korea. However, African countries have not adopted similar measures on a comparable scale. Limited research on radon exposure in Africa can be attributed to a lack of awareness among policymakers and the public, insufficient expertise in radiation protection and measurements, and restricted access to resources such as laboratories and testing equipment. This review examines existing research articles on radon exposure conducted in African countries, focusing on the efforts made by specific nations, such as Tunisia and Sudan, to address this issue. It analyzes the scope, scale, and impact of these initiatives compared to global efforts in managing radon exposure risks. The findings reveal that the study of radon exposure in Africa is still in its early stages, with limited progress and modest initiatives compared to other regions. While some efforts have been made, they are insufficient to effectively address the significant health risks associated with radon exposure. There is an urgent need for African policymakers and researchers to prioritize radon exposure as a public health issue. Developing frameworks, standards, and mitigation strategies is essential to reduce risks in homes and workplaces. This review emphasizes the importance of addressing radon exposure in African countries and offers recommendations to guide future research and policy development.

Global health aims to improve health outcomes and promote equity by addressing transnational health issues through cross-disciplinary collaboration. This field merges preventive measures with clinical care to enhance health and reduce disparities. On the other hand, human well-being includes material and non-material factors that influence quality of life and personal fulfillment. Together, they are crucial for sustainable development, aligning with the UN's Sustainable Development Goals. Though often examined separately, understanding their interconnectedness can reveal the root causes of global challenges, such as pandemics and climate change, and inform comprehensive strategies for a healthier, more equitable world. This systematic review updates the current challenges and opportunities in global health and well-being. It highlights the importance of scalable, cost-effective solutions, incorporating global health, environmental sustainability, and local contexts to address issues like antimicrobial resistance (AMR), zoonotic diseases, and climate-related health impacts. The study advocates for a multidisciplinary approach, integrating knowledge from medical microbiology, agriculture, environmental science, and traditional practices. Effective solutions should be holistic and inclusive, incorporating bioinformatics in AMR, One Health strategies, and sustainable food systems through regenerative agriculture. These recommendations support broader health equity goals, emphasizing the deep connections among human, animal, and environmental health that are essential for global well-being.

Background: Sleep impairment and work-related stress are common issues that influence employee well-being and organizational outcomes. Impaired sleep depletes cognitive and emotional resources, increasing stress and the likelihood of counterproductive work behaviors directed toward the organization (CWB-O). This cross-sectional study, guided by the conservation of resources (COR) theory, explores the relationships between impaired sleep, work-related stress, and CWB-O, considering substance use as a dysfunctional coping strategy.

Methods: A sample of 302 Italian employees completed an online survey. Sleep impairment was assessed using the Insomnia Severity Index, work-related stress was assessed with the Perceived Stress Scale, CWB-O was assessed with the Counterproductive Work Behavior Checklist, and substance use as a coping strategy was assessed using the Brief COPE. A moderated mediation model was tested to examine the indirect effects of sleep impairment on CWB-O via work-related stress, with substance use moderating both the sleep-stress and stress-CWB-O relationships.

Results: The results supported the hypothesis that the relationship between sleep impairment and CWB-O is mediated by work-related stress. Sleep difficulties significantly increased work-related stress, which in turn led to higher levels of CWB-O. Substance use did not moderate the relationship between sleep and work-related stress. It did, however, significantly moderate the relationship between work-related stress and CWB-O, with higher levels of substance use amplifying the impact of stress on behavioral dysregulation.

Conclusion: This study contributes to our understanding of how impaired sleep, work-related stress, and substance use interact to influence deviant behaviors at work. The findings align with COR theory, highlighting the role of resource depletion and dysfunctional coping in workplace behavior, and suggest that organizational interventions should also consider programs aimed at improving sleep quality and addressing substance use to reduce the likelihood of deviant behaviors at work.

Background: One of the primary challenges that hinders organizational effectiveness and prosperity is organizational cynicism. Organizational cynicism is defined as a general or specific attitude of disappointment, insecurity, burnout, and mistrust towards individuals or groups. Paradoxical leadership, as applied by nurse managers, involves acknowledging and navigating the inherent tensions and contradictions within healthcare organizations, which enables managers to sustain balance in the workplace.

Aim of the study: This study aims to investigate the relation between organizational cynicism and a nurses' occupational burnout (testing nurse managers' paradoxical leadership moderation effects).

Research design: A non-experimental cross-sectional prospective design was employed for this study.

Subjects: A stratified random sample of 314 nurses participated in the study.

Setting: The study was conducted at Main Tanta University Hospital, which is affiliated with the Ministry of Higher Education and Scientific Research.

Method: Three tools were used for data collection: the Organizational Cynicism Scale, the Nurse Managers' Paradoxical Leadership Scale, and the Maslach Burnout Inventory (MBI).

Results: A statistically significant positive correlation was found between organizational cynicism and occupational burnout. Additionally, a statistically significant negative correlation was observed between the nurse managers' paradoxical leadership and both organizational cynicism and occupational burnout.

Recommendations: Healthcare leaders should take proactive measures to address organizational cynicism to mitigate a nurses' occupational burnout, which can contribute to the nursing shortage.

Background: Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease in the United States and healthcare resources used to manage the disease are disproportionately consumed by a small subset of users. Consequently, there is a potential to reduce the healthcare costs and to improve the health outcomes through the early detection and consistent management of high-cost users.

Objective: The objectives of this study were to characterize the pattern of medical utilization and cost of commercially-insured people with type 2 diabetes (T2DM) in Texas and to identify predictors of high-cost users.

Methods: Using claims data from a large commercial insurance plan spanning the period from 2016 to 2019, the total medical costs of a randomly selected 12-month period were analyzed for eligible commercially-insured people with T2DM, and the patients were categorized into the top 20% of high-cost users and the bottom 80% of lower-cost users. Descriptive analyses were conducted to describe the baseline characteristics of the people with T2DM, the patterns of healthcare utilization, and the costs of the two types of users. Multivariate logistic regression models were estimated to identify the predictors of being a high-cost T2DM user.

Results: The top 20% of high-cost users accounted for 83% of the total medical cost, with an average cost of $41,370 as compared to only $2064 for the bottom 80% of lower-cost users. Several chronic conditions were identified to be strong predictors of being a high-cost patient. Rural high-cost users had, on average, fewer specialist visits but more inpatient stays compared to the urban high-cost users.

Conclusion: Healthcare utilization and expenditures among commercially insured individuals with T2DM followed the 80-20 rule. High-cost users were strongly associated with worse health status. Residential rurality was not associated with high-cost use, though the patterns of resource utilization differed between urban and rural high-cost users.

Background: Prevention of acute cardiovascular events in patients with cardiovascular disease (CVD) requires promoting health-protective behaviors (e.g., physical activity) and reducing health-compromising behaviors (e.g., sitting). Digital interventions addressing health behavior offer great potential. Based on a multiple behavior change theory, an intervention in the form of a digital health application (app) was evaluated in a pilot trial, testing the following hypotheses (H): H1: Health behaviors (physical activity, sitting) and disease self-management (self-care maintenance, self-care confidence) are closely related; H2: changes in health behaviors and disease self-management indicators over time (T0 to T1) are more pronounced in the intervention group (IG, app users) than in the control group (CG); H3: within the IG, changes in systolic and diastolic blood pressure indicate a positive trajectory.

Methods: A 12-week randomized controlled trial (RCT) was conducted with two measurement points. The IG received an app addressing self-management and health behavior change. A total of N = 40 CVD patients were randomized equally to the CG (45% women; mean age = 60.6 years) and the IG (35% women; mean age = 61.5 years).

Results: Findings support H1 with correlations between behaviors (r = -0.66-0.79) and disease self-management (r = -0.06-0.70). H2 was also partially supported, with significant improvements over time in self-management indicators, especially self-care maintenance, in the IG (Eta² = 0.35; p < 0.001). H3 could not be confirmed as no significant changes were found.

Conclusions: This study provides evidence that an app addressing different behavior change techniques (BCTs) can help to manage CVD by promoting health-protective behaviors and preventing health-compromising behaviors. Taking different behaviors into account may increase the effectiveness of behavioral intervention, thereby improving individual and public health. Replications with larger samples and more objective measures are needed.