To examine whether disparities in preventable adverse events (AEs) and family experience for hospitalized children of parents with and without limited comfort with English (LCE) changed following implementation of a health literacy-informed, structured family-centered rounds intervention, Patient and Family Centered I-PASS. Seven-center prospective before and after intervention study conducted from December 2014 to January 2017. Inclusion criteria includes parents and caregivers of hospitalized children less than 18years old. LCE defined as parent and caregiver reporting any language other than English as the language in which they were most comfortable speaking to physicians and nurses. Preventable AE rates determined via (1) daily medical record surveillance, solicited clinician reports, hospital incident reports, and family safety interviews, followed by (2) dual-physician masked review and consensus rating. Changes assessed through multivariable mixed-effects logistic regression, controlling for complex chronic conditions, length of stay, parent race and ethnicity, education, and clustering by site. Family experience assessed via predischarge survey (6 domains, 5-point scale). Mixed-effects linear regression estimated changes in mean domain scores by language comfort. Of 1666 patients, 8.8% (n = 147) had parents with LCE. Preimplementation, over twice as many children of parents expressing LCE experienced preventable AEs, compared with children of parents expressing comfort with English (18.8% vs 7.6%; P = .001; adjusted odds ratio, 3.29; 95% CI, 1.48-7.31). Postimplementation, there were no significant differences between groups (6.4 vs 5.3%; P = .68; adjusted odds ratio, 1.26; 95% CI, 0.42-3.75). Some domains of family experience improved for both groups, although disparities in experience persisted in nurse communication. Patient safety disparities related to parental comfort with English narrowed after implementing a family-centered rounds communication intervention.

Workplace Environment and Lifestyle Factors Associated With Hyperuricemia Risk Among Male Manufacturing Workers: A Cross-Sectional Study at a Single Company in Japan

This study examined the job motivation of Bachelor of Science in Tourism Management students undergoing on-the-job training (OJT) in hotels with different classifications. Specifically, it investigated whether significant differences existed in the job motivation levels of students assigned to 3-star, 4-star, and 5-star hotels. The study employed a quantitative comparative research design involving 60 tourism management students selected through convenience sampling. Data were gathered using a researcher-made questionnaire that underwent expert validation to ensure content relevance and clarity. The instrument measured students’ perceived job motivation during their internship experiences across various hotel environments. Descriptive statistics, including mean and standard deviation, were used to describe respondents’ motivation levels, while one-way Analysis of Variance (ANOVA) was utilized to determine significant differences among the groups. The findings revealed that students assigned to 4-star hotels obtained the highest mean job motivation score, followed by those in 3-star hotels, while students assigned to 5-star hotels recorded the lowest mean score. However, the results of the ANOVA indicated no statistically significant difference in job motivation among students across the three hotel classifications. These findings suggest that hotel classification alone does not significantly influence the motivational experiences of tourism students during their OJT. Instead, factors such as mentorship quality, workplace support, task relevance, and organizational culture may play more substantial roles in shaping student motivation. The study highlights the importance of strengthening internship programs through effective supervision, meaningful learning experiences, and supportive workplace environments. The results provide valuable insights for academic institutions, hospitality organizations, and policymakers in enhancing internship programs and fostering positive learning outcomes among future tourism professionals.

The risk assessment for video display terminal (VDT) operators in occupational settings often relies on indirect estimates, such as self-reported screen time, which may not accurately reflect the true visual workload. The objective is to assess visual workload in VDT workers by measuring active screen fixation time with a non-invasive monitoring system and to explore its relationship with ocular surface alterations and fatigue-related indicators. An observational cross-sectional study was conducted on 38 administrative workers employed at a hospital booking center. Active VDT screen fixation, as well as shift duration and time spent in front of the VDT screen, were objectively measured using a patented video-based monitoring system. Ophthalmological evaluation included the Ocular Surface Disease Index (OSDI®), tear break-up time (BUT), and slit-lamp examination. Other investigated markers included blink rate, the Percentage of Eyelid Closure over the Pupil over Time (PERCLOS), and the Fatigue Assessment Scale (FAS). Active screen fixation accounted for approximately 60% of the total recorded working time. Ophthalmological assessment identified alterations of the ocular surface in a substantial proportion of workers, with pathological BUT values observed in nearly half (47%) of the study population. No statistically significant associations were found between objectively measured fixation time and ocular or fatigue-related outcomes. PERCLOS80 and blink rate values remained within physiological ranges across the work shift. Objective measurement of screen fixation provides a more accurate characterization of visual workload among VDT workers than indirect exposure estimates and may support occupational health surveillance and risk assessment in VDT-exposed workers.

Providing compassionate care continually can result in nurses developing compassion fatigue - a state of physical, emotional and psychological exhaustion. Critical care nurses are particularly at risk of compassion fatigue, in part due to their constant exposure to patients with life-threatening conditions and patient deaths. This article details a literature review that aimed to explore compassion fatigue among critical care nurses, with a view to identifying interventions and coping strategies to enhance their well-being as well as to guide nurse managers in protecting staff well-being. Five main themes were generated through narrative synthesis. The findings indicate that: compassion fatigue is prevalent among critical care nurses, particularly younger nurses and those with lower levels of education; there is a lack of education regarding coping with patients' deaths; and various factors can increase the risk of compassion fatigue, such as insufficient staffing levels, limited time off and consecutive shifts. Interventions such as mindfulness and debriefing can mitigate compassion fatigue in critical care nurses, but their effectiveness depends on managerial and organisational support. Nurse managers have an essential role in supporting critical care nurses' well-being through consistent leadership, supporting staff to undertake further education and training, encouraging supportive workplace environments and implementing structured debriefing.

Previous research has consistently demonstrated that organizational politics can negatively affect employee well-being, although the strength of this relationship may vary depending on individual coping resources. Drawing on cognitive appraisal theory and attachment theory, this study examines whether attachment to God moderates the relationship between perceived organizational politics and employee well-being. Data were collected through a structured survey of 300 employees working in various organizations in South Korea. Hierarchical multiple regression analyses were conducted to examine the proposed relationships. The results indicated that attachment to God significantly moderated the effects of perceived organizational politics on both psychological health and job satisfaction. Specifically, the negative associations between perceived organizational politics and employee well-being were weaker among employees reporting higher levels of attachment to God. These findings suggest that attachment to God may serve as a meaningful interpretive resource through which employees understand and respond to politically charged workplace environments. The study contributes to the literature on workplace spirituality, organizational politics, and employee well-being by highlighting the potential role of spiritual attachment in shaping workplace experiences.

This study proposes and evaluates a novel, proxy method for assessing the performance of back support exoskeletons (BSEs), to address some limitations of electromyography (EMG) and metabolic cost (MC) measurements in workplace and field environments. We introduce the use of interface force between the user and exoskeleton as an alternative evaluation metric. To enable this, a compact load cell was integrated into the exoskeleton's thigh cuff, providing reliable force measurements without noticeably altering the system's kinematics or inertia. While interface force measurements can be affected by sweat and other human-related factors like EMG and MC, interface force can still represent the assistive force, allowing for real-time assessment of exoskeleton assistance in both laboratory and real-world settings. Experimental results demonstrated a statistically significant, strong correlation between mean interface force and lower-back muscle EMG activity during the upright phase of a squat lifting task with load. Whereas for MC, though not statistically significant, there was a strong correlation between mean interface force and MC reduction during a repetitive squat lifting task. These findings indicate that interface force sensing offers a promising proxy alternative to traditional EMG and MC evaluations, enabling more feasible, field-ready assessment of BSE performance in real-world workplace environments.

Objective: To investigate the incidence characteristics of occupational contraindications among workers exposed to occupational hazard factors in the Guangzhou area and providing reference data for effective occupational health surveillance. Methods: In March 2024, a cross-sectional study was conducted to collect health examination data from individuals who underwent occupational health examinations at the Guangzhou Occupational Disease Prevention and Treatment Institute between 2021 and 2023. Statistical analysis was performed on the detection rates of occupational contraindications across different genders, ages, examination categories, and occupational hazard factors/special operations. Intergroup comparisons were conducted using t-tests, or analysis of variance (ANOVA), group comparisons were conducted using chisquare (χ(2)) tests. Results: A total of 205938 occupational health examinations were screened, yielding 2883 detected cases of occupational contraindications (detection rate: 1.40%). Among these, 1971 cases (68.37%) were identified during active employment (χ(2)=208.41, P<0.001) ; males accounted for the majority (2673 cases, 92.72%), with no statistically significant gender difference (χ(2)=0.02, P=0.893). The primary exposure hazard factors or special operations included noise exposure (1443 cases, 47.64%), high-temperature work (567 cases, 18.72%), and occupational motor vehicle driving (356 cases, 11.75%). Significant differences in detection rates were observed across years, age groups, and hazard factors/special operations (χ(2)=6.43, 972.62, 2861.94; all P<0.05) . Conclusion: The detection rate of occupational contraindications among workers exposed to occupational hazard factors in the Guangzhou area is relatively low, predominantly affecting young and middle-aged male workers engaged in on-the-job activities. Targeted health surveillance should be intensified for key populations and core hazard factors to mitigate occupational health risks.

ABSTRACT Objectives This study estimated the prevalence of TMD symptoms among Southeast Asian nurses, examined their associations with psychological, somatic, musculoskeletal symptoms, and identified biopsychosocial factors related to TMD and musculoskeletal symptom burden. Methods A cross-sectional study of 438 nurses from two hospitals collected sociodemographic and occupational data. Validated instruments assessed TMD symptoms , somatic burden, psychological distress , and musculoskeletal complaints. Results TMD symptoms were present in 22.8% of participants, with combined intra-articular and pain-related TMD (CT) having the highest burden. CT participants demonstrated significantly greater psychological distress, somatic symptom burden, and musculoskeletal complaints. spanning the cranio-cervical region, spine, upper limbs, and lower limbs. Somatic symptom burden showed moderate correlations with psychological distress, global musculoskeletal, spinal, and lower limb burden. Conclusion TMD symptoms are prevalent among nurses and influenced by occupational conditions. Findings support the inclusion of TMDs in occupational health surveillance and integrated biopsychosocial care to address cumulative burdens in nursing populations.

A prospective study of the impact of variability in insomnia symptoms on work productivity.

Work is a social determinant of Cardiovascular (CV) and general health and can both influence and be influenced by health. The type of work, working conditions, and work environment are fundamental social determinants of CV and general health status. Climate change presents an urgent and increasing threat to workers' health, via both direct exposure to environmental risks and the indirect worsening of social and health inequalities. Occupational health, which focuses on the promotion of mental and physical health and well-being of workers, and the avoidance of occupationrelated health risks, is a crucial but less discussed concern and component of human health. Relevant research at the intersection of climate change and occupational health remains scarce. Additionally, mitigation of climate change and adaptation efforts are driving forces for rapid transformations in the workplace, including shifts towards sustainability and circular economy models. These transitions are creating new occupational hazards, including those concerning renewable energy and the circular economy sectors. Investment in occupational health research and surveillance should be increased to address the evolving influences of both climate change and the green transition, to enhance and protect workers' CV and general health. Among the work-related factors that play an important role in patients with CVD, the following seem crucial: work participation, physical and mental work capability, appropriate work, support from and flexibility of the work environment, inter-personal communication, person-centered milieu, and interdisciplinary communication. A moderate leisure-time physical activity combined with moderate occupational physical activity may be a more plausible way to combine these two activities to sustain and/or improve CV health. Such an approach may be able to ameliorate workrelated outcomes in patients with CVD. Finally, lifestyle interventions targeting multiple behaviors are also most important to prevent CVD and attain cardiometabolic health. All these issues of occupational CVD are herein reviewed, and relevant meta-analyses are tabulated and discussed.

Introduction: As global cancer incidence and survival rates continue to rise, understanding the experiences and needs of individuals in the survivorship phase is critical to inform policies that promote equitable care and adequate support for cancer survivors. Objective: The objective of this study was to examine the lived social and workplace experiences of cancer survivors in Newfoundland and Labrador (Canada) using a qualitative research design. Methods: The study was open to cancer survivors of majority age who resided in Newfoundland and Labrador after their diagnosis. Between June 2023 and August 2024, twenty-five individuals participated in the study. Data were collected virtually through focus groups, individual interviews, or written responses. Demographic and socioeconomic characteristics of participants were collected via a survey. Thematic analysis was performed on all qualitative data. Two patient partner investigators informed the research throughout the entire project. Results: Data were rich and diverse, revealing a range of positive and negative experiences in social and workplace settings. Major themes included stigma in social and workplace environments, financial toxicity, workplace accommodations, social support and information needs. Young participants had unique challenges. Participants offered recommendations aimed at enhancing available supports and improving the quality of life of cancer survivors. Overall, findings highlight shared experiences across different regions and cultures while also painting the local context. Discussion: The results of this study reveal diverse experiences among cancer survivors within social and workplace settings. The findings and resulting recommendations can inform meaningful improvement to policies and programs, thus promoting equity and enhancing the lived experiences of cancer survivors.

Inhalation of crystalline silica dust causes lung cancer, although evidence assessing risk at low levels of exposure is needed. We sought to estimate the association between cumulative silica exposure and lung cancer risk in a cohort of miners in Ontario, Canada. A cohort of 48 772 hard rock miners enumerated from a medical surveillance programme was followed for lung cancer diagnoses in the Ontario Cancer Registry from 1964 through 2022. Silica dust exposure was estimated using a linear prediction model based on 12 325 personal sampling measurements from Ontario mines. Exposure-response associations were estimated, with adjustments for uranium mining, arsenic dust and screening CXR. Probabilistic bias analysis was used to evaluate differential outcome misclassification due to loss to follow-up using a known bias parameter. 3218 lung cancer cases were diagnosed during a median of 44 years of follow-up. Positive associations between cumulative silica exposure and incident lung cancer rates were observed in all categories of exposure, with 0.5-2.0 mg/m3-years of exposure associated with 1.33 times (95% CI 1.06 to 1.66) the adjusted rate of lung cancer compared with<0.5 mg/m3-years. The positive exposure-response association remained after excluding known silicotics and increased in magnitude when excluding radon-exposed uranium miners. Bias adjustment for outcome misclassification increased the monotonicity and slope of the exposure-response relationship, but attenuated the IRR in the 0.5-2.0 mg/m3-year category to 1.08. Silica exposure was positively associated with lung cancer risk at low levels of cumulative exposure in a universally exposed population of miners. Findings were robust to suspected sources of bias.

The health workforce shortage in low- and middle-income countries (LMICs) remains a critical challenge. The quality of health personnel impacts population health, particularly in LMICs. While development partners invest in training programmes to improve quality, evaluation of these programmes remains rare, with limited evidence on the structural and contextual factors influencing outcomes. This study aims to evaluate Japan's Official Development Assistance (ODA) capacity-building training programmes conducted in Japan for LMIC health workforces and to identify key structural factors to guide future workforce development strategies. A cross-sectional questionnaire-based study was conducted from January to June 2023 in the Lao People's Democratic Republic and Mongolia. A total of 148 health professionals who had participated in ODA training programmes between 2013 and 2020 were included. Exploratory factor analysis (EFA) was applied to 97 questionnaire items developed based on the training transfer literature, followed by Wilcoxon rank-sum tests and structural equation modelling (SEM) with robust estimation. EFA identified six latent factors related to training effectiveness. Wilcoxon rank-sum tests showed that five factors-Feasible Action Plan, Collaborative Work Environment, Encouraging Learning Environment, Job-aligned Training and Readiness, and Altruistic Desire-were significantly associated with training effectiveness. During SEM refinement, two factors (Limited Authority and Altruistic Desire) were excluded due to non-significant effects or construct instability. The final model retained four factors, with Feasible Action Plan showing the strongest direct effect on training effectiveness (β = 0.72, p < 0.001). Collaborative Work Environment influenced training effectiveness indirectly through Job-aligned Training and Readiness and Feasible Action Plan. The model explained 45% of the variance in training effectiveness. Training effectiveness, defined as self-reported application of acquired knowledge, skills, and attitudes in the workplace, is shaped by interrelated factors operating before, during, and after training. The Feasible Action Plan emerged as the strongest direct predictor, highlighting the importance of translating learning into concrete and implementable actions. Collaborative and supportive workplace environments further facilitate this process. These findings underscore the importance of a holistic, process-oriented approach to ODA capacity-building training to enhance training transfer and sustain impact in LMIC settings.

Association of single and combined metal burdens with systemic immune inflammation in smelter workers: A population-based study.

Xeroderma Pigmentosum (XP), is a rare genetic condition characterised by extreme sensitivity to ultra violet (UV) radiation, conferring a 2,000- to 10,000-fold increased risk of developing melanoma and non-melanoma skin cancers. Families affected by XP face intense emotional strain, ongoing medical surveillance and intervention, and stringent lifelong adaptations to minimise UV exposure. Despite these challenges, little is known about the psychosocial burden experienced by children with XP and their immediate family members. This study explored the lived experiences and support needs, both medical and psychosocial, of families caring for a child with XP. We conducted qualitative semi-structured interviews, in person or via Zoom, with parents and children affected by XP, examining diagnostic experiences, psychosocial impacts, care preferences, and informational needs. The interview guide was developed by a multidisciplinary expert panel. Eligible participants included parents of children with XP, and patients or siblings aged 5-18 years without intellectual disability. Participants were recruited via the Australian Paediatric XP Support Group, representing the full known XP cohort in Australia. Of the seven identified families, five contributed at least one parent participant. Among eight identified children, four were ineligible, and one was not enrolled. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive, line-by-line coding in NVivo Pro. Descriptive statistics summarised participant demographics. Eight parents (63% female, mean age 45 years) and three children (67% female, mean age 10 years) participated. Four themes emerged: (1) a prolonged and distressing diagnostic journey, often marked by misdiagnosis and uncertainty; (2) strong preferences for integrated, multidisciplinary care to reduce fragmentation; (3) significant psychosocial impacts, including isolation, anxiety-driven vigilance, and challenges adapting to absolute UV-protective routines; and (4) substantial unmet information needs at diagnosis, leaving families feeling overwhelmed and underprepared. Families affected by XP experience significant and enduring psychosocial burden. Findings highlight the urgent need for coordinated, interdisciplinary support that extends beyond medical care. This study contributes to the growing call within the rare disease community for integrated care models that centre patient and family wellbeing.

Singapore's pragmatic governance of sex work, combining criminalisation and toleration, is exemplified by the Medical Surveillance Scheme (MSS) introduced in 1976 to manage sexually transmitted infections (STIs)/HIV among registered sex-workers. While the MSS provides conditional healthcare access, it excludes undocumented migrant sex-workers, leaving them vulnerable to health inequalities, precarity, and state violence. Drawing on an ethnographically-informed study conducted between March 2022 and July 2023 in collaboration with Singapore's sex-worker community, this study examines how migrant sex-worker bodies are regulated and marginalised under entangled logics of biopolitical inclusion (via medical surveillance) and sovereign exclusion (via consistent policing and moralisation). We argue that public health governance of migrant sex-workers functions not only for disease control but also as a mechanism of social ordering, sustaining the structure of violence tied to sexuality, mobility, and nation-building. By centring migrant sex-workers' lived experiences, we challenge dominant epidemiological framings that reduce them to "risk categories," instead unpacking how state interventions enact coercion, fear and danger. The study calls for a reorientation of public health policy from punitive regulation towards grounding in dignity, equality and justice.

Anomaly detection models based on autoencoders often suffer from unstable training, inconsistent reproducibility, and sensitivity to manually selected hyperparameters. These challenges limit their reliability across domains with varying data scales and feature distributions. This paper proposes an adaptive anomaly detection framework that combines a dual autoencoder architecture with a fully automated training-stability pipeline. The dual encoders capture global structural patterns and fine-grained local variations, enabling robust detection of subtle and heterogeneous anomalies. Unlike existing automated approaches which focus primarily on architecture search, our method targets the overlooked problem of training reproducibility and dataset-adaptive optimization. The proposed framework integrates (i) dynamic seed initialization for bias-resistant reproducibility, (ii) adaptive batch size estimation through a statistically derived logarithmic scaling function, (iii) iterative epoch optimization with multi-attempt checkpointing, and (iv) automated dropout tuning via Keras Tuner. To improve decision reliability, we further incorporate Monte Carlo dropout to estimate predictive uncertainty and reduce false-positive classifications. Extensive experiments on medical imaging, industrial inspection, 2D/3D textures, and surveillance datasets demonstrate consistent improvements over 11 state-of-the-art anomaly detection methods, yielding AUROC gains of up to 12.4% and significantly higher recall–precision stability. Ablation studies confirm that each optimization component contributes meaningfully to performance and reproducibility. • The framework eliminates manual tuning by integrating dynamic seed initialization, empirical batch size estimation, and attempt-level early stopping with model checkpointing. • Incorporates input gradient heatmaps and reconstruction error visualizations to explain model predictions, helping domain experts understand anomaly decisions. • Uses a min-distance ROC method to automatically determine optimal classification thresholds. • Evaluated on diverse datasets from medical, industrial, and surveillance domains. • Achieves better or comparable results to existing methods, while being more reproducible, scalable, and less sensitive to hyperparameter selection.

To describe the prevalence, age at first radiographic detection, severity, and progression of thoracic spondylosis deformans (SD) in search-and-rescue (SAR) dogs enrolled in a long-term medical surveillance program. This retrospective case series analyzed thoracic radiographs from 127 SAR dogs. All dogs participated in a 15-year medical surveillance program beginning in 2001. Thoracic radiographs and health data were submitted annually by handlers when available; however, radiographs were not submitted each year consistently, and some data points were missing. One board-certified radiologist reviewed the radiographs for the presence, severity, and progression of thoracic SD. Descriptive statistics were used to summarize signalment and radiographic findings. Of the 127 dogs evaluated, 81 (63.8%) had thoracic SD identified on radiographs. The average age at first detection was 8.7 years (range, 2.0 to 15.8 years). Severity was classified as mild in 52.9% of cases, moderate in 32.8%, and severe in 14.2%. Radiographic progression occurred in 40% of affected dogs. The condition was observed across multiple breeds, including German Shepherd Dogs and Labrador Retrievers. Thoracic SD, an enthesopathy, is a common and sometimes progressive finding in SAR dogs. Although historically considered an incidental finding, the identification of thoracic SD may inform long-term musculoskeletal monitoring and clinical management strategies for SAR and other working dogs.

Abstract This study investigates the role of industrial relations in ensuring workplace safety and employee discipline in the manufacturing sector, with specific reference to TVS Wheels India. The manufacturing environment involves high operational risks, making safety compliance and disciplined behavior essential for productivity and accident prevention. The primary objective of this research is to analyze how industrial relations practices such as communication systems, grievance handling, employee participation, and training influence safety awareness and discipline among employees. A descriptive research design was adopted, and primary data was collected from 106 employees across various departments using a structured questionnaire. Statistical tools including Pearson correlation, Chi-square test, and One-way ANOVA were applied using SPSS software. The findings reveal a statistically significant positive relationship between industrial relations practices and safety compliance (r = 0.274, p &lt; 0.01), indicating that improved industrial relations contribute to better safety behavior. The study also identifies significant associations between work experience and discipline levels, along with departmental differences in safety perception. The study concludes that strong industrial relations systems are essential for developing a safe, disciplined, and productive workplace environment. Keywords Industrial Relations, Workplace Safety, Discipline, Manufacturing Industry, HR Practices, SPSS Analysis, TVS Wheels India