Working Conditions Research Articles

Evaluating occupational health and safety practices in an airport construction project in Nepal

PurposeThis study examines the implementation and performance of Occupational Health and Safety (OHS) practices in the Pokhara Regional International Airport Project (PRIAP), a key public infrastructure initiative in Nepal. Given airports' significance to Nepal’s economy, particularly for tourism and trade, the research highlights the unique safety challenges in airport construction, addressing gaps in OHS management in developing countries.Design/methodology/approachA case study methodology focused on the PRIAP enabled a thorough analysis of safety practices. Data were gathered using structured questionnaires from various stakeholders. The Cronbach’s alpha and relative importance index (RII) were used to assess response reliability and ranked factors affecting safety performance.FindingsThe study identifies both strengths and weaknesses in the project’s OHS practices. While plant and equipment handling and financial aspects, such as budget allocation for safety measures and accident compensation, were deemed satisfactory, significant deficiencies were found in hazard identification and the investigation of near misses. These results suggest that improvements are needed in proactive safety management, particularly in worker-management communication.Research limitations/implicationsThis study provides valuable insights but is limited by its single-site focus and use of descriptive statistics. Future research should employ advanced statistical methods, like ANOVA, and include multiple construction sites to capture a broader range of OHS challenges. Evaluating the long-term effectiveness of proposed interventions is also essential. Addressing these limitations will enhance the development of comprehensive safety management strategies tailored to the specific needs of construction projects in developing countries.Practical implicationsThis study provides practical recommendations for improving OHS practices in airport construction and similar large-scale projects in developing countries. Enhanced hazard identification and improved communication among stakeholders can help reduce accidents and boost project efficiency.Social implicationsImproving safety regulations and culture can reduce workplace injuries, enhancing workers' well-being and quality of life. This research supports stronger public policies, helping lower economic burdens from accidents, promoting social stability and increasing public trust in regulatory bodies.Originality/valueThis research contributes to the limited literature on OHS in airport construction projects in developing countries, particularly in Nepal. The case study methodology provides a detailed examination of safety practices and offers a framework for improving OHS in similar projects.

COVID-19 Pandemic's Effects on Occupational Health and Perceived Work Ability of a Large Group of Italian Banking Employees.

The COVID-19 pandemic compelled changes to the structure and organization of many occupational sectors that may impact workers' well-being and work-related symptoms. Evaluate the effects of working modifications related to the COVID-19 pandemic on occupational health outcomes and work ability (WA) among a large group of Italian banking employees. 2,859 employees visited during health surveillance in 2021 were divided into two job groups: front-office (FO) and back-office workers (BO). Data on conditions associated with office work, psychological distress, WA, and fitness-to-work judgment were analyzed and compared with available data from the pre-pandemic period (2018-2019). The prevalence of analyzed outcomes was lower than in pre- and post-COVID evaluation literature. After COVID-19, a 28% increase in asthenopin was found in BO, while musculoskeletal symptoms increased about 22% in BO and 9% in FO. Post-COVID showed a 28% rise in stress-related symptoms and a 17% increase in psychotropic drug consumption in both groups. After the lockdown, the prevalence of moderate/poor scores decreased by 13% in each group. Fitness-to-work judgment without limitations prevalence was unchanged. The slight worsening in all examined outcomes at post-lockdown evaluation and the outcomes' prevalence consistently lower than the literature data could be linked to the measures the Institute took to support employees during the COVID-19 pandemic. In this context, a comprehensive integration between occupational safety and health promotion practices is recommended to ensure the highest level of safeguarding for workers' well-being.

Examining Changes in Compassion Satisfaction, Burnout, Secondary Traumatic Stress and Work-Related Quality-of-Life of Rural Surgical and Obstetrical Nurses in British Columbia During the COVID-19 Pandemic.

This survey of rural nurses' experiences is part of a program evaluation of the Rural Surgical and Obstetrical Networks (RSON), a five-year initiative (2018-2023) to strengthen and stabilize rural hospitals in British Columbia (BC), Canada. Our aim was to measure changes in professional and work-related quality-of-life of rural surgical and obstetrical nurses in eight communities across BC and determine if the RSON initiative mitigated impacts of the COVID-19 pandemic on nurses' quality of life. This longitudinal evaluation was administered via online surveys in 2021 and 2023. Work-related quality of life was measured with 23 items that assess job satisfaction, general wellbeing, work-life balance, stress level experienced at work, control, and working conditions. Professional quality of life was measured along three dimensions: compassion satisfaction (CS), burnout, and secondary traumatic stress (STS) (10 items each). Responses were linked by code and changes in quality of life were analyzed using paired Student's t-test. 107 nurses participated at time 1 and 28 at time 2. Burnout and secondary traumatic stress scores at time 1 were lower among older nurses and those with children. Over the two-year period (2021 to 2023), significant increases were observed in burnout (p < 0.001), and secondary traumatic stress (p = 0.04), while work-related Quality-of-Life decreased significantly (p = 0.04). Compassion satisfaction decreased over time, though not statistically significant. While the RSON initiative could not mitigate decreases in professional and work-related quality-of-life during COVID-19, it offered opportunities for clinical education and professional development among rural nurses.

Work-Related Injury and Healthcare Access Among Day Laborers. Struggling at the Esquina.

California has a significant day laborer population, with about one-third of the total U.S. day laborer population working in the state. Day laborers, characterized by a lack of labor protections, low socioeconomic status, English illiteracy, and irregular immigration status, face numerous challenges regarding work-related injuries and limited access to healthcare. Eighty percent of day laborers are undocumented, and most do not have access to healthcare. Despite recent research growth, little is known about their experiences with work-related injuries and healthcare treatment. Our findings reveal that only 8.4% of day laborers have health insurance, and around 26% have experienced work-related injuries. This paper highlights the challenges faced by this population and emphasizes the importance of understanding their experiences to improve occupational health and safety policy. Additionally, we acknowledge the critical role of worker centers and national efforts in addressing health and safety issues among day laborers.

Human Exposure to Asbestos in Central Asian Countries and Health Effects: A Narrative Review.

The discovery of the detrimental effects of asbestos on human health came long after its widespread use, with the first scientific evidence of asbestos-related diseases emerging in the late 19th and early 20th centuries. Despite efforts to ban its use, asbestos continues to be mined and used in Central Asia (as well as in Russia, China, and other countries). To gain a deeper understanding of the situation in Central Asia, we have conducted a systematic review of scientific literature on the use of asbestos, exposure assessment, and health consequences of asbestos exposure in this geographic area. This review encompasses studies about exposure assessments, epidemiological data, and biochemical or clinical surveys conducted in Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan, and Kyrgyzstan. A total of 18 articles met the inclusion criteria, and their content is summarised in this review, which represents the first attempt to systematically examine research on asbestos and its impact on the health of workers and the general population in Central Asia countries, including literature published in Russian and English. The findings here highlighted the substantial limitations of the currently available knowledge about the impact of asbestos on health in this geographical area.

The effect of surface profile and groove bottom profile on steady-state performance of dry gas seals

Purpose The purpose of this paper is to improve the film stiffness of a dry gas seal (DGS) through the proper design of 3D macroscopic surface structures based on numerical study. Design/methodology/approach A novel generalized three-dimensional (3D) geometric model is proposed to characterize macroscopic surface structures of a DGS, including grooves, waviness, radial taper and step. The mathematical model is established to simulate film pressure distribution. The effect of the surface profile and groove bottom profile on the steady-state performance of DGSs at different working conditions is investigated. Findings The unidirectional groove surface has the largest film stiffness at different speed conditions and the largest opening force at medium and high speed, whereas the annular groove has the largest opening force at static pressure. For obtaining the maximum film stiffness, unidirectional combined variable depth groove surface when ns = 0.4 and k = 0.5 outperforms the other unidirectional groove surfaces, whereas circumferential waviness when ns = 1 and k = 1 is the best choice among annular groove surfaces. Originality/value This study proposes a novel generalized 3D geometric model to characterize macroscopic surface structures of a DGS. The optimal groove bottom profile for different surface profiles of DGS is presented.

Discovery of reproductive tissue-associated bacteria and the modes of microbiota acquisition in male honey bees (drones).

Over the last decade, annual honey bee colony loss has increased, resulting in a critical need to determine what factors contribute to honey bee and colony health. Gut microbes have been shown to play important roles in the health of the nonreproductive female honey bee workers, which make up 90% or more of a honey bee colony. However, we currently know very little about the impact of microbes on the health of male honey bees (drones), who only make up a small portion of the colony population but play a very key role in the success of future colonies by mating with virgin queens. Here, we discovered microbes within the reproductive organs of drones and illustrated that social interactions with worker bees are necessary for the proper development of the gut and reproductive tissue microbial communities in drones. Further studies are needed to determine if microbes play an important role in honey bee reproductive health and fitness.

Thyroid doses for the Chornobyl Tissue Bank: improved estimates based on revised methodology and individual residence and diet history.

Increased thyroid cancer incidence has been one of the principal adverse health effects of the Chornobyl (Chernobyl) nuclear power plant accident. Accurate dose estimation is critical for assessing the radiation dose-response relationship. Current dosimetry estimates for individuals from the Chornobyl Tissue Bank (CTB) are based only on the limited information on their places of residence at the time of the accident and/or at the time of surgery for thyroid cancer. The present study aimed to assess whether additional residential and dietary history data collected during personal interviews would substantially impact dose estimates. This paper presents an assessment of thyroid doses from 131I intake for the 197 exposed individuals from the CTB with pathologically confirmed papillary thyroid cancer. Thyroid doses, which had been calculated for these individuals in 2010, were revised in this study using the recently substantially revised 'Thyroid Dosimetry 2020 system for Ukraine' (TDU20). In addition, residence and diet history data were collected during personal interviews with individuals for whom dosimetry-related data were scarce. The arithmetic mean of thyroid doses estimated in this study was 510 mGy (previously 700 mGy), while the median was 81 mGy (previously 120 mGy). A rather wide range of thyroid doses from zero to 11.9Gy (previously up to 15.0Gy) was observed among study participants. The uncertainties in doses were characterized by the geometric standard deviation of 1,000 individual stochastic doses. As a result, the geometric standard deviation varied from 1.3 to 5.3 with an overall arithmetic mean of 2.7 and a median of 2.9. This study clearly showed that the use of individual questionnaire data in dose assessment of individuals who completed personal dosimetry interviews had a noticeable impact on the thyroid dose values: the thyroid doses changed by more than 100 mGy in 31 out of 104 (29.8% of the total) individuals, while such changes due to the use of TDU20 were observed in 18 out of 104 (17.3%) individuals. Clearly, future focused studies using samples from the CTB would benefit from personal interviews to improve dose estimates. Another lesson learned from this study is that whenever a radiation accident occurs, it is important to ask affected people by health and radiation safety authorities to keep records of their own behavior and diet, and, if possible, those of their children.

Sodium toxicosis in chickens: case series (2014-2023) and literature review.

Cases of sodium toxicosis (ST), although reported infrequently, can result in acute morbidity and mortality and extensive losses in affected poultry. We analyzed the clinical, pathologic, and toxicologic findings of 7 diagnosed cases of ST in chicken autopsy submissions at the California Animal Health & Food Safety Laboratory System (CAHFS), University of California-Davis, from 2014 to 2023. We also evaluated the brain sodium concentrations in 10 clinically normal broiler chickens to elucidate potential differences with salt-intoxicated chickens, and reviewed the literature of field cases of ST in chickens and turkeys. Lesions of anasarca described in the 7 ST cases (66 chickens) identified from the CAHFS database included: ascites (62 of 66; 6 of 7 cases); hydropericardium and cardiomegaly (54; 6 of 7); edematous, congested lungs (24; 6 of 7); enlarged, pale kidneys (24; 6 of 7); subcutaneous edema (17; 4 of 7); cystic testes (14; 6 of 7); and cerebral edema (7; 4 of 7). Brain sodium concentrations exceeded 1,800 ppm in only 4 of 24 brains analyzed in our case series. In the feed samples analyzed from 5 ST cases, sodium concentrations exceeded the recommended 2,000 ppm; concentrations detected were 2,500-12,000 ppm. In brains from the 10 clinically normal chickens evaluated, brain sodium concentrations were 1,500-1,700 ppm.

Improving first responders' perceptions of overdose events and survivors through tailored occupational health-focused training co-facilitated by overdose survivors.

First responders (law enforcement officers, emergency medical services, and firefighters) frequently interact with people who use drugs (PWUD). Based on the nature and outcomes of such encounters, these interactions have the potential either to reduce harm, or perpetuate it. Given increased funding and attention for first responder-led interventions involving PWUD, we must identify the most critical training for improving negative beliefs about these interventions and populations. In this study, we aimed to develop and evaluate a novel, evidence-based first responder training with an occupational wellness framing aiming to increase knowledge regarding and improve attitudes toward people who overdose and toward the overdose antidote, naloxone. We developed and evaluated the DOTS/SHIELD (Drug Overdose Trust & Safety/Safety & Health Integration in the Enforcement of Laws on Drugs) first responder training with three components: (1) matched first responder and overdose survivor trainers; (2) locally tailored substance use service information and practical referral instructions; and (3) occupational health content designed to make first responders' jobs easier and safer. We conducted pre- and post-tests at 151 Missouri-based trainings (December 2020-May 2023) to assess associated attitudinal changes among law enforcement vs. emergency medical services [EMS]/fire. Among the matched sample (N = 1,003, 53.9% law enforcement), post-training attitudes toward people who overdose and toward naloxone were more positive than pre-training attitudes. On average, law enforcement held worse attitudes than EMS/fire toward people who overdose, though there were no professional differences in naloxone-related beliefs. This training approach effectively combines three training components - peer trainers, practical substance use service referral information, and an occupational wellness framing - to positively influence first responders' views toward those who use drugs and toward naloxone.

Choosing a pediatric surgery career: affecting factors and status assessment.

This study aims to investigate the factors influencing career choices in pediatric surgery with a focus on gender and generational differences in Türkiye. A cross-sectional survey study was conducted. A questionnaire, consisting of 42 questions was developed and distributed to pediatric surgeons via email and other digital platforms. The study included 121 participants (72 males, 49 females). During clinical internships, the recognition score for pediatric surgery specialty was significantly higher among those who volunteered in clinics or participated in surgical procedures (p < 0.05). Females had higher operating room participation compared to males (51.4% vs. 69.4%, p < 0.05). For career choice reasons, Baby Boomers (1943-1960) cited "affinity towards a specific clinic" (53.6%), while Millennials (1982-2004) prioritized the "TUS score effect" (50%) and "program's geographic location" (42.5%). Job satisfaction averaged 6.8/10, with dissatisfaction related to "harsh working conditions" and "low income." Regarding marital status, 87.5% of men and 59.2% of women were married (p < 0.05). Additionally, 23.6% of men and 55.1% of women had no children (p < 0.05). Pediatric surgery faces persistent challenges across generations. mproving training conditions, creating a supportive work environment, and increasing student involvement in pediatric surgery practices are critical. Adjustments are needed for future Generation Z residents.

Determination of nurses' occupational health and safety perceptions and occupational riskfactors

Introduction: This study aimed to examine nurses'perception of occupational health and safety anddetermine their notification status in case ofoccupational accidents and possible problems.Materials and methods: The study is descriptive. Atotal of 332 nurses working in a training and researchhospital in western Turkey between March 5, 2023and June 20, 2023, were collected by face-to-facesurvey method. The data were collected using theQuestionnaire Form and Occupational Safety Scale(OSS) for health personnel working in the hospital.The data were analyzed in SPSS data program.Results: It was found that 47.9% of the nurses werebetween 31-45 years of age, 90.1% were female, and78.6% had a bachelor's degree. It was reported that95.5% of the nurses used personal protectiveequipment, 85.5% felt time pressure during work,78.6% did not work with enough nurses, 72.6% reported that the physical conditions of the hospitalwere not suitable, and 95.5% reported that thehospital food was not sufficient. The mean total scoreof the OSS scale was found to be 3.301.06. It wasobserved that there was a statistically significantdifference between the OSS scale scores accordingto the age and working years of the nurses (p&lt;0.05).Conclusion: It was concluded that the mean OSSscale score of the nurses was at a moderate level, andthe mean occupational safety awareness increased asthe age and working years of the nurses increased. Itis recommended that occupational health and safetyareas, especially "Occupational Diseases and Com-plaints" and "Managerial Support and Approaches,"be improved.

Occupational health and safety management systems – analysis of selected requirements for evaluation of occupational health and safety performance

The publication undertakes the problems of occupational health and safety in the aspect of requirements for occupational health and safety management systems. The aim of the work was analysis of selected aspects of evaluation of occupational health and safety performance according to the ISO 45001:2018 standard. Performance evaluation and improvement are one of the basic requirements, that determine the suitability, adequacy, effectiveness and efficiency of management systems. The essential element of the study was the development of assumptions for evaluation of occupational health and safety performance, which include the analysis of occupational health and safety state and the evaluation of occupational health and safety management systems.

On the move: understanding home care workers’ experiences of using various modes of transportation at work in an occupational health perspective

BackgroundThe demand for home care workers (HCWs) is increasing, but home care services face challenges in recruiting and retaining skilled workers, partly due to hazards in the work environment. Transportation to client visits is an important part of HCWs' working conditions, with various modes (e.g., walking, cycling, driving) being utilized. However, these modes are often implemented without considering HCWs' perceptions of their use. Therefore, our study aimed to understand HCWs’ perceptions and experiences of using different transportation modes at work, and how they may influence health.MethodsFourteen HCWs from a home care unit in Trondheim (Norway) participated in focus group interviews. The interviews were analyzed using a reflexive thematic analysis approach including reflexive journaling. The analytical process was guided by a biopsychosocial understanding of health.ResultsThe analysis showed that when different transportation modes were assigned, predictability of the assignment was important for the HCWs. Both walking and driving were regarded to have both positive and negative health impacts. When walking, informants thought that getting fresh air outdoors and doing physical activity was health-promoting, while bad weather conditions and too much walking could be negative for their health. When driving a car, informants talked about privacy and getting physical rest as positive for their health, while traffic and parking conditions could be stressful. Individual factors such as age, physical health, and strong preferences were highlighted as important to consider when planning HCWs’ transportation modes in an occupational health perspective.ConclusionsWalking now and then between client visits was generally believed by the HCWs to lead to positive health effects compared to only driving a car. Introducing planning of various transportation modes in advance, so that they are predictable, seems important to reduce stress among HCWs. In addition, some individual factors should be considered in the planning, and it should be realized that the planning likely represents a trade-off between promoting the psychosocial work environment when driving a car and potentially enhancing long-term physical health when using active transportation. Thus, biopsychosocial aspects of health should be considered when planning the mode of transport between client visits for HCWs.

Seeking greener pastures: attitudes towards brain drain among turkish medical students

BackgroundMedical brain drain is a critical issue for healthcare systems worldwide. This study investigated attitudes toward brain drain and influencing factors among medical students at Pamukkale University.MethodsA cross-sectional study was conducted with 1,129 students (80.8% response rate) during the 2021–2022 academic year. Data, including sociodemographics, views on studying/working abroad, and the 16-item Brain Drain Attitude Scale (BDAS), were collected via a structured online questionnaire. Descriptive statistics, the Mann‒Whitney U test, the Kruskal‒Wallis test, and multiple linear regression were used for analysis.ResultsOver half (52.9%) of the students desired to work abroad, motivated by better working conditions (73.7%), higher salaries (57.8%), and social living conditions (66.8%). The BDAS score (mean = 61.26) indicated a moderate tendency toward brain drain. Key factors associated with higher brain drain attitude scores included financial constraints (B = 0.389, p = 0.001), independent living (B = 0.296, p < 0.001), initial reluctance to attend medical school (B = 0.598, p < 0.001), having friends or relatives abroad (B = 0.347, p < 0.001), considering exchange programs (B = 1.004, p < 0.001), and moderate foreign language proficiency (B = 0.300, p < 0.001).ConclusionA significant portion of Turkish medical students expressed a desire to work abroad, driven primarily by better working conditions, social living conditions, higher salaries, and excessive workloads in Türkiye. Financial constraints, independent living, dissatisfaction with medical school choices, and social networks with international experiences emerged as significant factors influencing attitudes toward brain drain.

Soft sensor modeling method for Pichia pastoris fermentation process based on substructure domain transfer learning

BackgroundAiming at the problem that traditional transfer methods are prone to lose data information in the overall domain-level transfer, and it is difficult to achieve the perfect match between source and target domains, thus reducing the accuracy of the soft sensor model.MethodsThis paper proposes a soft sensor modeling method based on the transfer modeling framework of substructure domain. Firstly, the Gaussian mixture model clustering algorithm is used to extract local information, cluster the source and target domains into multiple substructure domains, and adaptively weight the substructure domains according to the distances between the sub-source domains and sub-target domains. Secondly, the optimal subspace domain adaptation method integrating multiple metrics is used to obtain the optimal projection matrices Ws and Wt that are coupled with each other, and the data of source and target domains are projected to the corresponding subspace to perform spatial alignment, so as to reduce the discrepancy between the sample data of different working conditions. Finally, based on the source and target domain data after substructure domain adaptation, the least squares support vector machine algorithm is used to establish the prediction model.ResultsTaking Pichia pastoris fermentation to produce inulinase as an example, the simulation results verify that the root mean square error of the proposed soft sensor model in predicting Pichia pastoris concentration and inulinase concentration is reduced by 48.7% and 54.9%, respectively.ConclusionThe proposed soft sensor modeling method can accurately predict Pichia pastoris concentration and inulinase concentration online under different working conditions, and has higher prediction accuracy than the traditional soft sensor modeling method.

The Influence of Work Engagement on Employee Affect and Creativity: Insights from Occupational Mental Health

Affect plays a pivotal role in shaping employees’ work performance and mental health, with growing recognition of its capacity to drive creativity. However, the differential impacts of positive and negative affect on creative performance remain a subject of debate. This study aims to compare the relationships between high- and low-arousal affect, as well as PANA dimensions of affect, and creative performance, emphasizing the mediating role of work engagement from an occupational mental health perspective. A survey was conducted involving 278 employees and their managers across 25 companies in China. The findings reveal significant associations between high-arousal positive affect, low-arousal positive affect, high-arousal negative affect, and low-arousal negative affect with both work engagement and creative performance. Moreover, the results indicate that work engagement partially mediates the relationship between high-arousal affect and creative performance while fully mediating the relationship between low-arousal affect and creativity. These findings underscore the importance of occupational mental health—particularly work engagement—in fostering employee creativity and highlight its critical role in organizational management strategies.

Police officer occupational health: a model of organizational constraints, trauma exposure, perceived resources, and agency

BackgroundPolice officers constitute a work force at high risk due to their highly demanding work conditions. In a realistic paradigm, these conditions, and other determinants of their psychological health, can be linked to a multitude of variables that interplay altogether. However, current literature that simultaneously models–quantitatively from observed data–such a multitude of variables is sparse. This study took upon this objective to further theoretical and applied understandings through a measurement framework on empirical data, and allow the data to drive some features of model development, such as variable groupings into factors, and paths between factors.MethodsA total of 1312 officers from various police bureaus fully responded to a questionnaire composed of validated instruments for assessing factors related to psychological and occupational health, consisting of more than 25 variables. Statistical analyses were performed in progressing complexity, namely t-tests, correlations, multiple regression, factor analysis, and path analysis with latent factors.ResultsThe regression analysis identified 10 significant variables, in which decision latitude, organizational justice, and work recognition/meaning were the most protective, and these 10 variables coincided with those found significant in the t-test and correlational results. In higher complexity, the latent path analysis resulted in a model of 6 factors: Psychological Health, Organizational Constraints, Trauma Exposure, Perceived Resources, Sense of Agency, and Esteem. Organizational Constraints (β = -0.32, inferred by psychological demands and role conflict), Perceived Resources (β = 0.31, social support, a self/work-esteem subfactor, and organizational justice), Sense of Agency (β = 0.30, decision latitude, hierarchical position, right to carry a firearm), and Trauma Exposure (β = -0.14, frequency/time since event, used a firearm, years of service) were found significantly associated with Psychological Health. Within each factor, specific variables could be identified as the most associated, such as role conflict for constraints, self/work-esteem for resources, decision latitude for agency, and frequency of and time since trauma for trauma exposure. Our results therefore encourage us to take into account not only agency, but also past professional experiences in models for managing well-being.ConclusionsProviding police officers with social support at work, recognition, work meaning, fair proceedings and pay (organizational justice, especially for female and young officers), decision-making power (decision latitude), and minimizing conflictual information and procedures (role conflict) is of utmost importance. Officers with higher years of service, working in lower population cities, and who recently used their firearm, should be considered for trauma counseling. The degree of psychological demands of police officers should be regularly assessed, and reduced if possible. Reminders of support and integration in the force for officers with variables linked to a perceived lack of agency may be useful in their facing work challenges. Future integrative modeling research may be crucial to better understanding the relative contribution of each variable and their interplay in realistic settings, providing also a framework for measurement.

Positive Impact of Prefabrication on the Mental Health of Construction Workers

Based on the literature-established benefits of prefabrication to promote better working conditions and its potential to enhance workers’ overall mental health, this study compares the state of mental health of traditional and prefabricated construction workers. In addition to the mostly adopted negative measures of mental health such as anxiety and depression, positive mental health indicators were also used to measure and compare overall mental health conditions of the two categories of construction workers. Data were collected with a questionnaire from 93 prefabricated factory-based and site-based construction workers in Australia. The survey contains eight items to measure poor mental health and seventeen variables of four sub-constructs of positive mental health (emotional, social, psychological, and cultural/religious well-beings). An independent samples t-test was employed to examine the significance of the differences between the means of traditional and prefabricated construction workers on the measured variables and their underlying constructs of mental health and well-being. The findings revealed significantly lower symptoms of burn-out (reduced task accomplishment), suicide ideation (feeling less interested in life), and depression among the workers in prefabricated projects. Similarly, prefabrication tends to provide a positive-mental-health-supportive environment, as the workers were found to be significantly healthier than traditional construction workers on the subjective measures of emotional, social, psychological, and cultural/religious well-beings. Assessing the predictive influence of prefabrication on the overall mental health of different groups of construction workers, especially with qualitative data from different samples in different times, is recommended for future studies.

Building health systems resilience in Central Asia through nursing and midwifery: evidence to inform policy action

BackgroundThe recent announcement of the next WHO State of the World’s Nursing and Midwifery Reports calls for a review of the state of nursing and midwifery worldwide. In the WHO European region, a broad set of health system reforms have been introduced in Central Asian countries (CACs), namely, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Tajikistan, Turkmenistan and the Republic of Uzbekistan. These reforms have become the focus of a series of sub-regional policy dialogs between CACs, led by government chief nursing and midwifery officers, to accelerate the implementation of a package of policies to strengthen the capacity of nurses and midwives and build health system resilience. This study reviews the current state of nursing and midwifery capacity and documents future actions that can be taken in CACs.Case presentationA systematic approach was used to describe trends, capacity and gaps in CACs’ education, practice, regulation, leadership, and working conditions of nurses and midwives. Currently, CACs face challenges in increasing the level, quality and evidence-base of nursing and midwifery education, require efforts to expand the role of nurses, with emphasis on PHC and particular attention is required to decent working conditions, including fair income and security in the workplace. The GCNMOs have demonstrated experience in the oversight of both workforces and require support for effective work in making policies. To build health systems resilience in CACs through nursing and midwifery, a strategic package of evidence-informed actions that addresses education, practice, regulation, leadership, and working conditions of nurses and midwives is suggested for the period up to 2030.ConclusionsCurrent educational reforms and curricular development, combined with innovations in clinical practice and working environment can be pursued to foster better access to quality of care, enhance workplace satisfaction and improve recruitment and retention of nurses and midwives. However, to fully achieve this, CACs will require increased institutional capacity; strengthened data for nursing and midwifery planning in the context of health workforce policy and health priorities, and financial and non-financial investment in the nursing and midwifery workforce.