Archives of Public Health

BackgroundWhile veterinary surgeons are known to have particularly high rates of injury compared to other sectors, little is known about rates of injury among veterinary students. This study aims to understand animal-related injury rates, injury context and mechanisms, attitudes to reporting injuries, and behaviour change among UK and Irish veterinary students. MethodsA survey was distributed to students across all veterinary schools operating in the UK and Ireland in 2021. Questions explored participants experience of injury through asking about their most recent and most severe injuries via quantitative and free-text questions. Data were analysed using descriptive statistics, logistic regression, and qualitative content analysis. Results533 responses were included in the analyses. Overall, 47.5% of students reported having been injured by an animal during the veterinary degree, 35.5% of students reported being injured within the last 12 months. Most recent injuries were caused by companion animals (38.0%), livestock (37.6%), and equids (23.5%). For their most severe injuries, 48.7% involved livestock, 28.7% companion animals, and 22.1% equids. The content analysis highlighted that students normalised injuries and infrequently reported injuries to the university. It was very rare for students to take time off from their studies or placements, due to course pressures. ConclusionsThese findings reflect concerningly high levels of injury, which are being under-reported and reflect a culture of injury acceptance and expectation among students. Veterinary schools should consider lessons learnt in other work environments which have been successful in changing safety culture.

BackgroundThe COVID-19 pandemic required South African public sector HIV viral load (VL) laboratories to scale up Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) testing while maintaining essential HIV services. This placed additional pressure on diagnostic services. This dual mandate introduced significant occupational and environmental challenges (OEC) for staff that remain underexplored. ObjectiveThis study aimed to investigate the OEC and effects that staff experienced during the implementation of COVID-19 testing at public sector VL laboratories in South Africa. MethodsA quantitative, cross-sectional study utilised a census approach among technical and support staff. Data were collected via a structured REDCap questionnaire using 5-point Likert scales. Pre- and post-implementation challenges were assessed across four domains: workload, environmental conditions (space, ventilation, waste), communication, and PPE availability. Statistical analyses included the Wilcoxon Signed-Rank and Spearmans correlation tests. ResultsPerceived occupational challenges increased significantly across all domains post-implementation. Staff workload saw the highest rise (mean score 3.02 to 3.53). Adverse health effects were pervasive; 80.2% of staff reported burnout/fatigue, and 76.5% reported increased anxiety/stress. A strong positive correlation was observed between post-COVID-19 challenges and adverse mental and physical health outcomes (rho = 0.449, p < 0.001). Furthermore, 35.8% of staff considered resigning due to increased job demands. ConclusionIntegrating COVID-19 testing exacerbated systemic weaknesses, causing measurable psychological injury and threatening workforce retention. Findings suggest that the diagnostic workforce requires formal crisis surge staffing models and institutionalised mental health support to safeguard personnel and maintain essential services during future health emergencies.

Policing is one of the most rewarding occupations; however, it is stressful and demanding. This study was designed to explore stress, stress management, and coping mechanisms among Nigerian Police Officers working across four geopolitical zones in Nigeria. Using an exploratory design, forty in-depth interviews (IDIs) were conducted with police officers. Data was collected using an interview guide. The interviews were conducted in English and the participants indigenous languages (by preference), audio-recorded, and transcribed verbatim. Data were analyzed using the thematic approach. A range of contextual stressors were identified as barriers to the health and well-being of police officers in Nigeria. The police often lack the tools and equipment needed to perform their official duties effectively. This includes items like uniforms, bulletproof vests, and even operational vehicles. Shortage of manpower, lack of operational tools, poor welfare for police officers, and poor remuneration were also among their concerns. The participants were able to identify signs of stress that are common among police officers, which are majorly weaknesses, lack of sleep, dizziness, headache, anxiety, exhaustion, and anger. The common coping mechanisms include regular exercise, adequate rest, and relaxation through recreational activities, regular medical checkups, and seeking support from colleagues, among others. Nigerian police officers face many challenges that affect their health and daily routines. This analysis identifies potential opportunities to improve officers welfare in these contexts.

Compassion fatigue is a well-documented hazard among healthcare and veterinary professionals, yet the psychological toll on informal caregivers of feral cat colonies, likely numbering several tens of thousands in Portugal, remains largely unexplored. This cross-sectional study examines internal and external factors associated with the secondary traumatic stress component of compassion fatigue among 172 informal caregivers in Portugal. Secondary traumatic stress refers to work-related secondary exposure to individuals who have experienced extremely stressful or traumatic events. Structured telephone interviews assessed sociodemographics, colony management, compassion satisfaction, resilience, spiritual well-being, and perceived social support. Univariate and multivariable linear regression identified predictors of compassion fatigue. Results indicate that 47% of participants experienced moderate compassion fatigue, and 10% reported high levels. Multivariable analysis revealed that caring for large colonies (more than 25 cats) and being unemployed were significantly associated with higher fatigue. Conversely, older age, higher perceived family support, and the resilience dimension of serenity served as protective factors. Interestingly, finding meaning in life was positively correlated with fatigue, suggesting that caregivers who perceive their role as central to their life purpose may become more emotionally invested, increasing vulnerability to distress when unable to help animals. Official colony registration and formal institutional support did not significantly alleviate fatigue. These findings highlight that institutional support alone is insufficient to mitigate fatigue among informal caregivers, who experience significant distress driven by both practical burdens and profound emotional involvement. The most frequently reported concern among caregivers was the inability to cover the costs of feeding and veterinary care for the cats. Interventions must address both external needs (e.g., support to cover veterinary and feeding expenses for the cats) and internal coping mechanisms. Implementing psychosocial support alongside trap-neuter-return programs may also improve caregiver well-being and foster sustainable urban feral cat management. This underscores a One Health perspective, demonstrating that animal health is closely interconnected with human well-being and environmental health.

Engaging with stakeholders/contributors is vital to achieve a comprehensive approach to policymaking about the food (kai) system. The food system in Aotearoa New Zealand (Aotearoa NZ) is associated with high environmental impacts and inequitably distributed health consequences by ethnicity and socio-economic status. We engaged with contributors from government agencies, industry, academics, community, rural and urban M[a]ori communities to develop policy actions to support New Zealanders to eat healthy sustainable food. This paper outlines methods used to score contributor identified policies with follow-up focus groups and interviews where the highest scored policies were discussed, to understand contributor perspectives on the scope, implementation, barriers, and possible unintended consequences of these policies. Semi-structured interviews (12) and focus groups (6) were conducted. The top five scored policies among all contributors were: healthy food and drink policies in schools and kura (M[a]ori-language immersion schools); supporting m[a]ra kai (food garden) and community gardens; garden to table programmes in schools and kura; education about sustainable and healthy food; and increasing incomes. The top five policies for M[a]ori were: healthy food and drink policies in schools and kura; garden to table programmes in schools and kura; remove GST from core foods; increase incomes and make local food cheaper by supporting local growers. Considerations for policy implementation involved implementing multiple policies at once, the importance of evaluation, finding existing examples of policies, strong collaboration for long-term outcomes, and centring policies through a M[a]ori framework.

BackgroundValidated food portion size photographs can increase accuracy of estimatingportion sizes during dietary surveys. Our objective was to assess the validity of food portion size photographs in estimating portion sizes to be used in 24-hour dietary recall food consumption study. MethodsWe recruited two hundred and six women of reproductive age (13-45 years) residing in Roysambu sub-county in the northern parts of Nairobi City, Kenya. Eleven foods from the Photographic Food Atlas for Kenyan Adolescents (9-14 years) were examined. Participants were served pre-weighed portions. After eating, each participant was asked to estimate the amount of food they consumed, using the Food Atlas. Validity was assessed by calculating percentage of estimates within and outside of {+/-}10% of consumed portion size, the mean percent difference between estimated and consumed portions, Spearmans correlation coefficients, and Pearsons chi-square test. ResultsThe proportion of participants with estimates within {+/-} 10% of the consumed portion size ranged between 15-65%. Mean differences between the consumed and estimated portion sizes varied -45% for stewed beans to +60% for watermelon. Generally, small portions were overestimated while large portions were underestimated. Correlation coefficients ranged from 0.12 to 0.77 and all the coefficients were statistically significant except for watermelon (p=0.22). Accuracy of estimations was not associated with participants age or educational level. ConclusionsThe validity of the tested food proportion size photographs was adequate for quantifications of most food items. However, the studys findings also indicated that further improvement is needed before wider use in Kenya.

BackgroundAntimicrobial resistance (AMR) is a global public health threat driven significantly by antimicrobial misuse in agriculture, particularly in poultry farming. This study assessed the awareness, knowledge, practices, and associated factors related to antimicrobial resistance among poultry farmers in Osun State, Nigeria. MethodsA cross-sectional study was conducted among 289 poultry farmers selected through stratified random sampling across Osun State. The study included actively practicing poultry farmers aged 18 years and above who used antimicrobials in their operations. Farmers not using antimicrobials were excluded. Data were collected using a pre-tested, structured, interviewer-administered questionnaire and analyzed with SPSS version 27. Descriptive statistics, chi-square tests, and inferential analyses were used to examine relationships between variables. ResultsThe majority of respondents (89.6%) had heard of AMR, the majority 239 (92.3%) of the respondents heard it from veterinary doctors. The majority (77.2%) also demonstrated good knowledge. Most farmers (89.6%) used antibiotics, with 52.9% using them occasionally. Personal experience (57.8%) was the primary basis for antibiotic selection. About 71.6% implemented biosecurity measures, and 57.8% had received training on AMR. Significant associations were found between knowledge and practice (p<0.001) and between attitude and practice (p<0.001). ConclusionDespite high awareness, antibiotic misuse persists, driven by factors such as reliance on personal experience and limited veterinary consultation. There is a need for enhanced farmer education, stricter regulatory enforcement, and the implementation of targeted antimicrobial stewardship programs to mitigate AMR risks in poultry farming.

Front-of-pack nutrition labels (FOPLs) have been adopted as a key government strategy to address the significant burden of diet-related noncommunicable diseases. However, research on public knowledge and perceptions of FOPLs and their relationships with sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption remains limited. A cross-sectional study with 2870 individuals was conducted to explore their knowledge and perceptions of Nutri-Grade, a national front-of-pack nutrition labeling scheme introduced in Singapore in 2022. Knowledge was not significantly associated with SSB consumption; however, individuals who perceived these labels more positively were significantly less likely to consume SSBs daily (AOR=0.72, p<0.001) and consumed fewer types of SSBs weekly (IRR=0.91, p<0.001). Moderation analyses indicated that greater knowledge of Nutri-Grade FOPLs was associated with a higher likelihood of SSB consumption among younger individuals and those residing in areas with higher house prices. Additionally, individuals with positive perceptions were more likely to consume SSBs daily when living in areas with food court density exceeding 2.99 per km{superscript 2} (AOR = 1.12, p = 0.004). Individuals with positive perceptions of Nutri-Grade FOPL were also less likely to consume ASBs (AOR=0.69, p<0.001), whereas, in contrast to SSBs, greater knowledge of Nutri-Grade FOPLs was associated with increased ASB consumption (AOR=1.42, p<0.001). These findings indicate that informational labeling itself is insufficient to change consumption behavior. Although positive perceptions of Nutri-Grade FOPLs provide a protective effect, this effect diminishes when the food environment is taken into account.

BackgroundThe Canadian Guidelines for Post COVID-19 Condition (CAN-PCC), along with related knowledge mobilization (KM) resources, have been developed to support key interest-holders (e.g., public, healthcare providers, and policymakers) to make informed health decisions related to post COVID-19 condition (PCC). The purpose of this report is to describe the process and findings of our usability testing with members of the public on eight public-facing KM resources to support the CAN-PCC guidelines. These KM resources consist of an online resource sheet and an interactive infographic on four of the PCC guideline topics (1. prevention of PCC; 2. testing, identification and diagnosis; 3. pharmacological and non-pharmacological interventions; and 4. pediatric and adolescent health) that have been co-developed with interest-holders to enhance accessibility and understanding of the recommendations. MethodsA convenience sample of members of the public were recruited online through our organizations pre-established networks. Each participant was randomly assigned to review one of eight resources before completing a questionnaire, developed by the research team and pilot-tested by a national Public Advisory Group that was formed to inform this work. The questionnaire contained 24 usability questions (5-point Likert scale, multiple response questions, open-text) that assessed: (1) purpose and organization, (2) credibility, (3) usefulness, (4) desirability, (5) value, and (6) accessibility. Demographic information was also collected. Descriptive statistics and measures of central tendency were calculated to summarize usability and demographic data. Independent t-tests were used to evaluate differences in mean scores between resource formats for each guideline topic. Open-ended responses were analyzed using thematic content analysis. ResultsWe completed usability testing with 64 participants (n=8 assessments per resource) between March and April 2025. All eight resources were highly rated with average mean scores ranging from 3.8 to 4.6 on the 5-point scale, where five indicated Strongly Agree. No statistically significant differences were observed between total scores for the different resources, however, differences across some domains (e.g., credibility, desirability, value, accessibility; p<0.05) suggested that each resource type offers distinct strengths depending on the feature being assessed. Strengths of the resources included ease of understanding, clear and effective visual designs, and an empowering tone (e.g., sharing practice tips). Areas for improvement included clarifying the overall purpose and content related to the recommendations, as well as enhancing the visibility of embedded links within the resources. ConclusionsUsability testing provided valuable insights into the usefulness and clarity of the resources. Final resources were made publicly available on the CAN-PCC website (https://canpcc.ca/resources/#tab-content-patients-and-general-public) in April 2025. We further disseminated the resources through social media channels and other pre-established networks. The findings will guide future guideline-related KM product development to ensure resources are useful, accessible, user-friendly and better meet the needs of the public.

BackgroundNeonicotinoid pesticides are systemic insecticides with neurotoxic potential and environmental persistence, raising concerns about chronic low-dose exposure in humans and impacts on ecosystems. In Japan, regulatory restrictions are generally less stringent than in the European Union, yet risk perception among young adults remains underexplored. ObjectiveTo examine factors associated with university students interest in pesticide-related issues, focusing on family discussions about environmental topics, household preference for organic vegetables, agricultural experience, and depressive symptoms. MethodsWe conducted a cross-sectional questionnaire survey among 690 undergraduate students at a private university in the Tokyo metropolitan area (academic year 2024). Interest in pesticide issues was assessed on a 4-point scale and dichotomized as high (very/somewhat) vs low (not very/not at all). Explanatory variables included frequency of family discussions about environmental issues, household preference for organic vegetables, agricultural experience, the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR-J), age, and sex. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). ResultsParticipants mean age was 20.6 (SD 4.9) years and mean QIDS-SR-J score was 6.0 (SD 4.2). Overall, 74.6% reported high interest in pesticide issues. High interest was associated with more frequent family discussions about environmental issues (aOR 2.22, 95% CI 1.50-3.30; p<0.001) and household preference for organic vegetables (aOR 1.73, 95% CI 1.14-2.62; p=0.009). Agricultural experience, depressive symptoms, age, and sex were not significantly associated. Notably, while 53.2% supported pesticide-free/organic farming, 85.5% avoided blemished (insect-damaged) vegetables and 77.1% considered pesticides necessary, suggesting an attitude-behavior gap. O_TBL View this table: org.highwire.dtl.DTLVardef@102f85dorg.highwire.dtl.DTLVardef@1ffcd45org.highwire.dtl.DTLVardef@fd88b5org.highwire.dtl.DTLVardef@11a3a26org.highwire.dtl.DTLVardef@dfb213_HPS_FORMAT_FIGEXP M_TBL O_FLOATNOTable 1.C_FLOATNO O_TABLECAPTIONParticipant characteristics and related factors (N = 690) C_TABLECAPTION C_TBL ConclusionsAmong Japanese university students, interest in pesticide issues was linked to family-level environmental discourse and household organic orientation, rather than depressive symptoms. The observed gap between pro-organic attitudes and consumer preferences underscores the need for risk communication and environmental health education that connect values to feasible purchasing behaviors.

BackgroundDengue outbreaks have become a severe threat to Bangladesh as the infections and mortality numbers are skyrocketing in recent years. Favorable environmental and anthropogenic conditions have established the capital of Bangladesh, Dhaka city as the epicenter of dengue outbreak. Studies have showed that climate change induced extreme weather events are exacerbating Aedes mosquito breeding and dengue virus transmission conditions. Methodology/Principal FindingsIn this study, short-term (0-6 weeks) associations of maximum temperature and heatwave days on dengue cases in Dhaka city were examined through Distributed Lag Non-linear Model (DLNM) methodology for weekly measurement of 2016-2024, taking into account relative humidity, cumulative rainfall, seasonality and hospital closure effect. Two separate negative binomial models were constructed. The maximum temperature model rendered an overall inverted U-shaped association, where the maximum temperature range of 31.5-33.2{degrees}C showed a sustained elevated dengue risk, with highest risk estimate at 33.2{degrees}C [relative risk (RR): 1.186, 95% CI: 1.002, 1.403]. Whereas, results of weekly heatwave days showed an overall protective effect (RR<1) for dengue cases. The lowest risk of infection was found at 3 heatwave days per week, with RR 0.275 (95% CI: 0.178, 0.423). Multiple sensitivity analyses were conducted for both models to evaluate their robustness. Lastly, the optimized models were analyzed under three distinct sub-periods, to capture the association of exposure variables with predominant circulating serotypes. Conclusions/SignificanceThe findings of the study aim to support public health policymakers and healthcare authorities in designing and implementing effective vector control interventions under emerging climatic emergencies. Author SummaryDengue disease is one of the most buringing issue in Bangladesh in recent years. This vector-borne disease is inherently influenced by climatic variables, i.e., temperature, rainfall, humidity, etc. Moreover, these relations are complex and non-linearly associated. Due to shift in climatic conditions, the occurance of extreme weather events are becoming frequent, with increased magnitude and longer duration. In this study, the nonlinear and delayed association of dengue infections due to the exposure of extreme temperature events were assessed in climate-change vulnerable Dhaka city. To do this, a statistical method was used, called distributed lag nonlinear methodology (DLNM). The results showed that dengue infections had an inverted U-shaped (parabolic) relationship with maximum temperature, while compared to mean maximum temperature, and a suppressive association with heatwaves relative to days without heatwaves. The findings aim to work as an early warning system, and support to policymakes and healthcare authorities to tackle the dengue surge in the changing climate.

Purpose: The GIG-OSH cohort was established to investigate the impact of digital platform work on occupational safety and health (OSH), working and employment conditions, and health in seven countries in Europe. Participants: The cohort comprises 3,945 digital platform workers from seven European countries. The sample includes both web-based workers (e.g., micro-tasking, freelance design) and on-location workers (e.g., delivery, transport). Participants were recruited using non-probabilistic sampling strategies tailored to national contexts, including social media advertising, recruitment through micro-task platforms, and on-site field outreach. Multidimensional data have been collected through online surveys (implemented via REDCap) covering sociodemographic characteristics, working and employment conditions, psychosocial risks, algorithmic management, and physical and mental health indicators. Findings to date: Participants had a mean age of 32.6 years at baseline (SD 10.4), and the majority are male (58.8%), with a higher concentration of migrants in on-location tasks (62.2%) compared to web-based tasks (48.8%). Regarding educational attainment, 55.4% of the total cohort holds a tertiary degree, reaching 64.4% among web-based workers. Platform work intensity varies significantly: on-location workers averaged 85.4 hours of work in the last month, while web-based workers averaged 47.0 hours. Mean income from platform work as a percentage of the national median was 20.6% (SD 22.2). The mean WHO-5 Well-Being Index score was 58.7 (SD 20.3), which is notably lower than the European general population average (69.4), indicating poorer mental health outcomes among cohort members. Future plans: The GIG-OSH cohort represents the first large-scale, longitudinal study examining occupational safety and health among digital platform workers across multiple European countries. Future waves will prioritize developing precise tools to measure hourly earnings and unpaid waiting time. Future research should aim to include underrepresented subgroups, such as medical and domestic care workers, and explore potential linkage with administrative records to evaluate long-term health trajectories and the impact of new EU labour regulations.

ObjectiveThis study aimed to adapt and validate Levensteins Perceived Stress Questionnaire (PSQ) within the Ecuadorian sociocultural context. The PSQ measures perceived stress across two temporal frames: general (past two years) and specific (past month). MethodsThe research followed five sequential phases. Study 1: linguistic and cultural adaptation through standardized translation, back-translation, expert review, and a pilot test with 300 participants. Study 2: item refinement with an additional sample of 300 participants. Study 3: Exploratory Factor Analysis (EFA) with 395 participants. Study 4: Confirmatory Factor Analysis (CFA) with 391 participants, complemented by Structural Equation Modeling (SEM) to evaluate factorial structure, internal consistency, and convergent and discriminant validity through correlational analyses. Study 5: multigroup factorial invariance analysis by biological sex. ResultsThe original questionnaire of 30 items across seven factors was refined for the Ecuadorian context into two versions: a General version with 21 items grouped into three factors, and a Specific version with 23 items distributed across four factors. Both versions demonstrated strong reliability, along with satisfactory convergent and discriminant validity. ConclusionsThe findings endorse the PSQ-593 as a reliable and culturally appropriate instrument for assessing perceived stress among Ecuadorian university faculty. Its validation contributes to a deeper understanding of stress as a psychological risk factor for mental health.

BackgroundThis study used qualitative methods to test and refine a framework for educating cognitively unimpaired individuals about their individual risk for Alzheimers disease and related dementias (ADRD) and intrapersonal health belief factors as part of the TEACH (Tailored Education for Aging and Cognitive Health) intervention. MethodWe assessed individuals ADRD risk factors and health belief concepts. Personalized data were presented individually, followed by a semi-structured phenomenographic interview. Applied thematic analysis was used to identify representative statements, trends, and differences. ResultsIn N=11 individual interviews with middle-aged and older participants (ages 49-69; 45% women), participants had generally positive experiences of learning their personal dementia risk; the information was perceived to be unsurprising and occasionally consoling. They demonstrated a good understanding of the health belief concepts, including identifying relationships between intrapersonal health beliefs and health behaviors. Participants provided feedback on the visual aids and methods of conveying health belief information. ConclusionsWe used qualitative data from individual interviews to refine an explanatory framework for educating individuals about their personalized risk for ADRD and intrapersonal health beliefs that may be barriers or facilitators of health behavior change. The refined TEACH intervention is designed to promote long-term maintenance of target health behaviors in middle-aged adults to mitigate ADRD risk.

BackgroundOverweight and obesity are causing growing public health, economic and clinical burden, particularly within under-resourced communities. There is an urgent need to develop an in-depth understanding of experiences of weight management, and preferences for support within under-resourced communities, with a view to developing more effective weight management interventions. MethodsFocus groups were run in under-resourced communities using storyboarding; a method to facilitate inclusive communication (n=37). Thematic analysis was applied to textual and visual data, and a realist lens applied to provide in-depth insight into weight management experiences and needs. We believe this is the first study to use this combined methodology to explore weight management experiences and needs. ResultsCombining storyboarding with a realist lens, generated four themes. Living circumstances indicated that mental health, individual needs, and cost of weight management services were key contextual factors. Mechanisms of weight management identified emotional eating and portion control to be central to individual weight management. Yo-yo dieting centred on participants experiences of weight regain after attempting weight loss. Weight management intervention needs indicated psychological support was perceived as severely lacking, and the only route to attain sustained weight management. Offering both in-person and online support for weight management was considered important to reach more people. ConclusionMoving weight management support from short- to long-term and incorporating more robust psychological support would better serve the needs of people living in under-resourced communities who are overweight or obese. Ideally interventions should be multicomponent and tailored to individual needs and circumstances.

This study challenges the assumption that undiagnosed cognitive impairment (CI) is driven primarily by patient-level barriers like poor awareness. In a population-weighted cohort of 1,856 older Singaporeans, CI prevalence was 24.7% (95%CI 18.8-31.8); yet the undiagnosed rate was high (81.4%, 95%CI 65.6-90.9), especially for mild CI (97.9%, 95%CI 94.1-99.3). This diagnostic gap persisted despite high symptom awareness (81.3%, 95%CI 63.6-91.5) and help-seeking intent (63.3%, 95%CI 47.5-76.7), with informants becoming key as CI worsened. Findings suggest successful public health campaigns have shifted the bottleneck from community awareness to healthcare system capacity, creating an opportunity for a policy shift to meet rising demand for diagnosis--by empowering primary care with efficient case-finding tools, formalizing integrated diagnostic pathways, and establishing channels for family informants involvement. From these findings, we conceptualized a paradox of success model, providing a framework for other health systems to adapt policy as public engagement grows.

Emergency nursing is essential to healthcare systems worldwide. Triage plays a pivotal role in emergency nursing, prioritizing patients based on the urgency of their medical condition and focusing on rapid assessment and prioritization of patient care according to their condition and its severity. In the emergency department, the triage nurse assesses vital signs and gathers information from the patient to determine the severity of their condition. This aims to provide appropriate medical intervention quickly for life-threatening cases and minimize waiting times for less critical cases, thus contributing to the efficient allocation of scarce resources. Our study aimed to evaluate the triage knowledge, skills, and practices of emergency nurses in Mafraq, Jordan. MethodsA cross-sectional study used a previously validated questionnaire. Fifty emergency nurses from two public and one private hospital in Mafraq participated. We collected data through an online survey then analyzed in SPSS. Results92% of nurses had sufficient triage knowledge ([&ge;]60%), while 14% exhibited deficient triage skills (<60%) and 86% had moderate skills (60-80%). Regarding practices, 32% rated as "poor" (<60%) and 68% as "adequate" (>60%). Length working in emergency, hospital type significantly related to nurses triage knowledge, skills, and practices. ConclusionThe study underscores continual trainings, simulation programs and mentorships importance for enhancing emergency nurses triage knowledge, skills, especially in rural settings. Implementing clear triage protocols, continuous support and integrating triage competencies into curricula are recommended to improve overall triage competency

BackgroundWith the rapid ageing of Irans population, accidents among institutionalised older adults represent a major public health concern. This study aimed to determine the prevalence, characteristics, and risk factors of accidents among elderly residents of nursing homes in Shiraz, Iran, during 2024, with particular emphasis on functional limitations. MethodsA cross-sectional census-based study was conducted in all seven nursing homes in Shiraz, involving 550 residents aged [&ge;]60 years. Data were collected through structured interviews, review of medical records, caregiver reports, and an Accident Form. Accidents occurring during the previous year were analyzed using descriptive statistics, and associations between accident occurrence and participant characteristics were examined using chi-square tests. ResultsOverall, 72.0% of residents experienced at least one accident during the study period. Slipping was the leading cause, and bathrooms and toilets were the most frequent locations. Contusion or bruising was the most common outcome. Mobility limitation was the only factor significantly associated with accident occurrence (p < 0.001), whereas age, gender, marital status, and educational level showed no significant associations. ConclusionsAccidents were common among nursing home residents in Shiraz and were strongly associated with mobility limitation. These findings highlight the importance of addressing functional impairments alongside environmental hazards through targeted ergonomic modifications and mobility-support interventions.

AimThe aim of this study was to: 1) assess the practicality of conducting a feasibility randomised controlled trial and 2) undertake a process evaluation of MATILDA guided by the RE-AIM Framework (Acceptability, Reach, Effectiveness, Adoption, Implementation and Maintenance). MethodsThis was a 2-arm, single-blind, randomised feasibility trial with 1:1 allocation conducted in the UK. The intervention lasted 6-months. Clinical outcome variables (quality of life, anxiety, loneliness) were collated at baseline, 6- and 12-months post intervention. The RE-AIM framework was used to undertake the process evaluation. A health economic evaluation was also explored. ResultsWe recruited 57 participants of our target population of 64 (89%), 28 participants were randomly allocated to MATILDA and 29 to an active control group. We lost three participants in the intervention arm prior to commencement of the intervention. We were able to match all 25 participants to a community group, most with a mentor(s). With regards reach and implementation, most older adults with an intellectual disability were still attending their community groups at 6-months (N= 18, 72%) and at 12-months (N= 17, 94%). There was a slight decrease in the anxiety scores for the participants in Matilda over the 6- and 12-months follow-up periods compared to the control group. MATILDA was found to be clearly acceptable and adoptable by the community groups and mentors. There were some challenges identifying and recruiting community groups and getting mentors to complete their questionnaires. DiscussionMATILDA appears to be a promising community-based intervention to support older adults with an intellectual disability that promotes social inclusion, quality of life, and wellbeing. This study advances our empirical knowledge in understanding the contextual factors, mechanisms and outcomes in developing and delivering a community intervention for this population. Trial feasibility and process evaluation of the MATILDA intervention to support older adults with an intellectual disability to integrate into local community groups using the RE-AIM Framework

BackgroundProlonged wakefulness, restricted sleep, and circadian factors can impact driving performance and road safety. Currently, there are no effective objective roadside tests to detect the state of drivers sleepiness during or prior to driving, or predict future driving impairment risk. This paper reports on an extended wakefulness protocol used to determine if a portable virtual reality device to administer vestibular-ocular motor function (VOM) tests can effectively detect 1) drivers state of sleepiness during or just prior to driving, and 2) predict trait sleepiness and future driving risk. MethodsFifty healthy adults with regular sleep within 9pm to 8am were recruited for an experimental laboratory procedure which involved two phases: an initial overnight sleep study, and a subsequent period of extended wakefulness lasting ~29 hours. During the wakefulness phase, participants undertook neurobehavioural testing, a simulated driving test, and repeat assessments of VOM to establish if ocular markers can predict sleepiness state and sleepiness-related performance impairments (Trial registry ACTRN12621001610820). DiscussionThis protocol outlined a study that aimed to establish the sensitivity of VOM test the effects of extended wakefulness and circadian phase on driver state and trait sleepiness and subsequent sleepiness-related driving impairment. Furthermore, the protocol aims to define the best VOM predictors to identify driver sleepiness state (road side testing and pre-drive assessments) and sleepiness trait (predicting future driving risk) to establish proof of concept for its potential application as a roadside, pre-drive and general sleepiness related fitness to drive test.