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Many refugees and asylum seekers in Germany experience a high disease burden and low health literacy. The current study aims to focus on assessing these issues among African refugees and asylum seekers in Bavaria, Germany. The authors evaluated their self-perceived health status and health literacy, and identified barriers and gaps in health care utilization, intending to improve health care services for this group.

The authors conducted a cross-sectional, questionnaire-based study involving 69 refugees and asylum seekers from Ethiopia, Eritrea and Nigeria. The authors performed descriptive and exploratory statistical analyses.

The authors found a substantial disease burden in the early stages of resettlement in Germany, particularly mental health symptoms (53.6%) and musculoskeletal problems (47.8%). Challenges in health literacy were observed, such as difficulties in understanding health information and managing emergency situations. Access to interpreters was limited, and understanding treatment certificates was more challenging than using electronic health cards, with 18.2% of participants reporting denial of medical treatment.

These findings highlight the need for early and tailored health support for refugees, with a particular focus on mental health. Efforts should be made to reduce language barriers and improve navigational skills within the health-care system, particularly in emergency situations. Addressing the restricted access to health care and bureaucratic obstacles is crucial for improved health outcomes among refugees.

To the best of the authors’ knowledge, this research is the first to specifically explore the self-reported health status and health literacy of African refugees and asylum seekers in Bavaria, Germany, providing valuable insights into the unique healthcare challenges of this often underrepresented and overlooked population.

Policing requires atypical work hours. The present study examined associations between shiftwork and pregnancy loss among female police officers.

Participants were 91 female officers with a prior history of at least one pregnancy. Shiftwork information was assessed using daily electronic payroll work records. Any prior pregnancy loss (due to miscarriage) was self-reported. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for main associations.

On average, the officers were 42 years old, had 14 years of service, and 56% reported a prior pregnancy loss. Officers who worked dominantly on the afternoon or night shift during their career had 96% greater odds of pregnancy loss compared to those on day shift (OR = 1.96, 95% CI:0.71–5.42), but the result was not statistically significant. A 25% increase in percent of hours worked on night shift was associated with 87% increased odds of pregnancy loss (OR = 1.87, 95% CI:1.01–3.47). Associations were adjusted for demographic and lifestyle factors. Objective assessment of shiftwork via electronic records strengthened the study. Limitations include small sample size, cross-sectional design and lack of details on pregnancy loss or the timing of pregnancy loss with regard to shiftwork.

The present study is preliminary and cross-sectional.

With considerable further inquiry and findings into this topic, results may have an impact on police policy affecting shift work and pregnant police officers.

Implication on the health and welfare of police officers.

To our knowledge, there are no empirical studies which associate shiftwork and pregnancy loss among police officers. This preliminary study suggested an association between shiftwork and increased odds of pregnancy loss and points out the need for further study.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

The purpose of the study was to produce a healthier, convenient and traditional ready-to-eat (RTE) snack option with increased nutritional value, using spent hen meat, dietary fibre (DF) and simple technological methods. The product was designed to be stable without refrigeration and be easily adoptable by local self-help groups, rural women and youth and entrepreneurs in urban and semi-urban areas.

Conventional binder used for making snacks, i.e. rice flour was partially replaced by different sources of antioxidant DFs, i.e. oat flour (T₁ – 10%), finger millet flour (T₂ – 5%) and amaranth flour (T₃ –15%) to prepare spent hen snack sticks (SHSS). The snacks were then packaged in low density polyethylene (LDPE) pouches and evaluated for their storage stability at ambient temperature for a period of 35 days. Their physico-chemical, sensory and microbiological quality was evaluated at a regular interval of 7 days. The proximate composition of developed SHSS was compared to commercially available snack products (chakli/murukku – snacks without meat).

The fibre-enriched SHSS showed significant improvement in nutritive value, as they contained more fibre (p = 0.001) and protein (p = 0.029) than control SHSS. When compared to commercially available snack product SHSS showed three-fold significant increase in protein (p = 0.000) and ash content (p = 0.001) and only 11%–12% total fat as compared to 31% fat in the market-available product. The most acceptable treatment in terms of overall sensory quality and nutritional aspects was T₃; however, T₂ was more shelf-stable during the storage period. The study showed that fibre-enriched snacks can be stored at ambient temperature for up to 35 days without substantial loss in physico-chemical, sensory and microbial quality. Hence, substituting rice flour with DFs can lead to the development of products with better sensory attributes and improved functionality.

The simplicity of the product in terms of composition, machinery and low production costs makes it an easily adoptable one by small-scale entrepreneurs, especially those belonging to semi-urban areas.

Incorporation of spent hen meat, a relatively cheap but abundant source of protein, in RTE products can serve as an effective way to alleviate protein malnutrition, whereas addition of fibre further improves the functionality of the product. The methodology can be easily taken up by small-scale entrepreneurs and create a market for snack-based functional meat products.

This paper describes the development of a digital role play game (RPG) designed to help construction apprentices to better communicate with their supervisors about issues with the potential to impact on their physical and psychological health and safety.

A participatory approach was adopted to utilise the knowledge and insights of the target users to inform the digital RPG development. Apprentices and supervisors were interviewed to identify characteristics of effective supervisor-apprentice communication, which became the RPG’s learning objectives. The scenarios constructed in the RPG were drawn from lived experiences shared by the apprentices in the interviews. During the development process, consultations were conducted with an advisory committee comprising of apprentices and supervisors to improve the realism of the RPG scenarios.

Three scenarios were developed for the RPG. In each scenario, players are asked to make decisions at various interaction points about how the characters should respond to the unfolding and challenging situations. Scripts were developed for the game, which were acted out and motion captured to animate digital MetaHuman characters embedded in a virtual construction site. Two example situations are introduced in this paper to illustrate the development process.

To our knowledge, the RPG introduced is one of the first applications of digital game-based training in the construction industry. The adoption of a participatory design approach ensures that the game content relates to real-world experiences. The digital RPG is highly interactive and engaging in nature and presents a novel approach to developing “soft” skills in construction.

The low rate of exclusive breastfeeding and the early introduction of complementary feeding are among the causes of nutritional problems in children. The national coverage of exclusive breastfeeding in 2019 was 67.7%, surpassing the target of the 2019 Strategic Plan, which was 50%. However, there are still several practices of early and inappropriate complementary feeding (32.3%) that can be contributing factors to malnutrition problems in children. The purpose of this study was to determine the factors that influence mother’s self-efficacy levels regarding complementary feeding practices among toddlers in the Tengger tribe.

The study conducted was an observational study with a cross-sectional design. It focused on mothers with children aged 6–24 months in Wonokitri village, East Java. Data was collected using a structured questionnaire and information from the local health center. The analysis involved univariate and bivariate analysis using the chi-square test.

Most mothers were aged 20–34 years (78.9%), had a good level of knowledge (61.4%), the last education level of fathers and mothers was high school (47.4%; 54.4%), parents work as farmers (86.0%; 61.4%), Hinduism (98.2%), family income is less than the minimum wage (78.9%), and mothers receive good family support (73.7%). Most toddlers were boys (56.1%), aged 13–24 months (68.4%), and the second child (66.7%). Family support was the only factor that was significantly related to a mother’s self-efficacy in complementary breastfeeding practices (p-value = 0.042).

It is hoped that more families and health workers will support mothers in giving food to their babies based on the guidelines.

This paper collects evidence from indigenous people of the Tengger tribe.

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme’s aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners’ interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

The authors’ evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another’s experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

Despite a small sample size, the authors’ results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.

This paper aims to study the application of high-tolerance and flexible indigenous bacteria and fungi, along with the co-metabolism in recycled paper and cardboard mill (RPCM) wastewater treatment (WWT).

The molecular characterization of isolated indigenous bacteria and fungi was performed by 16S rRNA and 18S rRNA gene sequencing, respectively. Glucose was used as a cometabolic substrate to enhance the bioremediation process.

The highest removal efficiency was achieved for both chemical oxygen demand (COD) and color [78% COD and 45% color removal by Pseudomonas aeruginosa RW-2 (MZ603673), as well as approximately 70% COD and 48% color removal by Geotrichum candidum RW-4 (ON024394)]. The corresponding percentages were higher in comparison with the efficiency obtained from the oxidation ditch unit in the full-scale RPCM WWT plant.

Indigenous P. aeruginosa RW-2 and G. candidum RW-4 demonstrated effective capability in RPCM WWT despite the highly toxic and low biodegradable nature, especially with the assistance of glucose.

The COVID-19 pandemic is not a foodborne infectious disease, but it has dramatically impacted food safety practices worldwide due to its potential for transmission through contaminated surfaces and food. Accordingly, the Omicron variant seems to have affected food-related activities and behaviours and disturbed food supply networks since its appearance in November 2021. Hence, this paper aims to assess how the Omicron variant impacted food safety knowledge, attitudes and practices amongst adult consumers in five countries: Bosnia and Herzegovina, North Macedonia, Serbia, Montenegro and Russia.

The study is based on an online survey. The questionnaire was developed and revised based on previous research on the impact of previous COVID-19 waves on food-related activities in several countries. The questionnaire was distributed through the SurveyMonkey platform from January 15 to February 25, 2022. It consisted of 29 multiple-choice and one-option questions organised into three sections. A total of 6,483 valid responses were received. Statistical Package for Social Sciences (SPSS) version 25.0 was used to analyse the survey results.

According to the survey findings, food safety practices evolved during the Omicron wave in the studied countries. Firstly, less than half of the sample used a face mask whilst purchasing food. Secondly, regarding food safety knowledge, the survey results suggest that there is still a lack of knowledge in the studied countries. Thirdly, the survey indicates a lack of knowledge amongst the respondents regarding food safety attitudes. For instance, more than a third of the sample (34.4%) are unsure whether the COVID-19 virus can be transmitted through food. These results are surprising and alarming, especially considering that our sample has a higher education than the population of the studied countries.

The main limitation of this research is the sample bias. Survey participants were randomly chosen, enrolled voluntarily and not rewarded. As a result, the questionnaire was self-administered and completed exclusively by people motivated by an interest in the topic. Consequently, our survey does not represent the general population of the studied countries. People with a high degree of education and women, for example, were overrepresented in our sample.

This study is unique in that it is the first to gather information and analyse people’s perceptions of the effects of the Omicron variant on food safety. As a result, the findings of this survey offer a solid basis for future investigations into the impact of the pandemic on food safety in the Balkan region and Russia. This study can help further understand the changes during the COVID-19 pandemic. It provides crucial insights that can be used to guide future decision-making and policy development regarding improving food safety practices. This and other future studies will be a foundation for organisational and government readiness for future shocks, crises and pandemics. The effects of the present Ukrainian conflict on agricultural systems and supply chains throughout the globe (e.g. increased food prices) show that this is timely, urgent and highly required.