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In recent years, advances in technology have led to an influx of mental health apps, in particular the development of mental health and well-being chatbots, which have already shown promise in terms of their efficacy, availability, and accessibility. The ChatPal chatbot was developed to promote positive mental well-being among citizens living in rural areas. ChatPal is a multilingual chatbot, available in English, Scottish Gaelic, Swedish, and Finnish, containing psychoeducational content and exercises such as mindfulness and breathing, mood logging, gratitude, and thought diaries. The primary objective of this study is to evaluate a multilingual mental health and well-being chatbot (ChatPal) to establish if it has an effect on mental well-being. Secondary objectives include investigating the characteristics of individuals that showed improvements in well-being along with those with worsening well-being and applying thematic analysis to user feedback. A pre-post intervention study was conducted where participants were recruited to use the intervention (ChatPal) for a 12-week period. Recruitment took place across 5 regions: Northern Ireland, Scotland, the Republic of Ireland, Sweden, and Finland. Outcome measures included the Short Warwick-Edinburgh Mental Well-Being Scale, the World Health Organization-Five Well-Being Index, and the Satisfaction with Life Scale, which were evaluated at baseline, midpoint, and end point. Written feedback was collected from participants and subjected to qualitative analysis to identify themes. A total of 348 people were recruited to the study (n=254, 73% female; n=94, 27% male) aged between 18 and 73 (mean 30) years. The well-being scores of participants improved from baseline to midpoint and from baseline to end point; however, improvement in scores was not statistically significant on the Short Warwick-Edinburgh Mental Well-Being Scale (P=.42), the World Health Organization-Five Well-Being Index (P=.52), or the Satisfaction With Life Scale (P=.81). Individuals that had improved well-being scores (n=16) interacted more with the chatbot and were significantly younger compared to those whose well-being declined over the study (P=.03). Three themes were identified from user feedback, including \"positive experiences,\" \"mixed or neutral experiences,\" and \"negative experiences.\" Positive experiences included enjoying exercises provided by the chatbot, while most of the mixed, neutral, or negative experiences mentioned liking the chatbot overall, but there were some barriers, such as technical or performance errors, that needed to be overcome. Marginal improvements in mental well-being were seen in those who used ChatPal, albeit nonsignificant. We propose that the chatbot could be used along with other service offerings to complement different digital or face-to-face services, although further research should be carried out to confirm the effectiveness of this approach. Nonetheless, this paper highlights the need for blended service offerings in mental health care.

Global warming will unquestionably increase the impact of heat on individuals who work in already hot workplaces in hot climate areas. The increasing prevalence of this environmental health risk requires the improvement of assessment methods linked to meteorological data. Such new methods will help to reveal the size of the problem and design appropriate interventions at individual, workplace and societal level. The evaluation of occupational heat stress requires measurement of four thermal climate factors (air temperature, humidity, air velocity and heat radiation); available weather station data may serve this purpose. However, the use of meteorological data for occupational heat stress assessment is limited because weather stations do not traditionally and directly measure some important climate factors, e.g. solar radiation. In addition, local workplace environmental conditions such as local heat sources, metabolic heat production within the human body, and clothing properties, all affect the exchange of heat between the body and the environment. A robust occupational heat stress index should properly address all these factors. This article reviews and highlights a number of selected heat stress indices, indicating their advantages and disadvantages in relation to meteorological data, local workplace environments, body heat production and the use of protective clothing. These heat stress and heat strain indices include Wet Bulb Globe Temperature, Discomfort Index, Predicted Heat Strain index, and Universal Thermal Climate Index. In some cases, individuals may be monitored for heat strain through physiological measurements and medical supervision prior to and during exposure. Relevant protective and preventive strategies for alleviating heat strain are also reviewed and proposed.

Anal fistula is a complex and often prolonged condition that significantly impacts patients’ daily lives and psychological well-being. This qualitative study explored how individuals living with anal fistula experience stigma, disruption, and identity strain in everyday life. Fifteen participants undergoing active treatment were interviewed at two hospitals. Data was analyzed using qualitative content analysis. Findings show that living with anal fistula was marked by shame, uncertainty, and social withdrawal, often contributing to an altered or fractured sense of self. Participants navigated this experience through three identity-shaping mechanisms: Knowledge Uncertainty, Expectations and Experiences, and Quality-of-Life. These mechanisms influenced how participants made sense of their condition, coped with invisibility, and negotiated bodily control in the context of pain and stigma. While many struggled to maintain a coherent identity in the face of chronic symptoms, interactions with empathetic healthcare providers, particularly those offering consistent information and emotional support played a critical role in helping patients feel seen and supported. The study highlights the need for more holistic, person-centered approaches to care that address not only the physical but also the psychosocial dimensions of life with an anal fistula.

The Universal Thermal Climate Index (UTCI) aimed for a one-dimensional quantity adequately reflecting the human physiological reaction to the multi-dimensionally defined actual outdoor thermal environment. The human reaction was simulated by the UTCI-Fiala multi-node model of human thermoregulation, which was integrated with an adaptive clothing model. Following the concept of an equivalent temperature, UTCI for a given combination of wind speed, radiation, humidity and air temperature was defined as the air temperature of the reference environment, which according to the model produces an equivalent dynamic physiological response. Operationalising this concept involved (1) the definition of a reference environment with 50% relative humidity (but vapour pressure capped at 20 hPa), with calm air and radiant temperature equalling air temperature and (2) the development of a one-dimensional representation of the multivariate model output at different exposure times. The latter was achieved by principal component analyses showing that the linear combination of 7 parameters of thermophysiological strain (core, mean and facial skin temperatures, sweat production, skin wettedness, skin blood flow, shivering) after 30 and 120 min exposure time accounted for two-thirds of the total variation in the multi-dimensional dynamic physiological response. The operational procedure was completed by a scale categorising UTCI equivalent temperature values in terms of thermal stress, and by providing simplified routines for fast but sufficiently accurate calculation, which included look-up tables of pre-calculated UTCI values for a grid of all relevant combinations of climate parameters and polynomial regression equations predicting UTCI over the same grid. The analyses of the sensitivity of UTCI to humidity, radiation and wind speed showed plausible reactions in the heat as well as in the cold, and indicate that UTCI may in this regard be universally useable in the major areas of research and application in human biometeorology.

European and International sustainable development agendas aim to reduce inequalities in working conditions and work-related health, yet disparate occupational health outcomes are evident between both men and women and domestic- and foreign-born workers. In Sweden, major growth in online retail warehousing has increased occupational opportunities for foreign-born workers. The rapid change has left research lagging on working conditions, i.e., employment conditions, facility design, work organisation, physical and psychosocial work environment conditions, and their effects on worker health. Further, no known studies have considered patterns of inequality related to these factors. The overall aim of this study is to describe working conditions and musculoskeletal health in online retail warehousing, determine the extent to which differences exist related to sex/gender and place of birth (as a proxy for race/ethnicity), and examine factors at the organisational and individual levels to understand why any differences exist. Three online retail warehouses, each employing 50–150 operations workers performing receiving, order picking, order packing and dispatching tasks will be recruited. Warehouses will, to the extent possible, differ in their extent of digital technology use. Employment conditions, facility design (including digital tool use), work organisation, physical and psychosocial work environment conditions and worker health will be assessed by survey, interview and technical measurements. Analysis of quantitative data stratified by sex and place of birth will consider the extent to which inequalities exist. Focus group interviews with operations employees and in-depth interviews with managers, union and health and safety representatives will be conducted to assess how employee working conditions and musculoskeletal health are related to inequality regimes of sex/gender and/or race/ethnicity in organisational processes and practices in online retail warehousing. The study is pre-registered with the Open Science Framework. This study will describe working conditions and health in online retail warehouse workers and consider the extent to which patterns of inequality exist based on sex/gender and place of birth.

Small- and medium-sized enterprises (SMEs) have inherent characteristics, which require specific solutions for improving the sustainability performance of their operations. The purpose of this paper is to increase the knowledge on barriers and enablers for the adoption of sustainable manufacturing by manufacturing SMEs and to provide insights into what enablers can be used to overcome existing barriers. Taking, as a starting point, a systematic literature review, this paper presents a categorization of barriers and enablers for the adoption of sustainable manufacturing by manufacturing SMEs. In total, seven categories for classifying the barriers and enablers for the adoption of sustainable manufacturing within SMEs were identified: organizational, managerial and attitudinal; informational; governmental; financial; training and skills development; market and business context; and technological. Additionally, this study elaborates on what barriers could be mitigated through the enablers. This study found specific enablers with the potential to mitigate a significantly higher number of barriers and referred to them as ‘critical enablers’. SMEs aiming to adopt sustainable manufacturing practices or improve their sustainability performance are encouraged to focus on the enablers in these categories. This paper synthesizes and facilitates interpretation of the existing body of evidence on barriers and enablers for adopting sustainable manufacturing in SMEs.

Purpose Supply chains evolve and change in size, shape and configuration, and in how they are coordinated, controlled and managed. Some supply chains are mature and relatively unchanging. Some are subject to significant change. New supply chains may emerge and evolve for a variety of reasons. The purpose of this paper is to examine the nature of supply chain evolution and address the question “What makes a supply chain like it is?” Design/methodology/approach The paper analyses and develops key aspects, concepts and principal themes concerning the emergence and evolution of supply chains over their lifecycle. Findings The paper defines the supply chain lifecycle and identifies six factors that interact and may affect a supply chain over its lifecycle – technology and innovation, economics, markets and competition, policy and regulation, procurement and sourcing, supply chain strategies and re-engineering. A number of emergent themes and propositions on factors affecting a supply chain’s characteristics over its lifecycle are presented. The paper argues that a new science is needed to investigate and understand the supply chain lifecycle. Practical implications Supply chains are critical for the world economy and essential for modern life. Understanding the supply chain lifecycle and how supply chains evolve provides new perspectives for contemporary supply chain design and management. Originality/value The paper presents detailed analysis, critique and reflections from leading researchers on emerging, evolving and mature supply chains.

Social sustainability is the much emphasized organizational phenomenon in Western literature; however, in emerging economies, its importance has only been realized in the recent past. Social sustainability is the amiability of the relationship between employees and the organizations on a relatively permanent basis. Social sustainability is the key determinant of organizational sustainability and organizational effectiveness. As healthcare organizations are labor-intensive, the role of social sustainability in hospitals is more crucial. The purpose of the present study is to understand the role of work safety in improving social sustainability in public sector hospitals. To this effect, we collected data from 431 healthcare professionals of a large public sector tertiary and teaching hospital in the city of Lahore Pakistan and analyzed the data using structural equation modeling (SEM). The results uncovered certain important facts, which were not expected per se. Job design, coworkers’ behavior towards work safety, and supervisors’ role in ensuring work safety are the key factors that influence social sustainability. However, surprisingly, in the eyes of employees, management practices and safety programs/policies do not contribute to the work safety of the hospital under study. Keeping in view the findings, we suggest that management must participate in work safety affairs directly and formulate indigenous policies and programs according to local needs. Job analysis is needed to redesign job structures to meet workplace safety requirements. Formal and informal training will be beneficial to make workers and supervisors more aware, more sensitive, and more responsible regarding work safety.

This longitudinal study examines the impact of office type on employees’ perception of managers’ leadership behaviours, which is an unexplored area. The expanding research related to activity-based flexible offices (AFOs) has mainly focused on employees’ working conditions and health outcomes, not on the changes in leadership behaviours when moving from traditional offices to AFOs. Office workers (n = 261) from five office sites within a large Swedish government agency were included in a controlled study of a natural intervention. At four sites, traditional offices were replaced by AFOs, while workers at one site with no relocation acted as the control. The same employees rated different leadership behaviours in a web-based questionnaire at baseline and at one follow-up. The analyses showed that relocations from cell and open-plan offices to AFOs were clearly related to a decrease in the perception of relation-oriented leadership behaviours. However, coming from open-plan offices to AFOs also decreased the perception of the other leadership dimensions. As expected, the control group was stable over time in their perceptions. This emphasises the need for organisations to provide managers with prerequisites so they can keep up with behaviours that support employees’ performance and health when office designs and ways of working are changed.

Train drivers’ outside attention impacts the chance of acting in time to avoid potential collisions with people or other objects. This project aimed to study the effect of the in-cabin signalling system ETCS on driver attention. We specifically examined gaze behaviour in events of special relevance for train driving, such as unattended level-crossings, with and without speed changes. An eye-tracking study was conducted in a simulated environment with 40 experienced Swedish train drivers driving the same route equipped with the Swedish lineside signalling system ATC and ETCS, respectively. The results showed that ETCS generally affected drivers’ outside attention negatively. Compared to ATC, with ETCS significantly more glances were directed inside the cabin at the expense of outside glances. When assessing the gaze behaviour at unattended level-crossings with and without speed changes, approximately 20 percent less attention was spent towards the outside when approaching an unattended level-crossing with a speed change. We conclude that ETCS negatively affects outward attention and thus reduces the chances that the driver will detect a person or other object on the track and act in time to avoid a collision. As speed changes negatively affect outward attention, we recommend that speed changes should be avoided in critical parts of the track where the risk of collision is higher. The results should also have implications for the design of connected driver advisory systems, which provides the driver with real-time guidance on speed operation via a tablet or screen and thus, demand driver attention.