BACKGROUND: Public health emergencies of international concern (PHEICs) as the COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health and care systems. This is being a context for protests by health and care workers (HCWs) because of additional workload, working conditions and effects on mental and physical health. In this paper, we intended to analyze the demands of HCWs associated with industrial actions, protests, strikes and lockouts (IAPSLs) which occurred during COVID-19 pandemic and other PHEICs; to identify the impact of these grievances; and describe the relevant interventions to address these IAPSLs.
METHODS: We included studies published between January 2000 and March 2022 in PubMed, Embase, Scopus, BVS/LILACS, WHO\'s COVID-19 Research Database, ILO, OECD, HSRM, and Google Scholar for grey literature. Eligibility criteria were HCWs as participants, IAPSLs as phenomenon of interest occurring in the context of COVID-19 and other PHEICs. GRADE CERQual was used to assess risk of bias and confidence of evidence.
RESULTS: 1656 records were retrieved, and 91 were selected for full-text screening. We included 18 publications. A system-wide approach, rather than a limited approach to institutions on strike, makes it possible to understand the full impact of the strike on health and care services. PHEICs tend to aggravate already adverse working conditions of HCWs, acting as drivers for HCWs strikes, leading to staff shortages, and financial issues, both in the North and in the Global South, particularly evident in Asia and Africa. In addition, issues related to deficiencies in leadership and governance in heath sector and lack of medical products and technologies (e.g., lack of personal protective equipment) were the main drivers of strikes, each contributing 25% of the total drivers identified.
CONCLUSIONS: It is necessary to focus on the preparedness of health and care systems to respond adequately to PHEICs, and this includes being prepared for HCWs\' IAPSLs, talked much in the context of COVID-19 pandemic. Evidence to assist policymakers in defining strategies to respond adequately to the health and care needs of the population during IAPSLs is crucial. The main impact of strikes is on the disruption of health care services\' provision. Gender inequality being a major issue among HCWs, a proper understanding of the full impact of the strike on health and care services will only be possible if gender lens is combined with a systemic approach, rather than gender-undifferentiated approaches limited to the institutions on strike.

UNASSIGNED: Strikes in the health sector have been of growing concern, given their disruptive nature, negatively impacting the provision of health care and jeopardizing the well-being of patients. This study aims to identify the main actors, the reasons behind industrial actions protests, strikes and lockouts (IAPSL) in sub-Saharan African countries and their impact on health care workers (specifically doctors) and health services, as well as to identify the main strategies adopted to reduce their impact on healthcare services.
UNASSIGNED: Studies published between January 2000 and December 2021 and archived in MEDLINE, Google Scholar, Scopus, ProQuest, and Science Direct were included. Quantitative, observational (i.e., cohort, case-control, cross-sectional, and ecological) and experimental studies, as well as mixed methods, quasi-experimental, and qualitative studies were eligible.
UNASSIGNED: A total of 5521 studies were identified and after eliminating duplicates, applying the inclusion criteria, and assessing the risk of bias, a total of 11 studies were included in the review. Nurses and doctors are the actors most commonly involved in strikes. The main causes of strikes were salary claims and poor working conditions. The main strategies adopted to mitigate the strike consequences were to restrict services and prioritize emergency and chronic care, greater cooperation with the private sector and rearrange tasks of the available staff. The strikes led to a reduction in hospitalizations and in the number of women giving birth in health units, an increase in maternal and child morbidities and delays in the immunization process. Increased mortality was only reported in faith-based hospitals.
UNASSIGNED: This evidence can assist decision-makers in developing strategies and interventions to address IAPSL by health care workers, contributing to strengthen the health system. Strikes in the health sector disrupt healthcare services provision and compromise the well-being of patients, especially the most disadvantaged, with consequences that may be difficult to overcome ever. The potential health impacts of strikes highlights the importance of their prevention or timely resolution through regulation and negotiations to balance the rights of health care workers and the rights of patients.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=334173, identifier CRD42022334173.

OBJECTIVE: To provide an overview of the current state of physician unionization, potential factors surrounding increased unionization, and the ethical and financial issues that may arise.
METHODS: Review article.
METHODS: Not applicable.
METHODS: Not applicable.
RESULTS: Over the last few years, there has been a recent surge in physician unionization. Union membership among residents and fellows is also at an all-time high and continues to increase, as seven residency programs voted to unionize in 2023. The resulting threat of strikes has grown considerably over the last year as residents across 6 hospitals have threatened to strike, resulting in New York\'s first physician strike in over three decades. As physician practice continues to shift from private to corporate health system-based employment, more opportunities for unionization will arise. Globally, these trends have been comparable, with thousands of physicians striking across the United Kingdom, Germany, Italy, Nigeria, and New Zealand in the last year.
CONCLUSIONS: The current state of physician unionization is of increasing significance as more physicians are presented with opportunities for unionization. Physicians perceive a lack of autonomy, and the demand to deliver high level outcomes with diminishing resources is becoming an insurmountable challenge. Additionally, physician satisfaction with their workplace has decreased with increased burnout rates. Thus, it is important to understand the current state of unionization, potential reasons for unionization among physicians and residents, and its future impact on the field of medicine.

BACKGROUND: The UK National Health Service (NHS) is one of the largest employers in the world and employs around 360,000 registered nurses. Following a protracted pay dispute in December 2022 NHS nurses engaged in industrial action resulting in the largest nurse strikes in the 74-year history of the NHS. Initially it appeared these strikes were a direct consequence of pay disputes but evidence suggests that the situation was more complex. This study aimed to explore what the key factors were in driving UK NHS nurses\' decision to strike.
METHODS: A convergent parallel mixed methods design was used. The study was conducted throughout the UK and involved participants who were nurses working for the NHS who voted in favour of strike action. Data collection involved the use of an online survey completed by 468 nurses and 13 semi-structured interviews. Descriptive and inferential statistics were used for quantitative data analysis and a process of inductive thematic analysis for the qualitative data. The quantitative and qualitative data were analysed separately and then integrated to generate mixed methods inferences.
RESULTS: The quantitative findings showed that patient safety, followed by staff shortages, pay, and unmanageable work demands were the most important factors encouraging nurses\' decision to strike. The qualitative findings served to further the understanding of these factors particularly in relation to participants\' perception of the NHS and the consequences of inadequate pay and staff shortages. Three overarching and overlapping themes represented the qualitative findings: Save our NHS, Money talks, and It\'s untenable. Integration of the findings showed a high level of concordance between the two data sets and suggest that the factors involved are interconnected and inextricably linked.
CONCLUSIONS: The UK NHS is a challenging and demanding work environment in which the well-being of its patients is dependent on the well-being of those who care for them. Concerns relating to patient welfare, the nursing profession and the NHS played a large part in driving UK NHS nurses\' decision to strike. In order to address these concerns a focus on recruitment and retention of nurses in the NHS is needed.

This paper explores public sentiment towards strike action among healthcare workers, as a result of their perceived inadequate pay. By analysing survey data collected in England between 2022 and 2023, the study focuses on NHS nurses and junior doctors, due to their critical role in delivering essential public services. Results indicate higher public support for strikes by nurses and junior doctors compared to other professions such as postal workers, teachers, rail workers, airport workers, civil servants and university lecturers. However, variation in support for strikes by healthcare workers is observed across societal segments. Significant disparities in support are linked to individual political affiliations, left-right ideological positions and trust in the NHS. In short, nonconservative voters, individuals leaning towards left-wing politics and those with greater trust in the NHS demonstrate higher likelihoods of supporting strikes by health workers. These findings carry implications for future strike decisions and highlight specific target groups for enhanced communication efforts to garner increased public support.

In the UK, there has been a significant increase in strike activity since the summer of 2022. Due to these increased levels of strike activity, it is logical for academics and policy makers to turn to the official data on labour disputes to help us understand what has been happening. Strikes remain of core sociological interest, yet are under researched in this journal. This research note briefly examines the recent strike wave in the UK drawing on data from the Office for National Statistics. The limitations of these data are outlined before consideration is given to other potential sources of data on labour disputes.

Previous research has established that the success of strikes, and social movements more broadly, depends on their ability to garner support from the public. However, there is scant published research investigating the response of the public to strike action by healthcare workers. In this study, we address this gap through a study of public responses to UK nursing strikes in 2022-2023, using a data set drawn from Twitter of more than 2300 publicly available tweets. We focus on negative tweets, investigating which societal discourses social media users draw on to oppose strike action by nurses. Using a combination of corpus-based approaches and discourse analysis, we identified five categories of opposition: (i) discourse discrediting nurses; (ii) discourse discrediting strikes by nurses; (iii) discourse on the National Health System; (iv) discourse about the fairness of strikers\' demands and (v) discourse about potential harmful impact. Our findings show how social media users operationalise wider societal discourses about the nursing profession (e.g., associations with care, gender, vocation and sacrifice) as well as recent crises such as the Covid-19 pandemic to justify their opposition. The results also provide valuable insights into misconceptions about nursing, strike action and patient harm, which can inform strategies for public communication.

With the initial context of COVID-19 fuelling Amazon\'s exponential growth, this article investigates how the pandemic (re)defined labour struggles, i.e., cultivating labour\'s structural, associational and institutional powers in two case study countries, Germany and the US. By analysing these power resources in its two largest markets, I argue that Amazon\'s structural conditions by which it organises its warehouse labour, which predate the pandemic, have continued to act as obstacles to collective labour action. While in Germany, ver.di continues to mobilise its workplace power but has been unable to get Amazon to sign a collective agreement, the pandemic triggered unprecedented workplace mobilisations and the pursuit of associational power in the US, albeit with varying outcomes. Despite their different industrial relations systems and labour struggles, these two cases highlight the key role of shop-floor organising to put pressure on Amazon, while Amazon\'s continued rejection of unions as negotiating partners further underlines the importance of regulating Amazon\'s union-busting tactics.
Dans un contexte où la COVID-19 a alimenté la croissance exponentielle d\'Amazon, cet article examine comment la pandémie a (re)défini les luttes syndicales, en soulignant son impact sur les pouvoirs structurels, associatifs et institutionnels des travailleurs dans les deux pays étudiés, à savoir l\'Allemagne et les États-Unis. En analysant ces ressources de pouvoir sur les deux plus importants marchés d\'Amazon, l\'auteur fait valoir que les modalités structurelles de l\'organisation de sa main-d\'œuvre par Amazon dans les entrepôts d\'Amazon, qui sont antérieures à la pandémie, ont continué à faire obstacle à l\'action collective des travailleurs. En Allemagne, le syndicat unifié des services (ver.di) continue de mobiliser ses forces sur le lieu de travail sans parvenir à faire signer une convention collective à Amazon. Aux États-Unis, la pandémie a entraîné des mouvements de mobilisation sans précédent sur les lieux de travail, à la recherche d\'un pouvoir associatif, mais avec des résultats inégaux. Malgré leurs différences en termes de systèmes de relations industrielles et de luttes syndicales, ces deux cas mettent en évidence le rôle clé de la mobilisation des travailleurs à la base pour faire pression sur Amazon ; quant au fait qu\'Amazon continue de récuser les syndicats en tant que partenaires de négociation, il souligne l\'importance de réglementer les tactiques antisyndicales de cette entreprise.
Der Ausgangskontext für diesen Artikel ist das exponentielle Wachstum von Amazon infolge der COVID-19-Pandemie. Die Autorin untersucht, wie die Pandemie Arbeitskämpfe (neu) definiert hat, d. h. wie sie die strukturelle Macht, Organisationsmacht und institutionelle Macht der Arbeitnehmer:innen in zwei Ländern ihrer Fallstudie, in Deutschland und den USA, verändert hat. Anhand einer Analyse dieser Machtressourcen in den beiden größten Märkten von Amazon weist die Autorin nach, dass Amazons strukturelle Bedingungen, die gegen die Organisierung der Belegschaften in seinen Versandzentren bereits vor der Pandemie vorhanden waren, weiterhin als Hindernis für kollektive Aktionen der Arbeitnehmer:innen wirken. In Deutschland mobilisiert die Gewerkschaft ver.di weiterhin ihre betriebliche Machtbasis, konnte Amazon aber bisher nicht zur Unterzeichnung eines Tarifvertrags bewegen. In den USA hat die Pandemie zu einer ungeahnten Mobilisierungswelle in den Betrieben und zum weiteren Streben nach verbandlicher Macht geführt, allerdings mit unterschiedlichen Ergebnissen. Trotz der unterschiedlichen Systeme von Arbeitsbeziehungen und der unterschiedlichen Arbeitskampfsituationen in den beiden Ländern zeigen diese beiden Fallstudien die Schlüsselrolle auf, die der Organisierung in den Betrieben zukommt, um Druck gegenüber Amazon aufzubauen, während Amazons beharrliche Weigerung, Gewerkschaften als Verhandlungspartner anzuerkennen, weiter unterstreicht, wie wichtig eine Regulierung der gewerkschaftsfeindlichen Taktiken des Konzerns wäre.

BACKGROUND: Studies of the impact of health care workers\' strikes tend to look at facility-level activity rather than populations, with evidence from low and middle-income countries relatively sparse. This study explored the effect of national strikes on maternal and child health. It looked at the impact on health system activity in both public and non-public sectors (e.g. private, faith-based), on health promotion investments like immunisation, and on disease detection like post-partum haemorrhage (PPH). A 100 day doctors\' strike started in December 2016, a 150 day nurses strike from June 2017 and then the clinical officers for 21 days that September.
METHODS: Time series descriptive analysis of attendance data from the Kenyan Health Management Information System (public, non-public sector facilities). The setting was Kilifi, a coastal county in Kenya with a population of about 1.5 million.
RESULTS: Along the care pathway from antenatal, postnatal and out-patient child health clinics, activity levels dropped markedly in the public sector with only partial compensatory increases in non-public sector activity. The number of fully immunised children fell during the nurses strike as did women seen with PPH during all strikes. These health care strikes caused significant adverse health impacts at the time and potentially inter-generationally as exemplified by the fall in antenatal haematinics supplementation and syphilis testing. Some post-strike \'\'catch-up\" activity occurred, however this may have been too late in some instances.
CONCLUSIONS: Policy-makers at national and county level need to ensure population health is protected at times of strikes and ideally resolve disputes without such action. Not to do so risks major negative effects on maternal and child health. Increased use of the non-public health sector could be done by the authorities in mitigation should strikes occur again.

Freeway tunnel strikes by motor vehicles inflict serious damages to the infrastructure, cause personal injuries, and create traffic congestions. Freeway tunnel hits are a constant threat in South Korea due to its mostly mountainous terrain. Despite efforts by public agencies to include disaster remedial or preventative facilities in the development of freeway tunnels, these facilities are designed mainly to reduce the number of collisions instead of also mitigate the consequences of a crash. Hence, the Korea Ministry of Land, Infrastructure and Transport (KMOLIT) recently presented a plan to modify the list of risk factors affecting tunnel traffic safety, and it recommended several strategies for tunnel traffic safety management. The study presented here took a data-driven approach to quantitatively confirming the strategies recommended by KMOLIT through the random forest-based binomial regression. The following factors were found to be significantly associated with serious injury crashes involving freeway tunnel strikes: adverse weather, fatigued and distracted drivers, collision type (i.e., head-on/angle/rear-end), tunnel exit, tunnel width, curve radius (radius less than 1800 m), and heavy vehicle. This study compares specifications of each government strategy with the effects of the identified risk factors on injuries involved in tunnel crashes to quantitatively support recommendations to modify the government strategies.