Association of psychosocial factors at work with fertility and menstrual disorders: A systematic review.

OBJECTIVES: This systematic review aimed to assess the association between psychosocial factors in the workplace and menstrual abnormalities or fertility, focusing on literature implementing a prospective cohort design. METHODS: We searched MEDLINE, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society electronic databases for studies published from inception to February 26, 2020, and updated the search in PubMed on May 29, 2024. Inclusion criteria were (P) adult female workers (over 18 years old), (E) presence of adverse psychosocial factors at work, (C) absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility issues. Prospective cohort studies were included. The included studies were summarized descriptively. RESULTS: Database searching yielded 14,238 abstracts, with nine studies meeting the inclusion criteria. Outcomes included fertility (n = 5), irregular menstrual cycle (n = 1), early menopause (n = 1), endometriosis (n = 1), and serum hormones (n = 1). Study findings included that women with high job demands and low job control were less likely to conceive, and working over 40 h per week and frequent heavy lifting, and rotating night shift work increased the risk of earlier menopause. Studies on night shift/rotating work and fertility outcomes showed no significant differences. CONCLUSION: This review underscores the insufficient high-level evidence regarding the association of psychosocial factors at work with fertility and menstrual disorders, emphasizing the necessity for future well-designed studies.

Perfil epidemiológico dos acidentes por material biológico em médicos da atenção primária em Minas Gerais, de 2012 a 2021 / Epidemiological profile of accidents involving biological material among primary health care physicians in Minas Gerais, from 2012 to 2021 / Perfil epidemiológico de accidentes por material biológico en médicos de atención primaria en Minas Gerais, de 2012 a 2021

Introdução: Os acidentes ocupacionais com material biológico representam um problema de saúde pública. A exposição ocupacional dos profissionais da saúde configura-se como um risco de transmissão de diversos patógenos. Na literatura, há carência de estudos que analisem o perfil dos acidentes com material biológico nos médicos da atenção primária. Objetivo: Buscou-se compreender o perfil epidemiológico dos acidentes com material biológico em médicos da atenção primária em Minas Gerais. Métodos: Estudo epidemiológico descritivo com análise do perfil dos acidentes com material biológico em médicos da atenção primária em Minas Gerais, utilizando dados secundários. Resultados: No período analisado, foram registrados 111 acidentes com material biológico, dos quais 54% ocorreram somente em 2020 e 2021. A maioria dos casos deu-se em mulheres (59%), e os tipos mais frequentes de exposição foram mucosa (38%) e percutânea (33%). Dos médicos, 23% não possuíam esquema vacinal contra a hepatite B completo. Em média, em 36% dos acidentes os testes sorológicos foram negativos e em 61% não foram realizados ou o campo foi ignorado/deixado em branco. Em apenas 7,2% dos casos a quimioprofilaxia foi indicada, mas ressaltam-se os registros ignorados ou em branco. Mais da metade dos acidentados não emitiu a Comunicação de Acidente de Trabalho (CAT). Conclusões: Os acidentes com material biológico predominam em médicas e nas formas de exposição mucosa e percutânea. Investimentos em medidas de biossegurança e educação permanente são necessários para prevenir casos e estimular sua notificação.

Introduction: Occupational accidents with biological material represent a public health problem. The occupational exposure of health professionals represents a risk of transmission of various pathogens. In the literature, there is a lack of studies that analyze the profile of accidents with biological material among primary health care physicians. Objective: We aimed to understand the epidemiological profile of accidents involving biological material among primary health care physicians in Minas Gerais, Brazil. Methods: Descriptive epidemiological study that analyzed the profile of accidents with biological material among primary health care doctors in Minas Gerais, using secondary data. Results: In the period analyzed, 111 accidents with biological material were recorded, of which 54% occurred only in 2020 and 2021. Most cases occurred in women (59%) and the most frequent types of exposure were mucosal (38%) and percutaneous (33%). About a quarter (23%) of physicians did not have a complete immunization record for hepatitis B. On average, in 36% of accidents serological tests were negative and in 61% they were not performed or the field was ignored/left blank. In only 7.2% of cases, chemoprophylaxis was indicated, but ignored or blank records stood out. More than half of the victims did not fill out a work accident report. Conclusions: Accidents with biological material predominate in female doctors and in forms of mucosal and percutaneous exposure. Investments in biosafety measures and permanent education are necessary to prevent cases and encourage their notification.

Introducción: Los accidentes de trabajo con material biológico representan un problema de salud pública. La exposición ocupacional de los profesionales de la salud representa un riesgo de transmisión de varios patógenos. En la literatura faltan estudios que analicen el perfil de accidentes con material biológico en médicos de atención primaria. Objetivo: Buscamos comprender el perfil epidemiológico de los accidentes con material biológico en médicos de atención primaria en Minas Gerais. Métodos: Estudio epidemiológico descriptivo con análisis del perfil de accidentes con material biológico en médicos de atención primaria en Minas Gerais, utilizando datos secundarios. Resultados: En el período analizado se registraron 111 accidentes con material biológico, de los cuales el 54% ocurrió solo en 2020 y 2021. La mayoría de los casos ocurrieron en mujeres (59%) y los tipos de exposición más frecuentes fueron mucosa (38%) y percutánea (33%). El 23% de los médicos no disponía de un calendario completo de vacunación frente a la hepatitis B. En promedio, en el 36% de los accidentes, las pruebas serológicas fueron negativas y en el 61% no se realizó o se ignoró/dejó el campo en blanco. Solo en el 7,2% de los casos se indicó quimioprofilaxis, pero destacan los registros ignorados o en blanco. Más de la mitad de las víctimas no emitieron el CAT. Conclusiones: Predominan los accidentes con material biológico en médicas y en formas de exposición mucosa y percutánea. Son necesarias inversiones en medidas de bioseguridad y educación permanente para prevenir casos e incentivar su notificación.

Experiencias de duelo anticipado en cuidadoras informales de la Región Metropolitana (Chile): cambios ocupacionales

Introducción: La pérdida de un ser querido se construye como una experiencia humana inevitable, que genera una vivencia emocional que impacta tanto al individuo que experimenta la pérdida como a su entorno. Objetivo: Investigar la relación entre los procesos de duelo anticipado y las alteraciones en la participación ocupacional de quienes fueron cuidadoras principales informales de personas con enfermedad terminal en la Región Metropolitana de Chile. Método: Enfoque cualitativo con 7 entrevistas semiestructuradas individuales a cuidadoras adultas en el sur y poniente de la región. Resultados: Fueron categorizadas experiencias y subjetividades que expresan la importancia que las mujeres atribuyen al cuidado de sus familiares, con una escasa demostración emocional durante esta etapa. Además, emergen categorías como rutinas y roles, donde muchas mujeres priorizan el cuidado; redes de apoyo, con relatos frecuentes sobre la falta de ayuda y herramientas más allá de lo económico; y áreas de ocupación afectadas, predominantemente el descanso y sueño, aunque también se menciona el autocuidado y la participación social. Conclusión: Si bien el proceso de duelo anticipado genera dolor y desgaste propio, es el cuidado informal lo que genera cambios en la participación y calidad de vida de las mujeres cuidadoras.

Introdução: A perda de um ente querido é construída como uma experiência humana inevitável, que gera uma vivência emocional que afeta tanto o indivíduo que experimenta a perda quanto seu entorno. Objetivo: investigar a relação entre os processos de luto antecipado e as alterações na participação ocupacional daquelas que foram cuidadoras primárias informais de pessoas com doença terminal na Região Metropolitana do Chile. Método: abordagem qualitativa com 7 entrevistas individuais semiestruturadas com cuidadoras adultas no sul e oeste da região. Resultados: Foram categorizadas experiências e subjetividades que expressam a importância que as mulheres atribuem ao cuidado de seus familiares, com uma escassa demonstração emocional durante essa etapa. Além disso, surgem categorias como rotinas e papéis, em que muitas mulheres priorizam o cuidado; redes de apoio, com relatos frequentes sobre a falta de ajuda e ferramentas além das econômicas; e áreas de ocupação afetadas, predominantemente o descanso e o sono, embora o autocuidado e a participação social também sejam mencionados. Conclusão: Embora o processo de luto antecipado gere dor e desgaste próprio, é o cuidado informal que gera mudanças na participação e na qualidade de vida das mulheres cuidadoras.

Introduction: The loss of a loved one is constructed as an inevitable human experience, which generates an emotional experience that impacts both the individual experiencing the loss and his or her environment. Objective: To investigate the relationship between anticipated grief processes and alterations in the occupational participation of informal primary caregivers of terminally ill persons in the Metropolitan Region of Chile. Method: Qualitative approach with 7 individual semi-structured interviews with adult caregivers in the south and west of the region. Results: Experiences and subjectivities were categorized that express the importance that women attribute to the care of their relatives, with little emotional demonstration during this stage. In addition, categories such as routines and roles emerge, where many women prioritize caregiving; support networks, with frequent reports on the lack of help and tools beyond the economic; and areas of occupation affected, predominantly rest and sleep, although self-care and social participation are also mentioned. Conclusion: Although the process of anticipatory grief generates pain and self-exhaustion, it is informal caregiving that generates changes in the participation and quality of life of women caregivers.

Efectos cardiovasculares de la exposición ocupacional a pesticidas / Cardiovascular effects of occupational exposure to pesticides

Resumen Los trabajadores agrícolas se exponen frecuentemente a los pesticidas, los cuales pueden afectar el sistema cardiovascular. El objetivo de la investigación fue revisar la asociación entre la exposición ocupacional a pesticidas, el desarrollo de enfermedades cardiovasculares y los biomarcadores utilizados en la vigilancia de la salud de los trabajadores. Para ello se realizó una revisión no sistemática de la literatura en tres bases de datos: Pubmed, Embase y Scopus, con ecuaciones de búsqueda elaboradas con los términos "agrochemicals", "myocardial infarction", "occupational exposure" y "farmers", y se incluyeron artículos publicados entre 2007 y 2022. Se encontró que los pesticidas causan elevación de las cifras de presión arterial en trabajadores expuestos y en mujeres embarazadas se relaciona con hipertensión gestacional y preeclampsia. Respecto al infarto agudo de miocardio (IAM), el contacto con los pesticidas clorpirifós, coumafós, carbofurano, pendimetalina, trifluralina y acilalanina aumentan el riesgo de IAM en mujeres, y entre los trabajadores masculinos la exposición a dibromuro de etileno, maneb/mancozeb y dimetil-ditiocarbamato de zinc se asoció con mayor mortalidad. La vigilancia epidemiológica se realiza principalmente con la medición de la actividad de la acetilcolinesterasa eritrocitaria (AChE). Se puede concluir que la exposición a pesticidas puede desencadenar enfermedades cardiovasculares agudas y crónicas, como elevación de las cifras de presión arterial, IAM fatal y no fatal. Los pesticidas dimetil ditiocarbamato de zinc, clorpirifós, coumafós, carbofurano, paratión y malatión son las sustancias que tienen mayor relación con el desarrollo de enfermedad cardiovascular.

Abstract Farmworkers are frequently exposed to pesticides, which can affect the cardiovascular system. The objective of the research was to review the association between occupational exposure to pesticides and the development of cardiovascular diseases, and the biomarkers used in monitoring the health of workers. For this, a non-systematic review of the literature was carried out in three databases: Pubmed, Embase and Scopus, with search equations prepared with the terms "agrochemicals", "myocardial infarction", "occupational exposure" and "farmers". Articles published between 2007 and 2022 were included. Pesticides were found to cause elevated blood pressure levels in exposed workers, and in pregnant women it is related to gestational hypertension and preeclampsia. Regarding acute myocardial infarction (AMI), contact the pesticides chlorpyrifos, coumaphos, carbofuran, pendimethalin, trifluralin, and acylalanine increased the risk of AMI in women, and among male workers exposure to ethylene dibromide, maneb/mancozeb, and zinc dimethyldithiocarbamate was associated with increased mortality. Epidemiological surveillance is mainly carried out by measuring erythrocyte acetylcholinesterase (AChE) activity. It can be concluded that exposure to pesticides can trigger acute and chronic cardiovascular diseases, such as elevated blood pressure, fatal and non-fatal AMI. Zinc dimethyl dithiocarbamate, chlorpyrifos, coumafos, carbofuran, parathion and malathion pesticides are the substances most closely related to the development of cardiovascular disease.

Promoção da saúde do trabalhador e humanização no trabalho: relato das atividades realizadas na atenção primária e secundária / Promotion of worker's health and humanization at work: report of activities performed in primary and secondary care

Os objetivos deste estudo são: relatar a experiência do desenvolvimento das atividades de sensibilização dos trabalhadores relacionadas à promoção da saúde no ambiente laboral e à humanização no trabalho realizadas em dois serviços de saúde de um município do estado de Minas Gerais e avaliar junto à equipe a realização dessas atividades. As atividades de alongamento, massagens, escalda-pés, dinâmica de grupo e oficina da beleza foram realizadas na atenção primária e secundária. Utilizou-se um questionário e as respostas foram apresentadas por estatística simples. Os trabalhadores avaliaram as atividades como "excelentes"; referiram melhorar o dia de trabalho; sentiram-se valorizados e mais dispostos para o trabalho, além de solicitarem a continuidade de ações de promoção da saúde e humanização no trabalho. Por mais simples que sejam, essas atividades proporcionaram momentos de reflexões e a pausa laboral, tendo em vista a saúde do trabalhador e melhor qualidade de vida no trabalho.

The objectives of this study are: to report the experience of developing awareness activities for workers related to health promotion and humanization at work, carried out in two health services in a municipality in the state of Minas Gerais; and assess with the team these activities. Stretching activities, group dynamics, massages, foot baths, beauty workshop and health promotion were carried out in primary and secondary care. A questionnaire was used and the answers were presented by simple statistics. The workers rated the activities as "excellent"; reported improving their working day; they felt valued and more willing to work, in addition to requesting the continuity of actions to promote health and humanization at work. As simple as they are, these activities provided moments of reflection and a break from work, with a view to the worker's health and better quality of life at work.

Estresse percebido e sofrimento psíquico em gestoresde saúde na pandemia da Covid-19 / Perceived stress and psychic suffering in healthmanagers in the Covid-19 pandemic

Objetivo: analisar o nível de estresse percebido e sofrimento psíquico em gestores de saúde na pandemia da Covid-19. Método: estudo descritivo, transversal com abordagem quantitativa. A coleta ocorreu de abril a setembro de 2021, com 40 gestores de serviço de saúde. Utilizou-se para a coleta de dados um instrumento para caracterização sociodemográfica e ocupacional e as escalas "Perceived Stress Scale-14" e "Self Reporting Questionnaire" para avaliação do estresse percebido e sofrimento psíquico. Os dados coletados foram analisados no Statistical Package for the Social Sciences versão 22.0. O presente estudo faz parte de um projeto intitulado "Trabalhadores dos Serviços de Saúde Frente à Pandemia de Covid-19", aprovado pelo Comitê de Ética em Pesquisa sob CAAE número 35260620.9.0000.5231. Resultados: a maioria dos profissionais eram do sexo feminino (90%, N=36), casados (70%, N=28), com filhos (80%, N=32), com média de idade de 45 anos e com pós--graduação (47,5%, N=19). A média dos escores relacionados ao estresse percebido foi 31,13 pontos (DP=3,77) sendo o mínimo 24 e máximo de 42 pontos. Com relação ao sofrimento psíquico, (40%, N=16) os gestores apresentaram prováveis casos de transtornos. A prática de atividades físicas e de lazer (p<0,05) tem papel importante na diminuição do estresse percebido e do sofrimento psíquico. Conclusão: os gestores em saúde apresentaram, durante a pandemia, estresse e sofrimento psíquico, resultados esses que devem ser considerados para promoção de autocuidado aos gestores de saúde, enfatizando a necessidade da realização de atividades físicas e de lazer.

Objective: to analyze the level of perceived stress and psychological suffering in health managers during the Covid-19 pandemic. Method: descriptive, cross-sectional study with a quantitative approach. The collection took place from April to September 2021, with 40 health service managers. An instrument for socio-demographic and occupational characterization and the "Perceived Stress Scale-14" and "Self Reporting Questionnaire" scales were used for the assessment of perceived stress and psychic suffering. The collected data were analyzed using the Statistical Package for the Social Sciences version 22.0. The present study is part of a project entitled "Health Service Workers in the Face of the Covid-19 Pandemic", approved by the Research Ethics Committee under CAAE number 35260620.9.0000.5231. Results: most professionals were female (90%, N=36), married (70%, N=28), with children (80%, N=32), with a mean age of 45 years and with a postgraduate degree. -graduation (47.5%, N=19). The average score related to perceived stress was 31.13 points (SD=3.77), with a minimum of 24 and a maximum of 42 points. With regard to psychic suffering, (40%, N=16) the managers presented probable cases of disorders. The practice of physical and leisure activities (p<0.05) plays an important role in reducing perceived stress and psychological distress. Conclusion: health managers presented, during the pandemic, stress and psychic suffering, results that should be considered for promoting self-care to health managers, emphasizing the need to carry out physical and leisure activities.Keywords: Health manager; Occupational stress; Covid-19; Coronavirus infections.

Mind the glass ceiling: The gender gap in how depressive symptoms after age 55 relate to earlier career mobility in CONSTANCES.

A substantial body of research has shown an association between career mobility and mental health in later life through health selection and causal processes, with favourable health outcomes associated with upward mobility. However, gender differences in these associations have been largely overlooked, despite evidence of gender inequalities in career opportunities. We use data on individuals aged 55-69 from the CONSTANCES cohort. We examine their current mental health and career trajectories between ages 20-55, reconstructed through a retrospective questionnaire. Using sequence analysis, we identify 11 types of past occupational mobility (upward, downward, stagnant) across a gradient from unskilled to high-skilled occupations. We use nested logistic regression to assess their association with depressive symptoms (CES-D) in men and women separately, controlling for socio-demographic variables and occupational hazards. For both men and women, depressive symptoms are strongly associated with careers involving unskilled jobs, with no difference between directions of mobility. For men, upward mobility into skilled or high-skilled jobs is associated with fewer depressive symptoms compared to a stagnant career. This is not the case for women, for whom upward career mobility to high-skilled jobs is associated with more depressive symptoms compared to stagnation at origin. Our findings show a gendered relationship between mental health in later life and past career mobility and highlight the mental health issues faced by women who break through the glass ceiling. They call for further research into the circumstances of women's careers that challenge their mental health in later life.

Thyroid scintigraphy of healthy cats using small-field-of-view gamma cameras.

Introduction: Small-field-of-view (SFOV) gamma cameras can offer higher sensitivities than conventional gamma cameras. However, there are currently no reports on the efficacy and safety of thyroid scintigraphy using SFOV gamma cameras in veterinary medicine. Therefore, we aimed to evaluate the efficacy and radiation safety of an SFOV gamma camera for feline thyroid scintigraphy. Materials and methods: Three veterinary staff members (operator, staff 1, and staff 2) performed thyroid scintigraphy on 10 healthy cats in this study. The operator administered either 2 or 4 mCi of technetium-99m pertechnetate (99mTcO- 4) through the cephalic vein. At 20, 40, and 60 min after injection, thyroid images were obtained using a SFOV gamma camera under various acquisition conditions (100,000, 150,000, and 200,000 counts and 30 and 60 s). Thyroid scintigraphy images were analyzed by calculating the thyroid-to-salivary ratios (TSR) and thyroid-to-background ratios (TBR). Surface and ambient radiation were measured hourly from immediately after injection to 6 h. The cumulative occupational radiation doses were measured during the procedure. Results: The TSR and TBR median values aligned with the previously reported normal range obtained using a large-field-of-view gamma camera. There were no notable differences in TSR and TBR between the two doses of 99mTcO- 4, nor across acquisition conditions and timelines. The 4-mCi group consistently emitted more ambient (p < 0.05) and surface (p < 0.05) radiation than did the 2-mCi group. Staff 1 consistently received higher cumulative radiation doses than did staff 2 and the operator (p < 0.05). Conclusion: The SFOV gamma camera demonstrated adequate image quality for thyroid scintigraphy in healthy cats even with relatively low doses and short acquisition conditions. Radiation exposure during the procedure posed minimal safety concerns. Therefore, the SFOV gamma camera could be a valuable tool for evaluating thyroid glands in cats.

Redeployment experiences of healthcare workers in the UK during COVID-19: a cross-sectional analysis from the nationwide UK-REACH study.

Objectives: To assess how ethnicity, migration status and occupation are associated with healthcare workers (HCW) redeployment experiences during COVID-19 in a nationwide ethnically diverse sample. Design: A cross-sectional analysis using data from the nationwide United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort study. Setting: Healthcare settings. Participants: Healthcare workers (HCW). Main Outcome Measures: Outcome measures included redeployment, provision of training and supervision during redeployment, change in patient contact and interaction with COVID-19 patients. Methods: We used logistic regression to examine associations of ethnicity, migration status, and occupation with redeployment experiences of HCWs. Results: Of the 10,889 HCWs included, 20.4% reported being redeployed during the first UK national lockdown in March 2020. Those in nursing roles (Odds Ratio (OR) 1.22, 95% Confidence Interval (CI) 1.04-1.42, p = 0.009) (compared to medical roles) had higher likelihood of being redeployed as did migrants compared to those born in the UK (OR 1.26, 95% CI 1.06-1.49, p = 0.01) (in a subcohort of HCWs on the agenda for change (AfC) pay scales). Asian HCWs were less likely to report receiving training (OR 0.66, 95% CI 0.50-0.88, p = 0.005) and Black HCWs (OR 2.02, 95% CI 1.14-3.57, p = 0.02) were more likely to report receiving supervision, compared to White colleagues. Finally, redeployed Black (OR 1.33, 95% CI 1.07-1.66, p = 0.009) and Asian HCWs (OR 1.30, 95% CI 1.14-1.48, p < 0.001) were more likely to report face-to-face interaction with COVID-19 patients than White HCWs. Conclusions: Our findings highlight disparities in HCWs' redeployment experiences by ethnicity, migration, and job role which are potentially related to structural inequalities in healthcare.

Musculoskeletal disorders and quality of life of artisanal fishermen from riverside localities in the Brazilian Amazon.

BACKGROUND: Artisanal fishing is widely practiced in the Amazon region. However, the exhaustive labor demand impacts on the health of fishermen. Thus, this study aimed to evaluate the prevalence of musculoskeletal disorders (MSDs) and the relationship with the quality of life (QoL) of artisanal fishermen. METHODS: A cross-sectional study was carried out, evaluating male fishermen from two rural communities bordering Janauacá lake, Amazonas. Data were collected through interviews, using REDCap installed on smartphones. The Nordic Musculoskeletal Questionnaire was utilized to identify the body regions with the greatest pain complaints, and QoL was assessed using the mental and physical components of the SF-12. After the descriptive analysis, linear regression analysis was performed to evaluate the association between the occurrence of MSDs and the components of QoL. The analyses were performed using Stata SE software, version 17. RESULTS: In total, 115 fishermen were evaluated. MSDs were reported in all of the body regions assessed, with a higher prevalence in the lower (80.0%) and upper (43.5%) back, and knee (40.9%). Lower QoL scores were observed in emotional performance (20.7 ± 4.0), physical performance (25.1 ± 4.3), and mental health (29.0 ± 13.6). It was observed that individuals with any MSD presented worse QoL in the physical component (ßadj=-5.0; 95%CI=-9.7; -0.3). CONCLUSION: The findings showed a high prevalence of MSDs in the study population, as well as its impact on the QoL of artisanal fishermen. This highlights the need to reorganize health services to prevent the occurrence of MSDs, as well as for their treatment and rehabilitation.

Practical considerations for using personal cooling garments for heat stress management in physically demanding occupations: A systematic review and meta-analysis using realist evaluation.

INTRODUCTION: Due to rising temperature extremes, workplaces are seeking new solutions, such as using personal cooling garments (PCG) to mitigate and manage workplace heat exposure. This systematic review sought to assess the physiological and perceptual effects of PCGs on workers in standard work clothing performing moderate-to-heavy intensity tasks in hot environments. METHODS: A peer-reviewed search strategy was conducted in MEDLINE, Embase, CINAHL, Scopus, Global Health, and Business Source Complete with no language or time limits. A meta-analysis using a realist evaluation framework was then performed to evaluate the effectiveness of the PCGs. RESULTS: Thirty-three studies with 764 participants (98% male; average 21 ± 34 participants per study), conducted primarily in a laboratory setting (76%) were included. The studies were 193 ± 190 min in duration and consisted of a moderate-to-heavy work effort of 3.3 ± 1.0 METs in hot ambient conditions (temperature: 35.9 ± 3.3°C, 51.4 ± 12.1% relative humidity, wet bulb globe temperature [WBGT] 31.2 ± 2.6°C). The PCGs (n = 67) facilitated heat exchange through conduction (n = 39), evaporation (n = 4), convection (n = 2), radiation (n = 2), or hybrid combinations (n = 20). Conductive and hybrid PCGs offered the greatest thermoregulatory benefit, whereby core temperature (Tc) and heart rate (HR) reductions were consistently observed (Conductive: Tc: -0.3°C, HR: -12 bpm; Hybrid: Tc::-0.2°C, HR: -10 bpm), while PCGs directed at enhancing evaporative and radiative heat exchange had no or minimal effect on the physiological outcomes assessed (i.e., TC < 0.1°C, HR: <0.7 bpm). CONCLUSION: While the PCGs had a positive overall effect, conductive options offered the most consistent benefit to workers. WBGT, clothing insulation, and duration of wear significantly affected some physiological and perceptual outcomes.

Participation as Co-Occupation Between Parents and Adult Children With Profound Intellectual and Multiple Disabilities.

Adults with profound intellectual and multiple disabilities (PIMD) require high levels of assistance to participate in occupations. Otherwise, they experience low occupational engagement. This study aimed to explore how parents describe participation in occupations for their adult children with PIMD. Semi-structured interviews (n = 9) were conducted to understand how parents described their adult children's participation in occupations. Data were analyzed using the theory of co-occupation to identify themes and triangulate findings with the literature. Parents described participation as co-occupation in "essential" versus "non-essential" occupations. Participation in essential co-occupations emphasized shared physicality, while non-essential co-occupations focused on joint meaning (shared intentionality) and emotional responses (shared emotionality). Findings illustrate a way to conceptualize participation in essential versus non-essential co-occupations for adults with PIMD, highlight the importance of recognizing and illuminating subjective experiences of adults with PIMD, and provide a foundation for occupational therapists to increase occupational engagement within this population.

Parents Describe How Their Children With Profound Intellectual and Multiple Disabilities Participate in Everyday Activities With Other PeopleWhy was this study done? This study was done to learn about how people with profound intellectual and multiple disabilities (PIMD) participate in everyday activities. We know that these people need help and do not participate in activities as much as others. We must understand more to increase their opportunities for meaningful activities. What did the researchers do? The researcher talked to 10 parents about their 9 adult children with PIMD. The researcher asked questions about how the adult children participated in daily activities. The research team compared what the parents said and found similar themes. What did the researchers find? Parents said that their children with disabilities participated in activities as co-occupation, which means they needed someone else to do the activities with them. The parents described participation differently if the activity was essential or non-essential. Essential activities are things we need to do to stay alive and healthy. Non-essential activities are those that increase social or mental well-being. If the activity was essential, such as getting dressed, the parents mostly talked about the physical interactions. If the activity was non-essential, such as playing, the parents talked mostly about emotions and reasons for doing the activity. What do the findings mean? People with PIMD participate in activities as co-occupation. The type of help they need depends on the activity. It is also important to recognize all forms of expression when observing participation and figuring out what is meaningful to someone with physical disabilities. Occupational therapists can use this information to increase participation in meaningful activity for adults with PIMD and their caregivers. Future research should include observations and explore sibling's perspectives across different races and cultures.

Roles Caregivers Take on in Pediatric Rehabilitation Telehealth Services: A Scoping Review.

BACKGROUND: Caregivers and children continue to use pediatric rehabilitation telehealth services (PRTS) post-pandemic. Understanding how caregivers support children during PRTS can help us fully integrate caregivers for positive outcomes. This scoping review describes the roles caregivers take on during PRTS. METHODS: We searched MEDLINE, CINAHL, PsycINFO, and ERIC for research published January 2005 to July 2023. We included English articles on the effect of PRTS. We excluded qualitative and non-peer-reviewed literature. RESULTS: Thirty-four articles met inclusion criteria. Caregivers were gatekeepers, technicians, implementers, trainees, collaborators, telehealth consumers, and supervisors in PRTS. Caregivers took on roles throughout PRTS, and roles varied by type of PRTS delivered. CONCLUSIONS: Caregivers take on multiple roles to support children during PRTS. Our results can inform clinical decisions about how to integrate and support caregivers in PRTS. Future research should explore strategies that support caregiver role taking to maximize caregiver involvement and outcomes in PRTS.

The Roles Caregivers Play to Support Their Children During Pediatric Telehealth ServicesCaregivers and children continue to use telehealth services because they are convenient for busy family schedules and result in positive child outcomes. Since caregivers impact how children participate in therapy and the goals they achieve, we need to understand what caregivers do to support their children during telehealth interventions. Therefore, we reviewed published articles on telehealth services for children to describe the roles caregivers play during telehealth interventions. We searched medical, health, psychology, and education databases for articles published between January 2005 and July 2023. We included articles written in English that reported the results of telehealth services for children. We excluded articles that reported caregiver perceptions of telehealth services for children because those articles described how caregivers participated in interviews or focus groups, not the telehealth intervention. Thirty-four articles were included in this review. Caregivers shared information with providers and made decisions for the family (gatekeepers), managed telehealth technologies (technicians), participated in formal training to learn interventions (trainees), carried out the interventions (implementers), worked with providers to identify challenges and solutions (collaborators), accessed and engaged with telehealth technology to complete the intervention (telehealth consumers), and watched over child during sessions for safety (supervisors). Caregivers took on roles before, during, and after the telehealth intervention. The roles they played varied by the type of telehealth intervention provided. Our results can help occupational therapy practitioners (OTPs) make decisions about the best ways to involve caregivers in telehealth services for children. Future research should explore factors and strategies that support caregivers as they take on roles during telehealth services for children.

The responsiveness and clinical utility of the Australian therapy outcome measure for indigenous clients.

INTRODUCTION: The Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC) is a goal-setting tool designed to measure therapy outcomes with First Australians. It was originally developed and validated for use with First Australian children as a culturally responsive alternative to traditional western outcome measures. This research explored the applicability, responsiveness and clinical utility of the ATOMIC when used with First Australian adults attending an urban health service. METHODS: Separate parallel studies investigated responsiveness and clinical utility. The first employed quantitative methods to investigate change over time via pre- and post-intervention data. The second employed a qualitative phenomenological approach to determine the clinical utility of the tool. Semi-structured interviews and focus groups were used, respectively, to understand the experience of using the ATOMIC from a client and clinician perspective. Client perspectives on the purpose of the tool and its alignment with their views on health care and therapists' perspective on the ease of use and applicability of the tool to the health service setting were explored. These data were analysed using reflexive thematic analysis. CONSUMER AND COMMUNITY CONSULTATION: The methodological approach followed National Health and Medical Research Council (NHMRC, 2018) guidelines in considering cultural continuity, reciprocity and equity. This project was initiated and guided by Aboriginal and Torres Strait Islander leaders (the advisory group) as a prioritised need for a robust way of reporting outcomes to complement existing statistical and narrative data within a large community-controlled health service. The advisory group provided high level governance from project conception to conclusion and were involved in yarn-backs about research findings. RESULTS: Responsiveness: Wilcoxon test showed a statistically significant increase (P = 0.00) in ATOMIC scores pre- (mean = 1.8) and post- (mean = 8) intervention. Effect size (Cohen d) was deemed significant calculated at 2.1. CLINICAL UTILITY: Findings included: First Australian clients are adept at self-managing their conditions; the ATOMIC is a clinically useful outcome measure, which reflects this; ATOMIC is an acceptable tool to First Australian clients and clinicians and supports culturally responsive goal setting and occupational therapy practice. PLAIN LANGUAGE SUMMARY: The Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC) was created to measure how well therapy works for First Australian children. This research investigates whether it also works with adult First Australians. Two studies were undertaken: a quantitative study to see whether ATOMIC scores changed before and after therapy and a qualitative study, which asked people what they thought about using the ATOMIC. ATOMIC scores went up after therapy, indicating it is sensitive to change, and both clients and therapists liked using the ATOMIC and found it useful. It matched well with how First Australian adults see health care and helped set goals for therapy. The results of the study show that the ATOMIC is helpful for both clients and therapists in understanding how well therapy works and helps to set goals that make sense culturally. This study looked at one health service in one regional area, so more research is needed to establish whether it works elsewhere. Overall, the results indicate the ATOMIC is a promising step towards better therapy for Indigenous Australians.

Occupational Therapy Research Publications From 2001 to 2020 in PubMed: Trends and Comparative Analysis with Physiotherapy and Rehabilitation.

A limited understanding of trends in occupational therapy (OT) research publications exists. This study aimed to evaluate trends in OT research publications, in PubMed (2001-2020), compared to physiotherapy and rehabilitation. A method of secondary analysis of publication trends in the PubMed database was used. Medical subject headings for OT, physiotherapy, and rehabilitation were combined with search filters (e.g., population age, study design, and OT practice area). Linear regressions were computed to analyze changes in yearly growth. OT research publications increased by 5.86 per year and comprised less than 2.5% of rehabilitation research publications yearly. Knowledge synthesis was the predominant OT study design (2.94% yearly increase; p < .001). Intellectual/cognitive conditions and emergent practice areas in OT research publications increased over time (both p = .007). OT research publications were relatively evenly distributed across population age. OT research publications are increasing over time but lag relative to physiotherapy and rehabilitation broadly. Our findings may inform future OT research priorities.

Analyzing how occupational therapy research studies changed over 20 yearsOccupational therapy (OT) is a health care field that helps individuals and communities do what they need to, want to, and would like to do. Occupational therapy services may be provided to people with emotional concerns, brain disorders, or physical health concerns. To date, we do not fully know what types of OT research studies are published in PubMed, a database of health-related research publications. Nor do we know what people or groups are included in these studies, or how the methods and topics of these research papers change over time. We conducted this study to better understand how OT research papers change over time. We also wanted to know how OT research papers changed compared to physiotherapy and rehabilitation research papers. To do this, we looked at the trends in each of OT, physiotherapy, and rehabilitation research papers from 2001 to 2020. In our study, we found that each year, there are six more OT research papers than the year before. Although OT research papers are growing by six per year, physiotherapy research papers are growing by 173 per year and rehabilitation papers are growing by 292 per year. So, OT papers make up a small number of rehabilitation-related publications. OT research papers are relatively evenly distributed across age ranges (<18, 18­65, >65 years). However, physiotherapy and rehabilitation have more papers in the 18- to 65-year age group than in the younger or older age groups. In the past, OT research focused on children and individuals and groups with physical health needs, such as for their bones or muscles. In recent years, more OT research papers address other issues, such as people who have some difficulties with their brain. Our research helped to understand the landscape of OT.

Saudi Radiology Technologists' Perception of Occupational Hazards from a Personal and Social Lens.

Background: Occupational hazards among healthcare workers (HCWs) present serious risks, from infectious diseases to physical and chemical dangers, along with psychological stress, all of which threaten their health and safety. This study aims to identify the unique challenges and hazards encountered by radiology technologists in in Saudi Arabia by assessing the key factors contributing to these risks. Methods: A descriptive questionnaire study was conducted in January-February 2023, targeting 75 radiology technologists at King Abdulaziz Medical City (KAMC), Jeddah, with participants recruited via non-probability convenience sampling and invited to complete a widely recognized questionnaire previously used among radiographers. Descriptive statistics were calculated, and the Kruskal-Wallis H-test was conducted to examine the relationships between demographic factors and different aspects of occupational hazards. Results: Of the 75 technologists contacted, 63 responded, resulting in an 84% participation rate. Workload, work shifts, and patient-related factors are major contributors to occupational hazards, surpassing technologist-specific and organizational elements. Additionally, 68.3% cited rigid leadership and unequal treatment as aggravating factors, while insufficient staffing, inadequate protective devices, and patient interaction were also significant concerns. Over 60% identified bending, lifting heavy patients, prolonged radiation exposure, and frequent walking as major hazard sources. Conclusion: Key occupational hazards factors facing radiology technologists include high workloads, work shifts, and patient-related issues, with 68.3% citing rigid leadership and unequal treatment as exacerbating risks. Insufficient staffing and protective devices, along with demanding work conditions, further heighten these hazards. This study emphasizes the need for targeted interventions in staffing, resources, and culture to improve radiology technologists' safety.

Assessment of the microbial contamination in "Do It Yourself" (DIY) stores - a holistic approach to protect workers' and consumers' health.

Introduction: In "Do-It-Yourself" (DIY) stores, workers from the wood department are considered woodworkers. Given the health risks associated with woodworking, particularly from fungi and their metabolites, this study aims to assess microbial contamination and health risks for both workers and customers. Methods: The study was developed in 13 DIY stores in Lisbon Metropolitan Area, Portugal. It employed a comprehensive sampling approach combining active (MAS-100, Andersen six-stage, Coriolis µ, and SKC Button Aerosol Sampler) and passive (electrostatic dust collectors, surface swabs, e-cloths, settled dust, filters from vacuumed dust, filtering respiratory protection devices, and mechanical protection gloves) methods to assess microbial contamination. A Lighthouse Handheld Particle Counter HH3016- IAQ was used to monitor the particulate matter size, temperature, and humidity. Results: The wood exhibition area presented the highest fungal load, while the payment area exhibited the highest bacterial load. MAS-100 detected the highest fungal load, and surface swabs had the highest bacterial load. Penicillium sp. was the most frequently observed fungal species, followed by Aspergillus sp. Mycotoxins, namely mycophenolic acid, griseofulvin, and aflatoxin G1, were detected in settled dust samples and one filter from the vacuum cleaner from the wood exhibition area. Cytotoxicity evaluation indicates the wood-cutting area has the highest cytotoxic potential. Correlation analysis highlights relationships between fungal contamination and particle size and biodiversity differences among sampling methods. Discussion: The comprehensive approach applied, integrating numerous sampling methods and laboratory assays, facilitated a thorough holistic analysis of this specific environment, enabling Occupational and Public Health Services to prioritize interventions for accurate exposure assessment and detailed risk management.

Exploring geriatric assessment-driven rehabilitation referral patterns and its influence on functional outcomes and survival in older adults with advanced cancer.

BACKGROUND: Older adults with advanced cancer experience functional disability that warrants rehabilitation services; however, evidence indicates inconsistencies in referral. The purpose was to (1) identify predictors of geriatric assessment (GA)-driven referrals to rehabilitation services and (2) explore associations between referral and change in function, health-related quality of life (HRQoL), and overall survival among older adults with advanced cancer. METHODS: This was a secondary analysis (NCT020107443, UG1CA189961) of a nationwide GA clinical trial. Patients were older adults with advanced cancer who had at least one GA-defined physical performance or functional status impairment. Primary outcomes were oncologist-initiated discussion about or referral to rehabilitation services after the GA (Aim 1) and decline in activities of daily living (ADL), Instrumental ADL (IADL), and HRQoL within 3 months, and overall survival at 1 year (Exploratory Aims). Analyses included multivariable logistic regression and Cox proportional hazards models. Demographic and clinical factors were controlled for by using 1:1 propensity score matching. RESULTS: In total 265 patients were analyzed. After adjustment, impaired cognition (odds ratio [OR] = 2.25, p = 0.01), Karnofsky score indicating disability (OR = 2.86, p < 0.01), and receipt of monoclonal antibodies (OR = 1.95, p = 0.04) were associated with higher odds of referral. In contrast, polypharmacy was associated with lower odds of referral (OR = 0.31, p < 0.01). Referred patients were less likely to decline in ADL (OR 0.30, p = 0.07) and IADL (OR 0.64, p = 0.35), but more likely to decline in HRQoL (OR 1.20, p = 0.67) and have worse survival (HR 1.18, p = 0.62). CONCLUSIONS: Cancer treatment, polypharmacy, cognition, and disability status likely influence oncologists' decision to refer for rehabilitation. Referral was not independently associated with change in functional disability, HRQoL, or survival. Future studies should evaluate patients' utilization of rehabilitation services post-referral and determine whether dose/timing of rehabilitation services influence clinical outcomes.

Environmental pollution and cancer.

OBJECTIVE: To identify and describe pollutants with carcinogenic potential that contaminate indoor and outdoor air, food and soil. DATA SOURCE: The descriptors environmental pollutants, occupational cancer, prevention and soil pollutants were used to conduct the research for literature review. Articles published from 2003 to 2024 in the electronic databases Pubmed Medline, Lilacs and Scielo, in Portuguese and English, were included. SUMMARY OF FINDINGS: There are multiple sources of pollution in the external and internal environments, including motor vehicles, industrial facilities, smoke from tobacco products, agricultural activities, fires and domestic combustion devices. The most important pollutants related to chemical substances include all forms of asbestos, benzene, exhaust gases from gasoline engines, food and water contaminants, such as arsenic and inorganic arsenic compounds, in addition to persistent organic pollutants, such as dioxins. The use of fossil fuels and biomass for domestic heating are also important sources of pollution. The carcinogenic potential of pollutants varies according to the sources of pollution, climate conditions and the region's topography. CONCLUSIONS: Global environmental pollution is an international public health problem with multiple health effects. Many environmental pollutants are proven to be carcinogenic to adults, while few causes have been scientifically established for children. Pollution is mainly caused by uncontrolled urbanization and industrialization. Preventing environmental exposure to carcinogenic pollutants requires both government regulation and community action and commitment.

Percivall Pott (1713-1788): Father of Orthopaedics and Pioneer of Occupational Medicine.

Percivall Pott was an eighteenth-century English surgeon best known for three eponymous diseases: Pott's fracture, Pott's puffy tumour and Pott's disease of the spine. He wrote extensively, with treatises covering a wide range of surgical subjects, including cataracts, cranial trauma, hernias and neurology. Pott's practice came at a time when surgery was being transformed from the work of barbers into a scientific study. His publications had a wide-reaching impact, influencing contemporary practice and setting out building blocks for the work of those who came after him. This article aims to explore the life and career of Percivall Pott, looking in particular at his influence on the subjects of orthopaedics and occupational medicine.