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INTRODUCTION: The SARS-CoV-2/Covid-19 pandemic is a challenge for public health and occupational medicine and developing prevention and protection strategies needs expertise from many disciplines. To make prevention successful, individuals have to be motivated to participate and, in turn, motivation depends on understanding how and why prevention measures are implemented. We present a structured approach (the Cycle of prevention) which involves different stakeholders and perspectives to develop, and monitor, prevention strategies in transparent and effective ways.
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COVID-19 , Saúde Ocupacional , Humanos , Pandemias , Equipe de Assistência ao Paciente , SARS-CoV-2RESUMO
Nowadays, the roots of left-hand traffic (LHT) and right-hand traffic (RHT) - including fighting on horse-back and whipping horses that are drawing carriages - are at an all-time low; thus, it is time to assess and appreciate the nexus of road-safety practices and human neurophysiology. We hypothesize that safety of LHT and RHT can be associated with neurophysiology. We summarize scattered empirical research into plausible links between neurophysiological aspects such as handedness, eye movement bias, and hemispheric lateralisation and how safe, in theory, LHT vs. RHT may be for whom. The scarcity and limitations of empirical data into road traffic accidents associated with LHT or RHT are surprising. Even though it was claimed that countries with LHT have lower collision rates than countries with RHT some 50 years ago, we lack informative analyses of traffic accidents in countries with either LHT or RHT which consider plausibly associated neurophysiology. Overall, we predict that LHT (with the driver sitting on the right) is safer than RHT. As 'the rule of the road' and neurophysiology may have important unrecognized "side" effects, we suggest that (and how) this rationale should be tested.
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Acidentes de Trânsito , Lateralidade Funcional , Veículos Automotores , Neurofisiologia , Planejamento Ambiental , HumanosRESUMO
OBJECTIVES: In 2007, the International Agency for Research on Cancer classified shift work involving circadian disruption (CD) as probably carcinogenic to humans. Circadian disruption could be conceptualised as the overlap of activity, such as work, with an individual's biological night. The latter can be approximated from a worker's chronotype (or morning/evening preference). Few previous studies have taken chronotype into account when assessing CD caused by shift work. Our objective was to test the hypothesis that women working during their biological night would be at increased risk of breast cancer. METHODS: We used data from our case-control study of breast cancer to investigate associations between shift work involving CD and breast cancer risks. Previously, we had assumed that everyone working in jobs which involved work for two or more shifts between midnight and 05:00 hours was equally exposed to CD. In the present analyses, we reclassified as unexposed those who had a late chronotype in which their preferred bedtime was 2 hours after the end of their shift. RESULTS: Only 30 of 1385 night jobs changed classification and the overall finding (OR 1.17, 95% CI 0.98 to 1.41) was not different to the original finding when chronotype was not considered. CONCLUSIONS: We found virtually no difference between our new and old classifications of exposure. However, we were not able to calculate the total number of chronodisrupted shifts over a lifetime in order to assess dose and nor were we able to determine how many women were exposed to CD when doing shifts which began before midnight. Our first practical application highlights challenges for future chronobiology-based research.
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Neoplasias da Mama/etiologia , Doenças Profissionais/etiologia , Jornada de Trabalho em Turnos/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Ritmo Circadiano , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Sistema de Registros , Fatores de Risco , Jornada de Trabalho em Turnos/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
A Cochrane 2016 review indicated cycled light might benefit neonatal health in hospital. We systematically reviewed chronobiological factors for neonatal health in hospital units, identifying 56 relevant studies on light-dark cycles, feeding, noise, massage therapy, rooming-in, incubators vs. cribs, neonatal units vs. homes, and time-of-day of birth. Empirical evidence for benefits from chronobiology is weaker than expected, including light. Mechanisms of clinical benefits are unclear (e.g., changes to sleep/activity vs. other circadian-regulated processes). Regarding light, studies concerning sleep and circadian-related outcomes predominate; yet, neonatologists may be more interested in weight gain and time spent in hospital. Generalisability of findings is limited as most studies targeted neonates in stable condition and without congenital anomalies. Further research is needed, in particular concerning potential circadian entraining signals such as timing of meals or medications. Longer-term outcomes (regarding e.g., neurodevelopment and infection), and who may be at risk from time-of-day of birth effects and why remain to be explored. Overall, there is promise and ample scope for research into how chronobiological factors affect health in hospitalised neonates.
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Ritmo Circadiano , Unidades de Terapia Intensiva Neonatal , Recém-Nascido , Humanos , Fotoperíodo , Sono , Aumento de PesoRESUMO
Placement and removal of central venous catheters (CVC) are routine procedures in anesthesiology and on the intensive care unit. There are numerous possible complications associated with those interventions. Here, we report on a patient who developed respiratory failure immediately after removal of a CVC. The proof of air bubbles in echocardiography confirmed the diagnosis of air embolism. In this article we describe causes, symptoms and therapy of air embolism.
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Cateterismo Venoso Central/efeitos adversos , Cateteres Venosos Centrais/efeitos adversos , Remoção de Dispositivo/efeitos adversos , Embolia Aérea/etiologia , Embolia Aérea/terapia , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Adulto , Embolia Aérea/diagnóstico , Feminino , Humanos , Insuficiência Respiratória/diagnóstico , Resultado do TratamentoRESUMO
Posters are important vectors for science. During the pandemic, poster presentations via virtual platforms came to the fore due to necessary online conferences. For the post-pandemic era, we offer approaches for poster presenters and session organizers at modern, more sustainable conferences, which can be in-person, online, or combined (hybrid) formats.
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BACKGROUND: Many systematic reviews identify support animals or animal assisted activity as a beneficial and standard practice in several medical disciplines for patients (children, adolescents, and adults) and residents in care homes. A variety of animals are used such as dogs, cats, ponies, horses, alpacas, reindeer, penguins, rabbits, and tarantulas. Our objective was to explore the evidence regarding effects of animal assisted activity on a further population of interest; namely, healthcare staff. METHODS: We asked the question "how do support animals in healthcare settings affect the well-being of healthcare staff?" As an addendum, we were also interested in what - possibly more unique - animals have visited healthcare settings at Christmas time in particular. We conducted a scoping literature review using PubMed and Web of Science (search as of 26 April 2023). RESULTS: Twenty studies (in the USA, Australia, Europe; dogs: n = 19; cats: n = 1) since 2002 included: studies with biological measures (n = 3), longitudinal survey studies with analyses (n = 5), cross-sectional survey studies with analyses (n = 2), and cross-sectional survey studies with descriptive statistics (n = 10). Overall, animal assisted activities appear to be well-received by staff and there do not seem to be negative impacts on staff well-being. CONCLUSIONS: Relevant positive effects and avenues of research are identified. Our review suggests that, but not exactly how, animal assisted activity benefits staff. Study evidence is limited with most studies being cross-sectional, descriptive, having low participant numbers, and mostly only involving dogs. Nonetheless, the evidence is mostly positive. The potential of animal assisted activities impacting positively on staff well-being warrants systematic research. Gaps in hard-fact-evidence should not deter us - especially at the festive season - to encourage work with, and systematic research regarding, support animals that provide warmth, empathy, comfort, and more in healthcare settings.
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OBJECTIVE: To complement the 2020 ANZJPH editorial "How COVID-safe Santa can save Christmas". In addition to a concise update regarding SARS-CoV-2/COVID-19, we aimed to explore some risks of Christmas in terms of adverse health effects, which we call 'Chrishaps'. Our overall study question was "which hazards have been scientifically associated with old Christmas essentials such as decoration, gifts, menus, and Santa himself, as well as new challenges associated with COVID-19?" METHOD: We searched the PubMed, Web of Science, and Open Grey databases systematically and Google unsystematically. RESULTS: Thirty-six pertinent articles - most of them case reports or retrospective analyses - documented Chrishaps. CONCLUSION: Overall results suggested that Chrishaps come in different shapes and guises. Implications for public health: Chrishaps pose a potential minor public health threat that should be borne in mind every festive season. Assessing and discussing specific public health implications of Chrishaps requires systematic risk research to be conducted.
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COVID-19 , Humanos , Saúde Pública , Estudos Retrospectivos , SARS-CoV-2RESUMO
A historical Christmas card connecting two pioneers of modern chronobiology (Colin Pittendrigh and Jürgen Aschoff) brings together key evolutionary facets of the field at Christmas time. The importance of the field to physiology and medicine is conveyed by the Nobel Prize award in 2017 for discoveries of how body clocks facilitate the temporal organization of physiology across days and nights. Temporal organization can have relevance for dietary Christmas excesses and dietary New Year resolutions. Herein, we examine how diet around Christmas and New Year has been targeted in human health research and we examine published opinion on dietary practice concerning Christmas and New Year using a systematized literature review approach. Thereafter, via a selective literature synthesis regarding time-restricted eating, we explore the chronobiological notion that "when" we eat and drink may make differences in terms of whether we experience weight gain and adverse health effects during and after the festive days. Overall, current Christmas eating is typically detrimental to health in terms of "how much" we consume of "what". Regarding New Year's goal-setting, chronobiology-based advice could be considered insofar as "when" we eat may be a healthier and more sustainable nutritional habit alternative. While we need further studies in humans, individual and public health may benefit during and after Christmas by adhering to plausible principles of chrononutrition. That detrimental nutritional excesses over Christmas may encourage individuals to tackle their eating habits should not be left untapped.
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Dieta , Aumento de Peso , Ritmo Circadiano/fisiologia , Comportamento Alimentar , HumanosRESUMO
In June of 2019, a working group convened by the International Agency for Research on Cancer [IARC] concluded that "night shift work" is probably carcinogenic to humans (a Group 2A carcinogen). This was based on sufficient evidence of cancer and strong mechanistic evidence in experimental animals and limited evidence from human epidemiological studies. The biological basis from experimental work is clear and compelling: Disturbed chronobiology such as due to alterations in the light-dark schedule which shift-workers experience is associated with carcinogenicity. But is it correct to assume in epidemiological studies that "night shift work" provides the same dose of disturbed chronobiology to all night workers and that disturbed chronobiology from activities outside of work does not count? Both chronobiological theory and supporting evidence suggest that much-needed future epidemiology should address these questions and should consider disturbed chronobiology in all walks of life.
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A thought experiment places Henry Ford and Thomas Alva Edison in a modern regulatory environment. In a utopian occupational world devoid of night-shifts or artificial light, Ford wants to experiment with "working through the night". To support Ford's project, Edison offers his patented electric lamps to "turn nights into days". An ethics committee [EC] does not approve the night-work experiment and Utopia's Food and Drug Administration [FDA] does not approve the potential medical device as safe for use by humans. According to the EC and FDA, complex effects on circadian biology and thus safety of work and light at night are not understood. The thought experiment conveys that we should pay more attention to possible risks of work and light at chronobiologically unusual times.