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1.
Echocardiography ; 41(6): e15860, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38889076

RESUMEN

PURPOSE: Persistent microvascular obstruction (MVO) after successful percutaneous coronary intervention (PCI) in acute ST segment elevation myocardial infarction (STEMI) has been well-described. MVO predicts lack of recovery of left ventricular function and increased mortality. Sonothrombolysis utilizing diagnostic ultrasound induced cavitation of commercially available microbubble contrast has been effective at reducing infarct size and improving left ventricular ejection fraction (LVEF) when performed both pre- and post-PCI. However, the effectiveness of post-PCI sonothrombolysis alone after successful PCI has not been demonstrated. METHODS: A prospective randomized controlled trial was performed in 50 consecutive consenting patients with anterior STEMI who underwent a continuous microbubble infusion immediately following successful PCI. Intermittent high mechanical index (MI) impulses were applied only in the sonthrombolysis group. Delayed enhancement magnetic resonance imaging (MRI) was performed at 48 h and again at 6-8 weeks to assess for differences in infarct size, LVEF, and MVO. RESULTS: There were no differences between groups in age, gender, and cardiovascular risk factors. Significant (> 2 segments) MVO following successful PCI was observed in 66% of patients. Although sonothrombolysis reduced the extent of MVO acutely, there were no differences in infarct size, LVEF, or extent of MVO by MRI at 48 h. Twenty-eight patients returned for a follow up MRI at 6-8 weeks. LVEF improved only in the sonothrombolysis group (∆LVEF 7.81 ± 4.57% with sonothrombolysis vs. 1.77 ± 7.02% for low MI only, p = .011). CONCLUSION: Post-PCI sonothrombolysis had minimal effect on reducing myocardial infarct size but improved left ventricular systolic function in patients with acute anterior wall STEMI.


Asunto(s)
Intervención Coronaria Percutánea , Humanos , Femenino , Masculino , Intervención Coronaria Percutánea/métodos , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , Infarto del Miocardio con Elevación del ST/fisiopatología , Infarto del Miocardio con Elevación del ST/cirugía , Recuperación de la Función , Infarto del Miocardio/fisiopatología , Microburbujas , Ecocardiografía/métodos , Microcirculación/fisiología , Medios de Contraste , Anciano
2.
Clin J Sport Med ; 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38810121

RESUMEN

OBJECTIVE: To compare clinical outcomes following steroid injections using the anterior and posterior approaches. DESIGN: Systematic review with meta-analysis. SETTING: Embase, Web of Science, and Cochrane Center Register of Controlled Trials were searched for randomized control trials (RCTs) and prospective comparative studies. PATIENTS: Patients with adhesive capsulitis. INTERVENTIONS: Glenohumeral steroid injections using either anterior or posterior approach. MAIN OUTCOME MEASURES: Pain visual analog scale (VAS) and shoulder range of motion (ROM) at 12 weeks, accuracy, and adverse events. Standardized mean difference (SMD) for VAS and weighted mean difference (WMD) for ROMs. RESULTS: We identified 6 RCTs and one prospective comparative study with a total of 468 patients. While there was no difference in pain VAS at 12 weeks between the 2 approaches (SMD, -0.86; 95% CI, -1.76 to 0.04), the anterior approach resulted in greater improvements in external rotation (WMD, 8.08; 95% CI, 0.79-15.38) and abduction (WMD, 6.76; 95% CI, 3.05-10.48) compared with the posterior approach. Subgroup analysis with RCTs that utilized steroid injection with hydrodilatation for both approaches demonstrated greater reduction in pain VAS at 12 weeks with the anterior approach (SMD, -0.52; 95% CI, -0.98 to -0.07). Overall, procedures were well tolerated without major complications. CONCLUSIONS: While pain reduction is similar, the anterior approach may be more beneficial in restoring shoulder external rotation and abduction compared with the posterior approach at 12 weeks. Steroid injection combined with hydrodilatation may further improve pain control when performed with the anterior approach at 12 weeks.

3.
J Sleep Res ; 31(4): e13543, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-34967055

RESUMEN

Police officers experience exposures associated with increased inflammation, such as the stress associated with shiftwork and poor-quality diet, both of which have been shown to affect sleep duration and quality. This study examined the longitudinal and cross-sectional effects of the Energy-density Dietary Inflammatory Index (E-DII™) on objectively and subjectively measured sleep among police officers. Data were derived from the Buffalo Cardio-Metabolic Occupational Police Stress Cohort (n = 464 at baseline), with longitudinal data collected from 2004 to 2019. A food frequency questionnaire obtained estimated dietary intake from which E-DII scores were calculated. Dependent variables were objectively (Micro Motion Logger Sleep Watch™) and subjectively (Pittsburgh Sleep Quality Index) measured sleep quality and quantity. The analyses included a series of linear mixed-effects models used to examine cross-sectional and longitudinal associations between the E-DII and sleep quantity and quality. Cross-sectionally, more pro-inflammatory diets were associated with higher wake-after-sleep-onset but improved subjective sleep quality. In models accounting for both longitudinal and cross-sectional effects, for every 1-unit increase in the E-DII scores over time (representing a pro-inflammatory change), wake-after-sleep-onset increased by nearly 1.4 min (p = 0.07). This result was driven by officers who primarily worked day shifts (ß = 3.33, p = 0.01). Conversely, for every 1-unit increase in E-DII score, the Pittsburgh Sleep Quality Index global score improved. More pro-inflammatory diets were associated with increased wake-after-sleep-onset, an objective measure of sleep quality. Intervention studies to reduce dietary inflammatory potential may provide greater magnitude of effect for changes in sleep quality.


Asunto(s)
Estrés Laboral , Trastornos del Sueño-Vigilia , Estudios Transversales , Dieta , Humanos , Inflamación , Policia , Sueño
4.
Behav Sleep Med ; 20(5): 543-555, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34304645

RESUMEN

We examined the association between self-reported sleep quality, sleep duration, and dietary patterns among police officers in the Buffalo Cardio-Metabolic Occupational Stress (BCOPS) study.422 police officers aged 21-74 (2004-2009).We used a cross-sectional study design and obtained sleep quality and duration from responses to the 19-item Pittsburgh Sleep Quality Index. Using 46 energy-adjusted food groups derived from a 125-item food frequency questionnaire, we identified dietary patterns using exploratory factor analysis. Multiple linear regression analysis was used to examine the associations of sleep quality and duration with the derived dietary patterns.We identified major dietary patterns: fruits and vegetables (FV), dairy products, starches and fried foods, and meat and eggs. Individuals with poor sleep quality had a lower average FV score than those with optimal sleep (ß [SE] = -0.32 [0.13]; p = .01). Significant interactions were observed between sex and the FV and dairy products dietary patterns, where women with poor sleep quality had a lower mean FV score compared to women with optimal sleep quality (ß [SE] = -0.81 [0.29]; p = .01). Women with < 6 hours sleep duration had a lower mean dairy score compared to women with ≥ 7 hours sleep duration (ß [SE] = -0.69 [0.29]; p = .02). We did not observe these associations among men.Among women, good sleep quality and long sleep duration were associated with a dietary pattern high in consumption of both fruits and vegetables and dairy products.Abbreviations: BCOPS: Buffalo Cardio-Metabolic Occupational Stress study; BMI: body mass index; FFQ: food frequency questionnaire; FV: fruits and vegetables; KMO: Kaiser-Meyer-Olkin test; MET: metabolic equivalent of task score; PSQI: Pittsburgh Sleep Quality Index questionnaire.


Asunto(s)
Estrés Laboral , Policia , Estudios Transversales , Dieta , Femenino , Humanos , Sueño/fisiología , Calidad del Sueño
5.
Policing ; 45(5): 881-891, 2022 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-37192870

RESUMEN

Purpose ­: The goal of the present study is to determine the proportionate mortality and national rate of duty-related deaths from COVID-19 among US law enforcement officers during the year 2020. Design/methodology/approach ­: Data for the current study were obtained from the National Law Enforcement Officer Memorial Fund (NLEOMF) database for the year 2020. The database contains deaths designated as caused by incidents that occurred while in the line of duty. The chi-square test and two-sample t-test were used to compare characteristics of officers who died of COVID-19 versus other causes of death. Both the proportionate mortality and rates of death were calculated. To compute the rate of death, the authors obtained data on the total number of law enforcement officers employed in the United States (and therefore at risk) for the year 2020 from Bureau of Labor Statistics. Findings ­: COVID-19 deaths (n = 182) accounted for 62% of all duty-related law enforcement officer deaths during 2020. The national rate of death due to COVID-19 (12.8/100,000 per year) for law enforcement officers was higher compared to all other causes of death combined (8.0/100,000 per year). Research limitations/implications ­: A limitation of the study is the uncertainty of a definitive assessment that the viral infection was acquired through work (versus at home or other non-work-related community settings). Although highly unlikely, deaths designated as duty related entail financial benefits for the survivors and may be a potential source of bias. Given the complexity of personal exposures, the percentage of COVID-19 deaths attributed to duty may represent an over or under estimation of the actual value. Therefore, the data should be interpreted cautiously. Practical implications ­: These findings provide police organizations with information needed to understand the risk of death among officers during the COVID-19 pandemic and to make informed decisions about future preparedness strategies. Originality/value ­: There are presently no published scientific studies that examine both the proportionate mortality and national rate of death from COVID-19 among law enforcement officers for the year 2020.

6.
Policing ; 44(2): 200-212, 2021 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-34093068

RESUMEN

PURPOSE ­: To characterize changes in work hours across a career in law enforcement. DESIGN/METHODOLOGY/APPROACH ­: N = 113 police officers enrolled in the BCOPS cohort were studied. The police officers started their careers in law enforcement between 1994 and 2001 at a mid-sized, unionized police department in northwestern New York and continued to work at this police department for at least 15 years. Day-by-day work history records were obtained from the payroll department. Work hours, leave hours and other pay types were summarized for each calendar year across their first 15 years of employment. Linear mixed-effects models with a random intercept over subject were used to determine if there were significant changes in pay types over time. FINDINGS ­: A total of 1,617 individual-years of data were analyzed. As the police officers gained seniority at the department, they worked fewer hours and fewer night shifts. Total paid hours did not significantly change due to seniority-based increases in vacation time. Night shift work was increasingly in the form of overtime as officers gained seniority. Overtime was more prevalent at the beginning of a career and after a promotion from police officer to detective. ORIGINALITY/VALUE ­: Shiftwork and long work hours have negative effects on sleep and increase the likelihood of on-duty fatigue and performance impairment. The results suggest that there are different points within a career in law enforcement where issues surrounding shiftwork and long work hours may be more prevalent. This has important implications for predicting fatigue, developing effective countermeasures and measuring fatigue-related costs.

7.
Policing ; 44(6): 1014-1030, 2021 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-35928169

RESUMEN

Purpose ­: The purpose of this study is to examine cross-sectional associations between adverse childhood experiences (ACEs) and mental health among police officers. Design/methodology/approach ­: The sample was from the Buffalo Cardio-Metabolic Occupational Police Stress study data (132 male and 51 female officers). Standardized surveys were administered to participants. Regression coefficients were obtained from models adjusted for age, sex, race and alcohol intake. All statistical tests were performed using a statistical significance level at p < 0.05. Findings ­: Regression analyses showed significant positive associations between ACEs and mental health (Posttraumatic Stress Disorder [PTSD]: ß = 1.70, p < 0.001 and depressive symptoms: ß = 1.29, p < 0.001). Resiliency significantly modified the association between ACEs and PTSD. A positive and significant association was observed among officers with lower resiliency (ß = 2.65, p < 0.001). The association between ACEs and PTSD was stronger among male officers compared to females (ß = 2.66, p < 0.001 vs. ß = 0.59, p ≤ 0.248, respectively). Research limitations/implications ­: Child abuse and development of PTSD or depression could not be traced through time as this was a cross-sectional study. Recall bias may affect results. Practical implications ­: PTSD and depression associated with ACEs can affect the interpretation of threat and can exacerbate emotional regulation in officers. An inquiry should be expanded regarding work assignments of victimized officers, such as child exploitation and pornography investigation. Originality/value ­: There are few studies on ACEs and the mental health of police officers. The present study is among the first to associate multiple police mental health issues with ACEs.

8.
Policing ; 44(6): 1168-1187, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37200948

RESUMEN

Purpose ­: This study is a mortality assessment on police officers (68-years, 1950-2018) and includes all causes of death. Design/methodology/approach ­: The authors investigated 1,853 police deaths (1950-2018) using sources of mortality that included the National Death Index, NY State, and available records from the Buffalo NY police department. Standardized Mortality Ratios were calculated. Death codes were obtained from 8th and 9th International Classification of Disease revisions in accordance with the year of death. Findings ­: Compared to the US general population, white male police officers from 1950-2018 had elevated mortality rates for some causes of death, including diseases of the circulatory system, malignant neoplasms, cirrhosis of the liver, and mental disorders. Black and female officers had lower mortality rates for all causes of death compared to the general population. Research limitations/implications ­: The findings of elevated risk for chronic disease among police need to be studied in relation to stress, lifestyle, and exposure to chemical and physical agents. There is a special need to further study officers from minority populations as larger samples become available. Practical implications ­: The results of this study will provide police and occupational health practitioners with objective evidence to determine the health impact of work on law enforcement officers. Originality/value ­: This study is longest running mortality assessment on police officers ever conducted (1950-2018) and includes white, black, and female officers.

9.
BMC Genomics ; 21(1): 398, 2020 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-32532215

RESUMEN

BACKGROUND: The safety of genetically transformed plants remains a subject of scrutiny. Genomic variants in PRSV resistant transgenic papaya will provide evidence to rationally address such concerns. RESULTS: In this study, a total of more than 74 million Illumina reads for progenitor 'Sunset' were mapped onto transgenic papaya 'SunUp' reference genome. 310,364 single nucleotide polymorphisms (SNPs) and 34,071 small Inserts/deletions (InDels) were detected between 'Sunset' and 'SunUp'. Those variations have an uneven distribution across nine chromosomes in papaya. Only 0.27% of mutations were predicted to be high-impact mutations. ATP-related categories were highly enriched among these high-impact genes. The SNP mutation rate was about 8.4 × 10- 4 per site, comparable with the rate induced by spontaneous mutation over numerous generations. The transition-to-transversion ratio was 1.439 and the predominant mutations were C/G to T/A transitions. A total of 3430 nuclear plastid DNA (NUPT) and 2764 nuclear mitochondrial DNA (NUMT) junction sites have been found in 'SunUp', which is proportionally higher than the predicted total NUPT and NUMT junction sites in 'Sunset' (3346 and 2745, respectively). Among all nuclear organelle DNA (norgDNA) junction sites, 96% of junction sites were shared by 'SunUp' and 'Sunset'. The average identity between 'SunUp' specific norgDNA and corresponding organelle genomes was higher than that of norgDNA shared by 'SunUp' and 'Sunset'. Six 'SunUp' organelle-like borders of transgenic insertions were nearly identical to corresponding sequences in organelle genomes (98.18 ~ 100%). None of the paired-end spans of mapped 'Sunset' reads were elongated by any 'SunUp' transformation plasmid derived inserts. Significant amounts of DNA were transferred from organelles to the nuclear genome during bombardment, including the six flanking sequences of the three transgenic insertions. CONCLUSIONS: Comparative whole-genome analyses between 'SunUp' and 'Sunset' provide a reliable estimate of genome-wide variations and evidence of organelle-to-nucleus transfer of DNA associated with biolistic transformation.


Asunto(s)
Carica/genética , Carica/virología , Resistencia a la Enfermedad/genética , Enfermedades de las Plantas/genética , Enfermedades de las Plantas/virología , Potyvirus , Biolística , Genes de Plantas , Genómica , Mutagénesis Insercional , Plantas Modificadas Genéticamente/genética , Plantas Modificadas Genéticamente/virología , Polimorfismo de Nucleótido Simple , Eliminación de Secuencia , Transformación Genética , Secuenciación Completa del Genoma
10.
Bioconjug Chem ; 31(7): 1745-1749, 2020 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-32515945

RESUMEN

Solid-phase synthesis allowed the rapid generation of a peptide-drug conjugate. A peptide targeting the Thomsen-Friedenreich antigen (TFα) was conjugated to the alkylating subunit of the potent cytotoxin duocarmycin SA. The compound, containing a cathepsin B cleavable linker, was shown to be active and selective against TFα expressing tumor cell lines.


Asunto(s)
Antígenos de Carbohidratos Asociados a Tumores/efectos de los fármacos , Antineoplásicos/farmacología , Duocarmicinas/química , Péptidos/química , Secuencia de Aminoácidos , Antineoplásicos/química , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Humanos
11.
J Sleep Res ; 29(6): e12988, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32049409

RESUMEN

This study investigated the associations of baseline sleep onset latency, wake after sleep onset, longest wake episode, number of awakenings, sleep efficiency and sleep duration with incident hypertension during a 7-year follow-up (n = 161, 68% men) and the joint effect of insufficient sleep and obesity on incident hypertension. Sleep parameters were derived from 15-day actigraphy data. Relative risks and 95% confidence intervals were estimated using a robust Poisson regression model. Each 10-min increase in sleep onset latency was associated with an 89% higher risk of hypertension (95% confidence interval [CI] = 1.12-3.20). Each 10-min increase in longest wake episode was associated with a 23% higher risk of hypertension (95% CI = 1.01-1.50) and each 10% decrease in sleep efficiency was associated with a 50% higher risk of hypertension (95% CI = 1.02-2.22). These associations were independent of demographic and lifestyle characteristics, depressive symptoms, shift work, sleep duration and body mass index. Having <6 hr of sleep and a body mass index ≥30 kg/m2 increased the risk of hypertension (relative risk = 2.81; 95% CI = 1.26-6.25) compared with having ≥6 hr of sleep and a body mass index <30 after controlling for confounders. Relative excess risk due to interaction was 3.49 (95% CI = -1.69-8.68) and ratio of relative risk was 3.21 (95% CI = 0.72-14.26). These results suggest that poor sleep quality is a risk factor for hypertension. Longitudinal studies with larger sample sizes are warranted to examine the joint effect of insufficient sleep and obesity on development of hypertension.


Asunto(s)
Actigrafía/métodos , Hipertensión/etiología , Obesidad/complicaciones , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Adulto , Índice de Masa Corporal , Femenino , Humanos , Estudios Longitudinales , Masculino , Policia , Factores de Riesgo
12.
Inhal Toxicol ; 32(1): 24-38, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-32028803

RESUMEN

Objective: In this study, we compared in vitro and in vivo bioactivity of nitrogen-doped multi-walled carbon nanotubes (NDMWCNT) to MWCNT to test the hypothesis that nitrogen doping would alter bioactivity.Materials and Methods: High-resolution transmission electron microscopy (TEM) confirmed the multilayer structure of MWCNT with an average layer distance of 0.36 nm, which was not altered by nitrogen doping: the nanomaterials had similar widths and lengths. In vitro studies with THP-1 cells and alveolar macrophages from C57BL/6 mice demonstrated that NDMWCNT were less cytotoxic and stimulated less IL-1ß release compared to MWCNT. For in vivo studies, male C57BL/6J mice received a single dose of dispersion medium (DM), 2.5, 10 or 40 µg/mouse of NDMWCNT, or 40 µg/mouse of MWCNT by oropharyngeal aspiration. Animals were euthanized between 1 and 7 days post-exposure for whole lung lavage (WLL) studies.Results and Discussion: NDMWCNT caused time- and dose-dependent pulmonary inflammation. However, it was less than that caused by MWCNT. Activation of the NLRP3 inflammasome was assessed in particle-exposed mice by determining cytokine production in WLL fluid at 1 day post-exposure. Compared to DM-exposed mice, IL-1ß and IL-18 were significantly increased in MWCNT- and NDMWCNT-exposed mice, but the increase caused by NDMWCNT was less than MWCNT. At 56 days post-exposure, histopathology determined lung fibrosis in MWCNT-exposed mice was greater than NDMWCNT-exposed mice.Conclusions: These data indicate nitrogen doping of MWCNT decreases their bioactivity, as reflected with lower in vitro and in vivo toxicity inflammation and lung disease. The lower activation of the NLRP3 inflammasome may be responsible. Abbreviations: NDMWCNT: nitrogen-doped multi-walled carbon nanotubes; MWCNT: multi-walled carbon nanotubes; TEM: transmission electron microscopy; HRTEM: high resolution transmission electron microscopy; IL-1ß: interleukin-1ß; DM: dispersion medium; WLL: whole lung lavage; IL-18: interleukin-18; GSD: geometric standard deviation; XPS: X-ray photoelectron spectroscopy; SEM: standard error of the mean; PMA: phorbol 12-myristate 13-acetate; LPS: lipopolysacharride; LDH: lactate dehydrogenase; AM: alveolar macrophage; PMN: polymorphonuclear leukocyte.


Asunto(s)
Exposición por Inhalación/efectos adversos , Pulmón/efectos de los fármacos , Macrófagos Alveolares/efectos de los fármacos , Nanotubos de Carbono/toxicidad , Nitrógeno/toxicidad , Neumonía/inducido químicamente , Animales , Líquido del Lavado Bronquioalveolar/química , Citocinas/análisis , Relación Dosis-Respuesta a Droga , Humanos , Inflamasomas/inmunología , Inflamasomas/metabolismo , Pulmón/inmunología , Pulmón/patología , Macrófagos Alveolares/inmunología , Macrófagos Alveolares/patología , Masculino , Ratones Endogámicos C57BL , Nanotubos de Carbono/química , Nitrógeno/química , Tamaño de la Partícula , Neumonía/inmunología , Neumonía/patología , Propiedades de Superficie , Células THP-1 , Factores de Tiempo
13.
Am J Ind Med ; 63(4): 348-358, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31845385

RESUMEN

BACKGROUND: Long work hours may be associated with adverse outcomes, including cardiovascular disease. We investigated cross-sectional associations of current work hours with coronary artery calcification (CAC). METHODS: Participants (n = 3046; 54.6% men) were from the Multi-Ethnic Study of Atherosclerosis. The number of hours worked in all jobs was obtained by questionnaire and CAC from computed tomography. The probability of a positive CAC score was modeled using log-binomial regression. Positive scores were modeled using analysis of covariance and linear regression. RESULTS: Sixteen percent of the sample worked over 50 hours per week. The overall geometric mean CAC score was 5.2 ± 10.0; 40% had positive scores. In fully-adjusted models, prevalence ratios were less than 40 hours: 1.00 (confidence interval [CI]: 0.88-1.12), 40:(ref), 41 to 49:1.13 (CI: 0.99-1.30), and ≥50:1.07 (CI: 0.94-1.23) and longer current work hours were not associated with higher mean CAC scores (<40:56.0 [CI: 47.3-66.3], 40:57.8 [CI: 45.6-73.3], 41 to 49:59.2 [CI: 45.2-77.6], ≥50:51.2 [CI: 40.5-64.8]; P = .686). CONCLUSIONS: Current work hours were not independently associated with CAC scores.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedades Profesionales/epidemiología , Admisión y Programación de Personal/estadística & datos numéricos , Factores de Tiempo , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Enfermedades Cardiovasculares/etiología , Enfermedad de la Arteria Coronaria/etiología , Estudios Transversales , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Prevalencia , Análisis de Regresión , Estados Unidos/epidemiología , Tolerancia al Trabajo Programado/fisiología
14.
Policing ; 43(2): 330-344, 2020 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-37207254

RESUMEN

Purpose ­: Law enforcement is a dangerous profession not only due to assaults, accidents and homicides but also due to health risks. This study examined trends in the national frequency and rate of law enforcement jobrelated illness deaths in the United States over a 22-year period (1997-2018). Design/methodology/approach ­: Data were obtained from the National Law Enforcement Officers Memorial Fund (NLEOMF) on death frequencies related to health issues at work. Death rates were based on the total number of police officers in the United States [rate = (frequency/population at risk) × 100,000]. Trends were examined using standardized regression. Findings ­: A total of 646 deaths were attributed to job-related illness. There was a significant upward trend in overall job-related illness deaths (frequency analyses: ß = 0.88, p < 0.0001; rate analyses: ß = 0.82, p ≤ 0.0001) mainly driven by a significant increase in 911 cancer deaths (frequency analyses: ß = 0.88, p < 0.0001; rate analyses: ß = 0.88, p ≤ 0.0001). Nearly 82 percent of circulatory deaths were from a heart attack, with an average death age of 46.5 years. Research limitations/implications ­: Deaths were not included if they failed to meet medical requirements of the NLEOMF. The data are descriptive, do not estimate risk and should be interpreted cautiously. Practical implications ­: Police wellness programs may help to reduce the danger of deaths associated with job-related illness. Originality/value ­: This is among the first studies to examine frequency and rate of police health-related deaths due to job exposures.

15.
Policing ; 43(3): 483-494, 2020 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-34135688

RESUMEN

PURPOSE ­: The purpose of this paper is to assess whether shift work, sleep loss and fatigue are related to short-term unplanned absences in policing. DESIGN/METHODOLOGY/APPROACH ­: N = 367 police officers from the Buffalo Police Department were studied. Day-by-day work and sick leave data were obtained from the payroll. Absenteeism was defined as taking a single sick day on a regularly scheduled workday. Biomathematical models of fatigue (BMMF) predicted officers' sleep-wake behaviors and on-duty fatigue and sleepiness. Prior sleep, fatigue and sleepiness were tested as predictors of absenteeism during the next shift. FINDINGS ­: A total of 513,666 shifts and 4,868 cases of absenteeism were studied. The odds of absenteeism increased as on-duty fatigue and sleepiness increased and prior sleep decreased. This was particularly evident for swing shift officers and night shift officers who were predicted by BMMF to obtain less sleep and have greater fatigue and sleepiness than day shift officers. The odds of absenteeism were higher for female officers than male officers; this finding was not due to a differential response to sleep loss, fatigue or sleepiness. PRACTICAL IMPLICATIONS ­: Absenteeism may represent a self-management strategy for fatigue or compensatory behavior to reduced sleep opportunity. Long and irregular work hours that reduce sleep opportunity may be administratively controllable culprits of absenteeism. ORIGINALITY/VALUE ­: Police fatigue has consequences for police officers, departments and communities. BMMF provide a potential tool for predicting and mitigating police fatigue. BMMF were used to investigate the effects of sleep and fatigue on absenteeism.

16.
Am J Hum Biol ; 31(5): e23274, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31565838

RESUMEN

OBJECTIVE: Studies show that serum levels of 25-hydroxyvitamin D (25(OH)D), a biomarker for vitamin D status, are lower in persons with higher adiposity levels and that police officers have been found to have a high prevalence of obesity. The purpose of this study was to examine relationships between several adiposity measures and 25(OH)D, and also compare those measures to determine the best one that predicts insufficiency of 25(OH)D (<20 ng/mL) among police officers in the Northeast area of the United States. METHODS: Participants were 281 police officers (71.5% men) from the Buffalo Cardio-Metabolic Occupational Police Stress Study (2011-2016). Associations of body mass index (BMI), abdominal height (AbHt), waist circumference (WC), WC-to-height ratio (WCHtR), percent body fat (PBF), and fat mass index (FMI) with 25(OH)D were obtained using multiple regression models after adjustment for age, race/ethnicity, season, multivitamin supplement use, and high-density lipoprotein cholesterol. The area under the curve (AUC) was used to evaluate the predictive ability of each adiposity measure to identify insufficient 25(OH)D concentrations. RESULTS: The prevalence of obesity (BMI ≥ 30) was 50.7% in men and 21.3% in women. Mean levels of 25(OH)D were 32.4 ng/mL in men and 34.4 ng/mL in women. After adjustment for covariates, PBF and FMI among men were inversely associated with 25(OH)D: PBF (ß ± SE = -2.40 ± 1.01, P = .018); FMI (-2.21 ± 0.93, .018). Among women, no adiposity measure was associated with 25(OH)D. PBF was the best predictor of insufficient 25(OH)D concentrations regardless of gender (AUC = 0.878). CONCLUSION: Adiposity measures were inversely associated with 25(OH)D, but differed between female and male officers.


Asunto(s)
Adiposidad , Antropometría/métodos , Policia/estadística & datos numéricos , Vitamina D/análogos & derivados , Adulto , Área Bajo la Curva , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , New York , Vitamina D/sangre
17.
Am J Hum Biol ; 31(6): e23296, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31332861

RESUMEN

OBJECTIVE: Police officers have higher rates of cardiovascular disease (CVD) morbidity and mortality than the U.S. general population. Officers are exposed to conventional and unexpected workplace stressors. The hypothalamic-pituitary-adrenal (HPA) axis plays a major role responding to stressor exposure by releasing cortisol. Prolonged release or excessive levels may result in disease. Our study investigated cross-sectional associations between self-reported work stress and various salivary cortisol parameters. METHODS: A total of 285 police officers (76.5% male) from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004-2009) completed the Spielberger Police Stress Survey, reporting frequency and severity of work events during the past month and year to calculate stress indices. Officers provided saliva samples to measure levels of cortisol secretion. Linear regression assessed associations between stress indices and various cortisol parameters, adjusted for age, gender, race/ethnicity, abdominal height, and smoking status. RESULTS: Significant positive associations were observed between stress indices (overall stress, physical danger stress, and past-month lack of support) and diurnal cortisol (AUCg: total area under the curve). Administrative, overall, and physical danger stress in the past year were significantly associated with the diurnal slope. Overall, administrative, and physical danger stress were significantly associated with bedtime levels. There were no significant associations between the stress indices and the awakening cortisol parameters. CONCLUSIONS: Higher stress ratings were related to blunted diurnal decline in cortisol, suggesting conventional and unexpected police stressors may result in HPA axis dysfunction. Future studies investigating possible associations between elevated cortisol and subclinical CVD are needed.


Asunto(s)
Hidrocortisona/metabolismo , Estrés Laboral/epidemiología , Policia/estadística & datos numéricos , Adulto , Ritmo Circadiano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , New York/epidemiología , Estrés Laboral/psicología , Saliva/química , Autoinforme
18.
Policing ; 43(2): 247-261, 2019 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-32714068

RESUMEN

PURPOSE ­: Chronic exposure to occupational stress may lead to depressive symptoms in police officers. The association between police stress and depressive symptoms and the potential influences of coping and hardiness were evaluated. The paper aims to discuss this issue. DESIGN/METHODOLOGY/APPROACH ­: Stress level was assessed in the Buffalo Cardio-Metabolic Occupational Police Stress Study (2004-2009) with the Spielberger Police Stress Survey. The frequency and severity of events at work were used to calculate stress indices for the past year. The Center for Epidemiologic Studies Depression (CES-D) Scale was used to measure depressive symptoms during the past week. Linear regression was used to evaluate the association between the stress indices and depressive symptom scores. Models were adjusted for age, sex, race, smoking status and alcohol intake, and stratified by median values for coping (passive, active and support seeking) and hardiness (control, commitment and challenge) to assess effect modification. FINDINGS ­: Among the 388 officers (73.2 percent men), a significant positive association was observed between total stress and the CES-D score (ß = 1.98 (SE = 0.36); p < 0.001). Lower CES-D scores were observed for officers who reported lower passive coping (ß = 0.94 (SE = 0.45); p = 0.038) and higher active coping (ß = 1.41 (SE = 0.44); p = 0.002), compared with their counterparts. Officers higher in hardiness had lower CES-D scores, particularly for commitment (ß = 0.86 (SE = 0.35); p = 0.016) and control (ß = 1.58 (SE = 0.34); p < 0.001). ORIGINALITY/VALUE ­: Results indicate that high active coping and hardiness modify the effect of work stress in law enforcement, acting to reduce depressive symptoms.

19.
Nat Chem Biol ; 12(6): 399-401, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27089030

RESUMEN

We engineered a photoactivatable system for rapidly and reversibly exporting proteins from the nucleus by embedding a nuclear export signal in the LOV2 domain from phototropin 1. Fusing the chromatin modifier Bre1 to the photoswitch, we achieved light-dependent control of histone H2B monoubiquitylation in yeast, revealing fast turnover of the ubiquitin mark. Moreover, this inducible system allowed us to dynamically monitor the status of epigenetic modifications dependent on H2B ubiquitylation.


Asunto(s)
Núcleo Celular/metabolismo , Núcleo Celular/efectos de la radiación , Epigénesis Genética/efectos de la radiación , Flavoproteínas/metabolismo , Histonas/metabolismo , Luz , Ubiquitinación/efectos de la radiación , Flavoproteínas/química , Flavoproteínas/genética , Señales de Exportación Nuclear , Fototropinas/química , Dominios Proteicos , Transporte de Proteínas/efectos de la radiación , Saccharomyces cerevisiae/citología , Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/efectos de la radiación , Proteínas de Saccharomyces cerevisiae/metabolismo , Ubiquitina/metabolismo
20.
Int Arch Occup Environ Health ; 91(5): 513-522, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29516173

RESUMEN

PURPOSE: We hypothesized that effort-reward imbalance (ERI) is associated with an atypical cortisol response. ERI has been associated with higher job stress. Stress triggers cortisol secretion via the hypothalamic-pituitary-adrenal (HPA) axis, and significant deviation from a typical cortisol pattern can indicate HPA axis dysfunction. METHODS: 176 police officers participated from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. ERI was the exposure variable. Outcome variables were saliva-based peak and mean cortisol values, total area under the curve ground (AUCG) and baseline (AUCI); linear regression line fitted to log-transformed cortisol. Regression analyses were used to examine linear trend between ERI and cortisol parameters. Repeated measures analysis examined whether the pattern of cortisol over time differed between low ERI (< median) and high ERI (≥ median). RESULTS: Mean age was 46 years (SD = 6.6). After adjustment for potential confounders, there was a significant inverse association between ERI and peak cortisol (ß = - 0.20, p = 0.009), average cortisol (ß = - 0.23, p = 0.003), and total area under the curve (ß = - 0.21, p = 0.009). ERI was not significantly associated with AUCI (ß = - 0.11, p = 0.214); slope of the regression line fitted to the cortisol profile (ß = - 0.009, p = 0.908). Repeated measures analyses showed that the cortisol pattern did not vary significantly between high and low ERI using the median as a cut point (interaction p value = 0.790). CONCLUSIONS: ERI was inversely associated with the magnitude of awakening cortisol over time, indicating HPA axis dysregulation and potential future health outcomes.


Asunto(s)
Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisario/metabolismo , Estrés Laboral/fisiopatología , Sistema Hipófiso-Suprarrenal/metabolismo , Policia/psicología , Adulto , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , New York , Saliva/metabolismo , Encuestas y Cuestionarios , Vigilia
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