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Purpose: Malignant Mesothelioma (MM) is a rare malignancy of the serosa membranes with a high mortality rate and long latent period. The relationship between a group of mineral fibers known as asbestos and mesothelioma is now well accepted in which people can be exposed to these fibers by various means during their lifetime and has been its usage has banned in many countries, such as Iran, which announced its gradual elimination from 1999 over a period of 7 years by using safe substitutes. However, the mineral particles are able to sustain itself in the environment, air, water, and soil and on the other hand, symptoms may take up to half a century to develop in exposed individuals. Also, there remains a shortage of comprehensive investigation on the effects of asbestos exposure within the familial context (household or domestic exposure) or on individuals residing in proximity to asbestos mines or factories (environmental exposure). Based on the high number of MM cases in Iran, and also our hypothesis that residuals of asbestos in the environment and petroleum products may be the etiological factor for MM, we conducted this study to evaluate the clinic epidemiological features of MM in the south of Iran its relation to possible asbestos exposure. Methods: In this study, we analyzed the demographic features and occupations of confirmed cases of MM in Shiraz, southern Iran along with the follow-up of the patients' disease from 2008 to 2018, while also comparing the features of our patients with a control group compromising of 105 non-MM patients. Results: Among the 35 confirmed cases of MM, with an average age of 61 years, 9 (25.7%) were female, and 26 (74.3%) were male. During our assessment, 12 patients had already died, with a mean time of 11.26 months post-diagnosis. Our findings revealed a higher prevalence of MM among housekeepers and employees of oil companies. In comparison to the control group, individuals with occupational exposure and those residing near refinery locations were at a heightened risk of developing MM. However, based on regression analysis, only occupations associated with refineries exhibited a significant correlation with MM (p = 0.028; OR: 14.602; 95% CI: 1.328-160.499). Conclusion: Both occupational and para-occupational exposure demonstrated a significant correlation with MM, whereas our regression analysis did not affirm geographical and environmental factors as contributors to MM. Despite the industry's prohibition of direct asbestos usage, the persistent existence of asbestos particles in the environment for decades, coupled with the long latency period of MM, warrants further investigation. Health authorities and policymakers should recognize this potential hazard, prompting an enhancement of early detection within at-risk groups.
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PURPOSE: Both demand and need for assistive technology (AT) are growing worldwide. However, ensuring an optimal fit between the person and AT is complex. With health professionals often being the "gatekeeper" to AT, it is imperative to understand their experiences of AT. This study was positioned within a sociotechnical space known as "HabITec", which aims to bring together potential AT users with health professionals and technology developers to enhance the technology-person fit. The current paper reports on health professionals' experiences of the HabITec Lab (THL), the physical manifestation of HabITec that was piloted in a tertiary hospital for 12-months. MATERIALS AND METHODS: The study used a qualitative descriptive approach to explore the experiences of nine health professionals who referred patients to the lab. RESULTS: Four major themes were identified together with suggestions for the future of THL and HabITec. The themes focused on 1) Balancing service and independence; 2) Capitalising on possibilities and connections; 3) Negotiating multiple mismatches; and 4) Fitting it all together in a coherent service. CONCLUSIONS: It was clear that health professionals who referred patients to THL identified a range of benefits associated with it, but barriers to its effectiveness were identified and concerns were raised over health professionals becoming too reliant on the lab. For THL to be sustainably implemented, it appears that a policy-level shift is needed to enable its appropriate resourcing.
A sociotechnical space with the capacity to bring together assistive technology users with health professionals and technology developers has shown potential to enhance the technology-person fit.A policy-level shift is needed to ensure future successful and sustainable implementation of such a space; however, further comparison with standard assistive technology practice is needed to warrant investment.Such a space should be conscious of equipping health professionals with assistive technology knowledge and skills.Attention must be paid to adequate promotion of services to ensure appropriate uptake.
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BACKGROUND: Evidence-based medicine is defined as searching for medical information, reviewing and comparing it to each patient's situation, and then judging the optimal decision. We aimed to measure the psychometric properties of the Evidence-Based Performance Profile (EBP2) Questionnaire among the students of health-related fields at Shiraz University of Medical Sciences. METHODS: This cross-sectional study was conducted in 2021. The EBP2 questionnaire, which includes 74 five-Likert-scale items, was translated into the Persian language using the forward-backward translation method. A panel of five experts approved the face, content, and structural validity of the questionnaire. The Cronbach's alpha and McDonald's Omega coefficients were utilized to assess the questionnaire's internal consistency. Furthermore, both confirmatory and exploratory factor analyses were used to assess the questionnaire's construct validity. SPSS software version 25 and LISREL software version 8.8 were used for statistical analysis. RESULTS: Overall, 339 students participated in this study. The cultural adaptability, linguistic equivalence, and content validity of the Persian version of the EBP2 questionnaire were approved by a five-member team of medical experts. In addition, the results showed excellent internal consistency of the Persian version of the EBP2 questionnaire (Cronbach's alpha = 0.962, McDonald's Omega (ML) = 0.963). Moreover, all domains had acceptable reliability (> 0.7), except the Practice domain which had a marginally acceptable Cronbach's alpha coefficient equal to 0.686. Exploratory factor analysis discovered six domains for the questionnaire. Moreover, the confirmatory factor analysis demonstrated that all indices except the comparative fit index (CFI) and adjusted goodness of fit (AGFI) confirmed the validity of the EBP2 questionnaire. CONCLUSION: The study's findings indicate that the Persian translated of the EBP2 questionnaire exhibited satisfactory validity and reliability for assessing students' evidence-based performance in health-related fields.
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Psicometría , Humanos , Estudios Transversales , Reproducibilidad de los Resultados , Irán , Encuestas y Cuestionarios/normas , Masculino , Femenino , Adulto Joven , Estudiantes de Medicina/psicología , Traducciones , Práctica Clínica Basada en la Evidencia , AdultoRESUMEN
Care-planning is vital to the delivery of timely, person-centred, safe and effective care. Despite the understanding of the benefits of person-centred care-plan in both services, occupational therapists (OTs) within our forensic and rehabilitation services had difficulties in inputting into patient care-plan an efficient and person-centred manner.The OT team developed a Quality Improvement (QI) project to improve the efficiency of the OT process to create more time for care-planning and improve person-centredness of OT input into care-plans to 82% in the forensic services and rehabilitation services by December 2023.The results indicated an increase in the person-centredness of care-plans from 63.64% to 84.34% within the rehabilitation service and an increase from 65.15% to 95.45% in the forensic service. This project used feedback from patients to develop our input into care-plans. The project also increased the efficiency of the admission process and released time to be spent on care-planning and treatment.We improved the quality of our input to care-plans in a sustainable way by using the Royal Academy of Improvement sustainability measure and taking actions which included training our band 6 and 7 OTs to complete their monthly audit and reporting this as part of the head of nursing report for assurance in our monthly Clinical and Operational Assurance Team meetings. These actions ensured that our project fitted with the organisation's strategic aims and values. We also used low carbon alternatives by holding most of our improvement meetings online and eliminating the use of paper.Lastly, we improved the generalisability of this project by using the Goal Directed Care Plan audit tool, which is a well-researched, evidence-based tool created by service-users, carers and members of staff. This was used to train members of staff and develop an example of a person-centred input into care-plans to improve their practice.
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Terapia Ocupacional , Atención Dirigida al Paciente , Mejoramiento de la Calidad , Humanos , Atención Dirigida al Paciente/normas , Terapia Ocupacional/métodos , Terapia Ocupacional/normas , Servicios de Salud Mental/normas , Planificación de Atención al Paciente/normasRESUMEN
BACKGROUND: Limited data document the spectrum of exposures in the agricultural environment. We describe here the wide range of chemical and physical agents, and organizational factors, encountered in agricultural jobs held in the past in Canada and abroad. METHODS: We used data from a population-based case-control study of prostate cancer including 3,925 male participants residing in Montreal, Canada in 2005-2012. Lifetime occupational histories and detailed job descriptions were collected in-person. Industrial hygienists and an agronomist conducted semi-quantitative evaluations of exposure, including intensity and reliability, to some 300 chemical and physical agents in each job held. Analyses focused on the 156 agricultural jobs ever held in the study population. Clusters of agricultural co-exposures were derived. RESULTS: Agricultural jobs had taken place in 1946-2012, 53% ending in 1970 or after. Jobs were often (43%) held in Quebec, Canada; 22% in Italy, Portugal or Greece, and 10% in Haiti. Jobs entailed exposure to an average of 10 chemical agents (± 7) and most were characterized by long working hours, high physical activity levels, and did not provoke stress or anxiety. Few involved early morning shifts. Exposure to 78 agents was assigned with probable or definite certainty. The most common definite or probable carcinogens were ultraviolet radiation (92% of jobs), environmental tobacco smoke (39%), diesel engine exhaust (23%), wood dust (20%), lubricating oils and greases (20%) and lead (15%). Pesticide exposure (as a group) occurred in 31% of jobs. Fifty-four percent of jobs entailed exposure to ≥ 2 recognized carcinogens. Exposure clusters varied according to countries and type of agricultural activities (general, animal, crops, horticulture, vineyards, etc.). CONCLUSIONS: Findings highlight the heterogeneity of exposure patterns in past agricultural environments based on their setting and activities involved. Studies on health-related effects of farming should account for numerous potential exposures, beyond their typical focus on pesticides.
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OBJECTIVE: The purpose of this review was to identify assessment instruments and their measurement properties for assessing evidence-based practice (EBP) knowledge, skills, attitudes, and behavior among students of manual therapy education programs. METHODS: 7 electronic databases were systematically searched from inception to May 19, 2023. (MEDLINE, EMBASE, CINAHL, ERIC, EBSCO Discovery, LISA, Google Scholar.) Search terms were subject headings specific to each database (MeSH in MEDLINE) and relevant to evidence-based practice, assessment tools/instruments, and manual therapy healthcare professions. Eligible studies included students of manual therapy education programs (chiropractic, physiotherapy, occupational therapy, osteopathy) and provided evidence supporting instrument measurement properties (reliability, validity). Titles and abstracts were screened by 2 reviewers. Data on each instrument and its properties were extracted and tabulated by 2 reviewers. Instruments were compared using the Classification Rubric for EBP Assessment Tools in Education (CREATE) framework including the 5 steps in the EBP model. Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist were followed. RESULTS: 5 studies were identified, (3 physiotherapy, 2 chiropractic) Two studies used a physiotherapy-focused modification of the Fresno test. One study presented the Knowledge of Research Evidence Competencies instrument. Two studies presented original instruments. Instruments focused on the knowledge domain and did not assess all 5 EBP model steps. CONCLUSION: The current literature does not address all 5 steps of the EBP model. The identified instruments have the potential to ensure chiropractic institutions are graduating chiropractors who are highly skilled in evidence-based practice.
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Organizations have started more progressively using and offering family benefits including parental leaves to address the issues of balancing work and family life. Although such leaves are fundamental for supporting, attracting, and retaining women, we examine whether such leaves may also inadvertently affect women's careers in occupations that overly value masculine traits, unless managed carefully. Drawing on the literature on gender stereotypes (micro factors) and occupation gender type (macro factors), we argue that longer (vs. shorter) parental leaves negatively affect women's work outcomes (i.e., annual income, salary recommendation, hireability, and leadership effectiveness) in men-dominated but not in women-dominated occupations because it lowers perceptions of women's agency. We find support for our hypotheses across three studies in the Australian context with an archival data set and two experiments. Our work shows that men-dominated organizational structures reinforce traditional gender stereotypes, whereas such reinforcement does not happen in women-dominated organizational structures. Our research equips leaders and organizations with insights into the unintended negative consequences of parental leave for women. This understanding serves as a crucial first step in developing strategies and programs to mitigate these effects, thereby supporting women in men-dominated occupations and fostering more inclusive and healthy workplaces.
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This article investigates social influences that drive gender-specific differences in the degree of persistence individuals exhibit in regard to pursuing science, mathematics, engineering and technology (STEM), both as a field of study and as an occupation. It covers individuals' careers from entry into higher education to entry into the labor market. Following a life course perspective, I ask the following questions: (1) How stable are preferences regarding STEM subjects and occupations throughout young adulthood? (2) Are significant social ties, such as relations with friends and family members, factors that affect individuals' persistence in pursuing a STEM career throughout higher education and at entry into the labor market? Based on longitudinal data from the student cohort of the German National Educational Panel Study (NEPS), Starting Cohort 5 (SC5), I find that mothers who have a STEM occupation encourage their daughters to choose a STEM career when the latter enter higher education, but they do not encourage them to choose STEM studies or to choose a STEM occupation when they enter the labor market. Conversely, social factors contribute stronger to the persistence of men: fathers who have a STEM occupation promote sons choosing to pursue a STEM field, and to persist in such a field. Also, I find that support from friends and parents is especially important for men's persistence in pursuing STEM subjects during higher education.
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INTRODUCTION: Exploring health consumer preferences in care is an essential foundational, and ongoing activity, when designing and delivering models of care. We undertook a study to explore: (i) what allied health (AH) services are most important to health consumers and (ii) how health consumers expect to access these services in residential aged care (RAC) to determine consumer priorities in future AH models of care in RAC. METHODS: A mixed method study was conducted with aged care residents and community members (friends or family of residents/people who believe they may use RAC services). The study comprised two focus-group activities where participants were asked to (1) rank the AH services most important to them and then (2) categorise how they would prefer to access each AH service. Focus group members used card sort methods (Q-methodology) to aid prioritisation, categorisation and discussion. Card sorting data were analysed using inverted factor analysis and descriptive statistics. Qualitative focus group data were deductively coded using a coding structure created by the research team informed by quantitative results. RESULTS: Data were collected from 16 participants who formed five focus groups in a community forum. The analysis revealed three factors, that represented shared meaning amongst groups of participants (viewpoints) regarding prioritisation of AH services: 'Prioritising urgent needs', 'Prioritising long-term healthy habits and lifestyle', and 'Prioritising social well-being'. Data from the card sort activity, which related to 'how health consumers expect to access AH services', were also categorised into three categories: 'It is always provided', 'A professional will assess my need' and 'I or my family will ask for this service if I need it'. Participants wanted most AH services to be provided regularly, with some such as 'Exercise and rehabilitation' and 'Meaningful activity' to be provided up to one hour every day. CONCLUSION: Consumers value a range of AH services and have an expectation that these will be provided in RAC on a regular basis. To ensure consumers make informed preferences regarding the future of services in RAC, health systems need to trial innovative AH models of care and embed consumer evaluation.
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Grupos Focales , Humanos , Femenino , Masculino , Anciano , Anciano de 80 o más Años , Prioridad del Paciente , Hogares para Ancianos , Persona de Mediana Edad , Comportamiento del ConsumidorRESUMEN
Background: Long-haul truck drivers (LHTD) experience disproportionately greater chronic disease risk, which may be influenced by both occupational and lifestyle factors. This study aimed to explore the multilevel factors associated with LHTD's diet and physical activity (PA). Methods: Thirty in-depth interviews were conducted with LHTD in the Southern California border region. Interview questions captured occupational and lifestyle factors relating to PA and diet at multiple levels and were analyzed using thematic analysis. Results: Emergent themes relating to both diet and PA included time constraints, attitudes and perceived beliefs, and accessibility of environments to engage in PA and healthy eating. Themes specific to PA were weather conditions and flatbed job duties. Themes specific to diet included access to refrigerators/microwaves and social interactions. Conclusion: Findings from this study can inform the development of tailored, multi-level interventions to encourage PA and healthy dietary behaviors among LHTD.
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INTRODUCTION: People with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia are unable to access rehabilitation for promoting function and quality of life. Conducted in Australia, this study was designed to (1) explore barriers to access to dementia rehabilitation and (2) identify solutions that improve access to rehabilitation. METHODS: People living with dementia (n = 5) and care partners (n = 8) and health professionals (n = 13) were recruited nationally. Experience-based codesign across three virtual workshops was used to understand barriers and design solutions to improve access to rehabilitation treatments. Socio-ecological analyses, using the Levesque Access to Health care framework, were applied to findings regarding barriers and to aid selection of solutions. RESULTS: There was high attendance (92.3%) across the three workshops. Barriers were identified at a user level (including lack of knowledge, transport, cost and difficulty navigating the health, aged care and disability sectors) and health service level (including health professional low dementia knowledge and negative attitudes, inequitable funding models and non-existent or fragmented services). Solutions focused on widespread dementia education and training, including ensuring that people with dementia and their care partners know about rehabilitation therapies and that health professionals, aged care and disability co-ordinators know how to refer to and deliver rehabilitation interventions. Dementia care navigators, changes to Australia's public funding models and specific dementia rehabilitation programmes were also recommended. CONCLUSIONS: Barriers to accessing rehabilitation for people with dementia exist at multiple levels and will require a whole-community and systems approach to ensure change. PATIENT OR PUBLIC CONTRIBUTION: People with living experience (preferred term by those involved) were involved at two levels within this research. A Chief Investigator living with dementia was involved in the design of the study and writing of the manuscript. People with living experience, care partners and service providers were participants in the codesign process to identify barriers and design potential solutions.
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Demencia , Accesibilidad a los Servicios de Salud , Humanos , Demencia/rehabilitación , Australia , Femenino , Masculino , Anciano , Calidad de Vida , Persona de Mediana Edad , Personal de Salud/psicologíaRESUMEN
Objective: This study aimed to investigate the onset and prevalence of musculoskeletal disorders (MSD) in undergraduate students from the Faculty of Health Sciences at the University of Johannesburg during the COVID-19 pandemic. Methods: This was an explorative cross-sectional survey. The sample consisted of 106 Faculty of Health Sciences students recruited through 4 departments. The study was conducted through Google Forms and made use of a questionnaire that was adapted from 2 existing questionnaires, namely "Physical Activity and Sedentary Lifestyle in University Students: Changes During Confinement Due to the COVID-19 Pandemic" and "Musculoskeletal Health Questionnaire (MSK-HQ)." Variables that were tested included dietary changes, habitual and activity changes, perceived MSK health before COVID-19 and during COVID-19 restrictions, and the development and regional distribution of MSD. Data were analyzed using frequency tables for single-response questions, custom tables for multiple responses and Likert-type questions, summary statistics to analyze continuous variables, and paired samples t tests to analyze statistically significant differences in MSK health before and during the COVID-19 lockdown periods. Results: Prior to the implementation of the institutional academic restrictions, 33.0% of respondents reported having no MSD, while 67.0% reported already having had an MSD present. The prevalence of new MSD in descending order by region were back (78.3%), neck (71.7%), head (41.5%), lower limb (27.4%), pelvis and perineum (20.8%), thorax/chest (12.3%), abdomen (12.3%), and upper limb (11.3%). Of these new-onset MSD, 11.3% were induced by physical trauma, while 76.4% were not from any form of physical trauma. Of the 106 participants, 28 stated that their MSK health deteriorated over the 2 compared points in time, 18 remained unchanged, and 60 showed improvement in MSK health. Conclusion: Our findings suggest that even though students had MSD before the pandemic lockdown restrictions, new conditions were recorded as developing during the restricted period. Complaints of new-onset back, neck, and head pain were reported the most, although overall, MSK health appeared to have improved.
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Background: We investigated the relationship between employment status, work patterns, and sudden cardiac arrest (SCA). Methods: This was a case-control study from September 2017 through December 2022 involving 17 emergency departments and 9 public health centers. The cases included patients aged 20-79 years with SCA, excluding those with traumatic arrest, terminal illness, pregnancy, unreliable information, or a "Do Not Resuscitate" order. Controls were selected from various health screening centers in Korea. All participants completed structured questionnaires. Propensity score matching was used to ensure comparability by age, sex, and socioeconomic status. Results: Of the 1536 patients enrolled, 116 from the case group were excluded due to missing employment data, leaving 1420 cases and 2304 controls for analysis. Employment was reported by 47.5% of cases and 59.4% of controls. There was no significant difference in the proportion of sole proprietors (20.6% vs. 22.5%, p = 0.39). The case group had a higher proportion of employers (13.2% vs. 6.5%, p < 0.001) and fewer employees (63.3% vs. 69.1%, p = 0.02). Professional roles were more common among controls (23.6% vs. 31.6%, p < 0.001), while labor-intensive jobs were more frequent in cases (27.7% vs. 17.8%, p < 0.001). The case group had more evening and night shifts (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.01-1.06; OR: 1.05, 95% CI: 1.01-1.09) and longer workdays (OR: 1.06, 95% CI: 1.03-1.08). Conclusions: SCA patients were more likely to work evening and night shifts and have longer workdays, often exceeding 10 h.
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The Chiropractic Educators Research Forum convened a conference on June 22, 2024. During this meeting, attendees shared what chiropractic programs are doing, specifically focusing on education research related to technology. Presenters and panelists discussed what technology chiropractic programs should be using to educate chiropractors for the future.
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Simulation-based education is gaining attention worldwide as it is recognized as effective in fostering collaborative skills in healthcare students. We conducted a comprehensive review of simulation-based interprofessional education (IPE) to examine the current state of simulation-based IPE. This scoping review systematically analyzed studies on simulation-based IPE in South Korean healthcare education, following established guidelines. Relevant articles were comprehensively searched, and key data on simulation methods, implementations, and educational effectiveness were extracted for analysis. The present study included nine quantitative studies and one mixed-methods study. The majority of participants were undergraduate nursing and medical students. The duration of IPE interventions ranged from 2 hours to 2 weeks. Education methods included standardized patients, high-fidelity simulators, and role-playing. Educational outcomes focused on measuring IPE competencies and satisfaction levels, concentrating on Kirkpatrick levels 1 and 2. While most studies reported high satisfaction levels, there is a need for objective evaluation of educational effectiveness. As simulation-based IPE in Korean healthcare education evolves, there is a need for greater inclusivity of diverse roles, multidisciplinary respect, and scenario development allowing active participation across professions. Establishing institutional frameworks, community linkages, and a deep understanding of IPE's purpose and essence among practitioners is crucial for its academic maturation.
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Educación Interprofesional , Entrenamiento Simulado , Estudiantes del Área de la Salud , Humanos , Competencia Clínica , Curriculum , Educación Interprofesional/estadística & datos numéricos , Relaciones Interprofesionales , República de Corea , Estudiantes del Área de la Salud/estadística & datos numéricos , Estudiantes de Medicina , Estudiantes de EnfermeríaRESUMEN
BACKGROUND: This study aimed to explore the association between the emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder among Peruvian health science students. METHODS: We conducted a cross-sectional analytical study in which an online questionnaire was administered to 456 health science interns from four cities in Peru. We used the COVID-19 Emotional Impact Profile questionnaire, Mindful Eating Questionnaire, and Alcohol Use Disorders Identification Test. Spearman's correlations were calculated and two multiple linear regression models were developed. RESULTS: 68.4% of the participants were emotional eaters and 8.6% reported low-risk levels of alcohol use disorder. Based on the results of the first model, the overall emotional impact of COVID-19, being overweight or obese, depression and anxiety levels, and living with only one parent were factors associated with emotional eating. The results of the second model showed that the level of depression, living with just one parent, living alone, sex, and number of months as an intern were factors associated with the risk of alcohol use disorder. CONCLUSIONS: To reduce emotional eating and the risk of alcohol use disorder among interns, universities should implement interventions aimed at reducing the emotional impact of COVID-19 and provide nutritional counseling.
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COVID-19 , Emociones , Humanos , COVID-19/psicología , COVID-19/epidemiología , Femenino , Perú/epidemiología , Masculino , Estudios Transversales , Adulto , Adulto Joven , Encuestas y Cuestionarios , SARS-CoV-2 , Alcoholismo/psicología , Alcoholismo/epidemiología , Depresión/psicología , Depresión/epidemiología , Factores de Riesgo , Conducta Alimentaria/psicología , Ansiedad/psicología , Ansiedad/epidemiologíaRESUMEN
OBJECTIVE: To measure degree of depression, anxiety, and hours of sleep of chiropractic college students through an anonymous paper survey. METHODS: A convenience sample of 164 chiropractic college students completed a Major Depression Inventory (MDI) survey, a 2-item Generalized Anxiety Disorder (GAD-2) survey, and were asked the number of hours of sleep they had per night and demographic questions. The survey was distributed to trimester 1-6 students 4 weeks into their 15-week semester. RESULTS: Chiropractic students had an average MDI score of 18.1 ± 10.6 (mean ± SD), indicating the average chiropractic college student did not display depression. However, subset analysis revealed 18.9% of students had MDI scores over 30, which is associated with possible severe depression. Of students who demonstrated possible severe depression, 80.6% were female. Body mass index demonstrated no correlation with the number of respondents at risk for severe depression. Average GAD-2 score was 3.0 ± 1.9; male students scored 2.4 ± 1.8 and female 3.6 ± 1.8, indicating female students expressed anxiety more. Last, survey respondents reported they averaged 6.3 ± 1.1 hours of sleep per night with females reporting approximately 30 minutes less sleep per night than males. CONCLUSION: Chiropractic students, on average, did not display depression. However, a subset of female students near the age of 26 were at an increased risk of severe depression. Chiropractic students displayed a rate of anxiety greater than that of undergraduate college students based on existing data sets and reported approximately 6 hours of sleep per night.
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BACKGROUND: Early studies during the COVID-19 pandemic suggested dental occupations were among the highest risk for exposure to SARs-CoV-2 because of multiple factors increasing exposure, including close proximity to unmasked patients and performance of aerosol-generating procedures. However, to date, few studies have investigated COVID-19 deaths in United States dental occupations, and compared COVID-19 deaths among healthcare occupations. METHODS: We analyzed 2020 mortality data collected by the National Center for Health Statistics' National Vital Statistics System. Multivariable logistic regression was used to generate odds ratios (ORs) and 95% confidence intervals for COVID-19 as the underlying cause of death in relation to occupation in working-age decedents (≤65 years), after adjusting for age, sex, race/ethnicity, education, and medical conditions associated with severe COVID-19. RESULTS: Dental occupations did not have significantly higher risk for COVID-19 death when compared to all other occupations combined. Among healthcare occupations with frequent, direct patient- or client interactions, LPNs and LVNs, and speech and language pathologists had significantly elevated adjusted ORs for COVID-19 death when compared to dentists, dental hygienists, or dental assistants. Similarly, nurse practitioners had significantly higher ORs for COVID-19 mortality than dentists or dental hygienists, and approached significance when compared to dental assistants. Conversely, massage therapists and other health diagnosing and treating practitioners had significantly lower adjusted ORs for COVID-19 death compared with dental occupations. CONCLUSION: Our study highlights potential differences in work-related transmission of SARs-CoV-2 and subsequent COVID-19 deaths in healthcare occupations, and furthers a previously limited understanding of COVID-19 deaths in healthcare occupations in 2020, before COVID-19 vaccine availability. Our results indicate that dental occupations were not among the highest, nor lowest risk, healthcare occupations for COVID-19 deaths in 2020, despite their known risks of direct exposure.
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COVID-19 , Humanos , COVID-19/mortalidad , Estados Unidos/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , SARS-CoV-2 , Anciano , Empleos en Salud/estadística & datos numéricos , Odontología/estadística & datos numéricos , Odontólogos/estadística & datos numéricos , Enfermedades Profesionales/mortalidad , Enfermedades Profesionales/epidemiología , Exposición Profesional/estadística & datos numéricos , Exposición Profesional/efectos adversos , Causas de Muerte , Adulto JovenRESUMEN
Biomechanical stress may exacerbate inflammation in psoriatic arthritis (PsA). This study aimed to investigate disease activity, work disability, and drug response/retention rates in PsA patients among two different occupation's types: blue-collar workers (BCol) with manual labor versus white-collar workers (WCol) with sedentary occupations. PsA patients registered in the Swiss cohort (SCQM) were classified as BCol or WCol workers and assessed at the initiation of a biologic or targeted synthetic disease-modifying anti-rheumatic drug (b-/tsDMARD). We compared the baseline characteristics at treatment start and the DAS28-CRP for the 1-year remission. Treatment retention was investigated using Kaplan-Meier curves and Cox regression analysis. Multivariable models were adjusted for potential confounders. Of 564 patients, 29% were BCol, and 71% were WCol workers. Baseline disease activity was comparable between both groups. BCol workers were predominantly male (79.8%) and more work disabled at baseline (84.0% vs. 27.9%; p < 0.01). One hundred seventy-four treatment courses (TCs) of 165 PsA patients were included for longitudinal analysis. Occupation did not significantly influence the achievement of DAS28-CRP remission at 1 year. Kaplan-Meier analysis (n = 671) indicated longer retention for BCol workers (mean retention duration: 3.15 years vs. 2.15 years, (p = 0.006). However, adjusted Cox regression analysis did not corroborate these findings. This study indicates that physically demanding occupations correlate with increased rates of work disability among PsA patients, while treatment response seems to be unaffected by the patients' occupation type. Additional research is required to thoroughly comprehend the relationship between physical workload, disease activity, and treatment outcomes. Key Points ⢠This study indicates that physically demanding occupations correlate with increased rates of work disability among PsA patients. ⢠The treatment response among of PsA patients seems unaffected by the patients' occupation type.
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Antirreumáticos , Artritis Psoriásica , Ocupaciones , Humanos , Masculino , Femenino , Persona de Mediana Edad , Artritis Psoriásica/tratamiento farmacológico , Artritis Psoriásica/complicaciones , Suiza , Adulto , Antirreumáticos/uso terapéutico , Índice de Severidad de la Enfermedad , Estudios de Cohortes , Costo de Enfermedad , Estimación de Kaplan-Meier , Modelos de Riesgos ProporcionalesRESUMEN
BACKGROUND: Military physical fitness tests and standards often lack a scientific basis. Contrary to this traditional-historical precedent, US Air Force researchers use a "Two-Tier" health (Tier 1) and performance (Tier 2) approach to develop evidence-based criterion physical fitness tests, standards, and training. This study specifically and only addresses a physical demands analysis, the first step in a six-step process to develop Tier 2 occupationally specific, operationally relevant physical fitness tests and standards, and training guidance. OBJECTIVE: This study conducted a physical demands analysis to identify and delineate occupationally specific, operationally relevant critical physical tasks for eight physically demanding US Air Force occupational specialties. METHODS: A comprehensive five part physical demands analysis reviewed duty tasks, conducted focus groups, assessed incumbents, observed operational tasks, and interviewed senior leaders to detail critical physical tasks. RESULTS: The physical demands analysis delineated duty tasks to critical physical tasks for Special Tactics (556 to 40), Pararescue (981 to 50), Tactical Air Control (415 to 44), Special Operations Weather (586 to 50), Explosive Ordnance Disposal (1107 to 39), Security Forces (1286 to 25), Fire and Emergency Services (802 to 39), and Survival, Evasion, Resistance, and Escape (1099 to 25). CONCLUSIONS: The study approach proved efficacious for conducting a thorough physical demands analysis to identify and delineate occupationally specific, operationally relevant critical physical tasks for eight US Air Force physically demanding occupations. Critical physical tasks provide basis for the next overall research process step, developing physical task simulations to link to predictive physical fitness tests and training guidance.