1,721,036 research outputs found
"I think the humanity just gets lost over and over again": A phenomenological study of the experiences of higher-weight medical students.
Full text linkA growing body of research has found weight stigma to independently drive both morbidity and mortality, regardless of actual weight. This has, however, yet to translate into medical education and practice. Studies have shown doctors to be common sources of weight stigma, which may be driven, in part, by their medical training. Higher-weight doctors may be best placed to understand and support the health needs of higher-weight people. However, significant levels of implicit anti-fat bias towards higher-weight colleagues lingers in the medical profession. Inclusive practices and more holistic education around weight are therefore needed to support and retain higher weight doctors within the workforce, starting within medical schools. This may improve both staff experiences and patient care. This study aims to explore the experiences of higher weight medical students in the UK. This is an interpretive phenomenological study. Three higher-weight medical students (two women, 1 man, all 2nd year medical students, BMI range 31–50 kg/m2) underwent loosely structured interviews over Microsoft Teams. These were audio-recorded. Audio recordings were transcribed verbatim and underwent an interpretive phenomenological analysis. Participants reported logistic and environmental issues, such a lack of provision of larger uniform sizes or narrow small lecture room seat sizes. They also reported negative experiences with peers, teachers, and the general public in relation to their size. Despite this, higher-weight doctors were indeed felt to be important to advocate for higher-weight patients. Negative experiences seemed to stem from wider sociocultural issues and reflect the intersectional nature of weight stigma. To improve matters in the longer term, medical schools should review and update their weight-related teaching, alongside considering the accessibility of their physical environments. Medical schools could consider weight stigma as part of their current efforts to decolonise medical curricula
Sleep problems were unrelated to social media use in the late COVID-19 pandemic phase: A cross-national study
Full text linkSleep problems are commonly related to stress and mental health problems. However, social media use has become widespread in the general population during recent years, and their addictive potential may influence people’s sleep routine. In addition, the COVID-19 pandemic gave rise to substantial mental health problems in the population, and restrictions in social life gave social media a unique position as means for both entertainment and interpersonal contact. The aim of the study was to examine sleep problems in relationship to social media use in a cross-national sample two years after the COVID-19 outbreak. Participants were 1405 adults from four countries who completed a cross-sectional online survey. The data were analyzed with independent samples t-tests, Chi Squared tests of independence, and single and multivariable logistic regression analyses. Of the 858 (61.1%) participants who reported sleep problems during the past weeks, a substantial proportion (n = 353, 41.1%) related their sleep problems to their experience with COVID-19. With adjustments for age, gender, employment, and psychological distress, more hours of daily social media use was not significantly associated with sleep problems. However, higher age (OR: 1.13, p = 0.01), female gender (OR: 1.69, p<0.001), having employment (OR: 1.34, p = 0.04), and higher levels of psychological distress (OR: 1.20, p<0.001) were independently associated with sleep problems. While the debate about the pros and cons of social media use continue, this study suggests that higher levels of social media use was not of great concern for people’s sleep quality in the late COVID-19 pandemic phase. However, other aspects of social media use (eg, time of the day, content of interactions, associated stress experience) may be more relevant for understanding sleep problems and may be taken into consideration for people who experience such problems
Influence of a cardiac rehabilitation programme on the return to work of workers with ischaemic heart disease: Influence of a cardiac rehabilitation programme
No full textThis study aimed to examine the employment status of patients who have experienced ischemic heart disease one year after undergoing cardiac rehabilitation. For this, a quasi-experimental pre-post study without a control group of active workers aged 18 to 65 years diagnosed with ischemic heart disease and included in a cardiac rehabilitation programme was conducted. Sociodemographic and occupational data, cardiovascular risk factors and clinical-therapeutic data on heart disease were collected. A total of 214 patients were included, of which 115 patients returned to work. Several clinical factors contributing to return to work were identified: preserved left-ventricular ejection fraction (≥55%), < 3 obstructed coronary vessels, and stent revascularisation. Socio-occupational factors that may positively influence return to work were identified: age < 50 years, absence of anxious-depressive symptoms, higher level of education, and occupations with low physical strain. Cardiac rehabilitation is effective in improving cardiac function and health-related quality of life in workers with ischemic heart disease. Return to work and duration of temporary incapacity were associated with clinical-therapeutic variables and psycho-socio-occupational factors, such as type of job, physical strain, anxiety and depression, and age of the worker.Peer reviewe
Exposición laboral a factores de riesgo de cáncer de mama: trabajo nocturno en personal de enfermería
Full text linkIntroducción
El cáncer de mama es una enfermedad comúnmente diagnosticada en las mujeres y cuya
incidencia a nivel mundial ha aumentado en estas últimas décadas. Su etiopatología se ha
relacionado con múltiples factores carcinogénicos que confluyen en el ambiente laboral. Entre
estos factores, el incremento de la incidencia de cáncer de mama ocupacional se ha asociado
potencialmente con el desajuste circadiano y el trastorno de los patrones del sueño provocado
por el trabajo a turnos y el trabajo nocturno, algo común en una sociedad que organiza muchas
de sus profesiones en torno a las 24 horas del día. Estas condiciones laborales propician que la
labor del personal de enfermería sea particularmente estresante y que, además, puedan
alterarse otras esferas como la personal o la familiar debido a las incompatibilidades horarias y
los desajustes en el estilo de vida. De hecho, es posible que las enfermeras se aparten de los
estilos de vida saludables debido a su presencia en turnos irregulares que les imposibilita tener
rutinas físicas y alimentarias. Por ello, resulta prioritario conocer el impacto del trabajo nocturno
a corto y largo plazo en el colectivo de enfermeras y el perfil de riesgo de éstas para el desarrollo
de un cáncer de mama.
Objetivos
El objetivo de este estudio fue analizar la relación entre el trabajo a turnos, especialmente
el nocturno, y el riesgo de desarrollo de cáncer de mama en los profesionales de enfermería en
España. Para ello, se analizaron la incidencia y prevalencia de cáncer de mama ocupacional en
las enfermeras y la posible asociación entre la realización de turnos y noches consecutivas, el
tipo de estilo de vida, y el riesgo de padecer cáncer de mama. Entre los objetivos específicos que
se marcaron, este estudio evaluó la percepción subjetiva de la propia salud, de las
manifestaciones psicosomáticas relacionadas con el estrés y la satisfacción laboral de las
enfermeras.
Metodología
Se realizó un estudio observacional, descriptivo, de corte transversal y de aproximación
cuantitativa para responder a los objetivos marcados. Para este fin, primero se realizó una
descripción e identificación de la evidencia disponible sobre el cáncer de mama y el trabajo a
turnos en muestras de enfermeras a través de un análisis de la literatura. En la siguiente fase, se
realizó un estudio de campo con una muestra de 966 enfermeras españolas entre febrero y
septiembre de 2020, utilizando un cuestionario autoadministrado que contenía variables
sociodemográficas, variables ocupacionales, una escala de autovaloración de la salud, la versión
española del Cuestionario de Problemas Psicosomáticos y una adaptación del cuestionario de
Satisfacción Laboral SF21/26. Se realizó un análisis descriptivo de las variables y se contrastó la
relación mediante el test χ2 de independencia y cálculo de OR. El test de U-Mann Whitney
analizó las diferencias entre los subgrupos en relación con la autopercepción de la salud. Por
otra parte, el uso de técnicas de minería de datos, mediante árboles de clasificación, y la
realización de análisis multivariante permitieron dibujar un perfil ajustado de los profesionales
con cáncer de mama.
Resultados
En la mayoría de los estudios evaluados se encontró una asociación clara entre el cáncer
de mama y la prolongación de turnos rotatorios nocturnos en el tiempo. Del mismo modo, se
han hallado relaciones con alteración de ciertos marcadores del ritmo circadiano, como la
melatonina, o marcadores de alteración epigenética como la longitud de los telómeros. Entre
las variables de riesgo más significativas que se hallaron en el estudio de campo se encontraron
el número de años trabajados, las noches trabajadas a lo largo de la vida, y los años de trabajo
realizando más de 3 noches al mes. De este modo, superar los 16 años trabajados se presentó
como la variable más significativa para mujeres y hombres, y cuando el tiempo trabajado fue
inferior a 16 años, el número de casos aumentó cuando existían antecedentes familiares y se
habían trabajado más de 500 noches. La salud general fue percibida como buena en la muestra,
aunque se presentaron valores inferiores en aquellas personas que padecían cáncer de mama.
Además, otras manifestaciones psicosomáticas como el insomnio, las palpitaciones o el
cansancio extremo fueron destacadas en los casos de cáncer. Entre los aspectos más
apreciados para generar satisfacción laboral se encontraba la relación con los compañeros de
trabajo.
Discusión
Este estudio ha ofrecido una visión más cercana de la posible interacción de los factores
ocupacionales y los factores personales que pueden influir en el riesgo de cáncer de mama en
las enfermeras. De este modo, cuidar de personas dependientes en el domicilio, tomar
medicación para conciliar el sueño, tener una actividad física laboral exigente y estar expuesto
pasivamente al humo de tabaco en casa y en el trabajo resultaron especialmente significativos
en los casos de cáncer de mama, posiblemente indicando la aparición de conflictos entre la vida
personal, la vida familiar y el ritmo de trabajo de las enfermeras.
Por otra parte, el nivel de satisfacción laboral ha mostrado asociación con la calidad del
sueño percibida y con la valoración de la salud general, y también se ha relacionado con la
importancia del compañerismo, visibilizando que los profesionales de enfermería encuentran
una importante red de apoyo en los compañeros de trabajo.
El apoyo institucional para la adaptación del puesto de trabajo también podría ser
destacado en este estudio, dado que se ha podido observar que aquellos profesionales que
padecieron cáncer de mama realizaban trabajo a turnos rotativos y trabajo nocturno en menor
proporción que la muestra libre de enfermedad.
Conclusiones
El trabajo a turnos rotatorios puede provocar múltiples alteraciones clínicas y puede
generar problemas relacionados con la conciliación familiar, el autocuidado personal o con el
propio bienestar laboral. El trabajo nocturno de alta intensidad parece más perjudicial a edades
tempranas, especialmente si interfieren factores hereditarios, aunque la acumulación de años y
noches de trabajo aumenta el riesgo de cáncer de mama cuando se unen factores como la
alteración del sueño, el estrés físico o las responsabilidades familiares.
Aunque todavía es necesaria más experimentación para evidenciar los factores
biométricos de la disrupción circadiana y el mecanismo de desarrollo del cáncer de mama por la
exposición al trabajo nocturno, ciertas medidas preventivas podrían reducir los efectos
negativos en las enfermeras y prevenir la aparición de otros factores de riesgo. De este modo,
se recomiendan los descansos de 24h tras cada turno nocturno, favoreciendo el tiempo
personal y la conciliación familiar. También se hace hincapié en la necesidad de contar con
espacios protegidos ante el humo y de poder disfrutar de servicios de atención a la salud
ocupacional que evalúen los factores de riesgo carcinogénicos periódicamente.Introduction
Breast cancer is a disease which is commonly diagnosed in women and whose incidence
worldwide has increased in recent decades. Its etiopathology has been linked to multiple
carcinogenic factors that converge in the working environment. Among these factors, the
increased incidence of occupational breast cancer has potentially been associated with
circadian misalignment and sleep pattern disorders caused by shift-work and night work,
something common in a society that organizes many of its professions around 24 hours a day.
These working conditions make the labour of nurses particularly stressful and other spheres,
such as private or family, can also be altered due to time incompatibilities and lifestyle
mismatches. In fact, nurses may stay away from healthy lifestyles because of their presence in
irregular shifts that make it impossible for them to have physical and food routines. It is therefore
a priority to assess the impact of short- and long-term night work on the nurses' group and their
risk profile for the development of breast cancer.
Objectives
The objective of this study was to analyze the relationship between shift work, especially
night work, and the risk of breast cancer in the nurses of Spain. To do this, the incidence and
prevalence of occupational breast cancer in nurses were analyzed and the possible association
between consecutive shifts and nights, lifestyle type, and risk of breast cancer were assessed.
Among the specific objectives, this study assessed the subjective self-perception of the own
health, psychosomatic manifestations related to the stress and job satisfaction of nurses.
Methodology
An observational, descriptive, cross-sectional, and quantitative study was performed to
meet the objectives. To this end, a description and identification of available evidence on breast
cancer and shift work in nurse samples was first made through an analysis of the literature. In
the next phase, a field study was conducted with a sample of 966 Spanish nurses between
February and September 2020, using a self-administered questionnaire containing
sociodemographic variables, occupational variables, a scale of self-assessment of health, the
Spanish version of the Psychosomatic Problem Questionnaire and an adaptation of the SF21/26
Job Satisfaction questionnaire. A descriptive analysis of the variables was performed, and the
relationship was tested using the OR independence and χ2 test. Mann Whitney U-test analyzed
the differences between subgroups in relation to health self-perception. The use of data mining
techniques, using classification trees, and multivariate analysis allowed to draw a tight profile of
professionals with breast cancer.
Results
Most of the evaluated studies found a clear association between breast cancer and
prolongation of night rotating shifts over time. Similarly, relationships have been found
regarding the alteration of certain markers of circadian rhythm, such as melatonin, or markers
of epigenetic alteration such as telomere length. Among the most significant risk variables of
the field study, they were the number of years worked, the number of nights worked
throughout life, and years of work performing more than 3 nights per month. In this way,
exceeding the 16 years worked was presented as the most significant variable for women and
men, and when the time worked was shorter than 16 years, the number of cases increased when
there were family history of cancer and more than 500 nights had been worked. Overall health
was perceived as good in the sample, although lower values were present in those with breast
cancer. In addition, other psychosomatic manifestations such as insomnia, palpitations or
extreme tiredness were highlighted in cancer cases. Among the most appreciated aspects of
generating job satisfaction, the relationship with co-workers was underlined.
Discussion
This study has provided a closer look to the possible interaction of occupational factors
and personal factors that may influence the risk of breast cancer in nurses. In this way, caring for
dependents at home, taking medication to sleep, having a demanding physical work activity,
and being passively exposed to tobacco smoke at home and at work were especially significant
in cases of breast cancer, possibly indicating the emergence of conflicts between personal life,
family life and the pace of work of nurses. On the other hand, the level of job satisfaction has
shown associations with perceived sleep quality and the overall health and has also been linked
to the importance of partnership relations, making it visible that nurses find an important
support network in co-workers. Institutional support for workplace adaptation could also be
highlighted in this study, as it has been observed that those nurses with breast cancer worked
on rotating and night shifts in a smaller proportion than the sample free of disease.
Conclusions
Rotating shift work can cause multiple clinical alterations and can lead to problems related
to family conciliation, self-care, or wellness. High-intensity night work seems more harmful at an
early age, especially if hereditary factors interfere, although the accumulation of years and nights
of work increases the risk of breast cancer when factors such as sleep disturbance, physical
stress or family responsibilities come together.While more experimentation is still needed to
demonstrate the biometric factors of circadian disruption and the mechanism of development
of breast cancer from the exposure to night work, certain preventive measures could reduce
many negative effects on nurses and prevent the onset of other risk factors. In this way, 24h
breaks after each night shift are recommended, favoring personal time and family conciliation.
Emphasis is also placed on the need for smoke-protected spaces and occupational health care
services that assess carcinogenic risk factors periodically.Departamento de Biología Ambiental y Salud Públic
Planning, implementation, evaluation, and sustainment of digital health interventions for adolescent substance use prevention: a systematic review of influencing factors based on the RE-AIM framework
No full textSchool-based health interventions can help prevent adolescent substance use, but their success depends on various factors affecting planning and evaluation. This study examines the factors that facilitate or hinder the success of school-based digital health interventions. A systematic review was conducted in September–October 2024, following PRISMA guidelines, using PubMed, Scopus, Web of Science, CINAHL, and PsycINFO databases. From a total of 2530 studies, after removing duplicates and screening titles and abstracts, 51 full-text articles were assessed and 12 met the inclusion criteria. Data were extracted using an adapted tool for systematic reviews applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The methodological quality was assessed with Joanna Briggs Institute tools. The studies included cluster-randomized controlled trials, quasi-experimental designs, and one cross-sectional study, primarily targeting adolescents aged 11.9–17.4 years, with sample sizes ranging from 90 to nearly 5000 participants. Most interventions were implemented in schools in the USA, Europe, and Taiwan, with balanced gender distribution. Many studies reported on reach and effectiveness in reducing substance use, particularly alcohol. However, adoption and implementation factors influencing school participation were less frequently addressed, and maintenance was not mentioned. To maximize impact, future efforts should focus on enhancing sustainment and participation by leveraging emerging technologies for personalization.This study is part of the ‘ALERTA ALCOHOL: coste-efectividad de una intervención web basada en la gamificación vs. textos para la prevención del consumo del alcohol por atracón en adolescentes’ project. The project is financed by a grant from the Delegación del Gobierno para el Plan Nacional sobre Drogas, Spain under contract no. 2018I016.Peer reviewe
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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