- Disability Experiences and Perspectives Regarding Reproductive Decisions, Parenting, and the Utility of Genetic Services: a Qualitative Study. [Journal Article]
- JGJ Genet Couns 2018 Jun 16
- Genetic counselors adopt seemingly contradictory roles: advocating for individuals with genetic conditions while offering prenatal diagnosis and the option of selective termination to prevent the bir...
Genetic counselors adopt seemingly contradictory roles: advocating for individuals with genetic conditions while offering prenatal diagnosis and the option of selective termination to prevent the birth of a child with a disability. This duality contributes to the tension between the disability and clinical genetics communities. Varying opinions exist amongst the disability community: some value genetic services while others are opposed. However, there is limited research exploring the opinions of individuals with a disability regarding issues related to reproduction and genetic services in the context of personal experience. This exploratory qualitative study involved interviews with seven women and three men who self-identify as having a disability. We sought to gain their perspectives on experiences with disability, thoughts about reproduction and parenting, and perceptions of genetic services. Transcripts of the interviews were analyzed thematically using qualitative content analysis. Data analysis showed that societal views of disability affected the lived experience and impacted reproductive decision-making for those with a disability. It also showed differing interest in genetic services. Concerns about the perceived collective implications of genetic services were also raised. These findings contribute to the understanding of the disability perspective toward reproductive decision-making and genetic services. A further goal is to promote a meaningful dialogue between the genetics and disability communities, with the potential to enhance the genetic and reproductive care provided to individuals with disabilities.
- Indoor, outdoor, and night work and blood concentrations of vitamin D and parathyroid hormone. [Journal Article]
- SJScand J Work Environ Health 2018 Jun 17
- Objectives The aim of this study was to examine blood concentrations of 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) among indoor, outdoor, permanent and rotating night workers and the a...
Objectives The aim of this study was to examine blood concentrations of 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) among indoor, outdoor, permanent and rotating night workers and the association with hours spent outdoors on and off work days. Methods Blood samples were collected from 425 workers (162 indoor, 112 outdoor, 118 rotating night and 33 permanent night workers) throughout all seasons. Serum concentrations of 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) were analyzed by isotope dilution liquid chromatography-tandem mass spectrometry (LC MS/MS) and an automated immune analyzer, respectively. Personal light exposure levels were continuously recorded and used to estimate hours spent outdoors (all workers). Results Permanent night workers had 25.3% (95% CI 11.9-36.6) lower 25OHD concentration, 4.55 (95% CI 1.39-14.94) higher odds of vitamin D insufficiency (<50 nmol/L) and 14.5% [95% confidence interval (CI) 0.1-31.1] higher PTH concentration than indoor workers. Outdoor workers had similar 25OHD concentrations but 7.5% (95% CI -0.5-14.9) lower PTH concentration compared to indoor workers. Rotating night workers 25OHD and PTH concentrations did not differ from indoor workers. Concentration of 25OHD increased by 5.2% (95% CI 1.1-9.5) per hour spent outdoor at workdays in the summer. Conclusion Clinicians should be aware that vitamin D insufficiency may be more prevalent among permanent night workers and human resources should consider the positive effect of allowing workers to spend time outdoor during work hours.
- Structural validity of the Maslach Burnout Inventory and influence of depressive symptoms in banking workplace: Unfastening the occupational conundrum. [Journal Article]
- PRPsychiatry Res 2018 Jun 04; 267:168-174
- Burnout and mental disorders have been reported in the financial industry. This study aims to examine the structural validity of the Maslach Burnout Inventory (MBI) and to investigate the connection ...
Burnout and mental disorders have been reported in the financial industry. This study aims to examine the structural validity of the Maslach Burnout Inventory (MBI) and to investigate the connection between the dimensions of burnout and depressive symptoms in a sample of 1046 bank employees from North Brazil who completed the MBI and the Patient Health Questionnaire-9 (PHQ-9. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to cross-check the factorial structure of the MBI. One-way analysis of variance and correlation analysis were applied to elucidate the relationship between burnout and depressive symptoms. Both 3-factor and 4-factor oblique solutions were plausible EFA models of the burnout syndrome. Results of CFA supported the 19-item 4-factor structure as the best fitting model to data, with two exhaustion factors ("exhausted" and "strained"), depersonalization, and personal accomplishment. The PHQ-9 total score and individual score of depressive items were significantly correlated with all MBI dimensions, notably with the emotional exhaustion dimension. The moderate-to-high correlation observed between burnout and depression suggest the potential utility of the MBI for evaluating burnout among bank employees as well as to point out the need to evaluate systematically the burnout and depressive symptoms given to their potential association.
- Promoting Greater Diversity and Inclusion in Radiology Research: A Survey of the American Association for Women Radiologists. [Journal Article]
- ARAcad Radiol 2018 Jun 13
- CONCLUSIONS: Initiatives targeting the identified challenges to radiology research could help promote greater diversity and inclusion among radiologist researchers, which in turn has implications for improving the quality of such research.
- Comparable indicators of therapeutic misconception between epilepsy or Parkinson's disease patients between those with clinical trial experience and trial non-participants. [Journal Article]
- SSeizure 2018 Jun 09; 60:61-67
- CONCLUSIONS: While most in our study agreed that patients should be asked to participate in CTs, only 15% of subjects had done so. The discrepancy between willingness to participate and recruitment figures could be minimised by improving knowledge of CTs and communication between patients and researchers. Additionally, the groups displayed comparable false CT-related assumptions, raising questions about whether these subjects fully understood the clinical research's ultimate goal and CT participants had given true informed consent. These issues have practical and ethics implications for clinical investigators.
- Factors affecting empathetic patient care behaviour among medical doctors and nurses: an integrative literature review. [Review]
- EMEast Mediterr Health J 2018 Jun 10; 24(3):311-318
- CONCLUSIONS: The organizational culture is strongly implicated in inhibiting empathy. Healthcare providers' empathetic responses to patients are linked and connected to a well-resourced, collegial, professional organizational environment that builds empathy towards everyone (not only patients).
- Early-life and pubertal stress differentially modulate grey matter development in human adolescents. [Journal Article]
- SRSci Rep 2018 Jun 15; 8(1):9201
- Animal and human studies have shown that both early-life traumatic events and ongoing stress episodes affect neurodevelopment, however, it remains unclear whether and how they modulate normative adol...
Animal and human studies have shown that both early-life traumatic events and ongoing stress episodes affect neurodevelopment, however, it remains unclear whether and how they modulate normative adolescent neuro-maturational trajectories. We characterized effects of early-life (age 0-5) and ongoing stressors (age 14-17) on longitudinal changes (age 14 to17) in grey matter volume (GMV) of healthy adolescents (n = 37). Timing and stressor type were related to differential GMV changes. More personal early-life stressful events were associated with larger developmental reductions in GMV over anterior prefrontal cortex, amygdala and other subcortical regions; whereas ongoing stress from the adolescents' social environment was related to smaller reductions over the orbitofrontal and anterior cingulate cortex. These findings suggest that early-life stress accelerates pubertal development, whereas an adverse adolescent social environment disturbs brain maturation with potential mental health implications: delayed anterior cingulate maturation was associated with more antisocial traits - a juvenile precursor of psychopathy.
- Conflicting duties and restitution of the trusting relationship. [Journal Article]
- JMJ Med Ethics 2018 Jun 15
- It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a ...
It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a form of moral compensation. This paper challenges such a 'compensation view' of conflict and argues that it misleadingly makes the role morality into a personal contract between professional and patient. Two competing views are therefore considered. The 'unity view' argues that there are no real conflicts between professional duties. Hence, there can be no residual duties that are impossible to discharge and no special claim on the part of the patient. It is argued that this fails because the institutional nature of the role morality requires us to accept possibility of conflict. The paper articulates and defends a third view, where conflict triggers a professional duty of restitution. This duty is not a matter of making amends for a previous wrong, but rather a matter of rebuilding a trusting relationship that has been damaged due to blameless circumstances.
- Dietary Supplement Use in a Large, Representative Sample of the US Armed Forces. [Journal Article]
- JAJ Acad Nutr Diet 2018 Jun 12
- CONCLUSIONS: DS use was considerably higher in the US Armed Forces compared with civilian populations, although many demographic and lifestyle factors associated with use were similar. Some categories of DSs extensively used by SMs such as bodybuilding supplements have been associated with adverse events. Discouraging substance abuse through peer groups and leadership actions may reduce use of unnecessary or dangerous DSs.
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- Climate change and temperature extremes: A review of heat- and cold-related morbidity and mortality concerns of municipalities. [Review]
- MMaturitas 2018; 114:54-59
- Cold and hot weather are associated with mortality and morbidity. Although the burden of temperature-associated mortality may shift towards high temperatures in the future, cold temperatures may repr...
Cold and hot weather are associated with mortality and morbidity. Although the burden of temperature-associated mortality may shift towards high temperatures in the future, cold temperatures may represent a greater current-day problem in temperate cities. Hot and cold temperature vulnerabilities may coincide across several personal and neighborhood characteristics, suggesting opportunities for increasing present and future resilience to extreme temperatures. We present a narrative literature review encompassing the epidemiology of cold- and heat-related mortality and morbidity, related physiologic and environmental mechanisms, and municipal responses to hot and cold weather, illustrated by Detroit, Michigan, USA, a financially burdened city in an economically diverse metropolitan area. The Detroit area experiences sharp increases in mortality and hospitalizations with extreme heat, while cold temperatures are associated with more gradual increases in mortality, with no clear threshold. Interventions such as heating and cooling centers may reduce but not eliminate temperature-associated health problems. Furthermore, direct hemodynamic responses to cold, sudden exertion, poor indoor air quality and respiratory epidemics likely contribute to cold-related mortality. Short- and long-term interventions to enhance energy and housing security and housing quality may reduce temperature-related health problems. Extreme temperatures can increase morbidity and mortality in municipalities like Detroit that experience both extreme heat and prolonged cold seasons amidst large socioeconomic disparities. The similarities in physiologic and built-environment vulnerabilities to both hot and cold weather suggest prioritization of strategies that address both present-day cold and near-future heat concerns.