RESUMEN

Purpose: The construction industry is a diverse sector with exposure to multiple psychosocial and environmental workplace hazards that increase the risk of injury. This scoping review aims to consolidate the existing literature on the physical and psychosocial determinants influencing the risk of occupational physical injuries among construction workers globally. Methods: A scoping review was conducted using the PRISMA extension checklist guided. Literature searches were performed between June and October 2023 in electronic academic databases. Results: A total of 77 studies were identified, encompassing various geographical regions, including North America (n = 29), Africa (n = 18), Europe (n = 12), Asia (n = 9), the Middle East (n = 5), and Oceania (n = 4). The review identified physical and psychosocial factors in 3 domains influencing occupational physical injuries: workplace physical environment (eg, exposure to physical hazards, availability and utilization of personal protective equipment, company size, and job type), workplace culture (eg, psychosocial stressors, gender-related barriers, migrant and ethnic disparities, educational background), and physical wellbeing, health and aging (eg, age, obesity, sleep quality, marital stats, and physical health status). Notably, workers from social minority groups (eg, women, ethnic and migrant workers) of young (<25 years old) or older ages (45-55 years old) employed in smaller construction companies are vulnerable to increased injury risk and exposure to physical and psychosocial hazards in the workplace. Conclusion: The review emphasizes a global paucity of research examining the implications of physical and psychosocial factors on injury risk within the construction industry. Future research should prioritize investigating the impact of psychosocial hazards on younger and older workers to detect age-related differences in injury rate, treatment access, and work-related health outcomes.

RESUMEN

Home care rehabilitation professionals (hcRPs) provide health services for clients with a broad range of medical conditions. During the COVID-19 pandemic, home care rehabilitation professionals experienced exacerbations of pre-existing work-related stressors, increased risk of transmission of the COVID-19 virus, reduced resource availability, greater workloads, and staffing shortages. The primary aim of this study was to examine the experience and impact of occupational and mental stress on hcRPs working during the COVID-19 pandemic. Semi-structured interviews were conducted with 24 hcRPs working in Ontario, Canada during the COVID-19 pandemic. Inductive thematic analysis was used to interpret and organize the data into conceptualized themes. Interview data was organized into three themes: (a) unique challenges of a home care rehabilitation professional, (b) COVID-19 exacerbations of home care occupational and mental stress, and (c) personal and workplace coping strategies. Many participants reported reducing their hours or taking on adjunctive roles in different clinical settings outside of home care due to work-related stress exacerbated by the COVID-19 pandemic. With a focus on the effects of COVID-19 on the practice of home care, this study provides a unique perspective on the challenges experienced by hcRPs during an emergent and evolving global public health concern. The exploratory nature of this research works towards providing a framework of factors to be addressed when creating sustainable healthcare interventions, as well as recommendations to support hcRPs to benefit both the community and health-care providers.

RESUMEN

Several factors have been identified to influence the registration and retention of apprentices in the construction trades. Employer engagement is a key factor to promote growth in apprenticeships in the construction trades as participation rates continue to be low among small-to-medium-sized employers. In this study, we evaluated the effectiveness of the Ontario Electrical League's (OEL) employer mentorship program through the perspectives of small-to-medium-sized employers using a qualitative approach. Two focus groups were conducted virtually with 11 employers. Focus group audio transcripts were recorded and transcribed for thematic analysis. Themes were generated using a data-driven approach to examine the relationships between mentorship program outcomes and perspectives on industry-related recruitment and retention barriers. Three themes were identified: (a) long-term apprentice recruitment and retention challenges; (b) equity and mental health in the workplace; and (c) industry challenges and mentorship program outcomes. Generally, this sample of employers appreciated the value of the OEL mentorship program through praise of the continued educational support, employer management expertise, hiring resources, and apprentice onboarding tools despite industry barriers in trade stigma, equity and mental health in the workplace, and recruitment and retention challenges. Industry partners should work with these small-to-medium-sized employers to develop workplace initiatives and engage external partners to provide ongoing apprenticeship mentorship support to address the recruitment and retention barriers identified in this study.

Asunto(s)

RESUMEN

(i) Background: Working in the electrical and plumbing sectors is physically demanding, and the incidence of physical injury and work disability is high. This study aimed to assess the mental health and well-being of skilled trades workers working in the electrical and plumbing sectors; (ii) Methods: Forty participants completed an online survey assessing burnout, work-related factors, and mental health issues. Data were analyzed to determine the association between demographics, the availability, and importance of work-related factors, and burnout using a two-sample Mann-Whitney U test; (iii) Results: Our findings showed that among the work-related factors, workplace safety, family commitments, income and benefits, and full-time employment opportunities might be crucial factors to keep study participants working at their current position. Financial support for external training, which was found to be the most important factor in preventing colleague-related burnout, was available to the satisfaction of approximately 50% of the participants; (iv) Conclusion: Work-related factors such as workplace safety and the availability and support for external training may be protective against all types of burnout among this population. Future studies may consider a larger sample size with a more diverse group of participants and perform an intersectional analysis to incorporate minority identities in the analyses.

RESUMEN

Pediatric internalizing disorders are prevalent and characterized by a maladaptive cognitive, emotional response to a perceived stressor. The hypothesized effect of this response is observable changes in behavior mediated by homeostatic inflammatory cytokines. The aim of this study was to synthesize the literature and analyze the effect of cytokines on pediatric internalizing disorders. Influential moderating variables, including mean body mass index, fasting status at blood collection, participant sex, cytokine type, mean age, percentage of sample medicated, and diagnosis, were also assessed. A systematic literature search was performed in electronic databases (Medline, PubMed, and PsycINFO) from January 1, 1980 to June 15, 2022. Case-control studies of pediatric internalizing disorders, specifically anxiety and depression, were reviewed for their association with peripheral cytokine levels. Meta-analyses were performed using a random effects multi-variate model and effect sizes were calculated using Hedge's g for IL-2, CRP, IL-6, TNF-α, IL-1ß, IFN-γ, and IL-10. Thirty-three studies were reviewed and 28 studies were included in the meta-analysis (n = 1322 cases and n = 3617 controls). Peripheral cytokine levels were elevated in pediatric internalizing disorders compared to controls (Hedge's g = 0.19, p < 0.001). In the moderator analyses, depression diagnosis (Hedge's g = 0.18, p = 0.009) and non-fasting blood collection (Hedge's g = 0.20, p = 0.006) were significant. The meta-analytic findings are limited by methodological variation between studies, high heterogeneity, and low statistical power. Despite this, the findings suggest that elevated peripheral cytokine levels may play a role in the etiology and/or symptom maintenance of pediatric internalizing disorders.

RESUMEN

BACKGROUND AND OBJECTIVES: Patients with opioid use disorders and mood and anxiety symptoms have a variable prognosis. Few randomized controlled trials (RCTs) have evaluated treatment of depression or anxiety in patients receiving opioid agonist therapies (OAT). This review evaluates studies of pharmacotherapy/psychotherapy for treating symptoms of depression or anxiety in patients receiving OAT. METHODS: Public databases were searched for clinical trials of pharmacotherapy or psychotherapy for managing depression or anxiety symptoms in adults receiving OAT. Subsequently, we conducted a random effects meta-analysis model of RCTs by antidepressants subclasses. RESULTS: In our literature search, we identified 22 RCTs, eight of which were eligible for meta-analysis. Seven studies evaluated antidepressants in patients already maintained on OAT; two studies reported significant results for antidepressant effects versus placebo. Similarly, two of the seven studies that initiated antidepressants with OAT had advantages over placebo. Meta-analysis of grouped data revealed that tricyclic antidepressants (TCAs) (n = 235) significantly improved mean depression scores (SMD = -2.35, 95%CI: [-4.35, -0.34], z = -2.29, p = .022) while Selective Serotonin Reuptake Inhibitors (SSRIs) (n = 311) were not significantly different than placebo (SMD = 0.47, 95%CI: [-0.35, 1.30], z = 1.12, p = .263). Four out of five studies that implemented psychotherapeutic approaches reported a greater reduction of depressive symptoms than the comparison group. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: To date, psychotherapy has the most documented evidence for efficacy. TCAs appears effective but with more adverse effects than SSRIs. Further studies of OAT and adjunct antidepressant treatments for dual diagnosis patients are warranted. (Am J Addict 2017;26:551-563).

Asunto(s)

RESUMEN

Dysfunctional mechanisms in the serotonergic system have been implicated in suicidal behavior among patients with schizophrenia. However, previous association analyses of major serotonin genes have provided inconsistent findings regarding their role in suicidal behavior. The goal of the current study was to identify single-nucleotide polymorphisms (SNP) within HTR2A that directly affect CpG methylation sites in schizophrenic patients with suicidal behavior. Furthermore, direct methylation analysis was performed using genomic DNA from peripheral leukocytes employing bisulfite pyrosequencing to assess the contributions of six CpG sites in HTR2A exon I in 67 schizophrenia patients assessed for lifetime suicide attempt. Potential methylation in 25 CpG SNPs across the entire HTR2A gene was analyzed considering their direct contribution to methylation. When we compared direct methylation between attempters and nonattempters, we found that only the polymorphic T102C (rs6313) was significantly different between the two groups (p = 0.02). Furthermore, in the potential methylation analysis, we found a nominal association with suicide attempt for six of the 25 SNPs analyzed, i.e. rs2770293 (p = 0.045), rs6313 (p = 0.033), rs17068986 (p = 0.029), rs4942578 (p = 0.024), rs1728872 (p = 0.014), and rs9534511 (p = 0.003). The results of this investigation provide preliminary evidence that the combined analysis of CpG SNPs and methylation may be useful for investigating the genetic and epigenetic factors involved in suicidal behavior.

Asunto(s)

RESUMEN

Recent studies have shown an association between gene alterations by epigenetic mechanisms and suicidal behavior. These epigenetic mechanisms are mitotically, and in some cases meiotically, heritable changes in the genome through non-DNA sequence coding processes that alter gene expression as a result of variable changes in environmental stimuli. Genome-wide association studies have been inconsistent in elucidating the association between genes and suicidal behavior, thereby making the heritability of suicidal behavior is unclear. However, recent epigenetic studies have provided evidence that epigenetic mechanisms could deliver the missing link between the heritability of suicidal behavior and the interaction between environment and the genome. The present review provides an in-depth discussion of epigenetic mechanisms that may regulate gene expression in suicidal behavior. The findings of current epigenetic studies on suicidal behavior will also be discussed considering future epigenome-wide association studies on elucidating the contributions of environment and genome on suicidal behavior.

Asunto(s)

RESUMEN

The P300 waveform has been inconsistently linked to the maladaptive information-processing characterized in panic disorder (PD). The purpose of this study was to synthesize previous event-related potential (ERP) findings and determine whether patients with PD have significant abnormalities in the P300 wave compared to controls. We performed a systematic literature search for studies published between 1980 and 2013 that reported P300 measurements in patients with PD and controls. Effect size estimates were computed using the restricted maximum likelihood model. We identified 14 ERP studies that analyzed P300 amplitude (461 PD and 355 controls), and 11 ERP studies that analyzed latency (320 PD and 282 controls). Patients with PD had reduced P300 amplitudes compared to controls, but this difference was non significant at midline electrodes (n = 14, ES -0.16; z = -1.55, p = 0.122). However, P300 amplitude was significantly reduced when analyzing the Pz electrode independently (n = 7, ES -0.48, z = -3.92, p < 0.001). No significant differences between cases and controls in P300 latency were observed at the midline electrodes (n = 11, ES 0.11, z = 0.64, p = 0.524). This meta-analysis included non-peer reviewed literature and ERP stimuli with varying levels of emotional salience, which may have introduced bias into the analysis. There is no robust evidence that P300 latency alterations are present in patients with PD; however, there are indications of reduced amplitude at Pz relative to controls. Reductions in amplitude may be associated with reduced neural resources allocated to contextual updating, selective attention, and neural inhibition mechanisms.

Asunto(s)

RESUMEN

OBJECTIVE(S): In the present study, we examined whether there was an association between dopamine-ß hydroxylase (DBH) promoter polymorphisms (a 5'-ins/del and a GTn repeats) and a history of suicide attempt in 223 chronic schizophrenia individuals using statistical and molecular analyses. Within the genetic association study design, we compared the statistical haplotype phase with the molecular phase produced by the amplicon size analysis. MATERIALS AND METHODS: The two DBH polymorphisms were analysed using the Applied Biosystem 3130 and the statistical analyses were carried out using UNPHASED v.3.1.5 and PHASE v.2.1.1 to determine the haplotype frequencies and infer the phase in each patient. Then, DBH polymorphisms were incorporated into the Haploscore analysis to test the association with a history of suicide attempt. RESULTS: In our sample, 62 individuals had a history of suicide attempt. There was no association between DBH polymorphisms and a history of suicide attempt across the different analytical strategies applied. There was no significant difference between the haplotype frequencies produced by the amplicon size analysis and statistical analytical strategies. However, some of the haplotype pairs inferred in the PHASE analysis were inconsistent with the molecular haplotype size measured by the ABI 3130. CONCLUSION: The amplicon size analysis proved to be the most accurate method using the haplotype as a possible genetic marker for future testing. Although the results were not significant, further molecular analyses of the DBH gene and other candidate genes can clarify the utility of the molecular phase in psychiatric genetics and personalized medicine.

Asunto(s)

RESUMEN

The present meta-analysis investigated the clinical utility of the auditory P300 latency event-related potential in differentiating patients with Alzheimer's disease (AD), patients with mild cognitive impairment (MCI), and unaffected controls. Effect size estimates were computed from mean P300 latency measurements at midline electrodes between patients and unaffected controls using the random effects restricted maximum likelihood model. The effects of clinical and ERP/EEG methological variables were assessed in a moderator analysis. P300 latency was found to be significantly prolonged in patients with AD (and MCI) compared to unaffected controls. Shortened P300 latencies were observed when comparing patients with MCI to patients with AD. Clinically relevant differences in P300 latency effect sizes were associated with mean age, interstimulus interval, stimulus difference, target frequency, reference electrode, and sampling rate. The meta-analytic findings provide robust statistical evidence for the use of the auditory P300 latency subcomponent as a biological marker of prodromal AD.

Asunto(s)

RESUMEN

OBJECTIVES: The N200 latency subcomponent has the potential to be an accurate neurophysiological marker of the cognitive deterioration seen in Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS: Standard mean difference (SMD) estimates of the N200 latency subcomponent were compared in three treatment groups: patients with AD, patients with MCI, and an unrelated elderly control group. RESULTS: Patients with AD had significantly prolonged N200 latencies compared to the control group, pooled SMD: 0.866 (95% CI: 0.517 to 1.214, z=4.87, p<0.001). Patients with MCI had significantly prolonged N200 latencies compared to the control group, pooled SMD: 0.578 (95% CI: 0.213 to 0.943, z=3.31, p=0.002). When comparing patients with AD and MCI the N200 latencies were similar, pooled SMD: 0.096 (95% CI: -0.261 to 0.453, z=0.53, p=0.598). CONCLUSION: The abnormalities present in the N200 latency subcomponent validate previous research that N200 latency is an informative indicator of information-processing deterioration in patients with cognitive impairment. SIGNIFICANCE: Clinically, measurements of N200 latency can be used as a risk assessment of elderly patients that may be progressing to mild cognitive impairment and/or Alzheimer's disease.

Asunto(s)