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BACKGROUND: Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors. METHODS: The study population included working-age individuals, aged 22-62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304). Data were obtained from Swedish national and regional registers and were linked using pseudonymised unique personal identification numbers. The primary outcome was days with WD (sum of sickness absence and disability pension days) during the three years before and three years after a diagnosis of anxiety-, mood/affective-, or stress-related disorders in primary healthcare. A zero-inflated Poisson group-based trajectory model was used to identify groups of individuals with similar patterns of WD over the study period, with a multinomial logistic regression used to examine associations of sociodemographic, clinical, and clinical-related factors with trajectory group membership. RESULTS: Four distinct trajectory groups were found, high increasing (5.1%), with high levels, from 16 to 80 days of WD in six-monthly intervals during follow-up, peak (11.1%), with a peak in WD, up to 32 days of WD, around the time of the diagnosis, low increasing (12.8%), with an increase in days of WD from 4 to 22 during the study period, and constant low (71.1%), with almost no WD over the study period. In multinomial regression models, diagnostic category, psychotropic medication use, a diagnosis of a psychiatric disorder within secondary healthcare, age at diagnosis, and occupation were associated with WD trajectory groups. CONCLUSIONS: Around two-thirds of individuals treated for a new episode of any anxiety-, mood/affective-, or stress-related disorder in primary healthcare have an excellent prognosis regarding WD. Several sociodemographic and clinical characteristics were associated with group membership; these factors could identify individuals at risk of long-term welfare dependency and who might benefit from interventions to promote a return to work.

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Negative consequences of musculoskeletal pain and injuries on the nurses' health and well-being can increase job dissatisfaction and impose high costs on healthcare centers due to lost workdays and compensation claims. This study aimed to identify policies, programs, and interventions that might be effective in the prevention and reduction of sickness absence and improvement of work outcomes in nursing staff with these problems. The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Electronic databases were searched up to November 9-23, 2022. The keywords "musculoskeletal disorders", "nurse", "return to work", "sickness absence", and "sick leave" and their equivalents were combined using Boolean operators OR/AND. Reference lists of eligible literatures were also screened to identify related studies. In this study, a total of 3365 records were retrieved. After two rounds of screening, 15 studies were selected for qualitative synthesis. These studies included seven randomized controlled trial, five pre-post studies, two cohort, and one cross-sectional. Six types of interventions identified including back college, early workplace-based intervention, physical activity/training, psychosocial education, multifaceted intervention, and ergonomics program. There is insufficient evidence to identify effective interventions in preventing and reducing sickness absence, and improvement of work outcomes in nursing personnel with work-related musculoskeletal disorders. Numerous factors affected the occurrence of such disorders, and their consequences, therefore comprehensive strategy tailored to the injured person's needs should be considered.

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AIM: To explore newly qualified nurses and midwives' experience of continuing professional development (CPD) and factors associated with CPD participation during newly qualified nurses and midwives' transition, such as job satisfaction and intention to leave. BACKGROUND: Newly qualified nurses and midwives find it difficult to make the transition to their first registered post. During the transition, professional support through CPD is essential to build competence and confidence and increase job satisfaction and retention. DESIGN: A cross-sectional study. METHODS: This study was conducted from September 2021 to October 2022. The online survey, consisting of 83 items, included: the Questionnaire of Professional Development of Nurses (Q-PDN), the McCloskey/Mueller Satisfaction Scale, three questions about Intention to Leave and two open-ended questions. The analysis was conducted by combining the results from the three European countries. Descriptive and logistic regression analyses were performed. The participants were Newly qualified nurses and midwives from Ireland, Italy and Croatia RESULTS: A total of 476 Newly qualified nurses and midwives completed the survey. Of these, 32 % (n=152) were satisfied with opportunities to participate in CPD activities and 54.8 % (n=261) had participated in a formal CPD programme. Most newly qualified nurses and midwives (89.1 %, n=424) agreed that they would like to participate in a formal CPD programme. Almost half of the participants (46.4 %, n=219) had thought of leaving the profession in the previous 12 months. We found that 'having participated in a programme to support newly qualified nurses (OR=0.29; p<.001), 'participating in mandatory CPD activities' (OR=0.76; p=0.016) and 'working in the clinical area of community' (OR=0.31; p<.001) or in maternity (OR=0.46; p=0.040) were positively associated with better job satisfaction. CONCLUSIONS: Participation in support programs during the transition period contributes to increasing job satisfaction for newly qualified nurses and midwives. During their transition, newly qualified nurses and midwives need more support from their institution managers, in terms of ensuring a better learning environment, as well as formal and informal supports.

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The rise in the number of people on sick leave for common mental disorders is a growing concern, both from a societal and individual perspective. One common suggestion to improve the return-to-work process is increased cooperation between the relevant parties, including at least the employer, the social insurance agency and health care. This suggestion is often made on the presumption that all parties share the common goal of reintegrating the patient-employee back into the workplace. In this paper we investigate this presumption by mapping out the ethical frameworks of these three key actors in any return-to-work process. We show that although the goals of these actors often, and to a large extent, overlap there are potential differences and tensions between their respective goals. Further, we emphasise that there may be other limitations to an actor's participation in the process. In particular the health care system is required to respect patient autonomy and confidentiality. There is also an inherent tension in the dual roles of health care professionals as therapists and expert witnesses in work ability assessment. In conclusion, there are potential tensions between the key actors in the return-to-work process. These tensions need to be addressed in order to enable an increased cooperation between actors and to facilitate the development of a feasible plan of action for all parties, including the employee.

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AIMS: This study aimed to investigate body function and daily life activities 18 months after Covid-19 infection, depending on the initial severity of disease and according to sex. METHODS: All 11,955 individuals on sick leave due to Covid-19 during the first wave of the pandemic in Sweden were invited to answer a questionnaire regarding experiencing negative changes in body function and daily life activities approximately 18 months after the start of sick leave. The analysis of data included descriptive statistics, group comparisons and multivariable binary logistic regressions (two groups). RESULTS: Of 5464 responders (45.7%), 4676 (85.6%) reported experiencing at least one problem with body function, and the reported prevalence of problems with daily life activities was 46%. The most frequently reported problems were fatigue (66.3%), cognition, sleep and movement. In general, women and those initially hospitalised reported more problems. In the regression analyses, problems with body function could partly explain whether individuals experienced problems with daily life activities. However, only fatigue and movement significantly contributed throughout all groups (p<0.001). Furthermore, the odds ratios for fatigue were larger in regressions for women than for men. CONCLUSIONS: In this nationwide study, more than 8 out of 10 individuals experienced problems with body function 18 months after being on sick leave due to Covid-19, with women and those initially hospitalised reporting more problems. Problems with body function, such as fatigue, could partly explain problems with daily life activities. However, the mechanisms behind the consequences are not yet clear and need to be further investigated.

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Background: Childcare leave extensions can sometimes negatively affect the professional clinical training of early-career psychiatrists in Japan. During childcare leave, being able to learn in the examination room while staying at home would be useful. Therefore, we developed a training system using a teleoperated robot (Sota) for young psychiatrists who wanted to participate in the examination room during childcare leave while remaining at home. Case Presentation: We report the case of a patient with autism spectrum disorder (ASD) comorbid with Tourette's disorders (P). A young female psychiatrist (D) used the training system to learn from a board-certified psychiatrist. In this case, the board-certified psychiatrist, P, and the robot were placed in the examination room. D teleoperated Sota from home, allowing her to talk to the board-certified psychiatrist and P. She learned about the clinical features of Tourette's syndrome by observing the examination of the board-certified psychiatrist and hearing the patient's distress. P was satisfied with the fact that he was seen not only by a board-certified psychiatrist but also by D. Conclusion: These case findings suggest that our system is helpful for young psychiatrists who want to study in the examination room during childcare leave while staying at home. Future studies should include a single-case experimental design with information regarding key outcome variables and other relevant variables gathered regularly over time.

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PURPOSE: Optimal timing of knee arthroplasty (KA) is complex: operating at a younger age increases life time risk of revision, while delay results in an increased risk of job loss. This study evaluates whether disability benefits recipients due to knee osteoarthritis have an increased odds of returning to work (RTW) following KA. METHODS: A retrospective cohort study was performed among long-term disability benefits recipients due to knee osteoarthritis using data of the Dutch Employee Insurance Agency. Logistic regression assessed whether recipients with KA had a higher odds of RTW in 10 years following start of disability benefits, compared to those without KA. RESULTS: A total of 159 participants were included. During 10-year follow up, 42% had received KA and 37% had returned to work. No association was observed between KA and RTW (OR 1.39, 95% CI 0.62-3.12). Prognostic factors for RTW were being the main breadwinner (OR 7.93, 95% CI 2.95-21.32) and classification as 100% work disability (OR 0.20, 95% CI 0.09-0.45). CONCLUSIONS: KA has no beneficial effect on RTW among patients with knee osteoarthritis granted long-term disability in the Netherlands. For RTW, KA is probably best performed within the two years of paid sick leave before long-term disability is assessed in the Netherlands.

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OBJECTIVES: The objectives were to assess the prospective associations between work-related factors, including psychosocial and physical work factors and working time/hours factors, and sickness presenteeism alone or combined with sickness absence. METHODS: The study relied on prospective data of a national representative sample of 16 129 employees followed up from 2013 to 2016 in France. Work-related factors were assessed in 2013 and included 20 psychosocial work factors, 4 working time/hours factors and 4 physical work factors. Sickness presenteeism was studied using two items in 2016: the presence and duration of sickness presenteeism within the last 12 months. Weighted Hurdle and multinomial logistic regression models were performed to study the prospective associations between work-related factors at baseline and sickness presenteeism (both presence and duration) and sickness absence at follow-up. Models were adjusted for covariates. RESULTS: Almost all psychosocial and physical work factors were predictive of sickness presenteeism (ORs ranging from 1.30 to 2.07 for men, and from 1.16 to 2.30 for women) but only some of them predicted its duration. Dose-response associations were observed between multiple exposures to these factors and sickness presenteeism. These factors predicted more sickness presenteeism alone or combined with sickness absence than sickness absence alone. Gender differences were observed in these associations, as some associations were found to be stronger among women than among men. CONCLUSIONS: There is a need to study sickness presenteeism and sickness absence combined. Prevention oriented towards the psychosocial and physical work environment may contribute to reduce sickness presenteeism and sickness absence.

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BACKGROUND: Most studies about accidents and about PTSD, respectively, have been conducted either on blue-collar workers, or on the entire working population. There are very few such studies on white-collar workers. AIM: To examine diagnosis-specific sickness absence (SA) and disability pension (DP) after a work accident or PTSD, respectively, among white-collar workers in the private retail and wholesale industry. METHODS: A prospective population-based cohort study of all 192,077 such workers aged 18-67 (44% women) in Sweden in 2012, using linked microdata from nationwide registers. We identified individuals who had secondary healthcare due to work-related accidents (n = 1114; 31% women) or to PTSD (n = 216; 79% women) in 2012-2016. Their average number of net days of diagnosis-specific SA (in SA spells > 14 days) and DP were calculated for 365 days before and 365 days after the healthcare visit. RESULTS: 35% of the women and 24% of the men had at least one new SA spell during the 365 days after healthcare due to work accidents. Among women, the average number of SA/DP days increased from 14 in the year before the visit to 31 days the year after; among men from 9 to 21 days. SA days due to fractures and other injuries increased most, while SA days due to mental diagnoses increased somewhat. 73% of women and 64% of men who had healthcare due to PTSD had at least one new SA spell in the next year. Women increased from 121 to 157 SA/DP days and men from 112 to 174. SA due to stress-related disorders and other mental diagnoses increased the most, while DP due to stress-related diagnoses and SA due to musculoskeletal diagnoses increased slightly. CONCLUSIONS: About a quarter of those who had secondary healthcare due to work accidents, and the majority of those with such healthcare due PTSD, had new SA in the following year. SA due to injury and mental diagnoses, respectively, increased most, however, SA/DP due to other diagnoses also increased slightly. More knowledge is needed on factors associated with having or not having SA/DP in different diagnoses after work accidents and among people with PTSD.

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BACKGROUND: Little is known about associations between occupational prestige, that is, the symbolic evaluation and social positioning of occupations, and sickness absence (SA) or disability pension (DP). We explored whether occupational prestige was associated with future SA or DP among women and men. METHODS: A Swedish 4-year prospective cohort study of all those in paid work and aged 25-59 in 2010 (N = 2,605,227; 47% women), using linked microdata from three nationwide registers and Standard International Occupational Prestige Scale values, categorised as 'very low', 'low', 'medium', 'high', or 'very high'. Odds ratios (ORs), 95% confidence intervals (CIs), crude and adjusted for several sociodemographic factors, were calculated for three outcomes: at least one SA spell (>14 days), >90 SA days, or DP occurrence, during follow-up (2011-2013). RESULTS: The mean number of SA days in 2010 varied by occupational prestige group, for example, 'very high': 3.0, 'very low': 6.5. Compared to those in occupations with 'very high' prestige, all other groups had higher adjusted ORs for all three outcomes. Among men, those with 'very low' occupational prestige had the highest OR for at least one SA spell: OR 1.51 (95% CI 1.47-1.56); among women, the 'medium' group had the highest OR: 1.30 (1.27-1.32). The results were similar for SA >90 days. OR for DP among women with 'very low' occupational prestige was 2.01 (1.84-2.19), and 3.55 (3.15-4.01) for men. CONCLUSIONS: Working in lower occupational prestige occupations was generally associated with higher odds of future SA/DP than working in higher prestige occupations; these associations were stronger for men than for women.

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Introduction: In 2020, Michigan implemented its first Naloxone Leave-Behind Program for Emergency Medical Service (EMS) field providers. Under the program, EMS field providers leave naloxone kits to individuals aged 15 or older they encounter in the field who have overdosed, who indicate they have a substance use disorder, or exhibit signs of opioid use and/or to bystanders, friends, or family that are present at the encounter. Methods: Survey of EMS field providers and administrators to assess perspectives on the Michigan NLB program. Comparisons of perspectives between field providers and administrators working in EMS agencies operating in medical control authorities (MCAs) participating in the NLB program (i.e., participating agencies) with field providers and administrators working for EMS agencies serving non-participating MCAs. Results: Most EMS field providers and administrators supported the Michigan NLB program. However, some were concerned about the unintended consequences of leaving behind naloxone, including the potential for recipients to use more drugs or be less likely to seek treatment. Perspectives of NLB program effectiveness were similar between EMS administrators and field providers. Participating administrators' top-cited barrier to implementation was convincing field providers to leave behind naloxone, while non-participating administrators were concerned with stocking naloxone kits. Conclusions: Additional engagement and training to address concerns by EMS field providers and administrators about the benefits of the NLB program are needed to expand program participation intensity. Streamlining naloxone procurement and increasing messaging about free access to naloxone for participating in the program may help increase adoption.

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OBJECTIVES: Hair cortisol concentration (HCC) indicates chronic stress exposure, which is a risk factor in the pathogenesis of burnout and depression. However, findings on HCC are inconsistent. Similarly, intervention studies show mixed effects on HCC. The present study aimed to shed light on these inconsistencies, by additionally considering also hair cortisone. METHODS: Twenty-five patients with a burnout-related depressive disorder receiving a multimodal inpatient treatment for clinical burnout and 17 matched healthy controls participated in this study. All participants provided 1 cm long hair samples at the beginning and end of the treatment. HCC and hair cortisone levels (HCNC) were determined. Meteorological data and duration of sick leave were considered as potential covariates. Burnout and depression were assessed with self-ratings, the latter also with examiner ratings. RESULTS: There were no significant group differences in glucocorticoid levels. Treatment led to a decrease in both depression severity and hair glucocorticoid concentration in inpatients, while lower HCNC in particular predicted a greater reduction in depression severity. Moreover, meteorological data and the duration of sick leave were also found to have an effect on hair glucocorticoid concentrations. CONCLUSIONS: These results suggest that multimodal inpatient treatment of clinical burnout considerably reduced stress on both a psychological and biological level. In parallel, hair glucocorticoids appear to be sensitive biomarkers for the evaluation of treatment success and prediction. Examining both HCC and HCNC in intervention studies may provide clearer results than the usual examination of HCC alone.

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Introduction: Parental leave yields significant health benefits for parents and children. While many medical associations endorse parental leave, it is unknown what parental leave they provide for their employees. Objective: To assess parental leave policies of national physician societies for their employees including paid versus unpaid and parity between birth mothers and non-birthing parents. Methods and Materials: A cross-sectional analysis in 2023 examined parental leave policies of national physician societies, including the American Medical Association (AMA), American Osteopathic Association (AOA), and six specialty societies: American College of Obstetricians and Gynecologists (ACOG), American College of Osteopathic Obstetricians and Gynecologists (ACOOG), American Academy of Pediatrics (AAP), American College of Osteopathic Pediatricians (ACOP), American Academy of Family Physicians (AAFP), and American College of Osteopathic Family Physicians (ACOFP). Examination of policies included: duration, whether paid or unpaid; qualifications before receiving benefit; and whether non-birthing, adoptive, and foster parents were covered. Results: Among the eight societies surveyed, two (25%) did not disclose their policies (ACOG, ACOP), and one (12.5%) lacked a policy (ACOOG). Of the remaining five, two (40%) offered paid leave (AMA, AAP), while three (60%) provided unpaid leave in line with legal requirements (AOA, AAFP, ACOFP). Benefits for non-birthing parents mirrored those for birth mothers, although the AMA offered birth mothers enhanced benefits. Conclusions: Only a minority of surveyed physician societies provide paid parental leave. Physician societies should consider providing paid parental leave for their employees and making their policies publicly available to promote and model the benefit of paid parental leave.

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Accurately predicting the state of health (SOH) of lithium-ion batteries is fundamental in estimating their remaining lifespan. Various parameters such as voltage, current, and temperature significantly influence the battery's SOH. However, existing data-driven methods necessitate substantial data from the target domain for training, which hampers the assessment of lithium-ion battery health at the initial stage. To address these challenges, this paper introduces the multi-head attention-time convolution network (MHAT-TCN), amalgamating multi-head attention learning with random block dropout techniques. Additionally, it employs grey relational analysis (GRA) to select health indicators (HIs) highly correlated with battery capacity, thereby enhancing the accuracy of the model training. Employing leave-one-out crossvalidation (LOOCV), the MHAT-TCN network is pre-trained using data from batteries of the same model to facilitate comprehensive prediction of the target battery throughout its operational period. Results demonstrate that the MHAT-TCN network trained on HIs outperforms other models, enabling precise predictions across the entire operational period.

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We aimed to investigate the associations of working hour characteristics based on the international and local definitions with sickness absence (SA) among airport security personnel. The payroll-based registry data of daily working hours for 2016-2019 at one airport was limited to those with ≥30 work shifts in a year (n=377-687 employees). The conditional Poisson model for incidence rate ratios (IRR) with 95% confidence intervals (CI) was used for analyses. Based on the international definitions, only a few associations were found: each one-unit increase in weekly working hours and the number of consecutive working days were associated with a lower likelihood of SA. The local definitions were more consistently associated with SA: Each one-unit increase in shift length and time between shifts, higher variation in shift length, and the number of consecutive evening and night shifts were associated with a higher likelihood of SA. To conclude, especially the local definitions of working hour characteristics seem to be important limits for short SA. Thus, high variability of shift lengths and prolonged shifts could be avoided to reduce the risk of SA. Overall, keeping the working hours within any of the recommendations among airport security personnel could support well-being and health.

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AIM: The aim of this research is to determine the relationship between nurses' burnout status and their intention to leave the job during the COVID-19 pandemic. MATERIALS AND METHODS: The population of the descriptive study, which seeks a relationship, consists of nurses working in State Hospital, the sample consists of 213 nurses who agreed to participate in the research between April 2021 and August 2021. Data were collected using the 'Personal Data Collection Form', 'Burnout Scale' and 'Intention to Leave Scale'. Ethics committee approval was obtained for the study. RESULTS: Of the participants, 75.6% were women, 91.1% cared for patients with a diagnosis of COVID-19. The participants' Burnout Scale mean score was 4.34 ± 1.10, and the Intention to Leave Scale mean score was 2.94 ± 1.04. The relationship between burnout and age, gender, marital status, income status, unit of work, professional experience, choosing the profession voluntarily, being happy to do the job and caring for a patient with COVID-19 was found to be statistically significant (p < 0.05). It has been concluded that age, income status, unit of work, professional experience, choosing the profession willingly and being happy to do the job affect the intention to leave the job. A positive and significant relationship was found between the mean scores of the Burnout Scale and the mean scores of the Intention to Leave Scale. CONCLUSION: This study determined that as nurses' burnout level increased, their intention to quit their jobs increased.

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Introduction: Turnover of teachers is an mportant factor that impedes building and maintaining sustainable positive pedagogical practices to facilitate students' adjustment. The aim of this study was to elicit a portrait of teachers wanting to leave their profession. Methods: The research sample comprised 784 teachers from two European countries, namely 357 teachers from Latvia and 427 from Lithuania. Teachers were surveyed on their perceived stress, burnout, and intentions to leave their work alongside socio-demographic variables (age and work experience). Results: It was found that although teachers in both countries reported moderate stress and burnout levels, Lithuanian teachers indicated higher levels of two burnout dimensions, namely exhaustion and inadequacy. However, Latvian teachers indicated significantly higher turnover intentions. The portrait of teachers who intended to leave their profession was different in both countries. An unexpected finding was that Latvian teachers with a higher desire to leave their profession indicated lower stress and burnout rates. They were mostly 45-64 years old and had more than 25 years of work experience. In Lithuania, teachers' intention to leave their work was reported by older and more experienced teachers experiencing higher stress and burnout. Discussion: The findings highlight the need to consistently support the professional well-being of educators, both for committed teachers who want to stay in their profession and for those who might experience some detachment from their work at school.

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Introduction: Patriarchal norms continue to disadvantage women in Graduate Medical Education (GME). These norms are made salient when women trainees are pregnant. Although it is known that pregnant trainees experience myriad challenges, their experiences have not been examined through the lens of gendered organizations. To understand why these challenges persist, this study critically examined the experiences of pregnant trainees and their program directors (PDs) with navigating pregnancy. Methods: From October 2022 to April 2023, we recruited 13 resident or fellow trainees who experienced pregnancy while in training and their corresponding PDs. Data, in the form of semi-structured interviews, were collected, transcribed, and analyzed using thematic analysis. Guiding the analysis was feminist theory, in particular Acker's conceptualization of the ideal worker. The ideal worker norm promotes a culture of individuals who are singularly dedicated to their work with no external distractions or demands upon their time or effort. Results: Both sets of participants struggled with medicine's image of the ideal worker (i.e., a selfless and untethered professional). Trainees experienced guilt for using entitlements meant to assist them during this time, concern that their requests for help would signal personal weakness, and pressure to sacrifice their own wellbeing for work. While most PDs were aware of these phenomena, they experienced varying degrees of success in combating the negative effects of the ideal worker norm. Discussion: In each case, the image of the ideal worker lurked in the background of medical training, shaping trainees' experiences and PDs' perceptions and guidance. This study shows that even though the number of women has increased in medicine, the profession's underlying culture continues to signal that they must live up to the profession's expectations of the ideal worker.

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OBJECTIVE: The objective is to develop a natural and stable anti-oxidative stress and anti-ageing ingredient. In this study, we evaluated the changes in white tea leaves fermented with Eurotium cristatum PLT-PE and Saccharomyces boulardii PLT-HZ and their efficacy against skin oxidative stress. METHODS: We employed untargeted metabolomics technology to analyse the differential metabolites between tea extract (TE) and fermented tea extract (FTE). In vitro, using H2O2-induced HaCaT cells, we evaluated cell vitality, ROS, and inflammatory factors (TNF-α, IL-1ß, and IL-6). Additionally, we verified the effects on the extracellular matrix and nuclear DNA using fibroblasts or reconstructed skin models. We measured skin hydration, elasticity, wrinkle area, wrinkle area ratio, erythema area, and erythema area ratio in volunteers after using an emulsion containing 3% FTE for 28 and 56 days. RESULTS: Targeted metabolomics analysis of white tea leaves yielded more than 20 differential metabolites with antioxidant and anti-inflammatory activities, including amino acids, polypeptides, quercetin, and liquiritin post-fermentation. FTE, compared to TE, can significantly reduce reactive oxygen species (ROS) and protect against oxidative stress-induced skin damage in H2O2-induced HaCaT cells. FTE can inhibit H2O2-induced collagen degradation by suppressing the MAPK/c-Jun signalling pathway and can also mitigate the reactive oxygen species damage to nuclear DNA. Clinical studies showed that the volunteers' stratum corneum water content, skin elasticity, wrinkle area, wrinkle area ratio, erythema area, and erythema area ratio significantly improved from the baseline after 28 and 56 days of FTE use. CONCLUSION: This study contributes to the growing body of literature supporting the protective effects against skin oxidative stress and ageing from fermented plant extracts. Moreover, our findings might inspire multidisciplinary efforts to investigate new fermentation techniques that could produce even more potent anti-ageing solutions.

OBJECTIF: L'objectif est de développer un ingrédient naturel et stable contre le stress oxydatif et anti­âge. Dans cette étude, nous avons évalué les modifications dans les feuilles de thé blanc fermentées avec la PLT­PE Eurotium cristatum et la PLT­HZ Saccharomyces boulardii et leur efficacité contre le stress oxydatif cutané. MÉTHODES: Nous avons utilisé une technologie de métabolomique non ciblée pour analyser les métabolites différentiels entre l'extrait de thé (ET) et l'extrait de thé fermenté (ETF). In vitro, à l'aide de cellules HaCaT induites par l'H2O2, nous avons évalué la vitalité cellulaire, les ERO et les facteurs inflammatoires (TNF­α, IL­1ß, and IL­6). Nous avons également vérifié les effets sur la matrice extracellulaire et l'ADN nucléaire à l'aide de fibroblastes ou de modèles cutanés reconstruits. Nous avons mesuré l'hydratation de la peau, l'élasticité, la surface de rides, le rapport des surfaces de rides, la surface d'érythème, et le rapport des surfaces d'érythème chez des volontaires ayant utilisé une émulsion contenant 3% d'ETF pendant 28 et 56 jours. RÉSULTATS: L'analyse métabolomique ciblée des feuilles de thé blanc a révélé plus de 20 métabolites différentiels ayant des activités antioxydantes et anti­inflammatoires, notamment des acides aminés, des polypeptides, de la quercétine et de la liquiritine après fermentation. Par rapport à l'ET, l'ETF peut réduire significativement les espèces réactives de l'oxygène (ERO) et protéger contre les lésions cutanées induites par le stress oxydatif dans les cellules HaCaT induites par l'H2O2. L'ETF peut inhiber la dégradation du collagène induite par l'H2O2 en supprimant la voie de signalization MAPK/c­Jun et peut également atténuer les dommages causés par les espèces réactives de l'oxygène à l'ADN nucléaire. Les études cliniques ont montré que la teneur en eau de la couche cornée des volontaires, l'élasticité de la peau, la surface de rides, le rapport des surfaces de rides, la surface d'érythème et le rapport des surfaces d'érythème se sont significativement améliorés par rapport à la référence après 28 et 56 jours d'utilisation d'ETF. CONCLUSION: Cette étude contribue au corpus croissant de littérature soutenant les effets protecteurs des extraits de plantes fermentées contre le stress oxydatif cutané et le vieillissement. En outre, nos résultats pourraient inspirer des efforts pluridisciplinaires pour étudier de nouvelles techniques de fermentation susceptibles de produire des solutions anti­âge encore plus puissantes.

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Background: During the COVID-19 pandemic, nurses encountered substantial infection risks and psychological strain, which severely affected their emotional well-being, professional attitudes, and job performance. This study investigated the impact of nurses' fear of COVID-19 on their intention to leave the occupation and emotional labor as well as the moderating role of the implementation of knowledge management on these primary variables. Methods: To mitigate common method bias, this research adopted a two-phase questionnaire approach, targeting nurses at a medical center in central Taiwan. In the first phase, 300 copies of questionnaire were distributed for participants to complete self-assessment surveys covering fear of COVID-19, knowledge management implementation, and demographic information. After 1 month, the participants were invited to complete a follow-up questionnaire, focusing on the intention to leave the occupation and emotional labor. The questionnaire was conducted from June to July 2022. Through this two-phase distribution method, after exclusion of invalid responses, a total of 288 valid responses were collected, resulting in a response rate of 96%. The proposed hypotheses were verified using hierarchical regression conducted with SPSS version 25.0. Results: The findings indicated that nurses' fear of COVID-19 was significantly and positively associated with their intention to leave the occupation and surface acting, but negatively associated with their deep acting. Moreover, the implementation of knowledge management significantly moderated the positive relationship among fear of COVID-19, intention to leave the occupation, and surface acting. A robust knowledge management system weakened the positive association among fear of COVID-19, intention to leave the occupation, and surface acting. Conclusion: In summary, nurses' fear of COVID-19 may increase their tendency to leave the nursing profession and engage in more surface acting and less deep acting. However, effective knowledge management practices can mitigate these adverse effects. Hospitals can thus establish and employ comprehensive knowledge management systems to enhance nurses' resilience and help alleviate their fear of future pandemics and their potential negative repercussions.

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