Workers

工人
  • 文章类型: Journal Article
    回收电子废物(电子废物)会带来金属暴露的风险,可能导致健康损害。然而,以前在香港没有研究过这个问题。因此,从2021年6月到2022年9月,这项研究收集了香港101名电子垃圾工人和100名上班族的尿液样本,使用ICP-MS比较他们的尿液中金属含量。在包含的15种金属中(检测率高于70%阈值),与办公室工作人员相比,电子废物工作人员的尿中浓度(单位:μg/g肌酐)明显更高:Li(25.09vs.33.36),锰(1.78vs.4.15),Ni(2.10vs.2.77),铜(5.81vs.9.23),锌(404.35vs.431.52),高级(151.33vs.186.26),Tl(0.35vs.0.43),和Pb(0.69vs.1.16).香港的电子废物工人的金属含量普遍低于发展中地区的工人,但高于发达地区的工人。通过HPLC-MS/MS测定尿液中8-羟基-2-脱氧鸟苷(8-OHdG)的水平,两组间差异无统计学意义。多元线性回归模型显示,单个金属与尿中8-OHdG浓度之间没有显着关联。然而,通过分位数g计算模型,金属混合物被确定为略微升高8-OHdG浓度(1.12,95CI:0.04,2.19),Mn和Cd在这种效应中起着重要作用。总之,虽然香港电子废物工人的金属含量与其他地区的工人相比是有利的,他们的水平高于当地上班族。这凸显了政策制定者需要优先关注这个独特的行业。
    Recycling electronic waste (e-waste) poses risks of metal exposure, potentially leading to health impairments. However, no previous study has focused on this issue in Hong Kong. Therefore, from June 2021 to September 2022, this study collected urine samples from 101 e-waste workers and 100 office workers in Hong Kong to compare their urinary levels of metals using ICP-MS. Among the 15 included metals (with detection rates above the 70 % threshold), eight showed significantly higher urinary concentrations (unit: μg/g creatinine) in e-waste workers compared to office workers: Li (25.09 vs. 33.36), Mn (1.78 vs. 4.15), Ni (2.10 vs. 2.77), Cu (5.81 vs. 9.23), Zn (404.35 vs. 431.52), Sr (151.33 vs. 186.26), Tl (0.35 vs. 0.43), and Pb (0.69 vs. 1.16). E-waste workers in Hong Kong generally exhibited lower metal levels than those in developing regions but higher than their counterparts in developed areas. The urine level of 8-hydroxy-2-deoxyguanosine (8-OHdG) was determined by HPLC-MS/MS, and no significant difference was found between the two groups. Multiple linear regression models revealed no significant association between individual metal and urinary 8-OHdG concentrations. However, the metal mixture was identified to marginally elevate the 8-OHdG concentrations (1.12, 95 %CI: 0.04, 2.19) by quantile g‑computation models, with Mn and Cd playing significant roles in such effect. In conclusion, while the metal levels among Hong Kong e-waste workers compared favorably with their counterparts in other regions, their levels were higher than those of local office workers. This underscores the need for policymakers to prioritize attention to this unique industry.
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  • 文章类型: English Abstract
    目标锌缺乏,体内必需的微量元素,对味道产生不利影响,伤口愈合,和豁免权。本研究旨在通过因子分析的方法确定男女工人的膳食模式,并阐明膳食模式与锌摄入量之间的关系。方法研究对象为北九州地区395名市政雇员(男性193名,女性202名),年龄19-71岁。为了获得膳食摄入量数据,参与者被要求完成生活方式和健康问卷以及简短的自我管理饮食史问卷.每1,000kcal(mg/1,000kcal)评估锌摄入量。使用密度法对能量值进行了调整,并进行多元回归分析。结果为每个参与者确定了三种膳食模式。在男性中,“主菜型和配菜型”的特点是土豆摄入量较高,豆类,蔬菜,海鲜,肉,谷物含量低,“零食类型图案”的特点是糖果和咖啡的摄入量更高,和“地中海饮食模式”的特点是面包摄入量较高,意大利面,水果,鸡蛋,牛奶,并确定了低味增汤和米饭。对女人来说,“素食类型模式”的特点是豆类摄入量较高,蔬菜,蘑菇,和海藻,“主菜型和配菜型”的特点是大米摄入量低,并确定了以酒精饮料摄入量较高为特征的“晚餐饮酒模式”。锌摄入量与男性的“主菜和配菜型模式”和“地中海饮食模式”以及女性的“素食饮食”和“主菜和配菜型模式”呈正相关。此外,在女性中,锌摄入量与“晚餐饮酒模式”呈负相关。结论尽管调整了年龄,BMI,婚姻,职业,吸烟习惯,和锻炼习惯,“主菜和配菜型模式”和“地中海饮食模式”与男性锌摄入量呈正相关,与女性的“素食饮食”和“主菜和配菜型模式”呈正相关。数据表明,人们意识到有利于确保锌摄入的饮食模式。
    Objectives Deficiency of zinc, an essential trace element in the body, adversely affects taste, wound healing, and immunity. This study aimed to identify the dietary patterns of male and female workers using factor analysis and clarify the relationship between dietary patterns and zinc intake.Methods The participants were 395 municipal employees (193 men and 202 women) in Northern Kyushu aged 19-71 years. To obtain the dietary intake data, participants were asked to complete a lifestyle and health questionnaire and brief self-administered dietary history questionnaire. Zn intake was evaluated per 1,000 kcal (mg/1,000 kcal). The values were adjusted for energy using the density method, and multiple regression analysis was performed.Results Three dietary patterns were identified for each participant. Among men, \"main and side dish type pattern\" characterized by higher intakes of potatoes, legumes, vegetables, seafood, meat, and low for cereals, \"snack type pattern\" characterized by higher intakes of sweets and coffee, and \"Mediterranean diet pattern\" characterized by higher intakes of bread, pasta, fruits, eggs, and milk, and low for miso soup and rice were identified. For women, a \"vegetarian diet type pattern\" characterized by higher intakes of beans, vegetables, mushrooms, and seaweed, \"main and side dish type pattern\" characterized by low intake of rice, and \"dinner-time drinking pattern\" characterized by higher intakes of alcoholic beverages were identified. Zinc intake was positively associated with the \"main and side dish type pattern\" and \"Mediterranean diet pattern\" in men and \"vegetarian diet\" and \"main and side dish type pattern\" in women. Additionally, zinc intake was negatively associated with the \"dinner-time drinking pattern\" among women.Conclusion Despite adjusting for age, BMI, marriage, occupation, smoking habits, and exercise habits, the \"main and side dish type pattern\" and \"Mediterranean diet pattern\" were positively correlated with zinc intake in men and the \"vegetarian diet\" and \"main and side dish type pattern\" in women. The data suggest awareness of the dietary patterns that are conducive to ensuring zinc intake.
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  • 文章类型: Journal Article
    我们描述了一线医护人员在冠状病毒大流行期间预防与严重急性呼吸道综合症相关的冠状病毒在工作中和家庭成员传播的经验和策略。除了在线问卷(n=234),远程半结构化访谈(n=23:15临床医生,8名非临床医生)于2021年进行。从数据中确定了缓解挑战和促进者,以代表经验,作为一个考虑之前的过程,during,轮班后。旅程地图被用来直观地描述医护人员如何经历工作环境的阶段,离开工作,通勤回家,和家庭环境,以及为保持安全而实施的策略。主要促进者包括冠状病毒病疫苗的摄取和测试,关于病毒传播的信息,和足够的个人防护设备。确定的最关键的挑战包括缺乏指定的日终消毒区域,更衣室,淋浴,离开工作阶段的储物柜。在未来的医院大流行准备工作中,必须考虑社会心理和环境因素。
    We characterized experiences and strategies used by frontline healthcare workers to prevent severe-acute-respiratory-syndrome-related coronavirus transmission at work and to household members during the coronavirus disease pandemic. Alongside an online questionnaire (n = 234), remote semi-structured interviews (n = 23: 15 clinicians, 8 non-clinicians) were conducted in 2021. Mitigation challenges and facilitators were identified from data to represent experiences as a process considering the before, during, and after work shifts. Journey mapping was utilized to visually describe how healthcare workers experienced the stages of the work environment, leaving work, commuting home, and the home environment, and strategies implemented to stay safe. Major facilitators included the uptake of coronavirus disease vaccines and testing, information regarding virus transmission, and adequate personal protective equipment. The most critical challenges identified included a lack of designated areas for end-of-day disinfection, changing rooms, showers, and lockers in the leaving work stage. Psychosocial and environmental factors must be considered in future hospital pandemic preparations.
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  • 文章类型: Journal Article
    评估当前哮喘的患病率,哮喘发作/发作,和按行业和职业划分的哮喘相关急诊室(ER)访问,并估计2020-2021年与就业相关的当前哮喘病例的比例。
    分析了2020-2021年全国健康访谈调查数据,这些数据适用于在访谈前12个月内任何时间受雇的18岁以上的人。
    估计有1270万美国工作成年人目前患有哮喘。其中,40%有哮喘发作/发作,8.6%有哮喘相关的ER访视。患病率因社会人口统计学特征而异,工业,和职业。哮喘患病率最高的是行政部门的工作人员,支持,废物管理,和修复行业以及社区和社会服务职业。将近一半的艺术工作者患有目前的哮喘,娱乐,娱乐业和艺术,设计,娱乐,体育,和媒体职业报告有哮喘发作/发作。住宿和食品服务行业以及食品准备和服务相关职业的工人与哮喘相关的ER就诊次数最高。目前归因于就业的哮喘病例的比例估计为按行业划分的9.2%和按职业划分的12.2%。
    工人中估计有120万至150万例哮喘病例可能归因于按行业和职业划分的就业。哮喘患病率的差异,工人退出时哮喘发作/发作和哮喘相关的ER访视。这些发现强调了早期识别哮喘病例与工作和实施有针对性的干预措施(包括,培训和教育,个人防护设备的使用,健康监测,工作场所政策),特别是在哮喘患病率升高的行业和职业中就业的工人中。
    UNASSIGNED: Assess the prevalence of current asthma, asthma attacks/episodes, and asthma-related emergency room (ER) visits by industry and occupation and estimate the proportion of current asthma cases associated with employment during 2020-2021.
    UNASSIGNED: The 2020-2021 National Health Interview Survey data for persons aged ≥18 years who were employed at any time during the 12 months prior to the interview were analyzed.
    UNASSIGNED: An estimated 12.7 million US working adults had current asthma. Of those, 40% had an asthma attack/episode and 8.6% had an asthma-related ER visit. Prevalence varied by sociodemographic characteristics, industry, and occupation. Highest asthma prevalence was among workers in the administrative, support, waste management, and remediation industry and the community and social services occupation. Nearly half of workers with current asthma in the arts, entertainment, and recreation industry and arts, design, entertainment, sports, and media occupations reported having an asthma attack/episode. Workers in the accommodations and food services industry and food preparation and serving related occupation had the highest asthma-related ER visits. The proportion of current asthma cases attributable to employment was estimated to be 9.2% by industry and 12.2% by occupation.
    UNASSIGNED: An estimated 1.2-1.5 million asthma cases among workers might be attributable to employment by industry and occupation. Disparities in asthma prevalence, asthma attacks/episodes and asthma-related ER visits among workers exist. These findings underscore the importance of early identification of asthma cases in relation to work and implementation of targeted interventions (including, training and education, personal protective equipment use, health surveillance, workplace policies), especially among workers employed in industries and occupations with elevated asthma prevalence.
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  • 文章类型: Journal Article
    背景:人口变化和低出生率导致日本劳动力短缺。为了解决这个问题,政府促进女性就业。然而,女性就业的增加会影响女性的健康。使用物联网(IoT)和应用程序来管理女性的健康已经受到关注,但是很少有研究关注职业女性。
    目的:本研究旨在阐明职业女性的现状及其使用物联网或应用程序来管理健康。
    方法:大规模,在日本,对10,000名年龄从20岁到64岁的女性参与者进行了全国性的互联网调查。参与者是从一家市场研究公司的活跃调查小组招募的524万名成员。调查包括有关健康状况的问题,社会人口因素,心理特征,以及使用IoT或应用程序进行健康管理。我们使用t检验比较了感知的健康状况和当前物联网使用的原因,并使用C5.0决策树算法评估了预测物联网使用的参与者特征。道德批准由圣卢克国际大学授予。
    结果:在参与者中,14.6%(1455/10000)目前使用物联网或应用程序,7%(695/10000)以前使用过它们,78.5%(7850/10000)从未使用过。当前用户(42.7岁)比过去用户(39.7岁)大。观察到参与者感知到的健康问题与使用物联网或应用程序的目的之间存在差异,21.3%(2130/10,000)的女性报告她们经历了月经症状或紊乱,但只有3.5%(347/10,000)的女性使用物联网或应用程序来管理相同的症状。另一方面,当前用户更有可能使用物联网或应用程序来管理与营养相关的问题,例如体重不足或肥胖(405/1455,27.8%)。设备使用率在当前用户中最高,87.3%(1270/1455)使用智能手机,19.7%(287/1455)使用智能手表,和13.3%(194/1455)使用PC。决策树分析确定了6个集群,其中81.6%(5323/6523)的非物联网用户没有定期锻炼,而孕妇更有可能使用物联网或应用程序。
    结论:我们的发现强调了有特殊健康问题的女性(即,月经症状或紊乱和经前期综合征)使用物联网或应用程序较少,这表明在特定领域对物联网和应用程序的需求尚未满足。
    BACKGROUND: Demographic changes and a low birth rate have led to a workforce shortage in Japan. To address this issue, the government has promoted engagement of female employment. However, increased female employment can impact women\'s health. Using Internet of Things (IoT) and apps to manage women\'s health has gained attention, but few studies have focused on working women.
    OBJECTIVE: This study aimed to clarify the current situation of working women and their use of IoT or apps to manage their health.
    METHODS: A large-scale, nationwide internet survey was conducted among 10,000 female participants aged from 20 years to 64 years in Japan. Participants were recruited from a marketing research company\'s active survey panel of 5.24 million members. The survey included questions about health status, sociodemographic factors, psychological characteristics, and the use of IoT or apps for health management. We compared perceived health status and reasons for current IoT use using t tests and assessed participant characteristics that predicted IoT use using the C5.0 decision tree algorithm. Ethical approval was granted by St. Luke\'s International University.
    RESULTS: Among participants, 14.6% (1455/10,000) currently used IoT or apps, 7% (695/10,000) used them previously, and 78.5% (7850/10,000) had never used them. Current users (42.7 years old) were older than past users (39.7 years old). Discrepancies were observed between participants\' perceived health problems and the purpose for using IoT or apps, with 21.3% (2130/10,000) of all women reporting they experienced menstrual symptoms or disorders but only 3.5% (347/10,000) used IoT or apps to manage the same symptom. On the other hand, current users were more likely to use IoT or apps to manage nutrition-related problems such as underweight or obesity (405/1455, 27.8%). Device use was highest among current users, with 87.3% (1270/1455) using smartphones, 19.7% (287/1455) using smartwatches, and 13.3% (194/1455) using PCs. Decision tree analysis identified 6 clusters, the largest consisting of 81.6% (5323/6523) of non-IoT users who did not exercise regularly, while pregnant women were more likely to use IoT or apps.
    CONCLUSIONS: Our findings highlight the idea that woman with particular health problems (ie, menstrual symptoms or disorders and premenstrual syndrome) have lower use of IoT or apps, suggesting an unmet need for IoT and apps in specific areas.
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  • 文章类型: Journal Article
    Objectives.这项研究旨在调查12个月和7天的患病率的肌肉骨骼症状的工人的纸浆和造纸工业,评估年龄的贡献,性别,体重指数(BMI)和体力活动(PA)。方法。样本包括904名工人。使用北欧肌肉骨骼问卷评估肌肉骨骼症状。χ2检验评估肌肉骨骼症状与年龄/性别/BMI/PA之间的关联,和多变量逻辑回归模型预测了五个最普遍地区12个月的症状发生。结果。五个受影响最严重的身体区域是下背部,肩膀,脖子,膝盖和手腕/手。年长的工人在所有身体部位表现出更多的症状,除了背部;女性性别与颈部症状相关(p=0.001);超重与较高的下背部患病率相关(p=0.01),膝(p=0.017)和踝/足(p=0.037)症状;中度PA水平与大腿/髋部症状相关(p=0.006)。在所有五个受影响最严重的地区,年龄是一个显著的预测因素;性别是一个显著的预测因素,颈部和手腕/手;BMI是下背部症状的重要预测指标。结论。在纸浆和造纸工业的工人中,肌肉骨骼症状的12个月和7天患病率在下背部较高,肩膀,脖子,膝盖和手腕/手。
    Objectives. This study aimed to investigate 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry, and assess the contribution of age, gender, body mass index (BMI) and physical activity (PA). Methods. The sample comprised 904 workers. Musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. χ2 tests assessed the association between musculoskeletal symptoms and age/gender/BMI/PA, and multivariate logistic regression models predicted the 12-month occurrence of symptoms in the five most prevalent regions. Results. The five most affected body regions were the lower back, shoulders, neck, knees and wrists/hands. Older workers presented more symptoms in all body regions, except dorsal; female gender was associated with neck symptoms (p = 0.001); overweight was associated with a higher prevalence of lower back (p = 0.01), knee (p = 0.017) and ankle/foot (p = 0.037) symptoms; and a moderate PA level was associated with thigh/hip symptoms (p = 0.006). Age was a significant predictor in all five most affected regions; gender was a significant predictor for shoulders, neck and wrists/hands; and BMI was a significant predictor for lower back symptoms. Conclusion. The 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry is higher in the lower back, shoulders, neck, knees and wrists/hands.
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  • 文章类型: Journal Article
    背景:工人的心理健康问题给日本的公司造成了巨大的损失。然而,由于时间限制,工人被认为获得心理支持的机会有限,这使得他们很难进行面对面的心理支持干预。
    目的:这项研究旨在提出一项干预方案,该方案描述了一项随机对照试验,以检查智能手机应用程序提供的简短指导正念冥想(MM)或自我同情冥想(SCM)是否对工人的心理健康和与工作相关的结果有效。
    方法:这是一个开放标签,3臂随机对照试验。参与者将通过相关网站的公开电话会议招募,纳入标准如下:(1)每周工作超过20小时的员工,(2)年龄在18至54岁之间,(3)没有请假,(4)不是企业主或学生,(5)目前未被诊断患有精神障碍,并且Kessler心理困扰量表-6评分低于13分。我们将包括200名参与者,并将他们随机分配到SCM课程(n=67),MM课程(n=67),和一个等待名单组(n=66)。将指示干预组(SCM和MM)进行日常指导自助,自我同情,MMs每天持续6-12分钟,超过4周。主要结果将包括心理困扰和工作表现,次要结果将包括躯体症状,认知灵活性,自尊,自我同情,感知压力,幸福,情绪调节,工作参与,愤怒,心理安全,和创造力。所有程序均由东京大学伦理委员会批准(22-326)。所有参与者将通过网站被告知研究,书面知情同意书将通过基于网络的表格收集。
    结果:参与者的招募始于2022年12月,干预始于2023年1月。截至2023年9月,共有375名参与者注册。干预和数据收集于2023年10月下旬完成。
    结论:这项研究将有助于开发有效的自我护理干预内容,从而改善心理健康,工作表现,和相关的结果,并在面对痛苦时促进正念和自我同情的态度。
    背景:大学医院医疗信息网络临床试验注册UMIN000049466;https://tinyurl.com/23x8m8nf。
    DERR1-10.2196/53541。
    BACKGROUND: Mental health problems among workers cause enormous losses to companies in Japan. However, workers have been considered to have limited access to psychological support because of time constraints, which makes it difficult for them to engage in face-to-face psychological support interventions.
    OBJECTIVE: This study aimed to present an intervention protocol that describes a randomized controlled trial to examine whether brief guided mindfulness meditation (MM) or self-compassion meditation (SCM) provided by a smartphone app is effective for mental health and work-related outcomes among workers.
    METHODS: This is an open-label, 3-arm randomized controlled trial. The participants will be recruited through an open call on relevant websites with the following inclusion criteria: (1) employees who are working more than 20 hours per week, (2) between the ages of 18 and 54 years, (3) not on a leave of absence, (4) not business owners or students, and (5) not currently diagnosed with a mental disorder and have a Kessler Psychological Distress Scale-6 score below 13 points. We will include 200 participants and randomly assign them to an SCM course (n=67), an MM course (n=67), and a waitlist group (n=66). The intervention groups (SCM and MM) will be instructed to engage in daily guided self-help, self-compassion, and MMs lasting 6-12 minutes per day over 4 weeks. Primary outcomes will include psychological distress and job performance, and secondary outcomes will include somatic symptoms, cognitive flexibility, self-esteem, self-compassion, perceived stress, well-being, emotion regulation, work engagement, anger, psychological safety, and creativity. All procedures were approved by the ethics committee of the University of Tokyo (22-326). All participants will be informed of the study via the websites, and written informed consent will be collected via web-based forms.
    RESULTS: The recruitment of participants began in December 2022, and the intervention began in January 2023. As of September 2023, a total of 375 participants have been enrolled. The intervention and data collection were completed in late October 2023.
    CONCLUSIONS: This study will contribute to the development of effective self-care intervention content that will improve mental health, work performance, and related outcomes and promote mindful and self-compassionate attitudes when faced with distress.
    BACKGROUND: University Hospital Medical Information Network Clinical Trials Registry UMIN000049466; https://tinyurl.com/23x8m8nf.
    UNASSIGNED: DERR1-10.2196/53541.
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  • 文章类型: Journal Article
    如果发生严重的职业性热相关疾病,护理人员援助可能无法立即获得。工人的生存可能取决于他们的同事获得有效的基于现场的冷却方式。一种声称在基于现场的设置中实用的冷却方法是冰巾方法。
    本案例研究评估了冰巾方法在工业环境中的实用性,其中使用标准包括成本效益,便携性,可扩展性,并由一名工人在紧急情况下实施。
    本案例研究描述了在等待护理人员时使用冰巾方法的紧急应用,对于一名在远程工作现场遭受疑似劳力中暑的工人。
    冰巾能够被运送到偏远的现场,并由一名工人在可能危及生命的紧急情况的压力下成功应用。
    冰巾方法具有成本效益,可扩展,可运输,并迅速应用于基于现场的紧急情况。本案例研究证明了组织评估其热相关风险的重要性,并根据其独特设置的有效性和实用性来确定控件。
    UNASSIGNED: In the event of a severe occupational heat-related illness, paramedic assistance may not be immediately available. A worker\'s survival may depend on their co-workers access to efficacious field-based cooling modalities. One cooling method that has been claimed to be practical in field-based settings is the ice towel method.
    UNASSIGNED: This case study assessed the practicality of the ice towel method in an industrial setting, where criteria for use include cost effectiveness, portability, scalability, and implementation by a single worker under the stress of an emergency.
    UNASSIGNED: This case study describes the emergency application of the ice towel method while awaiting paramedics, for a worker suffering suspected exertional heat stroke on a remote job site.
    UNASSIGNED: Ice towels were able to be transported to a remote field site and applied successfully by a single worker under the stress of a potentially life-threatening emergency.
    UNASSIGNED: The ice towel method was cost effective, scalable, transportable, and rapidly applied in a field-based emergency. This case study demonstrates the importance of organizations assessing their heat-related risks, and determining controls based upon their efficacy and practicality for their unique setting.
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  • 文章类型: Journal Article
    背景:重症监护病房(ICU)经常发生与患者和亲属的冲突,由危重病及其治疗加剧的因素驱动。大多数ICU医疗保健专业人员都经历过口头和/或身体暴力。有必要了解ICU中的医疗保健专业人员如何体验和管理这种工作场所暴力。
    方法:使用与ICU医疗保健专业人员的半结构化焦点小组访谈,对瑞典的四家医院进行了定性描述性分析。
    结果:共有34名参与者(14名护士,对四家医院的6名医生和14名其他工作人员)进行了采访。总体主题:“医疗保健中的暴力悖论”说明了ICU护理中暴力的正常化,并表明了医疗保健专业人员之间的复杂关联,将暴力视为护理的一个组成部分。同时认定自己是这种暴力的受害者。医疗保健专业人员描述了准备不足,缺乏管理暴力局势的适当工具。因此,暴力管理主要基于自学成才的技能。
    结论:这项研究有助于理解ICU护理中暴力的正常化,并为其起源提供了可能的解释。悖论涉及多方面的方法,承认并面对医疗保健中暴力的结构和文化层面。这种方法将为更可持续的医疗保健系统奠定基础。
    BACKGROUND: Conflicts with patients and relatives occur frequently in intensive care units (ICUs), driven by factors that are intensified by critical illness and its treatments. A majority of ICU healthcare professionals have experienced verbal and/or physical violence. There is a need to understand how healthcare professionals in ICUs experience and manage this workplace violence.
    METHODS: A qualitative descriptive analysis of four hospitals in Sweden was conducted using semi-structured focus-group interviews with ICU healthcare professionals.
    RESULTS: A total of 34 participants (14 nurses, 6 physicians and 14 other staff) were interviewed across the four hospitals. The overarching theme: \"The paradox of violence in healthcare\" illustrated a normalisation of violence in ICU care and indicated a complex association between healthcare professionals regarding violence as an integral aspect of caregiving, while simultaneously identifying themselves as victims of this violence. The healthcare professionals described being poorly prepared and lacking appropriate tools to manage violent situations. The management of violence was therefore mostly based on self-taught skills.
    CONCLUSIONS: This study contributes to understanding the normalisation of violence in ICU care and gives a possible explanation for its origins. The paradox involves a multifaceted approach that acknowledges and confronts the structural and cultural dimensions of violence in healthcare. Such an approach will lay the foundations for a more sustainable healthcare system.
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  • 文章类型: Journal Article
    背景:关于整个大流行期间COVID-19死亡率差异的程度和模式的信息有限。我们旨在使用健康透镜的社会决定因素,研究加利福尼亚州工人在疫苗使用前后的人口统计学差异趋势。
    方法:使用死亡证明,我们确定了2020年1月至2022年5月间发生在加利福尼亚州(CA)18-64岁工人中的所有COVID-19死亡.我们使用当前人口调查得出了高危工人人口的估计值。在疫苗接种前的有效期内,COVID-19死亡率的波动是2020年3月至2020年6月(第一波),和2020年7月至2020年11月(第二波),在疫苗后有效期:2020年12月至2021年5月(第三波),2021年6月-2022年1月(第4波),和2022年2月至2022年5月(第5波)。使用具有稳健标准误差的泊松回归模型来确定波特异性死亡率比率(MRR)。我们通过在不同模型中包含每个人口统计学特征和波浪周期之间的相互作用项,检查了波浪之间MRR的变化。使用概率定量偏倚分析作为敏感性分析,检查了种族/种族的潜在错误分类在死亡证明上的作用。
    结果:在纳入研究的2410万工作年龄CA人群中,在2020年1月至2022年5月期间,有26068例COVID-19死亡。与他们各自的参照组相比,50-64岁的工人,男性,夏威夷原住民,拉丁裔,或者非洲裔美国人,外国出生的;受教育程度较低的人;和未婚的人不成比例地受到COVID-19死亡率的影响。虽然性别差异,种族/民族和外国出生的身份在后来的浪潮中缩小(疫苗后的可用性),按年龄划分的差距,教育水平和婚姻状况在不同时期没有实质性变化.
    结论:COVID-19死亡率的人口统计学差异在疫苗后可用波中缩小。然而,在大流行的所有浪潮中都存在差异,即使在疫苗覆盖广泛的时代,可能表明在预防和脆弱性方面仍然存在差距。解决潜在的社会问题,结构,造成这些差异的职业因素对于实现健康公平至关重要。
    BACKGROUND: There is limited information on the extent and patterns of disparities in COVID-19 mortality throughout the pandemic. We aimed to examine trends in disparities by demographics over variants in the pre- and post-vaccine availability period among Californian workers using a social determinants of health lens.
    METHODS: Using death certificates, we identified all COVID-19 deaths that occurred between January 2020 and May 2022 among workers aged 18-64 years in California (CA). We derived estimates for at-risk worker populations using the Current Population Survey. The waves of COVID-19 mortality in the pre-vaccine availability period were March 2020-June 2020 (wave 1), and July 2020-November 2020 (wave 2), and in the post-vaccine availability period: December 2020-May 2021 (wave 3), June 2021-January 2022 (wave 4), and February 2022-May 2022 (wave 5). Poisson regression models with robust standard errors were used to determine wave-specific mortality rate ratios (MRRs). We examined the change in MRR across waves by including an interaction term between each demographic characteristic and wave period in different models. The role of potential misclassification of Race/ethnicity on death certificates was examined using probabilistic quantitative bias analysis as sensitivity analysis.
    RESULTS: Among the 24.1 million working age CA population included in the study, there were 26,068 COVID-19 deaths in the period between January 2020 and May 2022. Compared with their respective reference groups, workers who were 50-64 years old, male, Native Hawaiian, Latino, or African American, foreign-born; individuals who had lower education; and unmarried were disproportionately affected by COVID-19 mortality. While disparities by sex, race/ethnicity and foreign-born status narrowed in later waves (post-vaccine availability), disparities by age, education level and marital status did not change substantially across waves.
    CONCLUSIONS: Demographic disparities in COVID-19 mortality narrowed in the post-vaccine availability waves. However, the existence of disparities across all waves of the pandemic, even in an era of widespread vaccine coverage, could indicate remaining gaps in prevention and differential vulnerability. Addressing the underlying social, structural, and occupational factors that contribute to these disparities is critical for achieving health equity.
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