Personal Risk Factors Research Articles

Depression in Working Professionals – A Systematic Review of the Literature

Introduction: Workplace depression is a debilitating public health issue with far-reaching impacts on employees, employers, and organizations. Depression among working professionals is on the rise, and is a direct and indirect threat to the overall health and well-being of the employees, the productivity of the organizations, and the economic progress of the nations as a whole. This systematic review synthesizes evidence from the existing literature regarding workplace depression and the factors implicated in the development of depression in this population. Methods: The author conducted a search on electronic research databases including PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar, without language restrictions. The studies published within the last 20 years were screened based on the title and abstract. The data extraction of the eligible studies included measures of mental health symptoms, screening (If included), work-related adverse outcomes, work-related satisfaction outcomes, quality of life, help- seeking behavior, risk factors, protective factors, and non-work-related factors. The health risk factors or health- related behaviors associated with workplace depression include overweight or obesity, daily tobacco or cigarette smoking, sleep duration, alcohol consumption, low physical activity, diagnosis of diabetes mellitus, diagnosis of other chronic conditions, and overall poor health status. Results: The development of depression in working professionals is a complex and multifaceted interplay of personal, work-related, and health risk factors of varying degrees. The personal risk factors comprise age, gender, having a partner at home, being a family caregiver, diagnosis of a chronic illness, having children at home, history of recurrent depression, low education level, widowed or divorced status, and history of diabetes mellitus. The workplace factors include role conflict, procedural injustice, .....

Prediction of incidence of neurological disorders in HIV-infected persons in Taiwan: a nested case–control study

BackgroundNeurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan.MethodsWe identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders. We applied a retrospective, nested case–control study design. The individuals with (case group) and without (control group) a neurological disorder were then matched by age, sex and time. Factors associated with neurological disorders were analyzed using a conditional logistic regression model, and a nomogram was generated to estimate the risk of developing a neurological disorder.ResultsThe incidence of neurological disorders was 13.67 per 1000 person-years. The incidence remained stable during the observation period despite the use of early treatment and more tolerable modern anti-retroviral therapy. The conditional logistic regression model identified nine clinical factors and comorbidities that were associated with neurological disorders, namely age, substance use, traumatic brain injury, psychiatric illness, HIV-associated opportunistic infections, frequency of emergency department visits, cART adherence, urbanization, and monthly income. These factors were used to establish the nomogram.ConclusionNeurological disorders are still prevalent in HIV-infected people in Taiwan. To efficiently identify those at risk, we established a nomogram with nine risk factors. This nomogram could prompt clinicians to initiate further evaluations and management of neurological disorders in this population.

Leading Risk Factors for Diseases of the Circulatory and Musculoskeletal Systems in Metallurgical Workers

Introduction: It is important to assess health impact of the entire set of heterogeneous risk factors and identify the key ones in order to develop personalized measures for prevention of non-occupational diseases in workers. Objective: To establish the major risk factors for circulatory and musculoskeletal disorders in employees of a metallurgical enterprise. Materials and methods: We used anonymized data from a special assessment of working conditions and production control of the forging departments of the forging-rod and forging-press shops of a metallurgical enterprise producing titanium alloys for the years 2016–2020. To determine the presence of personal biological and behavioral risk factors for diseases of the circulatory and musculoskeletal systems, we examined anonymized data of the periodic medical check-up conducted in 2020 of 146 male blacksmiths working with hammers and presses. The mean age of the workers was 35.9 ± 8.8 years (range: 21 to 57 years) and their mean length of current employment was 18.9 ± 9.7 years (range: 2 to 41 years). The method of simple and multiple logistic regression was used to build models for predicting the likelihood of a disease; odds ratios were calculated with a 95 % confidence interval. The quality of the models was assessed using the maximum likelihood estimation. Results: We determined the factors allowing prediction of the disease likelihood. The prevalence of circulatory diseases correlated with age, length of employment, and the body mass index, whole-body and hand-arm vibration, noise exposure, high ambient temperature, thermal radiation, and heavy physical work. The prevalence of musculoskeletal diseases, in its turn, had a somewhat weaker statistically significant association with the same risk factors. Models predicting the likelihood of circulatory and musculoskeletal diseases have been built. The best predictive model for circulatory diseases included the combined effect of the body mass index and heavy physical work while that for musculoskeletal disorders – of the body mass index and hand-arm vibration. Conclusion: Multiple logistic regression used to analyze statistical relationships between work-related risk factors and disease prevalence in employees in specific occupations allowed identification of the leading factors contributing the most to the disease development and can be recommended for solving practical problems in occupational medicine.

Psychological Symptoms Among Iranian Healthcare Workers During COVID-19 Pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic affected working conditions in healthcare systems and caused occupational stress and challenges for the majority of healthcare workers (HCWs). Objectives: This study aimed to examine the prevalence of anxiety, depression, burnout, and career resilience and assess the personal and occupational risk factors contributing to psychological symptoms in Iranian HCWs during the COVID-19 pandemic. Methods: Through a cross-sectional study, HCWs were surveyed within January to February 2022 to evaluate the prevalence of anxiety and depression (using the Hospital Anxiety and Depression Scale [HADS]), burnout (using the Maslach burnout inventory health services survey for medical personnel [MBI-HSS-MP]), and career resilience (using the Career Resilience Questionnaire [CRQ]). The correlation between demographic-occupational factors and psychological symptoms was analyzed. A total of 610 complete responses were received from Iranian HCWs. Results: Approximately 87.9% of HCWs had symptoms of both anxiety and depression (HADS score ≥ 11). The results indicated that most HCWs experienced various signs of burnout (i.e., emotional exhaustion, decreased sense of personal accomplishment, and depersonalization, respectively). The mean score for career resilience reported by the participants was appropriate; however, a fifth of the HCWs had poor career resilience. The highest scores of burnout, anxiety, and depression, in addition to the lowest scores of career resilience, were reported by intensive care unit (ICU) professionals. Conclusions: Marital status, long daily working hours, night shift work, access to personal protective equipment (PPE), and direct exposure to patients with COVID-19 had a significant impact on the anxiety, depression, burnout, and resilience of the HCWs.

Исследование факторов риска развития катаракты нерадиационной природы у лиц, подвергшихся хроническому радиационному воздействию

Relevance. Epidemiological data have revealed a significant association between exposure to ionizing radiation, loss of lens optical function, and cataract formation. Cataract is a multifactorial disease that is traditionally associated with age, exposure to ultraviolet radiation, diabetes, smoking, alcohol abuse, obesity, steroid hormones, hypertension, etc. The chronic nature of the effects of radiation on the body, including both cell damage and regenerative processes, complicates the issue of assessment of the nature and magnitude of the dose-dependence of effects. Purpose. To investigate the potential risk factors of cataract development in different morphological layers, depending on social conditions and several diseases (non-radiation factors) in the population affected by two radiation accidents (dumping of radioactive waste into the Techa River and the East Ural Radioactive Trace) in the Southern Urals. Material and methods. The data from an in-depth examination of patients by an ophthalmologist in the Clinical Department of the URCRM were analyzed. The study involved 1377 patients. The «case» and «control» groups, comparable in sex and age, were selected from the general population. The impact of each factor was assessed on the basis of the Odds Ratio (OR) indicator. Risk factors associated with the development of cataracts in different layers of the lens included arterial hypertension, body mass index, age at the onset of exposure, level of education, alcohol consumption, smoking, ethnicity. Results. An increased risk of developing cataracts in the lens nucleus (1st sample: OR=0.54 (1st sample: 95% CI: 0.34–0.86; 2nd sample: OR=0.51 (95% CI: 0.32–0.82) (p<0.05)) and the intensity of its color (1st sample: OR=0.48 (95% CI: 0.29–0.80); 2nd sample: OR=0.56 (95% CI: 0.34–0.94) (p<0.05)) was established in persons who were at the age over 6 at the onset of exposure. Conclusion. The analysis did not reveal a statistically significant relationship of changes in the cortical layers, the nucleus and the posterior capsule of the lens with other studied risk factors in persons exposed to chronic radiation at a low to medium dose range. There was an increased risk of cataract development in the lens nucleus and the intensity of its color in persons who began to be exposed at the age of over 6 years. Key words: risk factors, cortical cataract, nuclear cataract, posterior subcapsular cataract, chronic exposure

Personal Risk Factors Regarding the Presence of Autism Spectrum Disorders

<p style="text-align:justify">The current understanding of autism spectrum disorder (ASD) as an alteration of neurodevelopment requires deepening in the causes that originate it. This study aims to investigate the relationship between the presence of ASD in subjects aged 2-22 years and some related biological factors (sex/gender, age, and body mass index). A quasi-experimental study, with a cross-sectional retrospective design, was conducted on 209 subjects (n = 111 with ASD and n = 98 neurotypical) who were applied to the GARS-2 test in three areas: communication, social interaction, and stereotyped behaviours between 2016-2021. The risk factors identified are related to early age (OR = 2.27, 95% CI = 1.30-3.96), being male (OR = 2.67, 95% CI = 1.41-4.68) and having underweight (OR = 2.03, 95% CI = 1.09-3.80). Differences in stereotyped behaviours (OR = 1.10, 95% CI = 1.05-1.14), functional communication (OR = 1.13, 95% CI = 1.08-1.17) and social interaction (OR = 1.11, 95% CI = 1.08-1.15), were found, being at risk as soon as scores related to ASD diagnosis. In sum, rigorous and multidimensional understanding analysis among specialists regarding people with ASD allows to evaluate the development of the set of alterations and key variables to provide support and assistance to their quality of life.</p>

The Relationship Between Depression and Non-Suicidal Self-Injury: The Mediating Roles of Distress Intolerance and Perceived Social Support, the Moderating Role of Gender

ABSTRACT Depression has a substantial effect on non-suicidal self-injury (NSSI). The present study investigates the mediating effects of distress intolerance and perceived social support in the relationship between depression and NSSI, and the moderator effect of gender in this relationship. One of which is the risk factor and the other is the protective factor. In total, 533 university students (% 70 female) were examined. The brief NSSI assessment tool was used to assess NSSI. Depressive symptoms were examined in DASS21, and Distress Intolerance Scale was used to examine tolerance toward negative emotions. Finally, the Perceived Social Support scale was used to assess perceived social support. The current study investigated the prevalence of NSSI was 76,2%. To analyze hypothesis of the study, Structural Equation Model (SEM) was used. Results of this analysis show that distress intolerance has a positive mediator role and perceived social support has a buffer mediator role in the relationship between depression and NSSI. Also, gender has a moderator role in the relationship between depression and NSSI. The findings of the study revealed that depression and distress intolerance are important risks for NSSI, and perceived social support is protective. This study improves understanding of mechanisms involved in NSSI by interrelating significant personal and social risk and protective factors. The clinical application of these findings was also discussed.

The Loneliness of the Odd One Out: How Deviations From Social Norms Can Help Explain Loneliness Across Cultures.

Loneliness is an important health risk, which is why it is important to understand what can cause persistent or severe loneliness. Previous research has identified numerous personal or relational risk factors for loneliness. Cultural predictors, however, have been considered less. The new framework of norm deviations and loneliness (NoDeL) proposes that social norms, which are defining features of culture, can help explain loneliness within and across cultural contexts. Specifically, people who deviate from social norms are suggested to be at an increased risk for feeling lonely because they are more likely to experience alienation, inauthenticity, lower self-worth, social rejection, relationship dissatisfaction, and/or unfulfilled relational needs. Given that social norms vary by social, geographical, and temporal context, they can furthermore be considered cultural moderators between individual-level risk factors and loneliness: Personal or relational characteristics, such as shyness or being single, may increase the risk for loneliness particularly if they do not fit social norms in a specific environment. Integrating previous quantitative and qualitative findings, I hence offer a framework (NoDeL) to predict loneliness and cultural differences in risk factors for it. Thus, the NoDeL framework may help prepare culture-sensitive interventions against loneliness.

Prevalence and impact of falls as domestic injury among rural housewives of Raipur District, Chhattisgarh, India

Introduction: The most common domestic injury among housewives is falling from stairs and ramps or on the floor. The present study aimed to find and associate the prevalence of falls with various agents, risk factors causing falls and the impact of falls among rural housewives. Methods: A cross-sectional survey was carried out among 500 randomly selected housewives from rural areas of Raipur district, Chhattisgarh in the month of March to June 2019. Demographic data and information regarding the occurrence of falls, various agents & factors associated with falls were collected by questionnaires, lux meter, anemometer and sound level meter through interviews, and observation techniques. The Nordic questionnaire was used to assess the impact of falls. Collected data were analyzed by using SPSS 20 statistical package. Results: 295 out of 500 housewives had domestic injuries which included 12.8 % of fall injuries. Fall had a significant association with various physical agents like illumination in the living room (χ2=11.004, df=1), relative humidity of the kitchen (χ2=18.03, df=2) and presence of adequate natural light (χ2=11.232, df=1). Even various personal risk factors were significant causes of falls like wearing slippers on a wet floor (χ2=11.845, df=1), presence of open electric wires (χ2=4.84, df=1), self-cleaning of toilet & floor (χ2=11.371, df=1) and self-cooking (χ2=10.959, df=1). Heavy works like carrying water in a big container (χ2=6.025, df=1), working under direct sunlight (χ2=4.195, df=1), prolonged standing while cooking or on an agricultural field (χ2=32.073, df=1) and using of hand pump per day to draw water (χ2=42.329, df=1) were highly significant causes of domestic fall. Conclusion: Findings of the study concluded that fall was very much prevalent among housewives, and being at home still housewives are exposed to various agents and personal risk factors causing fall.

THU354 Enfortumab Vedotin Induced Refractory Hyperglycemia

Abstract Disclosure: M. Hussein: None. Introduction: Immunotherapy has transformed the treatment landscape of cancer therapy and has created promising hope for cancer patients. While immunotherapy has dramatic efficacy it also has unique toxicity profile. A spectrum of adverse events known as endocrinopathies have been reported with immune checkpoint inhibitors. One of the newer medications is Enfortumab Vedotin, an antibody-drug conjugate. This drug is approved for use in advanced urothelial carcinoma. Case: We present a 68-year-old male with advanced urothelial carcinoma who was started on Enfortumab vedotin after he progressed on a different chemotherapy/immunotherapy. His medical history was significant for prediabetes and morbid obesity.2 weeks after the first cycle of treatment he presented to emergency room with worsening dyspnea and fatigue. Vital signs: Temp: 37.3, HR: 90, BP: 122/65, RR 18, SPO2 95% on 3L O2 through nasal canula. BMI 44 kg/m. Biochemical workup revealed elevated Glucose level of 310 and anion gap of 12. He was started on subcutaneous insulin. He continued to be uncontrolled and was transferred to the ICU and switched to intravenous insulin due to hyperglycemia. His total daily insulin dose was close to 900 units to achieve blood glucose <180. It took 48-72 hours of Intravenous insulin use to get controlled blood glucose. Hgba1c was 7.3%. Insulin antibody, GAD65 and Islet cell antibodies were negative, C peptide 38 for a glucose of 428. Unfortunately, the patient developed multiorgan failure, and passed away on day 7 of the admission. Discussion: The mechanism of this drug inducing hyperglycemia is not well understood as of yet. But the presumed theory here is the patient developed severe acute insulin resistance that led to this refractory hyperglycemia, as evident by the high c peptide level. Absence of beta cell antibodies and elevated c peptide go against an autoimmune destructive beta cell pathway. The other theory is that there is a malfunction in the signaling pathway at the cellular level that led to hyperglycemia. Risk of developing hyperglycemia as a side effect to this medication increase with patient’s personal risk factors for developing diabetes mellitus (prediabetes and obesity). In phase 3 trial of Enfortumab vedotinEV301, treatment related hyperglycemia was reported in 6.4 % of patients. Hyperglycemia occurred more frequently in patients with hyperglycemia at baseline or with a body-mass index of 30 or higher. Conclusion: We are in need for further studies to understand the mechanism of refractory hyperglycemia induced by this drug. Patients on this type of therapy should be monitored very closely for developing a new onset of diabetes mellitus or worsening of established diabetes mellitus. Presentation: Thursday, June 15, 2023

Comprehensiveness and Context of Psychiatric Reports Submitted to Review Boards in Cases of People Found Not Criminally Responsible on Account of Mental Disorder

Recent research suggests that empirically validated risk factors for persons found not criminally responsible on account of mental disorder (NCRMD) are rarely mentioned by clinicians in reports for Review Boards in Canada. This study aims to better understand this observation by examining the styles of clinical reports (i.e., types of report according to their comprehensiveness and their content) and the contextual factors associated with them. To identify styles of reports, mentions of risk factors within reports were subjected to a series of latent class analyses. Regression analyses were then carried out to identify which contextual factors (characteristics related to the person found NCRMD, the timing of the report, and the clinical team/care setting) were significantly associated with the styles of reports. Findings revealed four styles of reports which were also correlated to contextual factors, some unrelated to the risk of violence and/or reoffending for the person found NCRMD. These results reinforce the need to implement evidence-based practices in forensic risk assessment and management.

Risk Factors for Breast Cancer-Related Lymphedema: An Umbrella Review.

Identification of risk factors facilitates the prevention of breast cancer-related lymphedema (BCRL). Several published systematic reviews have already addressed the risk factors for BCRL. This study aimed to systematically identify potential risk factors for BCRL and evaluate the quality of evidence. The study followed methodologic guidance from the Joanna Briggs Institute, and the Cochrane Handbook. The following electronic databases were systematically searched from inception to 15 November 2022: PubMed, Embase, CINAHL, Web of Science, Scopus, CNKI, SinoMed, Wanfang, JBI Database, Cochrane Database, ProQuest, and PROSPERO. Two authors independently screened studies, extracted data, and assessed methodologic quality using AMSTAR2, risk of bias using ROBIS, and evidence quality using GRADE. The study evaluated overlap, assessed the small-study effect, and calculated the I2 statistic and Egger's P value as needed. The study included 14 publications comprising 10 meta-analyses and 4 systematic reviews. The authors identified 39 factors and 30 unique meta-analyses. In the study, 13 innate personal trait-related risk factors, such as higher body mass index (BMI) and axillary lymph nodes dissection, showed statistically significant associations with BCRL incidence. Breast reconstruction was found to be a protective factor. The methodologic quality was low or critically low. The majority of the systematic reviews and/or meta-analyses were rated as having a high risk of bias. Evidence quality was low for 22 associations and moderate for 8 associations. The currently identified risk factors for BCRL all are innate personal trait-related factors. Future well-designed studies and robust meta-analyses are needed to explore potential associations between behavioral-, interpersonal-, and environmental-related factors and BCRL, as well as the role of genetic variations and pathophysiologic factors.

Association Between Optimism and Incident Stroke Among Stroke Survivors: Findings From the English Longitudinal Study of Ageing.

Personality has been implicated in stroke death. However, the role of personality in stroke incidence is unclear. Our primary aim was to investigate associations between optimism, determination, control, and the "Big Five" personality traits on incident stroke. A secondary aim was to assess the potential mediating role of health behaviors in the personality-stroke relationship. A total of 3,703 stroke-free participants from the English Longitudinal Study of Ageing provided data on personality using the Midlife Development Inventory at Wave 5 (2010/11). Self-reported incident stroke was assessed from Waves 6 to 8 (2012-2017). Associations were modeled using discrete-time survival proportional odds logistic models. Analyses were adjusted for sociodemographic factors, history of other cardiometabolic diseases, and health behaviors. Over 6 years follow-up there were 125 incident strokes. Higher optimism (hazard ratio [HR] = 0.66; 95% confidence interval [CI] 0.53, 0.82), openness (HR = 0.72; 95% CI 0.53, 0.98), and conscientiousness (HR = 0.59; 95% CI 0.42, 0.84) were associated with reduced incident stroke risk in unadjusted models. After adjustment for sociodemographic factors and history of cardiometabolic disease, only the association between optimism and incident stroke remained significant (HR = 0.72; 95% CI 0.57, 0.92). The effect of optimism remained significant in a final model adjusting for health behaviors (HR = 0.75; 95% CI 0.60, 0.96). There was evidence of a small but significant mediating effect of physical activity. Higher trait optimism was associated with reduced stroke risk. This association was partially mediated by physical activity albeit the effect was small, and caution warranted inferring causality. The interplay of personality, behavior, and clinical risk factors in stroke incidence and survivorship needs further investigation.

Detection of diabetic patients in people with normal fasting glucose using machine learning

BackgroundDiabetes mellitus (DM) is a chronic metabolic disease that could produce severe complications threatening life. Its early detection is thus quite important for the timely prevention and treatment. Normally, fasting blood glucose (FBG) by physical examination is used for large-scale screening of DM; however, some people with normal fasting glucose (NFG) actually have suffered from diabetes but are missed by the examination. This study aimed to investigate whether common physical examination indexes for diabetes can be used to identify the diabetes individuals from the populations with NFG.MethodsThe physical examination data from over 60,000 individuals with NFG in three Chinese cohorts were used. The diabetes patients were defined by HbA1c ≥ 48 mmol/mol (6.5%). We constructed the models using multiple machine learning methods, including logistic regression, random forest, deep neural network, and support vector machine, and selected the optimal one on the validation set. A framework using permutation feature importance algorithm was devised to discover the personalized risk factors.ResultsThe prediction model constructed by logistic regression achieved the best performance with an AUC, sensitivity, and specificity of 0.899, 85.0%, and 81.1% on the validation set and 0.872, 77.9%, and 81.0% on the test set, respectively. Following feature selection, the final classifier only requiring 13 features, named as DRING (diabetes risk of individuals with normal fasting glucose), exhibited reliable performance on two newly recruited independent datasets, with the AUC of 0.964 and 0.899, the balanced accuracy of 84.2% and 81.1%, the sensitivity of 100% and 76.2%, and the specificity of 68.3% and 86.0%, respectively. The feature importance ranking analysis revealed that BMI, age, sex, absolute lymphocyte count, and mean corpuscular volume are important factors for the risk stratification of diabetes. With a case, the framework for identifying personalized risk factors revealed FBG, age, and BMI as significant hazard factors that contribute to an increased incidence of diabetes. DRING webserver is available for ease of application (http://www.cuilab.cn/dring).ConclusionsDRING was demonstrated to perform well on identifying the diabetes individuals among populations with NFG, which could aid in early diagnosis and interventions for those individuals who are most likely missed.

The positive and negative effects of working with child sexual abuse for health and social care professionals: A systematic review

AbstractThe aim of this systematic review was to determine the positive and negative outcomes of working with children who had experienced sexual abuse for health and social care professionals. The following four databases were searched using predetermined terms: PsycINFO, PubMed, CINAHL and Web of Science. Inclusion criteria included peer‐reviewed qualitative, quantitative, multi‐method or mixed method studies written in the English language. Study identification, quality assessment and data extraction were independently completed by two researchers, with a high degree of inter‐rater reliability. Eight studies (six qualitative, one quantitative and one multi‐method) met the inclusion criteria. Reviewed studies were conducted in the United States, Israel, Ireland and South Africa. Both positive and negative outcomes for healthcare professionals working with childhood sexual abuse (CSA) were identified. Additionally, a range of personal and contextual mitigating and risk factors were identified that may affect professionals' vulnerability to negative outcomes from CSA work, which have implications for practice. Due to the limited evidence base, clinical implications are tentative. Future research should adopt longitudinal methodologies and focus on participants from a range of disciplines and work contexts, particularly outside the United States.

Strengthening stroke prevention and awareness in the Philippines: a conceptual framework.

Stroke is a leading cause of mortality and disability worldwide, with low and middle-income countries bearing the greatest burden. This article focuses on stroke prevention and awareness in the Philippines, a country grappling with high stroke incidence and limited healthcare resources. The two-pronged approach presented by the authors aims to address the challenges of stroke care by combining community-based prevention and targeted public awareness campaigns. The community-based stroke prevention component involves personalized risk factor assessments and tailored interventions conducted at local health centers. By identifying modifiable risk factors such as hypertension, diabetes, smoking, and elevated cholesterol levels, healthcare professionals can provide targeted education and interventions to individuals at risk. Additionally, the decentralized targeted stroke awareness campaigns emphasize public education through culturally adapted materials, engagement with local stakeholders, and media campaigns. These initiatives seek to increase awareness of stroke symptoms and prompt presentation in medical facilities. By implementing this comprehensive approach, we aim to mitigate the burden of stroke in the Philippines, improve stroke outcomes, and raise public awareness about stroke recognition and prevention.

The risk of developing postmenopausal breast cancer from ambient exposures to selected volatile organic compounds

ObjectivesTo estimate associations between incident postmenopausal breast cancer and environmental concentrations of five ambient volatile organic compounds (VOCs): benzene, hexane; ethylbenzene; n-decane; and 1,2,4-trimethylbenzene. MethodsWe conducted in Montreal a hospital-based case-control study between 1996 and 1997 and a population-based study between 2008 and 2011 of incident postmenopausal breast cancer. We measured five VOCs at about 130 locations during three sampling periods in 2005–2006 and we then used Bayesian geostatistical models to estimate concentrations of the VOCs at residential locations of participants in the two studies at the time of recruitment. We developed a directed acyclic graph to account for confounding but because of concerns with mis-specified models we used a series of unconditional logistic regression models to adjust for different combinations of personal risk factors, occupational exposures attributed by experts, air pollution data, and contextual variables. We estimated odds ratios (OR) for increases in concentrations across the interquartile ranges of the VOCs and associated 95% confidence intervals (CI). ResultsIn each study, we found that the ORs for each VOC were similar across the statistical models. In the hospital-based study, the ORs for the five VOCs varied between 0.77 and 1.04. In the population-based study, higher ORs were found for three VOCs: benzene, ORModel-7 = 1.12 (95%CI: 0.95, 1.31); hexane, ORModel-7 = 1.11 (95%CI: 0.97, 1.27); and 1,2,4-trimethyl-benzene, ORModel-7 = 1.07 (95%CI: 0.88, 1.31). We did not find important differences in sub-analyses by hormonal phenotype. ConclusionsIn the hospital-based study we did not find evidence of associations with these VOCs but in the population-based study there were indications of positive associations for environmental exposures to benzene and hexane.

Prevalence, time trends, and correlates of major depressive episode and other psychiatric conditions among young people amid major social unrest and COVID-19 in Hong Kong: a representative epidemiological study from 2019 to 2022

Hong Kong is among the many populations that has experienced the combined impacts of social unrest and the COVID-19 pandemic. Despite concerns about further deteriorations in youth mental health globally, few epidemiological studies have been conducted to examine the prevalence and correlates of major depressive episode (MDE) and other major psychiatric disorders across periods of population-level changes using diagnostic interviews. We conducted a territory-wide household-based epidemiological study from 2019 to 2022 targeting young people aged 15-24 years. MDE, generalised anxiety disorder (GAD), panic disorder (PD), and bipolar disorder (BD) were assessed using the Composite International Diagnostic Interview-Screening Scales in 3340 young people. Psychotic disorders were assessed by experienced psychiatrists according to the DSM. Help-seeking patterns were also explored. 16.6% had any mental disorder (13.7% 12-month MDE, 2.3% BD, 2.1% GAD, 1.0% PD, 0.6% psychotic disorder). The prevalence of MDE increased from 13.2% during period 1 (May 2019-June 2020) to 18.1% during period 2 (July-December 2020), followed by 14.0% during period 3 (January-June 2021) and 13.2% during period 4 (July 2021-June 2022). Different stressors uniquely contributed to MDE across periods: social unrest-related stressors during period 1, COVID-19 stressors during period 2, and personal stressors during periods 3-4. Lower resilience, loneliness, frequent nightmares, and childhood adversity were consistently associated with MDE. Compared to other conditions, those with MDE showed the lowest service utilisation rate (16.7%). Perceiving services to "cost too much" and "talked to friends or relatives instead" were among the major reasons for not seeking help. MDE was also significantly associated with poorer functioning and health-related quality of life. MDE can be sensitive to population-level changes, although its persistently elevated prevalence across the study period is of concern. Efforts to mitigate their impacts on youth mental health alongside personal risk factors are needed. Further work is required to increase the availability and acceptability of youth-targeted mental health services. Food and Health Bureau (HKSAR Government).

Breast cancer: genetic personal risk factors: A review

Determination of cancer risk factors allow us to develop diagnostics tests that improved identification and reduced the rate of mortality of most frequent cancer diseases including breast cancer, prostate cancer, gastrointestinal tumors. Today individual risk of breast cancer considers personal genetics, medical history of patient, lifestyle, and a number of additional factors. Calculation of the first mathematical models for breast cancer risk assessment included anthropometric data, hormonal status, and family history of cancer. The discovery of BRCA1 and BRCA2 genes role in the development of breast cancer and the accumulation of data from population studies contributed to the introduction of the genetic component into mathematical models. The trend of the last decade is the integration of the polygenic component into the scheme for calculating the individual risk of breast cancer. In this review, we have analyzed existing models, assessed their relevance for certain groups of patients, studied the trends in the development of methods for molecular genetic diagnosis of breast cancer and determining the personal risk of developing the disease.

Psychological distress in healthcare workers during COVID-19 pandemic: A systematic review

Objectives: Healthcare workers serving during the COVID-19 pandemic may have been exposed to high work overload, which may have had an impact on their physical, mental, and social health. The aim of this study was to assess the risk factors associated with psychological distress among healthcare workers serving during the COVID-19 pandemic from January 2020 to December 2022. Methods: A systematic review was conducted based on the 2020 PRISMA statement. Articles were searched in the Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO databases. Results: A total of 59 articles were included in this systematic review. It was observed that the prevalence of psychological distress during the COVID-19 pandemic was high. Female sex, being a nurse, being young, living alone/being single, and having a chronic disease or psychiatric disorder history are the main risk factors at the personal level. Other occupational and pandemic-related factors such as having many years of work experience, the presence of COVID-19 symptoms and contact history, not enough sleep, having lower family support and limited social relationships, fear of infecting friends and family, having a reduced perception of protection by personal protective equipment, working on the frontline, and having longer service duration were found to be factors influencing the development of psychological distress during the COVID-19 pandemic. Conclusions: There are personal, interpersonal, and organizational risk factors that can lead to the occurrence of psychological distress among healthcare staff working during the COVID-19 pandemic.