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Clinical Neuropsychiatry Oct 2023Workplace ethics is a central theme in occupational health; an ethical climate aims to implement and uphold standards of integrity and fairness. Furthermore, the... (Review)
Review
OBJECTIVE
Workplace ethics is a central theme in occupational health; an ethical climate aims to implement and uphold standards of integrity and fairness. Furthermore, the correlation between ethical climate and burnout has been highlighted in several studies, and the impact of a negative ethical climate in the workplace has been reported to affect workers' mental health and job performances, resulting in increased burnout incidence. The aim of this systematic review is to assess the relationship between ethical climate and burnout in the workplace.
METHOD
This review was conducted following the PRISMA statements. Three databases were screened, including research articles written in the English language during the last 10 years, investigating the relationship between burnout and ethics in the workplace. The quality of articles was assessed with the Newcastle-Ottawa Scale.
RESULTS
1153 records were found across three databases; after duplicate removal and screening for title and abstract, 46 manuscripts were screened by full text, resulting in 13 included studies. The majority of the included studies were performed on healthcare workers (n=7, 53.8%), and with a majority of female participants (n=9, 69.2%). Most of the included studies (n=9, 69.2%) evaluated the correlation between ethical climate and burnout, while the other four (n=4, 30.8%) evaluated ethical leadership. Four studies reported a positive correlation between ethics and work engagement. Two studies highlighted that an ethical workplace climate reduced turnover intention.
CONCLUSIONS
Ethical climate plays an important role in burnout mitigation in workers and in improving work engagement, thus helping to reduce turnover intentions. Since all of these variables have been reported to be present in clusters of workers, these aforementioned factors could impact entire workplace organizations and their improvement could lead to a better work environment overall, in addition to improving the single factors considered. Further studies are needed to investigate the role of ethical climate in the workplace.
PubMed: 38089739
DOI: 10.36131/cnfioritieditore20230502 -
Journal of Thermal Biology Aug 2023Given the increasing trend of global warming and extreme weather conditions, including heat waves and its effects on health, the present study was done to investigate... (Review)
Review
BACKGROUND
Given the increasing trend of global warming and extreme weather conditions, including heat waves and its effects on health, the present study was done to investigate adaptive behaviors of communities in the world for combating heat waves.
METHOD
ology: In this systematic review, out of 1529 results, 57 relevant and authoritative English papers on adaptation to heat waves hazard were extracted and evaluated using valid keywords from valid databases (PubMed, WOS, EMBASE, and Scopus). In addition, multiple screening steps were done and then, the selected papers were qualitatively assessed. Evaluation results were summarized using an Extraction Table.
RESULTS
In this paper, the adaptive behaviors for combating heat waves hazard were summarized into 11 categories: Education and awareness raising, Adaptation of critical infrastructure, Governments measures, Health-related measures, Application of early warning system, Protective behaviors in workplace, Physical condition, Adaptive individual behaviors, Design and architecture of the building, Green infrastructure (green cover), and Urban design.
CONCLUSION
The findings of this study showed that community actions have significant effects on adaptation to heat wave. Therefore, for reducing heat wave-related negative health effects and vulnerability, more attention should be paid to the above-mentioned actions for mitigation, preparation, and responding regarding heat waves.
PROSPERO REGISTRATION NUMBER
CRD42021257747.
Topics: Hot Temperature; Acclimatization; Adaptation, Physiological; Global Warming; Adaptation, Psychological; Climate Change
PubMed: 37499408
DOI: 10.1016/j.jtherbio.2023.103588 -
Disability and Rehabilitation Nov 2023A systematic review and meta-analysis investigating the duration and frequency of lower extremity prosthesis use and what factors were associated with changes in their... (Review)
Review
PURPOSE
A systematic review and meta-analysis investigating the duration and frequency of lower extremity prosthesis use and what factors were associated with changes in their use.
MATERIALS AND METHODS
A search of PubMed, CINAHL, and Scopus over 20 years revealed 2409 articles. After review, 29 studies remained, representing 4814 participants with lower limb loss. Quality, funding, publication, and quantitative analyses were addressed.
RESULTS
The mean prosthesis use was 9.6 (5.3) hours/day and 6.4 (1.9) days/week. Distal amputation sites averaged more hours/day of prostheses use than proximal amputations (13.2 [3.2] vs. 10.8 [5.0], < .001). After hemipelvectomy or hip dislocations, average prostheses use was less hours/day (6.0 [4.7]) than after transfemoral (12.9 [4.8]) or transtibial amputations (14.0 [4.5]) ( < .05). Pooled effects revealed an association between comorbidities and abandonment (OR 0.35, = .03). The data supported six empirical evidence statements concerning age, sex, social support, amputation proximity, balance, skin condition, comorbidities, pain, falls, and fitness in association with changes in prosthesis utilization.
CONCLUSIONS
The study provided systematic data on lower-extremity prosthesis use, thus helping to inform clinical decision-making and patient education. It also elucidated a path for future studies focused on modifiable factors related to prosthesis use and related outcomes.Implications for rehabilitationLower limb loss can trigger costly and debilitating sequela, which could be mitigated by increased prosthesis use and functionality, but there is no consensus on how often prostheses are being used and what affects changes in their use.When counseling patients on what they can expect after a lower extremity amputation and to set goals, the aggregated means of 9.6 (5.3) hours per day and 6.4 (1.9) days per week can be informative.Individuals who use a lower extremity prosthesis or may have to use one in the future can increase their prosthesis use and mobility by limiting further health deterioration.Rehabilitative care involving the multidisciplinary prioritization of proper socket fit, fitness training, gait training, and social support is associated with increased prosthetic device usage.
PubMed: 37927090
DOI: 10.1080/09638288.2023.2276838 -
The Lancet Regional Health. Western... Nov 2023Gaseous emissions have contributed to global warming, an increase in the frequency of extreme weather events and poorer air quality. The associated health impacts have... (Review)
Review
UNLABELLED
Gaseous emissions have contributed to global warming, an increase in the frequency of extreme weather events and poorer air quality. The associated health impacts have been well reported in temperate regions. In Singapore, key climate change adaptation measures and activities include coastal and flood protection, and mitigating heat impacts. We systematically reviewed studies examining climate variability and air quality with population health in Singapore, a tropical city-state in South-East Asia (SEA), with the aim to identify evidence gaps for policymakers. We included 14 studies with respiratory illnesses, cardiovascular outcomes, foodborne disease and dengue. Absolute humidity (3 studies) and rainfall (2 studies) were positively associated with adverse health. Extreme heat (2 studies) was inversely associated with adverse health. The effects of mean ambient temperature and relative humidity on adverse health were inconsistent. Nitrogen dioxide and ozone were positively associated with adverse health. Climate variability and air quality may have disease-specific, differing directions of effect in Singapore. Additional high quality studies are required to strengthen the evidence for policymaking. Research on effective climate action advocacy and adaptation measures for community activities should be strengthened.
FUNDING
There was no funding source for this study.
PubMed: 38116501
DOI: 10.1016/j.lanwpc.2023.100947 -
Environmental Health Perspectives Aug 2023Neural tube defects (NTDs) affect pregnancies worldwide annually. Few nongenetic factors, other than folate deficiency, have been identified that may provide... (Review)
Review
BACKGROUND
Neural tube defects (NTDs) affect pregnancies worldwide annually. Few nongenetic factors, other than folate deficiency, have been identified that may provide intervenable solutions to reduce the burden of NTDs. Prenatal exposure to toxic metals [arsenic (As), cadmium (Cd), mercury (Hg), manganese (Mn) and lead (Pb)] may increase the risk of NTDs. Although a growing epidemiologic literature has examined associations, to our knowledge no systematic review has been conducted to date.
OBJECTIVE
Through adaptation of the Navigation Guide systematic review methodology, we aimed to answer the question "does exposure to As, Cd, Hg, Mn, or Pb during gestation increase the risk of NTDs?" and to assess challenges to evaluating this question given the current evidence.
METHODS
We selected available evidence on prenatal As, Cd, Hg, Mn, or Pb exposure and risk of specific NTDs (e.g., spina bifida, anencephaly) or all NTDs via a comprehensive search across MEDLINE, Embase, Web of Science, and TOXLINE databases and applied inclusion/exclusion criteria. We rated the quality and strength of the evidence for each metal. We applied a customized risk of bias protocol and evaluated the sufficiency of evidence of an effect of each metal on NTDs.
RESULTS
We identified 30 studies that met our criteria. Risk of bias for confounding and selection was high in most studies, but low for missing data. We determined that, although the evidence was limited, the literature supported an association between prenatal exposure to Hg or Mn and increased risk of NTDs. For the remaining metals, the evidence was inadequate to establish or rule out an effect.
CONCLUSION
The role of gestational As, Cd, or Pb exposure in the etiology of NTDs remains unclear and warrants further investigation in high-quality studies, with a particular focus on controlling confounding, mitigating selection bias, and improving exposure assessment. https://doi.org/10.1289/EHP11872.
Topics: Female; Pregnancy; Humans; Cadmium; Lead; Prenatal Exposure Delayed Effects; Neural Tube Defects; Mercury; Manganese; Arsenic
PubMed: 37647124
DOI: 10.1289/EHP11872 -
Joint Commission Journal on Quality and... Jan 2024Voluntary event reporting (VER) systems underestimate the incidence of safety events and often capture only serious events. A limited amount of data is collected through... (Review)
Review
Voluntary event reporting (VER) systems underestimate the incidence of safety events and often capture only serious events. A limited amount of data is collected through these systems, and they may be inadequate to characterize disparities in reported safety events. We conducted a scoping review of the literature to summarize the state of the evidence as it relates to differences in safety events and safety event reporting by age, gender, and race. Using a broad-based query, a systematic search for published, peer-reviewed literature that discusses patient safety event reporting and differences by age, gender, race, and socioeconomic status was conducted. Based on modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 283 studies underwent title and abstract review, yielding 56 studies for full text review. After full text review, 23 studies were carefully reviewed individually, grouped thematically, and summarized to highlight the most pertinent findings. The studies reviewed yielded important insights, particularly with regard to race, gender, and the ways events are identified. Patients from minoritized groups may be less likely to have events reported and more likely to suffer serious events. Some studies found differences in rates of reporting safety events for female vs. male providers. The rate of VER is consistently lower than the rate of events identified through identified using automated detection. The current literature describing VER data shows disparities by race, language, age, and gender for patients and providers. Further research and systematic change are needed to specifically study these disparities to guide health care institutions on ways to mitigate bias and deliver more equitable care.
Topics: Humans; Male; Female; Patient Safety; Research Design
PubMed: 38057189
DOI: 10.1016/j.jcjq.2023.10.009 -
Academic Emergency Medicine : Official... Jun 2024The emergency department (ED) is a demanding and time-pressured environment where doctors must navigate numerous team interactions. Conflicts between health care... (Review)
Review
BACKGROUND
The emergency department (ED) is a demanding and time-pressured environment where doctors must navigate numerous team interactions. Conflicts between health care professionals frequently arise in these settings. We aim to synthesize the individual-, team-, and systemic-level factors that contribute to conflict between clinicians within the ED and explore strategies and opportunities for future research.
METHODS
Online databases PubMed and Web of Science were systematically searched for relevant peer-reviewed journal articles in English with keywords relating to "conflict" and "emergency department," yielding a total of 29 articles.
RESULTS
Narrative analysis showed that conflict often occurred during referrals or admissions from ED to inpatient or admitting units. Individual-level contributors to conflict include a lack of trust in ED workup and staff inexperience. Team-level contributors include perceptions of bias between groups, patient complexity, communication errors, and difference in practice. Systems-level contributors include high workload/time pressures, ambiguities around patient responsibility, power imbalances, and workplace culture. Among identified solutions to mitigate conflict are better communication training, standardizing admission guidelines, and improving interdepartmental relationships.
CONCLUSIONS
In emergency medicine, conflict is common and occurs at multiple levels, reflecting the complex interface of tasks and relationships within ED.
Topics: Humans; Emergency Service, Hospital; Emergency Medicine; Interprofessional Relations; Patient Care Team; Conflict, Psychological; Communication
PubMed: 38415363
DOI: 10.1111/acem.14874 -
Journal of Medical Internet Research Dec 2023Persons diagnosed with serious chronic illnesses and their caretakers experience multiple types of financial costs that strain their income and generate financial... (Review)
Review
BACKGROUND
Persons diagnosed with serious chronic illnesses and their caretakers experience multiple types of financial costs that strain their income and generate financial distress. Many turn to medical crowdfunding (MCF) to mitigate the harms of these costs on their health and quality of life.
OBJECTIVE
This scoping review aims to summarize the research on MCF for persons diagnosed with serious chronic illness regarding study designs and methods; the responsible conduct of research practices; and study foci as they relate to stress, stress appraisals, and the coping processes.
METHODS
This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eligible studies were conducted in countries designated as high income by the World Bank and focused on beneficiaries diagnosed with serious chronic illness. The findings of the included studies were summarized as they related to the key concepts in a conceptual framework derived from an established stress, appraisal, and coping framework and a conceptual model of financial toxicity in pediatric oncology.
RESULTS
Overall, 26 studies were eligible for inclusion in the review. The main findings included a lack of integration of qualitative and quantitative approaches and the inconsistent reporting of the responsible conduct of research practices. The included studies focused on financial stressors that contributed to financial burden, such as out-of-pocket payments of medical bills, basic living expenses, medical travel expenses, and lost income owing to illness-related work disruptions. Few studies addressed stress appraisals as threatening or the adequacy of available financial resources. When mentioned, appraisals related to the global financial struggle during the COVID-19 pandemic or the capacity of social network members to donate funds. The consequences of MCF included the receipt of 3 forms of social support (tangible, informational, and emotional), privacy loss, embarrassment, and the propagation of scientifically unsupported information. Studies found that friends and family tended to manage MCF campaigns. Although most of the studies (21/26, 81%) focused on monetary outcomes, a few (5/26, 19%) concentrated on peoples' experiences with MCF.
CONCLUSIONS
The identified methodological gaps highlight the need for more robust and reproducible approaches to using the copious data available on public MCF platforms. The integration of quantitative and qualitative methods will allow for nuanced explorations of the MCF experience. A more consistent elaboration of strategies to promote the responsible conduct of research is warranted to minimize risk to populations that are vulnerable and express concerns regarding the loss of privacy. Finally, an examination of the unanticipated consequences of MCF is critical for the development of future interventions to optimize existing supports while providing needed supports, financial and nonfinancial, that are lacking.
Topics: Child; Humans; Medical Tourism; Pandemics; Quality of Life; Health Expenditures; Chronic Disease
PubMed: 38048149
DOI: 10.2196/44530 -
BJOG : An International Journal of... Apr 2024The healthcare sector is responsible for 4%-10% of global greenhouse gas emissions. Considering the broad range of care that obstetricians and gynaecologists provide,... (Review)
Review
BACKGROUND
The healthcare sector is responsible for 4%-10% of global greenhouse gas emissions. Considering the broad range of care that obstetricians and gynaecologists provide, mitigation strategies within this specialty could result in significant reductions of the environmental footprint across the whole healthcare industry.
OBJECTIVES
The aim of this review was to identify for what services, procedures and products within obstetric and gynaecological care the environmental impact has been studied, to assess the magnitude of such impact and to identify mitigation strategies to diminish it.
SEARCH STRATEGY
The search strategy combined terms related to environmental impact, sustainability, climate change or carbon footprint, with the field of obstetrics and gynaecology.
SELECTION CRITERIA
Articles reporting on the environmental impact of any service, procedure or product within the field of obstetrics and gynaecology were included. Included outcomes covered midpoint impact categories, CO emissions, waste generation and energy consumption.
DATA COLLECTION AND ANALYSIS
A systematic literature search was conducted in the databases of MEDLINE (Ovid), Embase (Ovid) and Scopus, and a grey literature search was performed on Google Scholar and two websites of gynaecological associations.
MAIN RESULTS
The scope of the investigated studies encompassed vaginal births, obstetric and gynaecological surgical procedures, menstrual products, vaginal specula and transportation to gynaecological oncologic consultations. Among the highest yielding mitigation strategies were displacing disposable with reusable materials and minimising content of surgical custom packs. The lowest yielding mitigation strategy was waste optimisation, including recycling.
CONCLUSIONS
This systematic review highlights opportunities for obstetricians and gynaecologists to decrease their environmental footprint in many ways. More high-quality studies are needed to investigate the environmental impact of other aspects of women's and reproductive health care.
Topics: Female; Humans; Gynecology; Obstetrics; Carbon Footprint
PubMed: 37604701
DOI: 10.1111/1471-0528.17637