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Why you should read this article: • To enhance your understanding of the effects of sickle cell disease • To recognise the factors that can affect quality of life in children with sickle cell disease • To consider ways in which the care of children with sickle cell disease could be improved Background: Sickle cell disease is an inherited haematological condition with life-threatening consequences. It can affect all aspects of the lives of children with the condition, including biopsychosocial and cognitive aspects. These children tend to have a low health-related quality of life (HRQoL). Aim: To identify factors associated with HRQoL in Omani children with sickle cell disease. Method: The study was a secondary analysis of data from a randomised controlled trial conducted with 72 parent-and-child dyads who were recruited from two tertiary hospitals in Oman. The aim of the original study was to examine the effects of an educational programme on the knowledge and self-efficacy of parents of children with sickle cell disease. As part of that study, parents and children completed two questionnaires on HRQoL, one generic and one specific to sickle cell disease. Results: Parents' knowledge of sickle cell disease, parents' self-efficacy in managing their child's symptoms, parents' age, children's age and treatment with hydroxyurea were found to affect children's HRQoL. Conclusion: Healthcare providers need to include biopsychosocial and cognitive aspects of HRQoL in their assessments of children with sickle cell disease. Programmes designed to enhance parents' and children's knowledge and self-efficacy, as well as measures designed to ensure that children receive treatment with hydroxyurea, are likely to improve the HRQoL of children with sickle cell disease. [ABSTRACT FROM AUTHOR]

Background: Rotating shift work is common in high-hazard industries, despite documented associations with sleep disturbance and impairment. In the oil industry, where rotating and extended shift schedules are used to staff safety-sensitive positions, work intensification and increasing overtime rates have been broadly documented over the last few decades. Research on the impacts of these work schedules on sleep and health has been limited for this workforce. Methods: We examined sleep duration and quality among rotating shift workers in the oil industry and explored associations between schedule characteristics, sleep, and health outcomes. We recruited hourly refinery workers from the West and Gulf Coast oil sector members of the United Steelworkers union. Findings: Impaired sleep quality and short sleep durations were common and associated with health and mental health outcomes common among shift workers. Shortest sleep durations followed shift rotations. Early rise and start times were associated with shorter sleep duration and poorer sleep quality. Drowsiness and fatigue-related incidents were common. Conclusion/Application to Practice: We observed lower sleep duration and quality and increased overtime in 12-hour rotating shift schedules. These long workdays with early start times may reduce available hours for quality sleep; here they were associated with reduced exercise and leisure activity which correlated with good sleep. This safety-sensitive population appears severely impacted by poor sleep quality, which has broader implications for process safety management. Later start times, slower rotation, and a reconsideration of two-shift schedules are interventions to consider for improving sleep quality among rotating shift workers. [ABSTRACT FROM AUTHOR]

Hypertension is a key driver of cardiovascular diseases. However, how stressors contribute to the development of hypertension remains unclear. The objective of this study was to examine prospective associations of adverse childhood experiences (ACEs) and adulthood psychosocial disadvantages (APDs) with incident hypertension. Data were from the Mid-life in the United States (MIDUS) study, a national, population-based, prospective cohort study. ACEs were examined via retrospective reports, and APDs including work stress and social isolation were assessed using survey measures. Incident hypertension was defined based on self-reported physician diagnosis. Baseline data were collected in 1995, with follow-up in 2004–2006 and 2013–2014. Cox proportional hazards regression was applied to assess prospective associations of ACEs and APDs with incident hypertension in 2568 workers free from hypertension at baseline. After adjustment for covariates, baseline APDs were associated with increased incident hypertension (aHR and 95% CI = 1.48 [1.09, 2.01]) during a 20-year follow-up, whereas ACEs showed null associations. Moreover, a moderating effect by ACEs was observed—the effect of APDs on risk of hypertension was stronger when ACEs were present (aHR and 95% CI = 1.83 [1.17, 2.86]). These findings underscore the importance of psychosocial stressors as nontraditional risk factors of cardiometabolic disorders. [ABSTRACT FROM AUTHOR]

Context: Sixty-three percent of cancer survivors continue to work, or return to work after treatment. Among this population, work ability and challenges encountered in the workplace by young adult cancer survivors have not been well established.Purpose: The purposes of the study are to describe what is currently known about work-related issues for young adult cancer survivors diagnosed between ages 15 and 39, to identify gaps in the research literature, and to suggest interventions or improvements in work processes and occupational settings.Methods: A narrative review of articles using PubMed, CINAHL, and PsychInfo was conducted without date limitations. Search phrases included young adult cancer survivors, long-term cancer survivors, young adults affected by cancer, further combined with key terms employment, work, and occupationally active. Inclusion criteria for publications were young adult cancer survivors initially diagnosed between the ages of 15 and 39, data about work or employment was presented, and articles written in English.Results: Twenty-three publications met the inclusion criteria. Work-related issues included the potential for reduced work productivity from cancer-changed physical and cognitive functional ability that affected income, and resulted in distress. Coping style, support systems, and changing perspectives about work and life in general were also influential on career decisions among young adult cancer survivors.Conclusions: More research is needed to study interventions to better manage health changes in young adult cancer survivors within the context of the workplace. Since financial hardship has been shown to be especially high among young cancer survivors, employment is essential to ensure payment of cancer-associated costs and continued medical care.Implications For Cancer Survivors: While young adult cancer survivors may initially grapple with cancer-related physical and psychosocial changes that impact work productivity or influence choice of occupation, employment appears to enhance overall quality of life. [ABSTRACT FROM AUTHOR]

Background: Spontaneous preterm delivery (sPTD) is associated with a twofold increased risk of future maternal cardiovascular disease. We hypothesized that women with sPTD would demonstrate greater vascular dysfunction postpartum compared to women with term delivery. Materials and Methods: In a case-controlled, matched pilot study, we enrolled 20 women with sPTD (gestation ≤34 weeks), and 20 term control women (gestation ≥39 weeks) were matched for age (±5 years), parity, ethnicity, and route of delivery. Vascular function, serum lipids, C-reactive protein, and interleukin-6 were completed within 24–72 hours postpartum. Statistical analysis included paired t-tests based on match and mixed effects linear regression models and adjusted for potential confounders. Results: The mean age for sPTD and term controls was 33 ± 6 years and 32 ± 6 years, respectively. Women with sPTD had significantly lower augmentation index-75 (24.1% ± 16.1% vs. 39.9% ± 15.2%, p = 0.001) and central pulse pressure (29.1 ± 5.4 mmHg vs. 34.6 ± 4.7 mmHg, p = 0.004), but no difference in pulse wave velocity (5.1 ± 1.6 m/s vs. 5.6 ± 1.5 m/s, p = 0.12) compared to controls. Women with sPTD had significantly lower high-density lipoprotein cholesterol (59.4 ± 12.5 mg/dL vs. 67.6 ± 13.1 mg/dL, p = 0.035) compared to controls. Analysis of chorioamnionitis and magnesium sulfate did not alter the results. Conclusions: Women with sPTD have signs of lower smooth muscle tone in the early postpartum period compared to women with term delivery. Further research is required to understand mechanistic pathways in sPTD and future maternal cardiovascular disease risk. [ABSTRACT FROM AUTHOR]

Work provides satisfaction and stability to young adult cancer survivors. However, progressive health changes because of cancer may compromise safety and diminish functional ability. The purpose of this study was to describe long-term young adult cancer survivors' work experiences and describe their interactions with occupational and environmental health professionals (OEHPs) within the workplace. Cancer survivors were recruited from the Los Angeles County Cancer Surveillance Program. Professional organizations provided access to OEHPs. Constructivist grounded theory guided individual semi-structured interviews during data collection and analysis. Processes of interaction between cancer survivors and OEHPs found to influence work included revealing the survivor-self, sustaining work ability, gatekeeping (employment opportunities, return to work), and accessing support. OEHPs appeared to facilitate survivors' work ability in the long term if services were available, services were known to survivors, and survivors revealed needs. Educating workers about OEHP services throughout cancer experiences and survivorship could ultimately improve interactivity and provide supportive work environments. [ABSTRACT FROM AUTHOR]

Aim: To determine the relationships between job satisfaction, work environment and successful ageing and how these factors relate to Registered Nurses' intent to retire. Background: Although little studied, retention of older nurses by delaying early retirement, before age 65, is an important topic for research. Qualitative and quantitative studies have indicated that job satisfaction work environment and successful ageing are key motivators in acute care Registered Nurses retention and/or delaying retirement. This study was designed to provide information to administrators and policy makers about retaining older, experienced RNs longer and more productively. Design: This was a correlational, descriptive, cross-sectional study. Methods: An online survey of acute care Registered Nurses (N = 2,789) aged 40 years or older working in Florida was conducted from September - October 2013. Participants completed items related to job satisfaction, work environment, successful ageing and individual characteristics. Hypotheses derived from the modified Ellenbecker's Job Retention Model were tested using regression analysis. Results: Job satisfaction scores were high. Highest satisfaction was with scheduling issues and co-workers; lowest with advancement opportunities. Successful ageing scores were also high with 81% reporting excellent or good health. Work environment explained 55% of the variance in job satisfaction. Years to retirement were significantly associated with successful ageing (p < .001), age (p < .001) and income (p < .010). Conclusions: This study provides quantitative evidence that environment and successful ageing are important areas that have an impact on job satisfaction and delay of retirement in older nurses and further studies in these areas are warranted to expand on this knowledge. [ABSTRACT FROM AUTHOR]

Shared commutes to work, such as vanpooling, benefit the environment and provide economic gain for riders in terms of fuel costs, parking fees, and personal vehicle wear and tear. Although ride sharing is commonly believed to promote health through stress reduction, published evidence on this topic is limited, and findings vary. This study explored the perceived health and well-being of vanpoolers using a qualitative, descriptive design. Five focus groups of vanpoolers and two individual interviews with drivers were conducted (N = 40 participants). Stress, change in sleep patterns, and interpersonal relationships emerged as major themes. Employee insights about the impact of vanpooling on work productivity and how employer commitment to the vanpool program influences the vanpool experience also were important findings. [ABSTRACT FROM AUTHOR]

Although considerable attention has been given to zero-inflated count data, research on zero-inflated lognormal data is limited. In this article, we consider a study to examine human sperm cell DNA damage obtained from single-cell electrophoresis (COMET assay) experiment in which the outcome measures present a typical example of log-normal data with excess zeros. The problem is further complicated by the fact that each study subject has multiple outcomes at each of up to three visits separated by six-week intervals. Previous methods for zero-inflated log-normal data are based on either simple experimental designs, where comparison of means of zero-inflated log-normal data across different experiment groups is of primary interest, or longitudinal measurements, where only one observation is available for each subject at each visit. Their methods cannot be applied when multiple observations per visit are possible and both inter- and intra-subject variations are present. Our zero-inflated model extends the previous methods by incorporating a hierarchical structure using latent random variables to take into account both inter- and intra-subject variations in zero-inflated log-normal data. An EM algorithm has been developed to obtain the Maximum likelihood estimates of the parameters and their standard errors can be estimated by parametric bootstrap. The model is illustrated using the COMET assay data. [ABSTRACT FROM AUTHOR]

Abstract: Boron found as borates in soil, food, and water has important industrial and medical applications. A panel reviewing NTP reproductive toxicants identified boric acid as high priority for occupational studies to determine safe versus adverse reproductive effects. To address this, we collected boron exposure/dose measures in workplace inhalable dust, dietary food/fluids, blood, semen, and urine from boron workers and two comparison worker groups (n =192) over three months and determined correlations between boron and semen parameters (total sperm count, sperm concentration, motility, morphology, DNA breakage, apoptosis and aneuploidy). Blood boron averaged 499.2ppb for boron workers, 96.1 and 47.9ppb for workers from high and low environmental boron areas (p <0.0001). Boron concentrated in seminal fluid. No significant correlations were found between blood or urine boron and adverse semen parameters. Exposures did not reach those causing adverse effects published in animal toxicology work but exceeded those previously published for boron occupational groups. [Copyright &y& Elsevier]

The purpose of this work was to identify an accurate, noninvasive biomarker of boron exposure that could be used in worker populations. Occupational exposure to boron is of concern due to high numbers of workers exposed, animal toxicity data suggesting reproductive effects, and lack of human studies. Total daily boron exposure was determined from duplicate samples of 24-hr food and fluid intake, plus workplace personal air monitoring in boron workers and comparison groups in northern China during 2003 and 2004. Boron was also measured in blood, semen, creatinine-corrected postshift urine, and 24-hr urine. Total daily boron exposure (mg/day) averaged 41.2 for men working in the boron industry and 2.3 for the comparison group. Boron concentration in postshift urine was correlated with 24-hr urine boron concentration (Pearson correlation coefficient = 0.85, p < 0.0001). Boron concentration in postshift urine was correlated with total daily boron exposure measured through food, fluid, and personal air monitoring (Pearson correlation coefficient = 0.83, p < 0.0001). Boron concentration in postshift urine was also correlated with internal dose measures of boron in blood and semen (Pearson correlation coefficient = 0.85, 0.80 respectively, p < 0.0001). This work suggests that creatinine-corrected, postshift urine boron concentration can be used as a biomarker of human boron exposure in worker populations. [ABSTRACT FROM AUTHOR]

This article describes the lifestyle patterns of boron mining and processing workers (N = 936) and a comparison group (N = 251) in northeast China, and explores relationships between boron exposure and reproductive health. An English version of an interview guide addressing areas of work and lifestyle relevant to boron exposure and metabolism was developed by an occupational health research team, translated to Chinese, and translated back, for clarity. Modifications incorporated suggestions from a local community advisory board and boron industry workers; the translation-back translation process was reapplied, and cultural and semantic equivalence was attained. Results from the interviews showed more than 64% of workers and comparison group participants smoked tobacco and more than 92% reported exposure to environmental tobacco smoke. Boron workers and the comparison group varied in their food intake and alcohol consumption, but not in their smoking habits. Thirty-four percent of boron workers reported eating in the contaminated work area. Nearly all boron workers (99%) showered or bathed after work, although approximately 10% redressed in their contaminated clothes. Reproductive health outcomes were explored, including delayed pregnancy, multiple births, spontaneous miscarriages, induced abortions, stillbirths, and an unusual ratio of male to female offspring. Implications for occupational health nurses and recommendations for future research are provided. [ABSTRACT FROM AUTHOR]

Background: Although many atherosclerotic cardiovascular disease (ASCVD) risk factors are well established, less is known about a woman's cardiovascular response to pregnancy, which may be an early marker of future maternal CVD risk. Spontaneous preterm delivery (sPTD) has been associated with a 2-fold increased risk of maternal CVD later in life, yet little is known about the association. Methods: Our study, "Is Spontaneous Preterm Delivery Associated with Clustering of Future Maternal Cardiovascular Risk Markers?,'' enrolled 20 women with sPTD (gestation ≤ 34 weeks) and 20 control women (gestation ≥ 39 weeks) matched for age (±5 years), parity, race, and route of delivery collected between 24 and 72 hours postpartum. We measured total cholesterol (TC), high-density lipoprotein calculated (HDLc), triglycerides (TRG), low-density lipoprotein calculated, C-reactive protein (CRP), and interleukin-6 (IL-6) 24 to 72 hours postpartum. Paired t test based on match was used on the data. Mixed effects linear regression models with a random effect for match were used to compare lipids, CRP, and IL-6 between the groups (sPTD vs control) and adjust for potential confounders. Results: The mean age for sPTD and controls was 33 ± 6 years and 32 ± 6 years, respectively. Women with sPTD had lower family income compared with control women (P = .04). There were no other demographic differences between the 2 groups. Compared with matched controls, women with sPTD had significantly lower HDLc (67.4 mg/dL vs 59.37 mg/dL, respectively; P = .035). After adjusting for group (sPTD vs control), BMI, SBP at baseline, education level, and marital status, high-density lipoprotein difference between groups remained significant (P = .0039). There were no group differences in total cholesterol, triglycerides, low-density lipoprotein calculated, CRP, and IL-6. Conclusion: Because HDLc plays an important role in ASCVD prevention, further study is needed to determine if women with sPTD will benefit from earlier, more vigilant ASCVD monitoring and lifestyle interventions. [ABSTRACT FROM AUTHOR]