Iranian nursing staff's self-reported general and mental health related to working conditions and family situation.

BACKGROUND: There is increasing global evidence that today's work environment results in higher risk of adverse health among nursing staff than among other professions. AIM: To investigate self-reported general and mental health among Iranian nursing staff, and associations with organizational, physical and psychosocial working conditions and family situation. METHODS: 520 nursing personnel from 10 university hospitals in Tehran participated in this cross-sectional study. Data were collected using a validated questionnaire in the Persian language, containing the Copenhagen Psychosocial Questionnaire, physical items from the Nurse Early eXit Study and two scales relating to general health and mental health from the Short Form-36. The Chi-square test with P<0.05 and logistic regression were used to analyse data. RESULTS: Three out of four nursing staff reported overtime work. The self-reported general and mental health rates of participants were poor/fair (38%, 41%), good (44%, 39%) and very good/excellent (18%, 20%), respectively. Family demands were associated with general health but were not associated with mental health. Adverse physical and psychosocial work conditions gave an elevated odds ratio for poor health. CONCLUSION: Poor general and mental health was associated with adverse working conditions and family demands. Physical and psychosocial working conditions of nursing personnel should be improved. Social facilities such as daycare for children and care for the elderly should be available during work shifts to help Iranian nurses play their family roles.

Sense of coherence and psychosocial factors among adolescents.

AIM: The overall aim of the present study was to investigate whether there was a relationship between sense of coherence and psychosocial factors among adolescents. METHODS: A cross-sectional study was conducted in a sample of pupils in year eight from comprehensive schools in Stockholm city, selected with regard to socioeconomic area. In the final sample of the study there were 383 pupils: 196 girls and 187 boys. Two questionnaires, the Sense of Coherence Scale and the Health Profile Scale measuring health behaviour, were used to collect data. RESULTS: Girls showed a significantly more negative outcome compared with boys, in eight psychosocial factors. The most pronounced difference between boys and girls was seen in feeling depressed: 17% and 54% respectively. Five factors proved to be associated with low SOC in the multivariate analysis: life dissatisfaction, feeling depressed, worries about family members, poor psychosomatic health and being a girl. CONCLUSION: The findings reveal domains where adolescents, especially girls, seem to be more vulnerable. Psychosomatic health and mental health are related to low sense of coherence.

Predictors of leaving nursing care: a longitudinal study among Swedish nursing personnel.

OBJECTIVES: Despite extensive research on turnover among nursing personnel very little is known about the impact of physical workload and health on leaving. The aim of this study was to find predictors for leaving nursing care with special reference to physical working conditions and musculoskeletal problems. METHODS: This study is based on longitudinal data from a survey of nursing personnel who were employed at various county hospitals in Sweden from 1992-95. A self administrated follow up questionnaire was used to identify their present position in the labour market. The response rate was 73% (n = 1095). RESULTS: The results showed that nursing personnel reporting musculoskeletal problems of the neck/shoulder or knees and those who had limited use of transfer devices were more likely to leave nursing care. CONCLUSIONS: The study highlights the importance of taking musculoskeletal problems and use of transfer devices into consideration in order to retain nursing personnel.

The ancestry of the prolactin-releasing hormone precursor.

The prolactin-releasing hormone (PRLH) is implicated in food intake and is expressed in several parts of the mammalian brain. The origin of the peptide precursor (PRH) has been unclear, and the only feature resembling other known human neuropeptide sequences is the C-terminal RF-motif, also present in the neuropeptide FF and the neuropeptide RF amide-related peptide families (RFRP). We have recently found sequences of PRH and the closely related precursor C-RF amide in chicken, shedding light on the PRH ancestry.

Work-related low-back problems in nursing.

This scientific literature review focuses on the relation between nursing work and low-back problems. Its aim was to estimate the risk of physical, psychosocial, and work organizational exposure factors that may lead to low-back problems. In addition this paper reviews and evaluates reported ergonomic intervention, with the object of decreasing the prevalence and incidence of low-back problems among nurses. A considerable number of studies of nursing staff has shown the connection between lifts and transfers of patients on one hand and low-back problems on the other. Factors in nursing work that may be significant in this connection are staff density and work satisfaction. In this review the single individual factor that was indisputably related to low-back problems was "history of back problems". Prevention programs do not show unequivocally positive results. There is a great need to carry out prospective studies with preventive programs.

Evaluation of a 3 year education and training program. For nursing personnel at a Swedish hospital.

An education and training program comprising 1) patient transfer technique, 2) physical fitness exercise, and 3) stress management was conducted during 3 consecutive years at a Swedish hospital. The present study was based on data from four sets of questionnaires, distributed to 348 female nursing personnel who participated in the entire program. The aim of the study was to evaluate the program. It was evident from the questionnaires that 90% of the subjects were positive about participating in the program and 88% expected that participation would lead to decreased musculoskeletal disorders. However, no decrease in the prevalence of musculoskeletal symptoms during the study time period was observed. One year after the cessation of the program, 93% of all nurses reported they mostly or always used the new patient transfer technique and 99% considered it to be useful.

Musculoskeletal symptoms and job strain among nursing personnel: a study over a three year period.

OBJECTIVES: To examine the variation of symptoms from the neck, shoulders, and back over a three year period among female nursing personnel and the relation between job strain and musculoskeletal symptoms. METHODS: At a county hospital the female nursing personnel answered a questionnaire at baseline and then once a year over a period of three years. There were 565, 553, 562, and 419 subjects who answered the questionnaire at the first, second, third, and fourth survey, respectively. Of the study group, 285 nursing personnel answered the questionnaire on four occasions. Ongoing symptoms of the neck, shoulders, and back were assessed by means of a 10 point (0-9) scale with the verbal end points "no symptoms" and "very intense symptoms." Cases were defined as nursing personnel reporting ongoing symptoms, score > 6, from at least one of the body regions. For assessments of job strain, a Swedish version of Karasek and Theorell's model was used. RESULTS: Of the 285 subjects, 13% were defined as cases at all four assessments, and 46% varied between cases and not cases during the study period. In the repeated cross sectional surveys the estimated rate ratio (RR) for being a case was between 1.1 and 1.5 when comparing the group with job strain and the group without job strain. For the combination of job strain and perceived high physical exertion the estimated RR was between 1.5 and 2.1. When the potential risk factors were assessed one, two, or three years before the assessment of symptoms the estimated RR for becoming a case was between 1.4 and 2.2 when comparing the group with job strain and the group without job strain. CONCLUSION: Almost half of the healthcare workers varied between being a case and not, over a three year period. The analysis indicated that job strain is a risk factor for musculoskeletal symptoms and that the risk is higher when it is combined with perceived high physical exertion.

Reports of work related musculoskeletal injury among home care service workers compared with nursery school workers and the general population of employed women in Sweden.

OBJECTIVES: To describe the nationwide occurrence of work related musculoskeletal injuries among all home care service workers in Sweden, and to identify relative risks and risk factors of the injuries. METHODS: The study was based on work related injuries reported to the Swedish occupational injury information system in 1990-1. The work related musculoskeletal injuries were divided into overexertion accidents and musculoskeletal diseases. The incidence of the injuries in female home care service workers was compared with those in nursery school workers and all other employed women in Sweden. RESULTS: In home care service workers, the annual incidence of injury from overexertion accidents and musculoskeletal diseases were 19.2 and 15.1 per 1000 workers, respectively, which was higher than those in nursery school workers and all employed women in Sweden. For five injury locations including the back, all the age standardised relative risks (SRR) of overexertion accidents exceeded 4.0, and most of those for musculoskeletal diseases were 1.5 or more in home care service workers compared with all other employed women in Sweden. Total duration of sick leave due to overexertion accidents was 7.7 times, and musculoskeletal diseases 3.5 times, longer than in nursery school workers. National loss due to sick leave resulting from only musculoskeletal injuries in home care service workers was about 8.2% of the total work related sick leave in all employed women in Sweden, although the number of home care service workers represented only some 5% of this population. Lifting other people was most frequently reported as the main risk cause of overexertion accidents in both kinds of workers. CONCLUSIONS: The results support the hypothesis that home care service workers have higher annual injury incidence of musculoskeletal injuries than nursery school workers due to physically stressful tasks that are far less common in nursery school workers.

Occupational and individual factors related to musculoskeletal symptoms in five body regions among Swedish nursing personnel.

The relationship between individual factors, physical and psychosocial exposure at work, and musculoskeletal symptoms in the neck, shoulders, low back, hands, and knees was studied among female nursing personnel working at a Swedish hospital. The personnel had participated in a course in work technique (patient transfer and handling principles). Prior to the course, the subjects had filled in a questionnaire (n = 688). The aim of this cross-sectional study was to elucidate whether different individual and work factors are related to musculoskeletal symptoms in a specific body region. Due to the cross-sectional design, however, causality cannot be discussed. Univariate analyses and multiple logistic regression analyses were performed and yielded similar results. The latter analyses showed that in the present hospital setting, individual factors together with physical and psychosocial work factors were related to symptoms in the neck, low back, and hands; individual factors and psychosocial work factors were related to symptoms in the shoulders; while only individual factors were related to symptoms in the knees. The results of the present study showed that various individual factors and physical and psychosocial work factors were related to musculoskeletal symptoms in the different body regions. Thus, the identification of risk factors might have far-reaching implications for the way in which effective health programs for prevention should be designed in the hospital setting.

Long-term development for girls and boys at age 16-18 as related to birth weight and gestational age.

The present study was based on data from a longitudinal research program which consisted of 12,032 children, born in the Stockholm area in 1953 of which there were 494 children born with low birth weight (LBW, 2500 g or less). For all children at age 16 it was apparent that adjustment and psychiatric disturbances as well as juvenile delinquency were not related to birth weight and gestational age. LBW girls born at term, had significantly lower school grades, at age 16, than NBW (normal birth weight) girls. NBW boys born pre-term had lower school grades than NBW boys born at term. It is suggested that childhood development is gender related; in girls the birth weight--and in boys the length of the pregnancy was related to school marks at age 16. For boys at 18 years of age at the military draft, it was shown that LBW boys had smaller body size and lower IQ-test scores as compared to NBW boys. Additionally the length of the pregnancy was related to some measures of body size but not to IQ-test scores.

1.5-Mb YAC contig in Xq28 formatted with sequence-tagged sites and including a region unstable in the clones.

A contig of 20 yeast artificial clones (YACs) has been assembled across 1.5 Mb of Xq28 and formatted with nine previously reported probes and nine STSs developed from the sequence of probes and end fragments of YACs. YAC end fragments were obtained by subcloning, Alu-vector PCR, or primer-ligation PCR methods. Eighteen of the YACs were recovered from a library specific for Xq24-q28; two that fill a gap were obtained from a second library made from total human DNA. One region, containing probes pX78c and 2A1.1, was unstable in YACs, but it was possible to generate a self-consistent map of DNA over the entire contig. Overlaps were confirmed by Southern blot analyses of YAC DNAs, and pulsed-field gel electrophoresis confirmed the extent of the contig and identified at least four CpG islands in the region.

Psychological development in children born with very low birth weight after severe intrauterine growth retardation: a 10-year follow-up study.

Children born small for gestational age (SGA) and children having very low birth weight, less than 1500 g, are claimed to be at risk of developmental problems, even when obvious pathology and disability are absent. In this study, sensorimotor and cognitive development of 14 medically healthy, very-low-birth-weight and small-for-gestational-age children were investigated. The children were born at the Karolinska Hospital between 1979 and 1981. At the time of the assessment, the children were aged 8.7-11.2 years. The assessment instruments included the Wechsler Intelligence Scale for Children, a modified version of the Bruininks-Oseretsky Test of Motor Proficiency, as well as selected subtests from the Halstead-Reitan Neuropsychological Battery and from the Southern California Tests of Sensory Integration. Information was also obtained from obstetric, neonatal and pediatric records, which included early developmental assessments. As a control group, 14 children were recruited and matched for age, sex and socio-economic background. The very-low-birth-weight-small-for-gestational-age group scored significantly lower on measures of visuospatial ability, non-verbal reasoning, strategy formation and gross-motor coordination. The group differences were largely attributable to the subnormal performance of eight of the very-low-birth-weight-small-for-gestational-age children. These children, who also tended to be born earliest (less than 33 weeks), had a high incidence of behavioral and educational problems. These findings are consistent with the view that the very preterm infant develops a different neurobehavioral organization than a full-term infant. Developmental deficits may become increasingly evident in the early school years.

On the intraindividual and gender variability of haemostatic components.

The intraindividual variability in terms of coagulation analyses was explored in 10-16 samples collected from each of 15 women during one menstrual cycle. For comparison, six men were sampled six times during a period of 30 days. The following variables were analysed: FVII, FVIII, FX, vWF:Ag, vWF:ristocetin cofactor, fibrinogen, antithrombin, plasminogen and anti-plasmin. The results demonstrated mean coefficients of variation ranging between 4.5 (plasminogen) and 20.7 (vWF:Ag). In certain individuals, the intraindividual variability amounted to nearly 40%, in particular in the assays of FVIII and vWF:Ag. No direct relation between these two factors and oestradiol, progesterone or testosterone levels could be observed in our individuals. The implications of these variations are discussed in terms of disease prediction and diagnosis of coagulation disorders.

Capture PCR: efficient amplification of DNA fragments adjacent to a known sequence in human and YAC DNA.

We have devised a procedure, termed capture PCR (CPCR), that permits the rapid isolation of DNA segments situated adjacent to a characterized nucleotide sequence. In this procedure, a DNA sample is restriction-digested and a linker, comprising two base-paired oligonucleotides, is added to the ends by ligation. Multiple extension reactions are performed using a biotinylated primer derived from the known sequence, permitting the subsequent isolation of extension products on a streptavidin-coated support. The enriched fragments are amplified exponentially using another specific oligonucleotide, hybridizing 3' to the biotinylated primer in combination with one of the linker oligonucleotides, now functioning as a PCR primer. The convenience of CPCR is greatly enhanced by using a novel streptavidin-coated manifold, which is constructed so that it projects into each individual well of a microtiter plate. The procedure permits the simultaneous isolation of fragments from large numbers of DNA samples and minimizes the risk of contamination between reactions. We have applied this method to identify DNA sequences located downstream of known sequences in the human genome. The technique has also been used to identify end fragments of sequences cloned in a yeast artificial chromosome (YAC) vector. The reactions can be initiated directly from yeast colonies and provide access to DNA sequence information for these end fragments in a minimal number of steps. With the aid of the present technique, we have isolated over 100 end fragments from YACs derived from the human X chromosome. Isolated end sequences have been used to order YAC clones into a contig.

A deletion in the amelogenin gene (AMG) causes X-linked amelogenesis imperfecta (AIH1).

Amelogenesis imperfecta is characterized by the defective formation of tooth enamel. Here we present evidence that the X-linked form of this disorder (AIH1) is caused by a structural alteration in one of the predominant proteins in enamel, amelogenin. Southern blot analysis revealed a deletion extending over 5 kb of the amelogenin gene in males with the hypomineralization form of the AIH1. Carrier females were heterozygous for the molecular defect. The deletion appears to include at least two exons of the amelogenin gene and the extent of the deletion was verified by PCR analysis. The mutation was shown to segregate with the disease among 15 analyzed individuals belonging to the same kindred. Our results link a defect in the amelogenin gene to the abnormal formation of enamel. We thus conclude that the amelogenin protein has a role in biomineralization of tooth enamel.

School marks and IQ-test scores for low birth weight children at the age of 13.

The present study was based on data from a longitudinal research program. The cohort consisted of 12,079 children, born in the Stockholm area in 1953. There were 494 children born with low birth weight (LBW; 2500 g or less). The results of the present study showed, that the LBW children had significantly lower school marks and intelligence-test scores (numerical, verbal and logical abilities) at the age of 13 than the normal birth weight children (NBW). For girls reared in non-manual socio-economic status (SES), decreased school marks and IQ-test scores were related to birth weight, and this was especially pronounced for LBW girls born after pregnancy week 37. For boys, however, no decreased school marks and IQ-test scores were related to birth weight and gestational age, with the exception of verbal ability for LBW boys born after pregnancy week 37 reared in non-manual SES.

School performance and IQ-test scores at age 13 as related to birth weight and gestational age.

The cohort in the present longitudinal research program consisted of 873 children in an entire school grade, in a Swedish community. The present results showed a main effect of birth weight; low birth weight (LBW) children had lower school performance and intelligence-test (IQ) scores at age 13 than did normal birth weight (NBW) children irrespective of parental SES. Second, there was no significant main effect of gestational age (GA) on scholastic performance and IQ-test scores. Third, there was a significant main effect of the combination of birth weight and GA on scholastic performance and IQ-test scores. The LBW children born at term (38-40 pregnancy weeks; pw) had significantly lower scores and school grades as compared to the control group while the LBW children born with short gestational age (34-37 pw) and with very short gestational age (less than 34 pw) had significantly lower scores and marks in fewer areas of academic attainment.