Existing literature has highlighted concerns over working conditions in the UK National Health Service (NHS), with healthcare workers frequently citing work-life balance issues and stress as being ...drivers of attrition and burnout. However, we do not know whether these problems have become worse over time, particularly over the past decade, during which there have been multiple shocks to the UK healthcare system. To investigate this, we analysed data from NHS monthly workforce statistics and the UK Household Longitudinal Study. Three times as many workers left the NHS in 2021 for work-life balance reasons than in 2011, while estimated satisfaction with one's amount of leisure time for healthcare workers fell by three times the amount that it fell for non-healthcare workers. Both satisfaction with amount of leisure time and satisfaction with income have remained lower for healthcare workers than for other public sector workers. By 2020, a worker that had low satisfaction with their amount of leisure time was as much as 22 percentage points less likely than in 2010 to remain in healthcare in the following year. Overall, working conditions in UK healthcare have deteriorated between 2010 and 2020, especially relative to the private sector. However, overall job satisfaction has fallen faster in other areas of the public sector than it has in healthcare, which may indicate wider issues within the UK public sector as a whole.
This review aims to systematically evaluate the empirical literature relating to the interpersonal functioning of those with eating disorder psychopathology and presents a preliminary model to help ...the formulation of patients' problems. Following a thorough literature search, 35 papers were included in this systematic review. The vast majority of studies indicate a strong association between eating psychopathology and certain maladaptive personality traits. The origins of social anxiety and poor social support that have been described as maintaining eating disorders appear to differ according to diagnostic groups. Interpersonal difficulties in people with restrictive behaviors such as anorexia appear to be related to the avoidance of expressing feelings to others and to giving priority to other people's feeling over their own. While interpersonal difficulties in patients with bulimia nervosa appear to be more related to interpersonal distrust and negative interaction and conflict with others. These concepts are presented in a preliminary model of interpersonal functioning in the eating disorders.
► Association between eating psychopathology and certain personality traits. ► Restrictive behaviors associated to the avoidance of expressing feelings to others. ► Restrictive disorders linked to giving priority to people's feeling over their own. ► Bulimic behavior associated to interpersonal distrust. ► Bulimic disorders linked to negative interaction with others.
This paper presents a first integrated survey on the occurrence and distribution of geogenic contaminants in groundwater resources of Western Amazonia in Peru. An increasing number of groundwater ...wells have been constructed for drinking water purposes in the last decades; however, the chemical quality of the groundwater resources in the Amazon region is poorly studied. We collected groundwater from the regions of Iquitos and Pucallpa to analyze the hydrochemical characteristics, including trace elements. The source aquifer of each well was determined by interpretation of the available geological information, which identified four different aquifer types with distinct hydrochemical properties. The majority of the wells in two of the aquifer types tap groundwater enriched in aluminum, arsenic, or manganese at levels harmful to human health. Holocene alluvial aquifers along the main Amazon tributaries with anoxic, near pH-neutral groundwater contained high concentrations of arsenic (up to 700μg/L) and manganese (up to 4mg/L). Around Iquitos, the acidic groundwater (4.2≤pH≤5.5) from unconfined aquifers composed of pure sand had dissolved aluminum concentrations of up to 3.3mg/L. Groundwater from older or deeper aquifers generally was of good chemical quality. The high concentrations of toxic elements highlight the urgent need to assess the groundwater quality throughout Western Amazonia.
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•Hydrogeochemistry of groundwater resources in 2 regions of Peruvian Amazon studied•Arsenic, manganese, and aluminum detected in concentrations harmful to human health•Arsenic and manganese enriched mainly in reducing aquifers along main rivers•Aluminum enriched in oxic and acidic unconfined aquifers•Urgent need for investigation of quality groundwater resources in the Amazon region
Arsenic enrichment in groundwater resources in deltas and floodplains of large sediment-rich rivers is a worldwide natural hazard to human health. High spatial variability of arsenic concentrations ...in affected river basins limits cost-effective mitigation strategies. Linking the chemical composition of groundwater with the topography and fluvial geomorphology is a promising approach for predicting arsenic pollution on a regional scale. Here we correlate the distribution of arsenic contaminated wells with the fluvial dynamics in the Amazon basin. Groundwater was sampled from tube wells along the Amazon River and its main tributaries in three distinct regions in Peru and Brazil. For each sample, the major and trace element concentrations were analyzed, and the position of the well within the sedimentary structure was determined. The results show that aquifers in poorly weathered sediments deposited by sediment-rich rivers are prone to mobilization and accumulation of aqueous arsenic and manganese, both in sub-Andean foreland basins, and in floodplains downstream. Two zones at risk are distinguished: aquifers in the channel-dominated part of the floodplain (CDF) and aquifers in the overbank deposits on the less-dynamic part of the floodplain (LDF). Some 70 % of the wells located on the CDF and 20 % on the LDF tap groundwater at concentrations exceeding the WHO guideline of 10 μg/L arsenic (max. 430 μg/L), and 70 % (CDF) and 50 % (LDF) exceeded 0.4 mg/L manganese (max. 6.6 mg/L). None of the water samples located outside the actual floodplain of sediment-rich rivers, or on riverbanks of sediment-poor rivers exceed 5 μg/L As, and only 4 % exceeded 0.4 mg/L Mn. The areas of highest risk can be delineated using satellite imagery. We observe similar patterns as in affected river basins in South and Southeast Asia indicating a key role of sedimentation processes and fluvial geomorphology in priming arsenic and manganese contamination in aquifers.
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•Reconnaissance study of groundwater-chemistry of riverine areas in the Amazon Basin•Basin-wide geogenic groundwater arsenic and manganese contamination documented•Aquifers at risk of contamination delineated by fluvial geomorphology and topography•Highest risk in the dynamic part of floodplains of sediment-rich rivers•Reducing aquifer conditions in Amazonia comparable to floodplains in South and Southeast Asia
Biological treatment with tumor necrosis factor (TNF) inhibitors is successful in the management of inflammatory bowel disease (IBD). All TNF inhibitors antagonize the pro-inflammatory cytokine TNF-α ...but with varying efficacies in IBD. The variations in efficacy probably are caused by structural differences between the agents that affect their mechanisms of action and pharmacokinetic properties. Several mechanisms have been proposed, such as modulation of the expression of pro-inflammatory mediators and a reduction in the number of activated immune cells. However, it seems that clinical efficacy is the result of a number of different mechanisms and that binding of transmembrane TNF by TNF inhibitors. Knowledge of the mechanisms of action has been obtained mainly through the use of in vitro assays that may differ significantly from the situation in vivo. This review discusses the available data on TNF inhibitors in order to identify mechanisms of importance for their efficacy in IBD. Thus, a better understanding of the mechanistic basis for clinical efficacy can lead to a more rational use of TNF inhibitors in the management of IBD.
Depression is one of the most significant health conditions in personal, social, and economic impact. The aim of this review is to summarize existing literature in which machine learning methods have ...been used in combination with Electronic Health Records for prediction of depression.
Systematic literature searches were conducted within arXiv, PubMed, PsycINFO, Science Direct, SCOPUS and Web of Science electronic databases. Searches were restricted to information published after 2010 (from 1st January 2011 onwards) and were updated prior to the final synthesis of data (27th January 2022).
Following the PRISMA process, the initial 744 studies were reduced to 19 eligible for detailed evaluation. Data extraction identified machine learning methods used, types of predictors used, the definition of depression, classification performance achieved, sample size, and benchmarks used. Area Under the Curve (AUC) values more than 0.9 were claimed, though the average was around 0.8. Regression methods proved as effective as more developed machine learning techniques.
The categorization, definition, and identification of the numbers of predictors used within models was sometimes difficult to establish, Studies were largely Western Educated Industrialised, Rich, Democratic (WEIRD) in demography.
This review supports the potential use of machine learning techniques with Electronic Health Records for the prediction of depression. All the selected studies used clinically based, though sometimes broad, definitions of depression as their classification criteria. The reported performance of the studies was comparable to or even better than that found in primary care. There are concerns with generalizability and interpretability.
This project examined risk factors of disordered eating in athletes by adapting and applying a theoretical model. It tested a previously proposed theoretical model and explored the utility of a newly ...formed model within an athletic population across gender, age, and sport type to explain disordered eating.
The design was cross-sectional and the first phase in a series of longitudinal studies.
1,017 athletes completed online questionnaires related to social pressures, internalisation, body dissatisfaction, negative affect, restriction, and bulimia. Structural equation modelling was employed to analyse the fit of the measurement and structural models and to do invariance testing.
The original theoretical model failed to achieve acceptable goodness of fit (χ2 70, 1017 = 1043.07; p < .0001. CFI = .55; GFI = .88; NFI = .53; RMSEA = .12 90% CI = .111-.123). Removal of non-significant pathways and addition of social media resulted in the model achieving a parsimonious goodness of fit (χ2 19, 1017 = 77.58; p < .0001. CFI = .96; GFI = .98; NFI = .95; RMSEA = .055 90% CI = .043-.068). Invariance tests revealed that the newly revised model differed across gender, age, level, competition status, and length of sport participation.
This study showed that the formation of disordered eating symptomology might not be associated with sport pressures experienced by athletes. It revealed that disordered eating development varies across gender, competition level, sport type, and age, which must be considered to prevent and treat disordered eating in athletes.
Following recent scientific interest in the quality of life (QoL) of individuals with eating disorders (EDs), this paper aims to provide a summary of the relevant evidence. A literature review on QoL ...in EDs (EDQoL) was carried out and relevant articles are described in six main sections. Following an introduction to the area and a summary of the methods used in the review, assessment of QoL in EDs is discussed. The third section represents the body of the review and appraises EDQoL in more detail, discussing what idiosyncratic features of EDs might be important in affecting QoL. The review concludes with suggestions for further research in this evolving area and summarizes the main findings. An evidence base is constructed supporting the idea that those with EDs have impaired QoL compared to other psychiatric and physical health conditions. However, what determines impairments in QoL is yet to be delineated although ideas for such variables, such as the presence of bingeing and purging, are suggested. Development of ED-specific measures has aided greatly in the pursuit of clarity, although equivocal conclusions in this complex area necessitate further research.
►Eating disorders are associated with impaired quality of life relative to controls. ►Quality of life is also poorer than certain physical and psychiatric illness. ►Eating disorder-specific measures are sensitive to differences in quality of life. ►Features of an ED may affect the relationship with quality of life.
Given the links between parental obesity and eating psychopathology in their children, it is important to understand the mechanisms via which unhealthy relationships with eating are passed from ...generation to generation. The aim was to review research focusing on food-related parenting practices (FPPs) used by parents with overweight/obesity. Web of Science, PubMed and PsycINFO were searched. Studies that included a measure of FPPs were considered eligible and were required to have examined FPPs by parental weight status. Twenty studies were included. Single studies suggest differences between parents with healthy-weight vs. overweight/obesity with respect to; food accessibility, food availability and modelling. Multiple studies suggest that several parenting strategies do not differ according to parental weight status (child involvement, praise, use of food to control negative emotions, use of food-based threats and bribes, pressure, restriction, meal and snack routines, monitoring, and rules and limits). There was inconclusive evidence with respect to differences in parental control, encouragement and use of unstructured FPPs among parents with healthy-weight vs. overweight/obesity. The findings of this review imply some differences between parents with overweight/obesity and healthy-weight and the use of some food-related parenting practices, however, they should be interpreted with caution since research remains limited and is generally methodologically weak. The review highlights opportunities for further research, and suggests improvements to current measures of FPPs.
Having a high athletic identity is thought to increase vulnerability for compulsive exercise and Eating Disorder (ED) psychopathology. This study examined whether there is an association between ...athletic identity and levels of compulsive exercise and ED psychopathology in long-distance runners. A sample of 501 long-distance runners completed the Athletic Identity Measurement Scale (AIMS), Compulsive Exercise Test (CET) and Eating Disorders Examination Questionnaire (EDEQ). There was a significant positive association between participants' AIMS and total CET scores (moderate effect size; r=0.34 for males and 0.33 for females). BMI did not influence the relationship between AIMS and CET scores in males. However, for females, AIMS scores were positively associated with levels of Weight Control Exercise when covarying for BMI (small to moderate effect size, r=0.22). No significant associations with EDEQ scores were found (negligible to small effect sizes; r=0.06 for males and r=0.14 for females). Following replication, coaches might need to be vigilant to the welfare of endurance runners that have a strong athletic identity, since this could be linked to them exercising compulsively. Future work should examine whether having a strong athletic identity predicts ED psychopathology when this identity is challenged (e.g., due to injury).
•A high athletic identity might increase vulnerability for negative outcomes.•This study examined the relationship between athletic identity, compulsive exercise and eating psychopathology.•Runners with a high athletic identity had greater levels of compulsive exercise.•There was no association with eating psychopathology.•Coaches should be vigilant of the link between athletic identity and compulsive exercise.
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