Occupational Medicine-Oxford最新文献

{"title":"Too much or not enough? An analysis of best interests assessments for patients with anorexia nervosa","authors":"Sydney White","doi":"10.5287/ora-wvqyzx8wj","DOIUrl":"https://doi.org/10.5287/ora-wvqyzx8wj","url":null,"abstract":"In best interests assessments for patients with anorexia nervosa, judges face a complicated combination of ethical, medical, and legal considerations. This thesis dissects the question at the heart of that quandary: is it in the best interests of a patient with anorexia nervosa to withdraw compulsory treatment, including life-sustaining nutrition? Specifically, this research examines why that question is so difficult to answer. Using analogical case analysis, a critical framework based on theories of autonomy, and clinical studies, the project explains the Court of Protection’s general approach to best interests assessments, followed by an analysis of its approach to cases concerning anorexia nervosa patients. This leads to the identification of two confounding factors; that is, two factors which make it impossible to arrive at a legally, morally, and medically satisfying answer to the identified question. The first is the dilemma of autonomy. The potential for anorexia nervosa patients to autonomously refuse medical treatment—despite their lack of autonomy in relation to decisions about food—forces the judge to decide between prolonging the patient’s life at the cost of overriding her autonomy, or respecting her autonomy at the cost of her life. The second is the nature of compulsory treatment for anorexia nervosa. A hallmark of anorexia nervosa is patients’ intense need for control. Given that compulsory feeding entails complete removal of control over the body and a severe infringement of the right to bodily integrity, the treatment is precisely the thing that harms anorexia nervosa patients. Thus, judges must decide between authorising the patient’s death, or authorising and perpetuating suffering through treatment. In this way, the two confounding factors place judges in an invidious position. They create a conundrum such that there is no decision that can be deemed definitively ‘correct’.","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147921911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthesis and characterisation of conductive metal-organic framework materials","authors":"Wang, Yu","doi":"10.5287/ora-xobmj5jod","DOIUrl":"https://doi.org/10.5287/ora-xobmj5jod","url":null,"abstract":"Electrically conductive metal-organic frameworks (MOFs) have emerged as a promising new class of materials for use in applications ranging from organic electronics to chemical sensing. However, integration of MOFs into functional devices remains limited in part because of a variety of synthesis and processing challenges. For example, the growth of large oriented MOF crystals is difficult, and there are substantial challenges in creating MOF nanoparticle suspensions. In this thesis novel synthesis strategies are reported that enable control of the morphology, orientation, and processability of conductive MOFs. The application of these materials as chemiresistive gas sensors is investigated, and their paramagnetic spin activity is explored. These findings contribute to the broad goal of advancing the fundamental understanding of these new electrochemically-grown materials with a view to integrating them into novel electronic devices. An electrochemical deposition strategy was developed to fabricate highly oriented Cu3(HHTP)2 MOF films on ITO glass using a dual-working-electrode approach. A systematic investigation into the electrochemical synthesis mechanism reveals how ligand concentration and synthesis conditions influence film orientation. This method enables precise control over crystal orientation, which directly impacts charge transport behaviour. The anisotropic electrical conductivity of these films was analysed. Electrochemically-grown oriented Cu3(HHTP)2 films were used as the active material in chemiresistive gas sensors. By selecting the film orientation the sensors were optimised for ammonia detection with a limit of detection in the parts-per-billion (ppb) range. A direct correlation between MOF film structure and sensing response is shown. Structural and spectroscopic analyses (XRD, XPS, and FT-IR) before and after gas exposure provide insights into gas adsorption and charge transport mechanisms. To improve the processability of MOFs for scalable device fabrication, two solution-based synthesis methods were developed: a modulator-assisted and a surfactant-based approach. Highly dispersible Cu3(HHTP)2 nanocrystals with morphology control were created. These solution-processable conductive MOFs were successfully deposited onto interdigitated electrodes via spray-coating, yielding good gas sensing behaviour. Finally, the thesis describes experiments on redox-state tuning in MOFs. A 3D conductive MOF (Cu-DBC) was synthesized, where electrochemical oxidation-state modulation induces the formation of organic radicals. Pulsed electron paramagnetic resonance (EPR) measurements reveal spin characteristics with long spin-lattice relaxation times.","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147915094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On progress: a thick conception of moral-political progress","authors":"Wilkinson, Daniel Adam","doi":"10.5287/ora-gpv2d7e8e","DOIUrl":"https://doi.org/10.5287/ora-gpv2d7e8e","url":null,"abstract":"The concept of progress played a central role in political theorising during the eighteenth and nineteenth centuries. However, only a small number of political theorists engage with the concept today. This thesis argues that political theorists should re-engage with the concept of progress and investigates what form a conception of progress must take for it to enrich the normative toolbox of political theorists. The thesis begins by outlining the reasons why political theorists turned away from the concept of progress and then sets out the positive reasons why political theorists ought to re-engage with it. It clarifies that, in normative political theory, progress refers to moral-political progress and taxonomizes conceptions of moral political progress according to their normative-teleological, causal agential, and historical elements. It distinguishes between thin and thick concepts of progress and argues that the thick concept is the relevant one as it enables all-things-considered judgements about moral-political change. The thesis then advances in two sections. Section One engages in a geistesgeschichte analysis of three major historical conceptions of progress – Enlightenment, Kantian, and Hegelian – and evaluates their normative-teleological, causal-agential, and historical elements to assess which aspects remain tenable. Section Two engages in a conceptual analysis of the two contemporary approaches to theorising about a thick conception of progress. The thesis criticises and rejects the approach of philosophical pragmatism. It then defends the approach outlined by Amy Allen and highlights aspects of the approach that can be enhanced. To this end, the thesis integrates into the Allenian approach the methodological resources of Michael Walzer. The thesis concludes by detailing the resulting conception of moral-political progress, outlining how it can respond to the conceptual concerns, and identifying the commitments that must be maintained for it to serve as a tool for political theorising.","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147886382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to procedural ionizing radiation and cancer risk among physicians.","authors":"A N Simpson, R Sutradhar, E McArthur, P Tanuseputro, A Bharatha, J G Ray","doi":"10.1093/occmed/kqae093","DOIUrl":"10.1093/occmed/kqae093","url":null,"abstract":"<p><strong>Background: </strong>Physicians in certain specialities are routinely exposed to procedural ionizing radiation. Their risk of cancer is unknown, including by cancer sub-types.</p><p><strong>Aims: </strong>To assess cancer risk among exposed physicians.</p><p><strong>Methods: </strong>This population-based case-control study was completed in Ontario, Canada, where healthcare is universal, using linkage of physician billing claims to a province-wide cancer registry. Up to five cancer-free physician controls were matched to each cancer-affected physician, by sex, and both age at and year of, entry into practice. Cumulative exposure to procedural ionizing radiation was captured by physician billing claims. Conditional logistic regression generated an odds ratio (OR) of cancer per 1000 procedures performed and as a binary exposure comparing physicians above the upper 95th percentile cumulative number of procedures (≥200) to those below this cut point.</p><p><strong>Results: </strong>Mean (standard deviation) age of the 1265 cases and 5772 non-cancer controls was 39.7 (10.7) and 37.7 (9.0) years, and 45% and 49% were female, respectively. After a median (interquartile ranges) of 13.0 (6.9-20.4) and 12.5 (6.5-20.1) years of lookback among cases and controls, the OR of cancer was 1.02 (95% confidence interval 0.99-1.05; P = NS) per 1000 additional procedures performed. Modelling the cumulative exposure to procedures nonlinearly did not change the observed association (P > 0.40 for each). Comparing physicians above versus below the upper 95th percentile cumulative number of procedures, the OR of cancer was 1.23 (95% confidence interval 0.75-2.01, P = NS).</p><p><strong>Conclusions: </strong>Physician exposure to procedural ionizing radiation was not associated with a higher risk of cancer. Measures that minimize radiation exposure should continue.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"612-618"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sinonasal intestinal-type adenocarcinoma in northern Portugal: a woodworker's occupational hazard.","authors":"F Teixeira-Marques, I Pacheco, L Pinheiro-Guedes, R Estêvão, N Lousan","doi":"10.1093/occmed/kqae085","DOIUrl":"10.1093/occmed/kqae085","url":null,"abstract":"<p><strong>Background: </strong>Sinonasal carcinomas (SNC) constitute about 3% of all head and neck carcinomas, squamous cell carcinoma being the most common histologic subtype. Some geographical patterns in incidence are observed, as occupational exposure to wood dust is associated with intestinal-type adenocarcinoma (ITAC).</p><p><strong>Aims: </strong>This study aims to describe the prevalence and characteristics of sinonasal ITAC cases in a region of northern Portugal with a robust wood industry.</p><p><strong>Methods: </strong>A retrospective study of all sinonasal malignancies diagnosed over 5 years, in a tertiary hospital, primarily focused on ITAC subtypes. Data on sociodemographic and clinical variables were collected through electronic medical records and telephonic assessments.</p><p><strong>Results: </strong>Of all 33 cases, 85% were ITAC. ITAC predominantly affected males (96%) with a mean age of 66.2 years. Most patients diagnosed with sinonasal ITAC had occupational wood dust exposure (96%), particularly to hardwoods. Initial symptoms included unilateral nasal obstruction (75%) and epistaxis (71%). Despite a median time of 3 months from symptoms to consultation, 50% presented at an advanced stage, with a 29% mortality rate.</p><p><strong>Conclusions: </strong>Sinonasal ITAC is an occupational hazard of woodworkers and represents the vast majority of SNC in the region. This study advocates for targeted community interventions, emphasizing occupational safety measures and healthcare awareness to reduce morbimortality associated with this occupational cancer.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"596-600"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel approach to peer support for academic researchers.","authors":"S Khodabakhsh, C Hoffmann, S Sauchelli, G Shi, A Mitchell","doi":"10.1093/occmed/kqae091","DOIUrl":"10.1093/occmed/kqae091","url":null,"abstract":"<p><strong>Background: </strong>Academic researchers experience high levels of stress, isolation and loneliness, which compromise their well-being. There is a particular need to address these issues amongst early career and postgraduate research staff. 'Spaces for Listening' is an initiative to increase active listening and provide peer support.</p><p><strong>Aims: </strong>To assess the feasibility, acceptability and potential impacts of Spaces for Listening in an academic setting.</p><p><strong>Methods: </strong>Early career and postgraduate researchers from a large university in the UK were invited to attend 'Academic Spaces for Listening' (ASfL). Five ASfL sessions (including in-person and Chinese language) were held. A mixed-methods study using online survey and in-depth interviews was conducted. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using principles of thematic analysis. The qualitative and quantitative findings were integrated at the interpretation phase.</p><p><strong>Results: </strong>A total of 25 participants attended an ASfL session, 22 of them completed the survey and 6 participants participated in semi-structured interviews. Participants were very satisfied with the session content (68%, n = 15), organization (68%, n = 15) and delivery (68%, n = 15). Four themes were identified from qualitative analysis: (i) the 'Academic Spaces for Listening' (ASfL) experience; (2) impact of ASfL; (3) potential challenges of ASfL and (4) ASfL in the future. Interpersonal connectedness was an important outcome for participants during the session. Participants showed interest in the future of ASfL.</p><p><strong>Conclusions: </strong>Implementing Spaces for Listening in an academic setting is feasible and was well received by participants. The initiative may fill a gap in the social interactions amongst academic researchers.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"601-606"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Former jean sandblasters die younger.","authors":"A Aksakal, C Daharlı, B N Topal, B Kerget, K Kaşali, M Akgün","doi":"10.1093/occmed/kqae092","DOIUrl":"10.1093/occmed/kqae092","url":null,"abstract":"<p><strong>Background: </strong>Silicosis remains a critical public and occupational health issue, exacerbated by its expansion into non-traditional industries and resulting in significant global morbidity and mortality.</p><p><strong>Aims: </strong>This study aims to investigate the death rates associated with silicosis from jean sandblasting by comparing the results of diagnosed individuals to those of the general population.</p><p><strong>Methods: </strong>Conducted from 2008 to 2023 in Taşlıçay and Toklular villages, Bingöl City, Turkey, this retrospective cohort study analysed mortality among 220 diagnosed males versus 2851 undiagnosed residents. Data were derived from the Cohort database and validated with the Bingöl Provincial Health Directorate and the Turkish Statistical Institute. Statistical analysis involved univariate comparisons and survival analysis, utilizing the Mann-Whitney U-test, Kruskal-Wallis test and Cox proportional hazards model, with significance set at P < 0.05.</p><p><strong>Results: </strong>The analysis revealed a silicosis mortality rate of 10% in diagnosed individuals over 15 years, notably higher than the 4% in the general population. Higher radiological profusions and younger ages at diagnosis were significant mortality factors. A radiological profusion above five notably increased the mortality risk by 1.37 times, with age and radiological density proving critical in survival rates.</p><p><strong>Conclusions: </strong>This research highlights the increased mortality risk in silicosis patients, particularly among former jean sandblasters, underscoring the significant effects of radiological density and early age exposure on mortality, thereby addressing a crucial gap in understanding the impact of silicosis on life expectancy and community health.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"607-611"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived mental health skills and competence among occupational health physicians.","authors":"M Majuri, M Malin, A Antila, R Luukkonen, M Palosaari, K Reijula","doi":"10.1093/occmed/kqae080","DOIUrl":"10.1093/occmed/kqae080","url":null,"abstract":"<p><strong>Background: </strong>Mental-health-based consultations in occupational health (OH) are increasing due to ongoing changes in working life.</p><p><strong>Aims: </strong>We studied the self-assessed mental health competence of trainees and trainers in OH specialist physician training.</p><p><strong>Methods: </strong>We conducted an online survey from June to August 2022. We analysed how trainees and trainers in OH assessed their own competence in mental health practice with N (%) and means (standard deviation [SD]). We analysed the underlying assumptions about competences specific to OH using an explanatory factor analysis. We applied the Kruskal-Wallis test to determine differences between trainees and trainers using the variables in the factor analysis.</p><p><strong>Results: </strong>Respondents' perceptions of mental health competence were more positive among trainers (mean 3.97, SD 0.72) than trainees (mean 3.66, SD 1.08, P = 0.2123). Based on trainee physicians' own assessments, more experience increases competence, until after 7 years, when the perceived competence seems to decrease. The trainer physicians' self-assessed mental health competence decreased over time. With factor analyses, we identified five competence factors: general mental health, workplace risks and resources, rehabilitation, promotion and prevention, and special skills. In our results, individual-level mental health competences such as work ability evaluation and to manage return-to-work processes were evaluated better than community-based proactive processes.</p><p><strong>Conclusions: </strong>Physicians in OH specialist physician training self-assessed their mental health competence better at the employee level than at the workplace level. Based on our results, we need to develop the curriculum of OH specialist physician training to meet the needs of working life in support of mental health.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"581-588"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: O-105 how healthy is your workplace? occupational health programs in german companies - creation and validation of effective measures.","authors":"","doi":"10.1093/occmed/kqae087","DOIUrl":"10.1093/occmed/kqae087","url":null,"abstract":"","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"620"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: \"Sleep problems among Chinese clinical nurses working in general hospitals\".","authors":"","doi":"10.1093/occmed/kqae066","DOIUrl":"10.1093/occmed/kqae066","url":null,"abstract":"","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"619"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}