Continuing medical education and work commitment among rural healthcare workers: a cross-sectional study in 11 western provinces in China

AbstractObjectivesContinuing medical education (CME) and work commitment are important for rural healthcare workers (RHWs) and rural medical work. The significant association between continuing education and work commitment has been reported in many studies from several different industries. However, very few studies have analysed the association of CME with work commitment among healthcare workers, let alone among RHWs. This study aimed to identify the significance of CME for the work commitment of RHWs (doctors and nurses) in China.Design and settingThe cross-sectional study interviewed RHWs from 11 western provinces in China.ParticipantsIn total, 4118 RHWs, consisting of 2490 doctors and 1628 nurses who were working clinically, were included in the study.Primary outcome measuresWork commitment (ie, the relative importance of work to one’s sense of self) focussing on the affective component was the dependent variable, and it included four subdomains: pride, concern, and dedication, extracted by exploratory factor analysis of a 5-point Likert scale, and turnover intent, measured by a dichotomous question. CME (ie, a variety of educational and training activities to maintain, develop or increase knowledge, skills and professional performance and relationships) was the independent variable, including three subdomains: opportunity, participation and expectation, measured by three dichotomous questions.ResultsOf the 4118 respondents, 91.2% reported insufficient opportunities for CME, 21.3% had never participated in CME and 83.3% had a high expectation of CME. The mean scores of pride in, concern for and dedication to work were 3.54, 3.81 and 3.61 (out of a maximum of 5), respectively, and 30.6% presented turnover intent. After adjusting for gender, age, marriage, education, technical title, income and type of rural healthcare organisation, the multivariate analyses suggested that there was a significant positive association between CME and work commitment among RHWs. RHWs who had a significant high-level work commitment were those who reported a sufficient opportunity for CME (β and 95% CI for pride in, concern for and dedication to work: 0.33, 0.23 to 0.43; 0.19, 0.09 to 0.28; and 0.25, 0.15 to 0.35), had participated in CME (β and 95% CI for pride in, concern for and dedication to work: 0.11, 0.04 to 0.19; 0.09, 0.02 to 0.15; and 0.10, 0.03 to 0.17) and had a high expectation of CME (β and 95% CI for pride in, concern for and dedication to work: 0.22, 0.15 to 0.30; 0.21, 0.13 to 0.28; and 0.28, 0.20 to 0.36), and having sufficient opportunities for CME significantly increased the odds of having no turnover intent (OR and 95% CI: 1.70, 1.26 to 2.28). Age, marriage, education, technical title, income and type of rural healthcare organisation were significantly associated with the work commitment of RHWs. Differences were observed between rural doctors and nurses in the association of CME with work commitment.ConclusionsCME has a significant positive association with the work commitment of RHWs in China. RHWs’ work commitment should be further improved in future rural health workforce management. In addition, governments, healthcare organisations and professional associations should establish a professional and complete CME system in China to provide sufficient opportunities for CME for RHWs, encourage them to participate and meet their expectations.

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High HOMA-IR Index in Healthcare Shift Workers

Medicina ◽

10.3390/medicina55050186 ◽

2019 ◽

Vol 55 (5) ◽

pp. 186 ◽

Cited By ~ 8

Author(s):

Caterina Ledda ◽

Diana Cinà ◽

Serena Matera ◽

Nicola Mucci ◽

Massimo Bracci ◽

...

Keyword(s):

Insulin Resistance ◽

Shift Work ◽

Healthcare Workers ◽

Positive Association ◽

Cross Sectional Study ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Significant Positive Association ◽

Cross Sectional ◽

Shift Workers

Background and objectives: Evidence shows that shift work may be correlated with insulin resistance (IR). Therefore its estimation in clinical and prevention practice is of great significance. A cross-sectional study was performed to examine the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) Index among healthcare shift workers (HCSW). Materials and Methods: A total of 272 healthcare workers (HCWs) were invited to participate in the study within an occupational surveillance framework, 137 were HCSW while 135 were healthcare non-shift workers (HCNSW). Fasting glucose, insulin, and HOMA-IR Index were evaluated in each participant and correlated with shift workers. Results: Indicators of glucose metabolism were significantly higher in HCSW p < 0.001, and logistic regression analysis confirmed a significant positive association between increased values of HOMA-IR Index and shift workers (p < 0.05). Conclusions: Shift work could be a risk factor in developing insulin resistance and metabolic syndrome.

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How does job mobility relate to work commitment among rural healthcare workers? a cross-sectional study in western China

BMC Health Services Research ◽

10.1186/s12913-021-07166-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jinlin Liu ◽

Ying Mao ◽

Bin Zhu

Keyword(s):

Regression Analysis ◽

Healthcare Workers ◽

Job Mobility ◽

Healthcare Institution ◽

Hierarchical Level ◽

Turnover Intent ◽

Work Commitment ◽

Rural Healthcare ◽

Cross Sectional ◽

The Past

Abstract Background Rural healthcare workers (RHWs) are the core of the rural health system. The antecedents of turnover of RHWs have been well studied, but little is known about the consequences of job mobilities among RWHs. This study aimed to identify the association between job mobility and the work commitment of RHWs in China. Methods Based on a three-stage random sampling method, a cross-sectional survey was conducted in 11 western provinces in China. A total of 3783 RHWs, consisting of 2245 doctors and 1538 nurses, were included in our study. Confirmatory factor analysis, Pearson’s chi-squared test, one-way ANOVA, linear regression analysis, and binary logistic regression analysis were performed for data analyses. Results 46.3% of RHWs reported the experience of job mobility in the past. Work commitment of RHWs was not very high; specifically, the mean scores of pride in, concern for, and dedication to work were 3.54, 3.81, and 3.61 (out of a maximum of 5), respectively, and 29.9% presented turnover intent. RHWs’ overall experience of job mobility in the past was significantly associated with an increased odds of having the turnover intent. With respect to the last job mobilities of RHWs, the last job changes that occurred in the last 3 years, especially these lateral (i.e., job changes between two healthcare institutions at the same hierarchical level) and upward (i.e., job changes from a healthcare institution at a lower hierarchical level to current institution) mobilities, were significantly associated with a high level of work commitment (i.e., pride in, concern for, and dedication to work) among RHWs. However, the lateral mobilities in the last four to 5 years and the downward mobilities (i.e., job changes from a healthcare institution at a higher hierarchical level to current institution) 6 years ago or more significantly increased the odds of having turnover intent among RHWs, and RHWs whose last job changes were other mobilities (i.e., job changes from a non-healthcare institution to a healthcare institution) in the last four to 5 years reported had a significantly low level of pride in and concern for work and an increased odds of having the turnover intent. Conclusions The study suggests that the overall experience of job mobility in the past is a threat to RHWs’ work commitment to their current healthcare institutions. The honeymoon-hangover pattern exists in the association between a single job change and RHWs’ work commitment. Managers of rural healthcare institutions should pay more attention to these RHWs with the experience of job mobility to enhance their work commitment.

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Removable denture is a risk indicator for peri-implantitis and facilitates expansion of specific periodontopathogens: a cross-sectional study

BMC Oral Health ◽

10.1186/s12903-021-01529-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jasmin Grischke ◽

Szymon P. Szafrański ◽

Uthayakumar Muthukumarasamy ◽

Susanne Haeussler ◽

Meike Stiesch

Keyword(s):

Bacterial Species ◽

Positive Association ◽

Cross Sectional Study ◽

Risk Indicators ◽

Risk Indicator ◽

Sectional Study ◽

Significant Positive Association ◽

Cross Sectional ◽

Linear Discriminant ◽

Removable Denture

Abstract Background The prevalence of peri-implantitis ranges between 7 and 38.4% depending on risk indicators such as smoking, diabetes mellitus, lack of periodontal maintenance program, and history or presence of periodontitis. Currently, the possible effect of the type of superstructure on peri-implant health is unclear. This cross-sectional study aims to investigate the influence of the superstructure on the prevalence of peri-implant mucositis, peri-implantitis and peri-implant dysbiosis. Methods During a 32-month recruitment period dental implants were assessed to diagnose healthy peri-implant tissues, mucositis or peri-implantitis. The study included 1097 implants in 196 patients. Out of all peri-implantitis cases 20 randomly chosen submucosal biofilms from implants with fixed denture (FD) originating from 13 patients and 11 biofilms from implants with removable dentures (RD) originating from 3 patients were studied for microbiome analysis. Composition of transcriptionally active biofilms was revealed by RNAseq. Metatranscriptomic profiles were created for thirty-one peri-implant biofilms suffering from peri-implantitis and microbiome changes associated with superstructure types were identified. Results 16.41% of the implants were diagnosed with peri-implantitis, 25.00% of implants with RD and 12.68% of implants with FD, respectively. Multivariate analysis showed a significant positive association on patient (p = < 0.001) and implant level (p = 0.03) between the prevalence of peri-implantitis and RD. Eight bacterial species were associated either with FD or RD by linear discriminant analysis effect size method. However, significant intergroup confounders (e.g. smoking) were present. Conclusions Within the limitations of the present work, RDs appear to be a risk indicator for peri-implantitis and seem to facilitate expansion of specific periodontopathogens. Potential ecological and pathological consequences of shift in microbiome from RDs towards higher activity of Fusobacterium nucleatum subspecies animalis and Prevotella intermedia require further investigation.

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Determinants of corporate voluntary disclosure in a transition economy

Problems and Perspectives in Management ◽

10.21511/ppm.18(4).2020.12 ◽

2020 ◽

Vol 18 (4) ◽

pp. 130-141

Author(s):

Mofijul Hoq Masum ◽

Ahmed Razman Abdul Latiff ◽

Mohammad Noor Hisham Osman

Keyword(s):

Voluntary Disclosure ◽

Transition Economy ◽

Stock Exchange ◽

Positive Association ◽

Cross Sectional Study ◽

Significant Positive Association ◽

Cross Sectional ◽

Regulatory Bodies ◽

International University ◽

Chemical Companies

Corporate voluntary disclosure becomes a burning issue in the literature of accounting throughout the last two decades. The study aims to explore the most crucial determinants that influence corporate voluntary disclosure in a transition economy. A cross-sectional study based on the pharmaceutical and chemical companies listed in the Dhaka Stock Exchange is conducted to reconnoiter the crucial determinants affecting the voluntary disclosure. Based on the agency theory, stakeholder theory, and previous literature, the determinants are selected. An unweighted disclosure index is used to measure the extent of voluntary disclosure; after that, a multivariate analysis is steered to reconnoiter the key determinants of voluntary disclosure. It is found that firm leverage and firm liquidity are the key determinants that significantly influence the corporate voluntary disclosure in a transition economy. In contrast, no significant positive association is found between voluntary disclosure and board size. In additon, it is also found that market category significantly influences voluntary disclosure with an inverse direction. This study has important implications for both the corporate people and the regulatory bodies of the transition economy. The study also helps various stakeholders of the transition economy – Bangladesh, in designing their strategies regarding the most significant determinants of voluntary disclosure. Acknowledgment We are very thankful to the Institute of Advanced Research (IAR), United International University, Bangladesh, to grant us the fund by mobilizing which we generate our required data for the study and complete this empirical study.

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Association of Dietary and Lifestyle Inflammation Score With Metabolic Syndrome in a Sample of Iranian Adults

Frontiers in Nutrition ◽

10.3389/fnut.2021.735174 ◽

2021 ◽

Vol 8 ◽

Author(s):

Fatemeh Dehghani Firouzabadi ◽

Ahmad Jayedi ◽

Elaheh Asgari ◽

Zahra Akbarzadeh ◽

Nasim Janbozorgi ◽

...

Keyword(s):

Metabolic Syndrome ◽

Adult Population ◽

Positive Association ◽

Population Based ◽

Cross Sectional Study ◽

Significant Positive Association ◽

Cross Sectional ◽

General Adult Population ◽

Education Status ◽

Inflammation Score

Objective: We aimed to evaluate the association between the dietary and lifestyle inflammation score (DLIS) and metabolic syndrome (MetS) and its components in a sample of Iranian adults.Design: Population-based cross-sectional study.Setting: General adult population living in Tehran, Iran.Subjects: We included 827 adult men and women with an age range of 18–59 years who were referred to health centers in different districts of Tehran, Iran. Dietary intake was assessed by a semiquantitative food frequency questionnaire with 168 items. The DLIS was calculated based on four components, including dietary inflammation score, physical activity, cigarette smoking, and general obesity. Higher DLIS represents a more proinflammatory diet and lifestyle. The odds ratio (OR) and 95% confidence interval (CI) of the MetS across quartiles of the DLIS was calculated by using logistic regression analysis, controlling for age, sex, energy intake, marital status, education status, and occupation.Results: A total of 827 participants (31% men) were included, with a mean age of 44.7 ± 10.7 years. The prevalence of the MetS was 30.5%. The DLIS ranged between −2.35 and +3.19 (mean ± SD: 0.54 ± 1.09). There was a significant positive association between the DLIS and odds of MetS (OR fourthvs.thefirstquartile: 1.57, 95% CI: 1.01–2.45) in the fully adjusted model.Conclusion: Our results showed a significant positive association between the DLIS and odds of MetS. The results of the present crosssectional study suggested that having a more proinflammatory lifestyle can be associated with MetS. More prospective studies are needed to confirm the findings.

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Exploring the relationship of human–nature interaction and mindfulness: a cross-sectional study

10.31231/osf.io/9dx72 ◽

2021 ◽

Author(s):

Pooja Sahni ◽

Jyoti Kumar

Keyword(s):

Mental Health Problems ◽

Positive Association ◽

Cross Sectional Study ◽

Sectional Study ◽

Significant Positive Association ◽

Cross Sectional ◽

Nature Relatedness ◽

Relationship Of ◽

The Relationship ◽

Nature Experience

History is replete with examples where humans have sought refuge in nature for psychological restoration. In this cross-sectional study we explore the relationship of nature experience and mindfulness. Nature experience is assessed through “nature in the neighbourhood”, “frequency of visit” to nature-rich spaces, as well as one's inherent connection with nature described as “nature relatedness”. The study sample consisted of 334 Indian adults. The findings from this study show that frequency of visit to nature-rich spaces has a significant positive association with mindfulness. The hierarchical regression analysis suggests an interaction effect of “nature relatedness” in the association of the presence of nature rich spaces in the neighbourhood, frequency of visit as well as mindfulness. Interestingly, when childhood experiences were explored they had a significant association with “nature relatedness” and mindfulness. The evidence from this research suggests that nature experience may find its application as one of the mindfulness techniques prescribed for self-management of mental health problems.

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Working Conditions and Work-Related Health Issues of Female Domestic Workers in Four Districts of Karachi

Annals of Work Exposures and Health ◽

10.1093/annweh/wxaa019 ◽

2020 ◽

Vol 64 (4) ◽

pp. 378-386

Author(s):

Hira Tariq ◽

Shiraz Shaikh ◽

Mehjabeen Musharaf

Keyword(s):

Working Conditions ◽

Positive Association ◽

Domestic Workers ◽

Population Based ◽

Cross Sectional Study ◽

Health Issues ◽

Or Education ◽

Significant Positive Association ◽

Cross Sectional ◽

Work Related

Abstract Objectives To determine the working conditions and work-related health issues of female domestic workers (FDWs) in four districts of Karachi. Methods Population-based cross-sectional study was conducted in four squatter settlements of Karachi with sample size of 406 FDWs in 2018. Pretested questionnaire was administered to collect data through snowball technique. Multivariate logistic regression examined the association between different factors and experiencing violence, work-related injuries, and chemical exposures. Results Only (14.5%) of domestic workers earned Rs 15 000 (75 GBP month−1) and above. >1% had financial support for the health or education of children. Verbal violence included shouting (40.9%), constant critique of work (17.2%), and job threats (13.5%). Common workplace injuries were cuts (30.8%), burns (27.6%), and bruises (23.6%). Doing laundry showed significant positive association with experiencing cuts [odds ratio (OR) = 2.09; 1.15–3.71], looking after children to bruises (OR = 2.29; 1.07–4.88), and cooking to burns (OR = 4.66; 2.68–8.08). Conclusions Creating economic environment which is equal for all low wage workers, setting up domestic labor standards and holding employers accountable to them is essential.

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Menstrual characteristics, bleeding and other non-pelvic-pain symptoms in women presenting with severe endometriotic disease

Journal of Endometriosis and Pelvic Pain Disorders ◽

10.1177/2284026520905396 ◽

2020 ◽

Vol 12 (2) ◽

pp. 77-85

Author(s):

Robert Markham ◽

Georgina M Luscombe ◽

Frank Manconi ◽

Ian S Fraser

Keyword(s):

Pelvic Pain ◽

Positive Association ◽

Cross Sectional Study ◽

Significant Positive Association ◽

Cross Sectional ◽

Resistance To Infection ◽

Pain Symptoms ◽

Relationship Of ◽

The Relationship ◽

Detailed Nature

Introduction: The purpose of this study was to investigate the detailed nature of menstrual characteristics, bleeding and other symptoms in women with and without endometriosis. Pelvic pain symptoms in this cohort have been reported elsewhere. Method: This is a self-administered cross-sectional study and was conducted using a structural questionnaire. A total of 737 women completed the study: women with endometriosis (n = 529) and with no current gynaecological complaint, ‘control’ (n = 208). Results: Some of the key findings in this study included significant differences between the control and endometriosis subjects in terms of bleeding symptoms, increased length and heaviness of menses, rectal and bladder bleeding, infertility and obstetric complications which were all more common in the endometriosis group. Other symptoms found to have a highly significant positive association with endometriosis included abdominal bloating, low resistance to infection, fatigue, increased urinary frequency, diarrhoea and constipation (p < 0.000). Data were cross-tabulated to examine the association of a number of symptoms to each other. The relationship of symptoms to a range of psychosocial factors was investigated to determine how the effects of endometriosis impacted on the life of subjects. Most women reported that endometriosis sometimes or often interfered with daily aspects of their life. Conclusion: The range of non-pain symptoms in women with endometriosis was generally much more diverse and extensive than recognised by most clinicians.

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The association between living conditions and health among Syrian refugee children in informal tented settlements in Lebanon

Journal of Public Health ◽

10.1093/pubmed/fdz108 ◽

2019 ◽

Vol 42 (3) ◽

pp. e323-e333 ◽

Cited By ~ 2

Author(s):

Rima R Habib ◽

Micheline Ziadee ◽

Elio Abi Younes ◽

Khalil El Asmar ◽

Mohammed Jawad

Keyword(s):

Health Problem ◽

One Health ◽

Positive Association ◽

Cross Sectional Study ◽

Health Problems ◽

Living Conditions ◽

Refugee Children ◽

Significant Positive Association ◽

Cross Sectional ◽

Syrian Refugee

Abstract Background This cross-sectional study explores the relationship between housing, social wellbeing, access to services and health among a population of Syrian refugee children in Lebanon. Methods We surveyed 1902 Syrian refugee households living in informal tented settlements in Lebanon in 2017. Logistic regressions assessed relationships between housing problems, socioeconomic deprivation, social environment and health. Results Of the 8284 children in the study, 33.0% had at least one health problem. A considerable number of households (43.1%) had > 8 housing problems. Children in these households had higher odds to have three or more health problems compared to children in households with < 6 housing problems (adjusted odds ratio [AOR], 2.39; confidence interval [CI], 1.50–3.81). Nearly three-quarters (74.3%) of households were severely food insecure. Children in these households had higher odds to have one health problem than those in food secure households (AOR, 1.75; CI, 1.11–2.76). There was a significant positive association between households that reported being unhappy with their neighbourhood and the number of children with health problems in those households. Conclusions This study highlights the association between the physical and social living conditions and refugee children’s health. Without multidimensional interventions that consider improvements to living conditions, the health of young Syrian refugees will continue to worsen.

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Assessment of menstrual hygiene management and its determinants among adolescent girls: A cross-sectional study in school adolescent girls in Addis Ababa, Ethiopia

10.1101/450007 ◽

2018 ◽

Author(s):

Ephrem Biruk ◽

Worku Tefera ◽

Nardos Tadesse ◽

Ashagre Sisay

Keyword(s):

Addis Ababa ◽

Positive Association ◽

Cross Sectional Study ◽

Good Knowledge ◽

Significant Positive Association ◽

Cross Sectional ◽

Menstrual Hygiene ◽

Menstrual Hygiene Management ◽

Hygiene Management ◽

School Girls

AbstractIntroductionManaging menstruation is essentially dealing with menstrual flow and also in continuing regular activities like going to school, working etc. However, menstruation can place significant obstacles in girls’ access to health, education and future prospects if they are not equipped for effective menstrual hygiene management.ObjectiveTo assess the menstrual hygiene management and its determinant among school girls in Addis Ababa, Ethiopia.MethodsCross-sectional study design with quantitative method was carried out among 770 systematically selected adolescent school girls of Addis Ababa from April 1 to May 5, 2017. A self-administered pre-test close ended Amharic questionnaire at school setting was used for data collection. The coding was done using the original English version and entered to EPI-7 software. The quantitative file exported to statistical package for social science (SPSS) version 25.0 software for analysis. Total mean score was used to categorize individuals as good and poor while AOR; 95% CI with p < 0.05 was used to determine factors of menstrual hygiene management practice.ResultThis study had 98% response rate. 530 (70.1%) and 388(51.3%) respondents had good knowledge and practice of menstrual hygiene respectively. The findings also showed a significant positive association between good knowledge of menstruation and girls from mother’s whose education were secondary (AOR = 10.012, 95 % CI = 3.628-27.629). Wealth index quantile five (AOR = 9.038, 95 % CI = 3.728-21.909) revealed significant positive association with good practice of menstrual hygiene.Conclusion and recommendationMajority of participants had good knowledge and practice of menstrual hygiene and majority of them were from private school. Although knowledge was better than practice, girls should be educated about the process, use of proper pads or absorbents and its proper disposal.

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