What does it take to get a healthy diet at sea? A maritime study of the challenges of promoting a healthy lifestyle at the workplace at sea

Background and aim: Prevalence of obesity is high among Danish seafarers and appropriate health promotion interventions are required within the maritime setting. The aim of this study was to examine whether a training intervention for ship cooks could improve seafarers’ diet on board and, in particular, to identify possible challenges in practice on board of vessels from 2 Danish shipping companies.Materials and methods: Interviews and participant observations were conducted during a 2-day cooking course. Interviews were repeated 1 year after (N:35) the course in order to assess self-perceived changes in preparing meals and ordering supplies, as well as perceived challenges in implementing changes and maintaining them. In addition, changes in self-reported eating behaviour before the cooking course and 1 year after were assessed based on a 1-year follow-up quantitative questionnaire survey (N:193).Results: Participants reported positive opinions about the course and subsequent changes in promoting a nutritious and healthy diet at sea by way of health education. Also a significant change was found in these afarers’ self-reported eating behaviour from T1 to T2. However several challenges were identified during the transfer and maintenance phase such as many cooks having received little or no prior training which limited their cooking abilities. Confined physical capacities on board, restricted space for storage and lack of proper equipment were other barriers and so were low frequency of supply options and high prices for fresh fruit and vegetables.Conclusions: To fully realise the benefits of the changes, these challenges related to the specific maritime workplace setting need to be acknowledged and addressed at management level

Is physical and psychological work stress associated with fatigue in Danish ferry ship employees?

Background: Fatigue is a recognised risk factor for safety in seafaring. While always dangerous, fatigue in ferry shipping is especially hazardous as it may jeopardise passengers’ safety. To counteract fatigue, knowledge on its determinants is important. Little, however, is known on the influence from physical and psychosocial work environment factors within ferry shipping. The aim of the study was to investigate the association between work stress in terms of physical stressors, perceived job demands and job control and different dimensions of fatigue among ferry ship employees and to test whether a potential effect of work stress was mediated by sleep satisfaction. Materials and methods: The design was cross-sectional. 193 respondents answered to a self-administered questionnaire including standardised scales, i.e. the Swedish Occupational Fatigue Inventory and the Copenhagen Psychosocial Questionnaire for job demands and control. The association of risk factors with fatigue was determined using hierarchical multiple linear regression analyses. Results: Physical work stressors were positively associated with only one of five fatigue subscales: lack of energy. Higher levels of demands were related to more lack of energy, lack of motivation, physical exertion and sleepiness, while more control was related to lesser lack of energy, lack of motivation and sleepiness. No demand-control interaction was found. Effects of demand and control were partly mediated by sleep satisfaction. Conclusions: Although limited by its cross-sectional design this study provides support for the independent relevance of demands and control for employee fatigue in ferry shipping and for a mediating role of sleep satisfaction

Should I stay or should I go? Motivational profiles of Danish seafaring officers and non-officers

Background. Other studies have shed light on specific types of seafarers’ job stressors and job satisfaction. However, so far there have not been any systematic attempts to capture the motivational profile of seafarers when it comes to both work demands and work resources. The purpose of this study is to explore the motivational profiles of seafarers in the Danish merchant fleet by identifying factors which motivate or demotivate seafarers to stay in their specific profession. Furthermore, we examine if there is a difference in work motivators and demotivators between Danish seafaring officers and non-officers. Material and methods. A questionnaire was sent out to 560 Danish-speaking seafarers with a Danish postal address; 346 seafarers returned the questionnaire, equalling a 61% response rate. Results. The work motivators which were identified were: duration of home leave, level of responsibility, and level of challenge. The main demotivating factors that were identified were: being away from home, shipping company´s HRM, and regulatory requirements. Conclusions. The results contribute to a deeper understanding of how seafarers perceive their occupation, and help to identify areas and aspects which might need change if employers want to retain their workforce in the long run. Overall, the results show that most of the job demands and job resources that seafarers perceive are psychosocial. When it comes to the best aspects of seafaring, over 70% of the answers were related to psychosocial factors rather than organizational or structural factors. In relation to the perceived worst aspects in seafaring, about 85% of the responses fell into psychosocial categories. The differences in the motivational profiles of officers and non-officers showed the importance of not only looking at the seafaring profession as a whole but also considering the different characteristics of various jobs onboard. (Int Marit Health 2011; 62, 1: 20–30

Overeducation - new evidence for 25 European countries

This study investigates the incidence of overeducation among workers in the EU and its underlying factors based on the most recent wave of the European Labor Force Survey (EU-LFS 2013). Its main purpose is to shed light on the interplay of so far neglected explanatory factors such as household characteristics and field of study as well as to reveal country differences in the impact of these factors on vertical mismatch. Therefore, our innovative features are the large number of determinants as well as the considerable amount of European countries simultaneously analyzed. Moreover, we differentiate in our analysis between high- and medium-skilled workers. Our findings point to a considerable variation in the potential determinants of overeducation across countries as well as across skill levels. This variation is not restricted to job-related characteristics, but interestingly also concerns household variables. Among those determinants showing a largely uniform influence are nationality, job tenure, temporary employment and presence of unemployed household members

Overeducation: New evidence for 25 European countries

This study investigates the incidence of overeducation among workers in the EU and its underlying factors based on the most recent wave of the European Labor Force Survey (EU-LFS 2013). Its main purpose is to shed light on the interplay of so far neglected explanatory factors such as household characteristics and field of study as well as to reveal country differences in the impact of these factors. Therefore, our innovative features are the large number of determinants as well as the considerable amount of European countries simultaneously analyzed. Moreover, we differentiate in our analysis between high- and medium-skilled workers. Our findings point to a considerable variation in the potential determinants of overeducation across countries as well as across skill levels. This variation is not restricted to jobrelated characteristics, but interestingly also concerns household variables. Among those determinants showing a largely uniform influence are nationality, job tenure, temporary employment and presence of unemployed household members.Basierend auf der jüngsten Welle der Europäischen Arbeitskräfteerhebung (EU-LFS 2013) untersuchen wir in dieser Studie das Ausmaß und die Determinanten von formaler Überqualifikation unter Beschäftigten in EU-Staaten. Hierbei werden bislang vernachlässigte Erklärungsfaktoren wie zum Beispiel das Studienfach oder der Haushaltskontext berücksichtigt. Darüber hinaus differenzieren wir in unserer Analyse zwischen Personen mittlerer und hoher Bildung. Unsere Ergebnisse deuten auf eine beträchtliche Variation der Effekte zwischen einzelnen Ländern sowie zwischen den Qualifikationsniveaus hin. Diese Variation findet sich nicht nur bei den arbeitsplatzbezogenen Charakteristika, sondern auch bei den Haushaltsvariablen. Zu denjenigen Variablen, die einen weitgehend einheitlichen Einfluss auf das Risiko, überqualifiziert zu sein, haben, gehören Nationalität, Betriebszugehörigkeitsdauer, befristete Beschäftigung und die Anwesenheit von arbeitslosen Haushaltsmitgliedern

Knowledge, attitudes and practices related to avian influenza among poultry workers in Nepal: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Avian influenza is a considerable threat to global public health. Prevention and control depend on awareness and protective behaviours of the general population as well as high risk-groups. This study aims to explore the knowledge, attitudes and practices related to avian influenza among poultry workers in Nepal.</p> <p>Methods</p> <p>The study was based on a cross-sectional study design, using a structured questionnaire administered in face-to-face interviews with 96 poultry workers age 15 and above from the Rupandehi district in Nepal.</p> <p>Results</p> <p>The majority of respondents were male (80%), mean age was 35 (SD = 11.6). Nearly everybody was aware that AI cases had been detected in Nepal and that poultry workers were at risk for infection. The major sources of AI information were radio, TV and newspapers. Knowledge about preventive measures was high with regard to some behaviours (hand washing), but medium to low with regard to others (using cleaning and disinfecting procedures or protective clothing). Poultry workers who got their information from TV and newspapers and those who were more afraid of contracting AI had higher knowledge than those who did not. Being employed as compared to being an owner of a poultry farm as well as having a high level of knowledge was associated with practising more preventive behaviours. While on one hand many specific government control measures found a high degree of acceptance, a majority of study participants also thought that government control and compensation measures as a whole were insufficient.</p> <p>Conclusions</p> <p>The study provides information about knowledge and practices regarding avian influenza among poultry workers in Nepal. It highlights the importance of targeting lack of knowledge as well as structural-material barriers to successfully build preparedness for a major outbreak situation.</p

The relationship between parental socio-economic status and episodes of drunkenness among adolescents: findings from a cross-national survey

BACKGROUND: Behavioral factors such as (excessive) alcohol consumption play a major role in the explanation of social inequalities in health. The unequal distribution of health risk behaviors among socio-economic groups has important consequences for both the current and future health status of the younger generation. However, little is known about socio-economic differences in unhealthy lifestyles during adolescence. The purpose of the present study is to investigate socio-economic differences in adolescent drinking behaviour among 11–15 year old adolescents in Europe and North America. METHODS: Data was obtained from the Health Behaviour in School-aged Children (HBSC) study 2001/02, a cross-national survey conducted in collaboration with the World Health Organization. The present analysis is based on 69249 male and 73619 female students from 28 countries. The effect of parental occupation and family affluence on episodes of drunkenness was assessed using separate logistic regression models controlling for age. RESULTS: Socio-economic circumstances of the family had only a limited effect on repeated drunkenness in adolescence. For girls only in one out of 28 countries a significant association between family affluence and repeated drunkenness was observed, while boys from low and/or medium affluent families in nine countries faced a lower risk of drunkenness than boys from more affluent families. Regarding parental occupation, significant differences in episodes of drunkenness were found in nine countries for boys and in six countries for girls. Compared to family affluence, which was positively related to risk of drunkenness, a decreasing occupational status predicted an increasing risk of drunkenness. This pattern was identified within a number of countries, most noticeably for boys. CONCLUSION: Parental socio-economic status is only of limited importance for episodes of drunkenness in early adolescence, and this very limited role seems to apply for girls more than for boys and for parental occupation more than family affluence. For future studies it might be important to look at the effects of socio-economic status within the context of other peer, family and school related factors in order to assess to what extent those factors might mediate the effects of social class background

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity