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Full-Text Articles in Medicine and Health Sciences

A Theoretically-Based Mixed Methods Approach To Examining Mental Health Disorders And Help-Seeking Behaviors Among University-Enrolled African American Men, Kofoworola D.A. Williams Jan 2020

A Theoretically-Based Mixed Methods Approach To Examining Mental Health Disorders And Help-Seeking Behaviors Among University-Enrolled African American Men, Kofoworola D.A. Williams

Theses and Dissertations

Recent studies show that African American men in college are disproportionately experiencing high levels of psychological distress, increasing their risk of developing mental health symptoms associated with depression and anxiety. Despite being at higher risk for developing mental health symptoms, university-enrolled, African American men are not seeking help even when experiencing high levels of stress and anxiety, impacting their academic performance. The evidence base describing mental health symptom prevalence and evidence-based prevention strategies among university-enrolled, African American men is limited. To that end, this dissertation work utilized a concurrent, mixed methods approach, theoretically-based in the Social Ecological Model (SEM), to …


A Qualitative Analysis Of Caregiver Goals For Urban Children With And Without Asthma, Megan M. Carlson Jan 2020

A Qualitative Analysis Of Caregiver Goals For Urban Children With And Without Asthma, Megan M. Carlson

Theses and Dissertations

Pediatric asthma is a major public health concern that disproportionately affects children of color and youth living in low-income, urban areas. The implications for public health, child health, and family functioning necessitates our understanding and addressing experiences by families who are facing barriers within their socio-demographic context in addition to the stressors associated with managing pediatric asthma. The current study applied qualitative methods to interviews with caregivers of children with and without asthma in an effort to more deeply connect with caregivers’ experiences and yield richer information about the intersection of identities as Black caregivers living in an urban setting …


Signaling Mechanism Responsible For 5-Ht2a Receptor Tolerance To Psychedelic Induced Head-Twitch Behavior In Mice, Audrey R. Mcmurtrie Jan 2020

Signaling Mechanism Responsible For 5-Ht2a Receptor Tolerance To Psychedelic Induced Head-Twitch Behavior In Mice, Audrey R. Mcmurtrie

Theses and Dissertations

In recent years, there has been a growing interest in psychedelic compounds stemming from their promising use as therapeutic agents and research tools that can be used to treat and study several neuropsychiatric disorders. Psychedelics have proven useful in a broad range of these diseases - they serve as models for psychosis in schizophrenia but have also had promising results in treating major depressive disorder, anxiety, and other common disorders. Decreased stigmatization surrounding psychedelics has further increased their use in research and clinical settings. In light of these trends and the promising nature of their use, a thorough understanding of …


Black Women And Body Image: Implications Of The Racialized Beauty Aesthetic, Rachel L. Boutte Jan 2020

Black Women And Body Image: Implications Of The Racialized Beauty Aesthetic, Rachel L. Boutte

Theses and Dissertations

Black women have the highest prevalence of overweight and obesity relative to any other demographic group in the United States, however current weight management interventions appear least effective for them. Although several hypotheses have been proposed to explain these outcomes, few studies have collected data to evaluate how well they fit the lived experiences of Black women. In particular, the potential roles of body image and body dissatisfaction in the development and maintenance of overweight and obesity in Black women are not well understood. Extant literature largely reports that Black women are inoculated from body dissatisfaction due to cultural factors, …


Collective Healing Within Queer Paradoxes: Deconstructing Emotional Abuse In Lgbtq2sia* Communities To Cultivate More Accountable And Compassionate Worlds, Alexia Siebuhr Jan 2020

Collective Healing Within Queer Paradoxes: Deconstructing Emotional Abuse In Lgbtq2sia* Communities To Cultivate More Accountable And Compassionate Worlds, Alexia Siebuhr

Cal Poly Humboldt theses and projects

Emotional abuses within LGBTQ2SIA* communities are rarely acknowledged as existing or often normalized. Through care and anti-oppression works, transformative justice models such as community and self-accountability have helped carve out ways of addressing harm directly and breaking cycles of violence. The research in this thesis has been through mixed qualitative methodologies including semi-structured interviews and surveys. The participants' along with other authors, artists, activists and scholars’ narratives draws upon the experiences of emotional abuse lived within structural and social surveillance. The settler colonial state sanctioned projects have responded to harm by perpetuating violence upon those most marginalized. Deconstructing emotional abuse …


A Whole-School Approach To Promoting Staff Wellbeing, Leanne Lester, Carmel Cefai, Valeria Cavioni, Amy Barnes, Donna Cross Professor Jan 2020

A Whole-School Approach To Promoting Staff Wellbeing, Leanne Lester, Carmel Cefai, Valeria Cavioni, Amy Barnes, Donna Cross Professor

Australian Journal of Teacher Education

A caring school community can enhance whole-school wellbeing including the wellbeing of school staff, which directly impacts on student academic, social and emotional wellbeing. This study firstly examines the validity and reliability of a proposed whole-school staff wellbeing evaluation tool which uses a set of whole-school wellbeing indicators to identify strengths and areas for improvement within the school environment which may be impacting on staff wellbeing. Secondly, the association between factors found within the whole-school staff wellbeing tool with staff self-reported mental health are examined, and finally, the influence of person characteristics and role of factors on perceived whole-school staff …


The Politics Of Caregiving: Taking Stock Of State-Level Policies To Support Family Caregivers, Walter D. Dawson, Lauren Bangerter, Micheal Splaine Jan 2020

The Politics Of Caregiving: Taking Stock Of State-Level Policies To Support Family Caregivers, Walter D. Dawson, Lauren Bangerter, Micheal Splaine

Institute on Aging Publications

The U.S. population is aging rapidly. The changing demographics offer several benefits and opportunities at local, national, and global levels (Kluge, Zagheni, Loichinger, & Vogt, 2014). Yet, living to an advanced age remains a significant risk factor for the need of care and support during one’s lifetime. Half of all adults 65 years of age and older will reach a point where they require a high level of support due to either physical or cognitive challenges (Tumlinson, Juring, & Alkema, 2016). At the same time, the number of older adults living with chronic disease (e.g., diabetes, …


A Case Study: The Role Of Compassionate Cities, Healthy Cities, And Un Sustainable Development Goals In City Leadership And Planning, Lisa A. Berkley Jan 2020

A Case Study: The Role Of Compassionate Cities, Healthy Cities, And Un Sustainable Development Goals In City Leadership And Planning, Lisa A. Berkley

Antioch University Dissertations & Theses

This research is a case study examining the relevance of three holistic city frameworks—Compassionate Cities, Healthy Cities, and UN Sustainable Development Goals—to the intentional or tacit thinking of city leaders, community leaders, and activists of Marina, California. Beginning with a discussion of the origin and development of the three frameworks, the study occurred in three phases: Phase I involved interviewing the five elected leaders, city manager, community development leaders, and two planners; Phase II consisted of a survey of appointed city leaders and community organizers and activists; and Phase III was an analysis of relevant public discourse, drawing from local …


Job Stress Effects On Job Satisfaction And Attrition In 9-1-1 Call Centers, Damarys Jaile Gilligan Jan 2020

Job Stress Effects On Job Satisfaction And Attrition In 9-1-1 Call Centers, Damarys Jaile Gilligan

Theses and Dissertations

In 9-1-1 call centers across the nation the personnel shortage has become a crisis. The nature of the job of a 9-1-1 telecommunicator is stressful due to the high volume of emergency calls. This applied dissertation was designed to learn if there is a relationship between job stress, burnout levels, and job satisfaction in 9-1-1 telecommunicators. This was a nonexperimental quantitative survey research with a correlational approach. The population was a nonprobability convenience sample recruited through the Survey Monkey Audience platform. Data was collected at one point in time. A total of 37 participants took part in the study. All …


A Daily Diary Study Of Drinking And Nondrinking Days In Nonstudent Alcohol Users, Cathy Lau-Barraco, Ashley N. Linden-Carmichael Jan 2020

A Daily Diary Study Of Drinking And Nondrinking Days In Nonstudent Alcohol Users, Cathy Lau-Barraco, Ashley N. Linden-Carmichael

Psychology Faculty Publications

Background: Emerging adults with lower educational attainment are at higher long-term risk for problematic drinking and alcohol use disorders. Efforts to gain a more in-depth understanding of the drinking habits of nonstudent emerging adults are critical to reduce disparities and to shed light on targets of intervention for this vulnerable group.

Objectives: The current investigation aimed to: (1) provide a description of the daily drinking habits of nonstudent emerging adult drinkers using a 14-day diary method, and (2) examine nondrinking days by assessing their reasons for not drinking as well as strategies used to avoid drinking.

Methods: Participants were 27 …


On The Proposed Legalization Of Commercial Surrogacy: I Thought We Had Abolished The Sale Of Human Beings, Phyllis Chesler Jan 2020

On The Proposed Legalization Of Commercial Surrogacy: I Thought We Had Abolished The Sale Of Human Beings, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.


Therapists Who Specialize In Addiction: A Grounded Situational Analysis Of A Stigmatized Profession, Heather J. Humphrey-Leclaire Jan 2020

Therapists Who Specialize In Addiction: A Grounded Situational Analysis Of A Stigmatized Profession, Heather J. Humphrey-Leclaire

Antioch University Dissertations & Theses

This study used the methodology of a grounded situational analysis to explore the lives of therapists who specialize in addiction. Historians have researched the history of addiction treatment itself and some have identified parallel processes of discrimination, stigma, and stigma by association for therapist and client, but the complex intersectionality between social processes and organizational issues have been largely invisible. In this study, therapists who specialize in addiction (including social workers, clinical mental health counselors, and alcohol and drug counselors) were asked about their sense of how others see them in their role. These conversations made visible the many, enmeshed …


Impact Of Transnationalism On Multiracial Challenges And Resilience Among Asian Mixed-Race Adults In The United States, Sooyeon Lee-Garland Jan 2020

Impact Of Transnationalism On Multiracial Challenges And Resilience Among Asian Mixed-Race Adults In The United States, Sooyeon Lee-Garland

Antioch University Dissertations & Theses

This was a quantitative study which examined past and present transnational activities as predictors of multiracial identity challenges and resilience among second generation U.S. born Asian mixed-race adults. Two hundred seventeen participants completed the following three survey questionnaires: a demographic form, the Multiracial Challenge and Resilience Scale (MCRS; Salahuddin & O’Brien, 2011) and an author-adapted version of the Past and Present TS- Transnationalism Scale (Murphy & Mahalingam, 2004). This study is based on the idea of integrating critical race theory, critical mixed-race studies, and intersectionality of both participants’ and parents’ gender and ethnic/racial identity among self-identified Asian mixed-race individuals. The …


Emotional Response To Climate Change Learning: An Existential Inquiry, Jennifer Hutchinson Jan 2020

Emotional Response To Climate Change Learning: An Existential Inquiry, Jennifer Hutchinson

Antioch University Dissertations & Theses

This qualitative study aims to explore and explain the existential underpinnings of learning about climate change and potential emotional responses to climate change learning. Undergraduate students in environmental sciences and studies classes at the University of Washingrounded theory on in Seattle, WA participated in semi-structured interviews. Participants were asked about their experiences learning about climate change and how they responded emotionally to the learning. This dissertation examines the responses from those interviews and builds a theory out of the data analyzed. Constructivist Grounded theory as outlined by Kathy Charmaz (2014) was used to analyze the interviews. Codes were created and …


The Experience Of Children's Mental Health Leaders During Times Of Constraint: A Narrative Study, Jody Levison-Johnson Jan 2020

The Experience Of Children's Mental Health Leaders During Times Of Constraint: A Narrative Study, Jody Levison-Johnson

Antioch University Dissertations & Theses

Across the United States, each state has a public mental health system that is designed to support children and youth with emotional and behavioral challenges. This is critically important as recent estimates show that one in six children in the United States has a diagnosed mental health condition (Whitney & Peterson, 2019). The design and structure of these systems vary by state, but consistent across them is the presence of a state-designated leader who is faced with an array of constraining factors that influence their behavior and shape the resulting system. This study describes the experience of leaders in children’s …


Marital Satisfaction Of Couples In Heterosexual Relationships Where There Are Differences In Spirituality, Collins Anaeche Jan 2020

Marital Satisfaction Of Couples In Heterosexual Relationships Where There Are Differences In Spirituality, Collins Anaeche

Antioch University Dissertations & Theses

As the dynamics of the United States’ social landscape shifts in relation to the diversity of culture, ethnicity, values, and traditions, and as religion and spirituality have become highly diverse and fluid, diversity in spirituality has received limited attention in the field of marriage and family therapy. Utilizing an interpretative phenomenological analysis, this qualitative investigation explores common meanings and experiences of emotional intimacy of couples in heterosexual relationships where there are differences in spirituality. Overall, the results of this investigation demonstrate that in situations where heterosexual couples who display differences in spirituality attentively attuned to their individual and relational needs, …


Mental Health Service Use In The Kingdom Of Saudi Arabia, Abdulaziz S. Alangari Jan 2020

Mental Health Service Use In The Kingdom Of Saudi Arabia, Abdulaziz S. Alangari

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objectives: The goal of this project was to increase knowledge concerning the current prevalence, needs and barriers to mental health service use in the Kingdom of Saudi Arabia (KSA). It’s purpose was to gather data that would help to inform future policy decisions aimed at optimizing the use and availability of these services in the KSA. There were three specific aims: 1) Examine the barriers to initiation and continuation of mental health treatment in people with a disorder diagnosed during the previous 12-months. 2) Explore the prevalence and predictors of mental health treatment dropout. 3) Examine the prevalence and patterns …


Integrating The Natural Healing Process For Post-Traumatic Stress Disorder Treatment In Veterans Through A Healing Garden., Taiwo A. Ajibade Jan 2020

Integrating The Natural Healing Process For Post-Traumatic Stress Disorder Treatment In Veterans Through A Healing Garden., Taiwo A. Ajibade

Graduate Theses, Dissertations, and Problem Reports (ETD)

In 2002, several ex-service personnel brought a court case against the Ministry of Defense for the inability to identify PTSD issues at an early stage and to provide support and effective treatment (Langston et al. 2007). Also in recent times, reports have suggested that US marine and army infantry units returning from duty in Iraq and Afghanistan have a higher level of expected proportions of mental disorders and that about 10% of personnel are returning home are with symptoms of post-traumatic stress disorder (Smith et al., 2008). This discovery made it pertinent to look for natural ways to assist veterans …


Tobacco Cessation In A Dental School Setting, Kerri T. Simpson Jan 2020

Tobacco Cessation In A Dental School Setting, Kerri T. Simpson

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction

Tobacco use remains the single largest preventable cause of death in the United States. Currently, the prevalence of tobacco use is 20.7% in adults (≥18 years old) and 31.2% among high school students. According to various studies, over 60% of Americans want to quit tobacco, but it takes a person several attempts to quit before they are successful. There is limited data in the literature that discusses the effectiveness of tobacco cessation programs in US dental schools. Therefore, information on the effectiveness of a tobacco cessation program in a dental school setting could benefit this state and the problem …


Association Of Common Chronic Pain Conditions To Incident Alzheimer’S Disease And Related Dementias In Two Cohorts Of Older Medicare Beneficiaries, Sumaira Khalid Jan 2020

Association Of Common Chronic Pain Conditions To Incident Alzheimer’S Disease And Related Dementias In Two Cohorts Of Older Medicare Beneficiaries, Sumaira Khalid

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objective: The purpose of this research was to study the collective and incremental association of common non-cancer chronic pain conditions (NCPC) to risk for Alzheimer’s disease and related dementias (ADRD); to explore the potential mediating influence of mood and sleep disorders; and to assess the potential synergistic effects of NCPC’s and multimorbidity on ADRD risk. This research also aimed to study the contribution of NCPC to ADRD risk in poor, rural, underserved United States populations who suffer a disproportionate burden of ADRD risk factors. To achieve these goals, this dissertation pursued three specific aims: 1) assess the association of …


Pilot Study Of Behavioral Activation As Adjunct Treatment For Depression In Primary Care, Lindsay Ellen Toler Jan 2020

Pilot Study Of Behavioral Activation As Adjunct Treatment For Depression In Primary Care, Lindsay Ellen Toler

Graduate Theses, Dissertations, and Problem Reports (ETD)

Many individuals receiving care at a predominantly free primary health care clinic in the northern part of West Virginia are experiencing depression, and medication therapy is the most common form of management with limited resources for psychosocial treatment. Brief psychosocial therapy interventions provided by the primary care provider should be explored as an adjunct treatment for this population in the primary care setting.

A pilot study was conducted to explore the integration of behavioral activation, a brief psychosocial intervention focused on decreasing depressed behavior by increasing nondepressed behavior to reinforce corresponding improvements in mood. Eligible patients were invited to attend …


Breaking The Chain: Evaluating The Links Between Opioid Use Disorder, Overdose, And Suicide, Amanda Nicole Stover Mph Jan 2020

Breaking The Chain: Evaluating The Links Between Opioid Use Disorder, Overdose, And Suicide, Amanda Nicole Stover Mph

Graduate Theses, Dissertations, and Problem Reports (ETD)

Previous research has estimated that 20–30% of individuals with opioid use disorder (OUD) have a history of both suicide attempt and unintentional opioid overdose. In 2018, more than 1.9 million adults 18 years and older had an OUD; while 1.4 million adults attempted suicide that same year (SAMHSA, 2019). The key to understanding this relationship is examining behaviors that precede these potentially fatal behaviors. One such precursory behavior is self-injury. Self-injurious behaviors (SIB) are one of the most important risk factors for future suicide (Cavanagh et al.,2003). This study has three primary objectives. The first is to conduct a systematic …


Creating A Community-Based Protocol To Prevent Unintended Pregnancy In Homeless Women In Monongalia County, West Virginia, Jessica Eva Wukasch Jan 2020

Creating A Community-Based Protocol To Prevent Unintended Pregnancy In Homeless Women In Monongalia County, West Virginia, Jessica Eva Wukasch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At any given time, 10% of homeless women are pregnant, about twice the rate of all U.S. women of reproductive age (5%) (Healthcare for the Homeless, 2001). According to Healthcare for the Homeless Council ([HHC], 2012), approximately “73% of pregnancies among homeless women were unintended at the time of conception.” In addition, “about 12% of homeless children are placed in foster care compared to 1% of other children” (HHC, 2012). There is an evident need to address unintended pregnancy among homeless women.

Objective: The overall objective was to create an accessible and useful community-based protocol to reduce the rate …


Racial Segregation As A Social Determinant Of Health: Evidence From The State Of Georgia, Simon Medcalfe, Catherine P. Slade, Divesia Lee Jan 2020

Racial Segregation As A Social Determinant Of Health: Evidence From The State Of Georgia, Simon Medcalfe, Catherine P. Slade, Divesia Lee

Journal of the Georgia Public Health Association

Background: Despite decades of research, determining the causes of racial disparities in health remains a pernicious problem in the public health arena. Challenges include further refining definitions of health as well as expanding frameworks for social determinants of health to include relevant and related predictors. Racial segregation as a social determinant of health is understudied but of growing interest in the discourse on health disparities. This paper explores empirically the relationship between racial segregation and other predictors of social determinants of health and their collective impact on health outcomes defined in both objective and subjective terms.

Methods: Ordinary least squares …


Public Policies For Drug Abuse In Brazil And The Us, Daniely Tatmatsu, Carlos Eduardo Siqueira, Zilda Del Prette Jan 2020

Public Policies For Drug Abuse In Brazil And The Us, Daniely Tatmatsu, Carlos Eduardo Siqueira, Zilda Del Prette

Gastón Institute Publications

The study’s objective was to discuss public policies for drug abuse prevention targeted to young people in Brazil and the United States. Brazil has formulated its policy with programs that are questioned at the international level on epistemological, theoretical, and methodological grounds. The authors conclude that social policymaking in Latin America is still permeated by dependence on central countries, since the tension between the prohibitionist and harm reduction policies persists in the policy provisions for drug abuse prevention under the National Secretariat for Drug Policies and the Ministry of Health and what is actually implemented. The article suggests pursuing autonomy …


A Scoping Review Of Theoretical Models And Conceptual Frameworks Used In Public Health Services And Systems Research (Phssr) Literature, Zahra Shahin, Anna Messick, Jenna Harris, Kristie C. Waterfield, Gulzar H. Shah Jan 2020

A Scoping Review Of Theoretical Models And Conceptual Frameworks Used In Public Health Services And Systems Research (Phssr) Literature, Zahra Shahin, Anna Messick, Jenna Harris, Kristie C. Waterfield, Gulzar H. Shah

Health Policy & Community Health: Faculty Publications

Objectives

Theoretical models and conceptual frameworks are often used to design research methods. This study aims to provide an overview of the application of theoretical models and conceptual frameworks in Public Health Services and Systems Research (PHSSR). We also examine how the integration of such terms in research can improve intervention designs and support the decision-making process within the field of public health practice.

Methods

A scoping review was conducted using publications from public health journals to identify relevant articles in the field of PHSSR. The eligibility of studies was determined after performing evaluations through a full-text review of each …


Maternal Mortality Among African American Women In The State Of Georgia, Causes, Policy, And Ethical Considerations, Zahra Shahin, Isabella M. Hardwick, Nancy Jeffery, Jalisa Jordan, William Mase Jan 2020

Maternal Mortality Among African American Women In The State Of Georgia, Causes, Policy, And Ethical Considerations, Zahra Shahin, Isabella M. Hardwick, Nancy Jeffery, Jalisa Jordan, William Mase

Health Policy & Community Health: Faculty Publications

Background

The U.S. is currently one of thirteen countries where maternal mortality rates (MMR) is worse now than it was fifteen years ago. Reducing maternal mortality is one of the significant challenges facing the health system in the United States, especially in the State of Georgia, which has one of the highest MMR in the nation. The purpose of this review is to explore the causes, policy, and ethical contextual factors contributing to increased maternal mortality rates among African American women in the State of Georgia. Also, identifying and addressing weaknesses and gaps that exist in the healthcare system and …


Well-Being, Discrimination, And Self-Management Among Racialized Lgbq+ Newcomers Living In Waterloo Region, Ontario, Emily Cox Jan 2020

Well-Being, Discrimination, And Self-Management Among Racialized Lgbq+ Newcomers Living In Waterloo Region, Ontario, Emily Cox

Theses and Dissertations (Comprehensive)

Racism and homo/biphobia may negatively impact the well-being of racialized LGBTQ+ newcomers. While current research focuses predominantly on negative aspects of well-being (e.g., distress, exclusion), research on resilience and positive aspects of well-being (e.g., positive affect) is limited. Although self-management strategies (i.e., activities and attitudes to improve one’s well-being) could be a key factor in promoting well-being, previous research has not addressed how racialized LGBTQ+ newcomers use self-management strategies. Further, there is limited research about the role service providers (e.g., settlement services, mental and physical health services) play in supporting these strategies. In this study, eight racialized LGBQ+ newcomers and …


Fall Reading Week: Exploring The Effects On Student Well-Being, Roobina Medhizadah Jan 2020

Fall Reading Week: Exploring The Effects On Student Well-Being, Roobina Medhizadah

Theses and Dissertations (Comprehensive)

Mental health is a concerning issue in post-secondary institutions across Ontario. Post-secondary students are challenged with many stressors such as time management and living independently for the first time (Wagner & Rhee, 2013). In an attempt to help students, maintain or improve their mental health, universities across Ontario have implemented fall reading week, a mid-semester break (Poole et al., 2017). Previous studies (Cramer & Pschibul, 2017; Poole et al., 2017) provided mixed results in whether fall reading week positively influences student mental health and well-being. To date, few studies have explored the influence of fall reading week on student health …


Adherence To Dietary And Physical Activity Guidelines Among Shift Workers: Associations With Individual And Work-Related Factors, Ciara Kelly, Fiona M. Nea, Kirsty Pourshahidi, John Kearney, Victoria M O'Brien, M Barbara E Livingstone, Clare Corish Jan 2020

Adherence To Dietary And Physical Activity Guidelines Among Shift Workers: Associations With Individual And Work-Related Factors, Ciara Kelly, Fiona M. Nea, Kirsty Pourshahidi, John Kearney, Victoria M O'Brien, M Barbara E Livingstone, Clare Corish

Articles

Objectives Shift work is associated with adverse effects on the health and lifestyle behaviours of employees. This study aimed to examine factors associated with adherence among shift workers to selected indicators of dietary and physical activity guidelines. Methods A cross-sectional study was conducted on 1300 shift workers. Data were collected using a 15 minute telephone-administered questionnaire. Logistic regression methods were used for data analysis. Results Male shift workers (p