Objective To estimate the efficacy of exercise on depressive symptoms compared with non-active control groups and to determine the moderating effects of exercise on depression and the presence of publication bias. Design Systematic review and meta-analysis with meta-regression. Data sources The Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, Embase, SPORTDiscus, PsycINFO, Scopus and Web of Science were searched without language restrictions from inception to 13 September2022 (PROSPERO registration no CRD42020210651). Eligibility criteria for selecting studies Randomised controlled trials including participants aged 18 years or older with a diagnosis of major depressive disorder or those with depressive symptoms determined by validated screening measures scoring above the threshold value, investigating the effects of an exercise intervention (aerobic and/or resistance exercise) compared with a non-exercising control group. Results Forty-one studies, comprising 2264 participants post intervention were included in the meta-analysis demonstrating large effects (standardised mean difference (SMD)=−0.946, 95% CI −1.18 to −0.71) favouring exercise interventions which corresponds to the number needed to treat (NNT)=2 (95% CI 1.68 to 2.59). Large effects were found in studies with individuals with major depressive disorder (SMD=−0.998, 95% CI −1.39 to −0.61, k=20), supervised exercise interventions (SMD=−1.026, 95% CI −1.28 to −0.77, k=40) and moderate effects when analyses were restricted to low risk of bias studies (SMD=−0.666, 95% CI −0.99 to −0.34, k=12, NNT=2.8 (95% CI 1.94 to 5.22)). Conclusion Exercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option focusing on supervised and group exercise with moderate intensity and aerobic exercise regimes. The small sample sizes of many trials and high heterogeneity in methods should be considered when interpreting the results.
The Job Demand & Resources model suggests work characteristics are related to mental well-being and work engagement. Previous work describes the development of a combined construct ‘engaged well-being at work’ (EWB). To what extent changes in measures of this construct are responsive to changes in job demands and resources or associated with changes in job-related attitudes has not been established. Longitudinal employee-level data from three waves (German Linked Personnel Panel) were used. Logistic and linear fixed effects regression analyses explored longitudinal associations between changes in EWB for participants over a three-year period with changes in job demands and resources and job-related attitudes (job commitment, satisfaction, and turnover intentions). While job resources were associated with increased odds for a change into a healthier and/or more engaged category of EWB, job demands reduced them. Job resources were more strongly related to higher EWB (ORrange = 1.22 – 1.61) than job demands (ORrange = 0.79 – 0.96). Especially psychological job demands showed negative associations with improved EWB (OR = 0.79). A change from the least desirable category ‘disengaged strain’ to any other category of EWB was associated with greater odds by up to 20.6 % for increased commitment and job satisfaction and lower odds for turnover intentions. Improving work characteristics, especially job resources, could increase employees' EWB, emphasizing the importance of job characteristics for a healthy workplace. Because EWB seems to be associated with job attitudes, an improvement of this indicator would be relevant for employees and employers.
Nonmelanoma skin cancer (NMSC) is the most common cancer type in Western industrialized countries. However, research into the knowledge and awareness in the general population regarding NMSC is still scarce. This qualitative study aims to fill this research gap. Face-to-face, semi-structured interviews with 20 individuals aged 55–85 years were conducted between February and October 2020. Transcribed interviews were analyzed using qualitative content analysis. The term “white skin cancer”—the German colloquial term of NMSC—was well-known, but the incidence was underestimated. None of the participants could give a precise definition of NMSC, and various alterations in the skin were, partially wrongly, stated as potential signs for NMSC. As risk factors for NMSC, solar radiation, and fair skin type were mentioned most often. The perceived individual risk of developing NMSC and risk compared to individuals of the same age and gender were low in our sample. Own knowledge about NMSC was mostly perceived to be insufficient, and the majority of the sample would like to receive more information on NMSC. Our results emphasize a need to inform about the signs and risks of NMSC not only in the studied older age group but also in younger people.
Background: This study explored the association of an employee-friendly work environment with employees’ job attitudes (engagement, commitment, turnover intentions, and job satisfaction), and health (mental and general health), applying matched employer–employee data. Methods: The German Linked Personnel Panel (LPP; n = 14,182) survey simultaneously captures the data of employees and the human resources (HR) management of companies. A two-step cluster analysis of 16 items of the HR valuation identified relatively more- and less-employee-friendly companies (EFCs). Logistic regressions tested differences between these companies in the assessment of job attitudes and health of their employees. Results: Compared to less-EFCS, more-EFCS had a reduced risk of poorer job attitudes and substandard health of their employees. For example, the risk for higher turnover intentions was reduced by 33% in more-EFCS (OR = 0.683, 95% C.I. = 0.626–0.723), and more-EFCS had an 18% reduced chance of poor mental health reporting of their employees (OR = 0.822, 95% C.I. = 0.758–0.892). Conclusions: More-EFCS have more motivated and healthier employees. The most distinct factors for more-EFCS were: the existence of development plans for employees, opportunities for advancement and development, and personnel development measures.
Background/Objectives: The increasing incidence rates of keratinocyte carcinoma (KC), particularly in fair-skinned populations, call for efforts to intensify health education of the general population in addressing this prevalent skin cancer type. As a preparatory step, this systematic review summarizes the published research on the knowledge and risk perception regarding KC among individuals without medical training. Methods: The review was registered in PROSPERO (CRD42024618851) and adheres to PRISMA guidelines. The databases PubMed, Scopus, Web of Science, PsycArticles, and PsycINFO were searched on 30 July 2024. Studies were eligible if knowledge and/or risk perception was assessed in lay people. Risk of bias (ROB) was assessed with the Joanna Briggs Institute checklist for prevalence studies. Comparable outcomes (e.g., awareness of terms for KC) were meta-analyzed. Results: Included reports (n = 17) were published between 1991 and 2024 with 16,728 individuals assessed. Awareness for the most common type of KC, basal cell carcinoma (BCC), was low (20.75% of respondents (95% confidence interval (CI): 15.24–27.61)), while more respondents were familiar with colloquial terms (60.9–72.8%). Meta-analysis indicated an underestimation of the frequency of KC, with only 7.21% (CI: 4.03–12.58) identifying BCC as the most common type of skin cancer. Furthermore, concern about developing KC as assessed in only two overlapping studies was reported by only 25–30% of respondents, indicating a significant gap in risk awareness and a lack of research on risk perception regarding KC. Conclusions: This review highlights the need for targeted health education interventions to improve knowledge and preventive behaviors regarding KC. Given the limitations of the included studies, characterized by high ROB, heterogeneity of results, and a lack of standardized assessment tools, further research is essential to enhance the understanding and awareness of KC in diverse populations.
Immunosuppressed patients have a substantially increased risk for developing skin cancer. Therefore, it is mandatory that such patients are adequately informed and aware of skin cancer and their increased risk to modify their behavior. Numerous studies have evaluated the topic, but no synthesis of their findings exists. The protocol of this systematic review was registered on PROSPERO (CRD42024618851) and its reporting followed the PRISMA-2020 guideline. To identify all studies assessing knowledge or perception of skin cancer in immunosuppressed patients, forward and backward citation tracking was employed in addition to an electronic literature search across five databases. For the risk of bias (ROB) assessment, the Joanna Briggs Institute checklist for prevalence studies was used. Quantitatively comparable outcomes were meta-analyzed, while all others were qualitatively synthesized. Thirty-two reports comprising 4214 patients were included. Acknowledging substantial heterogeneity between studies, just over two thirds of patients recalled having been informed about their increased skin cancer risk (pooled proportion: 68.34%, 95% confidence interval (CI): 55.48–78.90). Awareness of the increased risk for skin cancer varied widely (34.5–100%), and pooled mean Skin Cancer and Sun Knowledge scores were 14.77 (CI = 8.57–20.96). About half of those patients asked about risk factors for skin cancer knew that immunosuppression was among them. This indicates that immunosuppressed patients are insufficiently educated about their increased skin cancer risk. However, the high heterogeneity in the synthesized outcomes and the minimal proportion (3%) of low ROB ratings for the included studies call for further research to better understand the awareness of skin cancer risk in this vulnerable population.