Burnout and Metabolic Syndrome in Female Nurses: An Observational Study
Nurses are at risk of having burnout due to workload and job stress-studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectio...
Gespeichert in:
Veröffentlicht in: | International journal of environmental research and public health 2019-06, Vol.16 (11), p.1993 |
---|---|
Hauptverfasser: | , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | |
---|---|
container_issue | 11 |
container_start_page | 1993 |
container_title | International journal of environmental research and public health |
container_volume | 16 |
creator | Chico-Barba, Gabriela Jiménez-Limas, Karime Sánchez-Jiménez, Bernarda Sámano, Reyna Rodríguez-Ventura, Ana Lilia Castillo-Pérez, Rafael Tolentino, Maricruz |
description | Nurses are at risk of having burnout due to workload and job stress-studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectional study from 2016 to 2018 in a tertiary hospital in Mexico City. All nurses that work in the hospital were invited to participate. Information pertaining to sociodemographic (age, education level), work (labor seniority, service area, shift work), anthropometric (weight, waist circumference, blood pressure) and biochemical (glucose, serum lipids) variables were collected. Burnout was assessed using the Maslach Burnout Inventory test, and metabolic syndrome was defined according to the International Diabetes Federation criteria. A total of 168 nurses participated with a median age of 44 years. The prevalence of burnout and metabolic syndrome was 19.6% and 38.7%, respectively. There was no association between burnout and metabolic syndrome (
= 0.373). However, associations of emotional exhaustion (aOR: 14.95; 95% CI: 1.5-148.7), personal accomplishment (aOR: 0.13; 95% CI: 0.01-0.99), and night shift (aOR: 12.39; 95% CI: 1.02-150.5) with increased waist circumference were found. Strategies are needed to prevent burnout and metabolic syndrome in nurses, especially in those who work at night shift. |
doi_str_mv | 10.3390/ijerph16111993 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6603913</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2329389605</sourcerecordid><originalsourceid>FETCH-LOGICAL-c484t-21b0a05935835523aa69bb1ddaa97f2c0749dc9d20802dce8a468f64cc0599d03</originalsourceid><addsrcrecordid>eNpdkU1PAjEQhhujEUSvHk0TL17AfuyWrQcTJIImKAf03HTbIkt2W2x3Sfj3loAGPM0k88w7Hy8A1xj1KOXovlgav1pghjHmnJ6ANmYMdROG8OlB3gIXISwRolnC-Dlo0UinKadtMH5qvHVNDaXV8M3UMndloeBsY7V3lYGFhSNTydLA98YHEx7gwMJpHoxfy7pwVpZwVjd6cwnO5rIM5mofO-Bz9PwxfOlOpuPX4WDSVUmW1F2CcyRRnJxmNE0JlZLxPMdaS8n7c6JQP-FacU1QhohWJpMJy-YsUSo2cY1oBzzudFdNXplI2NrLUqx8UUm_EU4W4rhii4X4cmsRX0E5plHgbi_g3XdjQi2qIihTltIa1wRBSBxEMcVpRG__oUsXvxXPE4QSTjPO0Jbq7SjlXQjezP-WwUhsPRLHHsWGm8MT_vBfU-gPZs-Now</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2329389605</pqid></control><display><type>article</type><title>Burnout and Metabolic Syndrome in Female Nurses: An Observational Study</title><source>MEDLINE</source><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Chico-Barba, Gabriela ; Jiménez-Limas, Karime ; Sánchez-Jiménez, Bernarda ; Sámano, Reyna ; Rodríguez-Ventura, Ana Lilia ; Castillo-Pérez, Rafael ; Tolentino, Maricruz</creator><creatorcontrib>Chico-Barba, Gabriela ; Jiménez-Limas, Karime ; Sánchez-Jiménez, Bernarda ; Sámano, Reyna ; Rodríguez-Ventura, Ana Lilia ; Castillo-Pérez, Rafael ; Tolentino, Maricruz</creatorcontrib><description>Nurses are at risk of having burnout due to workload and job stress-studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectional study from 2016 to 2018 in a tertiary hospital in Mexico City. All nurses that work in the hospital were invited to participate. Information pertaining to sociodemographic (age, education level), work (labor seniority, service area, shift work), anthropometric (weight, waist circumference, blood pressure) and biochemical (glucose, serum lipids) variables were collected. Burnout was assessed using the Maslach Burnout Inventory test, and metabolic syndrome was defined according to the International Diabetes Federation criteria. A total of 168 nurses participated with a median age of 44 years. The prevalence of burnout and metabolic syndrome was 19.6% and 38.7%, respectively. There was no association between burnout and metabolic syndrome (
= 0.373). However, associations of emotional exhaustion (aOR: 14.95; 95% CI: 1.5-148.7), personal accomplishment (aOR: 0.13; 95% CI: 0.01-0.99), and night shift (aOR: 12.39; 95% CI: 1.02-150.5) with increased waist circumference were found. Strategies are needed to prevent burnout and metabolic syndrome in nurses, especially in those who work at night shift.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph16111993</identifier><identifier>PMID: 31195593</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adult ; Blood pressure ; Body weight ; Burnout ; Burnout, Professional - epidemiology ; Cholesterol ; Chronic illnesses ; Correlation analysis ; Cross-Sectional Studies ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Fasting ; Female ; Females ; Glucose ; Glucose tolerance ; Health risks ; Hemoglobin ; High density lipoprotein ; Humans ; Hypertension ; Lipids ; Metabolic disorders ; Metabolic syndrome ; Metabolic Syndrome - epidemiology ; Mexico - epidemiology ; Middle Aged ; Nurses ; Observational studies ; Prevalence ; Questionnaires ; Risk analysis ; Risk factors ; Sociodemographics ; Stress ; Studies ; Tertiary Care Centers ; Triglycerides ; Waist Circumference ; Workloads</subject><ispartof>International journal of environmental research and public health, 2019-06, Vol.16 (11), p.1993</ispartof><rights>2019. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 by the authors. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-21b0a05935835523aa69bb1ddaa97f2c0749dc9d20802dce8a468f64cc0599d03</citedby><cites>FETCH-LOGICAL-c484t-21b0a05935835523aa69bb1ddaa97f2c0749dc9d20802dce8a468f64cc0599d03</cites><orcidid>0000-0001-5490-1363 ; 0000-0002-5741-0241 ; 0000-0002-6506-8212 ; 0000-0001-7213-0080 ; 0000-0001-8000-755X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603913/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603913/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31195593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chico-Barba, Gabriela</creatorcontrib><creatorcontrib>Jiménez-Limas, Karime</creatorcontrib><creatorcontrib>Sánchez-Jiménez, Bernarda</creatorcontrib><creatorcontrib>Sámano, Reyna</creatorcontrib><creatorcontrib>Rodríguez-Ventura, Ana Lilia</creatorcontrib><creatorcontrib>Castillo-Pérez, Rafael</creatorcontrib><creatorcontrib>Tolentino, Maricruz</creatorcontrib><title>Burnout and Metabolic Syndrome in Female Nurses: An Observational Study</title><title>International journal of environmental research and public health</title><addtitle>Int J Environ Res Public Health</addtitle><description>Nurses are at risk of having burnout due to workload and job stress-studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectional study from 2016 to 2018 in a tertiary hospital in Mexico City. All nurses that work in the hospital were invited to participate. Information pertaining to sociodemographic (age, education level), work (labor seniority, service area, shift work), anthropometric (weight, waist circumference, blood pressure) and biochemical (glucose, serum lipids) variables were collected. Burnout was assessed using the Maslach Burnout Inventory test, and metabolic syndrome was defined according to the International Diabetes Federation criteria. A total of 168 nurses participated with a median age of 44 years. The prevalence of burnout and metabolic syndrome was 19.6% and 38.7%, respectively. There was no association between burnout and metabolic syndrome (
= 0.373). However, associations of emotional exhaustion (aOR: 14.95; 95% CI: 1.5-148.7), personal accomplishment (aOR: 0.13; 95% CI: 0.01-0.99), and night shift (aOR: 12.39; 95% CI: 1.02-150.5) with increased waist circumference were found. Strategies are needed to prevent burnout and metabolic syndrome in nurses, especially in those who work at night shift.</description><subject>Adult</subject><subject>Blood pressure</subject><subject>Body weight</subject><subject>Burnout</subject><subject>Burnout, Professional - epidemiology</subject><subject>Cholesterol</subject><subject>Chronic illnesses</subject><subject>Correlation analysis</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Fasting</subject><subject>Female</subject><subject>Females</subject><subject>Glucose</subject><subject>Glucose tolerance</subject><subject>Health risks</subject><subject>Hemoglobin</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Lipids</subject><subject>Metabolic disorders</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Mexico - epidemiology</subject><subject>Middle Aged</subject><subject>Nurses</subject><subject>Observational studies</subject><subject>Prevalence</subject><subject>Questionnaires</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Sociodemographics</subject><subject>Stress</subject><subject>Studies</subject><subject>Tertiary Care Centers</subject><subject>Triglycerides</subject><subject>Waist Circumference</subject><subject>Workloads</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkU1PAjEQhhujEUSvHk0TL17AfuyWrQcTJIImKAf03HTbIkt2W2x3Sfj3loAGPM0k88w7Hy8A1xj1KOXovlgav1pghjHmnJ6ANmYMdROG8OlB3gIXISwRolnC-Dlo0UinKadtMH5qvHVNDaXV8M3UMndloeBsY7V3lYGFhSNTydLA98YHEx7gwMJpHoxfy7pwVpZwVjd6cwnO5rIM5mofO-Bz9PwxfOlOpuPX4WDSVUmW1F2CcyRRnJxmNE0JlZLxPMdaS8n7c6JQP-FacU1QhohWJpMJy-YsUSo2cY1oBzzudFdNXplI2NrLUqx8UUm_EU4W4rhii4X4cmsRX0E5plHgbi_g3XdjQi2qIihTltIa1wRBSBxEMcVpRG__oUsXvxXPE4QSTjPO0Jbq7SjlXQjezP-WwUhsPRLHHsWGm8MT_vBfU-gPZs-Now</recordid><startdate>20190605</startdate><enddate>20190605</enddate><creator>Chico-Barba, Gabriela</creator><creator>Jiménez-Limas, Karime</creator><creator>Sánchez-Jiménez, Bernarda</creator><creator>Sámano, Reyna</creator><creator>Rodríguez-Ventura, Ana Lilia</creator><creator>Castillo-Pérez, Rafael</creator><creator>Tolentino, Maricruz</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5490-1363</orcidid><orcidid>https://orcid.org/0000-0002-5741-0241</orcidid><orcidid>https://orcid.org/0000-0002-6506-8212</orcidid><orcidid>https://orcid.org/0000-0001-7213-0080</orcidid><orcidid>https://orcid.org/0000-0001-8000-755X</orcidid></search><sort><creationdate>20190605</creationdate><title>Burnout and Metabolic Syndrome in Female Nurses: An Observational Study</title><author>Chico-Barba, Gabriela ; Jiménez-Limas, Karime ; Sánchez-Jiménez, Bernarda ; Sámano, Reyna ; Rodríguez-Ventura, Ana Lilia ; Castillo-Pérez, Rafael ; Tolentino, Maricruz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-21b0a05935835523aa69bb1ddaa97f2c0749dc9d20802dce8a468f64cc0599d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Blood pressure</topic><topic>Body weight</topic><topic>Burnout</topic><topic>Burnout, Professional - epidemiology</topic><topic>Cholesterol</topic><topic>Chronic illnesses</topic><topic>Correlation analysis</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Fasting</topic><topic>Female</topic><topic>Females</topic><topic>Glucose</topic><topic>Glucose tolerance</topic><topic>Health risks</topic><topic>Hemoglobin</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Lipids</topic><topic>Metabolic disorders</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Mexico - epidemiology</topic><topic>Middle Aged</topic><topic>Nurses</topic><topic>Observational studies</topic><topic>Prevalence</topic><topic>Questionnaires</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Sociodemographics</topic><topic>Stress</topic><topic>Studies</topic><topic>Tertiary Care Centers</topic><topic>Triglycerides</topic><topic>Waist Circumference</topic><topic>Workloads</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chico-Barba, Gabriela</creatorcontrib><creatorcontrib>Jiménez-Limas, Karime</creatorcontrib><creatorcontrib>Sánchez-Jiménez, Bernarda</creatorcontrib><creatorcontrib>Sámano, Reyna</creatorcontrib><creatorcontrib>Rodríguez-Ventura, Ana Lilia</creatorcontrib><creatorcontrib>Castillo-Pérez, Rafael</creatorcontrib><creatorcontrib>Tolentino, Maricruz</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of environmental research and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chico-Barba, Gabriela</au><au>Jiménez-Limas, Karime</au><au>Sánchez-Jiménez, Bernarda</au><au>Sámano, Reyna</au><au>Rodríguez-Ventura, Ana Lilia</au><au>Castillo-Pérez, Rafael</au><au>Tolentino, Maricruz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Burnout and Metabolic Syndrome in Female Nurses: An Observational Study</atitle><jtitle>International journal of environmental research and public health</jtitle><addtitle>Int J Environ Res Public Health</addtitle><date>2019-06-05</date><risdate>2019</risdate><volume>16</volume><issue>11</issue><spage>1993</spage><pages>1993-</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><abstract>Nurses are at risk of having burnout due to workload and job stress-studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectional study from 2016 to 2018 in a tertiary hospital in Mexico City. All nurses that work in the hospital were invited to participate. Information pertaining to sociodemographic (age, education level), work (labor seniority, service area, shift work), anthropometric (weight, waist circumference, blood pressure) and biochemical (glucose, serum lipids) variables were collected. Burnout was assessed using the Maslach Burnout Inventory test, and metabolic syndrome was defined according to the International Diabetes Federation criteria. A total of 168 nurses participated with a median age of 44 years. The prevalence of burnout and metabolic syndrome was 19.6% and 38.7%, respectively. There was no association between burnout and metabolic syndrome (
= 0.373). However, associations of emotional exhaustion (aOR: 14.95; 95% CI: 1.5-148.7), personal accomplishment (aOR: 0.13; 95% CI: 0.01-0.99), and night shift (aOR: 12.39; 95% CI: 1.02-150.5) with increased waist circumference were found. Strategies are needed to prevent burnout and metabolic syndrome in nurses, especially in those who work at night shift.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>31195593</pmid><doi>10.3390/ijerph16111993</doi><orcidid>https://orcid.org/0000-0001-5490-1363</orcidid><orcidid>https://orcid.org/0000-0002-5741-0241</orcidid><orcidid>https://orcid.org/0000-0002-6506-8212</orcidid><orcidid>https://orcid.org/0000-0001-7213-0080</orcidid><orcidid>https://orcid.org/0000-0001-8000-755X</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1660-4601 |
ispartof | International journal of environmental research and public health, 2019-06, Vol.16 (11), p.1993 |
issn | 1660-4601 1661-7827 1660-4601 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6603913 |
source | MEDLINE; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
subjects | Adult Blood pressure Body weight Burnout Burnout, Professional - epidemiology Cholesterol Chronic illnesses Correlation analysis Cross-Sectional Studies Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Fasting Female Females Glucose Glucose tolerance Health risks Hemoglobin High density lipoprotein Humans Hypertension Lipids Metabolic disorders Metabolic syndrome Metabolic Syndrome - epidemiology Mexico - epidemiology Middle Aged Nurses Observational studies Prevalence Questionnaires Risk analysis Risk factors Sociodemographics Stress Studies Tertiary Care Centers Triglycerides Waist Circumference Workloads |
title | Burnout and Metabolic Syndrome in Female Nurses: An Observational Study |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T09%3A28%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Burnout%20and%20Metabolic%20Syndrome%20in%20Female%20Nurses:%20An%20Observational%20Study&rft.jtitle=International%20journal%20of%20environmental%20research%20and%20public%20health&rft.au=Chico-Barba,%20Gabriela&rft.date=2019-06-05&rft.volume=16&rft.issue=11&rft.spage=1993&rft.pages=1993-&rft.issn=1660-4601&rft.eissn=1660-4601&rft_id=info:doi/10.3390/ijerph16111993&rft_dat=%3Cproquest_pubme%3E2329389605%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2329389605&rft_id=info:pmid/31195593&rfr_iscdi=true |