Παρασκευή 31 Μαρτίου 2017

Shift work and cognitive aging: a longitudinal study

Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed. Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986–2012. Night work history (ever/never) from 1998–2002 was available from a subsample (N=320). Early adult cognitive test scores were available for 77 men. Results In latent growth curve modeling, there were no main effects of "any-type" or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand. Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife. by Bokenberger K, Ström P, Dahl Aslan AK, Åkerstedt T, Pedersen NL. doi:10.5271/sjweh.3637

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IJERPH, Vol. 14, Pages 364: Individual and Store Characteristics Associated with Brand Choices in Select Food Category Redemptions among WIC Participants in Virginia

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) often allows participants to redeem food benefits for various brands at different costs. To aid the program’s food cost containment efforts, it is important to understand the individual and store characteristics associated with brand choices. This study used the WIC Electronic Benefit Transfer (EBT) data for 239,062 Virginia WIC participants’ brand choices in infant fruits and vegetables (F&Vs) and whole grain bread in May 2014–February 2015, one of the first such data sets available in the U.S. for research purposes. Mixed effects logistic regression models were used to analyze the choice of higher-priced brands over lower-priced brands. Minority participants were significantly more likely to redeem higher-priced brands of infant F&Vs, but more likely to choose lower-priced brands of bread. Participants shopping in urban stores or midsized stores (with 5–9 registers) were less likely to choose higher-priced brands compared to rural stores or large stores (with 9+ registers). Race/ethnicity and store characteristics may be significant factors in participants’ brand choices. The results can help develop interventions that encourage targeted participants to redeem lower-priced but equivalently healthy brands. This may not only help contain WIC program costs, but help participants manage their own non-WIC food expenses as well.

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IJERPH, Vol. 14, Pages 363: A Risk Assessment Matrix for Public Health Principles: The Case for E-Cigarettes

Besides nicotine replacement therapies, a realistic alternative for smoking cessation or for smoking substitution may come from electronic cigarettes (ECs), whose popularity has been steadily growing. As for any emerging behaviour associated with exposure to inhalational agents, there is legitimate cause for concern and many health organizations and policy makers have pushed for restrictive policy measures ranging from complete bans to tight regulations of these products. Nonetheless, it is important to reframe these concerns in context of the well-known harm caused by cigarette smoking. In this article, we discuss key public health principles that should be considered when regulating ECs. These include the concept of tobacco harm reduction, importance of relative risk and risk continuum, renormalization of smoking, availability of low-risk product, proportionate taxation, and reassessment of the role of non-tobacco flavours. These public health principles may be systematically scrutinized using a risk assessment matrix that allows: (1) to determine the measure of certainty that a risk will occur; and (2) to estimate the impact of such a risk on public health. Consequently, the ultimate goal of responsible ECs regulation should be that of maximizing the favourable impact of these reduced-risk products whilst minimizing further any potential risks. Consumer perspectives, sound EC research, continuous post-marketing surveillance and reasonable safety and quality product standards should be at the very heart of future regulatory schemes that will address concerns while minimizing unintended consequences of ill-informed regulation.

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IJERPH, Vol. 14, Pages 365: Socio-Economic Position and Suicidal Ideation in Men

People in low socio-economic positions are over-represented in suicide statistics and are at heightened risk for non-fatal suicidal thoughts and behaviours. Few studies have tried to tease out the relationship between individual-level and area-level socio-economic position, however. We used data from Ten to Men (the Australian Longitudinal Study on Male Health) to investigate the relationship between individual-level and area-level socio-economic position and suicidal thinking in 12,090 men. We used a measure of unemployment/employment and occupational skill level as our individual-level indicator of socio-economic position. We used the Index of Relative Socio-Economic Disadvantage (a composite multidimensional construct created by the Australian Bureau of Statistics that combines information from a range of area-level variables, including the prevalence of unemployment and employment in low skilled occupations) as our area-level indicator. We assessed suicidal thinking using the Patient Health Questionnaire (PHQ-9). We found that even after controlling for common predictors of suicidal thinking; low individual-level and area-level socio-economic position heightened risk. Individual-level socio-economic position appeared to exert the greater influence of the two; however. There is an onus on policy makers and planners from within and outside the mental health sector to take individual- and area-level socio-economic position into account when they are developing strategic initiatives.

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IJERPH, Vol. 14, Pages 360: Severe Pneumonia Caused by Influenza A (H1N1) Virus Successfully Managed with Extracorporeal Life Support in a Comorbid Former Preterm Infant

Influenza A (H1N1) virus infection is a global health burden, leading to significant pediatric morbidity and mortality. Prematurity, young age and comorbidities are important risk factors for unfavorable outcomes. Preventive strategies, such as healthcare workers and household contacts vaccination as well as the implementation of infection control practices during the epidemic season, are crucial to protect the most vulnerable populations. Early diagnosis, timely administration of antiviral drugs and supportive therapy are crucial to lead to a complete recovery. When conventional treatment fails, extracorporeal life support (ECLS) may be employed. In neonates and young infants, this high-tech support is burdened by specific technical complexity. Despite the potential risks related to this aggressive approach, ECLS is a life-saving procedure in 65% of pediatric viral pneumonia and in 73% of sepsis cases. Here, we report the successful outcome of a 51-day formerly preterm infant, suffering from a surgical necrotizing enterocolitis (NEC), complicated with hospital-acquired pneumonia due to influenza A (H1N1) virus. She developed a severe respiratory failure, unresponsive to conventional therapy, and successfully treated with ECLS. To our knowledge, this is the first report on the use of ECLS in a formerly preterm infant, suffering from NEC complicated by influenza A (H1N1) virus infection.

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IJERPH, Vol. 14, Pages 362: Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005–2012

The research on industrial food animal production (IFAP) and asthma exacerbations in the United States has relied on small sample sizes and/or self-reported outcomes. We assessed associations of proximity to large-scale and densely stocked swine and dairy/veal IFAP with three types of asthma exacerbations: hospitalizations, emergency encounters, and oral corticosteroid (OCS) medication orders from Geisinger Clinic in Pennsylvania. We used a diagnosis code (International Classification of Diseases, 9th Revision, Clinical Modification code 493.x) and medication orders from electronic health records to identify these exacerbations among asthma patients (n = 35,269) from 2005–2012. We compared residential proximity to swine or dairy/veal IFAP (dichotomized as <3 miles (4.8 km) or ≥3 miles) among asthma patients with and without exacerbations and estimated odds ratios using multilevel logistic regression. In adjusted models, proximity to IFAP was associated (odds ratio (95% confidence interval)) with OCS orders (1.11 (1.04–1.19)) and hospitalizations (1.29 (1.15–1.46)), but not emergency encounters (1.12 (0.91–1.37)). This study contributes to growing evidence that IFAP may impact health, in this case clinically-documented asthma exacerbations. No prior study has evaluated the association of IFAP and clinically-documented asthma exacerbations in the United States.

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IJERPH, Vol. 14, Pages 361: The Promise and the Challenge of Technology-Facilitated Methods for Assessing Behavioral and Cognitive Markers of Risk for Suicide among U.S. Army National Guard Personnel

Suicide was the 10th leading cause of death for Americans in 2015 and rates have been steadily climbing over the last 25 years. Rates are particularly high amongst U.S. military personnel. Suicide prevention efforts in the military are significantly hampered by the lack of: (1) assessment tools for measuring baseline risk and (2) methods to detect periods of particularly heightened risk. Two specific barriers to assessing suicide risk in military personnel that call for innovation are: (1) the geographic dispersion of military personnel from healthcare settings, particularly amongst components like the Reserves; and (2) professional and social disincentives to acknowledging psychological distress. The primary aim of this paper is to describe recent technological developments that could contribute to risk assessment tools that are not subject to the limitations mentioned above. More specifically, Behavioral Signal Processing can be used to assess behaviors during interaction and conversation that likely indicate increased risk for suicide, and computer-administered, cognitive performance tasks can be used to assess activation of the suicidal mode. These novel methods can be used remotely and do not require direct disclosure or endorsement of psychological distress, solving two challenges to suicide risk assessment in military and other sensitive settings. We present an introduction to these technologies, describe how they can specifically be applied to assessing behavioral and cognitive risk for suicide, and close with recommendations for future research.

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IJERPH, Vol. 14, Pages 369: Time Trend and Demographic and Geographic Disparities in Childhood Obesity Prevalence in China—Evidence from Twenty Years of Longitudinal Data

Childhood overweight and obesity (ow/ob) has become a serious threat to many countries, including China. However, limited evidence was obtained from longitudinal data in China. This study examined the secular trends and geographic variation in the prevalence of ow/ob and obesity only, and age, gender, and urban-rural disparities among school-aged children across China. Data from children aged 6–17 surveyed in China Health and Nutrition Survey (CHNS) from 1991 (n = 2712) to 2011 (n = 1054) were used. Overweight and obesity were defined based on the International Obesity Task Force (IOTF) recommended Asian age-sex-specific BMI cut-off-points. We found that: (1) childhood ow/ob and obesity prevalence increased from 11.7% to 25.2% and from 2.8% to 10.1% during 1991–2011, respectively; (2) children aged 6–12 experienced a 1.3 and 1.6 times increase in ow/ob and obesity prevalence than children aged 13–17, respectively; (3) the urban-rural gap in ow/ob prevalence widened; (4) ow/ob prevalence in boys was higher and increased faster than in girls, especially in an urban setting; and (5) geographic variation was observed with faster increases in more economically developed east, central and northeast regions than in the less developed west. The findings added more nuances to the picture of temporal changes in ow/ob prevalence among Chinese children.

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IJERPH, Vol. 14, Pages 368: The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure

Abstract: The aim of the current study was to test the hypothesis that forest bathing would be beneficial for elderly patients with chronic heart failure (CHF) as an adjunctive therapy. Two groups of participants with CHF were simultaneously sent to the forest or an urban control area for a four-day trip, respectively. Subjects exposed to the forest site showed a significant reduction of brain natriuretic peptide (BNP) in comparison to that of the city group and their own baseline levels. The values for the cardiovascular disease related pathological factors, including endothelin-1 (ET-1), and constituents of the renin-angiotensin system (RAS), including renin, angiotensinogen (AGT), angiotensin II (ANGII), and ANGII receptor type 1 or 2 (AT1 or AT2) in subjects exposed to the forest environment were lower than those in the urban control group. Obviously, a decreased level of inflammatory cytokines and improved antioxidant function was observed in the forest group rather than in the city group. The assessment of the profile of mood states (POMS) indicated that the negative emotional mood state was alleviated after forest bathing. As anticipated, a better air quality in the forest site was observed according to the detection of PM2.5 (particulate matter <2.5 μm) and negative ions. These results provided direct evidence that forest bathing has a beneficial effect on CHF patients, and thus may pave the way for potential development of forest bathing as an effective adjunctive therapy on cardiovascular disorders.

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IJERPH, Vol. 14, Pages 366: Proactive Approach for Safe Use of Antimicrobial Coatings in Healthcare Settings: Opinion of the COST Action Network AMiCI

Infections and infectious diseases are considered a major challenge to human health in healthcare units worldwide. This opinion paper was initiated by EU COST Action network AMiCI (AntiMicrobial Coating Innovations) and focuses on scientific information essential for weighing the risks and benefits of antimicrobial surfaces in healthcare settings. Particular attention is drawn on nanomaterial-based antimicrobial surfaces in frequently-touched areas in healthcare settings and the potential of these nano-enabled coatings to induce (eco)toxicological hazard and antimicrobial resistance. Possibilities to minimize those risks e.g., at the level of safe-by-design are demonstrated.

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IJERPH, Vol. 14, Pages 367: Knowledge, Attitudes, and Practices about the Prevention of Mosquito Bites and Zika Virus Disease in Pregnant Women in Greece

A survey among 573 pregnant women in Greece was conducted through self-completion of a questionnaire in July 2016. Traveling abroad the last six months was declared by 10.5% and 13.0% of pregnant women and their male sex partners, respectively, while 77.4% (441/570) had heard about Zika virus disease (ZVD). A lack of knowledge about sexual transmission of ZVD was identified in 63.3% of pregnant women, and 24.1% of responders did not know the risks to the fetus and baby. Approximately 73% of responders believed that the mosquito bites can affect their fetus and baby and 18% did not take measures to prevent mosquito bites routinely. Multivariable logistic regression models showed that traveling abroad the last six months by pregnant women correlated with correctly answering the question about the transmission of ZVD through bites of infected mosquitoes (Odds Ratio, OR = 10.47, 95% CI = 1.11–98.41). Traveling abroad with a male sex partner over the last six months correlated (OR = 2.05, 95% CI = 0.99–4.23) with responding correctly to the four key questions about the transmission of ZVD through mosquito bites, the risk of microcephaly, and the risks of traveling to the affected countries. A score of ≥5 for the nine responses given to questions of knowledge and attitudes was associated with a Bachelor of Science degree (OR = 1.54, 95% CI = 1.09–2.18), antenatal care at a public hospital (OR = 2.26, 95% CI = 1.28–3.98), being a civil servant as occupation (OR = 1.96, 95% CI = 1.10–3.48), and having gotten information about ZVD from the public health sector (OR = 2.04, 95% CI = 1.05–3.98). In conclusion, we found considerable knowledge gaps related to ZVD among Greek pregnant women. These study results are useful in targeting pregnant women for the prevention of potential Zika virus infections.

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De Gruyter congratulates Ziad Bou Akl

Author wins Sheik Zayed Book Award for Translation



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Πέμπτη 30 Μαρτίου 2017

Fire tests of Magnesium Oxide board lined light gauge steel frame wall systems

Publication date: June 2017
Source:Fire Safety Journal, Volume 90
Author(s): Mohamed Rusthi, Anthony Ariyanayagam, Mahen Mahendran, Poologanathan Keerthan
Recently, Magnesium Oxide (MgO) board has been widely used in LSF wall systems because of its improved acoustic properties, impact resistance, structural strength and serviceability. However, their thermal properties and fire performance have not been fully investigated. Therefore, in this research study thermal properties of two different types of MgO boards available in Australia were measured and their fire performance was investigated using three full-scale fire tests of LSF walls lined with two types of MgO board. Although the tests were conducted on two different types of MgO boards with different configurations, the fire test results gave a fire resistance level (FRL) of 30min, in which the failure was initiated by integrity of the board with either board cracking or board joint opening. This paper presents the details of the thermal property tests and the three full-scale fire tests, and their results. In addition, the effects of different MgO boards, joint configurations and compounds, noggings, screw fastening techniques and cavity insulation on the fire performance of LSF walls are also presented.



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IJERPH, Vol. 14, Pages 359: The Associations between Types of Ambient PM2.5 and Under-Five and Maternal Mortality in Africa

Exploring the effects of different types of PM2.5 is necessary to reduce associated deaths, especially in low- and middle-income countries (LMICs). Hence we determined types of ambient PM2.5 before exploring their effects on under-five and maternal mortality in Africa. The spectral derivate of aerosol optical depth (AOD) from Moderate Resolution Imaging Spectroradiometer (MODIS) products from 2000 to 2015 were employed to determine the aerosol types before using Generalized Linear and Additive Mixed-Effect models with Poisson link function to explore the associations and penalized spline for dose-response relationships. Four types of PM2.5 were identified in terms of mineral dust, anthropogenic pollutant, biomass burning and mixture aerosols. The results demonstrate that biomass PM2.5 increased the rate of under-five mortality in Western and Central Africa, each by 2%, and maternal mortality in Central Africa by 19%. Anthropogenic PM2.5 increased under-five and maternal deaths in Northern Africa by 5% and 10%, respectively, and maternal deaths by 4% in Eastern Africa. Dust PM2.5 increased under-five deaths in Northern, Western, and Central Africa by 3%, 1%, and 10%, respectively. Mixture PM2.5 only increased under-five deaths and maternal deaths in Western (incidence rate ratio = 1.01, p < 0.10) and Eastern Africa (incidence rate ratio = 1.06, p < 0.01), respectively. The findings indicate the types of ambient PM2.5 are significantly associated with under-five and maternal mortality in Africa where the exposure level usually exceeds the World Health Organization’s (WHO) standards. Appropriate policy actions on protective and control measures are therefore suggested and should be developed and implemented accordingly.

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IJERPH, Vol. 14, Pages 358: Multiphysics and Thermal Response Models to Improve Accuracy of Local Temperature Estimation in Rat Cortex under Microwave Exposure

The rapid development of wireless technology has led to widespread concerns regarding adverse human health effects caused by exposure to electromagnetic fields. Temperature elevation in biological bodies is an important factor that can adversely affect health. A thermophysiological model is desired to quantify microwave (MW) induced temperature elevations. In this study, parameters related to thermophysiological responses for MW exposures were estimated using an electromagnetic-thermodynamics simulation technique. To the authors’ knowledge, this is the first study in which parameters related to regional cerebral blood flow in a rat model were extracted at a high degree of accuracy through experimental measurements for localized MW exposure at frequencies exceeding 6 GHz. The findings indicate that the improved modeling parameters yield computed results that match well with the measured quantities during and after exposure in rats. It is expected that the computational model will be helpful in estimating the temperature elevation in the rat brain at multiple observation points (that are difficult to measure simultaneously) and in explaining the physiological changes in the local cortex region.

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IJERPH, Vol. 14, Pages 357: Heat Wave Vulnerability Mapping for India

Assessing geographic variability in heat wave vulnerability forms the basis for planning appropriate targeted adaptation strategies. Given several recent deadly heatwaves in India, heat is increasingly being recognized as a public health problem. However, to date there has not been a country-wide assessment of heat vulnerability in India. We evaluated demographic, socioeconomic, and environmental vulnerability factors and combined district level data from several sources including the most recent census, health reports, and satellite remote sensing data. We then applied principal component analysis (PCA) on 17 normalized variables for each of the 640 districts to create a composite Heat Vulnerability Index (HVI) for India. Of the total 640 districts, our analysis identified 10 and 97 districts in the very high and high risk categories (> 2SD and 2-1SD HVI) respectively. Mapping showed that the districts with higher heat vulnerability are located in the central parts of the country. On examination, these are less urbanized and have low rates of literacy, access to water and sanitation, and presence of household amenities. Therefore, we concluded that creating and mapping a heat vulnerability index is a useful first step in protecting the public from the health burden of heat. Future work should incorporate heat exposure and health outcome data to validate the index, as well as examine sub-district levels of vulnerability.

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Self-audit of lockout/tagout in manufacturing workplaces: A pilot study

Background

Occupational health and safety (OHS) self-auditing is a common practice in industrial workplaces. However, few audit instruments have been tested for inter-rater reliability and accuracy.

Methods

A lockout/tagout (LOTO) self-audit checklist was developed for use in manufacturing enterprises. It was tested for inter-rater reliability and accuracy using responses of business self-auditors and external auditors.

Results

Inter-rater reliability at ten businesses was excellent (κ = 0.84). Business self-auditors had high (100%) accuracy in identifying elements of LOTO practice that were present as well those that were absent (81% accuracy). Reliability and accuracy increased further when problematic checklist questions were removed from the analysis.

Conclusions

Results indicate that the LOTO self-audit checklist would be useful in manufacturing firms’ efforts to assess and improve their LOTO programs. In addition, a reliable self-audit instrument removes the need for external auditors to visit worksites, thereby expanding capacity for outreach and intervention while minimizing costs.



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Lung function not affected by asbestos exposure in workers with normal Computed Tomography scan

Background: It has been suggested that asbestos exposure affects lung function, even in the absence of asbestos-related pulmonary interstitial or pleural changes or emphysema. Methods: We analyzed associations between well-known asbestos-related risk factors, such as individual cumulative asbestos exposure, and key lung function parameters in formerly asbestos-exposed power industry workers (N = 207) with normal CT scans. For this, we excluded participants with emphysema, fibrosis, pleural changes, or any combination of these. Results: The lung function parameters of FVC, FEV1, DLCO/VA, and airway resistance were significantly associated with the burden of smoking, BMI and years since end of exposure (only DLCO/VA). However, they were not affected by factors directly related to amount (eg, cumulative exposure) or duration of asbestos exposure. Conclusions: Our results confirm the well-known correlation between lung function, smoking habits, and BMI. However, we found no significant association between lung function and asbestos exposure.



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The negative impact of prison work on sleep health

Objectives

To examine the prevalence of sleep disorders, deprivation, and quality in a sample of prison employees, and investigate the relationship between exposure to work-related critical incidents and sleep.

Methods

We surveyed 355 Washington State Department of Corrections employees. The survey included the Pittsburg Sleep Quality Index and the Critical Incident History Questionnaire.

Results

We found 28% and 45% of the sample reported suffering from Apnea and insomnia, respectively. Over half of the sample reporting sleeping less than 2 h between shifts and being constantly fatigued. We found significant associations between exposure to critical incidents and sleep problems.

Conclusions

Prison workers are in desperate need of help to improve their sleep. Our findings suggest the importance of continued investigation of prison worker sleep health using objective measures, toward the development of programs for improving sleep and resilience to critical incidents and stress.



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Τετάρτη 29 Μαρτίου 2017

Occupational exposure and amyotrophic lateral sclerosis in a prospective cohort

Objective

To prospectively study suspected occupational risk factors for amyotrophic lateral sclerosis (ALS).

Methods

For this case–cohort analysis within the prospective Netherlands Cohort Study, 58 279 men and 62 573 women aged 55–69 years at enrolment in 1986 were followed up for 17.3 years on ALS mortality. Information on occupational history and potential confounders were collected at baseline through a self-administered questionnaire and entered for a random subcohort (2092 men and 2074 women) and ALS deaths (76 men and 60 women). Occupational exposure to solvents, pesticides, metals, extremely low frequency magnetic fields (ELF-MFs) and electrical shocks was estimated by means of job exposure matrices (JEMs). Associations between ever/never occupationally exposed and cumulative exposure and ALS mortality were analysed by gender using Cox regression.

Results

Occupational exposure to ELF-MF showed a possible association with ALS mortality among men: HR for ever holding a job with high exposure versus background 2.19 (95% (CI): 1.02 to 4.73) and HR for the highest tertile of cumulative exposure versus background 1.93 (95% CI 1.05 to 3.55).

Interpretation

These results strengthen the evidence suggesting a positive association between ELF-MF exposure and ALS. We did not replicate earlier positive findings for other occupational exposures.



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IJERPH, Vol. 14, Pages 326: Text Messaging: An Intervention to Increase Physical Activity among African American Participants in a Faith-Based, Competitive Weight Loss Program

African American adults are less likely to meet the recommended physical activity guidelines for aerobic and muscle-strengthening activity than Caucasian adults. The purpose of this study was to assess whether a text message intervention would increase physical activity in this population. This pilot study used a pre-/post-questionnaire non-randomized design. Participants in a faith-based weight loss competition who agreed to participate in the text messaging were assigned to the intervention group (n = 52). Participants who declined to participate in the intervention, but agreed to participate in the study, were assigned to the control group (n = 30). The text messages provided strategies for increasing physical activity and were based on constructs of the Health Belief Model and the Information-Motivation-Behavioral Skills Model. Chi square tests determined the intervention group participants increased exercise time by approximately eight percent (p = 0.03), while the control group’s exercise time remained constant. The intervention group increased walking and running. The control group increased running. Most participants indicated that the health text messages were effective. The results of this pilot study suggest that text messaging may be an effective method for providing options for motivating individuals to increase physical activity.

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IJERPH, Vol. 14, Pages 355: Incidence of Breast, Prostate, Testicular, and Thyroid Cancer in Italian Contaminated Sites with Presence of Substances with Endocrine Disrupting Properties

The aim of the present study was to investigate the incidence of breast (females), prostate, testicular, and thyroid cancer in the Italian National Priority Contaminated Sites (NPCSs), served by cancer registries, where the presence of endocrine disruptors (EDs), reported to be linked to these tumours, was documented. Evidence of carcinogenicity of EDs present in NPCSs was assessed based on evaluation by international scientific institutions and committees. Standardized Incidence Ratios (SIRs) were computed for each NPCS and cancer site between 1996 and 2005. Excess incidence of one or more cancer site studied was found in twelve out of fourteen NPCSs. Significantly increased SIRs were found for breast cancer in eight NPCSs, for prostate cancer in six, for thyroid cancer (both gender) in four, and for testicular cancer in two. Non-significantly increased SIRs were found in five NPCSs for testicular cancer and in two for thyroid cancer (males). In a small number of instances a significant deficit was reported, mainly for thyroid and prostate cancer. Although increased incidence of one or more cancer sites studied were found in several NPCSs, the ecological study design and the multifactorial aetiology of the considered tumours do not permit concluding causal links with environmental contamination. Regarding the observation of some excesses in SIRs, continuing epidemiological surveillance is warranted.

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IJERPH, Vol. 14, Pages 354: Urinary Concentrations of Insecticide and Herbicide Metabolites among Pregnant Women in Rural Ghana: A Pilot Study

Use of pesticides by households in rural Ghana is common for residential pest control, agricultural use, and for the reduction of vectors carrying disease. However, few data are available about exposure to pesticides among this population. Our objective was to quantify urinary concentrations of metabolites of organophosphate (OP), pyrethroid, and select herbicides during pregnancy, and to explore exposure determinants. In 2014, 17 pregnant women from rural Ghana were surveyed about household pesticide use and provided weekly first morning urine voids during three visits (n = 51 samples). A total of 90.1% (46/51) of samples had detectable OP metabolites [geometric mean, GM (95% CI): 3,5,6-trichloro-2-pyridinol 0.54 µg/L (0.36–0.81), para-nitrophenol 0.71 µg/L (0.51–1.00)], 75.5% (37/49) had detectable pyrethroid metabolites [GM: 3-phenoxybenzoic acid 0.23 µg/L (0.17, 0.32)], and 70.5% (36/51) had detectable 2,4-dichlorophenoxyacetic acid levels, a herbicide [GM: 0.46 µg/L (0.29–0.73)]. Concentrations of para-nitrophenol and 2,4-dichlorophenoxyacetic acid in Ghanaian pregnant women appear higher when compared to nonpregnant reproductive-aged women in a reference U.S. population. Larger studies are necessary to more fully explore predictors of exposure in this population.

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IJERPH, Vol. 14, Pages 356: Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

This study aims to examine whether the urban elderly in the Zhejiang Province of China signed contracts with their general practitioner (GP) based on their health service needs, and to further identify the determinants of their demand and signing decisions. A community-based cross-sectional study was conducted in 16 community health service (CHS) institutions in Zhejiang Province, China. The urban elderly over 60 years of age were enrolled when visiting the sampled CHS. Baseline characteristics were compared between participants using Chi-Square tests for categorical variables. Univariate and multivariable logistic regression analyses were used to identify determinants of the GP contract service demand and signing decisions, respectively. Among the 1440 urban elderly, 56.67% had signed contracts with their GP, and 55.35% had a demand of the GP contract service. The influencing factors of demand were a history of diabetes or cardiovascular disease (OR = 1.33, 95% CI, 1.05–1.68); urban resident basic medical insurance (URBMI) vs. urban employee basic medical insurance (UEBMI) (OR = 1.96, 95% CI, 1.46–2.61); and middle-income vs. low-income (OR = 0.67, 95% CI, 0.50–0.90 for RMB 1001–3000; OR = 0.59, 95% CI, 0.39–0.90 for RMB 3001–5000). Having a demand for the GP contract service was the strongest determinant of signing decisions (OR = 13.20, 95% CI, 10.09–17.27). Other factors also contributed to these decisions, including gender, caregiver, and income. The urban elderly who had signed contracts with GPs were mainly based on their health care needs. Elderly people with a history of diabetes or cardiovascular disease, as well as those with URBMI, were found to have stronger needs of a GP contract service. It is believed that the high-income elderly should be given equal priority to those of low-income.

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Τρίτη 28 Μαρτίου 2017

Employees’ drug purchases before and after organizational downsizing: a natural experiment on the Norwegian working population (2004–2012)

Objectives This study investigated the association between organizational downsizing and purchases of prescribed drugs by private sector employees in Norway. Methods A natural experiment was constructed using individual-level employer and employee data linked to the national prescription database for the period 2004–2012. The study population comprised 144 089 employees who had been exposed to major downsizing in the same period. Random effects logistic regression models were used to investigate relative changes in drug purchases (antidepressants, hypnotics/sedatives, anxiolytics, and anti-psychotics, as well as anti-obesity, anti-diabetic, cardiovascular, and thyroid drugs, anti-inflammatory drugs, opioids, and analgesics/antipyretics) in the five-year-period before and after exposure to downsizing. Results Compared with the situation three years before exposure, the odds ratios (OR) of purchasing psychotropic drugs one year after exposure increased for antidepressants (OR 1.44, 95% CI 1.34–1.55), hypnotics/sedatives (OR 1.39, 95% CI 1.29–1.49), anxiolytics (OR 1.32, 95% CI 1.22–1.43), and antipsychotics (OR 1.34, 95% CI 1.19–1.52). Similar associations were found for cardiovascular, anti-diabetic, and thyroid drugs. Stratified analyses showed that the odds of purchasing psychotropic, anti-diabetic, and cardiovascular drugs in the years around downsizing was more pronounced in men compared with women. Elevated odds were also found for employees in the oldest age group and those with less than tertiary education. Conclusions Exposure to organizational downsizing increased the odds of purchasing prescribed psychotropic, cardiovascular, anti-diabetic, and thyroid drugs. The clinical implications of these results might be systematic involvement from medical personnel and occupational health services in workforce reduction processes. by Kaspersen SL, Pape K, Carlsen F, Ose SO, Bjorngaard JH. doi:10.5271/sjweh.3636

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Occupation-related chromium toxicity a rare cause of renal failure and rhabdomyolysis

Manjeera Jagannati, I Ramya, Sowmya Sathyendra

Indian Journal of Occupational and Environmental Medicine 2016 20(3):150-152

A 21-year-old gentleman, a worker in a mobile phone shop, was admitted with rhabdomyolysis, renal failure, and pulmonary edema requiring mechanical ventilation and hemodialysis. After extensive workup and ruling out other causes, heavy metal poisoning was considered. Investigations during the course of the hospital stay revealed chromium poisoning. With repeated hemodialysis, his parameters normalized and he was discharged home in a stable condition. Diagnosis of chromium toxicity needs high index of suspicion. A history of occupational exposure might offer a clue to diagnosis. With hemodialysis and supportive care, it is a potentially salvageable condition.

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Awareness of blood-borne infections and burden of occupational exposures to blood and body fluids among health care personnel in a tertiary care teaching hospital

Swetharani , KV Vinod, Abdoul Hamide, Tarun K Dutta, KT Harichandrakumar

Indian Journal of Occupational and Environmental Medicine 2016 20(3):138-143

Background and Objectives: Occupational exposures (OEs) to blood and body fluids (BBFs) pose significant risk of transmission of blood-borne infections (BBIs) to health care personnel (HCP) and are grossly underreported. We aimed to study the awareness of BBIs and their prevention, burden of OEs, assess factors contributing to them and their poor reporting and assess the practices for their prevention among HCP. Materials and Methods: This cross-sectional study conducted at a tertiary care teaching hospital located in south India used a self-administered questionnaire to assess the awareness of BBIs, attitude and practice of HCP for prevention of OEs, and to quantify the burden of exposures. All formally self-reported OEs during the study period of 2 years were documented prospectively. Results: Majority (369/401, 92%) of HCP surveyed had fair general awareness of BBIs. Though 90% were aware of the concept of universal precautions (UPs), self-reported adherence to barrier precautions was acceptable in only 80%. Overall, 56% and 46% of HCP were aware of human immunodeficiency virus (HIV) and hepatitis B post-exposure prophylaxis (PEP) respectively. Eighteen percent (74/401) were either not vaccinated or incompletely vaccinated against hepatitis B. Recapping of used needles was reported by 79% (317/401). Nearly half (208/401) reported OEs over preceding year and 70% (146/208) of exposed had not formally reported them. Over the 2-year study period, 53 formally self-reported exposures were documented prospectively. Needle stick injuries accounted for 83% of the exposures, and appropriate personal protective devices were not being used during 47% of exposures. Though doctors had the highest awareness, they reported lowest adherence to barrier precautions and highest burden of exposures (P < 0.05). Conclusion: Though majority of HCP had fair awareness of BBIs, it did not translate into adequate adherence to UPs and safe practices. High burden of OEs and their poor reporting emphasize the need to motivate our HCP to adhere to safe work practices and to promptly seek professional counselling after exposures. There is an urgent need to educate HCP about the availability and effectiveness of PEP for HIV and hepatitis B. A uniform national policy for prevention and reporting of OEs has to be framed.

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Physical activity levels and prevalence of low back pain in Thai call-center operators

Chaikumarn Montakarn, Nakphet Nuttika

Indian Journal of Occupational and Environmental Medicine 2016 20(3):125-128

Background: Call-center operators are exposed to working conditions that indicate an increased risk of developing musculoskeletal disorders. Nevertheless, there are few studies regarding health and working condition in call-center operators. Thus, this study was designed to investigate the physical activity levels and prevalence of low back pain (LBP) in Thai call-center operators. Materials and Methods: A self-reported questionnaire was distributed to 150 operators at a call center to identify the physical activity levels, prevalence of LBP, personal characteristics, and associated work factors. Results: The questionnaire response rate was 70% (n = 105). The participants' age was 27.8 ± 3.1 years, height was 159.97 ± 6.26 cm, weight was 52.89 ± 12.89 kg, and females 86.7% (n = 91), and males 13.3% (n = 14). Participants worked at least 6 days every week, with an average of 8 hours each day. Sixty-one percent of them worked over time with an average 2 h/day. Forty percent of the participants had no exercise; 34.3% exercised 1–2 times/week. Those who did physical exercise spent less than 30 min/time. The overall self-reported prevalence of LBP was 65.7%, and they reported high severity of LBP for 42.9%. All participants reported that their LBP as recurring, and 62.9% reported that LBP was aggravating by sitting during working hours. Conclusion: The call-center operators had a sedentary work style. The majority of operators in this study had low level of physical activity and suffered from low back pain. The prevalence of low back pain was associated to their level of physical activity and work factors.

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Fitness and return to work challenges for occupational health physician

Ganesh K Kulkarni

Indian Journal of Occupational and Environmental Medicine 2016 20(3):123-124



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Level of stress and its determinants among Intensive Care Unit staff

Arunesh Kumar, Prasad Pore, Sachin Gupta, Aziz O Wani

Indian Journal of Occupational and Environmental Medicine 2016 20(3):129-132

Context: Stress is a usual and normal part of our daily lives. It is a normal physical reaction to an internal or external pressure that is placed on a person's system. Extended periods of stress can cause destructive changes in the body. Objectives: (1) To assess the prevalence of stress and its level among intensive care unit (ICU) staff (doctors and nurses) of various hospitals and (2) to correlate the level of stress with certain variables. Settings and Design: A cross-sectional study was conducted in the ICU of various hospital of Pune for a period of 1 month. Materials and Methods: Eighty-two ICU staff (doctors and nurses) were contacted and interviewed using pretested proforma containing DASS stress rating scale (for stress only). Statistical Analysis Used: Data analysis was performed using the Statistical Package for the Sciences (SPSS) version 19.0 software. To compare the level of stress with various parameters, we used Chi-square test. P value <0.05 was considered to be significant. Results: The overall prevalence of stress among ICU staff (doctors and nurses) was 52.43%. Prevalence of stress among ICU doctors was 36.58% and nurses was 68.29%. According to the DASS (for stress only), 19.51% doctors were mildly stressed, 14.63% were moderately stressed, and 2.44% were severely stressed. Among nurses, 48.78% were mildly stressed and 19.51% were moderately stressed. Conclusions: The result indicated that prevalence of stress among ICU staff (doctors and nurses) is high.

http://ift.tt/2nh6lHW

Musculoskeletal morbidity among construction workers: A cross-sectional community-based study

Gopireddy M. M Reddy, B Nisha, Thangaraj G Prabhushankar, V Vishwambhar

Indian Journal of Occupational and Environmental Medicine 2016 20(3):144-149

Background: Construction industry is one of the stable growing industries in India. People working in construction industries are at a risk of various occupational diseases. Musculoskeletal disorder (MSD) is the single largest cause of work-related illness, accounting for over 33% of all newly reported occupational illnesses in the general population and approximately 77% in construction workers. In spite of the high prevalence and wide range of adverse consequences, the studies highlighting the burden and impact of musculoskeletal morbidities are very scarce in India. The current study is aimed at filling this vital gap in the current knowledge. Objective: To assess the musculoskeletal morbidities among construction workers using the modified Nordisk Scale. Materials and Methods: A cross-sectional community-based study was conducted by 30 × 10 multistage cluster random sampling method in Chennai Metropolitan city. Results: Out of the 308 participants included in the final analysis, majority were 21–40 years. Working hours ranged from 8 to 12 hours. Duration of work ranged from 2 months to 20 years. Out of 308 participants, 104 workers (33.8%) had musculoskeletal problems. Three most common disorders discovered were low backache seen in 64 (20.8%), shoulder pain seen in 36 (11.7%), and wrist pain seen in 36 (11.7%) participants. The proportion of hospitalized participants in the last 1 year was 7.8%. Total duration in the construction field, duration of work hours, and higher age had statistically significant impact on musculoskeletal morbidity. Conclusion: The prevalence of musculoskeletal morbidity was very high in construction workers, with resulting adverse impact on the workers. Immense attention, in the form of appropriate prevention measures, is needed to effectively address this public health problem.

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Visual functions of workers exposed to organic solvents in petrochemical industries

R Indhushree, R Monica, K Coral, Narayanasamy Angayarkanni, R Punitham, BM Subburathinam, R Krishnakumar, PP Santanam

Indian Journal of Occupational and Environmental Medicine 2016 20(3):133-137

Aim: The purpose of this study was to evaluate the visual functions of workers exposed to organic solvents in petrochemical industries. Materials and Methods: Thirty workers from the petroleum refinery and 30 age-matched controls (mean age) were recruited. Visual functions and occupational exposure levels were assessed among both the groups. Visual acuity, contrast sensitivity, color vision, and visual fields were evaluated at the workplace. The biological samples, namely blood and urine, were collected at the workplace and transported to the laboratory for analysis. The urinary excretion of hippuric and methylhippuric acid as well as creatinine was measured by high performance liquid chromatography. Results: The mean age of the workers and controls were 39.7 ± 7.6 years and 38.6 ± 8.1, years respectively. The mean years of experience of the workers were 15.6 ± 6.8 years. Visual acuity was >0.01 LogMAR among both the control and case groups. The contrast sensitivity was reduced at 12cpd among workers. Comparison between groups was done using independent sample t-test. The mean difference in color confusion index was 0.11 ± 0.05 (P = 0.037*). The mean difference in visual fields was −0.31 ± 0.36 dB (P = 0.933). The mean difference in urinary hippuric acid level (urinary metabolite of toluene) between the groups was 0.19 ± 0.96 g/g creatinine (P = 0.049*). The mean difference in the excretion of methylhippuric acid (urinary metabolite of xylene) was 0.06 ± 0.04g/g creatinine (P = 0.154). We also found that exposure was a significant risk factor for color vision defect with an odds ratio of 4.43 (95% CI: 1.36–14.4); P = 0.013. Conclusion: The study results showed that contrast sensitivity and color vision were affected among workers in petrochemical industry.

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Choosing controls in a case control study

Sunil Kuma Raina

Indian Journal of Occupational and Environmental Medicine 2016 20(3):153-153



http://ift.tt/2nylVkI

IFC (Editorial Board)

Publication date: April 2017
Source:Fire Safety Journal, Volume 89





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Experimental investigation on thermal and mechanical behaviour of composite floors exposed to standard fire

Publication date: April 2017
Source:Fire Safety Journal, Volume 89
Author(s): Guo-Qiang Li, Nasi Zhang, Jian Jiang
This paper presents experimental investigations on the thermal and mechanical behavior of composite floors subjected to ISO standard fire. Four 5.2m×3.7m composite slabs are tested with different combinations of the presence of one unprotected secondary beam, direction of ribs, and location of the reinforcement. The experimental results show that the highest temperature in the reinforcements occurs during the cooling phase (30–50°C increment after 10-min cooling). The temperature at the unexposed side of the slabs is below 100°C up to 100-min heating, compared to the predicted fire resistance close to 90mins from EC4. For the slabs without secondary beams, the cracks first occur around the boundaries of the slab, while for the slabs supported by one unprotected secondary beam, concrete cracks first occur on the top of the slab above the beam due to the negative bending moment, and later on develop around boundaries. Debonding is observed between the steel deck and concrete slab. The secondary beam significantly impacts the deformation shape of tested slabs. Although a large deflection, 1/20 of the span length, is reached in the tests, the composite slabs can still provide sufficient load-bearing capacity due to membrane action. The occurrence of tensile membrane action is confirmed by the measured tensile stress in the reinforcement and compressive stress in the concrete. A comparison between measured and predicted fire resistance of the slabs indicates that EC4 calculations might be used for the composite slabs beyond the specified geometry limit, and the prediction is conservative.



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IJERPH, Vol. 14, Pages 351: Modeling the Relationship between Safety Climate and Safety Performance in a Developing Construction Industry: A Cross-Cultural Validation Study

This study attempts to validate a safety performance (SP) measurement model in the cross-cultural setting of a developing country. In addition, it highlights the variations in investigating the relationship between safety climate (SC) factors and SP indicators. The data were collected from forty under-construction multi-storey building projects in Pakistan. Based on the results of exploratory factor analysis, a SP measurement model was hypothesized. It was tested and validated by conducting confirmatory factor analysis on calibration and validation sub-samples respectively. The study confirmed the significant positive impact of SC on safety compliance and safety participation, and negative impact on number of self-reported accidents/injuries. However, number of near-misses could not be retained in the final SP model because it attained a lower standardized path coefficient value. Moreover, instead of safety participation, safety compliance established a stronger impact on SP. The study uncovered safety enforcement and promotion as a novel SC factor, whereas safety rules and work practices was identified as the most neglected factor. The study contributed to the body of knowledge by unveiling the deviations in existing dimensions of SC and SP. The refined model is expected to concisely measure the SP in the Pakistani construction industry, however, caution must be exercised while generalizing the study results to other developing countries.

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IJERPH, Vol. 14, Pages 349: Improving Suicide Prevention in Dutch Regions by Creating Local Suicide Prevention Action Networks (SUPRANET): A Study Protocol

The European Alliance against Depression (EAAD) program is to be introduced in The Netherlands from 2017 onwards. This program to combat suicide consists of interventions on four levels: (1) increasing the awareness of suicide by local media campaigns; (2) training local gatekeepers, such as teachers or police officers; (3) targeting high-risk persons in the community; and (4) training and support of professionals in primary care settings. The implementation starts in seven Dutch pilot regions. Each region is designated as a Suicide Prevention Action NETwork (SUPRANET). This paper describes the SUPRANET program components and the evaluation of its feasibility and impact. The findings will be used to facilitate the national implementation of EAAD in The Netherlands and to add new findings to the existing literature on EAAD.

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IJERPH, Vol. 14, Pages 352: Pathways to Suicide in Australian Farmers: A Life Chart Analysis

Farmers have been found to be at increased risk of suicide in Australia. The Interpersonal-Psychological Theory of Suicidal Behaviour suggests that the proximal factors leading to the suicidal desire or ideation include an individual’s experiences of both perceived burdensomeness and thwarted belongingness. Suicidal desire with acquired capability to engage in lethal self-injury is predictive of suicidal behaviour. This study investigates the pathways to suicide of 18 Australian male farmers in order to understand the suicidal process and antecedents to suicide in Australian male farmers. The psychological autopsy (PA) method was used to generate life charts. Two pathways with distinct suicidal processes were identified: acute situational (romantic relationship problems and financial concerns/pending retirement) and protracted (long-term psychiatric disorder). Long working hours, interpersonal conflicts, physical illnesses and pain, alcohol abuse, access to firearms, and exposure to drought were additional common factors identified. An understanding of the interrelatedness of diverse distal and proximal risk factors on suicidal pathways in the wider environmental context for male farmers is required when developing and implementing rural suicide prevention activities.

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IJERPH, Vol. 14, Pages 350: Are Brief Alcohol Interventions Adequately Embedded in UK Primary Care? A Qualitative Study Utilising Normalisation Process Theory

Despite substantial evidence for their effectiveness, the adoption of alcohol screening and brief interventions (ASBI) in routine primary care remains inconsistent. Financial incentive schemes were introduced in England between 2008 and 2015 to encourage their delivery. We used Normalisation Process Theory-informed interviews to understand the barriers and facilitators experienced by 14 general practitioners (GPs) as they implemented ASBI during this period. We found multiple factors shaped provision. GPs were broadly cognisant and supportive of preventative alcohol interventions (coherence) but this did not necessarily translate into personal investment in their delivery (cognitive participation). This lack of investment shaped how GPs operationalised such “work” in day-to-day practice (collective action), with ASBI mostly delegated to nurses, and GPs reverting to “business as usual” in their management and treatment of problem drinking (reflexive monitoring). We conclude there has been limited progress towards the goal of an effectively embedded preventative alcohol care pathway in English primary care. Future policy should consider screening strategies that prioritise patients with conditions with a recognised link with excessive alcohol consumption, and which promote more efficient identification of the most problematic drinkers. Improved GP training to build skills and awareness of evidence-based ASBI tools could also help embed best practice over time.

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IJERPH, Vol. 14, Pages 353: Conceptions of Contraceptive Use in Rural KwaZulu-Natal, South Africa: Lessons for Programming

Community family planning programmes in South Africa arose from the controversial apartheid history of controlling the African population while encouraging the growth of European migrant population. Post-apartheid population policies shifted away from population control to aligning policies to the global agenda that placed emphasis on the link between population and development. The focus on population and development polices in post-apartheid South Africa is on social equality, justice and peace rather than controlling sections of the population. Given the shift, this paper interrogates the conceptions of contraceptive use among rural communities in KwaZulu-Natal. Our primary objective is to understand the dynamics surrounding access to and use of family planning services in peri-urban and rural areas of KwaZulu-Natal. Using focus group data, the findings of the study suggest that different social categories interact with the family planning programmes differently. How teenagers and married women perceive the value of family planning differs. Gender differences regarding the use of condoms are also evident. The paper attempts to grapple with the non-use of condoms despite the knowledge that these prevent pregnancy and provide protection from sexually-transmitted diseases. The contribution of this paper lies in its identification of socio-cultural factors and the political economy underlying the different attitudes towards contraceptive use in rural KwaZulu-Natal.

http://ift.tt/2o5II9l

The psychosocial work environment is associated with risk of stroke at working age

Objective The aim of this study was to explore the relation between the risk of first-ever stroke at working age and psychological work environmental factors. Methods A consecutive multicenter matched 1:2 case–control study of acute stroke cases (N=198, age 30–65 years) who had been working full-time at the time of their stroke and 396 sex- and age-matched controls. Stroke cases and controls answered questionnaires on their psychosocial situation during the previous 12 months. The psychosocial work environment was assessed using three different measures: the job–control–demand model, the effort–reward imbalance (ERI) score, and exposures to conflict at work. Results Among 198 stroke cases and 396 controls, job strain [odds ratio (OR) 1.30, 95% confidence interval (95% CI) 1.05–1.62], ERI (OR 1.28, 95% CI 1.01–1.62), and conflict at work (OR 1.75, 95% CI 1.07–2.88) were independent risk factors of stroke in multivariable regression models. Conclusions Adverse psychosocial working conditions during the past 12 months were more frequently observed among stroke cases. Since these factors are presumably modifiable, interventional studies targeting job strain and emotional work environment are warranted. by Jood K, Karlsson N, Medin J, Pessah-Rasmussen H, Wester P, Ekberg K. doi:10.5271/sjweh.3635

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Δευτέρα 27 Μαρτίου 2017

IJERPH, Vol. 14, Pages 348: A Mixed-Methods Examination of Physical Activity and Sedentary Time in Overweight and Obese South Asian Men Living in the United Kingdom

South Asian men living in the UK have higher rates of central obesity and Type 2 Diabetes Mellitus (T2DM) compared with their white British counterparts. Physical activity (PA) and sedentary time (ST) are important risk factors for the development of T2DM. The purpose of this study was to objectively measure PA, ST, and to explore the factors influencing these behaviours in this high-risk population. A mixed-methods cross-sectional research design was employed, including the quantification of PA and ST using the self-report International Physical Activity Questionnaire (IPAQ)-long form and accelerometry in overweight and obese UK South Asian men (n = 54), followed by semi-structured interviews in a purposive sub-sample to explore the factors influencing PA and ST (n = 31). Accelerometer-derived moderate-to-vigorous PA (MVPA) and ST were 298.9 ± 186.6 min/week and 551.4 ± 95.0 min/day, respectively. IPAQ-derived MVPA was significantly lower than accelerometer-derived MVPA (p < 0.001). IPAQ-derived ST was significantly higher than accelerometer-derived ST (p < 0.001). Lack of time and family commitments were identified as the main barriers to being more physically active, with group exercise identified as an important facilitator to being more active. A cultural norm of focusing on promoting education over sport participation during childhood was identified as an important factor influencing long-term PA behaviours. Work commitments and predominantly sedentary jobs were identified as the main barriers to reducing ST. Healthcare professionals and researchers need to consider the socio-cultural factors which affect PA engagement in overweight and obese South Asian men living in the UK, to ensure that advice and future interventions are tailored to address the needs of this population.

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IJERPH, Vol. 14, Pages 347: The Economic Cost of Suicide and Non-Fatal Suicide Behavior in the Australian Workforce and the Potential Impact of a Workplace Suicide Prevention Strategy

Suicide and non-fatal suicide behavior (NFSB) are significant problems faced by most countries. The objective of this research is to quantify the economic cost of suicide and NFSB in the Australian workforce and to examine the potential impact of introducing a workplace suicide prevention intervention to reduce this burden. The analysis used the best available suicide data, a well-established costing methodology, and a proven workplace intervention. In 2014, 903 workers died by suicide, 2303 workers harmed themselves resulting in full incapacity, and 11,242 workers harmed themselves resulting in a short absence from work. The present value of the economic cost of suicide and NFSB is estimated at $6.73 billion. Our analysis suggests the economic benefit of implementing a universal workplace strategy would considerably outweigh the cost of the strategy. For every one dollar invested, the benefits would be in excess of $1.50 ($1.11–$3.07), representing a positive economic investment. All variations of the key parameter hold the positive benefit-cost ratio. Rates of suicide and NFSB are far too high in Australia and elsewhere. More needs to be done to reduce this burden. Although workplace strategies are appropriate for those employed, these interventions must be used within a multifaceted approach that reflects the complex nature of self-harming behavior.

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IJERPH, Vol. 14, Pages 346: Harmful Use of Alcohol: A Shadow over Sub-Saharan Africa in Need of Workable Solutions

Alcohol consumption and alcohol-attributable burden of disease in Africa are expected to rise in the near future, yet. increasing alcohol-related harm receives little attention from policymakers and from the population in general. Even where new legislation is proposed it is rarely enacted into law. Being at the center of social and cultural activities in many countries, alcohol’s negative role in society and contribution to countries’ burden of disease are rarely questioned. After the momentum created by the adoption in 2010 of the WHO Global Strategy and the WHO Regional Strategy (for Africa) to Reduce the Harmful Use of Alcohol, and the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases, in 2013, little seems to have been done to address the increasing use of alcohol, its associated burden and the new challenges that derive from the growing influence of the alcohol industry in Africa. In this review, we argue that to have a positive impact on the health of African populations, action addressing specific features of alcohol policy in the continent is needed, namely focusing on particularities linked to alcohol availability, like unrecorded and illicit production, outlet licensing, the expansion of formal production, marketing initiatives and taxation policies.

http://ift.tt/2nmzsKv

Κυριακή 26 Μαρτίου 2017

IJERPH, Vol. 14, Pages 345: Genomic Evidence for Bacterial Determinants Influencing Obesity Development

Obesity is a major global public health problem requiring multifaceted interventional approaches including dietary interventions with probiotic bacteria. High-throughput genome sequencing of microbial communities in the mammalian gastrointestinal system continues to present diverse protein function information to understand the bacterial determinants that influence obesity development. The goal of the research reported in this article was to identify biological processes in probiotic bacteria that could influence the mechanisms for the extraction of energy from diet in the human gastrointestinal system. Our research strategy of combining bioinformatics and visual analytics methods was based on the identification of operon gene arrangements in genomes of Lactobacillus species and Akkermansia muciniphila that include at least a gene for a universal stress protein. The two major findings from this research study are related to Lactobacillus plantarum and Akkermansia muciniphila bacteria species which are associated with weight-loss. The first finding is that Lactobacillus plantarum strains have a two-gene operon that encodes a universal stress protein for stress response and the membrane translocator protein (TSPO), known to function in mitochondrial fatty acid oxidation in humans. The second finding is the presence of a three-gene operon in Akkermansia muciniphila that includes a gene whose human mitochondrial homolog is associated with waist-hip ratio and fat distribution. From a public health perspective, elucidation of the bacterial determinants influencing obesity will help in educating the public on optimal probiotic use for anti-obesity effects.

http://ift.tt/2mD71Lq

Σάββατο 25 Μαρτίου 2017

Mesothelin promoter variants are associated with increased soluble mesothelin-related peptide levels in asbestos-exposed individuals

Background

Soluble mesothelin-related peptide (SMRP) is a promising diagnostic biomarker for malignant pleural mesothelioma (MPM), but various confounders hinder its usefulness in surveillance programmes. We previously showed that a single nucleotide polymorphism (SNP) within the 3’untranslated region (3’UTR) of the mesothelin (MSLN) gene could affect the levels of SMRP.

Objectives

To focus on SNPs located within MSLN promoter as possible critical genetic variables in determining SMRP levels.

Methods

The association between SMRP and SNPs was tested in 689 non-MPM subjects and 70 patients with MPM. Reporter plasmids carrying the four most common haplotypes were compared in a dual luciferase assay, and in silico analyses were performed to investigate the putative biological role of the SNPs.

Results

We found a strong association between serum SMRP and variant alleles of rs3764247, rs3764246 (in strong linkage disequilibrium with rs2235504) and rs2235503 in non-MPM subjects. Inclusion of the genotype information led to an increase in SMRP specificity from 79.9% to 85.5%. Although not statistically significant, the group with MPM showed the same trend of association. According to the in vitro luciferase study, rs3764247 itself had a functional role. In silico approaches showed that the binding sites for transcription factors such as Staf and ZNF143 could be affected by this SNP. The other SNPs were shown to interact with each other in a more complex way.

Conclusions

These data support the suggestion that SMRP performance is affected by individual (ie, genetic) variables and that MSLN expression is influenced by SNPs located within the promoter regulatory region.



http://ift.tt/2nUgBtx

Παρασκευή 24 Μαρτίου 2017

Risk factors for persistence of lower respiratory symptoms among community members exposed to the 2001 World Trade Center terrorist attacks

Objectives

We studied the course of lower respiratory symptoms (LRS; cough, wheeze or dyspnoea) among community members exposed to the 9/11/2001 World Trade Center (WTC) attacks during a period of 12–13 years following the attacks, and evaluated risk factors for LRS persistence, including peripheral airway dysfunction and post-traumatic stress disorder (PTSD).

Methods

Non-smoking adult participants in a case-control study of post-9/11-onset LRS (exam 1, 2008–2010) were recruited for follow-up (exam 2, 2013–2014). Peripheral airway function was assessed with impulse oscillometry measures of R5 and R5-20. Probable PTSD was a PTSD checklist score ≥44 on a 2006–2007 questionnaire.

Results

Of 785 exam 1 participants, 545 (69%) completed exam 2. Most (321, 59%) were asymptomatic at all assessments. Among 192 participants with initial LRS, symptoms resolved for 110 (57%) by exam 2, 55 (29%) had persistent LRS and 27 (14%) had other patterns. The proportion with normal spirometry increased from 65% at exam 1 to 85% at exam 2 in the persistent LRS group (p<0.01) and was stable among asymptomatic participants and those with resolved LRS. By exam 2, spirometry results did not differ across symptom groups; however, R5 and R5-20 abnormalities were more common among participants with persistent LRS (56% and 46%, respectively) than among participants with resolved LRS (30%, p<0.01; 27%, p=0.03) or asymptomatic participants (20%, p<0.001; 8.2%, p<0.001). PTSD, R5 at exam 1, and R5-20 at exam 1 were each independently associated with persistent LRS.

Conclusions

Peripheral airway dysfunction and PTSD may contribute to LRS persistence. Assessment of peripheral airway function detected pulmonary damage not evident on spirometry. Mental and physical healthcare for survivors of complex environmental disasters should be coordinated carefully.



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IJERPH, Vol. 14, Pages 344: Geographical Correlations between Indoor Radon Concentration and Risks of Lung Cancer, Non-Hodgkin’s Lymphoma, and Leukemia during 1999–2008 in Korea

Indoor radon is the second most important risk factor for lung cancer and may also be a risk factor for hematopoietic cancers, particularly in children and adolescents. The present study measured indoor radon concentration nationwide at 5553 points during 1989–2009 and spatially interpolated using lognormal kriging. The incidences of lung cancer, non-Hodgkin’s lymphoma (NHL), and leukemia, stratified by sex and five-year age groups in each of the 234 administrative regions in the country during 1999–2008, were obtained from the National Cancer Registry and used to calculate the standardized incidence ratios. After considering regional deprivation index values and smoking rates by sex in each region as confounding variables, the cancer risks were estimated based on Bayesian hierarchical modeling. We found that a 10 Bq/m3 increase in indoor radon concentration was associated with a 1% increase in the incidence of lung cancer in male and a 7% increase in NHL in female children and adolescents in Korea aged less than 20 years. Leukemia was not associated with indoor radon concentration. The increase in NHL risk among young women requires confirmation in future studies, and the radon control program should consider children and adolescents.

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IJERPH, Vol. 14, Pages 341: Study of the Accumulation of Toxic and Essential Ultra-Trace Elements in Fruits of Sorbus domestica L.

In the present work, the accumulation of selected toxic and essential ultra-trace elements in fruits of service tree (Sorbus domestica L.) were determined depending on harvest time. Samples were collected from the same sampling area in two different years and within one year in September and October (maturity state). Harvesting the fruits in the same area excludes the influence of metals taken up via roots, thus the impact of airborne contamination by heavy metal translocation can be studied. All samples were dried and digested using an acidic microwave assisted digestion system prior to quantification by inductively coupled plasma—sector field mass spectrometry (ICP–SFMS). The elements chosen were Arsenic and Cadmium as well as Lithium, Molybdenum, and Selenium. The Arsenic content rose with maturity in mesocarp. Cadmium found in the mesocarp was unaffected by ripeness. For Selenium and Molybdenum, no statistically significant effect of ripeness could be found on their content in mesocarp. Lithium could not be detected in the majority of fruit samples. Differences between the metal concentrations based on the year of harvest were found for Arsenic, Molybdenum, and Selenium, depending on precipitation. The drier the season, the more Arsenic was accumulated. For Molybdenum and Selenium, the opposite effect was observed.

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IJERPH, Vol. 14, Pages 340: Pesticide Knowledge and Safety Practices among Farm Workers in Kuwait: Results of a Survey

The unsafe and indiscriminate use of pesticides in agriculture represents a major hazard to the environment and human health. The aim of this study was to assess the levels of knowledge, attitude and practices of Kuwaiti farmers regarding the safe use of pesticides. A total of 250 farmers participated in this study through in-depth interviews and observations on-farm. The majority of the farmers acknowledged that pesticides were harmful to their health (71%) and the environment (65%). However, farmers’ level of knowledge of pesticide safety is insufficient. Over 70% of the farmers did not read or follow pesticide label instructions, and 58% did not use any personal protective equipment (PPE) when handling pesticides. Educated farmers were significantly more likely to use PPE compared with famers with limited formal education (χ2 = 9.89, p < 0.05). Storage of pesticides within living areas was reported by 20% of farmers. When disposing of pesticide wastes, respondents adopted unsafe practices such as discarding, incinerating, or burying empty pesticide containers on-farm, or reusing the containers. Farmers also reported disposing leftover pesticide solution or old pesticide stocks on-farm or in the sewer. A significant number (82%) of the farmers reported at least one symptom of acute pesticide poisoning. Although farmers’ knowledge of pesticide hazards was high, the reported safety measures were poor. Comprehensive intervention measures to reduce the health and environmental risks of pesticides are needed, including pesticide safety training programs for farmers, stringent enforcement of pesticide laws, and promoting integrated pest management and non-synthetic methods of pest control.

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IJERPH, Vol. 14, Pages 343: Unintentional Injuries and Violence among Adults in Northern Jordan: A Hospital-Based Retrospective Study

Injuries (unintentional and intentional) are the main cause of death and disability worldwide, including Jordan. The main purpose of this hospital-based retrospective study was to identify characteristics, causes, and risk factors of unintentional injuries and violence among all adult patients who approached the Accidents and Emergency department because of injury in Northern Jordan. Data were collected retrospectively from four major hospitals from January 2008 to January 2013. A total of 2425 Jordanian individuals who accessed and were treated by the four hospitals were included in this study. The findings show that the majority of patients who approached the Accidents and Emergency departments in the four hospitals were males (n = 2044, 87.16%) versus females (n = 301, 12.8%). Violence was the most common reason of injury (70.66%), followed by road traffic crashes (23.21%). The most common anatomical locations of reported injuries were the head (38.74%), followed by abdomen/pelvis and lower back, among males and females (9.93%). Violence had a high significant effect on the site of injuries. Patients who had been injured to the head because of a stab wound or fighting were substantially over-involved in head injuries, with injury rates 3.88 and 7.51 times higher than those who had been injured to the head due to gunshot, respectively. Even patients who had been injured to the head because of assault show much higher involvement in injury risk than non-assault patients (Odds Ratio = 8.46). These findings highlight the need for a large national study to confirm the findings. It also draws attention to the importance of public awareness and to special injury prevention programs that not only focus on saving lives and lessening the number of injuries, illnesses, and fatalities, but also to limit the social and economic burden of injury among adults in Northern Jordan.

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IJERPH, Vol. 14, Pages 342: Slum Upgrading and Health Equity

Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals (SDGs) focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits.

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Πέμπτη 23 Μαρτίου 2017

IJERPH, Vol. 14, Pages 338: Perceptions and Experiences with Flavored Non-Menthol Tobacco Products: A Systematic Review of Qualitative Studies

Although a few countries have banned flavored cigarettes (except menthol), flavors in most tobacco products remain unregulated across the globe. We conducted a systematic review of qualitative studies examining perceptions of and experiences with flavored non-menthol tobacco products. Of 20 studies on flavored tobacco products included in our qualitative systematic review, 10 examined hookah, six examined e-cigarettes, two examined little cigars and cigarillos (LCCs), and three examined other tobacco products, including cigarettes. The majority of studies, regardless of product type, reported positive perceptions of flavored tobacco products, particularly among young adults and adolescents. In six studies that assessed perceptions of harm (including hookah, LCCs, and other flavored tobacco products), participants believed flavored tobacco products to be less harmful than cigarettes. In studies that examined the role of flavors in experimentation and/or initiation (including three studies on e-cigarettes, one hookah study and one LCC study), participants mentioned flavors as specifically leading to their experimentation and/or initiation of flavored tobacco products. Given that many countries have not yet banned flavors in tobacco products, these findings add to existing research on why individuals use flavored tobacco products and how they perceive harm in flavored tobacco products, providing further support for banning non-menthol flavors in most tobacco products.

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Experimental and numerical study of temperature developments in PIR core sandwich panels with joint

Publication date: June 2017
Source:Fire Safety Journal, Volume 90
Author(s): Y.C. Wang, A. Foster
This paper presents the results of an experimental and numerical investigation of temperature developments in sandwich panels consisting of steel sheeting and polyisocyanurate (PIR) core. Fire experiments were carried out on individual PIR sandwich panels and PIR sandwich panels with joint. The fire test results were used to validate a temperature dependent thermal conductivity model for PIR, through numerical heat transfer modelling using the general finite element package ABAQUS. The fire test results indicate that the temperatures at the joint on the unexposed side of a sandwich panel is initially lower than that on the panel. However, at high temperatures, the ablation of PIR core creates large gaps up to 25mm. Due to high radiation within the gap, the joint temperature becomes much higher than the panel temperature. The results of a numerical parametric study indicate that if the joint gap can be controlled to be no greater than 5mm, the joint and the panel temperatures on the unexposed surface would be similar. Joint gaps of 10mm or greater would result in joint temperatures much higher than panel temperatures and would reduce the sandwich panel system insulation performance of less than 60min even though the panel may be able to reach much longer standard fire resistance rating.



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IJERPH, Vol. 14, Pages 339: Understanding the Psychosocial Correlates of the Intention to Use Condoms among Young Men in KwaZulu-Natal, South Africa

South Africa leads the world with the number of people infected with HIV. Even with all attempts that have been made to curb HIV, it is still evident that new infections are on the rise. Condom use remains one of the best tools against this challenge yet a small number of sexually active men use them. This study investigates the psychosocial correlates of the intention to use condoms among young men in KwaZulu-Natal province. Using the Theory of Planned Behaviour as a framework, hierarchical linear regression models were used to determine the unique contribution of the study measures in explaining the overall variance of intention to consistently use condoms. Subjective norms and perceived behavioural control towards consistent condom use explained 46% of the variance in the intention to use a condom, suggesting that health behaviour interventions should focus on targeting the normative beliefs as well as control beliefs of the target population. Furthermore, subjective norms and intentions towards reducing alcohol and marijuana use explained an additional 7% to the final model in intentions to condom use, implying that substance use and condom usage may influence each other. No significant contributions were found for beliefs underlying cultural aspects of responsible manhood.

http://ift.tt/2nUYD79

Τετάρτη 22 Μαρτίου 2017

IJERPH, Vol. 14, Pages 337: Occupational Respiratory Diseases of Miners from Two Gold Mines in Ghana

n/a

http://ift.tt/2mslCZX

IJERPH, Vol. 14, Pages 333: Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland

The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75–90-year-old adults living independently in Central Finland were interviewed (n = 839) and reassessed for self-reported physical activity one or two years later (n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score ≤9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was calculated from geographic information and categorized into tertiles. Accelerometer-based step counts were registered for one week (n = 174). Better walkability was associated with higher numbers of perceived environmental facilitators (p < 0.001) and higher physical activity (self-reported p = 0.021, step count p = 0.010). Especially among those with physical limitations, reporting more environmental facilitators was associated with higher odds for reporting at least moderate physical activity (p < 0.001), but not step counts. Perceived environmental facilitators only predicted self-reported physical activity at follow-up. To conclude, high walkability of the living environment provides opportunities for physical activity in old age, but among those with physical limitations especially, awareness of environmental facilitators may be needed to promote physical activity.

http://ift.tt/2nJr4rO

De Gruyter sponsors Directory of Open Access Books

Almost 900 titles available in De Gruyter Open Access Book Library



http://ift.tt/2nmMf1H

IJERPH, Vol. 14, Pages 334: Endocrine Disrupting Chemicals and Endometrial Cancer: An Overview of Recent Laboratory Evidence and Epidemiological Studies

Background: Although exposure to endocrine disruptor compounds (EDCs) has been suggested as a contributing factor to a range of women’s health disorders including infertility, polycystic ovaries and the early onset of puberty, considerable challenges remain in attributing cause and effect on gynaecological cancer. Until recently, there were relatively few epidemiological studies examining the relationship between EDCs and endometrial cancer, however, in the last years the number of these studies has increased. Methods: A systematic MEDLINE (PubMed) search was performed and relevant articles published in the last 23 years (from 1992 to 2016) were selected. Results: Human studies and animal experiments are confirming a carcinogenic effect due to the EDC exposure and its carcinogenesis process result to be complex, multifactorial and long standing, thus, it is extremely difficult to obtain the epidemiological proof of a carcinogenic effect of EDCs for the high number of confusing factors. Conclusions: The carcinogenic effects of endocrine disruptors are plausible, although additional studies are needed to clarify their mechanisms and responsible entities. Neverthless, to reduce endocrine disruptors (ED) exposure is mandatory to implement necessary measures to limit exposure, particularly during those periods of life most vulnerable to the impact of oncogenic environmental causes, such as embryonic period and puberty.

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IJERPH, Vol. 14, Pages 335: Reducing Risk of Salmonellosis through Egg Decontamination Processes

Eggs have a high nutritional value and are an important ingredient in many food products. Worldwide foodborne illnesses, such as salmonellosis linked to the consumption of eggs and raw egg products, are a major public health concern. This review focuses on previous studies that have investigated the procedures for the production of microbiologically safe eggs. Studies exploring pasteurization and decontamination methods were investigated. Gamma irradiation, freeze drying, hot air, hot water, infra-red, atmospheric steam, microwave heating and radiofrequency heating are all different decontamination methods currently considered for the production of microbiologically safe eggs. However, each decontamination procedure has different effects on the properties and constituents of the egg. The pasteurization processes are the most widely used and best understood; however, they influence the coagulation, foaming and emulsifying properties of the egg. Future studies are needed to explore combinations of different decontamination methods to produce safe eggs without impacting the protein structure and usability. Currently, eggs which have undergone decontamination processes are primarily used in food prepared for vulnerable populations. However, the development of a decontamination method that does not affect egg properties and functionality could be used in food prepared for the general population to provide greater public health protection.

http://ift.tt/2mTYL5y

IJERPH, Vol. 14, Pages 336: Impacts from Land Use Pattern on Spatial Distribution of Cultivated Soil Heavy Metal Pollution in Typical Rural-Urban Fringe of Northeast China

Under rapid urban sprawl in Northeast China, land conversions are not only encroaching on the quantity of cultivated lands, but also posing a great threat to black soil conservation and food security. This study’s aim is to explore the spatial relationship between comprehensive cultivated soil heavy metal pollution and peri-urban land use patterns in the black soil region. We applied spatial lag regression to analyze the relationship between PLI (pollution load index) and influencing factors of land use by taking suburban cultivated land of Changchun Kuancheng District as an empirical case. The results indicate the following: (1) Similar spatial distribution characteristics are detected between Pb, Cu, and Zn, between Cr and Ni, and between Hg and Cd. The Yitong River catchment in the central region, and the residential community of Lanjia County in the west, are the main hotspots for eight heavy metals and PLI. Beihu Wetland Park, with a larger-area distribution of ecological land in the southeast, has low level for both heavy metal concentrations and PLI values. Spatial distribution characteristics of cultivated heavy metals are related to types of surrounding land use and industry; (2) Spatial lag regression has a better fit for PLI than the ordinary least squares regression. The regression results indicate the inverse relationship between heavy metal pollution degree and distance from long-standing residential land and surface water. Following rapid urban land expansion and a longer accumulation period, residential land sprawl is going to threaten cultivated land with heavy metal pollution in the suburban black soil region, and cultivated land irrigated with urban river water in the suburbs will have a higher tendency for heavy metal pollution.

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IJERPH, Vol. 14, Pages 332: A Pilot Study to Examine Exposure to Residential Radon in Under-Sampled Census Tracts of DeKalb County, Georgia, in 2015

While DeKalb County, Georgia, offers free radon screening for all eligible residents, portions of the county remain relatively under-sampled. This pilot study focused on 10% of the census tracts in the county with the lowest proportion of radon testing; most were in southern DeKalb County. In total, 217 households were recruited and homes were tested for indoor radon concentrations on the lowest livable floor over an eight-week period from March–May 2015. Tract-level characteristics were examined to understand the differences in socio-demographic and economic factors between the pilot study area and the rest of the county. The pilot study tracts had a higher proportion of African Americans compared to the rest of DeKalb County (82% versus 47%). Radon was detected above 11.1 Bq/m3 (0.3 pCi/L) in 73% of the indoor samples and 4% of samples were above 148 Bq/m3 (4 pCi/L). Having a basement was the strongest predictive factor for detectable and hazardous levels of radon. Radon screening can identify problems and spur homeowners to remediate but more research should be done to identify why screening rates vary across the county and how that varies with radon levels in homes to reduce radon exposure.

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IJERPH, Vol. 14, Pages 328: Prevalence of Malocclusion in 3- to 5-Year-Old Children in Shanghai, China

The aim of the present study was to obtain the prevalence of malocclusions in preschool children in Shanghai, China. A cross-sectional survey was conducted among 2335 children aged 3–5 years from kindergartens. Several occlusal parameters were clinically assessed, including second deciduous molar terminal plane, canine relationship, degree of overjet and overbite, anterior and posterior crossbite, and the presence or absence of physiologic spaces and crowding. All parents of subjects were asked to fill in the oral health knowledge questionnaires. The prevalence of malocclusion in primary dentition in Shanghai was 83.9%, and no significant differences were found in genders. Data showed that the prevalence of deep overbite (63.7%) was the highest in children with malocclusion, followed by deep overjet (33.9%), midline deviation (26.6%), anterior crossbite (8.0%) and anterior crowding (6.5%). The results revealed a high prevalence of malocclusion in primary dentition in children aged 3–5 years old of Shanghai, especially in vertical anomalies. The need for preventive orthodontic therapy is extremely desired and oral health education about malocclusion should be strengthened.

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IJERPH, Vol. 14, Pages 331: Adverse Childhood Experiences, Commitment Offense, and Race/Ethnicity: Are the Effects Crime-, Race-, and Ethnicity-Specific?

Adverse childhood experiences are associated with an array of health, psychiatric, and behavioral problems including antisocial behavior. Criminologists have recently utilized adverse childhood experiences as an organizing research framework and shown that adverse childhood experiences are associated with delinquency, violence, and more chronic/severe criminal careers. However, much less is known about adverse childhood experiences vis-à-vis specific forms of crime and whether the effects vary across race and ethnicity. Using a sample of 2520 male confined juvenile delinquents, the current study used epidemiological tables of odds (both unadjusted and adjusted for onset, total adjudications, and total out of home placements) to evaluate the significance of the number of adverse childhood experiences on commitment for homicide, sexual assault, and serious persons/property offending. The effects of adverse childhood experiences vary considerably across racial and ethnic groups and across offense types. Adverse childhood experiences are strongly and positively associated with sexual offending, but negatively associated with homicide and serious person/property offending. Differential effects of adverse childhood experiences were also seen among African Americans, Hispanics, and whites. Suggestions for future research to clarify the mechanisms by which adverse childhood experiences manifest in specific forms of criminal behavior are offered.

http://ift.tt/2nArFM1

IJERPH, Vol. 14, Pages 330: Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place.

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IJERPH, Vol. 14, Pages 329: Efficacy and Safety Evaluation of a Chlorine Dioxide Solution

In this study, a chlorine dioxide solution (UC-1) composed of chlorine dioxide was produced using an electrolytic method and subsequently purified using a membrane. UC-1 was determined to contain 2000 ppm of gaseous chlorine dioxide in water. The efficacy and safety of UC-1 were evaluated. The antimicrobial activity was more than 98.2% reduction when UC-1 concentrations were 5 and 20 ppm for bacteria and fungi, respectively. The half maximal inhibitory concentrations (IC50) of H1N1, influenza virus B/TW/71718/04, and EV71 were 84.65 ± 0.64, 95.91 ± 11.61, and 46.39 ± 1.97 ppm, respectively. A 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test revealed that the cell viability of mouse lung fibroblast L929 cells was 93.7% at a 200 ppm UC-1 concentration that is over that anticipated in routine use. Moreover, 50 ppm UC-1 showed no significant symptoms in a rabbit ocular irritation test. In an inhalation toxicity test, treatment with 20 ppm UC-1 for 24 h showed no abnormality and no mortality in clinical symptoms and normal functioning of the lung and other organs. A ClO2 concentration of up to 40 ppm in drinking water did not show any toxicity in a subchronic oral toxicity test. Herein, UC-1 showed favorable disinfection activity and a higher safety profile tendency than in previous reports.

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Τρίτη 21 Μαρτίου 2017

IJERPH, Vol. 14, Pages 327: Is Accessibility to Dental Care Facilities in Rural Areas Associated with Number of Teeth in Elderly Residents?

Given that public transportation networks are less developed in rural than in urban areas, a lack of accessibility to dental care facilities could be a barrier to routine dental checkups. Thus, we hypothesized that the distance to the dental care facilities is a risk factor for tooth loss. The aim of this study was to test whether there is an association between the distance to dental care facilities, estimated by geographic information systems, and number of teeth, assessed by an oral examination, among elderly residents of a rural area in Japan. Data were collected in 2016 from a cross-sectional study conducted in Shimane prefecture, Japan. After excluding participants with missing data (n = 21), we analyzed data from 710 participants. Of them, 40.6% were male and the mean (standard deviation) age was 67.4 (7.4) years. Further, 68.0% (n = 483) had at least 20 teeth. We found that the distance to dental care facilities was significantly associated with the number of teeth (less than 20) (odds ratio = 1.07, 95% confidence interval = 1.01–1.12) after adjustment for potential confounders. This result suggested that individuals without easy access to dental care facilities may be important targets for dental care.

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IJERPH, Vol. 14, Pages 325: The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry

International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization. The level of development of AFTH was estimated by the share of human resources allocated to those alternatives in the hospital enrolling the staff of each sector. Multi-level modelling was carried out to adjust the analysis on other factors potentially associated with the LOS (patients’, psychiatric sectors’ and environmental characteristics). We observed considerable variations in the LOS between sectors. Although the majority of these variations resulted from patients’ characteristics, a significant negative association was found between the LOS and the development of AFTH, after adjusting for other factors. Our results provide first evidence of the impact of the development of AFTH on mental health care and will provide a lever for policy makers to further develop these alternatives.

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IJERPH, Vol. 14, Pages 324: Public Preferences for the Use of Taxation and Labelling Policy Measures to Combat Obesity in Young Children in Australia

Objective: Childhood obesity is a serious concern for developed and developing countries. This study aimed to assess the level of support in Australia for regulation and to assess whether systematic differences occur between individuals who support increased regulation and individuals who oppose it. Methods: An online survey (n = 563) was used to assess parental/caregiver preferences for taxation policy options and nutrition labelling designed to address the incidence of childhood obesity. Participants were parents or caregivers of young children (3 to 7 years) who were actively enrolled in an existing birth cohort study in South-East Queensland, Australia. Results: The majority of the parents (over 80%) strongly agreed or agreed with labelling food and drink with traffic light or teaspoon labelling. Support for taxation was more variable with around one third strongly supporting and a further 40% of participants equivocal about using taxation; however, a quarter strongly rejected this policy. Cluster analysis did not detect any socio-demographic differences between those who strongly supported taxation and those who did not. Conclusions: Better food labelling would be welcomed by parents to enhance food choices for their children. Taxation for health reasons would not be opposed by most parents. Implications for Public Health: Governments should consider taxation of unhealthy drinks and improved labelling to encourage healthy food purchasing.

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IJERPH, Vol. 14, Pages 323: An Eco-Safety Assessment of Glyoxal-Containing Cellulose Ether on Freeze-Dried Microbial Strain, Cyanobacteria, Daphnia, and Zebrafish

The objective of this study was to investigate the aquatic-toxic effects of glyoxal-containing cellulose ether with four different glyoxal concentrations (0%, 1.4%, 2.3%, and 6.3%) in response to global chemical regulations, e.g., European Union Classification, Labeling and Packaging (EU CLP). Toxicity tests of glyoxal-containing cellulose ether on 11 different microbial strains, Microcystis aeruginosa, Daphnia magna, and zebrafish embryos were designed as an initial stage of toxicity screening and performed in accordance with standardized toxicity test guidelines. Glyoxal-containing cellulose ether showed no significant toxic effects in the toxicity tests of the 11 freeze-dried microbial strains, Daphnia magna, and zebrafish embryos. Alternatively, 6.3% glyoxal-containing cellulose ether led to a more than 60% reduction in Microcystis aeruginosa growth after 7 days of exposure. Approximately 10% of the developmental abnormalities (e.g., bent spine) in zebrafish embryos were also observed in the group exposed to 6.3% glyoxal-containing cellulose ether after 6 days of exposure. These results show that 6.3% less glyoxal-containing cellulose ether has no acute toxic effects on aquatic organisms. However, 6.3% less glyoxal-containing cellulose ether may affect the health of aquatic organisms with long-term exposure. In order to better evaluate the eco-safety of cellulosic products containing glyoxal, further studies regarding the toxic effects of glyoxal-containing cellulose ether with long-term exposure are required. The results from this study allow us to evaluate the aquatic-toxic effects of glyoxal-containing cellulosic products, under EU chemical regulations, on the health of aquatic organisms.

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Occupational and recreational physical activity and Parkinson’s disease in Denmark

Objectives This study aimed to examine whether occupational and physical activity (PA) at different ages contribute to Parkinson’s disease (PD) risk in a large population-based case-control study in Denmark. Methods We identified 1828 PD patients from the Danish National Hospital Register and recruited 1909 gender and year of birth matched controls from the Danish Central Population Register. Occupational and leisure-time PA were determined from a job exposure matrix based on occupational history and self-reported leisure-time information. Results No association was found for occupational PA alone in men, but higher leisure-time PA (≥5 hours/week of strenuous activities) in young adulthood (15–25 years) was associated with a lower PD risk (adjusted odds ratio (ORadj) 0.75, 95% confidence interval (95% CI) 0.62–0.90); men who engaged in high occupational and high leisure-time PA in young adulthood had the lowest PD risk (ORadj 0.58, 95% CI 0.41–0.81). Among women, inverse associations were found for occupation PA before age 50 (highest vs lowest, ORadj 0.75, 95% CI 0.55–1.06) and strenuous leisure-time PA after age 50 (ORadj 0.65, 95% CI 0.87–0.99); no clear pattern was seen for leisure and occupational PA combined. Conclusions We observed gender-specific inverse associations between occupational and leisure-time PA and PD risk; however, we cannot preclude reverse causation especially in older ages since PD has a long prodromal stage that might lead to a reduction of PA years before motor symptom onset and PD diagnosis. by Shih I-F, Starhof C, Lassen CF, Hansen J, Liew Z, Ritz B. doi:10.5271/sjweh.3632

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