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Xu Y, Chen J, Du J, Jin Y. Knowledge, attitudes, and practices among the general community population toward heatstroke. Front Public Health 2024; 12:1373025. [PMID: 38855448 PMCID: PMC11157029 DOI: 10.3389/fpubh.2024.1373025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Background and objective Heatstroke (HS) is a life-threatening condition resulting from thermal injury within the body, and it is associated with a significantly high mortality rate. This study aimed to assess the knowledge, attitudes and practices (KAP) among the general community population toward heatstroke. Methods The web-based cross-sectional study was conducted between September 2023 and October 2023 at the Emergency Department of Dongyang People's Hospital. A self-designed questionnaire was developed to collect demographic information of the general community population and to assess their knowledge, attitudes and practices toward heatstroke. Results A total of 1,356 valid questionnaires were collected. Among the participants, 875 (64.53%) were female, and 496 (36.58%) had regular exercise. The mean knowledge, attitudes and practices scores were 12.73 ± 1.42 (possible range: 0-14), 33.74 ± 2.91 (possible range: 8-40) and 34.65 ± 5.30 (possible range: 8-40), respectively. The structural equation model demonstrated that education had direct effects on knowledge (β = 0.017, p < 0.001), attitudes (β = 0.123, p < 0.001), and practices (β = -0.094, p < 0.001). Moreover, knowledge had direct effects on attitudes (β = 1.920, p < 0.001), and attitudes had direct effects on practices (β = 0.642, p < 0.001). Conclusion The findings revealed that the general community population have sufficient knowledge, active attitudes and proactive practices toward the heatstroke. However, there is still room for improvement and it is necessary to develop and implement educational initiatives and interventions designed to further enhance their KAP toward heatstroke.
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Affiliation(s)
- Yangfeng Xu
- Department of Emergency, Dongyang People's Hospital, Dongyang, China
| | - Jianping Chen
- Department of Emergency, Dongyang People's Hospital, Dongyang, China
| | - Jinkang Du
- Intensive Care Unit, Dongyang People's Hospital, Dongyang, China
| | - YunYing Jin
- Intensive Care Unit, Dongyang People's Hospital, Dongyang, China
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Murray KO, Brant JO, Spradlin RA, Thome T, Laitano O, Ryan TE, Riva A, Kladde MP, Clanton TL. Exertional heat stroke causes long-term skeletal muscle epigenetic reprogramming, altered gene expression, and impaired satellite cell function in mice. Am J Physiol Regul Integr Comp Physiol 2024; 326:R160-R175. [PMID: 38047316 PMCID: PMC11283893 DOI: 10.1152/ajpregu.00226.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/26/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023]
Abstract
The effect of exertional heat stroke (EHS) exposure on skeletal muscles is incompletely understood. Muscle weakness is an early symptom of EHS but is not considered a major target of multiorgan injury. Previously, in a preclinical mouse model of EHS, we observed the vulnerability of limb muscles to a second EHS exposure, suggesting hidden processes contributing to declines in muscle resilience. Here, we evaluated the possible molecular origins of EHS-induced declines in muscle resilience. Female C57BL/6 mice [total n = 56; 28/condition, i.e., EHS and exercise control (EXC)] underwent forced wheel running at 37.5°C/40% relative humidity until symptom limitation (unconsciousness). EXC mice exercised identically at room temperature (22-23°C). After 1 mo of recovery, the following were assessed: 1) specific force and caffeine-induced contracture in soleus (SOL) and extensor digitorum longus (EDL) muscles; 2) transcriptome and DNA methylome responses in gastrocnemius (GAST); and 3) primary satellite cell function (proliferation and differentiation). There were no differences in specific force in either SOL or EDL from EXC. Only EHS solei exhibited lower caffeine sensitivity. EHS GAST exhibited higher RNA expression of genes encoding structural proteins of slow fibers, heat shock proteins, and myogenesis. A total of ∼2,500 differentially methylated regions of DNA that could potentially affect many cell functions were identified. Primary satellite cells exhibited suppressed proliferation rates but normal differentiation responses. Results demonstrate long-term changes in skeletal muscles 1 mo after EHS that could contribute to declines in muscle resilience. Skeletal muscle may join other, more recognized tissues considered vulnerable to long-term effects of EHS.NEW & NOTEWORTHY Exertional heat stroke (EHS) in mice induces long-term molecular and functional changes in limb muscle that could reflect a loss of "resilience" to further stress. The phenotype was characterized by altered caffeine sensitivity and suppressed satellite cell proliferative potential. This was accompanied by changes in gene expression and DNA methylation consistent with ongoing muscle remodeling and stress adaptation. We propose that EHS may induce a prolonged vulnerability of skeletal muscle to further stress or injury.
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Affiliation(s)
- Kevin O Murray
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, United States
| | - Jason O Brant
- Department of Biostatistics, University of Florida, Gainesville, Florida, United States
- University of Florida Health Cancer Center, University of Florida, Gainesville, Florida, United States
| | - Ray A Spradlin
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, United States
| | - Trace Thome
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, United States
| | - Orlando Laitano
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, United States
| | - Terence E Ryan
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, United States
| | - Alberto Riva
- University of Florida Health Cancer Center, University of Florida, Gainesville, Florida, United States
- Interdisciplinary Center for Biotechnology Research, University of Florida, Gainesville, Florida, United States
| | - Michael P Kladde
- Department of Biochemistry and Molecular Biology, College of Medicine, University of Florida, Gainesville, Florida, United States
- University of Florida Health Cancer Center, University of Florida, Gainesville, Florida, United States
| | - Thomas L Clanton
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, United States
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Yezli S, Yassin Y, Ghallab S, Abdullah M, Abuyassin B, Vishwakarma R, Bouchama A. Diagnosing and managing heat exhaustion: insights from a systematic review of cases in the desert climate of Mecca. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2023-0059. [PMID: 37535673 DOI: 10.1515/reveh-2023-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/14/2023] [Indexed: 08/05/2023]
Abstract
Heat exhaustion (HE) is a common, yet obscure, heat-related illness that affects millions of people yearly and its burden is projected to rise due to climate change. A comprehensive literature synthesis is lacking despite previous studies on various HE aspects. This systematic review aims to fill this gap by identifying and synthesizing available evidence on the risk factors, symptoms, biomarkers, treatment options, and outcomes for HE. The review focused on HE during the Muslim (Hajj) pilgrimage where the condition is endemic. We conducted a structured search of MEDLINE/PubMed, Embase, Web of Science Core Collection, SCOPUS, and CINAHL databases. We summarized the data from eligible studies and synthesized them in narrative form using pooled descriptive statistics. Ten studies were included between 1980 and 2019, reporting over 1,194 HE cases. HE cases presented with elevated core temperature (up to 40°C) and mainly affected older males from the Middle East and North Africa region, with overweight individuals at a higher risk. Clinical symptoms included hyperventilation, fatigue, dizziness, headaches, nausea, and vomiting, but not central nervous system disturbances. HE was associated with cardiac stress, and with water, electrolyte, and acid-base alterations. Cooling and hydration therapy were the primary management strategies, leading to a low mortality rate (pooled case fatality rate=0.11 % [95 % CI: 0.01, 0.3]). Most cases recovered within a few hours without complications. HE is associated with cardiac stress and changes in homeostasis, leading to distinct clinical symptoms. Early diagnosis and treatment of HE are crucial in reducing the risk of complications and mortality. The review provides insights into the pathophysiology and outcomes of HE, adding to the scarce literature on the subject. Prospero registration number: CRD42022325759.
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Affiliation(s)
- Saber Yezli
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia
| | - Yara Yassin
- Federation of Saudi Chambers Institute, Federation of Saudi Chambers, Riyadh, Saudi Arabia
| | - Sujoud Ghallab
- Saudi Field Epidemiology Training Program, Assistant Agency of Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Mashan Abdullah
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia
| | - Bisher Abuyassin
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia
| | - Ramesh Vishwakarma
- Norwich Clinical Trial Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Riyadh, Saudi Arabia
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Almuzaini Y, Alburayh M, Alahmari A, Alamri F, Sabbagh AY, Alsalamah M, Khan A. Mitigation strategies for heat-related illness during mass gatherings: Hajj experience. Front Public Health 2022; 10:957576. [PMID: 36062122 PMCID: PMC9433897 DOI: 10.3389/fpubh.2022.957576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/29/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction To mitigate morbidity, mortality, and impacts of heat-related illnesses (HRIs) on health, it was vital to implement a comprehensive framework for HRI prevention and control. A recognized tool from the field of trauma prevention known as the Haddon matrix was applied. The matrix states that any event is affected by three factors: host, agent, and environment. In addition, another recognized tool known as the combined model was used in this study. The combined model is a three-dimensional model that includes the idea for the three axes of Haddon's matrix with the methodology of the community risk reduction (CRR) model. Aim of the study To identify the environmental and individual risk factors of HRIs based on the Haddon matrix and the recommended prevention strategies by the CRR tool by using the combined model. Methodology An extensive literature review was conducted to assess all the risk factors associated with HRI, as well as preventive measures. Then the Haddon matrix was used to structure, separating human factors from technical and environmental details and timing. After that, the combined model was used to set all responses and mitigation measures for each element obtained from the Haddon matrix tool. Conclusion Projected increases in heat stress over the globe require the formulation and implementation of evidence-based HRI mitigation and preventive measures. In this study, we implemented the combined model that was utilized as a systematic strategy for the more theoretical framework of Haddon's matrix. Using the Haddon matrix to determine the HRI risk factors and the combined model to mitigate its impact was practical and helpful in planning, preparedness, and mitigating the HRIs during Hajj, provided a broad approach equivalent to the Swiss cheese model, and would facilitate an informed decision.
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Affiliation(s)
- Yasir Almuzaini
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Marriyah Alburayh
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Ahmed Alahmari
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Fahad Alamri
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Majid Alsalamah
- Department of Emergency Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Anas Khan
- Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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