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Hao T, Wang X, Han S, Yao Q, Ding J. Investigating the impact of weather on stroke in summer. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02724-3. [PMID: 38913080 DOI: 10.1007/s00484-024-02724-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/15/2024] [Accepted: 06/10/2024] [Indexed: 06/25/2024]
Abstract
The objective of this study is to explore how changes in weather contribute to an increase in hospital admissions for stroke in summer. We collected 96,509 cases of stroke hospitalization data in Tianjin from 2016 to 2022 summer, along with corresponding meteorological data. The generalized additive model and distributed lag nonlinear model were used to analyze the lag and cumulative effects of temperature on stroke hospitalization. The research results show both the cold effect and the heat effect in summer would increase the risk of hospitalization. The effect of daily maximum temperature on stroke hospitalization was immediate when the temperature was higher, and delayed when the temperature was lower. However, the risk of stroke hospitalization increased more significantly with increasing temperature than with decreasing temperature. In the presence of one or more of the following three weather changes: sharp temperature increase, sharp temperature decrease, continuous high temperature, the daily number of stroke inpatients were higher than the average in the same period. 83% of the Inpatient-heavy events within the study period were caused by a combination of dramatic temperature changes and continuous high temperatures. In 48% of Inpatient-heavy events, continuous high temperature weather above 30℃ for at least 4 consecutive days were observed. And 55% of high temperature weather was accompanied by high humidity. When the daily relative humidity was greater than 70% and the daily maximum temperature was between 26 and 28℃ or more than 34℃, or the daily maximum temperature changes over 10℃ within 48 h, the number of daily inpatients was more than 1.2 times of the average daily inpatients. More attention should be paid to the combined effects of continuous high temperature and sudden temperature changes in summer stroke prevention.
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Affiliation(s)
- Tianyi Hao
- Tianjin Environmental Meteorological Center, Tianjin, 300074, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin, 300074, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, 300074, China
| | - Xiaojia Wang
- Tianjin Environmental Meteorological Center, Tianjin, 300074, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin, 300074, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, 300074, China
| | - Suqin Han
- Tianjin Environmental Meteorological Center, Tianjin, 300074, China.
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin, 300074, China.
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, 300074, China.
| | - Qing Yao
- Tianjin Environmental Meteorological Center, Tianjin, 300074, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin, 300074, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, 300074, China
| | - Jing Ding
- Tianjin Environmental Meteorological Center, Tianjin, 300074, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin, 300074, China
- Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, 300074, China
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Whyte M, Douwes J, Ranta A. Green space and stroke: A scoping review of the evidence. J Neurol Sci 2024; 457:122870. [PMID: 38219382 DOI: 10.1016/j.jns.2024.122870] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/18/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Global industrialisation and urbanisation has led to an increased interest in the link between the environment and health. Stroke is a major cause of morbidity and mortality, and there is increased evidence that environmental factors may affect both the incidence and severity of stroke. This review summarises the evidence for relationship between green space exposure and stroke incidence and outcomes. METHODS We conducted a literature search in Medline and Scopus until 1 August 2023, and screened references of relevant articles. Selected articles were appraised for their relevance, and critically reviewed. The findings were thematically categorised. RESULTS Of the 1342 papers identified, 27 were included. These involved a mix of study designs (cohort, cross-sectional, quasi-experimental, time stratified case crossover and ecological). There was consistent evidence indicating a protective association between green space exposure and disability and stroke-related death with mortality hazard ratios between 0.66 and 0.95. Most studies also showed that green space was inversely associated with stroke risk, with risk estimates from studies showing a protective effect ranging between 0.4 and 0.98; however, results were more mixed and some did not reach statistical significance. The moderating effects of green spaces on ambient temperatures, noise and air pollution, and psychosocial health plus greater enjoyment and opportunity for exercise and enrichment of the human microbiome may underly these associations. CONCLUSION There is likely some protective effect of green space on stroke, with the benefits most convincingly shown for post-stroke outcomes. More research is recommended to confirm the protective association between green space exposure and reduced stroke risk.
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Affiliation(s)
- Mina Whyte
- Department of Medicine, University of Otago Wellington, PO Box 7343, Wellington 6242, New Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Annemarei Ranta
- Department of Medicine, University of Otago Wellington, PO Box 7343, Wellington 6242, New Zealand.
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Sherratt S. Hearing Loss and Disorders: The Repercussions of Climate Change. Am J Audiol 2023; 32:793-811. [PMID: 37812783 DOI: 10.1044/2023_aja-23-00136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023] Open
Abstract
PURPOSE Climate change is considered to be the greatest threat to human health in the 21st century, and its effects are accelerating. Extensive research has clearly demonstrated its increasing impact across the continuum of health conditions. Despite this, there has been limited attention to the ramifications of climate change on hearing loss and hearing disorders. This lack of consideration is somewhat surprising as the environment itself and its changing nature have a substantial effect on hearing. METHOD Tackling climate change could be the greatest global health opportunity of the 21st century. To address this issue, this tutorial provides a general introduction to climate change and its three major elements (pollution, infectious diseases, and extreme weather events) and their effects on health. The substantial consequences of climate change for the incidence, development, and exacerbation of hearing loss and disorders are clearly described and detailed. CONCLUSIONS The challenge of responding to this very real and escalating threat to hearing requires a combination of prevention, advocacy, and education. These three roles place audiologists in the perfect position to take action on the far-reaching effects of climate change on hearing loss and disorders. To respond to this challenge and to fulfill these roles, several strategies, ranging from the individual level to the global level, are delineated for audiologists to incorporate into their practice.
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Affiliation(s)
- Sue Sherratt
- Communication Research Australia, Newcastle, New South Wales
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Folyovich A, Mátis R, Biczó D, Pálosi M, Béres-Molnár AK, Al-Muhanna N, Jarecsny T, Dudás E, Jánoska D, Toldi G, Páldy A. High average daily temperature in summer and the incidence of thrombolytic treatment for acute ischemic stroke. L'ENCEPHALE 2023:S0013-7006(23)00202-6. [PMID: 38040506 DOI: 10.1016/j.encep.2023.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Meteorological factors can increase stroke risk; however, their impact is not precisely understood. Heat waves during summer increase total mortality. Therefore, we hypothesized that the average daily temperature in summer may correlate with the incidence of thrombolytic treatment for acute ischemic stroke in Budapest and Pest County, Hungary. METHODS We analyzed the relationship between the average daily temperature in summer months and the daily number of thrombolytic treatments (TT) performed with the indication of acute ischemic stroke between 1st June and 31st August each year from 2007 to 2016. The analysis was also performed after the omission of the data of the last day of the months due to possible psychosocial impact reported in our previous study. Spearman's correlation was used for statistical analysis. RESULTS No significant correlation was found between the average summer daily temperature and the number of TT in the entire sample of the 10-year period. When omitting the data of the last day of each month, positive correlations were suspected in 2014 (r=0.225, P=0.034) and 2015 (r=0.276, P=0.009). CONCLUSION Our findings did not confirm an association between the average daily temperature in summer and the daily number of TT throughout the examined 10-year period. However, importantly, in 2014 and 2015, the years with the highest average daily temperatures in this period, a positive correlation was found. The level of correlation is modest, indicating that risk factors, both meteorological and non-meteorological, other than the average temperature, play equally important roles in determining the incidence of thrombolytic treatment for acute ischemic stroke on the population level.
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Affiliation(s)
- András Folyovich
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Réka Mátis
- Faculty of Public Governance and International Studies, University of Public Service, Budapest, Hungary
| | | | - Mihály Pálosi
- National Institute of Health Insurance Fund Management, Budapest, Hungary
| | | | - Nadim Al-Muhanna
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Tamás Jarecsny
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Eszter Dudás
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Dorottya Jánoska
- Department of Neurology and Stroke, Szent János Hospital, Budapest, Hungary
| | - Gergely Toldi
- Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Anna Páldy
- National Public Health Center, Budapest, Hungary
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Wang G, Lin G, Yang FF, Wang Z. Effect of abnormal values of three temperature indicators on ischemic stroke hospital admissions in Guangzhou, China. J Therm Biol 2023; 116:103649. [PMID: 37478582 DOI: 10.1016/j.jtherbio.2023.103649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/21/2023] [Accepted: 06/29/2023] [Indexed: 07/23/2023]
Abstract
Abnormal temperature has important effects on the occurrence of ischemic stroke (IS). However, relatively less efforts have been taken to systematically unravel the association between various abnormal temperature and IS hospital admission. Focusing on three temperature indicators (i.e., mean temperature, maximum temperature, and minimum temperature), this study attempts to analyse how their abnormal values affect IS hospital admission. The dataset covers the period between September 17, 2012 and August 28, 2018, and includes a total of 1464 cases who were admitted to the hospital for the first onset of IS and lived in the main urban area of Guangzhou. The study adopts the time-stratified case-crossover analysis. Abnormal values of temperature were measured using the 2.5th and 97.5th quantile values of each temperature indicator, with the former refers to a low value whereas the latter a high one. The effects of abnormal temperature on IS hospital admission were assessed through calculating the relative risks induced by the low and high values (the median values of each temperature indicators were taken as the references). The results show that the risk window periods for IS hospital admission associated with the low values of the temperature indicators are the lags of 3-7 days and 18-19 days. The risks of high temperature values on IS admission, however, are insignificant with either one-day lag or cumulative lag. As to different population groups, females show higher risks of IS hospital admission at low temperature values than males; and elderly people, compared with young people, are more vulnerable to low temperature values. To cities with similar climate of Guangzhou, particular attention should be paid to the impact of low temperature values, especially the low value of minimum temperature, on IS admission, and to females and elderly people who are more sensitive to abnormal temperatures.
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Affiliation(s)
- Guobin Wang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, 510006, China
| | - Geng Lin
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, 510006, China; Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai, 519000, China
| | - Fiona Fan Yang
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, 510006, China.
| | - Zhuoqing Wang
- Department of Scientific Research & Discipline Development, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
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Koo GPY, Zheng H, Aik JCL, Tan BYQ, Sharma VK, Sia CH, Ong MEH, Ho AFW. Clustering of Environmental Parameters and the Risk of Acute Ischaemic Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4979. [PMID: 36981888 PMCID: PMC10049712 DOI: 10.3390/ijerph20064979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Acute ischaemic stroke (AIS) risk on days with similar environmental profiles remains unknown. We investigated the association between clusters of days with similar environmental parameters and AIS incidence in Singapore. We grouped calendar days from 2010 to 2015 with similar rainfall, temperature, wind speed, and Pollutant Standards Index (PSI) using k-means clustering. Three distinct clusters were formed 'Cluster 1' containing high wind speed, 'Cluster 2' having high rainfall, and 'Cluster 3' having high temperatures and PSI. We aggregated the number of AIS episodes over the same period with the clusters and analysed their association using a conditional Poisson regression in a time-stratified case-crossover design. Comparing the three clusters, Cluster 3 had the highest AIS occurrence (IRR 1.09; 95% confidence interval (CI) 1.05-1.13), with no significant difference between Clusters 1 and 2. Subgroup analyses in Cluster 3 showed that AIS risk was amplified in the elderly (≥65 years old), non-smokers, and those without a history of ischaemic heart disease/atrial fibrillation/vascular heart disease/peripheral vascular disease. In conclusion, we found that AIS incidence may be higher on days with higher temperatures and PSI. These findings have important public health implications for AIS prevention and health services delivery during at-risk days, such as during the seasonal transboundary haze.
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Affiliation(s)
| | - Huili Zheng
- National Registry of Diseases Officer, Health Promotion Board, Singapore 168937, Singapore
| | - Joel C. L. Aik
- Environmental Epidemiology and Toxicology Division, Environmental Health Institute, National Environment Agency, Singapore 228231, Singapore
- Pre-Hospital & Emergency Research Center, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Benjamin Y. Q. Tan
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Vijay K. Sharma
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Ching Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore
| | - Marcus E. H. Ong
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Andrew F. W. Ho
- Pre-Hospital & Emergency Research Center, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Centre of Population Health Research and Implementation, SingHealth Regional Health System, Singapore 168753, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
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Peng K, Yan W, Cao Y, Cai W, Liu F, Lin K, Xie Y, Li Y, Lei L, Bao J. Impacts of birthplace and complications on the association between cold exposure and acute myocardial infarction morbidity in the Migrant City: A time-series study in Shenzhen, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 852:158528. [PMID: 36063933 DOI: 10.1016/j.scitotenv.2022.158528] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Ke Peng
- National Clinical Research Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518057, Guangdong, China; Shenzhen Center for Chronic Disease Control, Shenzhen 518020, Guangdong, China
| | - Wenhua Yan
- Department of Cardiology, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
| | - Yue Cao
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Weicong Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, Guangdong, China
| | - Fangjiang Liu
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, Guangdong, China
| | - Kaihao Lin
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, Guangdong, China
| | - Yuxin Xie
- National Clinical Research Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518057, Guangdong, China; Scool of public health, Hengyang Medical School, University of South China, 421009, Hunan, China
| | - Yichong Li
- National Clinical Research Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518057, Guangdong, China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen 518020, Guangdong, China.
| | - Junzhe Bao
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.
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Association between extreme ambient temperature and onset of ischemic stroke: Time series study in Wuhan and Yichang, China. eNeurologicalSci 2021. [DOI: 10.1016/j.ensci.2021.100372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Amiri M, Peinkhofer C, Othman MH, De Vecchi T, Nersesjan V, Kondziella D. Global warming and neurological practice: systematic review. PeerJ 2021; 9:e11941. [PMID: 34430087 PMCID: PMC8349167 DOI: 10.7717/peerj.11941] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background Climate change, including global warming, will cause poorer global health and rising numbers of environmental refugees. As neurological disorders account for a major share of morbidity and mortality worldwide, global warming is also destined to alter neurological practice; however, to what extent and by which mechanisms is unknown. We aimed to collect information about the effects of ambient temperatures and human migration on the epidemiology and clinical manifestations of neurological disorders. Methods We searched PubMed and Scopus from 01/2000 to 12/2020 for human studies addressing the influence of ambient temperatures and human migration on Alzheimer’s and non-Alzheimer’s dementia, epilepsy, headache/migraine, multiple sclerosis, Parkinson’s disease, stroke, and tick-borne encephalitis (a model disease for neuroinfections). The protocol was pre-registered with PROSPERO (2020 CRD42020147543). Results Ninety-three studies met inclusion criteria, 84 of which reported on ambient temperatures and nine on migration. Overall, most temperature studies suggested a relationship between increasing temperatures and higher mortality and/or morbidity, whereas results were more ambiguous for migration studies. However, we were unable to identify a single adequately designed study addressing how global warming and human migration will change neurological practice. Still, extracted data indicated multiple ways by which these aspects might alter neurological morbidity and mortality soon. Conclusion Significant heterogeneity exists across studies with respect to methodology, outcome measures, confounders and study design, including lack of data from low-income countries, but the evidence so far suggests that climate change will affect the practice of all major neurological disorders in the near future. Adequately designed studies to address this issue are urgently needed, requiring concerted efforts from the entire neurological community.
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Affiliation(s)
- Moshgan Amiri
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Costanza Peinkhofer
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Medical Faculty, University of Trieste, Trieste, Italy
| | - Marwan H Othman
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Teodoro De Vecchi
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Medical Faculty, University of Trieste, Trieste, Italy
| | - Vardan Nersesjan
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Daniel Kondziella
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Yu K, Zhu S, He M, Li Z, Zhang L, Sui Z, Li Y, Xia X. Epidemiological characteristics of 561 cases of intracerebral hemorrhage in Chengdu, China. Medicine (Baltimore) 2021; 100:e24952. [PMID: 33847611 PMCID: PMC8052055 DOI: 10.1097/md.0000000000024952] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 12/03/2020] [Accepted: 02/05/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT To explore the epidemiology of patients with spontaneous intracerebral hemorrhage (sICH) in Chengdu, China, we retrieved the data of patients with spontaneous cerebral hemorrhage admitted to the First Affiliated Hospital of Chengdu Medical College from January 2017 to December 2019. We performed a comprehensive analysis of the location of hemorrhage, demographics, factors of hemorrhage, condition of body, severity of disturbance of consciousness, treatment, length of stay (days), inpatient costs, prognosis, and mortality rate in patients with sICH. In total, data of 561 in patients with sICH were included. The hemorrhage site was primarily located in the basal ganglia and thalamus (64.71%). The mean patient age was 63.2 ± 12.4 years (64.17% men, 35.83% women). Male patients (mean age 62.3 ± 12.5 year) were younger than female patients (mean age 64.9 ± 12.1 year). The age of sICH onset in our sample was between 40 and 79 years; this occurred in 87.70% of the included cases. There were more males than females, which may be related to more daily smoking, longer drinking years, and overweight in males than in females. Cases occurred most frequently during the winter and spring months, and the relationship between sICH visits and hospitalizations appeared as a U-shape. The median time from illness onset to hospital admission was 3.0 hours. According to the Glasgow Coma Scale (GCS) score at admission, 20.50% of sICH cases were of mild intensity, 39.93% were moderate, and 39.57% were severe. Moderate disorder is the most common sICH severity. Factors influencing the disturbance of consciousness were blood glucose level at the time of admission as well as the number of years with hypertension. The lower the degree of disturbance of consciousness and the more they smoked per day indicated they had a higher likelihood of receiving surgical treatment while in hospital. The median hospital stay was 13.0 days, while the median inpatient cost was USD 3609. The 30-day mortality rate was 18.36%. sICH is an important public health problem in Chengdu, China. A governmental initiative is urgently needed to establish a sICH monitoring system that covers the Chengdu region to develop more effective and targeted measures for sICH prevention, treatment, and rehabilitation.
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Affiliation(s)
- Kai Yu
- Department of Neurosurgery
| | - Shu Zhu
- Neurology, Clinical Medical College, The First Affiliated Hospital of Chengdu Medical College
| | | | | | | | | | - Yunming Li
- Department of Medical Management, Division of Health Services, The General Hospital of Western Theater Command
- Department of Statistics, College of Mathematics, Southwest Jiaotong University, Chengdu
- School of Public Health, Southwestern Medical University, Lu Zhou, Sichuan Province, China
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Sherratt S. What are the implications of climate change for speech and language therapists? INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:215-227. [PMID: 33258529 DOI: 10.1111/1460-6984.12587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The emerging global issue of climate change has large-scale effects on health and well-being, including communication disorders. The broad range of the speech and language therapy profession's scope of practice incorporates prevention, advocacy and equality in service delivery. These act as a springboard for involvement in climate change and health. AIMS This is an appeal to speech and language therapists (SLTs) to focus and take action on this issue and its considerable effects on communication and swallowing disorders. METHODS & PROCEDURES This article discusses the importance of taking a public health position on prevention and equality of services to manage environmental determinants of communication and swallowing disorders. It also describes the extent to which climate change affects these disorders and exacerbates the inequality of healthcare services in low- and middle-income countries. MAIN CONTRIBUTION Five strategies are provided for action on fulfilling therapists' roles in reducing the incidence, development and exacerbation of climate-related communication and swallowing disorders, as well as the role of SLTs in acting as advocates. The case is made for expanding the scope of services to focus on prevention and service equality so as to best meet the needs of the wider community. CONCLUSIONS & IMPLICATIONS Despite other challenges currently facing SLTs, climate change and its increasing effects on communication disorders and dysphagia is difficult to ignore. SLTs owe it to their clients, the wider community, low- and middle-income countries, the economy, and the future to take action. What this paper adds What is already known on the subject Multiple studies published in peer-reviewed scientific journals show that climate change is extremely likely to be due to human activities. The global effects will be higher temperatures, changes in precipitation, more droughts and heatwaves, stronger and more intense hurricanes, and a rising sea level which directly threaten the health of entire populations. Other health professions are beginning to take climate change into account in training and practice. What this paper adds to existing knowledge Many disorders of communication and swallowing are caused or exacerbated by the effects of climate change. Increasing temperatures, extremes of precipitation, population displacement and air pollution contribute to cardiovascular and cerebrovascular events, respiratory disease, malnutrition, premature birth, air- and water-borne diseases, and mental illness. These may affect the communication and swallowing abilities across the lifespan, but particularly those of children and older adults. What are the potential or actual clinical implications of this work? SLTs' roles in prevention, advocacy and education act as a starting point for involvement in climate change and health. Three practical strategies for action include educating SLTs and other health professionals on climate change and its effects on communication and swallowing, promoting awareness with clients and their families, and gathering and disseminating reliable data.
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Affiliation(s)
- Sue Sherratt
- Communication Research Australia, Rankin Park, NSW, Australia
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12
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Lei L, Bao J, Guo Y, Wang Q, Peng J, Huang C. Effects of diurnal temperature range on first-ever strokes in different seasons: a time-series study in Shenzhen, China. BMJ Open 2020; 10:e033571. [PMID: 33444167 PMCID: PMC7682471 DOI: 10.1136/bmjopen-2019-033571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Diurnal temperature range (DTR) is an important meteorological indicator of global climate change; high values of DTR may induce stroke morbidity, while the related high-risk periods and sensitive populations are not clear. This study aims to evaluate the effects of DTR on first-ever strokes in different seasons and in relation to sensitive populations. METHODS We collected data on 142 569 first-ever strokes during 2005-2016 in Shenzhen. We fitted a time-series Poisson model in our study, estimating the associations between DTR and first-ever strokes, with a distributed lag non-linear model. Then, we calculated strokes attributable to high DTR in different genders, age groups, education levels and stroke subtypes. RESULTS High DTR had a significant association with first-ever strokes, and the risk of stroke increased with the rise of DTR in the summer and winter. In total, 3.65% (95% empirical CI (eCI) 1.81% to 5.53%) of first-ever strokes were attributable to high DTR (5.5°C and higher) in the summer, while 2.42% (95% eCI 0.05% to 4.42%) were attributable to high DTR (8°C and higher) in the winter. In the summer, attributable fraction (AF) was significant in both genders, middle-aged and old patients, patients with different levels of education, as well as patients with cerebral infarction (CBI); in the winter, AF was significant in middle-aged patients, patients with primary and lower education level, as well as patients with CBI. CONCLUSIONS High DTR may trigger first-ever strokes in the summer and winter, and CBI is more sensitive than intracerebral haemorrhage to DTR. Most people are sensitive to high DTR in the summer, while middle-aged and low-education populations are sensitive in the winter. It is recommended that the DTR values be reported and emphasised in weather forecast services, together with the forecasts of heat and cold.
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Affiliation(s)
- Lin Lei
- Department of Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Junzhe Bao
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yanfang Guo
- Department of Non-Communicable Disease Control and Prevention, Bao'an District Hospital for Chronic Diseases Prevention and Cure, Shenzhen, Guangdong, China
| | - Qiong Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China
| | - Ji Peng
- Department of Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Cunrui Huang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
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Su Y, Cheng L, Cai W, Lee JKW, Zhong S, Chen S, Li T, Huang X, Huang C. Evaluating the effectiveness of labor protection policy on occupational injuries caused by extreme heat in a large subtropical city of China. ENVIRONMENTAL RESEARCH 2020; 186:109532. [PMID: 32334170 DOI: 10.1016/j.envres.2020.109532] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/11/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
On March 1, 2012, the Chinese government implemented the Administrative Measures on Heatstroke Prevention (AMHP2012) to combat the occupational health impacts of extreme heat, and reducing occupational injury was one of the main purposes. This study aimed at quantifying the intervention effects of the AMHP2012 on extreme heat-related occupational injuries and subsequent insurance payouts in Guangzhou, China. Data on occupational injuries and insurance payouts were collected from March 1, 2011, to February 28, 2013, from the occupational injury insurance system of Guangzhou. A quasi-experimental design with before-after control was adopted. Interrupted time series analysis was performed to quantify the change of occupational injuries and insurance payouts after policy implementation. The distributed lag non-linear model was used to explore whether injury claims and insurance payouts due to extreme heat decreased. A total of 9851 injury claims were included in the analysis. After policy implementation, the risk of occupational injuries and insurance payouts decreased by 13% (RR = 0.87, 95%CI: 0.75, 0.99) and 24% (RR = 0.76, 95% CI: 0.58, 0.94), respectively. The attributable fraction of extreme heat-related occupational injuries decreased from 3.17% (95%eCI: 1.35, 4.69) to 1.52% (95%eCI: -0.36, 3.15), which contributed to 0.86 million USD reduction of insurance payouts. Both males and females, low-educated, young and middle-aged workers, workers at small or medium-sized enterprises, engaging in manufacturing, and with both minor and severe injuries were apparently associated with decreased rates of extreme heat-related occupational injuries. The AMHP2012 policy contributed to the reduction of extreme heat-related occupational injuries and insurance payouts in Guangzhou, China, and this research provided novel evidence for decision-makers to better understand the necessity of implementing health protection policies among laborers under climate change.
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Affiliation(s)
- Yanan Su
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, 200030, China
| | - Liangliang Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wenjia Cai
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing, 100084, China; Joint Center for Global Change Studies (JCGCS), Beijing, 100875, China
| | - Jason Kai Wei Lee
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Global Asia Institute, National University of Singapore, Singapore; N.1 Institute for Health, National University of Singapore, Singapore
| | - Shuang Zhong
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, 510275, China
| | - Siyu Chen
- Institute for Economic and Social Research, Jinan University, Guangzhou, 510632, China
| | - Teng Li
- International School of Business and Finance, Sun Yat-sen University, Guangzhou, 510275, China
| | - Xinfei Huang
- International School of Business and Finance, Sun Yat-sen University, Guangzhou, 510275, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, 200030, China; School of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
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