Sociodemographic and environmental characteristics associated with thoughts of death and suicidal ideation in community-dwelling residents of a rural town in Japan: analyses from a perspective of accompanying problems

OBJECTIVE

Suicide prevention has been focused on primary prevention as a group rather than individuals. However, we aimed to identify sociodemographic and environmental characteristics of individuals with suicidal thoughts among rural residents in Japan.

METHODS

In 2015, a cross-sectional home visit survey was conducted in a rural town in Akita Prefecture. A total of 1,844 residents aged ≥ 20 years (response rate, 65%) answered a self-administered questionnaire about suicidal thoughts in the past one month. Multivariate logistic regression analyses were used to investigate sociodemographic and environmental characteristics associated with suicidal thoughts in models with accompanying problems for human relations problems (HRP), health problems (HP), and financial problems (FP), or with no accompanying problems.

RESULTS

In total, 218 (men 9.4%, women 13.8%) had suicidal thoughts with accompanying problems for HRP (n = 104), HP (n = 112), and FP (n = 72). The risk characteristics were Kessler Psychological Distress Scale scores ≥ 9 in models with HRP, HP, and FP or with no accompanying problems; being a woman and current smoking with no accompanying problems; absence of a person for help in a model of FP; and absence of family member for help in a model of HRP or with no accompanying problems. The mitigating factor were being optimistic (a domain of resilience skills identified by factor analysis) in models of HRP, HP, and FP or with no accompanying problems; being aged 70-79 and being aged ≥ 80 in a model of HRP.

CONCLUSIONS

Suicidal thoughts among rural residents in Japan were associated with multifactorial sociodemographic and environmental characteristics.

Investigation of Working Conditions and Health Status in Platform Workers in the Republic of Korea

Background

The present study aimed to analyze several aspects of the working conditions and health status of platform workers in the Republic of Korea, such as ergonomic and emotional hazards. We also compared the health status of the platform workers with that of the general population.

Methods

A total of 1,000 platform workers participated in this survey from August 7 to August 17, 2022. The participants included 400 designated drivers, 400 food-delivery drivers, and 200 housekeeping managers. A face-to-face survey with a structured questionnaire was conducted by researchers who had received specific instructions. The focus of the survey extended to the work environment, encompassing factors such as workplace violence, as well as physical, chemical, and ergonomic hazards. Health-related data for the previous year were also collected, covering a range of issues such as hearing problems, skin problems, musculoskeletal symptoms, headaches, injuries, mental health issues, and digestive problems. Subsequently, we compared the health symptom data of the responders with those of the general population in the Republic of Korea.

Results

Platform workers, including designated drivers, food-delivery drivers, and housekeeping managers, existed in the blind spot of social insurance, facing frequent exposure to physical and chemical hazards, ergonomic risk factors, and direct or indirect violence. The prevalence of health problems, including musculoskeletal symptoms, general fatigue, and depressive symptoms, in each occupational group was statistically higher than that in the general population after standardization for age and gender.

Conclusion

The results revealed unfavorable working environment and inferior occupational health of platform workers compared with those of the general population.

Assessment of the association between health problems and cooking fuel type, and barriers towards clean cooking among rural household people in Bangladesh

BACKGROUND

In low- and middle-income countries, households mainly use solid fuels like wood, charcoal, dung, agricultural residues, and coal for cooking. This poses significant public health concerns due to the emission of harmful particles and gases. To address these issues and support Sustainable Development Goals (SDGs), adopting cleaner cooking fuels like electricity and gas are acknowledged as a viable solution. However, access to these cleaner fuels is limited, especially in rural areas.

METHODS

This study conducted a face-to-face survey with 1240 individuals in rural Bangladesh to explore the link between health issues and cooking fuel type, as well as barriers to transitioning to clean cooking. Using a convenient sampling technique across four divisions/regions, the survey gathered socio-demographic and health data, along with information on clean cooking barriers through a semi-structured questionnaire. Binary and multivariable logistic regression analyses were then employed to identify significant associations between cooking fuel type and health problems.

RESULTS

The study revealed that a majority of participants (73.3%) relied on solid fuel for cooking. The use of solid fuel was significantly correlated with factors such as lower education levels, reduced family income, location of residence, and the experience of health issues such as cough, chest pressure while breathing, eye discomfort, diabetes, asthma, and allergies. Economic challenges emerged as the foremost obstacle to the adoption of clean cooking, accompanied by other contributing factors.

CONCLUSION

The use of solid fuel in rural Bangladeshi households poses substantial health risks, correlating with respiratory, eye, cardiovascular, and metabolic issues. Lower education and income levels, along with specific residential locations, were associated with higher solid fuel usage. Economic challenges emerged as the primary obstacle to adopting clean cooking practices. These findings emphasize the need for implementing strategies to promote clean cooking, address barriers, and contribute to achieving Sustainable Development Goal targets for health and sustainable energy access in Bangladesh.

The Process of Sterilizing Tattoo Inks Releases Formaldehyde

INTRODUCTION

Around 12% of Europeans and 20% of Americans have at least one tattoo. Tattoo inks, the substances used to create tattoos on the body, consist of chemicals that contain formaldehyde, which can be harmful to human health. The amount of formaldehyde present in commercially available tattoo inks and its causes are not well understood.

METHODS

We investigated the levels of formaldehyde in tattoo ink products sold in different countries and identified the factors contributing to its production. We also explored methods to reduce formaldehyde generation in tattoo inks. Seven tattoo inks from various brands were tested.

RESULTS

Formaldehyde release was predominantly associated with gamma radiation sterilization. Formaldehyde levels were observed to be higher in compositions containing organic components compared to those with inorganic components, irrespective of sterilization method and container type. Glycerin released over seven times more formaldehyde than other components during gamma-ray sterilization.

CONCLUSION

The results suggest that the presence of hydroxyl groups in carbon organic compounds in tattoo ink leads to photodegradation during gamma-ray radiation sterilization, resulting in increased concentrations of formaldehyde. Further research is needed to examine the chemical reactions occurring during sterilization processes and identify alternative sterilization methods that minimize formaldehyde formation. Additionally, the development of tattoo inks with reduced formaldehyde content and the establishment of strict quality control measures can help ensure the safety of tattooing practices.

The complexity of obesity-related health problems after bariatric surgery: The patient perspective

Background

Bariatric surgery aims to improve quality of life by means of weight loss. Obesity-related physical and psychological health problems should improve, but long-term data are scarce.

Objectives

To evaluate preoperative physical and mental health problems perceived by the patient and the association with weight loss and quality of life, 5 years after bariatric surgery.

Methods

101 persons (response rate 67%) who had had bariatric surgery an average of 4.6 years before this study completed a written survey on obesity-related physical and psychological health problems and three psychological questionnaires collecting information on eating behavior and quality of life. Over half of the participants (55%) had had a laparoscopic adjustable gastric banding.

Results

Preoperatively reported health problems improved but were not necessarily associated with weight loss. Minimal improvement in tiredness, shame and weight instability were associated with significantly less weight loss. Preoperative type 2 diabetes mellitus (T2D) improved but participants had significantly less weight loss and more dissatisfaction regarding the bariatric trajectory than participants without T2D. Eating concerns, emotional eating and external eating improved but not restrained eating. Compared to the Dutch population reference, most quality of life scores of the participants were lower.

Conclusion

In this analysis, participants did report satisfaction although from a patients' perspective, improvements of weight and health did not necessarily lead to satisfaction regarding the bariatric trajectory. Participants with postoperative reported fatigue and shame as well as participants with preoperative T2D showed significant less weight loss. More long-term research is necessary to close the current knowledge gap.

Widening the knowledge of non-employment as a risk factor for suicide: a Norwegian register-based population study

BACKGROUND

There is a known association between employment status and suicide risk. However, both reason for non-employment and the duration affects the relationship. These factors are investigated to a lesser extent. About one third of the Norwegian working age population are not currently employed. Due to the share size of this population even a small increase in suicide risk is of importance, and hence increased knowledge about this group is needed.

METHODS

We used discrete time event history analysis to examine the relationship between suicide risk and non-employment due to either unemployment or health-problems, and the duration of these non-employment periods. We analyze data from the Norwegian population registry from 2004 to 2014, which includes all Norwegian residents in the ages 19-58 born between 1952 and 1989. In total the data consists of 1 063 052 men and 1 024 238 women, and 2 039 suicides.

RESULTS

The suicide risk among the non-employed men and women is significantly higher than that of the employed. For the unemployed men, the suicide risk is significantly higher than the employed within the first 18 months. For the unemployed women we only find a significant association with suicide risk among those unemployed for six to twelve months. The suicide risk is especially increased among those with temporary health-related benefits. In the second year of health-related non-employment men have eightfold and women over twelvefold the OR for suicide, compared to the employed.

CONCLUSION

There is an association between non-employment and suicide risk. Compared to the employed both unemployed men and men and women with health-related non-employment have elevated suicide risk, and the duration of non-employment may be the driving force. Considering the large share of the working age population that are not employed, non-employment status should be considered in suicide risk assessment by health care professionals and welfare providers.

Potential of electronic devices for detection of health problems in older adults at home: A systematic review and meta-analysis

OBJECTIVE

The aim of this review was to evaluate the overall diagnostic performance of e-devices for detection of health problems in older adults at home.

METHODS

A systematic review was conducted following the PRISMA-DTA guidelines.

RESULTS

31 studies were included with 24 studies included in meta-analysis. The included studies were divided into four categories according to the signals detected: physical activity (PA), vital signs (VS), electrocardiography (ECG) and other. The meta-analysis showed the pooled estimates of sensitivity and specificity were 0.94 and 0.98 respectively in the 'VS' group. The pooled sensitivity and specificity were 0.97 and 0.98 respectively in the 'ECG' group.

CONCLUSIONS

All kinds of e-devices perform well in diagnosing the common health problems. While ECG-based health problems detection system is more reliable than VS-based ones. For sole signal detection system has limitation in diagnosing specific health problems, more researches should focus on developing new systems combined of multiple signals.

Sex differences in Cannabis use disorder and associated psychosocial problems among US adults, 2012-2013

While men show greater prevalence of cannabis use disorder (CUD) than women, whether cannabis use frequency drives this difference is unknown, and little is known about sex differences in problems associated with CUD. We therefore assessed the association of CUD with sex, adjusted for frequency of use, and compared the association of psychosocial and health-related problems with CUD between men and women. We included US adults age ≥ 18 who reported past-year cannabis use in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 3701). Cannabis use frequency, DSM-5 CUD and problems (interpersonal, financial, legal, health-related) were assessed. Associations between psychosocial problems, sex and DSM-5 CUD were assessed using prevalence differences (PD) and 95% confidence intervals (CI) from logistic regression models, controlling for demographics and cannabis use frequency, and effect modification by sex was assessed. We found that the prevalence of CUD among men versus women was not significantly greater after adjusting for use frequency. Women had significantly higher prevalence of interpersonal, financial and health-related problems than men, adjusting for frequency of use. Women showed significantly greater association of CUD with interpersonal problems with a boss or co-workers (p < 0.05) and a neighbor, relative or friend (p < 0.05) compared to men. Lack of sex differences in CUD after adjusting for frequency of use suggests use frequency may be an important target of CUD prevention efforts. CUD showed stronger associations for interpersonal problems among women than men, suggesting the need for particular emphasis on treating interpersonal problems related to cannabis use among women.

The impact of emotional contagion on workplace safety: Investigating the roles of sleep, health, and production pressure

Using emotional contagion theory and the Job Demands-Resources model as a theoretical foundation, we tested the proposition that higher levels of contagion of anger (i.e., a demand) vs. higher levels of contagion of joy (i.e., a resource) will be associated respectively with more vs. fewer sleep disturbances and health problems, which in turn are related to more workplace accidents and injuries. Moreover, we examined the moderating impact of production pressure (i.e., a contextual demand) on the relationship between emotional contagion and employee poor sleep and health. Data from 1000 employees in Italy showed that the conditional indirect effects of contagion of anger, but not of joy, on accidents and injuries via sleep and health problems were intensified as levels of production pressure increased. Furthermore, contagion of anger was positively associated with both sleep disturbances and health problems whereas contagion of joy was negatively related to only sleep disturbances. These findings suggest that the effect of anger that employees absorb during social interactions at work likely persists when coming at home and represents an emotional demand that impairs the physiological functions that regulate restorative sleep and energies recharging; and, this effect is even stronger among employees who perceived higher levels of organizational production pressure.

Living conditions, lifestyle habits and health in the general population in spring 2020 and one year into the COVID-19 pandemic in Sweden - Results from two cross-sectional studies carried out in 2020 and 2021

The aim of the study was to investigate mental and physical health as well as living conditions and lifestyle habits in the adult general population in spring 2020 and one year into the COVID-19 pandemic in Sweden comparing results from two cross-sectional studies carried out in February-May 2020 and 2021. The study population comprises 2,273 persons in 2020 and 2,216 persons in 2021 who responded to the national public health survey sent to random population samples in one county in Sweden. The age group was 16-84 years, and the response rates were 45% and 44%, respectively. Differences in living conditions (economic difficulties, social support and worrying about losing one's job), lifestyle habits (physical activity, daily smoking, sitting duration and alcohol use), and health (self-rated health, pain in shoulders or neck, sleeping difficulties, anxiety or worry, and obesity) between years 2020 and 2021 were analysed using multiple binary logistic regression in men and women, adjusting for age group and educational level. Very few statistically significant differences were observed between 2020 and 2021 regarding living conditions, lifestyle factors and health. The main finding was that the prevalence of anxiety and worry increased among women. Surveillance of the long-term public health consequences of the pandemic in the general population using robust data and methods, is important for planning and targeting preventive activities.

Occupational ocular health problems among marble workers at Shaq El Tho'ban industrial area in Egypt

Eye health of the working population is an essential condition for productivity. Marble industry is processed at large scale at Shaq El Tho'ban area where much dust, crushed pieces of stone, and fluctuating temperatures are endangering employees' health generally and eye health specifically. The objectives of this study were assessing the prevalence of the most common ocular health problems associated with marble industry and investigating the impact of the working environment and occupational risk factors on the oculo-visual status of marble workers. A cross-sectional study was conducted among 250 workers, working at Shaq El Tho'ban area in Egypt during the period from August 2020 to September 2021, using a semi-structured questionnaire and eye examination comprised of full ocular history, visual acuity testing (unaided/aided), slit lamp examination, ophthalmoscopy, and Schirmer's type I and tear break up time tests. The current study showed that gritty sensation (65.2%) and eye dryness (51.2%) were the commonest symptoms complained. By examination, conjunctival hyperemia (59.6%) was the most prevalent finding. By performing dry eye tests, dry eye was diagnosed in 60.4% and 51.2% of workers by Schirmer's test and tear break up time test respectively. The study's results indicated that age, working category, smoking, and diabetes had significant impact on development of ocular symptoms, while working duration, diabetes, smoking, ocular symptoms, and ocular foreign body had significant impact on development of dry eye disease. Implementation of engineering control measures, proper designing, and supply of eye PPE together with adequate health education to all workers about occupational health risks and preventive measures are recommended.

Living conditions, lifestyle habits and health among adults before and after the COVID-19 pandemic outbreak in Sweden - results from a cross-sectional population-based study

BACKGROUND

Studies on the public health consequences of COVID-19 pandemic showing data based on robust methods are scarce. The aim of this study was to investigate mental and physical health as well as living conditions and lifestyle habits in the general population before and after the COVID-19 outbreak in Sweden.

METHODS

The study is based on 2273 persons 16-84 years who responded to the national public health survey in February-May 2020 in Värmland county (overall response rate 45%). The differences between early respondents (before the outbreak, n = 1711) and late respondents (after the outbreak, n = 562) were studied using multivariate logistic regression, adjusting for background characteristics: age, gender, educational level, and country of birth. The same analyses were also completed in the corresponding survey carried out in February-June 2018.

RESULTS

Statistically significant differences between the groups were obtained for economic difficulties and worry about losing one's job, which were more common among late respondents, and for sleeping difficulties, which were more common among early respondents after adjusting for background characteristics. There were no differences in other living conditions nor in lifestyle factors. Prevalence of good self-rated health, high blood pressure, aches in shoulders or neck, anxiety or worry and stress did not differ between the groups. In 2018, the only statistically significant difference between early and late respondents concerned economic difficulties.

CONCLUSIONS

Very few differences in living conditions, lifestyle factors and health were observed in the study population before and after the COVID-19 outbreak. The results suggest that, in addition to a possible decrease in sleeping difficulties, the prevalence of being worried about losing one's job increased among the employed after the outbreak.

"A lot of medical students, their biggest fear is failing at being seen to be a functional human": disclosure and help-seeking decisions by medical students with health problems

BACKGROUND

Although medical students have a duty to seek advice for their health conditions, they tend to avoid disclosure and help-seeking behaviours, therefore potentially posing a risk to themselves and their patients. The literature regarding their decisions to seek help or disclose health conditions is limited. The study's purpose was to explore the factors that determine disclosure and help-seeking decision processes by medical students who have health conditions with or without disability.

METHODS

We recruited by purposive sampling and conducted in-depth semi-structured interviews with 11 male and female medical students from a UK medical school, who had physical or mental health disorders. Thematic analysis was used to identify themes. A mix of inductive and deductive techniques was used while using an organising framework proposed by Llewellyn-Thomas (1995).

RESULTS

The impact of individuals' features, such as personality traits on medical students' disclosure and help-seeking decisions were identified. Different aspects of the condition, such as its type and severity were found to influence these decisions. Participants made an evaluation of the potential receiver of a disclosure, consisting of factors such as the receiver's characteristics and attitudes. The culture of the medical environment, such as role models, had a major impact on their decisions. Finally, systemic factors, such as the lack of clarity of policies influenced students' decisions.

CONCLUSION

Medical students' disclosure and help-seeking decision processes are influenced by risk-benefit evaluations and factors in interlinked spheres of their lives. They tend to avoid or postpone disclosure and seeking help, especially when the university is involved, due to a perceived risk to their future. Future research should examine the role of personality traits and the medical culture. Medical schools should encourage earlier help-seeking and disclosure behaviours by clarifying procedures and building trust via online and confidential platforms; interpersonal channels and normalisation processes within the medical education and the profession as a whole.

adults

BACKGROUND

Although the problems associated with alcohol use disorder (AUD) are well known, little is known about the psychosocial problems associated with cannabis use disorder (CUD), and the harmfulness of CUD relative to AUD. We compared the odds of psychosocial and health-related problems between individuals with DSM-5 AUD-only, CUD-only and co-occurring AUD+CUD.

METHODS

The 2012-2013 NESARC-III, a nationally representative cross-sectional survey of non-institutionalized US adults (n = 36,309), assessed participants for DSM-5 AUD, CUD, and psychosocial (interpersonal, financial, legal) and health-related problems. Based on their responses, participants were categorized into mutually exclusive groups: no AUD/CUD, AUD-only, CUD-only, and AUD+CUD. Multivariable logistic regression models examined the associations between psychosocial problems and the four AUD/CUD groups, adjusting for sociodemographic characteristics.

RESULTS

People with AUD-only, CUD-only, and AUD+CUD had higher odds of most interpersonal problems (adjusted odds ratio [aORs] 1.07-4.01), financial problems (aORs 1.53-4.28), legal problems (aORs 3.34-7.71), and health-related problems (aORs 1.29-1.92). The odds of psychosocial and health-related problems were similar for CUD-only and AUD-only in direct comparisons. Compared to those with AUD-only, those with AUD+CUD had higher odds of most problems examined (aORs 1.42-2.31). In contrast, there were few differences when comparing AUD+CUD with CUD-only.

CONCLUSIONS

AUD and CUD were similarly associated with interpersonal, financial, and legal problems, emergency treatment and suicide attempt. People with AUD+CUD had higher odds of certain problems than individuals with either AUD-only or CUD-only. Although most people who use cannabis do not experience harms, our results indicate that CUD does not appear to be less harmful than AUD.

Applying a novel approach to scoping review incorporating artificial intelligence: mapping the natural history of gonorrhoea

BACKGROUND

Systematic and scoping literature searches are increasingly resource intensive. We present the results of a scoping review which combines the use of a novel artificial-intelligence-(AI)-assisted Medline search tool with two other 'traditional' literature search methods. We illustrate this novel approach with a case study to identify and map the range of conditions (clinical presentations, complications, coinfections and health problems) associated with gonorrhoea infection.

METHODS

To fully characterize the range of health outcomes associated with gonorrhoea, we combined a high yield preliminary search with a traditional systematic search, then supplemented with the output of a novel AI-assisted Medline search tool based on natural language processing methods to identify eligible literature.

RESULTS

We identified 189 health conditions associated with gonorrhoea infection of which: 53 were identified through the initial 'high yield' search; 99 through the systematic search; and 124 through the AI-assisted search. These were extracted from 107 unique references and 21 International Statistical Classification of Diseases and Related Health Problems Ninth and Tenth Revision (ICD 9/10) or Read codes. Health conditions were mapped to the urogenital tract (n = 86), anorectal tract (n = 6) oropharyngeal tract (n = 5) and the eye (n = 14); and other conditions such as systemic (n = 61) and neonatal conditions (n = 7), psychosocial associations (n = 3), and co-infections (n = 7). The 107 unique references attained a Scottish Intercollegiate Guidelines Network (SIGN) score of ≥2++ (n = 2), 2+ (14 [13%]), 2- (30 [28%]) and 3 (45 [42%]), respectively. The remaining papers (n = 16) were reviews.

CONCLUSIONS

Through AI screening of Medline, we captured - titles, abstracts, case reports and case series related to rare but serious health conditions related to gonorrhoea infection. These outcomes might otherwise have been missed during a systematic search. The AI-assisted search provided a useful addition to traditional/manual literature searches especially when rapid results are required in an exploratory setting.

Training load characteristics and injury and illness risk identification in elite youth ski racing: A prospective study

PURPOSE

The study aimed to investigate the role of training load characteristics and injury and illness risk in youth ski racing.

METHODS

The training load characteristics as well as traumatic injuries, overuse injuries, and illnesses of 91 elite youth ski racers (age = 12.1 ± 1.3 years, mean ± SD) were prospectively recorded over a period of 1 season by using a sport-specific online database. Multiple linear regression analyses were performed to monitor the influence of training load on injuries and illnesses. Differences in mean training load characteristics between preseason, in-season, and post-season were calculated using multivariate analyses of variance.

RESULTS

Differences were discovered in the number of weekly training sessions (p = 0.005) between pre-season (4.97 ± 1.57) and post-season (3.24 ± 0.71), in the mean training volume (p = 0.022) between in-season (865.8 ± 197.8 min) and post-season (497.0 ± 225.5 min) and in the mean weekly training intensity (Index) (p = 0.012) between in-season (11.7 ± 1.8) and post-season (8.9 ± 1.7). A total of 185 medical problems were reported (41 traumatic injuries, 12 overuse injuries, and 132 illnesses). The weekly training volume and training intensity was not a significant risk factor for injuries (p > 0.05). Training intensity was found to be a significant risk factor for illnesses in the same week (β = 0.348; p = 0.044; R² = 0.121) and training volume represents a risk factor for illnesses in the following week (β = 0.397; p = 0.027; R² = 0.157).

CONCLUSION

A higher training intensity and volume were associated with increased illnesses, but not with a higher risk of injury. Monitoring training and ensuring appropriate progression of training load between weeks may decrease incidents of illness in-season.

A longitudinal study monitoring the quality of life in a national cohort of older adults in Chile before and during the COVID-19 outbreak

BACKGROUND

Confinement during the COVID-19 pandemic has placed great stress on older adults, which may be affecting their quality of life. Thus, this study aims to describe the changes in mental and physical health, isolation and loneliness, residence and socioeconomic resources in a national cohort of Chilean older adults before and during the COVID-19 outbreak. It also analyzes the changes in depressive symptoms by changes in the other quality of life indicators before and during the COVID-19 outbreak. Possible methodological biases of telephone surveys in older adults living in non-developed countries are also discussed.

METHODS

Between June and September 2020, a random subsample of 720 people who had participated in the face-to-face V National Survey on Quality of Life in Older Adults in Chile conducted at the end of 2019 was followed up by telephone. Descriptive bivariate analyses were performed using t-test and non-parametric tests for independent variables, comparing the baseline sample with the current 2020 follow-up sample during the peak of the pandemic outbreak in Latin America. Furthermore, descriptive bivariate analysis through t-test and non-parametric test for paired samples compared the follow-up subsample at baseline with the not-included sample, examining possible biases of the telephone interview compared with the face-to-face interview.

RESULTS

In the panel, there was no variation in self-rated health. The health symptoms that worsened were memory, stomach, and mood problems. Depressive symptoms and anxiety increased; similarly, smartphone users, social contacts, intergenerational co-residence and resilience increased. The telephone follow-up sample had a higher educational level and greater smartphone use than those not included in the subsample.

CONCLUSIONS

Although some physical and mental health indicators have worsened during the pandemic, older adults mobilized resources that could allow them to maintain their quality of life, such as improved resilience. Thus, these findings can guide future research and the development of efficient strategies to improve these resources among older adults to ensure wellbeing.

Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units

BACKGROUND

In the event of coronavirus disease-2019 (COVID-19) spread worldwide, frontline healthcare workers play a key role in the containment of this devastating pandemic, and to prevent the cross-transmission and gain confidence in battle with the pandemic, they are wearing personal protective equipment (PPE).

AIM AND OBJECTIVE

To explore the adverse health problems and skin reactions caused by the use of PPEs among the frontline nurses in the ICUs of COVID hospital.

MATERIALS AND METHODS

A cross-sectional study was conducted using an online-based questionnaire assessing the physical problems, and adverse skin reactions of PPEs were sent among the 150 frontline nurses in ICUs of COVID hospital. The collected data were analyzed using descriptive statistics.

RESULTS

We got 137 valid responses from frontline nurses, and the most common adverse health effects expressed by them were headache (73.4%), extreme sweating (59.6%), and difficulty in breathing (36.7%); 91.7% complained about the fogging of the goggle. Majority of frontline nurses expressed nasal bridge scarring (76.64%) and indentation and pain on the back of the ears (66.42%) as the adverse skin reactions after wearing N95 masks. The common skin problems identified due to double gloving of latex gloves were excessive skin soakage with sweat (70.07%) and skin chapping (19%). The protective clothing caused minimal adverse reactions, and excessive sweating (71.53%) was the most reported.

CONCLUSION

The healthcare workers wearing PPE for a prolonged period show significant adverse effects, so appropriate strategies should be taken to prevent the adverse effects by designing effective PPEs and education of preventive measures among healthcare workers.

HOW TO CITE THIS ARTICLE

Jose S, Cyriac MC, Dhandapani M. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Indian J Crit Care Med 2021;25(2):134-139.

Fluoride and arsenic contamination in drinking water due to mining activities and its impact on local area population

Contamination of arsenic and fluoride in drinking water reservoirs is a serious health issue in the Sibi district, Balochistan, Pakistan. The contamination has already been affecting a large population of the district. Dental fluorosis and dermatitis are the most common reported illnesses in the area. This study focused on the evaluation of the root causes and pathway by which it reached to the body. Questioner analysis, simple examination, and pictorial representation were used to study the prevalence of diseases caused by As and F. People of the Sibi district were found to consume both surface and groundwater, which were highly contaminated with arsenic and fluoride. The saturation index, ranging from 1 to 7, showed high enrichment of contaminants in both types of water. Geochemical calculations and the sodium absorption ratio were evaluated. High values of the saturation index of different salts showed high saturation of salts in water. The principal component analysis grouped the data into three clusters, showing that the surface water has no resemblance with the control water. High degree of contamination was observed for most of the samples, whereas, some samples of ground water were closed to the control group; a group of samples within WHO limits. The correlation studies and other calculations also revealed that the F and As reached lethal limits in the drinking water and thus caused severe health damage to the local area population. The diseases found in the area are fluorosis, keratosis, dermatitis, and melanosis.

Travel patterns, risk behaviour and health problems of travellers with rheumatic diseases compared to controls: A multi-centre, observational study

BACKGROUND

Patients with chronic conditions travel around the world more than ever. Only few studies have examined travel patterns and health outcomes of patients with rheumatic diseases during international travel.

METHOD

We conducted a multi-centre prospective cohort study in Switzerland, in which we studied the immunogenicity and safety of vaccinations in patients with rheumatic diseases and travellers without rheumatic diseases (controls). Participants who travelled internationally received questionnaires 1 and 13 weeks post-travel. We compared travel patterns, risk behaviours, and travel-associated problems during and after the trips in both groups.

RESULTS

274 participants returned post-travel questionnaires (65 rheumatic patients, 209 controls). Controls more frequently travelled to subtropical/tropical destinations and stayed longer abroad. 64% of all participants experienced health problems during travel (74% rheumatic patients vs. 62% controls, P = 0.11). Pre-travel, patients reported a higher susceptibility to gastrointestinal infections . During travel, a higher percentage of rheumatic patients cancelled the day programme due to health problems (13% vs. 4%, P = 0.024). The main problems in rheumatic patients occurred due to the underlying rheumatic diseases, or were of psychological nature. Although not statistically significant, infectious disease symptoms (rhinitis, cough) occurred more frequently in controls. When only considering subtropical/tropical destinations, rheumatic patients more frequently had gastrointestinal problems during travel - and skin infections after the trip.

CONCLUSIONS

This study does not support the notion that patients with rheumatic diseases should avoid international travel for an increased risk of infections. In patients with subtropical/tropical destinations, however, gastrointestinal problems may be increased during travel - and skin infections post-travel.

Risk perception of health problems among travelers visiting a travel clinic in Bangkok, Thailand

BACKGROUND

Effective pre-travel consultations cannot be achieved only through individual risk assessment and advice on vaccinations and chemoprophylaxis. Travelers' perceptions of the risk of health problems represent another key factor in successful risk communication and co-operation with pre-travel advice. The objective of this study was to determine perception of travel-related health risks among Thais and westerners visiting the Thai Travel Clinic for consultation before visiting developing countries.

METHODS

A novel pictorial scale questionnaire-based study was conducted with both Thai and western travelers who visited the Thai Travel Clinic for pre-travel consultation. All participants were approached before and after completing the consultation, and were asked about their demographic data and perceptions of travel-related health risk. The perceptions of risk before and after consultation were compared using the McNemar test, and were also compared with the actual estimated risk.

RESULTS

During May to November 2019, 594 travelers (330 Thais and 264 Westerners) were enrolled and completed the pictorial scale questionnaires. Most Thai travelers visited Africa/South America (63%), and 20% had previously received counseling. Westerners were mostly backpackers (37.5%), traveling for > 30 days (71.6%), while 43.6% had previously received counseling. Overall, the westerners (n = 264) changed their risk perceptions slightly after counseling in contrast with the Thais. The change in perception of most health problems was observed statistically significant (p-value < 0.05) after receiving pre-travel consultation among both groups of travelers. Risk perception among western travelers after consultation compared with estimated actual risk showed accurate risk perception toward most of health problems especially in travelers who had previously received counseling in ones' home countries.

CONCLUSIONS

Risk perception of health problems plays an important role in successful risk communication and their response to pre-travel advices. Differences in risk perceptions were evident between the two groups. Therefore, this highlight the importance of obtaining pre-travel advice in one's home country before travelling. Raised awareness of the risks should be emphasized during consultations for underestimated health risks, especially for rabid animal exposure and sexually transmitted diseases.

Health problems and healthcare service utilisation amongst homeless adults in Africa- a scoping review

BACKGROUND

Homelessness is a growing concern as it affects a large number of people worldwide. Individuals and families experiencing homelessness are vulnerable in terms of health and underutilise health services. Despite being a global problem, not much is known about the range and breath of literature exploring health problems and health care service utilisation among homeless adults in Africa.

OBJECTIVES

To identify the nature and scope of existing evidence on physical and mental health, and health service utilisation among homeless adults in Africa. The review aimed to examine how research is conducted, identify gaps, guide future research, and make recommendations for development and implementation of policies and practices.

METHODS

A search of articles and reports involving six databases: Scopus, MEDLINE, CINAHL, PubMed, African Journal Online, and Google Scholar was conducted from June 2018 to February 2019. Studies published between 1980 and 2019 that examined the health problems and health service utilisation among homeless adults in Africa were considered. Manual search in reference lists and grey literature was also done to add reports. Data was extracted manually using a charting developed. A descriptive analysis and narrative synthesis were performed.

RESULTS

Of 761 records found, 14 satisfied the pre-determined inclusion and exclusion criteria. Three themes emerged from the studies: Physical health problems, mental health problems; and healthcare services utilisation. Of the 14 included studies, nine studied and reported physical health problems such as sexually transmitted infections, injuries and disabilities, respiratory and cardiac diseases. Five studies explored mental health problems such as psychotic disorders, mood disorders, self-harm and suicidal behaviour. Only five studies investigated utilisation of different types of health care services among homeless people.

CONCLUSIONS

Evidence shows that homeless adults suffered from a range of physical and mental health problems, and underutilisation of health care services. However, there is lack of information on the complex interrelationship between homelessness and health, as well as differences in prevalence of health problems among the various sub-groups of homeless. There is also lack of information regarding utilisation other important healthcare services such as mental health services, alcohol and drugs services, and accident and emergency service, and future researches should address that. Also, attention should be given to intervention models for complex and effective physical and psychiatric care as well as social support to address the homeless people's health vulnerabilities.

Socio economic and health status of street sweepers of Mekelle city, Ethiopia

A questionnaire survey to determine the socio economic and health status of street sweepers of Mekelle city, Ethiopia was held during April and May 2019. The random sample chosen was 137 out of a total of 297 street sweepers of the city. The major lot (86.13%) worked both in the morning and evening shifts whereas the rest 13.87% worked only in the morning shift in all days of the week. They served for a poor monthly salary of 500-1500 Birr. As a result of continuous working with municipal solid waste they developed several health problems. The most wide spread health issues were cuts and laceration (84.67%), respiratory and eye problems (58.39%) and musculoskeletal problems (53.28%). In addition, sweepers reported cases such as fracture by fall, joint pain, cough, asthma, low back pain and dysentery during the previous one year of their service. The study result also showed significant differences in health issues of different sub cities. Sweepers of Qedamay Weyane subcity were worst affected. These sweepers received no medical aid from their employers. In addition they faced several challenges at work place particularly bad weather of early morning, insults and sexual harassments by miscreants on the road. It was reckoned that 97.81% of sweepers had no job satisfaction. It is concluded that the socio economic and health status of street sweepers of Mekelle city was deplorable. In this study suggestions for improving their socio economic status and controlling or minimizing their occupational health hazards are given.

[Efficacy and safety of medicinal cannabis: results of the CaPRis study]

In the 1990s, the endocannabinoid system was discovered as part of the human physiology. Since then, the effects of cannabis as a medicine have been researched more systematically. To summarize the scientific knowledge, the German Federal Ministry of Health commissioned an expertise.The project "Cannabis: Potential and Risks: a Scientific Analysis" (CaPRis), which started in 2016, aimed at analyzing the potential of medicinal cannabis and the risks of recreational cannabis use. A search of systematic reviews (SRs) and randomized-controlled trials (RCTs) were conducted in five international databases (publication date: 2006-2017). For the medical use of cannabis 16 SRs (of 186 RCTs) were included from a global search and nine further RCTs were comprised from a de novo search. All studies were methodologically assessed.Evidence for the efficacy of cannabis medicine (given as an adjunct to other medication) was found in patients with chronic pain and spasticity due to multiple sclerosis. Benefits were also found for appetite stimulation, improvement of nausea, and weight gain in patients with cancer, HIV/AIDS or in palliative care. Effects were often small. For other physical or mental disorders, only few or no controlled human studies are available. Adverse effects of cannabis medicine are often reported; severe adverse effects were mentioned in single cases only.To provide reliable treatment recommendations for clinicians and patients, more large-sized RCTs with follow-up assessments, consistent outcome measures, and active comparisons are needed.

Health issues in a Bangalore slum: findings from a household survey using a mobile screening toolkit in Devarajeevanahalli

Background

Slums are home to nearly one billion people in the world and are expanding at an exponential rate. Devarjeevanahalli is a large notified slum in Bangalore, South India which is characterised by poverty, overcrowding, hazardous living environment and social complexities. The poor living conditions not only affect the health of the people living there but also poses distinctive challenges to conducting health surveys. The purpose of this paper is to report the findings of a household survey that was done to study the health condition of people living in a slum.

Methods

A community-based cross-sectional survey was designed to determine the prevalence of health conditions using a mobile screening toolkit-THULSI (Toolkit for Healthy Urban Life in Slums Initiative). Devarjeevanahalli slum was chosen purposively as it is fairly representative of any slum in a big city in India. Sample size was calculated as 1100 households and demographic parameters at the household level and parameters related to priority health conditions (hypertension, diabetes mellitus, anaemia and malnutrition) at the individual level were studied.

Six zones within the slum were purposively selected and all the contiguous households were selected. The last of the six zones was partially surveyed as the desired sample size was achieved.

Results

A total of 1186 households were surveyed and 3693 people were screened. More than three fourth (70.4%) of the population were below poverty line. Only one third had a regular job and the average daily income was 5.3$ and 2.6$ in men and women respectively. The prevalence of hypertension (35.5%), diabetes (16.6%) and anaemia (70.9%) was high in the screened slum population. Most of the people (56.5% of hypertensives and 34.4% diabetics) were screened for the first time. Almost half of the children under the age of five years were stunted.

Conclusions

Poor income security and huge burden of health issues were reported among adults and children in the household health screening in a large notified slum in South India. Most people were unaware of their disease condition prior to the screening. Relatively simple technological solutions enabled the local health team to screen the slum population despite many challenges.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6756-7) contains supplementary material, which is available to authorized users.

Work stress and health problems of professional drivers: a hazardous formula for their safety outcomes

Background

Several empirical studies have shown that professional drivers are a vulnerable occupational group, usually exposed to environmental stressors and adverse work conditions. Furthermore, recent studies have associated work-related stress with negative job performances and adverse health outcomes within this occupational group, including cardiovascular diseases and unsafe vehicle operation.

Objective

The aim of this study was to describe the working conditions and the health status of this occupational group, and to evaluate the association between the Demand-Control model of job stress and their self-reported health and safety outcomes.

Methods

A pooled sample of 3,665 Colombian professional drivers was drawn from five different studies. The Job Content Questionnaire and the General Health Questionnaire were used to measure work stress and self-reported mental health, respectively. Additionally, professional drivers self-reported health problems (hypertension, dyslipidemia, diabetes and overweight) and health-related risky behaviors (smoking and sedentary behavior).

Results

Regarding the Job Demands-Control (JDC) model, it was found that approximately a third part of Colombian professional drivers suffer from high job strain (29.1%). Correlational and multivariate analyses suggest that de JDC model of stress is associated with the professional drivers' mental health, traffic accidents and fines, but not with other physical and behavioral health-related outcomes, which are highly prevalent among this occupational group, such as hypertension, dyslipidemia, diabetes, overweight, smoking and sedentary behavior.

Conclusion

The results of this study suggest that (a) stressful working conditions are associated with health and lifestyle-related outcomes among professional drivers, and (b) that evidence-based interventions are needed in order to reduce hazardous working conditions, job stress rates and their negative impact on the health of this occupational group.

Medical and health surveillance in postaccident recovery: experience after Fukushima

The accident at Fukushima Daiichi nuclear power plant occurred following the huge tsunami and earthquake of 11 March 2011. After the accident, there was considerable uncertainty and concern about the health effects of radiation. In this difficult situation, emergency responses, including large-scale evacuation, were implemented. The Fukushima Health Management Survey (FHMS) was initiated 3 months after the accident. The primary purposes of FHMS were to monitor the long-term health of residents, promote their well-being, and monitor any health effects related to long-term, low-dose radiation exposure. Despite the severity of the Fukushima accident and the huge impact of the natural disaster, radiation exposure of the public was very low. However, there were other serious health problems, including deaths during evacuation, increased mortality among displaced elderly people, mental health and lifestyle-related health problems, and social issues after the accident. The Nuclear Emergency Situations - Improvement of Medical and Health Surveillance (SHAMISEN) project, funded by the Open Project For European Radiation Research Area, aimed to develop recommendations for medical and health surveillance of populations affected by previous and future radiation accidents. This paper briefly introduces the points that have been learned from the Fukushima accident from the perspective of SHAMISEN recommendations.

The association between Korean employed workers' on-call work and health problems, injuries

Background

On-call work is a form of work that requires the person to work at any time during the on-call period. Thus, on-call work is often regarded as one of the most severe stress factors. This study investigates the associations between on-call work and health problems, injuries.

Methods

This study was based on the 3rd Korean Working Conditions Survey. Total of 29,246 employed workers who had been working for at least 1 year were included. Logistic regression analysis was performed to investigate the association between on-call work and health problems, injuries.

Results

The odds ratios for on-call workers in terms of physical health problems, psychological health problems, and injuries were 1.33 (95% confidence interval [CI] 1.22-1.44), 1.31 (95% CI 1.08-1.60), and 2.76 (95% CI 2.26-3.37), respectively. Analysis of the detailed symptoms revealed odds ratios in on-call workers of 2.06 for hearing problems (95% CI 1.63-2.62); 1.71 for skin problems (95% CI 1.38-2.12); 1.22 for back pain (95% CI 1.08-1.38); 1.23 for muscular pains in upper limbs (95% CI 1.12-1.34); 1.27 for muscular pains in lower limbs (95% CI 1.15-1.40); 1.46 for headache, eye fatigue (95% CI 1.32-1.60); 1.37 for abdominal pain (95% CI 1.02-1.85); 1.43 for depression or anxiety disorders (95% CI 1.07-1.93); 1.36 for fatigue (95% CI 1.24-1.49); and 1.41 for insomnia and general sleep difficulties (95% CI 1.13-1.76).

Conclusions

The present study found that on-call work results in an increased risk of health problems and injuries. This study is the result of analyses of broad range of the job spectrum in Korean employed workers; thus, future studies are necessary to determine the effects of on-call work in various job groups.

Perceived health and work-environment related problems and associated subjective production loss in an academic population

Background

The aim was to investigate the prevalence of health problems and work environment problems and how these are associated with subjective production loss among women and men at an academic workplace. An additional aim was to investigate whether there were differences between women and men according to age group, years at current workplace, academic rank or managerial position.

Methods

A questionnaire was sent in 2011 to all employees at a Swedish university (n = 5144). Only researchers and teachers were included in the study (n = 3207). Spearman correlations were performed to investigate differences in health and work environment problems. Employees who reported having experienced work environment or health problems in the previous seven days (n = 1475) were included in the analyses in order to investigate differences in subjective production loss. This was done using Student’s t-test, One-way Anova and generalized linear models.

Results

The response rate was 63% (n = 2022). A total of 819 academic staff (40% of the population) reported experiencing either health problems, work environment problems or both during the previous seven days. The prevalence of health problems only or a combination of work environment and health problems was higher among women than men (p-value ˂0.05). This was especially the case for younger women, those in lower academic positions and those who had worked for fewer years at their current workplace. No difference was found for work environment problems. The majority of the employees who reported problems said that these problems affected their ability to perform at work (84–99%). The average production loss varied between 31 and 42% depending on the type of problem. Production loss due to health-related and work-environment related problems was highest among junior researchers and managers. No significant difference between men and women was found in the level of production loss.

Conclusion

Subjective production loss in academia can be associated with health and work- environment problems. These losses appear similar for women and men even though younger female academics, women in lower academic ranks and those with fewer years of employment in their current workplace report a higher prevalence of health problems and combined work-environment and health problems than men.

A survey of health problems of Nepalese female migrants workers in the Middle-East and Malaysia

BACKGROUND

Nepal is a key supplier of labour for countries in the Middle East, India and Malaysia. As many more men than women leave Nepal to work abroad, female migrant workers are a minority and very much under-researched. The aim of the study was to explore the health problems of female Nepalese migrants working in the Middle-East and Malaysia.

METHODS

The study was conducted among 1010 women who were registered as migrant returnees at an organisation called Pourakhi Nepal. Secondary data were extracted from the records of the organisation covering the five-year period of July 2009 to July 2014.

RESULTS

The 1010 participants were aged 14 to 51 with a median age of 31 (IQR: 38-25) years. A quarter of respondents (24%) reported having experienced health problems while in the country of employment. Fever, severe illness and accidents were the most common health problems reported. Working for unlimited periods of time and not being able to change one's place of work were independently associated with a greater likelihood of health problems. Logistic regression shows that migrant women who are illiterate [OR = 1.56, 95% CI: 1.02 to 2.38, p = 0.042], who had changed their workplace [OR = 1.63, 95% CI: 1.14 to 2.32, p = 0.007], who worked unlimited periods of time [OR = 1.64, 95% CI: 1.44 to 1.93, p = 0.020], had been severely maltreated or tortured in the workplace [OR = 1.84, 95% CI: 1.15 to 2.92, p = 0.010], were not being paid on time [OR = 2.38, 95% CI: 1.60 to 3.55, p = 0.038] and migrant women who had family problems at home [OR = 3.48, CI 95%: 1.22 to 9.98, p = 0.020] were significantly associated with health problems in their host country in the Middle East.

CONCLUSION

Female migrant workers face various work-related health risks, which are often related to exploitation. The Government of Nepal should initiate awareness campaigns about health risks and rights in relation to health care services in the host countries. Recruiting agencies/employers should provide information on health risks and training for preventive measures. Raising awareness among female migrant workers can make a change in their working lives.

Incidence and spectrum of health problems among travellers to Myanmar

BACKGROUND

The number of international travellers visiting Myanmar increases each year. However, information about pre-travel preparation and incidence of health problems among these travellers is limited.

METHODS

This cross-sectional study was conducted at three international airports in Thailand. Travellers returning from Myanmar completed questionnaires querying demographic profile, pre-travel health preparations and health problems during their stay in Myanmar.

RESULTS

From March 2015 to May 2017, we collected and analysed questionnaires completed by 397 Thai and 467 non-Thai travellers (total: 50.1% men, median age 37 years). Non-Thai travellers were from Europe (59%), Northern America (21.4%), Asia (16.5%) and Australia or New Zealand (3.0%). Approximately 74% of non-Thais sought pre-travel health information; only 36% of Thais did so. Tourism was the main purpose for travel among both Thais (58.4%) and non-Thais (85.2%). Non-Thais were more likely than Thais to travel as backpackers and perform outdoor activities such as trekking, cycling or swimming. The average length of stay in Myanmar among non-Thais was significantly longer than that of Thais (26.58 days vs 7.08 days, P < 0.001). Health problems were reported by 22.9% of non-Thais; the most common was diarrhoea (21.0%) followed by upper respiratory tract symptoms (9.2%), fever (3.4%) and skin problems (3.0%). Only 12.6% of Thais reported health problems, the most common being upper respiratory tract symptoms (7.6%), followed by diarrhoea (3.1%), fever (2.8%) and skin problems (2.0%). Most health problems were mild and self-limited in both groups. Only one Thai and eight non-Thai travellers required a doctor's visit during their trip to Myanmar, and two non-Thais required hospitalization.

CONCLUSIONS

Health problems are not very common among travellers to Myanmar. Overall, health problems were reported among 18.2% of travellers in our study. Most problems were mild, with spontaneous recovery. Only two foreign travellers required hospitalization.

Migrants and Refugees in Europe: Challenges, Experiences and Contributions

Due to the current geopolitical situation more refugees from crisis countries were and will be treated in Europe. In 2015 the number of displaced people reached an unprecedented level, with more than one million crossing into Europe. The migration itself can impair both mental and physical health. Therefore, the provision of medical care for refugees and migrants is a novel and major challenge for the health care systems in Europe. In this article we describe our experiences and contribution in providing medical care for refugees who have newly arrived in Stuttgart, Baden-Wuerttemberg, Germany. Furthermore, we report our experiences from a tertiary referral University center in Regensburg, Bavaria, Germany. We focus on challenges in both the outpatient and the inpatient setting, with a special focus on intensive care patients. In addition, we provide an overview about the spectrum of diseases in this specific patient cohort.

Drinking despite health problems among individuals with liver disease across the United States

BACKGROUND

Heavy drinking is harmful for individuals with liver disease. However, some of these individuals drink despite knowledge of the risks. The current study aims to identify factors underlying drinking despite health problems among individuals with liver disease.

METHODS

The current study utilizes a subsample of individuals reporting past-year liver disease and at least one drink in the past year (n=331), taken from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a large nationally representative survey of the United States. Participants reported on drinking despite health problems, symptoms of psychopathology, and family history of alcohol problems in a cross-sectional survey.

RESULTS

Drug use disorders (Adjusted Odds Ratio [AOR]=2.68), as well as borderline, antisocial, and schizotypal personality disorders (AORs=2.50-4.10), were associated with increased likelihood of drinking despite health problems among individuals with liver disease, all ps<0.05. Any anxiety disorder trended toward significance (AOR=2.22), p=0.06, but major depressive disorder was not associated with increased risk, (AOR=0.99), ps=0.97. Individuals with a family history of alcohol problems were also more likely to drink despite health problems (AOR=2.79), p<0.05.

CONCLUSIONS

Several types of psychopathology, as well as a family history of alcohol problems, increased the likelihood of drinking despite health problems among individuals with liver disease. These findings highlight the need to intervene with heavily drinking individuals with liver disease, who may be drinking due to familial risk and/or comorbid psychopathology.

The growth of chronic conditions: Search for solutions to the problem

The chronic conditions growth is determined by an increase of cases of adaptive system imbalance following a recent disease. One of its most significant causes is decrease of crisis importance (a stage of disease) as a moderator of a qualitative changeover of an adaptive system. The contemporary treatment methods increase efficiency of pre-crises adaptive responses, but simultaneously they equalize the crisis to a level, which is insufficient for complete after-crisis alignment of body defenses. But the crisis is the very key to a solution to a chronic conditions problem. One of the ways of the problem solving is medical interventions, which cause sparing provocation crisis and a successive changeover of an adaptive system. Based on this it is worth reviewing critically, studying and developing the existing experience of bio-regulatory therapy, where the principle of sparing provocation is often used. The new term definitions, such as “medical intervention”, “health problems”, “crisis” are described in terms of biomedicine. The patients and physicians should be motivated to deal with chronic conditions correction and the aforesaid sets new tasks before a health care system.

Occupation Hazards - Pattern, Awareness and Preventive Measures among Welders from an Unorganized Sector in India

INTRODUCTION

Welding is an occupation associated with tremendous physical and chemical hazards. In spite of the risk involved, usage of Personal Protective Gears (PPGs) among welders in developing countries has been reported to be poor, due to their limited awareness of occupational hazards.

AIM

To assess morbidity pattern, awareness of occupational hazards and usage practices of protective gears among welders.

MATERIALS AND METHODS

Cross-sectional study was conducted at welding sites from unorganized sector situated in and around Mangalore. A total of 155 welders chosen randomly from as many sites were interviewed at their workplace using a pilot tested structured interview schedule with both closed and open ended questions. Clinical examination of the participant and inspection of the work site was also done by the investigators. Statistical analysis used for analysis was Chi-Square test, unpaired t-test and ANOVA test.

RESULTS

Working >8 hours a day was reported by 30 (19.4%) welders. Overcrowding was present at 10.3%, ventilation status was inadequate at 6.9% and exhaust ventilation was not present at 25.9% sites. Awareness about occupational health hazards associated with welding was present among 97(62.6%) welders. Periodicity of medical examination was associated with awareness of occupational hazards among welders (p=0.032). First aid kit was present at 60 (38.7%) sites. The most common morbidity over the past year was wounds 119 (76.8%). Non-usage of most essential protective gears such as face shields, masks or eye goggles was seen among 18 (11.6%) welders. Mean number of morbidities over the past one month was found to be more, in those welders doing continuous work of ≥6 hours (p=0.05), at sites with overcrowding (p=0.002) and at sites where >10 welders work together (p=0.031).

CONCLUSION

The period prevalence of morbidity was high among the welders surveyed. Ignorance of health hazards associated with occupation and non-usage of protective gears was reported by number of them. Therefore, health education and safety policies need to be strengthened at welding sites.

Why whey? Camel whey protein as a new dietary approach to the management of free radicals and for the treatment of different health disorders

The balance between free radicals and antioxidants is an important factor for maintaining health and slowing disease progression. The use of antioxidants, particularly natural antioxidants, has become an important strategy for dealing with this cause of widespread diseases. Natural antioxidants have been used as therapeutic tools against many diseases because they are safe, effective, and inexpensive and are among the most commonly used adjuvants in the treatment of several diseases. Camel whey protein (CWP) is considered a strong natural antioxidant because it decreases oxidative stress, enhances immune system function, and increases glutathione levels. The structure of CWP is very similar to that of other types of whey protein from different types of milk. CWP contains many components, such as lactoferrin (LF), lactalbumin, lactoglobulins, lactoperoxidase, and lysozyme, and is rich in immunoglobulins. However, in contrast to other WPs, CWP lacks β-lactoglobulin, the main cause of milk allergies in children. The components of CWP have many beneficial effects, including stimulation of both innate and adaptive immunity and anti-inflammatory, anticancer, antibacterial, and antiviral activities. Recently, it has been shown that CWP and its unique components can facilitate the treatment of impaired diabetic wound healing. However, the molecular mechanisms underlying the protective effects of CWP in human and other animal disorders are not fully understood. Therefore, the current review presents a concise summary of the scientific evidence of the beneficial effects of CWP to support its therapeutic use in disease treatment and nutritional intervention.

Gestational age and chronic 'body-mind' health problems in childhood: dose-response association and risk factors

Understanding the developmental course of all health issues associated with preterm birth is important from an individual, clinical and public health point-of-view. Both the number of preterm births and proportion of survivors have increased steadily in recent years. The UK Millennium Cohort Study (n = 18,818) was used to examine the association of gestational age with maternal ratings of general health and behavior problems at ages 5 and 11 years using binary and multinomial logistic regression analyses. The association between mothers' ratings of general health and behavior problems was relatively weak at each time point. Children rated as being in poor general health remained constant over time (4.0 % at age 5, 3.8 % at age 11), but children rated as having behavioral problems increased by almost 100 % (5.6 % at 5; 10.5 % at 11). A gradient of increasing risk with decreasing gestational age was observed for a composite health measure (general health problems and/or behavior problems) at age 5, amplified at age 11 and was strongest for those with chronic problems (poor health at both age 5 and age 11). This association was found to be compounded by child sex, maternal characteristics at birth (education, employment, marital status) and duration of breast feeding. Integrated support to at-risk families initiated during, or soon after pregnancy, may prevent chronic problems and might potentially reduce long term health costs for both the individual and health services.

Bacterial pathogens and health problems of Acipenser gueldenstaedtii and Acipenser baerii sturgeons reared in the eastern Black Sea region of Turkey

Farming sturgeons is an economically important practice in a number of Asian and European countries. However, since it is not widely implementedin Turkey, fertilized eggs necessary for research and industrial activities are imported from Germany. Due to the interest of several fish farms in culturing sturgeon in Turkey and the lack of relevant data, this study investigated bacteria related health problems of two different sturgeon species, the diamond sturgeon (Acipenser gueldenstaedtii) and the Siberian sturgeon (Acipenser baerii). The fungal, parasitic and bacterial pathogens found in these fish were investigated until the fish reached about 3 kg of weight (3+ years). A number of bacterial disease pathogens (Acinetobacter radioresistens, some Aeromonas and Pseudomonas species and Bacillus mycoides) and parasite Trichodina sp. and fungus Saprolegnia sp. were identified in the fish. Both phenotypic and molecular characterizations of the isolated bacteria were performed. Furthermore, swim bladder and spinal problems, cannibalism, tumor growth and mechanical injuries on the external surface of the fish were observed during the study period.

Health and participation problems in older adults with long-term disability

BACKGROUND

More attention and understanding of the health and participation problems of adults with early and later onset disabilities in the Netherlands is needed.

OBJECTIVE

To explore health/participation problems and unmet needs in adults aged ≥40 years with long-term disabilities and their relationship with the time of onset.

METHODS

Participants were recruited in the Netherlands through newsletters and social media to participate in a web-based questionnaire. The questionnaire assessed background characteristics, (change in) health/participation problems, and unmet needs. Spearman's rho was used to examine the relationships with time of onset.

RESULTS

Of the 163 survey respondents, 42% acquired their disability before age 25 years and reported fatigue (77%), walking problems (66%), and pain (59%). In 21% of the respondents with early-onset disability fatigue, pain and depressive feelings co-occurred. Early-onset disability correlated with joint deformities, pain and anxiety. Participation problems included loss of income and fewer social activities. Early-onset correlated with the need for more information about diagnosis and prognosis.

CONCLUSIONS

People aged over 40 years with long-term disability have significant and increasing health and participation problems. Adults with early-onset disability are more likely to have health or participation problems than adults with late-onset disability. Early identification is needed for preventive care and access to specialized services that focus on improving and maintaining physical symptoms, energy management, and participation.

Usage of Plastic Bags and Health Hazards: A Study to Assess Awareness Level and Perception about Legislation Among a Small Population of Mangalore City

INTRODUCTION

Plastic bag users are at risk of number of health hazards. There is paucity of data with regard to awareness of health hazards among general population in India.

AIM

This study was done to find out the status of awareness of the health hazards associated with the usage of plastic bags among people and their perception towards the legislation prohibiting the usage of plastic bags.

MATERIALS AND METHODS

This cross-sectional study conducted in Mangalore city in August 2013. Data was collected by interviewing any adult member (aged above 18 years) in each of the selected households using an interview schedule.

RESULTS

Mean age of the 250 participants was 32.8±10.8 years. Majority 160(64%) were females educated up to undergraduate level or above 187(74.8%). Among the participants 216(86.4%) were aware of the health hazards associated with the use of plastic bags. Awareness was significantly more amongst females (p=0.027), well-educated participants (p=0.004) and among professionals and semi-professionals (p<0.001). There were 50(20%) participants reusing plastic bags for shopping after initial usage. The cloth bags were used for shopping in place of plastic bags by 13(5.2%) participants. Among the participants 213(85.2%) were aware of the legislation banning the use of plastic bags and out of which 166(77.9%) were in its favour. Semi-professionals and students favoured the ban on plastic bags whereas unskilled and semiskilled workers were against the ban (p=0.01).

CONCLUSION

Most of the participants in the settings had the awareness of hazards of plastic bag usage. However, there is a need for spreading the awareness of using alternative strategies and effective implementation of legislation in order to minimize the usage of plastics in the community.

Adolescent health: present status and its related programmes in India. Are we in the right direction?

Adolescence is a phase of rapid growth and development during which physical, physiological and behavioural changes occur. They constitute more than 1.2 billion worldwide, and about 21% of Indian population. Morbidity and mortality occurring in this age group is mostly due to preventable causes. Young and growing children have poor knowledge and lack of awareness about physical and psychological changes that occurs during adolescence and the ill health affecting them. Existing Adolescent health programmes focus on rendering services like immunization, health education for sexual and reproductive health, nutritional education and supplementation, anemia control measures and counseling. Adolescent health programmes are fragmentary at present and there is no comprehensive programme addressing all the needs of adolescents. Access and availability of health care services are severely limited. Lack of accurate information, absence of proper guidance, parent's ignorance, lack of skills and insufficient services from health care delivery system are the major barriers. Interventions should focus on providing psychological and mental health services and behaviour change communication towards leading a healthy lifestyle, restricting advertisement related to junk food products, awareness creation about reproductive and sexual health, educating parents to prevent early marriage, teenage pregnancy and to counsel their children on nutrition and reproductive health. Universal coverage of Adolescent friendly clinics is highly recommended. To be cost effective, all health services addressing adolescent should come under single programme. This review is intended to create awareness among the stakeholders about the importance of strengthening adolescent health services in order to meet their felt needs.

Therapeutic abdominoplasty: Report of a case

•

Excessive drooping belly may lead to severe issues majorly affecting the person’s health as well as the quality of life.

•

Abdominoplasty could be used not only for cosmetic purposes but also for therapeutic purposes by eliminating morbidity and improving the quality of life.

Background

Abdominoplasty is a surgical procedure which is commonly used for cosmetic purposes. However, there are very few reports in the world literature describing the abdominoplasty procedure for therapeutic purposes rather than for cosmetic reasons.

Methods

A 58 year old female presented with an excessive drooping belly and a concomitant minor umbilical stoma hernia, who suffered from chronic back pain, urinary incontinence, nerve atrophy of the low extremes, central-type obesity, gastric disorders, and spinal osteophytes who underwent abdominoplasty and umbilical hernia repair.

Result

On discharge from the hospital after 11 days, the patient mentioned satisfactory elimination of the back pain as well as amelioration of the urinary incontinence. Within 14 months after the operation, the patient noticed extreme improvement of ambulation and postural stability as well as complete disappearance of the neuro-myodystrophy.

Conclusion

Wide abdominal rectus plication abdominoplasty should be considered to be performed for therapeutic purposes when major health problems occur.

Morbidity pattern and personal hygiene in children among private primary school in urban area: are the trends changing?

Introduction:

School health is an important intervention as a great deal of research tells us that schools can have a major effect on children's health, by teaching them about health and promoting healthy behaviors.

Aims:

The aim of this study is to determine common health problems and assess personal hygiene status among primary school children.

Settings and Design:

A cross-sectional study was conducted in academic years 2009-2010 and 2010-2011, with three health check-up camps organized in private primary school of Pune city.

Materials and Methods:

A total of 450 students were assessed for health problems and composite score of personal hygiene status was calculated ranging from 0 to 5 by examination of hairs, nails, skin and clothes.

Statistical Analysis Used:

Proportions calculated with application of Chi-square test and Pearson co-efficient applied to observe the relation between two quantitative variables.

Results:

Out of 450 students examined, 56.2% were boys and 43.8% were girls with age ranging from 5 to 10 years. The major morbidities observed were dental caries (65.1%), upper respiratory tract infections (38.2%), ear wax (29.9%) and myopia (10.0%). Mean hygiene score was significantly higher in girls (4.32) than boys (3.95) and poor hygiene observed in older boys.

Conclusion:

Increasing myopia and poor dental hygiene denotes a changing morbidity pattern in private primary school of the urban area. The hygiene status of the girls is significantly better than boys.

Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia

Objective: Sandstorms are metrological events and frequently occur in many regions throughout the world. Sandstorms are a main source of long-distance transport of dust, air pollution and cause various health problems. This study aimed to investigate the acute respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia.

Methodology: The present descriptive study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period March 2011- June 2012. We selected 517 (308 males, 59.58%) and (209 females, 40.42%), apparently healthy volunteers with mean age 28.6± 3.14 years, who had single outside exposure to sandstorm for the period of 24±2.68 minutes. The acute respiratory and general health complaints were recorded through a comprehensive questionnaire.

Results: A large proportion of the subjects who were exposed to sandstorm had complaints of cough 247 (47.77%), runny nose 264(51.06%), wheeze 173(33.46%), acute asthmatic attack 108 (20.88%), eye irritation / redness 252(48.74%), headache 179 (34.62%), body ache 199 (38.5%), sleep disturbance 157(30.36%) and psychological disturbances 194 (37.52%).

Conclusion: Exposure to sandstorm causes cough, runny nose, wheeze, acute asthmatic attack, eye irritation / redness, headache, body ache, sleep and psychological disturbances. These results indicate that sandstorm is a prolific source of respiratory and general ailments. It is therefore, suggested that an unnecessary exposure to sandstorm must be avoided.

Meeting the health care needs of street-involved youth

Health care providers who see homeless or street-involved youth can help to reduce the impact of many risk factors - physical, mental, emotional and social - pertaining to street culture. The present statement describes the types and scale of homelessness in Canada, and reviews reasons why youth turn to the street, risks of the 'street economy' and barriers to health care. Common physical and mental health problems are considered, along with legal and ethical issues that may affect care. Principles of care, including accessibility, confidentiality and harm reduction, and strategies to target and engage this population lead to recommendations for improving services, outcomes, advocacy and increased governmental support.

Health problems among the elderly: a cross-sectional study

Background:

Estimates of health problems of the elderly in developing countries are required from time to time to predict trends in disease burden and plan health care for the elderly. Developing countries have a poor track record of equitable distribution of health care. Marginalized groups living in urban slums and rural villages have poor penetration of health services.

Aims:

To identify the geriatric health problems in samples drawn from a slum and a village, and also to explore any gender and urban–rural difference morbidity.

Subject and Methods:

A community-based cross-sectional study was carried out by house to house survey of all people aged over 60 years in an urban slum and a village in the field practice area of a teaching hospital. The total elderly population in these two areas was 407, with an almost equal representation from urban slum and rural area. Information (most of them self-reported) was collected in a pre-tested instrument, which has been used earlier in a World Health Organization multicentric study in India. Categorical variables were summarized by percentages. Associations were explored with odds ratio (OR) and 95% confidence intervals (CIs).

Results:

Female elders outnumbered the male elders; widows outnumbered widowers. Tobacco use was very high at 58.97% (240/407). Visual impairment (including uncorrected presbyopia) was the most common handicap with prevalence of 83.29% (339/407), with males more affected than females (OR = 2.52, 95% CI 1.32-4.87). Uncorrected hearing impairment was also common. Urinary complaints were also more common in males (OR = 1.68, 95% CI = 0.93-3.04). More rural elders were living alone than their urban counterpart (OR = 2.87, 95% CI 1.23-6.86). History of weight loss was higher in the rural areas, while tendency to obesity was higher in the urban areas. An appreciable number 29.2% (119/407) had unoperated cataract. Prevalence of hypertension was 30.7% (125/407); 12% (49/407) had diabetes; 7.6% (31/407) gave history of ischemic heart disease, males more than females (OR = 3.75, 95% CI 1.62-8.82). A large proportion, 32.6%, (133/407) had dental problems. Almost half of the population gave history of depression.

Conclusion:

A large number of unmet health needs, such as unoperated cataract, uncontrolled hypertension, uncorrected hearing impairment and tobacco use, exist in marginalized groups. Health interventions for these are needed in developing countries. Preventive services such as tobacco cessation campaigns among the elderly should also get priority.

Occurrence and treatment of common health problems in a nigerian community

Medicines are cost-effective interventions for the treatment and management of health problems. This research was carried out to determine the common health problems and medicine-use practices in treating health problems in Lamingo, Jos, Nigeria. A total of 109 households covering 676 individuals were recruited and followed up for a period of one month between 6 November 2010 and 11 December 2010. A structured interview was conducted on weekly visits to households to identify illnesses suffered by household members and treatment given. The results showed that 146 common health problems representing 1.3 cases per household per month were found. The cost of treatment per household per month was found to be $14.7. Infectious and parasitic diseases (44.6%), diseases of the digestive (11.0%) and respiratory system (9.6%) were common in the community. Self-medication was common (34.6%) and the patent medicine stores were the most common sources of medicines. Common classes of medicines used by community members were analgesics (23.6%), antimalarials (17.9%) and antibiotics (14.2%). Factors that influenced choice of treatment were previous knowledge and experience of family members with service provider and treatment (44.4%), cost (18.9%) and severity of condition (16.7%). There is, therefore, high occurrence of health problems and self-medication practices in the Lamingo community.

Health Emergencies in Large Populations: The Orissa Experience

Natural disasters occur frequently in the country and civic authorities requisition medical aid from the Armed Forces for the succour of populations, with increasing regularity. The recent Orissa floods (2001) saw deployment of a Medical Team and the experiences of the team are discussed. Over a nine day period, 7450 cases were treated on site in medical aid posts established in flood affected areas. Of these patients, 4038 (54.20%) were affected by gastrointestinal illnesses (diarrhoea/acute gastroenteritis); 976 (13.10%) had suffered injuries and were treated accordingly; 2007 (26.94%) cases of respiratory infection were managed. 210 (2.82%) cases of undiagnosed fever were treated, and 18 (0.24%) cases of clinical malaria were diagnosed additionally. Skin and other infections comprised 186 (2.50%) cases of the total. Thus, this study provides a brief outline of the spectrum of illnesses that may be encountered in dealing with flood affected populations, for the benefit of planning for future humanitarian operations. The various stages of a disaster have been brought out, for an insight into the morbidity pattern in such deployments. The concept of "Health Emergencies in Large Populations" is introduced in the discussion, for policy to be evolved. Public health is closely interlinked with disaster management, and the Army with its resource of trained specialists is geared for response in the face of disaster in a professional manner. Recommendations on dealing with future situations under such conditions of deployment have also been made.