Self-reported body silhouettes: a diagnostic instrument for anthropometric parameters.

OBJECTIVE: Routine body size measurement of anthropometric values requires professionals, standardized techniques, and calibrated tools. Therefore, there is a need for easier screening tools such as the self-reported body silhouette (Self-bosi). The aim of this study was to analyze the performance of Self-bosi as a proxy of anthropometric values. STUDY DESIGN: Prospective analytic study of the Health Workers Cohort Study. METHODS: Adult participants of the Health Workers Cohort Study were included. Then, through the calculation sensitivity and specificity of Self-bosi to detect abnormal waist circumference (WC) (≥90 cm for male and ≥80 cm for female participants), elevated body fat percentage (BF%) (≥25% for male and ≥35% for female participants), as well as overweight and obesity (≥25 kg/m2) and obesity (≥30 kg/m2). RESULTS: A total of 2471 male and 5940 female participants were analyzed. Overall, Self-bosi discriminate high WC values (area under the curve [AUC]; male participants: 0.80, female participants: 0.82); increased BF% (AUC: male participants: 0.78, female participants: 0.83); overweight and obesity (AUC: male participants: 0.81, female participants: 0.86); and obesity (AUC: male participants: 0.83, female participants: 0.89). CONCLUSION: Self-bosi is an accurate method to assess increased WC, BF%, obesity, and overweight-obesity in Mexican adults. Given its simplicity and low-cost of the self-reported body silhouette, it might be considered a useful anthropometric screening instrument in large scale epidemiological research.

Are interventions effective at improving driving in older drivers?: A systematic review.

BACKGROUND: With the aging of the population, the number of older drivers is on the rise. This poses significant challenges for public health initiatives, as older drivers have a relatively higher risk for collisions. While many studies focus on developing screening tools to identify medically at-risk drivers, little research has been done to develop training programs or interventions to promote, maintain or enhance driving-related abilities among healthy individuals. The purpose of this systematic review is to synopsize the current literature on interventions that are tailored to improve driving in older healthy individuals by working on components of safe driving such as: self-awareness, knowledge, behaviour, skills and/or reducing crash/collision rates in healthy older drivers. METHODS: Relevant databases such as Scopus and PubMed databases were selected and searched for primary articles published in between January 2007 and December 2017. Articles were identified using MeSH search terms: ("safety" OR "education" OR "training" OR "driving" OR "simulator" OR "program" OR "countermeasures") AND ("older drivers" OR "senior drivers" OR "aged drivers" OR "elderly drivers"). All retrieved abstracts were reviewed, and full texts printed if deemed relevant. RESULTS: Twenty-five (25) articles were classified according to: 1) Classroom settings; 2) Computer-based training for cognitive or visual processing; 3) Physical training; 4) In-simulator training; 5) On-road training; and 6) Mixed interventions. Results show that different types of approaches have been successful in improving specific driving skills and/or behaviours. However, there are clear discrepancies on how driving performance/behaviours are evaluated between studies, both in terms of methods or dependent variables, it is therefore difficult to make direct comparisons between these studies. CONCLUSIONS: This review identified strong study projects, effective at improving older drivers' performance and thus allowed to highlight potential interventions that can be used to maintain or improve older drivers' safety behind the wheel. There is a need to further test these interventions by combining them and determining their effectiveness at improving driving performance.

Nutrition therapy in intensive care unit setting: what can be learned from a 6 months survey in a large academic hospital?

BACKGROUND: Malnutrition in Intensive Care Unit patients has been associated with worse clinical outcomes such as mortality and length of stay (LOS) in Intensive Care Unit (ICU), and nutritional status of Intensive Care Unit patients in particular seemed to be a significant predictor of mortality. Promptness of clinical nutrition administration is a key of nutritional support whenever volitional intake is unfeasible. Early enteral nutrition is associated with better clinical outcomes (reduced complications, LOS in ICU and in Hospital). The aim of this study is to investigate the nutrition therapy management in a large Academic Hospital, evaluating its effects on mortality and LOS in ICU and in the Hospital. STUDY DESIGN: Data were collected retrospectively from clinical records. Six physicians were trained on the data collection protocol and they reviewed every clinical record of patients included in the survey. METHODS: Data of 426 patients admitted to ICUs between November 2016, 1st and April 2017, 30th were collected. A multivariate logistic adjusted regression, with backward variables selection method, was performed in order to identify predictors of enteral and parenteral nutrition conducted within 48 hours after admission to the ICU. The relation between medical nutrition therapy, mortality and LOS in ICU and in the Hospital were also evaluated. RESULTS: Patients were given prompt parenteral and enteral nutrition in 25.12% and 27.46% of cases, respectively. No association was found between medical nutrition therapy and ICU or hospital mortality. Predictors of early enteral nutrition were type of admission and surgery before admission; early parenteral nutrition predictors were gender, ICU (A vs B), impaired immunity status and Central Venous Catheter presence at admission. CONCLUSIONS: Our study stresses the need of monitoring nutrition prescribing behaviors in acute hospitals in order to better set up tailored interventions to standardize clinicians' practices and to focus on specific training targets.

Nurses' perspectives on whether medical aid in dying should be accessible to incompetent patients with dementia: findings from a survey conducted in Quebec, Canada.

We conducted a survey in a random sample of 514 Quebec nurses caring for the elderly to assess their attitudes towards extending medical aid in dying to incompetent patients and to explore associated factors. Attitudes were measured using clinical vignettes featuring a hypothetical patient with Alzheimer disease. Vignettes varied according to the stage of the disease (advanced or terminal) and the presence or absence of a written request. Of the 291 respondents, 83.5% agreed with the current legislation that allows physicians to administer aid in dying to competent patients who are at the end of life and suffer unbearably. A similar proportion (83%, p = 0.871) were in favor of extending medical aid in dying to incompetent patients who are at the terminal stage of Alzheimer disease, show signs of distress, and have made a written request before losing capacity.

Effects of topical capsaicin combined with moderate exercise on insulin resistance, body weight and oxidative stress in hypoestrogenic obese rats.

BACKGROUND: Hypoestrogenic (HE) women are one of the most vulnerable groups for the development of obesity and its complications. Capsaicin and exercise have demonstrated to reduce body weight and to improve insulin sensitivity in different animal models, but it is unknown whether their combination could be useful in HE obese females. METHODS: We investigated whether topical capsaicin, exercise or their combination had better therapeutic effects in an obesity-hypoestrogenism model. Ovariectomized Wistar rats were given a 30% sucrose solution (HE-Obese (HEOb)) or purified water (HE) during 28 weeks ad libitum; four experimental groups per each condition. After shaving the abdominal skin, cold cream vehicle was applied to the Sedentary groups (Sed) and capsaicin cream 0.075% (0.6 mg kg-1 per day) to the Capsaicin groups (Cap). Exercise (Ex) groups ran on a treadmill every day for 20 min at speeds from 9 to 18 m per min increased every 10 days; combination groups (Cap+Ex) were given topical capsaicin 90 min before exercise. The treatments were performed for 6 weeks, and caloric intake and body weight were monitored. At the end of the experimental protocol, glucose tolerance tests were performed, the animals were killed by decapitation; blood and organs were obtained to perform oxidative profile, histology, biochemical analyses and Western blot. RESULTS: In HEOb rats, the combined therapy reduced caloric intake, body weight and abdominal fat in a higher proportion than the individual treatments; it also decreased insulin resistance (IR), oxidative stress and pancreatic islet size. It was the only treatment that significantly increased p-AMPK levels in the soleus muscle. In HE rats, topical capsaicin was the only treatment that reduced glucose intolerance and improved the oxidative profile in a higher proportion than the combined therapy or Ex alone. CONCLUSIONS: Capsaicin per se or its combination with moderate exercise could be a useful therapy against complications linked to obesity-IR in HE females.

Do Socioeconomic Factors Influence Knowledge, Attitudes, and Representations of End-of-Life Practices? A Cross-Sectional Study.

OBJECTIVE: Access to palliative and end-of-life (EOL) care might be influenced by knowledge, attitudes, and representations of these practices. Socioeconomic factors might then affect what people know about EOL care practices, and how they perceive them. This study aims to compare knowledge, attitudes, and representations regarding EOL practices including assisted suicide, medical assistance in dying, and continuous palliative sedation of adults, according to socioeconomic variables. METHODS: A cross-sectional community-based questionnaire study featuring two evolving vignettes and five end-of-life practices was conducted in Quebec, Canada. Three sample subgroups were created according to the participants' perceived financial situation and three according to educational attainment. Descriptive analysis was used to compare levels of knowledge, attitudes, and representations between the subgroups. RESULTS: Nine hundred sixty-six (966) people completed the questionnaire. Two hundred and seventy participants (28.7%) had a high school diploma or less, and 42 participants (4.4%) were facing financial hardship. The majority of respondents supported all end-of-life options and the loosening of eligibility requirements for medical assistance in dying. Differences between subgroups were minor. While respondents in socioeconomically disadvantaged subgroups had less knowledge about EOL practices, those with lower educational attainment were more likely to be in favor of medical assistance in dying, and less likely to favor continuous palliative sedation. CONCLUSIONS: People living with situational social and economic vulnerabilities face multiple barriers in accessing health care. While they may have poorer knowledge about EOL practices, they have a positive attitude towards medical assistance in dying and assisted suicide, and a negative attitude towards continuous palliative sedation. This highlights the need for future research and interventions aimed at empowering this population and enhancing their access to EOL care.

Productivity in older versus younger workers: A systematic literature review.

BACKGROUND: Worldwide ageing and thus, workforce ageing, is a concern for both developed and developing nations. OBJECTIVE: The aim of the current research was to determine, through a systematic literature review, the effects of age in three dimensions that are often used to define or assess productivity at work. METHODS: PICO framework was used to generate search strategies, inclusion criteria and terms. Scopus and PubMed databases were used. Peer-reviewed journal papers written in English and published (or in press) between January 2014 and December 2018 were included. RESULTS: After filtering through inclusion criteria, 74 papers were included in the review. Considering productivity, 41%of the findings showed no differences between younger and older workers, 31%report better productivity of younger workers and 28%reported that older workers had better productivity than younger workers. Performance was better in older workers (58%), presenteeism generally showed no significant differences between age groups (61%). Absenteeism was the only outcome where younger workers outperformed older workers (43%). CONCLUSION: Overall, there was no difference in productivity between older and younger workers. Older workers performed better than younger workers, but had more absenteeism, while presenteeism showed no differences. As ageing has come to workplaces, holistic approaches addressing total health are suggested to overcome the worldwide workforce ageing phenomenon.

Secular changes in the anthropometrics of Chilean workers and its implication in design.

BACKGROUND: Anthropometrics is very important when ensuring a physical match between end users and product or workstations. OBJECTIVES: The purpose of this study are twofold, to provide anthropometric data for the design of products and to examine the secular changes in the adult Chilean workers in a period of more than 20 years. METHODS: Nineteen anthropometric measurements from two samples from 1995 and 2016 were compared using independent t-test (95% confidence interval), where additionally absolute and relative differences were calculated. RESULTS: The secular trend observed for Stature is characterized by an increase average of 20mm and 10.5mm per decade for females and males, respectively. There is a positive secular trend for both genders, which is observed for most of the selected body measurements. The most pronounced increases were onWeight, Shoulder breadth, Body mass index, Popliteal height; Buttock-popliteal length and Hip width. CONCLUSIONS: Segmental dimensions that experienced a positive secular trend, together with Weight and Stature, are highly correlated with seating design, addressing the need to review products targeting Chilean adult workers, such as public transport seats, office furniture or industrial workplaces.

Identification of several intracellular carbohydrate-degrading activities from the halophilic archaeon Haloferax mediterranei.

Three different amylolytic activities, designated AMY1, AMY2, and AMY3 were detected in the cytoplasm of the extreme halophilic archaeon Haloferax mediterranei grown in a starch containing medium. This organism had also been reported to excrete an alpha-amylase into the external medium in such conditions. The presence of these different enzymes which are also able to degrade starch may be related to the use of the available carbohydrates and maltodextrins, including the products obtained by the action of the extracellular amylase on starch that may be transported to the cytoplasm of the organism. The behavior of these intracellular hydrolytic enzymes on starch is reported here and compared with their extracellular counterpart. Two of these glycosidic activities (AMY1, AMY3) have also been purified and further characterized. As with other halophilic enzymes, they were salt dependent and displayed maximal activity at 3 M NaCl, and 50 degrees C. The purification steps and molecular masses have also been reported. The other activity (AMY2) was also detected in extracts from cells grown in media with glycerol instead of starch and in a yeast extract medium. This enzyme was able to degrade starch yielding small oligosaccharides and displayed similar halophilic behavior with salt requirement in the range 1.5-3 M NaCl.

Natural killer cell activity decreases in workers occupationally exposed to extremely low frequency magnetic fields exceeding 1 microT.

In a preliminary study a reduction in natural killer (NK) cell activity in peripheral blood lymphocytes (PBL) was observed in a group of workers exposed to levels of extremely low frequency-magnetic fields (ELF-MF) exceeding 1 microT. This study was performed to confirm the results. In 121 workers engaged in various occupational activities, individual ELF-MF exposure was monitored for 2 work shifts. Exposure levels were calculated as time-weighted average (TWA). Subjects were classified as Low exposure (TWA < or = 0.2 microT), Medium exposure (TWA 0.21-0.99 microT), or Higher exposure (TWA > or = 1 microT). In higher exposure workers NK activity proved significantly reduced compared to low exposure,(p<0.01). In medium exposure a reduction was also observed, but the difference was not significant. Multivariate analysis also confirmed the relation between exposure and NK activity. It has been suggested that ELF might affect tumour progression by inducing changes in the immune system: due to the role played by NK activity in host defence against cancer, the interference with the NK cell activity observed in this study is in agreement with this hypothesis. Furthermore, an increased risk for some neurodegenerative disorders has been reported in some epidemiological studies in ELF-MF-exposed workers: changes in NK function were also described in these diseases. Our results, showing the effect on NK activity of exposure exceeding 1 microT, suggest a possible mechanism for ELF-MF effects. This could open new horizons regarding the adverse long-term effects of these fields.

[Comparing ethics committees from France and Quebec with respect to incapacity to consent to research]. / Comparaison des comités d'éthique de France et du Québec en regard de l'incapacité à consentir à la recherche.

BACKGROUND: French and Quebec legislation allow the inclusion of decisionally-incompetent subjects in research, provided certain conditions are met. In both jurisdictions, ethics committees are charged with ensuring that research protocols meet these conditions. We investigated committee members' knowledge and opinions regarding substitute consent for research purposes. METHODS: Two consecutive postal surveys were conducted among all members of ethics committees from France and Quebec. Knowledge and opinions about proxy consent were measured with clinical vignettes describing hypothetical situations involving incapable adults. For each vignette, respondents were asked to either identify the person legally authorized to consent or choose the substitute decision-maker whom they considered best suited to do so. RESULTS: Knowledge of the legislation governing substitute consent was poor in both samples, especially in situations involving an incompetent person who did not have a legal representative. Knowledge was worse among French ethics committee members (p<0.001). In hypothetical clinical studies that involved no risk to the subject's health, 59% of respondents favored consent from a close relative. As the risk increased, the proportion gradually decreased to 14.2%, while the proportion against soliciting the cognitively impaired older adult tended to increase (from 5.8 to 31.2%). These trends were observed in both samples. CONCLUSION: These findings underscore the need to better educate ethics committee members about legislation regarding prospective subjects who lack decisional capacity. Such efforts could improve both knowledge of and compliance with legal provisions that enable or restrict the participation of cognitively-impaired patients in research projects. Moreover, study findings provide some support for enlarging the category of persons who are authorized to consent to low-risk research on behalf of incapacitated adults who lack legal representation.

Association between sweetened beverage consumption and body mass index, proportion of body fat and body fat distribution in Mexican adolescents.

BACKGROUND/AIMS: It was the aim of this study to evaluate the relationships between sweetened beverage (SB) consumption and the following indicators of overweight/fatness among Mexican adolescents: body mass index, body composition and body fat distribution. METHODS: We performed a cross-sectional analysis of data from adolescents participating in the baseline assessment of the Health Workers Cohort Study. Information on sociodemographic conditions, sexual maturation, dietary patterns and physical activity was collected via self-administered questionnaires. SB consumption was evaluated through a validated semiquantitative food frequency questionnaire. Anthropometric measures were assessed with standardized procedures. The associations of interest were evaluated by means of multivariate regression and logistic regression models. RESULTS: A total of 1,055 adolescents, 10-19 years old (mean age 14.5+/-2.5 years), were evaluated. The overweight/obesity prevalence was 31.6% among girls and 31.9% among boys. We found that for each additional SB serving consumed daily, the subject's body mass index increased by on average 0.33 (p<0.001). Subjects consuming 3 daily servings of SB face a 2.1 times greater risk of proportionally excess body fat than those who consume less than 1 SB a day. CONCLUSIONS: Our data support the hypothesis that the consumption of SB increases the risk of overweight and/or obesity and encourages excess body fat and central obesity in Mexican adolescents.

A literature review of anthropometric studies of school students for ergonomics purposes: Are accuracy, precision and reliability being considered?

BACKGROUND: Despite offering many benefits, direct manual anthropometric measurement method can be problematic due to their vulnerability to measurement errors. OBJECTIVE: The purpose of this literature review was to determine, whether or not the currently published anthropometric studies of school children, related to ergonomics, mentioned or evaluated the variables precision, reliability or accuracy in the direct manual measurement method. METHODS: Two bibliographic databases, and the bibliographic references of all the selected papers were used for finding relevant published papers in the fields considered in this study. RESULTS: Forty-six (46) studies met the criteria previously defined for this literature review. However, only ten (10) studies mentioned at least one of the analyzed variables, and none has evaluated all of them. Only reliability was assessed by three papers. Moreover, in what regards the factors that affect precision, reliability and accuracy, the reviewed papers presented large differences. This was particularly clear in the instruments used for the measurements, which were not consistent throughout the studies. Additionally, it was also clear that there was a lack of information regarding the evaluators' training and procedures for anthropometric data collection, which are assumed to be the most important issues that affect precision, reliability and accuracy. CONCLUSIONS: Based on the review of the literature, it was possible to conclude that the considered anthropometric studies had not focused their attention to the analysis of precision, reliability and accuracy of the manual measurement methods. Hence, and with the aim of avoiding measurement errors and misleading data, anthropometric studies should put more efforts and care on testing measurement error and defining the procedures used to collect anthropometric data.

Reversible hyperintensity in middle cerebellar peduncles. An infrequent finding in Marchiafava-Bignami disease. / Hiperintensidad reversible en los pedúnculos cerebelosos medios. Un hallazgo infrecuente en la enfermedad de Marchiafava-Bignami.

TITLE: Hiperintensidad reversible en los pedúnculos cerebelosos medios. Un hallazgo infrecuente en la enfermedad de Marchiafava-Bignami.

[Evaluation of the genotoxicity of the extremely low frequency-magnetic fields (ELF-MF) in workers exposed for professional reasons]. / Valutazione della genotossicità dei campi magnetici a frequenza estremamente bassa (ELF-MF) in lavoratori esposti per ragioni professionali.

Whether or not ELF-MF has genotoxic potential is a controversial issue. In the present study, we investigated the genotoxic effect using cytogenetic assays (CA - SCE - MN), in 109 workers exposed to ELF-MF. The mean value of occupational exposure in the whole group was 0.35 microT. According to the exposure level the workers were stratified in two different groups: low exposed (n. 39, TWA < or = 0.2 microT) and higher exposed (n. 70; TWA > 0.2 microT): the groups did not significantly differ for the examined variables. Due to these results we decided to re-evaluate the effect only considering the highest exposed workers: we selected 31 workers exposed to TWA levels exceeding 1 microT, and compared vs. the low exposed subjects: again, the difference in the groups examined were not significant. At multivariate regression analysis was also applied: no correlation was observed with cytogenetic biomarkers. The results of this study does not support the hypothesis of any direct genotoxic effect of ELF-MF, at least at the environmental levels currently found in an occupational settings.

[ELF-MF occupational exposure: repeated measures on workers]. / Campi magnetici ELF ed esposizione professionale: misure ripetute della esposizione individuale in lavoratori addetti a varie mansioni.

The aim of our study was to estimate occupational exposure to Extremely Low Frequency-Magnetic Fields (ELF-MF). Using personal dosimeters we evaluated occupational exposure in 543 workers employed in 9 occupational settings (about 150 jobs), representative of the main occupational activities in Emilia-Romagna region. In the whole sample, the median Time-Weighted Average (TWA) exposure resulted 0.14 microT (5 degrees - 95 degrees percentiles: 0.04 - 2.50 microT); Tile production presented the highest occupational setting TWA (0.46 +/- 1.83 microT), while the lower job TWA was Stock Clerk in Tile Production and Stock Clerk in Garment Production. After 6-9 months we repeated measurement in about 10% of the original sample (about 48 subjects) to verify the resulted obtained. At repeated measurement analysis with SPSS 12.0 no variation was found compared the previous monitoring. Individual occupational exposure to ELF-MF evaluated in a relatively large group of workers engaged in the main occupational activities proved low values compared to the proposed occupational limit.

Escala ERVI en la radiografía de tórax y evolución hacia Fibrosis Pulmonar en los casos de infección por SARS-COV-2 / ERVI scale on chest X-ray and evolution towards Pulmonary Fibrosis in cases of SARS-COV-2 infection

Resumen abreviado: Se analizaron todas las radiografías de tórax con sospecha de afectación por COVID-19 durante la “primera ola”, aplicando el score ERVI al ingreso y correlacionando su evolución hacia fibrosis pulmonar documentada por TC, con el objetivo de identificar la relación entre ERVI grave y el desarrollo de fibrosis pulmonar.Objetivo: Analizamos todas las radiografías de tórax realizadas por el servicio de urgencias durante la primera ola de la COVID-19 con motivo de consulta “sospecha COVID-19”. Posteriormente, revisamos aplicando la escala ERVI y realizando un seguimiento de su evolución clínica y radiológica a los seis meses. Igualmente, todos aquellos pacientes positivos y que ingresaron en UCI fueron posteriormente revisados, realizando una TC de tórax de control. En el presente artículo nos centramos en intentar establecer una relación entre aquellas radiografías que presentaban un ERVI grave y el desarrollo de fibrosis pulmonar.Métodos: Identificamos un total de 653 radiografías de pacientes con clínica compatible y hallazgos sospechosos de infección por SARS-CoV-2. Del total, solo se realizaron TC de tórax a 83 pacientes, que son los que se han tenido en cuenta para este estudio, analizando la presencia de fibrosis pulmonar. Tras analizar la relación entre los valores del score ERVI y la presencia de fibrosis, en más de la mitad de los casos la fibrosis se desarrollaba en pacientes con ERVI grave al ingreso.Resultados: Existe una relación estadísticamente significativa con una p<0.005 entre la presencia de neumonía grave medida por la escala ERVI al ingreso y el posterior desarrollo de fibrosis pulmonar.Conclusiones: Consideramos sensata la recomendación de realizar seguimiento por TC a pacientes con enfermedad grave que pueda aportar datos para el diagnóstico de fibrosis pulmonar, especialmente a partir de tres semanas del inicio de los síntomas. (AU)

Short summary: All chest X-rays suspected of being affected by COVID-19 during the “first wave” were analyzed, applying the LVRI score at admission and correlating its evolution towards pulmonary fibrosis documented by CT, with the aim of identifying the relationship between severe ERVI and the development of pulmonary fibrosis.Objective: We analyzed all chest X-rays performed by the emergency department during the so-called first wave of COVID-19 with the reason for consultation "COVID-19 suspicion". Subsequently, these radiographs were reviewed, applying the ERVI scale and following their clinical and radiological evolution at six months. Similarly, all positive patients who were admitted to the ICU were subsequently reviewed and a control chest CT scan was performed. In the present article we focus on trying to establish a relationship between those radiographs showing severe ERVI and the development of pulmonary fibrosis.Methods: A total of 653 radiographs of patients with compatible symptoms and suspicious findings of SARS-CoV-2 infection have been identified. Of the total number of patients, chest CT scans were only performed in 83 patients, which are the ones taken into account for this study, analyzing the presence of pulmonary fibrosis. After analyzing the relationship between ERVI score values and the presence of fibrosis, in more than half of the cases patients with severe ERVI at admission developed pulmonary fibrosis.Results: We demonstrateda statistically significant association (p<0.005) between the presence of severe pneumonia measured by the ERVI scale on admission and the subsequent development of pulmonary fibrosis.Conclusions: We recommend CT follow-up of patients with severe disease that can provide data for the diagnosis of pulmonary fibrosis, especially if it is performed three weeks after the onset of symptoms. (AU)