RESUMO
Non-ferrous metal smelting poses significant risks to public health. Specifically, the copper smelting process releases arsenic, a semi-volatile metalloid, which poses an emerging exposure risk to both workers and nearby residents. To comprehensively understand the internal exposure risks of metal(loid)s from copper smelting, we explored eighteen metal(loid)s and arsenic metabolites in the urine of both occupational and non-occupational populations using inductively coupled plasma mass spectrometry with high-performance liquid chromatography and compared their health risks. Results showed that zinc and copper (485.38 and 14.00 µg/L), and arsenic, lead, cadmium, vanadium, tin and antimony (46.80, 6.82, 2.17, 0.40, 0.44 and 0.23 µg/L, respectively) in workers (n=179) were significantly higher compared to controls (n=168), while Zinc, tin and antimony (412.10, 0.51 and 0.15 µg/L, respectively) of residents were significantly higher than controls. Additionally, workers had a higher monomethyl arsenic percentage (MMA%), showing lower arsenic methylation capacity. Source appointment analysis identified arsenic, lead, cadmium, antimony, tin and thallium as co-exposure metal(loid)s from copper smelting, positively relating to the age of workers. The hazard index (HI) of workers exceeded 1.0, while residents and control were approximately at 1.0. Besides, all three populations had accumulated cancer risks exceeding 1.0 × 10-4, and arsenite (AsIII) was the main contributor to the variation of workers and residents. Furthermore, residents living closer to the smelting plant had higher health risks. This study reveals arsenic exposure metabolites and multiple metals as emerging contaminants for copper smelting exposure populations, providing valuable insights for pollution control in non-ferrous metal smelting.
Assuntos
Metalurgia , Exposição Ocupacional , Humanos , Exposição Ocupacional/análise , Exposição Ambiental/estatística & dados numéricos , Metais/urina , Metais/análise , Medição de Risco , Arsênio/análise , Monitoramento Ambiental , Adulto , Poluentes Ambientais/análise , Pessoa de Meia-IdadeRESUMO
Severe ground-level ozone (O3) pollution over major Chinese cities has become one of the most challenging problems, which have deleterious effects on human health and the sustainability of society. This study explored the spatiotemporal distribution characteristics of ground-level O3 and its precursors based on conventional pollutant and meteorological monitoring data in Zhejiang Province from 2016 to 2021. Then, a high-performance convolutional neural network (CNN) model was established by expanding the moment and the concentration variations to general factors. Finally, the response mechanism of O3 to the variation with crucial influencing factors is explored by controlling variables and interpolating target variables. The results indicated that the annual average MDA8-90th concentrations in Zhejiang Province are higher in the northern and lower in the southern. When the wind direction (WD) ranges from east to southwest and the wind speed (WS) ranges between 2 and 3 m/sec, higher O3 concentration prone to occur. At different temperatures (T), the O3 concentration showed a trend of first increasing and subsequently decreasing with increasing NO2 concentration, peaks at the NO2 concentration around 0.02 mg/m3. The sensitivity of NO2 to O3 formation is not easily affected by temperature, barometric pressure and dew point temperature. Additionally, there is a minimum [Formula: see text] at each temperature when the NO2 concentration is 0.03 mg/m3, and this minimum [Formula: see text] decreases with increasing temperature. The study explores the response mechanism of O3 with the change of driving variables, which can provide a scientific foundation and methodological support for the targeted management of O3 pollution.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Cidades , Monitoramento Ambiental , Redes Neurais de Computação , Ozônio , Ozônio/análise , Poluentes Atmosféricos/análise , China , Poluição do Ar/estatística & dados numéricos , Análise Espaço-TemporalRESUMO
Polychlorinated naphthalenes (PCNs) are detrimental to human health and the environment. With the commercial production of PCNs banned, unintentional releases have emerged as a significant environmental source. However, relevant information is still scarce. In this study, provincial emissions for eight PCNs homologues from 37 sources in the Chinese mainland during the period of 1960-2019 were estimated based on a source-specific and time-varying emission factor database. The results showed that the total PCNs emissions in 2019 reached 757.0 kg with Hebei ranked at the top among all the provinces and iron & steel industry as the biggest source. Low-chlorinated PCNs comprised 90% of emissions by mass, while highly chlorinated PCNs dominated in terms of toxicity, highlighting divergent priorities for mitigating emissions and safeguarding human health. The emissions showed an overall upward trend from 1960 to 2019 driven by emission increase from iron & steel industry in terms of source, and from North China and East China in terms of geographic area. Per-capita emissions followed an inverted U-shaped environmental Kuznets curve while emission intensities decreased with increasing per-capita Gross Domestic Product (GDP) following a nearly linear pattern when log-transformed.
Assuntos
Poluentes Atmosféricos , Monitoramento Ambiental , Naftalenos , China , Naftalenos/análise , Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricosRESUMO
Objective weather classification methods have been extensively applied to identify dominant ozone-favorable synoptic weather patterns (SWPs), however, the consistency of different classification methods is rarely examined. In this study, we apply two widely-used objective methods, the self-organizing map (SOM) and K-means clustering analysis, to derive ozone-favorable SWPs at four Chinese megacities in 2015-2022. We find that the two algorithms are largely consistent in recognizing dominant ozone-favorable SWPs for four Chinese megacities. In the case of classifying six SWPs, the derived circulation fields are highly similar with a spatial correlation of 0.99 between the two methods, and the difference in the mean frequency of each SWP is less than 7%. The six dominant ozone-favorable SWPs in Guangzhou are all characterized by anomaly higher radiation and temperature, lower cloud cover, relative humidity, and wind speed, and stronger subsidence compared to climatology mean. We find that during 2015-2022, the occurrence of ozone-favorable SWPs days increases significantly at a rate of 3.2 day/year, faster than the increases in the ozone exceedance days (3.0 day/year). The interannual variability between the occurrence of ozone-favorable SWPs and ozone exceedance days are generally consistent with a temporal correlation coefficient of 0.6. In particular, the significant increase in ozone-favorable SWPs in 2022, especially the Subtropical High type which typically occurs in September, is consistent with a long-lasting ozone pollution episode in Guangzhou during September 2022. Our results thus reveal that enhanced frequency of ozone-favorable SWPs plays an important role in the observed 2015-2022 ozone increase in Guangzhou.
Assuntos
Poluentes Atmosféricos , Monitoramento Ambiental , Ozônio , Tempo (Meteorologia) , Ozônio/análise , China , Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricosRESUMO
To explore air contamination resulting from special biomass combustion and suspended dust in Lhasa, the present study focused on the size distribution and chemical characteristics of particulate matter (PM) emission resulting from 7 types of non-fossil pollution sources. We investigated the concentration and size distribution of trace elements from 7 pollution sources collected in Lhasa. Combining Lhasa's atmospheric particulate matter data, enrichment factors (EFs) have been calculated to examine the potential impact of those pollution sources on the atmosphere quality of Lhasa. The highest mass concentration of total elements of biomass combustion appeared at PM0.4, and the second highest concentration existed in the size fraction 0.4-1 µm; the higher proportion (12 %) of toxic metals was produced by biomass combustion. The elemental composition of suspended dust and atmospheric particulate matter was close (except for As and Cd); the highest concentration of elements was all noted in PM2.5-10 (PM3-10). Potassium was found to be one of the main biomass markers. The proportion of Cu in suspended dust is significantly lower than that of atmospheric particulate matter (0.53 % and 3.75 %), which indicates that there are other anthropogenic sources. The EFs analysis showed that the Cr, Cu, Zn, and Pb produced by biomass combustion were highly enriched (EFs > 100) in all particle sizes. The EFs of most trace elements increased with decreasing particle size, indicating the greater influence of humanfactors on smaller particles.
Assuntos
Aerossóis , Poluentes Atmosféricos , Poeira , Monitoramento Ambiental , Tamanho da Partícula , Material Particulado , Poluentes Atmosféricos/análise , Aerossóis/análise , Material Particulado/análise , Poeira/análise , Oligoelementos/análise , Poluição do Ar/estatística & dados numéricos , Poluição do Ar/análise , China , Atmosfera/químicaRESUMO
China is the most important steel producer in the world, and its steel industry is one of the most carbon-intensive industries in China. Consequently, research on carbon emissions from the steel industry is crucial for China to achieve carbon neutrality and meet its sustainable global development goals. We constructed a carbon dioxide (CO2) emission model for China's iron and steel industry from a life cycle perspective, conducted an empirical analysis based on data from 2019, and calculated the CO2 emissions of the industry throughout its life cycle. Key emission reduction factors were identified using sensitivity analysis. The results demonstrated that the CO2 emission intensity of the steel industry was 2.33 ton CO2/ton, and the production and manufacturing stages were the main sources of CO2 emissions, accounting for 89.84% of the total steel life-cycle emissions. Notably, fossil fuel combustion had the highest sensitivity to steel CO2 emissions, with a sensitivity coefficient of 0.68, reducing the amount of fossil fuel combustion by 20% and carbon emissions by 13.60%. The sensitivities of power structure optimization and scrap consumption were similar, while that of the transportation structure adjustment was the lowest, with a sensitivity coefficient of less than 0.1. Given the current strategic goals of peak carbon and carbon neutrality, it is in the best interest of the Chinese government to actively promote energy-saving and low-carbon technologies, increase the ratio of scrap steel to steelmaking, and build a new power system.
Assuntos
Dióxido de Carbono , Pegada de Carbono , Aço , China , Dióxido de Carbono/análise , Poluentes Atmosféricos/análise , Metalurgia , Monitoramento Ambiental , Indústrias , Poluição do Ar/estatística & dados numéricos , Poluição do Ar/prevenção & controleRESUMO
Personal care products (PCPs) are a class of emerging pollutants that have attracted public concern owing to their harmful effects on humans and the environment. Biomonitoring data is valuable for insight the levels of PCPs in the human body and can be crucial for identifying potential health hazards. To gain a better understanding of timely exposure profiles and health risk of reproductive-age population to PCPs, we determined six parabens, six benzophenone-type ultraviolet filters, and three disinfectants in 256 urine samples collected from young adults aged 18-44 years in Beijing, China. The urinary levels of benzophenone-3 (BP-3) and 4-hydroxybenzophenone (4-OHBP) were significantly higher in summer compared to winter, suggesting these compounds have different seasonal usage patterns. Moreover, the total concentration of 15 PCPs in female was 430 ng/mL, approximately two times higher than that in male. Pchloro-m-xylenol (PCMX), as a new type of antibacterial agent, has the greatest level among all target analytes, indicating the increasingly use of this antibacterial alternative recently. Five potential influencing factors that lead to the elevated exposure level of PCPs were identified. Over 19% of the target population had a high hazard index value (greater than 1) which was attributed to exposure to propyl paraben (PrP), benzophenone-1 (BP-1), BP-3 and PCMX, indicating that PCPs may pose a relatively high exposure risk at environmental levels that should be a cause for concern.
Assuntos
Cosméticos , Exposição Ambiental , Humanos , Adulto , Adulto Jovem , Medição de Risco , Feminino , Masculino , Adolescente , Cosméticos/análise , Exposição Ambiental/estatística & dados numéricos , Exposição Ambiental/análise , Pequim , Poluentes Ambientais/análise , Benzofenonas/urina , Monitoramento AmbientalRESUMO
Furniture is identified as a vital volatile organic compound (VOC) emission source in the indoor environment. Leather has become the most common raw and auxiliary fabric material for upholstered furniture, particularly with extensive consumption in sofas, due to its abundant resources and efficient functions. Despite being widely traded across the world, little research has been conducted on the VOCs released by leather materials and their health risk assessment in the indoor environment. Accordingly, this study investigated the VOC emissions of leather with different grades and the health risk of the inhalation exposure. Based on the ultra-fast gas phase electronic nose (EN) and GC-FID/Qtof, the substantial emissions of aliphatic aldehyde ketones (Aks), particularly hexanal, appear to be the cause of off-flavor in medium and low grade (MG and LG) sofa leathers. The health risk assessment indicated that leather materials barely pose non-carcinogenic and carcinogenic effects to residents. Given the abundance of VOC sources and the accumulation of health risks in the indoor environment, more stringent specifications concerning qualitative and quantitative content should be extended to provide VOC treatment basic for the manufacturing industry and obtain better indoor air quality.
Assuntos
Poluição do Ar em Ambientes Fechados , Compostos Orgânicos Voláteis , Compostos Orgânicos Voláteis/análise , Poluição do Ar em Ambientes Fechados/análise , Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Medição de Risco , Monitoramento Ambiental , Poluentes Atmosféricos/análise , Humanos , Decoração de Interiores e Mobiliário , Exposição por Inalação/análise , Exposição por Inalação/estatística & dados numéricos , Têxteis/análiseRESUMO
Mercury (Hg), especially methylmercury (MeHg), accumulation in rice grain due to rice paddy possessing conditions conducive to Hg methylation has led to human Hg exposure through consumption of rice-based daily meals. In addition to being a food staple, rice is widely used as a raw material to produce a vast variety of processed food products. Little is known about Hg levels in snacking rice-food products and potential Hg exposure from consumption of them, besides previous studies on infant rice cereals. Aiming to provide complementary information for a more complete assessment on Hg exposure risk originated from Hg-containing rice, this study determined total Hg (THg) and MeHg levels in 195 rice-containing and rice-free processed food products covering all major types of snack foods marketed in China and the estimated daily intake (EDI) of dietary Hg from the consumption of these foods. The results clearly showed THg and MeHg contents in rice-containing foods were significantly higher than rice-free products, suggesting the transfer of Hg and MeHg from the rice to the end products, even after manufacturing processes. Moreover, significant positive correlations were observed between THg, MeHg, or MeHg/THg ratio and rice content for samples containing multiple grains as ingredients, further indicating the deciding role of rice for Hg levels in the end food products. Although the EDI of THg and MeHg via rice-based food products were relatively low compared to the reference dose, it should be considered these snacking food products would contribute additive Hg intake outside of the daily regular meals.
Assuntos
Exposição Dietética , Contaminação de Alimentos , Mercúrio , Compostos de Metilmercúrio , Oryza , Oryza/química , Mercúrio/análise , Contaminação de Alimentos/análise , China , Compostos de Metilmercúrio/análise , Exposição Dietética/análise , Exposição Dietética/estatística & dados numéricos , Humanos , Medição de RiscoRESUMO
Chinese diesel trucks are the main contributors to NOx and particulate matter (PM) vehicle emissions. An increase in diesel trucks could aggravate air pollution and damage human health. The Chinese government has recently implemented a series of emission control technologies and measures for air quality improvement. This paper summarizes recent control technologies and measures for diesel truck emissions in China and introduces the comprehensive application of control technologies and measures in Beijing-Tianjin-Hebei and surrounding regions. Remote online monitoring technology has been adopted according to the China VI standard for heavy-duty diesel trucks, and control measures such as transportation structure adjustment and heavy pollution enterprise classification control continue to support the battle action plan for pollution control. Perspectives and suggestions are provided for promoting pollution control and supervision of diesel truck emissions: adhere to the concept of overall management and control, vigorously promote the application of systematic and technological means in emission monitoring, continuously facilitate cargo transportation structure adjustment and promote new energy freight vehicles. This paper aims to accelerate the implementation of control technologies and measures throughout China. China is endeavouring to control diesel truck exhaust pollution. China is willing to cooperate with the world to protect the global ecological environment.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Monitoramento Ambiental , Material Particulado , Emissões de Veículos , Emissões de Veículos/análise , China , Poluentes Atmosféricos/análise , Poluição do Ar/prevenção & controle , Poluição do Ar/estatística & dados numéricos , Monitoramento Ambiental/métodos , Material Particulado/análise , Veículos AutomotoresRESUMO
Suicidal thought and behavior (STB) is highly stigmatized and taboo. Prone to censorship, yet pervasive online, STB risk detection may be improved through development of uniquely insightful digital markers. Focusing on Sanctioned Suicide, an online pro-choice suicide forum, this work derived 17 egocentric network features to capture dynamics of social interaction and engagement within this uniquely uncensored community. Using network data generated from over 3.2 million unique interactions of N = 192 individuals, n = 48 of which were determined to be highest risk users (HRUs), a machine learning classification model was trained, validated, and tested to predict HRU status. Model prediction dynamics were analyzed using introspection techniques to uncover patterns in feature influence and highlight social phenomena. The model achieved a test AUC = 0.73 ([0.61, 0.85], 95% CI), suggesting that network-based socio-behavioral patterns of online interaction can signal for heightened suicide risk. Transitivity, density, and in-degree centrality were among the most important features driving this performance. Moreover, predicted HRUs tended to be targets of social exchanges with lesser frequency and possessed egocentric networks with "small world" network properties. Through the implementation of an underutilized method on an unlikely data source, findings support future incorporation of network-based social interaction features in descriptive, predictive, and preventative STB research.
Assuntos
Aprendizado de Máquina , Interação Social , Suicídio , Humanos , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Feminino , Masculino , Adulto , Ideação Suicida , Internet , Rede SocialRESUMO
BACKGROUND: Although urinary tract infection (UTI) is a common and severe public health concern, and there are clear biological mechanisms between UTI and hot temperatures, few studies have addressed the association between hot temperatures and UTI. METHODS: We designed a time-stratified case-crossover study using a population-representative sample cohort based on the National Health Insurance System (NHIS) in South Korea. We obtained all NHIS-based hospital admissions through the emergency room (ER) due to UTI (using a primary diagnostic code) from 2006 to 2019. We assigned satellite-based reanalyzed daily summer (June to September) average temperatures as exposures, based on residential districts of beneficiaries (248 districts in South Korea). The conditional logistic regression was performed to evaluate the association between summer temperature and UTI outcome. RESULTS: A total of 4,436 ER visits due to UTI were observed during the summer between 2006 and 2019 among 1,131,714 NHIS beneficiaries. For 20% increase in summer temperatures (0-2 lag days), the odd ratio (OR) was 1.06 (95% CI: 1.02-1.10) in the total population, and the association was more prominent in the elderly (people aged 65 y or older; OR:1.11, 95% CI: 1.05-1.17), females (OR: 1.12, 95% CI: 1.05-1.19), and people with diabetes history (OR: 1.14, 95% CI: 1.07-1.23). The effect modification by household income was different in the total and elderly populations. Furthermore, the association between summer temperature and UTI increased during the study period in the total population. CONCLUSIONS: Our results are consistent with the hypothesis that higher summer temperatures increase the risk of severe UTIs, and the risk might be different by sub-populations.
Assuntos
Estudos Cross-Over , Serviço Hospitalar de Emergência , Estações do Ano , Infecções Urinárias , Humanos , República da Coreia/epidemiologia , Infecções Urinárias/epidemiologia , Masculino , Feminino , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pessoa de Meia-Idade , Idoso , Adulto , Temperatura Alta/efeitos adversos , Adulto Jovem , Adolescente , Pré-Escolar , Criança , Lactente , Idoso de 80 Anos ou mais , Fatores de Risco , Visitas ao Pronto SocorroRESUMO
BACKGROUND: A global schools-based programme within the Global Campaign against Headache is estimating the burden of headache in children (6-11 years) and adolescents (12-17 years), cluster-sampling the world by conducting national studies in all world regions. Its purpose is to complement population-based studies in adults, adding to knowledge of the burden of headache and informing educational and health policies. This study in Benin was the third in the programme from sub-Saharan Africa (SSA). METHODS: We followed the generic protocol for the global study. In a cross-sectional survey, the child and adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaire were administered to pupils within their classes in 16 schools selected from across the country to be representative of its diversities. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of undifferentiated headache (UdH). RESULTS: Very large proportions of pupils were absent on the survey days. The sampled population defined by class registers totalled 11,802 pupils, of whom only 2,488 were present. A further 193 pupils (or their parents) declined the survey. The surveyed sampled (N = 2,295; males 1,156 [50.4%], females 1,139 [49.6%]) included 1,081 children (47.1%) and 1,214 adolescents (52.9%), with a non-participating proportion (193/2,488) of 7.8%. Headache ever was reported by 97.3% of the sample. Age- and gender-adjusted 1-year prevalences, according to responses given, were 53.4% for migraine (almost three quarters of this being probable migraine), 21.3% for tension-type headache, 8.2% for UdH, 1.0% for probable medication-overuse headache (pMOH) and 2.6% for other headache on ≥ 15 days/month (H15+). Both pMOH and other H15 + were substantially more prevalent among adolescents. CONCLUSION: The finding for migraine is anomalous, but, within this series of studies, the same was found in Zambia and similar in Ethiopia, both in SSA. While many cases identified as probable migraine, especially among children, might better have been diagnosed as UdH, the true prevalence of migraine almost certainly exceeds 21%. Regardless of diagnosis, headache is very common among children and adolescents in Benin. The study sounds an alarm with regard to pMOH as a developing problem pre-adulthood.
Assuntos
Transtornos da Cefaleia , Humanos , Benin/epidemiologia , Adolescente , Masculino , Criança , Feminino , Prevalência , Estudos Transversais , Transtornos da Cefaleia/epidemiologia , Inquéritos e Questionários , Instituições Acadêmicas/estatística & dados numéricosRESUMO
BACKGROUND: Transport injuries (TI) remains one of leading causes of death in children in China. This study aimed to analyze the temporal trend of disease burden and associated risk factors of TI among children aged 0-14 years in China, utilizing data from 1990 to 2019. METHODS: We retrieved data of disease burden and risk factors of TI among children aged 0-14 year in China from 1990 to 2019 from the Global Burden of Disease (GBD) dataset. We estimated incidence rate, death rate, and disability adjusted life years (DALYs) rate with a 95% uncertainty interval (95% UI), stratified by age, sex, and all type-road users. Trends in disease burden with annual percentage changes (APC) and average annual percent change (AAPC) were performed by Joinpoint regression model. RESULTS: The incidence rate (AAPC = 1.18%, P < 0.001) of TI among children aged 0-14 years showed an increasing trend, whereas mortality rate (AAPC = -3.87%, P < 0.001) and DALYs rate (AAPC = -3.83%, P < 0.001) decreased annually. Notably, boys experienced a higher increase in incidence (1.30%) compared to girls (1.06%), but a faster decrease in mortality and DALYs rate (-3.90% vs. -3.82%, -3.88% vs. -3.79%, respectively) (Pall < 0.001). Declines in death rates and DALYs rates were observed across all age groups (Pall < 0.001), while remained the highest among children aged 0-4 in 2019. Among different road-type users, cyclist road injuries were identified as the primary cause of TI (182.3 cases per 100,000) while pedestrians were the group with the highest mortality (2.9 cases per 100,000) and DALYs rate (243 cases per 100,000) in 2019. Besides, alcohol use was a significant risk factors for TI, while low temperature appeared to be a protective factor. CONCLUSION: Future efforts must prioritize raising awareness among children and their guardians to mitigate the disease burden of TI in children. It's critical to enhance preventive interventions for boys, children aged 0-4 and vulnerable road users such as pedestrians and cyclists in future.
Assuntos
Acidentes de Trânsito , Ferimentos e Lesões , Humanos , Lactente , China/epidemiologia , Adolescente , Masculino , Pré-Escolar , Criança , Feminino , Fatores de Risco , Recém-Nascido , Acidentes de Trânsito/estatística & dados numéricos , Acidentes de Trânsito/mortalidade , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/mortalidade , Incidência , Anos de Vida Ajustados por Deficiência , Carga Global da Doença/tendências , Efeitos Psicossociais da DoençaRESUMO
BACKGROUND: The Scandinavian Neurotrauma Committee guideline (SNC-16) was developed and published in 2016, to aid clinicians in management of pediatric head injuries in Scandinavian emergency departments (ED). The objective of this study was to explore determinants for use of the SNC-16 guideline by Swedish ED physicians. METHODS: This is a nationwide, cross-sectional, web-based survey in Sweden. Using modified snowball sampling, physicians managing children in the ED were invited via e-mail to complete the validated Clinician Guideline Determinants Questionnaire between February and May, 2023. Baseline data, data on enablers and barriers for use of the SNC-16 guideline, and preferred routes for implementation and access of guidelines in general were collected and analyzed descriptively and exploratory with Chi-square and Fisher's tests. RESULTS: Of 595 invitations, 198 emergency physicians completed the survey (effective response rate 33.3%). There was a high reported use of the SNC-16 guideline (149/195; 76.4%) and a strong belief in its benefits for the patients (188/197; 95.4% agreement). Respondents generally agreed with the guideline's content (187/197; 94.9%) and found it easy to use and navigate (188/197; 95.4%). Some respondents (53/197; 26.9%) perceived a lack of organizational support needed to use the guideline. Implementation tools may be improved as only 58.9% (116/197) agreed that the guideline includes such. Only 37.6% (74/197) of the respondents agreed that the guideline clearly describes the underlying evidence supporting the recommendation. Most respondents prefer to consult colleagues (178/198; 89.9%) and guidelines (149/198; 75.3%) to gain knowledge to guide clinical decision making. Four types of enablers for guideline use emerged from free-text answers: ease of use and implementation, alignment with local guidelines and practice, advantages for stakeholders, and practicality and accessibility. Barriers for guideline use were manifested as: organizational challenges, medical concerns, and practical concerns. CONCLUSIONS: The findings suggest high self-reported use of the SNC-16 guideline among Swedish ED physicians. In updated versions of the guideline, focus on improving implementation tools and descriptions of the underlying evidence may further facilitate adoption and adherence. Measures to improve organizational support for guideline use and involvement of patient representatives should also be considered.
Assuntos
Traumatismos Craniocerebrais , Fidelidade a Diretrizes , Guias de Prática Clínica como Assunto , Humanos , Estudos Transversais , Suécia , Traumatismos Craniocerebrais/terapia , Fidelidade a Diretrizes/estatística & dados numéricos , Feminino , Masculino , Inquéritos e Questionários , Serviço Hospitalar de Emergência/normas , Serviço Hospitalar de Emergência/estatística & dados numéricos , Criança , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Oral health care behaviors during pregnancy affects maternal and child health outcomes. This scoping review sought to map the existing literature on the oral healthcare behaviors of pregnant women in Nigeria. METHODS: PubMed, Science Direct, Web of Science, EBSCOHOST, Sabinet, African Index Medicus, and Scopus data based were searched in August 2023. Articles with reports on the oral health behavior of pregnant women in Nigeria, published in English in peer review were included in the review. Articles whose full lengths could not be accessed, and commentaries on studies, and letters to the editor were also excluded. Data on authors and year of publication of the study, study location, study objective, study design, methodological approach for data collection, and study outcomes were extracted and descriptively synthesized. RESULTS: The search yielded a total of 595 articles of which 573 were unique. Only 21 articles were left after titles and abstracts screening and only 18 articles met the eligibility criteria. The proportion of pregnant women had utilized dental services ranged from 4 to 62.9%, the use of toothbrush and toothpaste ranged from 59.6 to 99.3%, twice daily tooth brushing ranged from 5.2 to 66.9%, and the use of toothbrush among pregnant women in the studies varies from 70.9 to 100%. Chewing stick was used by 0.1-27.7% of study participants. Dental problems such as caries, pain, swollen gums, and excessive salivation were reasons for seeking dental care. We identified individual, structural, and behavioral factors, including myths as barriers for dental service utilization. CONCLUSION: This scoping review shows that dental service utilization by pregnant women in Nigeria is poor and mainly due to curative than preventive needs. Oral health behaviours also need to be improved through tailored oral health education accessible to pregnant women in Nigeria.
Assuntos
Comportamentos Relacionados com a Saúde , Saúde Bucal , Humanos , Feminino , Gravidez , Nigéria , Assistência Odontológica/estatística & dados numéricos , Higiene Bucal/estatística & dados numéricos , Gestantes/psicologia , Escovação Dentária/estatística & dados numéricosRESUMO
BACKGROUND: Clonorchiasis has significant socioeconomic importance in endemic areas; however, studies investigating the disease burden in specific sub-regions are lacking. This study aims to address the gap by quantifying the current disease burden caused by clonorchiasis in Guangdong province and assessing its distribution characteristics. METHODS: Comprehensive measures, including prevalence rates, disability-adjusted life years (DALYs), and direct medical costs, were used to assess the disease burden of clonorchiasis. To estimate the prevalence rate, the number of infections was divided by the examined population, based on the annual surveillance data on clonorchiasis cases during 2016-2021. The calculation of DALYs was based on the epidemiological parameters according to the definition issued by the World Health Organization. Cost data of clonorchiasis were utilized to quantify the direct medical costs. The distribution characteristics of disease burden were assessed through comparisons of groups of population defined by geographic area, time, and characteristics of people. RESULTS: In 2021, clonorchiasis posed a significant disease burden in Guangdong Province. The prevalence rate was found to be 4.25% [95% CI (4.02%, 4.49%)], with an associated burden of DALYs of 406,802.29 [95% CI (329,275.33, 49,215,163.78)] person-years. The per-case direct medical costs of patients with clonorchiasis were estimated to be CNY 7907.2 (SD = 5154.4). Notably, while the prevalence rate and DALYs showed a steady decrease from 2016 to 2020, there was a rising trend in 2021. Spatial clustering of clonorchiasis cases and DALYs was also observed, particularly along the Pearl River and Han River. This suggests a concentration of the disease in these regions. Furthermore, significant differences in prevalence rates were found among various demographic groups, including sex, age, occupation, and education level. Additionally, patients with longer hospital stays were more likely to incur higher direct medical costs. CONCLUSIONS: The burden of clonorchiasis in Guangdong Province remains high, despite significant progress achieved through the implementation of the prevention and control programs. It is suggested that measures should be taken based on the distribution characteristics to maximize the effectiveness of prevention and control, with a primary focus on key populations and areas.