In-Office Pediatric Emergency Dental Visits During and After the COVID Pandemic.

Purpose: To describe the demographics of patients younger than 18 years of age who sought dental emergency visits during the COVID-19 pandemic, the treatment provided, the patients' payment sources and the impact of the pandemic on oral health. Methods: A retrospective electronic chart review was conducted for dental emergency visits between 2020 and 2023 at the University of Detroit Mercy School of Dentistry, Detroit, Mich., USA. The data set included the patients' demographics, insurance type, reason(s) for the dental emergency visit and the provider's diagnosis and treatment provided. Results: Six- to 10-year-old children were the most frequently seen group for an emergency dental visit (40 percent). The majority had public insurance. Delta Dental was the most common payment source (47 percent). Diseases of pulp and periapical tissues accounted for the highest proportion of emergency visits (55 percent) and extractions were the most common treatment performed (54 percent). Conclusion: During the COVID-19 pandemic, children may not have received optimum dental care and lacked regular dental visits and preventive treatment, which probably led to an increase in the severity of dental conditions.

Perspectives on Individual Animal Identification from Biology and Computer Vision.

Identifying individual animals is crucial for many biological investigations. In response to some of the limitations of current identification methods, new automated computer vision approaches have emerged with strong performance. Here, we review current advances of computer vision identification techniques to provide both computer scientists and biologists with an overview of the available tools and discuss their applications. We conclude by offering recommendations for starting an animal identification project, illustrate current limitations, and propose how they might be addressed in the future.

The Support, Education, and Research in Chronic Heart Failure Study (SEARCH): a mindfulness-based psychoeducational intervention improves depression and clinical symptoms in patients with chronic heart failure.

BACKGROUND: The Support, Education, and Research in Chronic Heart Failure (SEARCH) study was designed to assess the impact of a mindfulness-based psychoeducational intervention on clinical outcomes, depression, and quality of life in patients with chronic heart failure (CHF). Although research has shown that psychosocial factors including depression are important risk factors for adverse events in patients with CHF, no large clinical trials have investigated the efficacy of psychosocial interventions to reduce these factors in this population. METHODS: This was a prospective cohort study of 208 adults with left ventricular ejection fraction < or =40% and CHF geographically assigned to treatment or control groups with follow-up at 3, 6, and 12 months. Treatment groups met weekly for 8 consecutive weeks for training in mindfulness meditation, coping skills, and support group discussion. RESULTS: Subjects had a mean age of 61 years, left ventricular ejection fraction 26%, and median New York Heart Association class II. The majority were treated with angiotensin-converting enzyme inhibitors (80%) and beta-blockers (86%). At baseline, patients in the treatment group had more severe CHF with higher New York Heart Association class (P = .0209) and more severe psychological distress (Center of Epidemiology - Depression, Profile of Mood States; P < .05). When compared with controls, treatment resulted in lower anxiety (Profile of Mood States, P = .003), depression (Center of Epidemiology - Depression, P = .05), improved symptoms (Kansas City Cardiomyopathy Questionnaire symptom scale, P = .033) and clinical scores (Kansas City Cardiomyopathy Questionnaire clinical score, P = .024) over time. There were no treatment effects on death/rehospitalization at 1 year. CONCLUSIONS: An 8-week mindfulness-based psychoeducational intervention reduced anxiety and depression; this effect was attenuated at 1 year. Importantly, the intervention led to significantly better symptoms of CHF at 12 months compared to control subjects. Our results suggest that interventions of this type might have a role in optimal therapy for CHF.

The Vietnamese Community Members Who Were Part of GC-HARMS Are More Aware of Their Health, Environmental Impacts on Their Health, and How They Can Have Better Health: An Interview With Dustin Nguyen.

In this interview, Mr. Nguyen, Gulf Coast Health Alliance: Health risks related to the Macondo Spill Vietnamese community project hub manager (D'Iberville, Mississippi), describes his community's cultural and financial difficulties finding adequate avenues for healthcare and wellness information before the Deepwater Horizon oil spill. He comments extensively on how the project's clinical component in tandem with the Affordable Care Act promoted transformational changes in access to healthcare for his community and comments on generational shifts within the community in terms of language marginalization, its relationship to the pace of acculturation, and the allure of commercial fishing as a livelihood and a career.

"I Remember the Mental Chaos While They Tried To Seal the Well and Clean Up the Oil Spill - How Much Fear and Uncertainty Everyone Felt": An interview with Marylee and Michael Orr, Louisiana Environmental Action Network.

In this interview, Marylee Orr and her son, Michael Orr, of the Louisiana Environmental Action Network (Baton Rouge, LA) recall the massive trauma among fishing families (including those whose boats were used in the clean-up effort) caused by the Deep Water Horizon spill, the state and federal closures of fishing grounds, and the moratorium on oil exploration and production activity during the clean-up efforts. They recount the history of their organization's vision and growth, their role in regional environmental justice efforts, and outline how they developed an approach to rapid response community empowerment based on colearning, respect, consensus, and action-a vision that parallels the work of Paulo Freire and the practice values of community-based participatory research. They discuss the collaborative seafood sampling site map and toxicology primer they built and archived as a key community partner of the Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill Project.

"Losing Your Land You Feel Like You're Losing Your Identity, Like You're Experiencing Slow Death": An Interview With Chief Thomas Dardar-Houma Nation.

The Houma Nation was a major community hub for the Citizen Science Network seafood sampling conducted as part of the Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) research project. They also managed a clinical cohort to facilitate wellness checkups and collection of biological samples during the project. In this interview, Thomas Dardar, Principal Chief of the Houma Nation, outlines the historical and evolving changes-cultural as well as geophysical-that the Houma Nation must address in an uncharted era of climate-related impacts on weather patterns, sea levels, and sustainable land uses. He explores tribal efforts to cope with cumulative exposures, risks, and outcomes of industrial practices that have led to land loss and deterioration of natural marshlands. These changes challenge the perpetuation of traditional values based on multigenerational ties to their land base, and the bayous and estuarial waters they fish.

Ergonomics of abrasive blasting: a comparison of high pressure water and steel shot.

Abrasive blasting with silica sand has long been associated with silicosis. Alternatives to sand are being used increasingly. While NIOSH has done extensive investigations of the respiratory effects of the substitutes for sand, the ergonomic effects of the substitutes have not been examined. Too often, hazards are shifted, and technologies that might save workers' lungs could do so at the expense of their musculoskeletal systems. Hence, the objective of this study was to examine the ergonomic effects of alternatives to sand. Multiple methods, both qualitative and quantitative, were used to yield numerous kinds of data for the analysis of exposures to abrasive blasters. PATH, a method for quantifying ergonomic exposure in non-routine work, was combined with interviews with workers, biomechanical modeling and noise level readings to assess the ergonomics of two abrasive blasting operations: high-pressure water and steel shot. Advantages and disadvantages of each medium are discussed. High-pressure water was slightly less ergonomically stressful, environmentally cleaner, much quieter and less dusty that steel shot, and it was reported to be slower on those tasks where both media could be used.

Change in the world of occupational health: silica control, then and now.

To control silicosis, we need to understand how change happens in occupational health. Science alone does not drive policy, because we have known the causes of silicosis, and how to prevent it for decades, yet the disease persists. To control occupational disease, we need to enter the social realm of work. To investigate the determinants of a successful silicosis control program, we wrote a social history of the Vermont Granite Industry from 1938 to 1960, examining union journals, newspapers, industry journals, scientific literature and government documents, and interviewing key informants. The crucial factor of the successful program was a strong public health movement to control tuberculosis, rather than pressure to control the occupational disease. Using this lesson, to protect workers from silica exposure now, we chose to regulate silica under an environmental law, the Massachusetts Toxics Use Reduction Act. Science is but one small factor, necessary but insufficient, in policy change. We in occupational health need to hitch onto a stronger movement, currently the environmental movement. Where unions are too weak to demand safe technologies, we need to learn to speak the language of employers, because they may have little idea of the costs of interventions. We need to gather more economic information about the costs of interventions.

Home-based exercise improves functional performance and quality of life in women with diastolic heart failure.

BACKGROUND: Diastolic heart failure (DHF) is common in older women. There have been no clinical trials that have identified therapies to improve symptoms in these patients. A total of 32 women with New York Heart Association class II and III DHF (left ventricular ejection fraction >45% and symptoms of dyspnea or fatigue) were randomized into a 12-week home-based, low-to-moderate intensity (40% and 60%, respectively) exercise and education program (intervention) or education only program (control). Methods and results The intervention group improved in the 6-minute walk test from 840 +/- 366 ft to 1043 +/- 317 ft versus 824 +/- 367 ft to 732 +/- 408 ft in the control group (P =.002). Quality of life also improved in the intervention group compared with the control group as measured by the Living with Heart Failure Questionnaire (41 +/- 26 to 24 +/- 18 vs 27 +/- 18 to 28 +/- 22 at 12 weeks, P =.002; 24 +/- 18 to 19 +/- 18 vs 28 +/- 22 to 32 +/- 27 at the 3-month follow-up, P =.014) and the Geriatric Depression Scale (6 +/- 4 to 4 +/- 4 vs 5 +/- 3 to 7 +/- 5 at 12 weeks, P =.012; 4 +/- 4 to 4 +/- 4 vs 7 +/- 5 to 7 +/- 5 at the 3-month follow-up, P =.009). CONCLUSIONS: Women with DHF exhibit significant comorbidities and physical limitations. Home-based, low-to-moderate intensity exercise, in addition to education, is an effective strategy for improving the functional capacity and quality of life in women with DHF. Further study is needed to assess the long-term effect of exercise on clinical outcomes.

Changes in spirituality and well-being in a retreat program for cardiac patients.

CONTEXT: Many epidemiological studies indicate that spirituality or religion are positively correlated with health measures, but research is needed on interventions that change spirituality to verify that it actually affects health and to justify suggestions that changes in spiritual practices or beliefs may have health benefits. However, it is not clear that health interventions can influence spirituality or which techniques are effective. OBJECTIVE: To evaluate whether participation in a retreat program for cardiac patients and their partners resulted in changes in spirituality and whether changes in spirituality were related to changes in well-being meaning in life, anger, and confidence in handling problems. DESIGN: Participants filled out questionnaires before and after participating in the retreat. SETTING: Retreats were sponsored by the Health Promotion and Wellness Program, University of Wisconsin-Stevens Point, and were held in a remote training center. PARTICIPANTS: Notices were sent to cardiac rehabilitation programs and directly to heart patients, resulting in the enrollment of 72 first-time participants. INTERVENTION: The 2.5-day educational retreats included discussion and opportunities to experience healthy lifestyle options. Exercise, nutrition, stress management techniques, communication skills that enhance social support, and spiritual principles of healing were incorporated. Experiential practices included yoga, meditation, visualization, and prayer. RESULTS: Of the participants, 78% reported increased spirituality after the retreat. Changes in spirituality were positively associated with increased well-being meaning in life, confidence in handling problems, and decreased tendency to become angry. CONCLUSIONS: Programs that explore spirituality in a health context can result in increased spirituality that is associated with increased well-being and related measures. Many patients and their families want to integrate the spiritual and health dimensions of their lives. Further work is needed to develop healthcare settings that can support this integration.

Creative mistrust.

Based on six years spent investigating worker health and safety conditions at U.S. Department of Energy sites that were formerly engaged in the production of nuclear weapons, the authors report on a set of common themes that emerged in their interviews with workers. The initial focus of the authors was on behavior-based safety programs and their investigation revealed deep-seated mistrust of management by workers. The authors discuss the importance of trust issues for worker training and suggest that "creative mistrust" should be cultivated in training programs.

Social factors in occupational health: a history of hard hats.

Personal protective equipment (PPE) is the least desirable way to ensure workplace safety, and it is difficult to use consistently. Hard hats are different; they have cachet and are often worn even when they are not required. We investigated the history of this personal protective equipment to see if there were any lessons that could be applied to other forms of PPE. We learned that what makes hard hats special are social factors that are specific to a certain time and place. The importance of social factors illuminates the requirement that cultural and social norms of workers be included in any kind of worker safety and health training.

Interface Carpet and Fabric Company's sustainability efforts: what the company does, the crucial role of employees, and the limits of this approach.

Much has been written touting the environmental achievements of Interface Carpet and Fabric Company, but not much has been said about how this firm has accomplished it goals, using employee participation. This case study documents the importance and benefits of employee participation, employee perceptions of the experience, as well as limits to this approach in achieving the goal of sustainability.

Eula Bingham-experience bares "the real world" and smart politics saves lives.

Eula Bingham, toxicologist and former head of the Occupational Safety and Health Administration, is now at that place in her professional life where she can look back over her long career and identify its turning points and evaluate what worked and what didn't, what was important and what of lesser significance. In two interviews, she also looks at the present and the future and expresses concerns about the way we live now.

Hooked on a feeling: emotional labor as an occupational hazard of the post-industrial age.

Emotional labor is a subtle but serious occupational hazard that is likely to spread rapidly as the global service economy continues to grow. Emotional labor requires more than just acting friendly and being helpful to customers; the worker must manage his or her emotions to create a company-dictated experience for customers. The practice of emotional labor in an unsupportive work environment produces work-related stress, which has a wide range of potentially serious health effects. Though many employers do not acknowledge the existence of emotional labor, it is a real occupational hazard that may generate life-altering effects on physical and emotional health. While no official regulations or identification standards specify emotional labor as an occupational hazard, some guidelines exist regarding its outcome: occupational stress. Emotional labor should be recognized as an occupational hazard by the Occupational Safety and Health Administration (OSHA), but this hazard does not lend itself to regulation through standards. The business culture that demands its performance is questioned.

The cost effectiveness of occupational health interventions: prevention of silicosis.

BACKGROUND: The failure to recognize occupational health as an economic phenomenon limits the effectiveness of interventions ostensibly designed to prevent disease and injury. Hence, consideration of economic efficiency is essential in the evaluations of interventions to reduce hazardous working conditions. In this paper, we present an analysis of the cost effectiveness of alternative means of preventing silicosis. METHODS: To evaluate the cost effectiveness of specific interventions for the prevention of occupationally induced silicosis, we have used the simulation models based on the generalized cost-effectiveness analysis (GCEA) developed by the WHO-CHOICE initiative for two representative subregions namely AMROA (Canada, United States of America), and WPROB1 (China, Korea, Mongolia). RESULTS: In both of the two subregions, engineering controls are the most cost effective with ratios varying from 105.89 dollars per healthy year or disability adjusted life year saved in AMROA to approximately 109 dollars in WPROB1. In the two subregions, the incremental cost-effectiveness ratio of engineering controls (EC) looks most attractive. Although dust masks (DM) look attractive in terms of cost, the total efficacy is extremely limited. CONCLUSIONS: To the extent that this analysis can be generalized across other subregions, it suggests that engineering control programs would be cost effective in both developed and developing countries for reducing silica exposure to save lives. Note that this analysis understates health benefits since only silicosis and not all silica-related diseases are considered.