A qualitative study investigating the meaning of participation to improve the measurement of this construct

Quality of Life Research - The purpose of this study was to improve the measurement of participation. Research questions were as follows: (1) What constitutes participation according to adults? (2)...     

Exposure to Brominated Trihalomethanes in Water During Pregnancy and Micronuclei Frequency in Maternal and Cord Blood Lymphocytes

Background: Water disinfection by-products have been associated with an increased cancer risk. Micronuclei (MN) frequency in lymphocytes is a marker of genomic damage and can predict adult cancer risk.Objective: We evaluated maternal exposure to drinking water brominated trihalomethanes (BTHM) in relation to MN frequency in maternal and cord blood lymphocytes.Methods: MN frequency was examined in 214 mothers and 223 newborns from the Rhea mother–child cohort in Crete, Greece, in 2007–2008. Residential BTHM water concentrations were estimated during pregnancy using tap water analyses and modeling. Questionnaires on water related habits were used to estimate BTHM exposure from all routes. Associations between BTHM and MN frequency were estimated using negative binomial regression.Results: BTHM concentrations in residential tap water during pregnancy ranged from 0.06 to 7.1 μg/L. MN frequency in maternal binucleated lymphocytes was found to increase with BTHM concentrations in residential water for exposure during the first [rate ratio (RR) for 1 μg/L = 1.05; 95% CI: 1.00, 1.11] and second trimesters (RR for 1 μg/L = 1.03; 95% CI: 1.00, 1.06), and through all routes of BTHM exposure during the first trimester (RR for 1 μg/week = 3.14; 95% CI: 1.16, 8.50).Conclusions: These findings suggest that exposure to BTHM may increase the frequency of MN in maternal binucleated lymphocytes.Citation: Stayner LT, Pedersen M, Patelarou E, Decordier I, Vande Loock K, Chatzi L, Espinosa A, Fthenou E, Nieuwenhuijsen MJ, Gracia-Lavedan E, Stephanou EG, Kirsch-Volders M, Kogevinas M. 2014. Exposure to brominated trihalomethanes in water during pregnancy and micronuclei frequency in maternal and cord blood lymphocytes. Environ Health Perspect 122:100–106; http://dx.doi.org/10.1289/ehp.1206434     

Risks and Benefits of Green Spaces for Children: A Cross-Sectional Study of Associations with Sedentary Behavior,Obesity, Asthma,and Allergy

Background: Green spaces have been associated with both health benefits and risks in children; however, available evidence simultaneously investigating these conflicting influences, especially in association with different types of greenness, is scarce.Objectives: We aimed to simultaneously evaluate health benefits and risks associated with different types of greenness in children, in terms of sedentary behavior (represented by excessive screen time), obesity, current asthma, and allergic rhinoconjunctivitis.Methods: We conducted a cross-sectional study of a population-based sample of 3,178 schoolchildren (9–12 years old) in Sabadell, Spain, in 2006. Information on outcomes and covariates was obtained by questionnaire. We measured residential surrounding greenness as the average of satellite-derived Normalized Difference Vegetation Index (NDVI) in buffers of 100 m, 250 m, 500 m, and 1,000 m around each home address. Residential proximity to green spaces was defined as living within 300 m of a forest or a park, as separate variables. We used logistic regression models to estimate associations separately for each exposure–outcome pair, adjusted for relevant covariates.Results: An interquartile range increase in residential surrounding greenness was associated with 11–19% lower relative prevalence of overweight/obesity and excessive screen time, but was not associated with current asthma and allergic rhinoconjunctivitis. Similarly, residential proximity to forests was associated with 39% and 25% lower relative prevalence of excessive screen time and overweight/obesity, respectively, but was not associated with current asthma. In contrast, living close to parks was associated with a 60% higher relative prevalence of current asthma, but had only weak negative associations with obesity/overweight or excessive screen time.Conclusion: We observed two separable patterns of estimated health benefits and risks associated with different types of greenness.Citation: Dadvand P, Villanueva CM, Font-Ribera L, Martinez D, Basagaña X, Belmonte J, Vrijheid M, Gražulevičienė R, Kogevinas M, Nieuwenhuijsen MJ. 2014. Risks and benefits of green spaces for children: a cross-sectional study of associations with sedentary behavior, obesity, asthma, and allergy. Environ Health Perspect 122:1329–1335; http://dx.doi.org/10.1289/ehp.1308038     

Environments for healthy ageing: A critical review

Population health outcomes are shaped by complex interactions between individuals and the environments in which they live, work and play. Environments encompass streets and buildings (physical environment), attitudes, supports and relationships with others (social environment), as well as social and political systems and policies. The impact of environments on the physical, mental health and functioning of individuals has emerged as a growing body of research in population health and health disparities. Yet, the majority of studies in this area do not focus on older adults even though older adults are particularly susceptible to the characteristics of their local environments. In this paper we review the current state of the health literature on physical environments for healthy ageing, using the International Classification of Functioning Disability and Health as a framework. Collectively, the literature emphasizes the role of supportive, barrier-free environments particularly for older adults who are at greater risk for disability and poor health. As part of our review we identify conceptual as well as methodological limitations in the current literature, including (i) a theoretical and empirical neglect of the underlying mechanisms behind the person–environment relationship; (ii) a lack of studies using nationally representative samples; (iii) over-reliance on cross-sectional data; and (iv) a need for better definition and measurement of person-centered environments. We conclude by offering some suggestions and directions for future research in this area.     

The impact of common mental disorders on the work functioning of nurses and allied health professionals: A systematic review

Objective

This study aims to inventory aspects of work functioning of nurses and allied health professionals that are affected by common mental disorders.

Design

A systematic review of psychological and occupational health literature was performed.

Data sources

A sensitive systematic literature search based on index terms and text words was conducted in four electronic databases: PubMed, PsycINFO, Embase, and Cinahl. The literature search was limited to journal articles published between 1998 and 2008, written in English, German, or Dutch.

Review methods

For inclusion, studies had to examine a relationship between common mental disorders and a measure of work functioning in nurses or allied health professionals. No restrictions on study design were handled. Methodological quality was assessed for each study. The data were categorized into themes, for which the strength of evidence was assessed using six levels of evidence.

Results

Sixteen of 2792 studies met the inclusion criteria, of which 13 had a cross-sectional design, 1 was a vignette study, and 2 were narrative reviews. In all studies, the subjects were nurses. The retrieved aspects of sub-optimal work functioning due to common mental disorders were merged into 15 themes. Strong evidence was found for five themes: general errors, medication errors, near misses, patient safety, and patient satisfaction. Moderate evidence was found that common mental disorders are associated with complex motor skills and with general performance; while evidence for an association between common mental disorders and needle stick injuries was inconclusive. Seven themes had only narrative evidence: interpersonal behaviour, energy, focus on goals and responsibility, work speed, avoiding work while on the job, coping with emotions, and motivation.

Conclusion

Common mental disorders were found to be associated with various impairments in work functioning in nurses, these include task-related, intrapersonal and interpersonal aspects of work. In particular, strong evidence was found for an association between common mental disorders and general errors, medication errors, near errors, patient safety, and patient satisfaction. These results provide input for preventive actions to improve both health and work functioning in health care workers.     

Unmet needs and health care utilization in young adults with cerebral palsy

PURPOSE: To gain insight into the unmet needs and utilization of health care of young adults with cerebral palsy (CP) and to explore relations between unmet needs, health care utilization and subject characteristics. METHOD: A cross-sectional study was performed in 29 young adults with CP without severe learning disabilities (IQ > 70). Subject characteristics such as age, gender, limb distribution, level of gross motor functioning, level of education and perceived participation and autonomy were measured. Outcome measures were the Southampton Needs Assessment Questionnaire, Impact on Participation and Autonomy and a questionnaire on health care utilization. RESULTS: Young adults with CP reported unmet needs mostly on information (79%), mobility (66%) and health care (66%). About half of the participants visited a rehabilitation physician (52%) or a physical therapist (55%) in the past year. Participants with lower levels of gross motor functioning were found to have more unmet needs and visited various health care professionals more often than young adults with higher levels of gross motor functioning. However, participants with higher levels of gross motor functioning still reported several unmet needs. CONCLUSIONS: Although young adults with CP frequently receive treatment from health care professionals, they indicate unmet needs with respect to several areas such as information on diagnosis, functional mobility and formal health care. In the treatment of young adults with CP, attention should be paid to these aspects.     

Fatigue, level of everyday physical activity and quality of life after liver transplantation.

OBJECTIVE: To assess whether liver transplant recipients have a hypoactive (sedentary) lifestyle and whether the level of everyday physical activity is related to complaints of fatigue. In addition, we explored the relationship between activity level and health-related quality of life. DESIGN: Case comparison. SUBJECTS: Eight persons 6-36 months after liver transplantation with varying severity of fatigue and 8 persons without known impairments (matched for gender, age, social situation and employment). METHODS: Activity levels were assessed during 2 randomly selected consecutive weekdays with an accelerometry-based Activity Monitor. In the transplantation group, severity of fatigue (Fatigue Severity Scale) and health-related quality of life (RAND-36) were also assessed. RESULTS: Five liver transplant recipients had a hypoactive lifestyle, but there was no significant difference in activity level between the transplantation group and comparison group. Severity of fatigue was correlated (p=0.01) with both duration of dynamic activities and intensity of everyday activity (r(s)=-0.81 and -0.84, respectively). Activity level was correlated (p< or =0.05) with several domains of health-related quality of life (r(s)=0.72-0.78). CONCLUSION: As a group, liver transplant recipients were not significantly less active than comparison subjects. Activity level was related with severity of fatigue and health-related quality of life. These findings have implications for the development of interventions needed to rehabilitate persons after liver transplantation.