Effects of e-Cigarette Advertisements on Adolescents’ Perceptions of Cigarettes

ABSTRACT

This study examined the effect of exposure to “cigalike” (products resembling cigarettes) e-cigarette advertisements on adolescents’ perceptions of cigarettes. A nationally representative sample of 802 adolescents (13–17 years old) was randomly assigned to watch three e-cigarette or three control advertisements. Never-smokers who saw the e-cigarette advertisements (n = 352) reported significantly lower perceived risks of smoking than those in the control condition (n = 320). Ever-smokers (n = 130) did not show significant differences across the conditions. In subgroup analyses, current smokers (reported smoking in the past 30 days, n = 31) in the e-cigarette condition reported significantly lower perceived benefits of smoking than those in the control condition. E-cigarette advertisements can affect adolescents’ perceptions of cigarettes. Many advertisements, especially the ones promoting “cigalikes,” depict e-cigarettes as being similar to cigarettes (e.g., look, flavor) but also as a solution for cigarettes’ shortcomings (e.g., bad smell). While the advertisements include messages about problems posed by cigarettes, proposing e-cigarettes as a solution may decrease the perceived risks of smoking among never-smokers. It may also not be clear to adolescents whether advertisements are for cigarettes or e-cigarettes. Regulating e-cigarette advertisements to minimize adolescents’ exposure may prevent potential harmful effects on never-smokers’ perception of smoking.     

Penicillin dust exposure and penicillin resistance among pharmaceutical workers in Tehran,Iran

Background: Antimicrobial resistance (AMR) adversely impacts the prevention and treatment of a wide range of infections and is considered as a serious threat to global public health. Occupational-related AMR is a neglected area of research.

Objective: To assess exposure to penicillin dust, penicillin active materials, and to report the frequency of penicillin resistance among pharmaceutical workers in Tehran, Iran.

Methods: A quasi-experimental study was conducted among workers on a penicillin production line in a pharmaceutical company (n = 60) and workers in a food producing company (n = 60). Data were collected via survey, air sampling, and throat swab.

Results: The mean overall concentrations of penicillin dust and penicillin active material were 6.6 and 4.3 mg/m³, respectively, in the pharmaceutical industry. Streptococcus pneumoniae (S. pneumoniae) was detected in 45% (27) individuals in the exposed group, 92.6% of which showed penicillin resistance. Resistance was significantly higher among workers in penicillin production line (p = 0.014).

Conclusions: High level of AMR among workers in penicillin production line is a health risk for the workers as well as society as a whole through the spread of drug resistant micro-organisms.     

Association of aflatoxin exposure and height-for-age among young children in Guatemala

Aflatoxin exposure has been proposed to affect child height-for-age. The following hypothesized associations were tested in Guatemala: (1) aflatoxin (B₁, B₂, G₁, G₂) exposure and environmental enteric dysfunction (EED) and child height-for-age z-score; and (2) aflatoxin exposures and subsequent symptoms of aflatoxins. Maize consumption data, health data, and samples of maize from households were collected from mothers and their children – under five – in October 2016 (n = 320) and February 2017 (n = 120). Maize samples were tested for aflatoxin levels and maize consumption data were used to compute an aflatoxin exposure level. Results suggest that there was a significant negative correlation between the putative aflatoxin exposure level and child height-for-age z-score (?0.073, p = 0.030), but not for EED. Furthermore, aflatoxin exposure was significantly correlated with aflatoxin symptoms only at the same time point (0.123, p = 0.026). These results support the potential need for engineered solutions to household aflatoxin transmission problems in rural communities of Guatemala.     

Children’s Exposure to Mercury-Contaminated Soils: Exposure Assessment and Risk Characterization

Exposure to mercury (Hg)-contaminated soils may pose a health risk to children by way of oral, dermal, and inhalatory pathways. However, risk characterization studies, including contaminant bioaccessibility with child-specific exposure parameters and scenarios, are lacking. The objectives of this study were (1) to assess children’s Hg exposure using characterization and oral bioaccessibility data from Hg-contaminated soils characterized in previous studies (n = 8); and (2) to characterize probabilistic risk in terms of hazard index (HI) considering ingestion, dermal, and inhalation pathways. Total Hg concentrations in soils ranged from 2.61 to 1.15 × 10⁴ mg kg^?1. For moderately contaminated soils (S1–S5: Hg ≤ 12.15 mg kg^?1), low oral bioaccessibility values (1.5–7.5 %) lead to HI < 1 in all scenarios. However, exposure to highly contaminated soils (S6–S8) may pose serious risks to children under normal exposure (HI 0.89–66.5) and soil–pica behaviour scenarios (HI up to 131). All three pathways significantly contributed to the risk. Using total Hg concentrations in calculations (assuming 100 % bioavailability) instead of considering Hg bioavailability leads to risk overestimation. Further research on oral, inhalatory, and dermal bioavailability of Hg, as well as child play behaviour, is recommended to obtain more accurate risk estimates.     

Occupational and leisure-time physical activity and workload among construction workers – a randomized control study

Background: There is a lack of quantification of occupational physical activity (OPA) and leisure time physical activity (LTPA) among construction workers.

Objectives: To describe physical activity energy expenditure (PAEE), physical workload, and the effect of a PA-intervention among construction workers.

Methods: Sixty-seven Construction workers self-reported their physical activity (PA), had PA assessed directly (PAEE), and observed OPA using the tool “Posture, Activity, Tools and Handling.” The PA-intervention (Intervention; n = 29, Controls; n = 24) included 3x20-min training/week for 12 weeks.

Results: Baseline median OPA was 5036 MET-min/week and LTPA 2842 MET-min/week, p < 0.01. OPA directly recorded was (mean ± SE): 56.6 ± 3.2 J/kg/min and LTPA was: 35.7 ± 2.2 J/kg/min (p < 0.001). Manual material handling was performed for ≥ 25% of working time by more than 50% of the participants. Post-intervention, the training group reduced overall PAEE compared to the control group but not specifically during work.

Conclusions: OPA was within the maximum recommended level of 1/3 proposed in consensus guidelines but did not decrease with PA-intervention.     

Different pathways to children’s enjoyment of participation in daily activities

Background: The enjoyment arising from participating in an activity is considered to be related to health and well-being. However, only a few studies have focused on children’s enjoyment of participation.

Aim: To assess the contribution of various individual factors to the total explained variance of children’s enjoyment of participation from the perspectives of parents and children.

Methods: Ninety-eight typically developed children were evaluated using motor and cognitive tests; they completed the Children’s Assessment of Participation and Enjoyment. Their parents completed the Children Participation Questionnaire, the Performance Skills Questionnaire, and the Strengths and Difficulties Questionnaire.

Results: Age and gender were found to be significant predictors. Parents perceived enjoyment to be associated with their child’s performance skills and the efficient execution of daily tasks. Children perceived enjoyment to be associated with their psychosocial functioning.

Conclusions: The contribution of performance skills exceeds the contribution of motor or cognitive ability to the total explained variance of a child’s enjoyment of participation. A gap exists, however, between the perspectives of children and parents regarding enjoyment of participation. Enhancing participation is a central goal of the occupational therapy domain and process; our findings may provide insights into possible pathways to accomplish this goal.     

Bio-monitoring of DNA damage in matchstick industry workers from Peshawar Khyber Pakhtunkhwa,Pakistan

Background: Safety protocols are usually neglected in most of the matchstick industries rendering the laborer prone to various occupational hazards.

Objective: The present study highlights DNA damage among matchstick factory workers (n = 92) against a control group (n = 48) of healthy individuals.

Methods: Genotoxicity was measured in peripheral blood lymphocytes of the test subjects using a Single Cell Gel Electrophoresis assay (SCGE/comet assay).

Results: Our results substantiate a high Total Comet Score (TCS) for factory workers (74.5 ± 47.0) when compared to the control group (53.0 ± 25.0) (P ≤ 0.001). Age and duration of occupational exposure had no significant effect (P > 0.05) on TCS value. As for job function, the TCS value was greatest in sweepers (91.0 ± 56.1) and lowest in box-making operators (26.0 ± 25.0) indicating that waste disposal poses the higher risk of DNA damage.

Conclusions: Our study corroborates that matchstick chemicals can potentially damage the DNA of exposed subjects.     

Posttraumatic stress symptomology in parents of children with cancer: Implications related to criterion changes in DSM-IV-TR to DSM-5

Objective: This preliminary study compared a DSM-IV-TR screening tool for posttraumatic stress symptoms (PTSS) with a modified DSM-5 version for parents of children diagnosed with cancer.

Methods: Caregivers (n = 101) completed the Brief Symptom Inventory (BSI) and Impact of Event Scale-Revised (IES-R). Five BSI items were added to the IES-R to assess whether caregivers met DSM-5 specific posttraumatic stress disorder criteria.

Results: Chi-square analysis revealed three groups: caregivers who (1) did not meet screening criteria for DSM-IV-TR or DSM-5; (2) only met DSM-IV-TR criteria; and (3) met criteria for DSM-IV-TR and DSM-5, X²(1, n = 101) = 64.47, p < 0.001. Subgroup 2 had lower overall PTSS than subgroup 3 (p < 0.001), but more than Subgroup 1 (p < 0.001).

Conclusions: A “gap group” evidenced elevated PTSS but did not meet DSM-5 screening criteria. Further research is needed to clarify the prevalence and composition of PTSS among caregivers, and evaluate the clinical implications of the changes in diagnostic criteria.     

Metal dust exposure and lung function deterioration among steel workers: an exposure-response relationship

Background: Metallic dust is a heterogeneous substance with respiratory sensitizing properties. Its long term exposure adversely affected lung function, thus may cause acute or chronic respiratory diseases.

Methods: A cross-sectional study was conducted in a steel factory in Terengganu, Malaysia to assess the metal dust exposure and its relationship to lung function values among 184 workers. Metal dust concentrations values (Co, Cr, and Ni) for each worker were collected using air personal sampling. Lung function values (FEV₁, FVC, and %FEV₁/FVC) were determined using spirometer.

Results: Exposure to cobalt and chromium were 1–3 times higher than permissible exposure limit (PEL) while nickel was not exceeding the PEL. Cumulative of chromium was the predictor to all lung function values (FEV₁, FVC, and %FEV₁/FVC). Frequency of using mask was positively associated with FVC (Adj b = 0.263, P = 0.011) while past respiratory illnesses were negatively associated with %FEV₁/FVC (Adj b = –1.452, P = 0.026). Only few workers (36.4%) were found to wear their masks all times during the working hours.

Conclusions: There was an exposure-response relationship of cumulative metal dust exposure with the deterioration of lung function values. Improvement of control measures as well as proper and efficient use or personal protection equipment while at work could help to protect the respiratory health of workers.     

Chronic Health Risks in Commercial Fishermen: A Cross-Sectional Analysis from a Small Rural Fishing Village in Alaska

Objectives: The purpose of this study is to evaluate chronic health risks before and during the fishing season in a sample of commercial fishermen, addressing the NIOSH priority of Total Worker Health^TM.

Methods: Gillnet license holders in Cordova, Alaska (n = 607) were contacted to participate in a preseason survey (March 2015) assessing health behaviors. A mid-season survey (July 2015) was also conducted. Physical exams and additional assessments were performed on a subset of these fishermen.

Results: Sixty-six fishermen participated in the preseason survey and 38 participated in the mid-season survey. The study population was overwhelmingly white males with an average age of 49. The average BMI was 27 with 70% of the participants overweight or obese. Nearly 80% of the sample considered their health good or better. Participants reported longer working hours, less sleep, and less aerobic exercise during the fishing season (P < .05). FitBit^TM monitoring (n = 8) confirmed less sleep and fewer steps during fishing season. In one exam (n = 20), 80% of participants showed measured hearing loss at 4 kz (conversation range), and 70% had one or more upper extremity disorders, including 40% with rotator cuff tendonitis.

Conclusions: The prevalence of hearing loss, upper extremity disorders, and sleep apnea risk factors were higher than in the general population both before and during the fishing season. Occupational factors including exposure to noise, the upper extremity demands of gillnetting, and long working hours while fishing exacerbate these chronic health conditions. Health promotion programs targeted toward these conditions may present opportunities for improving total worker health.     

Dietary Diversity and Meal Frequency Practices among Children Aged 6-23 Months in Agro Pastoral Communities in Afar Region,Ethiopia: A Cross-sectional Study

ABSTRACT

Introduction: Inappropriate infant and young child feeding practices in the first two years of life are among the major causes of childhood malnutrition in developing countries, including Ethiopia. Dietary diversity refers to increasing the consumption of a variety of foods across and within the food groups. Therefore, this study aimed to assess the minimum dietary diversity and minimum meal frequency practices among children aged 6–23 months in Agro pastoral communities, Afar Region, Ethiopia.

Methods: A community-based cross-sectional study was conducted from December 1–30, 2018. A multi-stage stratified sampling followed by a systematic random sampling technique was used to select participants. An interviewer-administered questionnaire was used to collect data. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with minimum dietary diversity and meal frequency. The adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals (CI) were computed to see the association between the outcome and independent variables. The statistical significance was declared at p-value <0.05.

Results: The proportion of children who met the minimum dietary diversity and meal frequency were 21.8% (95% CI: 19.0%-24.7%) and 43.8% (95% CI: 40.4%-47.2%) respectively. Maternal education (AOR = 2.5, 95% CI = 1.1–5.3 and AOR = 3.9, 95% CI = 1.3–11.5), maternal occupation (AOR = 4.2, 95% CI = 2.3–7.8), sex of child (AOR = 2.6, 95% CI = 1.5–4.5) and history of postnatal care visit (AOR = 1.8, 95% CI = 1.1–3.2) were independently associated with minimum dietary diversity. Similarly, age of child (AOR = 2.8, 95% CI = 1.4–5.5 and AOR = 5.3, 95% CI = 2.3–12.4), sex of child (AOR = 2.6, 95% CI = 1.4–4.6) and history of postnatal care visit (AOR = 2.2, 95% CI = 1.3–3.8) were the factors significantly associated with minimum meal frequency practices.

Conclusions: The current study showed that the proportions of children who met the minimum dietary diversity and meal frequency were low. Increasing maternal education, being a housewife, being a male child and attending a postnatal care visit were independently associated with minimum dietary diversity. Likewise, increasing the age of a child, being a male child and attending a postnatal care visit were significantly associated with minimum meal frequency. Improving maternal education and health care utilization, health and nutrition counseling during postnatal care visits are highly recommended to improve infant and young child feeding practices.

Abbreviations ANC: Ante Natal Care, DHS: Demographic and Health Surveys, EDHS: Ethiopian Demographic and Health Surveys, RERC: Research and Ethical Review Committee, IYCF: Infant and Young Child Feeding, MDD: Minimum Dietary Diversity, MMF: Minimum Meal Frequency, PNC: Post Natal Care, WHO: World Health Organization.     

The consequences of task delegation for the process of care: Female patients seem to benefit more

ABSTRACT

The shift of tasks from primary care physicians to practice nurses and the continuing incease in the numbers of women involved in medical care may have consequences for the provision of health care and communication. The aim of the present study was to examine potential differences in female practice nurses’ application of communication skills, practice guidelines, and motivational interviewing skills during consultations with female and male patients. Nineteen female practice nurses and their patients (n = 181) agreed to have their consultations videotaped (during 2010–2011). The videotaped consultations were rated using two validated instruments: the Maas-Global (to assess generic communication skills and practice guidelines) and the Behaviour Change Counselling Index (to assess motivational interviewing skills). Multilevel linear and logistic regression analyses were performed. Female practice nurses provided significantly more comprehensive information during consultations with female patients (p = .03) and talked more about management with male patients (p = .04). Furthermore, nurses applied motivational interviewing skills more clearly during consultations with female than with male patients (p < .01). The shift in tasks from primary care physicians toward practice nurses may have implications for clinical and patient outcomes as patients will no longer be counseled by male professionals. Conceivably, female patients are motivated more by nurses to change their behavior, while male patients receive more concrete management information or advice.     

The Impact of Head Start Enrollment Duration on Migrant Children’s Health Outcomes

The purpose of this study is to examine whether family characteristics and the length of children’s enrollment in Migrant Head Start affects children’s health treatment. Children in the Michigan Migrant Head Start were classified depending on years of enrollments: One year (n = 638), two years (n = 293), and three or more years (n = 426). Logistic regression analyses were conducted to examine whether the probability of children receiving health treatment differed depending on years of enrollment. There is a higher health treatment rate among children who attended Head Start for multiple years than for those who attended for one year. Children’s special needs status, of siblings, ethnicity, parental educational level, and marital status were related to preventative dental and physical health treatment outcomes. Although the primary goal of Head Start is school readiness rather than health improvement, migrant and seasonal farmworker children are likely to receive more health treatment if they attend more years of comprehensive intervention, such as Head Start, for positive physical and dental health.     

Sociocultural hegemony,gendered identity,and use of traditional and complementary medicine in Ghana

ABSTRACT

This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ? .0001), and have health insurance (p ? .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28–47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002–0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22–47.60), while females’ TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21–11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78–17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.     

A Multiple Indicators Multiple Cause (MIMIC) Model of Respiratory Health and Household Factors in Chinese Children: The Seven Northeastern Cities (SNEC) Study

In China, with the rapid economic development and improvement of living standards over the past few decades, the household living environment has shifted dramatically. The aim of the present study is to assess the impact of home environment factors on respiratory symptoms and asthma in Chinese children. Investigators analyzed data collected in the 25 districts from the seven Northeastern cities to examine health effects on respiratory symptoms and asthma in 31,049 children aged 2–14 years. Factor analysis was used to reduce 33 children’s lifestyle and household variables to six new ‘factor’ variables. The multiple indicators multiple causes approach was used to examine the relationship between indoor air pollution and respiratory health status, controlling for covariates. Factor analyses generated six factor variables of potential household risk factors from an original list of 33 variables. The respiratory symptoms and asthma were significantly associated with the recent home renovation factor (estimate = 0.076, p < 0.001), pet ownership factor (estimate = 0.095, p < 0.001), environmental tobacco smoke (ETS) exposure factor (estimate = 0.181, p < 0.001) and PVC-flooring factor (estimate = 0.031, p = 0.007). Home ventilation factor was not related to any respiratory condition (estimate = 0.028, p = 0.074). Independent respiratory health effects existed for multiple household environmental factors recent home renovation, pet ownership, ETS, and PVC-flooring.     

Swiss Children Consuming Breakfast Regularly Have Better Motor Functional Skills and Are Less Overweight Than Breakfast Skippers

Objective: The aim of this study was to examine the associations among eating behavior, body mass index (BMI), and motor functional skills in Swiss elementary school children.

Methods: In total, 656 schoolchildren, aged 7 to 10 years, participated in the study. Five different, normalized, and standardized motor function tests (sidewise jumping, tapping, standing long jump, 20-m sprint, and shuttle run) that determine the coordinative and conditional skills were carried out with each child at 1 of 4 time points (8, 9, 10, or 11 am) along with anthropometric measurements. Furthermore, all children completed a nutrition survey including different questions on their eating habits with emphasis on breakfast and the morning snack at school.

Results: Children consuming breakfast almost every day had a significantly (p < 0.05) lower BMI (16.7 ± 2.2 kg/m²) compared with children eating breakfast only sometimes or almost never (18.2 ± 3.0 kg/m² and 18.8 ± 3.4 kg/m², respectively). They also reached better scores in 3 of the 5 motor function tests (standing long jump, 20-m sprint, and shuttle run, p < 0.05). Furthermore, overweight and obese children reached poorer results in 4 disciplines of the motor functional tests (sidewise jumping, standing long jump, 20-m sprint, and shuttle run) than normal-weight children, and they tended to eat lunch and dinner more frequently in front of the TV or in their rooms (p < 0.05). In multiple regression analysis, BMI was a significant predictor of the results for sprint, sidewise jumping, standing long jump, and shuttle run, whereas daytime, breakfast frequency, and gender predicted only some of the outcomes.

Conclusion: This study clearly underlines the importance of breakfast for school-aged children: Children eating breakfast almost every day had better motor functional skills and a lower BMI than children not regularly eating breakfast. The study further hints at the importance of generally healthy nutritional habits with regard to both motor functional skills and healthy weight status.     

Occupational Injuries of Aquaculture Workers: Washington State

Objective: To characterize occupational injuries of aquaculture workers in Washington State.

Methods: We reviewed accepted Washington State workers’ compensation claims from January 1, 2006 to December 31, 2014. Trends in employment, worker demographics (including age, sex, and body mass index), claim rate, and injury characteristics were summarized for accepted claims in the Washington State risk classes that include aquaculture workers.

Results: During the nine-year study period, there were 1,180 accepted claims, 836 (65.1%) were medical-aid only and 344 (26.8%) were compensable. Most commonly reported injury types included being struck by/against an object (n = 420) and work-related musculoskeletal disorders (n = 310). Over the study period, there was no statistically significant change in claim rates in aquaculture (p = 0.77), though they were elevated compared to claim rates for all WA industries combined. A significant upward trend (p = 0.003) in aquaculture employment was observed during our study period.

Conclusions: Given the growth in aquaculture production, and that aquaculture workers in Washington are experiencing higher occupational injury rates compared to other workers in the state, our study suggests that the industry should devote greater attention to prevention of work-related injuries, especially those resulting in being struck by/against objects or work-related musculoskeletal disorders. Enhanced occupational safety and health programs for this industry could help reduce injuries, as well as the cost of workers’ compensation claims.