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1.
Simon Endes Emmanuel Schaffner Seraina Caviezel Julia Dratva Daiana Stolz Christian Schindler Nino Künzli Arno Schmidt-Trucksäss Nicole Probst-Hensch 《International journal of hygiene and environmental health》2017,220(6):1030-1038
Introduction and objectives
Air pollution and insufficient physical activity have been associated with inflammation and oxidative stress, molecular mechanisms linked to arterial stiffness and cardiovascular disease. There are no studies on how physical activity modifies the association between air pollution and arterial stiffness. We examined whether the adverse cardiovascular effects of air pollution were modified by individual physical activity levels in 2823 adults aged 50–81 years from the well-characterized Swiss Cohort Study on Air Pollution and Lung and Heart Diseases (SAPALDIA).Methods
We assessed arterial stiffness as the brachial-ankle pulse wave velocity (baPWV [m/s]) with an oscillometric device. We administered a self-reported physical activity questionnaire to classify each subject’s physical activity level. Air pollution exposure was estimated by the annual average individual home outdoor PM10 and PM2.5 (particulate matter <10 μm and <2.5 μm in diameter, respectively) and NO2 (nitrogen dioxide) exposure estimated for the year preceding the survey. Exposure estimates for ultrafine particles calculated as particle number concentration (PNC) and lung deposited surface area (LDSA) were available for a subsample (N = 1353). We used mixed effects logistic regression models to regress increased arterial stiffness (baPWV ≥ 14.4 m/s) on air pollution exposure and physical activity while adjusting for relevant confounders.Results
We found evidence that the association of air pollution exposure with baPWV was different between inactive and active participants. The probability of having increased baPWV was significantly higher with higher PM10, PM2.5, NO2, PNC and LDSA exposure in inactive, but not in physically active participants. We found some evidence of an interaction between physical activity and ambient air pollution exposure for PM10, PM2.5 and NO2 (pinteraction = 0.06, 0.09, and 0.04, respectively), but not PNC and LDSA (pinteraction = 0.32 and 0.35).Conclusions
Our study provides some indication that physical activity may protect against the adverse vascular effects of air pollution in low pollution settings. Additional research in large prospective cohorts is needed to assess whether the observed effect modification translates to high pollution settings in mega-cities of middle and low-income countries. 相似文献2.
Cristina Vert Gonzalo Sánchez-Benavides David Martínez Xavier Gotsens Nina Gramunt Marta Cirach José Luis Molinuevo Jordi Sunyer Mark J. Nieuwenhuijsen Marta Crous-Bou Mireia Gascon 《International journal of hygiene and environmental health》2017,220(6):1074-1080
Background
The association between exposure to air pollutants and mental disorders among adults has been suggested, although results are not consistent.Objective
To analyze the association between long-term exposure to air pollution and history of anxiety and depression disorders and of medication use (benzodiazepines and antidepressants) in adults living in Barcelona.Methods
A total of 958 adults (45–74 years old) residents in Barcelona, most of them having at least one of their parents diagnosed with dementia (86%), and participating in the ALFA (Alzheimer and Families) study, were included. We used Land Use Regression (LUR) models to estimate long-term residential exposure (period 2009–2014) to PM2.5, PM2.5 absorbance (PM2.5 abs), PM10, PM coarse, NO2 and NOx. Between 2013 and 2014 participants self-reported their history of anxiety and depression disorders and related medication use. The analysis was focused on those participants reporting outcome occurrence from 2009 onwards (until 2014).Results
We observed an increased odds of history of depression disorders with increasing concentrations of all air pollutants [e.g. an increased odds of depression of 2.00 (95% CI; 1.37, 2.93) for each 10 μg/m3 NO2 increase]. Such associations were consistent with an increased odds of medication use in relation to higher concentrations of air pollutants [e.g. an increased odds of antidepressants use of 1.23 (1.04, 1.44) for each 20 μg/m3 NOx increase]. Associations regarding anxiety disorders did not reach statistical significance.Conclusions
Our study shows that increasing long-term exposure to air pollution may increase the odds of depression and the use of antidepressants and benzodiazepines. Further studies are needed to replicate our results and confirm this association. 相似文献3.
Han Wu Baofa Jiang Xingyi Geng Ping Zhu Zhong Liu Liangliang Cui Liping Yang 《International journal of hygiene and environmental health》2018,221(2):183-190
Background
Existing studies exploring the association between low birth weight (LBW) and maternal fine particulate matter (aerodynamic diameter < 2.5 μm, PM2.5) exposure have presented equivocal results, and one of the possible reasons for this finding might be due to relatively low maternal exposures. In addition, relatively narrow maternal exposure windows to PM2.5 have not been well established for LBW.Methods
We employed a nested matched case-control design among 43,855 term births in a large maternity and child care hospital in Jinan, China. A total of 369 cases were identified, and four controls per case matched by maternal age were randomly selected among those with normal birth weight (n = 1,476) from 2014 to 2016. Ambient air monitoring data on continuous measures of PM2.5, nitrogen dioxide (NO2), and sulfur dioxide (SO2) (24-h average concentrations) from 2013 to 2016 were collected from thirteen local monitoring stations. An inverse distance weighting method based on both home and work addresses was adopted to estimate the individual daily exposures to these air pollutants during pregnancy by weighting the average of the twelve nearest monitoring stations within 30 km of each 100 m × 100 m grid cell by an inverse squared distance, and then the average exposure concentrations for gestational months, trimesters and the entire pregnancy were calculated. Adjusted conditional logistic regression models were used to estimate the odds ratios (ORs) per 10 μg/m3 increment in PM2.5 and by PM2.5 quartiles during different gestational periods.Results
In this study, the estimated mean values of PM2.5, NO2, and SO2 exposure during the entire pregnancy were 88.0, 54.6, and 63.1 μg/m3, respectively. Term low birth weight (TLBW) increased in association with per 10 μg/m3 increment in PM2.5 for the 8th month [OR = 1.13, 95% confidence interval (CI): 1.04, 1.22], the 9th month (OR = 1.06, 95% CI: 0.99, 1.15), the third trimester (OR = 1.17, 95% CI: 1.05, 1.29), and the entire pregnancy (OR = 1.38, 95% CI: 1.07, 1.77) in models adjusted for one pollutant (PM2.5). In models categorizing the PM2.5 exposure by quartiles, comparing the second, third, and highest with the lowest PM2.5 exposure quartile, the PM2.5 was positively associated with TLBW during the 8th month (OR: 1.77, 95% CI: 1.09, 2.88; OR: 1.77, 95% CI: 1.03, 3.04; OR: 1.92, 95% CI: 1.04, 3.55, respectively) and for the 9th month, only association for exposure in the third versus the lowest quartile was significant (OR: 1.91, 95% CI: 1.02, 3.58).Conclusions
The study provides evidence that exposure to PM2.5 during pregnancy might be associated with the risk of TLBW in the context of very high pollution level of PM2.5, and the 8th and 9th months were identified as potentially relevant exposure windows. 相似文献4.
Daniela Dubois Marques Vicente Mora Llabata Julián Pacheco Arroyo Salvador Gasull Insertis Manuela Vicente Cañizares Ildefonso Roldán Torres 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(6):340-349
Objective
To determine whether antithrombotic treatment (ATT) in patients with non-valvular atrial fibrillation in a health area complies with the recommendations of current clinical guidelines.Design
Prospective observational study.Location
Primary Health Care Centres and Cardiology Department of a Health Department of the Valencian Community, Spain.Participants
A total of 505 patients with nonvalvular atrial fibrillation were included in the study.Main measurements
ATT was deemed to be inappropriate in patients with a CHA2DS2-VASc score ≥ 1 and who were not under oral anticoagulation, in patients treated with antivitamin K drugs, and poor control of oral anticoagulation, or with antiplatelet therapy inappropriately associated with anticoagulation, and in patients on ATT with a CHA2DS2-VASc score = 0.Results
The median age was 77.4 ± 10 years. The ATT was considered inadequate in 58% of cases. Factors independently associated with inadequate ATT were age (OR: 1.02 [1-1.04]; P = .029), hypothyroidism (OR: 1.98 [1.14-3.43]; P = .015), ischaemic heart disease (OR: 1.3 [1.15-2.59]; P = .008) and paroxysmal non-valvular AF (OR: 2.11 [1.41-3.17]; P < .0001).Conclusions
These data underline the high prevalence of inadequate ATT in daily practice, as well its different causes. 相似文献5.
Mariano de la Figuera Sergio Cinza Nuria Marín Isabel Egocheaga Miguel Angel Prieto 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(6):359-367
Objective
To analyse the clinical characteristics and management of patients with non-valvular atrial fibrillation (NVAF) treated with direct oral anticoagulants (DOAC).Design
Observational, cross-sectional and multicentre study.Location
Autonomous Communities in which the general practitioner can prescribe DOAC (n = 9).Participants
The study included a total of 790 patients on chronic treatment with anticoagulants, and on whom therapy was changed, as well as being currently on treatment with DOAC for at least for 3 months.Main measures
A record was made of the sociodemographic and clinical management date.Results
Mean age was 78.6 ± 8.4 years, and 50.5% of patients were men. Mean CHADS2 score was 2.6 ± 1.2, mean CHA2DS2-VASc score was 4.3 ± 1.6, and the mean HAS-BLED score was 2.3 ± 1.0. Mean duration of treatment with DOAC was 15.8 ± 12.5 months. Rivaroxaban was the DOAC most frequently prescribed (57.8%), followed by dabigatran (23.7%), and apixaban (18.5%). Of the patients receiving rivaroxaban, 70.2% were taking the dose of 20 mg/daily. Of the patients receiving dabigatran, 41.7% were taking the dose of 150 mg twice daily, and in the case of apixaban, 56.2% were taking the dose of 5 mg twice daily. Satisfaction (ACTS Burdens scale 52.0 ± 7.2 and ACTS Benefits scale 12.1 ± 2.2), and therapeutic adherence (97.8% of patients took their medication regularly) with DOAC were high.Conclusions
Patients treated with DOAC in Spain have a high thromboembolic risk. A significant proportion of patients receive a lower dose of DOAC than that recommended according to their clinical profile. Satisfaction and medication adherence are high. 相似文献6.
Andrés Cabrera-Leon Miguel Ángel Cantero-Braojos 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(9):527-538
Objective
To assess the impact of disabling chronic pain (DCP) on quality of life, work, consumption of medication and usage of health services.Design
Cross-sectional population study with face-to-face interview.Setting
Andalusian Health Survey (2011 edition).Participants
6,507 people over the age of 16 (p = q = 0.5; confidence level = 95%; sampling error = 1.49, design effect = 1.52).Interventions
Not applicable.Main measurements
Dependent variable: DCP: population limited in their activity by any of the CP specified in the survey. Independent variables: quality of life, absence from work, consumption of medication and utilization of health services.Results
Compared to a population without CP, DCP impact is 6 points less on the mental quality of life and 12 points on the physical one, medication consumption is triple, health services utilization is almost double, and long absence from work is triple. On the other hand, a population with nondisabling chronic pain (nDCP) presents similar results to a population without CP.Conclusions
We have considered DCP as another CP category because of its huge impact, as is shown in our study, on the study variables. On the contrary, the population with nDCP does not obtain significant impact differences when compared to the population without CP. Therefore, we believe that Primary Care and Public Health should lead different prevention strategies for DCP as well as for the identification of the nDCP population to decrease its possible deterioration towards DCP. 相似文献7.
J. Prud’homme 《Revue d'épidémiologie et de santé publique》2018,66(2):145-152
Background
In Paris, air pollution is now a persistent environmental problem, especially linked to diesel cars in circulation. Exposure of children to air pollution during the journey from home to school, which takes place during peak hours of traffic, is poorly documented.Methods
The purpose of this work was to identify spaces less exposed to PM10 pollution. We identified spatial recurrences in the relative distribution of air pollution levels using PM10 geolocated measures taken along a fixed circuit, crossing, among others, a speed regulation zone (< 30 km/h). Measurements were made eight mornings between 8 and 9 a.m., in April and September 2016 in the 14th district of Paris. We obtained a hierarchical classification of spaces in terms of recurrence of relative levels of PM10 concentration.Results
The cartography of the results revealed that the spaces more exposed to high concentrations were found similarly along main roads, side streets and speed regulation < 30 km/h) zones. These findings suggest speed regulation is insufficient to reduce individual exposure in city streets.Conclusion
Elements linked to the functional aspects of the street (commercial/residential) were apparently as important as traffic speed. 相似文献8.
Anna Maria Ingelido Vittorio Abate Annalisa Abballe Fulvia Lucia Albano Tatiana Battista Valter Carraro Michele Conversano Rosa Corvetti Silvia De Luca Silva Franchini Anna Rita Fulgenzi Laura Giambanco Nicola Iacovella Anna Laura Iamiceli Antonio Maiorana Francesco Maneschi Valentina Marra Flavia Pirola Elena De Felip 《International journal of hygiene and environmental health》2017,220(2):378-386
Background
Polychlorinated dibenzodioxins (PCDDs), polychlorodibenzofurans (PCDFs), and polychlorobiphenyls (PCBs) are persistent organic pollutants that represent a major concern for women of reproductive age because of the neurodevelopmental effects associated to perinatal exposure.Objectives
This study was aimed at characterizing exposure of women of reproductive age to PCDDs, PCDFs, and PCBs as a function of residence in different Italian Regions, in areas at presumable different environmental contamination and human exposure to these pollutants.Methods
Study participants were enrolled in 2011–2012 in 6 Italian Regions representative of Northern, Central and Southern Italy; in each region, areas at presumed different exposure (rural, urban and industrial) were selected for enrolment. Each participant provided a serum sample for the analysis of PCDDs, PCDFs and PCBs.Results
Median concentrations of PCDDs + PCDFs, DL-PCBs, NDL6-PCBs and NDL9-PCBs in serum samples were respectively 6.0 and 3.5 pgWHO-TE05/g fat, and 75 and 93 ng/g fat.Age was the variable that most affected median serum concentrations.Age adjusted concentrations were found significantly different between geographical zones: women from Northern Italy showed the highest values, followed by Central and Southern Italy.PCDDs + PCDFs concentrations were significantly higher in the group of women residing in industrial areas compared to the group residing in rural areas.A clear diminishing temporal trend was observed compared to levels reported in previous studies.Conclusions
This study produced the largest dataset on serum concentrations of PCDDs, PCDFs and PCBs in women of childbearing age in Italy.Results
confirmed that environmental and lifestyle factors may influence exposure to these contaminants and thereby the body burden.The observed marked temporal decline in body burden during three decades is in agreement with the general trend observed worldwide. 相似文献9.
Fran Calvo Xavier Carbonell Ramón Valero Jordi Costa Oriol Turró Cristina Giralt Marissa Ramírez 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(8):477-485
Aim
The aim of this study is to define the risk factors associated with early discharge in out-patients clinics.Design
Cross-sectional and observational study.Setting
Substance abuse clinics in Girona (Catalonia, Spain).Participants
A total of 264 individuals were included in the sample, and 34.8% of them abandoned the process within two months of starting the therapy (n = 92).Procedure
Clinical and socio-demographic variables of the clinical history were compared between participants with/without adherence.Main measurements
The Student t test was used to measure the comparison, and the chi-squared test was used for the analysis of qualitative variables. A binary logistic regression model was adjusted, with adherence as the dependent variable.Results
The results indicated that attending the appointments unaccompanied (OR = 3.13), being female (OR = 2.44), having cocaine related issues (OR = 1.14), and being younger (OR = 0.89) are the factors which increase the risk early abandonment. Contrarily, being referred to specialists from a Primary Health Centre reduces the risk (OR = 0.28).Conclusions
It is concluded that special attention must be devoted to the patients’ families, women, and young patients. Moreover, the appropriate coordination between specialist services and basic services increases adherence to treatment among drug users. 相似文献10.
Francisco Javier Valverde Bolívar Miguel Pedregal González Herminia Moreno Martos Inmaculada Cózar García Jesús Torío Durántez 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(10)
Objective
To determine the distribution of consultation times, the factors that determine their length, and their relationship with a more participative, patient-centred consulting style.Design
Cross-sectional multicentre study.Location
Primary Healthcare Centres in Andalusia, Spain.Participants
A total of 119 tutors and family medicine physician residents.Principal measurements
Consultation length and communication with the patient were analysed using the CICCAA scale (Connect, Identify, Understand, Consent, Help) during 436 interviews in Primary Care.Results
The mean duration of consultations was 8.8 min (sd: 3.6). The consultation tended to be longer when the physician had a patient-centred approach (10.37 ± 4.19 min vs 7.54 ± 2.98 min; p = 0.001), and when there was joint decision-making (9.79 ± 3.96 min vs 7.73 ± 3.42 min: p = 0.001). In the multivariable model, longer consultations were associated with obtaining higher scores on the CICAA scale, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and a smaller number of daily visits (r2 = 0.32). There was no correlation between physician or patient gender, or problem type.Conclusion
A more patient centred medical profile, increased shared decision-making, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and less professional pressure all seem to be associated with a longer consultation. 相似文献11.
12.
Teodoro Durá-Travé Fidel Gallinas-Victoriano María Jesús Chueca-Guindulain Sara Berrade-Zubiri Paula Moreno-Gónzalez María Malumbres-Chacón 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(7):422-429
Objective
To analyse the prevalence of hypovitaminosis D and associated factors in school children and adolescents living in a region of northern Spain.Design
Cross-sectional study (convenience sampling).Setting
Primary Health Care.Participants
A total of 602 Caucasian individuals (aged 3.1 to 15.4 years) were included in the study.Main measurements
Prevalence of hypovitaminosis D were calculated (dependent variable). Hypovitaminosis D is defined according to the US Endocrine Society criteria: deficiency (calcidiol < 20 ng/mL), insufficiency (calcidiol: 20-29 ng/mL), and sufficiency (calcidiol ≥ 30 ng/mL). Gender, age, body mass index, residence, and season of the year were recorded (independent variables), and their association with hypovitaminosis D was analysed by multiple regression.Results
The prevalence of hypovitaminosis D was 60.4% (insufficiency: 44.6%; deficiency: 15.8%). Multivariate analysis showed that factors associated to hypovitaminosis D were being female (OR: 1.6; 95% CI: 1.1-2.3), pubertal age (OR: 1.8; 95% CI: 1.2-2.6), autumn (OR: 9.5; 95% CI: 4.8-18.7), winter (OR: 8.8; 95% CI: 4.5-17.5) and spring time (OR: 13.2; 95% CI: 6.4-27.5), living in urban areas (OR:1.6; CI 95%: 1.1-2.2), and severe obesity (OR: 4.4; 95% CI: 1.9-10.3).Conclusions
There is a high prevalence of hypovitaminosis D in juvenile populations. being female, pubertal age, autumn, winter and spring seasons, severe obesity, and living in urban areas are factors associated to hypovitaminosis D. Consideration should be given to the administration of vitamin supplements and/or the increase in the ingestion of natural vitamin D dietary sources. 相似文献13.
Javier C. Angulo María P. Calderín Yolanda Fernández Miriam González Esther Gómez Maria B. Herreros Purificación Peñasco Manuela Zapatero Juan F. Dorado 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(2):79-87
Objective
Determining the prevalence of symptoms suggestive of overactive bladder (OAB) in a Spanish population and evaluate the impact of these symptoms on well-being and labour productivity in this population.Design
Transversal study.Location
Primary health care, Madrid, Spain.Participants
Males and females > 30 years.Interventions
Classification by primary care physicians with the Overactive Bladder Awareness Tool abbreviated version (OAB-V3). Subjects with score ≥ 3 and a similarly balanced control population with score < 3 were clinically investigated.Principal measurements
History, physical examination, urinalysis, sonography, general well-being scale and the questionnaires PPBC, OAB-q y WPAI-SHP.Results
A total 923 subjects were screened, of which 209 (22.6%), 35% males and 65% females, had probable OAB. Age distribution increased from 11.1% in 4th decade to 44.4% in 9th decade. Kappa coefficient between suspected OAB and definite diagnosis was .83. The area under ROC curve for diagnosis based on OAB-V3 questionnaire and the presence of perceived bother and coping strategies was 92%. Subjects classified by score ≥ 3 had worse well-being, higher PPBC score and worse parameters on total OAB-q and transformed scores for each OAB-q subscale (P < .0001). In these subjects labour productivity was not affected (P = .14) but the capacity to perform regular activities was (P < .0001).Conclusions
OAB-V3 is a simple questionnaire to screen OAB with good predictive accuracy in a primary care setting and reveals important implications on health related quality of life issues. 相似文献14.
Maria Isabel Vazquez-Arce Elena Marques-Sule 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(10):576-582
Aim
To analyse several cardiovascular risk factors by means of the physical activity performed by patients with acute coronary syndrome (ACS).Design
Cross-sectional study.Location
Cardiovascular prevention service (Health Department, Valencia, Spain).Participants
The study included 401 individuals with acute coronary syndrome and discharged from hospital 2-3 months before the assessment. The inclusion criteria included age between 30 and 80 years-old, no contraindication for physical activity, and no previous participation in cardiac rehabilitation programmes.Main measurements
Metabolic equivalent MET (Kcal/Kg) was calculated, based on the type of activity, frequency, duration and intensity. Participants were divided into two groups: sedentary group (< 10 METs/week) and physically active group (≥ 10 METs/week). Several variables associated with cardiovascular risk factors were assessed: body mass index (BMI), waist circumference, lipid profile, blood glucose, and arterial pressure.Results
The mean consumption was 8.24 ± 12.5 METs/week. Prevalent factors were overweight (77.05%), and dyslipidaemia (64.3%), whilst 64.8% were sedentary. The physically active group showed differences when compared to sedentary group in triglycerides (146.53 ± 72.8 vs. 166.94 ± 104.8 mg/dL; 95% CI; P = .031), and BMI (27.65 ± 3.86 vs. 28.50 ± 4.38 kg/m2; 95% CI; P = .045).Conclusion
Physical activity was performed by a limited number of patients with ACS, with a prevalence of overweight and dyslipidaemia. Being physically active improved triglycerides levels and BMI. Therefore, health promotion from Primary Care and encouraging physical activity amongst patients with ACS is crucial. 相似文献15.
16.
Laura Illamola Martin Juan José Rodríguez Cristobal Carlos Alonso-Villaverde Betlem Salvador-González Irene Moral Pelaez 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(6):325-331
Objectives
To determine whether the benefit on cardiovascular risk factors (CVRF) persists 5 years after an intensive intervention in lifestyle (LS) that lasted 2 years, in patients with hyperfibrinogenaemia and moderate or high cardiovascular risk.Design
multicentre prospective observational study.Location
13 Primary Care Centres in Barcelona and Baix Llobregat.Participants
A total of 300 patients who completed the EFAP study (146 intervention group, 154 control group).Interventions
The EFAP study, conducted on patients with normal cholesterol and elevated fibrinogen showed that lifestyle interventions are effective in reducing CVRF. After the EFAP study, the 2 groups followed the usual controls, and re-assessed after 5 years.Main measurements
Age, gender, cardiovascular diseases (CVD) (diabetes, dyslipidaemia, hypertension, obesity), laboratory parameters (fibrinogen, glucose, full blood count, cholesterol, triglycerides), blood pressure, weight, height, body mass index (BMI), tobacco and alcohol use, REGICOR.Results
At 5 years, the intervention group had a lower abdominal circumference (98 and 101 cm, respectively, P = .043), a lower weight (76.30 and 75.04 kg, respectively, P < .001), and BMI (29.5 and 30.97 kg/m2, P = .018). Fibrinogen level was lower in the intervention group (330.33 and 320.27 mg/dl respectively, P < .001), and REGICOR risk was also lower in the intervention group (5.65 and 5.59 respectively, P < .06).Conclusion
The benefit of an intensive intervention in LS for 2 years to reduce CVRF persists at 5 years, but decreases its intensity over time. It is recommended to repeat the interventions periodically to maintain the beneficial effect on LS. 相似文献17.
Gloria Aranda Auserón M. Rosario Elcuaz Viscarret Carmen Fuertes Goñi Victoria Güeto Rubio Pablo Pascual Pascual Enrique Sainz de Murieta García de Galdeano 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(3):141-150
Objective
To evaluate the effectiveness of a Mindfulness and Self-Compassion Program on the levels of stress and burnout in Primary Care health professionals.Design
Randomised, controlled clinical trial.Participants and setting
Training in Mindfulness was offered to 1,281 health professionals in Navarra (Spain) Primary Care, and 48 of them accepted. The participants were randomly assigned to groups: 25 to the intervention group, and the remaining 23 to the control group.Intervention
The Mindfulness and Self-Compassion training program consisted of sessions of 2.5chours/week for 8 weeks. The participants had to attend at least 75% of the sessions and perform a daily practical of 45 minutes.Main measurements
The levels of mindfulness, self-compassion, perceived stress, and burnout were measured using four questionnaires before and after the intervention.Results
After the intervention, the scores of the intervention group improved significantly in mindfulness (P < .001); perceived stress (P < .001); self-compassion: self-kindness P < .001, shared humanity P = .004, mindfulness P = .001; and burnout: emotional fatigue (P = .046). The comparison with the control group showed significant differences in mindfulness (P < .001), perceived stress (P < .001), self-kindness (P < .001) and emotional fatigue (P = .032).Conclusions
This work suggests that it may be beneficial to encourage mindfulness and self-compassion practices in the health environment. 相似文献18.
19.
Mark J. Travers Jessica A. Kulak Lisa Vogl 《International journal of hygiene and environmental health》2018,221(1):48-53
Introduction
The use of a waterpipe to smoke tobacco has emerged as a popular trend in the United States. Waterpipe smoking establishments have had an increasing presence in the U.S., despite smoke-free air legislation. Dangers of waterpipe smoking have been documented, but less data has been gathered about the waterpipe café itself. This project sought to determine a waterpipe-specific calibration factor (CF) for measuring waterpipe aerosol, and field-test this CF by conducting surveillance on the existing waterpipe cafés of western and central New York.Methods
Nine laboratory-controlled experiments were conducted to determine a waterpipe-specific CF. In the lab, two TSI SidePak AM510 Personal Aerosol Monitors and two sampling trains for gravimetric PM2.5 sampling were present during waterpipe smoking sessions (lasting 1–3 h). Indoor air quality was assessed in 7 waterpipe cafés in three counties of New York, and real-time measurements of particulate matter (PM2.5) and carbon monoxide (CO) were obtained.Results
Results from the 9 controlled waterpipe experiments determined a calibration factor of 0.38 (SD 0.08), which should be used to convert SidePak measurements to true PM2.5 measurements. When applying the CF to the measurements taken in the 7 public waterpipe venues, the mean PM2.5 concentration was 515 μg/m3 micrograms per cubic meter (SD = 338.8) while the mean ambient CO was 20.5 ppm (SD = 18.3). The mean active smoking density was 2.41 waterpipes per 100 m3 of air. The PM2.5 levels increased with increasing active smoking density (rho = 0.68, p = 0.09).Conclusions
Applying the waterpipe-specific CF for the SidePak, 0.38, allowed for field assessments to be conducted in locations with waterpipe smoke to determine accurate particle exposure concentrations. The concentrations of both particulate matter and carbon monoxide were above established air quality standards and therefore increase the health risks of both patrons and workers of these establishments. 相似文献20.
Zilong Zhang Gerard Hoek Ly-yun Chang Ta-Chien Chan Cui Guo Yuan Chieh Chuang Jimmy Chan Changqing Lin Wun Kai Jiang Yuming Guo Roel Vermeulen Eng-kiong Yeoh Tony Tam Alexis K.H. Lau Sian Griffiths Xiang Qian Lao 《International journal of hygiene and environmental health》2018,221(1):41-47