Faire des courses avec des atteintes cognitives : l’influence des facteurs environnementaux

People who have suffered a traumatic brain injury (TBI) often experience a decreased ability to carry out complex daily activities such as shopping, and these difficulties are likely amplified when confronted with a shopping environment that is not adapted to their cognitive difficulties.GoalThe purpose of this study was to identify the environmental factors present within a grocery store that influence, positively or negatively, the independence of persons who have suffered a TBI within the activity of shopping for groceries. This is an exploratory study in the form of a qualitative analysis of the performance of 10 participants with moderate or severe TBI who completed the “shopping for groceries” task of the IADL Profile. The main facilitators observed at the grocery store were the organization of food and the presence of signs. The main obstacles were the distractions, the wide variety of food and recent changes in food placement. Frequenting a supermarket appears to cause an increase in the use of environmental facilitators. This study highlights the various environmental factors that help or hinder grocery shopping for individuals with cognitive deficits. Particular attention should be paid to environmental obstacles in a grocery store when working with these individuals.     

某大学放射性同位素32P应用项目辐射环境监测与评价

目的 评价某大学放射性同位素³²P应用项目对周围环境的辐射影响。方法 依据国家相关标准规定的限值及监测方法作为评价标准和监测手段。结果 该放射性同位素³²P应用项目γ空气吸收剂量率为62.8~108 nGy/h，处于该市天然本底水平范围内。该³²P应用项目工作间，控制区β表面污染监测结果为0.057~0.235 Bq/cm²，符合《电离辐射防护与辐射源安全基本标准》（GB 18871-2002）。该³²P应用项目衰变池水中总α放射性为0.039 Bq/L，低于《医疗机构水污染物排放标准》（GB 18466-2005）中规定的1 Bq/L的标准限值；总β放射性为9.37 Bq/L，低于《医疗机构水污染物排放标准》（GB 18466-2005）中规定的10 Bq/L的标准限值。结论 该项目对职业工作人员和公众是安全的，对周围环境产生的影响较小。     

Quantification of the types of water in Eudragit RLPO polymer and the kinetics of water loss using FTIR

Coalescence of polymer particles in polymer matrix tablets influences drug release. The literature has emphasized that coalescence occurs above the glass transition temperature (T_g) of the polymer and that water may plasticize (lower T_g) the polymer. However, we have shown previously that nonplasticizing water also influences coalescence of Eudragit RLPO; so there is a need to quantify the different types of water in Eudragit RLPO. The purpose of this study was to distinguish the types of water present in Eudragit RLPO polymer and to investigate the water loss kinetics for these different types of water. Eudragit RLPO was stored in tightly closed chambers at various relative humidities (0, 33, 56, 75, and 94%) until equilibrium was reached. Fourier transform infrared spectroscopy (FTIR)-DRIFTS was used to investigate molecular interactions between water and polymer, and water loss over time. Using a curve fitting procedure, the water region (3100–3700 cm⁻¹) of the spectra was analyzed, and used to identify water present in differing environments in the polymer and to determine the water loss kinetics upon purging the sample with dry compressed air. It was found that four environments can be differentiated (dipole interaction of water with quaternary ammonium groups, water cluster, and water indirectly and directly binding to the carbonyl groups of the polymer) but it was not possible to distinguish whether the different types of water were lost at different rates. It is suggested that water is trapped in the polymer in different forms and this should be considered when investigating coalescence of polymer matrices.     

Evolución de los riesgos ambientales en el contexto de la crisis económica. Informe SESPAS 2014

This article aims to analyze the impact of the economic and financial crisis on environmental determinants of health. The World Health Organization estimates that between 13% and 27% of the disease burden in countries could be prevented by improving the environment. These effects are larger in vulnerable populations, especially among the poorest. In the last decade, outdoor air pollution (the most significant environmental health risk in most European countries) has declined, mostly due to the European policy of reducing emissions and to the decrease in activity following the economic crisis. During the last few years, this improvement in air quality has occurred simultaneously with a reduction in investment in environmental protection and could therefore be offset in the medium-term. The economic crisis has not reduced the trend for higher temperatures in Spain and Europe because climate change is a global phenomenon that is not directly related to local emissions. To reduce the risk of an increase in the health impact of environmental factors, certain key aspects should be considered, such as the need to maintain or develop adequate monitoring and control systems and the opportunity to implement policies that help improve the quality of the environment and reduce the vulnerability of different population groups in a cross-disciplinary framework of transparency and citizen participation.     

The impact of the clinical environment on family centred care in the neonatal unit: A qualitative investigation

It has been suggested that the clinical environment has a significant impact on the wellbeing and recovery of patients. Furthermore, the design, physical environment and use of resources within the neonatal unit (NNU) is crucial to family centred care (FCC) and the provision of a supportive infrastructure for patients, families, staff and carers. It has also been claimed that poorly designed NNU can hinder the best intentioned efforts of NNU staff. This paper reports the findings of a qualitative investigation using non-participant observation and follow up interviews with key informants aimed at understanding ways in which the clinical environment might influence and impact upon the behaviour and practice of those employed within the NNU. Results indicate that topics such as noise, lighting, heating, ventilation and particularly space in which to care for patients and families are significant issues. It is concluded that poor clinical environments may impede staff in achieving improvements in care quality, and that an ergonomic, supportive environment is required within the NNU in order to enable quality care and increase efficiency. Further investigation into resource managed NNU, guided by lean thinking and the productive ward literature may provide a means of enabling improved FCC.     

Consumption and Sources of Dietary Salt in Family Members in Beijing

In China, few people are aware of the amount and source of their salt intake. We conducted a survey to investigate the consumption and sources of dietary salt using the “one-week salt estimation method” by weighing cooking salt and major salt-containing food, and estimating salt intake during dining out based on established evidence. Nine hundred and three families (1981 adults and 971 children) with students in eight primary or junior high schools in urban and suburban Beijing were recruited. On average, the daily dietary salt intake of family members in Beijing was 11.0 (standard deviation: 6.2) g for children and adolescents (under 18 years old), 15.2 (9.1) g for adults (18 to 59 years old), and 10.2 (4.8) g for senior citizens (60 years old and over), respectively. Overall, 60.5% of dietary salt was consumed at home, and 39.5% consumed outside the home. Approximately 90% of the salt intake came from cooking (household cooking and cafeteria or restaurant cooking), while less than 10% came from processed food. In conclusion, the dietary salt intake in Beijing families far surpassed the recommended amounts by World Health Organization, with both household cooking and dining-out as main sources of salt consumption. More targeted interventions, especially education about major sources of salt and corresponding methods for salt reduction should be taken to reduce the risks associated with a high salt diet.     

A scoping review of public building accessibility

BackgroundThe built environment needs to be designed so that all people can participate in the activities they want and need to do. Yet, accessibility is difficult to put into practice, and accessibility issues tend to be overlooked in the building and planning processes.ObjectivesThe aim of this scoping review was to summarize the research front in the area of accessibility to public buildings. Specific aims were to identify knowledge gaps, to identify access activities in relation to environmental features and to link to predominant activities in terms of the International Classification of Functioning, Disability and Health (ICF).MethodsA literature search was performed in PubMed, PsycINFO, Inspec, Embase and Cochrane databases. Articles in English based on original empirical studies investigating accessibility of public buildings for adults aged ≥18 years with functional limitations were considered.ResultsOf the 40 articles included, ten involved study participants, while 30 only examined buildings using instruments to assess accessibility. In addition, the psychometric properties were only tested for a few of them. All articles concerned mobility and several visual limitations, while few addressed cognitive or hearing limitations. Ten main access activities were identified, from using parking/drop-off area to exiting building.ConclusionsBy using the ICF and theoretically relating the accessibility problems to activities, the results revealed that there are large knowledge gaps about accessibility to public buildings for older people and people with functional limitations and that there is a need for more methodological considerations in this area of research.     

Activity spaces in studies of the environment and physical activity: A review and synthesis of implications for causality

Activity spaces are increasingly used to understand how people interact with their environment and engage in activity but their use may raise challenges regarding causal inference. We conducted a systematic review of findings and the methodological, analytical and conceptual issues relevant to causal inference. Studies were included if they comprised a spatial summary of locations visited, assessed any part of the causal pathway between the environment, physical activity and health, and used quantitative or qualitative methods. We searched seven electronic databases in January 2018 and screened 11910 articles for eligibility. Forty-seven studies were included for review. Studies answered research questions about features of or environmental features within activity spaces using a range of spatial and temporal summary techniques. The conceptual challenge of using activity spaces to strengthen causal inference was rarely considered, although some studies discussed circularity, temporality, and plausibility. Future studies should use longitudinal and experimental designs and consider the potential and actual use of spaces for physical activity, and their relationship with total levels of activity.     

鸦胆子油软胶囊联合SOX方案治疗晚期结直肠癌的临床研究

目的研究鸦胆子油软胶囊联合SOX方案(奥沙利铂+替吉奥)治疗晚期结直肠癌的临床疗效。方法选取2018年8月-2019年8月在郑州大学附属洛阳中心医院治疗的80例晚期结直肠癌患者,所有患者随机分为对照组和治疗组,每组各40例。对照组患者入院后给予SOX方案治疗,第1~14天给予注射用奥沙利铂,推荐剂量130 mg/m^2,溶于500 mL 5%葡萄糖溶液中,输注时间小于3h;第1~21天口服替吉奥胶囊,1粒/次,2次/d。治疗组在对照组基础上口服鸦胆子油软胶囊,4粒/次,3次/d。21 d为1个治疗疗程,两组患者接受治疗3个疗程。观察两组的临床疗效,比较Karnofsky(KPS)评分、生活质量(QOL)评分及血清癌胚抗原(CEA)、基质金属蛋白酶(MMP)-2和MMP-9水平。结果经过治疗后,治疗组客观缓解率(ORR)和疾病控制率(CBR)显著高于对照组(P<0.05)。治疗后,两组患者KPS评分和QOL评分显著升高(P<0.05),且治疗组KPS评分和QOL评分升高程度较大(P<0.05)。治疗后,两组CEA、MMP-2和MMP-9水平显著降低(P<0.05);并且治疗组降低较多(P<0.05)。治疗组胃肠道反应、血小板减少、白细胞减少和转氨酶升高等不良反应发生率明显低于对照组(P<0.05)。结论鸦胆子油软胶囊联合SOX方案治疗晚期结直肠癌具有较好的治疗效果,能够提高患者生活质量,降低肿瘤标志物水平,安全性较高,值得在临床上推广应用。