This study explores the factor structure of the Indonesian version of the GHQ-12 based on several theoretical perspectives and determines the threshold for optimum sensitivity and specificity. ...Through a focus group discussion, we evaluate the practicality of the GHQ-12 as a screening tool for mental health problems among adult primary care patients in Indonesia.
This is a prospective study exploring the construct validity, criterion validity and reliability of the GHQ-12, conducted with 676 primary care patients attending 28 primary care clinics randomised for participation in the study. Participants' GHQ-12 scores were compared with their psychiatric diagnosis based on face-to-face clinical interviews with GPs using the CIS-R. Exploratory and Confirmatory Factor Analyses determined the construct validity of the GHQ-12 in this population. The appropriate threshold score of the GHQ-12 as a screening tool in primary care was determined using the receiver operating curve. Prior to data collection, a focus group discussion was held with research assistants who piloted the screening procedure, GPs, and a psychiatrist, to evaluate the practicality of embedding screening within the routine clinic procedures.
Of all primary care patients attending the clinics during the recruitment period, 26.7% agreed to participate (676/2532 consecutive patients approached). Their median age was 46 (range 18-82 years); 67% were women. The median GHQ-12 score for our primary care sample was 2, with an interquartile range of 4. The internal consistency of the GHQ-12 was good (Cronbach's α = 0.76). Four factor structures were fitted on the data. The GHQ-12 was found to best fit a one-dimensional model, when response bias is taken into consideration. Results from the ROC curve indicated that the GHQ-12 is 'fairly accurate' when discriminating primary care patients with indication of mental disorders from those without, with average AUC of 0.78. The optimal threshold of the GHQ-12 was either 1/2 or 2/3 point depending on the intended utility, with a Positive Predictive Value of 0.68 to 0.73 respectively. The screening procedure was successfully embedded into routine patient flow in the 28 clinics.
The Indonesian version of the GHQ-12 could be used to screen primary care patients at high risk of mental disorders although with significant false positives if reasonable sensitivity is to be achieved. While it involves additional administrative burden, screening may help identify future users of mental health services in primary care that the country is currently expanding.
Healthcare workers exposed to coronavirus 2019 (COVID-19) patients could be psychologically distressed. This study aims to assess the magnitude of psychological distress and associated factors among ...hospital staff during the COVID-19 pandemic in a large tertiary hospital located in north-east Italy.
All healthcare and administrative staff working in the Verona University Hospital (Veneto, Italy) during the COVID-19 pandemic were asked to complete a web-based survey from 21 April to 6 May 2020. Symptoms of post-traumatic distress, anxiety and depression were assessed, respectively, using the Impact of Event Scale (IES-R), the Self-rating Anxiety Scale (SAS) and the Patient Health Questionnaire (PHQ-9). Personal socio-demographic information and job characteristics were also collected, including gender, age, living condition, having pre-existing psychological problems, occupation, length of working experience, hospital unit (ICUs and sub-intensive COVID-19 units vs. non-COVID-19 units). A multivariable logistic regression analysis was performed to identify factors associated with each of the three mental health outcomes.
A total of 2195 healthcare workers (36.9% of the overall hospital staff) participated in the study. Of the participants, 35.7% were nurses, 24.3% other healthcare staff, 16.4% residents, 13.9% physicians and 9.7% administrative staff. Nine per cent of healthcare staff worked in ICUs, 8% in sub-intensive COVID-19 units and 7.6% in other front-line services, while the remaining staff worked in hospital units not directly engaged with COVID-19 patients. Overall, 63.2% of participants reported COVID-related traumatic experiences at work and 53.8% (95% CI 51.0%-56.6%) showed symptoms of post-traumatic distress; moreover, 50.1% (95% CI 47.9%-52.3%) showed symptoms of clinically relevant anxiety and 26.6% (95% CI 24.7%-28.5%) symptoms of at least moderate depression. Multivariable logistic regressions showed that women, nurses, healthcare workers directly engaged with COVID-19 patients and those with pre-existing psychological problems were at increased risk of psychopathological consequences of the pandemic.
The psychological impact of the COVID-19 pandemic on healthcare staff working in a highly burdened geographical of north-east Italy is relevant and to some extent greater than that reported in China. The study provides solid grounds to elaborate and implement interventions pertaining to psychology and occupational health.
Microbial fuel cells were rediscovered twenty years ago and now are a very active research area. The reasons behind this new activity are the relatively recent discovery of electrogenic or ...electroactive bacteria and the vision of two important practical applications, as wastewater treatment coupled with clean energy production and power supply systems for isolated low-power sensor devices. Although some analytical applications of MFCs were proposed earlier (as biochemical oxygen demand sensing) only lately a myriad of new uses of this technology are being presented by research groups around the world, which combine both biological–microbiological and electroanalytical expertises. This is the second part of a review of MFC applications in the area of analytical sciences. In Part I a general introduction to biological-based analytical methods including bioassays, biosensors, MFCs design, operating principles, as well as, perhaps the main and earlier presented application, the use as a BOD sensor was reviewed. In Part II, other proposed uses are presented and discussed. As other microbially based analytical systems, MFCs are satisfactory systems to measure and integrate complex parameters that are difficult or impossible to measure otherwise, such as water toxicity (where the toxic effect to aquatic organisms needed to be integrated). We explore here the methods proposed to measure toxicity, microbial metabolism, and, being of special interest to space exploration, life sensors. Also, some methods with higher specificity, proposed to detect a single analyte, are presented. Different possibilities to increase selectivity and sensitivity, by using molecular biology or other modern techniques are also discussed here.
•Proposed analytical applications of microbial fuel cells (MFC) were reviewed.•Future possibilities of microbially based analytical systems were discussed.•Microbial quantification and activity, and toxicity sensors were fully reviewed.•New developments including genetic engineering of MFC bacteria were discussed.•New applications (e.g. life detectors) were reviewed critically for the first time.
A pilot-scale wetland was constructed to assess the feasibility of treating the wastewater from a tool industry in Santo Tomé, Santa Fe, Argentina. The wastewater had high conductivity and pH, and ...contained Cr, Ni and Zn. This paper describes the growth of vegetation in the experimental wetland and the nutrient and metal removal.
The wetland was 6
×
3
×
0.4
m. Water discharge was 1000
l
d
−1 and residence time was 7
d. After the wetland was rendered impermeable, macrophytes from Middle Paraná River floodplain were transplanted. Influent and effluent quality was analyzed every 15
d. TP, Cr, Ni and Zn concentrations in leaves, roots and sediment (inlet and outlet) were measured monthly. Cover and biomass of predominant species were estimated. Also, greenhouse experiments were carried out to measure the effects of conductivity and pH on floating species.
The variables measured in the influent were significantly higher than those in the effluent, except for
HCO
3
-
and
NH
4
+
. TP and metal concentrations in sediment at the inlet were significantly higher than those at the outlet. Conductivity and pH of the incoming wastewater were toxic for the floating species.
Typha domingensis displaced the other species and reached positive relative cover rate and biomass greater than those at the undisturbed natural environment.
T. domingensis proved to be highly efficient for the treatment of wastewater. For that reason, it is the advisable species for the treatment of wastewater of high conductivity and pH enriched with metals, characteristic of many industrial processes.
There is a global increase in migrant workers. In Singapore, there are over 230,000 migrant domestic workers (MDWs). Female MDWs may experience high levels of stress and social isolation, which may ...negatively impact on their health and quality of life. There have also been documented cases of abuse and exploitation. However, there is a lack of empirical research with this population. This study aimed to investigate factors impacting on the health and quality of life of female MDWs in Singapore, including socio-demographic and job related characteristics, stress, social isolation, and working management style.
A cross-sectional survey was carried out with 182 female MDWs in Singapore. The survey examined health and quality of life (WHOQoL-Bréf), social connectedness (the Friendship Scale), and preferred and experienced working management style (the Theory X and Theory Y Questionnaire). Descriptive analyses were carried out in addition to ANOVA, t-tests, and chi-square tests, followed by a multivariate analysis using linear regression.
Participants were found to have good overall quality of life and satisfaction with health. Age and working experience were found to be significantly (p < 0.05) associated with overall quality of life and three domains (psychological, social, and environmental health). Agreement between experienced and preferred working management style was also found to be associated with higher quality of life scores (with the exception of the social relationships domain). Though women reported relatively good overall quality of life, more than half of participants reported feeling stressed. In addition, nearly 20% of participants reported being isolated or very isolated. Stress was identified to be associated with isolation. In the multivariate analysis, stress was found to contribute to worse quality of life in all domains except social relationships, after adjusting for confounders. Social connectedness was positively associated with all domains of quality of life, and agreement of working management style was positively associated with physical health, psychological health and environmental quality of life.
The findings serve as an evidence-base pointing to the need for policies aimed at decreasing stress and social isolation among female MDWs in order to improve their health and quality of life.
Horticulture has greatly increased in Argentina in recent decades mainly due to increasing greenhouse utilization and agrochemical consumption, thus representing a threat to adjacent water bodies. ...Riparian wetlands, however, could attenuate agrochemical contamination. The present work therefore compared insecticide concentrations in bottom sediments in addition to sediment toxicity to the amphipod Hyalella curvispina and investigated the macroinvertebrate composition upstream and downstream from a natural wetland in a small stream draining a basin undergoing intense horticultural production. The wetland surface was covered by macrophytes, mainly Thypha sp., and the insecticide concentrations measured downstream from the wetland were significantly lower, at roughly 19% of the upstream values. The growth rates of H. curvispina were significantly higher when exposed to the sediments downstream from the wetland, while the macroinvertebrate-assemblage composition was significantly different upstream and downstream: the snail Pomacea canaliculata was the dominant species upstream while the amphipod H. curvispina was dominant downstream. Pomacea canaliculata is often the dominant species in the regional streams draining agriculture and horticultural basins. Hyalella curvispina is sensitive to pesticide toxicity and is often dominant in streams draining extensive livestock basins and within a biosphere reserve. We conclude that riparian wetlands effectively attenuate horticulture contamination in pampean streams and should therefore be preserved and restored.
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•Agrochemicals from horticulture contaminate adjacent streams on the Argentine Pampas.•Pesticide concentrations in sediments were lower downstream from a riparian wetland.•Sediment toxicity to Hyalella curvispina decreased downstream from the wetland.•Pesticide-sensitive Hyalella curvispina was dominant downstream from the wetland.•Riparian marshes should be preserved and restored to attenuate stream contamination.
The first- and second-order streams, Brown and Horqueta, respectively, which are located in the main area of soybean production in Argentina were examined for insecticide contamination caused by ...runoff from nearby soybean fields. The insecticides most widely used in Argentina (chlorpyrifos, cypermethrin and endosulfan) were detected in sediments, suspended particles and water. Highest concentrations in suspended particles were 318
μg/kg for endosulfan in the stream Horqueta, while 226
μg/kg chlorpyrifos and 13.2
μg/kg cypermethrin were measured in the stream Brown. In the Horqueta stream 150 and 53
μg/kg chlorpyrifos and cypermethrin were detected in runoff sediments, respectively. Whereas cypermethrin concentrations in the suspended particles were relatively low, levels in the floodwater of Brown reached 0.7
μg/l. The highest chlorpyrifos concentration in floodwater was 0.45
μg/l in Brown. However, endosulfan was not detected in the water phase. In runoff water the highest concentrations measured were 0.3
μg/l for chlorpyrifos in Horqueta and 0.49
μg/l for cypermethrin in the Brown stream. On five sampling dates during the pesticide application period in Brown stream (2002/2003) the concentration of chlorpyrifos and cypermethrin in runoff and/or floodwater exceeded the water quality criteria for freshwater mentioned in this study. In three cases this insecticide concentration was measured in stream water, indicating an acute risk to aquatic life. The acute toxicity–exposure-ratio (TER) for chlorpyrifos and cypermethrin also shows an acute risk for aquatic invertebrates in the Brown stream. In the Horqueta chlorpyrifos concentrations in the runoff exceeded the safety levels three times during the application period (2001/2002), potentially endangering the aquatic fauna. Effects on aquatic macroinvertebrates after insecticide contamination were reported in earlier studies in Horqueta stream.
Toxicity to the locally dominant amphipod Hyalella curvispina was assessed in a first-order stream running through a cultivated farm. Cypermethrin, chlorpyrifos, endosulfan and glyphosate were ...sprayed throughout the studied period. Toxicity was assayed under controlled laboratory conditions with runoff and stream water samples taken from the field under steady state and flood conditions. Ephemeral toxicity pulses were observed as a consequence of farm pesticide applications. After pesticide application, runoff water showed 100% mortality to H. curvispina for 1 month, but no mortality thereafter. Toxicity persistence was shortest in stream water, intermediate in stream sediments and longest in soil samples. Runoff had a more important toxicity effect than the exposure to direct aerial fumigation. The regional environmental features determining fast toxicity dissipation are discussed.
We investigated relationships among insecticides and aquatic invertebrate communities in 22 streams of two soy production regions of the Argentine Pampas over three growing seasons. Chlorpyrifos, ...endosulfan, cypermethrin, and lambda-cyhalothrin were the insecticides most frequently detected in stream sediments. The Species at Risk (SPEAR) pesticide bioassessment index (SPEARpesticides) was adapted and applied to evaluate relationships between sediment insecticide toxic units (TUs) and invertebrate communities associated with both benthic habitats and emergent vegetation habitats. SPEARpesticides was the only response metric that was significantly correlated with total insecticide TU values for all three averaged data sets, consistently showing a trend of decreasing values with increasing TU values (r2=0.35 to 0.42, p-value=0.001 to 0.03). Although pyrethroids were the insecticides that contributed the highest TU values, toxicity calculated based on all insecticides was better at predicting changes in invertebrate communities than toxicity of pyrethroids alone. Crustaceans, particularly the amphipod Hyalella spp., which are relatively sensitive to pesticides, played a large role in the performance of SPEARpesticides, and the relative abundance of all crustaceans also showed a significant decreasing trend with increasing insecticide TUs for two of three data sets (r2=0.30 to 0.57, p-value=0.003 to 0.04) examined. For all data sets, total insecticide TU was the most important variable in explaining variance in the SPEARpesticides index. The present study was the first application of the SPEAR index in South America, and the first one to use it to evaluate effects of pesticides on invertebrate communities associated with aquatic vegetation. Although the SPEAR index was developed in Europe, it performed well in the Argentine Pampas with only minor modifications, and would likely improve in performance as more data are obtained on traits of South American taxa, such as pesticide sensitivity and generation time.
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•Increasing insecticide toxic units were associated with decreases in percent crustaceans and SPEARpesticide index values•The SPEARpesticide index performed well for both benthic and emergent vegetation invertebrate communities•Insecticides were more important in explaining variability in the SPEARpesticide index than other environmental stressors•Total insecticides were better at predicting changes to invertebrate communities than were pyrethroids alone
•High P concentrations were efficiently removed from water.•Short-term P accumulation was significantly low in vegetated sediments.•Vegetated and unvegetated sediment presented the same P ...fractionation pattern.•Phosphate removal could be enhanced by using wetlands vegetated with T. domingensis.
A greenhouse experiment was conducted to evaluate the removal of high P concentration from water by vegetated and unvegetated wetlands. Reactors containing 4kg of sediment and two plants of Typha domingensis (vegetated treatments) and reactors containing only sediment (unvegetated treatments) were arranged. Reactors were dosed with 100 and 500mgL−1 of P-PO4. The studied concentrations tried to simulate an accidental dump. Controls without P addition were also disposed. Water samples were collected periodically and analyzed for phosphorus. Sediment (0–3 (surface), 3–7 (medium) and 7–10cm (deep)) and plant samples (roots, rhizomes, submerged leaves and aerial leaves) were collected at the beginning and at end of the experiment and were analyzed for total phosphorus. P fractionation was performed in the surface sediment layer. Relative growth rate (RGR) was calculated in each treatment considering initial and final plant height. P was efficiently removed from water in both, vegetated and unvegetated treatments. However, the major P removal was achieved in vegetated treatments. T. domingensis has a high capacity to tolerate and accumulate high P concentrations, especially in leaves, causing P accumulation in sediment to be significantly low in vegetated treatments. P accumulation was produced in the surface sediment layer (0–3cm) in all treatments, mainly retained as iron-bound P. Present results point the large removal capacity of phosphate of systems planted with T. domingensis. Therefore T. domingensis is suitable for phytoremediation practice, being capable to tolerate high P concentration.
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