The National Asthma Education and Prevention Program guidelines emphasize environmental control as an integral part of asthma management; however, limited national-level data exist on how clinicians ...implement environmental control recommendations.
We analyzed data on clinicians’ self-reported use of recommended environmental control practices in a nationally representative sample (n = 1645) of primary care physicians, asthma specialists, and advanced practice providers from the National Asthma Survey of Physicians, a supplemental questionnaire to the 2012 National Ambulatory Medical Care Survey.
We examined clinician and practice characteristics as well as clinicians’ decisions and strategies regarding environmental trigger assessment and environmental control across provider groups. Regression modeling was used to identify clinician and practice characteristics associated with implementation of guideline recommendations.
A higher percentage of specialists assessed asthma triggers at home, school, and/or work than primary care or advanced practice providers (almost always: 53.6% vs 29.4% and 23.7%, respectively, P < .001). Almost all clinicians (>93%) recommended avoidance of secondhand tobacco smoke, whereas recommendations regarding cooking appliances (eg, proper ventilation) were infrequent. Although assessment and recommendation practices differed between clinician groups, modeling results showed that clinicians who reported almost always assessing asthma control were 5- to 6-fold more likely to assess environmental asthma triggers. Use of asthma action plans was also strongly associated with implementation of environmental control recommendations.
Environmental assessment and recommendations to patients varied among asthma care providers. High adherence to other key guideline components, such as assessing asthma control, was associated with environmental assessment and recommendation practices on environmental control.
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Harmful Internet use (HIU) describes unintended use of the Internet. It could be both self-harm and harming others. Our research goal is to develop a more accurate method for ...measuring HIU by this novel peer assessment. As such, it may become, with our call for more research, a paradigm shift supplementing every rating scale or other type of Internet use assessment. In addition to classic statistical analysis, structural equations have been employed. Results indicate that the true positive rate (TPR) is substantially higher than assessed in other studies.•Peer assessment improvement.•AUC for ROC was computed to establish cut-off points for the used scale.•Results obtained by the Structural Equation model indicate that parental care has a moderate influence on subjects’ attempts to fight HIU.
Quantum information science promises transformative impact over a range of key technologies in computing, communication, and sensing. A prominent example uses entangled photons to overcome the ...resolution-degrading effects of dispersion in the medical-imaging technology, optical coherence tomography. The quantum solution introduces new challenges: inherently low signal and artifacts, additional unwanted signal features. It has recently been shown that entanglement is not a requirement for automatic dispersion cancellation. Such classical techniques could solve the low-signal problem, however they all still suffer from artifacts. Here, we introduce a method of chirped-pulse interferometry based on shaped laser pulses, and use it to produce artifact-free, high-resolution, dispersion-cancelled images of the internal structure of a biological sample. Our work fulfills one of the promises of quantum technologies: automatic-dispersion-cancellation interferometry in biomedical imaging. It also shows how subtle differences between a quantum technique and its classical analogue may have unforeseen, yet beneficial, consequences.
Malignant mesothelioma is a neoplasm associated with occupational and environmental inhalation exposure to asbestos* fibers and other elongate mineral particles (EMPs) (1-3). Patients have a median ...survival of approximately 1 year from the time of diagnosis (1). The latency period from first causative exposure to malignant mesothelioma development typically ranges from 20 to 40 years but can be as long as 71 years (2,3). Hazardous occupational exposures to asbestos fibers and other EMPs have occurred in a variety of industrial operations, including mining and milling, manufacturing, shipbuilding and repair, and construction (3). Current exposures to commercial asbestos in the United States occur predominantly during maintenance operations and remediation of older buildings containing asbestos (3,4). To update information on malignant mesothelioma mortality (5), CDC analyzed annual multiple cause-of-death records
for 1999-2015, the most recent years for which complete data are available. During 1999-2015, a total of 45,221 deaths with malignant mesothelioma mentioned on the death certificate as the underlying or contributing cause of death were reported in the United States, increasing from 2,479 deaths in 1999 to 2,597 in 2015 (in the same time period the age-adjusted death rates
decreased from 13.96 per million in 1999 to 10.93 in 2015). Malignant mesothelioma deaths increased for persons aged ≥85 years, both sexes, persons of white, black, and Asian or Pacific Islander race, and all ethnic groups. Despite regulatory actions and the decline in use of asbestos the annual number of malignant mesothelioma deaths remains substantial. The continuing occurrence of malignant mesothelioma deaths underscores the need for maintaining measures to prevent exposure to asbestos fibers and other causative EMPs and for ongoing surveillance to monitor temporal trends.
OBJECTIVE:The primary objective of this study was to estimate current smoking among workers in the health care and social assistance sector.
METHODS:We analyzed the 2008 to 2012 National Health ...Interview Survey data for adults (age 18 years or more) working in health care and social assistance sector who reported current cigarette smoking.
RESULTS:Of the approximately 18.9 million health care and social assistance workers, 16.0% were current cigarette smokers. Smoking prevalence was highest in women (16.9%) and among workersage 25 to 44 years (17.7%); with a high school education or less (24.4%); with income less than $35,000 (19.5%); with no health insurance (28.5%); in the nursing and residential care facilities (26.9%) industry; and in the material recording, scheduling, dispatching, and distributing (34.7%) occupations.
CONCLUSIONS:These findings suggest that specific group of workers in the health care and social assistance sector might particularly benefit from cessation programs and incentives to quit smoking.
We linked an outbreak of cryptosporidiosis to ozonated apple cider by using molecular and epidemiologic methods. Because ozonation was insufficient in preventing this outbreak, its use in rendering ...apple cider safe for drinking is questioned.
Traumatic brain injury (TBI) is one of the most important causes of disability and death among young adults and referred to as "silent" epidemic. The most frequent consequences of a TBI are ...extra-axial hematomas, comprising of acute subdural (SDH) and epidural hematoma (EDH). Most of the factors affecting the mortality have been analyzed in a wide group of TBI. The aim of this study is to identify factors affecting in-hospital mortality in patients undergoing surgery for acute traumatic subdural and epidural hematoma.
The study included 128 patients operated on due to extra-axial hematomas. Twenty-eight patients were operated on for EDH and 100 on for SDH. Patients were treated at the Department of Neurosurgery Medical University in Lublin, during almost three years. The following factors were analyzed: demographic data, physiological factors, laboratory factors, computed tomography scan characteristics and time between the trauma and the surgery. All the factors were correlated with in-hospital mortality rate.
The univariate analysis has confirmed the influence of many factors affecting the in-hospital mortality.
It is interesting that factors such as GSC score, systolic blood pressure, respiratory rate and glycemia were associated with in-hospital mortality rate with highly statistically significant differences (Tab. 3, Fig. 2, Ref. 40).
The article presents the results of research on the enrichment of fine-grained coal grades, also known as coal slurries. The research was carried out on a semi-technical scale, using the method of ...gravity flow enrichment on a spiral separator type Reichert LD-4. The research material used in the research were three types of coal slurries, diversified in qualitative terms that were taken from technological process of the preparation plants. The enrichment efficiency tests were carried out in relation to changes in the density of the feed directed to the separator. The best distribution results for all tested coal slurries were obtained for the feed density of β = 300 g/dm3, where weighted averages of ash content in the obtained concentrates reached values of several percent. A statistical analysis was also performed, to which the multiple regression model was used. Using the constructed models, it is possible to determine which technological parameters affect the process of enriching coal sludge.
Invasive predators are responsible for almost 60% of all vertebrate extinctions worldwide with the most vulnerable faunas occurring on islands. The brown treesnake (
Boigairregularis
) is a notorious ...invasive predator that caused the extirpation or extinction of most native forest birds on Guam. The success of avian reintroduction efforts on Guam will depend on whether snake-control techniques sufficiently reduce contact rates between brown treesnakes and reintroduced birds. Mouse-lure traps can successfully reduce brown treesnake populations at local scales. Over a 22-week period both with and without active snake removal, we evaluated snake-trap contact rates for mouse- and bird-lure traps. Bird-lure traps served as a proxy for reintroduced nesting birds. Overall, mouse-lure traps caught more snakes per trap night than did bird-lure traps. However, cameras revealed that bird-lure traps had a snake contact rate almost 15 times greater than the number of successfully captured snakes. Snakes that entered bird-lure traps tended to be larger and in better body condition and were mostly captured in bird-lure traps, despite numerous adjacent mouse-lure traps. Traps placed along grid edges caught more snakes than interior traps, suggesting continuous immigration into the trapping grid within which bird-lure traps were located. Contact between snakes and bird-lure traps was equivalent before and after snake removal, suggesting mouse-lure traps did not adequately reduce the density of snakes that posed a risk to birds, at least at the timescale of this project. This study provides evidence that some snakes exhibit prey selectivity for live birds over live mouse lures. Reliance on a single control tool and lure may be inadequate for support of avian reintroductions and could lead to unintended harvest-driven trait changes of this invasive predator.
Background Healthy People 2020 –specific respiratory diseases objectives seek to increase the proportion of people with current asthma who receive appropriate asthma care. For adults, this includes a ...discussion of whether asthma is work-related. Purpose To establish a baseline measure of physician–patient communication regarding asthma and work. Methods This study used data from 27,157 non-institutionalized U.S. adult respondents of the 2010 National Health Interview Survey (analyzed in 2011). Adults employed at any time in the 12 months prior to the interview with a health-professional diagnosis of current asthma who have been told by a health professional that their asthma was probably work-related or ever discussed the relatedness of asthma and work were identified. Weighted proportions and, using logistic regression analysis, prevalence ORs for factors that may have predicted communication with a health professional regarding an asthma–work relationship were calculated. Results An estimated 6.6% (95% CI=5.1%, 8.2%) of employed adults with current asthma have been told that their asthma is work-related. Among those not so informed, 7.4% (95% CI=5.6%, 9.2%) ever discussed the topic. When responses to both questions were considered, the proportion was 13.5% (95% CI=11.3%, 15.8%). Employed adults aged ≥30 years, those reporting adverse asthma outcomes, and those of Hispanic ethnicity had higher odds of having communication with a health professional about the relation between their asthma and their work. Conclusions One in seven employed adults with asthma report communicating with their health professional about the role of workplace exposures in their asthma. Opportunities to increase this dialogue should be examined.
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