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PubMed2001

A worksite intervention module encouraging the use of stairs: results and evaluation issues.

OBJECTIVES: Recent recommendations suggest that health benefits can also be derived from regular daily activities of moderate intensity which accelerate breathing, such as climbing stairs. The purpose of this study was to examine the effect of an intervention programme on behaviour change in stair use in a working environment. METHODS: Intervention field workers were instructed to offer attractive or pull actions. 338 employees of four offices of the Swiss federal government were involved in the evaluation. Two methods were used to assess stair and lift use both before and after the four month intervention period: a non-covered personal observation and an automatic measurement. RESULTS: Taking all four offices together, a significant increase in stair use, from 61.8% to 67.1% (p = 0.028), was found between the baseline and the follow-up observation. The automatic measurement during observation time reveals a change in stair use from 68.8% to 71.4% (p = 0.268). The pattern of stair use examined for 24 hours by automatic means, however, was not so consistent. Due to the proportion of stair use in each office it is assumed that environmental factors influences the behaviour. The highest percentage of stair use at baseline (86.2%) was identified in an office with a bright stairwell and a small number of steps between floors. The lowest proportion (31.4%) was observed in an office with a dark stairwell, a large number of steps between floors and a stairwell accessible only with a key. CONCLUSIONS: However, our findings indicate that intervention with "rewarding" elements encourage individuals to use stairs.

Activities of Daily Living↗
PubMed2003

Prevalence and correlates of diarrhea.

OBJECTIVE: The present study aimed to estimate the prevalence of acute diarrhea and its correlates in remote rural villages of south Pakistan. METHODS: The authors selected 1878 children less than 3 years of age through stratified random sampling from 64 villages having the number of children enrolled proportionate to the size of each village, in rural Sindh, Pakistan. Trained field workers completed child physical measurements and maternal interviews. RESULTS: Among the children examined, 961 (51%) had diarrhea in the preceding 14 days prior to the date of survey. The prevalence of diarrhea was marginally higher among girls than boys (53% versus 49%, odds ratio 1.18, 95% CI 0.98, 1.41). The factors related with higher prevalence of diarrhea were lack of education of mother, lack of exclusive breast feeding, breast feeding for less than one year, roundworm infestation, low weight-for height, night blindness, female sex and number of older siblings more than 2 in the family. CONCLUSION: This study demonstrated that the acute diarrhea is major problem among children in rural Pakistan. Appropriate intervention programmes should be formulated focused on identified risk factors.

Breast Feeding↗
PubMedDate not supplied

Neonatal screening by mid-arm circumference.

One hundred and ninety-seven neonates were screened within 24 hours after birth by a tricolored mid-arm circumference (MAC) measuring tape with a borderline yellow-zone between 7.5 cm and 8.5 cm and two peripheral zones, red and green beyond 7.5 cm and 8.5 cm respectively. All of the neonates identified by red-zone had birth weight less than 1500 g. Majority (89.7%) of neonates identified by yellow-zone had birth weight between 1500 g and 2000 g, but only a small (10.3%) number of neonates had birth weight more than 2000 g. A very large proportion of neonates identified by green-zone had birth weight more than 2000 g (98.8% vs 1.2% weighed less than 2000 g at birth). The sensitivity and specificity of MAC critical limit 8.5 cm identifying neonate below 2000 g were 93.7% and 98.2% respectively. It was not worthy in this study to calculate the sensitivity and specificity of the critical limit of 7.5 cm for MAC to identify neonates below 1500 g because of the very small sample size. But, this simple MAC measuring tape can be used by field worker for easy assessment of low birth weight neonates.

Arm↗
PubMed2002

Gamergates in the myrmicine genus Metapone (Hymenoptera: Formicidae).

Gamergates (i.e. mated reproductive workers) are mostly known from ant species within the Ponerinae. We report here the discovery of gamergates in two species of the subfamily Myrmicinae. Until now, mated reproductive females in colonies of myrmicine species have been considered morphologically distinct from the worker caste. However, in two species of the myrmicine Metapone (Metapone madagascarica and a newly discovered, not yet described Metapone species) all workers have six ovarioles and a spermatheca; and some of them are mated. There are no morphological differences between mated and non-mated workers. Field observations and laboratory studies indicate that colonies of the Metapone species can reproduce with gamergates only.

Animals↗
PubMed1983

A comparison of Norinyl and Brevicon in three sites in Sri Lanka.

A set of 3 four-cell randomized, blind clinical trials was carried out in Sri Lanka to evaluate the impact of vitamin supplements and different oral contraceptive formulations. This paper concentrates on the comparisons of oral contraceptives. There seems to be no important difference between Norinyl, a standard-dose oral contraceptive, and Brevicon of a lower estrogen dosage--in either continuation or side effects. Continuation at one site was higher among Norinyl users, but several factors led us to the belief that this difference was due to differences in field worker performance rather than to the pharmacological properties of the drugs. Some differences in side effects were observable along predictable lines; breakthrough bleeding was more common among Brevicon users than Norinyl users, and most other side effects were more frequent among Norinyl users, although these latter differences were quite small, and there were several exceptions.

Adolescent↗
PubMed1981

Leishmaniasis in Brazil: XVI. Isolation and identification of Leishmania species from sandflies, wild mammals and man in north Para State, with particular reference to L. braziliensis guyanensis causative agent of "pian-bois".

A total of 125 wild mammals (14 different species) were examined for evidence of infection with Leishmania in an area of primary forest highly endemic for "pian-bois", due to Leishmania braziliensis guyanensis, in north Pará State, Brazil. Parasites isolated were characterized biologically, and biochemically on enzymic profiles. L. b. guyanensis was isolated from the viscera of one lesser anteater (Tamandua tetradactyla) and one opossum (Didelphis marsupialis), and the skin of one rodent (Proechimys guyannensis). The isolates were indistinguishable from 10 others previously made from the sandfly vectors Lutzomyia umbratilis (five) and Lu. whitmani (five), and nine isolates from field-workers who became infected during these studies. Leishmania mexicana amazonensis was obtained from the skin of 21 animals, including three species of opossums (D. marsupialis, Philander opossum and Metachirus nudicaudatus) and two species of rodents (proechimys guyannensis and Dasyprocta sp.). A peripylarian Leishmania isolated from the viscera of two armadillos (Dasypus novemcinctus) was shown to be different, biologically and biochemically, from L. b. guyanensis and L. m. amazonensis. Four other isolates of Leishmania, from the rodents Rhipidomys leucodactylus (one) and P. guyannensis (three) have yet to be characterized owing to their very poor growth in both hamster skin and in vitro culture: they appear closest, however, to L. braziliensis braziliensis. The complexity of Amazonian leishmaniasis is discussed, and attention drawn to the importance of edentates as reservoir hosts of some leishmanias in the New World. Whereas L. mexicana subspecies appear largely restricted to the skin of their natural hosts, subspecies of L. braziliensis are commonly found in the viscera.

Animal Population Groups↗
PubMed1983

A trial of ascorbic acid and of multivitamin supplementation on the oral health of West African children.

204 children between the ages of 1.5 and 6.5 years living in a West African village where the incidence of gingivitis and bleeding gums is about 40% of the population at the end of the rainy season, were given vitamin C or a placebo for 69 days, followed by a multivitamin supplement or placebo for 47 days. The condition of their gums was continuously monitored by trained field workers and by a paediatrician during the supplementation period, and was also assessed in greater detail by the paediatrician at the beginning and end of each treatment period. No benefit of either type of supplement could be detected, either on incidence of bleeding, or on over-all severity of gingivitis, although there was a clear-cut seasonal trend towards lower incidence of bleeding in both groups as the study progressed.

Ascorbic Acid↗
PubMed1984

Oral rehydration therapy in the home by village mothers in Burma.

Acceptability and effectiveness of oral rehydration therapy (ORT) when given by mothers in the home under village conditions was investigated in six (two control and four test) communities at Htauk-kyant near Rangoon, Burma. The control and test village communities had populations of 2085 and 4278 respectively, of which 218 and 623 were children under five. In the test villages, Oral Rehydration Salts (ORS) were made constantly available by providing each household with one packet of ORS, which was replenished whenever a used packet was returned to the field workers during their daily surveillance rounds. In control villages ORS packets were not provided. Daily diarrhoea surveillance was made for one year, including daily weighing of each child with diarrhoea, and across-episode weight changes were calculated. Monthly mass anthropometric measurements (weight and height) were carried out on over 90% of all children in test and control villages. Stool samples were investigated for bacterial aetiological agents. In test villages 327 children developed diarrhoea (52% of all children) with a total of 639 episodes and an incidence of 1.3 episodes per child per year. 314 diarrhoea episodes (49% of all) occurred in 67 children who had three or more episodes each. ORS was readily accepted and administered by mothers in 96% of the diarrhoea episodes. The impact of ORS on mortality and morbidity could not be demonstrated as there was no death, nor necessity for admission to hospital for diarrhoea in either test or control village populations.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Height↗
PubMed1992

Cutaneous toxicity and absorption of paraquat in porcine skin.

Paraquat, a commonly used herbicide, has been shown to be toxic in exposed field workers. The objectives of this study were to (a) assess the cutaneous toxicity of paraquat in vivo in pig skin and in vitro in the isolated perfused porcine skin flap (IPPSF) and (b) quantitate its absorption in the IPPSF. The amounts of 3, 24, and 200 mg of paraquat were topically applied (5 cm2 surface area) on the ventral abdomen of pigs and biopsied after 6-8 hr for light microscopy (LM) and transmission electron microscopy (TEM). IPPSFs were topically dosed with the same concentrations and perfused for 8 hr (n = 4/treatment). The dosed area of the skin was sampled for LM, TEM, and enzyme histochemistry. IPPSFs were also treated topically with [14C]paraquat dichloride at the aforementioned concentrations (n = 4/dose) and hourly perfusate samples were collected for radiolabel determination and assessment of biochemical and physiological parameters. The epidermal changes were similar both in vivo and in vitro. The changes included epidermal intercellular edema which increased with dose and epidermal-dermal separation at the 200-mg dose. Acid phosphatase and nonspecific esterase activities were increased in the upper layers of the epidermis, while alkaline phosphatase showed a greater activity in the stratum basale layer. Glucose utilization of all treated IPPSFs was lower than that of the controls and a variation in the vascular resistance profiles was seen in all the treated flaps. Radiotracer studies indicated that a majority of the compound remained on top of the application site and minimal absorption or penetration into skin was observed. Thus, at high concentrations and prolonged exposure, paraquat may have deleterious effects on epidermal morphology in the absence of significant percutaneous absorption.

Acid Phosphatase↗
PubMed1995

An event recorder for infant feeding research.

An Event Recorder program was developed for the HP 48 calculator to record the durational events associated with breastfeeding behavior. The Event Recorder menu structure is flexible and allows for the recording of response variables such as menstrual history and fertility symptoms. A Windows program was written in Visual C++ to give a graphical representation of the time-series data and to extract useful measures of breastfeeding activity from the raw data for each 24-h day postpartum. These time varying covariates include the mean and median bout length, median interbout interval, breastfeeding frequency and total 24-h suckling duration. The HP 48 calculator has proven to be a robust instrument for the self-recording of breastfeeding data collected as part of a prospective study on the factors that maintain postpartum amenorrhea. We have found also that the behavioral data collected are easily transferred electronically each month when our field workers make home visits.

Breast Feeding↗
PubMed1989

Schistosomiasis in Brazil: Does social development suffice?

Up to 15 years ago, when asked to identify the major public health problems of Brazil, there would be no hesitation in naming infant diarrhoea, Chagas disease and Schistosoma mansoni. While most field workers have now eliminated schistosomiasis from the list, now certainly headed by malaria, in academic and bureaucratic circles the old priorities are still maintained.

Journal Article↗
PubMed1989

A 90-day inhalation toxicity study with benomyl in rats.

Benomyl [methyl 1-(butylcarbamoyl)-2-benzimidazolecarbamate, CAS Registry No. 17804-35-2] is a fungicide and the possibility for inhalation exposure exists for field workers. To assess the toxicity of benomyl, groups of 20 male and 20 female CD rats were exposed nose-only 6 hr a day, 5 days a week, to concentrations of 0, 10, 50 or 200 mg/m3 of a benomyl atmosphere. At the midpoint (approximately 45 days on test) and at the end of the exposure period, blood and urine samples for clinical evaluation were collected from 10 rats/group/sex, and these animals were sacrificed for pathological examination. Similar evaluations were performed on all remaining rats at the end of the 90-day test period. After approximately 45 days on test, compound-related degeneration of the olfactory epithelium was observed in all males and in 8 of 10 female rats exposed to 200 mg/m3 benomyl. Two male rats exposed to 50 mg/m3 had similar, although less severe, areas of olfactory epithelial degeneration. After approximately 90 days of exposure, the remaining 10 rats/group/sex were sacrificed and examined. Of these rats, all of the males and females exposed to 200 mg/m3 had olfactory degeneration, along with 3 males exposed to 50 mg/m3 of benomyl. No other observed lesions were interpreted to have been caused by the benomyl exposure. In addition, male rats exposed to 200 mg/m3 benomyl had depressed mean body weights compared to controls and this finding correlated with a reduction in food consumption. Based on pathological observations, 10 mg/m3 represents the no-observable-effect level (NOEL) for the male rats, and 50 mg/m3 is the NOEL for the female rats.

Administration, Inhalation↗
PubMed1984

Evaluation of pesticides which pose carcinogenicity potential in animal testing. II. Consideration of human exposure conditions for regulatory decision making.

In reaching a regulatory decision on the use of pesticides with carcinogenic potential, it is of great importance to investigate the extent of dermal exposure and absorption of a pesticide to users and field workers. By applying this information, along with the appropriate carcinogenicity categorization of a pesticide, a reasonably sound regulatory decision can be derived. Seven pesticides were selected, based on adequacy of tumor data, and were taken through the tumor evaluation system as reported in Part I 1984, Regul. Toxicol. Pharmacol. 4, 355-360). A step-by-step analysis on how a regulatory decision is reached on each pesticide by the EPA and CDFA was discussed.

Agricultural Workers' Diseases↗
PubMed2006

Prevalence of hepatitis B among Afghan refugees living in Balochistan, Pakistan.

OBJECTIVE: Continued civil war and political instability in Afghanistan have lead to a huge influx of refugees into the neighboring provinces in Pakistan. This study was conducted to estimate seroprevalence of hepatitis B and to identify potential risk factors for hepatitis B virus (HBV) transmission among the refugees living in the camps of Balochistan Province, Pakistan. METHODS: A cross-sectional survey of hepatitis B surface antigen (HBsAg) was conducted during October 2003. We obtained the registration list to select families randomly from the refugee camps. A husband, wife and one of their children, selected at random, were enrolled in the study. Study subjects with positive laboratory results for HBsAg were compared with those who were negative for HBsAg. RESULTS: Field workers interviewed 301 families with a total of 903 study subjects. Blood specimens of 75 study subjects (8.3%, 95% CI 6.6-10.3) were positive for HBsAg. There were 37 husbands (12.3%, 95% CI 7.2-14.4) and 21 wives (7.0%, 95% CI 4.5-10.6) positive for HBsAg. Out of 301 children, 17 (5.6%, 95% CI 3.4-9.1) were positive for HBsAg. Receiving more than ten injections during the previous year increased the risk of HBV infection (OR 3.5, 95% CI 1.8-6.7). A child positive for HBsAg was more likely to have a positive parent compared to an HBsAg negative child (OR 5.7, 95% CI 2.0-16.5). CONCLUSION: Hepatitis B is highly endemic among Afghan refugees living in these camps. Unsafe injection practices will continue to cause a steady increase in the magnitude of this health problem until appropriate control measures are taken. The possibility of mother-to-child transmission underscores the need to include vaccination against hepatitis B as part of routine immunization in this population.

Adolescent↗
PubMed2006

Cat allergen level: its determinants and relationship to specific IgE to cat across European centers.

BACKGROUND: Cat allergen level in settled house dust and its determinants in Europe are unknown. OBJECTIVE: The aim of this study is to quantify the level of cat allergens in mattress dust, to study its determinants, and to analyze the relationship with cat specific IgE on community level across European centers. METHODS: Trained field workers collected dust from approximately 3000 mattresses during home visits in 22 European Community Respiratory Health Survey II centers. Sieved dust extracts were assayed for cat allergen using a mAb ELISA assay. RESULTS: The overall geometric mean cat allergen was 0.94 microg/g, ranging from 0.12 microg/g in Huelva, Spain, to 3.76 microg/g in Antwerp, Belgium. Current cat owners' homes showed substantially higher levels than past cat owners' and never cat owners' homes (geometric mean and 95% CI, 61.4 microg/g [48.4-77.9] vs 1.37 microg/g [0.97-1.9] vs 0.29 microg/g [0.27-0.31]). Community prevalence of cat ownership was moderately correlated with cat allergen levels in noncat owners (r(s) = 0.50), but not for past or current cat owners. The multilevel model identified community prevalence of cat keeping as the only statistically significant determinant of mattress cat allergen levels for noncat owners. However, averaged cat allergen levels per center were not related to community prevalence of detectable specific IgE to cat. CONCLUSION: Not having a cat in the home is associated with substantially lower Fel d 1 concentration, but does not protect against high Fel d 1 exposure in communities where cat ownership is common. CLINICAL IMPLICATIONS: People (including patients with cat allergy) who do not own cats may be exposed to high levels of cat allergen in their home, particularly if they live in communities with high levels of cat ownership.

Allergens↗
PubMed2004

Evidence for relatively greater subcutaneous fat deposition in stunted girls in the North West Province, South Africa, as compared with non-stunted girls.

OBJECTIVE: We examined differences in body composition between stunted and non-stunted girls, with adjustments for confounding factors. METHODS: A cross-sectional study was conducted in a representative sample of 478 African school girls, ages 10 to 15 y, in the North West Province, South Africa. Height, weight, skinfold thicknesses, and waist and mid upper arm circumferences were measured by trained biokineticists using standard methods. Trained field workers measured dietary intakes by 24-h recall, and physical activity was measured by using the physical activity recall of the previous day. Body mass index and physical activity category were calculated. RESULTS: Stunted girls had significantly lower weight and skinfold thicknesses than did non-stunted ones. After including the covariates: age, years since menarche, school, type of housing, dietary energy and fat intakes, physical activity category, body weight, and stratum of urbanization in analysis of variance, the mean sum of triceps skinfold and subscapular skinfold thicknesses of stunted girls was greater than that of the non-stunted girls (P < 0.002). Stunted subjects were less active than non-stunted ones. CONCLUSION: This manifestation of relatively more subcutaneous fat and greater waist circumference in stunted girls may be involved in the development of obesity among black women in South Africa.

Adipose Tissue↗
PubMed2006

Some issues in the provision of adult bereavement support by UK hospices.

This paper considers some issues in the provision of adult bereavement support in UK hospices. The paper is based on the findings of a multi-method study conducted in two phases over 30 months (2003-2005) to examine the nature and quality of adult bereavement support in UK hospices from the perspectives of bereaved people and professional and volunteer bereavement workers [Field, Reid, Payne, & Relf (2005). Adult Bereavement Support in Five Hospices in England. Sheffield, UK: Palliative and End-of-Life Care Research Group, University of Sheffield. (Available from Professor Payne)]. It discusses the importance of continuity between pre-bereavement and bereavement support, the integration of bereavement services within hospices and the involvement of volunteers in bereavement support. It then discusses the engagement of UK hospices in the broader development of bereavement support. Although hospices have developed expertise in supporting bereaved people, our research suggests that they have not had a major impact on other health service providers, such as general practitioners and distinct nurses and staff in acute hospital trusts, in this area.

Data Collection↗
PubMed2006

Using focus groups to develop contingent valuation scenarios--a case study of women's groups in rural Nepal.

The construction of a contingent valuation (CV) scenario forms a critical component of willingness-to-pay (WTP) survey design, especially when working across diverse cultural and socio-economic settings. However, the methods used to develop CV scenarios have not been well reported in the health economics literature. This paper begins by describing how qualitative methods can be used to develop CV surveys. It then presents a case study illustrating how focus groups were used to develop a CV survey to value a women's group intervention in rural Nepal. A series of focus group discussions were conducted with three stakeholder groups. These were used to determine the most appropriate description of the good to be valued and the means by which payment would be elicited. These methods were very helpful in designing the survey tool and choosing the key attributes to describe the intervention. They also familiarised field workers with the concept of WTP. Further work of this kind will help to highlight additional advantages and limitations of qualitative approaches to survey design.

Data Collection↗