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PubMed1989

The external costs of a sedentary life-style.

Using data from the National Health Interview Survey and the RAND Health Insurance Experiment, we estimated the external costs (costs borne by others) of a sedentary life-style. External costs stem from additional payments received by sedentary individuals from collectively financed programs such as health insurance, sick-leave coverage, disability insurance, and group life insurance. Those with sedentary life-styles incur higher medical costs, but their life expectancy at age 20 is 10 months less so they collect less public and private pensions. The pension costs come late in life, as do some of the medical costs, and so the estimate of the external cost is sensitive to the discount rate used. At a 5 percent rate of discount, the lifetime subsidy from others to those with a sedentary life style is $1,900. Our estimate of the subsidy is also sensitive to the assumed effect of exercise on mortality. The subsidy is a rationale for public support of recreational facilities such as parks and swimming pools and employer support of programs to increase exercise.

Adult↗

PubMed2002

[Encouraging healthy habits by playing with the child in the family milieu: the snakes and ladders game].

In recent decades society has been undergoing many changes and these have had a strong incidence on infant morbidity and mortality. Diseases that have practically vanished due to the impact of vaccinations and the improvement of the standard of living have given way to others derived from the changes in eating habits and life style; accidents, on the other hand, have come to be the first cause of morbidity and mortality after the first year of life has been passed. Strategies must be directed towards avoiding the causes of this new way of falling ill. We present a Spanish version of a game similar to "snakes and ladders" called "the healthy goose", which encourages healthy living habits. In order that the child should internalize safe habits by means of the game, certain squares in the game have been replaced by positive drawings, in which the child carries out healthy activities, receiving prizes for these, and others in which risky activities are performed, which are penalized. The areas dealt with are: habits (nutrition, sleep, study, games, etc.), Accidents at home, road safety (pedestrian, cyclist and automobile traveler), and swimming pools. The game starts with a child of 3-4 years and the goal is reached as a healthy adolescent. Given that the variation in personalities is enormous, we believe the family milieu should be the complement to legislative and educational measures and general campaigns in the means of communication, since it is what the child knows best and where he learns his deepest attitudes. This game could be a help to parents in this difficult task.

English Abstract↗

PubMed2006

Toxicosis associated with ingestion of quick-dissolve granulated chlorine in a dog.

CASE DESCRIPTION: A dog was referred for treatment after ingestion of quick-dissolve chlorine granules intended for use in a swimming pool. CLINICAL FINDINGS: At evaluation 18 hours after ingestion of the granules, the dog had tachypnea, signs of depression, approximately 5% dehydration, oral mucositis, and a productive cough. Increased respiratory tract sounds and wheezes were ausculted in all lung fields. Complete blood count revealed erythrocytosis and lymphopenia. Serum biochemical analyses revealed mildly high activities of hepatic enzymes and creatine kinase. Arterial blood gas concentrations were consistent with hypoxemia and hyperventilation. Thoracic radiography revealed widespread pulmonary alveolar infiltrates predominantly affecting the ventral portions of both lungs, consistent with noncardiogenic pulmonary edema secondary to aspiration of the granulated chlorine. TREATMENT AND OUTCOME: Initial treatment included IV administration of an electrolyte solution with supplemental KCl, ranitidine, furosemide, cefotaxime, buprenorphine, and supplemental oxygen. Subsequent treatment included administration of meloxicam and an endoscopically placed percutaneous gastrostomy tube. Endoscopic examination revealed esophagitis and mild gastritis; therefore, metoclopramide and sucralfate were also administered. Fifteen days later, the gastrostomy tube was removed prior to discharge; endoscopic examination revealed grossly normal esophageal and gastric mucosa, and thoracic radiography revealed complete resolution of the lung lesions. CLINICAL RELEVANCE: Although ingestion of granulated chlorine is rare in veterinary patients, the resulting disease processes are common and can be treated successfully.

Animals↗

PubMed1977

Emotional sequelae of parents and sibs following the drowning or near-drowning of a child.

This study reports the findings from an investigation to evaluate the intra-family dynamics that occurred with 111 cases of childhood drowning and near-drowning in the City of Brisbane in 1971-1975. Personal interviews were obtained with 77 of the families. 24 per cent of parent-dyads separated following the drowning of their child, whereas none of the 54 families of surviving children separated. Accident generated stresses within the studied families tended to persist for years after the incident. Parents volunteered the information that they drank more, experienced sleep disorders and nightmares, and reported significant anxiety states. 19 per cent of parents of drowned children received specialist psychiatric treatment following the drowning. Two cases of surviving children received specialist psychiatric therapy (these were both parents who had inflicted non-accidental injury on their child, and had attempted to drown their child in the bath). In one sense, a child's death is more honourable from society's point of view if the child dies from a chronic medical illness such as leukaemia. In the case of a child's death in the family bath tub or the backyard swimming pool, the extra society sanctions of culpability and accusation further intensified the likelihood of the normal grief process being transformed into a pathological variant.

Adult↗

PubMed1981

Education and self-care of patients with low back pain.

Two groups of patients with 'low back pain', comparable regarding sex, age and diagnosis, all hospitalized at the Hospital for Rheumatology, Kristiansand, for a period of 4-6 weeks, were treated as follows: Group I (209 (180) patients): Education program combined with practise of exercises and correct use of the back. Group II (190 (153) patients): Usual physiotherapeutic treatment methods (individual or group exercises in the charge of a physiotherapist). Further, both groups received similar swimming pool exercises and electrotherapy. Group I was studied on the basis of a questionnaire completed by patients before beginning the education program and both groups were studied on a similar basis after 12 months. Results are extracted from these questionnaires. In spite of various and extensive previous treatment (Table I), not many patients in group I had received information prior to the education program. Significantly more patients in group I than in group II stated that they had received tuition at our hospital (p less than 0.01) (Table II). Group I seemed to practise self-care more than group II and was statistically in less need of physiotherapy during the year after leaving the hospital (p less than 0.05). This seems to be beneficial for the patients and of economic importance for society at large. We conclude that education is important and has to be organized in the form of special lessons.

Back Pain↗

PubMed1998

Daily physical activity in adults with mild and moderate learning disabilities: is there enough?

PURPOSE: Whilst the health benefits associated with regular physical activity are well known, little objective evidence exists regarding the activity profiles of adults with mild and moderate learning disabilities. The aims of the present study were to establish 7 day physical activity profiles for 24 adults with mild and moderate learning disabilities and to compare them with the general population and current Department of Health recommendations for physical activity. METHOD: A descriptive study was used, based on interviews with 24 adults with learning disabilities (mean age 34 years) triangulated by daytime and residential care workers. Participants volunteered from two residential homes and one social education centre (SEC) in a city in the North of England. RESULTS: The physical activity profiles show that the participants led sedentary lifestyles that were more exaggerated than those of the general population. Twenty-two participants (93%) performed significantly less than the minimum daily levels of physical activity recommended by the Department of Health. CONCLUSIONS: Few adults with learning disabilities can choose to walk to work, go for a run or visit the local swimming pool without adequate support. This study suggests that there may not be enough moderate or vigorous physical activity choices available in day and residential care settings to empower adults with mild and moderate learning disabilities to meet the minimum recommendations of the Department of Health. Hence some people with learning disabilities have no alternatives to a sedentary lifestyle and the health risks associated with physical inactivity.

Adult↗

PubMed1994

Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation.

In this two year retrospective review, 86 cases of chlorine gas inhalation from 49 medical facilities were treated with nebulized sodium bicarbonate on the recommendation of the Kentucky Regional Poison Center. Typical manifestations included cough, chest discomfort, shortness of breath, and wheezing. No patients developed pulmonary edema or respiratory insufficiency requiring ventilatory support. Sixty-three cases (73.3%) were exposures to chlorine producing acid/hypochlorite mixtures. Six (7.0%) were exposed to chlorine gas in industrial settings. Twelve (14.0%) were exposed to chlorine gas in swimming pool settings. Sixty-nine (80.2%) were treated and released from the emergency department. In 53 patients, clinical condition was clearly improved on emergency department discharge. Seventeen (19.8%) were admitted to the hospital. All admitted patients gradually improved and had a mean hospital stay of 1.4 days (range 1 to 3 days). No patients in this study deteriorated clinically after nebulized sodium bicarbonate use. Nebulized sodium bicarbonate appears safe and merits prospective evaluation in the therapy of chlorine gas inhalation.

Administration, Intranasal↗

PubMed2003

Mycobacterial aerosols and respiratory disease.

Environmental opportunistic mycobacteria, including Mycobacterium avium, M. terrae, and the new species M. immunogenum, have been implicated in outbreaks of hypersensitivity pneumonitis or respiratory problems in a wide variety of settings. One common feature of the outbreaks has been exposure to aerosols. Aerosols have been generated from metalworking fluid during machining and grinding operations as well as from indoor swimming pools, hot tubs, and water-damaged buildings. Environmental opportunistic mycobacteria are present in drinking water, resistant to disinfection, able to provoke inflammatory reactions, and readily aerosolized. In all outbreaks, the water sources of the aerosols were disinfected. Disinfection may select for the predominance and growth of mycobacteria. Therefore, mycobacteria may be responsible, in part, for many outbreaks of hypersensitivity pneumonitis and other respiratory problems in the workplace and home.

Aerosols↗

PubMed1992

[Immunological approach for classification of free-living amoeba in Korea].

Acanthamoeba spp., free-living amoebae inhabited in moist soil, pond, freshwater, sewage, atmosphere and swimming pool, may be causative protozoa of the fatal primary amoebic meningoencephalitis in experimental animals and humans. In this study, Acanthamoeba spp., including Acanthamoeba sp. YM-4 (isolated strain from Korea) had been compared by the two-dimensional electrophoresis and hybridoma technique as well as the difference of morphological characteristics. Trophozoite of Acanthamoeba sp. YM-4 is usually uninucleate and show the hyaline filamentous projections (acanthopoda). No flagellate stage observed. Cysts have two walls, the outer wall is nearly circular, but inner wall is oval or some irregular. As results of SDS-PAGE for lysate of Acanthamoeba sp. YM-4, 16 major protein fractions are similar to those of A. culbertsoni, but different to A. royreba and A. polyphaga. Findings of two-dimensional electrophoretic patterns of Acanthamoeba sp. YM-4 are almost same to those of A. culbertsoni, The isotype of monoclonal antibodies produced from McAY 6, McAY 7, McAY 8, McAY 13 and McAY 16 clones were IgG1, and McAY 10 and McAY 11 clones were IgM. As results of the cross-reactivity among various amoebae using ELISA with monoclonal antibodies, McAY 7 monoclonal antibody (molecular weight 43 kDa by EITB) was only reacted with Acanthamoeba sp. YM-4, but McAY 6 and McAY 10 monoclonal antibodies were reacted to A. culbertsoni as well as Acanthamoeba sp. YM-4.

Amoeba↗

PubMed1988

Child accident-mortality in the Northern Territory, 1978-1985.

The mortality in children who were aged 0-14 years in the Northern Territory in 1983-1985 was 2.5-times higher than it was for Australia generally over the same period. Total accidental-death rates over the period 1979-1983 in Aboriginal children were 2.2-times higher than in non-Aboriginal children. A trend towards an excess in Aboriginal child mortality was present in most categories except drowning and was particularly noteworthy for deaths due to natural and environmental causes (predominantly caused by box-jellyfish stings). Non-Aboriginal children experienced higher rates of death due to drowning than they did elsewhere in Australia; most of these occurred in domestic swimming-pools. A higher mortality was encountered in rural areas. The pattern of motor-vehicle-related deaths differed between Aboriginal children and non-Aboriginal children, with the former experiencing a greater number of deaths due to non-collision accidents that involved "loss of control". The implications of these findings for the development of appropriate preventive strategies is discussed.

Accidents↗

PubMed1989

Traumatic deaths in children: the importance of prevention.

In order to determine the preventable factors in fatal accidents, a retrospective review of paediatric deaths after admission to a suburban teaching hospital was conducted. The medical records and coroners' reports for 64 consecutive cases over a 68-month period were reviewed. The main causes of death were pedestrian injuries (42% of deaths), drowning (20% of deaths) and injuries to vehicular passengers (17% of deaths) and cyclists (13% of deaths). There was a male predominance (64%). Children who were aged less than five years were at greatest risk at home, with death by drowning (46% of deaths) predominating. For children who were over five years of age, accidents on the roadway as pedestrians (58% of deaths) and pedal-cyclists (20% of deaths) were the most-common causes of death. Analysis of the accidents showed that preventive strategies were underutilized. Thirty per cent of deaths could have been avoided by the wearing of restraints in motor vehicles, the wearing of cycle-helmets and the proper use of swimming-pool barrier equipment. Adequate supervision of children who were less than 10 years of age at road crossings could have prevented a further 17% of deaths. In comparison, even the most-optimal postinjury care would have salvaged only 5% of the cases. Therefore, while the ideal organization of services after injury is a logical aim in the management of childhood trauma, if lives are to be saved, the main emphasis must be on prevention.

Accident Prevention↗

PubMedDate not supplied

Patterns of drowning in Australia, 1992-1997.

OBJECTIVE: To determine patterns of victims, circumstances and locations of drownings in Australia in 1992-1997, inclusive. METHODS: Population figures and available details of all drownings were obtained from the Australian Bureau of Statistics. Accidental non-boating drownings (ICD E910), boating incidents (E830-832), homicide (E964), suicide (E954), and other deaths without a drowning E code but "flagged" because drowning was involved (although not the primary cause of death) were included. RESULTS: The overall accidental non-boating drowning rate was 1.44/100,000 population/year. The commonest sites for non-boating drowning were ocean or estuary (22%), private swimming pools (17%), non-tidal lakes and lagoons (17%), surfing beach (10%) and bathtub (7%). 22% of victims were aged under 5 years; this group had a drowning rate of 4.6/100,000 population/year. Very few young children drowned in the ocean or in boating incidents. The rate of boating drownings was 0.29/100,000 population/year. Overseas tourists comprised 4.7% of all non-boating drownings, 18% of surf and ocean drownings, and 25% of all scuba drownings. Indigenous people had a much higher drowning rate than the general population. CONCLUSIONS: Drownings in children aged less than 5 years continue to be the greatest challenge for water safety organisations and legislators. Drownings in the Indigenous community and among tourists requires more detailed study and action. To assist in developing preventive strategies, the National Water Safety Council will need to clarify the categories described as "ocean/estuary" and "lake, lagoon, dam and waterhole".

Accidents↗

PubMedDate not supplied

Weather patients will come?

OBJECTIVES: To determine whether weather conditions affect emergency department (ED) attendance and admissions from the ED. DESIGN AND SETTING: A retrospective observational study in a large metropolitan ED. MAIN OUTCOME MEASURES: ED attendance (total and via ambulance) and admissions to hospital from ED, as a function of weather variables. RESULTS: On warm, dry, sunny and good weather days there were significantly more ED attendances in total than there were on cool, rainy, dull and bad weather days, respectively (P < or = 0.001). There were significant correlations between ED attendance and temperature (r = 0.36, P < 0.001), rainfall (r = - 0.20, P < 0.001) and hours of sunshine (r = 0.17, P = 0.001). Attendance via ambulance was not affected by weather variables. Admissions from the ED were positively correlated with temperature (r = 0.15, P < 0.01) and negatively correlated with rainfall (r = - 0.12, P = 0.02). CONCLUSIONS: As there is a clear relationship between weather conditions and ED attendance, incorporating meteorological forecasting into emergency medicine training may improve ED scheduling. To improve the morale of ED staff coping with an onslaught of patients on good weather days, the ED environment should simulate sunny weather, with swimming pools, sun lamps, palm trees and Beach Boys music.

Australia↗

PubMed1999

Characteristic feature of oxygen cost at simulated laboratory triathlon test in trained triathletes.

BACKGROUND: The present study was carried out in order to investigate the respiratory and circulatory features during a simulated laboratory triathlon test in trained triathletes. METHODS EXPERIMENTAL DESIGN: Sixteen male triathletes were divided into superior (n = 8) and slower triathletes (n = 8) according to their race time. These subjects performed both maximal exercise tests and a simulated laboratory triathlon test (ST). The latter test consisted of flume-pool swimming for 30 min, ergometer cycling for 75 min and treadmill running for 45 min as a continuous task. The exercise intensity was 60% of VO2 max during swimming, cycling and running, respectively. RESULTS: In slower triathletes, VO2, minute ventilation (VE), heart rate (HR) and temperature of external auditory canal were increased from an earlier stage compared with those in superior athletes. The percent increase (delta) of VO2, VE and HR between the 10th and last min of cycling and running stages in superior triathletes were significantly smaller than those in slower athletes. The oxygen cost (oxygen uptake/running velocity) of running stage was significantly lower in superior triathletes (0.220 +/- 0.020 ml.kg-1.m-1) compared with slower athletes (0.264 +/- 0.014 ml.kg-1.m-1). CONCLUSIONS: These results suggest that superior triathletes performed ST more economically than slower athletes and had excellent thermoregulatory adaptation.

Analysis of Variance↗

PubMed1999

Suicidal drowning in south Florida.

Autopsy protocols at the office of the Chief Medical Examiner were reviewed with respect to suicidal drowning. Between July 1, 1994 and June 30, 1998, there were 267 drownings and 873 people committed suicide in Broward County, Florida. Of those, 25 were suicidal drownings, representing 2.86% of all suicides, and overall the 8th leading cause of suicidal death. When considering suicide in the age group of 65 years and older, (n = 239), which accounts for 19.8% of the population and 27.4%, of all suicides, drowning represents 6.7% of all suicidal deaths, and within females in this group represents the third most common form of suicidal death (13.8%). The presence of alcohol or other drugs is less usual in elderly suicide victims than younger victims. Of the 25 drowning suicides, there was a preference for swimming pools, canals, and lakes as the locations of choice. Additional drowning and suicide related criteria were evaluated including marital status, mental health, clothing worn, previous attempts or threats, suicide notes, and personal effects at the scene; with the intention of establishing a profile for drowning by suicide. Given the relative abundance of water, the suicidal drowning rate appears to be lower than what might otherwise be anticipated.

Adult↗

PubMed1999

Epidemiological analysis of Pseudomonas aeruginosa strains isolated from a selected patient population in Brno, Czech Republic.

In the 1996/97 period, 1,413 Pseudomonas aeruginosa (PA) strains were isolated from 843 patients of the Brno teaching hospitals of St. Anne and Bohunice together with small groups from other hospitals. In the same period, 203 PA strains, used as controls, were isolated from 187 patients treated outside hospitals. Statistical evaluation was based on 1,023 hospital isolates and 189 control strains. A total of 16 isolates were recovered from the hospital environments and two from therapeutic swimming pools. The epidemiological analysis of these PA strains was based on pyocin typing, serological typing and phage typing. The most frequently occurring pyocin types amongst our strains fell into 8 pyocin-type groups. The prevailing groups differed significantly between the hospital patient and control groups. Similarly, serological typing identified differences in the predominant serotypes between hospital and control patients. The phage typing method revealed that the control PA strains were significantly more sensitive to 21 polyvalent bacteriophages used than the hospital isolates. In relation to pyocin and serological typing, strains isolated from the hospital environment showed characteristics similar to those of the PA strains isolated from hospital patients. Our results indicate that the majority of strain isolated from hospitalised patients had their origin from human or inanimate contacts in the hospitals.

Bacteriophage Typing↗

PubMed2000

[Epidemiology, physiopathology and treatment of a frequent ailment: tinea pedis].

Tinea pedis is an infection of the stratum corneum caused by dermatophytes. Nowadays, fitness centers, saunas, subtropical swimming pools and sport-shoes are more and more fashionable and are certainly responsible for the increase of cases of tinea pedis as dermatophytes grow preferentially in warm and humid environments. The clinical aspect is affected by several factors such as the host reaction to the infection, the virulence of the infective strain, species, and some local and environmental factors. If a dermatophytosis is suspected, it is mandatory to validate the provisional diagnosis by demonstration of the fungus (by culture or/and microscopic examination) to avoid useless and expensive treatments. The new antifungal molecules are very effective, well tolerated and allow short course of therapy improving the compliance of the patient in clinical practice. Relapse of tinea pedis is very common but could be avoided by several simple preventive measures of hygiene.

Antifungal Agents↗

PubMedDate not supplied

The history of injury control and the epidemiology of child and adolescent injuries.

Unintentional injuries claim the lives of more children each year than any other cause of death. A substantial proportion of child hospitalizations and emergency department visits also are attributable to unintentional injuries. The conceptualization of unintentional injuries as a public health problem that is preventable has gained credibility over the past few decades, as effective solutions to reduce the burden of injuries--such as child safety seats, bicycle helmets, and smoke detectors--have been identified. Successful implementation of these strategies requires a clear understanding of the circumstances surrounding injuries and the risk and protective factors that influence the likelihood that a child will be injured. Although adequate data on these factors is available for some causes of injury, such as motor vehicle crashes, it is almost nonexistent for others, such as unintentional firearm injuries. Overall, unintentional injury rates are highest among adolescents ages 15 to 19, males, children from impoverished families, and minorities. Also, some injuries occur more often in rural areas. Although these demographic risk factors cannot be modified, environmental and behavioral risks, such as unsafe roads, alcohol intoxication, unfenced swimming pools, and the absence of a smoke detector in the home, can be modified successfully with appropriate strategies. Motor vehicle occupant, drowning, and pedestrian injuries were the most common unintentional injuries causing death among children ages 0 to 19 in 1996. Together, these mechanisms accounted for more than half of all unintentional injury deaths among children and adolescents, although rates varied considerably by age. Child injury death rates across most age categories and mechanisms of injury have declined during the past 20 years, yet the reasons for these declines are poorly understood. Additional research about risk and protective factors, and efforts to implement successful injury prevention strategies among populations at highest risk for injuries, are necessary to further reduce the toll on children's lives.

Accident Prevention↗