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Contaminants in the Canadian Arctic: 5 years of progress in understanding sources, occurrence and pathways.

Recent studies of contaminants under the Canadian Northern Contaminants Program (NCP) have substantially enhanced our understanding of the pathways by which contaminants enter Canada's Arctic and move through terrestrial and marine ecosystems there. Building on a previous review (Barrie et al., Arctic contaminants: sources, occurrence and pathways. Sci Total Environ 1992:1-74), we highlight new knowledge developed under the NCP on the sources, occurrence and pathways of contaminants (organochlorines, Hg, Pb and Cd, PAHs, artificial radionuclides). Starting from the global scale, we examine emission histories and sources for selected contaminants focussing especially on the organochlorines. Physical and chemical properties, transport processes in the environment (e.g. winds, currents, partitioning), and models are then used to identify, understand and illustrate the connection between the contaminant sources in industrial and agricultural regions to the south and the eventual arrival of contaminants in remote regions of the Arctic. Within the Arctic, we examine how contaminants impinge on marine and terrestrial pathways and how they are subsequently either removed to sinks or remain where they can enter the biosphere. As a way to focus this synthesis on key concerns of northern residents, a number of special topics are examined including: a mass balance for HCH and toxaphene (CHBs) in the Arctic Ocean; a comparison of PCB sources within Canada's Arctic (Dew Line Sites) with PCBs imported through long-range transport; an evaluation of concerns posed by three priority metals--Hg, Pb and Cd; an evaluation of the risks from artificial radionuclides in the ocean; a review of what is known about new-generation pesticides that are replacing the organochlorines; and a comparison of natural vs. anthropogenic sources of PAH in the Arctic. The research and syntheses provide compelling evidence for close connectivity between the global emission of contaminants from industrial and agricultural activities and the Arctic. For semi-volatile compounds that partition strongly into cold water (e.g. HCH) we have seen an inevitable loading of Arctic aquatic reservoirs. Drastic HCH emission reductions have been rapidly followed by reduced atmospheric burdens with the result that the major reservoir and transport agent has become the ocean. In the Arctic, it will take decades for the upper ocean to clear itself of HCH. For compounds that partition strongly onto particles, and for which the soil reservoir is most important (e.g. PCBs), we have seen a delay in their arrival in the Arctic and some fractionation toward more volatile compounds (e.g. lower-chlorinated PCBs). Despite banning the production of PCB in the 1970s, and despite decreases of PCBs in environmental compartments in temperate regions, the Arctic presently shows little evidence of reduced PCB loadings. We anticipate a delay in PCB reductions in the Arctic and environmental lifetimes measured in decades. Although artificial radionuclides have caused great concern due to their direct disposal on Russian Shelves, they are found to pose little threat to Canadian waters and, indeed, much of the radionuclide inventory can be explained as remnant global fallout, which was sharply curtailed in the 1960s, and waste emissions released under license by the European reprocessing plants. Although Cd poses a human dietary concern both for terrestrial and marine mammals, we find little evidence that Cd in marine systems has been impacted by human activities. There is evidence of contaminant Pb in the Arctic, but loadings appear presently to be decreasing due to source controls (e.g. removal of Pb from gasoline) in Europe and North America. Of the metals, Hg provokes the greatest concern; loadings appear to be increasing in the Arctic due to global human activities, but such loadings are not evenly distributed nor are the pathways by which they enter and move within the Arctic well understood.

Animals↗

The skin we are in--knowledge and practices regarding skin cancer in pre-clinical medical students.

OBJECTIVE: To assess the level of knowledge about skin cancer in youth and to explore the influence of gender and system of education on their knowledge and practices. MATERIALS AND METHODS: A questionnaire-based study was conducted at The Aga Khan University Medical College (AKUMC), on Year 2 pre-clinical medical students. Descriptive analyses to examine the frequency distribution, chi-square test and factor analysis were applied using SPSS. RESULTS: Seventyone students participated in the study; 90% scored > 55% in the questions regarding knowledge of Malignant melanoma (MM), whereas in the questions assessing practice only 11% of the respondents scored > 52%. They were largely unaware that appearance of a new mole is a risk factor for MM (56% respondents incorrect) and that skin cancer is one of the most common cancers (54% respondents incorrect). 73% reported being sunburned at least once during childhood and 40% suffered sunburns at least once this summer, which points to the inadequacy of sun protection. The risk of MM may double if severe sunburns are experienced during childhood. Education system and gender did not affect the knowledge and practices. The popular sources of learning about skin cancer were magazines (52%) followed by television (42%). CONCLUSION: There is a need for epidemiological studies in Pakistani population regarding skin cancer. For preventing excessive solar exposure which leads to sunburns, we recommend interventions like a Pilot Program for photoprotection education and Sun Awareness Week to improve knowledge and sun protection behavior.

Adolescent↗

Alcohol-based hand rub: influence of healthcare workers' knowledge and perception on declared use.

Handrubbing with alcohol-based hand rub (AHR) is a validated alternative to handwashing. The aims of this study were to compare knowledge and declared use of AHR between different categories of healthcare worker (HCW), and to assess factors associated with the use of AHR. A standardized questionnaire was sent to all HCWs in a tertiary care university hospital. The following data were collected for each HCW: job title (physician, nurse, nursing assistant or other), sources of information about AHR; knowledge and perception of AHR and declared use of AHR in daily practice instead of unmedicated or antiseptic soap. Of 5238 questionnaires, 1811 were returned. Physicians had better knowledge about AHR than other HCWs. HCWs' knowledge of AHR efficacy and skin tolerance were independently associated with the use of AHR instead of unmedicated or antiseptic soap. The declared use of AHR differed according to professional category.

Alcohols↗

Patients' perceptions of methicillin-resistant Staphylococcus aureus and source isolation: a qualitative analysis of source-isolated patients.

A group of 19 individuals who had been infected with methicillin-resistant Staphylococcus aureus (MRSA) and placed in source isolation were interviewed about their views of MRSA infection and the experience of source isolation. Participants were unclear about the nature of MRSA, and generally did not perceive the infection to have a significant impact upon their life (either in terms of the presence of symptoms or in restriction of activities). Despite this, roughly half the sample thought that an MRSA infection was 'serious'. Only one participant clearly viewed their MRSA as hospital-acquired, most being uncertain about the mode of transmission or viewing it as unrelated to the behaviour of care staff. Few respondents displayed an accurate knowledge of the reasons for source isolation and barrier nursing. Isolation was viewed as having advantages and disadvantages. There was little evidence of a detrimental psychological effect of isolation. Patients infected with MRSA appear to understand little about their condition or the necessity for barrier nursing and source isolation. This has implications for understanding patients' adherence with infection control procedures.

Adult↗

SPECT electronic collimation resolution enhancement using chi-square minimization.

An electronic collimation technique is developed which utilizes the chi-square goodness-of-fit measure to filter scattered gammas incident upon a medical imaging detector. In this data mining technique, Compton kinematic expressions are used as the chi-square fitting templates for measured energy-deposition data involving multiple-interaction scatter sequences. Fit optimization is conducted using the Davidon variable metric minimization algorithm to simultaneously determine the best-fit gamma scatter angles and their associated uncertainties, with the uncertainty associated with the first scatter angle corresponding to the angular resolution precision for the source. The methodology requires no knowledge of materials and geometry. This pattern recognition application enhances the ability to select those gammas that will provide the best resolution for input to reconstruction software. Illustrative computational results are presented for a conceptual truncated-ellipsoid polystyrene position-sensitive fibre head-detector Monte Carlo model using a triple Compton scatter gamma sequence assessment for a 99mTc point source. A filtration rate of 94.3% is obtained, resulting in an estimated sensitivity approximately three orders of magnitude greater than a high-resolution mechanically collimated device. The technique improves the nominal single-scatter angular resolution by up to approximately 24 per cent as compared with the conventional analytic electronic collimation measure.

Algorithms↗

Hazards in the home: using older adults' perceptions to inform warning design.

Older adults' perceptions of hazards associated with home product usage and beliefs about product warnings were assessed. Focus group interview data were coded along the dimensions of (a) product type; (b) hazard type; (c) hazard knowledge; (d) hazard avoidance; (e) product warning presence; and (f) product warning necessity. A survey supplemented the focus group results by gathering measures of usage patterns and usability difficulties associated with various types of household products. Older adults reported routine use of products they considered to be hazardous and identified an array of home safety concerns. Furthermore, personal experience was an important source of older adults' hazard knowledge and they described a number of hazard avoidance strategies. These data provide insight into older adults' home safety behaviour and suggest a number of approaches to improving hazard communication and warning design.

Aged↗

Urban malaria: primary caregivers' knowledge, attitudes, practices and predictors of malaria incidence in a cohort of Ugandan children.

OBJECTIVES: To assess malaria-related knowledge, attitude and practices (KAP) among primary caregivers, to identify associations between primary caregivers' characteristics and positive KAP towards malaria, and to identify independent predictors of childhood malaria incidence in an urban setting. METHODS: Children aged 6 months to 5 years living in Kampala, Uganda were enrolled as part of a longitudinal study on antimalarial therapy. Primary caregivers of 307 children were interviewed and information was collected on demographics, malaria-related KAP, environmental and household factors. Malaria incidence was measured prospectively using passive surveillance. RESULTS: A total of 90% of respondents reported mosquitoes and/or malaria as the cause of fever. Caregivers reported that if their child had fever, 63% would go to a clinic or hospital as their first action and 97% as their first or second action. Only 38% knew that chloroquine was the recommended first-line treatment for malaria and 29% knew the correct dose. Preventive measures for malaria were reported in 45% of households but only 25% reported using bednets. Higher levels of education for the caregiver were associated with positive malaria-related KAP. Malaria incidence varied widely. The following were independent predictors of malaria incidence: (1). Children aged 24-41 months at enrolment had a higher incidence of malaria. (2). Reported bednet or chemoprophylaxis use reduced the incidence of malaria. (3). A child's place of residence was associated with incidence. (4). Children from households using open water sources had a higher incidence than those using closed sources. CONCLUSION: Primary caregivers were knowledgeable about malaria and used modern health care facilities but knew less about the proper administration of antimalarials and had limited use of preventive measures. Malaria incidence was associated with child's age at enrolment, geography, source of water and the use of preventive measures.

Caregivers↗

Nurses' knowledge and opinions about the nursing research process in The Netherlands.

Nursing research is just gaining ground in The Netherlands, as it is in every European country. Therefore, this study had the purpose of discovering to what extent Dutch nurses in the clinical areas have acquired research-based knowledge since it was introduced into the country, in the 1970s. Questionnaires, which included provision for demographic data, were distributed to 110 nurses, comprising head nurses, recently qualified nurses and final-year student nurses. A 65% response was achieved and the findings revealed that nursing research as a concept was not new to the Dutch nurses. They claimed they had obtained their knowledge through nursing training, reading, conferences and other sources such as mass media. The head nurses were the most knowledgeable followed by the recently qualified nurses and then the student nurses. However, the respondents claimed that their knowledge was superficial. The need to extend nurses' knowledge through support and encouragement in relation to nursing research seminars and conferences is recommended.

Adult↗

Knowledge and attitude of general outpatient attendants in Nigeria to cervical cancer.

OBJECTIVES: This study sets out to determine: a. How much women in low socio-economic settings know about cancer and cervical cancer. b. Their source of information. c. Their general attitude to cervical cancer. DESIGN: A cross sectional study. SETTING: General outpatient (GOP) department of a tertiary hospital in Ibadan, Nigeria. SUBJECTS: 254 randomly selected women aged 20 to 65 years attending or visiting the GOP department in a University Teaching Hospital were studied. MAIN OUTCOME MEASURES: Knowledge about cancer and cervical cancer as well as source of information. RESULTS: The response rate was 100%. Of the respondents, 90% had heard of cancer at one time or the other while only 15% had heard of cervical cancer. The media (38%) and peers (36%) were the major sources of information on cancer. Fifty five percent, 53% and 61% had no knowledge while 40% and 23% had poor to moderate overall knowledge of cervical cancer. CONCLUSION: Knowledge about cervical cancer is poor in these women, unlike findings in developed countries. There is need to educate our women on the early warning signs of cervical cancer as failure to recognise the early symptoms and signs contribute to the late presentation common in Nigeria.

Adult↗

Learning needs of Taiwanese nurses caring for patients with irritable bowel syndrome.

This study, building on work on irritable bowel syndrome conducted by Letson and Dancey (1996), explores Taiwanese nurses' knowledge, perceptions and beliefs about caring for patients with irritable bowel syndrome (IBS). A 46-item questionnaire was completed voluntarily by 120 registered nurses from a large tertiary acute care facility in Taiwan. The study used a descriptive research design and a questionnaire was developed that used a five-point Likert scale (strongly agree = 5, to strongly disagree = 1). The questionnaire consisted of six categories: demographic information; nurses' sources of IBS information; nurses' knowledge about IBS; nurses' perceptions about patients with IBS; nurses' beliefs about IBS; and learning requirements for nurses. Overall, the results indicted that Taiwanese nurses who participated in this study had little specific knowledge of IBS. The researchers developed a booklet containing information on the condition of IBS that may be used by the participants in this study to fill the knowledge gaps about this condition and provide useful information.

Attitude of Health Personnel↗

Knowledge, attitude, and behavior of female students concerning contraception in Athens, Greece.

The aims of this study were to investigate the knowledge, attitudes and behavior of female high school and university students concerning contraception. The study was performed at the Alexandra University Hospital in Athens. A total of 297 female students participated in the study. A questionnaire was used to evaluate the depth of knowledge and attitude of respondents concerning contraception. Our findings suggest students have a defective knowledge of contraception. Their main source of information were friends but the majority would prefer to receive information from doctors. The most popular contraceptive method was the male condom. The attitude and behavior of young women in our study were consequently defective. In conclusion, there is a need to provide students with correct, detailed and broad-based information on conception and contraception as part of the school curriculum to help them acquire adequate knowledge and develop appropriate attitudes on contraception and sexual health.

Adolescent↗

Polycyclic aromatic hydrocarbons in the atmosphere: monitoring, sources, sinks and fate. I: Monitoring and sources.

This is the first of a series of two papers intended to review the state-of-the-art knowledge on atmospheric PAHs, concerning their monitoring, sources and transformation processes in the atmosphere. The monitoring section briefly introduces this class of compounds, mainly focusing on the 16 PAHs indicated by the US-EPA as priority pollutants. These compounds undergo partitioning between the gas phase and particulate, which has to be considered in the choice of the sampling methodology. Furthermore, sampling artifacts may arise from further phase transfers inside the sampling device. After sampling, extraction, clean up and detection/quantification procedures will follow. They are closely related since the choice of the extraction technique will heavily condition the clean-up step, and both procedures will place demands on the performance of the detection technique (usually GC-MS or HPLC). This is particularly true in the case of complex samples such as those arising from atmospheric sampling. The sources of atmospheric PAHs are then discussed with a particular focus on receptor models, which can allow the apportionment of PAH sources based on concentration data that can be routinely obtained by pollution control networks.

Air Pollutants↗

The relative efficacy of different forms of knowledge of results for the learning of a new relative timing pattern.

The goal of the present study was to determine the relative efficacy of verbal and auditory knowledge of results for promoting learning of a new constrained relative timing pattern. In a series of four experiments we compared the efficiency of verbal knowledge of results to that of auditory knowledge of results. The results of all four experiments revealed that verbal knowledge of result is a very effective source of information to promote learning of a new imposed relative timing pattern. Auditory knowledge of results favoured learning of a new relative timing pattern in a very limited set of circumstances. In the present study, this was only the case when movement velocity remained constant from one segment of the task to the next and if it resulted in an unfamiliar temporal pattern. The results of all four experiments also provided evidence that movement parameterization and relative timing are independent processes that can be developed in parallel.

Cognition↗

Locating far-field impulsive sound sources in air by triangulation.

The firing of a gun generates an acoustic impulse that propagates radially outwards from the source. Acoustic gun-ranging systems estimate the source position by measuring the relative time of arrival of the impulse at a number of spatially distributed acoustic sensors. The sound-ranging problem is revisited here using improved time-delay estimation methods to refine the source position estimates. The time difference for the acoustic wavefront to arrive at two spatially separated sensors is estimated by cross correlating the digitized outputs of the sensors. The time-delay estimate is used to calculate the source bearing, and the source position is cross fixed by triangulation using the bearings from two widely separated receiving nodes. The variability in the bearing and position estimates is quantified by processing acoustic sensor data recorded during field experiments for a variety of impulsive sound sources: artillery guns, mortars, and grenades. Imperfect knowledge of the effective speed of sound travel results in bias errors in the source bearing estimates, which are found to depend on the orientation of the sensor pair axis with respect to the source direction. Combining the time-delay estimates from two orthogonal pairs of sensors reduces these bias errors.

Air↗

Pathways to evidence-based knowledge in orthopaedic surgery: an international survey of AO course participants.

The aim of this study was to gain information about how orthopaedic surgeons use evidence-based literature and how this is influenced by their knowledge of evidence-based medicine. We administered a questionnaire to participants at courses of the Association for the Study of Internal Fixation (AO-ASIF) in Davos, Switzerland, in December 2003. Special attention was paid to the surgeons' educational level, affiliations, and the infrastructure and evidence sources they used. In addition, we tested participants on their knowledge and attitude to evidence-based orthopaedic surgery (EBOS). Of 1,274 course participants, 456 completed the questionnaire. Of 446 respondents, 300 had heard of EBOS, but only 45% could define it correctly. Nearly two thirds identified scientific publications as their main source of scientific knowledge. The respondents' attitudes to and awareness of EBOS principles was high, but it did not influence their manner of searching for scientific information or their trust in various sources of recommendations.

Adult↗

Cellular interactions of L-glutamic acid60-L-alanine30-L-tyrosine10 (GAT)-specific suppressor factors. I. Inhibition of the activity of GAT-specific helper T cell clones by monoclonal GAT-specific suppressor T cell factors.

Considerable information concerning the serology and biochemistry of antigen-specific, T cell-derived suppressor factors has been obtained with the use of T cell hybridomas as a source of homogeneous material. Similarly, knowledge of helper T cell products and receptors is accumulating from studies of helper T cell clones and hybridomas. Our strategy for studying the mechanisms by which suppressor factors inhibit responses was to determine whether monoclonal suppressor factors could inhibit antibody responses specific for L-glutamic acid60-L-alanine30-L-tyrosine10 (GAT) in cultures containing unprimed splenic B cells, macrophages, and GAT-specific T cell clones as a source of helper activity. The MHC-restricted, two chain suppressor factors, GAT-TsF2, inhibited these responses if the helper T cell clones and suppressor factor were derived from H-2-compatible mice. Furthermore, responses were inhibited by briefly pulsing T cell clones with GAT-TsF2 in the presence of GAT, indicating that suppressor factors need not be present continuously. In addition, helper T cell clones adsorbed syngeneic, but not allogeneic, GAT-TsF2 in the presence of GAT. Adsorption also requires a shared antigenic specificity between the H-2b-derived helper T cells and TsF2 factor. Thus, helper T cells can serve as the cellular target of antigen-specific, MHC-restricted GAT-TsF2, and cloned helper T cells can be used as a homogeneous target population for analysis of the molecular mechanisms of T cell suppression.

Adsorption↗

Contraceptive use in a rural general practice.

All women aged 20-49 in a general practice were sent a questionnaire about their reproductive health, and 72% responded. 78% of respondents were using a method of fertility control. More than a quarter of women were obtaining their contraceptive supplies (condoms especially) from non-medical outlets. Knowledge of the existence of emergency contraception was high (83%). The general practitioner (GP) was the most popular source of contraceptive supplies for those aged under 40 years and more than four-fifths of women said that they would rather turn to their GP than to other sources for future contraceptive advice.

Adult↗

Knowledge of vitamin D and perceptions and attitudes toward sunlight among Chinese middle-aged and elderly women: a population survey in Hong Kong.

BACKGROUND: Physical and biological risk factors for vitamin D inadequacy are known; however, cultural- and population-specific behaviours and attitudes that influence these risk factors, particularly among Asian people, are less well documented. To understand more about prevailing attitudes and behaviour toward sunlight and knowledge of vitamin D among a population at greater risk of impaired vitamin D status, poor bone health and osteoporosis, we conducted a telephone interview survey of 547 middle-aged and elderly Chinese women living in Hong Kong. METHODS: All telephone interviews were conducted using the Computer Assisted Telephone Technique and target respondents were selected by random sampling. Interviews were conducted in Cantonese and eighteen main questions were asked pertaining to personal characteristics, perceptions, attitudes and behaviour toward sunlight, and knowledge about vitamin D. RESULTS: The survey results showed that 62.3% (n = 341) did not like going in the sun and 66.7% of respondents spent an average of 6-10 hours indoors, between 6:30 am and 7:00 pm, during weekdays. However, 58% of people thought that they had enough exposure to sunlight. The majority had heard of vitamin D, but knowledge about the role and sources of vitamin D was low. Among those who knew that sunlight was a source of vitamin D, the majority spent less than 1 h in the sun in the past week (76.4% vs 23.6%, < 1 h in the sun in the past week vs > 1 h in the sun in the past week, chi-square p < 0.05). There were significantly more users of sunscreen products (75.5% vs 53.0%, p < 0.0001, sunscreen users vs non-users) and parasols (68.4% vs 43.7%, p < 0.0001, parasol users vs non-users) among respondents who knew that vitamin D was good for bone health and that sunlight was a source of vitamin D. Age, occupation, subjects who liked going in the sun were factors associated with awareness of vitamin D but age was the only predictive factor for giving correct answers to the actions and sources of vitamin D. CONCLUSION: The survey revealed considerable ignorance and confusion about the role of sunlight in vitamin D production, and the function and sources of vitamin D. Attitudes and behaviour toward sunlight were largely negative and many took measures to avoid sunlight, particularly among younger (middle-aged) women who had good awareness of vitamin D.

Aged↗