International journal of environmental research and public health
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Int J Environ Res Public Health · Aug 2018
Effect of Hypothermia in the Emergency Department on the Outcome of Trauma Patients: A Cross-Sectional Analysis.
This study aimed to assess whether hypothermia is an independent predictor of mortality in trauma patients in the condition of defining hypothermia as body temperatures of <36 °C. Data of all hospitalized adult trauma patients recorded in the Trauma Registry System at a level I trauma center between 1 January 2009 and 12 December 2015 were retrospectively reviewed. A multivariate logistic regression analysis was performed in order to identify factors related to mortality. ⋯ This study revealed that low body temperature is associated with the mortality outcome in the multivariate logistic regression analysis but not in the propensity score matching (PSM) model that compared patients with hypothermia defined as body temperatures of <36 °C to those who had normothermia. These contradicting observations indicated the limitation of the traditional definition of body temperature for the diagnosis of hypothermia. Prospective randomized control trials are needed to determine the relationship between hypothermia following trauma and the clinical outcome.
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Int J Environ Res Public Health · Aug 2018
ReviewNutritional and Environmental Factors in Thyroid Carcinogenesis.
Several epidemiological studies suggest an increased incidence of thyroid carcinoma (TC) in recent years, especially for the papillary histotype (PTC), suggesting that specific carcinogens might promote molecular abnormalities that are typical of PTC. The increased incidence is probably attributed to more intensive and sensitive diagnostic procedures, even if recent data suggest that various toxic elements could explain the phenomenon. Ionizing radiation exposure represents the most accepted risk factor for differentiated thyroid cancer that includes both the follicular and papillary histotypes. ⋯ The gas, ash, and lava emissions of volcanoes are composed of various toxic compounds that pollute ground water, vegetables, and animals, contaminating humans via the food chain. Finally, the risk of developing PTC has also been associated with exposure of the population to xenobiotics in the environment or in the home. Their carcinogenic effects are probably caused by their accumulation, but additional studies are necessary to better understand the mechanisms of action.
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Int J Environ Res Public Health · Aug 2018
Do Challenge Stress and Hindrance Stress Affect Quality of Health Care? Empirical Evidence from China.
Severe job stress has adverse effects on the health of Chinese healthcare workers. We investigated associations between job stress, health, and quality of health care among Chinese healthcare workers. To analyze associations between stress, health, and quality of health care among healthcare workers in 74 Chinese hospitals, we surveyed 2426 healthcare workers of primary, secondary, and tertiary hospitals in Western, Central, and Eastern China in 2017. ⋯ A partial mediation effect was in the final model. The health status of healthcare workers is an important concern at all levels of Chinese hospitals. To improve quality of healthcare, appropriate challenge stress is recommended among young staff, and interventions targeting hindrance stress should be developed and implemented in all hospital departments.
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Int J Environ Res Public Health · Jul 2018
ReviewWhat Are the Net Benefits of Reducing the Ozone Standard to 65 ppb? An Alternative Analysis.
In October 2015, the United States Environmental Protection Agency (EPA) lowered the level of the ozone National Ambient Air Quality Standard (NAAQS) from 0.075 ppm to 0.070 ppm (annual 4th highest daily maximum 8-h concentration, averaged over three years). The EPA estimated a 2025 annual national non-California net benefit of $1.5 to $4.5 billion (2011$, 7% discount rate) for a 0.070 ppm standard, and a -$1.0 to $14 billion net benefit for an alternative 0.065 ppm standard. The purpose of this work is to present a combined toxicological and economic assessment of the EPA's benefit-cost analysis of the 2015 ozone NAAQS. ⋯ We also considered the strengths and weaknesses of the EPA's cost estimates (e.g., marginal abatement costs), as well as estimates completed by other authors, and provided our own alternative cost estimate. Based on our alternative benefits and cost calculations, we estimated an alternative net benefit of between -$0.3 and $1.8 billion for a 0.070 ppm standard (2011 $, 7% discount rate) and between -$23 and -$17 billion for a 0.065 ppm standard. This work demonstrates that alternative reasonable assumptions can generate very difference cost and benefits estimates that may impact how policy makers view the outcomes of a major rule.
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A move towards more compact and climate-resilient cities is being encouraged around the world. As part of these plans, there is a need to manage the potential conflict between increasing urban densities and the extent of tree canopy in cities. Reductions in tree canopy are a major contributor to the urban heat island (UHI) effect, which will act to reduce rather than increase climate resilience in many cities. ⋯ Recommended actions to overcome this behaviour were determined by the identification of leverage points in the system. These included a shift to a sustainable development paradigm that places greater value on the environmental and social benefits provided by trees and a greater emphasis on a climate-resilient future. Market and legislative mechanisms should be integrated into the city's greening strategy and development plans to ensure the protection of existing trees and the inclusion of new trees on public and private land.