Hair mercury levels in Amazonian populations: spatial distribution and trends

<p>Abstract</p> <p>Background</p> <p>Mercury is present in the Amazonian aquatic environments from both natural and anthropogenic sources. As a consequence, many riverside populations are exposed to methylmercury, a highly toxic organic form of mercury, because of their intense fish consumption. Many studies have analysed this exposure from different approaches since the early nineties. This review aims to systematize the information in spatial distribution, comparing hair mercury levels by studied population and Amazonian river basin, looking for exposure trends.</p> <p>Methods</p> <p>The reviewed papers were selected from scientific databases and online libraries. We included studies with a direct measure of hair mercury concentrations in a sample size larger than 10 people, without considering the objectives, approach of the study or mercury speciation. The results are presented in tables and maps by river basin, displaying hair mercury levels and specifying the studied population and health impact, if any.</p> <p>Results</p> <p>The majority of the studies have been carried out in communities from the central Amazonian regions, particularly on the Tapajós River basin. The results seem quite variable; hair mercury means range from 1.1 to 34.2 μg/g. Most studies did not show any significant difference in hair mercury levels by gender or age. Overall, authors emphasized fish consumption frequency as the main risk factor of exposure. The most studied adverse health effect is by far the neurological performance, especially motricity. However, it is not possible to conclude on the relation between hair mercury levels and health impact in the Amazonian situation because of the relatively small number of studies.</p> <p>Conclusions</p> <p>Hair mercury levels in the Amazonian regions seem to be very heterogenic, depending on several factors. There is no obvious spatial trend and there are many areas that have never been studied. Taking into account the low mercury levels currently handled as acceptable, the majority of the Amazonian populations can be considered exposed to methylmercury contamination. The situation for many of these traditional communities is very complex because of their high dependence on fish nutrients. It remains difficult to conclude on the Public Health implication of mercury exposure in this context.</p

Measuring career adaptability in a sample of Italian university students: psychometric properties and relations with the age, gender, and STEM/no STEM courses

The continuous transformation of the labor market, characterized by great instability and uncertainty, and by rapid technological changes, has strongly influenced the construction and management of career paths. Nowadays, individuals are faced with careers that are fluid and boundaryless, characterized by discontinuity and a variety of organizations to deal with. In this scenario, the ability to adapt and react to continuous changes in the labor market and in organizations is now a priority for workers. This study presents the psychometric properties of the construct of Career Ability measured through Proactive Personality and Boundaryless Mindset as proxy variables in a sample of 579 adults enrolled at the University of Cagliari (Italy), or recently graduated therein. We aim to rate the factorial structure of the items and to evaluate their multi-group invariance regarding the gender variable. Moreover, the criterion and concurrent validity were assessed. The instrument shows good psychometric characteristics; factorial structure, factorial invariance in relation to the gender variable, concurrent, and criterion validities were confirmed

Circular economy: analysis of the implementation of practices in the Brazilian network

Purpose – In total, 19 practices of circular economy divided into three groups, internal environmental management, ecological design and investment recovery were studied in a local network composed of small companies and individual entrepreneurs related to common product and by-product flows. The paper aims to discuss these issues. Design/methodology/approach – This research presents an applied nature, is characterized as exploratory and adopted the case study as a technical procedure using sources and methods of data collection. The primary data were collected through direct observation of the processes and semi-structured interviews with managers and owners. Findings – The most widespread practices are related to product design. However, in most cases, the implementation was punctual and did not present continuous and corresponding actions, which highlights the embryonic contours of European Commission (EC) in the observed network. The practices from the management category were less observed, which revels the environmental variable is not included in the strategic business planning. Research limitations/implications – The research documents the application of CE practices in a local network and brings this current paradigm shift to the Brazilian context. Practical implications – To overcome barriers to the implementation of EC practices, it is suggested to restructure commercial relations, to formulate public policies and to develop infrastructures that facilitate the materiality of flows and the market. Social implications – The study highlights the need of public policies that promotes cross-sectoral cooperation in accordance with NSWP objectives. Originality/value – Despite the focus on EC implemented practices this study offers a framework of the research routes on the main barriers and suggests actions to overcome the challenges in the transition from the economy to the circular model

Cardiovascular Health in Children and Adolescents With Congenital Adrenal Hyperplasia Due to 21-Hydroxilase Deficiency

Increasing evidence indicates that adults with Congenital Adrenal Hyperplasia (CAH) may have a cluster of cardiovascular (CV) risk factors. In addition, ongoing research has highlighted that children and adolescents with CAH are also prone to developing unfavorable metabolic changes, such as obesity, hypertension, insulin resistance, and increased intima-media thickness, which places them at a higher risk of developing CV disease in adulthood. Moreover, CAH adolescents may exhibit subclinical left ventricular diastolic dysfunction and impaired exercise performance, with possible negative consequences on their quality of life. The therapeutic management of patients with CAH remains a challenge and current treatment regimens do not always allow optimal biochemical control. Indeed, overexposure to glucocorticoids and mineralocorticoids, as well as to androgen excess, may contribute to the development of unfavorable metabolic and CV abnormalities. Long-term prospective studies on large cohorts of patients will help to clarify the pathophysiology of metabolic alterations associated with CAH. Meanwhile, further efforts should be made to optimize treatment and identify new therapeutic approaches to prevent metabolic derangement and improve long-term health outcomes of CAH patients

Indicador organizacional de la cultura de seguridad en un hospital universitario

Objetivo: avaliar a cultura de segurança organizacional de um hospital universitário português a partir da percepção dos enfermeiros. Método: estudo transversal, tipo survey, com 567 enfermeiros de um hospital universitário do Porto, Portugal, realizado de abril a dezembro de 2014. Utilizou-se o instrumento do Hospital Survey on Patient Safety Culture. Para análise, realizou-se a recodificação da Escala de Likert e aplicou-se a estatística descritiva. Resultados: as dimensões que apresentaram percentual elevado de respostas positivas foram: Trabalho em equipe dentro das unidades (78,69%) e Expectativa e ações de promoção de segurança do paciente dos supervisores (65,94%). Evidenciou-se que 248 (44,4%) profissionais não notificaram nenhum evento e apenas 13 (2,3%) notificaram mais de seis eventos no último ano. Conclusão: a avalição permitiu identificar uma dimensão forte e algumas fragilidades da organização. Os resultados são relevantes e servem de embasamento para os gestores e líderes de enfermagem, permitindo avançar na cultura de segurança.Objective: to evaluate the organizational safety culture of a Portuguese university hospital on the basis of nurses’ perceptions. Method: this cross-sectional, survey-type study of 567 nurses at a university hospital in Porto, Portugal, was conducted from April to December 2014, using the Survey on Patient Safety Culture instrument. For the analysis, the Likert Scale was recoded, and descriptive statistics were used. Results: the dimensions that returned high percentage positive responses were: Teamwork within units (78.69%) and Supervisor Expectations and Actions Promoting Patient Safety (65.94%). It was found that 248 (44.4%) of personnel did not report any event, and only 13 (2.3%) had reported more than six events in the prior year. Conclusion: the assessment identified one strong dimension in the organization, and some weaknesses. The results are significant and offer a foundation for nursing managers and leaders to improve safety culture. Descriptors: Organizational culture; patient safety; hospitals; quality of nursing care.Objetivo: evaluar la cultura de seguridad de la organización de un hospital universitario portugués desde el punto de vista de las enfermeras. Método: estudio transversal, tipo encuesta, junto a 567 enfermeros de un hospital universitario en Oporto, Portugal, que tuvo lugar entre abril y diciembre de 2014. Utiliza el instrumento de Hospital Survey on Patient Safety Culture. Para el análisis, se realizó recodificación de la Escala de Likert y se utilizó la estadística descriptiva. Resultados: Las dimensiones que presentaron un alto porcentaje de respuestas positivas fueron: Trabajo en equipo dentro de las unidades (78,69%) y Expectativa y acciones de promoción de seguridad del paciente de los supervisores (65,94%). Se evidenció que 248 (44,4%) de los profesionales no notificaron ningún evento y sólo 13 (2,3%) notificaron más de seis eventos el último año. Conclusión: la evaluación permitió identificar una dimensión fuerte y algunas fragilidades de la organización. Los resultados son relevantes y sirven de base para los gestores y líderes de enfermería, permitiendo avanzar en la cultura de seguridad.info:eu-repo/semantics/publishedVersio

Cultura de segurança dos enfermeiros entre os serviços de um hospital universitário

To evaluate nurse safety culture in a teaching hospital, as well as to verify differences in the safety culture dimensions between services.Objetivo: Avaliar a cultura de segurança dos enfermeiros de um hospital de ensino e verificar as diferenças das dimensões dessa cultura entre os serviços. Método: Estudo transversal e quantitativo, realizado em outubro a dezembro de 2015, em um hospital universitário. Foi aplicado o instrumento Hospital Survey on Patient Safety Culture. Resultados: Participaram 195 enfermeiros de quatro serviços. Identificou-se diferença significativa entre os serviços para cinco dimensões de cultura de segurança: aprendizado organizacional (p = 0.012); retorno da informação e comunicação a respeito de erro (p = 0.014); suporte da gestão para segurança do paciente (p = 0.001); percepções gerais sobre segurança do paciente (p = 0.005); e frequência da notificação de eventos (p = 0.003). Conclusão: O serviço de clínica médica apresentou maior diferença estatística entre as dimensões. Essas avaliações permitem que os gestores identifiquem as diferenças entre os serviços do mesmo hospital, servindo de alerta e aperfeiçoando os serviços. Descritores: Segurança do Paciente; Cultura Organizacional; Qualidade da Assistência à Saúde; Hospitais; Gestão de Riscos.info:eu-repo/semantics/publishedVersio

ESTUDO, DESENVOLVIMENTO E APLICAÇÃO DE CAMPANHA DE PREVENÇÃO DE ACIDENTES DE TRABALHO COM A UTILIZAÇÃO DE ESTRATÉGIAS ALTERNATIVAS PARA A BUSCA DE RESULTADOS

A saúde e a segurança dos trabalhadores devem ser estudadas e analisadas através de um novo paradigma, onde o estudo da segurança deve ter como foco o entendimento de como as pessoas reagem frente à segurança. Os aspectos técnicos são sempre lembrados para sempre explorados, mas é fundamental também desenvolver discernimento e bom senso nos trabalhadores. Como fazer os trabalhadores terem uma visão diferente da segurança, como tornar a segurança um assunto rotineiro também da família e agradável são alguns dos objetivos da campanha de prevenção de acidentes de trabalho inovadora desenvolvida e implantada com quinze trabalhadores da construção civil do meio oeste catarinense, durante quatro encontros temáticos (com decorações, música e dinâmicas variadas) de duração de 1 hora. Através de assuntos e conexões incomuns, trazemos uma abordagem nova, com o objetivo de melhorar os resultados da prevenção de acidentes. Os primeiros resultados positivos já foram percebidos logo no inicio, quando soubemos que no primeiro encontro quase nenhum trabalhador estava disposto a participar e depois os trabalhadores estavam “disputando” uma vaga para participar dos encontros seguintes. O tema da campanha foi sonhos e nome da campanha foi “Qual é o seu sonho?” sendo fomentado pelo IFC Campus Luzerna. Através deste assunto que carrega tanta emoção tentamos demonstrar alguns passos importantes para se conseguir realizar um sonho e como é importante cuidar de si mesmo e de quem amamos pra que nós possamos realizar nossos sonhos

Circular economy: analysis of the implementation of practices in the Brazilian network

Purpose - In total, 19 practices of circular economy divided into three groups, internal environmental management, ecological design and investment recovery were studied in a local network composed of small companies and individual entrepreneurs related to common product and by-product flows. The paper aims to discuss these issues. Design/methodology/approach - This research presents an applied nature, is characterized as exploratory and adopted the case study as a technical procedure using sources and methods of data collection. The primary data were collected through direct observation of the processes and semi-structured interviews with managers and owners. Findings - The most widespread practices are related to product design. However, in most cases, the implementation was punctual and did not present continuous and corresponding actions, which highlights the embryonic contours of European Commission (EC) in the observed network. The practices from the management category were less observed, which revels the environmental variable is not included in the strategic business planning. Research limitations/implications - The research documents the application of CE practices in a local network and brings this current paradigm shift to the Brazilian context. Practical implications - To overcome barriers to the implementation of EC practices, it is suggested to restructure commercial relations, to formulate public policies and to develop infrastructures that facilitate the materiality of flows and the market. Social implications - The study highlights the need of public policies that promotes cross-sectoral cooperation in accordance with NSWP objectives. Originality/value - Despite the focus on EC implemented practices this study offers a framework of the research routes on the main barriers and suggests actions to overcome the challenges in the transition from the economy to the circular model

Grand Rounds: Could Occupational Exposure to n-Hexane and Other Solvents Precipitate Visual Failure in Leber Hereditary Optic Neuropathy?

CONTEXT: Leber hereditary optic neuropathy (LHON) is a maternally inherited loss of central vision related to pathogenic mutations in the mitochondrial genome, which are a necessary but not sufficient condition to develop the disease. Investigation of precipitating environmental/occupational (and additional genetic) factors could be relevant for prevention. CASE PRESENTATION: After a 6-month period of occupational exposure to n-hexane and other organic solvents, a 27-year-old man (a moderate smoker) developed an optic neuropathy. The patient had a full ophthalmologic and neurologic investigation, including standardized cycloergometer test for serum lactic acid levels and a skeletal muscle biopsy. His exposure history was also detailed, and he underwent genetic testing for LHON mitochondrial DNA mutations. The patient suffered a sequential optic neuropathy with the hallmarks of LHON and tested positive for the homoplasmic 11778G → A/ND4 mutation. Routine laboratory monitoring revealed increased concentrations of urinary 2.5 hexandione (n-hexane metabolite) and hippuric acid (toluene metabolite) in the period immediately preceding the visual loss. DISCUSSION: In a subject carrying an LHON mutation, the strict temporal sequence of prolonged appreciable occupational exposure followed by sudden onset of visual loss must raise a suspicion of causality (with a possible further interaction with tobacco smoke). RELEVANCE: In this article, we add to the candidate occupational/environmental triggers of LHON and highlight the need for appropriate case–control (and laboratory) studies to validate the causal effect of mixed toxic exposures