Air pollution and emergency department visits for conjunctivitis: A case-crossover study

Objectives: The purpose of this study was to examine the associations between emergency department (ED) visits for conjunctivitis and ambient air pollution levels in urban regions across the province of Ontario, Canada. Material and Methods: Information from the National Ambulatory Care Reporting System was used to create time-series records, for the period of April 2004 to December 2011, on emergency department visits of patients suffering from conjunctivitis. A total of 77 439 emergency department visits for conjunctivitis were analyzed. A time-stratified case-crossover design was applied, completed with meta-analysis in order to pool inter-city results. Odds ratio (OR) for an emergency department visit was calculated in different population strata per one-unit increase (one interquartile range – IQR increase in a pollutant’s daily level) while controlling for the impacts of temperature and relative humidity. Results: Statistically significant positive results were observed in the female population sample, for nitrogen dioxide (NO2) exposure lagged 5–8 days, with the highest result for the 7-day lag (OR = 1.035, 95% CI: 1.018–1.052) and for fine particulate matter with a median aerodynamic diameter of less than 2.5 μm (PM2.5), for lags 6 and 7 days, with the highest result for lag 7 (OR = 1.017, 95% CI: 1.003–1.031). In the male population sample, statistically significant positive results were observed for NO2 at lag 5 days (OR = 1.024, 95% CI: 1.004–1.045) and for ozone (O3), at lags 0–3 and 7 days, with the highest result for lag 0 (OR = 1.038, 95% CI: 1.012–1.056). Also for males, statistically significant results were observed in the case of PM2.5 exposure lagged by 5 days (OR = 1.003, 95% CI: 1.000–1.038) and sulfur dioxide (SO2) exposure lagged by 1 and 2 days (OR = 1.016, 95% CI: 1.000–1.031 and OR = 1.018, 95% CI: 1.002–1.033). Conclusions: The findings of this study suggest that there are associations between levels of air pollution and ED visits for conjunctivitis, with different temporal trends and strength of association by age, sex, and season

Climate change interventions

The nursing profession must address climate change to protect and promote human health. Climate change activities as corporate social responsibility provide a promising avenue to both scale successful organizational initiatives and to generate hope, transformative improvements, and renewed professional commitments for nursing. Addressing climate change through corporate social responsibility is urgent and timely in the COVID-19 disaster recovery period for the nursing profession

Social support, educational, and behavioral modification interventions for improving household disaster preparedness in the general community-dwelling population: a systematic review and meta-analysis

Background: The efficacy of household emergency preparedness interventions for community-dwelling, non-institutionalized people is largely unknown. Objective: To ascertain the state of the science on social support, educational, and behavioral modification interventions to improve all-hazard household disaster preparedness. Design: Systematic review and meta-analysis. Methods: Databases, trial registers, reports, and websites were searched, and citation trails followed utilizing replicable methods. Individual, cluster, and cross-over randomized controlled trials of non-institutionalized, community-dwelling populations and non-randomized controlled trials, controlled before-after, and program evaluation studies were included. At least two review authors independently screened each potentially relevant study for inclusion, extracted data, and assessed the risk of bias. Risk of bias was assessed using Cochrane’s RoB2 tool for randomized studies and ROBINS-I tool for nonrandomized studies. Meta-analyses were applied using a random-effects model. Where meta-analysis was not indicated, results were synthesized using summary statistics of intervention effect estimates and vote counting based on effect direction. The evidence was rated using GRADE. Results: 17 studies were included with substantial methodological and clinical diversity. No intervention effect was observed for preparedness supplies (OR = 6.12, 95% 0.13 to 284.37) or knowledge (SMD = 0.96, 95% CI −0.15 to 2.08) outcomes. A small positive effect (SMD = 0.53, 95% CI 0.16 to 0.91) was observed for preparedness behaviors, with very low certainty of evidence. No studies reported adverse effects from the interventions. Conclusion: Research designs elucidating the efficacy of practical yet complex and multi- faceted social support, educational, and behavioral modification interventions present substantial methodological challenges where rigorous study design elements may not match the contextual public health priority needs and resources where interventions were delivered. While the overall strength of the evidence was evaluated as low to very low, we acknowledge the valuable and informative work of the included studies. The research represents the seminal work in this field and provides an important foundation for the state of the science of household emergency preparedness intervention effectiveness and efficacy. The findings are relevant to disaster preparedness practice and research, and we encourage researchers to continue this line of research, using these studies and this review to inform ongoing improvements in study designs

Social support, educational, and behavioral modification interventions for improving household disaster preparedness in the general community-dwelling population

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To ascertain the state of the science on social support, educational, and behavioural modification interventions to improve all‐hazard household disaster preparedness The PICO research question is as follows: in the general, non‐institutionalised, community‐dwelling population (P), do social support, educational, and behavioural modification interventions (I) compared to no intervention or usual mass public service messaging (C) improve all‐hazard household disaster preparedness behaviours, supplies, and/or knowledge (O) To assess whether social support, educational, and behavioural modification interventions have effects on healthcare utilisation (emergency department utilisation, hospitalisation, morbidity), mortality, and mental health or physical functioning post disaster

Ancient water supports today's energy needs

The water footprint for fossil fuels typically accounts for water utilized in mining and fuel processing, whereas the water footprint of biofuels assesses the agricultural water used by crops through their lifetime. Fossil fuels have an additional water footprint that is not easily accounted for: ancient water that was used by plants millions of years ago, before they were transformed into fossil fuel. How much water is mankind using from the past to sustain current energy needs? We evaluate the link between ancient water virtually embodied in fossil fuels to current global energy demands by determining the water demand required to replace fossil fuels with biomass produced with water from the present. Using equal energy units of wood, bioethanol, and biodiesel to replace coal, natural gas, and crude oil, respectively, the resulting water demand is 7.39 × 1013 m3 y−1, approximately the same as the total annual evaporation from all land masses and transpiration from all terrestrial vegetation. Thus, there are strong hydrologic constraints to a reliance on biofuel energy produced with water from the present because the conversion from fossil fuels to biofuels would have a disproportionate and unsustainable impact on the modern water. By using fossil fuels to meet today's energy needs, we are virtually using water from a geological past. The water cycle is insufficient to sustain the production of the fuel presently consumed by human societies. Thus, non‐fuel‐based renewable energy sources are needed to decrease mankind's reliance on fossil fuel energy without placing an overwhelming pressure on global freshwater resources

Environmental Health Research Institute for Nurse and Clinician Scientists (EHRI-NCS)

A train-the-trainer workshop for those who mentor, educate, and train nurses and nurse scientists in environmental health researc

Jessica Castner, “Nurse-Initiated Protocols in Emergency Departments”

Episode 9 of The Baldy Center Podcast features Jessica Castner, a board-certified emergency nurse and an emergency nurse scientist. In 2014 she received a research grant from The Baldy Center, entitled, Complaint-Specific Protocols: Layers of Regulation and Emergency Nurse Scope of Practice. In this podcast Castner discusses her current research and recent publication on nurse-initiated protocols in emergency departments, and offers perspective on policy and protocol impacts on pandemic emergency room care in hospitals

Air pollution and emergency department visits for conjunctivitis: A case-crossover study

Objectives: The purpose of this study was to examine the associations between emergency department (ED) visits for conjunctivitis and ambient air pollution levels in urban regions across the province of Ontario, Canada. Material and Methods: Information from the National Ambulatory Care Reporting System was used to create time-series records, for the period of April 2004 to December 2011, on emergency department visits of patients suffering from conjunctivitis. A total of 77 439 emergency department visits for conjunctivitis were analyzed. A time-stratified case-crossover design was applied, completed with meta-analysis in order to pool inter-city results. Odds ratio (OR) for an emergency department visit was calculated in different population strata per one-unit increase (one interquartile range – IQR increase in a pollutant’s daily level) while controlling for the impacts of temperature and relative humidity. Results: Statistically significant positive results were observed in the female population sample, for nitrogen dioxide (NO2) exposure lagged 5–8 days, with the highest result for the 7-day lag (OR = 1.035, 95% CI: 1.018–1.052) and for fine particulate matter with a median aerodynamic diameter of less than 2.5 μm (PM2.5), for lags 6 and 7 days, with the highest result for lag 7 (OR = 1.017, 95% CI: 1.003–1.031). In the male population sample, statistically significant positive results were observed for NO2 at lag 5 days (OR = 1.024, 95% CI: 1.004–1.045) and for ozone (O3), at lags 0–3 and 7 days, with the highest result for lag 0 (OR = 1.038, 95% CI: 1.012–1.056). Also for males, statistically significant results were observed in the case of PM2.5 exposure lagged by 5 days (OR = 1.003, 95% CI: 1.000–1.038) and sulfur dioxide (SO2) exposure lagged by 1 and 2 days (OR = 1.016, 95% CI: 1.000–1.031 and OR = 1.018, 95% CI: 1.002–1.033). Conclusions: The findings of this study suggest that there are associations between levels of air pollution and ED visits for conjunctivitis, with different temporal trends and strength of association by age, sex, and season