Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals

Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT). Methods. Postal questionnaire (n = 13 604) and record linkage with population-based register on health care costs. Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population. Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group

Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?

<p>Abstract</p> <p>Background</p> <p>The widening socioeconomic gap in smoking during pregnancy remains a challenge to the Swedish antenatal care services. However, the influence of cultural factors in explaining the socioeconomic differences in smoking during pregnancy is not clear among the immigrant women. The aim of this study was to investigate whether the development of smoking prevalence among pregnant immigrant women in Sweden followed the trajectory which could be expected from the stages of the global smoking epidemic model in the women's countries of origin, or not.</p> <p>Methods</p> <p>Delivery data on pregnancies in Sweden from 1982 to 2001 was collected from the Swedish Medical Birth Registry. From a total of 2,224,469 pregnant women during this period, all immigrant pregnant women (n = 234,731) were selected to this study. A logistic regression analysis and attributable fraction were used to investigate the association between smoking during pregnancy and the socioeconomic differences among immigrant women.</p> <p>Results</p> <p>Overall, the prevalence of smoking among pregnant immigrant women decreased from 30.3% in 1982 to 11.0% in 2001, albeit with remarkable differences between educational levels and country of origin. The greatest decline of absolute prevalence was recorded among low educated women (27,9%) and among other Nordic countries (17,9%). In relative terms, smoking inequalities increased between educational levels regardless of country of origin. The odds ratios for low educational level for women from other Nordic countries increased from 4.9 (95% CI 4.4-5.4) in 1982 to 13.4 (95% CI 11.2-16.2) in 2001, as compared to women with high education in the same group. Further, the total attributable fraction for educational difference increased from 55% in 1982 to 62% in 2001, demonstrating the strong effect of educational attainment.</p> <p>Conclusions</p> <p>Our hypothesis that the socioeconomic time trend of smoking based on the stage of the world wide tobacco epidemic model related to country of origin of the immigrant women was not supported by our analyses. Our findings does not support a call for specific "culture sensitive" antismoking policies or interventions in Sweden or similar countries, but reinforce the existing evidence with a focus on women with a low educational level, regardless of cultural background.</p

Prophylactic treatment uptake and compliance with recommended follow up among HIV exposed infants: a retrospective study in Addis Ababa, Ethiopia

<p>Abstract</p> <p>Background</p> <p>Children are being infected by HIV/AIDS mainly through mother-to-child transmission. In Ethiopia currently more than 135,000 children are living with HIV/AIDS. The aim of this study was to describe the pattern of ARV uptake after birth, co-trimoxazole prophylaxis and follow up compliance, and to examine which factors are associated with the intervention outcome.</p> <p>Methods</p> <p>A retrospective quantitative study design was used for data collection through two hospitals. All infants who were delivered by HIV infected mothers between October 2008 and August 2009 were included and information regarding treatment adherence during their first 6 months of age was collected.</p> <p>Findings</p> <p>118 HIV exposed infant-mother pairs were included in the study. 107 (90.7%) infants received ARV prophylaxis at birth. Sixty six (56%) of the infants were found to be adherent to co-trimoxazole prophylactic treatment. The majority (<it>n </it>= 110(93.2%)) of infants were tested HIV negative with DNA/PCR HIV test at the age of sixth weeks. Infants who took ARV prophylaxis at birth were found to be more likely to adhere with co-trimoxazole treatment: [OR = 9.43(95% CI: 1.22, 72.9)]. Similarly, infants whose mothers had been enrolled for HIV/ART care in the same facility [OR = 14(95% CI: 2.6, 75.4)], and children whose fathers were tested and known to be HIV positive [OR = 3.0(95% CI: 1.0, 9.0)] were more likely to adhere than their counterparts. Infants feeding practice was also significantly associated with adherence <it>χ</it>²-test, <it>p </it>< 0.01.</p> <p>Conclusion</p> <p>The proportion of ARV uptake at birth among HIV exposed infants were found to be high compared to other similar settings. Mother-infant pair enrolment in the same facility and the infant's father being tested and knew their HIV result were major predictors of infants adhering to treatment and follow up. However, large numbers of infants were lost to follow up.</p

Subjective annoyance attributed to electrical equipments and smells - Epidemiology and stress physiology

Self-reported annoyance from electrical equipment has been in evidence since the mid-eighties, and the first reports of illness from everyday chemicals arose already in the 1960?s. However, the extent of the problem or the mechanisms behind the development of environmentally related annoyance has not yet been fully established. Increased vulnerability to stress has been suggested to be a possible mechanism behind sensitivity to electricity and common smells. The aim of this thesis was to estimate the prevalence of annoyance related to electrical and chemical factors in a Swedish general population, and to assess possible relations to subjective health, daily functioning and health care utilisation. A further aim was to disclose differential patterns of cortisol secretion in three environmentally annoyed groups, compared with non-annoyed persons, and to test whether the environmentally annoyed subjects would fail to show a suppressed hypothalamic-pituitary-adrenal (HPA) response after an overnight dexamethasone suppression test. A population based health survey encompassing 13 604 persons were used for the epidemiological analyses regarding prevalence of environmental annoyance, and relation to subjective health and well being. Record linkage was performed to analyse health care utilisation. The stress study included 141 subjects, recruited from the survey population. During a two-week period, the participants filled in a logbook including questions regarding sleep quality, subjective stress and health complaints. During four days, the participants also collected saliva samples, four samples each day, with reference to awakening. The functioning of the HPA axis was tested by an overnight dexamethasone suppression test. Annoyance attributed to environmental factors was common in the general Scanian population studied. Of the respondents, 30% stated to be annoyed to any degree, and 6% reported ?much? annoyance, attributed to some electrical factors, chemicals or smells. Subjects associating annoyance with electrical factors, chemicals or smells rated their overall health and functional capacity significantly poorer than the general population. Despite this, the health care utilisation was not much increased in a group with annoyance attributed to both electricity and chemicals/smells. In the stress study, the environmentally annoyed subjects did not present elevated physiological stress levels during daily life. The group with annoyance attributed to both electricity and smells experienced higher levels of subjective stress and health complaints during the two-week period, although these feelings did not influence the HPA activity. All groups showed normal suppression of the HPA axis after ingestion of dexamethasone. Subjective annoyance attributed to electrical and chemical factors was common in the population. Subjects attributing annoyance to both electrical and chemical factors appeared to be the most affected regarding subjective stress and well being. However, no evidence of elevated physiological stress response was found in any of the examined groups

The relationship between physical workload and quality within line-based assembly

Reducing costs and improvement of product quality are considered important to ensure productivity within a company. Quality deviations during production processes and ergonomics have previously shown to be associated. This study explored the relationship between physical workload and real (found during production processes) and potential (need of extra time and assistance to complete tasks) quality deviations in a line-based assembly plant. The physical workload on and the work rotation between 52 workstations were assessed. As the outcome, real and potential quality deviations were studied during 10 weeks. Results show that workstations with higher physical workload had significantly more real deviations compared to lower workload stations. Static work posture had significantly more potential deviations. Rotation between high and low workload was related to fewer quality deviations compared to rotation between only high workload stations. In conclusion, physical ergonomics seems to be related to real and potential quality deviation within line-based assembly. Practitioner Summary: To ensure good productivity in manufacturing industries, it is important to reduce costs and improve product quality. This study shows that high physical workload is associated with quality deviations and need of extra time and assistance to complete tasks within line-based assembly, which can be financially expensive for a company