Reporting back environmental exposure data and free choice learning.

Reporting data back to study participants is increasingly being integrated into exposure and biomonitoring studies. Informal science learning opportunities are valuable in environmental health literacy efforts and report back efforts are filling an important gap in these efforts. Using the University of Arizona's Metals Exposure Study in Homes, this commentary reflects on how community-engaged exposure assessment studies, partnered with data report back efforts are providing a new informal education setting and stimulating free-choice learning. Participants are capitalizing on participating in research and leveraging their research experience to meet personal and community environmental health literacy goals. Observations from report back activities conducted in a mining community support the idea that reporting back biomonitoring data reinforces free-choice learning and this activity can lead to improvements in environmental health literacy. By linking the field of informal science education to the environmental health literacy concepts, this commentary demonstrates how reporting data back to participants is tapping into what an individual is intrinsically motivated to learn and how these efforts are successfully responding to community-identified education and research needs

The Possibilities of Reducing Food Choice to Improve the Performance of College Foodservices

College administrative and management leaders, foodservice personnel, and student residents value social, nutritional, financial, and environmental sustainability in their dining expectations. Menu choice reduction looks promising as a strategy to achieve these goals. However, foodservice research about dominant attitudes across these stakeholders is limited. Objective is to identify qualitative views from all stakeholders about choice reduction to ensure that any changes to the meal service are not to the detriment of consumer satisfaction. A comprehensive list of 74 statements representing the spectrum of attitudes surrounding choice was generated by searching a variety of resources, including academic literature and Internet sites, and by conducting semistructured interviews with stakeholders. A final set of 42 statements resulted from researcher scrutiny for optimum balance, clarity, appropriateness, simplicity, and applicability. A new sample of participants was then asked to sort these 42 statements into a normal distribution grid from “strongly disagree” to “strongly agree.” A purposive convenience sample of stakeholders (staff n=5 and residents n=4) was used to identify statements about choice reduction. A second sample of stakeholders (staff n=6 and residents n=29) were recruited to sort the final 42 statements. Q methodology analysis techniques were used. This involved conducting a by-person factor analysis, using the centroid factor extraction method because of the permissiveness it allows for data exploration. A varimax factor rotation to enhance interpretability of the results identified shared viewpoints. Three dominant viewpoints toward the possibility of choice reduction in the meal service were identified. Factor 1 was “health driven” (in which healthiness was paramount). Factor 2 was “variety seekers” (in which choice had instrumental value). Factor 3 was “choice lovers” (in which choice had intrinsic value). Although participants could see a number of benefits of choice reduction, strong attitudinal barriers existed toward adopting choice reduction initiatives. These barriers need to be overcome to avoid dissatisfaction with the foodservice should choice reduction measures be implemented

Facemask use for community protection from air pollution disasters: An ethical overview and framework to guide agency decision making

Disasters involving severe air pollution episodes create a pressing public health issue. During such emergencies, there may be pressure on agencies to provide solutions to protect affected communities. One possible intervention to reduce exposure during such crises is facemasks. Ethical values need to be considered as part of any decision-making process to assess whether to provide advice on, recommend and/or distribute any public health intervention. In this paper, we use principles from public health ethics to analyse the critical ethical issues that relate to agencies providing advice on, recommending and/or distributing facemasks in air pollution disasters, given a lack of evidence of both the specific risk of some polluting events or the effectiveness of facemasks in community settings. The need for reflection on the ethical issues raised by the possible recommendation/use of facemasks to mitigate potential health issues arising from air pollution disasters is critical as communities progressively seek personal interventions to manage perceived and actual risks. This paper develops an ethical decision-making framework to assist agency deliberations. We argue that clarity around decision-making by agencies, after using this framework, may help increase trust about the intervention and solidarity within and between populations affected by these disasters and the agencies who support public health or provide assistance during disasters

In Utero Exposure to Particulate Air Pollution during Pregnancy:Impact on Birth Weight and Health through the Life Course

In high-income countries, and increasingly in lower-and middle-income countries, chronic non-communicable diseases (NCDs) have become the primary health burden. It is possible that in utero exposure to environmental pollutants such as particulate matter (PM) may have an impact on health later in life, including the development of NCDs. Due to a lack of data on foetal growth, birth weight is often used in epidemiologic studies as a proxy to assess impacts on foetal development and adverse birth outcomes since it is commonly recorded at birth. There are no research studies with humans that directly link PM exposure in utero to birth weight (BW) and subsequently, the effects of lower BW on health outcomes in old age. It is, however, plausible that such associations exist, and it is thus important to assess the potential public health impacts of PM across the life course, and it is plausible to use birth weight as an indicator of risk. We therefore split this narrative review into two parts. In the first part, we evaluated the strength of the evidence on the impact of PM exposure during the entire pregnancy on birth weight outcomes in ten meta-analyses. In the second part, we reviewed the literature linking lower birth weight to childhood and adult chronic cardiovascular disease to explore the potential implications of PM exposure in utero on health later in life. Within the reviewed meta-studies on birth weight, there is sufficient evidence that PM pollution is associated with lower birth weight, i.e., the majority of meta-studies found statistically significant reductions in birth weight. From the second part of the review, it is evident that there is good evidence of associations between lower birth weight and subsequent cardiovascular disease risk. It is thus plausible that in utero exposure to PM is associated with lower birth weight and persisting biological changes that could be associated with adverse health effects in adulthood. Based on the reviewed evidence, however, the magnitude of later life cardiovascular health impacts from in utero exposure and its impact on BW are likely to be small compared to health effects from exposure to particulate air pollution over a whole lifetime.</p

APHH-Beijing clean air for health: how to protect yourself

It includes infographics to illustrate the scale of the air pollution problem in China, the sources of personal exposure, and possible ways to mitigate personal exposur

Insulin adherence and the associated factors among patients with type 2 diabetes mellitus at the Hospital Queen Elizabeth II, Sabah

Aim The purposes of this study were to: (a) determine the insulin adherence rate and reasons for non-adherence among patients with T2DM, (b) determine the relationship between the Health Belief Model (HBM) construct and insulin adherence, (c) assess the patient’s characteristics that influence the Health Belief Model (HBM) construct, and (d) identify the predictors of insulin non-adherence among patients with T2DM. Subject and methods An analytical cross-sectional survey was carried out on 360 T2DM outpatients at the Diabetes Clinic in Hospital Queen Elizabeth II (HQE II), Sabah. Insulin adherence was measured using a validated Medication Compliance Questionnaire (MCQ). Results A total of 360 patients took part in this study. Majority were female (60.6%) with an age range from 28 to 87 years (54.07 ± 13.62 years). The overall prevalence of insulin adherence was 60.3%. Forgetfulness was the most common factor for insulin non-adherence (66.9%). The majority of the respondents showed positive perceptions and beliefs of their insulin treatments, with a mean 71.11 (SD = 9.59). There was a significant correlation between insulin adherence and all the HBM constructs. Overall, the HBM constructs predicted 40.9% of the variance in insulin adherence. The strongest predictor of insulin adherence was perceived benefits followed by self-efficacy. Conclusions The current study suggests an acceptable level of insulin adherence among the T2DM outpatients in HQE II. It is recommended that the high-risk group of non-adherence should be identified, the insulin regimen adjusted, and an individual intensive health education designed in order to increase insulin adherence

The effect of workplace mobility on air pollution exposure inequality - a case study in the Central Belt of Scotland

A large number of epidemiological studies have identified air pollution as a major risk to human health. Exposures to the pollutants PM2.5, NO2 and O3 cause cardiovascular and respiratory diseases, cancer and premature mortality. Whilst previous studies have reported demographic inequalities in exposure, with the most deprived and susceptible often being disproportionately exposed to the highest pollutant concentrations, the vast majority of these studies have quantified exposure based only on individuals' place of residence. Here we use anonymised personal data from UK Census 2011, and hourly modelled air pollution concentrations at 0.8 km × 1.4 km spatial resolution in the Central Belt of Scotland, to investigate how inclusion of time spent at place of work or study affects demographic inequalities in exposure. We split the population by sex, ethnic group, age and socio-economic status. Exposure gradients are observed across all demographic characteristics. Air pollution exposures of males are more affected by workplace exposures than females. The White ethnic group has the lowest exposures to NO2 and PM2.5, and highest to O3. Exposures to NO2 and PM2.5 tend to peak between the ages of 21 and 30, but those aged 31–50 tend to be most impacted by the inclusion of time spent at workplace in the exposure assessment. People in the two least deprived deciles consistently have the lowest residential-only and combined residential-workplace exposure to NO2 and PM2.5, but experience the highest increase in exposure when including workplace. Overall, including workplace exposure results in relatively small change in median exposure but attenuates some of the exposure inequalities associated with ethnicity and socioeconomic status observed in exposure assessments based only on place of residence