Environmental Heat Stress Among Young Working Women: A Pilot Study

BackgroundHeat waves are increasing significantly in frequency and severity and threaten the health and income of outdoor workers. Pregnant women workers are particularly at risk due to their delicate physiological systems and accountabilities to future generations. Animal and human studies propose that elevated body temperatures during pregnancy can induce adverse pregnancy outcomes.ObjectiveTo measure the change in internal body temperature (Tcore) in young working women before, after, and during work (both outdoor and indoor) on hot humid days and relate threshold temperature to the upshot adverse effects of pregnancy (teratogenicity and related miscarriage).MethodsTympanic temperatures were measured using infrared ear thermometers and workplace temperatures were collected using Lascar Data Logger. Brief exploratory interviews were conducted to gather qualitative data, and content analysis was also carried out.FindingsBody temperatures were found elevated among outdoor women workers compared with that of indoor women workers.ConclusionsThe present study found that outdoor work during pregnancy in hot, humid days might increase body temperature up to levels that could induce fetal destruction or anomaly

MONTHLY AND DIURNAL VARIATIONS OF LIMNOLOGICAL CONDITIONS OF TWO PONDSR

A study on monthly and diurnal changes of limnological conditions of two ponds was conducted in the Bangladesh Agricultural University campus, Mymensingh. The research work was performed by studying the limnological parameters such as transparency, temperature, dissolved oxygen, free carbon dioxide, pH, total alkalinity, nitrate-nitrogen, phosphate-phosphorus and plankton. Diurnal variations of physico-chemical factors were studied fortnightly at 6 hrs intervals at 6 a.m., 12 noon, 6 p.m. and 12 midnight. The amounts of transparency, dissolved oxygen and pH were higher during winter months than in summer months in both the ponds. Transparency, water temperature, total alkalinity, NO3-N and PO4-P were higher during summer months than in winter months in both the ponds. But the amount of free carbon dioxide was higher during winter months than in summer months in pond 1 while in pond 2 the amount of free carbon dioxide was higher during summer months than in winter months. Qualitative and quantitative monthly variations of phytoplankton and zooplankton were observed in both the ponds during the study period. The highest amount of dissolved oxygen, pH and total alkalinity were recorded at 6 p.m. and the lowest amounts of those at 6 a.m. in both the ponds. The highest temperature was recorded at 12 noon and the lowest at 12 midnight. But the highest amount of free carbon dioxide was recorded at 6 a.m. and the lowest at 6 p.m. in both the ponds. All the factors showed appreciable diel variations throughout the study period, which indicate that the ponds are productive

An evaluation of speed management measures in Bangladesh based upon alternative accident recording, speed measurements, and DOCTOR traffic conflict observations

With 21,000 people annually killed in road traffic (estimated figure by World Health Organization), Bangladesh has one of the highest fatality rates in the world. Vulnerable road users (VRUs) account for over 50% of road traffic casualties, and 70% of casualties occur in rural areas. As in many Low and Middle Income Countries (LMICs), the official road accident statistics are incomplete and biased. Safe Crossings (Netherlands) and the Centre for Injury Prevention and Research Bangladesh (CIPRB) (Bangladesh) received permission from the Bangladesh government in 2014 to design and implement an integrated speed management program (consisting of a combination of small-scale infrastructural measures, active community involvement and road user education) at three locations where a national highway intersects small communities. The infrastructural countermeasures to improve road safety consisted of speed humps, rumble strips, signs and road markings and were designed following the Dutch road design guidelines. In a Before–After study design, we used a combination of three research methods to monitor and evaluate the road safety interventions. We created our own traffic accident recording system with trained local record keepers, we conducted laser-gun speed measurements of motorized traffic (both at intervention and control locations), and we applied the Dutch Objective Conflict Technique for Operation and Research (DOCTOR) for observing serious traffic conflicts at the intervention locations. The latter was based upon DOCTOR scores from video recordings of the behaviour at the three experimental locations Before and After the interventions. Prior to installing the intervention program, the three locations combined had, on average, about 100 serious accidents, 10 deaths, and 200 injured people on a yearly basis. In April 2015, all infrastructural measures were completed. In the after period (till the end of January 2016), the alternative accident recording system showed a 66% reduction in the number of serious accidents, a 73% reduction in the number of injured people, and a 67% reduction in the number of people killed. The unobtrusive laser-gun speed measurements resulted in a net reduction of 13.3 km/h (or 20% in relative terms) on average at the intervention locations by taking the general speed development at the control locations into account. According to Nilsson’s power law this would result in a 59% reduction of the number of people killed, well in line with the actual accident figures. The total number of serious conflicts (only DOCTOR scores 3, 4, and 5) was significantly reduced from 64 serious conflicts per location in a 4.5 h period Before to 29 serious conflicts in the After period, on average (Poisson distributed variable, p < 0.01), or a 55% reduction in relative terms. By including the traffic volumes, the reduction in conflict risk overall is 54%. Moreover, the severity of conflicts was reduced in the After period with only one most severe conflict (DOCTOR score 5) left. Buses represent the largest portion of road users involved in serious conflicts at all three locations, followed by cars and CNGs (Compressed Natural Gas vehicle). By far, the most frequently occurring conflict is of the type head-on conflict between an overtaking bus or car that is encountering a road user in opposite direction (for the greater part a CNG). All three evaluation measures point to a similar impact of the intervention program and unveil an improvement in road safety between 54% and 60%. The speed-reducing measures indeed considerably reduce the speed of motorized traffic, both the mean speed and 85th percentile values, both the number and severity of serious conflicts are reduced, and the actual number of accidents has decreased. It appears that Nilsson’s power law for the relation between a difference in mean speed and the change in the number of accidents also applies to LMICs. Speed management measures as common in high-income countries appear to be also effective in LMICs. For evaluation purposes of road safety impacts, a Traffic Conflicts Technique approach (also developed in high-income countries) seems valid and effective as well for application in LMICs. As there are thousands of traffic black spots with similar characteristics as the three intervention locations in Bangladesh, this integrated approach may well offer similar road safety improvements elsewhere

The first integrated speed management program benefitting vulnerable road users in Bangladesh : results and implications for LMICS

Over 20,000 people are killed due to road traffic crashes in Bangladesh annually. The country has over 100 road traffic deaths per 10,000 motor vehicles, one of the highest rates in the world. 70% of crash fatalities occur in rural areas. In 2014, Safe Crossings (Netherlands) and CIPRB (Bangladesh) received permission from the government of Bangladesh to design and implement an integrated speed management program to prevent road traffic injuries at three locations on a national highway that passes through villages. The study goal was to understand and quantify the improvement in road safety as a result of small-scale infrastructural adaptations combined with active community involvement and road user education. We had a specific interest in the effects on VRUs. Prior to installing the interventions, the three intervention locations combined had, on average, per year: 110 serious accidents, 12 deaths, and 240 injured people. Pedestrians accounted for 63% of all fatalities in the Before Period. In an ideal world one would like to use accident statistics as the ultimate measure of road safety. In reality, this was not possible as the accident statistics were neither sufficiently accurate nor complete. Hence we had to design an alternative monitoring &amp; evaluation approach. The basic research design is a Before and After study using three methods: i) speed measurement (also in control locations), ii) an accident recording system using local record keepers that we set up ourselves, and iii) conflict observation using the DOCTOR method with video recording. Implementation of all infrastructural interventions was completed in April 2015. The integrated speed management for three locations in Bangladesh has resulted a reduction in road traffic injuries and fatalities of around 60%. The net speed effect is a reduction on average of 13,3 km/h (or 20% in relative terms), suggesting a reduction in the number of people killed of 59% using Nilsson’s power law. Our accident recording system shows a 66% reduction in the number of serious accidents (significant at p &lt; 0.01), a 73% reduction in the number of injured people (significant at p &lt; 0.01), and a 67% reduction in the number of road traffic deaths (significant at p &lt; 0.10).Analysis of the conflict data revealed a 54% reduction in relative terms (52% reduction when taking the traffic volumes into account) in the number of serious conflicts. In addition, no conflicts of the highest severity category occurred in the after period. An additional advantage of the integrated speed management program is that it can be implemented relatively quickly (in 6 to 12 months) and the cost-effectiveness is very high. Our calculation suggests a ‘cost per DALY saved’ of below USD 100. We would like to suggest three specific areas of future research based on this study: i) traffic calming in city environments in LMICs, ii) interventions to further reduce the speed of fast-moving traffic in general and buses in particular and iii) investigating the potential of an integrated speed management program in a large number of locations in LMICs with the joint aim of significantly improving road safety and generating valuable road safety data on (cost-) effectiveness and implementation challenges and solutions

An evaluation of the outcomes associated with peritoneal catheter use in neonates undergoing cardiac surgery: A multicenter studyCentral MessagePerspective

Objective: The study objective was to determine if intraoperative peritoneal catheter placement is associated with improved outcomes in neonates undergoing high-risk cardiac surgery with cardiopulmonary bypass. Methods: This propensity score–matched retrospective study used data from 22 academic pediatric cardiac intensive care units. Consecutive neonates undergoing Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery category 3 to 5 cardiac surgery with cardiopulmonary bypass at centers participating in the NEonatal and Pediatric Heart Renal Outcomes Network collaborative were studied to determine the association of the use of an intraoperative placed peritoneal catheter for dialysis or passive drainage with clinical outcomes, including the duration of mechanical ventilation. Results: Among 1490 eligible neonates in the NEonatal and Pediatric Heart Renal Outcomes Network dataset, a propensity-matched analysis was used to compare 395 patients with peritoneal catheter placement with 628 patients without peritoneal catheter placement. Time to extubation and most clinical outcomes were similar. Postoperative length of stay was 5 days longer in the peritoneal catheter placement cohort (17 vs 22 days, P = .001). There was a 50% higher incidence of moderate to severe acute kidney injury in the no-peritoneal catheter cohort (12% vs 18%, P = .02). Subgroup analyses between specific treatments and in highest risk patients yielded similar associations. Conclusions: This study does not demonstrate improved outcomes among neonates with placement of a peritoneal catheter during cardiac surgery. Outcomes were similar apart from longer hospital stay in the peritoneal catheter cohort. The no-peritoneal catheter cohort had a 50% higher incidence of moderate to severe acute kidney injury (12% vs 18%). This analysis does not support indiscriminate peritoneal catheter use, although it may support the utility for postoperative fluid removal among neonates at risk for acute kidney injury. A multicenter controlled trial may better elucidate peritoneal catheter effects