Transportation noise exposure, noise annoyance and respiratory health in adults : a repeated-measures study

Transportation noise leads to sleep disturbance and to psychological and physiological sustained stress reactions, which could impact respiratory health. However, epidemiologic evidence on associations of objective transportation noise exposure and also perceived noise annoyance with respiratory morbidity is limited. We investigated independent associations of transportation noise exposure and noise annoyance with prevalent respiratory symptoms and incident asthma in adults. Using 17,138 observations (from 7049 participants) from three SAPALDIA (Swiss Cohort Study on Lung and Heart Diseases in Adults) surveys, we assessed associations of transportation noise exposure and noise annoyance with prevalent respiratory symptoms, and with incident asthma (in 10,657 nested observations from 6377 participants). Annual day-evening-night transportation noise comprising road, railway and aircraft Lden (Transportation Lden) was calculated for the most exposed façade of participants' residence using Swiss noise models. Transportation noise annoyance was assessed using an 11-point scale, and participants reported respiratory symptoms and doctor-diagnosed asthma at each survey. We estimated associations with transportation Lden (as well as source-specific Lden) and noise annoyance, independent of air pollution and other potential confounders, using mutually-adjusted mixed logistic and Poisson models and applying random intercepts at the level of the participants. Prevalent respiratory symptoms ranged from 5% (nocturnal dyspnoea) to 23% (regular cough/phlegm). Transportation noise annoyance, but not Lden, was independently associated with respiratory symptoms and current asthma in all participants, with odds ratios (OR) and 95% confidence intervals (CI) ranging between 1.03 (95%CI: 1.01, 1.06) and 1.07 (95% CI: 1.04, 1.11) per 1-point difference in noise annoyance. Both noise annoyance and Lden showed independent associations with asthma symptoms among asthmatics, especially in those reporting adult-onset asthma [OR; Lden; : 1.90 (95% CI: 1.25, 2.89) per 10 dB; p-value of interaction (adult-onset vs. childhood-onset): 0.03; OR; noise annoyance; : 1.06 (95%CI: 0.97, 1.16) per 1-point difference; p-value of interaction: 0.06]. No associations were found with incident asthma. Transportation noise level and annoyance contributed to symptom exacerbation in adult asthma. This suggests both psychological and physiological noise reactions on the respiratory system, and could be relevant for asthma care. More studies are needed to better understand the effects of objective and perceived noise in asthma aetiology and overall respiratory health

Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies

<p>Abstract</p> <p>Background</p> <p>The Bangladesh government implemented a pilot Hospital Improvement Initiative (HII) in five hospitals in Sylhet division between 1998 and 2003. This included management and behaviour change training for staff, waste disposal and procurement, and referral arrangements. Two linked cross-sectional surveys in 2000 and 2003 assessed the impact of the HII, assessing both patients' experience and satisfaction and public views and use of the hospitals.</p> <p>Methods</p> <p>In each survey we asked 300 consecutive outpatients and a stratified random sample of 300 inpatients in the five hospitals about waiting and consultation time, use of an agent for admission, and satisfaction with privacy, cleanliness, and staff behaviour. The field teams observed cleanliness and privacy arrangements, and visited a sample of households in communities near the hospitals to ask about their opinions and use of the hospital services. Analysis examined changes over time in patients' experience and views. Multivariate analysis took account of other variables potentially associated with the outcomes. Survey managers discussed the survey findings with gender stratified focus groups in each sample community.</p> <p>Results</p> <p>Compared with 2000, an outpatient in three of the hospitals in 2003 was more likely to be seen within 10 minutes and for at least five minutes by the doctor, but outpatients were less likely to report receiving all the prescribed medicines from the hospital. In 2003, inpatients were more likely to have secured admission without using an agent. Although patients’ satisfaction with several aspects of care improved, most changes were not statistically significant. Households in 2003 were significantly more likely to rate the hospitals as good than in 2000. Use of the hospitals did not change, except that more households used the medical college hospital for inpatient care in 2003. Focus groups confirmed criticisms of services and suggested improvements.</p> <p>Conclusion</p> <p>Improvements in some aspects of patients' experience may have been due to the programme, but the decreased availability of medicines in government facilities across the country over the period also occurred in these hospitals. Monitoring patients’ experience and satisfaction as well as public views and use of hospital services is feasible and useful for assessing service interventions.</p

Maternal perceptions of advice on sleep in young children: how, what and when

Objectives: Parental knowledge on sleep hygiene in children may be a contributing factor for sleep difficulties in preschoolers. As sleep is crucial for healthy development, it is important to understand how parental knowledge can be improved. The aim of this qualitative study was to develop an understanding of advice available in the United Kingdom (UK) on sleep in young children. Design: This study employed constructivist grounded theory methodology. Methods: Participants were recruited via social media and a previously constructed participant database. Interviews were audio-recorded, transcribed, and analysed. Results: Fourteen mothers were interviewed independently, whilst one mother was interviewed together with her husband. Themes relating to how UK mothers wish advice on sleep to be formulated, what they believe it should include and when they would like to receive it, were identified from the data. Specifically, this study suggests that UK mothers value experience and thus recommends that advice be made through collaboration projects involving both professionals and parents. It also suggests that advice should be readily available and given to expecting parents prior to the arrival of their baby as well as at regular follow-ups. In addition, the participating mothers wanted advice to be balanced and non-judgemental. Conclusion: This study looks at the views of mainly White British mothers currently residing within the United Kingdom. Thus, it may not represent the views of everyone in the United Kingdom. Nevertheless, it still makes important recommendations for practice. For example, relationships between health professionals and parents need to be improved and information on different sleeping practices widely dispersed

Effect of process variables and sintering method on the microstructure and properties of ITO-borosilicate glass composites

Composites consisting of indium tin oxide, the predominant transparent conducting oxide, as a filler within a borosilicate glass matrix have been fabricated via hot pressing (HP) and spark plasma sintering (SPS). Both sintering methods are shown to allow a grain-like glass matrix structure to form without incorporating the ITO into the glass particles, leading to the formation of segregated ITO networks and an accompanying drop in impedance of up to 12 orders of magnitude. In doing so, these networks imparted electrical conductivity to the composites while requiring far less filler material (under 1 vol% ITO under all studied conditions) to achieve percolation than other fabrication methods. It was found that the HP process achieved consolidation of the powder mixes at a temperature 70°C lower than that required by the SPS process, despite many previous reports in the literature that SPS generally imparts superior properties and requires lower temperatures. While investigating the reasons behind this apparent contradiction, it was found that the mechanisms at play in the SPS process were more numerous and complicated than those in HP, thus requiring a more detailed study. To date, it has not been possible to accurately predict the sintering processing parameters necessary to achieve a specific microstructure or properties for a given material due to the complexity of the underlying mechanisms. The SPS process introduces additional complications due to the application of an applied current. A systematic investigation found that interactions between the temperature, pressure, applied current and resulting voltage, hold time, heating rate, and material variables make it difficult to isolate the effects of changing a single variable. Furthermore, there is a widespread lack of understanding regarding the significance of the applied current and resultant electric field on the densification process, as well as the codependence between these parameters and other processing variables. Throughout this study, many conventional characterization methods such as SEM and XRD were employed to characterize the fabricated composites. Additionally, a detailed ac impedance spectroscopy study on both powder compacts and sintered samples was undertaken. Results showed how the SPS applied current and voltage are related to other variables such as the heating rate, applied pressure, maximum temperature, and equipment/tooling geometry. By enabling separation of the electrical responses of the different microstructural features present in the sample via equivalent circuit fitting, the impedance data provided extensive insight on the effects of changing sintering process variables and showed strong potential for facilitating further understanding and advancement in this field.Ph.D

Segregation of Ruthenium to Edge Dislocations in Uranium Dioxide

Atomic-level simulation methods are used to determine the interaction of a metallic fission product, Ru4+, with the core of a o/2\u3c1 1 0\u3e {1 1 0} and ao/2\u3c1 1 0\u3e {0 0 1} edge dislocations in UO2, experimentally the most active slip systems. Specifically, the segregation behavior of Ru4+ is examined at the cationic substitution site; comparisons are made with both continuum-elastic results and with the results of atomistic simulations on strained single crystals. The results on strained single crystals suggest that segregation behavior is a strong function of the elastic strain field around the detailed atomic structure at the dislocation core. Furthermore, the segregation is affected by the orientation of the dislocation and electrostatic interactions at the atomic defect site