Health Risk Situations Research Articles

Telemedicine Alert API Engine System for Vital Signs.

Telemedicine is used to assist and support remote medical care for patients. Our objective was to build up a REST Webservices alert engine that receives clinical parameters from patients of vital signs and basic laboratories to monitor patients remotely. We built a REST API using FHIR, so it can interoperate with other applications, send data to be processed, and receive a response. If the API detects a health risk situation, it sends an alert about the medical parameters that are controlled. The results of the processed data, news and alert, can return synchronously or asynchronously, at the same time that the data to be processed is being sent. The alerts generated can be automatically sent to a web service, mail or WhatsApp of the physician. The alert message comes out as normal, low, medium and high risk. The presented approach establishes communication that enables timely health information exchange. We conducted an experiment (with fictitious data) where we sent several queries by Postman. Finally, we evaluated the communication to be successful by manual checking. The use of the API significantly improves the monitoring of chronic patients. Many works show the effectiveness of telemedicine to improve the control of certain chronic diseases. In addition, telemedicine interventions were also found to significantly improve other health outcomes. Our API enables us to transfer data and produce alerts successfully. This gives us hope that a future with ubiquitous healthcare information interoperability is possible using our system.

Immigration and work, considerations about the challenges in Brazil: bibliographic review of the literature

Introduction: Migratory flows towards countries that have more labor supply are not recent. In this sense, the arrival of immigrants in host countries, in many cases, makes this population more susceptible to health risk situations because of work activities, lack of integration with the local population and the immigration process itself. Methods: The study used a bibliographic review of the literature as a method. In this context, integration policies and the recognition of educational training in the country of origin can contribute to improving the living conditions of this population in Brazil. Results: In this context, this study aims to provide a summary of the challenges faced by immigrants in search of improved living conditions. Furthermore, this study contributes to identifying the main challenges facing immigrants recently arrived in Brazil and the difficult process of integration into local society. It is observed that the authors highlight in common that, worldwide, in the different receiving countries, regardless of the social, political, and economic context in which the immigrants find themselves, there is some destructive process that conditions the health-disease process of this population, resulting from the various factors mentioned above. Conclusion: Yet the positive contribution of migration to development is increasingly recognized, and these targeted policies will maximize their benefits in both countries of origin and destination.

The dual effects of health risks and crowd perception on marine traveller behaviour: The case of shared day cruise charter

This study investigates the dynamics of traveller behaviour toward shared day cruise charters regarding Covid-19 as a health-risk situation through the theory of planned behaviour. Following interviews with 22 customers, the findings were evaluated using directed content analysis. The results show that, besides Covid-19's moderating role, physical (e.g., high noise, absence of physical barriers) and social (e.g., a high number of out-group members, high customer heterogeneity) attributes of the service concept intensify the perceived crowdedness in the yacht. Despite being a one-day outdoor activity, the tour is perceived as risky due to the crowded service environment. Thus, crowds and health risks have a dual impact on travellers' attitudes toward tours. The perceived risk is not the only concern related to the traveller personally, it also includes risks related to the transmission of the virus to one’s family and friends. Travellers attributed crowding to the opportunistic behaviours of service providers, hence relying on their own precautions. Furthermore, there is an inverse relationship between crowding and the perceived hedonic value of the service. Companion unavailability is a significant barrier; however, there is a negotiation dilemma to persuade hesitant group members. The study contributes to the travel services offered in crowded environments that especially pose health risks and offer important implications for yacht tourism practitioners.

Promoting Family Health for Prediabetes Persons: Project Report

Family health promotion is the most important goal of family nursing practice, Especially, in the present day which family has inappropriate living pattern that can impact on family members getting sick both body and mind. Thus, professional nurse and health personnel should have knowledge and skill of promoting family health. Application the related family theories and concepts should be analyzed based on each family context. Especially, family should involve as the health owner with awareness and accepting actual health risk situation. Families need to set their goal and cooperating within family system that can help them to be success. As project report presented in this paper, it could reflect the process of increasing family awareness, right perception, and accepting to have prediabetes person in family, and then they had developed their competency of health promotion to solve their problem that could help the persons free from diabetes. However, some families could not modify new health pattern and lifestyle with consistently, including lacking commitment and fatigue from working. Thus, nurses and health care personnel should strengthen family motivation and morale continuously. In addition, family nurse and health care team should develop new knowledge and skills from lesson learned both success and unsuccessful cases to increase understanding and developing more knowledge, including, effective interventions for achieving health outcomes.

Telework During the Pandemic. Alternative Solution, or Legal Obligation?

The Covid-19 pandemic has forced all economic sectors to reconsider their forms and means of work in order to protect the life and health of their employees. Under these circumstances, telework - used for over two decades in sectors related to information technology - has become a generally applicable solution (with the exception of some areas such as agriculture, construction, services requiring direct activities, etc.). The authorities initially recommended that as many workers as possible should telework and revised the legislation to adapt it to the challenges of today. Then, given the positive results, they introduced various incentives to encourage telework. Lately, there has been a shift towards establishing legal rules making telework a mandatory form of telework in health risk situations. Our paper thus details the status of telework in most European countries.

Human Health Risk Assessment by exposure to arsenic through groundwater in a rural area of Canelones, Uruguay

BACKGROUND AND AIM: In Uruguay, safe drinking water is supplied to 94% of the population by the state company. However, some rural areas didn´t have this “official” water supply and people drink water from their own wells, that couldn´t be properly controlled. Groundwater quality has been the focus of Medical Geology multidisciplinary research studies in Uruguay, being Arsenic (As) one of its main concerns for health impacts in regions where As levels are higher than WHO recommendations (10 µg/L). The aim of this work was to assess the health risk related to As exposure through drinking water in a small Uruguayan population located in Canelones department. METHODS: The study was performed in San Antonio (1650 rural inhabitants) where we studied 30 private wells with As levels over 10 µg/L. Health risk was estimated with exposure frequency and exposure duration to these wells´ water. The As levels in water were used to calculate the As average daily dose (ADD). The risk was represented by the hazard quotient (HQ) and the cancer risk (CR). HQ was estimated for dermatological manifestations, using As toxicity reference dose of 0.0003 mg/kg/day. Health risk situation was assumed when HQ levels were 1. Cancer risk (CR) was calculated using the cancer slope factor of 1.5 mg/kg/day−1. Values between 10-4 y 10-6 are considered safe. RESULTS:Ten percent of the wells had a HQ greater than 1 if the water is consumed by the residents daily for ten years. The CR was higher than 10−4 if 10 years of residence was assumed, so 93 % of the wells are no safe and the population had an increased cancer risk. CONCLUSIONS:These results showed that more studies linking groundwater As levels and rural population consumption, should be carried out to address risk assessment and health management including biomonitoring of arsenic in urine of exposed population. KEYWORDS: Water quality, Arsenic long-term exposure, Risk assessment, Environmental epidemiology

Participatory Research on Environmental Health: Exploring the perceptions of family health strategy professionals

The increasing environmental degradation and the diversity of environmental issues affecting public health in Brazil have required changing the routines and norms of primary healthcare services. The aim of the current study was to explore the perceptions of family health strategy professionals about priority environmental issues associated with risks to the health of local communities. Participatory action research based on the photovoice and focal group techniques and conducted with 28 professionals from two family health strategies in the Casimiro de Abreu County, Rio de Janeiro State, Brazil. Although participants were sensitive to health risk situations associated with inadequate environmental sanitation conditions, they showed limited perception about these risks and about possible actions to be taken in order to change local issues. Professionals of the two localities did not perceive themselves as co-responsible actors for improving the environmental conditions of the territory. There is need of taking contextualized environmental education actions focused on empowering and engaging health professionals, and the investigated community, to reduce health risk conditions through the equal access to sanitation services.

Assessment of groundwater quality and human health risk related to arsenic using index methods and GIS: A case of Şuhut Plain (Afyonkarahisar/Turkey)

In this study the spatial variation of groundwater quality and the potential health risk situation arising were evaluated determining Water Quality Index (WQI and IWQI) for drinking and irrigation water in Şuhut Plain (Afyonkarahisar, Turkey). A total of 27 groundwater samples were collected from wells in May-2019 and physicochemical analysis results were evaluated.According to analysis results of the water samples, the orders of anion and cations are HCO3>SO4-2>Cl- > CO3-2 and Ca+2 > Mg+2 > Na+>K+, respectively. It has been determined that groundwater samples are generally in “excellent” and “good” water class according to the WQI and IWQI assessment. At the same time, groundwater in the study area is suitable for agricultural irrigation water. However, many water samples cannot be used as drinking water in terms of TDS, Mg, NO3 and AsT according to limit values of TSI-266 (2005) and WHO (2011). Health risk assessment indicate that, the risk of developing cancer due to arsenic exposure in healthy adults or children is very low. But, arsenic has a high non-carcinogenic and carcinogenic potentially harmful effect.

Relationship Between Energy Demand, Indoor Thermal Behaviour and Temperature-Related Health Risk Concerning Passive Energy Refurbishment Interventions

Abstract The main objective of this article is to demonstrate that passive energy refurbishment interventions influence comfort conditions of households for both cold and hot annual periods, while they help to avoid or promote temperature-related health risk situations. However, improving the thermal efficiency of the building envelope is encouraged in order to reduce energy demand for heating and cooling instead of considering also their impact on users’ health. The calculation methodology to quantify improvements, on the other hand, is drawn from regulation-based standards, which describe the optimal achievable efficiency levels and energy cost savings. The present study, however, addresses how diverse thermal performance variables are (climate, thermal comfort range and occupancy rate), and shows that different thermal assessment standards influence the obtained results. An energy simulation approach was developed to evaluate different scenarios and compare the results. In conclusion, the results contribute to an understanding or to a discussion of the suitability of current energy renovation policies with regard to indoor thermal comfort and temperature-related health risk situations.

Framing Analysis of the Kompas' COVID-19 Coverage: January 2020 Edition

The advent of health risk situation brings about several challenges to be addressed, e.g., risk preparedness and clear information to reduce uncertainties. At the end of 2019, the world was once again confronted with a health-threatening situation: the emergence of the novel coronavirus. Media can construct health risk information through narratives or stories they provide. Nevertheless, not every pandemic represented was equal. The media could build risk perception about global or local outbreaks. In light of that, this article aims to describe how the media in Indonesia framed the novel coronavirus disease issue (COVID-19) before the pandemic. This article utilized the framing analysis method, literature review, and was guided by health and risk communication framework. This article provided contextual novelty by presenting the analysis of Indonesian newspaper coverage concerning health and risk communication. The research suggested that media play an important role in shaping public perception about health and risk by employing four frame functions: problem definition, causal interpretation, moral evaluation, and treatment recommendation.

COVID-19 Response in Sub-Saharan Africa: Lessons From Uganda.

The prolongation of the Ebola epidemic may have allowed some countries to prepare and respond to the coronavirus disease (COVID-19) outbreak. In Uganda, the surveillance structure built for Ebola virus disease (EVD) has become a pillar in the COVID-19 response. This testing and tracing apparatus has limited disease spread to clusters with zero mortality compared with the neighboring East African countries. As more sub-Saharan countries implement social distancing to contain the outbreak, the interventions should be phased and balanced with health risk and socioeconomic situation. However, having a decision-making matrix would better guide the response team. These initial lessons from EVD-experienced Uganda may be helpful to other countries in the region.

Nutritional profile of women assisted by the program of Family Health Strategy in Maranhão State, Brazil

Introduction: Inadequate diet, whether due to excess or insufficient calories and nutrients, results in health risk situations as well as inadequate nutritional profile. The presence of nutritional deficiencies is more visible in women and, therefore, is more likely to reflect the risks of such deficiencies. Knowing the profile of the nutritional status of the female population of Maranhão, Brazil, which provide evidence of the nutritional status of their families, may support the creation of specific actions to combat eating problems and, consequently, improve their health. Objective: To evaluate the nutritional profile and its relationship with social determinants in a population of women attended by the program of Family Health Strategy in Maranhão. Methods: Cross-sectional study with 989 women aged 15 to 49 years, carried out during July to September 2010. Socioeconomic data were collected through a questionnaire, in addition it was applied of the Brazilian Food Insecurity Scale to know the level of food insecurity. Body mass index (BMI) and hip and waist circumference measurements were obtained to verify the nutritional profile. The variables were analyzed for frequencies, distribution and central tendency. Bivariate analysis was performed as to the associations between socioeconomic variables and BMI. The Spearman correlation coefficient was used between the food safety score and the BMI, adopting a significance level of 5%. Multivariate linear regression analysis was performed. Results: It was found a relationship between the BMI classification with some social determinants such as age, family income and food insecurity. There is a high prevalence of women at nutritional risk, especially for overweight and obesity, as well as the presence of thinness and short stature. Conclusion: Socioeconomic factors have a significant association with women's Body Mass Index indicating that there is an important relationship between age-matched maternal Body Mass Index and food insecurity.

Health behaviour change among commercially sexually exploited Israeli youth and young adults in a multi-module program.

Commercially sexually exploited youth and young adults (hereafter CSEY) are at high risk for various health adversities, but little is known about interventions that can improve their health outcomes. This study reports changes in health behaviours-positive health behaviours, drug use and risky sexual behaviour-in the first stages of treatment of 122 participants in a comprehensive multi-module program for CSEY in Israel. Data included sociodemographic and background information upon program entry, monthly reports on the treatment the participants received and their status. Data were collected monthly through online questionnaires completed by case managers for each of the CSEY in their care. A three-part analytic strategy assessed changes in repeated measures over time and their contributors. Latent class analysis helped identify differential trajectories of change over time among different participant groups. Findings showed overall significant decrease in risky sexual behaviours and improvement in positive health behaviours among certain CSEY groups. Participants with higher levels of health-risk situations and behaviour at program entry (e.g. more victimisation, less residential safety) were more likely to show improvement in health behaviours during intervention, but less likely to change their moderately risky sexual behaviours. Program participants with high levels of drug use did not show improvement in drug use patterns over time. This study demonstrates that a comprehensive multi-module intervention for CSEY can significantly improve health behaviour outcomes among serviced CSEY, and highlights the value of person-oriented care, and of research that can detect vulnerable subpopulations within CSEY who require uniquely tailored interventions. Personalising treatment to specific differential needs of CSEY, coupled with early detection and intervention, can improve program outcomes. Further research is needed to understand contributors to change and changes in subsequent health outcomes.

Environmental health: emancipatory care challenges and possibilities by the nurse.

to discuss challenges and possibilities for the construction of Environmental Health emancipatory care practices by the nurse. reflective analysis based on conceptual, theoretical, and methodological aspects of nursing care, under the emancipatory and critical perspective. contemporary environmental issues involve complex determinants of the health-disease process. This fact requires the accomplishment of educative actions that encourage the change of environmental attitudes related to health-risk situations. In this sense, there are significant demands for emancipatory practices of primary care in Environmental Health by nurses, which need to be systematized by health and education institutions. the nurse, as an educator and social actor, should offer emancipatory practices of risk management, empowerment, and shared social and environmental responsibility, with a view to recovering an ecological well-being and social transformation, to improve environmental quality and human life.

PROBLEMS OF WORKING CAPACITY EXPERTISE IN PATIENTS WITH HEARING LOSS

Results of the analytical research are given to justify methods of working capacity expertise in patients with hearing loss. The goal is to provide the successful professional rehabilitation of these workers and minimize the risk of occupational trauma or occupational disease because of harmful occupational factors. Since 2014 hearing loss patients have been allowed to work with many harmful and dangerous factors. Up-to-date laws and regulations have some logical contradictions with controversial interpretation. Some criteria for determination of working capacity in these workers have not been justified from the point of view of the professional risk yet. The paper discusses the need for the optimization of normative acts by the way of exclusion of logical contradictions and incorrect formulations. Today the determination of professional risk for the workers with hearing loss who work in noise and under the action of other harmful occupational factors is topical. According to results of this research the criteria of working capacity expertise for these cases should be revised to prevent health risk and disaster situations. Working capacity expertise in hearing loss patients should be provided by specialists in occupational medicine and labor protection. Individual peculiarities of the disease and prospective work place should be also taken into account.

Will naturally ventilated dwellings remain safe during heatwaves?

Heatwaves are responsible for many deaths due to hot weather. Natural ventilation is promoted as a cooling solution to reduce the impacts of climate change because of its energy-saving potential.This paper addresses the prediction of heat-related health risk situations in naturally ventilated dwellings, where indoor thermal conditions depend on external climate and occupant behaviour. Thus, the operating limits of a dwelling vary according to its dynamic thermal response to indoor and outdoor stresses.To secure a building design, a method to improve the prediction of heat-related health risks is proposed that links predicted percentage dissatisfied (PPD) and wet-bulb globe temperature (WBGT) indicators to distinguish a moderately warm situation from a heat stress situation (WBGT > 29 °C). Simulations are performed for a dwelling during the 2015 heatwave in Paris (France) to test the method.In the example, natural ventilation was found to reduce the indoor temperature, but there remains ambiguity regarding the ability of natural ventilation to provide moderate conditions. According to the scope of the ergonomic standards, “moderate thermal environment” and “heat stress” temperature ranges are not contiguous. Bridging of this gap requires establishing thermal comfort ranges and heat stress thresholds adapted to people according to their acclimatisation level and their sensitivity to heat.

Development of a decision support system for the practice of responsible self-medication

Responsible self-medication is an integral part of the health system that consists of community pharmacists counseling patients on treating minor illness using non-prescription medications. Systems for properly managing information can assist disease identification and clinical decision-making. To develop a software program to assist community pharmacists in clinical decision-making regarding selfmedication. The study was conducted in northeastern Brazil. The study was conducted from February 2012 to January 2014. System development included identifying minor illnesses commonly treated by community pharmacists and creating simulations of community pharmacies using a simulated patient methodology. Clinical pharmacists, production engineering students, professors, and a pharmacist researcher comprised the development group. Five meetings were held to develop the software, and the system was completed in December 2013. Minor illnesses commonly treated by community pharmacists, and simulated patient methodology. In the first meeting the final list of topics for inclusion in the algorithm indicated the exact questions to be addressed by the community pharmacist to properly manage the complaint. In the second meeting, the discussions in the focus group indicated consensus among pharmacists as to the medications on the list of Groups and Specified Therapeutic Indications of Brazilian Legislation. In the third meeting were defined the parameters to refer patients to the doctor. In the fourth meeting the algorithm was tested using a simulated patient, to observe whether the question order ensures an effective, efficient, and safe decision process for the patient. In the fifth meeting, the algorithm was tested again using a simulated patient with the flu, and all group members agreed upon its final incarnation after refinements to the situations that determined referral to the doctor. The software may contribute to identifying health risk situations (potentially unsafe medications based on clinical history, clinical hazards, and past adverse events) requiring medical treatment.

NUTRITIONAL STATUS, DIET AND NON-ALCOHOLIC FATTY LIVER DISEASE IN ELDERS.

evaluate the inter-relations between non-alcoholic fatty liver disease (NAFLD) and dietary factors in a population of hypertensive elders. 229 hypertensive elder patients were evaluated, from June to December 2009. All the patients that accepted to participate in the study signed a free consent term. An anthropometric evaluation was carried out and the body composition was evaluated. The diagnosis of NAFLD was determined by the American guidelines. The regular food intake was estimated through a 24 hour questionnaire. the weighted excess, by the body mass index and excess of abdominal fat, were associated with NAFLD (p < 0.001). An inverse profile was found with the diet variables. the studied group presents a health risk situation, considering the nutritional status markers. The regular diet appeared to be inadequate, showing excess of sodium and low fiber and vegetables intake.

Trace elements in animal-based food from Shanghai markets and associated human daily intake and uptake estimation considering bioaccessibility

The concentrations of four human essential trace elements [iron (Fe), manganese (Mn), zinc (Zn), chromium (Cr)] and non-essential elements [cadmium (Cd), lead (Pb), arsenic (As), and mercury (Hg)] in eighteen animal-based foods including meat, fish, and shellfish collected from markets in Shanghai, China, were analyzed, and the associated human daily intake and uptake considering bioaccessibility were estimated. The mean concentration ranges for eight trace elements measured in the foods were 3.98–131µgg−1 for Fe, 0.437–18.5µgg−1 for Mn, 5.47–53.8µgg−1 for Zn, none detected–0.101µgg−1 for Cr, 2.88×10−4–2.48×10−2µgg−1 for Cd, 1.18×10−3–0.747µgg−1 for Pb, none detected–0.498µgg−1 for As, and 8.98×10−4–6.52×10−2µgg−1 for Hg. The highest mean concentrations of four human essential elements were all found in shellfish. For all the trace elements, the observed mean concentrations are mostly in agreement with the reported values around the world. The total daily intake of trace elements via ingestion of animal-based food via an average Shanghai resident was estimated as 7371µgd−1 for the human essential elements and 13.0µgd−1 for the human non-essential elements, but the uptake decreased to 4826µgd−1 and 6.90µgd−1, respectively, after trace element bioaccessibility was considered. Livestock and fish for human essential and non-essential elements, respectively, were the main contributor, no matter whether the bioaccessibility was considered or not. Risk estimations showed that the intake and uptake of a signal trace element for an average Shanghai resident via ingestion animal-based foods from Shanghai markets do not exceed the recommended dietary allowance values; consequently, a health risk situation is not indicated.

Influence of mood states, group discussion, and interpersonal comparison on change in decision-making and information processing

This study examines the joint effects of moods and group processes on decision-making and information processing; 462 students participated from the Indian Institute of Technology Kharagpur. They reported their choices to economic gain, loss and health-risk situations, reasons for their choices, and the response times to complete the questionnaire. Then, positive and negative moods were induced, followed by a group discussion and an interpersonal comparison of the choices in four conditions. Comparison of post- and pre-test responses revealed choice polarisation and improvement in decision quality following positive-mood and negative-mood group discussion conditions. The information attributes of fluency, originality, and flexibility, and the response time are higher following a negative-mood discussion and negative-mood comparison conditions than following their counterpart conditions. Negative moods slow down thinking. When active cognitive processes are triggered through group discussion, choices polarise with information certification in interpersonal communication, and the effect of a mood degenerates gradually.