<p>Cardiovascular disease and diabetes are a growing problem around the world and both considered leading causes of death in the United States. Cardiovascular disease is often not diagnosed until it advances to causing serious problems such as heart attacks. Diabetes can greatly increase the risk of cardiovascular disease so diagnoses is important. Metabolic syndrome is a relatively easy way to predict who is at risk of these diseases or to make an early diagnoses. The syndrome is diagnosed in patients that meet 3 or more criteria relating to obesity, blood pressure, triglycerides, cholesterol, and glucose in an individual. Calcium scores, a result of a specific body scan, are a good indicator of cardiovascular disease but are not commonly performed. Metabolic syndrome can be diagnosed using information from a routine physical with blood work. This paper observed the prevalence rate of metabolic syndrome in a cohort of police officers who responded to the September 11th attack at the World Trade Center in New York City. In our study population, the prevalence of metabolic syndrome was 26%. We also found a correlation between calcium scores and the number of metabolic syndrome criteria met; patients meeting all 5 criteria had significantly higher calcium scores with a p-value of .02 and 95% confidence interval of 1.084-2.583.

<p> Farmworkers and their families may experience increased levels of agricultural pesticides in their homes due to both (1) take-home/soil track-in on shoes, clothes and skin, and (2) air infiltration from nearby agriculture fields via agricultural pesticide drift in the vapor phase or adhered to resuspended soil particles. This dissertation estimates the relative contributions o the take-home/soil track-in and air infiltration pathways of agricultural pesticides into homes, as well as identifies the risk factors for increased in-home agricultural pesticide levels for farmworkers and their families living near agriculture fields. Samples of outdoor air, yard soil, and house dust from 21 farmworkers' homes in Yuma County, Arizona were collected and analyzed for a suite of agricultural pesticides. To capture household information, such as behaviors, demographics, and housing structure, a participant questionnaire was administered at the time of the sampling. A pesticide transport model was developed, evaluated, and applied to quantify relative contributions of the air infiltration and the take-home/soil track-in pathways of agricultural pesticides into the house dust of the farmworkers&rsquo; homes. To explore a wide-range of potential risk factors for increased agricultural pesticide levels in the homes, traditional statistical methods and Classification and Regression Tree (CART) analyses were used. The results of this study, found that the air infiltration pathway contributes to over 90% of some agricultural pesticides in the house dust found in the farmworkers&rsquo; homes. In addition, among the influential risk factors for increased in-home agricultural pesticide levels was the home being a closer distance to an agricultural field, as well as the home having carpeted floors, more farmworkers per square footage of the home, and less months of heating and cooling the home. It is suggested that future intervention efforts to reduce in-home agricultural pesticide levels put more emphasis on targeting the air infiltration pathway, and take into consideration relevant risk factors for increased pesticide levels in the home.</p>

<p> Vibrio bacteria are emerging pathogens responsible for 80,000 illnesses and 100 deaths in the United States each year. Infections are directly linked to the marine environment and are acquired by consuming contaminated seafood or exposing wounds during aquatic activities. Florida has the highest national incidence of vibriosis, with 20% of its cases reported from the Indian River Lagoon region, a popular recreation destination. This study utilized a combination of cultivation and molecular techniques to investigate the local distribution of V. vulnificus, V. parahaemolyticus and V. cholerae in this local waterway. </p><p> The targeted species were found in an array of samples which may facilitate their transmission to humans. Overall, these bacteria were abundant in estuarine sediments (Vp: 2,439 CFU/g, Vv: 303 CFU/g, Vc: 176 CFU/g), on the sharp edges of oyster shells (Vp: 82 CFU/cm, Vv: 102 CFU/cm, Vc: 41 CFU/cm), and in the water column (Vp: 3.78 CFU/ml, Vv: 5.51 CFU/ml, Vc: 2.46 CFU/ml). Vibrio also pose a hazard to recreational anglers as they were recovered from fish (Vp: 61%, Vv: 55%, Vc: 30%), live bait shrimp (Vp: 80%, Vv: 37%, Vc: 0%) and hooks (Vp: 32%, Vv: 18%, Vc: 0%). Additionally, a molecular analysis of the V. vulnificus virulence revealed that the local population was dominated by disease-causing (vcgC) strains, which may explain why wound-related infections are common in this region. </p><p> Vibrio occurrence varied both spatially and temporally due to their relationship with salinity and temperature. These bacteria exhibited a strong negative correlation with salinity, being particularly abundant near freshwater discharge locations. Due to Florida&rsquo;s year-round warm climate, these species were found to be permanent members of the local microbial community. Seasonal peaks in abundance occurred between August and October, a period which corresponds with the warmest water temperatures as well as frequent rainfall. Predictive models were constructed based on these parameters to provide a better understanding of how, when and where Vibrio spp. may be encountered by humans. This information is important for both water management and healthcare initiatives, with an overall goal of improving local recreational safety.</p>

<p> The use of pharmaceutical products has steadily increased in the United States from 2 billion prescriptions in 1999 to 3.9 billion in 2009. Half of patients do not comply with the recommended prescription regimen and dispose of unused drugs in the environment. The U.S. Environmental Protection Agency and many researchers have highlighted the human-health risks associated with improperly disposing of pharmaceutical products. This quantitative cross-sectional study examined the potential correlations between people&rsquo;s actual disposal practices and their knowledge of the impact of disposal practices on the environment and human health, and availability of disposal options. The conceptual framework selected for this study comprised 2 models: the health belief model and the theory of planned behavior. Respondents to an online survey were 485 residents of the northeast United States, polled from the general population. Descriptive statistics and logistic regression were used to model responses from the dependent variable actual disposal practice (ADP) across the independent variables, and analysis of variance explored whether ADP differed across demographic variables. Statistically significant associations emerged among individuals&rsquo; knowledge of environment and human-health impact, recommended disposal practices, disposal options, and that person&rsquo;s likelihood to practice recommended disposal. Demographic variables did not impact disposal behavior. To promote positive social change, it is recommended that policymakers plan and implement the expansion of convenient drug disposal options, as well as information campaigns on proper disposal practices. In parallel, health care professionals should stress to their patients the importance of complying with prescribed regimens, thus minimizing the amount of unused or expired medications.</p><p>

<p>Firefighters and asphalt pavers are exposed to polycyclic aromatic hydrocarbons (PAHs) during various work activities. The purpose of this study was to evaluate urinary PAH levels and compare these bio-monitoring levels among firefighters, asphalt pavers, and non-occupationally exposed individuals. The National Institute of Standards and Technology (NIST) urinary PAH levels were used for non-occupationally exposed controls. When compared to the NIST standard for smokers and non-smokers, firefighters demonstrated statistically significant differences in urinary concentration differences for the following metabolites: 2-OH-fluorene, 3-OH-fluorene and 1-OH-pyrene, which were lower in firefighters than the NIST mean for smokers. 1-OHphenanthrene, 2-OH-phenanthrene and 3-OH-phenanthrene were higher among world trade center exposed firefighters than the NIST mean for smokers. When firefighters were compared to the NIST non-smoker standard, firefighters demonstrated elevated levels in all tested PAH biomarkers due to a mixture of smokers and non-smokers in the firefighter cohort. </p><p> Asphalt workers had statistically significant higher urinary concentration elevations in 2OH-fluorene, 1-OH-phenanthrene and 3-OH-phenanthrene as compared to the NIST smoker mean. When asphalt pavers were compared to the NIST non-smoker mean, asphalt pavers had statistically significant increases in all tested PAH biomarkers, with the exception of 2-OHphenanthrene. While firefighters did not demonstrate a substantial change in urinary PAH metabolite levels compared to control populations of smokers and non-smokers, asphalt pavers experienced concentrations that were in some cases increased by orders of magnitude compare to NIST controls. Future research may be needed to evaluate any potential health risk posted to occupational exposed asphalt pavers. </p>

Health and Wellbeing Boards (HWBs) are new local government (LG) sub-committees tasked with assessing local health and social care needs, and developing strategies for promoting integration and tackling health inequalities; yet they have no statutory authority to compel action. This research explored how they approached tackling health inequalities, focussing on the role of environmental health (EH), the LG public health occupation, in the pre-shadow and shadow stages and as they went live in April 2013. Four case study sites (based around individual HWBs) were purposively sampled to ensure that a variety of HWBs were included, including unitary and two-tier authorities and urban, suburban and rural areas. Data collection at each case study site included semi-structured interviews, observation of HWB meetings, and documentary analysis and extended for 18 months from early 2012. In addition, EH practitioners and managers were interviewed from each of the English regions to provide a wider context. The data was analysed thematically both inductively and deductively using Atlas.ti. and conclusions drawn. HWBs were varied in their structures, practices and intentions and some changed considerably during the research, as would be expected at a time of new policy development and implementation. There was evident commitment and enthusiasm from HWB members to improve the health of local populations. However it is unclear what ‘success’ will be or how it will be measured and attributed to the work of the HWB, and there were some tensions between the various parties involved. There was an espoused commitment to the principles of Marmot, in particular to children, however much of the focus during HWB meetings was on integrating health and social care. Taking action on many of the social determinants of health is outside the core sphere of HWB control, however they did not generally appear to be utilising some of the readily available tools, such as EH work to improve local living and working conditions. EH was found to be largely ‘invisible’ within its own public health community and does not have a tradition of evidence based practice needed to secure funding in the new system. This, along with the decline of the regulatory role, has led to a period of reflection and adaptation. The research findings are linked by the policy approaches of ‘doodle’ and localism, including the shrinking of the state, and in particular the retreat of statutory and regulatory roles and the introduction of overt political values in policy making; shifting the focus to relationships, partnership-building, integration and the impact of individuals. The contexts in which the research has taken place, both at local and national levels, including financial austerity, major health restructuring, and high national and local expectations are all significant factors which have shaped the findings.

Submitted by Maria Aparecida (cidazen@gmail.com) on 2017-04-19T11:48:21Z No. of bitstreams: 1 Eulália carvalho.pdf: 6016176 bytes, checksum: 0a59893b28b2f78c565fbdf92edf617f (MD5) / Made available in DSpace on 2017-04-19T11:48:21Z (GMT). No. of bitstreams: 1 Eulália carvalho.pdf: 6016176 bytes, checksum: 0a59893b28b2f78c565fbdf92edf617f (MD5) Previous issue date: 2017-03-09 / Introduction: Historically, the field of food hygiene was more restricted to aspects such as the presence or absence of a particular contaminant. Today, the discussion surrounding this issue is extended, considering the risks involved in the different stages of production to consumption. This scenario reflects the advances arising with the Brazilian Sanitary Movement, the Industrial Revolution and women entering the labor market and the demand for collective food services and the provision of healthy and safe food with satisfactory hygienic and sanitary conditions. Objectives: To analyze the health profile of food services at the Hope Village neighborhood, Sao Luis - MA; categorize the food services; relate hygienic and sanitary conditions with the risk of food contamination and use of control measures (Good Manufacturing Practices); know the perception of the owners or technicians responsible about their working conditions. Methodology: it is a descriptive quantitative and qualitative, and an epidemiological and cross-sectional survey. Use It will be a checklist of federal health legislation - Ordinance 817/2013 and RDC n ° 216/2004, with interview 10 working in establishments in Hope Village neighborhood, 6 snack bars and 4 restaurants. In the analysis of the data will be used the Epi-info® 7 programs and Excel® 2013.Conclusion: This research aimed to categorization of food services Hope Village neighborhood in São Luís - MA, as allowed to characterize the variation of the sanitary quality of these establishments, among the 10 food service: 8 were categorized in group B (Good sanitary quality) and 2 were eliminated for lack of adequate water supply. / Introdução: Historicamente, o campo da higiene dos alimentos estava mais restrito a aspectos como a presença ou a ausência de determinado contaminante. Hoje, a discussão que envolve essa questão se amplia, contemplando os riscos envolvidos nas diferentes etapas de produção até o consumo. Esse cenário é reflexo dos avanços advindos com o Movimento Sanitário Brasileiro, a Revolução Industrial e da inserção da mulher no mercado de trabalho, bem como a demanda por serviços de alimentação coletivos e o fornecimento de alimentos saudáveis e seguros com condições higiênicossanitárias satisfatórias. Objetivos: analisar o perfil sanitário dos serviços de alimentação no bairro Vila Esperança, São Luís - MA; categorizar os serviços de alimentação; relacionar as condições higiênicossanitárias com os riscos de contaminação dos alimentos e uso das medidas de controles (Boas Práticas de Fabricação), e conhecer a percepção dos donos ou responsáveis técnicos sobre suas condições de trabalho. Metodologia: é uma pesquisa descritiva quanti-qualitativa, sendo um inquérito epidemiológico e transversal. Utilizou-se um check-list da legislação sanitária federal – Portaria 817/2013 e RDC n° 216/2004, com entrevista em 10 estabelecimentos em funcionamento no bairro Vila Esperança, 6 lanchonetes e 4 restaurantes. Na análise dos dados será utilizado os programas Epi-info® 7 e Excel® 2013. Conclusão: A presente pesquisa visou à categorização dos serviços de alimentação do bairro Vila Esperança, em São Luís - MA, pois permitiu caracterizar a variação da qualidade sanitária destes estabelecimentos, dentre os 10 serviços de alimentação: 8 foram categorizados no grupo B (Boa qualidade sanitária) e 2 foram eliminados por falta de abastecimento de água adequado.