Int. J. Environ. Res. Public Health2014, 11(3), 2804-2817; doi:10.3390/ijerph110302804 (doi registration under processing) - published online 7 March 2014 Show/Hide Abstract
Abstract: There is a lack of comparable health-related quality of life (HRQoL) and utility data across all mental disorders and all inpatient and outpatient settings. Our objective was to investigate the HRQoL and utility scores of people with mental disorders in France, treated in outpatient and inpatient settings, and to identify the HRQoL and utility score losses attributable to mental disorders compared to the non-mentally ill general population. A cross-sectional survey was conducted to assess HRQoL (SF-12) and utility scores of patients with mental disorders and followed in four psychiatric sectors in France. Scores were described by demographic and clinical characteristics and were then adjusted on age and gender and compared with those of the non-mentally ill general population. Median HRQoL and utility scores were significantly lower in patients with mental disorders than in the non-mentally ill general population; median differences amounted to 5.4 for the HRQoL physical score, to 11.8 for the HRQoL mental score and to 0.125 for the utility score. Our findings underscore the negative impact of mental disorders on HRQoL in France and provide a baseline to assess the global impact of current and future organizational changes in the mental health care system.
Int. J. Environ. Res. Public Health2014, 11(3), 2793-2803; doi:10.3390/ijerph110302793 (doi registration under processing) - published online 7 March 2014 Show/Hide Abstract
Abstract: Objective:To quantify the radiation dose in the thyroid attributable to different CT scans and to estimate the thyroid cancer risk in pediatric patients. Methods:The information about pediatric patients who underwent CT scans was abstracted from the radiology information system in one general hospital between 1 January 2012 and 31 December 2012.The radiation doses were calculated using the ImPACT Patient Dosimetry Calculator and the lifetime attributable risk (LAR) of thyroid cancer incidence was estimated based on the National Academies Biologic Effects of Ionizing Radiation VII model. Results: The subjects comprised 922 children, 68% were males, and received 971 CT scans. The range of typical radiation dose to the thyroid was estimated to be 0.61–0.92 mGy for paranasal sinus CT scans, 1.10–2.45 mGy for head CT scans, and 2.63–5.76 mGy for chest CT scans. The LAR of thyroid cancer were as follows: for head CT, 1.1 per 100,000 for boys and 8.7 per 100,000 for girls; for paranasal sinus CT scans, 0.4 per 100,000 for boys and 2.7 per 100,000 for girls; for chest CT scans, 2.2 per 100,000 for boys and 14.2 per 100,000 for girls. The risk of thyroid cancer was substantially higher for girls than for the boys, and from chest CT scans was higher than that from head or paransal sinus CT scans. Conclusions: Chest CT scans caused higher thyroid dose and the LAR of thyroid cancer incidence, compared with paransal sinus or head CT scans. Therefore, physicians should pay more attention to protect the thyroid when children underwent CT scans, especially chest CT scans.
Int. J. Environ. Res. Public Health2014, 11(3), 2780-2792; doi:10.3390/ijerph110302780 (doi registration under processing) - published online 7 March 2014 Show/Hide Abstract
Abstract: The aim of this study was to investigate oral and hand hygiene behaviour and risk factors among 13 to 15 year-old in-school adolescents in four Southeast Asian countries. Data were collected by self-reported questionnaire from nationally representative samples (total 13,824) of school children aged 13 to 15 years in India, Indonesia, Myanmar and Thailand. Results indicate that overall, 22.4% of school children reported sub-optimal oral hygiene (<twice a day tooth brushing), 45.2% did not always wash their hands before meals, 26.5% after toileting and 59.8% washing their hands with soap (59.8%). In multivariate analysis, male gender, health risk behaviours and lack of protective factors were associated with sub-optimal tooth brushing, and lower socioeconomic status, health risk behaviours, psychological distress and lack of protective factors were found to be associated with sub-optimal hand washing hygiene behaviour. As a conclusion, the cross-national data on oral and hand hygiene behaviour from four Southeast Asian countries found sub-optimal hygiene behaviour. Several determinants of sub-optimal hygiene behaviour were identified that can inform programmes in order to improve oral and hand hygiene behaviour of this adolescent population.
Int. J. Environ. Res. Public Health2014, 11(3), 2764-2779; doi:10.3390/ijerph110302764 (doi registration under processing) - published online 7 March 2014 Show/Hide Abstract
Abstract: In this study of autoimmunity among a population of Gullah African Americans in South Carolina, the links between environmental exposures and autoimmunity (presence of antinuclear antibodies (ANA)) have been assessed. The study population included patients with systemic lupus erythematosus (n = 10), their first degree relatives (n = 61), and unrelated controls (n = 9) where 47.5% (n = 38) were ANA positive. This paper presents the methodology used to model ANA status as a function of individual environmental influences, both self-reported and measured, while controlling for known autoimmunity risk factors. We have examined variable dimension reduction and selection methods in our approach. Following the dimension reduction and selection methods, we fit logistic spatial Bayesian models to explore the relationship between our outcome of interest and environmental exposures adjusting for personal variables. Our analysis also includes a validation “strip” where we have interpolated information from a specific geographic area for a subset of the study population that lives in that vicinity. Our results demonstrate that residential proximity to exposure site is important in this form of analysis. The use of a validation strip network demonstrated that even with small sample numbers some significant exposure-outcome relationships can be detected.
Int. J. Environ. Res. Public Health2014, 11(3), 2741-2763; doi:10.3390/ijerph110302741 - published online 6 March 2014 Show/Hide Abstract
Abstract: In this paper we describe an algorithm for clustering multivariate time series with variables taking both categorical and continuous values. Time series of this type are frequent in health care, where they represent the health trajectories of individuals. The problem is challenging because categorical variables make it difficult to define a meaningful distance between trajectories. We propose an approach based on Hidden Markov Models (HMMs), where we first map each trajectory into an HMM, then define a suitable distance between HMMs and finally proceed to cluster the HMMs with a method based on a distance matrix. We test our approach on a simulated, but realistic, data set of 1,255 trajectories of individuals of age 45 and over, on a synthetic validation set with known clustering structure, and on a smaller set of 268 trajectories extracted from the longitudinal Health and Retirement Survey. The proposed method can be implemented quite simply using standard packages in R and Matlab and may be a good candidate for solving the difficult problem of clustering multivariate time series with categorical variables using tools that do not require advanced statistic knowledge, and therefore are accessible to a wide range of researchers.
Int. J. Environ. Res. Public Health2014, 11(3), 2729-2740; doi:10.3390/ijerph110302729 - published online 5 March 2014 Show/Hide Abstract
Abstract: This study aims to model road traffic noise levels and estimate the human exposure at the 25 districts in the metropolitan Seoul, Republic of Korea. The SoundPLAN® Version 7.1 software package was used to model noise levels and simulated road traffic noise maps were created. The people exposed to daytime/nighttime road traffic noise were also estimated. The proportions of the population exposed to road traffic noise in major cities in the EU were also estimated and compared. Eight (8) districts show the exceeded rate (percentage of the exposed population exceeding the daytime standard) of 20% or more, and eleven (11) districts show 10%-20% and six (6) districts show less than 10%, which indicates considerable variation among districts. Two districts (Nowon-gu and Yangcheon-gu) show the highest exposure rate during the daytime (35.2%). For nighttime noise levels, fourteen (14) districts show the exceeded rate (percentage of exposed population exceeding the nighttime standard) over 30%. The average percentages of the exposed population exceeding the daytime/nighttime standards in Seoul and the EU were 16.6%/34.8% and 13.0%/16.1%, respectively. The results show that road traffic noise reduction measures should urgently be taken for the nighttime traffic noise in Seoul. When the grid noise map and the 3-D façade noise map were compared, the 3-D façade noise map was more accurate in estimating exposed population in citywide noise mapping.