Medical, psychological and socio-economic implications of chronic hand eczema: a cross-sectional study.

BACKGROUND Hand eczema (HE) is a common skin disease with major medical psychological and socio-economic implications. Onset and prognosis of HE are determined by individual as well as environmental factors. So far, most epidemiological data on HE have been reported from Scandinavian and recently German studies. OBJECTIVE To investigate the characteristics and medical care of patients with chronic HE (CHE) in Switzerland, and identify risk factors. METHODS In this cross-sectional study, data from patients with chronic HE were obtained by means of medical history, dermatological examination and patient questionnaires. Multiple logistic regression analysis was applied to identify risk factors for high severity and dermatology life quality index (DLQI). RESULTS In seven dermatology departments, 199 patients (mean age 40.4 years, 50.8% female) with CHE (mean duration 6.6 years) were enrolled. Moderate to severe HE was reported by 70.9% of patients, and was associated with age <30 or >50 years, localization of lesions and pruritus. Because of the CHE, 37.3% of patients were on sick leave over the past 12 months, 14.8% had changed or lost their job. Practically all patients applied topical therapy, 21% were treated with alitretinoin, and 21% with psoralen plus UVA light (PUVA). The effects on the health-related quality of life was moderate to large in 33.7% and 39.4% of CHE patients, respectively. Factors associated with a high impact on DLQI (mean 9.7 ± 5.8) were female sex, lesions on back of the hands and pruritus as well as mechanical skin irritation and wearing gloves. CONCLUSION In agreement with recent studies, the Swiss data demonstrate the high impact of CHE on medical well-being, patient quality of life and work ability. As it is associated with an intense use of health care services, high rate of sick leave, job loss and change, CHE may cause a high socio-economic burden.

The effect of African Americans' ethnographic paradigms and cultural explanatory model of breast cancer in framing the male partner's attitudes and behaviors about the woman's breast cancer diagnosis

The disparate burden of breast cancer-related morbidity and mortality experienced by African American women compared with women of other races is a topic of intense debate in the medical and public health arenas. The anomaly is consistently attributed to the fact that at diagnosis, a large proportion of African American women have advanced-stage disease. Extensive research has documented the impacts of cultural factors and of socioeconomic factors in shaping African American women's breast-health practices; however, there is another factor of a more subtle influence that might have some role in establishing these women's vulnerability to this disease: the lack of or perceived lack of partner support. Themes expressed in the research literature reflect that many African American breast cancer patients and survivors consider their male partners as being apathetic and nonsupportive. ^ The purpose of this study was to learn how African American couples' ethnographic paradigms and cultural explanatory model of breast cancer frame the male partners' responses to the women's diagnosis and to assess his ability to cope and willingness to adapt to the subsequent challenges. The goal of the study was to determine whether these men's coping and adaptation skills positively or negatively affect the women's self-care attitudes and behaviors. ^ This study involved 4 African American couples in which the woman was a breast cancer survivor. Participants were recruited through a community-based cancer support group and a church-based cancer support group. Recruitment sessions were held at regular meetings of these organizations. Accrual took 2 months. In separate sessions, each male partner and each survivor completed a demographic survey and a questionnaire and were interviewed. Additionally, the couples were asked to participate in a communications activity (Adinkra). This activity was not done to fulfill any part of the study purpose and was not included in the data analysis; rather, it was done to assess its potential use as an intervention to promote dialogue between African American partners about the experience of breast cancer. ^ The questionnaire was analyzed on the basis of a coding schema and the interview responses were analyzed on the principles of hermeneutic phenomenology. In both cases, the instruments were used to determine whether the partner's coping skills reflected a compassionate attitude (positive response) versus an apathetic attitude (negative response) and whether his adaptation skills reflected supportive behaviors (the positive response) versus nonsupportive behaviors (the negative response). Overall, the women's responses showed that they perceived of their partners as being compassionate, yet nonsupportive, and the partner's perceived of themselves likewise. Only half of the women said that their partners' coping and adaptation abilities enabled them to relinquish traditional concepts of control and focus on their own well-being. ^ The themes that emerged indicate that African American men's attitudes and behaviors regarding his female partner's diagnosis of breast cancer and his ability to cope and willingness to adapt are influenced by their ritualistic mantras, folk beliefs, religious teachings/spiritual values, existential ideologies, socioeconomic status, and environmental factors and by their established perceptions of what causes breast cancer, what the treatments and outcomes are, and how the disease affects the entire family, particularly him. These findings imply that a culturally specific intervention might be useful in educating African American men about breast cancer and their roles in supporting their female partners, physically and psychologically, during diagnosis, treatment, and recovery. ^

Environmental influences on self-reported leisure-time physical activity in the Austin/Travis County STEPS survey 2005--2009

This study was an examination of environmental and social correlates of physical inactivity in a socio-economically disadvantaged community. This study was a secondary analysis of data collected by the Austin/Travis County Department of Health and Human Services. The study included an analysis of perceived environmental influences (e.g. access to physical support features like sidewalks and streetlights). This study also investigated several features of the social environment (e.g. perceived neighborhood crime and social influence). Participants’ beliefs and attitudes about the neighborhood were investigated. Results included estimates of the association between neighborhood factors and physical inactivity controlling for age, gender and education. This study found significant associations for social and environmental variables with physical inactivity. The goal of this work was to identify factors that contribute to inactivity and address a number of environmental and neighborhood risk factors that contribute to sedentary behaviors in a population of relative social and economic disadvantage.^

Community diagnosis: A working tool for developing culturally appropriate diarrhea intervention programs

Most studies related to diarrhea have been focused narrowly on the etiological and pathophysiological factors involved in inducing the disease. Such studies have often failed to consider other facets contributing to and possibly prolonging the problem, namely: socio-economic conditions, educational opportunities and attainments, cultural characteristics and beliefs, and the political administration and its commitment towards fulfilling its moral and ethical obligations in responding to and fostering human development.^ This study utilized the diagnostic approach of the PRECEDE model. The acronym stands for the predisposing reinforcing, and enabling constructs in educational diagnosis and evaluation. The constituents of this model were identified by utilizing participant observation field methods, traditionally applied by ethnographers to collect data describing the multiple facets of a culture, and linguistic anthropology used to capture and define characteristic semantics and viewpoints. The household study sample was randomly selected from a defined list of households known to have at least one child less than five years of age. An open-ended questionnaire format was used to interview the 115 mothers in the selected households sample.^ Kalama, the study community, is characteristically an agricultural village, situated in the Governorate of Kaliobia and located approximately 25 Km (about 15.5 miles) from the capital, Cairo, Egypt. The 1986 census indicates a population size of 13,328 people in 4,818 households. There were 65 deaths occurring among children less than five years in 1986. The causes of death were primarily related to diarrhea, followed by upper respiratory infections, congenital anomalies and birth injuries.^ This study outlines (a) practices related to the management of diarrhea, including the administration of foods and drinks during such episodes; (b) influences of governmental policies; and (c) recommended strategies for overcoming barriers and promoting effective diarrhea intervention programs. ^

Estado de situación del agro pampeano. Bases para teorizar sobre indicadores de vulnerabilidad socio-territorial

El estado de situación del agro pampeano desde la implantación del modelo económico neoliberal en la década del '70 hasta nuestros días, plantea el desafío de repensar las categorías de análisis que nos permitan abordar el estudio de la vulnerabilidad socio-territorial de los actores sociales implicados en el agro. Los supuestos neoliberales que han conducido el modelo de producción agropecuario de acumulación y rápida rotación de capital, especulación financiera, externalización de costos sociales y ambientales, entre otros generan situaciones de profundas desigualdades socio-territoriales, que incrementan los grados de vulnerabilidad. Resulta ineludible entonces teorizar sobre indicadores que, bajo otros supuestos, nos permitan valorar los niveles de vulnerabilidad para proponer alternativas que respondan al principio de justicia socio-territorial. Para la consecución de dicho objetivo, se parte de un análisis del estado de situación del agro en el sur cordobés; se analizan luego los supuestos neoliberales que han orientado la producción agropecuaria, para pensar caminos alternativos al modelo de capitalismo agrario, a fin de realizar nuestro aporte a la discusión sobre la construcción de indicadores de vulnerabilidad socio-territorial.

Estado de situación del agro pampeano. Bases para teorizar sobre indicadores de vulnerabilidad socio-territorial

El estado de situación del agro pampeano desde la implantación del modelo económico neoliberal en la década del '70 hasta nuestros días, plantea el desafío de repensar las categorías de análisis que nos permitan abordar el estudio de la vulnerabilidad socio-territorial de los actores sociales implicados en el agro. Los supuestos neoliberales que han conducido el modelo de producción agropecuario de acumulación y rápida rotación de capital, especulación financiera, externalización de costos sociales y ambientales, entre otros generan situaciones de profundas desigualdades socio-territoriales, que incrementan los grados de vulnerabilidad. Resulta ineludible entonces teorizar sobre indicadores que, bajo otros supuestos, nos permitan valorar los niveles de vulnerabilidad para proponer alternativas que respondan al principio de justicia socio-territorial. Para la consecución de dicho objetivo, se parte de un análisis del estado de situación del agro en el sur cordobés; se analizan luego los supuestos neoliberales que han orientado la producción agropecuaria, para pensar caminos alternativos al modelo de capitalismo agrario, a fin de realizar nuestro aporte a la discusión sobre la construcción de indicadores de vulnerabilidad socio-territorial.

Estado de situación del agro pampeano. Bases para teorizar sobre indicadores de vulnerabilidad socio-territorial

El estado de situación del agro pampeano desde la implantación del modelo económico neoliberal en la década del '70 hasta nuestros días, plantea el desafío de repensar las categorías de análisis que nos permitan abordar el estudio de la vulnerabilidad socio-territorial de los actores sociales implicados en el agro. Los supuestos neoliberales que han conducido el modelo de producción agropecuario de acumulación y rápida rotación de capital, especulación financiera, externalización de costos sociales y ambientales, entre otros generan situaciones de profundas desigualdades socio-territoriales, que incrementan los grados de vulnerabilidad. Resulta ineludible entonces teorizar sobre indicadores que, bajo otros supuestos, nos permitan valorar los niveles de vulnerabilidad para proponer alternativas que respondan al principio de justicia socio-territorial. Para la consecución de dicho objetivo, se parte de un análisis del estado de situación del agro en el sur cordobés; se analizan luego los supuestos neoliberales que han orientado la producción agropecuaria, para pensar caminos alternativos al modelo de capitalismo agrario, a fin de realizar nuestro aporte a la discusión sobre la construcción de indicadores de vulnerabilidad socio-territorial.

Component-resolved diagnosis of wheat flour allergy in baker's asthma.

Baker's asthma is one of the most common types of occupational asthma and its prevalence is increasing in the last years. Diagnosis of occupational asthma is complex. The poor specificity of current diagnostic approaches may be associated with insufficient purity of wheat extracts or lack of inclusion of major allergens in them. In this work, we use microarray technology to characterize the allergenic profiles of baker's asthma patients from three regions in Spain and to analyze the influence of other environmental allergens on the sensitization pattern.

The role of rehabilitation of building in the urban integration, social cohesion and environmental responsibility

In the framework ofthe National Research Plan2008-2011, our research poses estrategy for the design and evaluation of plans and programmes of urban integrated regeneration. The objective is to develop a study on the role of rehabilitation of buildings in concepts like urban integration, social cohesion and environmental responsibility. The research proposes a methodological tool for evaluating urban regeneration processes from a holistic perspective that can serve as a guide for governments and technical teams to address intervention in consolidated urban areas with physical and socio-economic problems. The development of the tool has inevitably led to delve into different areas where you can intervene but has not lost sight of the complex interplay of factors involved in the process.It is an open source tool to visualize Urban Integrated Rehabilitation processes.

Complejos turísticos residenciales: análisis del crecimiento del turismo residencial en el Mediterráneo español y en el Litoral Nordestino (Brasil) y su impacto socio-ambiental

Entre las diversas formas de turismo que aparecen a partir de la segunda mitad del siglo pasado, el turismo residencial surge como uno de los principales fenómenos en los escenarios brasileño e internacional. El crecimiento de esta actividad ha sido un factor importante para la generación de empleo e ingresos en los municipios del litoral sudeste de Brasil y de la costa española mediterránea. Pero recientemente, se observa un crecimiento acelerado de esta modalidad de turismo en la costa del Nordeste de Brasil. Este proceso ha generado beneficios económicos para la región al igual que impactos socioambientales. El primer objetivo de este artículo fue realizar un enfoque exploratorio, identificando el escenario de la oferta y la demanda de la construcción de complejos turísticos residenciales en el Nordeste brasileño por medio del relevamiento de sites y entrevistas a las inmobiliarias, constructoras, incorporadoras, operadoras hoteleras y organismos públicos. Los resultados de la investigación muestran el gran interés del capital internacional en construir mega proyectos de segunda residencia en el nordeste, adaptados a la demanda internacional, principalmente europea. El segundo objetivo fue comparar y analizar la evolución, las etapas y las características del turismo residencial en la costa española mediterránea, como ejemplo de modelo consolidado, con la actividad en el Nordeste brasileño, como modelo en expansión. Se verificó que ambas regiones turísticas fueron afectadas por la crisis económica y por deficiencias estructurales de sus respectivos modelos, las cuales potencian impactos económicos y socioambientales.

Uso do zoneamento ambiental do Médio Rio Grande como instrumento de gestão no município de Delfinópolis-MG

Este trabalho faz parte do Projeto Grande Minas - União Pelas Águas, que realizou o Zoneamento Ambiental das Sub-Bacias Hidrográficas dos Afluentes Mineiros do Médio Rio Grande. O zoneamento foi concluído em 2013 e produziu importantes informações sobre os meios físico, biótico e socioeconômico dos 22 municípios que compõem a bacia hidrográfica, dentre eles o local de estudo, que é o município de Delfinópolis - MG. Dentre os instrumentos que podem contribuir para o desenvolvimento sustentável, o município pode utilizar, além do zoneamento ambiental, o plano diretor municipal e o plano de manejo do Parque Nacional da Serra da Canastra, uma vez que esta unidade de conservação insere-se no município. Torna-se importante, entretanto, a integração destes três importantes instrumentos de gestão para que o planejamento municipal e as ações de política pública possam ser realizados de forma consistente. Este trabalho vem contribuir na avaliação e integração destas informações (Plano Diretor Municipal, Plano de Manejo, Zoneamento Ambiental) e os resultados deverão contribuir com os administradores públicos na tomada de decisões e na resolução dos problemas enfrentados na região, como exemplo as queimadas, o uso inadequado dos recursos hídricos, as atividades modificadoras do meio físico. A sistemática metodológica adotada envolveu a avaliação de dados existentes e a construção de um banco de dados digital do município; análise dos instrumentos legais de planejamento e gestão municipal e elaboração de produtos cartográficos interpretativos de fácil leitura e entendimento que possam ser utilizados diretamente pelos gestores públicos. A análise e avaliação dos dados existentes permitiu diagnosticar algumas características peculiares ao município, como a sua vocação para o turismo, com mais de 40 atrativos ligados ao ecoturismo; o grande número de minerações de areia e cascalho, grande parte delas não regularizada; e os conflitos locais existentes diante das atividades da economia rural e a necessidade de preservação impostas pela unidade de conservação.

Assessment of Socio-Economic and Climate Change Effects on Water Resources and Agriculture in Southern and Eastern Mediterranean countries. MEDPRO Technical Paper No. 28/March 2013

This study aims at assessing the socio-economic and environmental effects of different societal and human development scenarios and climate change in the water-scarce southern and eastern Mediterranean. The study develops a two-stage modelling methodology that includes an econometric analysis for the southern and eastern Mediterranean region as a whole and a detailed, integrated socioecological assessment focusing on Jordan, Syria and Morocco. The results show that water resources will be under increasing stress in future years. In spite of country differences, a future path of sustainable development is possible in the region. Water withdrawals could decrease, preserving renewable water resources and reversing the negative effects on agricultural production and rural society. This, however, requires a combination across the region of technical, managerial, economic, social and institutional changes that together foster a substantive structural change. A balanced implementation of water supply-enhancing and demand-management measures along with improved governance are key to attaining a cost-effective sustainable future in which economic growth, a population increase and trade expansion are compatible with the conservation of water resources.

Routine histological technique applied to a biological model for environmental studies

Introduction and aim Earthworms are an important test organisms used in several standard ecotoxicological tests (e.g. ISO, 2008, 2012; OECD, 2004, 1094) and they are also model organisms to test soil structure and permeability, as well as for important soil services as the degradation organic matter. Although histopathological changes have been demonstrated to be good biomarkers to assess the exposure of these animals to different physical and chemical stress agents, studies with clear and high quality images describing normal tissue conditions are scarce in the literature, so the aim of this work was to better characterize this biological model. Material and Methods Eight adult earthworms exposed to an artificial standard soil (OECD, 2004) for 28 days, were extracted and placed in a plastic box to depurate their gut content, fixed in 10% neutral-buffered formalin and processed for routine histopathological diagnosis. Results and discussion Satisfactory histological sections were obtained. Some difficulties were faced related with microtome sectioning, resulting in artefacts, namely lines across sections produced by a nick in the cutting edge of the microtome knife cutting tear, motivated by the presence of sand and other solid particles that persisted in the gut of earthworms. Nevertheless, it was possible to obtain representative figures from different earthworm sections. Conclusion Routine histological technique was effective for obtaining satisfactory histological sections and the knowledge of the histology of earthworms could be very useful for future application in environmental studies, using this biological model.

Characterization of histopathological lesions in a biological model for environmental studies: Eisenia andrei Bouché. Preliminar results

Introduction The strong expansion of the world production of plastics caused a severe accumulation of plastic debris in the environment, which makes them one of the most important contaminants, growing as a global environmental problem. Although the production in Europe has been relatively constant in the last 10 years, world plastic production continues to increase, affecting soil biota and their functions. Objectives Thus, in order to evaluate the effects of MP in soil-dwelling organisms, earthworms (Eisenia andrei Bouché), were exposed to standard artificial soil mixed with MPs and the authors documented, using microscopic figures, the pathological lesions found in this biological model. Material and Methods Eight adult earthworms extracted from soils contaminated with different concentrations of MP (mg/kgdw) with sizes ranging between 250-1000 m, were fixed in 10% neutral-buffered formalin and processed for routine histopathological diagnosis. Results and discussion Contrary to what would be expected, MP were not found throughout the GI tube of earthworms but several lesions were found in the individuals extracted from the soils with high MP concentrations, when compared with control group, namely epithelial intestinal atrophy and evidences of inflammatory responses to this stress agent. Conclusion Earthworms have probably avoided the consumption of the biggest MPs. However, evidences point for lesions that were likely caused by the smallest MPs that were likely egested during the depuration phase.