Irregular working times and metabolic disorders among truck drivers: a review

A number of studies to better understand the complex physiological mechanism involved in regulating body weight have been conducted. More specifically, the hormones related to appetite, leptin and ghrelin, and their association to obesity have been a focus of investigation. Circadian patterns of these hormones are a new target of research. The behaviour of these hormones in individuals subject to atypical working times such as shiftwork remains unclear. Shiftwork is characterized by changes in biological rhythms and cumulative circadian phase changes, being associated with high rates of obesity and metabolic syndrome. Truck drivers, who work irregular shifts, frequently present a high prevalence of obesity, which might be associated with work-related factors and/or lifestyle. In this context, the aim of this paper was to discuss the relationship of body mass index, appetite-related hormones and sleep characteristics in truck drivers who work irregular shifts compared with day workers.

Amphetamine, cocaine and cannabinoids use among truck drivers on the roads in the State of Sao Paulo, Brazil

Drugs are important risk factors for traffic accidents. In Brazil, truck drivers report using amphetamines to maintain their extensive work schedule and stay awake. These drugs can be obtained without prescription easily on Brazilian roads. The use of these stimulants can result in health problems and can be associated with traffic accidents. There are Brazilian studies that show that drivers use drugs. However, these studies are questionnaire-based and do not always reflect real-life situations. The purpose of this study was to demonstrate the prevalence of drug use by truck drivers on the roads of Sao Paulo State, Brazil, during 2009. Drivers of large trucks were randomly stopped by police officers on the interstate roads during morning hours. After being informed of the goals of the study, the drivers gave written informed consent before providing a urine sample. In addition, a questionnaire concerning sociodemographic characteristics and health information was administered. Urine samples were screened for amphetamines, cocaine, and cannabinoids by immunoassay and the confirmation was performed using gas chromatography-mass spectrometry (GC-MS). Of the 488 drivers stopped, 456 (93.4%) provided urine samples, and 9.3% of them (n = 42) tested positive for drugs. Amphetamines were the most commonly found (n = 26) drug, representing 61.9% of the positive samples. Ten cases tested positive for cocaine (23.8%), and five for cannabinoids (11.9%). All drivers were male with a mean age of 40 +/- 10.8 years, and 29.3% of them reported some health problem (diabetes, high blood pressure and/or stress). A high incidence of truck drivers who tested positive for drug use was found, among other reported health problems. Thus, there is an evident need to promote a healthier lifestyle among professional drivers and a need for preventive measures aimed at controlling the use of drugs by truck drivers in Brazil. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work

This article is the product of research that analyzed the work of bus drivers of a public transportation company that is considered a benchmark reference in its field of operations, in which it strives to achieve operating excellence. Within this context, the authors sought to understand how such a company has managed to maintain a policy that is capable of reconciling quality public transport while also providing working conditions compatible with the professional development, comfort and health of its workers. Ergonomic work analysis and activity analysis were the guiding elements used in this study. Initial analyses indicate that the activity of drivers includes serving a population and providing mobility for it, which depends on driving the vehicle itself and on relationships with colleagues, users, pedestrians, drivers and others.

Social support, socioeconomic and clinical risk: comparison between to neighborhoods in a Brazilian upcountry town

The objective of this study was to compare the perceptions of two families living in two different neighborhoods (rated according to risk levels) regarding social support. A questionnaire was designed to assess social support according to the following dimensions: instrumental, emotional, religious, and support from friends, neighbors and family. The sample was comprised as follows: considering the 114 families living in neighborhood 1, 52 families were interviewed; and among the 162 families living in neighborhood 2, 60 families were interviewed. No significant difference was found related to instrumental, religious and emotional support, including the support from relatives among the families from both neighborhoods. The results disagree with the reviewed literature, which indicated a strong association between social support and families living at socioeconomic risk. In conclusion, social support is important for families, regardless of their risk stratification.

Spatial analysis of leprosy incidence and associated socioeconomic factors

OBJECTIVE: To identify clusters of the major occurrences of leprosy and their associated socioeconomic and demographic factors. METHODS: Cases of leprosy that occurred between 1998 and 2007 in Sao Jose do Rio Preto (southeastern Brazil) were geocodified and the incidence rates were calculated by census tract. A socioeconomic classification score was obtained using principal component analysis of socioeconomic variables. Thematic maps to visualize the spatial distribution of the incidence of leprosy with respect to socioeconomic levels and demographic density were constructed using geostatistics. RESULTS: While the incidence rate for the entire city was 10.4 cases per 100,000 inhabitants annually between 1998 and 2007, the incidence rates of individual census tracts were heterogeneous, with values that ranged from 0 to 26.9 cases per 100,000 inhabitants per year. Areas with a high leprosy incidence were associated with lower socioeconomic levels. There were identified clusters of leprosy cases, however there was no association between disease incidence and demographic density. There was a disparity between the places where the majority of ill people lived and the location of healthcare services. CONCLUSIONS: The spatial analysis techniques utilized identified the poorer neighborhoods of the city as the areas with the highest risk for the disease. These data show that health departments must prioritize politico-administrative policies to minimize the effects of social inequality and improve the standards of living, hygiene, and education of the population in order to reduce the incidence of leprosy.

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992–2003

Abstract Background The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992–1994, 1995–1997, 1998–2000, and 2001–2003). Results Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.

Cesarean section and increased body mass index in school children: two cohort studies from distinct socioeconomic background areas in Brazil

Abstract Background Recent studies have raised controversy regarding the association between cesarean section and later obesity in the offspring. The purpose of this study was to assess the association of cesarean section with increased body mass index (BMI) and obesity in school children from two Brazilian cities with distinct socioeconomic backgrounds. Methods Two birth cohorts respectively born in 1994 in Ribeirao Preto, a wealthy city in Southeast, and in 1997/98 in Sao Luis, a less wealthy city in Northeast of Brasil, were evaluated. After birth, 2,846 pairs of mothers-newborns were evaluated in Ribeirao Preto and 2,542 in Sao Luis. In 2004/05, 790 children aged 10/11 years were randomly reassessed in Ribeirao Preto and 673 at 7/9 years in Sao Luis. Information on type of delivery, maternal and child characteristics, socioeconomic position and anthropometric measurements were collected after birth and at school age. Obesity was defined as BMI ≥ 95th percentile at school age. Results Obesity rate was 13.0% in Ribeirao Preto and 2.1% in Sao Luis. Cesarean section was associated with obesity and remained significant after adjustment only in Ribeirao Preto [OR = 1.74 (95% CI: 1.04; 2.92)]. The association between cesarean section and BMI remained significant after adjustment for maternal schooling, maternal smoking during pregnancy, duration of breastfeeding, gender, birth weight and gestational age, type of school and, only in Sao Luis, pre-pregnancy maternal weight. In Ribeirao Preto children born by cesarean section had BMI 0.31 kg/m2 (95%CI: 0.11; 0.51) higher than those born by vaginal delivery. In Sao Luis BMI of children born by cesarean section was 0.28 kg/m2 higher (95%CI: 0.08; 0.49) than those born by vaginal delivery. Conclusion A positive association between cesarean section and increased BMI z-score was demonstrated in areas with different socioeconomic status in a middle-income country.

Observational study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers - protocol study

Abstract Background Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interstate bus drivers who travel medium and long distances. Methods/Design An observational, analytic study will be carried out involving adult male subjects of an interstate bus company. Those who agree to participate will undergo a detailed patient history, physical examination involving determination of blood pressure, anthropometric data, circumference measurements (hips, waist and neck), tonsils and Mallampati index. Moreover, specific questionnaires addressing sleep apnea and excessive daytime sleepiness will be administered. Data acquisition will be completely anonymous. Following the medical examination, the participants will perform a spirometry, NEP test and standard overnight polysomnography. The NEP test is performed through the administration of negative pressure at the mouth during expiration. This is a practical test performed while awake and requires little cooperation from the subject. In the absence of expiratory flow limitation, the increase in the pressure gradient between the alveoli and open upper airway caused by NEP results in an increase in expiratory flow. Discussion Despite the abundance of scientific evidence, OSA is still underdiagnosed in the general population. In addition, diagnostic procedures are expensive, and predictive criteria are still unsatisfactory. Because increased upper airway collapsibility is one of the main determinants of OSA, the response to the application of NEP could be a predictor of this disorder. With the enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers.

Dental caries-related quality of life and socioeconomic status of preschool children, Bauru, SP

AIM: To evaluate oral health-related quality of life of preschool children of Bauru, State of São Paulo, Brazil, and associate it with socioeconomic profile of households. METHODS: The sample consisted of 229 preschool children between 3 and 5 years and the dmft (decayed, missing due to caries, filled teeth) index was adopted for assessment children's dental caries in accordance with the standards recommended by the World Health Organization. Questionnaires were used for evaluation oral health-related quality of life (Early Childhood Oral Health Impact Scale) and socioeconomic profile of parents or guardians of the preschool children. Statistical analysis was performed descriptively by relative and absolute frequencies and by Spearman's correlation and Kruskal-Wallis test (p <0.05). RESULTS: A dmft of 1.65 (± 2.87) and a Sic Index 4.88 (± 3.20) were found, indicating the polarization of dental caries in the studied group. It was verified low influence of oral health on quality of life of the children examined. With respect to socioeconomic classification, 66.38% of families were in the lower middle class. Linear and statistically significant correlation was found between dmft and oral health-related quality of life for the overall score and domains of the questionnaire (p<0.001). CONCLUSIONS: It was found low influence of oral health on quality of life of the preschool children and the assessment of socioeconomic conditions of the children's families may guide practices aiming to reducing inequalities in the distribution of dental caries in the population.

Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children

Abstract Background Disparities in utilization of oral healthcare services have been attributed to socioeconomic and individual behavioral factors. Parents’ socioeconomic status, demographics, schooling, and perceptions of oral health may influence their children’s use of dental services. This cross-sectional study assessed the relationships between socioeconomic and psychosocial factors and the utilization of dental health services by children aged 1–5 years. Methods Data were collected through clinical exams and a structured questionnaire administered during the National Day of Children’s Vaccination. A Poisson regression model was used to estimate prevalence ratios and 95% confidence intervals. Results Data were collected from a total of 478 children. Only 112 (23.68%) were found to have visited a dentist; 67.77% of those had seen the dentist for preventive care. Most (63.11%) used public rather than private services. The use of dental services varied according to parental socioeconomic status; children from low socioeconomic backgrounds and those whose parents rated their oral health as “poor” used dental services less frequently. The reason for visiting the dentist also varied with socioeconomic status, in that children of parents with poor socioeconomic status and who reported their child’s oral health as “fair/poor” were less likely to have visited the dentist for preventive care. Conclusion This study demonstrated that psychosocial and socioeconomic factors are important predictors of the utilization of dental care services.

The relative influence of local to regional drivers of variation in reef fishes

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External drivers of biogeochemical cycles in a tropical montane forest in Ecuador

Successful conservation of tropical montane forest, one of the most threatened ecosystems on earth, requires detailed knowledge of its biogeochemistry. Of particular interest is the response of the biogeochemical element cycles to external influences such as element deposition or climate change. Therefore the overall objective of my study was to contribute to improved understanding of role and functioning of the Andean tropical montane forest. In detail, my objectives were to determine (1) the role of long-range transported aerosols and their transport mechanisms, and (2) the role of short-term extreme climatic events for the element budget of Andean tropical forest. In a whole-catchment approach including three 8-13 ha microcatchments under tropical montane forest on the east-exposed slope of the eastern cordillera in the south Ecuadorian Andes at 1850-2200 m above sea level I monitored at least in weekly resolution the concentrations and fluxes of Ca, Mg, Na, K, NO3-N, NH4-N, DON, P, S, TOC, Mn, and Al in bulk deposition, throughfall, litter leachate, soil solution at the 0.15 and 0.3 m depths, and runoff between May 1998 and April 2003. I also used meteorological data from my study area collected by cooperating researchers and the Brazilian meteorological service (INPE), as well as remote sensing products of the North American and European space agencies NASA and ESA. My results show that (1) there was a strong interannual variation in deposition of Ca [4.4-29 kg ha-1 a-1], Mg [1.6-12], and K [9.8-30]) between 1998 and 2003. High deposition changed the Ca and Mg budgets of the catchments from loss to retention, suggesting that the additionally available Ca and Mg was used by the ecosystem. Increased base metal deposition was related to dust outbursts of the Sahara and an Amazonian precipitation pattern with trans-regional dry spells allowing for dust transport to the Andes. The increased base metal deposition coincided with a strong La Niña event in 1999/2000. There were also significantly elevated H+, N, and Mn depositions during the annual biomass burning period in the Amazon basin. Elevated H+ deposition during the biomass burning period caused elevated base metal loss from the canopy and the organic horizon and deteriorated already low base metal supply of the vegetation. Nitrogen was only retained during biomass burning but not during non-fire conditions when deposition was much smaller. Therefore biomass burning-related aerosol emissions in Amazonia seem large enough to substantially increase element deposition at the western rim of Amazonia. Particularly the related increase of acid deposition impoverishes already base-metal scarce ecosystems. As biomass burning is most intense during El Niño situations, a shortened ENSO cycle because of global warming likely enhances the acid deposition at my study forest. (2) Storm events causing near-surface water flow through C- and nutrient-rich topsoil during rainstorms were the major export pathway for C, N, Al, and Mn (contributing >50% to the total export of these elements). Near-surface flow also accounted for one third of total base metal export. This demonstrates that storm-event related near-surface flow markedly affects the cycling of many nutrients in steep tropical montane forests. Changes in the rainfall regime possibly associated with global climate change will therefore also change element export from the study forest. Element budgets of Andean tropical montane rain forest proved to be markedly affected by long-range transport of Saharan dust, biomass burning-related aerosols, or strong rainfalls during storm events. Thus, increased acid and nutrient deposition and the global climate change probably drive the tropical montane forest to another state with unknown consequences for its functions and biological diversity.

The drivers and implications of environmental innovations: European evidence at different levels of analysis

The present work is a collection of three essays devoted at understanding the determinants and implications of the adoption of environmental innovations EI by firms, by adopting different but strictly related schumpeterian perspectives. Each of the essays is an empirical analysis that investigates one original research question, formulated to properly fill the gaps that emerged in previous literature, as the broad introduction of this thesis outlines. The first Chapter is devoted at understanding the determinants of EI by focusing on the role that knowledge sources external to the boundaries of the firm, such as those coming from business suppliers or customers or even research organizations, play in spurring their adoption. The second Chapter answers the question on what induces climate change technologies, adopting regional and sectoral lens, and explores the relation among green knowledge generation, inducement in climate change and environmental performances. Chapter 3 analyzes the economic implications of the adoption of EI for firms, and proposes to disentangle EI by different typologies of innovations, such as externality reducing innovations and energy and resource efficient innovations. Each Chapter exploits different dataset and heterogeneous econometric models, that allow a better extension of the results and to overcome the limits that the choice of one dataset with respect to its alternatives engenders. The first and third Chapter are based on an empirical investigation on microdata, i.e. firm level data extracted from innovation surveys. The second Chapter is based on the analysis of patent data in green technologies that have been extracted by the PATSTAT and REGPAT database. A general conclusive Chapter will follow the three essays and will outline how each Chapter filled the research gaps that emerged, how its results can be interpreted, which policy implications can be derived and which are the possible future lines of research in the field.

Sicurezza stradale: Proposta di traduzione di un estratto del research report "The Nature of Errors Made by Drivers"

The aim of this dissertation is to provide a translation from English into Italian of an extract from the research report “The Nature of Errors Made by Drivers”. The research was conducted by the MUARC (the Monash University Accident Research Centre) and published in June 2011 by Austroads, the association of Australasian road transport and traffic agencies. The excerpt chosen for translation is the third chapter, which provides an overview of the on-road pilot study conducted to analyse why drivers make mistakes during their everyday drive, including the methodology employed and the results obtained. This work is divided into six sections. It opens with an introduction on the topic and the formal structure of the report, followed by the first chapter, which provides an overview of the main features of the languages for special purposes and the specialised texts, an analysis of the text type and a presentation of the extract chosen for translation. In the second chapter the linguistic and extralinguistic resources available to specialised translators are presented, focussing on the ones used to translate the text. The third chapter is dedicated to the source text and its translation, while the fourth one provides an analysis of the strategies chosen to translate the text and a comment on the solutions to problematic passages. Finally, the last section – the conclusion – provides a comment on the entire work and on the professional activity of translators. The work closes with an appendix, which contains a glossary of the terms extracted from the translated text.