Iowa Department of Public Health, Occupational Health & Safety Surveillance Program Annual Report, July 1, 2013- June 30, 2014, August 1, 2014

The mission of the Iowa OHSSP is to promote and protect the health and safety of Iowans in the workplace. The fundamental or core program provides administrative coordination and continuity across all IDPH OHSSP projects, explores options to improve the surveillance and data translation capacity of the entire program, and provides outreach, dissemination, and evaluation functions to support each project. The core program is also responsible for the Occupational Health Indicators project and Adult Blood Lead Epidemiology and Surveillance (ABLES), as well as working with external partner projects and reports.

Evaluating conservation and fisheries management strategies by linking spatial prioritization software and ecosystem and fisheries modelling tools

Well-designed marine protected area (MPA) networks can deliver a range of ecological, economic and social benefits, and so a great deal of research has focused on developing spatial conservation prioritization tools to help identify important areas. However, whilst these software tools are designed to identify MPA networks that both represent biodiversity and minimize impacts on stakeholders, they do not consider complex ecological processes. Thus, it is difficult to determine the impacts that proposed MPAs could have on marine ecosystem health, fisheries and fisheries sustainability. Using the eastern English Channel as a case study, this paper explores an approach to address these issues by identifying a series of MPA networks using the Marxan and Marxan with Zones conservation planning software and linking them with a spatially explicit ecosystem model developed in Ecopath with Ecosim. We then use these to investigate potential trade-offs associated with adopting different MPA management strategies. Limited-take MPAs, which restrict the use of some fishing gears, could have positive benefits for conservation and fisheries in the eastern English Channel, even though they generally receive far less attention in research on MPA network design. Our findings, however, also clearly indicate that no-take MPAs should form an integral component of proposed MPA networks in the eastern English Channel, as they not only result in substantial increases in ecosystem biomass, fisheries catches and the biomass of commercially valuable target species, but are fundamental to maintaining the sustainability of the fisheries. Synthesis and applications. Using the existing software tools Marxan with Zones and Ecopath with Ecosim in combination provides a powerful policy-screening approach. This could help inform marine spatial planning by identifying potential conflicts and by designing new regulations that better balance conservation objectives and stakeholder interests. In addition, it highlights that appropriate combinations of no-take and limited-take marine protected areas might be the most effective when making trade-offs between long-term ecological benefits and short-term political acceptability.

Variation in composition of macro-benthic invertebrates as an indication of water quality status in three bays in Lake Victoria

Knowledge of how biota can be used to monitor ecosystem health and assess impacts by human alterations such as land use and management measures taken at different spatial scales is critical for improving the ecological quality of aquatic ecosystems. This knowledge in Uganda is very limited or unavailable yet it is needed to better understand the relationship between environmental factors at different spatial scales, assemblage structure and taxon richness of aquatic ecosystems. In this study, benthic invertebrate community patterns were sampled between June 2001 and April 2002 and analysed in relation to water quality and catchment land use patterns from three shallow near-shore bays characterized by three major land uses patterns: urban (Murchison Bay); semi-urban (Fielding Bay); rural (Hannington Bay). Variations in density and guild composition of benthic macro-invertebrates communities were evaluated using GIS techniques along an urban-rural gradient of land use and differences in community composition were related to dissolved oxygen and conductivity variation. Based on numerical abundance and tolerance values, Hilsenhoff's Biotic Index ofthe invertebrates was determined in order to evaluate the relative importance of water quality in the three bays. Murchison Bay supported a relatively taxa-poor invertebrate assemblage mainly comprising stenotopic and eurytopic populations of pollution-tolerant groups such as worms and Chironomus sp. with an overall depression in species diversity. On the contrary, the communities in Fielding and Hannington bays were quite similar and supported distinct and diverse assemblages including pollution-intolerant forms such as Ephemeroptera (mayflies), Odonata (dragonflies). The Hilsenhoff Biotic Index in Murchison Bay was 6.53. (indicating poor water quality) compared to 6.34 for Fielding Bay and 5.78 for Hannington Bay (both indicating fair water quality). The characterization of maximum taxa richness balanced among taxa groups with good representation of intolerant individuals in Hannington Bay relative to Fielding and Murchison bays concludes that the bay is the cleanest in terms of water quality. Contrary, the dominance of few taxa with many tolerant iqdividuals present in Murchison Bay indicates that the bay is degraded in terms of water quality. These result are ofimportance when planning conservation and management measures, implementing large-scale biomonitoring programs, and predicting how human alterations (e.g nutrient loading) affect water ecosystems. Therefore, analysis of water quality in relation to macro-invertebrate community composition patterns as bio-indicators can lead to further understanding of their responses to environmental manipulations and perturbations.

Report of the Workshop on Growth-increment Chronologies in Marine Fish: climate-ecosystem interactions in the North Atlantic 2 (WKGIC2). 18-22 April 2016 Esporles, Mallorca, Spain

Over the past several decades, thousands of otoliths, bivalve shells, and scales have been collected for the purposes of age determination and remain archived in European and North American fisheries laboratories. Advances in digital imaging and computer software combined with techniques developed by tree-ring scientists provide a means by which to extract additional levels of information in these calcified structures and generate annually resolved (one value per year), multidecadal time-series of population-level growth anomalies. Chemical and isotopic properties may also be extracted to provide additional information regarding the environmental conditions these organisms experienced.Given that they are exactly placed in time, chronologies can be directly compared to instrumental climate records, chronologies from other regions or species, or time-seriesof other biological phenomena. In this way, chronologies may be used to reconstruct historical ranges of environmental variability, identify climatic drivers of growth, establish linkages within and among species, and generate ecosystem-level indicators. Following the first workshop in Hamburg, Germany, in December 2014, the second workshop on Growth increment Chronologies in Marine Fish: climate-ecosystem interactions in the North Atlantic (WKGIC2) met at the Mediterranean Institute for Advanced Studies headquarters in Esporles, Spain, on 18–22 April 2016, chaired by Bryan Black (USA) and Christoph Stransky (Germany).Thirty-six participants from fifteen different countries attended. Objectives were to i) review the applications of chronologies developed from growth-increment widths in the hard parts (otoliths, shells, scales) of marine fish and bivalve species ii) review the fundamentals of crossdating and chronology development, iii) discuss assumptions and limitations of these approaches, iv) measure otolith growth-increment widths in image analysis software, v) learn software to statistically check increment dating accuracy, vi) generate a growth increment chronology and relate it to climate indices, and vii) initiate cooperative projects or training exercises to commence after the workshop.The workshop began with an overview of tree-ring techniques of chronology development, including a hands-on exercise in cross dating. Next, we discussed the applications of fish and bivalve biochronologies and the range of issues that could be addressed. We then reviewed key assumptions and limitations, especially those associated with short-lived species for which there are numerous and extensive otolith archives in European fisheries labs. Next, participants were provided with images of European plaice otoliths from the North Sea and taught to measure increment widths in image analysis software. Upon completion of measurements, techniques of chronology development were discussed and contrasted to those that have been applied for long-lived species. Plaice growth time-series were then related to environmental variability using the KNMI Climate Explorer. Finally, potential future collaborations and funding opportunities were discussed, and there was a clear desire to meet again to compare various statistical techniques for chronology development using a range existing fish, bivalve, and tree growth-increment datasets. Overall, we hope to increase the use of these techniques, and over the long term, develop networks of biochronologies for integrative analyses of ecosystem functioning and relationships to long-term climate variability and fishing pressure.

Coping as a moderator of the influence of economic stressors on psychological health

Since 2008, there has been a decline in the economy of several European countries, including Portugal. In the literature, it is emphasized that periods of economic uncertainty propitiate the appearance of mental health problems and diminish populations’ well-being. The aim of the present study, with 729 Portuguese participants, 33.9% (n=247) males and 66.1% (n=482) females with an average age of 37 years old (M=36.99; SD=12.81), was to examine the relationship between economic hardship, financial threat, and financial well-being (i.e., economic stressors) and stress, anxiety, and depression (i.e., psychological health indicators), as well as to test the moderation effect of coping in the aforementioned relationship. To achieve these goals, a cross-sectional design was implemented and structural equation modeling (SEM) was used to analyze the obtained data. Our results underline that coping affects the relationship between economic stressors and psychological health since subjects with lower coping levels are more vulnerable to economic stress factors than those with higher coping levels. The moderation effect was more evident in the relationships between economic hardship and stress, anxiety, and depression. The main implications of this study are presented, as well as its’ limitations and suggestions for future research.

Indicators for Traumatic Brain Injury, December 2008

Although it is not a cause or intent of injury, traumatic brain injury (TBI) is included as a specific indicator due to its deadly and debilitating nature. Although the death and hospitalization rates of TBI injuries in Iowa (17.3/100,000 and 56.8/100,000, respectively) is lower than the national NCIPC states’ 2004 average (17.9/100,000 and 74.2/100,000, respectively), the TBI death rate is still the highest among all the specific indicators for death in Iowa. On average, there are 1.5 TBI‐related deaths/day, 5 hospitalizations, and nearly 40 TBI‐related ED visits per day in all of Iowa.

Biotic and abiotic parameters that distinguish types of temporary ponds in a Portuguese Mediterranean ecosystem

Temporary ponds are seasonal wetland habitats subjected to extreme and unstable ecological conditions. Some are classified as priority habitats for conservation by the European Union Habitats Directive. Our study area was the coastal plain of southwest Portugal, which spans across 100km north to south and hosts a large number of temporary ponds as a consequence of climatic and edaphic characteristics. Field sampling of floristic and edaphic data was carried out in 24 temporary ponds every spring between 2005 and 2008. We recorded a total of 174 plant species identified within visually homogeneous plots. We included the data in a geographic information system and classified ponds according to their floristic composition, using a biotic regionalization analysis based on species presence/absence, which is a practical and unambiguous criterion. We found three significantly different groups of ponds which corresponded to an eco-physiognomic pond typology: Mediterranean temporary ponds, marshlands, and disturbed ponds. For the first two pond types we defined characteristic or indicator plant species. We searched also for relationships between pond type and a series of large-scale climatic, geographic, and geological variables, as well as local-scale physical and chemical properties of the soil. Pond type was distinguished by a complex combination of some of these variables, including environmental energy, soil texture, nitrogen content of the soil and pH. A practical way of discriminating between different

The Burden Of Eclampsia: Results From A Multicenter Study On Surveillance Of Severe Maternal Morbidity In Brazil.

Maternal mortality (MM) is a core indicator of disparities in women's rights. The study of Near Miss cases is strategic to identifying the breakdowns in obstetrical care. In absolute numbers, both MM and occurrence of eclampsia are rare events. We aim to assess the obstetric care indicators and main predictors for severe maternal outcome from eclampsia (SMO: maternal death plus maternal near miss). Secondary analysis of a multicenter, cross-sectional study, including 27 centers from all geographic regions of Brazil, from 2009 to 2010. 426 cases of eclampsia were identified and classified according to the outcomes: SMO and non-SMO. We classified facilities as coming from low- and high-income regions and calculated the WHO's obstetric health indicators. SPSS and Stata softwares were used to calculate the prevalence ratios (PR) and respective 95% confidence interval (CI) to assess maternal characteristics, clinical and obstetrical history, and access to health services as predictors for SMO, subsequently correlating them with the corresponding perinatal outcomes, also applying multiple regression analysis (adjusted for cluster effect). Prevalence of and mortality indexes for eclampsia in higher and lower income regions were 0.2%/0.8% and 8.1%/22%, respectively. Difficulties in access to health care showed that ICU admission (adjPR 3.61; 95% CI 1.77-7.35) and inadequate monitoring (adjPR 2.31; 95% CI 1.48-3.59) were associated with SMO. Morbidity and mortality associated with eclampsia were high in Brazil, especially in lower income regions. Promoting quality maternal health care and improving the availability of obstetric emergency care are essential actions to relieve the burden of eclampsia.

Indicadores de saude em mulheres acima de 50 anos de idade participantes de um programa de atividades fisicas no complexo da Mare-RJ

Univesidade Estadual de Campinas. Faculdade de Educação Física

O modelo de atenção a saúde bucal no Médio e Baixo Xingu: parcerias, processos e perspectivas

Este artigo tem por objetivo apresentar as ações desenvolvidas na construção do modelo de atenção em saúde no Distrito Especial Indígena - Xingu (DSEI-Xingu), mais especificamente, na área de saúde bucal, com a efetiva parceria entre a Universidade Federal do Estado de São Paulo (UNIFESP), Faculdade de Odontologia de Ribeirão Preto - Universidade de São Paulo (FORP-USP) e a Colgate®, que permitiu a construção social da práxis em saúde no Médio e Baixo Xingu. Ao longo da história, o DSEI "Espaço Social" é onde as comunidades se constituem e, por meio do processo social de produção, cria acessos diferenciados aos bens de consumo, além de formar a base para a organização dos serviços de atenção à saúde dos povos indígenas. Para o DSEI-Xingu, são pontos básicos o estabelecimento de parcerias institucionais e a participação efetiva dos povos indígenas na gestão da saúde em seu território. Estruturado no planejamento baseado em problemas sentidos pela população, utiliza-se da construção coletiva de redes explicativas, apontando soluções em vários planos com abordagem intersetorial. É através da observação dos indicadores de saúde que se torna perceptível a assimilação das comunidades indígenas com o recente modelo de atenção básica à saúde bucal, uma vez que constantemente está sendo adaptado à cultura, à tradição e às singularidades desses povos indígenas.

A situação epidemiológica da tuberculose na República da Guiné-Bissau, 2000 - 2005

INTRODUÇÃO: A tuberculose na República da Guiné-Bissau não apresenta bons indicadores de saúde, assim como na maioria dos países em vias de desenvolvimento. OBJETIVO: Estudar na República da Guiné-Bissau e nas suas Províncias, a situação epidemiológica da doença no período de 2000 a 2005. MÉTODO: Realizou-se levantamento de dados secundários junto ao Programa Nacional de Luta Contra Lepra e Tuberculose, no período de 2000 a 2005, e análise de relatórios anuais da Capital e das Províncias da Guiné-Bissau, para o cálculo de coeficientes e taxas dos indicadores. RESULTADOS: O número de casos de tuberculose manteve-se estável no período de 2000 (1.959 casos) a 2005 (1.888 casos). O percentual de casos pulmonares variou de 96,0 a 98,8%, dos quais 55% eram bacilíferos. Em 2005 o coeficiente de prevalência foi de 142,4/100.000, o de incidência 131,3/100.000 e o de mortalidade, 16,8/100.000 habitantes. A maior concentração de casos ocorreu na região da Capital. A taxa de cura variou entre 46,5% em 2000 e 69,6% em 2005, e a de abandono de tratamento de 29,8% em 2000 para 12,1% em 2005. CONCLUSÃO: Os indicadores do Plano Estratégico Nacional devem ser melhorados, sobretudo no que diz respeito à busca ativa de casos, à descentralização do atendimento aos doentes, à implantação da estratégia DOTS e à necessidade de um sistema de informação e notificação eficientes.

Condições de vida e mortalidade infantil no município do Embu, São Paulo

OBJETIVO: Descrever a distribuição do coeficiente de mortalidade infantil e seus componentes no município do Embu, São Paulo, no período de 1995 a 1998, segundo os estratos de condições de vida. MÉTODOS: Estudo descritivo com análise por conglomerados,dos 135 setores censitários do município de Embu, agrupados em quatro estratos de condições de vida: estrato 1, com melhores condições de moradia, renda e escolaridade; estratos 2 e 3, intermediários; estrato 4, no qual todas as moradias eram aglomerados subnormais ou favelas. Foram calculados os coeficientes de mortalidade infantil, neonatal e pós-neonatal, a proporção entre óbitos neonatais e pós-neonatais, o risco atribuível populacional e mortalidade proporcional por causas, para os anos de 1995 a 1998, segundo os quatro estratos de condições de vida estabelecidos. RESULTADOS: O estrato 4 apresentou maiores coeficientes de mortalidade infantil e risco atribuível populacional em relação aos estratos intermediários, em todos os anos do estudo. Esse estrato apresentou, também, as menores proporções entre mortalidade neonatal e pós-neonatal. O risco atribuível populacional no estrato 4 foi maior que os demais estratos para as afecções perinatais (159,4), doenças respiratórias (271,4) e doenças infecciosas (415,6). Identificaram-se dados demográficos semelhantes em áreas próximas aos limites geograficamente constituídos pelo estudo e heterogeneidade de eventos num mesmo território. CONCLUSÕES: Identificou-se uma relação entre desigualdades sociais e mortalidade infantil, segundo os critérios de condições de vida estabelecidos para este estudo, entretanto, não houve distribuição homogênea nos quatro estratos populacionais, revelando dificuldades em utilizá-los como parâmetros para desigualdades sociais em grandes centros urbanos.

Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974–2007

Objective To assess trends in the prevalence and social distribution of child stunting in Brazil to evaluate the effect of income and basic service redistribution policies implemented in that country in the recent past. Methods The prevalence of stunting (height-for-age z score below \22122 using the Child Growth Standards of the World Health Organization) among children aged less than 5 years was estimated from data collected during national household surveys carried out in Brazil in 1974\201375 (n = 34 409), 1989 (n = 7374), 1996 (n = 4149) and 2006\201307 (n = 4414). Absolute and relative socioeconomic inequality in stunting was measured by means of the slope index and the concentration index of inequality, respectively. Findings Over a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1 per cent to 7.1 per cent. Prevalence dropped from 59.0 per cent to 11.2 per cent in the poorest quintile and from 12.1 per cent to 3.3 per cent among the wealthiest quintile. The decline was particularly steep in the last 10 years of the period (1996 to 2007), when the gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sanitation services; and reproductive health indicators.Conclusion In Brazil, socioeconomic development coupled with equity-oriented public policies have been accompanied by marked improvements in living conditions and a substantial decline in child undernutrition, as well as a reduction of the gap in nutritional status between children in the highest and lowest socioeconomic quintiles. Future studies will show whether these gains will be maintained under the current global economic crisis

Gênero, saúde materna e o paradoxo perinatal

Nos últimos 20 anos, houve uma melhoria de praticamente todos os indicadores da saúde materna no Brasil, assim como grande ampliação do acesso aos serviços de saúde. Paradoxalmente, não há qualquer evidência de melhoria na mortalidade materna. Este texto tem como objetivo trazer elementos para a compreensão deste paradoxo, através do exame dos modelos típicos de assistência ao parto, no SUS e no setor privado. Analisaremos as propostas de mudança para uma assistência mais baseada em evidências sobre a segurança destes modelos, sua relação com os direitos das mulheres, e com os conflitos de interesse e resistências à mudança dos modelos. Examinamos os pressupostos de gênero que modulam a assistência e os vieses de gênero na pesquisa neste campo, expressos na superestimação dos benefícios da tecnologia, e na subestimação ou na negação dos desconfortos e efeitos adversos das intervenções. Crenças da cultura sexual não raro são tidas como explicações 'científicas' sobre o corpo, a parturição e a sexualidade, e se refletem na imposição de sofrimentos e riscos desnecessários, nas intervenções danosas à integridade genital, e na negação do direito a acompanhantes. Esta 'pessimização do parto' é instrumental para favorecer, por comparação, o modelo da cesárea de rotina. Por fim, discutimos como o uso da categoria gênero pode contribuir para promover direitos e mudanças institucionais, como no caso dos acompanhantes no parto

Prevalence of Adverse Life Events, Depression and Suicidal Thoughts and Behaviour among a Community Sample of Young People aged 15-24 Years

Objective: To provide prevalence data on several key mental health indicators for young people aged 15 to 24 years. Methods: A cross-sectional household survey, using telephone recruitment followed by a postal pencil-and-paper questionnaire. The overall response rate was 67.3%. Results: Difficulties with interpersonal relationships are common causes of distress for young people, in particular problems with parents, problems with friends and relationship break-ups. Depressive symptomatology is common among young people with approximately one in eight males and one in four females reporting current depressive symptomatology. One in three young people reported that they had had suicidal thoughts at some time in the past, 1.2% of young people reported that they had made a plan on how to kill themselves in the four-week period prior to completing the survey and 6.9% of young people reported that they had tried to kill themselves at some time during their life time (4.2% of males and 9.0% of females). Conclusions and implications: The prevalence figures for the various mental health indicators presented in this paper represent good baseline information upon which to examine the progress over time of interventions designed to improve the mental health of young people.