Prevalence of Farmer's Lung in Scotland: A Pilot Survey

In a survey of the farming population of Orkney, Ayrshire, and East Lothian the prevalence of farmer''s lung was estimated at 86 per 1,000 in both Orkney and Ayrshire and 23 per 1,000 in East Lothian. If cases with a negative farmer''s lung hay (F.L.H.) precipitin test are excluded these figures are reduced to 43, 36, and nil respectively, but those for Orkney and Ayrshire are still about 20 times higher than any figure previously reported for the prevalence of farmer''s lung in Britain.Regional variations in prevalence are probably related both to climatic conditions and to differences in agricultural methods, the latter often being dictated by economic circumstances. Nevertheless the prevalence of farmer''s lung could be reduced considerably by the energetic application of preventive measures, backed by financial incentives. The most important of these are efficient drying of hay and cereals before storage, more extensive use of silage, better ventilation of farm buildings, and the introduction of mechanical feeding systems. Individual farmworkers could be taught how to recognize the early symptoms of the disease and encouraged to wear respirators when handling mouldy fodder.     

Hyaluronate and type III procollagen peptide concentrations in bronchoalveolar lavage fluid as markers of disease activity in farmer's lung.

Ten patients were studied during an acute episode of farmer''s lung. Prominent findings were an impaired diffusion capacity (on average only 51% of predicted) and substantially increased amounts of hyaluronate and type III procollagen peptide recovered during bronchoalveolar lavage; mean concentrations of these constituents in lavage fluid were 547 (range 137-1125) and 9.7 (2.8-19.4) micrograms/l, respectively. In bronchoalveolar lavage fluid from healthy controls (n = 21) hyaluronate concentrations were less than 15 micrograms/l and procollagen peptide concentrations less than 0.2 micrograms/l. Lavage fluid concentrations of these potential markers of fibroblast activation declined during the recovery phase of farmer''s lung; four to 10 weeks after admission (n = 7) mean concentrations of hyaluronate and procollagen peptide were 154 (range 38-650) and 4.4 (0.6-15.8) micrograms/l, respectively. At clinical remission six to 14 months after admission concentrations of these markers had returned almost to normal, though slightly increased concentrations were still evident in about half the patients (n = 7). At that time lung volumes were normal but diffusion capacity remained slightly subnormal. It was concluded that in farmer''s lung release of hyaluronate and type III procollagen peptide reflects activity of the disease. Increased synthesis of these connective tissue components continuing in a patient avoiding mouldy plant material may signal an increased risk of developing fibrotic lung disease. The abnormal accumulation of hyaluronate in the smaller airways in acute farmer''s lung may be expected to immobilize water and thereby provide a possible mechanism of the interstitial inflammatory lung oedema with associated impaired gas diffusion. This hypothesis is supported by the relation found between hyaluronate in lavage fluid and reduced diffusion capacity.     

Lung disease in farmers.

Lung diseases in farmers attributable to their occupation include (a) farmer''s lung, caused by exposure to mouldy hay, (b) the asthma caused by exposure to grain dust and (c) silo-filler''s disease. Their prevalence in Canada is unknown. Farmer''s lung results from inhalation of mould spores in hay; the mechanism is immunologic. The exact cause and mechanism of grain dust asthma are unknown but may be immunologic. Silo-filler''s disease is caused by the toxic effects of inhaled nitrogen dioxide.     

Coeliac disease with farmers' lung.

Two patients with allergic alveolitis due to mouldy hay antigens (farmer''s lung) were shown to have malabsorption due to coeliac disease. As similar associations have been found with other alveolar diseases, this association is probably not fortuitous and further population screening should be done.     

Respiratory disorders in Manitoba cattle farmers.

A group of 76 cattle farmers from southern Manitoba answered the National Heart, Lung, and Blood Institute questionnaire on respiratory symptoms and supplementary questions on farming and farming-related syndromes. Lung function was tested, serum was examined for precipitating antibodies, and skin testing with common allergens was performed. Analysis of the men''s answers revealed a high prevalence of chronic respiratory symptoms among the farmers in all categories of smoking history, and the presence of these symptoms was significantly associated with a history of symptoms related to handling mouldy hay or grain; 51% of the men had chronic symptoms and 55% had symptoms related to crop handling. In seven farmers (9%) the symptoms related to crop handling suggested an attack of farmer''s lung. One other farmer, with a history of illness after handling mouldy hay, had a reduced total lung capacity, and in 18 the ratio of the forced expiratory volume in the first second to the forced vital capacity was lower than predicted. Precipitating antibodies against Thermoactinomyces were absent in all farmers, but two farmers had antibodies against Aspergillus ruber. Immediate hypersensitivity was found in 16 (21%) of the farmers; sensitivity to Dermatophagoides farinae was commonest.     

生计方式对农户生活能源消费模式的影响——以甘南高原为例

生计方式变迁对农户的生活能源消费模式产生深远影响,从而给农村能源与环境问题带来新的挑战。以地处青藏高原东缘的甘南高原为研究区,基于农户调查资料,采用STIRPAT模型与二元logistic模型分析了生计方式对农户的生活能源消费量及生活能源消费模式选择的影响。结果发现:(1)随着非农化水平的提高,甘南高原农户的生活能源消费量显著下降,但它引起的生活能源消费量下降速度低于其自身的变化速度;此外,家庭规模扩大、收入提高将使农户的生活能源消费量增加;(2)生计方式对农户能源消费模式选择的影响远高于其他因素,随着非农化水平的提高,农户选择以商品性能源为主消费模式的概率将增大,收入增加、受教育程度提高及商品性能源的可得性改善亦会如此,但生物质能源的可得性增强会降低农户选择以商品性能源为主消费模式的概率。最后,提出了优化农户生活能源消费模式的建议。     

Colonic Crohn's disease and use of oral contraception.

The prevalence of use of oral contraception before the onset of disease was established in 100 consecutive women attending follow up clinics for inflammatory bowel disease. A significant excess of women with Crohn''s disease confined to the colon had taken oral contraceptives in the year before developing symptoms (10/16 (63%] compared with women with small-intestinal Crohn''s disease (12/49 (24%); p less than 0.02) and women with ulcerative colitis (3/35 (9%); p less than 0.0005). When the patient groups were matched for age and year of onset of disease usage of oral contraception before the onset of disease was still more common among women with isolated colonic Crohn''s disease (9/12, 75%) than among those with ulcerative colitis (2/12 (17%); p less than 0.02) and was also more common than would be expected from reported figures for oral contraception in England and Wales (31.4% of women aged under 41; p less than 0.005). A survey of current patient records showed that isolated colonic disease was at least twice as common among women with Crohn''s disease (63/218, 29%) compared with men (25/181, 14%; p less than 0.001). These data support the suggestion made previously that oral contraceptives may predispose to a colitis that resembles colonic Crohn''s disease.     

我国农户生计转型的生态效应研究综述

生计作为人类最主要的行为方式,对人地系统的演化起着主导驱动作用,探讨人类生计与生态环境的相互关系成为当前人地系统科学的研究热点,农户作为广大农村最主要的经济活动主体与最基本的决策单位,其所采取的生计策略对生态环境产生着深远影响。在阐释农户生计转型及其驱动因素的基础上,建立了农户生计转型的生态效应分析框架,梳理了近年来国内农户生计转型的生态效应研究主要进展,指出未来研究中需关注农户的生计演变规律及其调控机制、农户生计策略对生态环境的作用机制、农户生计转型的生态效应评估与监测、农户的可持续生计方式塑建等关键问题。     

Is there a familial link between Down's syndrome and neural tube defects? Population and familial survey

Objective To verify whether Down''s syndrome and neural tube defects arise more often in the same family than expected by chance.Design Population and familial survey.Setting Network of maternity hospitals in the Latin American collaborative study of congenital malformations (ECLAMC) in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela between 1982 and 2000.Probands 2421 cases of neural tube defects, 952 of hydrocephalus, and 3095 of Down''s syndrome registered from a total of 1 583 838 live births and stillbirths.Main outcome measures Observed number of cases of Down''s syndrome among siblings of probands with a neural tube defect or hydrocephalus and number expected on the basis of maternal age; observed number of cases of neural tube defects or hydrocephalus among siblings of probands with Down''s syndrome and number expected according to the prevalence in the same population.Results Five cases of Down''s syndrome occurred among 5404 pregnancies previous to a case of neural tube defect or hydrocephalus, compared with 5.13 expected after adjustment by maternal age. Twelve cases of neural tube defect or hydrocephalus occurred among 8066 pregnancies previous to a case of Down''s syndrome, compared with 17.18 expected on the basis of the birth prevalence for neural tube defects plus hydrocephalus in the same population.Conclusion No association occurred between families at risk of neural tube defects and those at risk of Down''s syndrome.     

Prevalence of Chronic Conditions in Australia

Objectives

To estimate prevalence of chronic conditions among patients seeing a general practitioner (GP), patients attending general practice at least once in a year, and the Australian population.

Design, setting and participants

A sub-study of the BEACH (Bettering the Evaluation and Care of Health) program, a continuous national study of general practice activity conducted between July 2008 and May 2009. Each of 290 GPs provided data for about 30 consecutive patients (total 8,707) indicating diagnosed chronic conditions, using their knowledge of the patient, patient self-report, and patient''s health record.

Main outcome measures

Estimates of prevalence of chronic conditions among patients surveyed, adjusted prevalence in patients who attended general practice at least once that year, and national population prevalence.

Results

Two-thirds (66.3%) of patients surveyed had at least one chronic condition: most prevalent being hypertension (26.6%), hyperlipidaemia (18.5%), osteoarthritis (17.8%), depression (13.7%), gastro-oesophageal reflux disease (11.6%), asthma (9.5%) and Type 2 diabetes (8.3%). For patients who attended general practice at least once, we estimated 58.8% had at least one chronic condition. After further adjustment we estimated 50.8% of the Australian population had at least one chronic condition: hypertension (17.4%), hyperlipidaemia (12.7%), osteoarthritis (11.1%), depression (10.5%) and asthma (8.0%) being most prevalent.

Conclusions

This study used GPs to gather information from their knowledge, the patient, and health records, to provide prevalence estimates that overcome weaknesses of studies using patient self-report or health record audit alone. Our results facilitate examination of primary care resource use in management of chronic conditions and measurement of prevalence of multimorbidity in Australia.     

Immunofluorescence Identification of Thermopolyspora polyspora,the Causative Agent of Farmer's Lung

Farmer''s lung is a serious disabling pulmonary disease found in agricultural workers. The disease is believed to be a hypersensitivity to the thermophilic actinomycetes, principally Thermopolyspora polyspora. This organism is difficult to stain with the usual bacteriological stains and thus far has not been demonstrated in the lung tissue by microscopic methods. In this paper, it is demonstrated that the fluorescent-antibody technique is a simple method for the positive identification of T. polyspora. The technique can also be used as a rapid screening test for the detection of antibodies to T. polyspora in the patient''s serum. In addition, it opens up the possibility of the identification of T. polyspora in the lung tissue of patients with farmer''s lung and makes available a means for the study of the immunological reaction in the lung parenchyma. No false positive or cross-reactions with Thermoactinomyces vulgaris or Streptomyces griseus could be demonstrated.     

Point prevalence of mental disorder in unconvicted male prisoners in England and Wales.

OBJECTIVES: To determine prevalence of mental disorder among male unconvicted prisoners and to assess the treatment needs of this population. DESIGN: Semi-structured interview and case note review of randomly selected cross section of male remand population. Non-attenders were replaced by the next name on prison roll. SETTING: Three young offenders'' institutions and 13 adult men''s prisons. SUBJECTS: 750 prisoners, representing 9.4% cross sectional sample of male unconvicted population. MAIN OUTCOME MEASURES: Prevalence of ICD-10 diagnoses of mental disorder, and associated treatment needs. RESULTS: Psychiatric disorder was diagnosed in 469 (63%) inmates. The main diagnoses were: substance misuse, 285 (38%); neurotic illness, 192 (26%); personality disorder, 84 (11%); psychosis, 36 (5%); other and uncertain, 36 (0.5%). Subjects could have more than one diagnosis. The average refusal rate was 18%. In total 414 inmates (55%) were judged to have an immediate treatment need: transfer to an NHS bed, 64 (9%); treatment by prison health care services, 131 (17%); motivational interviewing for substance misuse, 115 (15%); and therapeutic community placement, 104 (14%). CONCLUSIONS: Mental disorder was common among male unconvicted prisoners. Psychosis was present at four or five times the level found in the general population. Extrapolation of our results suggests that remand population as a whole probably contains about 680 men who need transfer to hospital for psychiatric treatment, including about 380 prisoners with serious mental illness.     

Prevalence of gestational diabetes mellitus among James Bay Cree women in northern Quebec

BACKGROUND: The prevalence of gestational diabetes mellitus has been reported to vary widely in aboriginal populations. Most of the data have come from the United States. To help determine the extent of gestational diabetes in Canada''s aboriginal population, the authors assessed the prevalence in a population of Cree women in northern Quebec. METHODS: A cross-sectional study was conducted using the National Diabetes Data Group (NDDG) criteria. Information was obtained from patient charts on pregnancies between January 1995 and December 1996 among women residing in 9 Cree communities in the eastern James Bay region of northern Quebec. Women who were not Cree, had pre-existing diabetes, had spontaneous abortion or were receiving glucocorticoid treatment were excluded. RESULTS: Data on 654 pregnancies that met the inclusion criteria were available. Results of the screening oral glucose challenge test were available for 579 of the pregnancies; the remaining 75 were excluded. The mean gestational age at screening was 28.3 (standard deviation 2.6) weeks. The prevalence of gestational diabetes was 12.8% (74/579) (95% confidence interval [CI] 10.1%-15.5%). The prevalence in the inland communities was twice as high as that in the coastal communities (18.0% v. 9.3%, p = 0.002). Women with gestational diabetes or impaired glucose tolerance tended to be older, have had more pregnancies, weigh more before pregnancy and have heavier babies than those with a normal glycemic status. INTERPRETATION: The prevalence of gestational diabetes among James Bay Cree women in northern Quebec is twice as high as that among women in the general North American population and the second highest reported in an aboriginal group worldwide.     

Obesity and Smoking: Comparing Cessation Treatment Seekers With the General Smoking Population

Obesity and smoking represent the leading preventable causes of morbidity and mortality in the United States. This study compared the prevalence of obesity among smokers seeking cessation treatment (n = 1,428) vs. a general population (n = 4,081) of never smokers, former smoker, and current smokers. Data from treatment‐seeking smokers in the Wisconsin Smokers' Health Study (WSHS) and individuals who completed the National Health and Nutrition Examination Survey (NHANES) 2005–2006 were pooled and obesity rates and other health characteristics were compared. The prevalence of obesity was significantly higher among WSHS treatment‐seeking smokers (36.8%) vs. NHANES current smokers (29.6%), but the obesity rates of WSHS treatment‐seeking smokers did not differ from NHANES former smokers (36.5%) or never smokers (36.5%). Treatment‐seeking smokers were more likely to be female and to have higher educational attainment compared to NHANES participants. Analysis of health characteristics revealed that treatment‐seeking smokers had higher levels of dietary fiber and vitamin C and lower blood levels of total cholesterol, triglycerides, and fasting glucose compared to NHANES current smokers. Results suggest that treatment‐seeking smokers may have a different health profile than current smokers in the general population. Health care providers should be aware of underlying heath issues, particularly obesity, in patients seeking smoking cessation treatment.     

甘南高原不同生计方式农户的碳足迹分析

二氧化碳增加导致的全球气候变暖已成为当前人类社会面临的最严峻挑战,减少碳排放迫在眉睫。以地处青藏高原东缘的甘南高原为研究区,基于农户调查数据,采用生命周期评价法估算了甘南高原不同生计方式农户的生活直接能源消费碳足迹和间接能源消费碳足迹,并运用最小二乘法分析了影响农户碳足迹的关键因素。结果发现:(1)甘南高原农户年人均碳足迹达2.67 t CO2,其中,生活直接能源消费碳足迹比例达76.53%,间接能源消费碳足迹比例仅占23.47%;(2)随着非农化水平的提高,甘南高原农户的碳足迹依次下降,其中,纯农户人均碳足迹达4.32 t,兼业户与非农户分别为2.37 t和1.07 t;(3)随着农户家庭规模的增大、收入水平的提高、距县城距离的增加和消费水平的提高,农户碳足迹不断增加;随着劳动力受教育程度的提高、恩格尔系数的增加和非农化程度的提高,农户碳足迹不断减少。     

农户生活消费对环境影响的空间差异及其原因——基于张掖市2010年调查数据

农户是农村最主要的行为主体,其生活消费对环境有重要影响,然而农户的生活消费模式等因素的差异导致对环境的影响在空间上存在差异,为了缓解农户生活消费对环境的压力,需要研究其消费对环境影响的空间差异。基于张掖市2010年调查数据和统计资料研究了农户生活消费对环境影响空间差异,并分析了原因,研究结果显示:(1)张掖市2010年人均生态足迹为1.056hm2/人,人均生态承载力为1.705hm2/人,人均生态盈余0.649hm2/人;(2)从生态足迹的构成看,当地的生活消费主要是以生物资源和化石能源消耗为主,占总生态足迹的81%,而建筑用地和水域消耗最少,占总生态足迹的1.2%。;(3)张掖市五县(区)农户生活消费对环境的影响总体差异较小,Gini系数为0.309。但是区域间的差异远远大于区域内的差异,区域间的差异为0.442,占总差异的71.1%,区域内的差异为0.18,占总差异的28.9%。其中,甘州区农户生活消费对环境影响差异最大,Theil指数为0.078;(4)农户消费模式、家庭规模和人均年收入增多,将加剧农户对环境的压力,劳动力受教育程度、社会资本存量和非农化程度提高,将在一定程度上减缓农户对环境的影响。     

Patient-physician sexual involvement: a Canadian survey of obstetrician-gynecologists.

OBJECTIVE: To determine obstetrician-gynecologists'' (ob-gyns'') awareness of and experience with sexual abuse of patients and former patients and their opinions about appropriate consequences. DESIGN: Mailed survey. SETTING: Canada. PARTICIPANTS: All 792 members of the Society of Obstetricians and Gynaecologists of Canada (SOGC); 618 (78%) responded. Approximately half of all ob-gyns in Canada belong to the SOGC. MAIN OUTCOME MEASURES: Knowledge of sexual involvement by an ob-gyn colleague with a patient or former patient (as defined by the respondents and by the College of Physicians and Surgeons of Ontario [CPSO]), self-report of such involvement, attitudes toward physician sexual abuse, desirable length of time a physician should wait before seeing a former patient in a situation that could lead to a sexual encounter, suggested consequences of sexual abuse. RESULTS: Overall, 10% of the respondents indicated that they knew about another ob-gyn who at some time had been sexually involved with a patient. In all, 3% of the male respondents and 1% of the female respondents reported sexual involvement with a patient; the corresponding proportions of those who reported having been accused of sexual abuse by a patient were 4% and 2%. Significantly more of the female ob-gyns than of their male counterparts (37% v. 19%) reported awareness of a colleague''s sexual involvement with a patient that would meet the CPSO''s definition of sexual impropriety, transgression or violation. Most of the respondents felt that the consequence of proven sexual impropriety should be reprimand and fine (chosen by 33%) or rehabilitation without loss of licence (28%). Most of the physicians supported loss of licence for proven sexual transgression (57%) or proven sexual violation (74%), but fewer felt that loss of licence should be permanent for these types of abuse (4% and 24% respectively). The female ob-gyns supported stronger sanctions against sexual transgression and sexual violation than the male ob-gyns. A wide range of opinion was seen regarding the propriety of sexual relationships with former patients. CONCLUSIONS: Ob-gyns have varied opinions about how sexual abuse of patients should be defined and how it should be sanctioned. There is a discrepancy between proposed public policy and the beliefs of physicians to whom the policy is to be applied.     

Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study.

OBJECTIVE--To estimate the prevalence of dementia and its subtypes in the general population and examine the relation of the disease to education. DESIGN--Population based cross sectional study. SETTING--Ommoord, a suburb of Rotterdam. SUBJECTS--7528 participants of the Rotterdam study aged 55-106 years. RESULTS--474 cases of dementia were detected, giving an overall prevalence of 6.3%. Prevalence ranged from 0.4% (5/1181 subjects) at age 55-59 years to 43.2% (19/44) at 95 years and over. Alzheimer''s disease was the main subdiagnosis (339 cases; 72%); it was also the main cause of the pronounced increase in dementia with age. The relative proportion of vascular dementia (76 cases; 16%), Parkinson''s disease dementia (30; 6%), and other dementias (24; 5%) decreased with age. A substantially higher prevalence of dementia was found in subjects with a low level of education. The association with education was not due to confounding by cardiovascular disease. CONCLUSIONS--The prevalence of dementia increases exponentially with age. About one third of the population aged 85 and over has dementia. Three quarters of all dementia is due to Alzheimer''s disease. In this study an inverse dose-response relation was found between education and dementia--in particular, Alzheimer''s disease.     

Prenatal and postnatal prevalence of Turner's syndrome: a registry study.

OBJECTIVE--To study prevalence of Turner''s syndrome in Denmark and to assess validity of prenatal diagnosis. DESIGN--Study of data on prenatal and postnatal Turner''s syndrome in Danish Cytogenetic Central Register. SUBJECTS--All registered Turner''s syndrome karyotypes (100 prenatal cases and 215 postnatal cases) during 1970-93. MAIN OUTCOME MEASURES--Prevalence of Turner''s syndrome karyotypes among prenatally tested fetuses and Turner''s syndrome among liveborn infants. RESULTS--Among infant girls, prevalence of Turner''s syndrome was 32/100,000. Among female fetuses tested by amniocentesis, prevalence of Turner''s syndrome karyotypes was 176/100,000 (relative risk of syndrome, 6.74 compared with prevalence among untested pregnancies). Among female fetuses tested by chorion villus sampling, prevalence of syndrome karyotypes was 392/100,000 (relative risk, 16.8). We excluded prenatal tests referred because of results of ultrasound scanning: among fetuses tested by amniocentesis revised relative risk was 5.68, while revised relative risk among fetuses tested by chorion villus sampling was 13.3. For 29 fetuses with prenatal diagnosis of possible Turner''s syndrome, pregnancy was allowed to continue and 24 children were live born. Thirteen of these children were karyotyped postnatally, and diagnosis of Turner''s syndrome had to be revised for eight, seven being normal girls and one boy. This gives tentative predictive value of amniocentesis in diagnosing Turner''s syndrome of between 21% and 67%. There was no significant relation between mother''s age and risk of Turner''s syndrome. CONCLUSIONS--Discrepancy between prenatal and postnatal prevalence of Turner''s syndrome challenges specificity of prenatal examination in diagnosing Turner''s syndrome.     

Quantitative health impact of indoor radon in France

Radon is the second leading cause of lung cancer after smoking. Since the previous quantitative risk assessment of indoor radon conducted in France, input data have changed such as, estimates of indoor radon concentrations, lung cancer rates and the prevalence of tobacco consumption. The aim of this work was to update the risk assessment of lung cancer mortality attributable to indoor radon in France using recent risk models and data, improving the consideration of smoking, and providing results at a fine geographical scale. The data used were population data (2012), vital statistics on death from lung cancer (2008–2012), domestic radon exposure from a recent database that combines measurement results of indoor radon concentration and the geogenic radon potential map for France (2015), and smoking prevalence (2010). The risk model used was derived from a European epidemiological study, considering that lung cancer risk increased by 16% per 100 becquerels per cubic meter (Bq/m³) indoor radon concentration. The estimated number of lung cancer deaths attributable to indoor radon exposure is about 3000 (1000; 5000), which corresponds to about 10% of all lung cancer deaths each year in France. About 33% of lung cancer deaths attributable to radon are due to exposure levels above 100 Bq/m³. Considering the combined effect of tobacco and radon, the study shows that 75% of estimated radon-attributable lung cancer deaths occur among current smokers, 20% among ex-smokers and 5% among never-smokers. It is concluded that the results of this study, which are based on precise estimates of indoor radon concentrations at finest geographical scale, can serve as a basis for defining French policy against radon risk.