International journal of environmental research and public health
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Int J Environ Res Public Health · Sep 2019
ReviewDoes Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review.
Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive increase in opioid consumption once the block wears off. We reviewed published literature describing pathophysiology and occurrence of rebound pain after peripheral nerve blocks in patients undergoing orthopedic procedures. ⋯ Multimodal strategies including preemptive analgesia before the block wears off, intra-articular or intravenous anti-inflammatory medications, and use of adjuvants in nerve block solutions may reduce the burden of rebound pain. Additionally, patient education regarding the possibility of rebound pain is paramount to ensure appropriate use of prescribed pre-emptive analgesics and establish appropriate expectations of minimized opioid requirements. Understanding the impact of rebound pain and strategies to prevent it is integral to effective utilization of regional anesthesia to reduce negative consequences associated with long-term opioid consumption.
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Int J Environ Res Public Health · Jul 2019
Meta AnalysisDose-Response Relationship of Outdoor Exposure and Myopia Indicators: A Systematic Review and Meta-Analysis of Various Research Methods.
Myopia in children has dramatically increased worldwide. A systematic review and meta-analysis were conducted to evaluate the effects of outdoor light exposure on myopia. According to research data from 13 studies of 15,081 children aged 4-14 at baseline, outdoor light exposure significantly reduced myopia incidence/prevalence (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.80-0.91, p < 0.00001; I2 = 90%), spherical equivalent refractive error (SER) by 0.15 D/year (0.09-0.27, p < 0.0001), and axial elongation by 0.08 mm/year (-0.14 to -0.02, p = 0.02). ⋯ Daily outdoor light exposure of more than 120 min was the most effective intervention, and weekly intervention time exhibited a dose-response relationship with all three indicators. Subgroup comparisons revealed that interventional studies report greater benefits from outdoor light exposure compared with cohort and cross-sectional studies, and individuals with myopia in intervention studies experienced slightly greater benefits than individuals without, in terms of SER and axial elongation. Therefore, this study suggests 120 min/day of outdoor light exposure at school.
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Int J Environ Res Public Health · Jul 2019
Review Historical ArticleRace and 1918 Influenza Pandemic in the United States: A Review of the Literature.
During epidemics, the poorest part of the population usually suffers the most. Alfred Crosby noted that the norm changed during the 1918 influenza pandemic in the US: The black population (which were expected to have higher influenza morbidity and mortality) had lower morbidity and mortality than the white population during the autumn of 1918. Crosby's explanation for this was that black people were more exposed to a mild spring/summer wave of influenza earlier that same year. ⋯ The results also show that the black population had lower influenza morbidity prior to 1918. The reasons for lower morbidity among the black population both at baseline and during the herald and later waves in 1918 remain unclear. Results may imply that black people had a lower risk of developing the disease given exposure, but when they did get sick, they had a higher risk of dying.
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Int J Environ Res Public Health · Jun 2019
ReviewRisk Riding Behaviors of Urban E-Bikes: A Literature Review.
In order to clearly understand the risky riding behaviors of electric bicycles (e-bikes) and analyze the riding characteristics, we review the research results of the e-bike risky riding behavior from three aspects: the characteristics and causes of e-bike accidents, the characteristics of users' traffic behavior, and the prevention and intervention of traffic accidents. The analysis results show that the existing research methods on risky riding behavior of e-bikes mainly involve questionnaire survey methods, structural equation models, and binary probability models. The illegal occupation of motor vehicle lanes, over-speed cycling, red-light running, and illegal manned and reverse cycling are the main risky riding behaviors seen with e-bikes. ⋯ The strong association rules between risky riding behavior and traffic accidents should be explored using big data analysis. The relationships between risk awareness, risky cycling, and traffic accidents should be studied using the scales of risk perception, risk attitude, and risk tolerance. In a variety of complex mixed scenes, the risk degree, coupling characteristics, interventions, and the coupling effects of various combination intervention measures of e-bike riding behaviors should be researched using coupling theory in the future.
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Int J Environ Res Public Health · Jun 2019
Systematic Literature Review of Health Impact Assessments in Low and Middle-Income Countries.
Health Impact Assessments (HIAs) motivate effective measures for safeguarding public health. There is consensus that HIAs in low and middle-income countries (LMICs) are lacking, but no study systematically focuses on those that have been successfully conducted across all regions of the world, nor do they highlight factors that may enable or hinder their implementation. Our objectives are to (1) systematically review, geographically map, and characterize HIA activity in LMICs; and (2) apply a process evaluation method to identify factors which are important to improve HIA implementation in LMICs. ⋯ Only 12% of HIAs were based on participatory approaches; 92% of HIAs considered multiple outcomes; and 61% of HIAs provided recommendations and fostered cross-national collaboration. The limited transparency in process, weak participation, and inconsistent delivery of recommendations were potential limitations to HIA implementation in low and middle-income countries. Scaling and improving HIA implementation in low and middle-income countries in the upcoming years will depend on expanding geographically by increasing HIA governance, adapting models and tools in quantitative methods, and adopting better reporting practices.