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Biomedical subjects

M Hodgson

Publications and source records attributed to M Hodgson.

At least 19 recordsLinked to original sources
PubMed2005

Mainstreaming prevention: prescribing fruit and vegetables as a brief intervention in primary care.

This paper examines a brief preventive intervention as a model for embedding public health action in primary care. BACKGROUND: Low fruit and vegetable intake is a major risk factor for cancer, coronary heart disease and stroke. The recommended intake of five portions per day would reduce death rates from these causes by 20%. However, average daily consumption in the UK is under three portions, and it is significantly lower in men, young people and lower socio-economic groups. In order to tackle risk factors such as poor diet, the white paper Choosing Health promises action and funding to mainstream prevention and transform the NHS from a sickness service to a genuine health service. THE INTERVENTION: To promote increased fruit and vegetable consumption, primary care professionals working in a deprived area issue prescriptions which offer the patient discounts on fruit and vegetable purchases. Hand over of each prescription to the patient is linked explicitly to key five a day messages. This brief intervention takes 1-2 min to deploy. IMMEDIATE OUTCOMES: Evaluation is ongoing. However, early feedback suggests that the intervention of prescription plus key messages has a significant impact on patients in highlighting the connection between food and health. Clinicians express satisfaction at having a preventive intervention that can be deployed with confidence and consistency in routine primary care consultations. DISCUSSION: This brief intervention is presented as a potential model for embedding prevention in the day-to-day work of health professionals. Primary care is a natural setting for the promotion of health, but despite success in implementing some public health programmes, it has a patchy record in primary prevention. The reasons for this are examined, the impact of new contractual and commissioning levers is explored, and a general framework for mainstreaming public health action in primary care is proposed.

Cardiovascular Diseases↗
PubMed2003

Simultaneous real-time measurements of mastication, swallowing, nasal airflow, and aroma release.

Mastication, swallowing, breath flow, and aroma release were measured simultaneously in vivo using electromyography, electroglottography, a turbine air flow meter, and the MS-Nose, respectively. Signals were synchronized either electronically or by aligning the nasal airflow data with the breath by breath release of acetone. Chewing affected nasal airflow, with the flow fluctuations following the mastication pattern. Data analysis suggested that air was pumped out of the mouth into the throat with each chew, and the mean volume was 26 mL. Aroma release was associated with the pulses of air pumped from the mouth with each chew. During swallowing, there was no nasal airflow, but after swallowing, aroma release was evident. The volume of the retronasal route was estimated at 48 mL when swallowing and 72 mL when samples were chewed. The combination of techniques shows the effects of physiological processes on aroma release.

Deglutition↗
PubMed2001

Low relative humidity and aircraft cabin air quality.

Mucosal irritation remains a common complaint among travelers and flight attendants in aircraft cabins. Despite the fact that very low humidity is routinely encountered, few studies of its effects have been conducted in the cabin environment. The authors reviewed chamber and field studies in the experimental literature to explore whether there is an association and, if so, at what level it was likely to be present. Subjects who participated in prior research were not always able to perceive low humidity or changes in the humidity level and, at times, this inability has been confused in the literature with the lack of a humidity effect. The studies with more powerful experimental designs have demonstrated the effects of low humidity, such as drying of the skin and mucus membranes, and that a modest increase in relative humidity seems to alleviate a great number of symptoms. The exposure duration below during which the effects of low humidity are not noticeable is in the order of 3 to 4 h. It is conceivable that some symptoms experienced by flight attendants and passengers, especially on flights lasting 3 h or longer, may stem from low humidity.

Adult↗
PubMed2001

Reinforcement of occupational history taking: a success story.

BACKGROUND: This article describes the results of a retrospective study of 3 classes of medical students who participated in a targeted occupational and environmental health curriculum at the University of Connecticut School of Medicine. PURPOSE: We wanted to determine if targeted focused curricular interventions which integrated occupational and environmental health principles into routine history taking would result in increased scores on the number of questions posed during the Clinical Skills Assessment Program in the 4th year. METHODS: We analyzed Clinical Skills Assessment Program questions for 3 graduating medical school classes from 1997 to 1999. RESULTS: It appears that intense, focused training may increase the occupational and environmental questions which students ask. By revisiting the components of the history during the 3rd year, the final assessment of 4th-year students substantially and significantly increased. CONCLUSIONS: Those who wish to stem the decline in history-taking skills as students enter their clinical years should consider reinforcing these skills using structured programs and practice in areas of the history that are traditionally neglected but recognized as essential in gathering comprehensive data on patients.

Analysis of Variance↗
PubMed2000

Mood and behavioral symptoms in individuals with chronic solvent exposure.

Psychiatric symptoms have been reported for individuals who experience chronic exposure to low levels of organic solvents. However, it is not known what proportion of such individuals experience psychiatric disorder; which specific disorders may be characteristic of this population; or whether bioaccumulation of lead contributes to the relationship between solvent exposure and psychiatric symptoms. Twenty-nine male journeymen painters and 32 male non-painter control subjects were administered semi-structured diagnostic interviews for DSM-III-R Axis I and Axis II disorders. Career solvent exposure and blood lead levels were also measured. Painters and control subjects did not differ significantly with respect to age, intelligence, or demographic characteristics. Results showed that the probability of being diagnosed with a mood disorder differed significantly in painters (41%) and control subjects (16%). Painters (66%) and control subjects (50%) did not differ for substance use diagnoses. Groups also did not differ for personality disorders involving an onset before 25 years of age. In contrast, painters exhibited a sub-clinical pattern of personality dysfunction involving symptomatology that was measured allowing for late onset (after age 25). Finally, a significant dose-response relationship was observed between career solvent exposure, blood lead level, and personality symptoms. In summary, these data showed an increased rate of psychological disturbance in a significant and substantial number of painters. However, not all painters were so characterized. This overall pattern raises a question regarding a potential role for differential vulnerability, which requires empirical validation.

Adult↗
PubMed2000

Needs and opportunities for improving the health, safety, and productivity of medical research facilities.

Medical research facilities, indeed all the nation's constructed facilities, must be designed, operated, and maintained in a manner that supports the health, safety, and productivity of the occupants. The National Construction Goals, established by the National Science and Technology Council, envision substantial improvements in occupant health and worker productivity. The existing research and best practices case studies support this conclusion, but too frequently building industry professionals lack the knowledge to design, construct, operate, and maintain facilities at these optimum levels. There is a need for more research and more collaborative efforts between medical and facilities engineering researchers and practitioners in order to attain the National Construction Goals. Such collaborative efforts will simultaneously support attainment of the National Health Goals. This article is the summary report of the Healthy Buildings Committee for the Leadership Conference: Biomedical Facilities and the Environment sponsored by the National Institutes of Health, the National Association of Physicians for the Environment, and the Association of Higher Education Facilities Officers on 1--2 November 1999 in Bethesda, Maryland, USA.

Air Pollution, Indoor↗
PubMed1999

Occupational tuberculosis among deputy sheriffs in Connecticut: a risk model of transmission.

OBJECTIVES: The purpose of this study was to identify risk factors for tuberculin skin test conversions among non-infected deputy sheriffs in Connecticut and during an out-break in an urban lock-up. METHODS: 377 tuberculin skin-test negative sheriffs statewide in 1994-1995 and 37 sheriffs in the lock-up in 1995 were screened and questionnaires administered. Cellblock volumetric air flow was measured. The Wells-Riley model of airborne transmission [C = S(1-e-Iqpt/Q)] was applied to the epidemiologic and ventilation data. RESULTS: Statewide, of 377 sheriffs screened, 22 (5.8%) had positive skin tests. Risk factors included older age (p < .0075) and longer tenure (p < .036). In the lock-up, of 37 sheriffs screened, 4 (10.8%) had positive skin tests. Measured mean outside air flow per occupant (8.0 cfm; S.D. = 2.2) was below design (15 cfm) and recommended (20 cfm) standards. Mathematical modeling estimated that TB transmission would be reduced by 62.5 percent with ventilation at design specifications. CONCLUSIONS: Inadequate ventilation may increase the risk for occupational transmission of tuberculosis. Since lock-ups do not have the time to conduct inmate TB screenings, supplemental engineering controls may be required.

Adult↗
PubMed1999

Industrial hygiene recommendations as interventions: a collaborative model within occupational medicine.

The authors conducted a cross-sectional telephone survey of patients and employers to evaluate the effectiveness of conducting industrial hygiene work site visits as part of the medical management of clinic patients with suspected occupational disease. Industrial hygiene interventions were intended to keep the index patient from ongoing exposure while simultaneously protecting co-workers from future disease. The demographics of the 76 work sites and patients are summarized. According to the employers, 78 percent had implemented at least one recommended intervention, and 52 percent of the employers had implemented the priority intervention. The factors associated with the employers' implementation of the recommended industrial hygiene controls are presented. Employers were 3.7 times more likely to implement the priority intervention (p = .04) if they believed a worker's illness was work-related. Employers with joint labor-management health and safety committees were 3.8 times as likely to implement the priority intervention (p = 0.04). The factors associated with changes in the patients' self-reported disease status are explored and the social and economic implications of this model, are discussed. Patients who reported an improvement in disease status were 5.5 times more likely to have maintained or increased their salary (p = 0.03). Patients were 10.4 times more likely to be working if the employer had implemented any intervention (p = 0.02) and 13.3 times more likely if the priority intervention (p = 0.01) had been adopted. Those patients who left their original employer suffered a median decrease in salary of 35 percent if they found work with a different employer and a 90 percent decrease when they failed to find a new job.

Connecticut↗
PubMed1998

Hypersensitivity pneumonitis: a sentinel event investigation in a wet building.

Hypersensitivity pneumonitis (HP) as a sentinel event implies a remediable exposure and an exposed cohort that require evaluation. A patient with HP convincingly related to her building led to a questionnaire survey in follow-up. Building coworkers demonstrated substantially higher symptom rates than did controls in five other buildings, although no further cases of disease were identified. It is likely that moisture sources in the building included an oversized cooling system and below-grade moisture, but the building met all applicable regulations and standards. Screening investigations for disease are not mandated by law and are often not conducted, in part because cost coverage is unclear. The absence of regulatory or professional standards that adequately address moisture in the built environment forces occupational health professionals to rely on disease documentation strategies to justify intervention.

Alveolitis, Extrinsic Allergic↗
PubMed1997

Neuropsychological performance of journeymen painters under acute solvent exposure and exposure-free conditions.

Journeymen painters were evaluated with a comprehensive battery of neuropsychological tests and compared to demographically similar nonexposed controls. For painters, a cumulative exposure to solvents was estimated from a structured interview that derived an index based on lifetime exposure and exposure in the past year. Painters were tested either shortly after having painted or after an exposure-free interval. Significant between-group differences were found on a cluster of tests measuring learning and memory. Within the painter group, scores on the learning and memory tests were significantly related to the interaction of condition and exposure. That is, those painters who were tested soon after painting and who also had a higher overall lifetime exposure, performed worst on tests of learning and memory. These results are consistent with the view that neuropsychological function--particularly learning and memory--may be compromised in active workers with a history of chronic solvent exposure. Furthermore, both the chronicity of solvent exposure, as well as the acuteness of the exposure, are significant factors in cognitive performance.

Adult↗
PubMed1996

Effects of unreasonable pay discrepancies for under- and overpayment on double demotivation.

The "double demotivation" hypothesis that pay discrepancies decrease work motivation among both lower and higher paid groups was tested in two experiments. In experiment 1, 70 Australian undergraduates received either $1 or $2 to work on an intrinsically rewarding puzzle, with or without knowledge of what amount other participants were receiving. A comparison of participants with a no-payment control showed that participants exhibited significantly reduced intrinsic motivation (seconds spent interacting with the puzzle during a free-choice period) when they knew that they were being under- or overpaid. In experiment 2, 126 occupationally matched Australian workers receiving wages equal to, lower than, or higher than those of counterparts reported their level of job satisfaction and whether they would stay on the job, change jobs, or retire, if given the financial opportunity. Compared with equitably paid workers, employees who felt they were being under- or overpaid reported lower job satisfaction and greater readiness to change jobs. The results provide experimental support for double demotivation, which is relevant not only to international development cooperation but also to Western enterprise bargaining, merit pay, and minority groups in the multicultural workplace.

Analysis of Variance↗
PubMed1994

Occupational impairment and disability among applicants for Social Security disability benefits in Pennsylvania.

OBJECTIVE: The study goal was to assess the extent of workplace-related disease and injury among Social Security Disability Insurance applicants. METHODS: A convenience sample of 240 consecutive applicants to the Pennsylvania Bureau of Disability Determination was studied to assess the prevalence of work-related disorders. An applicant had a work-related condition if there was a clear statement of a workplace illness or injury associated with the impairment, or if the applicant had worked at an occupation with a high likelihood of exposures known or suspected to contribute to the condition of interest. RESULTS: Of the 240 applicants, 166 (69%) were awarded disability insurance benefits; a total of 27 (11%) had work-related conditions, including 14 of the 166 (8%) who were found to be disabled. Forty percent of the 27 had a disorder that was musculoskeletal in origin. Of 59 applicants with cancer, 10.2% had some work-related etiological component. Of an estimated 71,680 adult disability insurance applicants in Pennsylvania in 1990, 5134 new insurance beneficiaries had a projected occupationally related disability. CONCLUSIONS: A substantial number of applicants for disability insurance benefits suffer from an impairment caused or exacerbated by prior workplace exposures. These individuals may serve as sentinel events for initiating follow-up surveillance and prevention activities.

Accidents, Occupational↗
PubMed1994

Epidemiology of the sick building syndrome.

The sick building syndrome (SBS) has been the subject of serious scientific inquiry only in the past 10 years. It is commonly accepted to represent eye, nose, and throat irritation; headaches, lethargy, difficulty concentrating, and sometimes dizziness; nausea, chest tightness; and other symptoms. Evidence suggests that what is called the SBS is at least three separate entities, each of which has at least one cause. This review will summarize the epidemiologic investigations of the SBS and present an overview of etiologic hypotheses.

Air Pollution, Indoor↗
PubMed1994

Volatile organic compounds and indoor air.

Volatile organic compounds represent one of the two major pollutant categories implicated in the sick-building syndrome. This article reviews measurement and analytic methods, presents a summary of the etiologic considerations, and presents newer, nonregulatory intervention strategies that can be used to prevent complaints resulting from this pollutant category.

Aerosols↗
PubMed1994

Patients and the sick building syndrome.

Physicians encounter patients who have complaints related to indoor environments with increasing frequency. Physicians must distinguish between approaches to identify disease in individual patients, characterization of group effects, and analysis of environmental exposure characteristics. Simultaneously they must consider the influence of illness behavior, work stress, and organization function on the presentation of complaints. They must distinguish discomfort and irritation from disabling disease and communicate the implications of pathophysiology and the limits of knowledge to patients. Joint teams with engineers and industrial hygienists, and, at times, organizational analysis is an approach to problem solving for indoor environmental problems.

Air Pollution, Indoor↗
PubMed1993

N-of-one clinical trials. The practice of environmental and occupational medicine.

The randomized clinical trial is the paradigm of causal documentation in clinical medicine. It spawned an extension, the "N-of-one clinical trial," used as diagnostic instrument in the clinical practice of internal medicine to demonstrate the presence or absence of truly beneficial treatment. The author presents an extension of the method to environmental and occupational medicine, provides an example, and discusses the limitations of the approach. A guideline and justification for the provision of such services is suggested.

Causality↗