Background: Some above ground nuclear tests conducted from 1949 to 1962 at the Semipalatinsk Nuclear Test Site led to radiation exposure of the public. We conducted medical examinations for hypothyroidism, thyroid cancer, and thyroid nodules with the purpose of providing documentation that might be used in determining whether these exposures had an impact on public health.

Methods: A series of medical field studies were carried out from 1999 – 2009 among volunteers living either in settlements which were potentially affected or which were not affected by the nuclear testing. Risk ratios were estimated between exposed and unexposed individuals.

Results: 1,287 examinations were carried out among 1,067 study participants. 456 were believed to have been exposed and 577 were not. For 34 participants, the exposure situation could not be determined. Risks for hypothyroidism and for thyroid cancer were lower in the exposed compared to the unexposed, i.e., the risk ratios were 0.22 (95%CI, 0.11-0.47) and 0.75 (95%CI, 0.37-1.54), respectively. Looking at affected settlements only did not change the result. For thyroid nodules the risk ratio was 0.99 (95%CI, 0.73-1.35), in affected settlements it was 1.26 (95%CI, 0.81-1.95).

Conclusion: There was no indication for an elevated risk of hypothyroidism or thyroid cancer among those who were believed to have been exposed compared to those who were likely unexposed. However, an elevated risk for thyroid nodules could not be ruled out among those living in affected settlements. The strength of these f indings is limited by the absence of individual radiation dose estimates.

Introduction: Ambient Assisted Living (AAL) services are expected to foster economic, environmental, and social growth. Many different strategies are used today to create infrastructures that support effective implementation of e-services and facilitate the transition to an individual-centred system. However generic implementation of e-services that contribute to develop new alternatives to deliver social care and wellbeing services in AAL-environments has not yet taken place.

Aim: The purpose of this paper is to present an overview of the issues that influence the effectiveness of implementation of e-services in ambient assisted living contexts.

Method: The paper uses knowledge sampled in a report produced by one of the authors of this article for the Swedish Innovation Agency (VINNOVA) in Sweden, where issues related to implementation of IT-based applications and e-services were discusses as well as in data collected in two European projects connected to the Ambient Assisted Living (AAL) Programme in which strategies to implement e-services were studied and analyzed.

Results: The paper identifies ex-ante and ex-post enablers and concerns that are of importance at the moment to implement e-services in ambient assisted living contexts. The knowledge presented in this paper can be of importance for decision-makers, managers, and individuals who need to develop strategies that facilitate the implementation of e-services across a whole organization.

Background: Diarrhoeal disease is the second leading cause of death due to infectious diseases among children under the age of 5 years worldwide, with developing countries bearing the most of the burden. The study was aimed at determining the effect of Sociodemographic and feeding practices on prevalence of diarrhoeal disease in infants less than six months of age in Makurdi, Benue State.

Methods: Structured questionnaire was used to collect information from 300 mothers of infants attending selected Child Welfare Clinics in Makurdi, Nigeria. The chi-square test was used to determine the association between having diarhoea in the last two weeks and Sociodemographic and infant feeding practices.

Results: Women who reported their infants had diarhoea in the previous two weeks were 21 (7.0 %). Factors that were significantly associated with diarhoea in the previous two weeks were not attending antenatal care in last pregnancy, drinking from bottle with a teat giving water use of infant formula and non- exclusive breastfeeding. Age of the infant, mother’s age, education of the mother and number of previous deliveries were not significantly associated with diarhea disease in the two last two weeks.

Conclusion: The prevalence of diarhoea is relatively low among infants attending under five clinics in Makurdi. However feeding practices significantly affects prevalence of diarhoea disease. There is need to step up efforts in encouraging exclusive breastfeeding in the first six months through health education during antenatal care.

In Iran, discrimination based on gender in the enjoyment of right to health is prohibited. Health of Iranian women has improved considerably in recent years. Making health services physically and financially accessible to all the population and removing social and cultural barriers of women’s access to health services are main considerations of health laws and policies of Iran. But in practice, disparities in health indicators and access of women to health services can be seen. Some groups of women including unemployed women, women without an appropriate male guardian, widows, divorced women, women living with disabilities, migrant and indigenous women, women belonging to ethnic and religious minorities, elderly women, street women, rural women, and poor women do not have equal access to health services in Iran. To realise everyone’s right to health, this country should immediately remove the disparities.Empowerment of women and providing opportunities for them to work and participate in the society will help them to enjoy their rights too. Defining rights in the Constitution or legislation is not enough for the protection of rights, they must be translated into realities. Iran should use all the necessary means; legislative, administrative, budgetary, and judicial towards the full realisation of women’s right to health. National plans on women’s empowerment and support should be interpreted in provincial programs and action plans with detailed lists of related authorities and their responsibilities. Moreover, a monitoring system and defined benchmarks for assessment of women’s enjoyment of right to health should be established in the health system of Iran. Realising other economic, social and cultural rights including the rights to food, shelter, education, employment and a standard of life will improve the enjoyment of Iranian women’s of their right to health

Background: Culex quinquefasciatus is a vector of lymphatic filariasis and a biting nuisance in many developing countries with a warm and humid climate. In north eastern part of Tanzania, the burden of chronic lymphatic filariasis disease is still high. There is limited information on the factors that contribute to higher abundance of this mosquito species in rural areas. This study was therefore aimed at assessing the seasonal variation of Cx. quinquefasciatus abundance in pit latrines in rural areas in Muheza.

Methods: A cross-sectional study was conducted in rural settings of Muheza district for the duration of 11 months consecutively in 24 villages which were randomly selected. Collection of adult Culex mosquitoes emerged from wet pit latrines was done by using emergence traps. In each village three houses were selected basing on the presence of pit latrines.

Results: A total of 12,762 mosquitoes consisting of Culex quinquefasciatus (12%) and Culex cinereus (88%) species were collected from 24 villages. Majority of Cx. quinquefasciatus mosquitoes were collected during cool and dry season followed by long rains season with 48.52% (n=722) and 41.53% (n=618), respectively. Only one Cx. quinquefasciatus (0.07%) was collected during hot and dry season.

Conclusion: The present study has revealed the variation in the densities of Cx. quinquefasciatus emerged from pit latrines across the seasons. Wet pit latrines were found to be potential breeding sites for Cx. quinquefasciatus. The present study has provided important information on mosquito seasonality density in rural setting for employing alternative vector control such as larviciding in wet pit latrines.

Background: Non-response and attrition are serious problems in the field of longitudinal cohort studies. This paper examines the role of rapport between interviewers and respondents on attrition at a follow-up assessment.

Methods: Evaluation forms filled out by the respondents and the interviewers at the end of the baseline assessment were used to assess if good or bad rapport was built during the interview and whether this was associated with attrition at a self-administered follow-up assessment by mail. Respondents and interviewers judged the interview experience on pleasantness, tiresomeness and length of the interview.

Results: Our analyses first show significant associations between pleasantness, tiresomeness, experienced length of the interview and attrition. When respondents and interviewers judge the evaluation items more positive the chance of attrition at the subsequent assessment declined. Second, we compared the evaluation items of the interviewers and respondents to establish whether good or bad rapport was built and if this was associated with attrition. Results show that there is an association between good or bad rapport and attrition.

Conclusion: Rapport seems to play a role in attrition of respondents at follow-up assessments. This f inding can be used to diminish attrition in longitudinal studies by using this information for training and guiding interviewers on building good rapport. Information about the interview experience and the rapport that was built during an assessment can also be used to tailor the approach of respondents at follow up measurements and thereby diminishing attrition.

A preliminary study on the occurrence, fate, and environmental risk assessment of residual Poly-Diallyl Dimethyl Ammonium Chloride (Poly-DADMAC), and some disinfection by-products, in raw dam and treated potable waters, was undertaken. Residual poly-DADMAC in drinking water was determined by the gold nanoparticle, UV-Vis, colorimetric method. The observed, residual poly-DADMAC levels, (range: 1-5µg/L) were, on average (±SD) (µg/L), for the potable water levels, 1.63 (±0.59) for Hazelmere Dam, 1.52 (±0.42) for Midmar Dam, 3.64 (±0.34) for Inanda Dam, and 4.33 (±0.97) for Nagle Dam. The analytical method used to quantify the residual poly-DADMAC was found to be fairly acceptable for the environmental risk assessment of this polymeric coagulant in drinking water. The study indicated compliance of all treated, potable water, for residual poly-DADMAC, to the current international limit of ≤50µg/L. The estimated N-Nitrosodimethylamine (N-NDMA) levels were 142ng/L for Hazelmere and 139ng/L for DV Harris, which exceeded the World Health Organization (WHO) limit of ≤100 ng/L.

Abdominal pain is one of the main symptoms evaluated in patients with Human Immunodeficiency Virus (HIV) infection. This population is special because the differential diagnosis is broad and the clinical presentation is usually atypical. This article will review general information on the evaluation and management of abdominal pain in patients with human immunodeficiency virus infection.

Background: This study aimed to evaluate equity in the utilization and resource distribution of pre-hospital emergency care in Guangdong province for 2015 by using the Concentration Index (CI), Gini index, and Theil index.

Methods: Concentration Index (CI) was used to estimate the equity of emergency calls and emergency ambulance dispatches as two utilization indicators. Gini index and Theil index was used to evaluate the equity of ambulances, first-aid stations, and dispatchers as three resources distribution indicators. We used EXCEL software to calculate indicators.

Results: This study suggests that inequities favoring the wealthy exist in the utilization and resource distribution of pre-hospital emergency care. Specifically, emergency ambulance dispatches, for which the CI ranged from 0.0651 to 0.1099, had a higher-grade pro-wealthy inequity compared with emergency calls, for which the CI ranged from 0.0461 to 0.0114. Moreover, the Gini indexes of ambulances, first-aid stations, and dispatchers were 0.2217, 0.2421, and 0.3011 based on population distribution, while they were 0.4402, 0.4696, and 0.4214 based on geographic area, which indicated that the equity of population distribution was superior to the equity of area distribution. Meanwhile, the Theil indexes represented these inequities were mainly attributed to intra-regional differences.

Conclusions: Pre-hospital emergency care utilization and resources distribution were inequitable in Guangdong. Not only comprehensive policies but also the equity of geographical area should be taken into account properly by the government.

Background: Stroke is a leading cause of death and disability worldwide and it is increasing in developing countries. Treatment for stroke is applied in the first 4.5 hours after the initiation of symptoms. Perceiving stroke as a severe illness could be implied in the early arrival and prognosis of stroke patients.

Objective: The aim of our study was to assess the perception of stroke and to evaluate their prognosis.

Methods: We applied 109 standardized questionnaires by phone call to patients who were admitted to our Stroke Care Unit with a diagnosis of acute ischemic stroke during the period January 2014 - January 2015.

Results: Mean age was 60±13, 60 were men and 58 cursed only primary school. Prevalent stroke risk factors were sedentarism (71.4%), hypertension (67.9%) and diabetes (44%). We compared the results between severe and non-severe perception and found a statistical difference in hospital arrival (p=0.04) and hospital stay days (p=0.04). Our study demonstrates the importance of recognizing stroke symptoms as a severe illness.

Conclusion: Perception of stroke arises as an additional point to emphasize during educational campaigns, leading this to a better timing in stroke patients and, therefore, an increased possibility to receive thrombolysis.

Objective: To examine whether the 30-day Risk-Standardized Mortality Rate (RSMR) of hospitals across the US are associated with neighborhood Socioeconomic Status (SES).

Data sources: Secondary data were collected from the US Census Bureau, Centre

Study design: Income data, mortality rates and RSMRs were gathered from their respective databases. These data were compared in terms of income (SES) and stratified according to state or specific zip-codes. Linear regression, T-test and ANOVA were performed.

Principal findings: Both at the local and at the state level, as the SES increases, RSMR for myocardial infarction, heart failure and pneumonia were reduced. Mortality rates further showed a negative association between income and RSMR for all such causes. This trend was not observed for RSMR on readmission

Conclusions: As the SES of an area increases, the RSMR of the associated hospitals is reduced both at the local and at the state level across US. Such information may be helpful in resource allocation towards health improvement.