Health-related quality of life 24 months after sustaining a minor musculoskeletal injury in a road traffic crash: A prospective cohort study

Objectives: A better understanding of the long-term factors that independently predict poorer quality of life following mild to moderate musculoskeletal injuries is needed. We aimed to establish the predictors of quality of life (including sociodemographic, health, psychosocial, and pre-injury factors) 24 months after a noncatastrophic road traffic injury.

Methods: In a prospective cohort study of 252 participants with mild/moderate injury sustained in a road traffic crash, quality of life was measured 24 months following the baseline survey. A telephone-administered questionnaire obtained information on various potential explanatory variables. Health-related quality of life was measured using the European Quality of Life–5 Dimensions (EQ-5D) and Medical Outcomes Survey Short Form–12 (SF-12). Multivariable linear regression analyses determined the associations between explanatory variables and quality of life measures.

Results: Mean SF-12 physical component summary (PCS) and mental component summary (MCS) scores increased by 7.3 and 2.5 units, respectively, from baseline to 24-month follow-up. Each 10-year increase in baseline age was independently associated with 3.1-unit (P < .001) and 1.5-unit (P = .001) decrease in EQ Visual Analogue Scale (VAS) and SF-12 PCS scores at follow-up, respectively. Poor/fair compared to excellent pre-injury health was associated with a 0.16-, 21.3-, and 11.5-unit decrease in EQ-5D summary (P = .03), VAS scores (P = .001), and SF-12 PCS scores (P < .001), respectively. Baseline pain severity ratings and pain catastrophizing scores were inversely associated with 24-month EQ VAS scores (both P < .001). Each unit increase in baseline pain score (P = .001) and pain catastrophizing score (P = .02) was associated with a 1.0- and 4.6-unit decrease in SF-12 MCS scores at 24 months, respectively. Other observed predictors of quality of life measures (EQ-5D summary and/or VAS scores and/ or SF-12 MCS) included marital status, smoking, hospital admission, pre-injury health (anxiety/depression and chronic illness), and whiplash injury.

Conclusion: Sociodemographic indicators, pre-injury health, and biopsychosocial correlates were independently associated with health-related quality of life 24 months following a noncatastrophic road traffic crash injury.     

A cognitive approach to the post-Soviet Central Asian pasture puzzle: new data from Kyrgyzstan

Regional Environmental Change - Despite internationally recognized definitions, there remains debate over what constitutes ‘actual’ degradation in various agro-pastoral contexts. This...     

Mercury Contamination of Fish and Its Implications for Other Wildlife of the Tapajós Basin, Brazilian Amazon

Abstract: Since 1979 the gold rush in the Brazilian Amazon has caused serious environmental damage to one of the most complex ecosystems on Earth. Mainly due to the toxicity of mercury to humans, this problem has received wide public attention and prompted many studies. Although these studies have involved sampling of fish, the negative effect of mercury contamination to fish themselves and other wildlife has been largely ignored. To assess the present level of mercury contamination of fish, and its implication for fish and other animals, we collected and examined data on mercury concentration in fish of the Brazilian Amazon, especially for the Tapajós basin, between 1991 and 1996. We conclude that omnivores and piscivores that live nearer to gold mining areas in the Tapajós basin are already at high risk of mercury toxification, especially reproductive failure. Mercury concentrations in these fish are also high enough to have detrimental effects on animals at higher trophic levels. The same conclusion applies to other mercury-contaminated areas in the Brazilian Amazon. Because most Amazonian rivers or their tributaries have favorable conditions for mercury contamination, we can expect the problem to persist in the Amazon for a long time, and the consequences are likely to become more significant in the future. These conclusions have important implications for all tropical rainforests where gold mining operations have caused extensive mercury pollution.     

The state of ambient air quality in Pakistan—a review

Background and purpose  

Pakistan, during the last decade, has seen an extensive escalation in population growth, urbanization, and industrialization, together with a great increase in motorization and energy use. As a result, a substantial rise has taken place in the types and number of emission sources of various air pollutants. However, due to the lack of air quality management capabilities, the country is suffering from deterioration of air quality. Evidence from various governmental organizations and international bodies has indicated that air pollution is a significant risk to the environment, quality of life, and health of the population. The Government has taken positive steps toward air quality management in the form of the Pakistan Clean Air Program and has recently established a small number of continuous monitoring stations. However, ambient air quality standards have not yet been established. This paper reviews the data being available on the criteria air pollutants: particulate matter (PM), sulfur dioxide, ozone, carbon monoxide, nitrogen dioxide, and lead.     

Correlations between in situ denitrification activity and nir-gene abundances in pristine and impacted prairie streams

Denitrification is a process that reduces nitrogen levels in headwaters and other streams. We compared nirS and nirK abundances with the absolute rate of denitrification, the longitudinal coefficient of denitrification (i.e., K_den, which represents optimal denitrification rates at given environmental conditions), and water quality in seven prairie streams to determine if nir-gene abundances explain denitrification activity. Previous work showed that absolute rates of denitrification correlate with nitrate levels; however, no correlation has been found for denitrification efficiency, which we hypothesise might be related to gene abundances. Water-column nitrate and soluble-reactive phosphorus levels significantly correlated with absolute rates of denitrification, but nir-gene abundances did not. However, nirS and nirK abundances significantly correlated with K_den, as well as phosphorus, although no correlation was found between K_den and nitrate. These data confirm that absolute denitrification rates are controlled by nitrate load, but intrinsic denitrification efficiency is linked to nirS and nirK gene abundances.     

Farmer knowledge and a priori risk analysis: pre-release evaluation of genetically modified Roundup Ready wheat across the Canadian prairies

Background, aim, and scope  

The controversy over the world’s first genetically modified (GM) wheat, Roundup Ready wheat (RRW), challenged the efficacy of ‘science-based’ risk assessment, largely because it excluded the public, particularly farmers, from meaningful input. Risk analysis, in contrast, is broader in orientation as it incorporates scientific data as well as socioeconomic, ethical, and legal concerns, and considers expert and lay input in decision-making. Local knowledge (LK) of farmers is experience-based and represents a rich and reliable source of information regarding the impacts associated with agricultural technology, thereby complementing the scientific data normally used in risk assessment. The overall goal of this study was to explore the role of farmer LK in the a priori risk analysis of RRW.     

The Silver Valley Lead Study:The Relationship between Childhood Blood Lead Levels and Environmental Exposure

This paper is directed to those persons concerned with the relationship between blood lead levels and environmental exposures to lead. Information presented in this paper represents one of the largest collections of epidemiologica! data relating blood lead levels to environmental exposures. The observed annual average ambient air lead concentration ranged from approximately 0.5 ng Pb/m³ to 23 ng Pb/m³, while lead in soil ranged from 50-24,600 ppm. Blood lead levels of children (ages 1-9 years) are related to a host of environmental variables via regression techniques. Blood lead levels were found to be most influenced by five variables. These variables are: ambient air lead, soil lead, age of the child, dustiness of the home, and occupational status of the parents. It is concluded, based upon the results of this study, that any environmental control strategy should address both the air and the soil. Soil levels in excess of 1000 ppm lead as well as air lead levels greater than 2 jug Pb/m³, 30 day average, were found to be unacceptable.     

Understanding the impact of hydropower developments in the context of upstream–downstream relations in the Mekong river basin

Hydropower developments along the main stem of the Mekong River and its tributaries cause transboundary effects within the Mekong Basin Region, which comprises parts of six countries. On the one hand, the provision of hydropower triggers economic development and helps to meet the rising energy demand of the Mekong riparian countries, especially China, Thailand, and Vietnam. On the other hand, the negative impact of dam construction, mainly altered water flow and sediment load, has severe impacts on the environment and the livelihoods of the rural Mekong population. Several discrepancies exist in the needs, demands, and challenges of upstream versus downstream countries. Against the common apprehension that downstream countries are powerlessly exposed to mainly negative impacts whereas upstream countries unilaterally benefit from hydropower, the authors argue that upstream–downstream relations are not really clear-cut. This conclusion is based on a consideration of the complex power play between Mekong riparians, with a focus on recent power trade interactions. The article investigates the consequences of hydropower dams for the Mekong region as well as the role of supranational players, such as the Mekong River Commission and the Greater Mekong Subregion Initiative, on the hydropower debate. It is not nations that are the winners or losers in the hydropower schemes in the Mekong, but rather parts of the riparian population: a few influential and powerful elites versus the large mass of rural poor.