Objective: The objective of this study was to determine the frequency of health care provider (HCP) driving safety/cessation-related anticipatory guidance provision and predictors of driving safety-related anticipatory guidance provision by HCPs.
Methods: HCPs in several central/upper Midwest states were surveyed about frequency of anticipatory guidance provision (n = 265).
Results: More than half of HCPs stated that they frequently or always provide driving safety/cessation-related anticipatory guidance to patients aged 85 or older, 38.7% provided this guidance to patients aged 75 to 84, and 13.7% to patients aged 65 to 74. Predictors of driving safety/cessation-related anticipatory guidance provision differed by patient age. For patients aged 65–74, HCP personal experience with a motor vehicle crash (either the HCP themselves or a friend/family member) was significant in predicting anticipatory guidance provision. However, for patients aged 75 and older, significant predictors included HCP rural practice, HCP age, and percentage of HCP patients who were older adults.
Conclusion: HCP counseling provision related to driving issues differs by patient age and several HCP characteristics, including HCP rurality, age, and personal experience with motor vehicle crashes. Because aging results in physical and mental changes that affect driving and can be identified by HCPs, HCPs are in a position to counsel patients on the potential impacts of aging on the act of driving. Future research should examine the reasons for the differences in anticipatory guidance provision found in this study. 相似文献
Metallurgical production is the largest polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) emission source in China. However, PCDD/F monitoring and research are rarely conducted on primary metallurgical production. In this study, a demonstration primary copper smelter in China was selected to investigate PCDD/F characteristics and control. Samples were collected from major PCDD/F release points in the smelter process (fly ashes and waste water sludge). Specific analysis of PCDD/F congeners was carried out using a high resolution gas chromatography/high resolution mass spectrometry method. The results showed that PCDD/Fs might be unintentionally produced in the primary copper smelter processes, with sample concentrations of 180–6110 pg/g dry wt; highly chlorinated PCDD/F homologues were predominant. The toxicity of all the samples was calculated to be 120 pg WHO TEQ/g, fly ashes from the refining process furnaces air pollution control device and sludge were hazardous waste with higher PCDD/F toxicity. Both precursor formation and de novo synthesis were found to contribute to PCDD/F formation in the smelter process. PCDD/F characteristics and formation were compared with reported secondary copper smelters. Life-cycle control of PCDD/F was proposed for retrofitting of this smelter and for similar plants in China's primary copper production sector, including control at the PCDD/F formation, removal and disposal stages. 相似文献
Abstract Spatial and temporal variations and the factors influencing primary production have been studied in three different mangrove waters (Pichavaram, Ennore Creek and Adyar Estuary) of South India characterised by different anthropogenic impacts. the gross primary productivity in the unpolluted Pichavaram mangrove was 113 g Cm?2yr?1 exhibiting natural variability with the environmental forcing factors. Human activities have elevated primary productivity in the Ennore Creek mangrove (157g Cm?2yr?1) primarily through the direct discharge of fertilizer effluents. By contrast, a combination of domestic and industrial effluent discharges into the Adyar Estuary mangrove has considerably reduced phytoplankton primary productivity 83g Cm?2yr?1 the Redfield N: P ratio varies from 0.96 N: 1P at Ennore Creek, 1.75N: 1P at Adyar Estuary to 15.2 N: 1P at Pichavaram mangroves. This suggests that the Pichavaram mangroves represent a well equilibrated ecosystem with N: P ratio close to steady-state values in contrast to the anthropogenically altered mangrove ecosystems studied. Results show a significant temporal variability in nutrient concentration in the three mangrove areas. Distinct differences in nutrient concentrations between the dry and the wet seasons have been observed. 相似文献