Hipopotasemia no medicamentosa como biomarcador de nefropatía crónica temprana en adultos del sur de Honduras

Introducción: La hipopotasemia es un trastorno hidroelectrolítico frecuente, asociado a enfermedades sistémicas y multifactoriales, cuya forma aguda puede complicarse y causar la muerte, pero en su presentación crónica puede ser un marcador de nefropatía. Objetivo: Caracterizar el perfil del paciente con hipopotasemia no medicamentosa atendidos de emergencia. Métodos: Se revisaron los registros de pacientes mayores de 18 años con diagnóstico de hipopotasemia, ingresados en el hospital en el período de junio 2018 a diciembre de 2019. Se colectaron datos demográficos, antecedentes médicos y evolución postratamiento. Se comparó con 108 pacientes sin hipopotasemia atendidos en el período de estudio. Resultados: Se encontraron 87 casos con edad media de 38,5 años. El 90,8 % eran hombres menores de 50 años, de oficio agricultor (29,9 %), con historia de exposición a plaguicidas y a altas temperaturas ambientales. La mayoría de ellos no tenía historia de enfermedad cardiometabólicas o renal previa. El 48,3 % de todos los pacientes con hipopotasemia (n = 42) tenía creatinina mayor a 1,2 mg/dL y 63 % tenía hiponatremia. La hipopotasemia fue moderada en 39 % y severa en 12 %, los hombres 4,7 veces más afectados que las mujeres. Respecto al grupo sin hipopotasemia y creatinina anormal, tenían mayor frecuencia de enfermedad crónica (92,5 % versus 8 %). Conclusiones: Se encontró hipopotasemia no medicamentosa en varones agricultores, sin enfermedad crónica, pero con datos de nefropatía temprana e hiponatremia, se sugirió la posibilidad de nefropatía mesoamericana. Debe establecerse una alerta epidemiológica regional y un programa de prevención y control.

Introduction: Hypokalemia is a frequent hydroelectrolytic disorder, associated with systemic and multifactorial diseases, whose acute form can be complicated and cause death, but in its chronic presentation it can be a marker of nephropathy. Objective: To characterize the profile of the patient with non-drug hypokalemia seen in an emergency. Methods: The records of patients older than 18 years diagnosed with hypokalemia, admitted to the hospital from June 2018 to December 2019, were reviewed. Demographic data, medical history, and post-treatment evolution were collected. It was compared with 108 patients without hypokalemia seen in the same period. Results: 87 cases with mean age of 38.5 years were studied. 90.8% were men under 50 years of age, who worked as farmers (29.9%), with history of exposure to pesticides and high ambient temperatures. Most of them had no history of previous cardiometabolic or renal disease. 48.3% of all patients with hypokalemia (n = 42) had creatinine higher than 1.2 mg/dL and 63% had hyponatremia. Hypokalemia was moderate in 39% and severe in 12%, and it was found that men were affected 4.7 times more than women. Regarding the group without hypokalemia and abnormal creatinine, they had higher frequency of chronic disease (92.5% versus 8%). Conclusions: Non-drug hypokalemia was found in male farmers, without chronic disease, but with evidence of early nephropathy and hyponatremia. The possibility of Mesoamerican nephropathy was suggested. A regional epidemiological alert and a prevention and control program should be established.

Malignant tumors in farmers over 60 years old of the high-risk population in a town in Shanghai / 上海预防医学

Objective To screen for malignant tumors and high-risk factors in rural residents over 60 years old， so as to prevent and control the occurrence and development of tumors in the future. Methods The survey was conducted with reference to part of the questionnaire in the "Urban Cancer Early Diagnosis and Treatment Project and Evaluation of High-risk Populations". Clinical examinations included serum tumor marker detection， CT screening for lung cancer， occult blood （+） plus colonoscopy screening for colorectal cancer， and mammography screening. Individuals who were positive in the abovementioned clinical tests were defined as high-risk subjects. Results A total of 271 high-risk subjects （1.91%） were screened out of 14 161. Among the high-risk subjects， 71 cases of malignant tumors （26.19%） were found， with an incidence rate of 501.38 per 105. The top five tumors （63.38% of all diagnosed） were mainly concentrated in lung， upper digestive tract， blood system， urinary system， and rectum-colon. The proportion of malignant tumors detected by positive indicators was 61.54% of blood； 46.15% of carcinoembryonic antigen and carbohydrate antigen 125； 23.08% of alpha-fetoprotein； 16.66% of lung CT； and 3.09% of prostate PSA. The positive indicators in the high-risk subjects were mainly for the tumors in the prostate， lungs， liver， and CEA/CA125. The subjects with positive test indicators had lower average annual income in the last 5 years than the normal subject group （χ2=3.380， P=0.040）. The subjects with positive test indicators had higher proportion in family history of tumors than the normal group （χ2=2.596， P=0.046）. People in thehigh-risk group had a higher proportion than the normal group in suffering from hypertension， liver disease， gastrointestinal disease， respiratory system disease， and surgical treatment. Patients with high-risk tumors were found to have higher proportion than the normal group in showing pre-tumor clinical symptoms in the last 1 year. Study of the tumor-related risk factors found that the high-risk group had a higher proportion of high-fat/high-cholesterol diet， alcohol drinking， passive smoking， and personality depression. Conclusion High tumor risk factors have been identified in this population. It is necessary to strengthen the corresponding intervention and follow-up treatment of precancerous diseases in the future. We recommend the government to conduct tumor screening among high-risk groups to improve cost-effectiveness.

Effect of non-surgical interventions on pain relief and symptom improvement in farmers with diseases of the musculoskeletal system or connective tissue: an exploratory systematic review based on randomized controlled trials / Journal of Rural Medicine

Objective: There are many observational and clinical studies on pain treatment in farmers; however, little is known about the effects of interventions based only on randomized controlled trials (RCTs) on diseases of the musculoskeletal system or connective tissue (D-MSCT). This review aimed to summarize evidence on the effects of non-surgical interventions for pain relief and symptom improvement in farmers with D-MSCT.Materials and Methods: We searched seven databases, including MEDLINE, and three clinical trial registries, including the International Clinical Trials Registry Platform, from inception up to February 15, 2021, to identify studies that included at least one treatment group wherein nonsurgical interventions were applied. We focused on 1) pain relief and symptom improvement and 2) quality of life and improvement in physical fitness.Results: Four studies (three on low back pain and one on knee osteoarthritis) met all the inclusion criteria. Overall, the risk of bias was high, and meta-analysis could not be performed due to heterogeneity. However, a participatory ergonomic approach, exercise centered on strength training with a transtheoretical model, and/or a combination of both could be included in effective educational programs, at least in the short term, to prevent and/or reduce exacerbation of D-MSCT in farmers. Based on internal and external validity, we could postulate a future research agenda and a conceptual education model to prevent D-MSCT in farmers.Conclusion: Participatory ergonomic intervention, exercise centered on strength training, and/or a combination of both could be included for effective educational programs to prevent and reduce exacerbation of D-MSCT in farmers. High-quality RCTs with a less risk of bias will be implemented for many agricultural work types in various parts worldwide (especially developing countries and regions) during the COVID-19 pandemic.

Farmers' perception of agricultural cooperatives: the case of Şanlıurfa, Turkey / A percepção dos agricultores sobre as cooperativas agrícolas: o caso de Şanlıurfa, Turquia

ABSTRACT: Şanlıurfa is the province with the third-largest agricultural area in Turkey. However, it has only 0.62% of the total number of cooperatives in the country. This study aimed to determine the perceptionsof farmers in Şanlıurfa regarding agricultural cooperatives and the factors affecting them. The main research material was obtained through face-to-face surveys involving farmers in Şanlıurfa selected by a simple random sampling method. The sampling volume was determined with a 95% confidence limit and a 5% error margin. Multiple regression analysis was used in Stata software. According to the results of the research, 39.7% of the participants were cooperative members and more than half of them were not active members. Of the participants, 30.3% had a positive perception of cooperatives, 36.82% were undecided, and 32.88% had negative opinions. Age, marital status, non-agricultural income, experience, social security, farmer registration system, cooperative membership, and land variables positively affected farmers' perceptions. However, the variables of education, income, and union membership had negative effects on farmers' perceptions. No statistically significant relationship was reported between a farmer's perception and any of the following variables: the number of people that make up the farmer's household, the number of individuals engaged in agriculture and non-agricultural work in the family, and the status of the farmer's lease. Conceptual, local, cultural, educational, and structural problems related to cooperatives exist in Şanlıurfa.These issues need to be given more attention by the public. This research is the first study on this subject to be conducted in Şanlıurfa.

RESUMO: Şanlıurfa é a província com a terceira maior área agrícola da Turquia. No entanto, possui apenas 0,62% do número total de cooperativas no país. Este estudo teve como objetivo determinar as atitudes e a percepção dos agricultores em Şanlıurfa em relação às cooperativas agrícolas e os fatores que as afetam. O principal material de pesquisa foi obtido através de pesquisas presenciais envolvendo agricultores em Şanlıurfa, selecionados por um método simples de amostragem aleatória. O volume amostral foi determinado com um limite de confiança de 95% e uma margem de erro de 5%. A análise de regressão múltipla foi utilizada. De acordo com os resultados da pesquisa, 39,7% dos participantes eram cooperados e mais da metade deles não eram ativos. Dos participantes, 30,3% tinham percepção positiva das cooperativas, 36,82% estavam indecisos e 32,88% tinham opiniões negativas. Idade, estado civil, renda não agrícola, experiência, previdência social, sistema de registro de agricultores, participação em cooperativas e variáveis de terra afetaram positivamente as atitudes dos agricultores. No entanto, as variáveis educação, renda e filiação sindical tiveram efeitos negativos nas atitudes dos agricultores em relação às cooperativas. Não foi encontrada relação estatisticamente significante entre a percepção das cooperativas por parte de um agricultor e qualquer uma das seguintes variáveis: número de pessoas que compõem a família do agricultor, número de indivíduos envolvidos na agricultura e trabalho não agrícola na família e status de arrendamento do fazendeiro. Problemas conceituais, locais, culturais, educacionais e estruturais relacionados às cooperativas existem em Şanlıurfa. Esta pesquisa é o primeiro estudo sobre esse temarealizado em Şanlıurfa.

Determinants of Rulindo tea farmers' perception towards organic farming: a MASS::stepAIC() approach / Determinates da percepção dos cafeicultores de Rulindo em relação à agricultural orgânica: uma abordagem MASS::stepAIC

ABSTRACT: The current study determined the factors influencing the perception of tea farmers towards organic tea production in Rulindo District, Rwanda. This study used both qualitative and quantitative data from face to face interviews and questionnaires completed with 156 tea farmers and other key informants in the tea sector who were randomly selected in 2019. Using function step AIC in R's MASS package, the final multiple logistic regression model showed that generating income from tea production, participation in Umuganda, conveying messages at Ihangari, participation to agricultural shows, and receiving training from Farmers Field Schools (FFS) influenced farmers' perceptions towards organic tea production. Thus, the results of this study could be useful to stakeholders in Rwanda's tea sector, such as policymakers and decision-makers. They can act as a source of information when developing a more sustainable research-based tea extension program. Moreover, the results of this study can be used during the capacity building of farmers about organic tea production.

RESUMO: O objetivo deste estudo é determinar os fatores que influenciam a percepção dos produtores de chá em relação à produção de chá orgânico no distrito de Rulindo, Ruanda. Esta pesquisa utilizou dados qualitativos e quantitativos de entrevistas e questionários presenciais preenchidos com 156 cafeicultores e outros informantes-chave do setor de chá que foram alocados aleatoriamente em 2019. Usando a etapa de função AIC no pacote MASS de R, o modelo final de regressão logística múltipla mostrou que a participação em Umuganda, transmitindo mensagens na ihangari, discussões com um revendedor Agro nas aldeias, obtendo renda com as vendas de folhas de chá verde fresco, acesso dos cafeicultores à Internet, participação na exposição agrícola e treinamento em escolas agrícolas da Cooperativa Os cafeicultores tiveram à previsão da percepção da produção orgânica de chá. Assim, os resultados deste estudo podem ser úteis para as partes interessadas no setor de chá de Ruanda, como formuladores de políticas e tomadores de decisão. Eles podem atuar como fonte de informação ao desenvolver um programa de extensão do chá mais sustentável, baseado em pesquisa. Além disso, os resultados deste estudo podem ser utilizados durante a capacitação dos agricultores sobre o cultivo de chá orgânico.

Informal credit constraints and farmers' health: an empirical study of China / Restrições ao crédito e à saúde de agricultores: um estudo empírico da China

ABSTRACT: Based on survey data of the income distribution and living conditions of urban and rural residents collected by the China Economic Monitoring and Analysis Center in 2014, we investigated the mechanisms related to informal credit constraints on farmer health and then empirically analyzed the impacts of such constraints. Results showed that, in general, informal credit constraints significantly negatively impact farmer health. Compared with farmers whose credit was not informally constrained, the probability of farmers who faced informal credit constraints describing their self-rated health as "very good" fell by 6.64%. After controlling for endogenous problems, this proportion rose to 28.87%. Correspondingly, the probability of describing self-rated health as "very bad" increased by 0.45%. After controlling for endogenous problems, this proportion rose to 0.81%. The robustness test showed that our conclusions are strongly robust. Informal credit constraints significantly positively impacted the number of days of illness in 2013 in the sample of farmers, which means farmers who suffered from informal credit constraints required more sick days than those who did not experience informal credit constraints in 2013. As far as we know, this is the first study on the impact of informal credit constraints on Chinese farmer health.

RESUMO: Com base nos dados da pesquisa sobre a distribuição de renda e as condições de vida dos residentes urbanos e rurais coletados pelo Centro de Análise e Monitoramento Econômico da China em 2014, investigamos os mecanismos relacionados às restrições informais de crédito à saúde dos agricultores e, em seguida, analisamos empiricamente os impactos dessas restrições. Os resultados mostram que, em geral, as restrições informais de crédito afetam significativamente a saúde dos agricultores. Em comparação com os agricultores cujo crédito não foi informalmente restrito, a probabilidade de agricultores que enfrentaram restrições informais de crédito que descrevem sua auto-avaliação de saúde como "muito boa" caiu 6,64%. Após o controle de problemas endógenos, essa proporção subiu para 28,87%. Da mesma forma, a probabilidade de descrever a auto-avaliação de saúde como "muito ruim" aumentou 0,45%. Após o controle de problemas endógenos, essa proporção subiu para 0,81%. O teste de robustez mostrou que nossas conclusões são fortemente robustas. As restrições informais de crédito impactaram significativamente o número de dias de doença em 2013 na amostra de agricultores, o que significa que os agricultores que sofreram restrições informais de crédito permaneceram mais dias doentes do que aqueles que não tiveram restrições informais de crédito em 2013. Tanto quanto sabemos, este é o primeiro estudo sobre o impacto das restrições informais ao crédito na saúde dos agricultores chineses.

Effectiveness of agricultural extension's farmer field schools (FFS) in Pakistan: the case of citrus growers of Punjab province / Eficácia das escolas de extensão agrícola de campo (FFS) no Paquistão: o caso dos produtores de frutas cítricas da província de Punjab

ABSTRACT: Citrus is one of the major exported fruits of Pakistan. Especially Kinnow cultivar is famous across the globe because of its aroma and taste. The overall production of citrus is reported as half of the potential because of the non-adoption of research-based practices and lack of agricultural extension services and training of the citrus growers. In the last few years, the department of agricultural extension has started training programs called Farmer Field Schools (FFS) for citrus growers in the major citrus growing zone of the Punjab province, i.e., Sargodha region. This research was conducted in the Sargodha district to evaluate the knowledge and skills gained by the farmers from the FFS. The interview schedule was designed for the purpose of data collection. The data was collected from 120 farmers randomly selected from 15 FFS in the study area. All the respondents were participants of the FFS. The data was analyzed using Statistical Package for Social Sciences (SPSS). The Results of the study showed that 40% of the farmers learned about citrus verities, one-third of respondents learned about the management of new plants/orchards, 28% of the respondents got knowledge about the cultivation of fruits, and one-fourth of respondents acquired knowledge and skills about layout and management of citrus orchards. These findings conclude that training course has a positive influence on farmers' farm management skills; hence emphasize on its persistence and further improvement by the concerned authorities.

RESUMO: Os citros são as principais frutas exportadas do Paquistão, especialmente, a cultivar Kinnow é famosa em todo o mundo por causa de seu aroma e sabor. A produção geral de citros é relatada como a metade do potencial devido a não adoção de práticas baseadas em pesquisas e a falta de serviços de extensão agrícola e treinamento dos citricultores. Nos últimos anos o departamento de extensão agrícola iniciou programas de treinamento chamados Farmer Field Schools (FFS) para citricultores na maior zona de cultivo de citros da província de Punjab, no distrito de Sargodha. Esta pesquisa é conduzida no distrito de Sargodha para avaliar o conhecimento e as habilidades adquiridas pelos agricultores da FFS. O cronograma de entrevistas foi elaborado para fins de coleta de dados. Os dados foram coletados de 120 agricultores aleatoriamente de 15 FFS na área de estudo. Todos os entrevistados eram participantes da FFS. Os dados foram analisados ​​por meio do programa estatístico "Statistical Package for the Social Sciences (SPSS"). Os resultados do estudo mostraram que 40% dos agricultores aprenderam informações importantes sobre citros, um terço dos entrevistados aprenderam sobre o manejo de novas plantas / pomares, 28% dos entrevistados aprenderam sobre o cultivo de frutas e um quarto dos entrevistados adquiriu os conhecimentos e habilidades sobre layout e manejo de pomares de citros. Essas descobertas concluem que o curso de treinamento tem uma influência positiva nas habilidades de gestão das propriedades; portanto, suporta a necessidade de sua persistência e melhorias adicionais pelas autoridades para alavancar ainda a produtividade essa atividade no futuro.

As exigências cognitivas e a complexidade do trabalho para o agricultor urbano: um estudo de caso / The cognitive demands and the complexity of work for the urban farmers: a case study

Resumo O trabalho na agricultura vem aumentando as exigências impostas ao trabalhador com o uso de tecnologias. Porém, para atividades agrícolas onde o incremento do uso de tecnologias é limitado, como na agricultura urbana orgânica, pouco se sabe sobre a carga cognitiva da atividade. Atualmente, não há registros de estudos sobre a carga cognitiva de trabalhadores da agricultura urbana orgânica, mesmo porque esse ainda é um movimento tímido. A importância deste estudo reside no fato de aumentar o conhecimento e as informações sobre esta população para fomentar o desenvolvimento da área. O objetivo deste artigo foi relatar as exigências cognitivas impostas a estes trabalhadores de forma a identificar a complexidade do seu trabalho. Para isso, realizou-se um estudo de caso com agricultores urbanos que utilizam práticas orgânicas, comercializam seus produtos e fazem dessa sua atividade econômica principal. Os achados comprovam que a carga cognitiva é elevada, contribuindo para um trabalho complexo para estes agricultores. Assim, a importância em ampliar os estudos para validar as informações encontradas e contribuir para a construção de políticas públicas efetivas é urgente.

Abstract Agricultural work has been increasing the demands placed on workers with the use of technologies. However, for agricultural activities, in which the increase in the use of technologies is limited, such as organic urban agriculture, little is known about the cognitive load of this activity. Currently, there are no records of studies on the cognitive load of workers in organic urban agriculture, since this is still a timid movement. The importance of this study lies in the fact that it increases the knowledge and information about this population to encourage the development of the area. The purpose of this article was to report the cognitive requirements imposed on these workers to identify the complexity of their work. A case study was conducted with urban farmers that use organic practices, market their products and make of this their main economic activity. The findings prove that the cognitive load is high, contributing to a complex job for these farmers. Thus, the importance of expanding the studies to validate the information found and contribute to the construction of effective public policies is urgent.

Rice farmer's poverty and its determinants: evidence from Dogofiri village of Office du Niger zone in Mali / A pobreza dos agricultores de arroz e seus determinantes: evidências da aldeia de Dogofiri na zona do Office du Niger, Mali

ABSTRACT: The aim of this research was to contribute to a better understanding of rice farmer's poverty of Office du Niger (ON) in Mali at village-level. Data were collected through survey with 110 head family farms in the village of Dogofiri. Quantitative data were analyzed using descriptive statistics. Multiple linear regression models were used to analyze the main determinants of poverty. Results indicated that the factors of physical capital and human capital as well as government policy have a significant influence on the poverty of family farms through production, age, family size, education and health support, agricultural credit and water fees. Policies aimed to improve the family farm's income and boosting rice production to alleviate poverty ought to be based on these factors.

RESUMO: O objetivo desta pesquisa é contribuir para uma melhor compreensão da pobreza dos produtores de arroz do Office du Niger (ON), no Mali, ao nível das aldeias. Os dados foram coletados por meio de pesquisa em 110 propriedades familiares da aldeia de Dogofiri. Os dados quantitativos foram analisados por meio de estatística descritiva. Modelos de regressão linear múltipla foram utilizados para analisar os principais determinantes da pobreza. Os resultados indicaram que os fatores de capital físico e de capital humano, bem como a política governamental, influenciam significativamente na pobreza das propriedades familiares por meio da produção, idade, tamanho da família, educação e apoio à saúde, crédito agrícola e taxas de água. Políticas destinadas para melhorar a renda da agricultura familiar e aumentar a produção de arroz para atenuar a pobreza devem basear-se nesses fatores.

Exposição a agrotóxicos e associação com sintomas físicos e auditivos de trabalhadores rurais / Pesticide exposure and association with physical and hearing symptoms of rural workers

A exposição crônica e combinada de agrotóxicos pode causar danos a saúde do trabalhador rural, inclusive à audição. O propósito do estudo foi caracterizar os trabalhadores rurais quanto aos aspectos sociodemográficos e de exposição aos agrotóxicos, assim como analisar a relação entre esta exposição e a ocorrência de sintomas físicos e auditivos. Pesquisa de natureza quantitativa, com alcance descritivo e explicativo, com delineamento transversal, realizada com 71 trabalhadores rurais, do sexo masculino, expostos a agrotóxicos. A coleta de dados foi realizada por duas formas: (i) instrumento de coleta para caracterização do contato aos agrotóxicos, sintomas físicos e auditivos (ii) triagem auditiva para a pesquisa dos limiares auditivos aéreos. A análise dos dados deu-se através da estatística descritiva e por meio do teste de Wilcoxon e da correlação de Spearman. Foi considerado nível de 5% de significância para os testes estatísticos. Sobre os sintomas físicos associados ao uso de agrotóxicos, prevaleceu a dor de cabeça (31,0%). Quanto ao resultado da triagem auditiva, 31 (43,7%) trabalhadores rurais falharam em ambas as orelhas, 28 (39,4%) obtiveram o resultados de "passa" e 12 (16,9%) falharam em apenas uma orelha. Ao analisar-se a associação entre o resultado da triagem auditiva e variáveis quanto a exposição aos agrotóxicos, o tempo de exposição foi a única variável que mostrou associação significativa. Os achados esclarecem que a atividade profissional dos agricultores oferece risco à audição, porém, é preciso considerar que outros fatores, como ruído e vibração, podem ser agravantes da perda auditiva nesta população.

The chronic and combined exposure to pesticides can cause damage to the health of the rural worker, including hearing. The purpose of the study was to characterize rural workers in terms of sociodemographic aspects and exposure to pesticides, as well as to analyze the relationship between this exposure and the occurrence of physical and auditory symptoms. This was a quantitative study, with a descriptive and explanatory scope, using a cross-sectional design, carried out with 71 rural workers, males, exposed to pesticides. Data collection was performed in two ways: (i) a collection instrument for characterizing contact with pesticides, physical and auditory symptoms (ii) auditory screening for the investigation of aerial hearing thresholds. Data analysis was performed through descriptive statistics and through the Wilcoxon test and Spearman's correlation. The levei of significance was set at 5% for statistical tests. Among the physical symptoms associated with the use of pesticides, headaches prevailed (31 .0%). As for the result of auditory screenings, 31 (43.7%) rural workers failed in both ears, 28 (39.4%) obtained the results of "passing" and 12 (16.9%) failed in only one ear. When analyzing the association between the results of auditory screenings and variables regarding exposure to pesticides, exposure time was the only variable that showed a significant association. The findings clarify that the professional activity of íarmers poses a risk to hearing, however, it is necessary to consider that other factors, such as noise and vibration, can aggravate hearing loss in this population.

Investigation on food safety related knowledge and behavior of employees in the farmer markets in Yangpu District of Shanghai / 上海预防医学

Objective To determine the potential sources of food safety risk and food safety related awareness of employees in the farmer markets in Yangpu District of Shanghai, and to provide evidence for food safety management. Methods The investigation on food safety and food-borne disease knowledge were conducted in 13 farmer markets in Yangpu District, and to assess the impact of employees′ behavior on food safety. Results A total of 368 employees in the 13 farmer markets were included in the study.Employees with high school education and above had better knowledge of food safety (P < 0.001).There was significant difference in the physical examination and habit of smoking in public places among the employees with different education levels.In addition, the employees in various positions in the markets differed significantly in the knowledge of food safety and behavior, such as taking physical examination, washing hands before meal and continuing working when feeling sick. Conclusion Food safety related risk in the farmer markets in Yangpu District mainly originates from the inadequate knowledge of the employees with low education levels, which further affects their behavior.Market management should strengthen the training of food safety related knowledge in the employees and advocate healthy behavior, such as taking physical examination and stop smoking, which contributes to creating a healthy work and shopping environment.

A Systematic Review of Association between Pesticide Exposure and Respiratory Outcomes among Farmers and Farmworkers

@#This review paper aimed to analyze scientific evidence and provide an overview of the relationship of pesticide exposure with respiratory outcomes among farmers and farmworkers. It also synthesized the association of exposure to specific pesticides and other factors with respiratory outcomes. Articles published in PubMed, Scopus, and ScienceDirect databases from 1991 to 2018 were reviewed and the scientific evidence was evaluated. Forty-five articles were selected for synthesis. Twenty-nine pesticides revealed an association with respiratory diseases and 49 pesticides with respiratory symptoms. In addition, 14 pesticides had an association with both respiratory diseases and symptoms (seven for herbicides, six for insecticides, and one for fungicide). Although the evidence from these reviewed studies suggested an association between pesticide exposure and respiratory outcomes among farmers and farmworkers, several limitations from the studies were found. Toward a better quality for further research, prospective study, standardized tools for exposure and outcome assessment, appropriate sample size and sampling method, and controlled confounding factors, should be thoroughly considered.

Principales causas de muerte de agricultores en Colombia periodo 2010-2016 / Leading causes of deaths among farmers in Colombia 2010 -2016

Resumen Introducción: En la literatura, los agricultores presentan mayor mortalidad por algunos tipos de cáncer y causas externas. Sin embargo, los resultados entre estudios no son concluyentes, debido a las diferencias metodológicas, como por las heterogeneidades implícitas en las actividades desarrolladas por los individuos en los diferentes sectores agrícolas y unidades geográficas. Objetivo: Describir las principales causas de muerte de los agricultores en Colombia para el periodo 2010 - 2016, e identificar si la ocupación en sí misma es un factor de riesgo para la mortalidad por dichas causas. Metodología: Se utilizaron los certificados de defunción para establecer la causa de muerte de los individuos, y se estimó por medio de regresión logística odds ratios ajustados por variables socioeconómicas como medida del riesgo ocupacional. Resultados: Los agricultores presentan mayor riesgo de mortalidad por neoplasias (OR; 1.14 IC 95% 1.12-1.71), por enfermedades del sistema circulatorio (OR; 1.030 IC 95% 1.01-1.04), y por signos y síntomas mal definidos (OR; 1.22 IC 95% 1.15 - 1.30). Discusión: Los resultados pueden estar sesgados por los errores habituales de los estudios retrospectivos. Sin embargo, las limitaciones podrían suscribirse a diferencias numéricas del riesgo y no de su significancia, por lo que los hallazgos de este trabajo serían consistentes con la presencia del riesgo más que con su magnitud. Conclusiones: Para establecer con mayor precisión el riesgo ocupacional de los agricultores colombianos, se requieren esfuerzos institucionales y estudios prospectivos como los realizados por la AHS en Estados Unidos.

Abstract Introduction: In the liturature, farmers have higher mortality from some type of cancer and external causes. However, the results are not conclusive, due to differential approaches and methodologies used in the studies, and differences in the activities developed by farmers in the geographical areas. Objective: Describe the main causes of death of farmers in Colombia from 2010 to 2016, and identify if the occupation itself is a risk factor for mortality. Methodology: We used odds ratios adjusted by logistic regression and socioeconomics variables as a measure of occupational risk in each cause of death. Death certificates were used to establish underlying cause of death. Results: Farmers have higher risk of die by neoplasm (OR; 1.14 CI 95% 1.12-1.71), circulatory system diseases (OR; 1.030 IC 95% 1.01-1.04), and missdefinition disease (OR; 1.22 IC 95% 1.15 - 1.30). Discussion: Our results could be biased, due the retrospective design. Nonetheless, these results could be consistent with the existence of risk more than magnitude itself. Conclusions: To have a major precision in the risk estimation is necessary institutional efforts to make prospective studies as AHS in United States.

Condiciones de trabajo y de seguridad social en asociaciones de pequeños y medianos agricultores campesinos con prácticas de economía solidaria en tres municipios del oriente antioqueño, Colombia, 2015 / Conditions of working and social security in peasant communities with solidarity economy practices in three municipalities in eastern Antioquia, Colombia 2015 / Condições de trabalho e segurança social nas comunidades camponesas com práticas de economia solidária em três municípios do leste de Antioquia, Colômbia 2015

Resumen Introducción: En algunas asociaciones de pequeños y medianos productores agropecuarios del oriente de Antioquia se identifican prácticas de economía solidaria y de producción agrícola que se han constituido en escenarios de resistencia y alternativas de trabajo para una población económica y socialmente vulnerable. La economía campesina fundamentada en el trabajo agrícola y las incertidumbres relacionadas con las transformaciones productivas que supone la cercanía del oriente antioqueño al Área Metropolitana son aspectos relevantes que deben considerarse a la hora de propender por el fortalecimiento de las organizaciones campesinas de la economía solidaria. Objetivo: Analizar las condiciones de trabajo y de seguridad social de un grupo de pequeños y medianos agricultores del sector solidario, comprometidos con la seguridad alimentaria, en tres municipios del oriente de Antioquia. Metodología: Se hizo un estudio descriptivo transversal de 111 productores, asociados activos de diez asociaciones campesinas de economía solidaria, legalmente constituidas. Se recolectó información primaria mediante encuestas. Se analizaron variables sociodemográficas, laborales y de seguridad social. Resultados: 85,6 % de los asociados pertenecen a estratos bajos y son trabajadores independientes, con ingreso promedio de $296 000 mensual; el 72 % posee seguridad social en salud en régimen subsidiado; el 91 % presenta desprotección en riesgos laborales, y el 88,3 %, en pensiones. Conclusión: Los ingresos de estos colectivos de agricultores del sector solidario son inferiores al salario mínimo legal y al ingreso promedio de los trabajadores del campo colombiano; las desigualdades son protuberantes en relación con los ingresos del resto de trabajadores del país. La protección social supone retos para el Gobierno, en cuanto a incrementar la cobertura en pensiones y riesgos laborales.

Abstract Introduction: The agricultural-based solidarity economy practiced by rural communities in Eastern Antioqua, Colombia, has become a tool for resistance, as well as an alternative source of employment for a socially and economically vulnerable population. Economies based on agriculture and the uncertainties of the productive transformations derived from a community's proximity to Medellin metropolitan area, are important factors that should be taken into account when examining the potentials of a solidary economy. Objective: To analyze the working and social conditions of a group of small and medium-scale farmers, from 3 towns in Eastern Antioquia, who follow the solidarity economy and are committed to food security. Methodology: A descriptive, transversal study was carried out with 111 active producers belonging to 10 legally consolidated solidarity economy farmers associations. Primary data was gathered through polls and workshops. Variables in respondents sociodemographics, work and social security were analyzed based on the statistical measurements of frequency, proportion and central tendency. Results: 85.6% of respondents are independent workers and belong to a lower socioeconomical strata with a mean monthly income of COP 296.000; 72% have health insurance through the country's subsidized system; 91% work without occupational hazard insurance; 88.3% do not contribute to a pension fund. Discussion: Income of the surveyed population was found to be lower than both the legal minimum wage and average wages of workers in the same field; income inequalities are very pronounced compared to other Colombian workers; increasing pension enrollment and occupational hazard coverage are challenges the government continues to face.

Resumo Introdução: As comunidades camponesas do Leste de Antioquia praticam economia de solidariedade que foi constituída em cenários de resistência e alternativas trabalho para populacoes economica e socialmente vulneráveis. A economia baseada na agricultura e as incertezas associadas com as transformações produtivas colocadas pela sua proximidade à área metropolitana de Medellin, são fatores importantes a ter em conta para demonstrar as possibilidades que tem a economia solidária, através da abordagem com as experiências das comunidades. Objetivo: O objetivo foi analisar as condições de trabalho e segurança social de um grupo do setor de pequenos e medios agricultores, comprometidos com a segurança alimentar em três municípios do Leste de Antioquia. Metodologia: Um estudo descritivo transversal foi realizado em 111 produtores associados ativos de 10 associações camponesas de economia solidária, legalmente constituídas. As informações primárias foram coletadas por meio de pesquisas e workshops. Variáveis sociodemográficas, trabalhistas e de seguranca social foram analisadas. A análise foi feita com medidas estatísticas de frequência, proporção e tendência central. Resultados: 85,6% dos associados pertencem ao estrato baixo e são trabalhadores independentes com renda média de $ 296 mil pesos por mês; 72% têm segurança social em saúde em regime subsidiado; 91% tem falta de proteção nos riscos ocupacionais e 88,3% nas posibilidades de ter aposentadoria. Discussão: A renda é menor do que o salário mínimo legal da média dos trabalhadores no campo colombiano; as desigualdades são acentuadas em relação à renda do resto dos trabalhadores do país; na proteção social apresentam-se desafios para o governo para aumentar a cobertura em pensões e riscos ocupacionais.

Cryptococcal Meningitis in an Immunocompetent Swiftlet Rancher – First Reported Case

@#Cryptococcal meningitis is a central nervous system infection cause by Cryptococcus neoformans. Although Cryptococcus is found in bird droppings, it has never been reported for those ranchers involved in the niche swiftlet ranching industry despite having close proximity with the bird droppings. We present here a case of a 41-year-old healthy swiftlet rancher who presents with a history of prolonged fever, headache and altered behaviour of a month duration. Cerebral spinal fluid analysis revealed the presence of Cryptococcus. He was treated with intravenous amphotericin B and flucytosine and discharged well with fluconazole consolidation therapy for 8 weeks, followed by maintenance therapy for 1 year. We believe this is the first reported case of Cryptococcal meningitis (CM) occurring in an immunocompetent swiftlet rancher. This case should highlight the needs to wear a proper personal protective equipment inside a swiftlet ranch due to the constant exposure to the potential cryptococcal-rich environment. A high index of suspicion, careful history taking and physical examination focusing on neurologic assessment is key to early diagnosis and timely management of CM.

The health impact of pesticide use in Lao farmers / Lao Medical Journal

Background and Rational@#WHO reported that 735,000 people suffering from chronic disease due to pesticide use. However, no study has been conducted to assess this health burden in the Lao PDR. Therefore, no appropriate strategy was implemented even though pesticide is widely used in Lao PDR. @*Objective@#To study the health impact amongst farmers utilizing pesticides for agriculture in Vientiane Capital.@*Methodology@#The cross-sectional study was conducted in farmers using pesticides. The total number included in the study was 247 people in Hadsayfong and Xaythany Districts. The data were collected from April to June 2017. The data were analysed using Stata version xx. Multiple logistic regression was used to assess the relationship between the health impact and pesticide use.@*Result@#We found that farmers are less educated and used pesticides incorrectly. The proportion of people having small and moderate symptoms were 56.3% and 43.7%, respectively. The factors associated with having symptoms were larger household size (Adjusted Odd Ratio =1.9; 95%CI= 1.0-3.6; P-value = 0.02), using pesticide longer than 3 hours each occasion (AOR=4.8; 95%CI= 2.6-8.9; P-value < 0.001), and using pesticide more than 8 times per month (AOR=0.5; 95%CI= 0.2-1; P-value = 0.01). Significant factors associated with not having symptoms included using materials to stir pesticide (AOR=0.5; 95%CI= 0.2-1; P-value=0.002) and wearing masks during pesticide spraying (AOR=0.4; 95%CI= 0.2-0.7; P-value=0.004).@*Conclusion and recommendation@#The study found that the knowledge of farmers towards pesticide’s side effects was mostly low with incorrect use. Without any appropriate education, farmers risk of suffering from chronic diseases such as cancer and dermatological diseases.

Difference in health status of Korean farmers according to gender

BACKGROUND: The objective of this study was to compare differences in lifestyle diseases, musculoskeletal pain, psychosocial stress, and self-health awareness according to gender in Korean farmers. METHODS: The study population comprised 436 farmers residing in rural areas in Korea. A self-administered questionnaire was used to survey demographic characteristics, health-related behaviors, and musculoskeletal pain. The psychosocial well-being index short form (PWI-SF) was used to survey psychosocial stress, and the 12-item short form health survey (SF-12) was used to survey self-health awareness. In addition, a clinical examination was performed for each participant, and lifestyle diseases were identified through a health checkup. RESULTS: Among lifestyle diseases, females showed a significantly higher proportion than males for metabolic syndrome (OR: 4.57 [95% CI, 1.67–12.51]). For musculoskeletal pain, females again showed significantly higher proportion than males for hand pain (OR: 16.79 [95% CI, 3.09–91.30]), and pain in at least one body part (OR: 2.34 [95% CI, 1.16–4.70]). For psychosocial stress, females showed a significantly higher proportion than males for high-risk stress (OR: 3.10 [95% CI, 1.17–8.24]). Among the items in self-health awareness, females showed significantly higher proportion than males for mental component score (MCS) (OR: 3.10 [95% CI, 1.52–6.31]) and total score (OR: 2.34 [95% CI, 1.11–4.90]). CONCLUSIONS: For all items that showed significant differences, females showed higher proportion than males, which indicates that female farmers tended to have poorer overall health than male farmers. Therefore, specialized programs will have to be developed to improve the health of female farmers.

Prevalence of Upper Extremity Musculoskeletal Diseases and Disability among Fruit Tree Farmers in Korea: Cross-Sectional Study

PURPOSE: The aim of this study was to examine the prevalence of upper extremity musculoskeletal (MSK) diseases and to identify factors influencing disability among fruit tree farmers in Korea. MATERIALS AND METHODS: Of the 1150 subjects of the Namgaram study, 460 fruit tree farmers completed a questionnaire and underwent clinical evaluations, including physical assessments, laboratory tests, simple radiographic examinations, and magnetic resonance imaging studies of the upper extremities. Disability was assessed using the Disabilities of the Arm, Shoulder, and Hand outcome measure. Data were analyzed with descriptive statistics and regression analyses using SPSS Win 24.0. RESULTS: The prevalences of upper extremity MSK diseases were 60.4% for rotator cuff tear, 20.9% for golf elbow, 40.9% for tennis elbow, and 58.0% for hand osteoarthritis. Disability in fruit farmers was associated with female sex (B=−4.47, p<0.001), smoking (B=−4.00, p=0.026), depression (B=2.83, p<0.001), working hours (B=0.96, p=0.001), injuries of the arms (B=10.78, p<0.001) and shoulders (B=6.75, p<0.001), and numbers of upper extremity MSK diseases (B=2.02, p=0.001), with 26.5% of the variance explained (R2=0.265, Durbin-Watson test=1.81, p<0.001). CONCLUSION: Fruit tree farmers remain at risk for MSK diseases of the upper extremities. Disability tended to worsen with more MSK diseases. It is necessary to not only educate farmers about prevention strategies, but also to develop an effective management system for agricultural work-related MSK diseases and a surveillance system at the government level for the health problems of farmers.

Pesticide exposure among students and their families in Nova Friburgo, Rio de Janeiro / Exposição a agrotóxicos entre estudantes e seus familiares em Nova Friburgo, Rio de Janeiro

Abstract Farming is a risky occupation, especially family farming in developing country. The occupational hazards commonly used in such activity could affect all family members, including children and adolescents. This study describes the pattern of pesticide exposure among students and their families from a farming region located in Nova Friburgo, State of Rio de Janeiro, Brazil. Sociodemographic characteristics, habits, working practices and the degree of exposure to pesticides were assessed by a questionnaire. Our study population consisted of students and family members of both sexes, aged between 6 and 85 years old (N = 352) being 167 women and 185 men. There was a predominance of participants between 10-19 years (71.3%), singles (77.5%), and most had not completed primary education (54.5%). In terms of occupation, 45.5% reported to be farmers and 39.6% were students. The variables mostly associated with pesticide exposure were sex (p < 0.001), educational level (p < 0.001), and being a farmer (p < 0.001). Our results showed that children and teenagers seemed to have the same degree of exposure to pesticides as the adults. Our findings also suggest that sex, occupation and educational level, despite teachers were included, are directly associated with degree of exposure.

Resumo Agricultura é uma ocupação de risco, principalmente a familiar em países em desenvolvimento. Os perigos ocupacionais comuns a essa atividade podem atingir a toda família, incluindo crianças e adolescentes. Este estudo descreve o padrão do uso de agrotóxicos entre estudantes e seus familiares em uma região agrícola localizada em Nova Friburgo, Estado do Rio de Janeiro, Brasil. Características sociodemográficas, hábitos, práticas de trabalho e grau de exposição a agrotóxicos foram adquiridas através do uso de questionário. Nossa população de estudo consistiu em estudantes e seus familiares de ambos os sexos, entre 6 e 85 anos de idade (N = 352) sendo 167 mulheres e 185 homens. Houve a predominância de participantes entre 10 - 19 anos (71,3%), solteiros (77,5%), e a maioria com o ensino fundamental incompleto (54,5%). Quanto à ocupação, 45,5% reportaram-se como agricultores e 39,6% como estudantes. As variáveis mais associadas à exposição a agrotóxicos foram sexo (p < 0,001), nível educacional (p < 0,001) e ser agricultor (p < 0,001). Nossos resultados mostraram que crianças e adolescentes parecem ter o mesmo grau de exposição a agrotóxicos que adultos. Nossos achados também sugerem que sexo, ocupação e nível educacional, incluindo professores, estão diretamente associados ao grau de exposição.

Analysis on cardio-metabolic related risk factors in farmers of 15 provinces in China / 中华流行病学杂志

Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.