Annoyance and health symptoms and their influencing factors: a population-based air pollution intervention study.

OBJECTIVES: Interventions for reducing air pollution are important means for improving public health. The role of psychological factors in understanding annoyance and health symptoms due to air pollution is limited and further investigation is required. This study aimed to investigate the effects of an intervention to reduce air pollution (predominantly dust and soot) with respect to perceived pollution, risk perception, annoyance and health symptoms. Another objective was to test a model that describes inter-relations between air pollution, perceived pollution, health risk perception, annoyance and health symptoms. STUDY DESIGN: An interventional, population-based questionnaire study. METHODS: Surveys were performed before (pre-test) and after (post-test) closure of a sinter plant. Instead, pellets were shipped to the community's harbour for steel production. Individuals in the community aged 18-75 years were selected at random for participation in the pre-test (n=738; 74% of the sample participated) and post-test (n=684; 68% of the sample participated). The two samples were representative of the populations at the two points in time, and thus not identical. RESULTS: After the sinter plant was closed, the environment was perceived as being less dusty, the residents were more positive in their risk perception, and they reported less annoyance due to dust, soot and odorous substances. No difference was found for health symptoms between the pre-test and the post-test. Based on path analyses, a model is proposed of inter-relations between air pollution, perceived pollution, health risk perception, annoyance and health symptoms. CONCLUSION: The intervention was successful with respect to perceived dust and soot pollution; to annoyance attributed to dust, soot and odorous substances; and to risk perception. The path analyses suggest that perceived pollution and health risk perception play important roles in understanding and predicting environmentally induced annoyance and health symptoms.

Gender differences in factors affecting rejection of food in healthy young Swedish adults.

With the objectives to better understand gender-related differences in variables of importance for food intake, and interrelations between these variables, 100 healthy, young women and 100 healthy, young men responded to self-administrated questionnaires about general food rejection, learned illness-associated food aversions, disgust (the Disgust Scale), food neophobia (the Food Neophobia Scale), nausea and appetite. The results show that food rejection and aversions were more common in women (69 and 38%, respectively) than in men (47 and 18%), and that women are more disgust sensitive than men. However, no differences between women and men were observed regarding reasons for rejecting food (predominantly sensory attributes), prevalence of gastrointestinal illness as an associated aversion symptom (95 vs 89%), type of aversive food due to associated illness (predominantly high protein items), or food neophobia. Based on path analyses, a model is proposed of interrelations between disgust, food neophobia, learned food aversions, nausea, appetite, and general food rejection in healthy young adults.

Environmental influences on psychological restoration.

Research on psychological restoration and restorative environments is a needed complement to work on stress and environmental stressors. Two laboratory experiments tested the utility of two restorative environments theories, one concerned with directed attention capacity renewal and the other with stress reduction and associated changes in emotion. Various strategies were employed to distinguish restorative effects from other effects, to limit the role of arousal reduction in attentional restoration, and to begin mapping the time course for the emergence of outcomes. Both experiments tested for differential emotional and performance effects as a function of photographic environmental simulation (natural or urban environment). Across the experiments the natural environment simulation engendered generally more positive emotional self-reports. That consistent performance effects were not found in either study suggests that attentional restoration as reflected in performance is a more time-intensive process.

Hemisphere inactivation and mood-state changes.

Mood-state changes were studied during a sodium Amytal testing procedure in epilepsy patients with unilateral temporal lobe foci. The results showed that inactivation of the left hemisphere, but not the right hemisphere, produced a negative mood state. This decline in mood was not specifically related to side of focus or sex. As expected, the inactivation of either hemisphere also lead to an impairment in memory performance. This impairment was somewhat worse during a left than a right hemisphere inactivation. Furthermore, patients with left hemisphere foci showed a lower memory performance than patients with a right-hemisphere lesion. These results suggest (a) a hemispheric specialization for emotion that underlie changes in mood and (b) a discrepancy between mood states at encoding (during inactivation) and retrieval (after inactivation).

Psychological factors in orthognathic surgery.

27 patients subjected to various orthognathic surgery procedures were studied preoperatively and during a period of 18 months postoperatively by a team of psychologists to evaluate the patients' own opinions concerning the indication for surgery, information about the surgical procedure, the postoperative period and the long-term aesthetic and functional results. The patients were interviewed 5 times: 2 days before surgery, 2 days after surgery and 2, 6 and 18 months after surgery. The decision to undergo surgery was taken after a long period of time, 4 years on average, and half of the patients were influenced by their family or dentist before they made their decision. 60% gave three or more reasons for surgery, 85% mentioned functional problems, 74% facial appearance and 59% craniomandibular symptoms. 63% indicated that the facial appearance problems had negatively influenced their personal life and 44% their social life. Women experienced this problem more often than men. The results showed that the overall majority of patients were relieved of their presurgical problems. The aesthetic improvement was better than expected. It was found that improvements in facial features had a beneficial influence on the patients as individuals and also on their social life situation.

Epidural analgesia with bupivacaine reduces postoperative paralytic ileus after hysterectomy.

This study was undertaken to compare the effects of postoperative bupivacaine epidural analgesia with those of intermittent injections of ketobemidone (a synthetic opioid) on postoperative bowel motility in patients who had had hysterectomies. The epidural group (N = 20) received continuous epidural anesthesia with bupivacaine postoperatively for 26-30 hours and the control group (N = 20) received intermittent injections of ketobemidone for postoperative pain relief. Postoperative bowel movements and propulsive colonic motility were estimated from the first passage of flatus and feces and by following radiopaque markers by serial abdominal radiographs. In the epidural group, the times for first passing of flatus (31 +/- 22 hours; mean +/- SD) and feces (70 +/- 44 hours) were significantly shorter than in the control group (flatus 58 +/- 14 hours and feces 103 +/- 26 hours). The average position of the markers was significantly more distally in the epidural group immediately after operation and the markers continued to move forward during the first postoperative day. In the control group, the markers did not move during this period. The results demonstrate that postoperative bowel peristalsis returned earlier in the patients given epidural analgesia with bupivacaine for pain relief than in patients given a narcotic.

Effects of epidural bupivacaine and epidural morphine on bowel function and pain after hysterectomy.

A comparison was made of the effects of continuous epidural analgesia with bupivacaine and intermittent epidural morphine on bowel function after abdominal hysterectomy. The duration of postoperative ileus was assessed as the time from the end of operation to the first postoperative passage of flatus and feces. Twenty-two patients were randomly allocated to two equal groups. An "epidural morphine" group received general anesthesia and epidural morphine for postoperative pain relief, and an "epidural bupivacaine" group was given combined general anesthesia and epidural anesthesia with 0.5% bupivacaine intraoperatively and epidural analgesia with 0.25% bupivacaine postoperatively. Epidural morphine or bupivacaine was given for 42 h postoperatively. Pain intensity (visual analog scale) was low in both groups, but lower (P less than 0.05) in the epidural bupivacaine group. The time to first passage of flatus was 22 +/- 16 h in the epidural bupivacaine group and 56 +/- 22 h in the epidural morphine group (P less than 0.001). The time to first postoperative passage of feces was shorter (P less than 0.05) in the former than in the latter 57 +/- 44 h vs 92 +/- 22 h). The patients of the epidural bupivacaine group started intake of oral fluids earlier (P less than 0.01) and to a greater extent (P less than 0.05) than those in the epidural morphine group. It is concluded that the duration of postoperative ileus after hysterectomy is shorter when epidural bupivacaine is given for postoperative pain relief than when this is achieved by epidural morphine.