ABSTRACT
Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children's noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built at different locations at increasing distances from the child's bedroom window using a validated strategic noise map. Multilevel logistic models were constructed to investigate factors associated with noise annoyance in children. Noise indicators in front of the child's bedroom (p ≤ 0.01), family residential satisfaction (p ≤ 0.03) and socioeconomic characteristics of the individuals and their neighbourhood (p ≤ 0.05) remained associated with child annoyance. These findings illustrate the complex relationships between our environment, how we may perceive it, social factors and health. Better understanding of these relationships will undoubtedly allow us to more effectively quantify the actual effect of noise on human health.
Subject(s)
Environmental Exposure/adverse effects , Noise, Transportation/prevention & control , Noise, Transportation/statistics & numerical data , Noise/adverse effects , Urban Population , Anger , Child , Cross-Sectional Studies , Environmental Exposure/prevention & control , Female , France/epidemiology , Housing , Humans , Male , Noise/prevention & control , Residence Characteristics , Schools , Self Report , Social Class , Surveys and QuestionnairesABSTRACT
BACKGROUND: Guidelines recommend antibiotic prophylaxis (AP) in well-selected groups of cirrhotic patients, but the impact of these recommendations has not been assessed in France. AIM: To evaluate AP prescription tendencies for gastrointestinal bleeding, and primary and secondary prophylaxis of spontaneous bacterial peritonitis (SBP). METHODS: Practitioners (n = 1,159) working in general hospitals (GH) or in university hospitals (UH) received a self-administered questionnaire. RESULTS: Three hundred and eighty-nine (33.6%; GH 35% and UH 30.4%) practitioners responded. AP was prescribed by 97.7%, 72.3% and 94.8% of practitioners, without significant differences between UH and GH, respectively, for gastrointestinal bleeding (quinolones 48.2%, third-generation cephalosporins 27.7% and amoxicillin-clavulanic acid 22.2%), primary (quinolones 97.2%) and secondary prophylaxis of SBP (quinolones 99%). For gastrointestinal bleeding, ofloxacin (47.6%) and norfloxacin (37.4%) were the main quinolones prescribed, and ceftriaxone (77%) was the main third-generation cephalosporin prescribed. The principal reasons for prescribing AP were a decrease in bacterial infection (88.9% for gastrointestinal bleeding, 91.3% for primary and 94.3% for secondary prophylaxis of SBP), a recommendation by a consensus conference (83%, 38% and 74.4% respectively) and an improvement in survival (72.8%, 41.3% and 57.7% respectively). Only 31.7% of practitioners (39.6% for UH vs. 28.6% for GH; P = 0.038) believed that AP may reduce the risk of bleeding recurrence. Reported side effects (28%) of AP mainly concerned the risk of quinolone resistance (62% of cases). CONCLUSION: Antibiotic prophylaxis is well-recognized by French practitioners, but its routine use depends on the expertise of practitioners. Quinolones remain the main antibiotic class prescribed irrespective of the type of prophylaxis.
