This document provides instructions for a narrated PowerPoint presentation assignment for an international social work course. Students must create a 10-15 slide presentation on an approved topic related to international social work. The presentation must include at least 4 references formatted in APA style. It should be presented as if to a Christian high school audience. Students must include notes and an audio recording. Suggested topics are provided or students can suggest their own topic for instructor approval. The completed presentation is due by the specified deadline.
Screening Tool for Developmental Disorders in ChildrenApollo Hospitals
Developmental problems are a diverse group of conditions that affect and limit children and their life-chances. A ready reference for a Paediatrician would be the first six chapters of the latest edition (18th) of the Nelson Textbook of Pediatrics (The Field of Pediatrics, Growth & Development, Psychological Disorders, Social Issues, Children with Special Health Needs and Nutrition and Human Genetics and Metabolic Diseases).
Prevalence of Anamiea and Its Predictors in Pregnant Women Attending Antenata...iosrjce
Background: Anemia impairs cognitive development, reduces physical work capacity and in severe cases
increases risk of mortality particularly during prenatal period. In India, 16% of maternal deaths are attributed
to anemia. However, high prevalence of anemia among pregnant women persists in India despite the
availability of effective, low-cost interventions for prevention and treatment. Aknowledge of them
sociodemographic factors associated with anemia will help to formulate multipronged strategies to attack this
important public health problem in pregnancy.
Objective: To assess the prevalence of anaemia and its predicting factors among pregnant women attending
antenatal clinic at Tertiary care center.
Study Design: Descriptive cross-sectional study
Methods: A hospital based cross-sectional study design was conducted from January 2014 – September 2014
among 5788 pregnant womens who had been attending antenatal clinic. Red blood cell morphology and Hgb
level determination were assessed following the standard procedures. Socio-demographic data was collected by
using a structured questionnaire. The data entered and analyzed by using the SPSS version 16.0 statistical
software. P<0.05 was considered as statistically significant.
Result: Overall prevalence of anemia among the pregnant women was found to be 86.37%. Factors such as
diet, level of education of women and their husbands and socioeconomic status were found to be significantly
associated with the prevalence of anemia in pregnancy.
Conclusion: The present study showed high prevalence of anemia and the majority of them were of the
moderate type (hemoglobin: 10-10.9 g/dl). Low socioeconomic class, illiteracy, Multiparous were significantly
associated with high prevalence of anemia during pregnancy in Indian women.
Screening Tool for Developmental Disorders in ChildrenApollo Hospitals
Developmental problems are a diverse group of conditions that affect and limit children and their life-chances. A ready reference for a Paediatrician would be the first six chapters of the latest edition (18th) of the Nelson Textbook of Pediatrics (The Field of Pediatrics, Growth & Development, Psychological Disorders, Social Issues, Children with Special Health Needs and Nutrition and Human Genetics and Metabolic Diseases).
Prevalence of Anamiea and Its Predictors in Pregnant Women Attending Antenata...iosrjce
Background: Anemia impairs cognitive development, reduces physical work capacity and in severe cases
increases risk of mortality particularly during prenatal period. In India, 16% of maternal deaths are attributed
to anemia. However, high prevalence of anemia among pregnant women persists in India despite the
availability of effective, low-cost interventions for prevention and treatment. Aknowledge of them
sociodemographic factors associated with anemia will help to formulate multipronged strategies to attack this
important public health problem in pregnancy.
Objective: To assess the prevalence of anaemia and its predicting factors among pregnant women attending
antenatal clinic at Tertiary care center.
Study Design: Descriptive cross-sectional study
Methods: A hospital based cross-sectional study design was conducted from January 2014 – September 2014
among 5788 pregnant womens who had been attending antenatal clinic. Red blood cell morphology and Hgb
level determination were assessed following the standard procedures. Socio-demographic data was collected by
using a structured questionnaire. The data entered and analyzed by using the SPSS version 16.0 statistical
software. P<0.05 was considered as statistically significant.
Result: Overall prevalence of anemia among the pregnant women was found to be 86.37%. Factors such as
diet, level of education of women and their husbands and socioeconomic status were found to be significantly
associated with the prevalence of anemia in pregnancy.
Conclusion: The present study showed high prevalence of anemia and the majority of them were of the
moderate type (hemoglobin: 10-10.9 g/dl). Low socioeconomic class, illiteracy, Multiparous were significantly
associated with high prevalence of anemia during pregnancy in Indian women.
A Study to Assess the Effectiveness of Structured Teaching Programme on Knowl...ijtsrd
Statement of problem “A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention and Prevalence of Anemia among Adolescent Girls in A Selected areas.â€Material and Methods In the present study one group pre test and post test experimental descriptive research design is used to collect the sample from selected areas of Mohali of 100 adolescent girls. The sample is collected through purposive sampling technique. The data is collected by socio demographic questionnaire and self instructional module.Result Majority 58 58 of the adolescent girls had inadequate knowledge, 40 40 had moderate knowledge and 02 2 had adequate knowledge in pre test before administering structured teaching program. After getting structured teaching program, 15 15 of adolescent girls had moderate knowledge and 85 85 of adolescent girls had reported adequate knowledge. It is significantly shows that there is association between knowledge levels of adolescent girls regarding prevention and prevalence of anemia and demographic variables.Conclusion It was concluded that there is gain in knowledge after teaching program and there is significant association between level of knowledge and demographic variables. Ms. Deepti | Dr. Priyanka Chaudhary | Ms. Ramanpreet Kaur | Ms. P. Chitra "A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention and Prevalence of Anemia among Adolescent Girls in Selected Areas" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd49097.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/49097/a-study-to-assess-the-effectiveness-of-structured-teaching-programme-on-knowledge-regarding-prevention-and-prevalence-of-anemia-among-adolescent-girls-in-selected-areas/ms-deepti
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
SCOOTEROER31c Sickle Cell in Schools SurveyVivien Rolfe
Lecture series on research into the educational experiences of young people with sickle cell disease. A narrated version is available on the SCOOTER project website. http://www.sicklecellanaemia.org/OER/resources/scooter30-35/scooter31.html
A systematic review of prevention interventions to reduce prenatal alcohol ex...BARRY STANLEY 2 fasd
Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol
exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention
interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates
the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work.
The EWC is very interested in your synchronous advising experience.docxmehek4
The EWC is very interested in your synchronous advising experience, and we invite you to
complete a short survey: EWC Synchronous Advising Survey.
The information that you share will help us to improve and customize our services.
If you want to schedule another appointment, please email [email protected]
WRTG 391
· annotated bibliography of 12 sources.
· each reference will be followed by a short analytical summary of 150-200 words.
· At the end of the short summary, you will include a sentence or two that critically analyzes the source and mentions distinctive features about the article and why it may or may not be useful for you in writing a literature review.
instructor said:
ROUGH DRAFT FEEDBACK:
Ronald, the sources you have gathered appear to be scholarly and credible. They also appear to be linked to your general topic for the literature review. While your summary of each source is mostly clear and on track (although much more editing is needed to correct phrasing and grammatical errors), your paper lacks a 1-2 sentence critical analysis for each source; in your critical analysis, you should be explaining why each source will or will not be useful for your literature review.assignment. It also looks as though your bibliographical entries for each source are missing a volume number and "doi" or "retrieved from" at the end of the citation. Please check for correct citation format. I would recommend submitting your draft to UMUC's Writing Center for free feedback in order to edit and proofread your paper for grammatical errors ("raised game concerning," "focuses on trend," "changed on children environment," etc.). Also, try reading each sentence out loud. Sometimes "a" and "the" are missing in your sentences. Good luck on your revision!
We discussed correcting his references. Then we read through most of his draft.ACTION STEPS
1. Left align your paper.
2. Your citations are NOT APA compliant. Use this link to see what they should be: http://sites.umuc.edu/library/libhow/apa_examples.cfm
3. Read your essay out loud to hear errors.
4. Eliminate contractions.
5. Learn about possessive nouns.
6. Mention the author(s) in your summaries.
7. Keep one idea to one paragraph.
8. Stay with past tense.
POSSESSIVE NOUNS
From http://www.beth.k12.pa.us/schools/wwwclass/kgrammes/kgrammesgrammar.htm#Possessive
A possessive noun indicates ownership.
Rules:
1. Add an 's to make a singular noun possessive
Example: Chris's coat, the puppy's ears, Mark Twain's stories
2. Add only an ' to make a plural noun possessive
Example: doctors' offices, the Evanses' trip, soldiers' uniforms
3. Add an 's to a plural noun that does not end in s
Example: mice's hole, children's toys, women's dresses
4. Add an 's or only an ' to the end of a compound noun
Example: salesperson's smile, father-in-law's tool, police officers' badges
This handout on possessive nouns will help clarify this issue.
Schedule your next session!
Thanks for contacting th ...
Running head POPULATION STUDY1POPULATION STUDY5.docxtoltonkendal
Running head: POPULATION STUDY 1
POPULATION STUDY 5
Population Study
Student’s Name
University Affiliation
Population Study: Adolescents of Age 14-24 Years
Population study typically refers to a study of a group of individuals that is taken from the general population, have similar characteristics, for example, health condition, sex or age. There are several reasons for taking such studies related to such a specific group, and this may include the risk of contracting a disease or response to a drug. Examples of such study groups include school going age adolescents, newborn babies, pregnant women between the age of 20 and 40 years, aged population, among others.
Awareness and Knowledge of HIV and Other Sexually Transmitted Diseases among Adolescents of Age 14-24 Years
HIV, as well as other sexually transmitted diseases, constitutes the largest portion of health cases affecting the youths globally. Such diseases if not taken care of may lead to more complicated cases in future such as cancer, AIDS, infertility, among other cases. Such cases occur mostly in youths due to a vulnerability to which they are exposed to. And thus, there is need to create awareness as well as health education among such school-going adolescents so as to reduce these cases (Berglund, 2001).
Criteria for Inclusion
For this kind of study group, it should include all school attending students of ages between 14 years and 24 years, should be conducted and published between 1990 and 2015, be a cross-sectional studies, the studies should focus on knowledge as well as awareness of HIV and other sexually transmitted diseases among the adolescents, and lastly the studies should have measurement of knowledge or awareness (Health protection Surveillance Centre, 2005).
Exclusion Criteria
The exclusion criteria should include case reports, non-specific risk groups (such as the drug users, homosexuals, etc.), studies that seek to evaluate intervention programs, review, expert opinions, editorials, letters, and studies that are mainly on sexual activities and or behaviors.
The study group should be chosen randomly and be done majorly by targeting the institutions of learning where there is a normal distribution of such youths. In this manner, the results obtained will likely be accurate since the equal distribution represents the reality about the population.
Risk Factors: Health risk factors includes young adolescents who are exposed to sex and possess little knowledge and awareness concerning safe sex. In targeting such population, it should be taken into account that there could be an increase in the number of infections facing adolescents of age between 14 and 18 years (World Health Organisation, 2001).
Demographics: The population understudies will include all young adolescents both girls and boys falling under the age bracket that has been considered for the study.
Socio-economics: Knowledge and awareness of sexually transmitted diseases will majorl ...
Identifying and Prioritizing Chemicals with Uncertain Burden oMalikPinckney86
Identifying and Prioritizing Chemicals with Uncertain Burden of Exposure:
Opportunities for Biomonitoring and Health-Related Research
Edo D. Pellizzari,1 Tracey J. Woodruff,2 Rebecca R. Boyles,3 Kurunthachalam Kannan,4 Paloma I. Beamer,5 Jessie P. Buckley,6
Aolin Wang,2 Yeyi Zhu,7,8 and Deborah H. Bennett9 (Environmental influences on Child Health Outcomes)
1Fellow Program, RTI International, Research Triangle Park, North Carolina, USA
2Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San
Francisco, San Francisco, California, USA
3Bioinformatics and Data Science, RTI International, Research Triangle Park, North Carolina, USA
4Wadsworth Center, New York State Department of Health, Albany, New York, USA
5Department of Community, Environment and Policy, Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
6Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Heath, Johns Hopkins University,
Baltimore, Maryland, USA
7Northern California Division of Research, Kaiser Permanente, Oakland, California, USA
8Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
9Department of Public Health Sciences, University of California, Davis, Davis, California, USA
BACKGROUND: The National Institutes of Health’s Environmental influences on Child Health Outcomes (ECHO) initiative aims to understand the
impact of environmental factors on childhood disease. Over 40,000 chemicals are approved for commercial use. The challenge is to prioritize chemi-
cals for biomonitoring that may present health risk concerns.
OBJECTIVES: Our aim was to prioritize chemicals that may elicit child health effects of interest to ECHO but that have not been biomonitored nation-
wide and to identify gaps needing additional research.
METHODS: We searched databases and the literature for chemicals in environmental media and in consumer products that were potentially toxic. We
selected chemicals that were not measured in the National Health and Nutrition Examination Survey. From over 700 chemicals, we chose 155 chemi-
cals and created eight chemical panels. For each chemical, we compiled biomonitoring and toxicity data, U.S. Environmental Protection Agency ex-
posure predictions, and annual production usage. We also applied predictive modeling to estimate toxicity. Using these data, we recommended
chemicals either for biomonitoring, to be deferred pending additional data, or as low priority for biomonitoring.
RESULTS: For the 155 chemicals, 97 were measured in food or water, 67 in air or house dust, and 52 in biospecimens. We found in vivo endocrine, de-
velopmental, reproductive, and neurotoxic effects for 61, 74, 47, and 32 chemicals, respectively. Eighty-six had data from high-throughput in vitro
assays. Positive results for endocrine, developmental, neurotoxicity, ...
Fetal Alcohol Spectrum Disorder is a clinical condition that has aroused the interest of researchers as it is considered relatively common in the population, with an incidence of approximately 10 cases per 1,000 births. The neurodevelopmental changes that characterize the phenotype of this condition are described by deficits in memory, attention, visual-spatial and executive function, learning disabilities and the presence of spoken language impairment. Considering the language deficit as part of Fetal Alcohol Spectrum Disorder, we proposed to review the literature to identify which procedures are used in the assessment of language and findings reported in language in Fetal Alcohol Spectrum Disorder. The 21 articles selected in this review reflect variability in methodology and commonly used procedures assessment of spoken language. The spoken language profile of individuals diagnosed with Fetal Alcohol Spectrum Disorder is characterized by different performance and with varying degrees of impairment. Several factors influence the variability of spoken language impairment described in Fetal Alcohol Spectrum Disorders, and the amount of alcohol consumed, the gestation period when consumption took place and individual susceptibility of each fetus to metabolize alcohol in the body are often described
Correlation between Blood group, Hypertension, Obesity, Diabetes, and combina...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
For this assignment, you will be developing and presenting an EducShainaBoling829
For this assignment, you will be developing and presenting an Educational, Narrative PowerPoint. In the presentation of your chosen topic, be sure to examine the pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan (MN551-3).
Narrative, PowerPoint Assignment Requirements
· Make sure all of the content topics of the assignment have been addressed.
· Cite at least three references in your PowerPoint; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
· All reference sources must be within 5 years.
· Do not use sources such as Wikipedia or UpToDate as a reference.
ASSIGMENT DIRECCION
Design and develop a 8- to 12-slide PowerPoint presentation using voice/narrative feature on each slide (the title and reference slides do not count in the slide count, but must be included in the assignment), that will be used to educate the community about one of the following topics:
· Type II Diabetes
· Atherosclerosis
· Hypertension
· Depression
· Urinary Tract Infection
Narrative, PowerPoint Contents to include, but not be limited to:
· Risk factors and causes
· Possible consequences
· Prevention Strategies
· Treatment Modalities
PowerPoint Format:
· Follow APA 7th edition format for PowerPoint presentations.
· Use the slide notes section in the presentation to include information that follows your narration, being sure to follow the conventions of Standard English.
· Slide content should include brief points that identify the areas that will be addressed in the narration.
· In-text citations should be included with any brief points that were researched from outside sources, and the narration should fully explain the points.
· Reference all sources on a separate reference slide at the end of the presentation and cite each source in the body of the presentation using 7th edition APA format.
· Identify the sources of any pictures you use, being sure to cite them correctly in 7th edition APA style, using in-text citations.
Narration Guidelines:
· Maintain a professional tone by summarizing observations and evaluations for each slide.
· Ensure that your presentation is highly ordered, logical, and unified.
· Words should be clearly enunciated and professional tone should be sustained throughout the presentation narration.
· Audio recording should be free of background noise and interruptions.
Before finalizing your work, it is important to:
· Review Narrative PowerPoint Assignment Requirements (described above) and the Narrative PowerPoint Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
· Make sure to review your chosen topic carefully to make sure you have answered all content effectively.
· Utilize spelling and grammar checks to minimize errors.
· Follow the conventions of Standard English (correct grammar, punctuation, etc.).
· ...
In this unit, you will experience the powerful impact communication .docxwhitneyleman54422
In this unit, you will experience the powerful impact communication and miscommunication can have on cultural diversity.
Download the Communication: The Journey of Message Template
Follow the template instructions
Demonstrate your understanding of key concepts from the weekly content by including analysis of specific evidence in your responses within the template.
Use in-text citations and APA formatting for all source material references in your template.
Upload the completed template to this assessment.
.
In this task, you will write an analysis (suggested length of 3–5 .docxwhitneyleman54422
In this task, you will write an analysis (
suggested length of 3–5 pages
) of one work of literature. Choose
one
work from the list below:
Classical Period
• Sappho, “The Anactoria Poem” ca. 7th century B.C.E. (poetry)
• Aeschylus, “Song of the Furies” from
The Eumenides
, ca. 458 B.C.E. (poetry)
• Sophocles,
Antigone
, ca. 442 B.C.E. (drama)
• Aristotle, Book 1 from the
Nichomachean Ethics
, ca. 35 B.C.E. (philosophical text)
• Augustus,
The Deeds of the Divine Augustus
, ca. 14 C.E. (funerary inscription)
• Ovid, “The Transformation of Daphne into a Laurel” an excerpt from Book 1 of
The Metamorphoses
, ca. 2 C.E. (poetry)
Renaissance
• Francesco Petrarch, “The Ascent of Mount Ventoux” 1350 (letter)
• Giovanni Pico della Mirandola, the first seven paragraphs of the “Oration on the Dignity of Man” ca. 1486 (essay excerpt)
• Leonardo da Vinci, Chapter 28 “Comparison of the Arts” from
The Notebooks
ca. 1478-1518 (art text)
• Edmund Spenser, Sonnet 30, “My Love is like to Ice” from
Amoretti
1595 (poetry)
• William Shakespeare, Sonnet 18, “Shall I Compare Thee to a Summer’s Day” 1609 (poetry)
• Francis Bacon, “Of Studies” from
The Essays or Counsels…
1625 (essay)
• Anne Bradstreet, “In Honour of that High and Mighty Princess, Queen Elizabeth” 1643 (poetry)
• Andrew Marvell, “To his Coy Mistress” 1681 (poetry)
Enlightenment
• René Descartes, Part 4 from
Discourse on Method
, 1637 (philosophical text)
• William Congreve,
The Way of the World
, 1700 (drama-comedy)
• Jonathan Swift, “A Modest Proposal” 1729 (satirical essay)
• Voltaire, “Micromégas” 1752 (short story, science fiction)
• Phillis Wheatley, “To S.M., a Young African Painter, on Seeing his Works” 1773 (poetry)
• Thomas Paine, “Common Sense” 1776 (essay)
• Johann Wolfgang von Goethe, “The Fisherman” 1779 (poetry)
• Immanuel Kant, “An Answer to the Question: What is Enlightenment?” 1784 (essay)
Romanticism
• Lord Byron, “She Walks in Beauty” 1813 (poetry)
• Samuel Taylor Coleridge, “Kubla Khan” 1816 (poetry)
• Edgar Allan Poe, “The Fall of the House of Usher” 1839 (short story)
• Alexander Dumas,
The Count of Monte Cristo
, 1844 (novel)
• Emily Brontë,
Wuthering Heights
, 1847 (novel)
• Herman Melville, “Bartleby, the Scrivener: A Story of Wall-Street” 1853 (short story)
• Emily Dickinson, “A Narrow Fellow in the Grass” 1865 (poetry)
• Friedrich Nietzsche, Book 4 from
The Joyful Wisdom
, 1882 (philosophical text)
Realism
• Charles Dickens,
A Christmas Carol
, 1843 (novella)
• Karl Marx and Friedrich Engles,
The Communist Manifesto
, 1848 (political pamphlet)
• Christina Rossetti, “Goblin Market” 1862 (poetry)
• Matthew Arnold, “Dover Beach” 1867 (poetry)
• Robert Louis Stevenson,
The Strange Case of Dr. Jekyll and Mr. Hyde
, 1886 (novella)
• Kate Chopin, “The Story of an Hour” 1894 (short story)
• Mark Twain, “The.
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Similar to SOWK 425PowerPoint Presentation InstructionsFor this assignmen.docx
A Study to Assess the Effectiveness of Structured Teaching Programme on Knowl...ijtsrd
Statement of problem “A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention and Prevalence of Anemia among Adolescent Girls in A Selected areas.â€Material and Methods In the present study one group pre test and post test experimental descriptive research design is used to collect the sample from selected areas of Mohali of 100 adolescent girls. The sample is collected through purposive sampling technique. The data is collected by socio demographic questionnaire and self instructional module.Result Majority 58 58 of the adolescent girls had inadequate knowledge, 40 40 had moderate knowledge and 02 2 had adequate knowledge in pre test before administering structured teaching program. After getting structured teaching program, 15 15 of adolescent girls had moderate knowledge and 85 85 of adolescent girls had reported adequate knowledge. It is significantly shows that there is association between knowledge levels of adolescent girls regarding prevention and prevalence of anemia and demographic variables.Conclusion It was concluded that there is gain in knowledge after teaching program and there is significant association between level of knowledge and demographic variables. Ms. Deepti | Dr. Priyanka Chaudhary | Ms. Ramanpreet Kaur | Ms. P. Chitra "A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention and Prevalence of Anemia among Adolescent Girls in Selected Areas" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd49097.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/49097/a-study-to-assess-the-effectiveness-of-structured-teaching-programme-on-knowledge-regarding-prevention-and-prevalence-of-anemia-among-adolescent-girls-in-selected-areas/ms-deepti
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
SCOOTEROER31c Sickle Cell in Schools SurveyVivien Rolfe
Lecture series on research into the educational experiences of young people with sickle cell disease. A narrated version is available on the SCOOTER project website. http://www.sicklecellanaemia.org/OER/resources/scooter30-35/scooter31.html
A systematic review of prevention interventions to reduce prenatal alcohol ex...BARRY STANLEY 2 fasd
Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol
exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention
interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates
the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work.
The EWC is very interested in your synchronous advising experience.docxmehek4
The EWC is very interested in your synchronous advising experience, and we invite you to
complete a short survey: EWC Synchronous Advising Survey.
The information that you share will help us to improve and customize our services.
If you want to schedule another appointment, please email [email protected]
WRTG 391
· annotated bibliography of 12 sources.
· each reference will be followed by a short analytical summary of 150-200 words.
· At the end of the short summary, you will include a sentence or two that critically analyzes the source and mentions distinctive features about the article and why it may or may not be useful for you in writing a literature review.
instructor said:
ROUGH DRAFT FEEDBACK:
Ronald, the sources you have gathered appear to be scholarly and credible. They also appear to be linked to your general topic for the literature review. While your summary of each source is mostly clear and on track (although much more editing is needed to correct phrasing and grammatical errors), your paper lacks a 1-2 sentence critical analysis for each source; in your critical analysis, you should be explaining why each source will or will not be useful for your literature review.assignment. It also looks as though your bibliographical entries for each source are missing a volume number and "doi" or "retrieved from" at the end of the citation. Please check for correct citation format. I would recommend submitting your draft to UMUC's Writing Center for free feedback in order to edit and proofread your paper for grammatical errors ("raised game concerning," "focuses on trend," "changed on children environment," etc.). Also, try reading each sentence out loud. Sometimes "a" and "the" are missing in your sentences. Good luck on your revision!
We discussed correcting his references. Then we read through most of his draft.ACTION STEPS
1. Left align your paper.
2. Your citations are NOT APA compliant. Use this link to see what they should be: http://sites.umuc.edu/library/libhow/apa_examples.cfm
3. Read your essay out loud to hear errors.
4. Eliminate contractions.
5. Learn about possessive nouns.
6. Mention the author(s) in your summaries.
7. Keep one idea to one paragraph.
8. Stay with past tense.
POSSESSIVE NOUNS
From http://www.beth.k12.pa.us/schools/wwwclass/kgrammes/kgrammesgrammar.htm#Possessive
A possessive noun indicates ownership.
Rules:
1. Add an 's to make a singular noun possessive
Example: Chris's coat, the puppy's ears, Mark Twain's stories
2. Add only an ' to make a plural noun possessive
Example: doctors' offices, the Evanses' trip, soldiers' uniforms
3. Add an 's to a plural noun that does not end in s
Example: mice's hole, children's toys, women's dresses
4. Add an 's or only an ' to the end of a compound noun
Example: salesperson's smile, father-in-law's tool, police officers' badges
This handout on possessive nouns will help clarify this issue.
Schedule your next session!
Thanks for contacting th ...
Running head POPULATION STUDY1POPULATION STUDY5.docxtoltonkendal
Running head: POPULATION STUDY 1
POPULATION STUDY 5
Population Study
Student’s Name
University Affiliation
Population Study: Adolescents of Age 14-24 Years
Population study typically refers to a study of a group of individuals that is taken from the general population, have similar characteristics, for example, health condition, sex or age. There are several reasons for taking such studies related to such a specific group, and this may include the risk of contracting a disease or response to a drug. Examples of such study groups include school going age adolescents, newborn babies, pregnant women between the age of 20 and 40 years, aged population, among others.
Awareness and Knowledge of HIV and Other Sexually Transmitted Diseases among Adolescents of Age 14-24 Years
HIV, as well as other sexually transmitted diseases, constitutes the largest portion of health cases affecting the youths globally. Such diseases if not taken care of may lead to more complicated cases in future such as cancer, AIDS, infertility, among other cases. Such cases occur mostly in youths due to a vulnerability to which they are exposed to. And thus, there is need to create awareness as well as health education among such school-going adolescents so as to reduce these cases (Berglund, 2001).
Criteria for Inclusion
For this kind of study group, it should include all school attending students of ages between 14 years and 24 years, should be conducted and published between 1990 and 2015, be a cross-sectional studies, the studies should focus on knowledge as well as awareness of HIV and other sexually transmitted diseases among the adolescents, and lastly the studies should have measurement of knowledge or awareness (Health protection Surveillance Centre, 2005).
Exclusion Criteria
The exclusion criteria should include case reports, non-specific risk groups (such as the drug users, homosexuals, etc.), studies that seek to evaluate intervention programs, review, expert opinions, editorials, letters, and studies that are mainly on sexual activities and or behaviors.
The study group should be chosen randomly and be done majorly by targeting the institutions of learning where there is a normal distribution of such youths. In this manner, the results obtained will likely be accurate since the equal distribution represents the reality about the population.
Risk Factors: Health risk factors includes young adolescents who are exposed to sex and possess little knowledge and awareness concerning safe sex. In targeting such population, it should be taken into account that there could be an increase in the number of infections facing adolescents of age between 14 and 18 years (World Health Organisation, 2001).
Demographics: The population understudies will include all young adolescents both girls and boys falling under the age bracket that has been considered for the study.
Socio-economics: Knowledge and awareness of sexually transmitted diseases will majorl ...
Identifying and Prioritizing Chemicals with Uncertain Burden oMalikPinckney86
Identifying and Prioritizing Chemicals with Uncertain Burden of Exposure:
Opportunities for Biomonitoring and Health-Related Research
Edo D. Pellizzari,1 Tracey J. Woodruff,2 Rebecca R. Boyles,3 Kurunthachalam Kannan,4 Paloma I. Beamer,5 Jessie P. Buckley,6
Aolin Wang,2 Yeyi Zhu,7,8 and Deborah H. Bennett9 (Environmental influences on Child Health Outcomes)
1Fellow Program, RTI International, Research Triangle Park, North Carolina, USA
2Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San
Francisco, San Francisco, California, USA
3Bioinformatics and Data Science, RTI International, Research Triangle Park, North Carolina, USA
4Wadsworth Center, New York State Department of Health, Albany, New York, USA
5Department of Community, Environment and Policy, Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
6Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Heath, Johns Hopkins University,
Baltimore, Maryland, USA
7Northern California Division of Research, Kaiser Permanente, Oakland, California, USA
8Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
9Department of Public Health Sciences, University of California, Davis, Davis, California, USA
BACKGROUND: The National Institutes of Health’s Environmental influences on Child Health Outcomes (ECHO) initiative aims to understand the
impact of environmental factors on childhood disease. Over 40,000 chemicals are approved for commercial use. The challenge is to prioritize chemi-
cals for biomonitoring that may present health risk concerns.
OBJECTIVES: Our aim was to prioritize chemicals that may elicit child health effects of interest to ECHO but that have not been biomonitored nation-
wide and to identify gaps needing additional research.
METHODS: We searched databases and the literature for chemicals in environmental media and in consumer products that were potentially toxic. We
selected chemicals that were not measured in the National Health and Nutrition Examination Survey. From over 700 chemicals, we chose 155 chemi-
cals and created eight chemical panels. For each chemical, we compiled biomonitoring and toxicity data, U.S. Environmental Protection Agency ex-
posure predictions, and annual production usage. We also applied predictive modeling to estimate toxicity. Using these data, we recommended
chemicals either for biomonitoring, to be deferred pending additional data, or as low priority for biomonitoring.
RESULTS: For the 155 chemicals, 97 were measured in food or water, 67 in air or house dust, and 52 in biospecimens. We found in vivo endocrine, de-
velopmental, reproductive, and neurotoxic effects for 61, 74, 47, and 32 chemicals, respectively. Eighty-six had data from high-throughput in vitro
assays. Positive results for endocrine, developmental, neurotoxicity, ...
Fetal Alcohol Spectrum Disorder is a clinical condition that has aroused the interest of researchers as it is considered relatively common in the population, with an incidence of approximately 10 cases per 1,000 births. The neurodevelopmental changes that characterize the phenotype of this condition are described by deficits in memory, attention, visual-spatial and executive function, learning disabilities and the presence of spoken language impairment. Considering the language deficit as part of Fetal Alcohol Spectrum Disorder, we proposed to review the literature to identify which procedures are used in the assessment of language and findings reported in language in Fetal Alcohol Spectrum Disorder. The 21 articles selected in this review reflect variability in methodology and commonly used procedures assessment of spoken language. The spoken language profile of individuals diagnosed with Fetal Alcohol Spectrum Disorder is characterized by different performance and with varying degrees of impairment. Several factors influence the variability of spoken language impairment described in Fetal Alcohol Spectrum Disorders, and the amount of alcohol consumed, the gestation period when consumption took place and individual susceptibility of each fetus to metabolize alcohol in the body are often described
Correlation between Blood group, Hypertension, Obesity, Diabetes, and combina...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
For this assignment, you will be developing and presenting an EducShainaBoling829
For this assignment, you will be developing and presenting an Educational, Narrative PowerPoint. In the presentation of your chosen topic, be sure to examine the pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan (MN551-3).
Narrative, PowerPoint Assignment Requirements
· Make sure all of the content topics of the assignment have been addressed.
· Cite at least three references in your PowerPoint; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
· All reference sources must be within 5 years.
· Do not use sources such as Wikipedia or UpToDate as a reference.
ASSIGMENT DIRECCION
Design and develop a 8- to 12-slide PowerPoint presentation using voice/narrative feature on each slide (the title and reference slides do not count in the slide count, but must be included in the assignment), that will be used to educate the community about one of the following topics:
· Type II Diabetes
· Atherosclerosis
· Hypertension
· Depression
· Urinary Tract Infection
Narrative, PowerPoint Contents to include, but not be limited to:
· Risk factors and causes
· Possible consequences
· Prevention Strategies
· Treatment Modalities
PowerPoint Format:
· Follow APA 7th edition format for PowerPoint presentations.
· Use the slide notes section in the presentation to include information that follows your narration, being sure to follow the conventions of Standard English.
· Slide content should include brief points that identify the areas that will be addressed in the narration.
· In-text citations should be included with any brief points that were researched from outside sources, and the narration should fully explain the points.
· Reference all sources on a separate reference slide at the end of the presentation and cite each source in the body of the presentation using 7th edition APA format.
· Identify the sources of any pictures you use, being sure to cite them correctly in 7th edition APA style, using in-text citations.
Narration Guidelines:
· Maintain a professional tone by summarizing observations and evaluations for each slide.
· Ensure that your presentation is highly ordered, logical, and unified.
· Words should be clearly enunciated and professional tone should be sustained throughout the presentation narration.
· Audio recording should be free of background noise and interruptions.
Before finalizing your work, it is important to:
· Review Narrative PowerPoint Assignment Requirements (described above) and the Narrative PowerPoint Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
· Make sure to review your chosen topic carefully to make sure you have answered all content effectively.
· Utilize spelling and grammar checks to minimize errors.
· Follow the conventions of Standard English (correct grammar, punctuation, etc.).
· ...
Similar to SOWK 425PowerPoint Presentation InstructionsFor this assignmen.docx (20)
In this unit, you will experience the powerful impact communication .docxwhitneyleman54422
In this unit, you will experience the powerful impact communication and miscommunication can have on cultural diversity.
Download the Communication: The Journey of Message Template
Follow the template instructions
Demonstrate your understanding of key concepts from the weekly content by including analysis of specific evidence in your responses within the template.
Use in-text citations and APA formatting for all source material references in your template.
Upload the completed template to this assessment.
.
In this task, you will write an analysis (suggested length of 3–5 .docxwhitneyleman54422
In this task, you will write an analysis (
suggested length of 3–5 pages
) of one work of literature. Choose
one
work from the list below:
Classical Period
• Sappho, “The Anactoria Poem” ca. 7th century B.C.E. (poetry)
• Aeschylus, “Song of the Furies” from
The Eumenides
, ca. 458 B.C.E. (poetry)
• Sophocles,
Antigone
, ca. 442 B.C.E. (drama)
• Aristotle, Book 1 from the
Nichomachean Ethics
, ca. 35 B.C.E. (philosophical text)
• Augustus,
The Deeds of the Divine Augustus
, ca. 14 C.E. (funerary inscription)
• Ovid, “The Transformation of Daphne into a Laurel” an excerpt from Book 1 of
The Metamorphoses
, ca. 2 C.E. (poetry)
Renaissance
• Francesco Petrarch, “The Ascent of Mount Ventoux” 1350 (letter)
• Giovanni Pico della Mirandola, the first seven paragraphs of the “Oration on the Dignity of Man” ca. 1486 (essay excerpt)
• Leonardo da Vinci, Chapter 28 “Comparison of the Arts” from
The Notebooks
ca. 1478-1518 (art text)
• Edmund Spenser, Sonnet 30, “My Love is like to Ice” from
Amoretti
1595 (poetry)
• William Shakespeare, Sonnet 18, “Shall I Compare Thee to a Summer’s Day” 1609 (poetry)
• Francis Bacon, “Of Studies” from
The Essays or Counsels…
1625 (essay)
• Anne Bradstreet, “In Honour of that High and Mighty Princess, Queen Elizabeth” 1643 (poetry)
• Andrew Marvell, “To his Coy Mistress” 1681 (poetry)
Enlightenment
• René Descartes, Part 4 from
Discourse on Method
, 1637 (philosophical text)
• William Congreve,
The Way of the World
, 1700 (drama-comedy)
• Jonathan Swift, “A Modest Proposal” 1729 (satirical essay)
• Voltaire, “Micromégas” 1752 (short story, science fiction)
• Phillis Wheatley, “To S.M., a Young African Painter, on Seeing his Works” 1773 (poetry)
• Thomas Paine, “Common Sense” 1776 (essay)
• Johann Wolfgang von Goethe, “The Fisherman” 1779 (poetry)
• Immanuel Kant, “An Answer to the Question: What is Enlightenment?” 1784 (essay)
Romanticism
• Lord Byron, “She Walks in Beauty” 1813 (poetry)
• Samuel Taylor Coleridge, “Kubla Khan” 1816 (poetry)
• Edgar Allan Poe, “The Fall of the House of Usher” 1839 (short story)
• Alexander Dumas,
The Count of Monte Cristo
, 1844 (novel)
• Emily Brontë,
Wuthering Heights
, 1847 (novel)
• Herman Melville, “Bartleby, the Scrivener: A Story of Wall-Street” 1853 (short story)
• Emily Dickinson, “A Narrow Fellow in the Grass” 1865 (poetry)
• Friedrich Nietzsche, Book 4 from
The Joyful Wisdom
, 1882 (philosophical text)
Realism
• Charles Dickens,
A Christmas Carol
, 1843 (novella)
• Karl Marx and Friedrich Engles,
The Communist Manifesto
, 1848 (political pamphlet)
• Christina Rossetti, “Goblin Market” 1862 (poetry)
• Matthew Arnold, “Dover Beach” 1867 (poetry)
• Robert Louis Stevenson,
The Strange Case of Dr. Jekyll and Mr. Hyde
, 1886 (novella)
• Kate Chopin, “The Story of an Hour” 1894 (short story)
• Mark Twain, “The.
In this SLP you will identify where the major transportation modes a.docxwhitneyleman54422
In this SLP you will identify where the major transportation modes are used in the EESC from SLP3: rail, inland water, ocean steamer, and/or OTR.
There are five basic transportation modes: rail, inland water ways, ocean, over-the-road, and air. We will not be concerned about air transport in this SLP as it is the least used and most expensive in general supply chain transportation.
Review and read these resources on these three transportation modes: rail, inland water, and OTR. Ocean is not included in these readings since it is mainly used for importing and exporting. This will be covered in more detail in LOG502. But you are asked to identify where ocean transport is used, but not in detail.
RESOURCES - SEE SLP 3 RESOURCES IN BACKGROUND PAGE
Session Long Project
Review the EESC from SLP2. Identify in the EESC where each of the four modes of transportation are used: rail, inland water, ocean, and OTR. You can use topic headings for each mode. Identify the materials being transported from which industry to which industry. Discuss why this mode is being used and what the costs are on a per ton-mile basis.
SLP Assignment Expectations
The paper should include:
Background:
Briefly
review and discuss the targeted product, company, and industry
Diagram: Include the diagram of the EESC
Transportation Discussion: Discuss each of the four transportation modes (rail, inland water, ocean, OTR) in the EESC and where each one is used. Discuss why this mode is used and the costs of using.
Clarity and Organization: The paper should be well organized and clearly discuss the various topics and issues in depth and breadth.
Use of references and citations: at least six (6) proper references should be used correctly, cited in the text, and listed in the references using proper APA format.
Length: The paper should be three to four pages – the body of the paper excluding title page and references page.
NOTE: You can use the transportation resources. You should also do independent research and find at least two additional appropriate references, for a total of at least six.
SLP Resources
Waterways
American Society of Civil Engineers. (2014). Report card for America’s infrastructure.
Infrastructure Report Card.
Retrieved from
http://www.infrastructurereportcard.org/fact-sheet/inland-waterways
Texas Transportation Institute. (2009). A Modal Comparison Of Domestic Freight Transportation Effects On The General Public, retrieved from
http://www.nationalwaterwaysfoundation.org/study/FinalReportTTI.pdf
U.S. Army Corps of Engineers. (2014). The U.S. Waterway System, Transportation Facts & Information; Navigation Center. Retrieved from
http://www.navigationdatacenter.us/factcard/factcard12.pdf
Railroads
Bureau of Transportation Statistics (Rail), retrieved from
https://www.bts.gov/topics/rail
USDOT (2012). Freight rail: data & resources. Retrieved on 20 Sep 2016 from
https://www.fra.dot.gov/Page/P0365
American Association of Railroads. Ret.
In this module the student will present writing which focuses attent.docxwhitneyleman54422
In this module the student will present writing which focuses attention on himself or herself (personal writing). We will start into college composition by reading a series of essays that explore the rhetorical modes of narration and decscription. If you think about your own lives, you'll note the importance of the stories that surround you. Think of your family's story, your friends' stories, and your very own story. Think of the detail that constitute these stories, of how they engage your sense of taste, touch, sound, smell, and sight. This module will focus on how you can better craft your own story and share it with others.
Competencies Addressed in this Module:
Competency #1: The student will demonstrate an understanding of the writing process by:
Choosing and limiting a subject that can be sufficiently developed within a given time, for a specific purpose, for a specific purpose and audience.
Developing and refining pre-writing and planning skills.ormulating the main point to reflect the subject and purpose of the writing.
Formulating the main point to reflect the subject and purpose of the writing.
Supporting the main point with specific details and arranging them logically.
Writing an effective conclusion.
Competency #3: The student will demonstrate the ability to proofread, edit, and revise by:
Recognizing and correcting errors in clarity
Recognizing and correcting errors in unity and coherence.
Using conventional sentence structure and correcting sentence errors such as fragments, run-ons, comma splices, misplaced modifiers and faulty parallelism.
Recognizing and correcting errors in utilizing the conventions of Standard American English including:
Using standard verb forms and consistent tense.
Maintaining agreement between subject and verb, pronoun and antecedent.
Using proper case forms--consistent point of view.
Using standard spelling, punctuation, and capitalization.
Selecting vocabulary appropriate to audience, purpose, and occasion.
Aditional inf: I am a woma. I am 25 years old. I have a husband and a one year old son
.
In this module, we looked at a variety of styles in the Renaissa.docxwhitneyleman54422
In this module, we looked at a variety of styles in the Renaissance in Italy. Artists like Botticelli, Bellini, Michelangelo, and Bronzino all incorporated Renaissance characteristics into their works, and yet their works look different from each other.
To address form and content in the artistic developments and trends that took place in the Renaissance, look closely at examples from each of these artists.
Choose one painting by one of the artists listed above, and identify characteristics and techniques of the Renaissance style.
Then, address how the work departed from typical Renaissance formulas to become signature to that artist's particular style.
Finally, why did you select this artist? What draws you to their work?
.
In this experiential learning experience, you will evaluate a health.docxwhitneyleman54422
In this experiential learning experience, you will evaluate a healthcare plan using the attached worksheet. The selected plan can be your own health insurance or another plan.
Step 1
Use published information on the selected health insurance plan to complete the
assignment 5.1 worksheet
.
Step 2
Create a 7-10 slide Power Point presentation to include the following:
Introduction to the plan, including geographic boundaries
Major coverage inclusions and exclusions (Medical, Dental, Vision etc.)
Costs to consumer for insurance under the plan (include premiums, deductibles, copays, prescription costs)
Health insurance plan ratings if available. If no ratings are found for this plan, include a possible explanation for this situation.
Evaluation of the health insurance plan-include your evaluation of this plan from two standpoints:
a consumer-focused on costs, coverage, and ease of use
a public health nurse- focused on access to care for populations and improving health outcomes.
Cite all sources in APA format on a reference slide and with on-slide citations.
.
In this essay you should combine your practice responding and analyz.docxwhitneyleman54422
In this essay you should combine your practice responding and analyzing short stories with support derived from research. So far in class, we have practiced primarily formal analysis. Now I want you to practice "joining the conversation." In this essay you will write a literary analysis that incorporates the ideas of others. The trick is to accurately present ideas and interpretations gathered from your research while adding to the conversation by presenting
your own
ideas and analysis.
You will be evaluated based on how well you use external sources. I want to see that you can quote, paraphrase and summarize without plagiarizing. Remember, any unique idea must be credited, even if you put it in your own words.
Choose one of the approaches explained in the "Approaches to Literary Analysis" located at the bottom of this document. Each approach will require research, and that research should provide the context in which you present your own ideas and support your thesis. Be sure to properly document your research. Review the information, notes, and pamphlets I have distributed in class as these will help guide you.
While I am asking you to conduct outside research, do not lose sight of the primary text to which you are responding---the story! Your research should support
your
interpretations of the story. Be sure that your thesis is relevant to the story and that you quote generously from the story.
Purpose:
critical analysis, Argument, writing from sources
Length:
approx 1200 words
Documentation:
Minimum of 4 sources required (one primary source—the story or poem analyzed, and three secondary, peer reviewed journals). (Note: review the material in "finding and evaluating sources.ppt" to help you choose relevant and trustworthy sources.)
Choose from the following short stories:
The Lottery,
Shirley Jackson
A Rose for Emily,
William Faulkner
The Dead
, James Joyce
The Veldt
, Ray Bradbury
Hills Like White Elephants,
Ernest Hemingway
The Cask of Amontillado or The Tell-Tale Heart,
Edgar Allen Poe
Below are some examples.
They are just here to give you an idea of the type of approaches that will work for this essay.
1. Philosophical analysis: How do the stories by Jean Paul Sartre and Albert Camus reflect the philosophy of existentialism?
2. Socio/cultural analysis: What opinion about marriage and gender roles does Hemingway advance in "The Short Happy Life of Francis Macomber"?
3. Historical analysis:: What social dilemmas faced by African Americans in the 1960s might have inspired Toni Cade Bambara to write "The Lesson"?
4. Biographical analysis: What events in Salman Rushdie's life might have influenced the events in "At the Auction of the Ruby Slippers"?
5. Psychological analysis: How is John Cheever's "The Swimmer" a metaphor for the psychology of addiction?
Approaches to Literary analysis
Formal analysis
- This type of analysis focuses on the formal elements of the work (language.
In this Discussion, pick one film to write about and answer ques.docxwhitneyleman54422
In this Discussion, pick one film to write about and answer questions below the film descriptions. If it has been a while since you have seen these films, they are available through online sources and various rental outlets. Although I have provided links to some of the films, I cannot guarantee they are still operable. If the links do not work, try your own online sources.
Dances with Wolves
(1990). Lt. John Dunbar (Kevin Costner) is assigned to the Western frontier on his own request after an act of bravery. He finds himself at an abandoned outpost. At first he maintains strict order using the methods and practices taught to him by the military, but as the film progresses, he makes friends with a nearby Native American tribe, and his perceptions of the military, the frontier, and Native Americans change dramatically.
Working Girl
(1988) Tess McGill (Melanie Griffith) works as a secretary for a large firm involved in acquiring media corporations such as radio and television. When her boss has a skiing accident, Tess gets a chance to use her own ideas and research, ideas that she has been keeping within herself for years – ideas that are arguably better, and more insightful into mass media practices, than her boss’s ideas were.
Schindler’s List
(1993). In Poland during World War II, Oskar Schindler (Liam Neeson) gradually becomes concerned for his Jewish workforce after witnessing their persecution by the Nazis. He initially was motivated by profit, but as the war progressed he began to sympathize with his Jewish workers and attempted to save them. He was credited with saving over 1000 Jews from extermination. (Based on a true story.)
Gran Torino
(2008). Walt Kowalski (Clint Eastwood), a recently widowed Korean War veteran alienated from his family and angry at the world. Walt's young neighbor, an Asian American, is pressured into stealing Walt's prized 1972 Ford Gran Torino by his cousin for his initiation into a gang. Walt thwarts the theft and subsequently develops a relationship with the boy and his family.
Describe the specific theories, assumptions, or “schools of thought” that the characters in the film have. How do their schools of thought differ?
How do the main characters change over the course of a film? How do their goals or desires change? Do they see themselves differently by the end of the film?
Which reflective theory from the course best illustrates the process the main characters go through during the film? How so?
Would you say that the main characters evolved or grew after learning something that was new, or a new approach, a new theory, or a new understanding of their place in the world?
I suggest that you refrain from reiterating the plotline. Rather, stay focused on character changes and the influences on those changes. Be sure to refer to the readings; use proper citations! This discussion will be scored based on the
Grading Rubric for Discussions
Please include the name of your film in the d.
In this assignment, you will identify and interview a family who.docxwhitneyleman54422
In this assignment, you will identify and interview a family who is currently undergoing stress. The stress may arise from a new baby, new marriage, new divorce or separation, new job, new house, having a child with special needs, etc. Explain the assignment to the family and obtain written consent for participation. Please acknowledge that this information will only be used for classroom purposes, that no information will be published or disseminated and that their names will not be used.
Part 1: Interview
Interview family members to gain information about the following:
Family information – nuclear, extended family, ages, siblings, etc.
History – how and when the stress started
Life cycle events – have members describe events and how they responded to them (i.e., beginning of school, IEP, transition times, family events, interaction with siblings)
Family dynamics between members
Strengths of family
Cultural, religious, social networks and involvement
Family needs
Coping strategies
Community resources and support
Family goals for child
Other (i.e., personal stories)
Analyze the family from this information based on current research and theory,
Provide research-based recommendations for the family – this may include continuing things that they are currently doing and may include resources/agencies/supports that they can or could be receiving. Note: These resources can be ones that you are using for your major resource file (see Module 5).
Provide a personal reflection on this experience including the communication skills needed for effective interviewing.
Part 2: Results of the Interview
Create a 6 to 8-page paper (not including title or reference pages) in a Word document for your response.
Use APA format for the title page, references page, and in-text citations.
Develop an introduction and conclusion for your paper.
.
In this assignment, you will assess the impact of health legisla.docxwhitneyleman54422
In this assignment, you will assess the impact of health legislation on nursing practice and communicate your analysis to your peers. GovTrack.us provides a list of federal health bills that are currently in process in Congressional Committees.
CO4: Integrates clinical nursing judgment using effective communication strategies with patients, colleagues, and other healthcare providers. (PO#4)
CO7: Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings. (PO#7)
.
In this assignment, you will create a presentation. Select a topic o.docxwhitneyleman54422
In this assignment, you will create a presentation. Select a topic of your choice from any subject we have covered in this course.
TOPICS..
INTERNET
COMPUTERS
MOBILE AND GAME DEVICES
DATA AND INFORMATION
THE WEB
DIGITAL SECURITY AND PRIVACY
PROGRAMS AND APPS
COMMUNICATION AND NETWORKS
TECHNOLOGY USERS
THE INTERNET
GRAPHICS AND MEDIA APPLICATIONS
FILE, DISK AND SYSTEM MANAGEMENT TOOLS
PROCESSORS
CLOUD COMPUTING
ADAPTERS
POWER SUPPLY AND BATTERIES
WIRELESS SECURITY
Explain why you select this topic.
Explain why this topic is important.
Discuss the advantages and disadvantages of your select topic.
Include any other information you might thing is relative to your topic.
Your presentation should be a minimum of 15-20 slides in length. Include the title, references, images, graphics, and diagrams.
.
In this assignment, the student will understand the growth and devel.docxwhitneyleman54422
In this assignment, the student will understand the growth and development of executive leadership by looking at the dynamics between the president and Congress in the period from the founding to the Spanish-American War. In a 6–8- page paper, the student will focus on: 1) how presidents pursued international relations, 2) how presidents were able to project force, and 3) congressional restrictions on presidential actions. The student may write about the president of his/her choice.
.
In this assignment, I want you to locate two pieces of news detailin.docxwhitneyleman54422
In this assignment, I want you to locate two pieces of news detailing how an organization is responding to the COVID-19 crisis. You will turn this assignment into me via a Word Document attached to a separate email titled "extra credit assignment, Your Name" with your actual name in the subject line so I know to save the email for grading.
You need to analyze how businesses are handling the current COVID-19 crisis and I want to see if you can track down a press release from the organization, an email to their stakeholders, or even a screenshot of their website in which they explicitly address the actions they are taking in light of this new world we find ourselves in. However, the screenshots, hyperlinks to news stories, etc. are only one component of the assignment, your analysis is far and away from the more important component. Once you have tracked down two examples of how a business/organization is responding to the COVID-19 crisis, I want you to tell me how effective you perceive its action to be. Use any of the vocabulary or concepts that we have learned thus far in the semester to support your analysis. For example, is the business/organization using appropriate new media platforms to reach stakeholders? Is communication timely? Is the organization's tone sincere? What could have been done better? I am expecting one page, double-spaced for the length of your analysis, APA format. The images and or hyperlinks you compile will not be counted towards the length of your writing.
.
In this assignment worth 150 points, you will consider the present-d.docxwhitneyleman54422
In this assignment worth 150 points, you will consider the present-day relevance of history with a current event from a legitimate news source (your instructor will provide several options to choose from) and do the following: (1) summarize the article¿s main idea in a paragraph (5 sentences minimum), (2) write two paragraphs in which you utilize your textbook and notes to analyze how your current event selection relates to the past.
the topics are below, just choose one of the topic from list below..
Neanderthals and string
Neanderthals Left Africa Sooner Than We Think?
Discovery of Neanderthal Skeleton and Burial
Searching for Nefertiti
Discovery of Donkeys Used in Polo (Ancient China)
Ancient Maya Capital Found in Backyard
Long Lost Greek City Found
Ancient Roman Weapon
Viking Burial Discovery
Saving Timbuktu's Treasures
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In the readings thus far, the text identified many early American in.docxwhitneyleman54422
In the readings thus far, the text identified many early American interests in the Middle East from geopolitical to missionary. Using the text and your own research, compare these early interests with contemporary American interests in the Middle East.
In particular, how has becoming 1) a global hegemon after WWII and 2) the concurrent process of ‘secularization’ transformed American foreign policy thought and behavior toward Israel and the Middle East region generally? What themes have remained constant and what appear new? Would you attribute changes more to America’s new geopolitical role after WWII, or to the increasing secularization of American society? Explain carefully. In 500 words
.
In the Roman Colony, leaders, or members of the court, were to be.docxwhitneyleman54422
In the Roman Colony, leaders, or members of the court, were to be:
•Local elites•Be freeborn•Between the ages of 22 – 55•Community resident•Moral integrity
From the members, two were chosen as unpaid chief magistrates (Judges). They would have to “buy into” that position, but the recognition was worth the financial output. This week's discussion prompter is:
Money alone influences others. Please analyze and critically discuss.
In your response, remember that all this is about leadership, the context which is set in Rome.
.
In the provided scenario there are a few different crimes being .docxwhitneyleman54422
In the provided scenario there are a few different crimes being committed and each could be argued multiple ways.
Steve could be charged with attempted murder. He was stabbing Michelle in the chest repeatedly. Due to the details of the scenario his charge could only be attempted because Michelle got up from the attack and charged Stacy. If she later died from her injuries Steve would/could be charged with murder. Even though he was “visibly drunk” he still maintained the purposely, knowing, or reckless intent to cause harm. He was coherent enough to make statements to her about how much he loved her, but still showed an extreme indifference to life and intent cause serious bodily harm. The biggest obstacle to a murder charge for Steve is his death. He cannot be charged with anything if he cannot be alive to defend himself. This takes care of the Steve factor.
Initially Stacy could be found guilty of murder. She knowingly and intentionally took the life of another (Steve). She also expresses an intent to kill when she stated, “I have had enough of you Steve”. From the scenario it is documented that she did not care for Steve and along with her statements, it can be shown that she was “just waiting for the opportunity” to kill Steve. In her favor is the fact that she attempted to stop Steve from harming another person. Her actions, while resulting in the death of another, were in the defense of a harmed person. She possibly saved the life of Michelle by using reasonable force to stop the stabbing.
Michelle could be charged with attempted murder as well. She stabbed Stacey in the chest while screaming, “how dare you”. She intended to cause death or serious physical injury. Again, if Stacey died from the wounds suffered, Michelle could/would be charged with murder. It could also be argued that Michelle had no malice aforethought. She was being stabbed and may not have known her actions were wrong. Her extreme circumstance clouded her reasonable decision making and all she was aware of is that her boyfriend, whom she loved, was just killed. This is unlikely but still a small possibility. Without more facts from the scenario it is difficult to fully play out all possibilities.
respond to this discussion question in 150 words no references please
.
STOP THE MEETING MADNESS HOW TO FREE UP TIME FOR ME.docxwhitneyleman54422
STOP
THE
MEETING
MADNESS
HOW TO FREE UP TIME FOR
MEANINGFUL WORK
BY LESLIE A. PERLOW, CONSTANCE NOONAN HADLEY, AND EUNICE EUN
SHARE THIS ARTICLE. HBR LINK MAKES IT EASY.
SEE PAGE 41 FOR INSTRUCTIONS.
FEATURE STOP THE MEETING MADNESS
62 HARVARD BUSINESS REVIEW JULY–AUGUST 2017
EL
EN
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K
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LI
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VA
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IM
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JULY–AUGUST 2017 HARVARD BUSINESS REVIEW 63
P
Poking fun at meetings is the stuff of Dilbert car-
toons—we can all joke about how soul-sucking and
painful they are. But that pain has real consequences
for teams and organizations. In our interviews with
hundreds of executives, in fields ranging from high
tech and retail to pharmaceuticals and consulting,
many said they felt overwhelmed by their meetings—
whether formal or informal, traditional or agile, face-
to-face or electronically mediated. One said, “I cannot
get my head above water to breathe during the week.”
Another described stabbing her leg with a pencil to
stop from screaming during a particularly torturous
staff meeting. Such complaints are supported by re-
search showing that meetings have increased in length
and frequency over the past 50 years, to the point
where executives spend an average of nearly 23 hours
a week in them, up from less than 10 hours in the
1960s. And that doesn’t even include all the impromptu
gatherings that don’t make it onto the schedule.
Much has been written about this problem, but the
solutions posed are usually discrete: Establish a clear
agenda, hold your meeting standing up, delegate
someone to attend in your place, and so on. We’ve
observed in our research and consulting that real im-
provement requires systemic change, because meet-
ings affect how people collaborate and how they get
their own work done.
Yet change of such scope is rarely considered. When
we probed into why people put up with the strain that
meetings place on their time and sanity, we found
something surprising: Those who resent and dread
meetings the most also defend them as a “necessary
evil”—sometimes with great passion. Consider this
excerpt from the corporate blog of a senior executive
in the pharmaceutical industry:
I believe that our abundance of meetings at our
company is the Cultural Tax we pay for the inclusive,
learning environment that we want to foster…
and I’m ok with that. If the alternative to more
meetings is more autocratic decision-making, less
input from all levels throughout the organization,
and fewer opportunities to ensure alignment and
communication by personal interaction, then give
me more meetings any time!
To be sure, meetings are essential for enabling col-
laboration, creativity, and innovation. They often foster
relationships and ensure proper information exchange.
They provide real benefits. But why would anyone ar-
gue in defense of excessive meetings, especially when
no one likes them much?
Because executives want to be good soldiers. When
they sacrifice their own .
Stoichiometry Lab – The Chemistry Behind Carbonates reacting with .docxwhitneyleman54422
Stoichiometry Lab – The Chemistry Behind Carbonates reacting with Vinegar
Objectives: To visually observe what a limiting reactant is.
To measure the change in mass during a chemical reaction due to loss of a gas.
To calculate CO2 loss and compare actual loss to expected CO2 loss predicted by the balanced chemical equation.
Materials needed: Note: Plan ahead as you’ll need to let Part 1 sit for at least 24 hours.
plastic beaker graduated cylinder
electronic balance 2 eggs
1 plastic cup baking soda (5 g)
dropper vinegar (500mL)
2 identical cups or glasses (at least 500 mL)
Safety considerations: Safety goggles are highly recommended for this lab as baking soda and vinegar chemicals can be irritating to the eyes. If your skin becomes irritated from contact with these chemicals, rinse with cool water for 15 minutes.
Introduction:
The reaction between baking soda and vinegar is a fun activity for young people. Most children (and adults!) enjoy watching the foamy eruption that occurs upon mixing these two household substances. The reaction has often been used for erupting volcanoes in elementary science classes. The addition of food coloring makes it even more fun. The reaction involves an acid-base reaction that produces a gas (CO2). Acid-base reactions typically involve the transfer of a hydrogen ion (H+) from the acid (HA) to the base (B−):
HA + B− --> A− + BH (eq #1)
acid base
The base often (although not always) carries a negative charge. The acid usually (although not always) becomes negatively charged through the course of the reaction because it lost an H+. An example of a typical acid base reaction is below:
HCl(aq) + NaOH(aq) --> NaCl(aq) + H2O(l) (eq #2)
The reaction is actually taking place between the hydrogen ion (H+) and the hydroxide ion (OH−). The chloride and sodium are spectator ions. To write the reaction in the same form as eq #1:
HCl(aq) + OH- --> Cl- + H2O (l) (eq #3)
Sodium bicarbonate (NaHCO3) will dissociate in water to form sodium ion (Na+) and bicarbonate ion (HCO3−).
NaHCO3 --> Na+ + HCO3− (eq #4)
Vinegar is usually a 5% solution of acetic acid in water. The bicarbonate anion (HCO3−) can act as a base, accepting a hydrogen ion from the acetic acid (HC2H3O2) in the vinegar. The Na+ is just a spectator ion and does nothing.
HCO3− + HC2H3O2 --> H2CO3 + C2H3O2− (eq#5)
Bicarbonate acetic acid carbonic acid acetate ion
The carbonic acid that is formed (H2CO3) decomposes to form water and carbon dioxide:
H2CO3 --> H2O(l) + CO2(g) (eq#6)
carbonic acid water carbon dioxide
The latter reaction (production of carbon dioxide) accounts for the bubbles and the foaming that is observed upon mixing vinegar and baki.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
SOWK 425PowerPoint Presentation InstructionsFor this assignmen.docx
1. SOWK 425
PowerPoint Presentation Instructions
For this assignment, you will create a narrated PowerPoint
presentation of 10–15 slides that focuses on a special topic
related to international social work. The presentation must
include at least 4 references to the course textbook, scholarly
journal articles and/or the Bible. References must be in current
APA format. Topics must be cleared with the instructor in
advance by email.
Create your presentation as though you were going to present it
to a Christian high school audience. You may include images of
interest that will supplement and enhance the content; however,
ensure they are appropriate and do not distract from the overall
content of the presentation. Colorful graphics and themes must
be used on 4–8 slides, and the presentation must be 5–10
minutes. The presentation must contain your notes in the Notes
section of PowerPoint and a voice recording, also using the
audio option in PowerPoint (view tutorial here). If you have
difficulty or questions, contact your instructor.
Suggested Topics for Selection:
· Homelessness
· Human trafficking
· International adoption
· Female genital cutting
· Honor killing
· HIV/AIDS
· Hunger
· War
· Refugees
Note: You may choose a different topic than what is listed, but
it must be approved by the instructor.
Submit your presentation by 11:59 p.m. (ET) on Monday.
2. Annals of Agricultural and Environmental Medicine 2014, Vol
21, No 1, 49–54
www.aaem.plORIGINAL ARTICLE
Predictors of environmental lead exposure
among pregnant women – a prospective cohort
study in Poland
Kinga Polańska1, Wojciech Hanke1, Wojciech Sobala1,
Małgorzata Trzcinka-Ochocka2,
Danuta Ligocka2, Halina Strugała-Stawik3, Per Magnus4
Nofer Institute of Occupational Medicine, Department of
Environmental Epidemiology, Łódź, Poland
Nofer Institute of Occupational Medicine, Department of
Toxicology and Carcinogenesis, Łódź, Poland
The Foundation for Children from Copper Basin, Legnica,
Poland
Norwegian Institute of Public Health, Division of
Epidemiology, Oslo, Norway
Polańska K, Hanke W, Sobala W, Trzcinka-Ochocka M,
Ligocka D, Strugała-Stawik H, Magnus P. Lead exposure
among pregnant women. Ann
Agric Environ Med. 2014; 21(1): 49–54.
Abstract
Blood lead levels (BLL) in women of child-bearing age have
been decreasing in recent decades, but still remains a concern
for
long-term effects of child psychomotor development. The aim
of the study was to characterize lead exposure among Polish
pregnant women and assess the relationship between BLL and
selected socio-demographic, economic and lifestyle factors.
3. The study population consisted of 594 pregnant women who had
been the subjects of the prospective Polish Mother and
Child Cohort Study (REPRO_PL). The women were interviewed
three times during pregnancy (once in each trimester). Lead
concentration in the blood collected during the second trimester
of pregnancy was analyzed using graphite furnace atomic
absorption spectrometry (GF-AAS), or inductively coupled
plasma mass spectrometry (ICP-MS). Active and passive
smoking
was analyzed by the cotinine level in saliva using liquid
chromatography with tandem mass spectrometry (LC-MS/MS).
The
lead level in the blood ranged from 0.3 – 5.7 µg/dL, with a
geometric mean (GM) of 1.1 µg/dL (GSD ±0.2 µg/dL).
Statistically
significant associations were found between BLL and factors
such as maternal age (β=0.01; p=0.02), education (β=0.08;
p=0.04) and prepregnancy BMI (β=0.1; p=0.001). Additionally,
BLL increased with increasing cotinine level in saliva (β=0.02;
p=0.06) and decreased with the increasing distance from the
copper smelter (β=-0.1; p=0.009). Public health interventions,
especially in regions with a higher level of exposure to lead,
among women with lower SES and among smokers, are still
reasonable.
Key words
Blood lead level, pregnancy, distance from smelter, cotinine
INTRODUCTION
Lead in one of the well-established environmental toxicants,
and its negative effects, particularly in children as the most
vulnerable group, continues to be a major public health
issue worldwide [1, 2, 3, 4, 5]. It is well known that prenatal
and postnatal lead exposure is associated with cognitive
impairment and correlates with decreased IQ scores,
4. impaired attention and behavioural problems. For effective
prevention it is important to know the level of exposure and
predictive factors for BLL.
Thanks to public health and regulatory activities, including
restrictions on the use of tetraethyl lead as a petrol additive,
a significant reduction of lead emission has been observed
with more than 90% decrement in 24 countries in the EMEP
(Co-operative Programme for Monitoring and Evaluation of
the Long-range Transmission of Air Pollutants in Europe)
region between 1990 – 2003 [6, 7]. As another example,
in pre-school children in the USA, the lead level in blood
dropped from 15 µg/dL, noted in the 1970s, to 1.9 µg/dL at
the beginning of this century [3]. In Poland, analyses of BLL
in children from the Legnica-Głogów Copper Basin and in
Upper Silesia have been conducted [8, 9, 10, 11]. Based on
the analyses performed by The Foundation for Children
From The Copper Basin, the BLL in children decreased
from 10 µg/dL in 1991 to 4 µg/dL in 2009 [11]. Although the
magnitude of the socio-economic disparities has declined,
higher BLL are still noted more frequently in a minority of
children, children in low-income families and in those living
closer to the source of emission (such as copper smelters).
The governmental agencies, including the Environmental
Protection Agency (EPA) and the Centres for Disease Control
and Prevention (CDC), continue to use the value of 10 µg/dL
in whole blood samples as the criterion for concern in public
health advise. However, no safe threshold for BLL has been
identified. Significant poorer cognitive performance and
behavioural problems have been identified in children
with BLL less than 10 µg/dL, and even as low as 5 µg/dL.
Additionally, the rate of decline in IQ scores might be greater
at BLL below 10 µg/dL than it is at levels above 10 µg/dL [3,
12].
5. The aim of the presented study was to characterize lead
exposure among Polish pregnant women and assess the
relationship between BLL and selected socio-demographic,
economic and lifestyle factors.
Address for correspondence: Kinga Polańska, Nofer Institute of
Occupational
Medicine, Department of Environmental Epidemiology, Teresy
od Dzieciątka
Jezus 8, 91-348, Łódź, Poland
e-mail: [email protected]
Received: 19 September 2012; accepted: 09 April 2013
Annals of Agricultural and Environmental Medicine 2014, Vol
21, No 1
Kinga Polańska, Wojciech Hanke, Wojciech Sobala, Małgorzata
Trzcinka-Ochocka, Danuta Ligocka, Halina Strugała-Stawik,
Per Magnus. Predictors of environmental…
MATERIALS AND METHODS
Study design and population. The current analysis is based
on 594 pregnant women who participated in the prospective
Polish Mother and Child Cohort Study (REPRO_PL; www.
repropl.com). The complete description of the cohort has
been published elsewhere [13, 14]. Briefly, pregnant women
were recruited and followed up between 2007 – 2011 in
maternity units or clinics from the following regions of
Poland: Legnica (n=124), Łódż (400) and Silesia (70). The
enrolment included only women in single pregnancies
up to 12 weeks of gestation. Women whose pregnancies
were assisted by reproductive technologies or pregnancies
6. expected to be finished as spontaneous abortion, as well
as women with chronic diseases as specified in the study
protocol, were excluded from the study.
Questionnaires. Upon enrolment (up to 12 weeks of
pregnancy), a detailed questionnaire was administered to
each subject to collect socio-demographic data (age, marital
status, number of children, educational level and employment
status), medical and reproductive history, information
about occupational exposure, and lifestyle factors (active
and passive smoking, alcohol consumption and diet). Such
information was updated twice during the pregnancy (in the
2nd and 3rd trimesters). Because the lead level was analyzed
in blood collected during the 2nd trimester of pregnancy,
the relevant questionnaire data were chosen from the same
period and supplemented with information collected in 1st
and 3rd trimester of pregnancy, when appropriate.
Analysis of questionnaire data was restricted to factors that
potentially contribute to the lead exposure, including socio-
demographic variables, smoking status verified by cotinine
level in saliva, and subjective perception of traffic intensity
close to the place of residence. Income was divided into 3
categories (low, medium and high), based on the following
variables: type of housing (independent living), size of the
apartment and the women’s opinion regarding their financial
status. Financial status of the family was described based
on the following question: ‘What is the financial status of
your family?’ Women who declared that they have sufficient
money for current expenses and that it is possible for them to
put a substantial sum aside, and those with an independent
apartment bigger than 37m2 were allocated into the high
income category. These who indicated sufficient money for
current expenses, with possibility to put aside some money,
with or without an independent apartment bigger than 37 m2,
were allocated into the medium income category. Subjects
7. who declared insufficient money for current expenses and
living in an apartment smaller than 37m2 were allocated into
the low income category.
The data about medications (supplements) containing
calcium and/or iron was based on information filled by
the gynecologist (such information included: name of
medication, dosage and frequency). Additionally, based on
data from a food frequency questionnaire, information about
the frequency (times a week) of consumption of following
food: 1) calcium-rich food (such as milk, yogurt, cheese),
2) iron-rich food (such as red meats, iron-fortified cereals,
prunes, raisins, dark leafy green vegetables), and 3) food as a
major contributor to lead exposure (such as grains and grain-
based products, potatoes or leafy vegetables) was identified.
For each of the food groups (calcium-, iron-rich food and
food as a major contributor to lead exposure) the sum of
frequency (times a week) of consumption of selected food
products, was calculated. For the subpopulation of pregnant
women from the districts where copper smelters are located,
such as the Legnica-Głogow copper district (Głogów Copper
Smelter and Refinery and the Legnica Copper Smelter and
Refinery), or from the Silesia district, the exact distances (in
km) of place of residence (based on address) from the smelters
were calculated. The potential lead exposure of each smelter
was checked. 33 smelters (28 of which were in operation at
time of the women’s enrolment to the study) were taken into
account. The distance to the closest smelter was assigned
for each women. Of 194 pregnant women from the Legnica
and Silesia regions, the exact address (place of residence) for
193 women (necessary for calculation of the distance from
the smelter) was available, and these women were included in
the analysis of the association between the distance of place
of residence from the copper smelter, and the BLL.
8. Blood sample collection and analysis. During the 2nd
trimester of pregnancy, a blood sample was collected from
each pregnant women by venipuncture using S-Monovette
with Lithium Heparin as anticoagulant, and frozen at
-20 °C until analysis. Blood lead levels were analyzed in
2 laboratories: the laboratory at the Nofer Institute of
Occupational Medicine (NIOM) in Łódż (n=427) and the
laboratory at The Foundation for Children from the Copper
Basin in Legnica (n=167).
At NIOM, blood lead concentrations were determined
following the method of Stoeppler and Brandt (1978) with
the Razniewska and Trzcinka-Ochocka (1995) modification
[15]. The method based on deproteinisation of blood samples
(400 µl) by addition of 5% nitric acid (1600 µl) was regularly
checked by using reference materials (Seronorm, ClinCheck,
BCR), and by participation in the UK National External
Quality Assessment Schemes UK NEQAS (Wolfson EQA
Laboratory, PO Box 3909 Birmingham, B15 2UE, UK)
and in the German External Quality Control (G-EQUAS),
according to Guidelines of the German Federal Medical
Council. For these analyses, the technique of graphite furnace
atomic absorption spectrometry (GF-AAS) (Perkin Elmer
4100ZL, AAnalyst 600) and inductively coupled plasma
mass spectrometry (ICP-MS) (Perkin Elmer Elan – DRCe)
was used. The laboratory is accredited (No. PCA, AB 215)
according to PN/EN ISO/IEC 17025 to perform the analysis of
lead and cadmium levels in blood in the fields of occupational
medicine and environmental health. At the Foundation for
Children from the Copper Basin in Legnica, the blood lead
levels were analyzed using the GF-AAS method, as described
above.
For 20 randomly selected samples, a cross-laboratory
analysis was performed. The geometric mean was 30%
lower for the NIOM laboratory, compared to the analysis
9. performed at the laboratory at The Foundation for Children
from the Copper Basin in Legnica (1.3 µg/dL vs. 1.7 µg/dL).
The correlation was 0.83 (95% CI 0.62–0.93). All statistical
analyses were adjusted for laboratory differences and the
method used for lead level assessment (GF-AAS or ICP-MS).
Exposure to active and passive smoking. The cotinine
level in saliva was analyzed at the Environmental Organic
Pollutants Monitoring Laboratory, at NIOM using high
performance liquid chromatography, coupled with tandem
50
Annals of Agricultural and Environmental Medicine 2014, Vol
21, No 1
Kinga Polańska, Wojciech Hanke, Wojciech Sobala, Małgorzata
Trzcinka-Ochocka, Danuta Ligocka, Halina Strugała-Stawik,
Per Magnus. Predictors of environmental…
mass spectrometry/positive electrospray ionisation (LC-
MS/MS-ESI+) and isotope dilution method [16]. This
procedure has been validated under ISO 17025 criteria and
accredited by the Polish Centre for Accreditation (Certificate
AB215). Briefly, a 0.25 ml of saliva was extracted with the
SPE method on OASIS HLB 96-well Plate, and analysed on
an XTerraC18 MS, 3.5 μm, 150×2.1 mm column (Waters)
using Alliance High Performance Liquid Chromatograph
(Waters). Quantitative analysis was made by a Quattro Micro
API tandem mass spectrometer equipped with electrospray
probe (Micromass/Waters) with MRM mode. The calibration
curve was based on the peak area ratio of native cotinine and
deuterium-labelled surrogate (internal standard). To ensure
the highest quality of results, every series of analyses included
10. QC samples, such as: repeated samples (already analysed),
blank, in-house reference material, and calibration control
samples (2 levels of concentrations).
Statistical analysis. Statistical inference was based on
two-sided tests and a standard significance level of 0.05.
Linear regression was used. Univariate and multivariate
analyses were performed to identify the predictors of BLL.
All variables at the level of significance p<0.1 (except the
distance from smelter) identified in univariate analysis
were included in the multivariate method. Analyses of
the distance from smelter were conducted for a subset of
observations (n=193), but the results were adjusted for all
variables selected for multivariate analysis. The 3 variables:
BLL, cotinine level and distance from copper smelter were
log transformed. All variables were adjusted for methods
of BLL analysis, including the 2 laboratories where the
analysis were performed, and 2 method of assessment of
BLL (GF-AAS or ICP-MS). The following variables were
categorized into 2 categories: marital status (married-ref.,
unmarried), maternal education (>12 years of education-ref.,
≤12 years of education), maternal employment (unemployed-
ref., employed), number of children (no children prior to
current pregnancy-ref., ≥1child), income (high-ref, low and
medium), prepregnancy BMI (<25kg/m2-ref., ≥25kg/m2),
traffic intensity in the area of residence (low-ref., high), and
medications containing calcium and iron (no-ref., yes).
Maternal age, consumption of calcium- and iron-rich food
and food groups as the major contributors to lead exposure
were analyzed as continuous variables.
Statistical analysis was performed using R software version
2.15.1 (R Core Team (2012) [17].
RESULTS
11. Socio-demographic characteristics of the study population.
Table 1 presents descriptive statistics of the study population.
67% of the pregnant women were in the age category 20–30
years of age and one third (31%) of the study population were
older than 30. More than 75% of the women were married and
63% had no children prior to the current pregnancy. About
61% of women had more than 12 years of education and 85%
were employed. More than 60% of the subjects were allocated
into the medium income category and 16% into low income
according to the created subgroups described in the Method
section. More than 35% of the study subjects reported road
traffic close to their place of residence. Based on cotinine
levels in saliva (>10 ng/ml), 16% of the pregnant women could
be identified as smokers. 20% of the women were categorized
as overweight or obese, based on prepregnancy BMI. About
40% of the women declared consumption of supplements
containing calcium, and 50% of them supplements containing
iron. Based on data from the food frequency questionnaire,
the women consumed calcium-rich food on average 12 times
a week (SD±5) and iron-rich food 8 times a week (SD±4). The
women declared consumption of food groups identified as the
major contributors to lead exposure 11 times a week (SD±3).
For the subpopulation of the study sample (193 women) who
lived in the region where copper smelters were located, the
mean distance from the smelter was about 6 km (SD±4 km).
Level of lead exposure during pregnancy. On average, the
BLL measured during the 2nd trimester of pregnancy was low
(GM=1.1 µg/dL; GSD±0.2) and none of the women had levels
above 6.0 µg/dL (range 0.3–5.7 µg/dL) (Tab. 1).
In univariate analysis, the BLL increased significantly
with the age of the pregnant women (β=0.01; p=0.002)
(Tab. 2). Overweight and obese women had a significantly
higher BLL compared to those with normal weight (β=0.15;
12. p<0.001). Marital status, employment, income and subjective
perception of road traffic did not have a significant impact
on BLL (p≥0.1). Neither the consumption of medications
containing calcium and/or iron, nor the calcium and iron-
rich food, as well as food groups identified as the contributors
to lead exposure, had any statistically significant impact
on BLL (p>0.1). The following factors: maternal education,
number of children, smoking status and distance from
copper smelter, were at the level of significance <0.1, and
were finally included in the multivariable analysis.
Multivariable adjusted predictors of lead exposure.
Multivariable analysis confirmed that significantly higher
BLL was observed among older women (β=0.01; p=0.02),
those with less years of education (β=0.08; p=0.04) and
among those with prepregnancy BMI≥25kg/m2 (β=0.14;
p=0.001) (Tab. 3). The cotinine level in saliva was positively
correlated with BLL (β=0.02; p=0.06). With increasing
distance from the place of residence to the copper smelter,
the BLL were significantly decreasing (β=-0.1; p=0.009).
The number of children was not a statistically significant
predictor of BLL (p>0.05).
DISCUSSION
Blood lead levels in women of child-bearing age have been
decreasing in recent decades, but still remain a concern.
In the presented study, the BLL measured during the 2nd
trimester of pregnancy was low (GM=1.1 µg/dL; SD±0.2),
and all measurements showed levels below 6 µg/dL, which is
below the CDC level currently considered to be benchmark
for intervention (10 µg/dL). The National Health and
Nutrition Examination Survey (NHANES) data from 1999
– 2002 indicate that women aged 20–59 have a mean level of
1.2 µg/dL, and that 0.3% of women have BLL above 10 µg/dL
13. [18]. Analysis based on the Kraków cohort of pregnant
women also showed low levels, although a little higher than
in the presented study, GM for BLL (1.7µg/dL) [19]. On the
other hand, none of the women from Kraków had levels
above 4 µg/dL, which is lower than the maximum level
51
Annals of Agricultural and Environmental Medicine 2014, Vol
21, No 1
Kinga Polańska, Wojciech Hanke, Wojciech Sobala, Małgorzata
Trzcinka-Ochocka, Danuta Ligocka, Halina Strugała-Stawik,
Per Magnus. Predictors of environmental…
observed in the current analysis. The recruitment of pregnant
women into the Kraków cohort was performed about 6
years earlier than for the presented REPRO_PL cohort.
Additionally, in the previous cohort, the study participants
were selected only from the city of Kraków (with less diversity
of exposure), whereas in REPRO_PL the study participants
were selected from different (more diverse) regions of Poland
(from suburban as well as urban areas, and from the Legnica
district where copper smelters as the potential source of lead
exposure are located).
Previous epidemiological studies have indicated a few
predictors of BLL such as: age, education, income, age of
housing, living in urban areas and smoking [20].
The presented study confirmed the positive correlation of
BLL with the age of pregnant women. The same association
was observed in the analysis performed on the Kraków
14. cohort [19]. The association with age could be explained, on
one hand, by the fact that the older women might have been
exposed to higher environmental lead in the past than the
younger ones, and on the other hand, it could be the result
of the accumulation of lead over time and/or remobilization
of this heavy metal from bone stores during pregnancy [21].
Consistent with other studies, in the presented analysis,
women with a few years of education had higher BLL than
those who were more educated [3, 20]. This can be related to
higher standards of environmental hygiene among the more
educated women [21]. Other factors which can be proxies
of socio-economic status (SES), such as employment and
income, did not correlate with BLL in the presented study.
Table 1. Descriptive statistics of the study population
Variables
No. of
women
%
Age (years); N=590
≤ 20
20–30
≥ 31
10
394
186
1.7
66.8
31.5
18. 305
48.7
51.3
Calcium-rich food (frequency; times a week); N=536
Mean ± SD
11.6 ± 5.1
Iron-rich food (frequency; times a week); N=530
Mean ± SD
7.5 ± 4.0
Food groups as major contributors to lead exposure
(frequency; times a week); N=536
Mean ± SD
11.4 ± 3.2
Lead in maternal blood (µg/dL); N=594
Mean
SD
Geometric mean
GSD
Min
Max
1.2
±0.6
1.1
±0.2
0.3
5.7
19. Distance from copper smelter (km); N=193
Mean ± SD 6.1±4.1
SD – standard deviation, GSD – geometric standard deviation
Table 3. Multivariable analysis of log concentrations of
maternal BLL
related to potential predictor variables
Variables*
Beta
coefficient
SE p
Maternal age (per year) 0.01 0.005 0.02
No. of children (≥1child vs. no child) 0.03 0.04 0.5
Maternal education (≤12 years vs. > 12 years of
education)
0.08 0.04 0.04
BMI (≥25 kg/m2 vs. <25 kg/m2) 0.14 0.04 0.001
Cotinine level (ng/ml) (log transformed) 0.02 0.01 0.06
Distance from copper smelter (log transformed)** -0.1 0.04
0.009
*All variables were adjusted for methods of BLL analysis
** model based on population from districts where smelters (as
the potential source of lead
exposure) exist (adjusted for other variables in the Table)
20. Table 2. Univariable analysis of log concentrations of maternal
BLL related
to potential predictor variables
Variables*
Beta
coefficient
SE p
Maternal age (per year) 0.01 0.004 0.002
Marital status (unmarried vs. married) 0.02 0.04 0.7
No. of children (≥1child vs. no child) 0.06 0.03 0.08
Maternal education (≤12 years vs. > 12 years of
education)
0.06 0.03 0.08
Maternal employment (employed vs. unemployed) 0.08 0.05 0.1
Income (low and medium vs. high) 0.05 0.04 0.2
BMI (≥25 kg/m2 vs. <25 kg/m2) 0.15 0.04 <0.001
Cotinine level (ng/ml) (log transformed) 0.02 0.01 0.06
Traffic intensity in residence area (high vs. low) 0.02 0.03 0.7
Medications containing calcium (yes vs. no) 0.02 0.03 0.6
Medications containing iron (yes vs. no) 0.02 0.03 0.5
21. Calcium-rich food (frequency) -0.001 0.003 0.8
Iron-rich food (frequency) -0.001 0.004 0.7
Food groups as major contributors to lead exposure
(frequency)
-0.005 0.005 0.3
Distance from copper smelter (log transformed) -0.08 0.04 0.07
*All variables were adjusted for methods of BLL analysis
52
Annals of Agricultural and Environmental Medicine 2014, Vol
21, No 1
Kinga Polańska, Wojciech Hanke, Wojciech Sobala, Małgorzata
Trzcinka-Ochocka, Danuta Ligocka, Halina Strugała-Stawik,
Per Magnus. Predictors of environmental…
The income variable was categorized based on 3 selected
variables (described in Methods), not by monthly income
per family member, so that the educational level seems to be
a more accurate estimate of SES. The employment category
can be understood as the measure of SES, on one hand, but
on the other, it can be identified as the source of exposure
(especially in the regions where smelters exist).
In the current study, the association between cotinine level
in saliva and BLL was on the border of significance (p=0.06),
even after differences in educational level were controlled for.
Additional adjustment for income and employments status
22. (not shown) did not change the results. These findings are
in agreement with earlier published results showing that
active and even passive tobacco smokers have higher BLL
than nonsmokers not exposed to environmental tobacco
smoke [19, 20, 22]. As an example, the analysis performed
on US women of reproductive age (20–49 year old) who
were the subjects of NHANES III, indicated that smokers
had 4.5 times higher odds ratio for high BLL (>4.0 µg/dL)
than nonsmokers (p<0.001) [20] after controlling for socio-
demographic variables. Additional analysis on US adults who
participated in the above survey indicated BLL of 3.5 µg/dL in
current smokers, 2.9 µg/dL in former smokers and 2.3 µg/dL
in never smokers with high cotinine levels, and 1.8 µg/dL
in those with no detectable cotinine. The adjusted linear
model showed that geometric mean BLL were 30% higher
(95% CI 24%-36%) in adults with high cotinine levels than
they were in nonsmokers not exposed to environmental
tobacco smoke [22].
Cigarette smoke may contain lead and other heavy
metals, such as cadmium and mercury, which have been
shown to be synergistic in experimental animals [21]. The
estimates from Canada indicate that from 1968 – 1988 the
levels of lead inhaled by smokers declined by about 62% as
the consequence of decreasing the level of lead in ambient
air [23]. The Massachusetts Benchmark Study estimated
that mainstream tobacco smoke contains 60 ng of lead per
cigarette, and that side-stream smoke contains 5–10 ng of lead
per cigarette [24]. This level of lead is likely to be associated
with the particulate fraction of tobacco smoke and absorbed
through the respiratory system [22]. The mean lead levels in
the indoor air of homes in which smoking occurs (21.8 ng/m3)
was higher compared with levels in homes where no smoking
occurs (7.8 ng/m3) [25]. Additionally, lead in particulate
fraction could settle onto surfaces and food where it has the
potential to re-expose people through the gastrointestinal
23. route or the respiratory system [22].
Epidemiological data indicate that calcium and iron
supplementation, consumption of calcium and iron-rich food
may reduce BLL and foetal exposure to lead. In experimental
studies of adults, absorption of a single dose of lead (100–
300 µg lead chloride) was lower when the lead was ingested
together with calcium carbonate (0.2–1 g calcium carbonate)
than when the lead was ingested without additional calcium
[21]. Also, based on experimental animal models, absorption
of lead from the gastrointestinal tract has been shown to be
enhanced by dietary calcium depletion or administration of
vitamin D [21]. Iron deficiency may result in higher absorption
of lead or, possibly, other changes in lead biokinetics that
would
contribute to BLL. Evidence for the effect of iron deficiency on
lead absorption has been provided from animal studies. As the
example, in rats, iron deficiency increases the gastrointestinal
absorption of lead, possibly by enhancing binding of lead to
iron binding proteins in the intestine [21]. In the presented
analysis, neither the consumption of medications containing
calcium and/or iron, nor the calcium and iron-rich food,
as well as food groups identified as the contributors to lead
exposure, had a statistically significant impact on BLL.
With the low levels of lead exposure observed in the current
study and the lack of lead in the petrol used for vehicles, the
diet need not necessarily be identified as the predictor of
lead exposure. The Scientific Report of the European Food
Safety Authority (EFSA), indicated that more than a half of
the food tested had levels of lead at less than detection or
quantification limits, and that adult exposure was estimated
at 0.50 μg/kg body weight per day [26].
The study confirmed positive correlation between
24. prepregnancy BMI and BLL after controlling for
environmental, lifestyle and socio-demographic factors.
The same result was observed in analysis on pregnant
women from Kraków region [19]. This could be determined
by the total caloric or dietary fat intake. Based on a study
performed on preschool children, Lucas et al. speculated that
bile secreted into the gastrointestinal to aid in the digestion
and absorption of fat, may increase lead absorption [21, 27].
On the other hand, the influence of the total caloric intake
may reflect increased intake of lead through food.
There were no statistically significant association between
BLL and subjective traffic intensity in the place of residence.
In the case of the elimination of tetraethyl lead as a petrol
addictive, the traffic profile and intensity seems not to
be a significant predictor of lead exposure. Although the
possibility of misclassification exists (as this variable is
based on subjective information from pregnant women and
not actual traffic density), it seems to be less important.
The environmental data monitoring carried out in 2010
by the Chief Inspectorate of Environmental Protection,
demonstrated that there were no regions in Poland which
exceeded the 0.5 μg/m3 annual limit value for lead for the
protection of human health [28, 29].
The results of the presented study indicate that BLL
decreases with increasing distance from smelters as the
source of lead exposure. The results were significant after
controlling for socio-demographic and lifestyle factors
(such as age, educational level, number of children, BMI
and cotinine level). Additional adjustment for income and
employments status (not shown) did not have an impact
on the results. Thus, socio-economic status and related
environmental hygiene standards should not have an impact
on the association between distance from the smelter and
BLL. The systematic biomonitoring of BLL in children from
25. the Legnica-Głogów Copper Basin has been conducted by
the Foundation for Children from the Copper Basin. Based
on the analyses performed between 1991 – 2009, the mean
BLL in children decreased over the years (from 10 µg/dL in
1991 to 4 µg/dL in 2009) [11]. Additionally, in agreement
with the presented results, higher BLL were observed at a
shorter distance from a copper smelter (BLL decreased with
increasing distance from the smelter).
SUMMARY
In summary, the presented study conducted among Polish
pregnant women showed low BLL. This is an example of
the success of the public health intervention mostly aimed
53
Annals of Agricultural and Environmental Medicine 2014, Vol
21, No 1
Kinga Polańska, Wojciech Hanke, Wojciech Sobala, Małgorzata
Trzcinka-Ochocka, Danuta Ligocka, Halina Strugała-Stawik,
Per Magnus. Predictors of environmental…
at eliminating lead from petrol. Although poor pregnancy
outcomes were noted at maternal BLL higher than 15 µg/dL for
birth weight, and above 30 µg/dL for spontaneous abortion or
preterm delivery, which are much higher levels than observed
nowadays, there is still concern about the impact of relatively
low levels on child psychomotor development. The majority
of the studies confirm the neuro-developmental (including
cognitive and intellectual) effect of BLL above 10 µg/dL.
These include reduced intelligence, behavioural problems
and diminished school performance [3, 4, 12]. Many of the
26. studies also confirmed the existence of an adverse effect
below such levels, and additionally indicate that the rate of
decline in IQ scores might be greater at BLL below 10 µg/
dL than it is at levels above 10 µg/dL. It is important to note
that still higher BLL was observed among older, less educated
women, those who smoke cigarettes and lived close to a
copper smelter. Taking this into account, there is still good
reason to perform some programmes and interventions,
especially in the regions with higher levels of exposure to
lead, among women with lower SES and among smokers.
CONCLUSIONS
The blood lead levels observed in pregnant women did
not exceed 6ug/ml. Statistically significant associations
were found between BLL and factors such as maternal
age, education and prepregnancy BMI. Additionally, BLL
increased with increasing cotinine level in saliva and
decreased with the increasing distance from a copper smelter.
Acknowledgement
The study was supported by the project ‘Prenatal and
postnatal exposure to tobacco smoke, PAH and heavy metals
and the risk of respiratory diseases, allergy and poor mental
and physical development’, funded by Grant No. PNRF-218-
AI-1/07 from Norway through the Norwegian Financial
Mechanism within the Polish-Norwegian Research Fund.
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