The aim of the present study was to examine the relationship between reported environmental tobacco smoke (ETS) exposure and respiratory symptoms.In 1996, a postal questionnaire was randomly distributed in three areas of Estonia to a population-based sample, of which 4,995 females and 1,822 males had never smoked. The main outcome measures were current respiratory symptoms and the amount of reported ETS exposure outside the home.ETS exposure at home was more common in females (31% versus 19%), while exposure outside of the home was more common in males (53% versus 7%). Females reported more symptoms from tobacco smoke than males (37.7% versus 21.6%). If ETS exposure outside of the home exceeded 5 h daily, the risk for wheeze (odds ratio (OR) 2.67, 95% confidence interval (CI) 1.98-3.61) and physician-diagnosed asthma (OR 1.79, 1.02-3.16) were increased. ETS exposure outside of the home was shown to be strongly related to almost all respiratory symptoms in a dose/response manner. ETS exposure at home did not show significantly elevated ORs for any respiratory symptoms.This study shows that females seem to be more troubled by environmental smoke exposure than males and provides further evidence of the serious health hazards associated with environmental smoke exposure. Indeed, the findings of this study support a ban on smoking in the workplace and public areas. Eur Respir J 2003; 21: 672-676.

No abstract

It has been suggested that the basic building blocks of music mimic sounds of moving humans, and because the brain was primed to exploit such sounds, they eventually became incorporated in human culture. However, that raises further questions. Why do genetically close, culturally well-developed apes lack musical abilities? Did our switch to bipedalism influence the origins of music? Four hypotheses are raised: (1) Human locomotion and ventilation can mask critical sounds in the environment. (2) Synchronization of locomotion reduces that problem. (3) Predictable sounds of locomotion may stimulate the evolution of synchronized behavior. (4) Bipedal gait and the associated sounds of locomotion influenced the evolution of human rhythmic abilities. Theoretical models and research data suggest that noise of locomotion and ventilation may mask critical auditory information. People often synchronize steps subconsciously. Human locomotion is likely to produce more predictable sounds than those of non-human primates. Predictable locomotion sounds may have improved our capacity of entrainment to external rhythms and to feel the beat in music. A sense of rhythm could aid the brain in distinguishing among sounds arising from discrete sources and also help individuals to synchronize their movements with one another. Synchronization of group movement may improve perception by providing periods of relative silence and by facilitating auditory processing. The adaptive value of such skills to early ancestors may have been keener detection of prey or stalkers and enhanced communication. Bipedal walking may have influenced the development of entrainment in humans and thereby the evolution of rhythmic abilities.

Refers to the following text of the Journal: 2005;31(1):0

Background: Dysphagia occurs commonly in the intensive care unit (ICU). Despite the clinical relevance, there is little worldwide research on prevention, assessment, evaluation, and/or treatment of dysphagia for ICU patients. We aimed to gain insight into this international knowledge gap. Methods:We conducted a multi-center, international online cross-sectional survey of adult ICUs. Local survey distribution champions were recruited through professional and personal networks. The survey was administered from November 2017 to June 2019 with three email and a final telephone reminder. Results:Responses were received from 746 ICUs (26 countries). In patients intubated >48 hours, 17% expected a >50% chance that dysphagia would develop. This proportion increased to 43% in patients intubated >7 days, and to 52% in tracheotomized patients. Speech-language pathologist (SLP) consultation was available in 66% of ICUs, only 4% reported a dedicated SLP.Although 66% considered a routine post-extubation dysphagia protocol important, most (67%) did not have a protocol. Few ICUs routinely assessed for dysphagia after 48 hours intubation (30%) or tracheostomy (41%). A large proportion (46%) used water swallow screening tests to determine aspiration, few (8%) used instrumental assessments (i.e., flexible endoscopic evaluation of swallowing). Swallowing exercises were used for dysphagia management by 30% of ICUs.Conclusions: There seems to be limited awareness among ICU practioners that patients are at risk of dysphagia, particularly as ventilation persists, protocols, routine assessment and instrumental assessments are generally not used. We recommend the development of a research agenda to increase the quality of evidence and ameliorate the implementation of evidence-based dysphagia protocols by dedicated SLPs.

Synchronized movements (schooling) emit complex and overlapping sound and pressure curves that might confuse the inner ear and lateral line organ (LLO) of a predator. Moreover, prey-fish moving close to each other may blur the electro-sensory perception of predators. The aim of this review is to explore mechanisms associated with synchronous swimming that may have contributed to increased adaptation and as a consequence may have influenced the evolution of schooling. The evolutionary development of the inner ear and the LLO increased the capacity to detect potential prey, possibly leading to an increased potential for cannibalism in the shoal, but also helped small fish to avoid joining larger fish, resulting in size homogeneity and, accordingly, an increased capacity for moving in synchrony. Water-movements and incidental sound produced as by-product of locomotion (ISOL) may provide fish with potentially useful information during swimming, such as neighbour body-size, speed, and location. When many fish move close to one another ISOL will be energetic and complex. Quiet intervals will be few. Fish moving in synchrony will have the capacity to discontinue movements simultaneously, providing relatively quiet intervals to allow the reception of potentially critical environmental signals. Besides, synchronized movements may facilitate auditory grouping of ISOL. Turning preference bias, well-functioning sense organs, good health, and skillful motor performance might be important to achieving an appropriate distance to school neighbors and aid the individual fish in reducing time spent in the comparatively less safe school periphery. Turning preferences in ancestral fish shoals might have helped fish to maintain groups and stay in formation, reinforcing aforementioned predator confusion mechanisms, which possibly played a role in the lateralization of the vertebrate brain.

The development of the octavolateralis system in fish ancestors created the phenomenon of sensory reafference associated with the fish's own locomotion. Particularly in fish species living and moving in groups, there is a potential to produce complex pressure waves and other water movements interfering with the octavolateralis perception of critical environmental signals. The hypothesis presented is that the development of the octavolateralis system may have initiated, or been a factor in, the evolutionary development of synchronized group locomotion, eventually leading to schooling behaviour. Theoretical models suggest that schooling may be related to a reduction in masking of environmental signals, as well as to survival mechanisms, e.g. confusion of the lateral line and electrosensory systems of predators by overlapping pressure waves and overlapping electrical fields. The combined effects of reduced masking and predator confusion may help explain why schooling became an evolutionary success. Including pressure waves and other water movements in the model of join, stay or leave decisions might shed some light on fish shoal assortment. A model encompassing the complex effects of synchronized group locomotion on octavolateralis and electro-sensory perception of both prey and predator fish might increase the understanding of schooling behaviour.

The highly synchronized formations that characterize schooling in fish and the flight of certain bird groups have frequently been explained as reducing energy expenditure. I present an alternative, or complimentary, hypothesis that synchronization of group movements may improve hearing perception. Although incidental sounds produced as a by-product of locomotion (ISOL) will be an almost constant presence to most animals, the impact on perception and cognition has been little discussed. A consequence of ISOL may be masking of critical sound signals in the surroundings. Birds in flight may generate significant noise; some produce wing beats that are readily heard on the ground at some distance from the source. Synchronization of group movements might reduce auditory masking through periods of relative silence and facilitate auditory grouping processes. Respiratory locomotor coupling and intermittent flight may be other means of reducing masking and improving hearing perception. A distinct border between ISOL and communicative signals is difficult to delineate. ISOL seems to be used by schooling fish as an aid to staying in formation and avoiding collisions. Bird and bat flocks may use ISOL in an analogous way. ISOL and interaction with animal perception, cognition, and synchronized behavior provide an interesting area for future study.