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Sample records for adverse economic consequences

  1. Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article.

    PubMed

    Yazdkhasti, Mansureh; Pourreza, Abolghasem; Pirak, Arezoo; Abdi, Fatemeh

    2015-01-01

    Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation.

  2. Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article

    PubMed Central

    YAZDKHASTI, Mansureh; POURREZA, Abolghasem; PIRAK, Arezoo; ABDI, Fatemeh

    2015-01-01

    Abstract Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation. PMID:26060771

  3. Economic consequences of the adverse reactions related with antipsychotics: an economic model comparing tolerability of ziprasidone, olanzapine, risperidone, and haloperidol in Spain.

    PubMed

    Bobes, Julio; Cañas, Fernando; Rejas, Javier; Mackell, Joan

    2004-12-01

    Frequency of adverse reactions (ARs) related with antipsychotics usage is high. Along with clinical implications, economic impact might be important. The purpose of this study was to model the economic consequences of ARs related with ziprasidone, olanzapine, risperidone, and haloperidol in Spain, by means of a cost-effectiveness model developed using a Markov modeling approach. The model simulated treatment of a cohort of 1000 schizophrenics for 12 months, initiating treatment with one of four antipsychotic drugs; haloperidol, risperidone, olanzapine and ziprasidone. Conditional probabilities of developing any of four adverse events were calculated. Treatment was modified (decrease dose, switch medication) according to incidence of ARs and physician judgments, obtained from a local cross-sectional study and clinical trials previously published. The analysis was conducted in year 2002 from a third party payer perspective. Results are shown as annual cost per month with psychotic symptoms controlled and included univariate sensitivity analysis. The therapeutic strategy starting with ziprasidone showed the lower costs and the greater number of months with symptoms controlled in most scenarios evaluated versus the other options considered, although the differences were weak: 9.6, 9.3, 9.5 and 9.5 controlled months per patient in base scenario, with annual cost per patient per month with symptoms controlled of 1035 Euros, 1084 Euros, 1087 Euros and 1090 Euros for ziprasidone, haloperidol, risperidone and olanzapine, respectively. Results were robust to one-way sensitivity analysis. Despite the unlike drug prices of antipsychotics, a considerable economic impact due to adverse reactions was seen in our setting. These results should be taken into account by health decision makers and clinicians in the management of patients with schizophrenia.

  4. Adverse health consequences of the Iraq War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2013-03-16

    The adverse health consequences of the Iraq War (2003-11) were profound. We conclude that at least 116,903 Iraqi non-combatants and more than 4800 coalition military personnel died over the 8-year course. Many Iraqi civilians were injured or became ill because of damage to the health-supporting infrastructure of the country, and about 5 million were displaced. More than 31,000 US military personnel were injured and a substantial percentage of those deployed suffered post-traumatic stress disorder, traumatic brain injury, and other neuropsychological disorders and their concomitant psychosocial problems. Many family members of military personnel had psychological problems. Further review of the adverse health consequences of this war could help to minimise the adverse health consequences of, and help to prevent, future wars.

  5. Adverse health consequences of the Vietnam War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2015-01-01

    The 40th anniversary of the end of the Vietnam War is a useful time to review the adverse health consequences of that war and to identify and address serious problems related to armed conflict, such as the protection of noncombatant civilians. More than 58,000 U.S. servicemembers died during the war and more than 150,000 were wounded. Many suffered from posttraumatic stress disorders and other mental disorders and from the long-term consequences of physical injuries. However, morbidity and mortality, although difficult to determine precisely, was substantially higher among the Vietnamese people, with at least two million of them dying during the course of the war. In addition, more than one million Vietnamese were forced to migrate during the war and its aftermath, including many "boat people" who died at sea during attempts to flee. Wars continue to kill and injure large numbers of noncombatant civilians and continue to damage the health-supporting infrastructure of society, expose civilians to toxic chemicals, forcibly displace many people, and divert resources away from services to benefit noncombatant civilians. Health professionals can play important roles in promoting the protection of noncombatant civilians during war and helping to prevent war and create a culture of peace.

  6. Adverse health consequences of the Vietnam War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2015-01-01

    The 40th anniversary of the end of the Vietnam War is a useful time to review the adverse health consequences of that war and to identify and address serious problems related to armed conflict, such as the protection of noncombatant civilians. More than 58,000 U.S. servicemembers died during the war and more than 150,000 were wounded. Many suffered from posttraumatic stress disorders and other mental disorders and from the long-term consequences of physical injuries. However, morbidity and mortality, although difficult to determine precisely, was substantially higher among the Vietnamese people, with at least two million of them dying during the course of the war. In addition, more than one million Vietnamese were forced to migrate during the war and its aftermath, including many "boat people" who died at sea during attempts to flee. Wars continue to kill and injure large numbers of noncombatant civilians and continue to damage the health-supporting infrastructure of society, expose civilians to toxic chemicals, forcibly displace many people, and divert resources away from services to benefit noncombatant civilians. Health professionals can play important roles in promoting the protection of noncombatant civilians during war and helping to prevent war and create a culture of peace. PMID:26754766

  7. Workplace Bullying: A Tale of Adverse Consequences

    PubMed Central

    Sansone, Lori A.

    2015-01-01

    Workplace bullying is defined as the repetitive and systematic engagement of interpersonally abusive behaviors that negatively affect both the targeted individual and the work organization. According to the findings of 12 studies, being bullied in the workplace affects approximately 11 percent of workers. Victims are frequently blue-collar and unskilled workers. However, there also appear to be gender and milieu/management factors. Emotional/psychological consequences of workplace bullying may include increased mental distress, sleep disturbances, fatigue in women and lack of vigor in men, depression and anxiety, adjustment disorders, and even work-related suicide. Medical consequences of workplace bullying may include an increase in health complaints such as neck pain, musculoskeletal complaints, acute pain, fibromyalgia, and cardiovascular symptoms. Finally, socioeconomic consequences of workplace bullying may include absenteeism due to sick days and unemployment. Clinicians in both mental health and primary care settings need to be alert to the associations between bullying in the workplace and these potential negative consequences, as patients may not disclose workplace maltreatment due to embarrassment or fears of retribution. PMID:25852978

  8. Workplace bullying: a tale of adverse consequences.

    PubMed

    Sansone, Randy A; Sansone, Lori A

    2015-01-01

    Workplace bullying is defined as the repetitive and systematic engagement of interpersonally abusive behaviors that negatively affect both the targeted individual and the work organization. According to the findings of 12 studies, being bullied in the workplace affects approximately 11 percent of workers. Victims are frequently blue-collar and unskilled workers. However, there also appear to be gender and milieu/management factors. Emotional/psychological consequences of workplace bullying may include increased mental distress, sleep disturbances, fatigue in women and lack of vigor in men, depression and anxiety, adjustment disorders, and even work-related suicide. Medical consequences of workplace bullying may include an increase in health complaints such as neck pain, musculoskeletal complaints, acute pain, fibromyalgia, and cardiovascular symptoms. Finally, socioeconomic consequences of workplace bullying may include absenteeism due to sick days and unemployment. Clinicians in both mental health and primary care settings need to be alert to the associations between bullying in the workplace and these potential negative consequences, as patients may not disclose workplace maltreatment due to embarrassment or fears of retribution. PMID:25852978

  9. Mechanisms of adverse cardiometabolic consequences of obesity.

    PubMed

    Diaz-Melean, Carlos M; Somers, Virend K; Rodriguez-Escudero, Juan Pablo; Singh, Prachi; Sochor, Ondrej; Llano, Ernesto Manuel; Lopez-Jimenez, Francisco

    2013-11-01

    Obesity is an epidemic that threatens the health of millions of people worldwide and is a major risk factor for cardiovascular diseases, hypertension, diabetes, and dyslipidemia. There are multiple and complex mechanisms to explain how obesity can cause cardiovascular disease. In recent years, studies have shown some limitations in the way we currently define obesity and assess adiposity. This review focuses on the mechanisms involved in the cardiometabolic consequences of obesity and on the relationship between obesity and cardiovascular comorbidities, and provides a brief review of the latest studies focused on normal weight obesity and the obesity paradox. PMID:24048571

  10. Economic Consequences Of Climate Change

    NASA Astrophysics Data System (ADS)

    Szlávik, János; Füle, Miklós

    2009-07-01

    Even though the climate conflict resulting from green houses gases (GHG) emissions was evident by the Nineties and the well-known agreements made, their enforcement is more difficult than that of other environmental agreements. That is because measures to reduce GHG emissions interfere with the heart of the economy and the market: energy (in a broader sense than the energy sector as defined by statistics) and economical growth. Analyzing the environmental policy responses to climate change the conclusion is that GHG emission reduction can only be achieved through intensive environmental policy. While extensive environmental protection complements production horizontally, intensive environmental protection integrates into production and the environment vertically. The latter eliminates the source of the pollution, preventing damage. It utilizes the biochemical processes and self-purification of the natural environment as well as technical development which not only aims to produce state-of-the-art goods, but to make production more environmentally friendly, securing a desired environmental state. While in extensive environmental protection the intervention comes from the outside for creating environmental balance, in intensive environmental protection the system recreates this balance itself. Instead of dealing with the consequences and the polluter pays principle, the emphasis is on prevention. It is important to emphasize that climate strategy decisions have complex effects regarding the aspects of sustainability (economical, social, ecological). Therefore, all decisions are political. At present, and in the near future, market economy decisions have little to do with sustainability values under normal circumstances. Taking social and ecological interests into consideration can only be successful through strategic political aims.

  11. The Economic Consequences of Divorce.

    ERIC Educational Resources Information Center

    Espenshade, Thomas J.

    1979-01-01

    Examines the economic hardship that divorce entails. Wives are usually awarded custody of children without commensurate financial help from fathers and face other impediments in the labor market to higher pay and adequate employment opportunities. Policies dealing with these problems often center on income transfers and enforcement of child…

  12. Long Term Physical Health Consequences of Adverse Childhood Experiences

    PubMed Central

    Monnat, Shannon M.; Chandler, Raeven Faye

    2015-01-01

    This study examined associations between adverse childhood family experiences and adult physical health using data from 52,250 US adults aged 18–64 from the 2009–2012 Behavioral Risk Factor Surveillance System (BRFSS). We found that experiencing childhood physical, verbal, or sexual abuse, witnessing parental domestic violence, experiencing parental divorce, and living with someone who was depressed, abused drugs or alcohol, or who had been incarcerated were associated with one or more of the following health outcomes: self-rated health, functional limitations, diabetes, and heart attack. Adult socioeconomic status and poor mental health and health behaviors significantly mediated several of these associations. The results of this study highlight the importance of family-based adverse childhood experiences on adult health outcomes and suggest that adult SES and stress-related coping behaviors may be crucial links between trauma in the childhood home and adult health. PMID:26500379

  13. Narghile smoking and its adverse health consequences: a literature review.

    PubMed

    Dar-Odeh, N S; Abu-Hammad, O A

    2009-06-13

    Oral squamous cell carcinoma (OSCC) is a world health problem with approximately 50% of patients having a 5-year survival rate. A change in the demographics of the disease is now being recognised, particularly in Europe, where it is increasingly being seen in young males. While a variety of risk factors are important in OSCC, it is tobacco that plays a central part in the pathogenesis of the disease. Narghile is an old form of tobacco use but in the past decade, there has been a resurgence in this form of smoking. The practice is particularly common in young males and females from the Middle East but with the advent of immigration and globalisation, its use is becoming more widespread. It is now not uncommon to see narghile smoking in western countries such as the UK and USA. Studies describing the oral effects of narghile are unfortunately scarce. While adverse effects such as periodontal bone loss and dry socket have been described, its association with OSCC cannot be excluded. Variation in the type of narghile, the type of tobacco and the presence of co-factors such as cigarette smoking may all influence clinical outcome. In the present study, the practice of narghile smoking is reviewed in terms of its effect on health, particularly oral health. The association of narghile smoking and adverse effects on the orofacial region will be outlined, namely, periodontal disease, potentially malignant lesions and oral cancer. PMID:19521371

  14. Narghile smoking and its adverse health consequences: a literature review.

    PubMed

    Dar-Odeh, N S; Abu-Hammad, O A

    2009-06-13

    Oral squamous cell carcinoma (OSCC) is a world health problem with approximately 50% of patients having a 5-year survival rate. A change in the demographics of the disease is now being recognised, particularly in Europe, where it is increasingly being seen in young males. While a variety of risk factors are important in OSCC, it is tobacco that plays a central part in the pathogenesis of the disease. Narghile is an old form of tobacco use but in the past decade, there has been a resurgence in this form of smoking. The practice is particularly common in young males and females from the Middle East but with the advent of immigration and globalisation, its use is becoming more widespread. It is now not uncommon to see narghile smoking in western countries such as the UK and USA. Studies describing the oral effects of narghile are unfortunately scarce. While adverse effects such as periodontal bone loss and dry socket have been described, its association with OSCC cannot be excluded. Variation in the type of narghile, the type of tobacco and the presence of co-factors such as cigarette smoking may all influence clinical outcome. In the present study, the practice of narghile smoking is reviewed in terms of its effect on health, particularly oral health. The association of narghile smoking and adverse effects on the orofacial region will be outlined, namely, periodontal disease, potentially malignant lesions and oral cancer.

  15. Adverse metabolic and cardiovascular consequences of circadian misalignment.

    PubMed

    Scheer, Frank A J L; Hilton, Michael F; Mantzoros, Christos S; Shea, Steven A

    2009-03-17

    There is considerable epidemiological evidence that shift work is associated with increased risk for obesity, diabetes, and cardiovascular disease, perhaps the result of physiologic maladaptation to chronically sleeping and eating at abnormal circadian times. To begin to understand underlying mechanisms, we determined the effects of such misalignment between behavioral cycles (fasting/feeding and sleep/wake cycles) and endogenous circadian cycles on metabolic, autonomic, and endocrine predictors of obesity, diabetes, and cardiovascular risk. Ten adults (5 female) underwent a 10-day laboratory protocol, wherein subjects ate and slept at all phases of the circadian cycle-achieved by scheduling a recurring 28-h "day." Subjects ate 4 isocaloric meals each 28-h "day." For 8 days, plasma leptin, insulin, glucose, and cortisol were measured hourly, urinary catecholamines 2 hourly (totaling approximately 1,000 assays/subject), and blood pressure, heart rate, cardiac vagal modulation, oxygen consumption, respiratory exchange ratio, and polysomnographic sleep daily. Core body temperature was recorded continuously for 10 days to assess circadian phase. Circadian misalignment, when subjects ate and slept approximately 12 h out of phase from their habitual times, systematically decreased leptin (-17%, P < 0.001), increased glucose (+6%, P < 0.001) despite increased insulin (+22%, P = 0.006), completely reversed the daily cortisol rhythm (P < 0.001), increased mean arterial pressure (+3%, P = 0.001), and reduced sleep efficiency (-20%, P < 0.002). Notably, circadian misalignment caused 3 of 8 subjects (with sufficient available data) to exhibit postprandial glucose responses in the range typical of a prediabetic state. These findings demonstrate the adverse cardiometabolic implications of circadian misalignment, as occurs acutely with jet lag and chronically with shift work. PMID:19255424

  16. The Economic Consequences of Absent Parents

    ERIC Educational Resources Information Center

    Page, Marianne E.; Stevens, Ann Huff

    2004-01-01

    The effects of family structure on economic resources, controlling for unobservable family characteristics is examined. It is proposed that since the family structure makes a significant impact on the economic status of children, policies encouraging two-parents families will be justified.

  17. The epidemiology and economic consequences of pain.

    PubMed

    Henschke, Nicholas; Kamper, Steven J; Maher, Chris G

    2015-01-01

    Pain is considered a major clinical, social, and economic problem in communities around the world. In this review, we describe the incidence, prevalence, and economic burden of pain conditions in children, adolescents, and adults based on an electronic search of the MEDLINE and EMBASE databases for articles published from January 1, 2000, through August 1, 2014, using the keywords pain, epidemiology, burden, prevalence, and incidence. The impact of pain on individuals and potential risk factors are also discussed. Differences in the methodology and conduct of epidemiological studies make it difficult to provide precise estimates of prevalence and incidence; however, the burden of pain is unquestionably large. Improved concepts and methods are needed in order to study pain from a population perspective and further the development of pain prevention and management strategies. PMID:25572198

  18. Economic consequences of commercial space operations

    NASA Technical Reports Server (NTRS)

    Stone, Barbara A.; Wood, Peter W.

    1990-01-01

    The potential economic benefits generated from increased industry involvement and investment in space activities and the subsequent cost implications are discussed. A historical overview of commercial industry involvement in space is given and sources of new economic growth in space are discussed. These include communications satellites, small satellites, positioning and navigation services, space transportation and infrastructure, remote sensing, and materials processing in space such as the manufacturing of protein crystals and zeolites. Macroeconomic trends and principles such as limits on technology trade, eased restrictions on international joint ventures, foreign investments in U.S. firms, and increased foreign competition are discussed. Earth observations and mapping are considered. Opportunities for private sector involvement in building space infrastructure and space transportation are highlighted.

  19. Extreme events and their economic consequences

    NASA Astrophysics Data System (ADS)

    Ghil, M.

    2011-12-01

    This talk presents a modeling framework for macroeconomic dynamics that is motivated by recent attempts to formulate and study integrated models of the coupling between natural and socio-economic phenomena. The challenge is to describe the interfaces between human activities and the functioning of the earth system. We examine the way that this interface works in the presence of endogenous business cycle dynamics, based on a non-equilibrium dynamic model (NEDyM), and review the macroeconomic response to natural disasters. Our model reproduces fairly well the so-called stylized facts of business cycles, including their periodicity of 5-6 years and their sawtooth shape, with expansions lasting longer than recessions. The NEDyM model exhibits a vulnerability paradox in that its response to natural disasters is larger during expansions than during recessions. This result raises questions about the assessment of climate change damages or natural disaster losses that are based purely on long-term growth models. It also suggests a form of non-equilibrium fluctuation-dissipation theorem (FDT), with greater volatility during expansions than during recessions. In order to compare the theoretical findings with observational data, we present a new method for extracting cyclic behavior from the latter, based on multivariate singular spectral analysis. Results that use over 50 years of U.S. economic indicators support the FDT conjecture.

  20. Economic consequences of high throughput maskless lithography

    NASA Astrophysics Data System (ADS)

    Hartley, John G.; Govindaraju, Lakshmi

    2005-11-01

    Many people in the semiconductor industry bemoan the high costs of masks and view mask cost as one of the significant barriers to bringing new chip designs to market. All that is needed is a viable maskless technology and the problem will go away. Numerous sites around the world are working on maskless lithography but inevitably, the question asked is "Wouldn't a one wafer per hour maskless tool make a really good mask writer?" Of course, the answer is yes, the hesitation you hear in the answer isn't based on technology concerns, it's financial. The industry needs maskless lithography because mask costs are too high. Mask costs are too high because mask pattern generators (PG's) are slow and expensive. If mask PG's become much faster, mask costs go down, the maskless market goes away and the PG supplier is faced with an even smaller tool demand from the mask shops. Technical success becomes financial suicide - or does it? In this paper we will present the results of a model that examines some of the consequences of introducing high throughput maskless pattern generation. Specific features in the model include tool throughput for masks and wafers, market segmentation by node for masks and wafers and mask cost as an entry barrier to new chip designs. How does the availability of low cost masks and maskless tools affect the industries tool makeup and what is the ultimate potential market for high throughput maskless pattern generators?

  1. "Partier" self-concept mediates the relationship between college student binge drinking and related adverse consequences.

    PubMed

    Reslan, Summar; Saules, Karen K; Serras, Alisha

    2011-08-01

    The literature suggests that identity impairments play a role in certain forms of maladaptive behavior. Thus, this study was designed to evaluate the extent to which a "Partier" self-concept confers risk for adverse drinking-related consequences, mediating the well documented relationship between college student binge drinking and adverse outcomes. Participants completed an Internet survey examining binge drinking behaviors and related consequences, "Partier" self-concept, and demographic characteristics. This sample was comprised of 251 undergraduate psychology students (M(age)=19.90, SD(age)=1.80; 83% female). Results suggest that "Partier" self-concept partially mediates the relationship between binge drinking and adverse consequences, and it contributes unique variance beyond that explained by frequency of binge drinking and duration of alcohol consumed during binge episodes. Future research should explore whether, for undergraduate college students, binge drinking prevention efforts tailored towards self-concept may fare better than those that have traditionally focused on heavy alcohol use, negative consequences, and related sanctions.

  2. Development of economic consequence methodology for process risk analysis.

    PubMed

    Zadakbar, Omid; Khan, Faisal; Imtiaz, Syed

    2015-04-01

    A comprehensive methodology for economic consequence analysis with appropriate models for risk analysis of process systems is proposed. This methodology uses loss functions to relate process deviations in a given scenario to economic losses. It consists of four steps: definition of a scenario, identification of losses, quantification of losses, and integration of losses. In this methodology, the process deviations that contribute to a given accident scenario are identified and mapped to assess potential consequences. Losses are assessed with an appropriate loss function (revised Taguchi, modified inverted normal) for each type of loss. The total loss is quantified by integrating different loss functions. The proposed methodology has been examined on two industrial case studies. Implementation of this new economic consequence methodology in quantitative risk assessment will provide better understanding and quantification of risk. This will improve design, decision making, and risk management strategies.

  3. Epigenetics and life-long consequences of an adverse nutritional and diabetic intrauterine environment

    PubMed Central

    El Hajj, Nady; Schneider, Eberhard; Lehnen, Harald; Haaf, Thomas

    2014-01-01

    The phenomenon that adverse environmental exposures in early life are associated with increased susceptibilities for many adult, particularly metabolic diseases, is now referred to as ‘developmental origins of health and disease (DOHAD)’ or ‘Barker’ hypothesis. Fetal overnutrition and undernutrition have similar long-lasting effects on the setting of the neuroendocrine control systems, energy homeostasis, and metabolism, leading to life-long increased morbidity. There are sensitive time windows during early development, where environmental cues can program persistent epigenetic modifications which are generally assumed to mediate these gene–environment interactions. Most of our current knowledge on fetal programing comes from animal models and epidemiological studies in humans, in particular the Dutch famine birth cohort. In industrialized countries, there is more concern about adverse long-term consequences of fetal overnutrition, i.e. by exposure to gestational diabetes mellitus and/or maternal obesity which affect 10–20% of pregnancies. Epigenetic changes due to maternal diabetes/obesity may predispose the offspring to develop metabolic disease later in life and, thus, transmit the adverse environmental exposure to the next generation. This vicious cycle could contribute significantly to the worldwide metabolic disease epidemics. In this review article, we focus on the epigenetics of an adverse intrauterine environment, in particular gestational diabetes, and its implications for the prevention of complex disease. PMID:25187623

  4. Adverse Health Consequences of Performance-Enhancing Drugs: An Endocrine Society Scientific Statement

    PubMed Central

    Pope, Harrison G.; Wood, Ruth I.; Rogol, Alan; Nyberg, Fred; Bowers, Larry

    2014-01-01

    Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs. PMID:24423981

  5. The Economic Consequences of Widowhood for Older Minority Women

    ERIC Educational Resources Information Center

    Angel, Jacqueline L.; Jimenez, Maren A.; Angel, Ronald J.

    2007-01-01

    Purpose: We compare the economic consequences of widowhood for preretirement age and early-retirement age Black, Hispanic, and non-Hispanic White women. Methods: We use the 1992 and 2000 waves of the Health and Retirement Study to assess the effects of widowhood on the household incomes and assets of non-Hispanic White, Black, and Hispanic women…

  6. Adverse implications for university teaching concealed in economically driven policies

    PubMed Central

    Fraley, Lawrence E.

    1998-01-01

    Modern universities represent large economic operations fueled by funds that are increasingly derived from student tuition as government subsidies shrink. Student recruitment and retention are now mainly driven by the need for the dollars that students pay into the system. Policy that is responsive to these pressing economic realities, promulgated at all institutional levels, promotes professional behavior that encourages student retention while allowing this to occur through subtle sacrifice of the traditional essence of the university. A multiphase analysis relates the institution's economically driven policies on retention to their classroom implications and to other effects on the behavior of the teaching faculty. PMID:22478313

  7. Functional impairment and the economic consequences of female breast cancer.

    PubMed

    Chirikos, Thomas N; Russell-Jacobs, Anita; Jacobsen, Paul B

    2002-01-01

    Recent trends in breast cancer diagnosis and mortality suggest that long-term survivors are now more likely to be functionally impaired and, hence, more likely to experience adverse economic outcomes. This study tests whether women who have survived breast cancer for at least five years exhibit more, or more severe, functional impairments than otherwise similar women without breast cancer. It also tests whether women with more severe impairments experience poorer economic outcomes attributable to their functional status. A group of 105 breast cancer survivors was interviewed to obtain data on health and economic changes in the five-year period since diagnosis and initial treatment. An age- and work-matched group of 105 women without cancer was also interviewed to obtain the same data over the same time period. Key changes in the functional status of the subjects as well as economic outcomes such as changes in market earnings, household income, and insurance coverage were measured. Whether impairment is more severe in the breast cancer group than the comparison group was then tested statistically; whether economic outcomes are more adverse in more impaired than less impaired women regardless of their breast cancer status was also tested. The analysis turned up statistically significant evidence in regard to each of these relationships. Breast cancer survivors were more likely than controls to be functionally impaired at the five-year benchmark. Impaired women, in turn, were more likely to reduce work effort and experience downturns in market earnings, among other things. Policy and research implications are discussed. PMID:12215000

  8. Rapid estimation of the economic consequences of global earthquakes

    USGS Publications Warehouse

    Jaiswal, Kishor; Wald, David J.

    2011-01-01

    The U.S. Geological Survey's (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, operational since mid 2007, rapidly estimates the most affected locations and the population exposure at different levels of shaking intensities. The PAGER system has significantly improved the way aid agencies determine the scale of response needed in the aftermath of an earthquake. For example, the PAGER exposure estimates provided reasonably accurate assessments of the scale and spatial extent of the damage and losses following the 2008 Wenchuan earthquake (Mw 7.9) in China, the 2009 L'Aquila earthquake (Mw 6.3) in Italy, the 2010 Haiti earthquake (Mw 7.0), and the 2010 Chile earthquake (Mw 8.8). Nevertheless, some engineering and seismological expertise is often required to digest PAGER's exposure estimate and turn it into estimated fatalities and economic losses. This has been the focus of PAGER's most recent development. With the new loss-estimation component of the PAGER system it is now possible to produce rapid estimation of expected fatalities for global earthquakes (Jaiswal and others, 2009). While an estimate of earthquake fatalities is a fundamental indicator of potential human consequences in developing countries (for example, Iran, Pakistan, Haiti, Peru, and many others), economic consequences often drive the responses in much of the developed world (for example, New Zealand, the United States, and Chile), where the improved structural behavior of seismically resistant buildings significantly reduces earthquake casualties. Rapid availability of estimates of both fatalities and economic losses can be a valuable resource. The total time needed to determine the actual scope of an earthquake disaster and to respond effectively varies from country to country. It can take days or sometimes weeks before the damage and consequences of a disaster can be understood both socially and economically. The objective of the U.S. Geological Survey's PAGER system is

  9. Unintended environmental consequences and co-benefits of economic restructuring.

    PubMed

    Liang, Sai; Xu, Ming; Suh, Sangwon; Tan, Raymond R

    2013-11-19

    Current economic restructuring policies have ignored unintended environmental consequences and cobenefits, the understanding of which can provide foundations for effective policy decisions for green economy transformation. Using the input-output life cycle assessment model and taking China as an example, we find that household consumption, fixed capital formation, and export are main drivers to China's environmental impacts. At the product scale, major contributors to environmental impacts vary across different types of impacts. Stimulating the development of seven strategic emerging industries will cause unintended consequences, such as increasing nonferrous metal ore usage, terrestrial acidification, photochemical oxidant formation, human toxicity, and terrestrial ecotoxicity. Limiting the surplus outputs in the construction materials industry and metallurgy industry may only help mitigate some of the environmental impacts caused by China's regulated pollutants, with little effect on reducing other impacts, such as marine eutrophication, terrestrial acidification, photochemical oxidant formation, and particulate matter formation. However, it will bring cobenefits by simultaneously reducing mineral ore usage, human toxicity, marine ecotoxicity, and terrestrial ecotoxicity. Sustainable materials management and integrated policy modeling are possible ways for policy-making to avoid unintended consequences and effectively utilize cobenefits.

  10. Anticipating ocean acidification's economic consequences for commercial fisheries

    NASA Astrophysics Data System (ADS)

    Cooley, Sarah R.; Doney, Scott C.

    2009-06-01

    Ocean acidification, a consequence of rising anthropogenic CO2 emissions, is poised to change marine ecosystems profoundly by increasing dissolved CO2 and decreasing ocean pH, carbonate ion concentration, and calcium carbonate mineral saturation state worldwide. These conditions hinder growth of calcium carbonate shells and skeletons by many marine plants and animals. The first direct impact on humans may be through declining harvests and fishery revenues from shellfish, their predators, and coral reef habitats. In a case study of US commercial fishery revenues, we begin to constrain the economic effects of ocean acidification over the next 50 years using atmospheric CO2 trajectories and laboratory studies of its effects, focusing especially on mollusks. In 2007, the 3.8 billion US annual domestic ex-vessel commercial harvest ultimately contributed 34 billion to the US gross national product. Mollusks contributed 19%, or 748 million, of the ex-vessel revenues that year. Substantial revenue declines, job losses, and indirect economic costs may occur if ocean acidification broadly damages marine habitats, alters marine resource availability, and disrupts other ecosystem services. We review the implications for marine resource management and propose possible adaptation strategies designed to support fisheries and marine-resource-dependent communities, many of which already possess little economic resilience.

  11. Physical and economic consequences of climate change in Europe

    PubMed Central

    Ciscar, Juan-Carlos; Iglesias, Ana; Feyen, Luc; Szabó, László; Van Regemorter, Denise; Amelung, Bas; Nicholls, Robert; Watkiss, Paul; Christensen, Ole B.; Dankers, Rutger; Garrote, Luis; Goodess, Clare M.; Hunt, Alistair; Moreno, Alvaro; Richards, Julie; Soria, Antonio

    2011-01-01

    Quantitative estimates of the economic damages of climate change usually are based on aggregate relationships linking average temperature change to loss in gross domestic product (GDP). However, there is a clear need for further detail in the regional and sectoral dimensions of impact assessments to design and prioritize adaptation strategies. New developments in regional climate modeling and physical-impact modeling in Europe allow a better exploration of those dimensions. This article quantifies the potential consequences of climate change in Europe in four market impact categories (agriculture, river floods, coastal areas, and tourism) and one nonmarket impact (human health). The methodology integrates a set of coherent, high-resolution climate change projections and physical models into an economic modeling framework. We find that if the climate of the 2080s were to occur today, the annual loss in household welfare in the European Union (EU) resulting from the four market impacts would range between 0.2–1%. If the welfare loss is assumed to be constant over time, climate change may halve the EU's annual welfare growth. Scenarios with warmer temperatures and a higher rise in sea level result in more severe economic damage. However, the results show that there are large variations across European regions. Southern Europe, the British Isles, and Central Europe North appear most sensitive to climate change. Northern Europe, on the other hand, is the only region with net economic benefits, driven mainly by the positive effects on agriculture. Coastal systems, agriculture, and river flooding are the most important of the four market impacts assessed. PMID:21282624

  12. Physical and economic consequences of climate change in Europe.

    PubMed

    Ciscar, Juan-Carlos; Iglesias, Ana; Feyen, Luc; Szabó, László; Van Regemorter, Denise; Amelung, Bas; Nicholls, Robert; Watkiss, Paul; Christensen, Ole B; Dankers, Rutger; Garrote, Luis; Goodess, Clare M; Hunt, Alistair; Moreno, Alvaro; Richards, Julie; Soria, Antonio

    2011-02-15

    Quantitative estimates of the economic damages of climate change usually are based on aggregate relationships linking average temperature change to loss in gross domestic product (GDP). However, there is a clear need for further detail in the regional and sectoral dimensions of impact assessments to design and prioritize adaptation strategies. New developments in regional climate modeling and physical-impact modeling in Europe allow a better exploration of those dimensions. This article quantifies the potential consequences of climate change in Europe in four market impact categories (agriculture, river floods, coastal areas, and tourism) and one nonmarket impact (human health). The methodology integrates a set of coherent, high-resolution climate change projections and physical models into an economic modeling framework. We find that if the climate of the 2080s were to occur today, the annual loss in household welfare in the European Union (EU) resulting from the four market impacts would range between 0.2-1%. If the welfare loss is assumed to be constant over time, climate change may halve the EU's annual welfare growth. Scenarios with warmer temperatures and a higher rise in sea level result in more severe economic damage. However, the results show that there are large variations across European regions. Southern Europe, the British Isles, and Central Europe North appear most sensitive to climate change. Northern Europe, on the other hand, is the only region with net economic benefits, driven mainly by the positive effects on agriculture. Coastal systems, agriculture, and river flooding are the most important of the four market impacts assessed.

  13. Consequences and economics of metritis in Iranian Holstein dairy farms.

    PubMed

    Mahnani, A; Sadeghi-Sefidmazgi, A; Cabrera, V E

    2015-09-01

    The objectives of this study were (1) to describe the risk factors, incidence, and productive and reproductive consequences of metritis in dairy cows, and (2) to estimate the financial losses associated with metritis using data gathered from 4 Holstein dairy farms in Isfahan, Iran. Calving records from March 2008 to December 2013, comprising 43,488 calvings, were included in the data set. The effects of metritis on productive and reproductive performance were analyzed using a mixed linear model for primiparous and multiparous cows separately and in an overall data set (all cows combined), whereas risk factors on metritis incidence were examined using a multivariable logistical regression model for the overall data set. The incidence of metritis per cow per year was 13.2% on average and ranged from 9.0 to 15.8%. Results of logistic regression analysis demonstrated that calving year, parity number, calving season, twinning, dystocia, and retained placenta were significantly associated with the occurrence of metritis, whereas previous metritis incidence did not show an association. Greatest odds of metritis occurred in first-parity cows that calved in winter and had retained placenta, twinning, and dystocia in recent years. A case of metritis significantly reduced the 305-d milk yield in primiparous and multiparous cows and overall, but had no significant effects on 305-d fat and protein percentages in either primiparous or multiparous cows. Overall, a case of metritis reduced 305-d milk yield by 129.8±41.5kg/cow per lactation. The negative reproductive effects due to metritis were smaller and nonsignificant for primiparous cows compared with multiparous cows. Overall, a case of metritis increased days open and number of insemination per conception by 16.4±1.2 and 0.1±0.0 per cow per lactation, respectively. Among the individual farms, metritis costs ranged from $146.4 to $175.7 with a mean of $162.3/case. The model to calculate metritis costs proposed here could

  14. Adverse Childhood Experiences of Referred Children Exposed to Intimate Partner Violence: Consequences for their Wellbeing

    ERIC Educational Resources Information Center

    Lamers-Winkelman, Francien; Willemen, Agnes M.; Visser, Margreet

    2012-01-01

    Objective: This study investigated the relationships among Adverse Childhood Experiences (ACEs) in a high risk clinical sample of Dutch children whose mothers were abused by an intimate partner, and the severity of behavioral and emotional problems and trauma symptoms. Methods: The study population comprised 208 children (M = 7.81 years, SD =…

  15. Social consequences of early socioeconomic adversity and youth BMI trajectories: gender and race/ethnicity differences.

    PubMed

    Bae, Dayoung; Wickrama, K A S; O'Neal, Catherine Walker

    2014-08-01

    The present study investigated the mediating effects of adolescent BMI trajectories on socioeconomic continuity over the early life course using a nationally representative sample of 11,075 respondents. This study considered both the initial severity as well as change over time in BMI as psycho-physiological mediators. Consistent with the life course pathway model and the cumulative advantage and disadvantage principle, the results suggested that early socioeconomic adversity is associated with youth BMI trajectories over time, which in turn, impair young adult socioeconomic attainment. The results also revealed important gender and racial/ethnic differences in the hypothesized associations. These findings elucidate how early adversity exerts an enduring long-term influence on social attainment in young adulthood. Further, the findings suggest that effective obesity intervention and prevention programs should focus not only on the severity of obesity but also on growth in BMI over the early years.

  16. Evaluation of Economic and Social Consequences of Cooperative Extension Programs.

    ERIC Educational Resources Information Center

    Department of Agriculture, Washington, DC. Science and Education Administration.

    This report describes the cooperative extension system and evaluates the consequences of its educational programs. An executive summary provides an overview of the contents: background, highlights of findings related to consequences, interpretations, and implications for the future. Following an introduction, chapter 2 discusses extension in terms…

  17. The Economic Consequences of Absent Parents. JCPR Working Paper.

    ERIC Educational Resources Information Center

    Page, Marianne E.; Stevens, Ann Huff

    In recent years, the belief that marriage bestows large economic gains has generated enthusiasm for policy proposals that encourage the formation and continuation of two-parent families. This study examined the effects of family structure on economic resources, controlling for unobservable family background characteristics. Data were drawn from…

  18. Neoplasms involving the heart, their simulators, and adverse consequences of their therapy

    PubMed Central

    2001-01-01

    Primary cardiac tumors involving the heart may be either benign or malignant. Most of the benign tumors are myxomas, which are most commonly located in the left atrium. Primary malignant neoplasms usually involve the myocardium and the interior of the cardiac cavities, whereas neoplasms metastatic to the heart most commonly involve pericardium, and pericardial effusion and constriction are the most common consequences. Computed tomography and magnetic resonance imaging are becoming the most useful instruments of precision for the diagnosis of cardiac tumors. Pericardial cysts, teratomas, lipomatous hypertrophy of the atrial septum, papillary fibroelastomas, thrombi, and sarcoid are frequently mistaken for cardiac neoplasms. There are a number of cardiac consequences of malignancy, including radiation heart disease, cardiac hemorrhages, cardiac infection, cardiac adiposity or the corticosteroidtreated heart, cardiac hemosiderosis, and toxicity due to anthracycline chemotherapy. PMID:16369647

  19. Lognormal field size distributions as a consequence of economic truncation

    USGS Publications Warehouse

    Attanasi, E.D.; Drew, L.J.

    1985-01-01

    The assumption of lognormal (parent) field size distributions has for a long time been applied to resource appraisal and evaluation of exploration strategy by the petroleum industry. However, frequency distributions estimated with observed data and used to justify this hypotheses are conditional. Examination of various observed field size distributions across basins and over time shows that such distributions should be regarded as the end result of an economic filtering process. Commercial discoveries depend on oil and gas prices and field development costs. Some new fields are eliminated due to location, depths, or water depths. This filtering process is called economic truncation. Economic truncation may occur when predictions of a discovery process are passed through an economic appraisal model. We demonstrate that (1) economic resource appraisals, (2) forecasts of levels of petroleum industry activity, and (3) expected benefits of developing and implementing cost reducing technology are sensitive to assumptions made about the nature of that portion of (parent) field size distribution subject to economic truncation. ?? 1985 Plenum Publishing Corporation.

  20. The health care work environment and adverse health and safety consequences for nurses.

    PubMed

    Geiger-Brown, Jeanne; Lipscomb, Jane

    2010-01-01

    Nurses' working conditions are inextricably linked to the quality of care that is provided to patients and patients' safety. These same working conditions are associated with health and safety outcomes for nurses and other health care providers. This chapter describes aspects of the nursing work environment that have been linked to hazards and adverse exposures for nurses, as well as the most common health and safety outcomes of nursing work. We include studies from 2000 to the present by nurse researchers, studies of nurses as subjects, and studies of workers under similar working conditions that could translate to nurses' work environment. We explore a number of work organization factors including shift work and extended work hours, safety climate and culture, teamwork, and communication. We also describe environmental hazards, including chemical hazards (e.g., waste anesthetics, hazardous drugs, cleaning compounds) and airborne and bloodborne pathogen exposure. Nurses' health and safety outcomes include physical (e.g., musculoskeletal disorders, gastrointestinal, slips, trips and falls, physical assault) and psychosocial outcomes (e.g., burnout, work-family conflict). Finally, we present recommendations for future research to further protect nurses and all health care workers from a range of hazardous working conditions.

  1. Social and Economic Consequences of Indian Gaming in Oklahoma

    ERIC Educational Resources Information Center

    Grant, Kenneth W., II; Spilde, Katherine A.; Taylor, Jonathan B.

    2004-01-01

    The balancing framework of Indian gaming as it operates in Oklahoma constrains Oklahoma Indian nations from operating facilities according to the dictates of the marketplace on a large-scale Class III basis. Indian gaming actually brings substantial net economic benefits to the state, contrary to claims that Oklahoma Indian gaming benefits come at…

  2. Coping with the economic consequences of ill health in Indonesia.

    PubMed

    Sparrow, Robert; Van de Poel, Ellen; Hadiwidjaja, Gracia; Yumna, Athia; Warda, Nila; Suryahadi, Asep

    2014-06-01

    We assess the economic risk of ill health for households in Indonesia and the role of informal coping strategies. Using household panel data from the Indonesian socio-economic household survey (Susenas) for 2003 and 2004, and applying fixed effects Poisson models, we find evidence of economic risk from illness through medical expenses. For the poor and the informal sector, ill health events impact negatively on income from wage labour, whereas for the non-poor and formal sector, it is income from self-employed business activities which is negatively affected. However, only for the rural population and the poor does this lead to a decrease in consumption, whereas the non-poor seem to be able to protect current household spending. Borrowing and drawing on family network and buffers, such as savings and assets, seem to be key informal coping strategies for the poor, which may have negative long-term effects. While these results suggest scope for public intervention, the economic risk from income loss for the rural poor is beyond public health care financing reforms. Rather, formal sector employment seems to be a key instrument for financial protection from illness, by also reducing income risk.

  3. The Present Economic Sea Changes and Corresponding Consequences for Education.

    ERIC Educational Resources Information Center

    Brosio, Richard A.

    1988-01-01

    This article describes and analyzes the relationship between the sea changes in economics and education in the United States. It argues that the educational reform movements of the early 1980s are the result of interactions between capital and labor, the haves and the have nots. (CB)

  4. Presence of Atrazine in the Biological Samples of Cattle and Its Consequence Adversity in Human Health

    PubMed Central

    Peighambarzadeh, SZ; Safi, S; Shahtaheri, SJ; Javanbakht, M; Rahimi Forushani, A

    2011-01-01

    Background Cattle can be considered as an important source for herbicides through nutrition. Therefore, herbicide residue in animal products is a potential human exposure to herbicides causing public health problems in human life. Triazines are a group of herbicides primarily used to control broadleaf weeds in corn and other feed ingredients and are considered as possible human carcinogens. To evaluate trace residue of these pollutants molecular imprinted solid phase extraction (MISPE) method has been developed, using biological samples. Methods: Blood samples were taken from the jugular vein of 45 Holstein cows in 3 commercial dairy farms in Khuzestan Province, Iran. Urine samples were also taken from the cows. Results: The mean ± SD concentrations of atrazine in serum and urine samples of the study group (0.739 ± 0.567 ppm and 1.389 ± 0.633 ppm, respectively) were higher (P < 0.05) than the concentrations in serum and urine samples of the control group (0.002 ± 0.005 ppm and 0.012 ± 0.026 ppm, respectively). Conclusion: Atrazine in the feed ingredients ingested by cattle could be transferred into the biological samples and consequently can be considered as a potential hazard for the public health. PMID:23113110

  5. Institutional Capacity Building in Mozambique to Mitigate the Adverse Consequences of Extreme Weather Events

    NASA Astrophysics Data System (ADS)

    Freires L£cio, F. D.

    2001-05-01

    During Feb. - March 2000, floods resulting from the cyclones, Elaine, Felicia, and Gloria, devastated an area of about 100,000 km2 in southern Mozambique. About 700 people died, and more than a million people have been rendered homeless and destitute. This catastrophe drew attention to the urgent need of strengthening the infrastructure of Instituto Nacional de Meteorologia (INAM) to enable it to provide advance information about tropical cyclones, torrential rains, droughts, etc. so that their impact can be minimized locally. This can take the form of emergency preparedness systems to alert the communities at risk, structural and vegetational controls for the mitigation of floods and droughts, groundwater recharge of flood waters, protection from water-borne and mosquito-borne diseases, emergency shelters, educating the people how to cope, and micro-enterprises for the mitigation of floods and drought and for economic reconstruction, etc. Institutional capacity building involves the installation/upgrading of physical facilities, training of personnel and establishment of databases and networks in INAM, for (i) collection and collation of meteorological data from within the country, (ii) downloading and collation of meteorological data from external sources, and (iii) uploading of meteorological information to the concerned agencies in the government, and regional and international agencies.

  6. Serotonin deficiency alters susceptibility to the long-term consequences of adverse early life experience.

    PubMed

    Sachs, Benjamin D; Rodriguiz, Ramona M; Tran, Ha L; Iyer, Akshita; Wetsel, William C; Caron, Marc G

    2015-03-01

    Brain 5-HT deficiency has long been implicated in psychiatric disease, but the effects of 5-HT deficiency on stress susceptibility remain largely unknown. Early life stress (ELS) has been suggested to contribute to adult psychopathology, but efforts to study the long-term consequences of ELS have been limited by a lack of appropriate preclinical models. Here, we evaluated the effects of 5-HT deficiency on several long-term cellular, molecular, and behavioral responses of mice to a new model of ELS that combines early-life maternal separation (MS) of pups and postpartum learned helplessness (LH) training in dams. Our data demonstrate that this paradigm (LH/MS) induces depressive-like behavior and impairs pup retrieval in dams. In addition, we show that brain 5-HT deficiency exacerbates anxiety-like behavior induced by LH/MS and blunts the effects of LH/MS on acoustic startle responses in adult offspring. Although the mechanisms underlying these effects remain unclear, following LH/MS, 5-HT-deficient animals had significantly less mRNA expression of the mineralocorticoid receptor in the amygdala than wild-type animals. In addition, 5-HT-deficient mice exhibited reduced mRNA levels of the 5-HT2a receptor and p11 in the hippocampus regardless of stress. LH/MS decreased the number of doublecortin+ immature neurons in the hippocampus in both wild-type (WT) and 5-HT-deficient animals. Our data emphasize the importance of complex interactions between genetic factors and early life experience in mediating long-term changes in emotional behavior. These findings may have important implications for our understanding of the combinatorial roles of 5-HT deficiency, ELS, and postpartum depression in the development of neuropsychiatric disorders.

  7. Serotonin deficiency alters susceptibility to the long-term consequences of adverse early life experience

    PubMed Central

    Sachs, Benjamin D.; Rodriguiz, Ramona M.; Tran, Ha L.; Iyer, Akshita; Wetsel, William C.

    2015-01-01

    Brain 5-HT deficiency has long been implicated in psychiatric disease, but the effects of 5-HT deficiency on stress susceptibility remain largely unknown. Early life stress (ELS) has been suggested to contribute to adult psychopathology, but efforts to study the long-term consequences of ELS have been limited by a lack of appropriate preclinical models. Here, we evaluated the effects of 5-HT deficiency on several long-term cellular, molecular, and behavioral responses of mice to a new model of ELS that combines early-life maternal separation (MS) of pups and postpartum learned helplessness (LH) training in dams. Our data demonstrate that this paradigm (LH/MS) induces depressive-like behavior and impairs pup retrieval in dams. In addition, we show that brain 5-HT deficiency exacerbates anxiety-like behavior induced by LH/MS and blunts the effects of LH/MS on acoustic startle responses in adult offspring. Although the mechanisms underlying these effects remain unclear, following LH/MS, 5-HT-deficient animals had significantly less mRNA expression of the mineralocorticoid receptor in the amygdala than wild-type animals. In addition, 5-HT-deficient mice exhibited reduced mRNA levels of the 5-HT2a receptor and p11 in the hippocampus regardless of stress. LH/MS decreased the number of doublecortin+ immature neurons in the hippocampus in both wild-type (WT) and 5-HT-deficient animals. Our data emphasize the importance of complex interactions between genetic factors and early life experience in mediating long-term changes in emotional behavior. These findings may have important implications for our understanding of the combinatorial roles of 5-HT deficiency, ELS, and postpartum depression on the development of neuropsychiatric disorders. PMID:25602134

  8. The Economic Consequences of AIDS mortality in South Africa

    PubMed Central

    Bärnighausen, Till; Case, Anne; Menendez, Alicia

    2014-01-01

    We quantify the impact of adult deaths on household economic wellbeing, using a large longitudinal dataset spanning more than a decade. Verbal autopsies allow us to distinguish AIDS mortality from that due to other causes. The timing of the lower socioeconomic status observed for households with AIDS deaths suggests that the socioeconomic gradient in AIDS mortality is being driven primarily by poor households being at higher risk for AIDS, rather than AIDS impoverishing the households. Following a death, households that experienced an AIDS death are observed being poorer still. However, the additional socioeconomic loss following an AIDS death is very similar to the loss observed from sudden death. Funeral expenses can explain some of the impoverishing effects of death in the household. In contrast, the loss of an employed member cannot. To date, antiretroviral therapy has not changed the socioeconomic status gradient observed in AIDS deaths. PMID:25411517

  9. The economic consequences of reproductive health and family planning.

    PubMed

    Canning, David; Schultz, T Paul

    2012-07-14

    We consider the evidence for the effect of access to reproductive health services on the achievement of Millennium Development Goals 1, 2, and 3, which aim to eradicate extreme poverty and hunger, achieve universal primary education, and promote gender equality and empower women. At the household level, controlled trials in Matlab, Bangladesh, and Navrongo, Ghana, have shown that increasing access to family planning services reduces fertility and improves birth spacing. In the Matlab study, findings from long-term follow-up showed that women's earnings, assets, and body-mass indexes, and children's schooling and body-mass indexes, substantially improved in areas with improved access to family planning services compared with outcomes in control areas. At the macroeconomic level, reductions in fertility enhance economic growth as a result of reduced youth dependency and an increased number of women participating in paid labour.

  10. [The rural exodus in Iraq and its economic and social consequences].

    PubMed

    Ishow, H

    1983-01-01

    The causes and effects of the rural exodus in Iraq are examined using data from a number of published sources. The consequences considered include the effect on urban areas, particularly with regard to housing; labor force problems; transport problems; and the adverse effects on rural development.

  11. ERA: Adverse Consequences

    ERIC Educational Resources Information Center

    Martin, Brian

    2011-01-01

    Excellence in Research for Australia has a number of limitations: inputs are counted as outputs, time is wasted, disciplinary research is favoured and public engagement is discouraged. Most importantly, by focusing on measurement and emphasising competition, ERA may actually undermine the cooperation and intrinsic motivation that underpin research…

  12. Economics: An Analysis of Unintended Consequences. Volume 1: Introduction to Microeconomics.

    ERIC Educational Resources Information Center

    Schenk, Robert E.

    This curriculum guide introduces high school students to the basic principles of microeconomics. Chapter 1 provides a basic definition of economics, while chapter 2 introduces a number of important economic concepts and ideas and examines reasons for unintended or unexpected consequences of decision-making. Chapter 3 considers how individual…

  13. Economic Consequences Incurred by Living Kidney Donors: A Canadian Multi-Center Prospective Study

    PubMed Central

    Klarenbach, S; Gill, J S; Knoll, G; Caulfield, T; Boudville, N; Prasad, G V R; Karpinski, M; Storsley, L; Treleaven, D; Arnold, J; Cuerden, M; Jacobs, P; Garg, A X

    2014-01-01

    Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th–75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th–75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs. In a prospective costing study, the authors find that economic consequences incurred by living kidney donors are frequent and nontrivial, and a notable proportion of donors experience significant costs. PMID:24597854

  14. Economic consequences incurred by living kidney donors: a Canadian multi-center prospective study.

    PubMed

    Klarenbach, S; Gill, J S; Knoll, G; Caulfield, T; Boudville, N; Prasad, G V R; Karpinski, M; Storsley, L; Treleaven, D; Arnold, J; Cuerden, M; Jacobs, P; Garg, A X

    2014-04-01

    Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th-75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th-75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs.

  15. An economy of scales: A selective review of obesity's economic causes, consequences, and solutions.

    PubMed

    Cawley, John

    2015-09-01

    This paper reviews the economic research on obesity, covering topics such as the measurement of, and trends in, obesity, the economic causes of obesity (e.g. the monetary price and time cost of food, food assistance programs, income, education, macroeconomic conditions, and peer effects), and the economic consequences of obesity (e.g. lower wages, a lower probability of employment, and higher medical care costs). It also examines the extent to which obesity imposes negative externalities, and economic interventions that could potentially internalize such externalities, such as food taxes, subsidies for school-based physical activity programs, and financial rewards for weight loss. It discusses other economic rationales for government intervention with respect to obesity, such as imperfect information, time inconsistent preferences, and irrational behavior. It concludes by proposing a research agenda for the field. Overall, the evidence suggests that there is no single dominant economic cause of obesity; a wide variety of factors may contribute a modest amount to the risk. There is consistent evidence regarding the economic consequences of obesity, which are lower wages and higher medical care costs that impose negative externalities through health insurance. Studies of economic approaches to preventing obesity, such as menu labeling, taxes on energy-dense foods, and financial rewards for weight loss find only modest effects on weight and thus a range of policies may be necessary to have a substantial effect on the prevalence of obesity.

  16. An economy of scales: A selective review of obesity's economic causes, consequences, and solutions.

    PubMed

    Cawley, John

    2015-09-01

    This paper reviews the economic research on obesity, covering topics such as the measurement of, and trends in, obesity, the economic causes of obesity (e.g. the monetary price and time cost of food, food assistance programs, income, education, macroeconomic conditions, and peer effects), and the economic consequences of obesity (e.g. lower wages, a lower probability of employment, and higher medical care costs). It also examines the extent to which obesity imposes negative externalities, and economic interventions that could potentially internalize such externalities, such as food taxes, subsidies for school-based physical activity programs, and financial rewards for weight loss. It discusses other economic rationales for government intervention with respect to obesity, such as imperfect information, time inconsistent preferences, and irrational behavior. It concludes by proposing a research agenda for the field. Overall, the evidence suggests that there is no single dominant economic cause of obesity; a wide variety of factors may contribute a modest amount to the risk. There is consistent evidence regarding the economic consequences of obesity, which are lower wages and higher medical care costs that impose negative externalities through health insurance. Studies of economic approaches to preventing obesity, such as menu labeling, taxes on energy-dense foods, and financial rewards for weight loss find only modest effects on weight and thus a range of policies may be necessary to have a substantial effect on the prevalence of obesity. PMID:26279519

  17. A Longitudinal Assessment of Associations between Adolescent Environment, Adversity Perception, and Economic Status on Fertility and Age of Menarche

    PubMed Central

    Amir, Dorsa; Jordan, Matthew R.; Bribiescas, Richard G.

    2016-01-01

    Purpose Perceptions of environmental adversity and access to economic resources in adolescence can theoretically affect the timing of life history transitions and investment in reproductive effort. Here we present evidence of correlations between variables associated with subjective extrinsic mortality, economic status, and reproductive effort in a nationally representative American population of young adults. Methods We used a longitudinal database that sampled American participants (N ≥ 1,579) at four points during early adolescence and early adulthood to test whether perceptions of environmental adversity and early economic status were associated with reproductive effort. Results We found that subjectively high ratings of environmental danger and low access to economic resources in adolescence were significantly associated with an earlier age of menarche in girls and earlier, more robust fertility in young adulthood. Conclusion While energetics and somatic condition remain as possible sources of variation, the results of this study support the hypothesis that perceptions of adversity early in life and limited access to economic resources are associated with differences in reproductive effort and scheduling. How these factors may covary with energetics and somatic condition merits further investigation. PMID:27249338

  18. Drugs and adverse reactions: an economic view of a medical problem.

    PubMed

    Pedroni, G

    1984-01-01

    This monograph attempts to show how patient, physician and drug producer should assess the value and risks of a drug from the economic point of view. The value of a drug lies in its efficacy against disease and pain; the risks are the various side effects. A hypothetical example illustrates the evaluation from the point of view of an individual patient. A distinction must be made here between diseases which may prove fatal and those of a less serious nature. This means that a distinction must also be made in evaluating the risks attached to a drug and the individual attitude to side effects. For the physician, the task of recognizing an adverse drug reaction (ADR) is an extremely complex one. A 11-step flow chart for decision making is presented as a benchmark procedure. Several empirical studies on the incidence of ADRs in ambulatory and hospitalized patients are shown to use shortcuts, which are entirely justified in daily medical practice, but questionable in a scientific analysis. For various reasons the drug manufacturer too is anxious to recognize ADRs at an early stage and to avoid them whenever possible. Prolonged clinical trials, however, produce a steep rise in costs and delay the launching of the product, while the additional information obtained is not always comprehensive and exhaustive. Moreover, the mere fact of recognizing an ADR does not mean that it can be prevented. The producer is therefore forced to consider the risks and costs involved in speeding up or delaying the introduction of a product. The fact that the drug has been approved for sale does not automatically release introduction of a product. The fact that the drug has been approved for sale does not automatically release him from the obligation to carry out further intensive monitoring for the entire period that it is on the market.

  19. The Economic Consequences of Child Sexual Abuse for Adult Lesbian Women.

    ERIC Educational Resources Information Center

    Hyman, Batya

    2000-01-01

    This study extends investigation of the long-term consequences of child sexual abuse into the workplace and considers the economic effects on Lesbian women as determined by the National Lesbian Health Care Survey. It considers the effects of child sexual abuse on four spheres of a woman's life: her physical health, mental health, educational…

  20. The economic-wide consequences of large-scale floods. How resilient is the European economy?

    NASA Astrophysics Data System (ADS)

    Koks, Elco; Thissen, Mark; De Moel, Hans; Aerts, Jeroen

    2015-04-01

    For a successful adaptation strategy, it is necessary to have an in-depth understanding of the economic consequences of a flood. To assess the economic consequences of large-scale river floods in Europe, we introduce an integrated direct and indirect risk model for the European economy as a whole. The proposed methodology consists of multiple steps. First, a direct loss assessment is conducted for the 50 largest river basin districts in Europe, based on simulated floods for several return periods. Second, the direct losses in capital and labour are translated into the loss in production per sector. Third, the recovery of this production shock is modelled using a hybrid interregional input-output model, combining non-linear programming and input-output modelling. This combination makes it possible to find (1) the possible production losses in the affected regions and other European regions, (2) the required production in Europe to satisfy additional reconstruction demands from the affected regions and (3) the required production in other regions that is necessary to take over lost production in the affected region. Consequently, when knowing how much production is lost (or gained) in each region, the economic consequences can be assessed. Finally, the model outcome is loss estimation expressed in terms of expected annual damage. To assess these consequences, interregional supply and use tables are used, consisting of 256 different European NUTS2 regions. This data makes it possible to model the indirect losses for both the affected regions and the rest of Europe in detail. By combining the outcomes of all floods in all the river basin districts, it is possible to determine the flood risk of each region in Europe, even when a region is not directly hit by a flood. Consequently, the overall consequences for the European Union are found to be positive for small-scale floods and negative for large-scale floods.

  1. Use of the adverse outcome pathway framework to represent cross-species consequences of specific pathway perturbations

    EPA Science Inventory

    The adverse outcome pathway (AOP) framework has been developed as a means for assembling scientifically defensible descriptions of how particular molecular perturbations, termed molecular initiating events (MIEs), can evoke a set of predictable responses at different levels of bi...

  2. [Needs of schizophrenic's patients in perspective economical consequences of incapacity for work].

    PubMed

    Maciag, Agnieszka

    2007-01-01

    The main goal of the study was to analyze the indirect costs of schizophrenia. There was explained economic consequences of the disability and also the lost of the income of schizophrenia's patients. The aim of that research was to highlight: the social aspects of schizophrenia and the dyleme of the suitable for patients treatment and its indirect costs. In this research was proposed the variants for indirect costs analysis based on human capital approach. It was taken into account these problems linked to social costs assessment in psychiatry. It was introduced information's upon methods of costs estimation income lost in consequence diseases.

  3. Trends in the economic consequences of marital and cohabitation dissolution in the United States.

    PubMed

    Tach, Laura M; Eads, Alicia

    2015-04-01

    Mothers in the United States use a combination of employment, public transfers, and private safety nets to cushion the economic losses of romantic union dissolution, but changes in maternal labor force participation, government transfer programs, and private social networks may have altered the economic impact of union dissolution over time. Using nationally representative panels from the Survey of Income and Program Participation (SIPP) from 1984 to 2007, we show that the economic consequences of divorce have declined since the 1980s owing to the growth in married women's earnings and their receipt of child support and income from personal networks. In contrast, the economic consequences of cohabitation dissolution were modest in the 1980s but have worsened over time. Cohabiting mothers' income losses associated with union dissolution now closely resemble those of divorced mothers. These trends imply that changes in marital stability have not contributed to rising income instability among families with children, but trends in the extent and economic costs of cohabitation have likely contributed to rising income instability for less-advantaged children.

  4. Trends in the economic consequences of marital and cohabitation dissolution in the United States.

    PubMed

    Tach, Laura M; Eads, Alicia

    2015-04-01

    Mothers in the United States use a combination of employment, public transfers, and private safety nets to cushion the economic losses of romantic union dissolution, but changes in maternal labor force participation, government transfer programs, and private social networks may have altered the economic impact of union dissolution over time. Using nationally representative panels from the Survey of Income and Program Participation (SIPP) from 1984 to 2007, we show that the economic consequences of divorce have declined since the 1980s owing to the growth in married women's earnings and their receipt of child support and income from personal networks. In contrast, the economic consequences of cohabitation dissolution were modest in the 1980s but have worsened over time. Cohabiting mothers' income losses associated with union dissolution now closely resemble those of divorced mothers. These trends imply that changes in marital stability have not contributed to rising income instability among families with children, but trends in the extent and economic costs of cohabitation have likely contributed to rising income instability for less-advantaged children. PMID:25749487

  5. [Mental health of children, adolescents and young adults--part 1: prevalence, illness persistence, adversities, service use, treatment delay and consequences].

    PubMed

    Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A

    2013-11-01

    Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.

  6. Economic and Ethical Consequences of Natural Hazards in Alpine Valleys (EE-Con)

    NASA Astrophysics Data System (ADS)

    Ortner, Florian; Brantl, Dirk; Meyer, Lukas; Steininger, Karl; Sass, Oliver

    2015-04-01

    The Alps and their population are particularly vulnerable to geomorphological and hydrological hazards and this problem might be amplified by ongoing climate change. Natural disasters cause severe monetary damage which often leads to the difficult question whether it socially pays to protect settlements at high costs or whether alternatively settlement areas should better be abandoned. By investigations in the Johnsbachtal and the Kleinsölktal (Styria), the interdisciplinary project "Economic and Ethical Consequences of Natural Hazards in Alpine Valleys" (EE-Con), funded by the Austrian Academy of Sciences, seeks to answer the following questions: (1) Are natural hazards and associated damages in fact increasing, and is this due to meteorological triggers, to anthropogenic factors or to internal process dynamics? (2) What is the perception and knowledge of local people, how is risk and risk prevention communicated? (3) What is the respective cost ratio between protection infrastructure, soft measures of adaptation and other options (e.g. reduction of settlement area)? (4) What legitimate claims to compensation do people have, how far does societal responsibility go and where does individual responsibility start if parts of the settlement area had to be abandoned? These questions will be tackled in an interdisciplinary cooperation between geography, economics and normative theory (philosophy). EE-Con will follow broadly the path of risk analysis and risk assessment, focusing on the temporal dimension (past - present - future) with the aim to unravel the history of natural hazards in the areas and to analyse the economic values involved. In the following, natural hazard scenarios for the future (2050 and 2100) will be developed considering the economic consequences. Besides this, the project deals with local knowledge, risk perception and risk communication, which will be investigated via group interviews and stakeholder workshops and be integrated into a human

  7. Economic consequences of the Chernobyl accident in Norway in 1986 and 1987

    SciTech Connect

    Tveten, U.

    1988-01-01

    In the accident consequence assessment (ACA) area there is extensive cooperation between the Nordic countries (Denmark, Finland, Norway, and Sweden), performed within the Nordic Safety Program, and partially funded by the Nordic Council of Ministers, via the Nordic Liaison Committee for Atomic Energy. One of the 17 projects in the ACA-related program area is concerned with the economic consequences of the Chernobyl accident in Finland, Norway, and Sweden. This paper is limited to describing conditions in Norway. There are areas in Norway where the Chernobyl fallout is >100 kBq/m{sup 2}, and the total amount of radiocesium deposited over Norway is estimated by the National Institute for Radiation Hygiene to be 6% of the radiocesium released from the reactor. The areas where ground concentrations are highest are mostly in sparsely populated mountain areas. These areas are, however, important in connection with several nutritional pathways, notably, sheep, goats, reindeer, and freshwater fish. The purpose of this paper is to summarize information on mitigating actions and economic consequences of the deposited radioactive materials to Norwegian agriculture in the 1986-87 and 1987-88 slaughtering periods.

  8. Measuring the economic and social consequences of CVDs and diabetes in India and Pakistan.

    PubMed

    Govender, Veloshnee M; Ghaffar, Abdul; Nishtar, Sania

    2007-12-01

    In India and Pakistan, CVD and diabetes has assumed alarming levels. However,governments in these countries are ill-prepared for coping with this epidemic. This paper reviews the literature for those studies which have addressed the current and foreseen economic and social consequences of CVDs and diabetes in India and Pakistan. This review adopts a societal perspective by incorporating the impact on the individual, the household, and the health and economic sectors. The review finds that in both countries there has been a paucity of systematic efforts to measure the economic and social impact of CVDs and diabetes. Moreover, the review has found an absence of assessments of direct and indirect costs in the same study, inattention to the social consequences of these diseases and methodological inconsistencies which make comparative analyses restrictive. It is critically important that a research base of studies investigating the impact of the diseases in India and Pakistan be undertaken. Gathering these data is critical since both countries have many competing health priorities reflected in the intransigency of key health indicators and the data emerging from these countries suggests that the social gradient is reversing. Therefore, in the absence of hard evidence to these diseases are likely to remain outside of mainstream public health planning. With these data in hand, the choice for health planners with regard to important decisions may become clearer. Similarly, the implications for productivity and revenue earnings make a powerful argument in order to focus the attention of private sector employers on these issues.

  9. Epidemiology, geographical distribution, and economic consequences of swine zoonoses: a narrative review.

    PubMed

    Uddin Khan, Salah; Atanasova, Kalina R; Krueger, Whitney S; Ramirez, Alejandro; Gray, Gregory C

    2013-12-01

    We sought to review the epidemiology, international geographical distribution, and economic consequences of selected swine zoonoses. We performed literature searches in two stages. First, we identified the zoonotic pathogens associated with swine. Second, we identified specific swine-associated zoonotic pathogen reports for those pathogens from January 1980 to October 2012. Swine-associated emerging diseases were more prevalent in the countries of North America, South America, and Europe. Multiple factors were associated with the increase of swine zoonoses in humans including: the density of pigs, poor water sources and environmental conditions for swine husbandry, the transmissibility of the pathogen, occupational exposure to pigs, poor human sanitation, and personal hygiene. Swine zoonoses often lead to severe economic consequences related to the threat of novel pathogens to humans, drop in public demand for pork, forced culling of swine herds, and international trade sanctions. Due to the complexity of swine-associated pathogen ecology, designing effective interventions for early detection of disease, their prevention, and mitigation requires an interdisciplinary collaborative "One Health" approach from veterinarians, environmental and public health professionals, and the swine industry.

  10. Epidemiology, geographical distribution, and economic consequences of swine zoonoses: a narrative review

    PubMed Central

    Uddin Khan, Salah; Atanasova, Kalina R; Krueger, Whitney S; Ramirez, Alejandro; Gray, Gregory C

    2013-01-01

    We sought to review the epidemiology, international geographical distribution, and economic consequences of selected swine zoonoses. We performed literature searches in two stages. First, we identified the zoonotic pathogens associated with swine. Second, we identified specific swine-associated zoonotic pathogen reports for those pathogens from January 1980 to October 2012. Swine-associated emerging diseases were more prevalent in the countries of North America, South America, and Europe. Multiple factors were associated with the increase of swine zoonoses in humans including: the density of pigs, poor water sources and environmental conditions for swine husbandry, the transmissibility of the pathogen, occupational exposure to pigs, poor human sanitation, and personal hygiene. Swine zoonoses often lead to severe economic consequences related to the threat of novel pathogens to humans, drop in public demand for pork, forced culling of swine herds, and international trade sanctions. Due to the complexity of swine-associated pathogen ecology, designing effective interventions for early detection of disease, their prevention, and mitigation requires an interdisciplinary collaborative “One Health” approach from veterinarians, environmental and public health professionals, and the swine industry. PMID:26038451

  11. The economic and environmental consequences of implementing nitrogen-efficient technologies and management practices in agriculture.

    PubMed

    Zhang, Xin; Mauzerall, Denise L; Davidson, Eric A; Kanter, David R; Cai, Ruohong

    2015-03-01

    Technologies and management practices (TMPs) that reduce the application of nitrogen (N) fertilizer while maintaining crop yields can improve N use efficiency (NUE) and are important tools for meeting the dual challenges of increasing food production and reducing N pollution. However, because farmers operate to maximize their profits, incentives to implement TMPs are limited, and TMP implementation will not always reduce N pollution. Therefore, we have developed the NUE Economic and Environmental impact analytical framework (NUE) to examine the economic and environmental consequences of implementing TMPs in agriculture, with a specific focus on farmer profits, N fertilizer consumption, N losses, and cropland demand. Our analytical analyses show that impact of TMPs on farmers' economic decision-making and the environment is affected by how TMPs change the yield ceiling and the N fertilization rate at the ceiling and by how the prices of TMPs, fertilizer, and crops vary. Technologies and management practices that increase the yield ceiling appear to create a greater economic incentive for farmers than TMPs that do not but may result in higher N application rates and excess N losses. Nevertheless, the negative environmental impacts of certain TMPs could be avoided if their price stays within a range determined by TMP yield response, fertilizer price, and crop price. We use a case study on corn production in the midwestern United States to demonstrate how NUE can be applied to farmers' economic decision-making and policy analysis. Our NUE framework provides an important tool for policymakers to understand how combinations of fertilizer, crop, and TMP prices affect the possibility of achieving win-win outcomes for farmers and the environment. PMID:26023951

  12. Economic consequences of injury and resulting family coping strategies in Ghana.

    PubMed

    Mock, Charles N; Gloyd, Stephen; Adjei, Samuel; Acheampong, Frederick; Gish, Oscar

    2003-01-01

    The toll of human suffering from illness and injury is usually measured by mortality and disability rates. Economic consequences, such as treatment costs and lost productivity, are often considered as well. Lately, increasing attention has been paid to the economic effects of illness on a household level. In this study, we sought to assess the economic consequences of injuries in Ghana by looking at the effects on households and the coping mechanisms these households employed. Using cluster sampling and household interviews, we surveyed 21,105 persons living in 431 urban and rural sites. We sought information on any injury that occurred to a household member during the prior year and that resulted in one or more days of disability time.A total of 1609 injuries were reported for the prior year. Treatment costs and disability days were higher in the urban area than in the rural. Coping strategies were different between the two areas. Rural households were more likely to utilize intra-family labor reallocation (90%) than were urban households (75%). Rural households were also more likely to borrow money (24%) than were urban (19%). Households in both areas were equally likely to sell belongings, although the nature of the belongings sold were different. Although injuries in the urban area had more severe primary effects (treatment cost and disability time), the ultimate effect on rural households appeared more severe. A greater percentage of rural households (28%) reported a decline in food consumption than did urban households (19%). These findings result in several policy implications, including measures that could be used to assist family coping strategies and measures directed toward injuries themselves.

  13. Sources and consequences of hypothetical bias in economic analyses of risk behavior

    SciTech Connect

    Cantor, R.; Schoepfle, M. ); Szarleta, E. )

    1989-01-01

    Economic analyses are often used to address the tradeoffs people and constituencies face when selecting among alternative responses to risk changes. These analyses have become increasingly important in recent years as policy makers seek to understand what people will accept or give up to obtain a change in their exposure to risk from, for examples, an hazardous waste site, industrial plant, or biotechnological experiment. The literature on hypothetical bias indicates that the current elicitation techniques to investigate these tradeoffs are not sufficient to ensure meaningful responses to questions about risk preferences and intended behavior. A number of factors can influence the extent of hypothetical bias for a particular risk problem including the type of risk, language, who is affected, property rights, and the decision framework in which the risk problem is posed. We examine the major sources of hypothetical bias for the two predominant elicitation techniques in economics: contingent valuation and experimental economics. For each bias source, we discuss the possible consequences when interpreting the results of the technique, with a special focus on the policy context. We discuss how recent developments in psychology and cognitive anthropology can help mitigate many of the problems associated with hypothetical bias. To conclude, we identify the problems most likely to be resolved satisfactorily for scientific analysis and those that remain in need of further investigation. 38 refs.

  14. The economic consequences for parents of losing an adult child to AIDS: evidence from Thailand.

    PubMed

    Knodel, John; Im-Em, Wassana

    2004-09-01

    An examination of the economic consequences for older-age parents of losing an adult child to AIDS in Thailand based on quantitative data derived from a key informant study and a direct interview survey with parents yielded the following main findings: (1) parents frequently paid for their children's care and treatment, but government health insurance and to a lesser extent welfare measures helped alleviate these expenses; (2) parental caregiving often disrupted economic activity, although the resulting opportunity costs were limited by the typically short duration of caregiving; (3) parents commonly paid for funeral costs but benefited from funeral society memberships and customary contributions from those attending; (4) only a minority of parents supported AIDS orphans although orphaned grandchildren often ended up with their grandparents; (5) most deceased children had contributed financially to the parental household but only a minority were main providers. Poorer parents, however, were most likely to lose a main provider and experience severe financial hardship; and (6) although poorer parents spent much less on expenses related to the illness and death of their children, they were much more likely than better-off parents to be seriously burdened by these expenses. Programs are needed to address the plight of AIDS parents but should target those who are most susceptible to resulting economic hardship. PMID:15186899

  15. The health and economic consequences of cigarette smoking in Alabama, 2009-2010.

    PubMed

    Fosson, Gabriel H; McCallum, Debra M; Beeson, Diane H

    2014-01-01

    While CDC reports on the health and economic burden of smoking in the United States, state-specific data are not readily available. We estimated the health and economic consequences of cigarette smoking in Alabama to provide the state legislature with the state-specific data that reveal the direct impact of smoking on their constituents. We estimated that in 2009, almost 7,900 adult deaths (18% of all adult deaths) and approximately 121,000 years of potential life lost among Alabama adults aged 35 years and older were attributable to cigarette smoking. Productivity losses due to premature death and smoking-attributable illness were estimated at $2.84 billion and $941 million, respectively. Our findings support a strong need for tobacco control and prevention programs to decrease the health and economic burden of smoking in Alabama. These results are being used by the State Health Officer to illustrate the real costs of smoking in Alabama and to advocate for improved tobacco control policies.

  16. Economics of cardiac adverse events after smallpox vaccination: lessons from the 2003 US Vaccination Program.

    PubMed

    Ortega-Sanchez, Ismael R; Sniadack, Mercedes M; Mootrey, Gina T

    2008-03-15

    Of >39,000 civilian public health responders vaccinated against smallpox in 2003, 203 reported cardiovascular adverse events (CAEs). An association exists between the US vaccinia strain and myocarditis and/or pericarditis ("myo/pericarditis" [MP]). Other associations are inconclusive. We used surveillance and follow-up survey data of CAE case patients to estimate the resources used during the 2003 smallpox vaccination program and used a probabilistic model to estimate the potential costs of CAEs in a mass vaccination campaign. For every million adult vaccinees, 3001 CAEs (including 351 MP cases) would occur, with >92% in revaccinees. CAEs would require a median of 5934 outpatient visits, 1786 emergency department visits, 533 days in general wards, 132 days in intensive care units, 5484 cardiac enzymes tests, 3504 electrocardiograms, 3049 chemistry tests, 2828 complete blood counts, and 1444 transthoracic echocardiograms, among other procedures. CAEs would reduce productivity (15,969 work days lost) and cost $11 per vaccinee. In a mass vaccination campaign, the care of a sizable number of CAEs would be resource intensive. PMID:18284356

  17. Better Adherence to the Mediterranean Diet Could Mitigate the Adverse Consequences of Obesity on Cardiovascular Disease: The SUN Prospective Cohort

    PubMed Central

    Eguaras, Sonia; Toledo, Estefanía; Hernández-Hernández, Aitor; Cervantes, Sebastián; Martínez-González, Miguel A.

    2015-01-01

    Strong observational evidence supports the association between obesity and cardiovascular events. In elderly high-risk subjects, the Mediterranean diet (MedDiet) was reported to counteract the adverse cardiovascular effects of adiposity. Whether this same attenuation is also present in younger subjects is not known. We prospectively examined the association between obesity and cardiovascular clinical events (myocardial infarction, stroke or cardiovascular death) after 10.9 years follow-up in 19,065 middle-aged men and women (average age 38 year) according to their adherence to the MedDiet (<6 points or ≥6 points in the Trichopoulou’s Mediterranean Diet Score). We observed 152 incident cases of cardiovascular disease (CVD). An increased risk of CVD across categories of body mass index (BMI) was apparent if adherence to the MedDiet was low, with multivariable-adjusted hazard ratios (HRs): 1.44 (95% confidence interval: 0.93–2.25) for ≥25 – <30 kg/m2 of BMI and 2.00 (1.04–3.83) for ≥30 kg/m2 of BMI, compared to a BMI < 25 kg/m2. In contrast, these estimates were 0.77 (0.35–1.67) and 1.15 (0.39–3.43) with good adherence to MedDiet. Better adherence to the MedDiet was associated with reduced CVD events (p for trend = 0.029). Our results suggest that the MedDiet could mitigate the harmful cardiovascular effect of overweight/obesity. PMID:26556370

  18. Better Adherence to the Mediterranean Diet Could Mitigate the Adverse Consequences of Obesity on Cardiovascular Disease: The SUN Prospective Cohort.

    PubMed

    Eguaras, Sonia; Toledo, Estefanía; Hernández-Hernández, Aitor; Cervantes, Sebastián; Martínez-González, Miguel A

    2015-11-01

    Strong observational evidence supports the association between obesity and cardiovascular events. In elderly high-risk subjects, the Mediterranean diet (MedDiet) was reported to counteract the adverse cardiovascular effects of adiposity. Whether this same attenuation is also present in younger subjects is not known. We prospectively examined the association between obesity and cardiovascular clinical events (myocardial infarction, stroke or cardiovascular death) after 10.9 years follow-up in 19,065 middle-aged men and women (average age 38 year) according to their adherence to the MedDiet (<6 points or ≥6 points in the Trichopoulou's Mediterranean Diet Score). We observed 152 incident cases of cardiovascular disease (CVD). An increased risk of CVD across categories of body mass index (BMI) was apparent if adherence to the MedDiet was low, with multivariable-adjusted hazard ratios (HRs): 1.44 (95% confidence interval: 0.93-2.25) for ≥25 - <30 kg/m² of BMI and 2.00 (1.04-3.83) for ≥30 kg/m² of BMI, compared to a BMI < 25 kg/m². In contrast, these estimates were 0.77 (0.35-1.67) and 1.15 (0.39-3.43) with good adherence to MedDiet. Better adherence to the MedDiet was associated with reduced CVD events (p for trend = 0.029). Our results suggest that the MedDiet could mitigate the harmful cardiovascular effect of overweight/obesity. PMID:26556370

  19. Economic, ecological, food safety, and social consequences of the deployment of bt transgenic plants.

    PubMed

    Shelton, A M; Zhao, J-Z; Roush, R T

    2002-01-01

    Transgenic plants expressing insecticidal proteins from the bacterium, Bacillus thuringiensis (Bt), are revolutionizing agriculture. Bt, which had limited use as a foliar insecticide, has become a major insecticide because genes that produce Bt toxins have been engineered into major crops grown on 11.4 million ha worldwide in 2000. Based on the data collected to date, generally these crops have shown positive economic benefits to growers and reduced the use of other insecticides. The potential ecological and human health consequences of Bt plants, including effects on nontarget organisms, food safety, and the development of resistant insect populations, are being compared for Bt plants and alternative insect management strategies. Scientists do not have full knowledge of the risks and benefits of any insect management strategies. Bt plants were deployed with the expectation that the risks would be lower than current or alternative technologies and that the benefits would be greater. Based on the data to date, these expectations seem valid.

  20. Economic Inequalities in Latin America at the Base of Adverse Health Indicators.

    PubMed

    Ferre, Juan Cruz

    2016-07-01

    There is increasing evidence supporting the existence of a link between income inequalities and health outcomes. The main purpose of this article is to test whether economic inequalities are associated with poor population health in Latin American countries. Multi-country data from 1970 to 2012 were used to assess this question. The results show that the Gini coefficient has a strong correlation with health outcomes. Moreover, multiple linear regression analysis using fixed effects shows that after controlling for gross national income per capita, literacy rate, and health expenditure, the Gini coefficient is independently negatively associated with health outcomes. In Latin American countries, for every percentage point increase in the Gini coefficient, the infant mortality rate grows by 0.467 deaths per 1,000 live births, holding all other variables constant. Additionally, an ordinary least squares estimation model suggests that countries that do not use International Monetary Fund loans perform better on health outcomes. These findings should alert policymakers, elected officials, and the public of the need to fight income inequalities and rethink the role of international financial institutions that dictate state policies. PMID:27287670

  1. Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences.

    PubMed

    Younossi, Zobair M; Birerdinc, Aybike; Henry, Linda

    2016-10-01

    Hepatitis C virus infection (HCV) affects approximately 170-200 million individuals globally. HCV is one of the primary causes of hepatocellular carcinoma (HCC) and cirrhosis and has been identified as the leading indication for liver transplantation in most Western countries. Because HCV is a systemic disease with hepatic, extrahepatic, economic and patient reported consequences, it is important for healthcare practitioners to understand the comprehensive and multi-faceted picture of this disease. In this context, it is important to fully appreciate the impact of HCV on the individual patient and the society. With the recent advent of the new generation of direct antiviral agents, the long standing goal of eradicating HCV in most infected patients has been accomplished. Therefore, now more than ever, it is critical to assess the total benefits of sustained virological response in a comprehensive manner. This should not be limited to the clinical benefits of HCV cure, but also to account for the improvement of patient reported health and economic outcomes of HCV cure. It is only through this comprehensive approach to HCV and its treatment that we will understand the full impact of this disease and the tremendous gains that have been achieved with the new antiviral regimens. PMID:27641981

  2. Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences.

    PubMed

    Younossi, Zobair M; Birerdinc, Aybike; Henry, Linda

    2016-10-01

    Hepatitis C virus infection (HCV) affects approximately 170-200 million individuals globally. HCV is one of the primary causes of hepatocellular carcinoma (HCC) and cirrhosis and has been identified as the leading indication for liver transplantation in most Western countries. Because HCV is a systemic disease with hepatic, extrahepatic, economic and patient reported consequences, it is important for healthcare practitioners to understand the comprehensive and multi-faceted picture of this disease. In this context, it is important to fully appreciate the impact of HCV on the individual patient and the society. With the recent advent of the new generation of direct antiviral agents, the long standing goal of eradicating HCV in most infected patients has been accomplished. Therefore, now more than ever, it is critical to assess the total benefits of sustained virological response in a comprehensive manner. This should not be limited to the clinical benefits of HCV cure, but also to account for the improvement of patient reported health and economic outcomes of HCV cure. It is only through this comprehensive approach to HCV and its treatment that we will understand the full impact of this disease and the tremendous gains that have been achieved with the new antiviral regimens.

  3. [The Spanish economic crisis and its consequences on social spending. SESPAS report 2014].

    PubMed

    López-Casasnovas, Guillem

    2014-06-01

    This article offers a brief summary of the factors that the author believes should be considered when analyzing the multiple interrelations between the economic crisis and its effects on public finances, social spending, and the health and welfare of Spaniards. For the sake of brevity, a linear argument is followed, with the basic contents of the message, leaving some of the more controversial issues whose interpretation may be heavily influenced by ideology to the discussion. The core of the argument is that, despite the double dip of the Spanish recession, healthcare has survived the consequences of the crisis fairly well. This is particularly the case when the situation is analyzed in terms of the share of public expenditure to GDP and in per capita terms, given the evolution of these ratios, although the final effect is unknown in terms of the actual and potential beneficiaries. This relatively low incidence so far on the health of Spaniards is basically due to family networks, pooling their incomes, and to the acceptance by Spanish health professionals of budget cuts, which have allowed services and their apparent quality to be maintained, contrasting with private employment and public finances. Obviously, this is not a guarantee of sustainability unless economic growth recovers. Even if the Spanish economy and public finances improve, the composition of health care delivery needs to be reevaluated to achieve a new allocation between public and private responsibilities for healthcare in accordance with the social development of the 21st century.

  4. [The Spanish economic crisis and its consequences on social spending. SESPAS report 2014].

    PubMed

    López-Casasnovas, Guillem

    2014-06-01

    This article offers a brief summary of the factors that the author believes should be considered when analyzing the multiple interrelations between the economic crisis and its effects on public finances, social spending, and the health and welfare of Spaniards. For the sake of brevity, a linear argument is followed, with the basic contents of the message, leaving some of the more controversial issues whose interpretation may be heavily influenced by ideology to the discussion. The core of the argument is that, despite the double dip of the Spanish recession, healthcare has survived the consequences of the crisis fairly well. This is particularly the case when the situation is analyzed in terms of the share of public expenditure to GDP and in per capita terms, given the evolution of these ratios, although the final effect is unknown in terms of the actual and potential beneficiaries. This relatively low incidence so far on the health of Spaniards is basically due to family networks, pooling their incomes, and to the acceptance by Spanish health professionals of budget cuts, which have allowed services and their apparent quality to be maintained, contrasting with private employment and public finances. Obviously, this is not a guarantee of sustainability unless economic growth recovers. Even if the Spanish economy and public finances improve, the composition of health care delivery needs to be reevaluated to achieve a new allocation between public and private responsibilities for healthcare in accordance with the social development of the 21st century. PMID:24863990

  5. [Economic adjustment and its demographic consequences in Latin America: an overview].

    PubMed

    Bajraj, R F; Bravo, J H

    1994-06-01

    This work reviews the available literature on short and medium term demographic responses to the economic adjustment processes occurring in Latin America during the 1980s. The first section describes the immediate causes and scope of the economic crisis of the 1980s in Latin America and the measures taken to correct imbalances. An external crisis rendered the current accounts deficit of the early 1980s no longer sustainable, interest rates and commercial conditions deteriorated, and a recessive adjustment of enormous magnitude occurred. The term "adjustment" covers a wide and varied array of economic changes, fiscal and social policy reforms, and changes in international commerce. The structural adjustment measures caused deterioration in investment and in equity. Real purchasing power declined more than per capita product in most Latin American countries between 1980 and 1990. Primary income distribution underwent regressive changes. In most cases the deterioration was not compensated by social spending. As a result of the fiscal adjustment and reduced public sector spending, per capita investment in health and education was less in 1990 than in 1980 in almost all countries. The demographic consequences of the adjustment processes are difficult to gauge precisely because the experiences of individual countries were heterogeneous and because no single definition of adjustment exists that would serve as a point of reference for comparison of situations without adjustment or with different types of adjustment. Nevertheless, some studies have attempted to specify terms of comparison. Some have compared conditions before the crisis or adjustments with conditions later, and others have analyzed short term fluctuations in demographic variables from their medium or long term trends. Such works suggest that nuptiality is the variable responding most intensely, systematically, and immediately to short term economic fluctuations. Fertility also appears to have responded

  6. Potential ecological and economic consequences of climate-driven agricultural and silvicultural transformations in central Siberia

    NASA Astrophysics Data System (ADS)

    Tchebakova, Nadezhda M.; Zander, Evgeniya V.; Pyzhev, Anton I.; Parfenova, Elena I.; Soja, Amber J.

    2014-05-01

    Increased warming predicted from general circulation models (GCMs) by the end of the century is expected to dramatically impact Siberian forests. Both natural climate-change-caused disturbance (weather, wildfire, infestation) and anthropogenic disturbance (legal/illegal logging) has increased, and their impact on Siberian boreal forest has been mounting over the last three decades. The Siberian BioClimatic Model (SiBCliM) was used to simulate Siberian forests, and the resultant maps show a severely decreased forest that has shifted northwards and a changed composition. Predicted dryer climates would enhance the risks of high fire danger and thawing permafrost, both of which challenge contemporary ecosystems. Our current goal is to evaluate the ecological and economic consequences of climate warming, to optimise economic loss/gain effects in forestry versus agriculture, to question the relative economic value of supporting forestry, agriculture or a mixed agro-forestry at the southern forest border in central Siberia predicted to undergo the most noticeable landcover and landuse changes. We developed and used forest and agricultural bioclimatic models to predict forest shifts; novel tree species and their climatypes are introduced in a warmer climate and/or potential novel agriculture are introduced with a potential variety of crops by the end of the century. We applied two strategies to estimate climate change effects, motivated by forest disturbance. One is a genetic means of assisting trees and forests to be harmonized with a changing climate by developing management strategies for seed transfer to locations that are best ecologically suited to the genotypes in future climates. The second strategy is the establishment of agricultural lands in new forest-steppe and steppe habitats, because the forests would retreat northwards. Currently, food, forage, and biofuel crops primarily reside in the steppe and forest-steppe zones which are known to have favorable

  7. Global economic consequences of deploying bioenergy with carbon capture and storage (BECCS)

    NASA Astrophysics Data System (ADS)

    Muratori, Matteo; Calvin, Katherine; Wise, Marshall; Kyle, Page; Edmonds, Jae

    2016-09-01

    Bioenergy with carbon capture and storage (BECCS) is considered a potential source of net negative carbon emissions and, if deployed at sufficient scale, could help reduce carbon dioxide emissions and concentrations. However, the viability and economic consequences of large-scale BECCS deployment are not fully understood. We use the Global Change Assessment Model (GCAM) integrated assessment model to explore the potential global and regional economic impacts of BECCS. As a negative-emissions technology, BECCS would entail a net subsidy in a policy environment in which carbon emissions are taxed. We show that by mid-century, in a world committed to limiting climate change to 2 °C, carbon tax revenues have peaked and are rapidly approaching the point where climate mitigation is a net burden on general tax revenues. Assuming that the required policy instruments are available to support BECCS deployment, we consider its effects on global trade patterns of fossil fuels, biomass, and agricultural products. We find that in a world committed to limiting climate change to 2 °C, the absence of CCS harms fossil-fuel exporting regions, while the presence of CCS, and BECCS in particular, allows greater continued use and export of fossil fuels. We also explore the relationship between carbon prices, food-crop prices and use of BECCS. We show that the carbon price and biomass and food crop prices are directly related. We also show that BECCS reduces the upward pressure on food crop prices by lowering carbon prices and lowering the total biomass demand in climate change mitigation scenarios. All of this notwithstanding, many challenges, both technical and institutional, remain to be addressed before BECCS can be deployed at scale.

  8. Diagnosis and economic consequences of triclabendazole resistance in Fasciola hepatica in a sheep flock in south-east Scotland.

    PubMed

    Sargison, N D; Scott, P R

    2011-02-12

    Over the past decade, definite changes have been recorded in the regional prevalence, seasonality and severity of fasciolosis in the UK, related to increased rainfall, or localised flooding, prompting debate about the deleterious effects of climate change. As a consequence, effective management of fasciolosis has become problematic in areas where fluke traditionally exists, leading to serious loss of production in sheep and cattle. Meanwhile, in eastern districts, there have been unexpected outbreaks of disease, resulting in production losses and concerns about welfare. This case report describes the economic consequences of fasciolosis in a commercial sheep flock in south-east Scotland. The diagnosis and consequences of triclabendazole resistance are discussed, in the context of developing economically sustainable control strategies. PMID:21493511

  9. Economics: An Analysis of Unintended Consequences. Volume 2: Introduction to Macroeconomics.

    ERIC Educational Resources Information Center

    Schenk, Robert E.

    This curriculum guide emphasizes that economics is a method of thought or analysis and highlights the teaching of macroeconomic concepts. Definitions of economics, economic actions and their results, individual and group relationships, and supply and demand principles are reviewed. Macroeconomic concepts that are introduced include: (1) economic…

  10. Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system

    PubMed Central

    Rashid, Nazia; Koh, Han A; Baca, Hilda C; Lin, Kathy J; Malecha, Susan E; Masaquel, Anthony

    2016-01-01

    Background Breast cancer is treated with many different modalities, including chemotherapy that can be given as a single agent or in combination. Patients often experience adverse events from chemotherapy during the cycles of treatment which can lead to economic burden. Objective The objective of this study was to evaluate costs related to chemotherapy-related adverse events in patients with metastatic breast cancer (mBC) in an integrated health care delivery system. Methods Patients with mBC newly initiated on chemotherapy were identified and the first infusion was defined as the index date. Patients were ≥18 years old at time of index date, had at least 6 months of health plan membership and drug eligibility prior to their index date. The chemotherapy adverse events were identified after the index date and during first line of chemotherapy. Episodes of care (EOC) were created using healthcare visits. Chart review was conducted to establish whether the adverse events were related to chemotherapy. Costs were calculated for each visit, including medications related to the adverse events, and aggregated to calculate the total EOC cost. Results A total of 1,682 patients with mBC were identified after applying study criteria; 54% of these patients had one or more adverse events related to chemotherapy. After applying the EOC method, there were a total of 5,475 episodes (4,185 single episodes [76.4%] and 1,290 multiple episodes [23.6%]) related to chemotherapy-related adverse events. Within single episodes, hematological (1,387 EOC, 33.1%), musculoskeletal/pain related (1,070 EOC, 25.6%), and gastrointestinal (775 EOC, 18.5%) were the most frequent adverse events. Patients with adverse events related to single EOC with anemia and neutropenia had the highest total outpatient costs with 901 EOC ($81,991) and 187 EOC ($17,017); these patients also had highest total inpatient costs with 46 EOC ($542,798) and 16 EOC ($136,768). However, within multiple episodes

  11. Long-term consequences of non-intentional flows of substances: Modelling non-intentional flows of lead in the Dutch economic system and evaluating their environmental consequences

    SciTech Connect

    Elshkaki, Ayman Voet, Ester van der; Holderbeke, Mirja van; Timmermans, Veerle

    2009-06-15

    Substances may enter the economy and the environment through both intentional and non-intentional flows. These non-intentional flows, including the occurrence of substances as pollutants in mixed primary resources (metal ores, phosphate ores and fossil fuels) and their presence in re-used waste streams from intentional use may have environmental and economic consequences in terms of pollution and resource availability. On the one hand, these non-intentional flows may cause pollution problems. On the other hand, these flows have the potential to be a secondary source of substances. This article aims to quantify and model the non-intentional flows of lead, to evaluate their long-term environmental consequences, and compare these consequences to those of the intentional flows of lead. To meet this goal, the model combines all the sources of non-intentional flows of lead within one model, which also includes the intentional flows. Application of the model shows that the non-intentional flows of lead related to waste streams associated with intentional use are decreasing over time, due to the increased attention given to waste management. However, as contaminants in mixed primary resources application, lead flows are increasing as demand for these applications is increasing.

  12. A Methodology for Forecasting Damage & Economic Consequences to Floods: Building on the National Flood Interoperability Experiment (NFIE)

    NASA Astrophysics Data System (ADS)

    Tootle, G. A.; Gutenson, J. L.; Zhu, L.; Ernest, A. N. S.; Oubeidillah, A.; Zhang, X.

    2015-12-01

    The National Flood Interoperability Experiment (NFIE) held June 3-July 17, 2015 at the National Water Center (NWC) in Tuscaloosa, Alabama sought to demonstrate an increase in flood predictive capacity for the coterminous United States (CONUS). Accordingly, NFIE-derived technologies and workflows offer the ability to forecast flood damage and economic consequence estimates that coincide with the hydrologic and hydraulic estimations these physics-based models generate. A model providing an accurate prediction of damage and economic consequences is a valuable asset when allocating funding for disaster response, recovery, and relief. Damage prediction and economic consequence assessment also offer an adaptation planning mechanism for defending particularly valuable or vulnerable structures. The NFIE, held at the NWC on The University of Alabama (UA) campus led to the development of this large scale flow and inundation forecasting framework. Currently, the system can produce 15-hour lead-time forecasts for the entire coterminous United States (CONUS). A concept which is anticipated to become operational as of May 2016 within the NWC. The processing of such a large-scale, fine resolution model is accomplished in a parallel computing environment using large supercomputing clusters. Traditionally, flood damage and economic consequence assessment is calculated in a desktop computing environment with a ménage of meteorology, hydrology, hydraulic, and damage assessment tools. In the United States, there are a range of these flood damage/ economic consequence assessment software's available to local, state, and federal emergency management agencies. Among the more commonly used and freely accessible models are the Hydrologic Engineering Center's Flood Damage Reduction Analysis (HEC-FDA), Flood Impact Assessment (HEC-FIA), and Federal Emergency Management Agency's (FEMA's) United States Multi-Hazard (Hazus-MH). All of which exist only in a desktop environment. With this

  13. Economic Consequences of Restricting the Use of Organochlorine Insecticides on Cotton, Corn, Peanuts, and Tobacco.

    ERIC Educational Resources Information Center

    Davis, Velmar W.; And Others

    The Department of Agriculture continually reviews needs for insecticides and recommends those which are effective with least hazard to people and the environment. This report estimates the economic effects of reducing the use of organochlorine insecticides. Using data from a 1966 Economic Research Service Survey, the report concludes that these…

  14. The Educational Policy Consequences of Economic Instability: The Emerging Political Economy of American Education.

    ERIC Educational Resources Information Center

    Guthrie, James W.

    1985-01-01

    Persistant economic uncertainty fueled by continuing conditions such as high federal deficits, nagging unemployment, foreign trade imbalances, and growing overseas borrowings has evoked intensified public faith in education as a means for regaining U.S. economic vitality. (Author/LMO)

  15. Evaluating environmental and economic consequences of alternative pest management strategies: results of modeling workshops

    USGS Publications Warehouse

    Johnson, Richard L.; Andrews, Austin K.; Auble, Gregor T.L.; Ellison, Richard A.; Hamilton, David B.; Roelle, James E.; McNamee, Peter J.

    1983-01-01

    The model conceptualized at the first workshop simulates the effect of corn agrecosystem decisions on crop production, economic returns, and environmental indicators. The model is composed of five interacting submodels: 1) a Production Strategies submodel which makes decisions concerning tillage, planting, fertilizer and pesticide applications, and harvest; 2) a Hydrology/Chemical Transport submodel which represents soil hydrology, erosion, and concentrations of fertilizers and pesticides in the soil, runoff, surface waters, and percolation; 3) a Vegetation submodel which simulates growth of agricultural crops (corns and soybeans) and weeds; 4) a Pests submodel which calculates pest population levels and resulting crop damage; and 5) an Environmental Effects submodel which calculates indicators of potential fish kills, human health effects, and wildlife habitat. The most persistent data gaps encountered in quantifying the model were coefficients to relate environmental consequences to alternative pest management strategies. While the model developed in the project is not yet accurate enough to be used for real-world decisions about the use of pesticides on corn, it does contain the basic structure upon which such a model could be built. More importantly at this stage of development, the project has shown that very complex systems can be modeled in short periods of time and that the process of building such models increases understanding among disciplinary specialists and between diverse institutional interests. This process can be useful to EPA as the agency cooperates with other institutions to meet its responsibilities in less costly ways. Activities at the second 2 1/2-day workshop included a review of the model, incorporation of necessary corrections, simulation of policy scenarios, and examination of techniques to address remaining institutional conflicts. Participants were divided into three groups representing environmental, production or industry, and

  16. Social and economic consequences of onshore OCS-related activities in coastal Alabama: Final baseline report

    SciTech Connect

    Kelley, J.O.; Wade, W.W.

    1999-04-01

    This report documents existing economic conditions in the coastal Alabama region and highlights industry sectors important to the region`s economy. This report discusses the interplay among different users of the region`s natural resources, noting the tourism, fishing and offshore natural gas industries. Data are presented that show how the tourism and natural gas industries contribute to the economic growth of coastal Alabama and the State of Alabama. The recent conflict between the offshore gas and tourism industries over the use of coastal Alabama resources is discussed. Several case studies highlight local area experience relative to economic growth, industry coexistence and the importance of the coastal region`s natural resources to the local and state economies.

  17. Economic Socialization in the American Family: The Prevalence, Distribution, and Consequences of Allowance Arrangements.

    ERIC Educational Resources Information Center

    Mortimer, Jeylan T.; And Others

    1994-01-01

    Examined prevalence, distribution, and consequences of allowance for 1,000 ninth-grade students. Found positive relationship between parental socioeconomic status and provision of allowance, and most ninth graders did household chores in exchange. Although there were no significant effects on children's savings, receipt of allowance was associated…

  18. Social and Economic Consequences of Extreme Hydrological Regimes in Relationship to Federal Hydropower Generation on the Missouri River

    NASA Astrophysics Data System (ADS)

    parrish, M. A.; Otstot, R.; Moradkhani, H.

    2011-12-01

    After suffering from a ten year drought the main-stem Missouri reservoir system has now reached full capacity with flooding across a significant part of the region. Hydropower generation as a secondary purpose to both navigation and flood control is both directly and indirectly effected by these extreme hydrological regimes with sub-optimal generation timing, loss of dependable capacity, decrease in turbine efficiency, and operating in-flexibilities to buffer other renewable resources such as wind power. Hydropower operations under these extreme conditions are expected to continue with the recent SECURE Water Act Report issued by the Bureau of Reclamation predicting that the mean annual basin runoff may increase as much as 9.7% over the next fifty years. This study seeks to map the social and economic consequences of these extreme hydrologic regimes. First, using fifty years of historical generation a cumulative monthly frequency curve for each of the six federal plants on the Missouri River is developed. Then following the scenario analysis technique performed by the Department of Interior's study on the Deepwater Horizon Spill social and economic consequence chains are mapped into quartiles of the monthly frequency curves utilizing guidance from U.S Army Corps of Engineers, Bureau of Reclamation, and Western area Power Administration. Locating the placement of the monthly generation for periods of extreme hydrological conditions within the frequency curve provides an objective relationship between the extreme event and the social and economic consequences. Using this approach over the fifty year period of record provides a way to analyze the cumulative multi-year effect of drought and flood, while also providing a way to calculate the uncertainty of the consequence associated with the extreme event.

  19. The scorecard on globalization 1980-2000: its consequences for economic and social well-being.

    PubMed

    Weisbrot, Mark; Baker, Dean; Kraev, Egor; Chen, Judy

    2002-01-01

    The era of globalization has brought substantially less progress than was achieved in the preceding 20 years. This study by the Center for Economic and Policy Research concludes that the data provide no evidence that the policies associated with globalization have improved outcomes for developing countries, and its findings challenge economists and policymakers who cite globalization as an engine of growth while pressing for policies that strengthen the trend. The study also served as a backdrop to the release of the United Nations Development Program's Human Development Report on July 11, 2001. Using standard measures of economic growth, health outcomes, education, and literacy, the CEPR study compares the progress achieved during the period preceding globalization, 1960-80, with the period from 1980 to 2000, which was characterized by the reduction of tariff and nontariff barriers to trade, the removal of restrictions on international investment flows, and increasing intervention by the International Monetary Fund and World Bank on a wide range of economic and policy issues. While the evidence presented here does not prove that the policies associated with globalization were responsible for the deterioration in economic performance, it does present a very strong prima facie case that some structural and policy changes implemented during the last two decades are at least partly responsible for these declines. PMID:12067030

  20. The impact of the great recession on community-based mental health organizations: an analysis of top managers' perceptions of the economic downturn's effects and adaptive strategies used to manage the consequences in Ohio.

    PubMed

    Sweeney, Helen Anne; Knudsen, Kraig

    2014-04-01

    The Great Recession of 2007-2009 adversely affected the financial stability of the community-based mental health infrastructure in Ohio. This paper presents survey results of the type of adaptive strategies used by Ohio community-based mental health organizations to manage the consequences of the economic downturn. Results were aggregated into geographical classifications of rural, mid-sized urban, and urban. Across all groups, respondents perceived, to varying degrees, that the Great Recession posed a threat to their organization's survival. Urban organizations were more likely to implement adaptive strategies to expand operations while rural and midsized urban organizations implemented strategies to enhance internal efficiencies.

  1. Mortality, health, social and economic consequences of amyotrophic lateral sclerosis: a controlled national study.

    PubMed

    Jennum, Poul; Ibsen, Rikke; Pedersen, Stephen Wørlich; Kjellberg, Jakob

    2013-03-01

    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that imposes a great burden on the patient, the patient's family and society. However, we lack information about the total disease burden at a national level, especially regarding costs before and after diagnosis and the consequences for spouses. We aimed to estimate the factual direct and indirect costs of ALS in a national sample. Using records from the Danish National Patient Registry (1998-2009), 2,394 patients with ALS were identified and subsequently compared with 9,575 randomly chosen control subjects matched for age, gender and geographic area/civil status. Direct costs, including frequencies of primary and sector contacts and procedures, and medication from primary and secondary sectors, were obtained from the Danish Ministry of Health, the Danish Medicines Agency, and the National Health Security. Indirect costs included labour supply and social transfer payments, and were based on income data derived from Coherent Social Statistics. Patients with a diagnosis of ALS had poor survival. The average (95 % CI) 5-year survival rate was 0.278 (0.358-0.298) compared with 0.865 (0.858-0.872) among controls. Patients with ALS had significantly higher rates of health-related contact and medication use and higher socioeconomic costs. They also had very low employment rates, while those in employment had a lower income level than control subjects. The annual mean excess health-related cost was 18,918 for each ALS patient. However, spouses showed no excess health usage; in fact, their employment and income rates were higher, and the net cost was reduced by -3,420. We conclude that ALS has serious mortality, health and socioeconomic consequences for patients. However, the consequences for spouses are complex; they tend to compensate for the social consequences to patients by increasing their net income after ALS diagnosis.

  2. Social and economic antecedents and consequences of adolescent aggressive personality: Predictions from the interactionist model.

    PubMed

    Conger, Rand D; Martin, Monica J; Masarik, April S; Widaman, Keith F; Donnellan, M Brent

    2015-11-01

    The present study examined the development of a cohort of 279 early adolescents (52% female) from 1990 to 2005. Guided by the interactionist model of socioeconomic status and human development, we proposed that parent aggressive personality, economic circumstances, interparental conflict, and parenting characteristics would affect the development of adolescent aggressive personality traits. In turn, we hypothesized that adolescent aggressiveness would have a negative influence on adolescent functioning as an adult in terms of economic success, personality development, and close relationships 11 years later. Findings were generally supportive of the interactionist model proposition that social and economic difficulties in the family of origin intensify risk for adolescent aggressive personality (the social causation hypothesis) and that this personality trait impairs successful transition to adult roles (the social selection hypothesis) in a transactional process over time and generations. These results underscore how early development leads to child influences that appear to directly hamper the successful transition to adult roles (statistical main effects) and also amplify the negative impact of dysfunctional family systems on the transition to adulthood (statistical interaction effects). The findings suggest several possible points of intervention that might help to disrupt this negative developmental sequence of events. PMID:26439065

  3. The Felbertauern landslide of 2013: Traffic disruption, regional economic consequences and policy decisions

    NASA Astrophysics Data System (ADS)

    Pfurtscheller, Clemens; Genovese, Elisabetta

    2016-04-01

    The Felbertauern landslide of May 2013 caused the total destruction of approximately 100 meters of road including an avalanche gallery, generating several direct and indirect impacts on the regional-economy. The Felbertauern road, an important traffic arteria for the whole NUTS-3 region East-Tyrol (Austria), was totally blocked for several weeks. Short after the event, regional decision makers were hardly in need for an estimation of the regional-economic impacts of the road blockage to opt for alternatives to reopen the road. So, two weeks after the event, an analysis of the possible effects was carried out using only scattered information and statistical data. The analysis is based on a three-month interruption scenario. Retrospectively the road blockage was only two months. Due to the fact that short after the event no up-to-date data on regional-economics at necessary scales was available, impacts on tourism by analysing overnight stays, additional transportation costs and time losses for the local companies were calculated. Using these numbers, a cost-benefit-analysis was carried out for a projected bypass, a mid-term 1.5 kilometer long route as an alternative to the destroyed road. Finally, the impacts on the local companies were severe, due to additional transportation costs of approx. Euro 1.4 million and Euro 76 000 additional time costs using an alternative approach. The impacts on regional tourism were calculated with Euro 7.7 to 10.7 million - that means 0.6 to 0.8% of the total economic output of the region. The study shows the strong impact of indirect and business interruption costs on regional economies and describes the major problems faced during the study - in particular the low availability of input data. The results of consistent cost assessment are critical for decision makers who are responsible for the development of policies to prevent the impacts on societies.

  4. The Consequences of Job Displacement for Health: Moderating Influences of Economic Conditions and Educational Attainment

    PubMed Central

    Pearlman, Jessica

    2015-01-01

    This paper will examine the impact of worker displacement on health in the United States from 1975–2004, especially the extent to which the impact of displacement on health varies according to the economic conditions in the year of displacement and the education level of the displaced worker. Findings from ordered probit and fixed effects models suggest that the negative impact of displacement on health is exacerbated by a higher unemployment rate at the time of displacement and for displaced workers with a college degree. PMID:26004481

  5. Quantifying the broader economic consequences of quadrivalent human papillomavirus (HPV) vaccination in Germany applying a government perspective framework.

    PubMed

    Kotsopoulos, Nikolaos; Connolly, Mark P; Remy, Vanessa

    2015-12-01

    HPV infections can cause substantial burden in females and males as it is associated with several genital cancers, in addition to genital warts. Traditional economic evaluations often focus on quantifying cost-effectiveness, however, it is increasingly recognized that vaccinations may generate broader benefits not captured in cost-effectiveness analysis. Τhe aim of this study was to evaluate the broader economic consequences associated with HPV vaccination in males and females and to conduct a lifetime cost-benefit analysis of investing in universal vaccination in Germany from the perspective of government. Methodologies from generational accounting, human capital and health economics were combined to estimate the broader economic consequences of HPV vaccination including the fiscal impact for the government. A cohort model was developed simulating the medical costs and average lifetime fiscal transfers between the government and 12-year-old immunized and non-immunized males and females. To estimate tax revenue attributed to vaccination-related changes in morbidity and mortality, direct and indirect tax rates were linked to differences in age- and gender-specific earnings. Based on HPV vaccination costs, the base case cost-benefit analysis demonstrated that investing 1 in universal HPV vaccination could yield 1.7 in gross tax revenue over the lifetime of the cohorts. After taking into consideration the governmental transfers, universal HPV vaccination in Germany could result in incremental positive net discounted taxes (i.e. tax revenue-transfers) from 62 million for the German government. The vaccination of males and females with the quadrivalent HPV vaccine is likely to have positive effects on public finances.

  6. The health-related, social, and economic consequences of parkinsonism: a controlled national study.

    PubMed

    Jennum, Poul; Zoetmulder, Marielle; Korbo, Lise; Kjellberg, Jakob

    2011-08-01

    Parkinson's disease (PD) and atypical parkinsonism (AP) cause a significant socioeconomic burden, but there is insufficient information about the total disease burden at a national level. Thus, the goal of this study was to estimate the excess direct and indirect costs of PD and AP in a national sample. Using records from the Danish National Patient Registry (1997-2007), 13,400 PD and 647 AP patients were identified and compared with, respectively, 53,600 and 2,588 control cases randomly selected with respect to age, gender, civil status, and geographic location. Direct costs including frequencies of primary and sector contacts and procedures, and medication from primary and secondary sectors were obtained from the Danish Ministry of Health, the Danish Medicines Agency, and the National Health Security. Indirect costs, which included labor supply and social transfer payments, were based on income data derived from the Coherent Social Statistics. Patients with PD and AP had significantly higher rates of health-related contact and medication use and a higher socioeconomic cost. Furthermore, they had very low employment rates, and those in employment had a lower income level than employed control subjects. The annual mean excess health-related cost was 6,500 ($8,975/£5,543) and 9,771 ($13,491/£8,332) for each patient with PD and AP, respectively. In addition, the patients with PD and AP received an annual mean excess social transfer income of 324 (£276/$447) and 844 (£719/$1,165), respectively. The employment- and health-related consequences could be identified up to 8 years before the first diagnosis and increased with disease advancement. PD and AP have major socioeconomic consequences for patients and society. The health effects are present for up to more than 8 years before a diagnosis of PD/AP.

  7. Secondary materials: Engineering properties, environmental consequences, and social and economic impacts. Final report

    SciTech Connect

    Breslin, V.; Reaven, S.; Schwartz, M.; Swanson, L.; Zweig, M.; Bortman, M.; Schubel, J.

    1993-08-01

    This report investigates two secondary materials, plastic lumber made from mixed plastic waste, and cement blocks and structures made with incinerator ash. Engineering properties, environmental impacts, and energy costs and savings of these secondary materials are compared to standard lumber products and cement blocks. Market capacity and social acceptance of plastic lumber and stabilized ash products are analyzed. These secondary materials apparently have potential markets; however, their economic value is primarily that they will not take up landfill space. For plastic lumber and stabilized incinerator ash products, marine and highway construction seem ideal public works applications. Incinerator ash may be suitable to use in seawalls, jetties, fishing reefs, highway barriers, and roadbed applications. Docks, piers, highway sound barriers, parking stops, and park furniture may all be made from plastic lumber. To encourage public acceptance and improve the market potential of secondary materials, these activities could be beneficial: industry should emphasize developing useful, long-lived products; industry and governments should create product performance criteria; government should provide rigorous testing and demonstration programs; and government and industry should cooperate to improve public outreach and educational programs.

  8. The economic consequences of elevated body-lead burdens in urban children

    SciTech Connect

    Agree, M.D.

    1991-01-01

    The following analysis develops the theory and implementation of the observed behavior technique in an altruistic setting, to assess the health benefits of reducing environmental lead exposure in urban children. Three models are presented which allow for endogenous body lead burden, risk of irreversible neurological damages, and Bayesian information. Conditions are derived under which the observed behavior technique can be modified to value the health consequences of exposure to a general class of persistent micropollutants (PMP's): the heavy metals. Benefit expressions reflect the tradeoff between parental wealth and child health when children are exposed to low level doses of lead. The purpose is to derive exact measures of marginal welfare change associated with variations in child body lead burden, and to determine the conditions under which these measures will be functions of observable parameters. The analysis presents an entirely ex ante approach to the recovery of benefit estimates when PMP exposure involves risk of irreversible health damages. In doing so, an empirical estimate is also obtained for the parental value of child health information that is used in the revision of prior risk beliefs. Risk of chronic irreversible health effects in younger generations from environmental lead exposure may be experienced by a large share of metropolitan population in the US. Given the large numbers of possible victims, the aggregate social value of avoiding this risk is an important policy issues. Moreover, the value of health risk information is potentially important to the use of an information program as a policy instrument in reducing health risk because it would enable the comparison of societal benefits from an information program to the cost of it's implementation.

  9. Extreme Subduction Earthquake Scenarios and their Economical Consequences for Mexico City and Guadalajara, Jalisco, Mexico

    NASA Astrophysics Data System (ADS)

    Chavez, M.; Cabrera, E.; Perea, N.

    2007-05-01

    The destructive effects of large magnitude, thrust subduction superficial (TSS) earthquakes on Mexico City (MC) and Guadalajara (G) has been shown in the recent centuries. For example, the 7/04/1845 a TSS earthquake with Ms 7+ and epicentral distance of about 250 km from MC occurred on the coast of the state of Guerrero, a Maximum Mercalli Modified Intensity (MMI) of IX-X was reported in MC. Furthermore, the 19/09/1985 a Ms 8.1, Mw 8.01, TSS earthquake with epicentral distance of about 340 km from MC occurred on the coast of the state of Michoacan, a maximum MMI of IX-X was reported in MC. Also, the largest, Ms 8.2, instrumentally observed TSS earthquake in Mexico, occurred in the Colima-Jalisco region the 3/06/1932, with epicentral distance of the order of 200 km from G in northwestern Mexico. The 9/10/1995 another similar event, Ms 7.4, Mw 8, with an epicentral distance of about 240 km from G, occurred in the same region and produced MMI IX in the epicentral zone and MMI up to VI in G. The frequency of occurrence of large TSS earthquakes in Mexico is poorly known, but it might vary from decades to centuries [1]. On the other hand, the first recordings of strong ground motions in MC dates from the early 1960´s and most of them were recorded after the 19/09/1985 earthquake. In G there is only one recording of the later event, and 13 for the one occurred the 9/10/1995 [2]. In order to fulfill the lack of strong ground motions records for large damaging TSS earthquakes, which could have an important economical impact on MC [3] and G, in this work we have modeled broadband synthetics (obtained with a hybrid model that has already been satisfactorily compared with observations of the 9/10/1995 Colima-Jalisco Mw 8 earthquake, [4]) expected in MC and G, associated to extreme magnitude Mw 8.5, TSS scenario earthquakes with epicenters in the so-called Guerrero gap and in the Colima-Jalisco zone, respectively. The proposed scenarios are based on the seismic history and up

  10. The consequences of hospital autonomization in Colombia: a transaction cost economics analysis.

    PubMed

    Castano, Ramon; Mills, Anne

    2013-03-01

    Granting autonomy to public hospitals in developing countries has been common over recent decades, and implies a shift from hierarchical to contract-based relationships with health authorities. Theory on transactions costs in contractual relationships suggests they stem from relationship-specific investments and contract incompleteness. Transaction cost economics argues that the parties involved in exchanges seek to reduce transaction costs. The objective of this research was to analyse the relationships observed between purchasers and the 22 public hospitals of the city of Bogota, Colombia, in order to understand the role of relationship-specific investments and contract incompleteness as sources of transaction costs, through a largely qualitative study. We found that contract-based relationships showed relevant transaction costs associated mainly with contract incompleteness, not with relationship-specific investments. Regarding relationships between insurers and local hospitals for primary care services, compulsory contracting regulations locked-in the parties to the contracts. For high-complexity services (e.g. inpatient care), no restrictions applied and relationships suggested transaction-cost minimizing behaviour. Contract incompleteness was found to be a source of transaction costs on its own. We conclude that transaction costs seemed to play a key role in contract-based relationships, and contract incompleteness by itself appeared to be a source of transaction costs. The same findings are likely in other contexts because of difficulties in defining, observing and verifying the contracted products and the underlying information asymmetries. The role of compulsory contracting might be context-specific, although it is likely to emerge in other settings due to the safety-net role of public hospitals.

  11. Commercial Transnational and Neighbour Country TV in Europe. Economic Consequences and Consumer Perspectives. Case: Sky Channel and West German TV from a Danish Perspective. Skriftserie E, nr. 14.

    ERIC Educational Resources Information Center

    Sepstrup, Preben

    The commercials on the Sky Channel, the first pan-European satellite television channel, and on the West German Channel 2 (or ZDF) are analyzed in this report. The study summarizes an investigation of the economic consequences of transborder television advertising in Europe and the consequences for consumers if television advertising grows or is…

  12. The economic consequences of deinstitutionalisation of mental health services: lessons from a systematic review of European experience.

    PubMed

    Knapp, Martin; Beecham, Jennifer; McDaid, David; Matosevic, Tihana; Smith, Monique

    2011-03-01

    Many European mental health systems are undergoing change as community-centred care replaces large-scale institutions. We review empirical evidence from three countries (UK, Germany, Italy) that have made good progress with this rebalancing of care. We focus particularly on the economic consequences of deinstitutionalisation. A systematic literature review was conducted using a broad search strategy in accordance with established guidelines. We searched the International Bibliography of the Social Sciences, Health Management Information Consortium, British Nursing Index and PUBMED/Medline to 2008. The on-line search was supplemented by advice and assistance from contacts with government departments, European Commission, professional networks and known local experts. Community-based models of care are not inherently more costly than institutions, once account is taken of individuals' needs and the quality of care. New community-based care arrangements could be more expensive than long-stay hospital care but may still be seen as more cost-effective because, when properly set up and managed, they deliver better outcomes. Understanding the economic consequences of deinstitutionalisation is fundamental to success. Local stakeholders and budget controllers need to be aware of the underlying policy and operational plan. Joint planning and commissioning or devolving certain powers and responsibilities to care managers may aid development of effective and cost-effective care. People's needs, preferences and circumstances vary, and so their service requirements and support costs also vary, opening up the possibility for purposive targeting of services on needs to improve the ability of a care system to improve well-being from constrained resources. As the institutional/community balance shifts, strategic planning should also ensure that the new care arrangements address the specific contexts of different patient groups. Decision-makers have to plan a dynamic community

  13. The impact of economic activity in Asturias on greenhouse gas emissions: consequences for environmental policy within the Kyoto Protocol framework.

    PubMed

    Argüelles, Margarita; Benavides, Carmen; Junquera, Beatriz

    2006-11-01

    Climate change is one of the major worldwide environmental concerns. It is especially the case in many developed countries, where the greenhouse gas emissions responsible for this change are mainly concentrated. For the first time, the Kyoto Protocol includes an international agreement for the reduction of the net emissions of these gases. To fulfil this agreement measures designed to reduce or limit current emissions have to be brought into force. Consequently, fears have arisen about possible consequences on competitiveness and future development of manufacturing activities and the need for support mechanisms for the affected sectors is obvious. In this paper, we carry out a study of the emissions of gases responsible for climate change in Asturias (Spain), a region with an important economic presence of sectors with intensive emissions of CO(2), the chief greenhouse gas. To be precise, in the first place, the volumes of direct emissions of the said gases in 1995 were calculated, showing that the sectors most affected by the Kyoto Protocol in Asturias are iron and steel and electricity production. Secondly, input-output analysis was applied to determine the direct and indirect emissions and the direct, indirect and induced emissions of the different production sectors, respectively. The results derived from the direct and indirect emissions analysis and their comparison with the results of the former allow us to reach some conclusions and environmental policy implications.

  14. Failure of Passive Immune Transfer in Calves: A Meta-Analysis on the Consequences and Assessment of the Economic Impact.

    PubMed

    Raboisson, Didier; Trillat, Pauline; Cahuzac, Clélia

    2016-01-01

    Low colostrum intake at birth results in the failure of passive transfer (FPT) due to the inadequate ingestion of colostral immunoglobulins (Ig). FPT is associated with an increased risk of mortality and decreased health and longevity. Despite the known management practices associated with low FPT, it remains an important issue in the field. Neither a quantitative analysis of FPT consequences nor an assessment of its total cost are available. To address this point, a meta-analysis on the adjusted associations between FPT and its outcomes was first performed. Then, the total costs of FPT in European systems were calculated using a stochastic method with adjusted values as the input parameters. The adjusted risks (and 95% confidence intervals) for mortality, bovine respiratory disease, diarrhoea and overall morbidity in the case of FPT were 2.12 (1.43-3.13), 1.75 (1.50-2.03), 1.51 (1.05-2.17) and 1.91 (1.63-2.24), respectively. The mean (and 95% prediction interval) total costs per calf with FPT were estimated to be €60 (€10-109) and €80 (€20-139) for dairy and beef, respectively. As a result of the double-step stochastic method, the proposed economic estimation constitutes the first estimate available for FPT. The results are presented in a way that facilitates their use in the field and, with limited effort, combines the cost of each contributor to increase the applicability of the economic assessment to the situations farm-advisors may face. The present economic estimates are also an important tool to evaluate the profitability of measures that aim to improve colostrum intake and FPT prevention. PMID:26986832

  15. Failure of Passive Immune Transfer in Calves: A Meta-Analysis on the Consequences and Assessment of the Economic Impact

    PubMed Central

    Raboisson, Didier; Trillat, Pauline; Cahuzac, Clélia

    2016-01-01

    Low colostrum intake at birth results in the failure of passive transfer (FPT) due to the inadequate ingestion of colostral immunoglobulins (Ig). FPT is associated with an increased risk of mortality and decreased health and longevity. Despite the known management practices associated with low FPT, it remains an important issue in the field. Neither a quantitative analysis of FPT consequences nor an assessment of its total cost are available. To address this point, a meta-analysis on the adjusted associations between FPT and its outcomes was first performed. Then, the total costs of FPT in European systems were calculated using a stochastic method with adjusted values as the input parameters. The adjusted risks (and 95% confidence intervals) for mortality, bovine respiratory disease, diarrhoea and overall morbidity in the case of FPT were 2.12 (1.43–3.13), 1.75 (1.50–2.03), 1.51 (1.05–2.17) and 1.91 (1.63–2.24), respectively. The mean (and 95% prediction interval) total costs per calf with FPT were estimated to be €60 (€10–109) and €80 (€20–139) for dairy and beef, respectively. As a result of the double-step stochastic method, the proposed economic estimation constitutes the first estimate available for FPT. The results are presented in a way that facilitates their use in the field and, with limited effort, combines the cost of each contributor to increase the applicability of the economic assessment to the situations farm-advisors may face. The present economic estimates are also an important tool to evaluate the profitability of measures that aim to improve colostrum intake and FPT prevention. PMID:26986832

  16. Failure of Passive Immune Transfer in Calves: A Meta-Analysis on the Consequences and Assessment of the Economic Impact.

    PubMed

    Raboisson, Didier; Trillat, Pauline; Cahuzac, Clélia

    2016-01-01

    Low colostrum intake at birth results in the failure of passive transfer (FPT) due to the inadequate ingestion of colostral immunoglobulins (Ig). FPT is associated with an increased risk of mortality and decreased health and longevity. Despite the known management practices associated with low FPT, it remains an important issue in the field. Neither a quantitative analysis of FPT consequences nor an assessment of its total cost are available. To address this point, a meta-analysis on the adjusted associations between FPT and its outcomes was first performed. Then, the total costs of FPT in European systems were calculated using a stochastic method with adjusted values as the input parameters. The adjusted risks (and 95% confidence intervals) for mortality, bovine respiratory disease, diarrhoea and overall morbidity in the case of FPT were 2.12 (1.43-3.13), 1.75 (1.50-2.03), 1.51 (1.05-2.17) and 1.91 (1.63-2.24), respectively. The mean (and 95% prediction interval) total costs per calf with FPT were estimated to be €60 (€10-109) and €80 (€20-139) for dairy and beef, respectively. As a result of the double-step stochastic method, the proposed economic estimation constitutes the first estimate available for FPT. The results are presented in a way that facilitates their use in the field and, with limited effort, combines the cost of each contributor to increase the applicability of the economic assessment to the situations farm-advisors may face. The present economic estimates are also an important tool to evaluate the profitability of measures that aim to improve colostrum intake and FPT prevention.

  17. [Socio-economic impact at the household level of the health consequences of toxic waste discharge in Abidjan in 2006].

    PubMed

    Koné, B A; Tiembré, I; Dongo, K; Tanner, M; Zinsstag, J; Cissé, G

    2011-02-01

    In August 2006, toxic wastes were discharged in the district of Abidjan, causing important health consequences in many households in the area. In order to appreciate the socio-economic impact of the consequences of toxic waste discharge on the households and of the measures taken by the authorities to deal with this catastrophe, and to appreciate the spatial extent of the pollution, we undertook a multidisciplinary transversal investigation at the sites of discharge of oxic waste, from October the 19th to December the 8th, 2006, using a transect sampling methodology. This paper presents the results related to the socio-economic aspects of the survey while the environmental and epidemiological results are presented in two other published papers. The socioeconomics investigation, conducted using a questionnaire, concerned 809 households across the various sites of discharge of toxic waste. More than 62% of households had at least one person who had been affected by toxic waste (affected households). 62.47% of these households were in Cocody district (with 2 sites and 4 points of discharge), 30.14% in Abobo district (with 2 sites and 3 points) and 7.39% in Koumassi district (with 1 site and 1 point). To escape the bad smell and the nuisance, 22.75% of the 501 "affected" households had left their houses. To face the health consequences generated by the toxic waste, 30.54% of the "affected" households engaged expenses. Those were on average of 92 450 FCFA (€141), with a minimum of 1 000 FCFA (€1.5) and a maximum of 1500000 FCFA (€2.287), in spite of the advertisement of the exemption from payment treatment fees made by the government. The decision of destroying cultures and farms near the points of discharge of the toxic products in a radius of 200 meters, taken by the authorities, touched 2.22% of the households. For these households, it did nothing but worsen their state of poverty, since the zone of influence of the toxic waste went well beyond the 200 meters

  18. Increased biomass burning due to the economic crisis in Greece and its adverse impact on wintertime air quality in Thessaloniki.

    PubMed

    Saffari, Arian; Daher, Nancy; Samara, Constantini; Voutsa, Dimitra; Kouras, Athanasios; Manoli, Evangelia; Karagkiozidou, Olga; Vlachokostas, Christos; Moussiopoulos, Nicolas; Shafer, Martin M; Schauer, James J; Sioutas, Constantinos

    2013-01-01

    The recent economic crisis in Greece resulted in a serious wintertime air pollution episode in Thessaloniki. This air quality deterioration was mostly due to the increased price of fuel oil, conventionally used as a source of energy for domestic heating, which encouraged the residents to burn the less expensive wood/biomass during the cold season. A wintertime sampling campaign for fine particles (PM2.5) was conducted in Thessaloniki during the winters of 2012 and 2013 in an effort to quantify the extent to which the ambient air was impacted by the increased wood smoke emissions. The results indicated a 30% increase in the PM2.5 mass concentration as well as a 2-5-fold increase in the concentration of wood smoke tracers, including potassium, levoglucosan, mannosan, and galactosan. The concentrations of fuel oil tracers (e.g., Ni and V), on the other hand, declined by 20-30% during 2013 compared with 2012. Moreover, a distinct diurnal variation was observed for wood smoke tracers, with significantly higher concentrations in the evening period compared with the morning. Correlation analysis indicated a strong association between reactive oxygen species (ROS) activity and the concentrations of levoglucosan, galactosan, and potassium, underscoring the potential impact of wood smoke on PM-induced toxicity during the winter months in Thessaloniki.

  19. Economic Impact of Adverse Drug Events – A Retrospective Population-Based Cohort Study of 4970 Adults

    PubMed Central

    Gyllensten, Hanna; Hakkarainen, Katja M.; Hägg, Staffan; Carlsten, Anders; Petzold, Max; Rehnberg, Clas; Jönsson, Anna K.

    2014-01-01

    Background The aim was to estimate the direct costs caused by ADEs, including costs for dispensed drugs, primary care, other outpatient care, and inpatient care, and to relate the direct costs caused by ADEs to the societal COI (direct and indirect costs), for patients with ADEs and for the entire study population. Methods We conducted a population-based observational retrospective cohort study of ADEs identified from medical records. From a random sample of 5025 adults in a Swedish county council, 4970 were included in the analyses. During a three-month study period in 2008, direct and indirect costs were estimated from resource use identified in the medical records and from register data on costs for resource use. Results Among 596 patients with ADEs, the average direct costs per patient caused by ADEs were USD 444.9 [95% CI: 264.4 to 625.3], corresponding to USD 21 million per 100 000 adult inhabitants per year. Inpatient care accounted for 53.9% of all direct costs caused by ADEs. For patients with ADEs, the average societal cost of illness was USD 6235.0 [5442.8 to 7027.2], of which direct costs were USD 2830.1 [2260.7 to 3399.4] (45%), and indirect costs USD 3404.9 [2899.3 to 3910.4] (55%). The societal cost of illness was higher for patients with ADEs compared to other patients. ADEs caused 9.5% of all direct healthcare costs in the study population. Conclusions Healthcare costs for patients with ADEs are substantial across different settings; in primary care, other outpatient care and inpatient care. Hence the economic impact of ADEs will be underestimated in studies focusing on inpatient ADEs alone. Moreover, the high proportion of indirect costs in the societal COI for patients with ADEs suggests that the observed costs caused by ADEs would be even higher if including indirect costs. Additional studies are needed to identify interventions to prevent and manage ADEs. PMID:24637879

  20. Evaluation of the epidemiological and economic consequences of control scenarios for bovine viral diarrhea virus in dairy herds.

    PubMed

    Santman-Berends, I M G A; Mars, M H; van Duijn, L; van Schaik, G

    2015-11-01

    Bovine viral diarrhea virus (BVDV) is an important endemic infection. However, no information was available on whether it would be economically beneficial to implement a national control program in the Netherlands. Therefore, a stochastic simulation model was developed in which control scenarios were added to compare the epidemiological and economic consequences of BVDV control in Dutch dairy herds in the next 10 yr. In the epidemiological part of the model, herds could be classified as susceptible, infectious, recovered, or vaccinated. The outputs of the epidemiological module served as input for the economic module. Net costs that could be attributed to bovine viral diarrhea consisted of production losses, costs for testing, and culling persistently infected cattle in the present voluntary Dutch BVDV control program and costs for vaccination. Four different control scenarios were simulated, involving testing and culling of persistently infected (based on serum or ear-notch testing), and monitoring BVDV statuses and vaccination and were derived from BVDV control programs that are currently executed in Europe. The costs and benefits of BVDV control in the current situation and in each of the simulated control scenarios were evaluated assuming an annual discount rate of 2%. The model estimated a mean BVDV herd prevalence of 18.0% in 2014 and showed a slightly decreasing prevalence over time. The outputs seemed realistic for the present situation in the Netherlands when compared with actual survey data. The average annual net costs associated with bovine viral diarrhea were estimated at €27.8 million for the dairy industry. Two control scenarios were beneficial in controlling BVDV during the study period (between 2015 and 2025). In the scenario where tracing and removing of PI animals and monitoring of the subsequent status was obligatory, the benefit to cost (B/C) ratio was 1.5 (€1.5 benefit for each invested euro). In the scenario in which the BVDV status of

  1. The Long-Run Socio-Economic Consequences of a Large Disaster: The 1995 Earthquake in Kobe.

    PubMed

    duPont, William; Noy, Ilan; Okuyama, Yoko; Sawada, Yasuyuki

    2015-01-01

    We quantify the 'permanent' socio-economic impacts of the Great Hanshin-Awaji (Kobe) earthquake in 1995 by employing a large-scale panel dataset of 1,719 cities, towns, and wards from Japan over three decades. In order to estimate the counterfactual--i.e., the Kobe economy without the earthquake--we use the synthetic control method. Three important empirical patterns emerge: First, the population size and especially the average income level in Kobe have been lower than the counterfactual level without the earthquake for over fifteen years, indicating a permanent negative effect of the earthquake. Such a negative impact can be found especially in the central areas which are closer to the epicenter. Second, the surrounding areas experienced some positive permanent impacts in spite of short-run negative effects of the earthquake. Much of this is associated with movement of people to East Kobe, and consequent movement of jobs to the metropolitan center of Osaka, that is located immediately to the East of Kobe. Third, the furthest areas in the vicinity of Kobe seem to have been insulated from the large direct and indirect impacts of the earthquake.

  2. The Long-Run Socio-Economic Consequences of a Large Disaster: The 1995 Earthquake in Kobe.

    PubMed

    duPont, William; Noy, Ilan; Okuyama, Yoko; Sawada, Yasuyuki

    2015-01-01

    We quantify the 'permanent' socio-economic impacts of the Great Hanshin-Awaji (Kobe) earthquake in 1995 by employing a large-scale panel dataset of 1,719 cities, towns, and wards from Japan over three decades. In order to estimate the counterfactual--i.e., the Kobe economy without the earthquake--we use the synthetic control method. Three important empirical patterns emerge: First, the population size and especially the average income level in Kobe have been lower than the counterfactual level without the earthquake for over fifteen years, indicating a permanent negative effect of the earthquake. Such a negative impact can be found especially in the central areas which are closer to the epicenter. Second, the surrounding areas experienced some positive permanent impacts in spite of short-run negative effects of the earthquake. Much of this is associated with movement of people to East Kobe, and consequent movement of jobs to the metropolitan center of Osaka, that is located immediately to the East of Kobe. Third, the furthest areas in the vicinity of Kobe seem to have been insulated from the large direct and indirect impacts of the earthquake. PMID:26426998

  3. The Long-Run Socio-Economic Consequences of a Large Disaster: The 1995 Earthquake in Kobe

    PubMed Central

    duPont IV, William; Noy, Ilan; Okuyama, Yoko; Sawada, Yasuyuki

    2015-01-01

    We quantify the ‘permanent’ socio-economic impacts of the Great Hanshin-Awaji (Kobe) earthquake in 1995 by employing a large-scale panel dataset of 1,719 cities, towns, and wards from Japan over three decades. In order to estimate the counterfactual—i.e., the Kobe economy without the earthquake—we use the synthetic control method. Three important empirical patterns emerge: First, the population size and especially the average income level in Kobe have been lower than the counterfactual level without the earthquake for over fifteen years, indicating a permanent negative effect of the earthquake. Such a negative impact can be found especially in the central areas which are closer to the epicenter. Second, the surrounding areas experienced some positive permanent impacts in spite of short-run negative effects of the earthquake. Much of this is associated with movement of people to East Kobe, and consequent movement of jobs to the metropolitan center of Osaka, that is located immediately to the East of Kobe. Third, the furthest areas in the vicinity of Kobe seem to have been insulated from the large direct and indirect impacts of the earthquake. PMID:26426998

  4. A plan for application system verification tests: The value of improved meteorological information, volume 1. [economic consequences of improved meteorological information

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The framework within which the Applications Systems Verification Tests (ASVTs) are performed and the economic consequences of improved meteorological information demonstrated is described. This framework considers the impact of improved information on decision processes, the data needs to demonstrate the economic impact of the improved information, the data availability, the methodology for determining and analyzing the collected data and demonstrating the economic impact of the improved information, and the possible methods of data collection. Three ASVTs are considered and program outlines and plans are developed for performing experiments to demonstrate the economic consequences of improved meteorological information. The ASVTs are concerned with the citrus crop in Florida, the cotton crop in Mississippi and a group of diverse crops in Oregon. The program outlines and plans include schedules, manpower estimates and funding requirements.

  5. [Stent implantation as initial coronary interventional therapy? A theoretical model on clinical and economical consequences of in-stent restenosis].

    PubMed

    Pfund, A; Wendland, G; Baer, F; Lauterbach, K; Höpp, H W

    2000-08-01

    The reduction of acute complications and late restenosis compared to conventional PTCA has led to a rapid increase in stent implantation as initial treatment for coronary stenosis. As a result, in-stent restenosis has become an important clinical and economical problem, especially the diffuse form, which is much more likely to reappear. In order to compare the consequences of initial stenting and initial angioplasty, we developed an analytic model, considering the differences between diffuse and focal in-stent restenosis. The simulation based on the optimized therapeutic proceeding following an elective 1-vessel revascularization of a 60-year-old patient, dealing with probabilities for acute complications and late restenosis taken from the literature and in-hospital costs obtained from 200 elective interventions. In the stent group 71.0% of patients were free of any target lesion-related event, compared to 60.2% in the PTCA group. Catheter reintervention was necessary for 32.1% of the patients initially treated with angioplasty and for 17.6% of the initially stented patients, whereas 7.7% of the stent patients had to undergo elective bypass surgery as final treatment compared to 2.8% in the PTCA arm. Long-term medical costs for initial stenting (6,237 Euros) were 14% higher than for conventional PTCA (5,345 Euros). Taking also into consideration the indirect costs (loss of productivity) for a collective with an employment rate of 50%, the difference between stent implantation (9,067 Euros) and angioplasty (8,581 Euros) is smaller. Initial treatment of coronary stenosis by stent implantation decreases the rate of repeat revascularization compared to initial PTCA, but there is a greater likelihood that elective bypass surgery will become necessary. This difference in following treatment is related to the occurrence of diffuse in-stent restenosis. When calculating the long-term costs stenting still appeared to be more expensive than PTCAA because the savings in

  6. Adverse health consequences of cocaine abuse.

    PubMed Central

    Cregler, L. L.

    1989-01-01

    Cocaine creates a strong physical addiction and is becoming recognized as one of the most dangerous illicit drugs abused today. The myth is that cocaine is harmless and nonaddictive. An estimated 30 million Americans have used cocaine, but the number may be as high as 40 million. Five to six million individuals are compulsive users. A review of the current literature revealed multiple reports of acute myocardial infarction and cerebrovascular accident with a temporal relation to cocaine use. Cocaine has also been associated with acute rupture of the aorta, cardiac arrhythmia, and sudden death. Cocaine has multisystem toxicity involving neurologic, psychiatric, obstetric, pulmonary, dermatologic, and gastrointestinal systems. The dopamine depletion hypothesis may explain why cocaine is repeatedly administered; cocaine produces a transient increase in synaptic dopamine. Alterations in dopamine neurotransmission may be responsible for the development of compulsive use patterns. When cocaine use becomes compulsive, psychosocial dysfunction, deviant behaviors, and a wide spectrum of social, financial, and family problems invariably result. Addiction, major medical complications, and death are true hazards of cocaine use. PMID:2657079

  7. Modelling hydrological changes in surface in relation with anthropogenic drivers and consequences on human health and local economic

    NASA Astrophysics Data System (ADS)

    Sandoz, Alain; Leblond, Agnès; Boutron, Olivier

    2016-04-01

    Marais des Baux are located between Alpilles in the North and the plain of the Crau (South-East) of the town of Arles, in the South of France. Already built in Roman times, swamps located at the outlet of the Baux valley basin have experienced an increased human pressure during last centuries. Apotheosis of human development is the period of post-war with Marshall Plan and the development of the Common Agricultural Policy (CAP). At the beginning of the 21st century, inverse hydrologic dynamic is observed. Renaturation of the lower parts of the marshes, where land is less profitable, has reversed the trend of previous centuries. To be sustainable, this annealing must be accompanied by water governance at the watershed scale. This work aims to help policy makers and managers to good governance of the territory. Hierarchical multi-scale approach has enabled a better understanding of hydrological flows. In addition, knowledge of different actors' strategies is not enough. There may be different interests and strategies within the same group of actors. In this case, this is what we observe between farmers located on the upstream parts of the watershed eager, for some, to increase irrigation, and those located downstream, in the marshes, forced pump to maintain water levels corresponding to the expectations of the majority of the actors. On the other hand, there is a negative image of still marsh near a rural population and new rural population. Decreasing pumping or to send a higher volume of water could significantly increase flooded areas. This increase in flooded areas could facilitate the development of certain mosquito species. These mosquitoes not only represent a potential health risk for human populations but also increase the discomfort felt by the local population and tourists. This discomfort may also have an impact on economic activity linked with tourism. The work allowed the testing of different scenarios of flooding, according to the hydraulic management

  8. Inter-relationships between the economic and emotional consequences of colorectal cancer for patients and their families: a qualitative study

    PubMed Central

    2012-01-01

    Background While the evidence-base concerning the economic impact of cancer for patients and their families/carers has grown in recent years, there is little known about how emotional responses to cancer influence this economic impact. We investigated the economic costs of cancer in the context of patients’ emotions and how these both shaped the patient and family burden. Methods Health professionals from six hospitals invited patients diagnosed with colorectal cancer (ICD10 C18-C20) within the previous year to take part in the study. Semi-structured face-to-face interviews were conducted with patients and, where available, a family member. Interviews covered medical and non-medical costs incurred as a result of cancer and the impact of these on the lives of the patient and their family. Interviews were audio-recorded. Recordings were transcribed verbatim and these data were analysed qualitatively using thematic content analysis. Results Twenty-two patients with colorectal cancer (17 colon and 5 rectal; 14 women and 8 men) were interviewed; 6 were accompanied by a family member. Important cancer-related financial outlays included: travel and parking associated with hospital appointments; costs of procedures; increased household bills; and new clothing. Cancer impacted on employed individuals’ ability to work and depressed their income. The opportunity cost of informal care for carers/family members, especially immediately post-diagnosis, was a strong theme. All patients spoke of the emotional burden of colorectal cancer and described how this burden could lead to further costs for themselves and their families by limiting work and hindering their ability to efficiently manage their expenses. Some patients also spoke of how economic and emotional burdens could interact with each other. Support from employers, family/carers and the state/health services and patients’ own attitudes influenced this inter-relationship. Conclusions The economic impact of colorectal

  9. Assessment of the Broader Economic Consequences of HPV Prevention from a Government-Perspective: A Fiscal Analytic Approach

    PubMed Central

    Setiawan, Didik; Kotsopoulos, Nikolaos; Wilschut, Jan C.; Postma, Maarten J.; Connolly, Mark P.

    2016-01-01

    Background Cervical cancer poses a substantial burden in terms of morbidity, mortality, and economic losses, especially in low/middle-income countries. HPV vaccination and/or cervical cancer screening among females may reduce the burden of HPV-related diseases, including cervical cancer. However, limited funds may impede the implementation of population-based programmes. Governmental investments in the prevention of infectious disease may have broader economic and fiscal benefits, which are not accounted in conventional economic analyses. This study estimates the broader economic and fiscal impacts of implementing HPV vaccination and/or cervical cancer screening in Indonesia from the perspective of the government. Methods A government-perspective quantitative analytic framework was applied to assess the Net Present Value (NPV) of investment on cervical cancer prevention strategies including HPV vaccination, cervical screening and its combination in Indonesia. All monetary values were presented in International Dollars (I$). Results Based on a cohort of 10,000,000 Indonesian 12-year-old females, it was estimated that HPV vaccination and/or cervical cancer screening result in a positive NPV for the Indonesian government. The combination of cervical screening and HPV vaccination generated a substantial reduction of cervical cancer incidence and HPV-related mortality of 87,862 and 19,359, respectively. It was estimated that HPV vaccination in combination with cervical screening is the most favorable option for cervical cancer prevention (NPV I$2.031.786.000), followed by HPV vaccination alone (NPV I$1.860.783.000) and cervical screening alone (NPV I$375.244.000). Conclusion In addition to clinical benefits, investing in HPV vaccination and cervical screening may yield considerable fiscal benefits for the Indonesian governments due to lifelong benefits resulting from reduction of cervical cancer-related morbidity and mortality. PMID:27490258

  10. Economic consequences of improved temperature forecasts: An experiment with the Florida citrus growers (control group results). [weather forecasting

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A demonstration experiment is being planned to show that frost and freeze prediction improvements are possible utilizing timely Synchronous Meteorological Satellite temperature measurements and that this information can affect Florida citrus grower operations and decisions. An economic experiment was carried out which will monitor citrus growers' decisions, actions, costs and losses, and meteorological forecasts and actual weather events and will establish the economic benefits of improved temperature forecasts. A summary is given of the economic experiment, the results obtained to date, and the work which still remains to be done. Specifically, the experiment design is described in detail as are the developed data collection methodology and procedures, sampling plan, data reduction techniques, cost and loss models, establishment of frost severity measures, data obtained from citrus growers, National Weather Service, and Federal Crop Insurance Corp., resulting protection costs and crop losses for the control group sample, extrapolation of results of control group to the Florida citrus industry and the method for normalization of these results to a normal or average frost season so that results may be compared with anticipated similar results from test group measurements.

  11. Economic consequences of improved temperature forecasts: An experiment with the Florida citrus growers (control group results). Executive summary. [weather forecasting

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A demonstration experiment is being planned to show that frost and freeze prediction improvements are possible utilizing timely Synchronous Meteorological Satellite temperature measurements and that this information can affect Florida citrus grower operations and decisions so as to significantly reduce the cost for frost and freeze protection and crop losses. The design and implementation of the first phase of an economic experiment which will monitor citrus growers decisions, actions, costs and losses, and meteorological forecasts and actual weather events was carried out. The economic experiment was designed to measure the change in annual protection costs and crop losses which are the direct result of improved temperature forecasts. To estimate the benefits that may result from improved temperature forecasting capability, control and test groups were established with effective separation being accomplished temporally. The control group, utilizing current forecasting capability, was observed during the 1976-77 frost season and the results are reported. A brief overview is given of the economic experiment, the results obtained to date, and the work which still remains to be done.

  12. Economics.

    ERIC Educational Resources Information Center

    Online-Offline, 1998

    1998-01-01

    This issue focuses on the theme of economics, and presents educational resources for teaching basics to children. Web sites, CD-ROMs and software, videos, books, and additional resources, as well as activities which focus on economics are described. Includes short features on related topics, and the subtopics of trade, money and banking, and…

  13. Economics.

    PubMed

    Palley, Paul D; Parcero, Miriam E

    2016-10-01

    A review of literature in the calendar year 2015 dedicated to environmental policies and sustainable development, and economic policies. This review is divided into these sections: sustainable development, irrigation, ecosystems and water management, climate change and disaster risk management, economic growth, water supply policies, water consumption, water price regulation, and water price valuation.

  14. Economics.

    PubMed

    Palley, Paul D; Parcero, Miriam E

    2016-10-01

    A review of literature in the calendar year 2015 dedicated to environmental policies and sustainable development, and economic policies. This review is divided into these sections: sustainable development, irrigation, ecosystems and water management, climate change and disaster risk management, economic growth, water supply policies, water consumption, water price regulation, and water price valuation. PMID:27620113

  15. Some aspects of resource uncertainty and their economic consequences in assessment of the 1002 area of the Arctic National Wildlife Refuge

    USGS Publications Warehouse

    Attanasi, E.D.; Schuenemeyer, J.H.

    2002-01-01

    Exploration ventures in frontier areas have high risks. Before committing to them, firms prepare regional resource assessments to evaluate the potential payoffs. With no historical basis for directly estimating size distribution of undiscovered accumulations, reservoir attribute probability distributions can be assessed subjectively and used to project undiscovered accumulation sizes. Three questions considered here are: (1) what distributions should be used to characterize the subjective assessments of reservoir attributes, (2) how parsimonious can the analyst be when eliciting subjective information from the assessment geologist, and (3) what are consequences of ignoring dependencies among reservoir attributes? The standard or norm used for comparing outcomes is the computed cost function describing costs of finding, developing, and producing undiscovered oil accumulations. These questions are examined in the context of the US Geological Survey's recently published regional assessment of the 1002 Area of the Arctic National Wildlife Refuge, Alaska. We study effects of using the various common distributions to characterize the geologist's subjective distributions representing reservoir attributes. Specific findings show that triangular distributions result in substantial bias in economic forecasts when used to characterize skewed distributions. Moreover, some forms of the lognormal distribution also result in biased economic inferences. Alternatively, we generally determined four fractiles (100, 50, 5, 0) to be sufficient to capture essential economic characteristics of the underlying attribute distributions. Ignoring actual dependencies among reservoir attributes biases the economic evaluation. ?? 2002 International Association for Mathematical Geology.

  16. Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture

    PubMed Central

    Waterhouse, Benjamin; Wratten, Steve

    2016-01-01

    Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295–728 million annually. PMID:27441108

  17. Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture.

    PubMed

    Sandhu, Harpinder; Waterhouse, Benjamin; Boyer, Stephane; Wratten, Steve

    2016-01-01

    Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295-728 million annually.

  18. Scarcity of ecosystem services: an experimental manipulation of declining pollination rates and its economic consequences for agriculture.

    PubMed

    Sandhu, Harpinder; Waterhouse, Benjamin; Boyer, Stephane; Wratten, Steve

    2016-01-01

    Ecosystem services (ES) such as pollination are vital for the continuous supply of food to a growing human population, but the decline in populations of insect pollinators worldwide poses a threat to food and nutritional security. Using a pollinator (honeybee) exclusion approach, we evaluated the impact of pollinator scarcity on production in four brassica fields, two producing hybrid seeds and two producing open-pollinated ones. There was a clear reduction in seed yield as pollination rates declined. Open-pollinated crops produced significantly higher yields than did the hybrid ones at all pollination rates. The hybrid crops required at least 0.50 of background pollination rates to achieve maximum yield, whereas in open-pollinated crops, 0.25 pollination rates were necessary for maximum yield. The total estimated economic value of pollination services provided by honeybees to the agricultural industry in New Zealand is NZD $1.96 billion annually. This study indicates that loss of pollination services can result in significant declines in production and have serious implications for the market economy in New Zealand. Depending on the extent of honeybee population decline, and assuming that results in declining pollination services, the estimated economic loss to New Zealand agriculture could be in the range of NZD $295-728 million annually. PMID:27441108

  19. Economic consequences of improved temperature forecasts: An experiment with the Florida citrus growers (an update of control group results)

    NASA Technical Reports Server (NTRS)

    Braen, C.

    1978-01-01

    The economic experiment, the results obtained to date and the work which still remains to be done are summarized. Specifically, the experiment design is described in detail as are the developed data collection methodology and procedures, sampling plan, data reduction techniques, cost and loss models, establishment of frost severity measures, data obtained from citrus growers, National Weather Service and Federal Crop Insurance Corp. Resulting protection costs and crop losses for the control group sample, extrapolation of results of control group to the Florida citrus industry and the method for normalization of these results to a normal or average frost season so that results may be compared with anticipated similar results from test group measurements are discussed.

  20. The mental health consequences of the economic crisis in Europe among the employed, the unemployed, and the non-employed.

    PubMed

    Buffel, Veerle; Van de Velde, Sarah; Bracke, Piet

    2015-11-01

    Applying a multi-level framework to the data from the European Social Survey's Round 3 (2006) and Round 6 (2012), we assessed the crisis by increases in rates of unemployment, while also controlling for countries' pre-crisis economic conditions. We found a positive relationship between depression and an increase in national unemployment rates. This relationship can be only partly ascribed to an increase in the number of unemployed and those employed in nonstandard job conditions-with the exception of the self-employed and women working part-time. The crisis effect is more pronounced among men and those between 35 and 49years of age. Moreover, in strongly effected countries, the crisis has changed the relationship between part-time work and depression, between depression and certain subcategories of the unemployed (looking for a job or not looking), and between depression and the non-employed.

  1. Economics.

    ERIC Educational Resources Information Center

    James, L. D.

    1978-01-01

    Presents a literature review of the economic aspects of water pollution control covering publications of 1976-77. This review also includes the policy issues of water management. A list of 77 references is presented. (HM)

  2. [Social and economic consequences of night-time aircraft noise in the vicinity of Frankfurt/Main airport].

    PubMed

    Greiser, E; Glaeske, G

    2013-03-01

    A prospective calculation of disease-related social and economic costs due to night-time aircraft noise in the vicinity of Frankfurt/Main airport was performed for the calendar years 2012-2021. It was based on risk estimates for a variety of diagnostic entities (cardiovascular disease, depression, psychosis, diabetes mellitus, dementia and Alzheimer's disease, all cancers except malignancies of the respiratory system) from a previous case-control study on more than 1 million persons enrolled in compulsory sickness funds in the vicinity of the Cologne-Bonn airport, on disease-related cost estimates performed by the German Federal Statistical Office for the calender years 2002-2008, and calculations of the population exposed to night-time aircraft noise in the vicinity of Frankfurt/Main airport (2005 aircraft routes and flight frequencies). Total estimated costs came to more than 1.5 billion € with an excess of 23 400 cases of diseases treated in hospitals and of 3 400 subsequent deaths. PMID:23456959

  3. [Social and economic consequences of night-time aircraft noise in the vicinity of Frankfurt/Main airport].

    PubMed

    Greiser, E; Glaeske, G

    2013-03-01

    A prospective calculation of disease-related social and economic costs due to night-time aircraft noise in the vicinity of Frankfurt/Main airport was performed for the calendar years 2012-2021. It was based on risk estimates for a variety of diagnostic entities (cardiovascular disease, depression, psychosis, diabetes mellitus, dementia and Alzheimer's disease, all cancers except malignancies of the respiratory system) from a previous case-control study on more than 1 million persons enrolled in compulsory sickness funds in the vicinity of the Cologne-Bonn airport, on disease-related cost estimates performed by the German Federal Statistical Office for the calender years 2002-2008, and calculations of the population exposed to night-time aircraft noise in the vicinity of Frankfurt/Main airport (2005 aircraft routes and flight frequencies). Total estimated costs came to more than 1.5 billion € with an excess of 23 400 cases of diseases treated in hospitals and of 3 400 subsequent deaths.

  4. Estimating regional long-term economic consequences of natural hazards - a case study of the 2005 flood event in Tyrol (Austria)

    NASA Astrophysics Data System (ADS)

    Pfurtscheller, C.; Lochner, B.; Brucker, A.

    2012-04-01

    businesses as main beneficiaries and about 40% mentioned infrastructural improvements, as in streets or protective measures, as the most positive effect. We present an empirical approach to assess the economic consequences of fatal events and provide rules of thumb to quickly estimate indirect economic losses from natural disasters, at least for the Alpine Space, at the local and regional level. The methods and results of this study can help to improve ex-post loss estimations, and with it, ex-ante methods for the cost efficiency of risk reduction measures, e.g. cost-benefit-analysis.

  5. Consequences of strip mine reclamation: vegetation and economics of reclaimed and unreclaimed sites in west-central Pennsylvania

    SciTech Connect

    Hedin, R.S.

    1987-01-01

    A survey was conducted of the vegetation on 36 strip mines which varied in reclamation effort and age. Vegetation on sites that had not been resoiled was most influenced by site age and historic liming and fertilization efforts. Six sites, all older than 30-years-old, were closed canopy woodlots dominated by either planted Pinus or volunteer Populus. Three sites 15-23 years old that had undergone repeated liming and fertilization efforts before abandonment were also dominated by planted Pinus or volunteer Populus and had stem densities quite similar to woodlot sites. All other sites less than 30 years old had open canopies and ground cover dominated by Cladonia, Polytrichum, Andropogon virginicus, Danthonia spicata, and bare soil. These sites had low tree stem densities and growth, and were not rapidly developing into woodlots. Barren spoils were significantly associated with low pH values, and results suggest that soil chemistry is currently dominated by aluminum buffering, not pyrite oxidation. Historical information was used to reconstruct the history of mining and reclamation in a watershed within the study area. An economic analysis of the costs and benefits of minimal and total reclamation was performed. Reclamation costs, fishery benefits, land productivity benefits, and state financed reclamation expenditures were included. The results were quite sensitive to assumptions about the value of a fisherman-day, the analytical period, and the discount rate. When a fisherman-day was valued at $35, the analysis included 1945-1983, and a 4% discount rate was used, benefits of total reclamation exceeded costs by 6%.

  6. The Importance of Considering the Temporal Distribution of Climate Variables for Ecological-Economic Modeling to Calculate the Consequences of Climate Change for Agriculture

    NASA Astrophysics Data System (ADS)

    Plegnière, Sabrina; Casper, Markus; Hecker, Benjamin; Müller-Fürstenberger, Georg

    2014-05-01

    The basis of many models to calculate and assess climate change and its consequences are annual means of temperature and precipitation. This method leads to many uncertainties especially at the regional or local level: the results are not realistic or too coarse. Particularly in agriculture, single events and the distribution of precipitation and temperature during the growing season have enormous influences on plant growth. Therefore, the temporal distribution of climate variables should not be ignored. To reach this goal, a high-resolution ecological-economic model was developed which combines a complex plant growth model (STICS) and an economic model. In this context, input data of the plant growth model are daily climate values for a specific climate station calculated by the statistical climate model (WETTREG). The economic model is deduced from the results of the plant growth model STICS. The chosen plant is corn because corn is often cultivated and used in many different ways. First of all, a sensitivity analysis showed that the plant growth model STICS is suitable to calculate the influences of different cultivation methods and climate on plant growth or yield as well as on soil fertility, e.g. by nitrate leaching, in a realistic way. Additional simulations helped to assess a production function that is the key element of the economic model. Thereby the problems when using mean values of temperature and precipitation in order to compute a production function by linear regression are pointed out. Several examples show why a linear regression to assess a production function based on mean climate values or smoothed natural distribution leads to imperfect results and why it is not possible to deduce a unique climate factor in the production function. One solution for this problem is the additional consideration of stress indices that show the impairment of plants by water or nitrate shortage. Thus, the resulting model takes into account not only the ecological

  7. Human modification of a large meandering Amazonian river: genesis, ecological and economic consequences of the Masisea cutoff on the central Ucayali, Peru.

    PubMed

    Coomes, Oliver T; Abizaid, Christian; Lapointe, Michel

    2009-05-01

    Evidence is mounting regarding the significant extent and scope of long-term human modification of "pristine nature" in the neotropics. In Amazonia, recent studies point to the landscape imprint of human activity that has transformed the forests, savannas, soils, and waterways of the basin. In this report, we describe a massive meander cutoff in the Peruvian Amazon along the Ucayali River--the fifth-longest river in the Amazon basin--that was triggered by small-scale human actions and resulted in significant ecological and economic consequences for the region. The modern case of the Masisea cutoff-near the Amazonian port city of Pucallpa, Peru (285,000 inhabitants)-indicates that humans using simple tools can play a major role in transforming large meandering rivers and their floodplains.

  8. Health economic consequences of reducing salt intake and replacing saturated fat with polyunsaturated fat in the adult Finnish population: estimates based on the FINRISK and FINDIET studies

    PubMed Central

    Martikainen, J A; Soini, E J O; Laaksonen, D E; Niskanen, L

    2011-01-01

    Background/Objectives: To predict the health economic consequences of modest reductions in the daily intake of salt (−1.0 g per day) and replacement of saturated fat (SFA, −1.0 energy percent (E%)) with polyunsaturated fat (PUFA, +1.0 E%) in the Finnish population aged 30–74 years. Subjects/Methods: A Markov model with dynamic population structure was constructed to present the natural history of cardiovascular diseases (CVDs) based on the most current information about the age- and sex-specific cardiovascular risk factors, dietary habits and nutrient intake. To predict the undiscounted future health economic consequences of the reduction of dietary salt and SFA, the model results were extrapolated for the years 2010–2030 by replacing the baseline population in the year 2007 with the extrapolated populations from the official Finnish statistics. Finnish costs (€2009, societal perspective) and EQ-5D utilities were obtained from published references. Results: During the next 20 years, a population-wide intervention directed at salt intake and dietary fat quality could potentially lead to 8000–13 000 prevented CVD cases among the Finnish adults compared the situation in year 2007. In addition, the reduced incidence of CVDs could gain 26 000–45 000 quality-adjusted life years and save €150–225 million over the same time period. Conclusion: A modest reduction of salt and replacement of SFA with PUFA in food products can significantly reduce the burden of CVD in the adult Finnish population. This impact may be even larger in the near future due to the ageing of Finnish population. PMID:21587284

  9. Stillbirths: economic and psychosocial consequences.

    PubMed

    Heazell, Alexander E P; Siassakos, Dimitrios; Blencowe, Hannah; Burden, Christy; Bhutta, Zulfiqar A; Cacciatore, Joanne; Dang, Nghia; Das, Jai; Flenady, Vicki; Gold, Katherine J; Mensah, Olivia K; Millum, Joseph; Nuzum, Daniel; O'Donoghue, Keelin; Redshaw, Maggie; Rizvi, Arjumand; Roberts, Tracy; Toyin Saraki, H E; Storey, Claire; Wojcieszek, Aleena M; Downe, Soo

    2016-02-01

    Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity. PMID:26794073

  10. Stillbirths: economic and psychosocial consequences.

    PubMed

    Heazell, Alexander E P; Siassakos, Dimitrios; Blencowe, Hannah; Burden, Christy; Bhutta, Zulfiqar A; Cacciatore, Joanne; Dang, Nghia; Das, Jai; Flenady, Vicki; Gold, Katherine J; Mensah, Olivia K; Millum, Joseph; Nuzum, Daniel; O'Donoghue, Keelin; Redshaw, Maggie; Rizvi, Arjumand; Roberts, Tracy; Toyin Saraki, H E; Storey, Claire; Wojcieszek, Aleena M; Downe, Soo

    2016-02-01

    Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.

  11. Do Childhood Adversities Predict Suicidality? Findings from the General Population of the Metropolitan Area of São Paulo, Brazil

    PubMed Central

    Andrade, Laura Helena; Borges, Guilherme; Santana, Geilson Lima; Viana, Maria Carmen; Wang, Yuan-Pang

    2016-01-01

    Background Childhood adversities have been associated with a number of medical and psychiatric outcomes. However, the reported effects that specific childhood adversities have on suicidality vary across studies. Method This was a cross-sectional, stratified, multistage area probability investigation of a general population in Brazil, designated the São Paulo Megacity Mental Health Survey. The World Mental Health Composite International Diagnostic Interview was applied in 5037 individuals ≥ 18 years of age, in order to assess 12 different adversities occurring during childhood and/or adolescence, as well as to look for associations between those adversities and subsequent suicidality in different age strata. Results Over half of the respondents reported at least one childhood adversity. Only physical abuse was consistently associated with suicide attempts in all subsequent life stages (OR = 2.1). Among adults 20–29 years of age, the likelihood of a suicide attempt was correlated with parental divorce, whereas suicidal ideation was associated with prior sexual abuse. Among adults over 30 years of age, physical illness and economic adversity emerged as relevant childhood adversities associated with suicide attempts, whereas sexual abuse, family violence, and economic adversity were associated with suicidal ideation. Conclusion Childhood adversities, especially physical abuse, are likely associated with unfavorable consequences in subsequent years. For suicidality across a lifespan, the role of different childhood adversities must be examined independently. PMID:27192171

  12. United Nations/World Health Organization Meeting on Socio-Economic Determinants and Consequences of Mortality, Mexico City, 19-25 June 1979.

    PubMed

    1980-01-01

    The objectives of the United Nations/World Health Organization (WHO) Meeting on Socioeconomic Determinants and Consequences of Mortality, held in Mexico City in June 1979, were the following: to review the knowledge of differential mortality and to identify gaps in the understanding of its socioeconomic determinants and consequences; to discuss the methodological and technical problems associated with data collection and analysis; to consider the policy implications of the findings presented and to promote studies on the implications of socioeconomic differentials in mortality on social policy and international development strategies; to formulate recommendations and guidelines for the utilization of the 1980 round of population censuses for in-depth studies of mortality differentials; and to stimulate national and international research on differential mortality. Participants discussed the state of knowledge of socioeconomic differentials and determinants of mortality and described the socioeconomic measures available, the methods of data collection and analysis used, and the findings themselves. A number of characteristics had been employed in the study of differential mortality, and these could be grouped under the following headings: occupation; education; housing; income, wealth; family size; and place of residence. The techniques or methods used to analyze mortality were direct and indirect methods, and these are examined. Inequalities in mortality were found to be closely associated with inequalities in social and economic conditions. Any effort to reduce or remove those inequalities would have to be based on a clear understanding of their causes and interrelationships in order to succeed. Participants indicated a desire to see a resurgence of mortality research, and some research suggestions are outlined.

  13. Estimating the comparative clinical and economic consequences of tulathromycin for treatment of present or anticipated outbreaks of bovine respiratory disease in feedlot cattle in the United States.

    PubMed

    Nautrup, B Poulsen; Van Vlaenderen, I; Gasper, S M; Holland, R E

    2013-12-01

    The goal of this study was to determine the clinical and economic impact of using tulathromycin as first line treatment for bovine respiratory disease (BRD) compared with other commonly used antimicrobials. Two decision trees were developed simulating the consequences of treating cattle at high risk of developing BRD [control model (CM)] or cattle with first clinical BRD episode [treatment model (TM)]. As comparators florfenicol and tilmicosin were considered in both models whereas enrofloxacin was included in the TM because it was only labeled for treatment of BRD at the time of development of the calculators. A total of 5 (CM) and 10 (TM) comparative clinical studies that reported efficacy data for the selected drugs and indications were identified as suitable for model population. The following outcomes were considered: first treatment success, number of subsequent BRD treatments, chronics, and mortalities. Cost parameters were considered from the perspective of the producer and included treatment costs (first treatment and retreatments) and costs of chronics and deaths derived from published sources for 2010 (default). The models allowed the estimation of clinical and economic consequences according to each individual trial outcomes. Treatment with tulathromycin resulted in more first treatment successes and fewer removals (chronics and deaths) in all comparisons. The average total number of antimicrobial treatments required for the management of BRD was also least with tulathromycin as first treatment option. Because of better efficacy, total costs over the entire study periods were always lowest with tulathromycin. Depending on the study selected as the basis for the efficacy evaluation, cost savings with tulathromycin were calculated in the CM between US$21.00 and $47.86 (vs. florfenicol) and $11.37 and $72.64 (vs. tilmicosin); cost savings in the TM ranged between $28.47 and $143.87 (vs. florfenicol) and $7.75 and $84.91 (vs. tilmicosin) as well as between

  14. Class differences in the social consequences of illness?

    PubMed Central

    Lindholm, C; Burstrom, B; Diderichsen, F

    2002-01-01

    Study objective: To investigate adverse social consequences of limiting longstanding illness and the modifying effect of socioeconomic position on these consequences. Design: Cohort study on the panel within the annual Swedish Survey of Living Conditions where participants were interviewed twice with eight years interval 1979–89 and 1986–97. Sociodemographic characteristics, self reported longstanding illness, employment situation and financial conditions were measured at baseline. Social consequences (economic inactivity, unemployment, financial difficulties) of limiting longstanding illness were measured at follow up eight years later. Setting: National sample for Sweden during a period that partly was characterised by high unemployment and reduction in insurance benefits. Participants: Participants were 13 855 men and women, economically active, not unemployed, without financial difficulties at the first interview and aged 25–64 years at the follow up. Main results: Persons with limiting longstanding illness had a higher risk of adverse social consequences than persons without illness. The effect was modified by socioeconomic position only for labour market exclusion while the effects on unemployment and financial difficulties were equal across socioeconomic groups. Conclusions: Labour market policies as well as income maintenance policies that deal with social and economical consequences of longstanding illness are important elements of programmes to tackle inequalities in health. Rehabilitation within health care has a similar important part to play in this. PMID:11854339

  15. Causes and consequences of the sinkhole at El Trébol of Quito, Ecuador - implications for economic damage and risk assessment

    NASA Astrophysics Data System (ADS)

    Toulkeridis, Theofilos; Rodríguez, Fabián; Arias Jiménez, Nelson; Simón Baile, Débora; Salazar Martínez, Rodolfo; Addison, Aaron; Carreón Freyre, Dora; Mato, Fernando; Díaz Perez, Carmen

    2016-09-01

    The so-called El Trébol is a critical road interchange in Quito connecting the north and south regions of the city. In addition, it connects Quito with the highly populated Los Chillos Valley, one of the most traveled zones in the Ecuadorian capital. El Trébol was constructed in the late 1960s in order to resolve the traffic jams of the capital city and for that purpose the Machángara River was rerouted through an underground concrete box tunnel. In March 2008, the tunnel contained a high amount of discarded furniture that had been impacting the top portion of the tunnel, compromising the structural integrity. On 31 March 2008 after a heavy rainfall a sinkhole of great proportions formed in the Trébol traffic hub. In the first few minutes, the sinkhole reached an initial diameter of 30 m. The collapse continued to grow in the following days until the final dimensions of 120 m in diameter and some 40 m of depth, revealing the Machángara River at the base of the sinkhole.A state of emergency was declared. The cause of the sinkhole was a result of the lack of monitoring of the older subterranean infrastructure where trash had accumulated and damaged the concrete tunnel that channelized the Machángara River until it was worn away for a length of some 20 m, leaving behind the sinkhole and the fear of recurrence in populated areas.With the intent to understand the causes and consequences of this sinkhole event, rainfall data are shown together with hydrogeological characteristics and a view back to the recent history of sinkhole lineation or arrangement of the city of Quito. The economic impact is also emphasized, where the direct costs of the damage and the reconstruction are presented and compared to indirect costs associated with this socio-natural disaster. These analyses suggest that the costs of indirect financial damage, like time loss or delay, and subsequent higher expenses for different types of vehicles, are equivalent to many times the costs of the

  16. Vaccine Adverse Events

    MedlinePlus

    ... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Vaccines, Blood & Biologics Home Vaccines, Blood & Biologics Safety & Availability ( ... Center for Biologics Evaluation & Research Vaccine Adverse Events Vaccine Adverse Events Share Tweet Linkedin Pin it More ...

  17. The role of models in estimating consequences as part of the risk assessment process.

    PubMed

    Forde-Folle, K; Mitchell, D; Zepeda, C

    2011-08-01

    The degree of disease risk represented by the introduction, spread, or establishment of one or several diseases through the importation of animals and animal products is assessed by importing countries through an analysis of risk. The components of a risk analysis include hazard identification, risk assessment, risk management, and risk communication. A risk assessment starts with identification of the hazard(s) and then continues with four interrelated steps: release assessment, exposure assessment, consequence assessment, and risk estimation. Risk assessments may be either qualitative or quantitative. This paper describes how, through the integration of epidemiological and economic models, the potential adverse biological and economic consequences of exposure can be quantified.

  18. Environmental and economic development consequences of forest and agricultural sector policies in Latin America (a synthesis of case studies of Costa Rica, Ecuador, and Bolivia)

    SciTech Connect

    Stewart, R.; Gibson, D.

    1994-04-15

    This paper draws heavily on the results of case studies in Bolivia, Costa Rica, and Ecuador to explain how sectoral policies have tilted land use decisions against forestry and in favor of agriculture, and to present estimates of the economic development effects of those decisions. The paper summarizes information on forests and forest industries of the three countries, and it describes the framework within which policies are designed. It presents the effects of sectoral policies on land use and forest management, and then quantifies and discusses economic costs of relevant sectoral policies. Conclusions and recommendations for policy reform are offered.

  19. The Mental Health Consequences of the Recession: Economic Hardship and Employment of People with Mental Health Problems in 27 European Countries

    PubMed Central

    Evans-Lacko, Sara; Knapp, Martin; McCrone, Paul

    2013-01-01

    Objectives A period of economic recession may be particularly difficult for people with mental health problems as they may be at higher risk of losing their jobs, and more competitive labour markets can also make it more difficult to find a new job. This study assesses unemployment rates among individuals with mental health problems before and during the current economic recession. Methods Using individual and aggregate level data collected from 27 EU countries in the Eurobarometer surveys of 2006 and 2010, we examined changes in unemployment rates over this period among individuals with and without mental health problems. Results Following the onset of the recession, the gap in unemployment rates between individuals with and without mental health problems significantly widened (odds ratio: 1.12, 95% confidence interval: 1.03, 1.34). This disparity became even greater for males, and individuals with low levels of education. Individuals with mental health problems living in countries with higher levels of stigmatizing attitudes regarding dangerousness of people with mental illness were more vulnerable to unemployment in 2010, but not 2006. Greater agreement that people with mental health problems have themselves to blame, was associated with lower likelihood of unemployment for individuals with and without mental health problems. Conclusion These findings study suggest that times of economic hardship may intensify social exclusion of people with mental health problems, especially males and individuals with lower education. Interventions to combat economic exclusion and to promote social participation of individuals with mental health problems are even more important during times of economic crisis, and these efforts should target support to the most vulnerable groups. PMID:23922801

  20. Influence of the CYP2D6 Isoenzyme in Patients Treated with Venlafaxine for Major Depressive Disorder: Clinical and Economic Consequences

    PubMed Central

    Sicras-Mainar, Antoni; Guijarro, Pablo; Armada, Beatriz; Blanca-Tamayo, Milagrosa; Navarro-Artieda, Ruth

    2014-01-01

    Background Antidepressant drugs are the mainstay of drug therapy for sustained remission of symptoms. However, the clinical results are not encouraging. This lack of response could be due, among other causes, to factors that alter the metabolism of the antidepressant drug. Objective: to evaluate the impact of concomitant administration of CYP2D6 inhibitors or substrates on the efficacy, tolerability and costs of patients treated with venlafaxine for major depressive disorder in clinical practice. Methods We designed an observational study using the medical records of outpatients. Subjects aged ≥18 years who started taking venlafaxine during 2008–2010 were included. Three study groups were considered: no combinations (reference), venlafaxine-substrate, and venlafaxine-inhibitor. The follow-up period was 12 months. The main variables were: demographic data, comorbidity, remission (Hamilton <7), response to treatment, adverse events and costs. The statistical analysis included logistic regression models and ANCOVA, with p values <0.05 considered significant. Results A total of 1,115 subjects were recruited. The mean age was 61.7 years and 75.1% were female. Approximately 33.3% (95% CI: 30.5 to 36.1) were receiving some kind of drug combination (venlafaxine-substrate: 23.0%, and venlafaxine-inhibitor: 10.3%). Compared with the venlafaxine-substrate and venlafaxine-inhibitor groups, patients not taking concomitant drugs had a better response to therapy (49.1% vs. 39.9% and 34.3%, p<0.01), greater remission of symptoms (59.9% vs. 50.2% and 43.8%, p<0.001), fewer adverse events (1.9% vs. 7.0% and 6.1%, p<0.05) and a lower mean adjusted cost (€2,881.7 vs. €4,963.3 and €7,389.1, p<0.001), respectively. All cost components showed these differences. Conclusions The patients treated with venlafaxine alone showed a better response to anti-depressant treatment, greater remission of symptoms, a lower incidence of adverse events and lower healthcare costs. PMID:25369508

  1. Human-Computer Interactions: Are There Adverse Health Consequences?

    ERIC Educational Resources Information Center

    Emurian, Henry H.

    1989-01-01

    Discusses the hypothesis that similarities may exist between laboratory research paradigms evoking elevated blood pressure during task performance by normal subjects and video display terminal (VDT) work done by data clerks and college students. Type A behavior and the development of coronary heart disease are discussed, and further research needs…

  2. Clinical consequences of nonnarcotic analgesic use.

    PubMed

    Matzke, G R

    1997-02-01

    patients from an NSAID to acetaminophen would result in significantly decreased costs and morbidity. These authors, however, did not address one key issue that impacts their economic analysis: the relative efficacy of acetaminophen and NSAIDs. If efficacy is similar, then the risk/benefit ratio and economic consequences would favor the use of acetaminophen. However, if many patients are receiving NSAIDs because they did not obtain pain relief with the use of acetaminophen, there would be neither rationale or likely benefit with a change in therapy to acetaminophen. Finally, McGoldrick and Bailie did not evaluate an issue that has perhaps the most far-reaching consequence. Many OTC analgesics are currently marketed as combinations of aspirin, acetaminophen, salicylamide, or caffeine (Table 2). Although the intent of these combinations was [Table: see text] to enhance efficacy while minimizing adverse events, it is now apparent that at least concerning adverse events, the goal was not achieved. Therefore, in light of the markedly higher risk for renal injury with combination analgesics, these agents should be withdrawn from the marketplace. While some might argue that patient education is the key and that addition of an explicit warning on the label of OTC combination products should be an adequate intervention, this agreement is not supported by the Belgium experience. The removal of combination analgesics from the OTC marketplace could be accomplished by governmental action, such as the ban on phenacetin over 10 years ago. Alternatively, pharmacists could no longer sell these products and counsel patients on the rational use of OTC analgesics. The choice among single-entity agents could then be individualized on the basis of patient's current medical status and the adverse event profile of the available agents.

  3. Collateral Adverse Outcomes After Lumbar Spine Surgery.

    PubMed

    Daniels, Alan H; Gundle, Kenneth; Hart, Robert A

    2016-01-01

    Collateral adverse outcomes are the expected or unavoidable results of a procedure that is performed in a standard manner and typically experienced by the patient. Collateral adverse outcomes do not result from errors, nor are they rare. Collateral adverse outcomes occur as the direct result of a surgical procedure and must be accepted as a trade-off to attain the intended benefits of the surgical procedure. As such, collateral adverse outcomes do not fit into the traditional definition of a complication or adverse event. Examples of collateral adverse outcomes after lumbar spine arthrodesis include lumbar stiffness, postoperative psychological stress, postoperative pain, peri-incisional numbness, paraspinal muscle denervation, and adjacent-level degeneration. Ideally, a comparison of interventions for the treatment of a clinical condition should include information on both the negative consequences (expected and unexpected) and potential benefits of the treatment options. The objective evaluation and reporting of collateral adverse outcomes will provide surgeons with a more complete picture of invasive interventions and, thus, the improved ability to assess alternative treatment options. PMID:27049197

  4. Economic Costs of Alcohol and Drug Abuse in Texas: 1997 Update.

    ERIC Educational Resources Information Center

    Liu, Liang Y.

    This report provides an update of the costs of alcohol and drug abuse for 1997. The 1997 costs were estimated by multiplying the percent changes in various socioeconomic factors from 1989 to 1997 by the cost estimates. The adverse health and social consequences of substance abuse extensively increased costs to the state. The total economic costs…

  5. New thoughts on the "forgotten" aspect of antimicrobial stewardship: adverse event reporting.

    PubMed

    Hoffmann, Charles; Khadem, Tina; Schweighardt, Anne; Brown, Jack

    2015-01-01

    Antimicrobial stewardship is an activity that optimizes patient care through selection of the most appropriate antimicrobial therapy. Antimicrobial stewardship programs strive to enhance patient care and reduce preventable consequences of antimicrobial use. They are also vital in monitoring for the development of adverse events occurring as a result of antimicrobial therapy, although literature reviews of this activity are scarce. Although randomized controlled trials are considered the gold standard to study the efficacy of a medication, these trials are not designed to test safety end points and often are only able to identify the most commonly occurring and acute adverse events. In addition, prior to a drug going to market, it is difficult to detect rare adverse events because the associated costs are economically untenable given the limited pipeline of novel agents. These limitations in some ways may be resolved with the use of postmarketing surveillance and spontaneous reporting systems such as the United States Food and Drug Administration Adverse Event Reporting System. The focus of this commentary is to highlight the importance of adverse event reporting by antimicrobial stewardship programs to spontaneous reporting systems as a means to improve patient care.

  6. Adverse reactions to cosmetics.

    PubMed

    Gendler, E

    1987-06-01

    Adverse reactions to cosmetics can be irritant or allergic and are most often caused by fragrances or preservatives. Preservatives include formaldehyde, formaldehyde releasers, and parabens. Other agents that cause allergy are paraphenylenediamine in hair dyes and toluene sulfonamide formaldehyde resin in nail polishes.

  7. Scientists Trace Adversity's Toll

    ERIC Educational Resources Information Center

    Sparks, Sarah D.

    2012-01-01

    The stress of a spelling bee or a challenging science project can enhance a student's focus and promote learning. But the stress of a dysfunctional or unstable home life can poison a child's cognitive ability for a lifetime, according to new research. Those studies show that stress forms the link between childhood adversity and poor academic…

  8. Patient stratification and identification of adverse event correlations in the space of 1190 drug related adverse events

    PubMed Central

    Roitmann, Eva; Eriksson, Robert; Brunak, Søren

    2014-01-01

    Purpose: New pharmacovigilance methods are needed as a consequence of the morbidity caused by drugs. We exploit fine-grained drug related adverse event information extracted by text mining from electronic medical records (EMRs) to stratify patients based on their adverse events and to determine adverse event co-occurrences. Methods: We analyzed the similarity of adverse event profiles of 2347 patients extracted from EMRs from a mental health center in Denmark. The patients were clustered based on their adverse event profiles and the similarities were presented as a network. The set of adverse events in each main patient cluster was evaluated. Co-occurrences of adverse events in patients (p-value < 0.01) were identified and presented as well. Results: We found that each cluster of patients typically had a most distinguishing adverse event. Examination of the co-occurrences of adverse events in patients led to the identification of potentially interesting adverse event correlations that may be further investigated as well as provide further patient stratification opportunities. Conclusions: We have demonstrated the feasibility of a novel approach in pharmacovigilance to stratify patients based on fine-grained adverse event profiles, which also makes it possible to identify adverse event correlations. Used on larger data sets, this data-driven method has the potential to reveal unknown patterns concerning adverse event occurrences. PMID:25249979

  9. Assessment of surgical adverse events in Rio de Janeiro hospitals.

    PubMed

    Moura, Maria de Lourdes de Oliveira; Mendes, Walter

    2012-09-01

    A study on surgical adverse events (AE) is relevant because of the frequency of these events, because they are in part attributable to deficiencies in health care, because of their considerable impact on patient health and economic consequences on social and health expenditures, and because this study is an assessment tool for quality of care. We aimed to evaluate the incidence and the contributive factors of surgical AE in hospitals of Rio de Janeiro. This retrospective cohort study aimed to perform a descriptive analysis of secondary data obtained from the Adverse Events Computer Program, which was developed for collecting data for the assessment of AE in three teaching hospitals in the state of Rio de Janeiro. Incidence of patients with surgical AE was 3.5% (38 of 1,103 patients) (95% CI 2.4 - 4.4) and the proportion of patients submitted to surgery among patients with surgical AE was 5.9% (38 of 643) (95% CI 4.1 - 7.6). The proportion of avoidable surgical AE was 68.3% (28 of 41 events) and the proportion of patients with avoidable surgical AE was 65.8% (25 of 38 patients). One in five patients with surgical AE had a permanent disability or died. Over 60% of the cases were classified as not complex or of low complexity, and with low risk for care-related AE. PMID:23090300

  10. Reducing Adverse Impact Via a Measure of Applicant Disadvantagedness.

    ERIC Educational Resources Information Center

    Mann, Walter G.

    Recent attempts to reduce the adverse impact of examinations have focused on alternatives to written tests. The present report, however, demonstrates how the adverse impact of written tests can be reduced by correcting for the degree to which a job applicant had been educationally and/or economically disadvantaged or deprived. A measure of…

  11. Adverse Selection in Health Insurance Markets: A Classroom Experiment

    ERIC Educational Resources Information Center

    Hodgson, Ashley

    2014-01-01

    Adverse selection as it relates to health care policy will be a key economic issue in many upcoming elections. In this article, the author lays out a 30-minute classroom experiment designed for students to experience the kind of elevated prices and market collapse that can result from adverse selection in health insurance markets. The students…

  12. Adverse reactions to cosmetics.

    PubMed

    Dogra, A; Minocha, Y C; Kaur, S

    2003-01-01

    Adverse reaction to cosmetics constitute a small but significant number of cases of contact dermatitis with varied appearances. These can present as contact allergic dermatitis, photodermatitis, contact irritant dermatitis, contact urticaria, hypopigmentation, hyperpigmentation or depigmentation, hair and nail breakage. Fifty patients were included for the study to assess the role of commonly used cosmetics in causing adverse reactions. It was found that hair dyes, lipsticks and surprisingly shaving creams caused more reaction as compared to other cosmetics. Overall incidence of contact allergic dermatitis seen was 3.3% with patients own cosmetics. Patch testing was also done with the basic ingredients and showed positive results in few cases where casual link could be established. It is recommended that labeling of the cosmetics should be done to help the dermatologists and the patients to identify the causative allergen in cosmetic preparation.

  13. The multisystem adverse effects of NSAID therapy.

    PubMed

    James, D S

    1999-11-01

    The clinical utility of nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation is limited by adverse side effects. Although effective analgesic and anti-inflammatory agents, NSAIDs are associated with side effects that are a consequence of nonspecific inhibition of both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). The primary adverse events associated with NSAID therapy are upper gastrointestinal (GI) ulceration, perforation, or bleeding, all of which involve mucosal damage of varying severity and can be asymptomatic and occur with little warning. Clinicians who prescribe NSAIDs should be able to identify patients who are at risk of an NSAID-induced GI adverse event and to detect and manage the event should one occur. The use of COX-2-specific inhibitors to manage pain and inflammation may minimize the risks of NSAID-associated toxicities.

  14. Enduring psychobiological effects of childhood adversity.

    PubMed

    Ehlert, Ulrike

    2013-09-01

    This mini-review refers to recent findings on psychobiological long-term consequences of childhood trauma and adverse living conditions. The continuum of trauma-provoked aftermath reaches from healthy adaptation with high resilience, to severe maladjustment with co-occurring psychiatric and physical pathologies in children, adolescents and adults. There is increasing evidence of a strong interconnectivity between genetic dispositions, epigenetic processes, stress-related hormonal systems and immune parameters in all forms of (mal)-adjustment to adverse living conditions. Unfavorable constellations of these dispositions and systems, such as low cortisol levels and elevated markers of inflammation in maltreated children, seem to promote the (co)-occurrence of psychiatric and physical pathologies such as posttraumatic stress disorder, obesity, or diabetes. Although findings from prospective study designs support a deepened understanding of causal relations between adverse living conditions, including traumatic experiences, during childhood and its psychobiological effects, so far, little is known about the temporal coincidence of stress-sensitive developmental stages during childhood and adolescence and trauma consequences. Taken together, childhood adversity is a severe risk factor for the onset of psychobiological (mal)-adjustment, which has to be explained under consideration of diverse physiological systems and developmental stages of childhood and adolescence.

  15. Enduring psychobiological effects of childhood adversity.

    PubMed

    Ehlert, Ulrike

    2013-09-01

    This mini-review refers to recent findings on psychobiological long-term consequences of childhood trauma and adverse living conditions. The continuum of trauma-provoked aftermath reaches from healthy adaptation with high resilience, to severe maladjustment with co-occurring psychiatric and physical pathologies in children, adolescents and adults. There is increasing evidence of a strong interconnectivity between genetic dispositions, epigenetic processes, stress-related hormonal systems and immune parameters in all forms of (mal)-adjustment to adverse living conditions. Unfavorable constellations of these dispositions and systems, such as low cortisol levels and elevated markers of inflammation in maltreated children, seem to promote the (co)-occurrence of psychiatric and physical pathologies such as posttraumatic stress disorder, obesity, or diabetes. Although findings from prospective study designs support a deepened understanding of causal relations between adverse living conditions, including traumatic experiences, during childhood and its psychobiological effects, so far, little is known about the temporal coincidence of stress-sensitive developmental stages during childhood and adolescence and trauma consequences. Taken together, childhood adversity is a severe risk factor for the onset of psychobiological (mal)-adjustment, which has to be explained under consideration of diverse physiological systems and developmental stages of childhood and adolescence. PMID:23850228

  16. [Economical costs and consequences of childhood obesity].

    PubMed

    Ortega-Cortés, Rosa

    2014-01-01

    There is some concern because the generations born in the last decades of the 20th century could have lower longevity than the previous ones as a result of the diseases caused by obesity. Mexico has the highest index of prevalence of childhood obesity, and it has increased very fast. It is fundamental to generate healthcare models focused on obese patients, and oriented to the prevention of complications. Implementing preventive actions since childhood must be the priority. Health education in childhood obesity will be the only realistic way to solve the problem.

  17. The economic consequences of ageing populations.

    PubMed Central

    Mirrlees, J A

    1997-01-01

    The effect of low birth rates and lengthening lives on the economy is discussed. Two extreme cases are examined: where pensions are entirely on a pay-as-you-go basis, and where they are entirely funded. It is argued that the economy would grow faster in the latter case. The impact on the levels of consumption of each age cohort during its lifetime is assessed. The possible magnitude of changes in consumption as a result of an increase in the retired part of the population is illustrated. It is shown that, comparing later cohorts to earlier cohorts, the former are better off under a funded system. An argument is then sketched showing that a pay-as-you-go system favours earlier cohorts too much; while most probably, but not certainly, a fully funded system favours the later cohorts excessively. It is claimed that a gradual introduction of partial funding, and some increase in the length of working lives, can deal with the effects of an ageing population without an excessive burden on any cohort or age-group. PMID:9460073

  18. The Complement System and Adverse Pregnancy Outcomes

    PubMed Central

    Regal, Jean F.; Gilbert, Jeffrey S.; Burwick, Richard M.

    2015-01-01

    Adverse pregnancy outcomes significantly contribute to morbidity and mortality for mother and child, with lifelong health consequences for both. The innate and adaptive immune system must be regulated to insure survival of the feta allograft, and the complement system is no exception. An intact complement system optimizes placental development and function and is essential to maintain host defense and fetal survival. Complement regulation is apparent at the placental interface from early pregnancy with some degree of complement activation occurring normally throughout gestation. However, a number of pregnancy complications including early pregnancy loss, fetal growth restriction, hypertensive disorders of pregnancy and preterm birth are associated with excessive or misdirected complement activation, and are more frequent in women with inherited or acquired complement system disorders or complement gene mutations. Clinical studies employing complement biomarkers in plasma and urine implicate dysregulated complement activation in components of each of the adverse pregnancy outcomes. In addition, mechanistic studies in rat and mouse models of adverse pregnancy outcomes address the complement pathways or activation products of importance and allow critical analysis of the pathophysiology. Targeted complement therapeutics are already in use to control adverse pregnancy outcomes in select situations. A clearer understanding of the role of the complement system in both normal pregnancy and complicated or failed pregnancy will allow a rational approach to future therapeutic strategies for manipulating complement with the goal of mitigating adverse pregnancy outcomes, preserving host defense, and improving long term outcomes for both mother and child. PMID:25802092

  19. The complement system and adverse pregnancy outcomes.

    PubMed

    Regal, Jean F; Gilbert, Jeffrey S; Burwick, Richard M

    2015-09-01

    Adverse pregnancy outcomes significantly contribute to morbidity and mortality for mother and child, with lifelong health consequences for both. The innate and adaptive immune system must be regulated to insure survival of the fetal allograft, and the complement system is no exception. An intact complement system optimizes placental development and function and is essential to maintain host defense and fetal survival. Complement regulation is apparent at the placental interface from early pregnancy with some degree of complement activation occurring normally throughout gestation. However, a number of pregnancy complications including early pregnancy loss, fetal growth restriction, hypertensive disorders of pregnancy and preterm birth are associated with excessive or misdirected complement activation, and are more frequent in women with inherited or acquired complement system disorders or complement gene mutations. Clinical studies employing complement biomarkers in plasma and urine implicate dysregulated complement activation in components of each of the adverse pregnancy outcomes. In addition, mechanistic studies in rat and mouse models of adverse pregnancy outcomes address the complement pathways or activation products of importance and allow critical analysis of the pathophysiology. Targeted complement therapeutics are already in use to control adverse pregnancy outcomes in select situations. A clearer understanding of the role of the complement system in both normal pregnancy and complicated or failed pregnancy will allow a rational approach to future therapeutic strategies for manipulating complement with the goal of mitigating adverse pregnancy outcomes, preserving host defense, and improving long term outcomes for both mother and child.

  20. Adverse effects of cannabis.

    PubMed

    2011-01-01

    Cannabis, Cannabis sativa L., is used to produce a resin that contains high levels of cannabinoids, particularly delta9-tetrahydrocannabinol (THC), which are psychoactive substances. Although cannabis use is illegal in France and in many other countries, it is widely used for its relaxing or euphoric effects, especially by adolescents and young adults. What are the adverse effects of cannabis on health? During consumption? And in the long term? Does cannabis predispose users to the development of psychotic disorders? To answer these questions, we reviewed the available evidence using the standard Prescrire methodology. The long-term adverse effects of cannabis are difficult to evaluate. Since and associated substances, with or without the user's knowledge. Tobacco and alcohol consumption, and particular lifestyles and behaviours are often associated with cannabis use. Some traits predispose individuals to the use of psychoactive substances in general. The effects of cannabis are dosedependent.The most frequently report-ed adverse effects are mental slowness, impaired reaction times, and sometimes accentuation of anxiety. Serious psychological disorders have been reported with high levels of intoxication. The relationship between poor school performance and early, regular, and frequent cannabis use seems to be a vicious circle, in which each sustains the other. Many studies have focused on the long-term effects of cannabis on memory, but their results have been inconclusive. There do not * About fifteen longitudinal cohort studies that examined the influence of cannabis on depressive thoughts or suicidal ideation have yielded conflicting results and are inconclusive. Several longitudinal cohort studies have shown a statistical association between psychotic illness and self-reported cannabis use. However, the results are difficult to interpret due to methodological problems, particularly the unknown reliability of self-reported data. It has not been possible to

  1. Adverse effects of cannabis.

    PubMed

    2011-01-01

    Cannabis, Cannabis sativa L., is used to produce a resin that contains high levels of cannabinoids, particularly delta9-tetrahydrocannabinol (THC), which are psychoactive substances. Although cannabis use is illegal in France and in many other countries, it is widely used for its relaxing or euphoric effects, especially by adolescents and young adults. What are the adverse effects of cannabis on health? During consumption? And in the long term? Does cannabis predispose users to the development of psychotic disorders? To answer these questions, we reviewed the available evidence using the standard Prescrire methodology. The long-term adverse effects of cannabis are difficult to evaluate. Since and associated substances, with or without the user's knowledge. Tobacco and alcohol consumption, and particular lifestyles and behaviours are often associated with cannabis use. Some traits predispose individuals to the use of psychoactive substances in general. The effects of cannabis are dosedependent.The most frequently report-ed adverse effects are mental slowness, impaired reaction times, and sometimes accentuation of anxiety. Serious psychological disorders have been reported with high levels of intoxication. The relationship between poor school performance and early, regular, and frequent cannabis use seems to be a vicious circle, in which each sustains the other. Many studies have focused on the long-term effects of cannabis on memory, but their results have been inconclusive. There do not * About fifteen longitudinal cohort studies that examined the influence of cannabis on depressive thoughts or suicidal ideation have yielded conflicting results and are inconclusive. Several longitudinal cohort studies have shown a statistical association between psychotic illness and self-reported cannabis use. However, the results are difficult to interpret due to methodological problems, particularly the unknown reliability of self-reported data. It has not been possible to

  2. Vaccine adverse events.

    PubMed

    Follows, Jill

    2012-01-01

    Millions of adults are vaccinated annually against the seasonal influenza virus. An undetermined number of individuals will develop adverse events to the influenza vaccination. Those who suffer substantiated vaccine injuries, disabilities, and aggravated conditions may file a timely, no-fault and no-cost petition for financial compensation under the National Vaccine Act in the Vaccine Court. The elements of a successful vaccine injury claim are described in the context of a claim showing the seasonal influenza vaccination was the cause of Guillain-Barré syndrome.

  3. [Adverse events prevention ability].

    PubMed

    Aparo, Ugo Luigi; Aparo, Andrea

    2007-03-01

    The issue of how to address medical errors is the key to improve the health care system performances. Operational evidence collected in the last five years shows that the solution is only partially linked to future technological developments. Cultural and organisational changes are mandatory to help to manage and drastically reduce the adverse events in health care organisations. Classical management, merely based on coordination and control, is inadequate. Proactive, self-organising network based structures must be put in place and managed using adaptive, fast evolving management tools. PMID:17484160

  4. [Adverse events prevention ability].

    PubMed

    Aparo, Ugo Luigi; Aparo, Andrea

    2007-03-01

    The issue of how to address medical errors is the key to improve the health care system performances. Operational evidence collected in the last five years shows that the solution is only partially linked to future technological developments. Cultural and organisational changes are mandatory to help to manage and drastically reduce the adverse events in health care organisations. Classical management, merely based on coordination and control, is inadequate. Proactive, self-organising network based structures must be put in place and managed using adaptive, fast evolving management tools.

  5. Screening for adverse events.

    PubMed

    Karson, A S; Bates, D W

    1999-02-01

    Adverse events (AEs) in medical patients are common, costly, and often preventable. Development of quality improvement programs to decrease the number and impact of AEs demands effective methods for screening for AEs on a routine basis. Here we describe the impact, types, and potential causes of AEs and review various techniques for identifying AEs. We evaluate the use of generic screening criteria in detail and describe a recent study of the sensitivity and specificity of individual generic screening criteria and combinations of these criteria. In general, the most sensitive screens were the least specific and no small sub-set of screens identified a large percentage of adverse events. Combinations of screens that were limited to administrative data were the least expensive, but none were particularly sensitive, although in practice they might be effective since routine screening is currently rarely done. As computer systems increase in sophistication sensitivity will improve. We also discuss recent studies that suggest that programs that screen for and identify AEs can be useful in reducing AE rates. While tools for identifying AEs have strengths and weaknesses, they can play an important role in organizations' quality improvement portfolios. PMID:10468381

  6. Reactive School Closure During Increased Influenza-Like Illness (ILI) Activity in Western Kentucky, 2013: A Field Evaluation of Effect on ILI Incidence and Economic and Social Consequences for Families

    PubMed Central

    Russell, Elizabeth S.; Zheteyeva, Yenlik; Gao, Hongjiang; Shi, Jianrong; Rainey, Jeanette J.; Thoroughman, Douglas; Uzicanin, Amra

    2016-01-01

    Background. School closures are an important mitigation strategy during influenza pandemic: if implemented early in a local outbreak, they can slow the disease spread in the surrounding community. During seasonal influenza epidemics, school closures may occur reactively, after the disease is already widespread in the community. Such reactive closures are often too late to reduce influenza transmission. However, they can provide data to determine under which circumstances they might be effective in reducing influenza-like illness (ILI) transmission. Methods. We conducted a household survey in a school district in Kentucky. District A closed after high student absenteeism due to influenza-like illness (ILI), whereas adjacent Districts B and C remained open. We collected data on self-reported ILI among household members in these 3 districts 2 weeks before the District A closure, during closure, and 2 weeks after reopening, and we evaluated economic and social consequences of school closure on student households in District A. The difference-in-differences method was applied to compare changes in ILI rates from before to after closure between districts. Results. Estimated average daily ILI rate decreased less in District A than in District B or C for the entire sample and when stratified by age groups (0–5 years old, 6–18 years old, and above 18 years old). Twenty-five percent of District A households reported ≥1 closure-related economic or social difficulty. Conclusions. Closing schools after a widespread ILI activity in District A did not reduce ILI transmission but caused difficulties for some households. PMID:27800520

  7. ISMP Adverse Drug Reactions

    PubMed Central

    2013-01-01

    The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration’s (FDA’s) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: mmancano@temple.edu). Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices (ISMP) in cooperation with the FDA’s MedWatch program and Temple University School of Pharmacy. ISMP is an FDA MedWatch partner. PMID:24421544

  8. Protecting Pakistan's health during the global economic crisis.

    PubMed

    Jooma, R; Khan, A; Khan, A A

    2012-03-01

    The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources. PMID:22574485

  9. Protecting Pakistan's health during the global economic crisis.

    PubMed

    Jooma, R; Khan, A; Khan, A A

    2012-03-01

    The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources.

  10. Future Directions in Childhood Adversity and Youth Psychopathology

    PubMed Central

    McLaughlin, Katie A.

    2016-01-01

    Despite long-standing interest in the influence of adverse early experiences on mental health, systematic scientific inquiry into childhood adversity and developmental outcomes has emerged only recently. Existing research has amply demonstrated that exposure to childhood adversity is associated with elevated risk for multiple forms of youth psychopathology. In contrast, knowledge of developmental mechanisms linking childhood adversity to the onset of psychopathology—and whether those mechanisms are general or specific to particular kinds of adversity—remains cursory. Greater understanding of these pathways and identification of protective factors that buffer children from developmental disruptions following exposure to adversity is essential to guide the development of interventions to prevent the onset of psychopathology following adverse childhood experiences. This article provides recommendations for future research in this area. In particular, use of a consistent definition of childhood adversity, integration of studies of typical development with those focused on childhood adversity, and identification of distinct dimensions of environmental experience that differentially influence development are required to uncover mechanisms that explain how childhood adversity is associated with numerous psychopathology outcomes (i.e., multifinality) and identify moderators that shape divergent trajectories following adverse childhood experiences. A transdiagnostic model that highlights disruptions in emotional processing and poor executive functioning as key mechanisms linking childhood adversity with multiple forms of psychopathology is presented as a starting point in this endeavour. Distinguishing between general and specific mechanisms linking childhood adversity with psychopathology is needed to generate empirically informed interventions to prevent the long-term consequences of adverse early environments on children’s development. PMID:26849071

  11. Economic considerations for bariatric surgery and morbid obesity

    PubMed Central

    Frezza, Eldo E; Wacthell, Mitchell; Ewing, Bradley

    2009-01-01

    The obesity epidemic is also an economic tragedy. This analysis evaluates the economic effects and the potential to improve the well-being of both individual and societal wealth. Econometric techniques should carefully assess the degree to which obesity affects declines in business output, employment, income, and tax revenues at the regional and national levels. Microeconomics assesses lost productivity and associated wages and profit. Macroeconomics assesses trends associated with employment, inflation, interest rates, money supply, and output. To decrease the adverse economic consequences of the obesity epidemic, policy makers must emphasize bariatric surgery as a cost-effective option for qualified patients. Early intervention, education, and tax rebates for obese individuals who undergo bariatric surgery and for medical centers and doctors would likely have positive economic effects on the whole economy in a few years. PMID:21935309

  12. Economic considerations for bariatric surgery and morbid obesity.

    PubMed

    Frezza, Eldo E; Wacthell, Mitchell; Ewing, Bradley

    2009-01-01

    The obesity epidemic is also an economic tragedy. This analysis evaluates the economic effects and the potential to improve the well-being of both individual and societal wealth. Econometric techniques should carefully assess the degree to which obesity affects declines in business output, employment, income, and tax revenues at the regional and national levels. Microeconomics assesses lost productivity and associated wages and profit. Macroeconomics assesses trends associated with employment, inflation, interest rates, money supply, and output. To decrease the adverse economic consequences of the obesity epidemic, policy makers must emphasize bariatric surgery as a cost-effective option for qualified patients. Early intervention, education, and tax rebates for obese individuals who undergo bariatric surgery and for medical centers and doctors would likely have positive economic effects on the whole economy in a few years. PMID:21935309

  13. Clinical consequences of marijuana.

    PubMed

    Khalsa, Jag H; Genser, Sander; Francis, Henry; Martin, Billy

    2002-11-01

    As documented in national surveys, for the past several years, marijuana has been the most commonly abused drug in the United States, with approximately 6% of the population 12 years and older having used the drug in the month prior to interview. The use of marijuana is not without significant health hazards. Marijuana is associated with effects on almost every organ system in the body, ranging from the central nervous system to the cardiovascular, endocrine, respiratory/pulmonary, and immune systems. Research presented in this special supplement will show that in addition to marijuana abuse/dependence, marijuana use is associated in some studies with impairment of cognitive function in the young and old, fetal and developmental consequences, cardiovascular effects (heart rate and blood pressure changes), respiratory/pulmonary complications such as chronic cough and emphysema, impaired immune function leading to vulnerability to and increased infections, and the risk of developing head, neck, and/or lung cancer. In general, acute effects are better studied than those of chronic use, and more studies are needed that focus on disentangling effects of marijuana from those of other drugs and adverse environmental conditions.

  14. Health, "illth," and economic growth: medicine, environment, and economics at the crossroads.

    PubMed

    Egger, Garry

    2009-07-01

    Economic growth has been the single biggest contributor to population health since the Industrial Revolution. The growth paradigm, by definition, is dynamic, implying similar diminishing returns on investment at both the macro- and the micro-economic levels. Changes in patterns of health in developing countries, from predominantly microbial-related infectious diseases to lifestyle-related chronic diseases (e.g., obesity, type 2 diabetes) beyond a point of economic growth described as the epidemiologic transition, suggest the start of certain declining benefits from further investment in the growth model. These changes are reflected in slowing improvements in some health indices (e.g., mortality, infant mortality) and deterioration in others (e.g., disability-associated life years, obesity, chronic diseases). Adverse environmental consequences, such as climate change from economic development, are also related to disease outcomes through the development of inflammatory processes due to an immune reaction to new environmental and lifestyle-related inducers. Both increases in chronic disease and climate change can be seen as growth problems with a similar economic cause and potential economic and public health-rather than personal health-solutions. Some common approaches for dealing with both are discussed, with a plea for greater involvement by health scientists in the economic and environmental debates in order to deal effectively with issues like obesity and chronic disease.

  15. Adverse Reactions to Hallucinogenic Drugs.

    ERIC Educational Resources Information Center

    Meyer, Roger E. , Ed.

    This reports a conference of psychologists, psychiatrists, geneticists and others concerned with the biological and psychological effects of lysergic acid diethylamide and other hallucinogenic drugs. Clinical data are presented on adverse drug reactions. The difficulty of determining the causes of adverse reactions is discussed, as are different…

  16. ENDURING ECONOMIC HARDSHIP, WOMEN'S EDUCATION, MARRIAGE AND FERTILITY TRANSITION IN KINSHASA.

    PubMed

    Shapiro, David

    2015-03-01

    This paper examines fertility transition in Kinshasa, capital of the Democratic Republic of the Congo (DRC) and second-largest city in sub-Saharan Africa. Shapiro (1996) documented the onset of fertility transition in the city, using data from 1990. Women's education was strongly inversely related to fertility, beginning with secondary schooling, and increases in women's education were important in initiating fertility transition in the city. The paper uses data from the 2007 Demographic and Health Survey in the DRC to examine fertility in Kinshasa and assess fertility transition since 1990, a period characterized by severe adverse economic conditions in the DRC. Fertility transition has continued at a strong pace. In part this reflects increased educational attainment of women, but it appears also to be largely a consequence of enduring economic hardship. The ongoing fertility decline has been accompanied by substantial delays in entry to marriage and childbearing, reflecting adverse economic conditions, which in turn have contributed to continuing declines in fertility.

  17. Reverse Engineering Adverse Outcome Pathways

    SciTech Connect

    Perkins, Edward; Chipman, J.K.; Edwards, Stephen; Habib, Tanwir; Falciani, Francesco; Taylor, Ronald C.; Van Aggelen, Graham; Vulpe, Chris; Antczak, Philipp; Loguinov, Alexandre

    2011-01-30

    The toxicological effects of many stressors are mediated through unknown, or poorly characterized, mechanisms of action. We describe the application of reverse engineering complex interaction networks from high dimensional omics data (gene, protein, metabolic, signaling) to characterize adverse outcome pathways (AOPs) for chemicals that disrupt the hypothalamus-pituitary-gonadal endocrine axis in fathead minnows. Gene expression changes in fathead minnow ovaries in response to 7 different chemicals, over different times, doses, and in vivo versus in vitro conditions were captured in a large data set of 868 arrays. We examined potential AOPs of the antiandrogen flutamide using two mutual information theory methods, ARACNE and CLR to infer gene regulatory networks and potential adverse outcome pathways. Representative networks from these studies were used to predict a network path from stressor to adverse outcome as a candidate AOP. The relationship of individual chemicals to an adverse outcome can be determined by following perturbations through the network in response to chemical treatment leading to the nodes associated with the adverse outcome. Identification of candidate pathways allows for formation of testable hypotheses about key biologic processes, biomarkers or alternative endpoints, which could be used to monitor an adverse outcome pathway. Finally, we identify the unique challenges facing the application of this approach in ecotoxicology, and attempt to provide a road map for the utilization of these tools. Key Words: mechanism of action, toxicology, microarray, network inference

  18. Adverse effects of anabolic steroids.

    PubMed

    Hickson, R C; Ball, K L; Falduto, M T

    1989-01-01

    Anabolic steroids are used therapeutically for various disorders and as ergogenic aids by athletes to augment strength, muscular development, and to enhance performance. There is a wide range of concomitant temporary and permanent adverse effects with steroid administration. Several well-documented adverse actions of these hormones may develop rapidly within several weeks or less (i.e. altered reproductive function) or require up to several years of steroid intake (i.e. liver carcinoma). More recent studies indicate that glucose intolerance, insulin resistance, increased cardiovascular disease risk profiles, cerebral dangers, musculoskeletal injuries, prostate cancer, psychosis and schizophrenic episodes, among others, accompany anabolic steroid intake. There is, at present, no evidence to support the claim that athletes are less susceptible to adverse effects than those individuals receiving hormone treatment in a clinical setting. Based on the available information which has accumulated primarily from cross-sectional, short term longitudinal, and case studies, there is a need: (a) to develop a comprehensive battery of specific and sensitive markers of adverse effects, particularly those that would be able to detect the onset of adverse actions; and (b) to conduct controlled long term longitudinal studies in order to fully understand the extensiveness and mechanisms involved in the occurrence of adverse effects.

  19. Consequences of the ban of by-products from terrestrial animals in livestock feeding in Germany and the European Union: alternatives, nutrient and energy cycles, plant production, and economic aspects.

    PubMed

    Rodehutscord, M; Abel, H J; Friedt, W; Wenk, C; Flachowsky, G; Ahlgrimm, H J; Johnke, B; Kühl, R; Breves, G

    2002-04-01

    Consequences of the ban of meat and bone meal (MBM) and animal fat with regard to livestock feeding, cropping, ecology and economy where investigated with an inter-disciplinary approach for Germany and the European Union. Calculations were made for different production systems with pigs and poultry on the basis of statistical data for the production and for the feed markets as well as from requirement data for the respective species and production system. (1.) The ban of MBM from feeding caused a need for alternative protein sources. If all the amount of protein from MBM is to be replaced by soybean meal, in Germany and the EU about 0.30 and 2.30 x 10(6) t would be needed each year (supplementary amino acids not considered). Alternatively, doubling the grain legume acreage in Germany to about 420,000 ha would supply a similar amount of protein. A wider application of phase feeding with adjusted dietary amino acid concentrations, however, would allow for saving protein to an extent which is similar to the amount of protein that was contributed by MBM in recent years. Thus, the ban is a minor problem in terms of ensuring amino acid supply. (2.) However, alternative plant ingredients cannot compensate for the gap in P supply that is caused by the ban. An additional demand for inorganic feed phosphates of about 14,000 and 110,000 t per year is given in Germany and the EU, respectively. So far, this gap is filled almost completely by increased mining of rock phosphates. Alternatively, a general application of microbial phytase to all diets would largely fill this gap. Until the ban, MBM contributed to 57% of the supplementation of P that was needed for pigs and poultry. The ban of MBM makes large amounts of P irreversibly disappearing from the food chain. (3.) Energy from slaughter offal and cadavers can be utilized in different technologies, in the course of which the efficiency of energy utilisation depends on the technology applied. It is efficient in the cement work

  20. Consequences of the ban of by-products from terrestrial animals in livestock feeding in Germany and the European Union: alternatives, nutrient and energy cycles, plant production, and economic aspects.

    PubMed

    Rodehutscord, M; Abel, H J; Friedt, W; Wenk, C; Flachowsky, G; Ahlgrimm, H J; Johnke, B; Kühl, R; Breves, G

    2002-04-01

    Consequences of the ban of meat and bone meal (MBM) and animal fat with regard to livestock feeding, cropping, ecology and economy where investigated with an inter-disciplinary approach for Germany and the European Union. Calculations were made for different production systems with pigs and poultry on the basis of statistical data for the production and for the feed markets as well as from requirement data for the respective species and production system. (1.) The ban of MBM from feeding caused a need for alternative protein sources. If all the amount of protein from MBM is to be replaced by soybean meal, in Germany and the EU about 0.30 and 2.30 x 10(6) t would be needed each year (supplementary amino acids not considered). Alternatively, doubling the grain legume acreage in Germany to about 420,000 ha would supply a similar amount of protein. A wider application of phase feeding with adjusted dietary amino acid concentrations, however, would allow for saving protein to an extent which is similar to the amount of protein that was contributed by MBM in recent years. Thus, the ban is a minor problem in terms of ensuring amino acid supply. (2.) However, alternative plant ingredients cannot compensate for the gap in P supply that is caused by the ban. An additional demand for inorganic feed phosphates of about 14,000 and 110,000 t per year is given in Germany and the EU, respectively. So far, this gap is filled almost completely by increased mining of rock phosphates. Alternatively, a general application of microbial phytase to all diets would largely fill this gap. Until the ban, MBM contributed to 57% of the supplementation of P that was needed for pigs and poultry. The ban of MBM makes large amounts of P irreversibly disappearing from the food chain. (3.) Energy from slaughter offal and cadavers can be utilized in different technologies, in the course of which the efficiency of energy utilisation depends on the technology applied. It is efficient in the cement work

  1. Psychometric Properties of the Chinese Cultural Beliefs about Adversity Scale

    ERIC Educational Resources Information Center

    Leung, Janet T. Y.; Shek, Daniel T. L.

    2013-01-01

    Objective: The purpose of the study was to examine the psychometric properties of the Chinese Cultural Beliefs about Adversity scale (CBA). Methods: The CBA was administered in a sample of 275 Chinese parents experiencing economic disadvantage. Results: The CBA was found to be internally consistent. Consistent with the conceptual framework, factor…

  2. Alternative futures for health economics: implications for nursing management.

    PubMed

    Mannion, Russell; Small, Neil; Thompson, Carl

    2005-09-01

    As nursing has been subject to successive waves of 'managerialism' there has been a drive on the part of government and elements within the profession to enhance the science base and promote cost-effective health care interventions. This has generated new interest in the 'economics of nursing' as efficiency and 'value for money' are viewed as necessary precondition for the provision of a high quality nursing service. As an academic subject health economics has brought an elegant set of theories to bear on the topic of health and health care. However, mainstream health economics is premised on a series of simplifying assumptions that, if applied uncritically, can induce a range of unintended and adverse consequences. This paper asks how ideas developed in one sphere (health economics) can be become influential in another (nursing management and practice) and it seeks explanations in the theories of Michel Foucault, specifically in his exploration of the reciprocal relationship between power and knowledge. How are our assumptions about what is possible and desirable shaped, how far do mechanisms of surveillance and self-subjugation extend? A range of alternative economic approaches have been developed which challenge many mainstream health economics assumptions. Some of these are better suited to the complex social environment present within health care. Nurses, nurse managers and researchers should question the assumptions of dominant economic models and explore a range of economic frameworks when planning services and evaluating their practice. PMID:16108775

  3. Alcohol-Related Negative Consequences among Drinkers around the World

    PubMed Central

    Graham, Kathryn; Bernards, Sharon; Knibbe, Ronald; Kairouz, Sylvia; Kuntche, Sandra; Wilsnack, Sharon C.; Greenfield, Thomas K.; Dietze, Paul; Obot, Isidore; Gmel, Gerhard

    2013-01-01

    Aims This paper examines (1) gender and country differences in negative consequences related to drinking; (2) relative rates of different consequences; (3) country-level predictors of consequences. Design, setting and participants Multi-level analyses used survey data from the GENACIS collaboration. Measurements Measures included 17 negative consequences grouped into (a) high endorsement acute, (b) personal and (c) social. Country-level measures included average frequency and quantity of drinking, percent current drinkers, Gross Domestic Product (GDP) and Human Development Index (HDI). Findings Overall, the three groupings of consequences were reported by 44%, 12% and 7% of men and by 31%, 6% and 3% of women, respectively. More men than women endorsed all consequences but gender differences were greatest for consequences associated with chronic drinking and social consequences related to male roles. The highest prevalence of consequences was in Uganda, lowest in Uruguay. Personal and social consequences were more likely in countries with higher usual quantity, fewer current drinkers, and lower scores on GDP and HDI. However, significant interactions with individual-level quantity indicated a stronger relationship between consequences and usual quantity among drinkers in countries with lower quantity, more current drinkers and higher scores on GDP and HDI. Conclusions Both gender and country need to be taken into consideration when assessing adverse drinking consequences. Individual measures of alcohol consumption and country-level variables are associated with experiencing such consequences. Additionally, country-level variables affect the strength of the relationship between usual quantity consumed by individuals and adverse consequences. PMID:21395893

  4. Early adversity, immunity and infectious disease.

    PubMed

    Avitsur, Ronit; Levy, Sigal; Goren, Naama; Grinshpahet, Rachel

    2015-01-01

    Complex interactions between biological, behavioral and environmental factors are involved in mediating individual differences in health and disease. In this review, we present evidence suggesting that increased vulnerability to infectious disease may be at least, in part, due to long-lasting effects of early life psychosocial adversities. Studies have shown that maternal psychosocial stress during pregnancy is associated with long lasting changes in immune function and disease resistance in the offspring. Studies further indicated that harsh environmental conditions during the neonatal period may also cause lasting changes in host response to infectious disease. Although the mechanisms involved in these effects have not been fully examined, several potential mediators have been described, including changes in the development of the offspring hypothalamic-pituitary-adrenal axis, alterations in epigenetic pathways, stress-related maternal health risk behavior and infection during pregnancy. Although there are ample literature indicating that perinatal psychosocial stress increases vulnerability to disease, other reports suggest that mild predictable stressors may benefit the organism and allow better coping with future stressors. Thus, understanding the possible consequences of perinatal adversities and the mechanisms that are involved in immune regulation is important for increasing awareness to the potential outcomes of early negative life events and providing insight into potential therapies to combat infection in vulnerable individuals.

  5. Consequences of early childbearing.

    PubMed

    Monroy De Velasco, A

    1982-12-01

    By 2000, developing countries will have an estimated 1 billion adolescents who are physically old enough to reproduce themselves but far too young to be responsible, healthy parents of healthy children. Governments must become involved in the issues surrounding adolescent pregnancy and both custom and the laws must change to reflect the needs of young people. The consequences of early childbearing are felt by society as well as the families directly affected. The incidence of births to very young women, both married and unmarried is growing; each year approximately 13 million children are born to young mothers. The percentage of live births to mothers under the age of 20 ranges from 20% in some African and Caribbean countries, to 10-15% in many Latin American countries, 5-10% in Asia, and 1% in Japan. Increased out-of-wedlock adolescent pregnancy is due to many factors: earlier sexual maturity from better childhood health and nutrition, a trend toward later marriage, increased opportunity for opposite sex interaction in schools and in the labor force, and rapid urbanization which weakens traditional family structures and social and cultural controls. Early childbirth is especially dangerous for adolescents and their infants. Compared to women between the ages of 20-35, pregnant women under 20 are at a greater risk for death and disease including bleeding during pregnancy, toxemia, hemorrhage, prolonged and difficult labor, severe anemia, and disability. Life-long social and economic disadvantages may be a consequence of teenage birth. Educational and career opportunities may be limited, as may be opportunities for marriage. Teen mothers tend to have larger completed family sizes, shorter birth intervals resulting in both poorer health status for the family, and a more severe level of poverty. The children also suffer; teens mothers have a higher incidence of low birth weight infants which is associated with birth injuries, serious childhood illness, and mental and

  6. Consequences of early childbearing.

    PubMed

    Monroy De Velasco, A

    1982-12-01

    By 2000, developing countries will have an estimated 1 billion adolescents who are physically old enough to reproduce themselves but far too young to be responsible, healthy parents of healthy children. Governments must become involved in the issues surrounding adolescent pregnancy and both custom and the laws must change to reflect the needs of young people. The consequences of early childbearing are felt by society as well as the families directly affected. The incidence of births to very young women, both married and unmarried is growing; each year approximately 13 million children are born to young mothers. The percentage of live births to mothers under the age of 20 ranges from 20% in some African and Caribbean countries, to 10-15% in many Latin American countries, 5-10% in Asia, and 1% in Japan. Increased out-of-wedlock adolescent pregnancy is due to many factors: earlier sexual maturity from better childhood health and nutrition, a trend toward later marriage, increased opportunity for opposite sex interaction in schools and in the labor force, and rapid urbanization which weakens traditional family structures and social and cultural controls. Early childbirth is especially dangerous for adolescents and their infants. Compared to women between the ages of 20-35, pregnant women under 20 are at a greater risk for death and disease including bleeding during pregnancy, toxemia, hemorrhage, prolonged and difficult labor, severe anemia, and disability. Life-long social and economic disadvantages may be a consequence of teenage birth. Educational and career opportunities may be limited, as may be opportunities for marriage. Teen mothers tend to have larger completed family sizes, shorter birth intervals resulting in both poorer health status for the family, and a more severe level of poverty. The children also suffer; teens mothers have a higher incidence of low birth weight infants which is associated with birth injuries, serious childhood illness, and mental and

  7. Adverse ocular reactions to drugs.

    PubMed Central

    Spiteri, M. A.; James, D. G.

    1983-01-01

    Drugs acting on various parts of the body may also affect the eye insidiously. Increased awareness of such drug toxicity by the prescribing doctor should encourage him to consider effects on the cornea, lens, retina, optic nerve and elsewhere when checking the patient's progress. The following review concerns adverse ocular effects of systemic drug administration. PMID:6356101

  8. Urbanicity, social adversity and psychosis

    PubMed Central

    Heinz, Andreas; Deserno, Lorenz; Reininghaus, Ulrich

    2013-01-01

    In recent years, there has been increasing interest in research on geographical variation in the incidence of schizophrenia and other psychoses. In this paper, we review the evidence on variation in incidence of schizophrenia and other psychoses in terms of place, as well as the individual- and area-level factors that account for this variation. We further review findings on potential mechanisms that link adverse urban environment and psychosis. There is evidence from earlier and more recent studies that urbanicity is associated with an increased incidence of schizophrenia and non-affective psychosis. In addition, considerable variation in incidence across neighbourhoods has been observed for these disorders. Findings suggest it is unlikely that social drift alone can fully account for geographical variation in incidence. Evidence further suggests that the impact of adverse social contexts – indexed by area-level exposures such as population density, social fragmentation and deprivation – on risk of psychosis is explained (confounding) or modified (interaction) by environmental exposures at the individual level (i.e., cannabis use, social adversity, exclusion and discrimination). On a neurobiological level, several studies suggest a close link between social adversity, isolation and stress on the one hand, and monoamine dysfunction on the other, which resembles findings in schizophrenia patients. However, studies directly assessing correlations between urban stress or discrimination and neurobiological alterations in schizophrenia are lacking to date. PMID:24096775

  9. Adverse Childhood Experiences and Hallucinations

    ERIC Educational Resources Information Center

    Whitfield, C.L.; Dube, S.R.; Felitti, V.J.; Anda, R.F.

    2005-01-01

    Objective:: Little information is available about the contribution of multiple adverse childhood experiences (ACEs) to the likelihood of reporting hallucinations. We used data from the ACE study to assess this relationship. Methods:: We conducted a survey about childhood abuse and household dysfunction while growing up, with questions about health…

  10. Socioeconomic Adversity and Women's Sleep: Stress and Chaos as Mediators.

    PubMed

    El-Sheikh, Mona; Keiley, Margaret; Bagley, Erika J; Chen, Edith

    2015-01-01

    We examined income-to-needs ratio, perceived economic well-being, and education and their relations with European and African American women's sleep (n = 219). Sleep was examined through actigraphy and self-reports. Income-to-needs ratio was related to sleep minutes. Perceived economic well-being and education were associated with subjective sleep problems. Perceived stress mediated relations between both income-to-needs ratio and economic well-being and subjective sleep problems. Chaos emerged as a mediator linking income-to-needs ratio and subjective sleep problems. African American women had fewer sleep minutes and lower sleep efficiency than European Americans, and more robust relations between economic well-being and stress was observed for European Americans. Findings highlight the importance of economic adversity for women's sleep and explicate some pathways of risk.

  11. Cardiovascular Disease Consequences of CKD.

    PubMed

    Go, Alan S

    2016-07-01

    Chronic kidney disease, defined as reduced glomerular filtration rate (estimated using serum creatinine- and/or serum cystatin C-based equations) or excess urinary protein excretion, affects approximately 13% of adult Americans and is linked to a variety of clinical complications. Although persons with end-stage renal disease requiring chronic dialysis therapy experience a substantially high cardiovascular burden, whether mild-to-moderate chronic kidney disease is an independent risk factor for fatal and nonfatal cardiovascular events has been more controversial. This review evaluates the current evidence about the clinical and subclinical cardiovascular consequences associated with chronic kidney disease of varying levels of severity. In addition, it discusses the predictors of adverse cardiovascular outcomes while also focusing on recent insights into the relationships between chronic kidney disease and cardiovascular disease from the Chronic Renal Insufficiency Cohort study, a large current prospective cohort study of adults from across the spectrum of chronic kidney disease. PMID:27475660

  12. [Psychological consequences of severe overweight in teenagers].

    PubMed

    Grønbæk, Helle N; Holm, Jens-Christian

    2011-06-20

    Obese adolescents are adversely affected by the psychosocial consequences of their obesity, which affects their identity development negatively. Further, the obesity-associated psychosocial consequences deteriorate increasingly as the children grow older. Obese adolescents have poor health related quality of life and tend to develop serious emotional and social problems, and a negative body image compared to normal weight peers. Obese adolescents represent approximately 5% of all youths in Denmark, but the treatment options available do not meet the demands of this vulnerable group.

  13. Pharmacogenomics of adverse drug reactions

    PubMed Central

    2013-01-01

    Considerable progress has been made in identifying genetic risk factors for idiosyncratic adverse drug reactions in the past 30 years. These reactions can affect various tissues and organs, including liver, skin, muscle and heart, in a drug-dependent manner. Using both candidate gene and genome-wide association studies, various genes that make contributions of varying extents to each of these forms of reactions have been identified. Many of the associations identified for reactions affecting the liver and skin involve human leukocyte antigen (HLA) genes and for reactions relating to the drugs abacavir and carbamazepine, HLA genotyping is now in routine use prior to drug prescription. Other HLA associations are not sufficiently specific for translation but are still of interest in relation to underlying mechanisms for the reactions. Progress on non-HLA genes affecting adverse drug reactions has been less, but some important associations, such as those of SLCO1B1 and statin myopathy, KCNE1 and drug-induced QT prolongation and NAT2 and isoniazid-induced liver injury, are considered. Future prospects for identification of additional genetic risk factors for the various adverse drug reactions are discussed. PMID:23360680

  14. Tank bump consequence analysis

    SciTech Connect

    Board, B.D., Westinghouse Hanford

    1996-07-23

    Radiological and toxicological consequence calculations based on work performed by Sathyanarayana using the GOTH thermal hydraulics computer code. Mitigative effects of cover blocks are also calculated.

  15. [Adverse reaction induced by licorice preparations: clinical analysis of 93 cases].

    PubMed

    Mao, Min; Li, Wei; Wang, Wei; Wang, Shu-Xia; Lu, Jin; Chang, Zhang-Fu

    2013-11-01

    Licorice is a traditional Chinese medicine commonly used in clinic. The products,what contain licorice or licorice extract, has early been involved in the field of cosmetics except for the field of pharmaceuticals and food. Consequently, the reporting on adverse reactions induced by licorice preparations are more frequent. Based on the clinical data of licorice preparations adverse reactions, we described the characteristics of the licorice-related adverse reactions, and proposed specific measures to reduce the incidence of adverse reactions, provided a reference for the rational use of licorice preparations. PMID:24494570

  16. Idiosyncratic adverse reactions to antiepileptic drugs.

    PubMed

    Zaccara, Gaetano; Franciotta, Diego; Perucca, Emilio

    2007-07-01

    Idiosyncratic drug reactions may be defined as adverse effects that cannot be explained by the known mechanisms of action of the offending agent, do not occur at any dose in most patients, and develop mostly unpredictably in susceptible individuals only. These reactions are generally thought to account for up to 10% of all adverse drug reactions, but their frequency may be higher depending on the definition adopted. Idiosyncratic reactions are a major source of concern because they encompass most life-threatening effects of antiepileptic drugs (AEDs), as well as many other reactions requiring discontinuation of treatment. Based on the underlying mechanisms, idiosyncratic reactions can be differentiated into (1) immune-mediated hypersensitivity reactions, which may range from benign skin rashes to serious conditions such as drug-related rash with eosinophilia and systemic symptoms; (2) reactions involving unusual nonimmune-mediated individual susceptibility, often related to abnormal production or defective detoxification of reactive cytotoxic metabolites (as in valproate-induced liver toxicity); and (3) off-target pharmacology, whereby a drug interacts directly with a system other than that for which it is intended, an example being some types of AED-induced dyskinesias. Although no AED is free from the potential of inducing idiosyncratic reactions, the magnitude of risk and the most common manifestations vary from one drug to another, a consideration that impacts on treatment choices. Serious consequences of idiosyncratic reactions can be minimized by knowledge of risk factors, avoidance of specific AEDs in subpopulations at risk, cautious dose titration, and careful monitoring of clinical response.

  17. The impact on students of adverse experiences during medical school.

    PubMed

    Wilkinson, Tim J; Gill, Denzil J; Fitzjohn, Julie; Palmer, Claire L; Mulder, Roger T

    2006-03-01

    This study aimed to determine the consequences for, and coping method used by, medical students who experienced adverse experiences during their training. A nationwide questionnaire based census of all current medical students in New Zealand. The response rate was 83% (1384/1660). Two-thirds of students had at least one adverse experience, with humiliation being the most common and having the greatest adverse impact. Unwanted sexual advances, unfair treatment on the basis of gender or race had a lesser impact for most students. Most students took several hours or several days to get over an adverse episode and most commonly they then avoided that person or department. Around one half sought help. Only one-quarter felt it motivated their learning while one-sixth felt it made them consider leaving medical school. The most common perpetrators were senior doctors or nurses. Unwanted sexual advances were most common from other students or from patients. Humiliation is the experience that affected students the most and had a significant adverse effect on learning. There is a disturbing rate of unacceptable practice within medical schools, not all of which is from doctors. PMID:16707293

  18. [Adverse ocular effects of vaccinations].

    PubMed

    Ness, T; Hengel, H

    2016-07-01

    Vaccinations are very effective measures for prevention of infections but are also associated with a long list of possible side effects. Adverse ocular effects following vaccination have been rarely reported or considered to be related to vaccinations. Conjunctivitis is a frequent sequel of various vaccinations. Oculorespiratory syndrome and serum sickness syndrome are considered to be related to influenza vaccinations. The risk of reactivation or initiation of autoimmune diseases (e. g. uveitis) cannot be excluded but has not yet been proven. Overall the benefit of vaccination outweighs the possible but very low risk of ocular side effects.

  19. [Adverse ocular effects of vaccinations].

    PubMed

    Ness, T; Hengel, H

    2016-07-01

    Vaccinations are very effective measures for prevention of infections but are also associated with a long list of possible side effects. Adverse ocular effects following vaccination have been rarely reported or considered to be related to vaccinations. Conjunctivitis is a frequent sequel of various vaccinations. Oculorespiratory syndrome and serum sickness syndrome are considered to be related to influenza vaccinations. The risk of reactivation or initiation of autoimmune diseases (e. g. uveitis) cannot be excluded but has not yet been proven. Overall the benefit of vaccination outweighs the possible but very low risk of ocular side effects. PMID:27357302

  20. Adverse Effects of Electroconvulsive Therapy.

    PubMed

    Andrade, Chittaranjan; Arumugham, Shyam Sundar; Thirthalli, Jagadisha

    2016-09-01

    Electroconvulsive therapy (ECT) is an effective treatment commonly used for depression and other major psychiatric disorders. We discuss potential adverse effects (AEs) associated with ECT and strategies for their prevention and management. Common acute AEs include headache, nausea, myalgia, and confusion; these are self-limiting and are managed symptomatically. Serious but uncommon AEs include cardiovascular, pulmonary, and cerebrovascular events; these may be minimized with screening for risk factors and by physiologic monitoring. Although most cognitive AEs of ECT are short-lasting, troublesome retrograde amnesia may rarely persist. Modifications of and improvements in treatment techniques minimize cognitive and other AEs. PMID:27514303

  1. Youth Unemployment. The Causes and Consequences.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France).

    This report examines the causes and consequences of youth unemployment in Organisation for Economic Cooperation and Development (OECD) member countries. Summarized first is the youth unemployment situation since the 1974/1975 recession. In a section on recent developments in youth labor markets a series of tables and graphs provide data on youth…

  2. Migraine treatment: a chain of adverse effects.

    PubMed

    Veloso, Tiago Sousa; Cambão, Mariana Seixas

    2015-01-01

    This clinical vignette presents a 14 years old female, with a past medical history relevant only for migraine with typical aura of less than monthly frequency, complaining of a severe unilateral headache with rising intensity for the previous 4 h, associated with nausea, vomiting, photophobia and phonophobia. This episode of migraine with aura in a patient with recurrent migraine was complicated by side effects of medical diagnostic and therapeutic procedures (extrapyramidal symptoms, delirium, post-lumbar puncture headache, hospital admission) all of which could have been prevented-quaternary prevention. This case illustrates several important messages in migraine management: (1) use of acetaminophen is not based in high-quality evidence and better options exist; (2) among youngsters, domperidone should be preferred over metoclopramide because it does not cross the blood-brain barrier; (3) moderate to severe migraine crisis can be managed with triptans in teenagers over 12 years old; (4) it is important to recognize adverse drug effects; (5) harmful consequences of medical interventions do occur; (6) the school community must be informed about chronic diseases of the young.

  3. Using the lessons of behavioral economics to design more effective pay-for-performance programs

    PubMed Central

    Mehrotra, Ateev; Sorbero, Melony E. S.; Damberg, Cheryl L.

    2012-01-01

    Objective Although pay-for-performance (P4P) incentives are increasingly popular, the literature on health care has found that these incentives have had minimal impact. We believe a key reason for this finding is that current P4P programs are poorly designed and do not reflect what is known about the psychology of how people respond to incentives. Methods Using lessons from behavioral economics, we describe seven ways to improve program design in terms of frequency and types of incentive payments. After discussing why P4P incentives often have unintended adverse consequences, we outline potential ways to mitigate these consequences. Conclusions The lessons from behavioral economics can greatly enhance the design and effectiveness of P4P programs in healthcare, but future work is needed to demonstrate this empirically. PMID:20645665

  4. Adverse reactions to food additives.

    PubMed

    Simon, R A

    1986-01-01

    There are thousands of agents that are intentionally added to the food that we consume. These include preservatives, stabilizers, conditioners, thickeners, colorings, flavorings, sweeteners, antioxidants, etc. etc. Yet only a surprisingly small number have been associated with hypersensitivity reactions. Amongst all the additives, FD&C dyes have been most frequently associated with adverse reactions. Tartrazine is the most notorious of them all; however, critical review of the medical literature and current Scripps Clinic studies would indicate that tartrazine has been confirmed to be at best only occasionally associated with flares of urticaria or asthma. There is no convincing evidence in the literature of reactivity to the other azo or nonazo dyes. This can also be said of BHA/BHT, nitrites/nitrates and sorbates. Parabens have been shown to elicit IgE mediated hypersensitivity reactions when used as pharmaceutical preservatives; however, as with the other additives noted above, ingested parabens have only occasionally been associated with adverse reactions. MSG, the cause of the 'Chinese restaurant syndrome' has only been linked to asthma in one report. Sulfiting agents used primarily as food fresheners and to control microbial growth in fermented beverages have been established as the cause of any where from mild to severe and even fatal reactions in at least 5% of the asthmatic population. Other reactions reported to follow sulfite ingestion include anaphylaxis, gastro intestinal complaints and dermatological eruptions. The prevalence of these non asthmatic reactions is unknown. The mechanism of sulfite sensitive asthma is also unknown but most likely involves hyperreactivity to inhale SO2 in the great majority of cases; however, there are reports of IgE mediated reactions and other sulfite sensitive asthmatics have been found with low levels of sulfite oxidase; necessary to oxidize endogenous sulfite to sulfate.

  5. FOREST FRAGMENTATION AS AN ECONOMIC INDICATOR

    EPA Science Inventory

    Despite concern over the ecological consequences of conversion of land from natural cover to anthropogenic uses, there are few studies that show a quantitative relationship between fragmentation and economic factors. For the southside economic region of Virginia, we generated a ...

  6. Adverse events in healthcare: learning from mistakes.

    PubMed

    Rafter, N; Hickey, A; Condell, S; Conroy, R; O'Connor, P; Vaughan, D; Williams, D

    2015-04-01

    Large national reviews of patient charts estimate that approximately 10% of hospital admissions are associated with an adverse event (defined as an injury resulting in prolonged hospitalization, disability or death, caused by healthcare management). Apart from having a significant impact on patient morbidity and mortality, adverse events also result in increased healthcare costs due to longer hospital stays. Furthermore, a substantial proportion of adverse events are preventable. Through identifying the nature and rate of adverse events, initiatives to improve care can be developed. A variety of methods exist to gather adverse event data both retrospectively and prospectively but these do not necessarily capture the same events and there is variability in the definition of an adverse event. For example, hospital incident reporting collects only a very small fraction of the adverse events found in retrospective chart reviews. Until there are systematic methods to identify adverse events, progress in patient safety cannot be reliably measured. This review aims to discuss the need for a safety culture that can learn from adverse events, describe ways to measure adverse events, and comment on why current adverse event monitoring is unable to demonstrate trends in patient safety.

  7. Heroin use in Slovenia - a consequence or a vehicle of social changes.

    PubMed

    Flaker, Vito

    2002-11-01

    Slovenia is a country in transition with a relatively successful record both in the economic and social spheres. It has not escaped all the adverse consequences of transition (high unemployment, especially among youths, changes in values). Massive heroin use has also started in the 90s, and there are approximately 450 intravenous drug users or 900 regular users per 100,000 inhabitants. Those groups that were uprooted in the process of transition (young people, males, immigrants) are vulnerable to problematic use. The HIV prevalence is extremely low, while that of hepatitis C is relatively substantial. Difficulties with employment, housing shortage and severed social ties are all the result of problematic heroin use as well as the factor that promotes it along with the changes in youth culture and social values. Poverty is probably one of the most important vectors towards destructive outcomes while postindustrial hedonistic individualism is an important cultural vehicle toward the increase in drug use.

  8. Childhood adversity profiles and adult psychopathology in a representative Northern Ireland study.

    PubMed

    McLafferty, Margaret; Armour, Cherie; McKenna, Aine; O'Neill, Siobhan; Murphy, Sam; Bunting, Brendan

    2015-10-01

    Childhood adversities are key aetiological factors in the onset and persistence of psychopathology. The aims of this study were to identify childhood adversity profiles, and investigate the relationship between the adversity classes and psychopathology in Northern Ireland. The study utilized data from the Northern Ireland Study of Health and Stress, an epidemiological survey (N=1986), which used the CIDI to examine mental health disorders and associated risk factors. Latent Class Analysis revealed 3 distinct typologies; a low risk class (n=1709; 86%), a poly-adversity class (n=122; 6.1%), and an economic adversity class (n=155; 7.8%). Logistic Regression models revealed that individuals in the economic adversity class had a heightened risk of anxiety and substance disorders, with individuals in the poly-adversity class more likely to have a range of mental health problems and suicidality. The findings indicate the importance of considering the impact of co-occurring childhood adversities when planning treatment, prevention, and intervention programmes.

  9. Families under Economic Pressure.

    ERIC Educational Resources Information Center

    Elder, Glen H., Jr.; And Others

    The economic decline of rural America has widespread consequences for families, children, and education. Broad changes in farming and in the rural nonfarm sector have pushed the poverty rate for rural areas in the 1980s higher than the central cities rate. Projections indicate that by the mid-1990s, one-half of all farm families in the midwest may…

  10. Exercise hypertension: an adverse prognosis?

    PubMed

    Smith, Ryan G; Rubin, Stanley A; Ellestad, Myrvin H

    2009-01-01

    We sought to clarify the prognostic importance of an "exaggerated" or "hypertensive" systolic blood pressure response to exercise during an exercise test. Studies evaluating the prognosis for cardiovascular events and cardiovascular mortality in those with hypertension during exercise testing were systematically reviewed. Fourteen studies were identified. Six studies were of healthy volunteers or hypertensives. Eight studies were in subjects with known or suspected heart disease. Without established heart disease, exercise hypertension predicted cardiovascular events and cardiovascular death. However, two of the six studies included a multivariate analysis; both demonstrated no independent association. Studies in subjects with known or suspected heart disease demonstrated that exercise hypertension predicted fewer cardiac events and lesser mortality or, after multivariate adjustment, no associated risk. In a healthy population, a higher exercise blood pressure may indicate hypertension or prehypertension, instead of normal vascular function, and an associated long-term adverse prognosis. In a population with a high burden of heart disease, the highest risk subjects with the most extensive cardiac disease may not be capable of generating pressure or workload to allow the manifestation of exercise systolic hypertension. By comparison, therefore, those with exercise hypertension have a better prognosis. PMID:20409979

  11. Adverse effects of antihypertensive drugs.

    PubMed

    Husserl, F E; Messerli, F H

    1981-09-01

    Early essential hypertension is asymptomatic and should remain so throughout treatment. In view of the increasing number of available antihypertensive agents, clinicians need to become familiar with the potential side effects of these drugs. By placing more emphasis on non-pharmacological treatment (sodium restriction, weight loss, exercise) and thoroughly evaluating each case in particular, the pharmacological regimen can be optimally tailored to the patient's needs. Potential side effects should be predicted and can often be avoided; if they become clinically significant they should be rapidly recognised and corrected. These side effects can be easily remembered in most instances, as they fall into 3 broad categories: (a) those caused by an exaggerated therapeutic effect; (b) those due to a non-therapeutic pharmacological effect; and (c) those caused by a non-therapeutic, non-pharmacological effect probably representing idiosyncratic reactions. This review focuses mainly on adverse effects of the second and third kind. Each group of drugs in general shares the common side effects of the first two categories, while each individual drug has its own idiosyncratic side effects.

  12. The NAS Perchlorate Review: Adverse Effects?

    SciTech Connect

    Johnston, Richard B.; Corley, Richard; Cowan, Linda; Utiger, Robert D.

    2005-11-01

    ), a dose of 9.2 mg/kg per day for 4 weeks had no effect on thyroid function. In occupational studies, doses as high as 0.5 mg/kg per day were not associated with adverse effects on thyroid function in workers. In epidemiologic studies, there were no abnormalities in growth or thyroid function in children exposed life-long to 100 to 120 mg of perchlorate per liter of drinking water, or in pregnant women and newborn infants similarly exposed. Given the choice of a non-adverse effect (inhibition of iodide uptake by the thyroid) as the point of departure and the multiple studies in which doses of perchlorate much larger than 0.007 mg/kg per day had no effect on any aspect of thyroid function, the committee did not apply a database uncertainty factor. Finally, Ginsberg and Rice argue that inhibition of thyroid iodide uptake is adverse. That conclusion assumes that any acute inhibition would be sustained, so that thyroid hormone production would fall. That is not the case. There is remarkable compensation for even substantial reductions in thyroid iodide uptake – and thyroid hormone production. As noted above, subjects given 0.04 mg/kg per day for 6 months and 9.2 mg/kg per day for 4 weeks-doses that certainly would inhibit thyroid iodide uptake for a few weeks-had no fall in serum thyroid hormone or rise in serum thyrotropin concentrations (the hallmark of even minor systemic thyroid deficiency). Short-term inhibition of thyroid iodide uptake is not an adverse effect; it has no adverse consequences, because there is rapid compensation mediated by several independent processes. One is upregulation of the thyroid sodium-iodide transport system, as a result of intrathyroidal iodide deficiency. The second, should there be even a very small fall in thyroid hormone production, is an increase in thyrotropin secretion, resulting in overall stimulation of the thyroid gland.

  13. Energy Drink Consumption: Beneficial and Adverse Health Effects

    PubMed Central

    Alsunni, Ahmed Abdulrahman

    2015-01-01

    Consumption of energy drinks has been increasing dramatically in the last two decades, particularly amongst adolescents and young adults. Energy drinks are aggressively marketed with the claim that these products give an energy boost to improve physical and cognitive performance. However, studies supporting these claims are limited. In fact, several adverse health effects have been related to energy drink; this has raised the question of whether these beverages are safe. This review was carried out to identify and discuss the published articles that examined the beneficial and adverse health effects related to energy drink. It is concluded that although energy drink may have beneficial effects on physical performance, these products also have possible detrimental health consequences. Marketing of energy drinks should be limited or forbidden until independent research confirms their safety, particularly among adolescents. PMID:26715927

  14. Energy Drink Consumption: Beneficial and Adverse Health Effects.

    PubMed

    Alsunni, Ahmed Abdulrahman

    2015-10-01

    Consumption of energy drinks has been increasing dramatically in the last two decades, particularly amongst adolescents and young adults. Energy drinks are aggressively marketed with the claim that these products give an energy boost to improve physical and cognitive performance. However, studies supporting these claims are limited. In fact, several adverse health effects have been related to energy drink; this has raised the question of whether these beverages are safe. This review was carried out to identify and discuss the published articles that examined the beneficial and adverse health effects related to energy drink. It is concluded that although energy drink may have beneficial effects on physical performance, these products also have possible detrimental health consequences. Marketing of energy drinks should be limited or forbidden until independent research confirms their safety, particularly among adolescents. PMID:26715927

  15. Economics and cigarettes.

    PubMed

    Schelling, T C

    1986-09-01

    Economic facts on cigarette consumption and production are summarized, and the health consequences of cigarette smoking are reviewed. The magnitude and distribution of these health consequences among the population are discussed in economic terms, that is, in an "accounting framework" comprising such disparate elements as lost lives, lost livelihoods, pain, fear, discomfort, medical costs, excise taxes, and the costs of regulating smoking behaviors. The importance of these factors and their potential influence on public policy and individual behavior are considered. Difficulties include assigning a monetary value to an expected extension of life, the "voluntary" nature of smoking (even though most smokers wish they could quit), deciding what to include as economic consequences of smoking, and the attribution to smoking of some share of the costs for diseases known to be affected by smoking. "Transfers," or purely financial transactions, in contrast to expenditures for goods and services, are explained as one assessment component of the economic impact of smoking-related diseases. The issue of the economic benefit to the United States as a whole and to the population engaged in the cigarette industry, because of the earnings and employment generated by cigarette purchases, is examined, as is the issue of cigarette purchases as a significant source of federal and state revenue. PMID:3774784

  16. Infant mortality and infant care: cultural and economic constraints on nurturing in northeast Brazil.

    PubMed

    Scheper-Hughes, N

    1984-01-01

    The Brazilian 'Economic Miracle' has had an adverse effect on infant and childhood mortality which has been steadily rising throughout Brazil since the late 1960s. An analysis of the reproductive histories of 72 marginally employed residents of a Northeast Brazilian rural shantytown explores the economic and cultural context that inhibits these mother's abilities to rear healthy, living children and which forces them to devise 'ethnoeugenic' childrearing strategies that prejudice the life chances of those offspring judged 'less fit' for survival under the pernicious conditions of life on the Alto. it is suggested that the selective neglect of children is a direct consequence of the selective neglect of their mothers who have been excluded from participating in the national economy. The links between economic exploitation and maternal deprivation are further discussed with reference to the social causes of the 'insufficient breastmilk syndrome' and the commercial powdered milk dependency of these women. PMID:6484639

  17. Dispositional optimism: a psychological resource for Mexican-origin mothers experiencing economic stress.

    PubMed

    Taylor, Zoe E; Widaman, Keith F; Robins, Richard W; Jochem, Rachel; Early, Dawnte R; Conger, Rand D

    2012-02-01

    Dispositional optimism is believed to be an important psychological resource that buffers families against the deleterious consequences of economic adversity. Using data from a longitudinal study of Mexican-origin families (N = 674), we tested a family stress model specifying that maternal dispositional optimism and economic pressure affect maternal internalizing symptoms, which, in turn, affects parenting behaviors and children's social adjustment. As predicted, maternal optimism and economic pressure had both independent and interactive effects on maternal internalizing symptoms, and the effects of these variables on changes over time in child social adjustment were mediated by nurturant and involved parenting. The findings replicate and extend previous research on single-parent African American families (Taylor, Larsen-Rife, Conger, Widaman, & Cutrona, 2010), and demonstrate the generalizability of the positive benefits of dispositional optimism in another ethnic group and type of family structure.

  18. Antidepressants and cardiovascular adverse events: A narrative review

    PubMed Central

    Nezafati, Mohammad Hassan; Vojdanparast, Mohammad; Nezafati, Pouya

    2015-01-01

    BACKGROUND Major depression or deterioration of previous mood disorders is a common adverse consequence of coronary heart disease, heart failure, and cardiac revascularization procedures. Therefore, treatment of depression is expected to result in improvement of mood condition in these patients. Despite demonstrated effects of anti-depressive treatment in heart disease patients, the use of some antidepressants have shown to be associated with some adverse cardiac and non-cardiac events. In this narrative review, the authors aimed to first assess the findings of published studies on beneficial and also harmful effects of different types of antidepressants used in patients with heart diseases. Finally, a new categorization for selecting antidepressants according to their cardiovascular effects was described. METHODS Using PubMed, Web of Science, SCOPUS, Index Copernicus, CINAHL, and Cochrane Database, we identified studies designed to evaluate the effects of depression and also using antidepressants on cardiovascular outcome. A 40 studies were finally assessed systematically. Among those eligible studies, 14 were cohort or historical cohort studies, 15 were randomized clinical trial, 4 were retrospective were case-control studies, 3 were meta-analyses and 2 animal studies, and 2 case studies. RESULTS According to the current review, we recommend to divide antidepressants into three categories based on the severity of cardiovascular adverse consequences including (1) the safest drugs including those drugs with cardio-protective effects on ventricular function, as well as cardiac conductive system including selective serotonin reuptake inhibitors, (2) neutralized drugs with no evidenced effects on cardiovascular system including serotonin-norepinephrine reuptake inhibitors, and (3) harmful drugs with adverse effects on cardiac function, hemodynamic stability, and heart rate variability including tricyclic antidepressants, serotonin antagonist and reuptake inhibitors

  19. Early Life Adversity and Adult Biological Risk Profiles

    PubMed Central

    Friedman, Esther M.; Karlamangla, Arun S.; Gruenewald, Tara; Koretz, Brandon; Seeman, Teresa E.

    2015-01-01

    Objectives To determine whether there is a relationship between early life adversity (ELA) and biological parameters known to predict health risks and to examine the extent to which circumstances in midlife mediate this relationship. Methods We analyzed data on 1,180 respondents from the biomarker subsample of the second wave of the National Survey of Midlife Development in the United States (MIDUS) study. ELA assessments were based on childhood socioeconomic disadvantage (i.e. on welfare, perceived low income, less-educated parents) and other stressors (e.g., parental death, parental divorce, and parental physical abuse). The outcome variable was cumulative allostatic load (AL), a marker of biological risk. We also incorporate information on adult circumstances, including: education, social relationships, and health behaviors. Results Childhood socioeconomic adversity was associated with increased AL (B=0.094, SE=0.041) and physical abuse (B=0.263, SE=0.091), with non-significant associations for parental divorce and death. Adult education mediated the relationship between socioeconomic ELA and cumulative allostatic load to the point of non-significance, with this factor alone explaining nearly 40% of the relationship. The association between childhood physical abuse and AL remained even after adjusting for adult educational attainments, social relationships, and health behaviors. These associations were most pronounced for secondary stress systems, including inflammation, cardiovascular function, and lipid metabolism. Conclusions The physiological consequences of early life socioeconomic adversity are attenuated by achieving high levels of schooling later on. The adverse consequences of childhood physical abuse, on the other hand, persist in multivariable adjusted analysis. PMID:25650548

  20. Using Negative Consequences Effectively.

    ERIC Educational Resources Information Center

    Bacon, Ellen H.

    1990-01-01

    Methods of dealing with students' inappropriate behavior, noncompliance, and conflict can be implemented at different levels within the school. Schoolwide interventions include expulsion, suspension, and physical punishment. Classroom interventions include time out, verbal reprimands and commands, logical consequences, and surface management…

  1. Tank bump consequence analysis

    SciTech Connect

    Board, B.D.

    1996-09-01

    The purpose of this document is to derive radiological and toxicological consequences for a tank bump event based on analysis performed using the GOTH computer model, to estimate the mitigative effect of pump and sluice pit cover blocks, and to discuss preventative measures.

  2. Tank bump consequence analysis

    SciTech Connect

    Board, B.D.

    1996-08-07

    The purpose of this document is to derive radiological and toxicological consequences for a tank bump event based on analysis performed using the GOTH computer model, to estimate the mitigative effect of pump and sluice pit cover blocks, and to discuss preventative measures.

  3. Adverse effects of general anaesthetics.

    PubMed

    Berthoud, M C; Reilly, C S

    1992-01-01

    This review deals with the adverse reactions associated with general anaesthetic agents in current use. These reactions fall into 2 categories; those which are more common, predictable and often closely related, and those which are rare, unpredictable and carry a high mortality. Both inhalational and intravenous anaesthetic agents affect the central nervous and cardio-respiratory systems in a dose-related manner. Neuronal inhibition results in decreasing levels of consciousness and depression of the medullary vital centres which can lead to cardiorespiratory failure. Both groups of agents have some depressant effect on the myocardium and vascular smooth muscle leading to a fall in cardiac output and hypotension. Centrally-mediated respiratory depression is common to both groups and the inhalational agents have a direct effect on lung physiology. The most important idiosyncratic reactions to the volatile agents are malignant hyperpyrexia and 'halothane hepatitis'. Malignant hyperpyrexia has an incidence of 1:12,000 with a mortality of about 24%. It is triggered most often by halothane together with suxamethonium. Post halothane hepatic necrosis is rare. Evidence points to 2 distinct syndromes; direct toxicity from the products of reductive metabolism, and a more serious illness, immunologically mediated via haptens formed by liver proteins and the products of oxidative metabolism. Prolonged nitrous oxide exposure can cause bone marrow depression and life-threatening pressure effects by expansion of air-filled spaces within the body. The idiosyncratic reactions to the intravenous agents include anaphylactoid reactions (which are rare) and triggering of acute porphyria. Etomidate is immunologically 'clean', but it inhibits cortisol synthesis. PMID:1418699

  4. Early adversity, neural development, and inflammation.

    PubMed

    Chiang, Jessica J; Taylor, Shelley E; Bower, Julienne E

    2015-12-01

    Early adversity is a risk factor for poor mental and physical health. Although altered neural development is believed to be one pathway linking early adversity to psychopathology, it has rarely been considered a pathway linking early adversity to poor physical health. However, this is a viable pathway because the central nervous system is known to interact with the immune system via the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). In support of this pathway, early adversity has been linked to changes in neural development (particularly of the amygdala, hippocampus, and prefrontal cortex), HPA axis and ANS dysregulation, and higher levels of inflammation. Inflammation, in turn, can be detrimental to physical health when prolonged. In this review, we present these studies and consider how altered neural development may be a pathway by which early adversity increases inflammation and thus risk for adverse physical health outcomes.

  5. [Cutaneous adverse effects of TNFalpha antagonists].

    PubMed

    Failla, V; Sabatiello, M; Lebas, E; de Schaetzen, V; Dezfoulian, B; Nikkels, A F

    2012-01-01

    The TNFalpha antagonists, including adalimumab, etanercept and infliximab, represent a class of anti-inflammatory and immunosuppressive drugs. Although cutaneous adverse effects are uncommon, they are varied. There is no particular risk profile to develop cutaneous adverse effects. The principal acute side effects are injection site reactions and pruritus. The major long term cutaneous side effects are infectious and inflammatory conditions. Neoplastic skin diseases are exceptional. The association with other immunosuppressive agents can increase the risk of developing cutaneous adverse effects. Some adverse effects, such as lupus erythematosus, require immediate withdrawal of the biological treatment, while in other cases temporary withdrawal is sufficient. The majority of the other cutaneous adverse effects can be dealt without interrupting biologic treatment. Preclinical and clinical investigations revealed that the new biologics, aiming IL12/23, IL23 and IL17, present a similar profile of cutaneous adverse effects, although inflammatory skin reactions may be less often encountered compared to TNFalpha antagonists.

  6. Pathophysiology of Coronary Thrombus Formation and Adverse Consequences of Thrombus During PCI

    PubMed Central

    Srikanth, Sundararajan; Ambrose, John A

    2012-01-01

    Atherosclerosis is a systemic vascular pathology that is preceded by endothelial dysfunction. Vascular inflammation “fuels” atherosclerosis and creates the milieu for episodes of intravascular thromboses. Thrombotic events in the coronary vasculature may lead to asymptomatic progression of atherosclerosis or could manifest as acute coronary syndromes or even sudden cardiac death. Thrombus encountered in the setting of acute coronary syndromes has been correlated with acute complications during percutaneous coronary interventions such as no-reflow, acute coronary occlusion and long term complications such as stent thrombus. This article reviews the pathophysiology of coronary thrombogenesis and explores the complications associated with thrombus during coronary interventions. PMID:22920487

  7. Adverse Consequences of School Mobility for Children in Foster Care: A Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Pears, Katherine C.; Kim, Hyoun K.; Buchanan, Rohanna; Fisher, Philip A.

    2015-01-01

    Few prospective studies have examined school mobility in children in foster care. This study described the school moves of 86 such children and 55 community comparison children (primarily Caucasian), living in a medium-sized metropolitan area in the Pacific Northwest who were approximately 3 to 6 years old at the study start. Additionally, the…

  8. Mechanisms and Clinical Consequences of Vascular Calcification

    PubMed Central

    Zhu, Dongxing; Mackenzie, Neil C. W.; Farquharson, Colin; MacRae, Vicky E.

    2012-01-01

    Vascular calcification has severe clinical consequences and is considered an accurate predictor of future adverse cardiovascular events, including myocardial infarction and stroke. Previously vascular calcification was thought to be a passive process which involved the deposition of calcium and phosphate in arteries and cardiac valves. However, recent studies have shown that vascular calcification is a highly regulated, cell-mediated process similar to bone formation. In this article, we outline the current understanding of key mechanisms governing vascular calcification and highlight the clinical consequences. By understanding better the molecular pathways and genetic circuitry responsible for the pathological mineralization process novel drug targets may be identified and exploited to combat and reduce the detrimental effects of vascular calcification on human health. PMID:22888324

  9. Human Capital and Economic Growth.

    ERIC Educational Resources Information Center

    Mincer, Jacob

    1984-01-01

    The framework of an aggregate production function shows that growth of human capital is both a condition and a consequence of economic growth. The concurrent growth and diffusion of human capital, involving production of new knowledge, appears necessary to ensure sustained economic development worldwide. (TE)

  10. Severe Adverse Events Related to Tattooing: An Retrospective Analysis of 11 Years

    PubMed Central

    Wollina, Uwe

    2012-01-01

    Background: The incidence of tattoos has been increased markedly during the last 20 years. Aims: To analyze the patient files for severe adverse medical reactions related to tattooing. Settings: Academic Teaching Hospital in South-East Germany. Materials and Methods: Retrospective investigation from March 2001 to May 2012. Results: The incidence of severe adverse medical reactions has been estimated as 0.02%. Infectious and non-infectious severe reactions have been observed. The consequences were medical drug therapies and surgery. Conclusions: Tattooing may be associated with severe adverse medical reactions with significant morbidity. Regulations, education and at least hygienic controls are tools to increase consumer safety. PMID:23248361

  11. Behavioral economics.

    PubMed

    Camerer, Colin F

    2014-09-22

    Behavioral economics uses evidence from psychology and other social sciences to create a precise and fruitful alternative to traditional economic theories, which are based on optimization. Behavioral economics may interest some biologists, as it shifts the basis for theories of economic choice away from logical calculation and maximization and toward biologically plausible mechanisms.

  12. Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players.

    PubMed

    Gouttebarge, Vincent; Aoki, Haruhito; Kerkhoffs, Gino

    2015-12-22

    To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance) and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour) among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction). Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players' unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01) were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population. PMID:26925182

  13. Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

    PubMed Central

    Gouttebarge, Vincent; Aoki, Haruhito; Kerkhoffs, Gino

    2015-01-01

    To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance) and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour) among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction). Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players’ unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01) were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population. PMID:26925182

  14. The interplay between structure and agency in shaping the mental health consequences of job loss

    PubMed Central

    2013-01-01

    Background Job loss is a discrete life event, with multiple adverse consequences for physical and mental health and implications for agency. Our research explores the consequences of job loss for retrenched workers’ mental health by examining the interplay between their agency and the structures shaping their job loss experiences. Methods We conducted two waves of in-depth, semi-structured interviews with a sample of 33 of the more than 1000 workers who lost their jobs at Mitsubishi Motors in South Australia during 2004 and 2005 as a result of industry restructuring. Interviews capturing the mental health consequences of job loss were recorded and transcribed verbatim. Thematic analysis was employed to determine the health consequences of the job loss and the impact of structural factors. Results Main themes that emerged from the qualitative exploration of the psychological distress of job loss included stress, changes to perceived control, loss of self-esteem, shame and loss of status, experiencing a grieving process, and financial strain. Drawing on two models of agency we identified the different ways workers employed their agency, and how their agency was enabled, but mainly constrained, when dealing with job loss consequences. Conclusions Respondents’ accounts support the literature on the moderating effects of economic resources such as redundancy packages. The results suggest the need for policies to put more focus on social, emotional and financial investment to mediate the structural constraints of job loss. Our study also suggests that human agency must be understood within an individual’s whole of life circumstances, including structural and material constraints, and the personal or interior factors that shape these circumstances. PMID:23384322

  15. Consequences of infertility in developing countries.

    PubMed

    Rouchou, Brittany

    2013-05-01

    Infertility affects more than 10% of the world's population. In developing countries, there are severe social, psychological and economic consequences for infertile men and women. All of the cited references are compiled from primary peer-reviewed research articles that were conducted through one-to-one interviews or focus groups in countries of developing regions, such as Africa, Asia and the Middle East. The following paper seeks to raise awareness of the consequences of infertility in developing nations and identify infertility as an under-observed, but significant public health issue. It is proposed that education programmes tailored to each society's specific religious beliefs and grounded traditions must be implemented in order to reverse the social stigma, detrimental psychological effects, and loss of economic security that results from infertility.

  16. Adverse effects of glucocorticoids: coagulopathy.

    PubMed

    Coelho, Maria Caroline Alves; Santos, Camila Vicente; Vieira Neto, Leonardo; Gadelha, Mônica R

    2015-10-01

    Hypercortisolism is associated with various systemic manifestations, including central obesity, arterial hypertension, glucose intolerance/diabetes mellitus, dyslipidemia, nephrolithiasis, osteoporosis, gonadal dysfunction, susceptibility to infections, psychiatric disorders, and hypercoagulability. The activation of the hemostatic system contributes to the development of atherosclerosis and subsequent cardiovascular morbidity and mortality. Previous studies have identified an increased risk of both unprovoked and postoperative thromboembolic events in patients with endogenous and exogenous Cushing's syndrome (CS). The risk for postoperative venous thromboembolism in endogenous CS is comparable to the risk after total hip or knee replacement under short-term prophylaxis. The mechanisms that are involved in the thromboembolic complications in hypercortisolism include endothelial dysfunction, hypercoagulability, and stasis (Virchow's triad). It seems that at least two factors from Virchow's triad must be present for the occurrence of a thrombotic event in these patients. Most studies have demonstrated that this hypercoagulable state is explained by increased levels of procoagulant factors, mainly factors VIII, IX, and von Willebrand factor, and also by an impaired fibrinolytic capacity, which mainly results from an elevation in plasminogen activator inhibitor 1. Consequently, there is a shortening of activated partial thromboplastin time and increased thrombin generation. For these reasons, anticoagulant prophylaxis might be considered in patients with CS whenever they have concomitant prothrombotic risk factors. However, multicenter studies are needed to determine which patients will benefit from anticoagulant therapy and the dose and time of anticoagulation.

  17. [Clinical consequences of sarcopenia].

    PubMed

    Serra Rexach, J A

    2006-05-01

    The concept of sarcopenia implies loss of muscle mass and function. It is a condition that accompanies aging, although it not always has clinical consequences. It is produced by many factors: nervous system (loss of alpha motor units in the spinal cord), muscular (loss of muscle quality and mass), humoral (decrease in anabolic hormones such as testosterone, estrogens, GH, and increase of several interleukines), and life style (physical activity). The main clinical consequences of sarcopenia relate with functional independence. Thus, the sarcopenic elderly has greater difficulty walking, or do it more slowly, climbing up stairs, or doing basic daily living activities. These difficulties increase the risk for falls and, thus, fractures. They also affect bone formation, glucose tolerance, and body temperature regulation. Besides, dependency is a mortality risk factor.

  18. Couple resilience to economic pressure.

    PubMed

    Conger, R D; Rueter, M A; Elder, G H

    1999-01-01

    Over 400 married couples participated in a 3-year prospective study of economic pressure and marital relations. The research (a) empirically evaluated the family stress model of economic stress influences on marital distress and (b) extended the model to include specific interactional characteristics of spouses hypothesized to protect against economic pressure. Findings provided support for the basic mediational model, which proposes that economic pressure increases risk for emotional distress, which, in turn, increases risk for marital conflict and subsequent marital distress. Regarding resilience to economic stress, high marital support reduced the association between economic pressure and emotional distress. In addition, effective couple problem solving reduced the adverse influence of marital conflict on marital distress. Overall, the findings provided substantial support for the extended family stress model.

  19. Phenomenological consequences of supersymmetry

    SciTech Connect

    Hinchliffe, I.; Littenberg, L.

    1982-01-01

    This report deals with the phenomenological consequences of supersymmetric theories, and with the implications of such theories for future high energy machines. It is concerned only with high energy predictions of supersymmetry; low energy consequences (for example in the K/sub o/anti K/sub o/ system) are discussed in the context of future experiments by another group, and will be mentioned briefly only in the context of constraining existing models. However a brief section is included on the implication for proton decay, although detailed experimental questions are not discussed. The report is organized as follows. Section I consists of a brief review of supersymmetry and the salient features of existing supersymmetric models; this section can be ignored by those familiar with such models since it contains nothing new. Section 2 deals with the consequences for nucleon decay of SUSY. The remaining sections then discuss the physics possibilities of various machines; e anti e in Section 3, ep in Section 4, pp (or anti pp) colliders in Section 5 and fixed target hadron machines in Section 6.

  20. Strategic approaches to adverse outcome pathway development

    EPA Science Inventory

    Adverse outcome pathways (AOPs) are conceptual frameworks for organizing biological and toxicological knowledge in a manner that supports extrapolation of data pertaining to the initiation or early progression of toxicity to an apical adverse outcome that occurs at a level of org...

  1. Understanding adverse events: human factors.

    PubMed Central

    Reason, J

    1995-01-01

    (1) Human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. This includes healthcare systems. (2) Managing the human risks will never be 100% effective. Human fallibility can be moderated, but it cannot be eliminated. (3) Different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. The basic distinctions are between: Slips, lapses, trips, and fumbles (execution failures) and mistakes (planning or problem solving failures). Mistakes are divided into rule based mistakes and knowledge based mistakes. Errors (information-handling problems) and violations (motivational problems) Active versus latent failures. Active failures are committed by those in direct contact with the patient, latent failures arise in organisational and managerial spheres and their adverse effects may take a long time to become evident. (4) Safety significant errors occur at all levels of the system, not just at the sharp end. Decisions made in the upper echelons of the organisation create the conditions in the workplace that subsequently promote individual errors and violations. Latent failures are present long before an accident and are hence prime candidates for principled risk management. (5) Measures that involve sanctions and exhortations (that is, moralistic measures directed to those at the sharp end) have only very limited effectiveness, especially so in the case of highly trained professionals. (6) Human factors problems are a product of a chain of causes in which the individual psychological factors (that is, momentary inattention, forgetting, etc) are the last and least manageable links. Attentional "capture" (preoccupation or distraction) is a necessary condition for the commission of slips and lapses. Yet, its occurrence is almost impossible to predict or control effectively. The same is true of the factors associated with

  2. Understanding adverse events: human factors.

    PubMed

    Reason, J

    1995-06-01

    (1) Human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. This includes healthcare systems. (2) Managing the human risks will never be 100% effective. Human fallibility can be moderated, but it cannot be eliminated. (3) Different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. The basic distinctions are between: Slips, lapses, trips, and fumbles (execution failures) and mistakes (planning or problem solving failures). Mistakes are divided into rule based mistakes and knowledge based mistakes. Errors (information-handling problems) and violations (motivational problems) Active versus latent failures. Active failures are committed by those in direct contact with the patient, latent failures arise in organisational and managerial spheres and their adverse effects may take a long time to become evident. (4) Safety significant errors occur at all levels of the system, not just at the sharp end. Decisions made in the upper echelons of the organisation create the conditions in the workplace that subsequently promote individual errors and violations. Latent failures are present long before an accident and are hence prime candidates for principled risk management. (5) Measures that involve sanctions and exhortations (that is, moralistic measures directed to those at the sharp end) have only very limited effectiveness, especially so in the case of highly trained professionals. (6) Human factors problems are a product of a chain of causes in which the individual psychological factors (that is, momentary inattention, forgetting, etc) are the last and least manageable links. Attentional "capture" (preoccupation or distraction) is a necessary condition for the commission of slips and lapses. Yet, its occurrence is almost impossible to predict or control effectively. The same is true of the factors associated with

  3. Multiple adverse experiences and child cognitive development.

    PubMed

    Guinosso, Stephanie A; Johnson, Sara B; Riley, Anne W

    2016-01-01

    During childhood and adolescence, children's social environments shape their cognitive development. Children exposed to multiple adversities in their social environment are more likely to have poorer cognitive outcomes. These findings have prompted interest among pediatric and public health communities to screen and connect youth to appropriate interventions that ameliorate the detrimental effects of adverse exposures. Such intervention efforts can be improved with a stronger conceptual understanding of the relationship between multiple adverse exposures and child cognitive development. This includes disentangling adverse exposures from other risk factors or underlying mechanisms, specifying mechanisms of action, and determining when adverse exposures are most detrimental. This review summarizes findings from the literature on each of these areas and proposes a conceptual model to guide further research and intervention.

  4. Adverse effects of anabolic steroids in athletes.

    PubMed

    Kibble, M W; Ross, M B

    1987-09-01

    The effects of anabolic steroid use on athletic performance and the adverse effects associated with the use of anabolic steroids are reviewed. Anabolic steroids increase protein synthesis in skeletal muscles and reverse catabolic processes. Because of these properties, some athletes use anabolic steroids in an attempt to improve their athletic performance. However, studies indicate that increases in muscle mass and strength during anabolic steroid administration are observed only in athletes who already are weight-trained and who continue intensive training while maintaining high-protein, high-calorie diets. Adverse effects attributed to anabolic steroid use occur frequently. Serious adverse effects include hepatic and endocrine dysfunction; cardiovascular and behavioral changes also are reported. Some of the adverse effects associated with the use of these agents are irreversible, particularly in women. The use of anabolic steroids to improve athletic performance has become prevalent. However, the reported benefits are tempered by numerous adverse reactions.

  5. Adulthood personality correlates of childhood adversity

    PubMed Central

    Carver, Charles S.; Johnson, Sheri L.; McCullough, Michael E.; Forster, Daniel E.; Joormann, Jutta

    2014-01-01

    Objective: Childhood adversity has been linked to internalizing and externalizing disorders and personality disorders in adulthood. This study extends that research by examining several personality measures as correlates of childhood adversity. Method: In a college sample self-reports were collected of childhood adversity, several scales relating to personality, and current depression symptoms as a control variable. The personality-related scales were reduced to four latent variables, which we termed anger/aggression, extrinsic focus, agreeableness, and engagement. Results: Controlling for concurrent depressive symptoms and gender, higher levels of reported childhood adversity related to lower agreeableness and to higher anger/aggression and extrinsic focus. Conclusions: Findings suggest that early adversity is linked to personality variables relevant to the building of social connection. PMID:25484874

  6. Health and economic consequences of septic induced abortion.

    PubMed

    Konje, J C; Obisesan, K A; Ladipo, O A

    1992-03-01

    Over a period of 7 years, 230 cases of illegally induced abortions complicated by sepsis were treated at the University College Hospital, Ibadan, Nigeria. The number of terminations complicated by sepsis doubled from 25.4 (between 1981 and 1985) to 51.0 (between 1986 and 1987) cases per year. Peritonitis was the commonest associated complication while maternal mortality was 8.3%. The average cost of treatment was US$223.11, while the average monthly earnings was US$45.00. Legalization of abortion would have resulted in a saving of US$50,022.28. Provision of legal abortion would reduce the incidence of sepsis after termination while reproductive health education and information dissemination and provision of easily accessible family planning services would greatly reduce the number of unwanted pregnancies.

  7. The social and economic consequences of finger amputations.

    PubMed

    Hovgaard, C; Angermann, P; Hovgaard, D

    1994-06-01

    120 patients with amputation of at least 1 of the 4 ulnar fingers were admitted to hospital. In none was replantation considered to be possible because of serious damage to the soft tissues and bone. 12 (3-18) years after the accident 80 percent of the patients assessed their condition as good or fair, even those with proximal amputation or loss of 2 or 3 fingers. Our observations do not support replantation when only one of the second-to-fifth fingers have been amputated.

  8. Outlook for Soviet economic reform

    SciTech Connect

    Zycher, B.

    1990-12-01

    The central goal of the essay is presentation of the reasons for pessimism about the prospects for Soviet economic improvement in the short and medium terms. It first discusses some necessary conditions for real long-term growth in any economy; experience suggests that these underlying foundations will be difficult to attain in the Soviet context. Second, it turns to the short- and medium-term outlook for Soviet economic performance even if all the necessary policy changes and economic institutions were adopted. And, finally it addresses the Gorbachev reform program; this plan illustrates quite neatly the adverse constraints imposed by the past and the poor prospects for the future.

  9. Managing adverse effects of glaucoma medications

    PubMed Central

    Inoue, Kenji

    2014-01-01

    Glaucoma is a chronic, progressive disease in which retinal ganglion cells disappear and subsequent, gradual reductions in the visual field ensues. Glaucoma eye drops have hypotensive effects and like all other medications are associated with adverse effects. Adverse reactions may either result from the main agent or from preservatives used in the drug vehicle. The preservative benzalkonium chloride, is one such compound that causes frequent adverse reactions such as superficial punctate keratitis, corneal erosion, conjunctival allergy, and conjunctival injection. Adverse reactions related to main hypotensive agents have been divided into those affecting the eye and those affecting the entire body. In particular, β-blockers frequently cause systematic adverse reactions, including bradycardia, decrease in blood pressure, irregular pulse and asthma attacks. Prostaglandin analogs have distinctive local adverse reactions, including eyelash bristling/lengthening, eyelid pigmentation, iris pigmentation, and upper eyelid deepening. No systemic adverse reactions have been linked to prostaglandin analog eye drop usage. These adverse reactions may be minimized when they are detected early and prevented by reducing the number of different eye drops used (via fixed combination eye drops), reducing the number of times eye drops are administered, using benzalkonium chloride-free eye drops, using lower concentration eye drops, and providing proper drop instillation training. Additionally, a one-time topical medication can be given to patients to allow observation of any adverse reactions, thereafter the preparation of a topical medication with the fewest known adverse reactions can be prescribed. This does require precise patient monitoring and inquiries about patient symptoms following medication use. PMID:24872675

  10. Adverse events to monoclonal antibodies used for cancer therapy

    PubMed Central

    Baldo, Brian A

    2013-01-01

    Fifteen monoclonal antibodies (mAbs) are currently registered and approved for the treatment of a range of different cancers. These mAbs are specific for a limited number of targets (9 in all). Four of these molecules are indeed directed against the B-lymphocyte antigen CD20; 3 against human epidermal growth factor receptor 2 (HER2 or ErbB2), 2 against the epidermal growth factor receptor (EGFR), and 1 each against epithelial cell adhesion molecule (EpCAM), CD30, CD52, vascular endothelial growth factor (VEGF), tumor necrosis factor (ligand) superfamily, member 11 (TNFSF11, best known as RANKL), and cytotoxic T lymphocyte-associated protein 4 (CTLA4). Collectively, the mAbs provoke a wide variety of systemic and cutaneous adverse events including the full range of true hypersensitivities: Type I immediate reactions (anaphylaxis, urticaria); Type II reactions (immune thrombocytopenia, neutopenia, hemolytic anemia); Type III responses (vasculitis, serum sickness; some pulmonary adverse events); and Type IV delayed mucocutaneous reactions as well as infusion reactions/cytokine release syndrome (IRs/CRS), tumor lysis syndrome (TLS), progressive multifocal leukoencephalopathy (PML) and cardiac events. Although the term “hypersensitivity” is widely used, no common definition has been adopted within and between disciplines and the requirement of an immunological basis for a true hypersensitivity reaction is sometimes overlooked. Consequently, some drug-induced adverse events are sometimes incorrectly described as “hypersensitivities” while others that should be described are not. PMID:24251081

  11. Stimulating Economics

    ERIC Educational Resources Information Center

    Banaian, King

    2009-01-01

    With the current economic slump possibly the deepest since the Great Depression, interest in the subject of macroeconomics has reignited, and the number of students majoring in economics has increased during the last two years. While this would appear to be good news for educators in the economics field, the profession is nervous about more than…

  12. Television Economics.

    ERIC Educational Resources Information Center

    Owen, Bruce M.; And Others

    Intended as an introduction to the economics of commercial television for the general reader, this volume considers the theory and analytical basis of television and the policy implications of those economics. Part I considers the economics of television markets with particular attention of the determinants of viewer markets; the supply of…

  13. An examination of the consequences in high consequence operations

    SciTech Connect

    Spray, S.D.; Cooper, J.A.

    1996-06-01

    Traditional definitions of risk partition concern into the probability of occurrence and the consequence of the event. Most safety analyses focus on probabilistic assessment of an occurrence and the amount of some measurable result of the event, but the real meaning of the ``consequence`` partition is usually afforded less attention. In particular, acceptable social consequence (consequence accepted by the public) frequently differs significantly from the metrics commonly proposed by risk analysts. This paper addresses some of the important system development issues associated with consequences, focusing on ``high consequence operations safety.``

  14. Intuitions, principles and consequences.

    PubMed

    Shaw, A B

    2001-02-01

    Some approaches to the assessment of moral intuitions are discussed. The controlled ethical trial isolates a moral issue from confounding factors and thereby clarifies what a person's intuition actually is. Casuistic reasoning from situations, where intuitions are clear, suggests or modifies principles, which can then help to make decisions in situations where intuitions are unclear. When intuitions are defended by a supporting principle, that principle can be tested by finding extreme cases, in which it is counterintuitive to follow the principle. An approach to the resolution of conflict between valid moral principles, specifically the utilitarian and justice principles, is considered. It is argued that even those who justify intuitions by a priori principles are often obliged to modify or support their principles by resort to the consideration of consequences.

  15. The Role of ADHD in Academic Adversity: Disentangling ADHD Effects from Other Personal and Contextual Factors

    ERIC Educational Resources Information Center

    Martin, Andrew J.

    2014-01-01

    Students with attention-deficit/hyperactivity disorder (ADHD) experience significant academic difficulties that can lead to numerous negative academic consequences. With a focus on adverse academic outcomes, this study seeks to disentangle variance attributable to ADHD from variance attributable to salient personal and contextual covariates.…

  16. Childhood adversity and adult health: Evaluating intervening mechanisms.

    PubMed

    Turner, R Jay; Thomas, Courtney S; Brown, Tyson H

    2016-05-01

    Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience - implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences - a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N = 1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP-allostatic load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure. PMID:27030896

  17. Childhood adversities and psychosis: evidence, challenges, implications

    PubMed Central

    Morgan, Craig; Gayer‐Anderson, Charlotte

    2016-01-01

    There is a substantial body of research reporting evidence of associations between various forms of childhood adversity and psychosis, across the spectrum from experiences to disorder. This has been extended, more recently, to include studies of cumulative effects, of interactions with other factors, of specific effects, and of putative biological and psychological mechanisms. In this paper we evaluate this research and highlight the remaining methodological issues and gaps that temper, but do not dismiss, conclusions about the causal role of childhood adversity. We also consider the emerging work on cumulative, synergistic, and specific effects and on mechanisms; and discuss the broader implications of this line of research for our understanding of psychosis. We conclude that the current balance of evidence is that childhood adversities – particularly exposure to multiple adversities involving hostility and threat – do, in some people, contribute to the onset of psychotic experiences and psychotic disorders. PMID:27265690

  18. RACIAL RESIDENTIAL SEGREGATION AND ADVERSE BIRTH OUTCOMES

    EPA Science Inventory

    INTRODUCTION. The disparity between black and white women's adverse birth outcomes has been subject to much investigation, yet the factors underlying its persistence remain elusive, which has encouraged research on neighborhood-level influences, including racial residential segr...

  19. Encouraging spontaneous reporting of adverse effects.

    PubMed

    2015-02-01

    One priority when organising surveillance of health products is to remove barriers to reporting adverse effects. One way to encourage reporting is by providing regular feedback, as practised by the German drug bulletin arznei-telegramm, for example. PMID:25802925

  20. Adverse Outcome Pathways: From Definition to Application

    EPA Science Inventory

    A challenge for both human health and ecological toxicologists is the transparent application of mechanistic (e.g., molecular, biochemical, histological) data to risk assessments. The adverse outcome pathway (AOP) is a conceptual framework designed to meet this need. Specifical...

  1. Asymmetric information and economics

    NASA Astrophysics Data System (ADS)

    Frieden, B. Roy; Hawkins, Raymond J.

    2010-01-01

    We present an expression of the economic concept of asymmetric information with which it is possible to derive the dynamical laws of an economy. To illustrate the utility of this approach we show how the assumption of optimal information flow leads to a general class of investment strategies including the well-known Q theory of Tobin. Novel consequences of this formalism include a natural definition of market efficiency and an uncertainty principle relating capital stock and investment flow.

  2. Interventions to prevent adverse fetal programming due to maternal obesity during pregnancy.

    PubMed

    Nathanielsz, Peter W; Ford, Stephen P; Long, Nathan M; Vega, Claudia C; Reyes-Castro, Luis A; Zambrano, Elena

    2013-10-01

    Maternal obesity is a global epidemic affecting both developed and developing countries. Human and animal studies indicate that maternal obesity adversely programs the development of offspring, predisposing them to chronic diseases later in life. Several mechanisms act together to produce these adverse health effects. There is a consequent need for effective interventions that can be used in the management of human pregnancy to prevent these outcomes. The present review analyzes the dietary and exercise intervention studies performed to date in both altricial and precocial animals, rats and sheep, with the aim of preventing adverse offspring outcomes. The results of these interventions present exciting opportunities to prevent, at least in part, adverse metabolic and other outcomes in obese mothers and their offspring.

  3. Public health consequences of mercury spills: Hazardous Substances Emergency Events Surveillance system, 1993-1998.

    PubMed Central

    Zeitz, Perri; Orr, Maureen F; Kaye, Wendy E

    2002-01-01

    We analyzed data from states that participated in the Hazardous Substances Emergency Events Surveillance (HSEES) system maintained by the Agency for Toxic Substances and Disease Registry to describe the public health consequences of mercury releases. From 1993 through 1998, HSEES captured 406 events in which mercury was the only substance released. Schools and universities, private residences, and health care facilities were the most frequent locations involved in mercury events, and human error was the contributing factor for most of the releases. Fourteen persons experienced adverse health effects as a result of the releases. An additional 31 persons had documented elevated levels of mercury in the blood. No fatalities resulted. Evacuations were ordered in 90 (22%) of the events, and the length of evacuation ranged from 1 hr to 46 days. Mercury spills have a significant public health impact and economic burden. Some actions that could potentially lessen the consequences of mercury spills are to switch to mercury-free alternatives, train people in the safe handling and disposal of mercury, and keep mercury securely stored when it is necessary to have it on hand. PMID:11836139

  4. The Consequences of Hunger and Food Insecurity for Children: Evidence from Recent Scientific Studies.

    ERIC Educational Resources Information Center

    Brandeis Univ., Waltham, MA. Center on Hunger and Poverty.

    Asserting that 13 million U.S. children live in households with limited or uncertain access to sufficient food, this report highlights recent findings showing the adverse consequences of hunger and food insecurity for children. The findings are grouped into three broad areas: health consequences, psychosocial and behavioral impacts, and learning…

  5. Seismic Consequence Abstraction

    SciTech Connect

    M. Gross

    2004-10-25

    The primary purpose of this model report is to develop abstractions for the response of engineered barrier system (EBS) components to seismic hazards at a geologic repository at Yucca Mountain, Nevada, and to define the methodology for using these abstractions in a seismic scenario class for the Total System Performance Assessment - License Application (TSPA-LA). A secondary purpose of this model report is to provide information for criticality studies related to seismic hazards. The seismic hazards addressed herein are vibratory ground motion, fault displacement, and rockfall due to ground motion. The EBS components are the drip shield, the waste package, and the fuel cladding. The requirements for development of the abstractions and the associated algorithms for the seismic scenario class are defined in ''Technical Work Plan For: Regulatory Integration Modeling of Drift Degradation, Waste Package and Drip Shield Vibratory Motion and Seismic Consequences'' (BSC 2004 [DIRS 171520]). The development of these abstractions will provide a more complete representation of flow into and transport from the EBS under disruptive events. The results from this development will also address portions of integrated subissue ENG2, Mechanical Disruption of Engineered Barriers, including the acceptance criteria for this subissue defined in Section 2.2.1.3.2.3 of the ''Yucca Mountain Review Plan, Final Report'' (NRC 2003 [DIRS 163274]).

  6. Eusociality: origin and consequences.

    PubMed

    Wilson, Edward O; Hölldobler, Bert

    2005-09-20

    In this new assessment of the empirical evidence, an alternative to the standard model is proposed: group selection is the strong binding force in eusocial evolution; individual selection, the strong dissolutive force; and kin selection (narrowly defined), either a weak binding or weak dissolutive force, according to circumstance. Close kinship may be more a consequence of eusociality than a factor promoting its origin. A point of no return to the solitary state exists, as a rule when workers become anatomically differentiated. Eusociality has been rare in evolution, evidently due to the scarcity of environmental pressures adequate to tip the balance among countervailing forces in favor of group selection. Eusociality in ants and termites in the irreversible stage is the key to their ecological dominance and has (at least in ants) shaped some features of internal phylogeny. Their colonies are consistently superior to solitary and preeusocial competitors, due to the altruistic behavior among nestmates and their ability to organize coordinated action by pheromonal communication. PMID:16157878

  7. Evolutionary consequences of autopolyploidy.

    PubMed

    Parisod, Christian; Holderegger, Rolf; Brochmann, Christian

    2010-04-01

    Autopolyploidy is more common in plants than traditionally assumed, but has received little attention compared with allopolyploidy. Hence, the advantages and disadvantages of genome doubling per se compared with genome doubling coupled with hybridizations in allopolyploids remain unclear. Autopolyploids are characterized by genomic redundancy and polysomic inheritance, increasing effective population size. To shed light on the evolutionary consequences of autopolyploidy, we review a broad range of studies focusing on both synthetic and natural autopolyploids encompassing levels of biological organization from genes to evolutionary lineages. The limited evidence currently available suggests that autopolyploids neither experience strong genome restructuring nor wide reorganization of gene expression during the first generations following genome doubling, but that these processes may become more important in the longer term. Biogeographic and ecological surveys point to an association between the formation of autopolyploid lineages and environmental change. We thus hypothesize that polysomic inheritance may provide a short-term evolutionary advantage for autopolyploids compared to diploid relatives when environmental change enforces range shifts. In addition, autopolyploids should possess increased genome flexibility, allowing them to adapt and persist across heterogeneous landscapes in the long run. PMID:20070540

  8. [Rodenticide resistance and consequences].

    PubMed

    Esther, A; Endepols, S; Freise, J; Klemann, N; Runge, M; Pelz, H-J

    2014-05-01

    Resistance to anticoagulant rodenticides, such as warfarin was first described in 1958. Polymorphisms in the vitamin K epoxide reductase complex subunit 1 (VKORC1) gene and respective substitutions of amino acids in the VKOR enzyme are the major cause for rodenticide resistance. Resistant Norway rats in Germany are characterized by the Tyr139Cys genotype, which is spread throughout the northwest of the country. Resistant house mice with the VKOR variants Tyr139Cys, Leu128Ser and Arg12Trp/Ala26Ser/Ala48Thr/Arg61Leu (spretus type) are distributed over a number of locations in Germany. Resistance can reduce management attempts with consequences for stored product protection, hygiene and animal health. Anticoagulants of the first generation (warfarin, chlorophacinone, coumatetralyl) as well as bromadiolone and difenacoum are not an option for the control of resistant Norway rats. The same applies for house mice whereby the tolerance to compounds can be different between local incidences. Due to the higher toxicity and tendency to persist, the most potent anticoagulant rodenticides brodifacoum, flocoumafen and difethialone should be applied but only where resistance is known. In other cases less toxic anticoagulants should be preferred for rodent management in order to mitigate environmental risks. Resistance effects of further VKOR polymorphisms and their combinations, the spread of resistant rats and conditions supporting and reducing resistance should be investigated in order to improve resistance management strategies. PMID:24781908

  9. Cumulative Adverse Financial Circumstances: Associations with Patient Health Status and Behaviors

    ERIC Educational Resources Information Center

    Bisgaier, Joanna; Rhodes, Karin V.

    2011-01-01

    This article examines associations between cumulative adverse financial circumstances and patient health in a sample of 1,506 urban emergency department (ED) patients. Study participants completed a previously validated Social Health Survey between May and October 2009. Five categories of economic deprivation were studied: food insecurity, housing…

  10. Social work and adverse childhood experiences research: implications for practice and health policy.

    PubMed

    Larkin, Heather; Felitti, Vincent J; Anda, Robert F

    2014-01-01

    Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies.

  11. Economic inequality and economic crisis: a challenge for social workers.

    PubMed

    Goldberg, Gertrude Schaffner

    2012-07-01

    To social workers, extreme economic inequality is primarily a violation of social justice, but this article shows how growing economic inequality since the mid-1970s was not only unjust, but also dysfunctional to the U.S. economy and linked to the recent economic crisis with its devastating effects, particularly on the social work clientele. The article identifies interrelated changes in ideology, the market economy, and government policies since the mid-1970s; contrasts the political economy of this period with the preceding post-World War II decades when the trend was toward a "shared prosperity"; and shows how increased economic inequality and political consequences that undermined democracy itself contributed to the economic meltdown. The analysis has implications for the direction of social reform and for broadening the constituency of social movements in pursuit of the social work mission of social justice. How social workers can contribute to such movements and to a reduction of economic and political inequality is explored.

  12. Behavioral Economics

    PubMed Central

    Reed, Derek D.; Niileksela, Christopher R.; Kaplan, Brent A.

    2013-01-01

    In recent years, behavioral economics has gained much attention in psychology and public policy. Despite increased interest and continued basic experimental studies, the application of behavioral economics to therapeutic settings remains relatively sparse. Using examples from both basic and applied studies, we provide an overview of the principles comprising behavioral economic perspectives and discuss implications for behavior analysts in practice. A call for further translational research is provided. PMID:25729506

  13. ADVERSE DRUG REACTIONS IN THE ORAL CAVITY.

    PubMed

    Boras, Vanja Vučićević; Andabak-Rogulj, Ana; Brailo, Vlaho; Šimunković, Sonja Kraljević; Gabrić, Dragana; Vrdoljak, Danko Velimir

    2015-06-01

    Every medication may lead to adverse effects, even when used in standard doses and mode of application. In the oral cavity, adverse effects may affect every part of oral mucosa and are the result of medications taken either locally or systemically. Oral adverse reactions to drugs are not typical and therefore sometimes not easy to recognize. On diagnosing adverse side effects in the oral cavity, experienced clinician will usually diagnose the condition on the basis of detailed medical history and clinical finding. However, the only objective evidence for the offending drug is 're-challenge', i.e. exposure to the drug after its discontinuation. It carries a huge risk of anaphylactic reaction; therefore it has to be performed in a controlled hospital setting. Therapy is based on immediate exclusion of the offending drug and, if lesions are present in the oral cavity, topical or systemic corticosteroid therapy is prescribed. This article gives a review of patients with oral adverse drug reactions referred to the Department of Oral Medicine in Zagreb.

  14. Putative adverse outcome pathways relevant to neurotoxicity

    PubMed Central

    Bal-Price, Anna; Crofton, Kevin M.; Sachana, Magdalini; Shafer, Timothy J.; Behl, Mamta; Forsby, Anna; Hargreaves, Alan; Landesmann, Brigitte; Lein, Pamela J.; Louisse, Jochem; Monnet-Tschudi, Florianne; Paini, Alicia; Rolaki, Alexandra; Schrattenholz, André; Suñol, Cristina; van Thriel, Christoph; Whelan, Maurice; Fritsche, Ellen

    2016-01-01

    The Adverse Outcome Pathway (AOP) framework provides a template that facilitates understanding of complex biological systems and the pathways of toxicity that result in adverse outcomes (AOs). The AOP starts with an molecular initiating event (MIE) in which a chemical interacts with a biological target(s), followed by a sequential series of KEs, which are cellular, anatomical, and/or functional changes in biological processes, that ultimately result in an AO manifest in individual organisms and populations. It has been developed as a tool for a knowledge-based safety assessment that relies on understanding mechanisms of toxicity, rather than simply observing its adverse outcome. A large number of cellular and molecular processes are known to be crucial to proper development and function of the central (CNS) and peripheral nervous systems (PNS). However, there are relatively few examples of well-documented pathways that include causally linked MIEs and KEs that result in adverse outcomes in the CNS or PNS. As a first step in applying the AOP framework to adverse health outcomes associated with exposure to exogenous neurotoxic substances, the EU Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM) organized a workshop (March 2013, Ispra, Italy) to identify potential AOPs relevant to neurotoxic and developmental neurotoxic outcomes. Although the AOPs outlined during the workshop are not fully described, they could serve as a basis for further, more detailed AOP development and evaluation that could be useful to support human health risk assessment in a variety of ways. PMID:25605028

  15. 2009 AERA Distinguished Lecture: Causes and Consequences of Cognitive Functioning across the Life Course

    ERIC Educational Resources Information Center

    Hauser, Robert M.

    2010-01-01

    Research on variation in cognitive abilities has focused largely on their genetic or experiential sources and on their economic consequences. This article takes a broader look at the consequences of cognitive ability--IQ--across the life course. Contrary to received wisdom, the effects of IQ on economic success are almost entirely mediated by…

  16. Behavioral and physiological consequences of sleep restriction.

    PubMed

    Banks, Siobhan; Dinges, David F

    2007-08-15

    Adequate sleep is essential for general healthy functioning. This paper reviews recent research on the effects of chronic sleep restriction on neurobehavioral and physiological functioning and discusses implications for health and lifestyle. Restricting sleep below an individual's optimal time in bed (TIB) can cause a range of neurobehavioral deficits, including lapses of attention, slowed working memory, reduced cognitive throughput, depressed mood, and perseveration of thought. Neurobehavioral deficits accumulate across days of partial sleep loss to levels equivalent to those found after 1 to 3 nights of total sleep loss. Recent experiments reveal that following days of chronic restriction of sleep duration below 7 hours per night, significant daytime cognitive dysfunction accumulates to levels comparable to that found after severe acute total sleep deprivation. Additionally, individual variability in neurobehavioral responses to sleep restriction appears to be stable, suggesting a trait-like (possibly genetic) differential vulnerability or compensatory changes in the neurobiological systems involved in cognition. A causal role for reduced sleep duration in adverse health outcomes remains unclear, but laboratory studies of healthy adults subjected to sleep restriction have found adverse effects on endocrine functions, metabolic and inflammatory responses, suggesting that sleep restriction produces physiological consequences that may be unhealthy.

  17. [Medical and biological consequences of nuclear disasters].

    PubMed

    Stalpers, Lukas J A; van Dullemen, Simon; Franken, N A P Klaas

    2012-01-01

    Medical risks of radiation exaggerated; psychological risks underestimated. The discussion about atomic energy has become topical again following the nuclear accident in Fukushima. There is some argument about the gravity of medical and biological consequences of prolonged exposure to radiation. The risk of cancer following a low dose of radiation is usually estimated by linear extrapolation of the incidence of cancer among survivors of the atomic bombs dropped on Hiroshima and Nagasaki in 1945. The radiobiological linear-quadratic model (LQ-model) gives a more accurate description of observed data, is radiobiologically more plausible and is better supported by experimental and clinical data. On the basis of this model there is less risk of cancer being induced following radiation exposure. The gravest consequence of Chernobyl and Fukushima is not the medical and biological damage, but the psychological and economical impact on rescue workers and former inhabitants.

  18. [Medical and biological consequences of nuclear disasters].

    PubMed

    Stalpers, Lukas J A; van Dullemen, Simon; Franken, N A P Klaas

    2012-01-01

    Medical risks of radiation exaggerated; psychological risks underestimated. The discussion about atomic energy has become topical again following the nuclear accident in Fukushima. There is some argument about the gravity of medical and biological consequences of prolonged exposure to radiation. The risk of cancer following a low dose of radiation is usually estimated by linear extrapolation of the incidence of cancer among survivors of the atomic bombs dropped on Hiroshima and Nagasaki in 1945. The radiobiological linear-quadratic model (LQ-model) gives a more accurate description of observed data, is radiobiologically more plausible and is better supported by experimental and clinical data. On the basis of this model there is less risk of cancer being induced following radiation exposure. The gravest consequence of Chernobyl and Fukushima is not the medical and biological damage, but the psychological and economical impact on rescue workers and former inhabitants. PMID:22607840

  19. Economic Realities.

    ERIC Educational Resources Information Center

    Van Alstyne, Carol

    Concerns relating to the economics of higher education, including inflation, are considered. It is suggested that future sources of rising costs are energy, equipment, books, and federal requirements, and that another major economic concern involves trends in enrollments and in tuition revenues. Projections of declining enrollments should be…

  20. Adverse reaction; patent blue turning patient blue.

    PubMed

    Joshi, Meera; Hart, Matthew; Ahmed, Farid; McPherson, Sandy

    2012-11-30

    The authors report a severe anaphylactic reaction to Patent Blue V dye used in sentinel node biopsy for lymphatic mapping during breast cancer surgery to stage the axilla. Patent Blue dye is the most widely used in the UK; however, adverse reactions have been reported with the blue dye previously. This case highlights that reactions may not always be immediately evident and to be vigilant in all patients that have undergone procedures using blue dye. If the patients are not responding appropriately particularly during an anaesthetic, one must always think of a possible adverse reaction to the dye. All surgical patients should give consent for adverse reactions to patent blue dye preoperatively. Alternative agents such as methylene blue are considered.

  1. Adverse events related to blood transfusion

    PubMed Central

    Sahu, Sandeep; Hemlata; Verma, Anupam

    2014-01-01

    The acute blood transfusion reactions are responsible for causing most serious adverse events. Awareness about various clinical features of acute and delayed transfusion reactions with an ability to assess the serious reactions on time can lead to a better prognosis. Evidence-based medicine has changed today's scenario of clinical practice to decrease adverse transfusion reactions. New evidence-based algorithms of transfusion and improved haemovigilance lead to avoidance of unnecessary transfusions perioperatively. The recognition of adverse events under anaesthesia is always challenging. The unnecessary blood transfusions can be avoided with better blood conservation techniques during surgery and with anaesthesia techniques that reduce blood loss. Better and newer blood screening methods have decreased the infectious complications to almost negligible levels. With universal leukoreduction of red blood cells (RBCs), selection of potential donors such as use of male donors only plasma and restriction of RBC storage, most of the non-infectious complications can be avoided. PMID:25535415

  2. Identifying Adverse Drug Events by Relational Learning.

    PubMed

    Page, David; Costa, Vítor Santos; Natarajan, Sriraam; Barnard, Aubrey; Peissig, Peggy; Caldwell, Michael

    2012-07-01

    The pharmaceutical industry, consumer protection groups, users of medications and government oversight agencies are all strongly interested in identifying adverse reactions to drugs. While a clinical trial of a drug may use only a thousand patients, once a drug is released on the market it may be taken by millions of patients. As a result, in many cases adverse drug events (ADEs) are observed in the broader population that were not identified during clinical trials. Therefore, there is a need for continued, post-marketing surveillance of drugs to identify previously-unanticipated ADEs. This paper casts this problem as a reverse machine learning task, related to relational subgroup discovery and provides an initial evaluation of this approach based on experiments with an actual EMR/EHR and known adverse drug events. PMID:24955289

  3. Childhood obesity: contributing factors, consequences and intervention.

    PubMed

    Sidik, Sherina Mohd; Ahmad, Rozali

    2004-03-01

    Childhood obesity has been growing at an alarming rate and is the most common nutritional problem among children in developed as well as in developing countries. It is associated with significant morbidity and mortality, including cardiovascular, respiratory, gastrointestinal, endocrine and psychosocial morbidities. This unhealthy trend will progress to adulthood and is expected to lead to huge economic costs in health and social security systems. Among the many factors which contribute to the increasing prevalence of childhood obesity include environment and genetic factors. This paper discusses the aetiology, consequences and necessary interventions for this problem.

  4. Economic analysis and pharmaceutical policy.

    PubMed

    Rovira, J

    1995-10-01

    Economic evaluation, a comparative analysis of alternative actions in terms of costs and consequences, allows rational decisions to be made concerning the deployment of resources (people, time, equipment, facilities and knowledge). Pharmaceutical policy reflects the various objectives of the many social groups, some of which are conflicting. While new methodologies for evaluation of health care programmes still need to gain wider acceptance, resource limitations for both care providers and decision makers make economic analysis an increasingly important tool.

  5. Adverse effects of psychological therapy: An exploratory study of practitioners' experiences from child and adolescent psychiatry.

    PubMed

    Jonsson, Ulf; Johanson, Josefin; Nilsson, Elin; Lindblad, Frank

    2016-07-01

    The scientific knowledge about adverse effects of psychological therapies and how such effects should be detected is limited. It is possible that children and adolescents are particularly vulnerable and need specific support in order to express adverse effects. In this exploratory study, we used a qualitative approach to explore practitioners' experiences of this phenomenon. Fourteen practitioners providing psychological therapy within the Child and Adolescent Psychiatric Service were interviewed. Qualitative content analysis was applied to the data. Four overarching categories brought up by the practitioners were identified: vagueness of the concept (reflecting that the concept was novel and hard to define), psychotherapist-client interaction (encompassing aspects of the interaction possibly related to adverse effects), consequences for the young person (including a range of emotional, behavioural and social consequences) and family effects (e.g. professional complications and decreased autonomy for the parent). Professional discussions on these issues could improve psychological therapy for children and adolescents. Based on our findings and previous research, we propose three basic aspects to consider when adverse effects are detected and managed in this context: typology (form, severity and duration), aetiology (hypothesis about the causes) and perspective (adverse effects seen from the points of view of different interested parties).

  6. Adverse Reactions in Allogeneic Blood Donors: A Tertiary Care Experience from a Developing Country

    PubMed Central

    Sultan, Sadia; Baig, Mohammad Amjad; Irfan, Syed Mohammed; Ahmed, Syed Ijlal; Hasan, Syeda Faiza

    2016-01-01

    Objectives Fragmented blood transfusion services along with an unmotivated blood donation culture often leads to blood shortage. Donor retention is crucial to meet the increasing blood demand, and adverse donor reactions have a negative impact on donor return. The aim of this study was to estimate adverse donor reactions and identify any demographic association.   Methods We conducted a prospective study between January 2011 and December 2013. A total of 41,759 healthy donors were enrolled. Professionally trained donor attendants drew blood and all donors were observed during and following donation for possible adverse events for 20 minutes. Blood donors were asked to report if they suffered from any delayed adverse consequences.   Results Out of 41,759 blood donors, 537 (1.3%) experienced adverse reactions. The incidence was one in every 78 donations. The mean age of donors who experienced adverse events was 26.0±6.8 years, and all were male. Out of 537 donors, 429 (80%) developed vasovagal reaction (VVR), 133 (25%) had nausea, 63 (12%) fainted, 35 (6%) developed hyperventilation, 9 (2%) had delayed syncope, and 9 (2%) developed hematoma. Arterial prick, nerve injury, cardiac arrest, and seizures were not observed. Donors aged less than < 30 years and weighing < 70 kg were significantly associated with VVR, hyperventilation, and nausea (p < 0.005). Undergraduates and Urdu speaking donors also had a significant association with fainting and nausea, respectively (p < 0.05).   Conclusion The prevalence of adverse events was low at our tertiary center. A VVR was the predominant adverse reaction and was associated with age and weight. Our study highlights the importance of these parameters in the donation process. A well-trained and experienced phlebotomist and pre-evaluation counseling of blood donors could further minimize the adverse reactions. PMID:27168923

  7. [Cutaneous adverse reaction to Bio-Alcamid implant].

    PubMed

    Gómez-de la Fuente, E; Alvarez-Fernández, J G; Pinedo, F; Naz, E; Gamo, R; Vicente-Martín, F J; López-Estebaranz, J L

    2007-05-01

    In the last years new and numerous materials for the correction of defects and wrinkles have been developed. One of these materials is Bio-Alcamid, a non reabsorbable gel polymer constituted by meshes of poly-alkyl-imide, without known adverse effects. We report a 34-year-old woman that had Bio-Alcamid implants for acne scars and several months after presented nodular lesions together with a painful inflammatory nodule. The nodule was drained and culture of the purulent material yielded Streptococcus viridans. A cytology and a cellular block of that material showed a granulomatous inflammatory reaction together with a foreign body. The different types of reactions to implants and their pathogenic mechanism are discussed. It is important to know these possible reactions to filler materials given their increasing use and the potential medico-legal consequences.

  8. Are PRO discharge screens associated with postdischarge adverse outcomes?

    PubMed Central

    Wei, F.; Mark, D.; Hartz, A.; Campbell, C.

    1995-01-01

    OBJECTIVE. We evaluate whether patient outcomes may be affected by possible errors in care at discharge as assessed by Peer Review Organizations (PROs). DATA SOURCES/STUDY SETTING. The three data sources for the study were (1) the generic screen results of a 3 percent random sample of Medicare beneficiaries age 65 years or older who were admitted to California hospitals between 1 July 1987 and 30 June 1988 (n = 20,136 patients); (2) the 1987 and 1988 California Medicare Provided Analysis and Review (MEDPAR) data files; and (3) the American Hospital Association (AHA) 1988 Annual Survey of Hospitals. STUDY DESIGN. Multivariate logistic regression analysis was used to evaluate the association between the results of generic discharge administered by the PROs and two patient outcomes: mortality and readmission within 30 days. The analysis was adjusted for other patient characteristics recorded on the uniform discharge abstract. PRINCIPAL FINDINGS. Four discharge screens indicated an increased risk of an adverse outcome-absence of documentation of discharge planning, elevated temperature, abnormal pulse, and unaddressed abnormal test results at discharge. The other three discharge screens examined-abnormal blood pressure, IV fluids or drugs, and wound drainage before discharge-were unrelated to postdischarge adverse outcomes. CONCLUSIONS. Generic discharge screens based on inadequate discharge planning, abnormal pulse, increased temperature, or unaddressed abnormal tests may be important indicators of substandard care. Other discharge screens apparently do not detect errors in care associated with major consequences for patients. PMID:7649753

  9. Adversity in childhood and depression: linked through SIRT1.

    PubMed

    Lo Iacono, L; Visco-Comandini, F; Valzania, A; Viscomi, M T; Coviello, M; Giampà, A; Roscini, L; Bisicchia, E; Siracusano, A; Troisi, A; Puglisi-Allegra, S; Carola, V

    2015-01-01

    Experiencing an adverse childhood and parental neglect is a risk factor for depression in the adult population. Patients with a history of traumatic childhood develop a subtype of depression that is characterized by earlier onset, poor treatment response and more severe symptoms. The long-lasting molecular mechanisms that are engaged during early traumatic events and determine the risk for depression are poorly understood. In this study, we altered adult depression-like behavior in mice by applying juvenile isolation stress. We found that this behavioral phenotype was associated with a reduction in the levels of the deacetylase sirtuin1 (SIRT1) in the brain and in peripheral blood mononuclear cells. Notably, peripheral blood mRNA expression of SIRT1 predicted the extent of behavioral despair only when depression-like behavior was induced by juvenile--but not adult--stress, implicating SIRT1 in the regulation of adult behavior at early ages. Consistent with this hypothesis, pharmacological modulation of SIRT1 during juvenile age altered the depression-like behavior in naive mice. We also performed a pilot study in humans, in which the blood levels of SIRT1 correlated significantly with the severity of symptoms in major depression patients, especially in those who received less parental care during childhood. On the basis of these novel findings, we propose the involvement of SIRT1 in the long-term consequences of adverse childhood experiences. PMID:26327687

  10. Pharmacovigilance, risks and adverse effects of self-medication.

    PubMed

    Montastruc, Jean-Louis; Bondon-Guitton, Emmanuelle; Abadie, Delphine; Lacroix, Isabelle; Berreni, Aurélia; Pugnet, Grégory; Durrieu, Geneviève; Sailler, Laurent; Giroud, Jean-Paul; Damase-Michel, Christine; Montastruc, François

    2016-04-01

    Self-medication means resorting to one or more drugs in order to treat oneself without the help of a doctor. This phenomenon is developing fast. In this review, we will discuss the main definitions of self-medication; we will then present a few important characteristics of this therapeutic practice: prevalence, reasons, populations involved and drugs used. Whilst the theoretical risks of self-medication have been abundantly discussed in the literature (adverse effects, interactions, product, dosage or treatment duration errors, difficulty in self-diagnosis, risk of addiction or abuse…), there is in fact very little detailed pharmacovigilance data concerning the characteristics and the consequences of this usage in real life. This study therefore describes the all too rare data that is available: patients, clinical characteristics, "seriousness" and drugs involved in the adverse effects of self-medication. It also discusses leads to be followed in order to minimize medication risks, which are obviously not well known and clearly not sufficiently notified.

  11. Adversity in childhood and depression: linked through SIRT1

    PubMed Central

    Lo Iacono, L; Visco-Comandini, F; Valzania, A; Viscomi, M T; Coviello, M; Giampà, A; Roscini, L; Bisicchia, E; Siracusano, A; Troisi, A; Puglisi-Allegra, S; Carola, V

    2015-01-01

    Experiencing an adverse childhood and parental neglect is a risk factor for depression in the adult population. Patients with a history of traumatic childhood develop a subtype of depression that is characterized by earlier onset, poor treatment response and more severe symptoms. The long-lasting molecular mechanisms that are engaged during early traumatic events and determine the risk for depression are poorly understood. In this study, we altered adult depression-like behavior in mice by applying juvenile isolation stress. We found that this behavioral phenotype was associated with a reduction in the levels of the deacetylase sirtuin1 (SIRT1) in the brain and in peripheral blood mononuclear cells. Notably, peripheral blood mRNA expression of SIRT1 predicted the extent of behavioral despair only when depression-like behavior was induced by juvenile—but not adult—stress, implicating SIRT1 in the regulation of adult behavior at early ages. Consistent with this hypothesis, pharmacological modulation of SIRT1 during juvenile age altered the depression-like behavior in naive mice. We also performed a pilot study in humans, in which the blood levels of SIRT1 correlated significantly with the severity of symptoms in major depression patients, especially in those who received less parental care during childhood. On the basis of these novel findings, we propose the involvement of SIRT1 in the long-term consequences of adverse childhood experiences. PMID:26327687

  12. Ecological economics and economic growth.

    PubMed

    Victor, Peter A

    2010-01-01

    Boulding's 1966 paper on the economics of spaceship Earth established the framework for ecological economics and an understanding of economic growth. In ecological economics, economies are conceptualized as open subsystems of the closed biosphere and are subject to biophysical laws and constraints. Economic growth measured as an increase in real gross domestic product (GDP) has generally been associated with increases in the use of energy and materials and the generation of wastes. Scale, composition, and technology are the proximate determinants of environmental impacts. They are often reduced to two: scale (GDP) and intensity (impact per unit GDP). New work described in this paper defines "green" growth as intensity that declines faster than scale increases. Similarly, "brown" growth occurs when intensity declines more slowly than increases in scale, and "black" growth happens when both scale and intensity increase. These concepts are then related to the environmental Kuznets curve, which can be understood as a transition from brown to green growth. Ecological economics provides a macroperspective on economic growth. It offers broad policy principles, and it challenges the primacy of economic growth as a policy objective, but many important questions remain.

  13. Adverse life events and mental health in middle adolescence.

    PubMed

    Flouri, Eirini; Kallis, Constantinos

    2011-04-01

    This study's aim was to search for the appropriate functional form of the effect of proximal cumulative contextual risk (PCCR), measured with number of adverse life events experienced in the last 6 months, on adolescent psychopathology and prosocial behavior, measured with the Strengths and Difficulties Questionnaire. The study sample was 171 year ten (aged 14-15) adolescents from predominantly socio-economically disadvantaged families in the UK. Adjustment was made for parental education, and for child's age, gender, and academic achievement, which was measured with results in Standard Attainment Tests in English, mathematics and science taken in the previous year. PCCR predicted total difficulties, emotional symptoms, conduct problems and hyperactivity. The relationship between PCCR and total difficulties and emotional symptoms was non-quadratic; the PCCR/externalizing problems relationship was quadratic. The findings highlight the importance of considering both outcome specificity and non-linear patterns of associations when modelling cumulative contextual risk effects on adolescent psychopathology. PMID:20434208

  14. Resource Economics

    NASA Astrophysics Data System (ADS)

    Conrad, Jon M.

    1999-10-01

    Resource Economics is a text for students with a background in calculus, intermediate microeconomics, and a familiarity with the spreadsheet software Excel. The book covers basic concepts, shows how to set up spreadsheets to solve dynamic allocation problems, and presents economic models for fisheries, forestry, nonrenewable resources, stock pollutants, option value, and sustainable development. Within the text, numerical examples are posed and solved using Excel's Solver. Through these examples and additional exercises at the end of each chapter, students can make dynamic models operational, develop their economic intuition, and learn how to set up spreadsheets for the simulation of optimization of resource and environmental systems.

  15. Adverse outcome pathway (AOP) development and evaluation

    EPA Science Inventory

    The Adverse Outcome Pathway provides a construct for assembling mechanistic information at different levels of biological organization in a form designed to support regulatory decision making. In particular, it frames the link between molecular and cellular events that can be mea...

  16. The adverse outcome pathway knowledge base

    EPA Science Inventory

    The rapid advancement of the Adverse Outcome Pathway (AOP) framework has been paralleled by the development of tools to store, analyse, and explore AOPs. The AOP Knowledge Base (AOP-KB) project has brought three independently developed platforms (Effectopedia, AOP-Wiki, and AOP-X...

  17. Linezolid Induced Adverse Drug Reactions - An Update.

    PubMed

    Kishor, Kamal; Dhasmana, Neha; Kamble, Shashank Shivaji; Sahu, Roshan Kumar

    2015-01-01

    Treatment regimen recommended for resistant tuberculosis consists of various drugs and these drugs are prescribed for at least 12-15 months. Such a long duration therapy and high dose of antibiotics result in adverse drug reactions (ADRs). ADRs may lead to various complications in disease management like replacement of drugs, dose increment, therapy withdrawal, etc. Linezolid is one of those drugs, practiced as an anti-mycobacterial agent and it is an important member of drug regimen for MDR and XDR tuberculosis. Linezolid is a broad spectrum antibiotic known for its unique mechanism of inhibition of resistant pathogenic strains. However, it causes serious adverse effects like thrombocytopenia, optic neuropathy, peripheral neuropathy, lactic acidosis, etc. Literature suggests that Linezolid can cause severe ADRs which affect patient compliance and hinder in therapy to a larger extent. Recent studies confirm the possibility of ADRs to be predicted with genetic make-up of individuals. To effectively deliver the available treatment regimen and ensure patient compliance, it is important to manage ADRs more efficiently. The role of pharmacogenomics in reducing adverse drug effects has been recently explored. In the present review, we discussed about Linezolid induced adverse drug reactions, mechanisms and genetic associations. PMID:26424176

  18. Pharmacogenomics and adverse drug reactions in children

    PubMed Central

    Rieder, Michael J.; Carleton, Bruce

    2014-01-01

    Adverse drug reactions are a common and important complication of drug therapy in children. Over the past decade it has become increasingly apparent that genetically controlled variations in drug disposition and response are important determinants of adverse events for many important adverse events associated with drug therapy in children. While this research has been difficult to conduct over the past decade technical and ethical evolution has greatly facilitated the ability of investigators to conduct pharmacogenomic studies in children. Some of this research has already resulted in changes in public policy and clinical practice, for example in the case of codeine use by mothers and children. It is likely that the use of pharmacogenomics to enhance drug safety will first be realized among selected groups of children with high rates of drug use such as children with cancer, but it also likely that this research will be extended to other groups of children who have high rates of drug utilization and as well as providing insights into the mechanisms and pathophysiology of adverse drug reactions in children. PMID:24795743

  19. Adverse Stress, Hippocampal Networks, and Alzheimer's Disease

    PubMed Central

    Rothman, Sarah M.; Mattson, Mark P.

    2009-01-01

    Recent clinical data have implicated chronic adverse stress as a potential risk factor in the development of Alzheimer's disease (AD) and data also suggest that normal, physiological stress responses may be impaired in AD. It is possible that pathology associated with AD causes aberrant responses to chronic stress, due to potential alterations in the hypothalamic-pituitary-adrenal (HPA) axis. Recent work in rodent models of AD suggests that chronic adverse stress exacerbates the cognitive deficits and hippocampal pathology that are present in the AD brain. This review summarizes recent findings obtained in experimental AD models regarding the influence of chronic adverse stress on the underlying cellular and molecular disease processes including the potential role of glucocorticoids. Emerging findings suggest that both AD and chronic adverse stress affect hippocampal neural networks in a similar fashion. We describe alterations in hippocampal plasticity that occur in both chronic stress and AD including dendritic remodeling, neurogenesis and long-term potentiation. Finally, we outline potential roles for oxidative stress and neurotrophic factor signaling as key determinants of the impact of chronic stress on the plasticity of neural networks and AD pathogenesis. PMID:19943124

  20. Adverse Effects of Common Drugs: Dietary Supplements.

    PubMed

    Felix, Todd Matthew; Karpa, Kelly Dowhower; Lewis, Peter R

    2015-09-01

    Dietary supplement-induced adverse effects often resolve quickly after discontinuation of the offending product, especially in younger patients. The potential for unwanted outcomes can be amplified in elderly patients or those taking multiple prescription drugs, especially where interactions exist with drugs metabolized by cytochrome P450 enzymes. Attributing injury or illness to a specific supplement can be challenging, especially in light of multi-ingredient products, product variability, and variability in reporting, as well as the vast underreporting of adverse drug reactions. Clinicians prescribing a new drug or evaluating a patient with a new symptom complex should inquire about use of herbal and dietary supplements as part of a comprehensive evaluation. Clinicians should report suspected supplement-related adverse effects to the local or state health department, as well as the Food and Drug Administration's MedWatch program (available at https://www.safetyreporting.hhs.gov). Clinicians should consider discussing suspected adverse effects involving drugs, herbal products, or dietary supplements with their community- and hospital-based pharmacists, and explore patient management options with medical or clinical toxicology subspecialists.

  1. Reducing Adverse Impact: One City's Efforts.

    ERIC Educational Resources Information Center

    Prewitt, Jeff

    Following a workshop on "Innovations in Employment Testing that Improve Validity and Reduce Adverse Impact," the City of Louisville (Kentucky) implemented a strategy to develop a comprehensive testing and recruiting program for police recruits. To improve candidate expectations and preparation, the following activities were undertaken: intense…

  2. Helping Student Teachers Avoid Adverse Legal Actions.

    ERIC Educational Resources Information Center

    Peach, Larry; Reddick, Thomas L.

    1984-01-01

    Discusses five areas of the school environment lending themselves to the possibility of teacher and student teacher liability: negligence, malpractice, rights to privacy, field trips, and search of students and school property. Suggests specific guidelines for decreasing the possibility of adverse legal action. (NEC)

  3. Adverse effects of fillers and their histopathology.

    PubMed

    Haneke, Eckart

    2014-12-01

    Injectable fillers nowadays represent a pillar in facial rejuvenation and make a significant contribution to the success of the treatment. Despite their obvious benefits, a wide range of possible complications such as immediate, late, delayed, temporary, or irreversible adverse effects have to be respected. Differentiating the various filler materials, these effects are assigned to histopathology findings and currently available treatment options.

  4. Resilience in the Face of Adversity.

    ERIC Educational Resources Information Center

    Patterson, Jerry

    2001-01-01

    "Resilience" is the capacity for moving ahead under adverse circumstances. School superintendents are advised to stay upbeat and mindful of "both-and" opportunities; stay focused on what they care about; remain flexible and tolerant of ambiguity; be proactive, not reactive; and apply resilience-conserving strategies during tough times. (MLH)

  5. Adverse Effects of Psychotropic Medications on Sleep.

    PubMed

    Doghramji, Karl; Jangro, William C

    2016-09-01

    Psychotropic medications such as antidepressants, antipsychotics, stimulants, and benzodiazepines are widely prescribed. Most of these medications are thought to exert their effects through modulation of various monoamines as well as interactions with receptors such as histamine and muscarinic cholinergic receptors. Through these interactions, psychotropics can also have a significant impact on sleep physiology, resulting in both beneficial and adverse effects on sleep. PMID:27514301

  6. [Analysis of Spontaneously Reported Adverse Events].

    PubMed

    Nakamura, Mitsuhiro

    2016-01-01

    Observational study is necessary for the evaluation of drug effectiveness in clinical practice. In recent years, the use of spontaneous reporting systems (SRS) for adverse drug reactions has increased and they have become an important resource for regulatory science. SRS, being the largest and most well-known databases worldwide, are one of the primary tools used for postmarketing surveillance and pharmacovigilance. To analyze SRS, the US Food and Drug Administration Adverse Event Reporting System (FAERS) and the Japanese Adverse Drug Event Report Database (JADER) are reviewed. Authorized pharmacovigilance algorithms were used for signal detection, including the reporting odds ratio. An SRS is a passive reporting database and is therefore subject to numerous sources of selection bias, including overreporting, underreporting, and a lack of a denominator. Despite the inherent limitations of spontaneous reporting, SRS databases are a rich resource and data mining index that provide powerful means of identifying potential associations between drugs and their adverse effects. Our results, which are based on the evaluation of SRS databases, provide essential knowledge that could improve our understanding of clinical issues.

  7. Adverse effects of fillers and their histopathology.

    PubMed

    Haneke, Eckart

    2014-12-01

    Injectable fillers nowadays represent a pillar in facial rejuvenation and make a significant contribution to the success of the treatment. Despite their obvious benefits, a wide range of possible complications such as immediate, late, delayed, temporary, or irreversible adverse effects have to be respected. Differentiating the various filler materials, these effects are assigned to histopathology findings and currently available treatment options. PMID:25536126

  8. Long-Term Consequences of Neonatal Injury

    PubMed Central

    Beggs, Simon

    2015-01-01

    The maturation of the central nervous system’s (CNS’s) sensory connectivity is driven by modality-specific sensory input in early life. For the somatosensory system, this input is the physical, tactile interaction with the environment. Nociceptive circuitry is functioning at the time of birth; however, there is still considerable organization and refinement of this circuitry that occurs postnatally, before full discrimination of tactile and noxious input is possible. This fine-tuning involves separation of tactile and nociceptive afferent input to the spinal cord’s dorsal horn and the maturation of local and descending inhibitory circuitry. Disruption of that input in early postnatal life (for example, by tissue injury or other noxious stimulus), can have a profound influence on subsequent development, and consequently the mature functioning of pain systems. In this review, the impact of neonatal surgical incision on nociceptive circuitry is discussed in terms of the underlying developmental neurobiology. The changes are complex, occurring at multiple anatomical sites within the CNS, and including both neuronal and glial cell populations. The altered sensory input from neonatal injury selectively modulates neuronal excitability within the spinal cord, disrupts inhibitory control, and primes the immune system, all of which contribute to the adverse long-term consequences of early pain exposure. PMID:26174217

  9. Effect of exposure to adverse climatic conditions on production in Manchega dairy sheep.

    PubMed

    Ramón, M; Díaz, C; Pérez-Guzman, M D; Carabaño, M J

    2016-07-01

    The present study aimed to examine the effects of exposure to adverse weather conditions on milk production to assess the thermotolerance capability of the Manchega breed, a dairy sheep reared in the Mediterranean area, and the extent of decline in production outside the thermal comfort zone. To achieve this purpose, we merged data from the official milk recording of the breed with weather information and used to describe the cold and heat stress response for production traits. Production data consisted of 1,094,804 test-day records from the first 3 lactations of 177,605 ewes gathered between years 2000 to 2010. For each production trait and climate variable, the thermal load production response was characterized by the estimation of cold and heat stress thresholds that define a thermoneutral zone and the slopes of production decay outside this thermoneutral zone. Overall, we observed a comfort region between 10 and 22°C for daily average temperature, 18 and 30°C for daily maximum temperature, and from 9 to 18 units for a temperature-humidity index (THI) for all traits. Decline in production due to cold stress effects was of a greater magnitude than heat stress effects, especially for milk yield. Production losses ranged between 7 and 16 and from 0.2 to 0.6g/d per °C (or THI unit) for milk and for fat and protein yields, respectively. For heat stress, the observed decline in production was of 1 to 5 and 0.1 to 0.3g/d per °C (or THI unit) above the threshold for milk yield and for fat and protein yields, respectively. Highly productive animals showed a narrower comfort zone and higher slopes of decay. The study of lagged effects of thermal load showed how consequences of cold and heat stress are already visible in the first hours after exposure. Thus, production losses were due mainly to climate conditions on the day of control and the day before, with conditions on the previous days having a smaller effect. Annual economic losses due to thermal (cold and heat

  10. Effect of exposure to adverse climatic conditions on production in Manchega dairy sheep.

    PubMed

    Ramón, M; Díaz, C; Pérez-Guzman, M D; Carabaño, M J

    2016-07-01

    The present study aimed to examine the effects of exposure to adverse weather conditions on milk production to assess the thermotolerance capability of the Manchega breed, a dairy sheep reared in the Mediterranean area, and the extent of decline in production outside the thermal comfort zone. To achieve this purpose, we merged data from the official milk recording of the breed with weather information and used to describe the cold and heat stress response for production traits. Production data consisted of 1,094,804 test-day records from the first 3 lactations of 177,605 ewes gathered between years 2000 to 2010. For each production trait and climate variable, the thermal load production response was characterized by the estimation of cold and heat stress thresholds that define a thermoneutral zone and the slopes of production decay outside this thermoneutral zone. Overall, we observed a comfort region between 10 and 22°C for daily average temperature, 18 and 30°C for daily maximum temperature, and from 9 to 18 units for a temperature-humidity index (THI) for all traits. Decline in production due to cold stress effects was of a greater magnitude than heat stress effects, especially for milk yield. Production losses ranged between 7 and 16 and from 0.2 to 0.6g/d per °C (or THI unit) for milk and for fat and protein yields, respectively. For heat stress, the observed decline in production was of 1 to 5 and 0.1 to 0.3g/d per °C (or THI unit) above the threshold for milk yield and for fat and protein yields, respectively. Highly productive animals showed a narrower comfort zone and higher slopes of decay. The study of lagged effects of thermal load showed how consequences of cold and heat stress are already visible in the first hours after exposure. Thus, production losses were due mainly to climate conditions on the day of control and the day before, with conditions on the previous days having a smaller effect. Annual economic losses due to thermal (cold and heat

  11. Cumulative Adversity Sensitizes Neural Response to Acute Stress: Association with Health Symptoms

    PubMed Central

    Seo, Dongju; Tsou, Kristen A; Ansell, Emily B; Potenza, Marc N; Sinha, Rajita

    2014-01-01

    Cumulative adversity (CA) increases stress sensitivity and risk of adverse health outcomes. However, neural mechanisms underlying these associations in humans remain unclear. To understand neural responses underlying the link between CA and adverse health symptoms, the current study assessed brain activity during stress and neutral-relaxing states in 75 demographically matched, healthy individuals with high, mid, and low CA (25 in each group), and their health symptoms using the Cornell Medical Index. CA was significantly associated with greater adverse health symptoms (P=0.01) in all participants. Functional magnetic resonance imaging results indicated significant associations between CA scores and increased stress-induced activity in the lateral prefrontal cortex, insula, striatum, right amygdala, hippocampus, and temporal regions in all 75 participants (p<0.05, whole-brain corrected). In addition to these regions, the high vs low CA group comparison revealed decreased stress-induced activity in the medial orbitofrontal cortex (OFC) in the high CA group (p<0.01, whole-brain corrected). Specifically, hypoactive medial OFC and hyperactive right hippocampus responses to stress were each significantly associated with greater adverse health symptoms (p<0.01). Furthermore, an inverse correlation was found between activity in the medial OFC and right hippocampus (p=0.01). These results indicate that high CA sensitizes limbic–striatal responses to acute stress and also identifies an important role for stress-related medial OFC and hippocampus responses in the effects of CA on increasing vulnerability to adverse health consequences. PMID:24051900

  12. The Consequence of Consequence: Motivation, Anxiety, and Test Performance.

    ERIC Educational Resources Information Center

    Wolf, Lisa F.; Smith, Jeffrey K.

    1995-01-01

    The relationships of test consequence, motivation, anxiety, and performance were studied with 158 undergraduates taking a child development course. Results indicated that test consequence (grade or no grade) had a strong influence on motivation and a modest influence on performance. Motivation and anxiety had opposite effects on performance. (SLD)

  13. Ecological Economics

    NASA Astrophysics Data System (ADS)

    Common, Michael; Stagl, Sigrid

    2005-10-01

    Taking as its starting point the interdependence of the economy and the natural environment, this book provides a comprehensive introduction to the emerging field of ecological economics. The authors, who have written extensively on the economics of sustainability, build on insights from both mainstream economics and ecological sciences. Part I explores the interdependence of the modern economy and its environment, while Part II focuses mainly on the economy and on economics. Part III looks at how national governments set policy targets and the instruments used to pursue those targets. Part IV examines international trade and institutions, and two major global threats to sustainability - climate change and biodiversity loss. Assuming no prior knowledge of economics, this textbook is well suited for use on interdisciplinary environmental science and management courses. It has extensive student-friendly features including discussion questions and exercises, keyword highlighting, real-world illustrations, further reading and website addresses. A comprehensive introduction to a developing field which will interest students from science, economics and management backgrounds A global approach to the problems of sustainability and sustainable development, issues which are increasingly prominent in political debate and policy making Filled with student-friendly features including focus areas for each chapter, keyword highlighting, real-world illustrations, discussion questions and exercises, further reading and website addresses

  14. Behavioral economics.

    PubMed

    Hursh, S R

    1984-11-01

    Economics, like behavioral psychology, is a science of behavior, albeit highly organized human behavior. The value of economic concepts for behavioral psychology rests on (1) their empirical validity when tested in the laboratory with individual subjects and (2) their uniqueness when compared to established behavioral concepts. Several fundamental concepts are introduced and illustrated by reference to experimental data: open and closed economies, elastic and inelastic demand, and substitution versus complementarity. Changes in absolute response rate are analyzed in relation to elasticity and intensity of demand. The economic concepts of substitution and complementarity are related to traditional behavioral studies of choice and to the matching relation. The economic approach has many implications for the future of behavioral research and theory. In general, economic concepts are grounded on a dynamic view of reinforcement. The closed-economy methodology extends the generality of behavioral principles to situations in which response rate and obtained rate of reinforcement are interdependent. Analysis of results in terms of elasticity and intensity of demand promises to provide a more direct method for characterizing the effects of "motivational" variables. Future studies of choice should arrange heterogeneous reinforcers with varying elasticities, use closed economies, and modulate scarcity or income. The economic analysis can be extended to the study of performances that involve subtle discriminations or skilled movements that vary in accuracy or quality as opposed to rate or quantity, and thus permit examination of time/accuracy trade-offs.

  15. Adverse effects of creatine supplementation: fact or fiction?

    PubMed

    Poortmans, J R; Francaux, M

    2000-09-01

    The consumption of oral creatine monohydrate has become increasingly common among professional and amateur athletes. Despite numerous publications on the ergogenic effects of this naturally occurring substance, there is little information on the possible adverse effects of this supplement. The objectives of this review are to identify the scientific facts and contrast them with reports in the news media, which have repeatedly emphasised the health risks of creatine supplementation and do not hesitate to draw broad conclusions from individual case reports. Exogenous creatine supplements are often consumed by athletes in amounts of up to 20 g/day for a few days, followed by 1 to 10 g/day for weeks, months and even years. Usually, consumers do not report any adverse effects, but body mass increases. There are few reports that creatine supplementation has protective effects in heart, muscle and neurological diseases. Gastrointestinal disturbances and muscle cramps have been reported occasionally in healthy individuals, but the effects are anecdotal. Liver and kidney dysfunction have also been suggested on the basis of small changes in markers of organ function and of occasional case reports, but well controlled studies on the adverse effects of exogenous creatine supplementation are almost nonexistent. We have investigated liver changes during medium term (4 weeks) creatine supplementation in young athletes. None showed any evidence of dysfunction on the basis of serum enzymes and urea production. Short term (5 days), medium term (9 weeks) and long term (up to 5 years) oral creatine supplementation has been studied in small cohorts of athletes whose kidney function was monitored by clearance methods and urine protein excretion rate. We did not find any adverse effects on renal function. The present review is not intended to reach conclusions on the effect of creatine supplementation on sport performance, but we believe that there is no evidence for deleterious effects

  16. Prenatal alcohol and other early childhood adverse exposures: Direct and indirect pathways to adolescent drinking.

    PubMed

    Cornelius, Marie D; De Genna, Natacha M; Goldschmidt, Lidush; Larkby, Cynthia; Day, Nancy L

    2016-01-01

    We examined direct and indirect pathways between adverse environmental exposures during gestation and childhood and drinking in mid-adolescence. Mothers and their offspring (n=917 mother/child dyads) were followed prospectively from second trimester to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14years. Adverse environmental factors included gestational exposures to alcohol, tobacco, and marijuana, exposures to childhood maltreatment and violence, maternal psychological symptoms, parenting practices, economic and home environments, and demographic characteristics of the mother and child. Indirect effects of early child behavioral characteristics including externalizing, internalizing activity, attention, and impulsivity were also examined. Polytomous logistic regression analyses were used to evaluate direct effects of adverse environmental exposures with level of adolescent drinking. Structural equation modeling (SEM) was applied to simultaneously estimate the relation between early adversity variables, childhood characteristics, and drinking level at age 16 while controlling for significant covariates. Level of drinking among the adolescent offspring was directly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to drink at higher levels. There was a significant indirect effect between childhood exposure to violence and adolescent drinking via childhood externalizing behavior problems. All other hypothesized indirect pathways were not significant. Thus most of the early adversity measures directly predicted adolescent drinking and did not operate via childhood behavioral dysregulation characteristics. These results highlight the importance of adverse environmental exposures on pathways to adolescent drinking. PMID:26994529

  17. Prenatal alcohol and other early childhood adverse exposures: Direct and indirect pathways to adolescent drinking

    PubMed Central

    Cornelius, Marie D.; De Genna, Natacha M.; Goldschmidt, Lidush; Larkby, Cynthia; Day, Nancy L.

    2016-01-01

    We examined direct and indirect pathways between adverse environmental exposures during gestation and childhood and drinking in mid-adolescence. Mothers and their offspring (n = 917 mother/child dyads) were followed prospectively from second trimester to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14 years. Adverse environmental factors included gestational exposures to alcohol, tobacco, and marijuana, exposures to childhood maltreatment and violence, maternal psychological symptoms, parenting practices, economic and home environments, and demographic characteristics of the mother and child. Indirect effects of early child behavioral characteristics including externalizing, internalizing activity, attention, and impulsivity were also examined. Polytomous logistic regression analyses were used to evaluate direct effects of adverse environmental exposures with level of adolescent drinking. Structural equation modeling (SEM) was applied to simultaneously estimate the relation between early adversity variables, childhood characteristics, and drinking level at age 16 while controlling for significant covariates. Level of drinking among the adolescent offspring was directly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to drink at higher levels. There was a significant indirect effect between childhood exposure to violence and adolescent drinking via childhood externalizing behavior problems. All other hypothesized indirect pathways were not significant. Thus most of the early adversity measures directly predicted adolescent drinking and did not operate via childhood behavioral dysregulation characteristics. These results highlight the importance of adverse environmental exposures on pathways to adolescent drinking. PMID:26994529

  18. Neighborhood adversity, child health, and the role for community development.

    PubMed

    Jutte, Douglas P; Miller, Jennifer L; Erickson, David J

    2015-03-01

    Despite medical advances, childhood health and well-being have not been broadly achieved due to rising chronic diseases and conditions related to child poverty. Family and neighborhood living conditions can have lasting consequences for health, with community adversity affecting health outcomes in significant part through stress response and increased allostatic load. Exposure to this "toxic stress" influences gene expression and brain development with direct and indirect negative consequences for health. Ensuring healthy child development requires improving conditions in distressed, high-poverty neighborhoods by reducing children's exposure to neighborhood stressors and supporting good family and caregiver functioning. The community development industry invests more than $200 billion annually in low-income neighborhoods, with the goal of improving living conditions for residents. The most impactful investments have transformed neighborhoods by integrating across sectors to address both the built environment and the social and service environment. By addressing many facets of the social determinants of health at once, these efforts suggest substantial results for children, but health outcomes generally have not been considered or evaluated. Increased partnership between the health sector and community development can bring health outcomes explicitly into focus for community development investments, help optimize intervention strategies for health, and provide natural experiments to build the evidence base for holistic interventions for disadvantaged children. The problems and potential solutions are beyond the scope of practicing pediatricians, but the community development sector stands ready to engage in shared efforts to improve the health and development of our most at-risk children. PMID:25733725

  19. Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis

    PubMed Central

    Trindade, E; Menon, D; Topfer, L A; Coloma, C

    1998-01-01

    BACKGROUND: The use of antidepressant medications and the resulting costs have increased dramatically in recent years, partly because of the introduction of selective serotonin reuptake inhibitors (SSRIs). An assessment of the clinical and economic aspects of SSRIs compared with the older tricyclic antidepressants (TCAs) was initiated to generate information for purchasers of these drugs as well as clinicians. One component of this study was an examination of the adverse effects associated with the use of these drugs. METHODS: Searches of bibliographic databases (for January 1980 through May 1996) and manual scanning of both peer-reviewed publications and other documents were used to identify double-blind, randomized controlled trials involving at least one SSRI and one TCA. For the study of adverse effects, only trials that had at least 20 patients in each trial arm and that reported rates of adverse effects in both arms were retained. In total 84 trials reporting on 18 adverse effects were available. Meta-analyses were undertaken to calculate pooled differences in rates of adverse effects. The question of whether the method of eliciting information from patients about adverse effects made a difference in the findings was also examined. Finally, differences in drop-out rates due to adverse effects were calculated. RESULTS: The crude rates of occurrence of adverse effects ranged from 4% (palpitations) to 26% (nausea) for SSRIs and from 4% (diarrhea) to 27% (dry mouth) for TCAs. The differences in the rates of adverse effects between the 2 types of drugs ranged from 14% more with SSRIs (for nausea) to 11% more with TCAs (for constipation). The results did not depend on the method of eliciting information from patients. There were no statistically significant differences between drug classes in terms of drop-outs due to adverse effects. INTERPRETATION: SSRIs and TCAs are both associated with adverse effects, although the key effects differ between the drug classes

  20. The Consequences of School Desegregation.

    ERIC Educational Resources Information Center

    Rossell, Christine H., Ed.; Hawley, Willis D., Ed.

    Materials on a variety of subjects related to school desegregation are collected in this book. Chapter 1 discusses assumptions about the overall consequences of desegregation. Chapters 2 to 5 synthesize the findings of existing research on the consequences of school desegregation for children and communities. Finally, Chapter 6 describes…

  1. The effects of prices on alcohol use and its consequences.

    PubMed

    Xu, Xin; Chaloupka, Frank J

    2011-01-01

    Over the past three decades, economists and others have devoted considerable effort to assessing the impact of alcoholic-beverage taxes and prices on alcohol consumption and its related adverse consequences. Federal and State excise taxes have increased only rarely and, when adjusted for inflation, have declined significantly over the years, as have overall prices for alcoholic beverages. Yet studies examining the effects of increases of monetary prices (e.g., through raising taxes) on alcohol consumption and a wide range of related behavioral and health problems have demonstrated that price increases for alcoholic beverages lead to reduced alcohol consumption, both in the general population and in certain high-risk populations, such as heavier drinkers or adolescents and young adults. These effects seem to be more pronounced in the long run than in the short run. Likewise, price increases can help reduce the risk for adverse consequences of alcohol consumption and abuse, including drinking and driving, alcohol-involved crimes, liver cirrhosis and other alcohol-related mortality, risky sexual behavior and its consequences, and poor school performance among youth. All of these findings indicate that increases in alcoholic-beverage taxes could be a highly effective option for reducing alcohol abuse and its consequences. PMID:22330223

  2. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. (a) Records shall be maintained of any reports of complaints of adverse reactions... thorough investigation of each reported adverse reaction shall be made. A written report of...

  3. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. (a) Records shall be maintained of any reports of complaints of adverse reactions... thorough investigation of each reported adverse reaction shall be made. A written report of...

  4. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. (a) Records shall be maintained of any reports of complaints of adverse reactions... thorough investigation of each reported adverse reaction shall be made. A written report of...

  5. Glaucoma eye drops adverse skin reactions.

    PubMed

    Cantisani, Carmen; Ambrifi, Marina; Frascani, Federica; Fazia, Gilda; Paolino, Giovanni; Lisi, Roberto; Calvieri, Stefano

    2014-01-01

    The term "Glaucoma" is used to describe a number of diseases of the eye characterized by a particular form of optic nerve damage that is often associated with high intraocular pressure (IOP). The open-angle glaucoma is the most common form that is also referred to as chronic glaucoma. This is described as an optic neuropathy with multifactorial nature in which there is a loss of characteristics of the optic nerve fibers. Therapeutic options for the treatment of this disease are different, you can take advantage of eye drops, laser therapy and conventional surgery or more combined treatments. Medicated eye drops are the most common way to treat glaucoma. Although eye drops are widely used, adverse reactions are not frequently observed and described. In particular, the adverse skin reactions are not frequently described in the literature, but often seen in dermatologic clinic, we reported their skin reactions and possible alternative treatments described in literature and their patent applications. PMID:25487259

  6. Adverse reactions to injectable soft tissue fillers.

    PubMed

    Requena, Luis; Requena, Celia; Christensen, Lise; Zimmermann, Ute S; Kutzner, Heinz; Cerroni, Lorenzo

    2011-01-01

    In recent years, injections with filler agents are often used for wrinkle-treatment and soft tissue augmentation by dermatologists and plastic surgeons. Unfortunately, the ideal filler has not yet been discovered and all of them may induce adverse reactions. Quickly biodegradable or resorbable agents may induce severe complications, but they will normally disappear spontaneously in a few months. Slowly biodegradable or nonresorbable fillers may give rise to severe reactions that show little or no tendency to spontaneous improvement. They may appear several years after the injection, when the patient does not remember which product was injected, and treatment is often insufficient. In this review, we discuss the most commonly used fillers, their most frequent adverse reactions as well as the characteristic histopathologic findings that allow the identification of the injected filler agent. In conclusion, histopathologic study remains as the gold standard technique to identify the responsible filler.

  7. Adverse events occurring after smallpox vaccination.

    PubMed

    Lane, J Michael; Goldstein, Joel

    2003-07-01

    We reviewed the literature on adverse events reported to occur after smallpox vaccination. Nearly one-half of the United States population is vaccinia-naïve and may be at risk for development of serious adverse events. We describe the clinical features of postvaccinial central nervous system disease, progressive vaccinia, eczema vaccinatum, accidental implantations, "generalized vaccinia," and the common erythematous and/or urticarial rashes. In the 1960s, death occurred approximately once in every million primary vaccinations, with fatalities resulting from progressive vaccinia, postvaccinial encephalitis, and eczema vaccinatum. Death in revaccinees occurred less commonly and almost entirely from progressive vaccinia. In today's population, death rates might be higher because of the increased prevalence of immune deficiency and atopic dermatitis.

  8. Baby on board: do responses to stress in the maternal brain mediate adverse pregnancy outcome?

    PubMed

    Douglas, Alison J

    2010-07-01

    Stress and adverse environmental surroundings result in suboptimal conditions in a pregnant mother such that she may experience poor pregnancy outcome including complete pregnancy failure and preterm labor. Furthermore her developing baby is at risk of adverse programming, which confers susceptibility to long term ill health. While some mechanisms at the feto-maternal interface underlying these conditions are understood, the underlying cause for their adverse adaptation is often not clear. Progesterone plays a key role at many levels, including control of neuroendocrine responses to stress, procuring the required immune balance and controlling placental and decidual function, and lack of progesterone can explain many of the unwanted consequences of stress. How stress that is perceived by the mother inhibits progesterone secretion and action is beginning to be investigated. This overview of maternal neuroendocrine responses to stress throughout pregnancy analyses how they interact to compromise progesterone secretion and precipitate undesirable effects in mother and offspring.

  9. Race, Gender, and Chains of Disadvantage: Childhood Adversity, Social Relationships, and Health

    PubMed Central

    Umberson, Debra; Williams, Kristi; Thomas, Patricia A.; Liu, Hui; Thomeer, Mieke Beth

    2014-01-01

    We use a life course approach to guide an investigation of relationships and health at the nexus of race and gender. We consider childhood as a sensitive period in the life course, during which significant adversity may launch chains of disadvantage in relationships throughout the life course that then have cumulative effects on health over time. Data from a nationally representative panel study (Americans’ Changing Lives, N=3,477) reveal substantial disparities between black and white adults, especially pronounced among men, in the quality of close relationships and in the consequences of these relationships for health. Greater childhood adversity helps to explain why black men have worse health than white men, and some of this effect appears to operate through childhood adversity’s enduring influence on relationship strain in adulthood. Stress that occurs in adulthood plays a greater role than childhood adversity in explaining racial disparities in health among women. PMID:24578394

  10. [A near-miss event. A new approach in the study of adverse events].

    PubMed

    Gutiérrez Cía, I; Obón Azuara, B; Aibar Remón, C

    2008-04-01

    A near-miss event is defined as an event that could have resulted in an injury, fatality, or property damage if it had not been prevented. Analysis of near-miss events could be an efficient method in the study of adverse events. Reporting of near-misses has many benefits in the study of adverse events since near-misses occur more frequently than adverse events. In addition, as they have no consequences, fear that the professionals involved would have to report them is less. However, up to now, this method has been slow to develop. We present two clinical cases that help to understand the usefulness of the near-miss reporting system.

  11. Broken or maladaptive? Altered trajectories in neuroinflammation and behavior after early life adversity

    PubMed Central

    Ganguly, Prabarna; Brenhouse, Heather C.

    2014-01-01

    Exposure to adversity and stress early in development yields vulnerability to mental illnesses throughout the lifespan. Growing evidence suggests that this vulnerability has mechanistic origins involving aberrant development of both neurocircuitry and neuro-immune activity. Here we review the current understanding of when and how stress exposure initiates neuroinflammatory events that interact with brain development. We first review how early life adversity has been associated with various psychopathologies, and how neuroinflammation plays a role in these pathologies. We then summarize data and resultant hypotheses describing how early life adversity may particularly alter neuro-immune development with psychiatric consequences. Finally, we review how sex differences contribute to individualistic vulnerabilities across the lifespan. We submit the importance of understanding how stress during early development might cause outright neural or glial damage, as well as experience-dependent plasticity that may insufficiently prepare an individual for sex-specific or life-stage specific challenges. PMID:25081071

  12. Health care costs for prostate cancer patients receiving androgen deprivation therapy: treatment and adverse events

    PubMed Central

    Krahn, M.D.; Bremner, K.E.; Luo, J.; Alibhai, S.M.H.

    2014-01-01

    Background Serious adverse events have been associated with androgen deprivation therapy (adt) for prostate cancer (pca), but few studies address the costs of those events. Methods All pca patients (ICD-9-CM 185) in Ontario who started 90 days or more of adt or had orchiectomy at the age of 66 or older during 1995–2005 (n = 26,809) were identified using the Ontario Cancer Registry and drug and hospital data. Diagnosis dates of adverse events—myocardial infarction, acute coronary syndrome, congestive heart failure, stroke, deep vein thrombosis or pulmonary embolism, any diabetes, and fracture or osteoporosis—before and after adt initiation were determined from administrative data. We excluded patients with the same diagnosis before and after adt, and we allocated each patient’s time from adt initiation to death or December 31, 2007, into health states: adt (no adverse event), adt-ae (specified single adverse event), Multiple (>1 event), and Final (≤180 days before death). We used methods for Canadian health administrative data to estimate annual total health care costs during each state, and we examined monthly trends. Results Approximately 50% of 21,811 patients with no pre-adt adverse event developed 1 or more events after adt. The costliest adverse event state was stroke ($26,432/year). Multiple was the most frequent (n = 2,336) and the second most costly health state ($24,374/year). Costs were highest in the first month after diagnosis (from $1,714 for diabetes to $14,068 for myocardial infarction). Costs declined within 18 months, ranging from $784 per 30 days (diabetes) to $1,852 per 30 days (stroke). Adverse events increased the costs of adt by 100% to 265%. Conclusions The economic burden of adverse events is relevant to programs and policies from clinic to government, and that burden merits consideration in the risks and benefits of adt. PMID:24940106

  13. An Ss Model with Adverse Selection.

    ERIC Educational Resources Information Center

    House, Christopher L.; Leahy, John V.

    2004-01-01

    We present a model of the market for a used durable in which agents face fixed costs of adjustment, the magnitude of which depends on the degree of adverse selection in the secondary market. We find that, unlike typical models, the sS bands in our model contract as the variance of the shock increases. We also analyze a dynamic version of the model…

  14. Neuropsychiatric Adverse Effects of Amphetamine and Methamphetamine.

    PubMed

    Harro, Jaanus

    2015-01-01

    Administration of amphetamine and methamphetamine can elicit psychiatric adverse effects at acute administration, binge use, withdrawal, and chronic use. Most troublesome of these are psychotic states and aggressive behavior, but a large variety of undesirable changes in cognition and affect can be induced. Adverse effects occur more frequently with higher dosages and long-term use. They can subside over time but some persist long-term. Multiple alterations in the gray and white matter of the brain assessed as changes in tissue volume or metabolism, or at molecular level, have been associated with amphetamine and methamphetamine use and the psychiatric adverse effects, but further studies are required to clarify their causal role, specificity, and relationship with preceding states and traits and comorbidities. The latter include other substance use disorders, mood and anxiety disorders, attention deficit hyperactivity disorder, and antisocial personality disorder. Amphetamine- and methamphetamine-related psychosis is similar to schizophrenia in terms of symptomatology and pathogenesis, and these two disorders share predisposing genetic factors.

  15. Major adverse cardiac events during endurance sports.

    PubMed

    Belonje, Anne; Nangrahary, Mary; de Swart, Hans; Umans, Victor

    2007-03-15

    Major adverse cardiac events in endurance exercise are usually due to underlying and unsuspected heart disease. The investigators present an analysis of major adverse cardiac events that occurred during 2 consecutive annual long distance races (a 36-km beach cycling race and a 21-km half marathon) over the past 5 years. All patients with events were transported to the hospital. Most of the 62,862 participants were men (77%; mean age 40 years). Of these, 4 men (3 runners, 1 cyclist; mean age 48 years) collapsed during (n = 2) or shortly after the races, rendering a prevalence of 0.006%. Two patients collapsed after developing chest pain, 1 of whom needed resuscitation at the event site, which was successful. These patients had acute myocardial infarctions and underwent primary angioplasty. The third patient was resuscitated at the site but did not have coronary disease or inducible ventricular tachycardia or ventricular fibrillation and collapsed presumably because of catecholamine-induced ventricular fibrillation. The fourth patient experienced heat stroke and had elevated creatine kinase-MB and troponins in the absence of electrocardiographic changes. In conclusion, the risk for major adverse cardiac events during endurance sports in well-trained athletes is very low.

  16. Respiratory diseases of global consequence

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Respiratory diseases are one of the two major categories of poultry diseases that cause the most severe economic losses globally (the other being enteric disease). The economic impact of respiratory disease is both direct, from the production losses caused by primary disease and indirect from preve...

  17. Airship economics

    NASA Technical Reports Server (NTRS)

    Neumann, R. D.; Hackney, L. R. M.

    1975-01-01

    Projected operating and manufacturing costs of a large airship design which are considered practical with today's technology and environment are discussed. Data and information developed during an 18-month study on the question of feasibility, engineering, economics and production problems related to a large metalclad type airship are considered. An overview of other classic airship designs are provided, and why metalclad was selected as the most prudent and most economic design to be considered in the 1970-80 era is explained. Crew operation, ATC and enroute requirements are covered along with the question of handling, maintenance and application of systems to the large airship.

  18. Psychiatric adverse effects of pediatric corticosteroid use.

    PubMed

    Drozdowicz, Linda B; Bostwick, J Michael

    2014-06-01

    Corticosteroids, highly effective drugs for myriad disease states, have considerable neuropsychiatric adverse effects that can manifest in cognitive disorders, behavioral changes, and frank psychiatric disease. Recent reviews have summarized these effects in adults, but a comprehensive review on corticosteroid effects in children has not been published since 2005. Here, we systematically review articles published since then that, we find, naturally divide into 3 main areas: (1) chronic effects of acute prenatal and neonatal exposure associated with prematurity and congenital conditions; (2) immediate behavioral effects of acute exposure via oncological protocols; and (3) acute behavioral effects of sporadic use in children and adolescents with other conditions. PsycInfo, MEDLINE, Embase, and Scopus were queried to identify articles reporting psychiatric adverse effects of corticosteroids in pediatric patients. Search terms included corticosteroids, adrenal cortex hormones, steroid psychosis, substance-induced psychoses, glucocorticoids, dexamethasone, hydrocortisone, prednisone, adverse effects, mood disorders, mental disorders, psychosis, psychotic, psychoses, side effect, chemically induced, emotions, affective symptoms, toxicity, behavior, behavioral symptoms, infant, child, adolescent, pediatric, paediatric, neonatal, children, teen, and teenager. Following guidelines for systematic reviews from the Potsdam Consultation on Meta-Analysis, we have found it difficult to draw specific conclusions that are more than general impressions owing to the quality of the available studies. We find a mixed picture with neonates exposed to dexamethasone, with some articles reporting eventual deficits in neuropsychiatric functioning and others reporting no effect. In pediatric patients with acute lymphoblastic leukemia, corticosteroid use appears to correlate with negative psychiatric and behavioral effects. In children treated with corticosteroids for noncancer conditions

  19. The Unintended Consequences of Computerized Provider Order Entry: Findings From a Mixed Methods Exploration*

    PubMed Central

    Ash, Joan S.; Sittig, Dean F.; Dykstra, Richard; Campbell, Emily; Guappone, Kenneth

    2009-01-01

    Objective To describe the foci, activities, methods, and results of a four-year research project identifying the unintended consequences of computerized provider order entry (CPOE). Methods Using a mixed methods approach, we identified and categorized into nine types 380 examples of the unintended consequences of CPOE gleaned from fieldwork data and a conference of experts. We then conducted a national survey in the U.S.A. to discover how hospitals with varying levels of infusion, a measure of CPOE sophistication, recognize and deal with unintended consequences. The research team, with assistance from experts, identified strategies for managing the nine types of unintended adverse consequences and developed and disseminated tools for CPOE implementers to help in addressing these consequences. Results Hospitals reported that levels of infusion are quite high and that these types of unintended consequences are common. Strategies for avoiding or managing the unintended consequences are similar to best practices for CPOE success published in the literature. Conclusion Development of a taxonomy of types of unintended adverse consequences of CPOE using qualitative methods allowed us to craft a national survey and discover how widespread these consequences are. Using mixed methods, we were able to structure an approach for addressing the skillful management of unintended consequences as well. PMID:18786852

  20. Causes and Consequences of Cognitive Functioning Across the Life Course

    PubMed Central

    Hauser, Robert M.

    2012-01-01

    Research on variation in cognitive abilities has focused largely on their genetic or experiential sources and on their economic consequences. This article takes a broader look at the consequences of cognitive ability—IQ—across the life course. Contrary to received wisdom, the effects of IQ on economic success are almost entirely mediated by educational attainment. Among persons with equal levels of schooling, IQ has little influence on job performance, occupational standing, earnings, or wealth. But there are other, sometimes surprising consequences of IQ throughout adult life. The long-term correlates of adolescent cognition include drinking behavior, survey participation, Internet use, and the timing of menopause. These are surveyed primarily using findings from the Wisconsin Longitudinal Study. PMID:22383855

  1. Economic Imperative

    ERIC Educational Resources Information Center

    Sack, Joetta L.

    2005-01-01

    The signals had been there for years. Task force reports and researchers all predicted it. Then, in the late 1990s, the economic collapse in this blue-collar region of central Maine began. First, the Cascade Co. closed its textile mill. Then the C.F. Hathaway Co. shut down, and Dumont Industries followed suit soon after. Several stores and other…

  2. Home Economics.

    ERIC Educational Resources Information Center

    Ontario Dept. of Education, Toronto. School Planning and Building Research Section.

    This presentation of suggested layouts and specifications for home economics facilities has been prepared to be of service to school boards, architects, teachers, and administrators who are planning new schools or making renovations to existing structures. Room layouts are shown for a foods and nutrition room, or the foods and nutrition area of a…

  3. Economic Blues

    ERIC Educational Resources Information Center

    Stuart, Reginald

    2009-01-01

    Today, a national economy gone bust has derailed Black Americans' plans across the country. Gone are many of the economic gains, small as they were, achieved in the post-segregation era by millions of 1960s generation children and their children. Black America today is beset by job losses, business closures, pay cuts, furloughs, investment and…

  4. Cable Economics.

    ERIC Educational Resources Information Center

    Cable Television Information Center, Washington, DC.

    A guide to the economic factors that influence cable television systems is presented. Designed for local officials who must have some familiarity with cable operations in order to make optimum decisions, the guide analyzes the financial framework of a cable system, not only from the operators viewpoint, but also from the perspective of the…

  5. Economic impact

    SciTech Connect

    Technology Transfer Department

    2001-06-01

    In federal fiscal year 2000 (FY00), Berkeley Lab had 4,347 full- and part-time employees. In addition, at any given time of the year, there were more than 1,000 Laboratory guests. These guests, who also reside locally, have an important economic impact on the nine-county Bay Area. However, Berkeley Lab's total economic impact transcends the direct effects of payroll and purchasing. The direct dollars paid to the Lab's employees in the form of wages, salaries, and benefits, and payments made to contractors for goods and services, are respent by employees and contractors again and again in the local and greater economy. Further, while Berkeley Lab has a strong reputation for basic scientific research, many of the Lab's scientific discoveries and inventions have had direct application in industry, spawning new businesses and creating new opportunities for existing firms. This analysis updates the Economic Impact Analysis done in 1996, and its purpose is to describe the economic and geographic impact of Laboratory expenditures and to provide a qualitative understanding of how Berkeley Lab impacts and supports the local community. It is intended as a guide for state, local, and national policy makers as well as local community members. Unless otherwise noted, this analysis uses data from FY00, the most recent year for which full data are available.

  6. Resource Economics

    NASA Astrophysics Data System (ADS)

    Conrad, Jon M.

    2000-01-01

    Resource Economics is a text for students with a background in calculus, intermediate microeconomics, and a familiarity with the spreadsheet software Excel. The book covers basic concepts, shows how to set up spreadsheets to solve dynamic allocation problems, and presents economic models for fisheries, forestry, nonrenewable resources, stock pollutants, option value, and sustainable development. Within the text, numerical examples are posed and solved using Excel's Solver. These problems help make concepts operational, develop economic intuition, and serve as a bridge to the study of real-world problems of resource management. Through these examples and additional exercises at the end of Chapters 1 to 8, students can make dynamic models operational, develop their economic intuition, and learn how to set up spreadsheets for the simulation of optimization of resource and environmental systems. Book is unique in its use of spreadsheet software (Excel) to solve dynamic allocation problems Conrad is co-author of a previous book for the Press on the subject for graduate students Approach is extremely student-friendly; gives students the tools to apply research results to actual environmental issues

  7. Economic Growth.

    ERIC Educational Resources Information Center

    O'Neill, James B.; And Others

    1986-01-01

    A conceptual introduction for teachers explains economic growth and how it is measured. Four instructional units follow, beginning with a preschool and kindergarten unit which offers young students an opportunity to interview puppet workers, set up a classroom corner store, and learn the importance of capital resources for increasing productivity…

  8. Software Systems: Consequence versus Functionality

    SciTech Connect

    Berg, Ray; Winter, Victor L.

    1999-08-05

    The purpose of this panel is to present different perspectives and opinions regarding the issues surrounding why software should or shouldn't be entrusted with critical (high consequence) functionality.

  9. Systematic Review: Adverse Events of Fecal Microbiota Transplantation

    PubMed Central

    Wang, Weiqiang; Cao, Xiaocang; Piao, Meiyu; Khan, Samiullah; Yan, Fang; Cao, Hailong; Wang, Bangmao

    2016-01-01

    Background Fecal microbiota transplantation (FMT) is a microbiota-based therapy that shows therapeutic potential in recurrent or refractory Clostridium difficile infections and other intestinal or extra-intestinal disorders. Nonetheless, adverse events (AEs) remain a major challenge in the application of FMT. Aim To review the AEs of FMT and to address the concerns of safety during the procedure. Methods Publications were retrieved in the databases of Medline, Embase and Cochrane Library. AEs were classified according to their causality with FMT or their severity. Results A total of 7562 original articles about FMT were identified in this study, 50 of them fulfilled the inclusion criteria. Totally 78 kinds of AEs were revealed enrolled in these 50 selected publications. The total incidence rate of AEs was 28.5%. Among the 42 publications, 5 kinds were definitely and 38 kinds were probably related to FMT. The commonest FMT-attributable AE was abdominal discomfort, which was reported in 19 publications. For upper gastrointestinal routes of FMT, 43.6% (89/204) patients were compromised by FMT-attributable AE, while the incidence dropped to 17.7% (76/430) for lower gastrointestinal routes. In contrast, the incidences of serious adverse events (SAEs) were 2.0% (4/196) and 6.1% (40/659) for upper and lower gastrointestinal routes, respectively. A total of 44 kinds of SAEs occurred in 9.2% patients, including death (3.5%, 38/1089), infection (2.5%, 27/1089), relapse of inflammatory bowel diseases (0.6%, 7/1089) and Clostridium difficile infection (0.9%, 10/1089). Conclusion Consequently, both AEs and SAEs are not rare and should be carefully monitored throughout FMT. However, high quality randomized controlled trials are still needed for the more definite incidence of AEs of FMT. PMID:27529553

  10. Methods and systems to detect adverse drug reactions in hospitals.

    PubMed

    Thürmann, P A

    2001-01-01

    Detection of adverse drug reactions (ADRs) in hospitals offers the chance to detect serious ADRs resulting in hospitalisation and ADRs occurring in hospitalised patients, i.e. patients with high comorbidity and receiving drugs that are administered only in hospitals. The most commonly applied methods involve stimulated spontaneous reporting of doctors and nurses, comprehensive collection by trained specialists and, more recently, computer-assisted approaches using routine data from hospital information systems. The different methods of ADR detection used result in different rates and types of ADRs and, consequently, in different drug classes being responsible for these ADRs. Another factor influencing the results of surveys is the interpretation of the term ADR, where some authors adhere to the strict definition of the World Health Organization and many others include intended and unintended poisoning as well as errors in prescribing and dispensing, thus referring to adverse drug events. Depending on the method used for screening of patients, a high number of possible ADRs and only few definite ADRs are found, or vice versa. These variations have to be taken into account when comparing the results of further analyses performed with these data. ADR rates and incidences in relation to the number of drugs prescribed or patients exposed have been calculated in only a few surveys and projects, and this interesting pharmacoepidemiological approach deserves further study. In addition, the pharmacoeconomic impact of ADRs, either resulting in hospitalisation or prolonging hospital stay, has been estimated using different approaches. However, a common standardised procedure for such calculations has not yet been defined. Although detection of ADRs in hospitals offers the opportunity to detect severe ADRs of newly approved drugs, these ADRs are still discovered by spontaneous reporting systems. The prospects offered by electronic hospital information systems as well as

  11. The world economic crisis and the children: United States case study.

    PubMed

    Miller, C A; Coulter, E J; Schorr, L B; Fine, A; Adams-Taylor, S

    1985-01-01

    This is a review of the United States experience with issues of child health and services as they relate to changes in economic trends. No existing data systems are entirely adequate for reporting on the current health status of children. An important consideration for the monitoring of children's health in the United States is the status of subgroups such as those who are disadvantaged for reasons of poverty, discrimination or geographic isolation. Ample evidence confirms that children living in poverty suffer adverse health consequences and that the proportion of children living in poverty in the United States has increased steadily since 1975 and dramatically since 1981. Most measures of health status and health risks for children show steady improvements throughout the 1970s. The exercise of public responsibility for financing and providing essential services and supports held constant or improved during this period, especially during the recession of 1974-75. The health status and risks for children since 1981 appear to be adversely affected which must be attributed to a combination of circumstances that include serious recession, increased poverty rates for households with children and diminished health benefits and social support services. These findings suggest that when either local or widespread economic reversals are anticipated, health services and social supports for children need to be expanded rather than contracted.

  12. Anticoagulation-associated adverse drug events

    PubMed Central

    Piazza, Gregory; Nguyen, Thanh Nha; Cios, Deborah; Labreche, Matthew; Hohlfelder, Benjamin; Fanikos, John; Fiumara, Karen; Goldhaber, Samuel Z.

    2011-01-01

    Purpose Anticoagulant drugs are among the most common medications that cause adverse drug events (ADEs) in hospitalized patients. We performed a five-year retrospective study at Brigham and Women’s Hospital to determine clinical characteristics, types, root causes, and outcomes of anticoagulant-associated adverse drug events (ADEs). Methods We reviewed all inpatient anticoagulant-associated ADEs, including adverse drug reactions (ADRs) and medication errors, reported at Brigham and Women’s Hospital through the Safety Reporting System from May 2004 to May 2009. We also collected data regarding the cost associated with hospitalizations in which ADRs occurred. Results Of 463 anticoagulant-associated ADEs, 226 were MEs (48.8%), 141 were ADRs (30.5%), and 96 (20.7%) involved both a medication error and ADR. Seventy percent of anticoagulant-associated ADEs were potentially preventable. Transcription errors (48%) were the most frequent root cause of anticoagulant-associated medication errors, while medication errors (40%) were a common root cause of anticoagulant-associated ADRs. Death within 30 days of anticoagulant-associated ADEs occurred in 11% of patients. After an anticoagulant-associated ADR, most hospitalization expenditures were attributable to nursing costs (mean $33,189 per ADR) followed by pharmacy costs (mean $7,451 per ADR). Conclusion Most anticoagulant-associated ADEs among inpatients result from medication errors and are therefore potentially preventable. We observed an elevated 30-day mortality rate among patients who suffered an anticoagulant-associated ADE and high hospitalization costs following ADRs. Further Quality Improvement efforts to reduce anticoagulant-associated medication errors are warranted to improve patient safety and decrease health care expenditures. PMID:22114827

  13. Adverse reactions to fragrances. A clinical review.

    PubMed

    de Groot, A C; Frosch, P J

    1997-02-01

    This article reviews side-effects of fragrance materials present in cosmetics with emphasis on clinical aspects: epidemiology, types of adverse reactions, clinical picture, diagnostic procedures, and the sensitizers. Considering the ubiquitous occurrence of fragrance materials, the risk of side-effects is small. In absolute numbers, however, fragrance allergy is common, affecting approximately 1% of the general population. Although a detailed profile of patients sensitized to fragrances needs to be elucidated, common features of contact allergy are: axillary dermatitis, dermatitis of the face (including the eyelids) and neck, well-circumscribed patches in areas of "dabbing-on" perfumes (wrists, behind the ears) and (aggravation of) hand eczema. Depending on the degree of sensitivity, the severity of dermatitis may range from mild to severe with dissemination and even erythroderma. Airborne or "connubial" contact dermatitis should always be suspected. Other less frequent adverse reactions to fragrances are photocontact dermatitis, immediate contact reactions and pigmentary changes. The fragrance mix, although very useful for the detection of sensitive patients, both causes false-positive and false-negative reactions, and detects only 70% of perfume-allergic patients. Therefore, future research should be directed at increasing the sensitivity and the specificity of the mix. Relevance is said to be established in 50-65% of positive reactions, but accurate criteria are needed. Suggestions are made for large-scale investigation of several fragrances on the basis of literature data and frequency of use in cosmetics. The literature on adverse reactions to balsam of Peru (an indicator for fragrance sensitivity), essential oils (which currently appear to be used more in aromatherapy than in perfumery) and on fragrances used as flavours and spices in foods and beverages is not discussed in detail, but pertinent side-effects data are tabulated and relevant literature is

  14. ORAL ADVERSE DRUG REACTIONS TO CARDIOVASCULAR DRUGS.

    PubMed

    Torpet, Lis Andersen; Kragelund, Camilla; Reibel, Jesper; Nauntofte, Birgitte

    2004-01-01

    A great many cardiovascular drugs (CVDs) have the potential to induce adverse reactions in the mouth. The prevalence of such reactions is not known, however, since many are asymptomatic and therefore are believed to go unreported. As more drugs are marketed and the population includes an increasing number of elderly, the number of drug prescriptions is also expected to increase. Accordingly, it can be predicted that the occurrence of adverse drug reactions (ADRs), including the oral ones (ODRs), will continue to increase. ODRs affect the oral mucous membrane, saliva production, and taste. The pathogenesis of these reactions, especially the mucosal ones, is largely unknown and appears to involve complex interactions among the drug in question, other medications, the patient's underlying disease, genetics, and life-style factors. Along this line, there is a growing interest in the association between pharmacogenetic polymorphism and ADRs. Research focusing on polymorphism of the cytochrome P450 system (CYPs) has become increasingly important and has highlighted the intra- and inter-individual responses to drug exposure. This system has recently been suggested to be an underlying candidate regarding the pathogenesis of ADRs in the oral mucous membrane. This review focuses on those CVDs reported to induce ODRs. In addition, it will provide data on specific drugs or drug classes, and outline and discuss recent research on possible mechanisms linking ADRs to drug metabolism patterns. Abbreviations used will be as follows: ACEI, ACE inhibitor; ADR, adverse drug reaction; ANA, antinuclear antigen; ARB, angiotensin II receptor blocker; BAB, beta-adrenergic blocker; CCB, calcium-channel blocker; CDR, cutaneous drug reaction; CVD, cardiovascular drug; CYP, cytochrome P450 enzyme; EM, erythema multiforme; FDE, fixed drug eruption; I, inhibitor of CYP isoform activity; HMG-CoA, hydroxymethyl-glutaryl coenzyme A; NAT, N-acetyltransferase; ODR, oral drug reaction; RDM, reactive

  15. Reducing medical errors and adverse events.

    PubMed

    Pham, Julius Cuong; Aswani, Monica S; Rosen, Michael; Lee, HeeWon; Huddle, Matthew; Weeks, Kristina; Pronovost, Peter J

    2012-01-01

    Medical errors account for ∼98,000 deaths per year in the United States. They increase disability and costs and decrease confidence in the health care system. We review several important types of medical errors and adverse events. We discuss medication errors, healthcare-acquired infections, falls, handoff errors, diagnostic errors, and surgical errors. We describe the impact of these errors, review causes and contributing factors, and provide an overview of strategies to reduce these events. We also discuss teamwork/safety culture, an important aspect in reducing medical errors.

  16. Environmental Perchlorate Exposure: Potential Adverse Thyroid Effects

    PubMed Central

    Leung, Angela M.; Pearce, Elizabeth N.; Braverman, Lewis E.

    2014-01-01

    Purpose of review This review will present a general overview of the sources, human studies, and proposed regulatory action regarding environmental perchlorate exposure. Recent findings Some recent studies have reported significant associations between urinary perchlorate concentrations, thyroid dysfunction, and decreased infant IQ in groups who would be particularly susceptible to perchlorate effects. An update regarding the recent proposed regulatory actions and potential costs surrounding amelioration of perchlorate contamination is provided. Summary The potential adverse thyroidal effects of environmental perchlorate exposure remain controversial, and further research is needed to further define its relationship to human health among pregnant and lactating women and their infants. PMID:25106002

  17. Adverse effects of equine rabies immune gobulin.

    PubMed

    Wilde, H; Chomchey, P; Prakongsri, S; Puyaratabandhu, P; Chutivongse, S

    1989-02-01

    Following a recently published prospective study of 485 recipients of equine rabies immune globulin (ERIG) manufactured by Pasteur Vaccins (Paris), this paper reports a study of 323 postexposure rabies patients receiving ERIG manufactured by the Swiss Vaccine and Serum Institute (Berna). It is concluded that there may be significant differences in adverse reaction rates, reflecting differing manufacturing or purification processes and protein content. Further studies of different ERIG products and of different lots of the same product are needed while ERIG remains an essential component of postexposure rabies treatment in developing countries.

  18. Agomelatine: a review of adverse effects.

    PubMed

    2013-03-01

    More pharmacovigilance data on agomelatine became available in 2012. The main sources of information were surveillance data from the French national monitoring system, EU periodic safety update reports (PSURs), and the European pharmacovigilance database. The principal adverse effects of agomelatine consist of hepatic, pancreatic, neuropsychiatric, muscular and cutaneous disorders. The harms associated with agomelatine, which has no proven efficacy in depression, clearly outweigh the benefits. Until regulatory agencies decide to withdraw agomelatine from the market, it is up to healthcare professionals to protect patients from this unnecessarily dangerous drug.

  19. Adverse Effects of Psychotropic Medications: A Call to Action.

    PubMed

    Mago, Rajnish

    2016-09-01

    Adverse effects are common, bothersome, and a leading cause of discontinuation of treatment. The methodology for evaluating adverse effects of medications has been greatly neglected, however, especially in comparison to the methodology for assessment of efficacy of medications. Existing methods for assessment and reporting of adverse effects have important limitations leading to lack of much-needed data related to adverse effects. Lastly, there is little systematic research into management of most adverse effects. A series of recommendations are made in this article about how to improve identification, assessment, reporting, and management of adverse effects. PMID:27514294

  20. Environmental consequences of energy production: Proceedings

    SciTech Connect

    none,

    1989-01-01

    The Seventeenth Annual Illinois Energy conference entitled Environmental consequences of Energy Production was held in Chicago, Illinois on October 19-20, 1989. The purpose of the meeting was to provide a forum for exchange of information on the technical, economic and institutional issues surrounding energy production and related environmental problems. The conference program was developed by a planning committee which included Illinois energy and environmental specialists from the major sectors including energy industries, environmental organizations, research universities, utility companies, federal, state and local government agencies, and public interest groups. The conference included presentations on four major topic areas. The issue areas were: urban pollution: where are we now and what needs to be done in the future; the acid rain problem: implications of proposed federal legislation on the Midwest; global warming: an update on the scientific debate; and strategies to minimize environmental damage. Separate abstracts have been prepared for the individual presentations. (FL)

  1. Potential long-term consequences of fad diets on health, cancer, and longevity: lessons learned from model organism studies.

    PubMed

    Ruden, Douglas M; Rasouli, Parsa; Lu, Xiangyi

    2007-06-01

    While much of the third world starves, many in the first world are undergoing an obesity epidemic, and the related epidemics of type II diabetes, heart disease, and other diseases associated with obesity. The amount of economic wealth being directly related to a decline in health by obesity is ironic because rich countries contribute billions of dollars to improve the health of their citizens. Nevertheless, nutritional experiments in model organisms such as yeast, C. elegans, Drosophila, and mice confirm that "caloric restriction" (CR), which is defined generally as a 30-40% decrease in caloric intake, a famine-like condition for humans seen only in the poorest of countries, promotes good health and increases longevity in model organisms. Because caloric restriction, and dieting in general, requires a great deal of will power to deal with the feelings of deprivation, many fad diets, such as the Atkins, South Beach, and Protein Power, have been developed which allow people to lose weight purportedly without the severe feelings of deprivation. However, the long-term effects of such fad diets are not known and few experiments have been performed in the laboratory to investigate possible side affects and adverse consequences. In this paper, we review studies with fad-like dietary conditions in humans and model organisms, and we propose a "Dietary Ames Test" to rapidly screen fad diets, dietary supplements, and drugs for potential long-term health consequences in model organisms.

  2. Engendering economics.

    PubMed

    1995-08-01

    Gender has become a major issue in discussions of economic development, with international organizations having generated studies which demonstrate that investments in women yield high returns in productivity, child health, and family welfare. Discussions of gender usually have been compartmentalized, with little impact upon broader studies of development. Examining the role that gender plays in economic life, however, could lead to a better understanding of the role which social institutions play in development. The author discusses reexamining gender bias and collective action by men and women with respect to property rights, family law, and the labor market. It is noted in closing that individual preferences are partially shaped by social norms which are strongly influenced by the coalitions which hold power in a society. As women gain collective power, they are likely to challenge the social norms which are costly to them.

  3. Economic analysis

    SciTech Connect

    1980-06-01

    The Energy Policy and Conservation Act (EPCA) mandated that minimum energy efficiency standards be established for classes of refrigerators and refrigerator-freezers, freezers, clothes dryers, water heaters, room air conditioners, home heating equipment, kitchen ranges and ovens, central air conditioners, and furnaces. EPCA requires that standards be designed to achieve the maximum improvement in energy efficiency that is technologically feasible and economically justified. Following the introductory chapter, Chapter Two describes the methodology used in the economic analysis and its relationship to legislative criteria for consumer product efficiency assessment; details how the CPES Value Model systematically compared and evaluated the economic impacts of regulation on the consumer, manufacturer and Nation. Chapter Three briefly displays the results of the analysis and lists the proposed performance standards by product class. Chapter Four describes the reasons for developing a baseline forecast, characterizes the baseline scenario from which regulatory impacts were calculated and summarizes the primary models, data sources and assumptions used in the baseline formulations. Chapter Five summarizes the methodology used to calculate regulatory impacts; describes the impacts of energy performance standards relative to the baseline discussed in Chapter Four. Also discussed are regional standards and other program alternatives to performance standards. Chapter Six describes the procedure for balancing consumer, manufacturer, and national impacts to select standard levels. Details of models and data bases used in the analysis are included in Appendices A through K.

  4. Adverse reaction to lupine-fortified pasta.

    PubMed

    Hefle, S L; Lemanske, R F; Bush, R K

    1994-08-01

    A 5-year-old girl with peanut sensitivity experienced urticaria and angioedema after ingesting a spaghetti-like pasta fortified with sweet lupine seed flour. The pasta was extracted and used in immunologic studies in patients with peanut sensitivity to determine whether such individuals are at similar risk. Results of skin prick tests with the lupine pasta extract were positive in five of seven subjects; these patients also reported a history of adverse reactions to green peas. In direct RAST studies IgE binding from pooled sera from patients with peanut sensitivity to the lupine pasta extract was 7 times that of a nonallergic control serum, and individual serum samples demonstrated binding from 1 to 6 times that of the negative control. Direct RAST studies of lupine seed flour with serum samples from patients with peanut allergy demonstrated IgE binding 1 to 11 times that of the negative control. Immunoblotting studies of electrophoretically separated pasta extract and lupine seed flour proteins showed IgE-binding protein bands at approximately 21 kd and in the range of 35 to 55 kd molecular weight. We conclude that some peanut-sensitive patients may be at risk for adverse reactions to lupine.

  5. Adverse reactions to food: allergies and intolerances.

    PubMed

    Montalto, Massimo; Santoro, Luca; D'Onofrio, Ferruccio; Curigliano, Valentina; Gallo, Antonella; Visca, Dina; Cammarota, Giovanni; Gasbarrini, Antonio; Gasbarrini, Giovanni

    2008-01-01

    All the anomalous reactions secondary to food ingestion are defined as 'adverse reactions to food'. In 1995 the European Academy of Allergology and Clinical Immunology suggested a classification on the basis of the responsible pathogenetic mechanism; according to this classification, non-toxic reactions can be divided into 'food allergies' when they recognize immunological mechanisms, and 'food intolerances' when there are no immunological implications. The diagnostic approach to adverse reactions to food is based on accurate clinical history and objective examination, and further execution of specific tests when allergy or intolerance is suspected. The therapy for food allergies is the elimination of the food to which hypersensibility has been found; this strategy can lead, especially in pediatric age, to tolerance. If elimination diets cannot be completely performed, or if it is not possible to identify the food to eliminate, some drugs (e.g. antihistaminics, steroids, etc.) can be administered. Specific allergen immunotherapy has been recently introduced. Fundamental is food allergy prevention, especially in high-risk subjects. The therapeutic approach to secondary food intolerances is based principally on primitive disease resolution; on the other hand, some specific treatments (e.g. beta-galactosidases in lactose malabsorption) are available in case of primary intolerance. PMID:18431058

  6. Consumer reporting of adverse events following immunization

    PubMed Central

    Clothier, Hazel J; Selvaraj, Gowri; Easton, Mee Lee; Lewis, Georgina; Crawford, Nigel W; Buttery, Jim P

    2014-01-01

    Surveillance of adverse events following immunisation (AEFI) is an essential component of vaccine safety monitoring. The most commonly utilized passive surveillance systems rely predominantly on reporting by health care providers (HCP). We reviewed adverse event reports received in Victoria, Australia since surveillance commencement in July 2007, to June 2013 (6 years) to ascertain the contribution of consumer (vaccinee or their parent/guardian) reporting to vaccine safety monitoring and to inform future surveillance system development directions. Categorical data included were: reporter type; serious and non-serious AEFI category; and, vaccinee age group. Chi-square test and 2-sample test of proportions were used to compare categories; trend changes were assessed using linear regression. Consumer reporting increased over the 6 years, reaching 21% of reports received in 2013 (P <0.001), most commonly for children aged less than 7 years. Consumer reports were 5% more likely to describe serious AEFI than HCP (P = 0.018) and 10% more likely to result in specialist clinic attendance (P <0.001). Although online reporting increased to 32% of all report since its introduction in 2010, 85% of consumers continued to report by phone. Consumer reporting of AEFI is a valuable component of vaccine safety surveillance in addition to HCP reporting. Changes are required to AEFI reporting systems to implement efficient consumer AEFI reporting, but may be justified for their potential impact on signal detection sensitivity. PMID:25483686

  7. Ranking Adverse Drug Reactions With Crowdsourcing

    PubMed Central

    Gottlieb, Assaf; Hoehndorf, Robert; Dumontier, Michel

    2015-01-01

    Background There is no publicly available resource that provides the relative severity of adverse drug reactions (ADRs). Such a resource would be useful for several applications, including assessment of the risks and benefits of drugs and improvement of patient-centered care. It could also be used to triage predictions of drug adverse events. Objective The intent of the study was to rank ADRs according to severity. Methods We used Internet-based crowdsourcing to rank ADRs according to severity. We assigned 126,512 pairwise comparisons of ADRs to 2589 Amazon Mechanical Turk workers and used these comparisons to rank order 2929 ADRs. Results There is good correlation (rho=.53) between the mortality rates associated with ADRs and their rank. Our ranking highlights severe drug-ADR predictions, such as cardiovascular ADRs for raloxifene and celecoxib. It also triages genes associated with severe ADRs such as epidermal growth-factor receptor (EGFR), associated with glioblastoma multiforme, and SCN1A, associated with epilepsy. Conclusions ADR ranking lays a first stepping stone in personalized drug risk assessment. Ranking of ADRs using crowdsourcing may have useful clinical and financial implications, and should be further investigated in the context of health care decision making. PMID:25800813

  8. Adverse outcome pathway development II: best practices.

    PubMed

    Villeneuve, Daniel L; Crump, Doug; Garcia-Reyero, Natàlia; Hecker, Markus; Hutchinson, Thomas H; LaLone, Carlie A; Landesmann, Brigitte; Lettieri, Teresa; Munn, Sharon; Nepelska, Malgorzata; Ottinger, Mary Ann; Vergauwen, Lucia; Whelan, Maurice

    2014-12-01

    Organization of existing and emerging toxicological knowledge into adverse outcome pathway (AOP) descriptions can facilitate greater application of mechanistic data, including those derived through high-throughput in vitro, high content omics and imaging, and biomarker approaches, in risk-based decision making. The previously ad hoc process of AOP development is being formalized through development of internationally harmonized guidance and principles. The goal of this article was to outline the information content desired for formal AOP description and some rules of thumb and best practices intended to facilitate reuse and connectivity of elements of an AOP description in a knowledgebase and network context. For example, key events (KEs) are measurements of change in biological state that are indicative of progression of a perturbation toward a specified adverse outcome. Best practices for KE description suggest that each KE should be defined as an independent measurement made at a particular level of biological organization. The concept of "functional equivalence" can help guide both decisions about how many KEs to include in an AOP and the specificity with which they are defined. Likewise, in describing both KEs and evidence that supports a causal linkage or statistical association between them (ie, a key event relationship; KER), best practice is to build from and contribute to existing KE or KER descriptions in the AOP knowledgebase rather than creating redundant descriptions. The best practices proposed address many of the challenges and uncertainties related to AOP development and help promote a consistent and reliable, yet flexible approach. PMID:25466379

  9. Immunomodulatory drugs: Oral and systemic adverse effects

    PubMed Central

    Mattila, Riikka; Gomez-Font, Rafael; Meurman, Jukka H.

    2014-01-01

    Objectives: The main objectives are to present the different adverses effects of the immunomodulatory drugs that can impair the quality of life of the immunosupressed patients and study the impact of immunomodualtion on oral diseases. Immunomodulatory drugs have changed the treatment protocols of many diseases where immune functions play a central role, such as rheumatic diseases. Their effect on oral health has not been systematically investigated, however. Study Design: We review current data on the new immunomodulatory drugs from the oral health perspective based on open literature search of the topic. Results: These target specific drugs appear to have less drug interactions than earlier immunomodulating medicines but have nevertheless potential side effects such as activating latent infections. There are some data showing that the new immunomodulatory drugs may also have a role in the treatment of certain oral diseases such as lichen planus or ameliorating symptoms in Sjögren´s syndrome, but the results have not been overly promising. Conclusions: In general, data are sparse of the effect of these new drugs vs. oral diseases and there are no properly powered randomized controlled trials published on this topic. Key words:Immunomodulatory drugs, oral diseases, adverse effects, therapeutic action. PMID:23986016

  10. Adverse outcome pathway development II: best practices.

    PubMed

    Villeneuve, Daniel L; Crump, Doug; Garcia-Reyero, Natàlia; Hecker, Markus; Hutchinson, Thomas H; LaLone, Carlie A; Landesmann, Brigitte; Lettieri, Teresa; Munn, Sharon; Nepelska, Malgorzata; Ottinger, Mary Ann; Vergauwen, Lucia; Whelan, Maurice

    2014-12-01

    Organization of existing and emerging toxicological knowledge into adverse outcome pathway (AOP) descriptions can facilitate greater application of mechanistic data, including those derived through high-throughput in vitro, high content omics and imaging, and biomarker approaches, in risk-based decision making. The previously ad hoc process of AOP development is being formalized through development of internationally harmonized guidance and principles. The goal of this article was to outline the information content desired for formal AOP description and some rules of thumb and best practices intended to facilitate reuse and connectivity of elements of an AOP description in a knowledgebase and network context. For example, key events (KEs) are measurements of change in biological state that are indicative of progression of a perturbation toward a specified adverse outcome. Best practices for KE description suggest that each KE should be defined as an independent measurement made at a particular level of biological organization. The concept of "functional equivalence" can help guide both decisions about how many KEs to include in an AOP and the specificity with which they are defined. Likewise, in describing both KEs and evidence that supports a causal linkage or statistical association between them (ie, a key event relationship; KER), best practice is to build from and contribute to existing KE or KER descriptions in the AOP knowledgebase rather than creating redundant descriptions. The best practices proposed address many of the challenges and uncertainties related to AOP development and help promote a consistent and reliable, yet flexible approach.

  11. Adverse Outcome Pathway Development II: Best Practices

    PubMed Central

    Villeneuve, Daniel L.; Crump, Doug; Garcia-Reyero, Natàlia; Hecker, Markus; Hutchinson, Thomas H.; LaLone, Carlie A.; Landesmann, Brigitte; Lettieri, Teresa; Munn, Sharon; Nepelska, Malgorzata; Ottinger, Mary Ann; Vergauwen, Lucia; Whelan, Maurice

    2014-01-01

    Organization of existing and emerging toxicological knowledge into adverse outcome pathway (AOP) descriptions can facilitate greater application of mechanistic data, including those derived through high-throughput in vitro, high content omics and imaging, and biomarker approaches, in risk-based decision making. The previously ad hoc process of AOP development is being formalized through development of internationally harmonized guidance and principles. The goal of this article was to outline the information content desired for formal AOP description and some rules of thumb and best practices intended to facilitate reuse and connectivity of elements of an AOP description in a knowledgebase and network context. For example, key events (KEs) are measurements of change in biological state that are indicative of progression of a perturbation toward a specified adverse outcome. Best practices for KE description suggest that each KE should be defined as an independent measurement made at a particular level of biological organization. The concept of “functional equivalence” can help guide both decisions about how many KEs to include in an AOP and the specificity with which they are defined. Likewise, in describing both KEs and evidence that supports a causal linkage or statistical association between them (ie, a key event relationship; KER), best practice is to build from and contribute to existing KE or KER descriptions in the AOP knowledgebase rather than creating redundant descriptions. The best practices proposed address many of the challenges and uncertainties related to AOP development and help promote a consistent and reliable, yet flexible approach. PMID:25466379

  12. [Adverse drug reactions in pregnant women].

    PubMed

    Lacroix, Isabelle; Cabou, Cendrine; Montastruc, Jean-Louis; Damase-Michel, Christine

    2007-01-01

    A Prospective pharmacovigilance survey of adverse drug reactions (ADRs) in pregnant women was performed in collaboration with gynaecologists and obstetricians of Midi-Pyrenees area (south west of france). The aim of the study was to evaluate the incidence of adverse drug reactions in pregnant women. The incidence of ADRs in pregnant women was low: 0.3%. Moreover, a retrospective pharmacoepidemiological study was conducted to characterize ADRs in pregnant women. Reports of ADRs collected in the Midi-Pyrenees pharmacovigilance centre from 1982 to 2002 were used: type of ADRs, drugs involved and potential risk factors were compared for pregnant women and for age-matched non pregnant women. Forty seven and 94 reports of ADRs were collected in pregnant and non-pregnant women respectively. Anaphylactic reactions were only observed in pregnant women (3 cases, p = 0.04). We observed 1 ADR related stillbirth (due to anaphylactic reaction) in pregnant women. Drugs for gynaecological and cardiovascular systems were more frequently involved in ADRs in pregnant women than in controls. ADRs mainly occurred during the third trimester of pregnancy. The incidence of ADRs is very low in pregnant women. However, one must pay attention on the risk of anaphylactic reactions in pregnant women. PMID:18206108

  13. Economic viability of beef cattle grazing systems under prolonged drought

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Prolonged drought in the Southern Great Plains of the USA in recent years has raised concerns about vulnerability of beef cattle grazing systems under adverse climate change. To help address the economic viability of beef grazing operations in the Southern Great Plains, this paper provides an econom...

  14. Economically dispatching cogeneration facilities

    SciTech Connect

    Hernandez, E.

    1996-05-01

    Economic dispatching has been used by utilities to meet the energy demands of their customers for decades. The objective was to first load those units which cost the least to run and slowly increase the loading of more expensive units as the incremental energy price increased. Although this concept worked well for utility based systems where incremental costs rose with peak demand, the independent power producers(IPPs) and the power purchase agreements (PPAs) have drastically changed this notion. Most PPAs structured for the IPP environment have negotiated rates which remain the same during peak periods and base their electrical generation on specific process steam requirements. They also must maintain the required production balance of process steam and electrical load in order to qualify as a Public Utility Regulatory Policies Act (PURPA) facility. Consequently, economically dispatching Cogeneration facilities becomes an exercise in adhering to contractual guidelines while operating the equipment in the most efficient manner possible for the given condition. How then is it possible to dispatch a Cogeneration facility that maintains the electrical load demand of JFK Airport while satisfying all of its heating and cooling needs? Contractually, Kennedy International Airport Cogen (KIAC) has specific obligations concerning electrical and thermal energy exported to JFK Airport. The facility`s impressive array of heating and cooling apparatuses together with the newly installed cogen fulfilled the airport`s needs by utilizing an endless combination of new and previously installed equipment. Moreover, in order to economically operate the plant a well structured operating curriculum was necessary.

  15. Adverse allergic reaction to Technetium-99m methylene diphosphonate

    SciTech Connect

    Spicer, J.A.; Preston, D.F.; Stephens, R.L.

    1985-04-01

    Adverse allergic reactions to radiopharmaceuticals are rare but have been documented in the literature. This report presents data consistent with a definite adverse reaction to the radiopharmaceutical (/sup 99m/Tc)MDP.

  16. Adverse outcome pathway (AOP) development I: Strategies and principles

    EPA Science Inventory

    An adverse outcome pathway (AOP) is a conceptual framework that organizes existing knowledge concerning biologically plausible, and empirically-supported, links between molecular-level perturbation of a biological system and an adverse outcome at a level of biological organizatio...

  17. Adverse Outcome Pathways – Tailoring Development to Support Use

    EPA Science Inventory

    Adverse Outcome Pathways (AOPs) represent an ideal framework for connecting high-throughput screening (HTS) data and other toxicity testing results to adverse outcomes of regulatory importance. The AOP Knowledgebase (AOP-KB) captures AOP information to facilitate the development,...

  18. Adverse Outcome Pathway (AOP) Network Development for Fatty Liver

    EPA Science Inventory

    Adverse outcome pathways (AOPs) are descriptive biological sequences that start from a molecular initiating event (MIE) and end with an adverse health outcome. AOPs provide biological context for high throughput chemical testing and further prioritize environmental health risk re...

  19. Consequences of Essential Fatty Acids

    PubMed Central

    Lands, Bill

    2012-01-01

    Essential fatty acids (EFA) are nutrients that form an amazingly large array of bioactive mediators that act on a large family of selective receptors. Nearly every cell and tissue in the human body expresses at least one of these receptors, allowing EFA-based signaling to influence nearly every aspect of human physiology. In this way, the health consequences of specific gene-environment interactions with these nutrients are more extensive than often recognized. The metabolic transformations have similar competitive dynamics for the n-3 and n-6 homologs when converting dietary EFA from the external environment of foods into the highly unsaturated fatty acid (HUFA) esters that accumulate in the internal environment of cells and tissues. In contrast, the formation and action of bioactive mediators during tissue responses to stimuli tend to selectively create more intense consequences for n-6 than n-3 homologs. Both n-3 and n-6 nutrients have beneficial actions, but many common health disorders are undesired consequences of excessive actions of tissue n-6 HUFA which are preventable. This review considers the possibility of preventing imbalances in dietary n-3 and n-6 nutrients with informed voluntary food choices. That action may prevent the unintended consequences that come from eating imbalanced diets which support excessive chronic actions of n-6 mediators that harm human health. The consequences from preventing n-3 and n-6 nutrient imbalances on a nationwide scale may be very large, and they need careful evaluation and implementation to avoid further harmful consequences for the national economy. PMID:23112921

  20. Consequences of Predicted or Actual Asteroid Impacts

    NASA Astrophysics Data System (ADS)

    Chapman, C. R.

    2003-12-01

    Earth impact by an asteroid could have enormous physical and environmental consequences. Impactors larger than 2 km diameter could be so destructive as to threaten civilization. Since such events greatly exceed any other natural or man-made catastrophe, much extrapolation is necessary just to understand environmental implications (e.g. sudden global cooling, tsunami magnitude, toxic effects). Responses of vital elements of the ecosystem (e.g. agriculture) and of human society to such an impact are conjectural. For instance, response to the Blackout of 2003 was restrained, but response to 9/11 terrorism was arguably exaggerated and dysfunctional; would society be fragile or robust in the face of global catastrophe? Even small impacts, or predictions of impacts (accurate or faulty), could generate disproportionate responses, especially if news media reports are hyped or inaccurate or if responsible entities (e.g. military organizations in regions of conflict) are inadequately aware of the phenomenology of small impacts. Asteroid impact is the one geophysical hazard of high potential consequence with which we, fortunately, have essentially no historical experience. It is thus important that decision makers familiarize themselves with the hazard and that society (perhaps using a formal procedure, like a National Academy of Sciences study) evaluate the priority of addressing the hazard by (a) further telescopic searches for dangerous but still-undiscovered asteroids and (b) development of mitigation strategies (including deflection of an oncoming asteroid and on- Earth civil defense). I exemplify these issues by discussing several representative cases that span the range of parameters. Many of the specific physical consequences of impact involve effects like those of other geophysical disasters (flood, fire, earthquake, etc.), but the psychological and sociological aspects of predicted and actual impacts are distinctive. Standard economic cost/benefit analyses may not

  1. Uncertainties in offsite consequence analysis

    SciTech Connect

    Young, M.L.; Harper, F.T.; Lui, C.H.

    1996-03-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequences from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the U.S. Nuclear Regulatory Commission and the European Commission began co-sponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables using a formal expert judgment elicitation and evaluation process. This paper focuses on the methods used in and results of this on-going joint effort.

  2. [Indicators to monitor the evolution of the economic crisis and its effects on health and health inequalities. SESPAS report 2014].

    PubMed

    Pérez, Glòria; Rodríguez-Sanz, Maica; Domínguez-Berjón, Felicitas; Cabeza, Elena; Borrell, Carme

    2014-06-01

    The economic crisis has adverse effects on determinants of health and health inequalities. The aim of this article was to present a set of indicators of health and its determinants to monitor the effects of the crisis in Spain. On the basis of the conceptual framework proposed by the Commission for the Reduction of Social Health Inequalities in Spain, we searched for indicators of social, economic, and political (structural and intermediate) determinants of health, as well as for health indicators, bearing in mind the axes of social inequality (gender, age, socioeconomic status, and country of origin). The indicators were mainly obtained from official data sources published on the internet. The selected indicators are periodically updated and are comparable over time and among territories (among autonomous communities and in some cases among European Union countries), and are available for age groups, gender, socio-economic status, and country of origin. However, many of these indicators are not sufficiently reactive to rapid change, which occurs in the economic crisis, and consequently require monitoring over time. Another limitation is the lack of availability of indicators for the various axes of social inequality. In conclusion, the proposed indicators allow for progress in monitoring the effects of the economic crisis on health and health inequalities in Spain.

  3. [Indicators to monitor the evolution of the economic crisis and its effects on health and health inequalities. SESPAS report 2014].

    PubMed

    Pérez, Glòria; Rodríguez-Sanz, Maica; Domínguez-Berjón, Felicitas; Cabeza, Elena; Borrell, Carme

    2014-06-01

    The economic crisis has adverse effects on determinants of health and health inequalities. The aim of this article was to present a set of indicators of health and its determinants to monitor the effects of the crisis in Spain. On the basis of the conceptual framework proposed by the Commission for the Reduction of Social Health Inequalities in Spain, we searched for indicators of social, economic, and political (structural and intermediate) determinants of health, as well as for health indicators, bearing in mind the axes of social inequality (gender, age, socioeconomic status, and country of origin). The indicators were mainly obtained from official data sources published on the internet. The selected indicators are periodically updated and are comparable over time and among territories (among autonomous communities and in some cases among European Union countries), and are available for age groups, gender, socio-economic status, and country of origin. However, many of these indicators are not sufficiently reactive to rapid change, which occurs in the economic crisis, and consequently require monitoring over time. Another limitation is the lack of availability of indicators for the various axes of social inequality. In conclusion, the proposed indicators allow for progress in monitoring the effects of the economic crisis on health and health inequalities in Spain. PMID:24864001

  4. Adverse weather impacts on arable cropping systems

    NASA Astrophysics Data System (ADS)

    Gobin, Anne

    2016-04-01

    Damages due to extreme or adverse weather strongly depend on crop type, crop stage, soil conditions and management. The impact is largest during the sensitive periods of the farming calendar, and requires a modelling approach to capture the interactions between the crop, its environment and the occurrence of the meteorological event. The hypothesis is that extreme and adverse weather events can be quantified and subsequently incorporated in current crop models. Since crop development is driven by thermal time and photoperiod, a regional crop model was used to examine the likely frequency, magnitude and impacts of frost, drought, heat stress and waterlogging in relation to the cropping season and crop sensitive stages. Risk profiles and associated return levels were obtained by fitting generalized extreme value distributions to block maxima for air humidity, water balance and temperature variables. The risk profiles were subsequently confronted with yields and yield losses for the major arable crops in Belgium, notably winter wheat, winter barley, winter oilseed rape, sugar beet, potato and maize at the field (farm records) to regional scale (statistics). The average daily vapour pressure deficit (VPD) and reference evapotranspiration (ET0) during the growing season is significantly lower (p < 0.001) and has a higher variability before 1988 than after 1988. Distribution patterns of VPD and ET0 have relevant impacts on crop yields. The response to rising temperatures depends on the crop's capability to condition its microenvironment. Crops short of water close their stomata, lose their evaporative cooling potential and ultimately become susceptible to heat stress. Effects of heat stress therefore have to be combined with moisture availability such as the precipitation deficit or the soil water balance. Risks of combined heat and moisture deficit stress appear during the summer. These risks are subsequently related to crop damage. The methodology of defining

  5. Adirondack tourism: perceived consequences of acid rain

    SciTech Connect

    Metz, W.C.

    1984-03-01

    This report seeks to place in perspective the perceived effects of acid precipitation on the tourist industry in the Adirondacks. The 9375-square mile park is host to almost nine million tourists annually, not including seasonal residents. Since the park was established almost 100 years ago, there have been many changes in tourist characteristics, available recreational facilities, kinds of activities, accessibility of the area, and land use and resource management policies. The tourist industry has been influenced by both controllable and uncontrollable factors. At present the overwhelming majority of recreational opportunities and natural resources important to the Adirondack tourist industry are relatively unaffected by acid precipitation. Fishing, a significant component of the tourist industry, is the most vulnerable, but any presumed adverse economic effect has to be weighed against the location of the impacted waters, total Adirondack fishing habitat, substitution available, habitat usage, fisherman characteristics, resource management, and the declining importance of fishing as an Adirondack recreational attraction. Concern is expressed as to whether present minimal acidification impacts are the precursor of major future impacts on Adirondack terrestrial and aquatic environments, and ultimately tourism. Tourism in the Adirondacks is increasing, while many other regional employment sectors are declining. It is becoming a more stable multiseason industry. Its future growth and character will be affected by government, private organization, business community, and resident controversies regarding land use and resource management attitudes, policies, budgets, and regulations. The acid precipitation issue is only one of many related controversies. 65 references, 2 figures.

  6. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Adverse reaction file. 606.170 Section 606.170 Food... reaction file. (a) Records shall be maintained of any reports of complaints of adverse reactions regarding... investigation of each reported adverse reaction shall be made. A written report of the investigation of...

  7. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. Link to an amendment published at 77 FR 18, Jan. 3, 2012. (a) Records shall be maintained of any reports of complaints of adverse reactions regarding each unit of blood or blood...

  8. 36 CFR 800.6 - Resolution of adverse effects.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Resolution of adverse effects... PROTECTION OF HISTORIC PROPERTIES The section 106 Process § 800.6 Resolution of adverse effects. (a) Continue... the undertaking that could avoid, minimize, or mitigate adverse effects on historic properties....

  9. 20 CFR 655.207 - Adverse effect rates.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... adverse effect rate (computed pursuant to 20 CFR 655.207(b)(1), 43 FR 10317; March 10, 1978) by the... at 20 CFR 655.207(b)(2) (1985). (c) In no event shall an adverse effect rate for any year be lower... listed in paragraph (b)(2) of this section, and for Florida sugarcane work, the adverse effect rate...

  10. 20 CFR 655.207 - Adverse effect rates.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... adverse effect rate (computed pursuant to 20 CFR 655.207(b)(1), 43 FR 10317; March 10, 1978) by the... at 20 CFR 655.207(b)(2) (1985). (c) In no event shall an adverse effect rate for any year be lower... listed in paragraph (b)(2) of this section, and for Florida sugarcane work, the adverse effect rate...

  11. 20 CFR 655.207 - Adverse effect rates.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... adverse effect rate (computed pursuant to 20 CFR 655.207(b)(1), 43 FR 10317; March 10, 1978) by the... at 20 CFR 655.207(b)(2) (1985). (c) In no event shall an adverse effect rate for any year be lower... listed in paragraph (b)(2) of this section, and for Florida sugarcane work, the adverse effect rate...

  12. 20 CFR 655.207 - Adverse effect rates.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... adverse effect rate (computed pursuant to 20 CFR 655.207(b)(1), 43 FR 10317; March 10, 1978) by the... at 20 CFR 655.207(b)(2) (1985). (c) In no event shall an adverse effect rate for any year be lower... listed in paragraph (b)(2) of this section, and for Florida sugarcane work, the adverse effect rate...

  13. Adversity and Resilience: A Synthesis of International Research

    ERIC Educational Resources Information Center

    Noltemeyer, Amity L.; Bush, Kevin R.

    2013-01-01

    Children and adolescents worldwide experience a variety of adversities that have the potential to disrupt typical development. However, some of these individuals exhibit resilience, evidencing normal development in the face of adversity. Here we review research on these constructs of risk, adversity, and resilience; synthesize international…

  14. 36 CFR 800.5 - Assessment of adverse effects.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CFR part 68) and applicable guidelines, to avoid adverse effects. (c) Consulting party review. If the... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Assessment of adverse effects... PROTECTION OF HISTORIC PROPERTIES The section 106 Process § 800.5 Assessment of adverse effects. (a)...

  15. [Histamine intolerance - are the criteria of an adverse reaction met?].

    PubMed

    Reese, Imke

    2016-06-01

    Searching the internet for an explaination of recurring symptoms, many people come across the so-called histamine intolerance disorder. Also many practitioners like to diagnose this disorder without making sure that reproducibility, a prerequisite for an adverse reaction, is present. Consequently, presumably affected persons are often advised to follow a low-histamine diet. Depending on the source of information, these diets often avoid a huge variety of foods containing more or less histamine, which has a considerable impact on patient quality of life. While most persons benefit from such a diet in the beginning - this might be due to the change in dietary habits or the expectation of symptom improvement by dieting - in the long run the expected loss of symptoms will not happen. Underlying a diminished capacity for histamine degradation, the lack of partial or complete symptom improvement might be due to the fact that endogenous histamine release is responsible for reactions. The role of ingested histamine is discussed controversially. However, it is more than obvious that the histamine content of a certain food alone is not enough to predict its tolerance.If histamine intolerance is suspected, an individual diagnostic and therapeutic procedure is mandatory in order to minimize avoidance and to preserve a high quality of life. Ideally this is done in a close cooperation between allergologists and nutritionists/dieticians. PMID:27177895

  16. Adverse effects of perinatal nicotine exposure on reproductive outcomes.

    PubMed

    Wong, Michael K; Barra, Nicole G; Alfaidy, Nadia; Hardy, Daniel B; Holloway, Alison C

    2015-12-01

    Nicotine exposure during pregnancy through cigarette smoking, nicotine replacement therapies or e-cigarette use continues to be a widespread public health problem, impacting both fetal and postnatal health. Yet, at this time, there remains limited data regarding the safety and efficacy in using these nicotine products during pregnancy. Notably, reports assessing the effect of nicotine exposure on postnatal health outcomes in humans, including reproductive health, are severely lacking. Our current understanding regarding the consequences of nicotine exposure during pregnancy is limited to a few animal studies, which do not comprehensively address the underlying cellular mechanisms involved. This paper aims to critically review the current knowledge from human and animal studies regarding the direct and indirect effects (e.g. obesity) of maternal nicotine exposure, regardless of its source, on reproductive outcomes in pregnancy and postnatal life. Furthermore, this review highlights several key cellular mechanisms involved in these adverse reproductive deficits including oxidative stress, inflammation, and endoplasmic reticulum (ER) stress. By understanding the interplay of the cellular mechanisms involved, further strategies could be developed to prevent the reproductive abnormalities resulting from exposure to nicotine in utero and influence informed clinical guidelines for pregnant women.

  17. Families and Adversity in the Faltering U.S. Economy: The Misery Goes On and On. Family Review.

    ERIC Educational Resources Information Center

    Lindjord, Denise

    2002-01-01

    Reports on factors reflecting or contributing to family economic adversity in the current U.S. economy, including consumer confidence figures, a rise in long-term unemployment, the need to extend the temporary federal unemployment benefits program, and families' debt concerns and spending. Highlights findings that kindergartners from the lowest…

  18. Monitoring Adverse Drug Reactions: A Preliminary Study

    PubMed Central

    Reynolds, J. L.

    1981-01-01

    The feasibility of family physicians functioning as monitors of adverse drug reactions (ADR) was examined over one month in ten practices. This was done as a preliminary trial, before attempting to use the 200 family physicians of the National Reporting System of the College of Family Physicians of Canada to monitor ADRs on a national basis. Both of these trials were designed to examine the feasibility of family physicians acting as prospective monitors of ADRs in newly marketed drugs and to identify a drug group suitable for monitoring. This study examined the detection of ADRs, prescribing and practice profiles. No firm conclusion could be reached as to the value of family doctors monitoring ADRs. This study supports the evidence that older patients receive more drugs and are at even greater risk of an ADR. Antibiotics, cardiovascular, anti-inflammatory or antidepressant drugs are suggested as those most suitable for prospective monitoring in a family practice setting. PMID:21289786

  19. Adverse reactions to the sulphite additives

    PubMed Central

    Misso, Neil LA

    2012-01-01

    Sulphites are widely used as preservative and antioxidant additives in the food and pharmaceutical industries. Exposure to sulphites has been reported to induce a range of adverse clinical effects in sensitive individuals, ranging from dermatitis, urticaria, flushing, hypotension, abdominal pain and diarrhoea to life-threatening anaphylactic and asthmatic reactions. Exposure to the sulphites arises mainly from the consumption of foods and drinks that contain these additives; however exposure may also occur through the use of pharmaceutical products, as well as in occupational settings. Most studies report a prevalence of sulphite sensitivity of 3 to 10% among asthmatic subjects who ingest these additives. However, the severity of these reactions varies, and steroid-dependent asthmatics, those with marked airway hyperresponsiveness, and children with chronic asthma, appear to be at greater risk. Although a number of potential mechanisms have been proposed, the precise mechanisms underlying sulphite sensitivity remain unclear. PMID:24834193

  20. Adverse skeletal effects of drugs - beyond Glucocorticoids.

    PubMed

    O'Sullivan, Susannah; Grey, Andrew

    2015-01-01

    Osteoporotic fractures are an important public health problem with significant individual and societal costs. In addition to the major risk factors for osteoporotic fracture, low bone mineral density (BMD), age, low body weight and history of fracture or falls, some drugs are now considered to be important secondary risk factor for bone loss and fracture, particularly amongst predisposed individuals. Currently available data are often generated from small observational clinical studies, making risk assessment and development of management guidelines difficult. In many cases, the exposed population has a low baseline risk for fracture and additional assessment and treatment may not be necessary. In this review, we focus on drugs other than glucocorticoids identified as potentially causing adverse skeletal effects, summarizing the existing evidence from preclinical and clinical studies, and suggest recommendations for patient management. PMID:25039381

  1. Management of adverse effects of mood stabilizers.

    PubMed

    Murru, Andrea; Popovic, Dina; Pacchiarotti, Isabella; Hidalgo, Diego; León-Caballero, Jordi; Vieta, Eduard

    2015-08-01

    Mood stabilizers such as lithium and anticonvulsants are still standard-of-care for the acute and long-term treatment of bipolar disorder (BD). This systematic review aimed to assess the prevalence of their adverse effects (AEs) and to provide recommendations on their clinical management. We performed a systematic research for studies reporting the prevalence of AEs with lithium, valproate, lamotrigine, and carbamazepine/oxcarbazepine. Management recommendations were then developed. Mood stabilizers have different tolerability profiles and are eventually associated to cognitive, dermatological, endocrine, gastrointestinal, immunological, metabolic, nephrogenic, neurologic, sexual, and teratogenic AEs. Most of those can be transient or dose-related and can be managed by optimizing drug doses to the lowest effective dose. Some rare AEs can be serious and potentially lethal, and require abrupt discontinuation of medication. Integrated medical attention is warranted for complex somatic AEs. Functional remediation and psychoeducation may help to promote awareness on BD and better medication management.

  2. Adverse drug reactions: classification, susceptibility and reporting.

    PubMed

    Kaufman, Gerri

    2016-08-10

    Adverse drug reactions (ADRs) are increasingly common and are a significant cause of morbidity and mortality. Historically, ADRs have been classified as type A or type B. Type A reactions are predictable from the known pharmacology of a drug and are associated with high morbidity and low mortality. Type B reactions are idiosyncratic, bizarre or novel responses that cannot be predicted from the known pharmacology of a drug and are associated with low morbidity and high mortality. Not all ADRs fit into type A and type B categories; therefore, additional categories have been developed. These include type C (continuing), type D (delayed use), and type E (end of use) reactions. Susceptibility to ADRs is influenced by age, gender, disease states, pregnancy, ethnicity and polypharmacy. Drug safety is reliant on nurses and other healthcare professionals being alert to the possibility of ADRs, working with patients to optimise medicine use and exercising vigilance in the reporting of ADRs through the Yellow Card Scheme. PMID:27507394

  3. Early Childhood Adversity and Pregnancy Outcomes

    PubMed Central

    Smith, Megan V.; Gotman, Nathan; Yonkers, Kimberly A.

    2016-01-01

    Objectives To examine the association between adverse childhood experiences (ACEs) and pregnancy outcomes; to explore mediators of this association including psychiatric illness and health habits. Methods Exposure to ACEs was determined by the Early Trauma Inventory Self Report Short Form; psychiatric diagnoses were generated by the Composite International Diagnostic Interview administered in a cohort of 2303 pregnant women. Linear regression and structural equation modeling bootstrapping approaches tested for multiple mediators. Results Each additional ACE decreased birth weight by 16.33 g and decreased gestational age by 0.063. Smoking was the strongest mediator of the effect on gestational age. Conclusions ACEs have an enduring effect on maternal reproductive health, as manifested by mothers’ delivery of offspring that were of reduced birth weight and shorter gestational age. PMID:26762511

  4. Adverse effects of differential parental attention1

    PubMed Central

    Sajwaj, Thomas E.; Pinkston, Susan; Cordua, Glenn; Jackson, Carolyn; Herbert, Emily W.; Pinkston, Elsie M.; Hayden, M. Loeman

    1973-01-01

    In two independent parent training projects (Kansas and Mississippi), mothers of deviant young children were observed to follow almost all child behaviors with attention. The mothers were then trained to use differential attention procedures to increase their child's appropriate behaviors and to decrease deviant behaviors. Contrary to expectations, the differential attention procedure produced substantial increases in deviant behavior for four of the children. This adverse effect was maintained over many sessions and was replicated in single organism, reversal designs. A fifth child showed no change. A sixth child showed some improvement. However, this effect was not recovered in a second application of differential attention, and the child became worse. The results underline the importance of subject generality in applied behavior analysis and strongly suggest that service programs using operant techniques must carefully evaluate their effects on behavior. PMID:16795386

  5. Signal Detection of Adverse Drug Reaction of Amoxicillin Using the Korea Adverse Event Reporting System Database

    PubMed Central

    2016-01-01

    We conducted pharmacovigilance data mining for a β-lactam antibiotics, amoxicillin, and compare the adverse events (AEs) with the drug labels of 9 countries including Korea, USA, UK, Japan, Germany, Swiss, Italy, France, and Laos. We used the Korea Adverse Event Reporting System (KAERS) database, a nationwide database of AE reports, between December 1988 and June 2014. Frequentist and Bayesian methods were used to calculate disproportionality distribution of drug-AE pairs. The AE which was detected by all the three indices of proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC) was defined as a signal. The KAERS database contained a total of 807,582 AE reports, among which 1,722 reports were attributed to amoxicillin. Among the 192,510 antibiotics-AE pairs, the number of amoxicillin-AE pairs was 2,913. Among 241 AEs, 52 adverse events were detected as amoxicillin signals. Comparing the drug labels of 9 countries, 12 adverse events including ineffective medicine, bronchitis, rhinitis, sinusitis, dry mouth, gastroesophageal reflux, hypercholesterolemia, gastric carcinoma, abnormal crying, induration, pulmonary carcinoma, and influenza-like symptoms were not listed on any of the labels of nine countries. In conclusion, we detected 12 new signals of amoxicillin which were not listed on the labels of 9 countries. Therefore, it should be followed by signal evaluation including causal association, clinical significance, and preventability. PMID:27510377

  6. Acid Precipitation: Causes and Consequences.

    ERIC Educational Resources Information Center

    Babich, Harvey; And Others

    1980-01-01

    This article is the first of three articles in a series on the acid rain problem in recent years. Discussed are the causes of acid precipitation and its consequences for the abiotic and biotic components of the terrestrial and aquatic ecosystems, and for man-made materials. (Author/SA)

  7. Literacy in Somali: Linguistic Consequences.

    ERIC Educational Resources Information Center

    Biber, Douglas; Hared, Mohamed

    1991-01-01

    Linguistic consequences of literacy in Somalia are examined in a review of the literature and through a study of five dimensions of variation among Somali registers and the expansion of linguistic variation in Somali resulting from the introduction of written registers. (36 references) (LB)

  8. Consequences of Growing Up Poor.

    ERIC Educational Resources Information Center

    Duncan, Greg J., Ed.; Brooks-Gunn, Jeanne, Ed.

    The consequences and correlates of growing up poor as well as the mechanisms through which poverty influences children are explored. This book is organized with a primary focus on research findings and a secondary concern with policy implications. The chapters are: (1) "Poor Families, Poor Outcomes: The Well-Being of Children and Youth" (Jeanne…

  9. Social Consequences of Teenage Childbearing.

    ERIC Educational Resources Information Center

    Presser, Harriet B.

    Most research on teenage parenthood is concerned with illegitimacy and its determinants such as attitudes toward sex, contraceptive knowledge and practice, family relationships, and cultural factors. Empirical studies on the consequences of illegitimacy are generally limited to problems of recidivism, school dropouts, and welfare dependency.…

  10. Leadership Styles and Their Consequences.

    ERIC Educational Resources Information Center

    Warrick, D. D.

    1981-01-01

    Discusses leadership style theories and offers an integration of the theories by describing typical characteristics, skills, philosophies, and consequences associated with each major style. An experiential exercise is described which portrays the major styles and the productivity and satisfaction each is likely to produce. Nine figures accompany…

  11. Clinical outcomes and adverse effect monitoring in allergic rhinitis.

    PubMed

    Juniper, Elizabeth F; Ståhl, Elisabeth; Doty, Richard L; Simons, F Estelle R; Allen, David B; Howarth, Peter H

    2005-03-01

    reduced or absent CNS sedative effects. Therefore, the CNS effects are entirely avoidable, and the first-generation H 1 -antihistamines should no longer be used in the management of allergic rhinitis. The considerably rarer but potentially very serious cardiac arrhythmogenic effects of H 1 -antihistamines are appreciated to be molecule-specific rather than class-specific. The in vitro screening of new compounds to eliminate the further development of those with cardiotoxicity ideally will lead to this adverse effect being historic. The incorporation of electrocardiogram recording in clinical trials provides direct information relating to prolongation of QT interval corrected for heart rate. Although administered at low doses, intranasal steroids still have the potential for systemic absorption and adverse consequences. However, it is appreciated that meaningful differences exist in the bioavailability of different steroid molecules, and although a small but statistically significant effect on growth in children has been identified with the long-term use of intranasal beclomethasone when administered twice daily for 1 year, this is not evident with all intranasal steroids. In addition, twice-daily intranasal steroid administration may have more effect--from the endocrinologic perspective--than once-daily administration in the morning, which coincides better with the natural diurnal variation in cortisol. Thus, once-daily intranasal steroid administration is preferable, and when used in studies in children, measurement of height change during the study period is an important outcome variable together with other indices of systemic steroid bioavailability (eg, tests of hypothalamic-pituitary-adrenal axis function). These considerations have even greater relevance if children are concurrently also receiving inhaled steroids for asthma, because the total steroid load will be greater. PMID:15746880

  12. Economic Knowledge, Economic Education and Public Opinion on Economic Issues.

    ERIC Educational Resources Information Center

    Walstad, William B.

    This research study was based upon a national survey in March 1992, conducted to assess the economic literacy of the U.S. public. The survey data were used to measure the economic knowledge of the public, to identify factors that affect economic knowledge, and to evaluate the influence of economic knowledge on public opinion about current economic…

  13. Biometrical issues in the analysis of adverse events within the benefit assessment of drugs.

    PubMed

    Bender, Ralf; Beckmann, Lars; Lange, Stefan

    2016-07-01

    The analysis of adverse events plays an important role in the benefit assessment of drugs. Consequently, results on adverse events are an integral part of reimbursement dossiers submitted by pharmaceutical companies to health policy decision-makers. Methods applied in the analysis of adverse events commonly include simple standard methods for contingency tables. However, the results produced may be misleading if observations are censored at the time of discontinuation due to treatment switching or noncompliance, resulting in unequal follow-up periods. In this paper, we present examples to show that the application of inadequate methods for the analysis of adverse events in the reimbursement dossier can lead to a downgrading of the evidence on a drug's benefit in the subsequent assessment, as greater harm from the drug cannot be excluded with sufficient certainty. Legal regulations on the benefit assessment of drugs in Germany are presented, in particular, with regard to the analysis of adverse events. Differences in safety considerations between the drug approval process and the benefit assessment are discussed. We show that the naive application of simple proportions in reimbursement dossiers frequently leads to uninterpretable results if observations are censored and the average follow-up periods differ between treatment groups. Likewise, the application of incidence rates may be misleading in the case of recurrent events and unequal follow-up periods. To allow for an appropriate benefit assessment of drugs, adequate survival time methods accounting for time dependencies and duration of follow-up are required, not only for time-to-event efficacy endpoints but also for adverse events. © 2016 The Authors. Pharmaceutical Statistics published by John Wiley & Sons Ltd.

  14. Adverse reactions triggered by dental local anesthetics: a clinical survey.

    PubMed Central

    Kaufman, E.; Goharian, S.; Katz, Y.

    2000-01-01

    One hundred and seventy-nine patients completed a questionnaire focusing on adverse reactions to dental local anesthetics as manifested by 16 signs and symptoms. Twenty-six percent of the participants reported having at least 1 adverse reaction. It was found that most of the adverse reactions occurred within the first 2 hours following the injection of local anesthetics. Pallor, palpitations, diaphoresis, and dizziness were the most common adverse reactions reported in the study. The results pointed to a significant relationship between anxiety, gender, injection technique, and procedure with a higher incidence of adverse reactions. PMID:11432179

  15. Energy: Production, Consumption, and Consequences.

    ERIC Educational Resources Information Center

    Helm, John L., Ed.

    Energy policy in the United States and much of the analysis behind those policies is largely incomplete according to many. Systems for energy production, distribution, and use have traditionally been analyzed by supply sector, yet such analyses cannot capture the complex interplay of technology, economics, public policy, and environmental concerns…

  16. Respiratory diseases of global consequence

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Respiratory diseases are one of the two major categories of poultry diseases that cause the most severe economic losses globally, both as enzootic diseases and as causes of epizootics. Some respiratory diseases are of such importance they are reportable to the World Organization for Animal Health (O...

  17. Impact of early adversity on glucocorticoid regulation and later mental disorders.

    PubMed

    Strüber, Nicole; Strüber, Daniel; Roth, Gerhard

    2014-01-01

    Early adverse experiences such as abuse or neglect can influence brain development and consequently bring forth a predisposition toward mental and behavioral disorders. Many authors suggest that long-term changes in the functionality of the HPA axis might be involved in mediating this relationship. The direction of change and its consequences have not been clarified though: Do early adverse experiences yield a stable glucocorticoid hyperfunction or a long-term glucocorticoid hypofunction, and how is this change of functionality associated with mental or behavioral disorders? This review summarizes correlative findings and illustrates inconsistencies of current research literature. It focuses on the specific neurochemical milieu accompanying early adverse experiences and discusses possible interactions of the glucocorticoid system with oxytocin and components of the serotonergic system. On the basis of this physiological view, a novel two-pathway model is presented, according to which specific early experiences are associated with characteristic early changes in the functionality of these systems and result in a predisposition to distinct mental and behavioral disorders. PMID:24216122

  18. Cumulative early life adversity predicts longevity in wild baboons

    PubMed Central

    Tung, Jenny; Archie, Elizabeth A.; Altmann, Jeanne; Alberts, Susan C.

    2016-01-01

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations. PMID:27091302

  19. Cumulative early life adversity predicts longevity in wild baboons.

    PubMed

    Tung, Jenny; Archie, Elizabeth A; Altmann, Jeanne; Alberts, Susan C

    2016-01-01

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations.

  20. Cumulative early life adversity predicts longevity in wild baboons.

    PubMed

    Tung, Jenny; Archie, Elizabeth A; Altmann, Jeanne; Alberts, Susan C

    2016-01-01

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations. PMID:27091302

  1. Epigenomic Mechanisms of Early Adversity and HPA Dysfunction: Considerations for PTSD Research.

    PubMed

    McGowan, Patrick O

    2013-01-01

    Childhood adversity can have life-long consequences for the response to stressful events later in life. Abuse or severe neglect are well-known risk factors for post-traumatic stress disorder (PTSD), at least in part via changes in neural systems mediating the endocrine response to stress. Determining the biological signatures of risk for stress-related mental disorders such as PTSD is important for identifying homogenous subgroups and improving treatment options. This review will focus on epigenetic regulation in early life by adversity and parental care - prime mediators of offspring neurodevelopment - in order to address several questions: (1) what have studies of humans and analogous animal models taught us about molecular mechanisms underlying changes in stress-sensitive physiological systems in response to early life trauma? (2) What are the considerations for studies relating early adversity and PTSD risk, going forward? I will summarize studies in animals and humans that address the epigenetic response to early adversity in the brain and in peripheral tissues. In so doing, I will describe work on the glucocorticoid receptor and other well-characterized genes within the stress response pathway and then turn to genomic studies to illustrate the use of increasingly powerful high-throughput approaches to the study of epigenomic mechanisms. PMID:24133457

  2. The role of ADHD in academic adversity: disentangling ADHD effects from other personal and contextual factors.

    PubMed

    Martin, Andrew J

    2014-12-01

    Students with attention-deficit/hyperactivity disorder (ADHD) experience significant academic difficulties that can lead to numerous negative academic consequences. With a focus on adverse academic outcomes, this study seeks to disentangle variance attributable to ADHD from variance attributable to salient personal and contextual covariates. Responses from 136 students with ADHD and 3,779 non-ADHD peers from 9 high schools were analyzed using logistic regression. Dependent measures included academic failure, grade repetition, school refusal, changing classes and school, school exclusion, and schoolwork noncompletion. Covariates comprised personal (e.g., sociodemographics, personality, prior achievement, specific learning disabilities, motivation) and contextual (e.g., school size, school socioeconomic status, school average achievement) factors. Findings indicated that, after accounting for personal and contextual covariates, ADHD explained significant variance in numerous adversities (schoolwork noncompletion, school suspension, school expulsion, changing schools, grade repetition). Thus, beyond the effects of numerous personal and contextual covariates, ADHD has a distinct presence in students' academic adversity. Also interesting, after accounting for other personal and contextual factors, was academic adversity with which ADHD was not associated. Findings provide direction for educational intervention targeting ADHD and associated factors found to be significant in the study.

  3. Childhood Adversity and Neural Development: Deprivation and Threat as Distinct Dimensions of Early Experience

    PubMed Central

    McLaughlin, Katie A.; Sheridan, Margaret A.; Lambert, Hilary K.

    2014-01-01

    A growing body of research has examined the impact of childhood adversity on neural structure and function. Advances in our understanding of the neurodevelopmental consequences of adverse early environments require the identification of dimensions of environmental experience that influence neural development differently and mechanisms other than the frequently-invoked stress pathways. We propose a novel conceptual framework that differentiates between deprivation (absence of expected environmental inputs and complexity) and threat (presence of experiences that represent a threat to one’s physical integrity) and make predictions grounded in basic neuroscience principles about their distinct effects on neural development. We review animal research on fear learning and sensory deprivation as well as human research on childhood adversity and neural development to support these predictions. We argue that these previously undifferentiated dimensions of experience exert strong and distinct influences on neural development that cannot be fully explained by prevailing models focusing only on stress pathways. Our aim is not to exhaustively review existing evidence on childhood adversity and neural development, but to provide a novel framework to guide future research. PMID:25454359

  4. Childhood adversity and neural development: deprivation and threat as distinct dimensions of early experience.

    PubMed

    McLaughlin, Katie A; Sheridan, Margaret A; Lambert, Hilary K

    2014-11-01

    A growing body of research has examined the impact of childhood adversity on neural structure and function. Advances in our understanding of the neurodevelopmental consequences of adverse early environments require the identification of dimensions of environmental experience that influence neural development differently and mechanisms other than the frequently-invoked stress pathways. We propose a novel conceptual framework that differentiates between deprivation (absence of expected environmental inputs and complexity) and threat (presence of experiences that represent a threat to one's physical integrity) and make predictions grounded in basic neuroscience principles about their distinct effects on neural development. We review animal research on fear learning and sensory deprivation as well as human research on childhood adversity and neural development to support these predictions. We argue that these previously undifferentiated dimensions of experience exert strong and distinct influences on neural development that cannot be fully explained by prevailing models focusing only on stress pathways. Our aim is not to exhaustively review existing evidence on childhood adversity and neural development, but to provide a novel framework to guide future research.

  5. Revenge: behavioral and emotional consequences.

    PubMed

    Konečni, Vladimir J

    2013-02-01

    This commentary discusses dozens of ecologically powerful social-psychological experiments from the1960s and 1970s, which are highly relevant especially for predicting the consequences of revenge. McCullough et al. omitted this work – perhaps because of its misclassification as “catharsis” research. The findings are readily accommodated by Konecˇ ni’s anger-aggression bidirectional-causation (AABC) model and can be usefully incorporated in an adaptationist view of revenge.

  6. Effects of adverse early-life events on aggression and anti-social behaviours in animals and humans.

    PubMed

    Haller, J; Harold, G; Sandi, C; Neumann, I D

    2014-10-01

    We review the impact of early adversities on the development of violence and antisocial behaviour in humans, and present three aetiological animal models of escalated rodent aggression, each disentangling the consequences of one particular adverse early-life factor. A review of the human data, as well as those obtained with the animal models of repeated maternal separation, post-weaning social isolation and peripubertal stress, clearly shows that adverse developmental conditions strongly affect aggressive behaviour displayed in adulthood, the emotional responses to social challenges and the neuronal mechanisms activated by conflict. Although similarities between models are evident, important differences were also noted, demonstrating that the behavioural, emotional and neuronal consequences of early adversities are to a large extent dependent on aetiological factors. These findings support recent theories on human aggression, which suggest that particular developmental trajectories lead to specific forms of aggressive behaviour and brain dysfunctions. However, dissecting the roles of particular aetiological factors in humans is difficult because these occur in various combinations; in addition, the neuroscientific tools employed in humans still lack the depth of analysis of those used in animal research. We suggest that the analytical approach of the rodent models presented here may be successfully used to complement human findings and to develop integrative models of the complex relationship between early adversity, brain development and aggressive behaviour.

  7. Cardiovascular consequences of childhood obesity.

    PubMed

    McCrindle, Brian W

    2015-02-01

    Childhood and adolescent overweight and obesity is an important and increasingly prevalent public health problem in Canada and worldwide. High adiposity in youth is indicated in clinical practice by plotting body mass index on appropriate percentile charts normed for age and sex, although waist measures might be a further tool. High adiposity can lead to adiposopathy in youth, with associated increases in inflammation and oxidative stress, changes in adipokines, and endocrinopathy. This is manifest as cardiometabolic risk factors in similar patterns to those in noted in obese adults. Obesity and cardiometabolic risk factors have been shown to be associated with vascular changes indicative of early atherosclerosis, and ventricular hypertrophy, dilation, and dysfunction. These cardiovascular consequences are evident in youth, but childhood obesity is also predictive of similar consequences in adulthood. Childhood obesity and risk factors have been shown to track into adulthood and worsen in most individuals. The result is an exponential acceleration of atherosclerosis, which can be predicted to translate into an epidemic of premature cardiovascular disease and events. A change in paradigm is needed toward preventing and curing atherosclerosis and not just preventing cardiovascular disease. This would necessarily create an imperative for preventing and treating childhood obesity. Urgent attention, policy, and action are needed to avoid the enormous future social and health care costs associated with the cardiovascular consequences of obesity in youth. PMID:25661547

  8. Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders

    NASA Technical Reports Server (NTRS)

    Slack, Kelley J.; Schneiderman, Jason S.; Leveton, Lauren B.; Whitmire, Alexandra M.; Picano, James J.

    2015-01-01

    The NASA commitment to human space flight includes continuing to fly astronauts on the ISS until it is decommissioned as well as possibly returning astronauts to the moon or having astronauts venture to an asteroid or Mars. As missions leave low Earth orbit and explore deeper space, BHP supports and conducts research to enable a risk posture that considers the risk of adverse cognitive or behavioral conditions and psychiatric disorders “acceptable given mitigations,” for pre-, in, and post-flight.The Human System Risk Board (HSRB) determines the risk of various mission scenarios using a likelihood (per person per year) by consequences matrix examining those risks across two categories—long term health and operational (within mission). Colors from a stoplight signal are used by HSRB and quickly provide a means of assessing overall perceived risk for a particular mission scenario. Risk associated with the current six month missions on the ISS are classified as “accepted with monitoring” while planetary missions, such as a mission to Mars, are recognized to be a “red” risk that requires mitigation to ensure mission success.Currently, the HSRB deems that the risk of adverse cognitive or behavioral conditions and psychiatric outcomes requires mitigation for planetary missions owing to long duration isolation and radiation exposure (see Table 1). While limited research evidence exists from spaceflight, it is well known anecdotally that the shift from the two week shuttle missions to the six month ISS missions renders the psychological stressors of space as more salient over longer duration missions. Shuttle astronauts were expected just to tolerate any stressors that arose during their mission and were successful at doing so (Whitmire et al, 2013). While it is possible to deal with stressors such as social isolation and to live with incompatible crewmembers for two weeks on shuttle, “ignoring it” is much less likely to be a successful coping mechanism

  9. Can Community Colleges Afford to Improve Completion? Measuring the Cost and Efficiency Consequences of Reform

    ERIC Educational Resources Information Center

    Belfield, Clive; Crosta, Peter; Jenkins, Davis

    2014-01-01

    Community colleges are under pressure to improve completion rates and efficiency despite limited economic evidence on how to do so and the consequences of different reform strategies. Here, we set out an economic model of student course pathways linked to college expenditures and revenues. Using detailed data from a single college, we calculate…

  10. Opioid Therapy Pharmacogenomics for Noncancer Pain: Efficacy, Adverse Events, and Costs

    PubMed Central

    Johnson, Ana

    2013-01-01

    Chronic non-cancer pain is a debilitating condition associated with high individual and societal costs. While opioid treatment for pain has been available for centuries, it is associated with high variability in outcome, and a considerable proportion of patients is unable to attain relief from symptoms while suffering adverse events and developing medication dependence. We performed a review of the efficacy of pharmacogenomic markers and their abilities to predict adverse events, dependence, and associated economic costs, focusing on two genes: OPRM1 and CYP2D6. Data sources were articles indexed by PubMed on or before August 6, 2013. Articles were first selected after review of their titles and abstracts, and full papers were read to confirm eligibility. Initially, fifty-two articles were identified. Of these, 17 were relevant to biological actions of pharmacogenomic markers and their effect on therapeutic efficacy, 16 to adverse events, 15 to opioid dependence, and eight to economic costs. In conclusion, increasing costs of opioid therapy have made the advances in pharmacogenomics an attractive solution to personalize care with unclear repercussions related to the impact on costs, morbidity, and outcomes. This intersection of pharmacoeconomics and pharmacogenomics presents a unique platform to further examine current advances in clinical medicine and their utility in cost-effective treatment of chronic pain. PMID:24167729

  11. The economics of natural disasters

    NASA Astrophysics Data System (ADS)

    Hallegatte, S.

    2007-05-01

    Mitigating natural disasters is probably more important for society than it can be inferred from direct losses. Total economic losses, indeed, can be much larger than direct losses, especially for large disasters, which affect the economy for extended periods of time (e.g., New Orleans after Katrina), and represent an important obstacle to economic development in certain regions (e.g. Central America). A series of recent modelling exercises highlights several findings. First, total economic losses due to an event are increasing nonlinearly as a function of its direct losses, because destructions both increase reconstruction needs and reduce reconstruction capacity. Second, endogenous economic dynamics has to be taken into account in the assessment of disaster consequences. More particularly, an economy in the expansion phase of its business cycle appears to be more vulnerable to extreme events than an economy in recession. This result is supported by the fact that worker availability is found to be one of the main obstacles to a rapid and efficient reconstruction. Third, natural disasters can create poverty traps for poor countries, which have a lower ability to fund and carry out reconstruction. As a consequence, climate change impacts from extreme events may be significant, and will depend on how societies are able to adapt their reconstruction capacity to new levels of risk.

  12. Idiosyncratic Adverse Drug Reactions: Current Concepts

    PubMed Central

    Naisbitt, Dean J.

    2013-01-01

    Idiosyncratic drug reactions are a significant cause of morbidity and mortality for patients; they also markedly increase the uncertainty of drug development. The major targets are skin, liver, and bone marrow. Clinical characteristics suggest that IDRs are immune mediated, and there is substantive evidence that most, but not all, IDRs are caused by chemically reactive species. However, rigorous mechanistic studies are very difficult to perform, especially in the absence of valid animal models. Models to explain how drugs or reactive metabolites interact with the MHC/T-cell receptor complex include the hapten and P-I models, and most recently it was found that abacavir can interact reversibly with MHC to alter the endogenous peptides that are presented to T cells. The discovery of HLA molecules as important risk factors for some IDRs has also significantly contributed to our understanding of these adverse reactions, but it is not yet clear what fraction of IDRs have a strong HLA dependence. In addition, with the exception of abacavir, most patients who have the HLA that confers a higher IDR risk with a specific drug will not have an IDR when treated with that drug. Interindividual differences in T-cell receptors and other factors also presumably play a role in determining which patients will have an IDR. The immune response represents a delicate balance, and immune tolerance may be the dominant response to a drug that can cause IDRs. PMID:23476052

  13. Idiosyncratic adverse drug reactions: current concepts.

    PubMed

    Uetrecht, Jack; Naisbitt, Dean J

    2013-04-01

    Idiosyncratic drug reactions are a significant cause of morbidity and mortality for patients; they also markedly increase the uncertainty of drug development. The major targets are skin, liver, and bone marrow. Clinical characteristics suggest that IDRs are immune mediated, and there is substantive evidence that most, but not all, IDRs are caused by chemically reactive species. However, rigorous mechanistic studies are very difficult to perform, especially in the absence of valid animal models. Models to explain how drugs or reactive metabolites interact with the MHC/T-cell receptor complex include the hapten and P-I models, and most recently it was found that abacavir can interact reversibly with MHC to alter the endogenous peptides that are presented to T cells. The discovery of HLA molecules as important risk factors for some IDRs has also significantly contributed to our understanding of these adverse reactions, but it is not yet clear what fraction of IDRs have a strong HLA dependence. In addition, with the exception of abacavir, most patients who have the HLA that confers a higher IDR risk with a specific drug will not have an IDR when treated with that drug. Interindividual differences in T-cell receptors and other factors also presumably play a role in determining which patients will have an IDR. The immune response represents a delicate balance, and immune tolerance may be the dominant response to a drug that can cause IDRs. PMID:23476052

  14. Adverse immunologic effects of antithyroid drugs.

    PubMed Central

    Wing, S S; Fantus, I G

    1987-01-01

    Propylthiouracil and methimazole are frequently used in the management of hyperthyroidism. Two patients in whom adverse immunologic effects other than isolated agranulocytosis developed during treatment with propylthiouracil are described. A review of the literature revealed 53 similar cases over a 35-year period. Rash, fever, arthralgias and granulocytopenia were the most common manifestations. Vasculitis, particularly with cutaneous manifestations, occurs and may be fatal. The clinical evidence suggests that an immunologic mechanism is involved. A number of different autoantibodies were reported, but antinuclear antibodies were infrequent, and none of the cases met the criteria for a diagnosis of systemic lupus erythematosus. Thus, the reactions do not represent a true drug-induced lupus syndrome. Current hypotheses and experimental data regarding the cause of the reactions are reviewed. No specific clinical subgroup at high risk can be identified, and manifestations may occur at any dosage and at any time during therapy. Cross-reactivity between the two antithyroid drugs can be expected. Except for minor symptoms (e.g., mild arthralgias or transient rash), such reactions are an indication for withdrawal of the drug and the use of alternative methods to control the hyperthyroidism. In rare cases of severe vasculitis a short course of high-dose glucocorticoid therapy may be helpful. PMID:3539299

  15. Reporting vaccine-associated adverse events.

    PubMed Central

    Duclos, P.; Hockin, J.; Pless, R.; Lawlor, B.

    1997-01-01

    OBJECTIVE: To determine family physicians' awareness of the need to monitor and report vaccine-associated adverse events (VAAE) in Canada and to identify mechanisms that could facilitate reporting. DESIGN: Mailed survey. SETTING: Canadian family practices. PARTICIPANTS: Random sample of 747 family physicians. Overall response rate was 32% (226 of 717 eligible physicians). MAIN OUTCOME MEASURES: Access to education on VAAE; knowledge about VAAE monitoring systems, reporting criteria, and reporting forms; method of reporting VAAEs and reasons for not reporting them; and current experience with VAAEs. RESULTS: Of 226 respondents, 55% reported observing VAAEs, and 42% reported the event. Fewer than 50% were aware of a monitoring system for VAAE, and only 39% had had VAAE-related education during medical training. Only 28% knew the reporting criteria. Reporting was significantly associated with knowledge of VAAE monitoring systems and reporting criteria (P < 0.01). CONCLUSION: Physicians need more feedback and education on VAAE reporting and more information about the importance of reporting and about reporting criteria and methods. PMID:9303234

  16. Cutaneous Adverse Effects of Neurologic Medications.

    PubMed

    Bahrani, Eman; Nunneley, Chloe E; Hsu, Sylvia; Kass, Joseph S

    2016-03-01

    Life-threatening and benign drug reactions occur frequently in the skin, affecting 8 % of the general population and 2-3 % of all hospitalized patients, emphasizing the need for physicians to effectively recognize and manage patients with drug-induced eruptions. Neurologic medications represent a vast array of drug classes with cutaneous side effects. Approximately 7 % of the United States (US) adult population is affected by adult-onset neurological disorders, reflecting a large number of patients on neurologic drug therapies. This review elucidates the cutaneous reactions associated with medications approved by the US Food and Drug Administration (FDA) to treat the following neurologic pathologies: Alzheimer disease, amyotrophic lateral sclerosis, epilepsy, Huntington disease, migraine, multiple sclerosis, Parkinson disease, and pseudobulbar affect. A search of the literature was performed using the specific FDA-approved drug or drug classes in combination with the terms 'dermatologic,' 'cutaneous,' 'skin,' or 'rash.' Both PubMed and the Cochrane Database of Systematic Reviews were utilized, with side effects ranging from those cited in randomized controlled trials to case reports. It behooves neurologists, dermatologists, and primary care physicians to be aware of the recorded cutaneous adverse reactions and their severity for proper management and potential need to withdraw the offending medication.

  17. [Cutaneous adverse reactions to tattoos and piercings].

    PubMed

    Mataix, J; Silvestre, J F

    2009-10-01

    Piercings and tattoos have become very popular in western society in recent decades, particularly among younger generations. Reports of medical complications associated with these decorative techniques have increased in parallel with the rise in their popularity. Due to their high frequency, adverse cutaneous reactions are particularly important among these potential complications. Tattoo-related complications include a number of cutaneous and systemic infections secondary to breach of the epidermal barrier, acute and delayed inflammatory reactions with different histopathological patterns, the appearance of benign and malignant tumors on tattooed areas of skin, and certain dermatoses triggered by isomorphic phenomena. Piercing-related complications are similar, though some, such as pyogenic skin infections, are much more common due to the delayed wound healing after piercing in certain sites. We must differentiate between complications that are independent of the site of piercing, and specific complications, which are closely related to the body area pierced. The rate of complications after performing piercings or tattoos depends on the experience of the artist, the hygiene techniques applied, and the postprocedural care by the customer. However, some of these complications are unpredictable and depend on factors intrinsic to the patient. In this article, we review the most common decorative techniques of body art, with particular focus on the potential cutaneous complications and their management. PMID:19775542

  18. Adverse perinatal outcome in the older primipara.

    PubMed

    Dollberg, S; Seidman, D S; Armon, Y; Stevenson, D K; Gale, R

    1996-01-01

    Delayed childbearing has become common and has raised the awareness of the possible risks for the mother and the newborn infant. The increased maternal and neonatal risks have been attributed largely to the lack of proper prenatal care. The aim of this study was to assess whether advanced maternal age is a significant risk factor in mothers who receive good prenatal care. We matched 161 cases 1:1 according to the following criteria: maternal and paternal ethnic origin, chronic diseases, marital status, and smoking during pregnancy. Our results show that the older women had babies with a significantly higher incidence of low birth weight (< 2500 gm, p = 0.001), prematurity (< 37 weeks, p = 0.02), intrauterine growth retardation (p = 0.001), abruptio placentae (p = 0.002), and cesarean section (p < 0.001). The average hospital stay for the babies of the older mothers was longer than that for babies of the younger mothers (8.4 vs 6.1 days, p = 0.003), and the incidence of hospitalization for more than 3 days in the neonatal intensive care unit was increased (10.3% vs 2.2%). Logistic regression did not support maternal age of 35 years and older as being the single significant risk factor for adverse neonatal and maternal outcome. We conclude that maternal age older than 35 years entails a higher risk for the mother and her newborn infant, even when good prenatal care is taken.

  19. Cardiometabolic Consequences of Therapy For Chronic Schizophrenia Using Second-Generation Antipsychotic Agents in a Medicaid Population

    PubMed Central

    Ward, Alex; Quon, Peter; Abouzaid, Safiya; Haber, Noah; Ahmed, Saed; Kim, Edward

    2013-01-01

    Objective: We assessed the potential clinical and economic impact of coronary heart disease (CHD) and diabetes arising after the use of second-generation (“atypical”) antipsychotic agents for the treatment of chronic schizophrenia. We compared the use of these medications in patients with a higher risk of cardiometabolic adverse events (in a higher-risk scenario) and in patients with a lower risk (in a lower-risk scenario). Our U.S.-based analysis estimated the costs of CHD and diabetes arising from antipsychotic medication–related cardiometabolic effects. Methods: We constructed a health economic model to predict the 5-year incidence of CHD and diabetes and associated costs after treatment. In this cost-consequence model, we used CHD risk functions derived from the Framingham Heart Study and diabetes risk functions derived from the Atherosclerosis Risk in Communities (ARIC) study. Patient characteristics and treatment effects on cardiometabolic risk factors were estimated from the Clinical Trials of Antipsychotic Treatment Effectiveness (CATIE) study. We evaluated two cost-consequence scenarios: the incidence of CHD and diabetes predicted for 1,000 patients with chronic schizophrenia in a higher-risk scenario based on data from CATIE associated with olanzapine (Zyprexa) and in a lower-risk scenario with ziprasidone (Geodon). We evaluated rates of adverse outcomes for each scenario and the cost of treatment for CHD and diabetes. All costs were reported in 2011 U.S. dollars. Because Medicaid is often the payer for patients with chronic schizophrenia, all costs in this analysis were derived from the perspective of Medicaid. Results: Over a period of 5 years in 1,000 patients with chronic schizophrenia, the higher-risk scenario with olanzapine showed a 9% increased incidence of CHD and a 59% increased incidence of diabetes, compared with no change in treatment from baseline. By contrast, the lower-risk scenario with ziprasidone showed a 9% reduced incidence of

  20. Systematic Analysis of Adverse Event Reports for Sex Differences in Adverse Drug Events.

    PubMed

    Yu, Yue; Chen, Jun; Li, Dingcheng; Wang, Liwei; Wang, Wei; Liu, Hongfang

    2016-04-22

    Increasing evidence has shown that sex differences exist in Adverse Drug Events (ADEs). Identifying those sex differences in ADEs could reduce the experience of ADEs for patients and could be conducive to the development of personalized medicine. In this study, we analyzed a normalized US Food and Drug Administration Adverse Event Reporting System (FAERS). Chi-squared test was conducted to discover which treatment regimens or drugs had sex differences in adverse events. Moreover, reporting odds ratio (ROR) and P value were calculated to quantify the signals of sex differences for specific drug-event combinations. Logistic regression was applied to remove the confounding effect from the baseline sex difference of the events. We detected among 668 drugs of the most frequent 20 treatment regimens in the United States, 307 drugs have sex differences in ADEs. In addition, we identified 736 unique drug-event combinations with significant sex differences. After removing the confounding effect from the baseline sex difference of the events, there are 266 combinations remained. Drug labels or previous studies verified some of them while others warrant further investigation.

  1. Systematic Analysis of Adverse Event Reports for Sex Differences in Adverse Drug Events

    PubMed Central

    Yu, Yue; Chen, Jun; Li, Dingcheng; Wang, Liwei; Wang, Wei; Liu, Hongfang

    2016-01-01

    Increasing evidence has shown that sex differences exist in Adverse Drug Events (ADEs). Identifying those sex differences in ADEs could reduce the experience of ADEs for patients and could be conducive to the development of personalized medicine. In this study, we analyzed a normalized US Food and Drug Administration Adverse Event Reporting System (FAERS). Chi-squared test was conducted to discover which treatment regimens or drugs had sex differences in adverse events. Moreover, reporting odds ratio (ROR) and P value were calculated to quantify the signals of sex differences for specific drug-event combinations. Logistic regression was applied to remove the confounding effect from the baseline sex difference of the events. We detected among 668 drugs of the most frequent 20 treatment regimens in the United States, 307 drugs have sex differences in ADEs. In addition, we identified 736 unique drug-event combinations with significant sex differences. After removing the confounding effect from the baseline sex difference of the events, there are 266 combinations remained. Drug labels or previous studies verified some of them while others warrant further investigation. PMID:27102014

  2. Technical Note: Ethical Economics

    NASA Astrophysics Data System (ADS)

    Blodgett, J.

    Ethical economics is inspirational, expanding our vision beyond the narrow self-interest of the theoretical economic man. Ethical economics sees more value in space settlement than conventional economic calculations that can inappropriately discount the value of the future.

  3. Examining the Relationships Between Prenatal Methamphetamine Exposure, Early Adversity, and Child Neurobehavioral Disinhibition

    PubMed Central

    Abar, Beau; LaGasse, Linda L.; Newman, Elana; Smith, Lynne M; Huestis, Marilyn; Neal, Charles; DeRauf, Chris; Shah, Rizwan; Arria, Amelia; Grotta, Sheri Della; Dansereau, Lynne M.; Lester, Barry M.

    2013-01-01

    Methamphetamine use is a growing problem among pregnant women in the United States. Many negative consequences of methamphetamine use have been documented for the users, but little research has examined the long-term association between prenatal methamphetamine exposure (PME) and childhood outcomes. The current study examined the extent to which PME was predictive of childhood neurobehavioral disinhibition (ND), as well as the extent to which early adversity mediated this relationship. A sample of 320 mother–infant dyads (162 PME) was followed from birth through 6.5 years of age. ND was conceptualized as a two factor model consisting of deficits in (a) behavioral and emotional control, and (b) executive function. PME was associated with behavioral and emotional control at 5 years, which was associated with executive function deficits at 6.5 years. Early adversity (birth through year 3) significantly mediated the relationship between PME and ND. Associations with previous research and implications for prevention are discussed. PMID:23067308

  4. Adverse childhood experiences and trauma informed care: the future of health care.

    PubMed

    Oral, Resmiye; Ramirez, Marizen; Coohey, Carol; Nakada, Stephanie; Walz, Amy; Kuntz, Angela; Benoit, Jenna; Peek-Asa, Corinne

    2016-01-01

    Adverse childhood experiences (ACEs) are related to short- and long-term negative physical and mental health consequences among children and adults. Studies of the last three decades on ACEs and traumatic stress have emphasized their impact and the importance of preventing and addressing trauma across all service systems utilizing universal systemic approaches. Current developments on the implementation of trauma informed care (TIC) in a variety of service systems call for the surveillance of trauma, resiliency, functional capacity, and health impact of ACEs. Despite such efforts in adult medical care, early identification of childhood trauma in children still remains a significant public health need. This article reviews childhood adversity and traumatic toxic stress, presents epidemiologic data on the prevalence of ACEs and their physical and mental health impacts, and discusses intervention modalities for prevention.

  5. Examining the relationships between prenatal methamphetamine exposure, early adversity, and child neurobehavioral disinhibition.

    PubMed

    Abar, Beau; LaGasse, Linda L; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M; Arria, Amelia; Huestis, Marilyn; Della Grotta, Sheri; Dansereau, Lynne M; Neal, Charles; Lester, Barry M

    2013-09-01

    Methamphetamine use is a growing problem among pregnant women in the United States. Many negative consequences of methamphetamine use have been documented for the users, but little research has examined the long-term association between prenatal methamphetamine exposure (PME) and childhood outcomes. The current study examined the extent to which PME was predictive of childhood neurobehavioral disinhibition (ND), as well as the extent to which early adversity mediated this relationship. A sample of 320 mother-infant dyads (162 PME) was followed from birth through 6.5 years of age. ND was conceptualized as a two factor model consisting of deficits in (a) behavioral and emotional control, and (b) executive function. PME was associated with behavioral and emotional control at 5 years, which was associated with executive function deficits at 6.5 years. Early adversity (birth through year 3) significantly mediated the relationship between PME and ND. Associations with previous research and implications for prevention are discussed. PMID:23067308

  6. Gender Differences in Determinants and Consequences of Health and Illness

    PubMed Central

    2007-01-01

    This paper uses a framework developed for gender and tropical diseases for the analysis of non-communicable diseases and conditions in developing and industrialized countries. The framework illustrates that gender interacts with the social, economic and biological determinants and consequences of tropical diseases to create different health outcomes for males and females. Whereas the framework was previously limited to developing countries where tropical infectious diseases are more prevalent, the present paper demonstrates that gender has an important effect on the determinants and consequences of health and illness in industrialized countries as well. This paper reviews a large number of studies on the interaction between gender and the determinants and consequences of chronic diseases and shows how these interactions result in different approaches to prevention, treatment, and coping with illness. Specific examples of chronic diseases are discussed in each section with respect to both developing and industrialized countries. PMID:17615903

  7. Biological costs of economic transition: Stress levels during the transition from communism to capitalism in Poland.

    PubMed

    Lipowicz, Anna; Szklarska, Alicja; Mitas, Andrzej W

    2016-05-01

    At the end of the 1980s, Poland began the transformation from an essentially one-party communist system to a politically pluralistic democratic system. These political and economic changes had major social consequences, among others unemployment and a sharp decrease in real personal income. The aim of the study was to investigate the possible relationship between stress in adult men, measured by the Allostatic Load, and the socio-economic deterioration during the first part of the economic transition. The Allostatic Load included eleven markers assessing adverse nutritional intake, cardiovascular activity, inflammatory processes, and lung, hepatic and renal functions. The results indicate a significantly higher risk of metabolic dysregulation in men examined after 1990, compared to men from previous years. After adjustment for socioeconomic variables and lifestyle variables, men examined in 1991 had a 31% greater risk of higher Allostatic Load compared with men examined in 1985 (OR=1.31; p=0.0541), in 1992, this risk was 50% greater (OR=1.50; p<0.01), and in 1993, the risk was 66% greater (OR=1.66; p<0.05). The conclusion is drawn that significantly more stressogenic factors for men were those directly connected with the financial situation of their families, than a sudden but short increase of prices for goods and services.

  8. Biological costs of economic transition: Stress levels during the transition from communism to capitalism in Poland.

    PubMed

    Lipowicz, Anna; Szklarska, Alicja; Mitas, Andrzej W

    2016-05-01

    At the end of the 1980s, Poland began the transformation from an essentially one-party communist system to a politically pluralistic democratic system. These political and economic changes had major social consequences, among others unemployment and a sharp decrease in real personal income. The aim of the study was to investigate the possible relationship between stress in adult men, measured by the Allostatic Load, and the socio-economic deterioration during the first part of the economic transition. The Allostatic Load included eleven markers assessing adverse nutritional intake, cardiovascular activity, inflammatory processes, and lung, hepatic and renal functions. The results indicate a significantly higher risk of metabolic dysregulation in men examined after 1990, compared to men from previous years. After adjustment for socioeconomic variables and lifestyle variables, men examined in 1991 had a 31% greater risk of higher Allostatic Load compared with men examined in 1985 (OR=1.31; p=0.0541), in 1992, this risk was 50% greater (OR=1.50; p<0.01), and in 1993, the risk was 66% greater (OR=1.66; p<0.05). The conclusion is drawn that significantly more stressogenic factors for men were those directly connected with the financial situation of their families, than a sudden but short increase of prices for goods and services. PMID:26799229

  9. [Fertility transition in Brazil. Causes and consequences].

    PubMed

    Carvalho, J A; Wong, L R

    1992-12-01

    This work examines the determinants and most important consequences of the Brazilian fertility decline. Brazil's total fertility rate declined from 6.2 in 1940 to around 3.5 in 1985. the decline began in the 1960s and amounted to 45% in about 20 years. The most rapid drop began in the late 1970s, with much of it concentrated in 2 specific periods: 1970-75 and 1980-85. The early period coincided with Brazil's so-called "Economic Miracle", a period of rapid growth accompanied however by deteriorating living conditions for the poorest population sectors. The second period coincided with the international economic crisis of the early 1980s, which was felt more strongly in Brazil than elsewhere in Latin America because of Brazil's greater degree of industrialization and closer integration into the world economy. Most of the fertility decline has been accomplished by use of just two contraceptive methods, oral contraceptives and sterilization, which together account for around 85% of contraceptive usage throughout Brazil. The third most common method, rhythm, accounts for just 6%. No reliable data on abortion are available, but it appears to be a common practice equally accessible to all socioeconomic strata despite greater associated health risks for poorer women. Brazil's fertility transition appears to have been a response to the process of proletarianization and urbanization underway in the country as well as to particular circumstances in the country. The most evident and immediate consequence of the continuous fertility decline over more than 20 years is the change in the age structure of the population. The proportions of children under 5 will decline from 14.4% in 1980 to 9.2% in 2010. The proportion aged 5-14 will decline from 24.5% to 17.4%, while the proportion aged 65 and over will increase from 4.0% to 5.6%. Brazil's recent demographic changes are scarcely reflected in development plans and political and social projects. There is almost no mention of the new

  10. Behavioral economics.

    PubMed

    Chambers, David W

    2009-01-01

    It is human nature to overestimate how rational we are, both in general and even when we are trying to be. Such irrationality is not random, and the search for and explanation of patterns of fuzzy thinking is the basis for a new academic discipline known as behavioral economics. Examples are given of some of the best understood of our foibles, including prospect theory, framing, anchoring, salience, confirmation bias, superstition, and ownership. Humans have two cognitive systems: one conscious, deliberate, slow, and rational; the other fast, pattern-based, emotionally tinged, and intuitive. Each is subject to its own kind of error. In the case of rational thought, we tend to exaggerate our capacity; for intuition, we fail to train it or recognize contexts where it is inappropriate. Humans are especially poor at estimating probabilities, or even understanding what they are. It is a common human failing to reason backwards from random outcomes that are favorable to beliefs about our power to predict the future. Five suggestions are offered for thinking within our means.

  11. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study

    PubMed Central

    2009-01-01

    OBJECTIVE—To examine associations of neonatal adiposity with maternal glucose levels and cord serum C-peptide in a multicenter multinational study, the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study, thereby assessing the Pederson hypothesis linking maternal glycemia and fetal hyperinsulinemia to neonatal adiposity. RESEARCH DESIGN AND METHODS—Eligible pregnant women underwent a standard 75-g oral glucose tolerance test between 24 and 32 weeks gestation (as close to 28 weeks as possible). Neonatal anthropometrics and cord serum C-peptide were measured. Associations of maternal glucose and cord serum C-peptide with neonatal adiposity (sum of skin folds >90th percentile or percent body fat >90th percentile) were assessed using multiple logistic regression analyses, with adjustment for potential confounders, including maternal age, parity, BMI, mean arterial pressure, height, gestational age at delivery, and the baby's sex. RESULTS—Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, cord serum C-peptide results were available for 19,885 babies and skin fold measurements for 19,389. For measures of neonatal adiposity, there were strong statistically significant gradients across increasing levels of maternal glucose and cord serum C-peptide, which persisted after adjustment for potential confounders. In fully adjusted continuous variable models, odds ratios ranged from 1.35 to 1.44 for the two measures of adiposity for fasting, 1-h, and 2-h plasma glucose higher by 1 SD. CONCLUSIONS—These findings confirm the link between maternal glucose and neonatal adiposity and suggest that the relationship is mediated by fetal insulin production and that the Pedersen hypothesis describes a basic biological relationship influencing fetal growth. PMID:19011170

  12. The adverse health effects of chronic cannabis use.

    PubMed

    Hall, Wayne; Degenhardt, Louisa

    2014-01-01

    This paper summarizes the most probable of the adverse health effects of regular cannabis use sustained over years, as indicated by epidemiological studies that have established an association between cannabis use and adverse outcomes; ruled out reverse causation; and controlled for plausible alternative explanations. We have also focused on adverse outcomes for which there is good evidence of biological plausibility. The focus is on those adverse health effects of greatest potential public health significance--those that are most likely to occur and to affect a substantial proportion of regular cannabis users. These most probable adverse effects of regular use include a dependence syndrome, impaired respiratory function, cardiovascular disease, adverse effects on adolescent psychosocial development and mental health, and residual cognitive impairment.

  13. Mechanisms and consequences of entosis.

    PubMed

    Krishna, Shefali; Overholtzer, Michael

    2016-06-01

    Multiple mechanisms have emerged where the engulfment of whole live cells, leading to the formation of what are called 'cell-in-cell' structures, induces cell death. Entosis is one such mechanism that drives cell-in-cell formation during carcinogenesis and development. Curiously, entotic cells participate actively in their own engulfment, by invading into their hosts, and are then killed non-cell-autonomously. Here we review the mechanisms of entosis and entotic cell death and the consequences of entosis on cell populations. PMID:27048820

  14. Quantum Consequences of Parameterizing Geometry

    NASA Astrophysics Data System (ADS)

    Wanas, M. I.

    2002-12-01

    The marriage between geometrization and quantization is not successful, so far. It is well known that quantization of gravity , using known quantization schemes, is not satisfactory. It may be of interest to look for another approach to this problem. Recently, it is shown that geometries with torsion admit quantum paths. Such geometries should be parameterizied in order to preserve the quantum properties appeared in the paths. The present work explores the consequences of parameterizing such geometry. It is shown that quantum properties, appeared in the path equations, are transferred to other geometric entities.

  15. Metabolic consequences present new challenge.

    PubMed

    1998-09-01

    The 12th World AIDS Conference in Geneva reported disturbing metabolic side effects from potent new therapies, particularly those therapies that use protease inhibitors. Cases of lipodystrophy, hypercholesterole anemia, and coronary artery disease have been reported. Conference attendees also discussed a need for a new definition of AIDS-related wasting. One proposed definition was the involuntary loss of 3 percent body weight in 1 month, 5 percent in 6 months, or 10 percent and greater in 12 months. Diarrhea is a major consequence of wasting and antiretroviral therapies, however, it seems more controllable because of a new drug called Provir (SP-303). PMID:11365785

  16. Adverse Outcome Pathways as Tools to Assess Drug-Induced Toxicity.

    PubMed

    Vinken, Mathieu

    2016-01-01

    Adverse outcome pathways (AOPs) are novel tools in toxicology and human risk assessment with broad potential. AOPs are designed to provide a clear-cut mechanistic representation of toxicological effects that span over different layers of biological organization. AOPs share a common structure consisting of a molecular initiating event, a series of key events connected by key event relationships, and an adverse outcome. Development and evaluation of AOPs ideally complies with guidelines issued by the Organization for Economic Cooperation and Development. AOP frameworks have yet been proposed for major types of drug-induced injury, especially in the liver, including steatosis, fibrosis, and cholestasis. These newly postulated AOPs can serve a number of purposes pertinent to safety assessment of drugs, in particular the establishment of quantitative structure-activity relationships, the development of novel in vitro toxicity screening tests, and the elaboration of prioritization strategies. PMID:27311472

  17. A randomized controlled trial on the benefits and respiratory adverse effects of morphine for refractory dyspnea in patients with COPD: Protocol of the MORDYC study.

    PubMed

    Verberkt, C A; van den Beuken-van Everdingen, M H J; Franssen, F M E; Dirksen, C D; Schols, J M G A; Wouters, E F M; Janssen, D J A

    2016-03-01

    Dyspnea is one of the most reported symptoms of patients with advanced Chronic Obstructive Pulmonary Disease (COPD) and is often undertreated. Morphine has proven to be an effective treatment for dyspnea and is recommended in clinical practice guidelines, but questions concerning benefits and respiratory adverse effects remain. This study primarily evaluates the impact of oral sustained release morphine (morphine SR) on health-related quality of life and respiratory adverse effects in patients with COPD. Secondary objectives include the impact on exercise capacity, the relationship between description and severity of dyspnea and the presence of a clinically relevant response to morphine, and cost-effectiveness. A single-center, randomized, double blind, placebo controlled intervention study will be performed in 124 patients with COPD who recently completed a comprehensive pulmonary rehabilitation program. Participants will receive 20-30 mg/24h morphine SR or placebo for four weeks. After the intervention, participants will be followed for twelve weeks. Outcomes include: the COPD Assessment Test, six minute walking test, Multidimensional Dyspnea Scale and a cost diary. Furthermore, lung function and arterial blood gasses will be measured. These measures will be assessed during a baseline and outcome assessment, two home visits, two phone calls, and three follow-up assessments. The intervention and control group will be compared using uni- and multivariate regression analysis and logistic regression analysis. Finally, an economic evaluation will be performed from a societal and healthcare perspective. The current manuscript describes the rationale and methods of this study and provides an outline of the possible strengths, weaknesses and clinical consequences. PMID:26825021

  18. Endoscopic retrograde cholangiopancreatography-related adverse events: general overview.

    PubMed

    Rustagi, Tarun; Jamidar, Priya A

    2015-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) represents a monumental advance in the management of patients with pancreaticobiliary diseases, but is a complex and technically demanding procedure with the highest inherent risk of adverse events of all routine endoscopic procedures. Overall adverse event rates for ERCP are typically reported as 5-10%. The most commonly reported adverse events include post-ERCP pancreatitis, bleeding, perforation, infection (cholangitis), and cardiopulomary or "sedation related" events. This article evaluates patient-related and procedure-related risk factors for ERCP-related adverse events, and discusses strategies for the prevention, diagnosis and management of these events.

  19. 21 CFR 600.80 - Postmarketing reporting of adverse experiences.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... substantial disruption of a person's ability to conduct normal life functions. Life-threatening adverse... only referred to elevated hepatic enzymes or hepatitis. Similarly, cerebral thromboembolism...

  20. 21 CFR 600.80 - Postmarketing reporting of adverse experiences.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... substantial disruption of a person's ability to conduct normal life functions. Life-threatening adverse... only referred to elevated hepatic enzymes or hepatitis. Similarly, cerebral thromboembolism...

  1. 21 CFR 600.80 - Postmarketing reporting of adverse experiences.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... substantial disruption of a person's ability to conduct normal life functions. Life-threatening adverse... only referred to elevated hepatic enzymes or hepatitis. Similarly, cerebral thromboembolism...

  2. Determinants and Consequences of Obesity

    PubMed Central

    Hruby, Adela; Manson, JoAnn E.; Qi, Lu; Malik, Vasanti S.; Rimm, Eric B.; Sun, Qi; Willett, Walter C.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Studies (NHS and NHS II) in addressing hypotheses regarding risk factors for and consequences of obesity. Methods. Narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results. Long-term NHS research has shown that weight gain and being overweight or obese are important risk factors for type 2 diabetes, cardiovascular diseases, certain types of cancers, and premature death. The cohorts have elucidated the role of dietary and lifestyle factors in obesity, especially sugar-sweetened beverages, poor diet quality, physical inactivity, prolonged screen time, short sleep duration or shift work, and built environment characteristics. Genome-wide association and gene–lifestyle interaction studies have shown that genetic factors predispose individuals to obesity but that such susceptibility can be attenuated by healthy lifestyle choices. This research has contributed to evolving clinical and public health guidelines on the importance of limiting weight gain through healthy dietary and lifestyle behaviors. Conclusions. The NHS cohorts have contributed to our understanding of the risk factors for and consequences of obesity and made a lasting impact on clinical and public health guidelines on obesity prevention. PMID:27459460

  3. Nutritional consequences of food processing.

    PubMed

    Friedman, Mendel

    2003-01-01

    A variety of methods are used to process foods: if they are not edible, to render them so; to permit storage; to alter texture and flavor; to destroy microorganisms and other toxins. These methods include heating (baking, cooking, frying, microwaving), freezing, and high pH. It is a paradox of nature that the processing of foods can improve, nutrition, quality, and safety; yet, occasionally these processing alternatives can lead to the formation of anti-nutritional and toxic compounds. These multi-faceted consequences of food processing result from molecular interactions among nutrients and with other food ingredients, both natural and added. This paper outlines the following aspects of processing-induced formation of novel food ingredients and the resulting consequences for nutrition: protein-polyphenol and protein-carbohydrate enzymatic and non-enzymatic browning reactions; formation of heterocyclic amines in meat; inactivation of soybean inhibitors of digestive enzymes; formation of lysinoalanine and D-amino acids in food proteins; and the stability of phenolic compounds to high pH. Possible approaches to prevent the formation of deleterious food ingredients are also addressed. PMID:15806931

  4. Podocyte injury and its consequences.

    PubMed

    Nagata, Michio

    2016-06-01

    Podocytes maintain the glomerular filtration barrier, and the stability of this barrier depends on their highly differentiated postmitotic phenotype, which also defines the particular vulnerability of the glomerulus. Recent podocyte biology and gene disruption studies in vivo indicate a causal relationship between abnormalities of single podocyte molecules and proteinuria and glomerulosclerosis. Podocytes live under various stresses and pathological stimuli. They adapt to maintain homeostasis, but excessive stress leads to maladaptation with complex biological changes including loss of integrity and dysregulation of cellular metabolism. Podocyte injury causes proteinuria and detachment from the glomerular basement membrane. In addition to "sick" podocytes and their detachment, our understanding of glomerular responses following podocyte loss needs to address the pathways from podocyte injury to sclerosis. Studies have found a variety of glomerular responses to podocyte dysfunction in vivo, such as disruption of podocyte-endothelial cross talk and activation of podocyte-parietal cell interactions, all of which help us to understand the complex scenario of podocyte injury and its consequences. This review focuses on the cellular aspects of podocyte dysfunction and the adaptive or maladaptive glomerular responses to podocyte injury that lead to its major consequence, glomerulosclerosis. PMID:27165817

  5. Structural consequences of railgun augmentation

    SciTech Connect

    Wellman, G.W.; Schuler, K.W.

    1988-01-01

    An augmented railgun can provide the same driving force on a projectile at a lower plasma arc current and thus less potential erosion and barrel damage as an unaugmented railgun. However, there are structural consequences to railgun augmentation which must be overcome before the advantages of lower plasma arc currents can be realized. To investigate these consequences, a bolted V-block supporting structure is considered with two cores; unaugmented (a single pair of conducting rails), and augmented (conducting rails augmented by a second tandem set of conductors). The mechanical load on the cores consist of the static bolt preload, the plasma pressure behind the projectile, and the magnetic pressure induced by currents flowing in the rails or augmenting conductors. Assuming no current diffusion into the conductors, the magnetic pressure distribution on the conductors is determined by solving the two-dimensional magnetostatic field equations using an analogy with heat transfer. These loads are then used in a dynamic finite element structural model. The maximum rail current is found at which the unaugmented railgun can be repetitively fired without detrimental gaps forming at the bore. For the augmented railgun, at the same projectile acceleration, large permanent deformations can occur. Thus successful implementation of rail gun augmentation will require improvement of the supporting structure.

  6. Structural consequences of railgun augmentation

    SciTech Connect

    Wellman, G.W.; Schuler, K.W. . Applied Mechanics Div. III)

    1989-01-01

    An augmented railgun can provide the same driving force on a projectile at a lower plasma arc current and thus less potential erosion and barrel damage as an unaugmented railgun. However, there are structural consequences to railgun augmentation which must be overcome before the advantages of lower plasma arc currents can be realized. To investigate these consequences, a bolted V-block supporting structure is considered with two cores; unaugmented (a single pair of conducting rails), and augmented (conducting rails augmented by a second tandem set of conductors). The mechanical load on the cores consist of the static bolt preload, the plasma pressure behind the projectile, and the magnetic pressure induced by currents flowing in the rails or augmenting conductors. Assuming no current diffusion into the conductors, the magnetic pressure distribution on the conductors is determined by solving the two dimensional magnetostatic field equations using an analogy with heat transfer. These loads are then used in a dynamic finite element structural model. The maximum rail current is found at which the unaugmented railgun can be repetitively fired without detrimental gaps forming at the bore. For the augmented railgun, at the same projectile acceleration, large permanent deformations can occur. Thus successful implementation of rail gun augmentation will require improvement of the supporting structure.

  7. The shackles of misfortune: social adversity assessment and representation in a chronic-disease epidemiological setting.

    PubMed

    Surtees, Paul G; Wainwright, Nicholas W J

    2007-01-01

    Research evidence is accumulating to support an association between social adversity and the development of predisease processes and physical disease outcomes. While methodological advances have been achieved in the assessment of social adversity, significant barriers remain to their adoption in chronic disease epidemiological settings consequent upon the need to limit participant burden and restrictions imposed by cohort size and cost. A large-scale population-based cohort study, as part of the European Prospective Investigation into Cancer, Norfolk, UK, provided an opportunity to include a comprehensive postal assessment of social adversity. A total of 20,921 participants reported details of 16,031 adverse circumstances during childhood, 119,056 life events and 106,170 person-years of difficulties experienced during adulthood. Impact and adaptation indices were constructed from responses to questions regarding specific life events experienced. There was no evidence that younger participants reported more difficulties in childhood than those who were older, and no evidence of clustering of loss events involving the death of first degree relatives according to their recency. However, there was evidence of recall bias for events not involving loss with increased event rates observed in the few years immediately prior to questionnaire completion. Women reported similar events as more upsetting, and that they took longer to get over their effects, than men. Difficulties experienced in childhood, life events and difficulties in adulthood, event impact and adaptation were all associated with worse physical functional health. Reported slow adaptation to the effects of life events was associated with the largest decrement in physical functional health. These findings strengthen the rationale for including a collection of comprehensive social adversity data within chronic disease epidemiological settings and offer promise for aiding understanding of individual differences

  8. 2. Chernobyl's public health consequences.

    PubMed

    Yablokov, Alexey V

    2009-11-01

    Problems complicating a full assessment of the effects from Chernobyl included official secrecy and falsification of medical records by the USSR for the first 3.5 years after the catastrophe and the lack of reliable medical statistics in Ukraine, Belarus, and Russia. Official data concerning the thousands of cleanup workers (Chernobyl liquidators) who worked to control the emissions are especially difficult to reconstruct. Using criteria demanded by the International Atomic Energy Agency (IAEA), the World Health Organization (WHO), and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) resulted in marked underestimates of the number of fatalities and the extent and degree of sickness among those exposed to radioactive fallout from Chernobyl. Data on exposures were absent or grossly inadequate, while mounting indications of adverse effects became more and more apparent. Using objective information collected by scientists in the affected areas--comparisons of morbidity and mortality in territories characterized by identical physiography, demography, and economy, which differed only in the levels and spectra of radioactive contamination--revealed significant abnormalities associated with irradiation, unrelated to age or sex (e.g., stable chromosomal aberrations), as well as other genetic and nongenetic pathologies.

  9. Consequences of Post-Weaning Social Isolation on Anxiety Behavior and Related Neural Circuits in Rodents

    PubMed Central

    Lukkes, Jodi L.; Watt, Michael J.; Lowry, Christopher A.; Forster, Gina L.

    2009-01-01

    Exposure to adverse experiences in early-life is implicated in the later vulnerability to development of psychiatric disorders, including anxiety and affective disorders in humans. Adverse early-life experiences likely impart their long-term consequences on mental health by disrupting the normal development of neural systems involved in stress responses, emotional behavior and emotional states. Neural systems utilizing the neurotransmitters serotonin, dopamine and the neuropeptide corticotropin-releasing factor (CRF) are implicated in mediating emotive behaviors, and dysfunction of these neurochemical systems is associated with mood/anxiety disorders. These neural systems continue maturing until early or mid-adolescence in humans, thus alterations to their development are likely to contribute to the long-term consequences of adverse early-life experiences. A large body of literature suggests that post-weaning isolation rearing of rodents models the behavioral consequences of adverse early-life experiences in humans. Overall, the majority findings suggest that post-weaning social isolation that encompasses pre-adolescence produces long-lasting alterations to anxiety behavior, while measures of monoaminergic activity in various limbic regions during social isolation suggest alterations to dopamine and serotonin systems. The goal of this review is to evaluate and integrate findings from post-weaning social isolation studies specifically related to altered fear and anxiety behaviors and associated changes in neuroendocrine function and the activity of monoaminergic systems. PMID:19738931

  10. Insomnia causes, consequences, and therapeutics: an overview.

    PubMed

    Drake, Christopher L; Roehrs, Timothy; Roth, Thomas

    2003-01-01

    There is growing interest in insomnia both from the perspective of recent advances in clinical management as well as research aimed at elucidating its pathophysiology. This theoretical overview of insomnia describes the negative impact, etiological considerations, and pharmacological and behavioral treatments for the disorder, with an emphasis on areas receiving increased research attention. Insomnia, the most prevalent sleep disorder, affects 10-15% of the general population. In population-based studies severe insomnia has been shown to last for a median of 4 years. In addition, insomnia has a significant negative impact on an individual's work, physical, and social performance as well as overall quality of life. Furthermore, the economic cost of insomnia related to lost productivity, work-related accidents, absenteeism, and health-care costs are enormous. There is increasing evidence linking the precipitation of insomnia to stress, and converging evidence from cognitive, endocrine, neurological, and behavioral domains provide clear evidence for hyper-arousal in insomnia. However, there remains no consensus regarding the specific etiological mechanisms of this disorder. Although the pathophysiology of primary insomnia remains an enigma, numerous treatments both pharmacological and behavioral have been developed and found to be efficacious in controlled studies. Despite the wide availability of pharmacological treatments and increased knowledge of behavioral interventions, the vast majority of individuals with insomnia do not appear to be receiving adequate treatment. The inadequate treatment of insomnia leads to several important and under-recognized consequences including subsequent development of psychiatric disease and increased substance use.

  11. Anticipating the unintended consequences of security dynamics.

    SciTech Connect

    Backus, George A.; Overfelt, James Robert; Malczynski, Leonard A.; Saltiel, David H.; Simon Paul Moulton

    2010-01-01

    In a globalized world, dramatic changes within any one nation causes ripple or even tsunamic effects within neighbor nations and nations geographically far removed. Multinational interventions to prevent or mitigate detrimental changes can easily cause secondary unintended consequences more detrimental and enduring than the feared change instigating the intervention. This LDRD research developed the foundations for a flexible geopolitical and socioeconomic simulation capability that focuses on the dynamic national security implications of natural and man-made trauma for a nation-state and the states linked to it through trade or treaty. The model developed contains a database for simulating all 229 recognized nation-states and sovereignties with the detail of 30 economic sectors including consumers and natural resources. The model explicitly simulates the interactions among the countries and their governments. Decisions among governments and populations is based on expectation formation. In the simulation model, failed expectations are used as a key metric for tension across states, among ethnic groups, and between population factions. This document provides the foundational documentation for the model.

  12. Adverse Events Associated with Prolonged Antibiotic Use

    PubMed Central

    Meropol, Sharon B.; Chan, K. Arnold; Chen, Zhen; Finkelstein, Jonathan A.; Hennessy, Sean; Lautenbach, Ebbing; Platt, Richard; Schech, Stephanie D.; Shatin, Deborah; Metlay, Joshua P.

    2014-01-01

    Purpose The Infectious Diseases Society of America and US CDC recommend 60 days of ciprofloxacin, doxycycline or amoxicillin for anthrax prophylaxis. It is not possible to determine severe adverse drug event (ADE) risks from the few people thus far exposed to anthrax prophylaxis. This study’s objective was to estimate risks of severe ADEs associated with long-term ciprofloxacin, doxycycline and amoxicillin exposure using 3 large databases: one electronic medical record (General Practice Research Database) and two claims databases (UnitedHealthcare, HMO Research Network). Methods We include office visit, hospital admission and prescription data for 1/1/1999–6/30/2001. Exposure variable was oral antibiotic person-days (pds). Primary outcome was hospitalization during exposure with ADE diagnoses: anaphylaxis, phototoxicity, hepatotoxicity, nephrotoxicity, seizures, ventricular arrhythmia or infectious colitis. Results We randomly sampled 999,773, 1,047,496 and 1,819,004 patients from Databases A, B and C respectively. 33,183 amoxicillin, 15,250 ciprofloxacin and 50,171 doxycycline prescriptions continued ≥30 days. ADE hospitalizations during long-term exposure were not observed in Database A. ADEs during long-term amoxicillin were seen only in Database C with 5 ADEs or 1.2(0.4–2.7) ADEs/100,000 pds exposure. Long-term ciprofloxacin showed 3 and 4 ADEs with 5.7(1.2–16.6) and 3.5(1.0–9.0) ADEs/100,000 pds in Databases B and C, respectively. Only Database B had ADEs during long-term doxycycline with 3 ADEs or 0.9(0.2–2.6) ADEs/100,000 pds. For most events, the incidence rate ratio, comparing >28 vs.1–28 pds exposure was <1, showing limited evidence for cumulative dose-related ADEs from long-term exposure. Conclusions Long-term amoxicillin, ciprofloxacin and doxycycline appears safe, supporting use of these medications if needed for large-scale post-exposure anthrax prophylaxis. PMID:18215001

  13. Socioeconomic variation in the financial consequences of ill health for older people with chronic diseases: a systematic review.

    PubMed

    Valtorta, Nicole K; Hanratty, Barbara

    2013-04-01

    Chronic disease has financial consequences for older adults, but it is unclear how this varies between conditions with different disease trajectories. The aim of this study was to review evidence on the financial burden associated with cancer, heart failure or stroke in older people, to identify those most at risk of financial adversity. We systematically searched nine databases for studies with data on the illness-related financial burden (objective), or on the perception of financial hardship (subjective), of older patients and/or their informal caregivers in high-income countries. We identified thirty-eight papers published in English between 1984 and 2012. Studies fell into three categories: those reporting direct, out of pocket, costs (medical and/or non-medical); studies of the indirect costs associated with illness (such as wage or income loss); and papers reporting general financial or economic burdens secondary to illness. Three out of four studies focused on people with cancer. More affluent people had greater out of pocket costs, but were less financially burdened by illness, compared with older adults from lower socioeconomic backgrounds. Disadvantaged patients and families were more likely to report experiences of financial hardship, and spend a higher proportion of their income on all expenses related to their diagnoses. This review illustrates how little is known about the financial adversity experienced by patients with some common chronic conditions. It raises the possibility that higher expenditure by more affluent older people may be creating inequalities in how chronic illness is experienced. The development of effective strategies for financial protection at older ages will require more information on who is affected and at which point in their illness trajectory.

  14. Interpersonal consequences of social anxiety.

    PubMed

    Heerey, Erin A; Kring, Ann M

    2007-02-01

    The behavioral manifestations of social anxiety may have implications for social outcomes. Unfortunately, little is known about how anxiety shapes social interaction. The present study examined social interactions in dyads consisting of either 2 nonsocially anxious (NSA) individuals or 1 socially anxious (SA) and 1 NSA individual. Behavior, self-reported affect, and perceptions were examined. In comparison with the interactions of NSA pairs, high levels of fidgeting, poor reciprocity of smiling behavior, more self-talk, and more frequent reassurance seeking and giving characterized interactions between SA and NSA participants. Both SA participants and their NSA partners rated their interactions as being less smooth and coordinated than did participants in NSA-NSA dyads. In addition, SA participants' reassurance seeking and self-talk correlated negatively with partner positive affect and perceptions of interaction quality. The authors discuss self-focused attention and the interpersonal consequences of social anxiety.

  15. Hydrological consequences of global warming

    SciTech Connect

    Miller, Norman L.

    2009-06-01

    The 2007 Intergovernmental Panel for Climate Change indicates there is strong evidence that the atmospheric concentration of carbon dioxide far exceeds the natural range over the last 650,000 years, and this recent warming of the climate system is unequivocal, resulting in more frequent extreme precipitation events, earlier snowmelt runoff, increased winter flood likelihoods, increased and widespread melting of snow and ice, longer and more widespread droughts, and rising sea level. The effects of recent warming has been well documented and climate model projections indicate a range of hydrological impacts with likely to very likely probabilities (67 to 99 percent) of occurring with significant to severe consequences in response to a warmer lower atmosphere with an accelerating hydrologic cycle.

  16. Lipaemia: causes, consequences and solutions.

    PubMed

    Walker, P L; Crook, M A

    2013-03-15

    The detection of lipaemia in a patient blood sample can be a clinical conundrum as well as an analytical nuisance. With a reported prevalence of 0.7% in all blood samples received for lipid studies its finding has been suggested to be an underappreciated problem [1]. Its presence can have a significant impact on the validity of a number of routine blood tests. The intention of this report is to outline the causes of lipaemia, the clinical and analytical consequences of its presence and some of the tools the laboratory employ to reduce its effects. Both laboratory professionals and clinicians should have an appreciation of the analytical and clinical impact lipaemia may confer on routine biochemistry.

  17. Neurobiological consequences of sleep deprivation.

    PubMed

    Alkadhi, Karim; Zagaar, Munder; Alhaider, Ibrahim; Salim, Samina; Aleisa, Abdulaziz

    2013-05-01

    Although the physiological function of sleep is not completely understood, it is well documented that it contributes significantly to the process of learning and memory. Ample evidence suggests that adequate sleep is essential for fostering connections among neuronal networks for memory consolidation in the hippocampus. Sleep deprivation studies are extremely valuable in understanding why we sleep and what are the consequences of sleep loss. Experimental sleep deprivation in animals allows us to gain insight into the mechanism of sleep at levels not possible to study in human subjects. Many useful approaches have been utilized to evaluate the effect of sleep loss on cognitive function, each with relative advantages and disadvantages. In this review we discuss sleep and the detrimental effects of sleep deprivation mostly in experimental animals. The negative effects of sleep deprivation on various aspects of brain function including learning and memory, synaptic plasticity and the state of cognition-related signaling molecules are discussed.

  18. Neurobiological Consequences of Sleep Deprivation

    PubMed Central

    Alkadhi, Karim; Zagaar, Munder; Alhaider, Ibrahim; Salim, Samina; Aleisa, Abdulaziz

    2013-01-01

    Although the physiological function of sleep is not completely understood, it is well documented that it contributes significantly to the process of learning and memory. Ample evidence suggests that adequate sleep is essential for fostering connections among neuronal networks for memory consolidation in the hippocampus. Sleep deprivation studies are extremely valuable in understanding why we sleep and what are the consequences of sleep loss. Experimental sleep deprivation in animals allows us to gain insight into the mechanism of sleep at levels not possible to study in human subjects. Many useful approaches have been utilized to evaluate the effect of sleep loss on cognitive function, each with relative advantages and disadvantages. In this review we discuss sleep and the detrimental effects of sleep deprivation mostly in experimental animals. The negative effects of sleep deprivation on various aspects of brain function including learning and memory, synaptic plasticity and the state of cognition-related signaling molecules are discussed. PMID:24179461

  19. [Cardiovascular consequences of aerobic maneuvers].

    PubMed

    Trivelloni, Pierandrea; Berrettini, Umberto

    2010-10-01

    Gravitational (G) stress during aerobatics flights, both military and civilian, can suddenly incapacitate pilots in agile and supermaneuverable aircrafts. High +Gz stress, up to +9Gz, has two different physiological consequences: the first is the drop in head-level blood pressure that is proportional to the G load; the other, slightly delayed, is the blood pooling in the lower part of the body and the abdomen. This blood shift results in a decreased return of venous blood to the heart, decreased cardiac output, and decreased blood pressure, leading to a likely loss of consciousness. The natural countermeasure against the effects of high G stress is the baroreceptor reflex. The human physiological tolerance to the gravito-inertial forces developed in flight operations can be increased by physiological and technological means.

  20. Adverse events among Ontario home care clients associated with emergency room visit or hospitalization: a retrospective cohort study

    PubMed Central

    2013-01-01

    Background Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their related outcomes. The study reports on the incidence of HC adverse events, the magnitude of the events, the types of events that occur, and the consequences experienced by HC clients in the province of Ontario. Methods A retrospective cohort design was used, utilizing comprehensive secondary databases available for Ontario HC clients from the years 2008 and 2009. The data were derived from the Canadian Home Care Reporting System, the Hospital Discharge Abstract Database, the National Ambulatory Care Reporting System, the Ontario Mental Health Reporting System, and the Continuing Care Reporting System. Descriptive analysis was used to identify the type and frequency of the adverse events recorded and the consequences of the events. Logistic regression analysis was used to examine the association between the events and their consequences. Results The study found that the incident rate for adverse events for the HC clients included in the cohort was 13%. The most frequent adverse events identified in the databases were injurious falls, injuries from other than a fall, and medication-related incidents. With respect to outcomes, we determined that an injurious fall was associated with a significant increase in the odds of a client requiring long-term-care facility admission and of client death. We further determined that three types of events, delirium, sepsis, and medication-related incidents were associated directly with an increase in the odds of client death. Conclusions Our study concludes that 13% of clients in homecare experience an adverse event annually. We also determined that an injurious fall was the most