Science.gov

Sample records for adverse health consequences

  1. 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.

  2. 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.

  3. New Unintended Adverse Consequences of Electronic Health Records.

    PubMed

    Sittig, D F; Wright, A; Ash, J; Singh, H

    2016-11-10

    Although the health information technology industry has made considerable progress in the design, development, implementation, and use of electronic health records (EHRs), the lofty expectations of the early pioneers have not been met. In 2006, the Provider Order Entry Team at Oregon Health & Science University described a set of unintended adverse consequences (UACs), or unpredictable, emergent problems associated with computer-based provider order entry implementation, use, and maintenance. Many of these originally identified UACs have not been completely addressed or alleviated, some have evolved over time, and some new ones have emerged as EHRs became more widely available. The rapid increase in the adoption of EHRs, coupled with the changes in the types and attitudes of clinical users, has led to several new UACs, specifically: complete clinical information unavailable at the point of care; lack of innovations to improve system usability leading to frustrating user experiences; inadvertent disclosure of large amounts of patient-specific information; increased focus on computer-based quality measurement negatively affecting clinical workflows and patient-provider interactions; information overload from marginally useful computer-generated data; and a decline in the development and use of internally-developed EHRs. While each of these new UACs poses significant challenges to EHR developers and users alike, they also offer many opportunities. The challenge for clinical informatics researchers is to continue to refine our current systems while exploring new methods of overcoming these challenges and developing innovations to improve EHR interoperability, usability, security, functionality, clinical quality measurement, and information summarization and display.

  4. 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

  5. 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

  6. Adverse consequences of unintended pregnancy for maternal and child health in Nepal.

    PubMed

    Singh, Abhishek; Singh, Ashish; Thapa, Shyam

    2015-03-01

    In Nepal, 26%-38% of recent births are estimated to be from unintended pregnancies, but little is known whether these pregnancies have adverse consequences for the health of the mother and child. Data from the 2011 Nepal Demographic and Health Survey are used to examine the hypothesis that unintended pregnancies are associated with negative health outcomes for both mothers and children. When the pregnancy was unintended (compared with when it was intended) mothers were more likely to receive inadequate prenatal care (odds ratio OR = 1.50; 95% confidence interval [CI] = 1.28-1.77). They were also more likely to opt for home births (OR = 1.30; 95% CI = 1.11-1.52). Likewise, the resultant newborns of unintended pregnancies were more likely to receive inadequate immunization (OR = 1.18; 95% CI = 1.00-1.40) and to remain stunted (OR = 1.25; 95% CI = 1.00-1.56). Findings suggest significant associations between unintended pregnancy and negative health outcomes for both mothers and children in Nepal.

  7. Capitalizing on Advances in Science to Reduce the Health Consequences of Early Childhood Adversity.

    PubMed

    Shonkoff, Jack P

    2016-10-01

    Advances in biology are providing deeper insights into how early experiences are built into the body with lasting effects on learning, behavior, and health. Numerous evaluations of interventions for young children facing adversity have demonstrated multiple, positive effects but they have been highly variable and difficult to sustain or scale. New research on plasticity and critical periods in development, increasing understanding of how gene-environment interaction affects variation in stress susceptibility and resilience, and the emerging availability of measures of toxic stress effects that are sensitive to intervention provide much-needed fuel for science-informed innovation in the early childhood arena. This growing knowledge base suggests 4 shifts in thinking about policy and practice: (1) early experiences affect lifelong health, not just learning; (2) healthy brain development requires protection from toxic stress, not just enrichment; (3) achieving breakthrough outcomes for young children facing adversity requires supporting the adults who care for them to transform their own lives; and (4) more effective interventions are needed in the prenatal period and first 3 years after birth for the most disadvantaged children and families. The time has come to leverage 21st-century science to catalyze the design, testing, and scaling of more powerful approaches for reducing lifelong disease by mitigating the effects of early adversity.

  8. 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

  9. 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

  10. Unintended adverse consequences of electronic health record introduction to a mature universal HIV screening program.

    PubMed

    Medford-Davis, Laura N; Yang, Katharine; Pasalar, Siavash; Pillow, M Tyson; Miertschin, Nancy P; Peacock, William F; Giordano, Thomas P; Hoxhaj, Shkelzen

    2016-01-01

    Early HIV detection and treatment decreases morbidity and mortality and reduces high-risk behaviors. Many Emergency Departments (EDs) have HIV screening programs as recommended by the Centers for Disease Control and Prevention. Recent federal legislation includes incentives for electronic health record (EHR) adoption. Our objective was to analyze the impact of conversion to EHR on a mature ED-based HIV screening program. A retrospective pre- and post-EHR implementation cohort study was conducted in a large urban, academic ED. Medical records were reviewed for HIV screening rates from August 2008 through October 2013. On 1 November 2010, a comprehensive EHR system was implemented throughout the hospital. Before EHR implementation, labs were requested by providers by paper orders with HIV-1/2 automatically pre-selected on every form. This universal ordering protocol was not duplicated in the new EHR; rather it required a provider to manually enter the order. Using a chi-squared test, we compared HIV testing in the 6 months before and after EHR implementation; 55,054 patients presented before, and 50,576 after EHR implementation. Age, sex, race, acuity of presenting condition, and HIV seropositivity rates were similar pre- and post-EHR, and there were no major patient or provider changes during this period. Average HIV testing rate was 37.7% of all ED patients pre-, and 22.3% post-EHR, a 41% decline (p < 0.0001), leading to 167 missed new diagnoses after EHR. The rate of HIV screening in the ED decreased after EHR implementation, and could have been improved with more thoughtful inclusion of existing human processes in its design.

  11. [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.

  12. 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

  13. The health and social consequences of adverse childhood experiences (ACE) across the lifespan: an introduction to prevention and intervention in the community.

    PubMed

    Larkin, Heather; Shields, Joseph J; Anda, Robert F

    2012-01-01

    This introduction to the themed issue overviews of the Adverse Childhood Experiences (ACE) Study and discusses prevention and intervention with ACE and their consequences in communities. A commentary by Dr. Robert Anda, an ACE Study Co-Principal Investigator, is incorporated within this introduction. Implications of articles within the issue are addressed, and next steps are explored.

  14. The Public Health Burden of Early Adversity

    ERIC Educational Resources Information Center

    Schlueter, Lisa J.; Watamura, Sarah Enos

    2017-01-01

    Severe and chronic stress in early childhood has enormous physical and mental health costs across an individual's lifespan. Unfortunately, exposure to early life adversity is common, and costs accrue to individuals and society. This article highlights several promising approaches to buffer children from the negative health consequences associated…

  15. [Health consequence of stalking victimization].

    PubMed

    Will, R; Hintz, E; Blättner, B

    2012-05-01

    Life time prevalence of stalking is about 12-20%, while females are more often affected than male. Stalking is a statutory offense. However, it is not an assault of victims' law. For the purpose of health consequences for stalking victims, research in following database were conducted: EMBASE, CINAHL, MEDLINE, PsycINFO and Social Science Index. English and German published studies of the years 2002-2010 were included. 17 primary studies and 2 meta-analyses were identified. Direct physiological consequences are relatively rare; however stalking victims report a poorer physiological health status. Almost every second stalking victim shows impairments on his/her psychical well-being. Impairments of social well-being are common, too. As a result, there is still a lot of research, especially in long-term studies, required. Socio-legal reassessment of stalking will probably benefit only a few of the affected people.

  16. Early life adversity: Lasting consequences for emotional learning.

    PubMed

    Krugers, Harm J; Arp, J Marit; Xiong, Hui; Kanatsou, Sofia; Lesuis, Sylvie L; Korosi, Aniko; Joels, Marian; Lucassen, Paul J

    2017-02-01

    The early postnatal period is a highly sensitive time period for the developing brain, both in humans and rodents. During this time window, exposure to adverse experiences can lastingly impact cognitive and emotional development. In this review, we briefly discuss human and rodent studies investigating how exposure to adverse early life conditions - mainly related to quality of parental care - affects brain activity, brain structure, cognition and emotional responses later in life. We discuss the evidence that early life adversity hampers later hippocampal and prefrontal cortex functions, while increasing amygdala activity, and the sensitivity to stressors and emotional behavior later in life. Exposure to early life stress may thus on the one hand promote behavioral adaptation to potentially threatening conditions later in life -at the cost of contextual memory formation in less threatening situations- but may on the other hand also increase the sensitivity to develop stress-related and anxiety disorders in vulnerable individuals.

  17. Hypogonadism secondary to hyperprolactinaemia: successful treatment but adverse consequences.

    PubMed

    Narayanan, R P; Bujawansa, S; Qureshi, Z; Rimmer, M; Heald, A

    2012-05-01

    It is accepted that care must be taken in initiating testosterone replacement in hypogonadal individuals with historically low androgen levels. However less is reported about the influence of restoration of normal endogenous testosterone production on behaviour.Here we report how the adverse sequelae of successful treatment of hypogonadism secondary to hyperprolactinaemia, manifesting as irritability and low threshold to aggression, were managed through a joint approach between psychiatrist and physician.

  18. 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

  19. 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.

  20. 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.

  1. Amphotericin B nephrotoxicity: the adverse consequences of altered membrane properties.

    PubMed

    Sawaya, B P; Briggs, J P; Schnermann, J

    1995-08-01

    Amphotericin B (AmB) has been in clinical use for more than 30 yr but has remained the most effective drug for treatment of serious fungal infections. Its use has increased in recent years, as the result of increases in aggressive intensive care support and increased numbers of immunocompromised patients. Nephrotoxic manifestations are common, and this is the major factor limiting the clinical use of the drug. A number of recent studies have contributed to a better understanding of the mechanism by which AmB exerts its nephrotoxic effect. AmB alters cell membrane permeability and probably as a consequence alters tubular and vascular smooth muscle cell function, leading to various tubular transport defects and vasoconstriction. Decreased RBF appears to play a major role in AmB-induced reduction GFR, and recurrent ischemia may be the basis of permanent structural nephrotoxic effects. Salt loading is the only measure proven by controlled prospective study to ameliorate AmB nephrotoxicity in humans. Liposomal AmB and the formulation of an emulsion of AmB in lipid may provide a protective effect based on altering the affinity of AmB for mammalian cell membranes, while preserving high efficacy against fungal cells. However, further studies are needed to evaluate the efficacy and safety of these new AmB formulations.

  2. Adverse consequences of student drinking: the role of sex, social anxiety, drinking motives.

    PubMed

    Norberg, Melissa M; Olivier, Jake; Alperstein, Dion M; Zvolensky, Michael J; Norton, Alice R

    2011-08-01

    This study examined whether biological sex, social anxiety, and drinking motives relate differently to distinct types of alcohol-related consequences using Poisson regression. One hundred eighteen college students completed self-report measures assessing drinking motives and social anxiety and an interview assessing alcohol consumption and consequences. Highly socially anxious women were particularly apt to experience adverse role functioning consequences, while men were particularly apt to experience physical consequences. Although highly socially anxious women reported more personal consequences than did women with low to moderate social anxiety, men with low to moderate social anxiety reported experiencing more social and personal consequences than did women with low to moderate social anxiety. When taking into consideration the above associations, coping motives were statistically associated with social consequences and marginally related to personal consequences, while enhancement motives were significantly associated with physical consequences. Targeting these factors may lead to effective interventions for individuals with co-occurring social anxiety and drinking problems.

  3. HEALTH CONSEQUENCES OF DIOXIN EXPOSURE

    EPA Science Inventory

    Abstract TCDD is often called the most toxic man-made chemical because of its potency to cause health effects in a wide variety of vertebrates. Structurally related persistent compounds, known as 'dioxins', have the same plethora of responses. Dioxins have effects in mu...

  4. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 29 2013-07-01 2013-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  5. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 28 2011-07-01 2011-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  6. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 29 2012-07-01 2012-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  7. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 28 2014-07-01 2014-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  8. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  9. 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.

  10. Intimate Partner Violence, PTSD, and Adverse Health Outcomes

    ERIC Educational Resources Information Center

    Dutton, Mary Ann; Green, Bonnie L.; Kaltman, Stacey I.; Roesch, Darren M.; Zeffiro, Thomas A.; Krause, Elizabeth D.

    2006-01-01

    The high prevalence of adverse health outcomes related to intimate partner violence (IPV) is well documented. Yet we know little about the pathways that lead to adverse health outcomes. Research concerning the psychological, biological, neurological, behavioral, and physiological alterations following exposure to IPV--many of which are associated…

  11. Adverse childhood experiences and health anxiety in adulthood.

    PubMed

    Reiser, Sarah J; McMillan, Katherine A; Wright, Kristi D; Asmundson, Gordon J G

    2014-03-01

    Childhood experiences are thought to predispose a person to the development of health anxiety later in life. However, there is a lack of research investigating the influence of specific adverse experiences (e.g., childhood abuse, household dysfunction) on this condition. The current study examined the cumulative influence of multiple types of childhood adversities on health anxiety in adulthood. Adults 18-59 years of age (N=264) completed a battery of measures to assess adverse childhood experiences, health anxiety, and associated constructs (i.e., negative affect and trait anxiety). Significant associations were observed between adverse childhood experiences, health anxiety, and associated constructs. Hierarchical multiple regression analysis indicted that adverse childhood experiences were predictive of health anxiety in adulthood; however, the unique contribution of these experience were no longer significant following the inclusion of the other variables of interest. Subsequently, mediation analyses indicated that both negative affect and trait anxiety independently mediated the relationship between adverse childhood experiences and health anxiety in adulthood. Increased exposure to adverse childhood experiences is associated with higher levels of health anxiety in adulthood; this relationship is mediated through negative affect and trait anxiety. Findings support the long-term negative impact of cumulative adverse childhood experiences and emphasize the importance of addressing negative affect and trait anxiety in efforts to prevent and treat health anxiety.

  12. 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…

  13. Text mining electronic health records to identify hospital adverse events.

    PubMed

    Gerdes, Lars Ulrik; Hardahl, Christian

    2013-01-01

    Manual reviews of health records to identify possible adverse events are time consuming. We are developing a method based on natural language processing to quickly search electronic health records for common triggers and adverse events. Our results agree fairly well with those obtained using manual reviews, and we therefore believe that it is possible to develop automatic tools for monitoring aspects of patient safety.

  14. Increases in Wheelchair Breakdowns, Repairs, and Adverse Consequences for People with Traumatic Spinal Cord Injury

    PubMed Central

    Worobey, Lynn; Oyster, Michelle; Nemunaitis, Gregory; Cooper, Rory; Boninger, Michael L.

    2016-01-01

    Objective The aims of this study were to report the current incidence of wheelchair breakdowns, repairs, and consequences and to compare current data with historical data. Design A convenience sample survey of 723 participants with spinal cord injury who use a wheelchair for more than 40 hrs/wk treated at a Spinal Cord Injury Model Systems center was conducted. Results Significant increases were found in the number of participants reporting repairs (7.8%) and adverse consequences (23.5%) in a 6-mo period (2006Y2011) compared with historical data (2004Y2006) (P G 0.001). When examining current data, minorities experienced a greater frequency and higher number of reported consequences (P = 0.03). Power wheelchair users reported a higher number of repairs and consequences than did manual wheelchair users (P G 0.001). Wheelchairs equipped with seat functions were associated with a greater frequency of adverse consequences (P = 0.01). Repairs did not vary across funding source, but individuals with wheelchairs provided by Medicare and Medicaid reported a higher frequency of consequences than did the combined group of the Department of Vocational Rehabilitation, Worker’s Compensation, and the Veterans Administration (P = 0.034 and P = 0.013, respectively). Conclusions The incidence and consequences of repairs are increasing from what was already a very high statistic in this United States population. Further investigation into causality is required, and intervention is needed to reverse this potential trend. PMID:22549473

  15. Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter?

    PubMed Central

    Friedman, Esther M.; Montez, Jennifer Karas; Sheehan, Connor McDevitt; Guenewald, Tara L.; Seeman, Teresa E.

    2015-01-01

    Objective Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. Method We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health. Results The best-fitting specification of quantity of events was a linear measure reflecting a dose–response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women’s risk of heart disease. Discussion Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures. PMID:25903978

  16. [Climate changes, floods, and health consequences].

    PubMed

    Michelozzi, Paola; de' Donato, Francesca

    2014-02-01

    In the European Region, floods are the most common natural disaster, causing extensive damage and disruption. In Italy, it has been estimated that over 68% of municipalities are at high hydrogeological risk and with the recent intense rainfall events local populations have been facing severe disruptions. The health consequences of floods are wide ranging and are dependent upon the vulnerability of the environment and the local population. Health effects can be a direct or indirect consequence of flooding. The immediate health impacts of floods include drowning, heart attacks, injuries and hypothermia. The indirect effects include, injuries and infections, water-borne infectious disease, mental health problems, respiratory disease and allergies in both the medium and long term after a flood. Future efforts should be addressed to integrate health preparedness and prevention measures into emergency flood plans and hydrological warning systems.

  17. [Health consequences of the Chernobyl accident].

    PubMed

    Sewerin, I

    2001-10-22

    The Chernobyl accident in 1986 has been and still is the subject of great interest. Journalistic reports often contain exaggerations and undocumented statements and much uncertainty about the true consequences of the accident prevails in the population. This article reviews the current literature with the focus on reports from official commissions and documentation in the form of controlled studies. The fatal deterministic consequences comprise about 30 victims. The most important outcome is a marked increase in the incidence of thyroid cancer in children and adolescents in the most heavily contaminated area. Furthermore, pronounced psychosocial problems are dominant in the population of the contaminated area. Other significant and documented health consequences are not seen.

  18. Health consequences of sexual violence against women.

    PubMed

    Jina, Ruxana; Thomas, Leena S

    2013-02-01

    Sexual violence can lead to a multitude of health consequences, including physical, reproductive and psychological. Some may be fatal, whereas others, such as unhealthy behaviours, may occur indirectly as a result of the violence. In total, these result in a significant health burden and should be considered by service providers, government authorities and non-governmental agencies. For women who present early, immediate care should be provided with plans for follow up. Mental-health interventions are important, as women who are sexually assaulted have the highest burden of post-traumatic stress disorder. Cognitive- behavioural therapy has been found to be effective for preventing and treating post-traumatic stress disorder, but psychological debriefing for preventing post-traumatic stress disorder is not recommended. Implementing a routine screening and intervention programme in obstetrics and gynaecology departments may be valuable, as reproductive health consequences are common.

  19. Adverse effects of public health interventions: a conceptual framework.

    PubMed

    Lorenc, Theo; Oliver, Kathryn

    2014-03-01

    Public health interventions may have a range of adverse effects. However, there is limited guidance as to how evaluations should address the possibility of adverse effects. This discussion paper briefly presents a framework for thinking about the potential harms of public health interventions, focusing on the following categories: direct harms; psychological harms; equity harms; group and social harms; and opportunity harms. We conclude that the possibility of adverse effects needs to be taken into account by those implementing and evaluating interventions, and requires a broad perspective on the potential impacts of public health strategies.

  20. Overdependence on technology: an unintended adverse consequence of computerized provider order entry.

    PubMed

    Campbell, Emily M; Sittig, Dean F; Guappone, Kenneth P; Dykstra, Richard H; Ash, Joan S

    2007-10-11

    Computerized provider order entry (CPOE) and other clinical information systems can help reduce medical errors, promote practice standardization, and improve the quality of patient care. However, implementing these systems can result in unintended adverse consequences. Our multidisciplinary team used qualitative methods to gather and analyze data describing unintended adverse consequences related to CPOE adoption and use. Overdependence on technology emerged as one of nine major types we identified. Careful analysis of these data revealed three themes: 1) system downtime can create chaos when there are insufficient backup systems in place, 2) users have false expectations regarding data accuracy and processing, and 3) some clinicians cannot work efficiently without computerized systems. We provide recommendations for mitigating these important issues.

  1. Overdependence on Technology: An Unintended Adverse Consequence of Computerized Provider Order Entry

    PubMed Central

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

    Computerized provider order entry(CPOE) and other clinical information systems can help reduce medical errors, promote practice standardization, and improve the quality of patient care. However, implementing these systems can result in unintended adverse consequences. Our multidisciplinary team used qualitative methods to gather and analyze data describing unintended adverse consequences related to CPOE adoption and use. Overdependence on technology emerged as one of nine major types we identified. Careful analysis of these data revealed three themes: 1) system downtime can create chaos when there are insufficient backup systems in place, 2) users have false expectations regarding data accuracy and processing, and 3) some clinicians cannot work efficiently without computerized systems. We provide recommendations for mitigating these important issues. PMID:18693805

  2. Adverse health effects of non-medical cannabis use.

    PubMed

    Hall, Wayne; Degenhardt, Louisa

    2009-10-17

    For over two decades, cannabis, commonly known as marijuana, has been the most widely used illicit drug by young people in high-income countries, and has recently become popular on a global scale. Epidemiological research during the past 10 years suggests that regular use of cannabis during adolescence and into adulthood can have adverse effects. Epidemiological, clinical, and laboratory studies have established an association between cannabis use and adverse outcomes. We focus on adverse health effects of greatest potential public health interest-that is, those that are most likely to occur and to affect a large number of cannabis users. The most probable adverse effects include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health.

  3. 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.

  4. 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

  5. Measuring errors and adverse events in health care.

    PubMed

    Thomas, Eric J; Petersen, Laura A

    2003-01-01

    In this paper, we identify 8 methods used to measure errors and adverse events in health care and discuss their strengths and weaknesses. We focus on the reliability and validity of each, as well as the ability to detect latent errors (or system errors) versus active errors and adverse events. We propose a general framework to help health care providers, researchers, and administrators choose the most appropriate methods to meet their patient safety measurement goals.

  6. 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

  7. Potential adverse health effects of wood smoke

    SciTech Connect

    Pierson, W.E.; Koenig, J.Q.; Bardana, E.J. Jr.

    1989-09-01

    The use of wood stoves has increased greatly in the past decade, causing concern in many communities about the health effects of wood smoke. Wood smoke is known to contain such compounds as carbon monoxide, nitrogen oxides, sulfur oxides, aldehydes, polycyclic aromatic hydrocarbons, and fine respirable particulate matter. All of these have been shown to cause deleterious physiologic responses in laboratory studies in humans. Some compounds found in wood smoke--benzo(a)pyrene and formaldehyde--are possible human carcinogens. Fine particulate matter has been associated with decreased pulmonary function in children and with increased chronic lung disease in Nepal, where exposure to very high amounts of wood smoke occurs in residences. Wood smoke fumes, taken from both outdoor and indoor samples, have shown mutagenic activity in short-term bioassay tests. Because of the potential health effects of wood smoke, exposure to this source of air pollution should be minimal.29 references.

  8. Phentermine/topiramate for weight reduction and treatment of adverse metabolic consequences in obesity.

    PubMed

    Bays, H E; Gadde, K M

    2011-12-01

    Phentermine hydrochloride is a noradrenergic sympathetic amine approved for decades by the U.S. Food and Drug Administration (FDA) at doses as high as 37.5 mg/day for the short-term treatment of obesity. Topiramate is a sulfamate-substituted monosaccharide marketed since 1996, and approved by the FDA for seizure disorders at doses up to 400 mg/day and for the prevention of migraine headaches at doses up to 100 mg/day. Clinical trial data suggest topiramate promotes weight loss. The prescribing information of neither agent describes adverse drug interactions with the other. The controlled-release formulation of phentermine and topiramate at low, medium and full doses (with full dose containing 15 mg of phentermine hydrochloride and 92 mg of topiramate) promotes weight reduction, with clinical trial data supporting improvement in adiposopathic consequences leading to metabolic diseases. Reported adverse events with this combination agent are as expected, based upon knowledge of the individual components.

  9. Effects of Alcohol-Induced Working Memory Decline on Alcohol Consumption and Adverse Consequences of Use

    PubMed Central

    Lechner, William V.; Day, Anne M.; Metrik, Jane; Leventhal, Adam M.; Kahler, Christopher W.

    2015-01-01

    Rationale Alcohol use appears to decrease executive function acutely in a dose dependent manner, and lower baseline executive function appears to contribute to problematic alcohol use. However, no studies, to our knowledge, have examined the relationship between individual differences in working memory (a subcomponent of executive function) after alcohol consumption and drinking behaviors and consequences. Objectives The current study assessed the relationship between drinking behavior, alcohol-related consequences, and alcohol-induced changes in working memory (as assessed by Trails Making Test-B). Method Participants recruited from the community (n = 41), 57.3% male, mean age 39.2, took part in a three-session, within-subjects, repeated-measures design. Participants were administered a placebo, 0.4 g/kg, or 0.8 g/kg dose of alcohol. Working memory, past 30 day alcohol consumption, and consequences of alcohol use were measured at baseline; working memory was measured again after each beverage administration. Results Poorer working memory after alcohol administration (controlling for baseline working memory) was significantly associated with a greater number of drinks consumed per drinking day. Additionally, we observed a significant indirect relationship between the degree of alcohol-induced working memory decline and adverse consequences of alcohol use, which was mediated through greater average drinks per drinking day. Conclusions It is possible that greater individual susceptibility to alcohol-induced working memory decline may limit one’s ability to moderate alcohol consumption as evidenced by greater drinks per drinking day, and that this results in more adverse consequences of alcohol use. PMID:26407604

  10. Health Risks and Adverse Reactions to Functional Foods.

    PubMed

    Ameratunga, Rohan; Crooks, Christine; Simmons, Greg; Woon, See-Tarn

    2016-01-01

    Functional foods have become increasingly popular with consumers anxious to mitigate the effects of an unhealthy lifestyle or aging. In spite of attractive health claims, these products do not have legal or regulatory status in most countries and are regulated through their health claims. Regulation of functional foods by health claims does not address health risks and adverse effects of these products. In this essay regulatory aspects of functional foods are reviewed along with adverse effects published in the peer-reviewed literature. We detail why the lack of an internationally accepted definition of functional foods places consumers at risk of adverse outcomes. Our review will assist regulatory agencies, manufacturers and consumer groups to assess the benefits and reduce the risks associated with these products.

  11. Diabetes and adverse mental health among African Americans.

    PubMed

    Mount, David L; Hairston, Kristen G; Charles, Shelton M

    2011-01-01

    This article reviews the connection between diabetes and adverse mental health among African Americans. Concern about safe insulin prescribing and administration is raised, and the importance of integrated physical and mental health care in the prevention and control of diabetes is highlighted.

  12. Health consequences of shift work and implications for structural design.

    PubMed

    Figueiro, M G; White, R D

    2013-04-01

    The objective of the study was to perform a literature review on the health consequences of working rotating shifts and implications for structural design. A literature search was performed in June 2012 and a selection of the most relevant peer-review articles was included in the present review. Shift workers are more likely to suffer from a circadian sleep disorder characterized by sleepiness and insomnia. Shift work is associated with decreased productivity, impaired safety, diminished quality of life and adverse effects on health. Circadian disruption resulting from rotating shift work has also been associated with increased risk for metabolic syndrome, diabetes, cardiovascular disease and cancer. This article summarizes the known health effects of shift work and discusses how light can be used as a countermeasure to minimize circadian disruption at night while maintaining alertness. In the context of the lighted environment, implications for the design of newborn intensive care units are also discussed.

  13. Adverse Health Effects of Nighttime Lighting

    NASA Astrophysics Data System (ADS)

    Motta, M.

    2012-06-01

    The effects of poor lighting and glare on public safety are well-known, as are the harmful environmental effects on various species and the environment in general. What is less well-known is the potential harmful medical effects of excessive poor nighttime lighting. A significant body of research has been developed over the last few years regarding this problem. One of the most significant effects is the startling increased risk for breast cancer by excessive exposure to nighttime lighting. The mechanism is felt to be by disruption of the circadian rhythm and suppression of melatonin production from the pineal gland. Melatonin has an anticancer effect that is lost when its production is disrupted. I am in the process of developing a monograph that will summarize this important body of research, to be presented and endorsed by the American Medical Association, and its Council of Science and Public health. This paper is a brief overall summary of this little known potential harmful effect of poor and excessive nighttime lighting.

  14. 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…

  15. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    ERIC Educational Resources Information Center

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  16. Space Radiation and its Associated Health Consequences

    NASA Technical Reports Server (NTRS)

    Wu, Honglu

    2007-01-01

    During space travel, astronauts are exposed to energetic particles of a complex composition and energy distribution. For the same amount of absorbed dose, these particles can be much more effective than X- or gamma rays in the induction of biological effects, including cell inactivation, genetic mutations, cataracts, and cancer induction. Several of the biological consequences of space radiation exposure have already been observed in astronauts. This presentation will introduce the space radiation environment and discuss its associated health risks. Accurate assessment of the radiation risks and development of respective countermeasures are essential for the success of future exploration missions to the Moon and Mars.

  17. Health consequences of shift work and insufficient sleep.

    PubMed

    Kecklund, Göran; Axelsson, John

    2016-11-01

    This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause accidents and adverse health. Evidence shows that the effect of shift work on sleep mainly concerns acute sleep loss in connection with night shifts and early morning shifts. A link also exists between shift work and accidents, type 2 diabetes (relative risk range 1.09-1.40), weight gain, coronary heart disease (relative risk 1.23), stroke (relative risk 1.05), and cancer (relative risk range 1.01-1.32), although the original studies showed mixed results. The relations of shift work to cardiometabolic diseases and accidents mimic those with insufficient sleep. Laboratory studies indicate that cardiometabolic stress and cognitive impairments are increased by shift work, as well as by sleep loss. Given that the health and safety consequences of shift work and insufficient sleep are very similar, they are likely to share common mechanisms. However, additional research is needed to determine whether insufficient sleep is a causal pathway for the adverse health effects associated with shift work.

  18. Indoor air pollution: Acute adverse health effects and host susceptibility

    SciTech Connect

    Zummo, S.M.; Karol, M.H.

    1996-01-01

    Increased awareness of the poor quality of indoor air compared with outdoor air has resulted in a significant amount of research on the adverse health effects and mechanisms of action of indoor air pollutants. Common indoor air agents are identified, along with resultant adverse health effects, mechanisms of action, and likely susceptible populations. Indoor air pollutants range from biological agents (such as dust mites) to chemical irritants (such as nitrogen dioxide, carbon monoxide, sulfur dioxide, formaldehyde, and isocyanates). These agents may exert their effects through allergic as well as nonallergic mechanisms. While the public does not generally perceive poor indoor air quality as a significant health risk, increasing reports of illness related to indoor air and an expanding base of knowledge on the health effects of indoor air pollution are likely to continue pushing the issue to the forefront.

  19. The health consequences of early soy consumption.

    PubMed

    Badger, Thomas M; Ronis, Martin J J; Hakkak, Reza; Rowlands, J Craig; Korourian, Soheila

    2002-03-01

    Infants fed soy formula are the segment of the U. S. population that consumes the most soy. Before birth and after weaning, most Americans are not exposed to appreciable levels of soyfoods other than foods that have small amounts of processed soy components. The opposite scenario occurs in Asia, because Asians are more likely to consume relatively high levels of soyfoods throughout life, except between birth and weaning, when breastfeeding or milk-based formula are common. Soy formula is made with soy protein isolate containing isoflavones (SPI+) and supports normal growth and development in term infants. Recent data suggest that there are no long-term adverse effects of early exposure to soy formula through young adulthood. It is as yet unknown whether soy formula consumption by infants will result in health problems or benefits upon aging, but multigenerational animal studies with diets made with SPI+ have not revealed any problems. Soy isoflavones can function as estrogen agonists, antagonists or selective estrogen receptor modulators, depending on the conditions, and much research has focused on health effects of purified isoflavones. Results from several studies suggest that the effects of diets made with SPI+ differ significantly from those of diets to which purified soy isoflavones are added. Furthermore, it seems that soy protein processed to contain lower levels of isoflavones also provides significant health benefits. Further research is needed to confirm the results of the few studies that have been conducted and new studies are needed to investigate the more subtle effects that could occur during development or that could surface later in life.

  20. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child.

    PubMed

    Catalano, Patrick M; Shankar, Kartik

    2017-02-08

    Obesity is the most common medical condition in women of reproductive age. Obesity during pregnancy has short term and long term adverse consequences for both mother and child. Obesity causes problems with infertility, and in early gestation it causes spontaneous pregnancy loss and congenital anomalies. Metabolically, obese women have increased insulin resistance in early pregnancy, which becomes manifest clinically in late gestation as glucose intolerance and fetal overgrowth. At term, the risk of cesarean delivery and wound complications is increased. Postpartum, obese women have an increased risk of venous thromboembolism, depression, and difficulty with breast feeding. Because 50-60% of overweight or obese women gain more than recommended by Institute of Medicine gestational weight guidelines, postpartum weight retention increases future cardiometabolic risks and prepregnancy obesity in subsequent pregnancies. Neonates of obese women have increased body fat at birth, which increases the risk of childhood obesity. Although there is no unifying mechanism responsible for the adverse perinatal outcomes associated with maternal obesity, on the basis of the available data, increased prepregnancy maternal insulin resistance and accompanying hyperinsulinemia, inflammation, and oxidative stress seem to contribute to early placental and fetal dysfunction. We will review the pathophysiology underlying these data and try to shed light on the specific underlying mechanisms.

  1. The consequences of early-life adversity: neurobiological, behavioural and epigenetic adaptations.

    PubMed

    Maccari, S; Krugers, H J; Morley-Fletcher, S; Szyf, M; Brunton, P J

    2014-10-01

    During the perinatal period, the brain is particularly sensitive to remodelling by environmental factors. Adverse early-life experiences, such as stress exposure or suboptimal maternal care, can have long-lasting detrimental consequences for an individual. This phenomenon is often referred to as 'early-life programming' and is associated with an increased risk of disease. Typically, rodents exposed to prenatal stress or postnatal maternal deprivation display enhanced neuroendocrine responses to stress, increased levels of anxiety and depressive-like behaviours, and cognitive impairments. Some of the phenotypes observed in these models of early-life adversity are likely to share common neurobiological mechanisms. For example, there is evidence for impaired glucocorticoid negative-feedback control of the hypothalamic-pituitary-adrenal axis, altered glutamate neurotransmission and reduced hippocampal neurogenesis in both prenatally stressed rats and rats that experienced deficient maternal care. The possible mechanisms through which maternal stress during pregnancy may be transmitted to the offspring are reviewed, with special consideration given to altered maternal behaviour postpartum. We also discuss what is known about the neurobiological and epigenetic mechanisms that underpin early-life programming of the neonatal brain in the first generation and subsequent generations, with a view to abrogating programming effects and potentially identifying new therapeutic targets for the treatment of stress-related disorders and cognitive impairment.

  2. 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.

  3. Residential Proximity to Environmental Hazards and Adverse Health Outcomes

    PubMed Central

    Maantay, Juliana A.; Chakraborty, Jayajit

    2011-01-01

    How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses. PMID:22028451

  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. Predicting adverse drug events from personal health messages.

    PubMed

    Chee, Brant W; Berlin, Richard; Schatz, Bruce

    2011-01-01

    Adverse drug events (ADEs) remain a large problem in the United States, being the fourth leading cause of death, despite post market drug surveillance. Much post consumer drug surveillance relies on self-reported "spontaneous" patient data. Previous work has performed datamining over the FDA's Adverse Event Reporting System (AERS) and other spontaneous reporting systems to identify drug interactions and drugs correlated with high rates of serious adverse events. However, safety problems have resulted from the lack of post marketing surveillance information about drugs, with underreporting rates of up to 98% within such systems. We explore the use of online health forums as a source of data to identify drugs for further FDA scrutiny. In this work we aggregate individuals' opinions and review of drugs similar to crowd intelligence3. We use natural language processing to group drugs discussed in similar ways and are able to successfully identify drugs withdrawn from the market based on messages discussing them before their removal.

  6. [Progresses on adverse health effects of automobile exhaust].

    PubMed

    Cheng, Yibin; Jin, Yinlong; Liu, Yingchun

    2003-09-01

    The progresses on the latest studies at home and abroad on adverse health effects of automobile exhaust were reviewed in this paper. Particulates and poisonous gases from automobile exhaust were considered to be harmful to respiratory system, immune system and reproductive system. It showed that increased prevalence of respiratory disease (e.g. chronic bronchitis and asthma), and decreased lung function, immunity were associated with automobile exhaust. The carcinogenic potential from the exposure to automobile exhausts needs to be further explored because the carcinogenesis is multifactorial.

  7. 20 CFR 1002.194 - Can the application of the escalator principle result in adverse consequences when the employee...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., DEPARTMENT OF LABOR REGULATIONS UNDER THE UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT OF 1994... lawful adverse job consequences that result from the employee's restoration on the seniority ladder... or lower position, laid off, or even terminated. For example, if an employee's seniority or...

  8. 20 CFR 1002.194 - Can the application of the escalator principle result in adverse consequences when the employee...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., DEPARTMENT OF LABOR REGULATIONS UNDER THE UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT OF 1994... lawful adverse job consequences that result from the employee's restoration on the seniority ladder... or lower position, laid off, or even terminated. For example, if an employee's seniority or...

  9. Poverty in childhood and adverse health outcomes in adulthood.

    PubMed

    Raphael, Dennis

    2011-05-01

    The experience of poverty during childhood is a potent predictor of a variety of adverse health outcomes during middle and late adulthood. Children who live in poverty are more likely as adults than their peers to develop and die earlier from a range of diseases. These effects are especially strong for cardiovascular disease and type II diabetes. Most disturbingly, these effects appear in large part to be biologically embedded such that later improved life circumstances have only a modest ameliorative effect. Considering these findings and the relatively high rates of child poverty in nations such as Canada, UK, and USA, those concerned with improving the health of citizens should focus their attention on advocating for public policy that will reduce the incidence of child poverty.

  10. Sexual behaviour: related adverse health burden in the United States

    PubMed Central

    Ebrahim, S; McKenna, M; Marks, J

    2005-01-01

    As part of an analysis of the burden of disease and injury in the United States, we identified and quantified the incidence of adverse health events, deaths, and disability adjusted life years (DALY) attributed to sexual behaviour. In 1998, about 20 million such events (7532/100 000 people) and 29 782 such deaths (1.3% of all US deaths) occurred, contributing to 2 161 417 DALYs (6.2% of all US DALYs). The majority of incident health events (62%) and DALYs (57%) related to sexual behaviour were among females, and curable infections and their sequelae contributed to over half of these. Viral infections and their sequelae accounted for nearly all sexual behaviour related deaths—mostly HIV/AIDS. Sexual behaviour attributed DALYs in the United States are threefold higher than that in overall established market economies. PMID:15681721

  11. Adverse health effects of high-effort/low-reward conditions.

    PubMed

    Siegrist, J

    1996-01-01

    In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.

  12. Adverse health effects of anabolic-androgenic steroids.

    PubMed

    van Amsterdam, Jan; Opperhuizen, Antoon; Hartgens, Fred

    2010-06-01

    Anabolic-androgenic steroids (AAS) are synthetic drugs derived from testosterone. Illegally, these drugs are regularly self-administered by body builders and power lifters to enhance their sportive performance. Adverse side effects of AAS include sexual dysfunction, alterations of the cardiovascular system, psyche and behavior, and liver toxicity. However, severe side effects appear only following prolonged use of AAS at high dose and their occurrence is limited. Occasionally, AAS abuse may be linked to certain social and psychological traits of the user, like low self-esteem, low self-confidence, suffered hostility, childhood conduct disorder, and tendency to high-risk behavior. The overwhelming stereotype about AAS is that these compounds cause aggressive behavior in males. However, the underlying personality traits of a specific subgroup of the AAS abusers, who show aggression and hostility, may be relevant, as well. Use of AAS in combination with alcohol largely increases the risk of violence and aggression. The dependence liability of AAS is very low, and withdrawal effects are relatively mild. Based on the scores for acute and chronic adverse health effects, the prevalence of use, social harm and criminality, AAS were ranked among 19 illicit drugs as a group of drugs with a relatively low harm.

  13. Consequences of Circadian Disruption on Neurologic Health.

    PubMed

    Videnovic, Aleksandar; Zee, Phyllis C

    2015-12-01

    Circadian rhythms have a major role in physiology and behavior. Circadian disruption has negative consequences for physiologic homeostasis at molecular, cellular, organ-system, and whole-organism levels. The onset of many cerebrovascular insults shows circadian temporal trends. Impaired sleep-wake cycle, the most robust output rhythms of the circadian system, is significantly affected by neurodegenerative disorders, may precede them by decades, and may also affect their progression. Emerging evidence suggests that circadian disruption may be a risk factor for these neurologic disorders. This article discusses the implications of circadian rhythms in brain disorders, with an emphasis on cerebrovascular and neurodegenerative disorders.

  14. Consequences of Circadian Disruption on Neurologic Health

    PubMed Central

    Zee, Phyllis C.

    2015-01-01

    Circadian rhythms have a major role in physiology and behavior. Circadian disruption has negative consequences for physiological homeostasis at molecular, cellular, organ–system and whole-organism levels. The onset of many cerebrovascular insults exhibit circadian temporal trends. Impaired sleep-wake cycle, the most robust output rhythms of the circadian system is significantly affected by neurodegenerative disorders, may precede them by decades, and may also impact their progression. Emerging evidence suggest that circadian disruption may be a risk factor for these neurological disorders. In this review, we discuss the implications of circadian rhythms in brain disorders, with an emphasis on cerebrovascular and neurodegenerative disorders. PMID:26568123

  15. Asymmetric Information in Iranian’s Health Insurance Market: Testing of Adverse Selection and Moral Hazard

    PubMed Central

    Lotfi, Farhad; Gorji, Hassan Abolghasem; Mahdavi, Ghadir; Hadian, Mohammad

    2015-01-01

    Background: Asymmetric information is one of the most important issues in insurance market which occurred due to inherent characteristics of one of the agents involved in insurance contracts; hence its management requires designing appropriate policies. This phenomenon can lead to the failure of insurance market via its two consequences, namely, adverse selection and moral hazard. Objective: This study was aimed to evaluate the status of asymmetric information in Iran’s health insurance market with respect to the demand for outpatient services. Materials/sPatients and Methods: This research is a cross sectional study conducted on households living in Iran. The data of the research was extracted from the information on household’s budget survey collected by the Statistical Center of Iran in 2012. In this study, the Generalized Method of Moment model was used and the status of adverse selection and moral hazard was evaluated through calculating the latent health status of individuals in each insurance category. To analyze the data, Excel, Eviews and stata11 software were used. Results: The estimation of parameters of the utility function of the demand for outpatient services (visit, medicine, and Para-clinical services) showed that households were more risk averse in the use of outpatient care than other goods and services. After estimating the health status of households based on their health insurance categories, the results showed that rural-insured people had the best health status and people with supplementary insurance had the worst health status. In addition, the comparison of the conditional distribution of latent health status approved the phenomenon of adverse selection in all insurance groups, with the exception of rural insurance. Moreover, calculation of the elasticity of medical expenses to reimbursement rate confirmed the existence of moral hazard phenomenon. Conclusions: Due to the existence of the phenomena of adverse selection and moral hazard

  16. 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 =…

  17. Speed limits, enforcement, and health consequences.

    PubMed

    Elvik, Rune

    2012-04-01

    This review summarizes current knowledge regarding the effects of speed limit enforcement on public health. Speed limits are commonly used around the world to regulate the maximum speed at which motor vehicles can be operated on public roads. Speed limits are statutory, and violations of them are normally sanctioned by means of fixed penalties (traffic tickets) or, in the event of serious violations, suspension of the driver's license and imposition of prison sentences. Speed limit violations are widespread in all countries for which statistics can be found. Speeding contributes more to the risk of traffic injury than do other risk factors for which estimates of population-attributable risk are available. Traffic speed strongly influences impact speed in crashes and therefore has major implications for public health.

  18. Health consequences of child marriage in Africa.

    PubMed

    Nour, Nawal M

    2006-11-01

    Despite international agreements and national laws, marriage of girls <18 years of age is common worldwide and affects millions. Child marriage is a human rights violation that prevents girls from obtaining an education, enjoying optimal health, bonding with others their own age, maturing, and ultimately choosing their own life partners. Child marriage is driven by poverty and has many effects on girls' health: increased risk for sexually transmitted diseases, cervical cancer, malaria, death during childbirth, and obstetric fistulas. Girls' offspring are at increased risk for premature birth and death as neonates, infants, or children. To stop child marriage, policies and programs must educate communities, raise awareness, engage local and religious leaders, involve parents, and empower girls through education and employment.

  19. Veterans Health Care: Veterans Health Administration Processes for Responding to Reported Adverse Events

    DTIC Science & Technology

    2012-08-24

    outpatient, residential, and inpatient services.1 These health care services are delivered by physicians, dentists , and other providers and range...that may pose the risk of injury to a patient as the result of a medical intervention or lack of an appropriate intervention, such as a missed or...intervention. Close calls receive the same level of scrutiny as adverse events that result in actual patient injury. Adverse events may or may not

  20. Health and environmental consequences of the world trade center disaster.

    PubMed Central

    Landrigan, Philip J; Lioy, Paul J; Thurston, George; Berkowitz, Gertrud; Chen, L C; Chillrud, Steven N; Gavett, Stephen H; Georgopoulos, Panos G; Geyh, Alison S; Levin, Stephen; Perera, Frederica; Rappaport, Stephen M; Small, Christopher

    2004-01-01

    The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and

  1. Excessive folic acid intake and relation to adverse health outcome.

    PubMed

    Selhub, Jacob; Rosenberg, Irwin H

    2016-07-01

    The recent increase in the intake of folic acid by the general public through fortified foods and supplements, has raised safety concern based on early reports of adverse health outcome in elderly with low B12 status who took high doses of folic acid. These safety concerns are contrary to the 2015 WHO statement that "high folic acid intake has not reliably been shown to be associated with negative healeffects". In the folic acid post-fortification era, we have shown that in elderly participants in NHANES 1999-2002, high plasma folate level is associated with exacerbation of both clinical (anemia and cognitive impairment) and biochemical (high MMA and high Hcy plasma levels) signs of vitamin B12 deficiency. Adverse clinical outcomes in association with high folate intake were also seen among elderly with low plasma B12 levels from the Framingham Original Cohort and in a study from Australia which combined three elderly cohorts. Relation between high folate and adverse biochemical outcomes were also seen in the Sacramento Area Latino Study on Aging (High Hcy, high MMA and lower TC2) and at an outpatient clinic at Yale University where high folate is associated with higher MMA in the elderly but not in the young. Potential detrimental effects of high folic acid intake may not be limited to the elderly nor to those with B12 deficiency. A study from India linked maternal high RBC folate to increased insulin resistance in offspring. Our study suggested that excessive folic acid intake is associated with lower natural killer cells activity in elderly women. In a recent study we found that the risk for unilateral retinoblastoma in offspring is 4 fold higher in women that are homozygotes for the 19 bp deletion in the DHFR gene and took folic acid supplement during pregnancy. In the elderly this polymorphism is associated with lower memory and executive scores, both being significantly worse in those with high plasma folate. These and other data strongly imply that

  2. Investigating epigenetic consequences of early-life adversity: some methodological considerations

    PubMed Central

    Fiori, Laura M.; Turecki, Gustavo

    2016-01-01

    Stressful and traumatic events occurring during early childhood have been consistently associated with the development of psychiatric disorders later in life. This relationship may be mediated in part by epigenetic mechanisms, such as DNA methylation, which are influenced by the early-life environment. Epigenetic patterns can have lifelong effects on gene expression and on the functioning of biological processes relevant to stress reactivity and psychopathology. Optimization of epigenetic research activity necessitates a discussion surrounding the methodologies used for DNA methylation analysis, selection of tissue sources, and timing of psychological and biological assessments. Recent studies related to early-life adversity and methylation, including both candidate gene and epigenome-wide association studies, have drawn from the variety of available techniques to generate interesting data in the field. Further discussion is warranted to address the limitations inherent to this field of research, along with future directions for epigenetic studies of adversity-related psychopathology. Highlights of the article We identified issues regarding sample characteristics in epigenetic studies of early life adversity. We compared methods and technologies used for candidate gene analysis and whole epigenome studies. We discussed future perspectives, including combining multiple forms of large-scale data and newer technologies. PMID:27837582

  3. The uses and adverse effects of beryllium on health

    PubMed Central

    Cooper, Ross G.; Harrison, Adrian P.

    2009-01-01

    Context: This review describes the health effects of beryllium exposure in the workplace and the environment. Aim: To collate information on the consequences of occupational and environmental exposure to beryllium on physiological function and well being. Materials and Methods: The criteria used in the current review for selecting articles were adopted from proposed criteria in The International Classification of Functioning, Disability, and Health. Articles were classified based on acute and chronic exposure and toxicity of beryllium. Results: The proportions of utilized and nonutilized articles were tabulated. Years 2001–10 gave the greatest match (45.9%) for methodological parameters, followed by 27.71% for 1991–2000. Years 1971–80 and 1981–90 were not significantly different in the information published and available whereas years 1951–1960 showed a lack of suitable articles. Some articles were published in sources unobtainable through requests at the British Library, and some had no impact factor and were excluded. Conclusion: Beryllium has some useful but undoubtedly harmful effects on health and well-being. Measures need to be taken to prevent hazardous exposure to this element, making its biological monitoring in the workplace essential. PMID:20386622

  4. VA Health Care: Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events

    DTIC Science & Technology

    2015-07-01

    VA HEALTH CARE Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events Report to Congressional...2015 4. TITLE AND SUBTITLE VA Health Care: Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events 5a. CONTRACT NUMBER 5b...Analyses of Adverse Events Why GAO Did This Study Adverse events are incidents that pose a risk of injury to a patient as the result of a medical

  5. 75 FR 4655 - National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: Reporting on... Information on Physicians and Other Health Care Practitioners: Reporting on Adverse and Negative Actions... rule revises existing regulations under sections 401 through 432 of the Health Care Quality...

  6. Tobacco Smoking: Patterns, Health Consequences for Adults, and the Long-term Health of the Offspring

    PubMed Central

    Maritz, Gert S.; Mutemwa, Muyunda

    2012-01-01

    Tobacco use started several centuries ago and increased markedly after the invention of the cigarette making machine. Once people start smoking they find it difficult to quit the habit. This is due to the addictive effect of nicotine in tobacco smoke. Various epidemiologic and laboratory studies clearly showed that smoking is associated with various diseases such as heart diseases, asthma and emphysema and the associated increase in morbidity and mortality of smokers. Several studies implicate nicotine as the causative factor in tobacco smoke. Apart from nicotine, various carcinogens also occur in tobacco smoke resulting in an increase in the incidence of cancer in smokers. While the smoking habit is decreasing in developed countries, tobacco use increases in the developing countries. Smoking prevalence is also highest in poor communities and amongst those with low education levels. It is important to note that, although ther is a decline in the number of smokers in the developed countries, there is a three to four decades lag between the peak in smoking prevalence and the subsequent peak in smoking related mortality. It has been shown that maternal smoking induces respiratory diseases in the offspring. There is also evidence that parental smoking may program the offspring to develop certain diseases later in life. Various studies showed that maternal nicotine exposure during pregnancy and lactation via tobacco smoke of nicotine replacement therapy (NRT), program the offspring to develop compromised lung structure later in life with the consequent compromised lung function. This implies that NRT is not an option to assist pregnant or lactating smokers to quit the habit. Even paternal smoking may have an adverse effect on the health of the offspring since it has been shown that 2nd and 3rd hand smoking have adverse health consequences for those exposed to it. PMID:22980343

  7. ADVERSE CHILDHOOD EXPERIENCES, FAMILY FUNCTIONING AND ADOLESCENT HEALTH AND EMOTIONAL WELL-BEING

    PubMed Central

    Balistreri, Kelly Stamper; Alvira-Hammond, Marta

    2015-01-01

    Objectives Adverse childhood experiences (ACE) have been consistently linked in a strong and graded fashion to a host of health problems in later adulthood but few studies have examined the more proximate effect of ACE on health and emotional well-being in adolescence. Study Design Nationally representative cross-sectional study. Methods Using logistic regression on the 2011/12 National Survey of Children’s Health, we examined the cumulative effect of total ACE score on the health and emotional well-being of US adolescents ages 12 through 17. We investigated the moderating effect of family functioning on the impact of ACE on adolescent health and emotional well-being. Results Adolescents with higher ACE scores had worse reported physical and emotional well-being than adolescents with fewer ACEs net of key demographic and socioeconomic characteristics. Family functioning moderated the negative impact of cumulative ACE on adolescent health and emotional well-being. Conclusions Adolescent well-being has enduring consequences; identifying children with ACE exposure who also have lower-functioning family could also help identify those families at particular risk. PMID:26718424

  8. Reducing the adverse consequences of workplace aggression and violence: the buffering effects of organizational support.

    PubMed

    Schat, Aaron C H; Kelloway, E Kevin

    2003-04-01

    This study examined the buffering effects of 2 types of organizational support--instrumental and informational--on the relationships between workplace violence/aggression and both personal and organizational outcomes. Based on data from 225 employees in a health care setting, a series of moderated multiple regression analyses demonstrated that organizational support moderated the effects of physical violence, vicariously experienced violence, and psychological aggression on emotional well-being, somatic health, and job-related affect, but not on fear of future workplace violence and job neglect. These findings have implications for both research and intervention related to workplace violence.

  9. Climate Change in the US: Potential Consequences for Human Health

    NASA Technical Reports Server (NTRS)

    Maynard, Nancy G.

    2001-01-01

    The U.S. National Assessment identified five major areas of consequences of climate change in the United States: temperature-related illnesses and deaths, health effects related to extreme weather events, air pollution-related health effects, water- and food-borne diseases, and insect-, tick-, and rodent-borne diseases. The U.S. National Assessment final conclusions about these potential health effects will be described. In addition, a summary of some of the new tools for studying human health aspects of climate change as well as environment-health linkages through remotely sensed data and observations will be provided.

  10. Consequences of early adverse rearing experience (EARE) on development: insights from non-human primate studies

    PubMed Central

    Zhang, Bo

    2017-01-01

    Early rearing experiences are important in one's whole life, whereas early adverse rearing experience (EARE) is usually related to various physical and mental disorders in later life. Although there were many studies on human and animals, regarding the effect of EARE on brain development, neuroendocrine systems, as well as the consequential mental disorders and behavioral abnormalities, the underlying mechanisms remain unclear. Due to the close genetic relationship and similarity in social organizations with humans, non-human primate (NHP) studies were performed for over 60 years. Various EARE models were developed to disrupt the early normal interactions between infants and mothers or peers. Those studies provided important insights of EARE induced effects on the physiological and behavioral systems of NHPs across life span, such as social behaviors (including disturbance behavior, social deficiency, sexual behavior, etc), learning and memory ability, brain structural and functional developments (including influences on neurons and glia cells, neuroendocrine systems, e.g., hypothalamic-pituitary-adrenal (HPA) axis, etc). In this review, the effects of EARE and the underlying epigenetic mechanisms were comprehensively summarized and the possibility of rehabilitation was discussed. PMID:28271667

  11. Long-term health consequences of epilepsy diet treatments.

    PubMed

    Vining, Eileen P G

    2008-11-01

    The ketogenic diet (KD) typically provides a marginally healthy diet and in recent years has been used for more protracted courses of therapy. This results in concern about the impact of the diet on the general health of the child. Studies have demonstrated poor growth, dyslipidemia, kidney stones, and numerous other problems seen less frequently. Major areas of concern are reviewed as well as some emerging evidence of more beneficial long-term health consequences beyond the expected control of seizures.

  12. 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

  13. The consequence of land mines on public health.

    PubMed

    Kakar, F; Bassani, F; Romer, C J; Gunn, S W

    1996-01-01

    An estimated 110 million land mines scattered in 64 countries continue to terrorize people and destroy human lives long after wars and fighting have ceased. Despite efforts to clear these devices, their numbers continue to increase and their presence constitutes a substantial threat to public health in affected countries. Direct consequences include both the physical and emotional injuries from the impact, flying debris, and structural collapse associated with their detonation. Indirect consequences include increases in the incidence of waterborne diseases, diarrhea, malnutrition, infectious diseases, and spread of the human immunodeficiency virus associated with the increased use of blood. Those at highest risk of these later consequences are mostly the disadvantaged poor, especially children. Psychiatric disorders, such as post-traumatic stress disorder, occur in those not directly injured as well as those physically wounded by the explosion. Besides efforts to ban production, stockpiling and export of land mines, a comprehensive and integrated health program aimed at the prevention, treatment, and rehabilitation of those injured directly or indirectly by land mines is needed urgently. Strategies should include mine-awareness programs, enhanced transport of those directly injured, training the villagers in first aid, augmenting the capacity and quality of treatment facilities, improving the psychological support and treatment capabilities, development of rehabilitation programs, and the institution and enhancement of public-health programs directed at the indirect consequences associated with the presence of land mines. Land mines constitute a major public health problem in the world that must be addressed.

  14. Implementation of School Health Promotion: Consequences for Professional Assistance

    ERIC Educational Resources Information Center

    Boot, N. M. W. M.; de Vries, N. K.

    2012-01-01

    Purpose: This case study aimed to examine the factors influencing the implementation of health promotion (HP) policies and programs in secondary schools and the consequences for professional assistance. Design/methodology/approach: Group interviews were held in two schools that represented the best and worst case of implementation of a health…

  15. Health Consequences of Alcohol Use in Rural America.

    ERIC Educational Resources Information Center

    Brody, Gene H.; Neubaum, Eileen; Boyd, Gayle M.; Dufour, Mary

    Results of three national surveys suggest that the prevalence of drinking was lower in nonmetropolitan areas than in metropolitan areas. However, nonmetro and metro areas were similar in the presence of risk for heavy, dependent, and problem drinking. Therefore, they probably share similar risks for health consequences of such levels of…

  16. Transgenerational Consequences of Racial Discrimination for African American Health

    PubMed Central

    Goosby, Bridget J.; Heidbrink, Chelsea

    2014-01-01

    Disparities in African American health remain pervasive and persist transgenerationally. There is a growing consensus that both structural and interpersonal racial discrimination are key mechanisms affecting African American health. The Biopsychosocial Model of Racism as a Stressor posits that the persistent stress of experiencing discrimination take a physical toll on the health of African Americans and is ultimately manifested in the onset of illness. However, the degree to which the health consequences of racism and discrimination can be passed down from one generation to the next is an important avenue of exploration. In this review, we discuss and link literature across disciplines demonstrating the harmful impact of racism on African American physical health and the health of their offspring. PMID:24855488

  17. Workgroup report: base stations and wireless networks-radiofrequency (RF) exposures and health consequences.

    PubMed

    Valberg, Peter A; van Deventer, T Emilie; Repacholi, Michael H

    2007-03-01

    Radiofrequency (RF) waves have long been used for different types of information exchange via the air waves--wireless Morse code, radio, television, and wireless telephone (i.e., construction and operation of telephones or telephone systems). Increasingly larger numbers of people rely on mobile telephone technology, and health concerns about the associated RF exposure have been raised, particularly because the mobile phone handset operates in close proximity to the human body, and also because large numbers of base station antennas are required to provide widespread availability of service to large populations. The World Health Organization convened an expert workshop to discuss the current state of cellular-telephone health issues, and this article brings together several of the key points that were addressed. The possibility of RF health effects has been investigated in epidemiology studies of cellular telephone users and workers in RF occupations, in experiments with animals exposed to cell-phone RF, and via biophysical consideration of cell-phone RF electric-field intensity and the effect of RF modulation schemes. As summarized here, these separate avenues of scientific investigation provide little support for adverse health effects arising from RF exposure at levels below current international standards. Moreover, radio and television broadcast waves have exposed populations to RF for > 50 years with little evidence of deleterious health consequences. Despite unavoidable uncertainty, current scientific data are consistent with the conclusion that public exposures to permissible RF levels from mobile telephone and base stations are not likely to adversely affect human health.

  18. Workgroup Report: Base Stations and Wireless Networks—Radiofrequency (RF) Exposures and Health Consequences

    PubMed Central

    Valberg, Peter A.; van Deventer, T. Emilie; Repacholi, Michael H.

    2007-01-01

    Radiofrequency (RF) waves have long been used for different types of information exchange via the airwaves—wireless Morse code, radio, television, and wireless telephony (i.e., construction and operation of telephones or telephonic systems). Increasingly larger numbers of people rely on mobile telephone technology, and health concerns about the associated RF exposure have been raised, particularly because the mobile phone handset operates in close proximity to the human body, and also because large numbers of base station antennas are required to provide widespread availability of service to large populations. The World Health Organization convened an expert workshop to discuss the current state of cellular-telephone health issues, and this article brings together several of the key points that were addressed. The possibility of RF health effects has been investigated in epidemiology studies of cellular telephone users and workers in RF occupations, in experiments with animals exposed to cell-phone RF, and via biophysical consideration of cell-phone RF electric-field intensity and the effect of RF modulation schemes. As summarized here, these separate avenues of scientific investigation provide little support for adverse health effects arising from RF exposure at levels below current international standards. Moreover, radio and television broadcast waves have exposed populations to RF for > 50 years with little evidence of deleterious health consequences. Despite unavoidable uncertainty, current scientific data are consistent with the conclusion that public exposures to permissible RF levels from mobile telephony and base stations are not likely to adversely affect human health. PMID:17431492

  19. Adverse consequences of immunostimulation.

    PubMed

    Ponce, Rafael

    2008-01-01

    The therapeutic uses of immunostimulatory agents are generally in the treatments of infections or cancer. The traditional example of vaccination is one form of immunostimulation used in the prevention of pathogenic infections or cancer (e.g., human papillomavirus vaccine). Recombinant cytokines are increasingly used to stimulate immune system function. For example, interferon-alpha (IFNalpha) and interleukin (IL)-2 have been used to treat chronic hepatitis C virus infection and metastatic melanoma, respectively. In contrast, monoclonal antibodies are used to target malignant cells for elimination via antibody-dependent cytotoxicity mechanisms or apoptosis, including the anti-CD20 monoclonal antibody rituximab and the anti-CD56 monoclonal antibody alemtuzumab used in the treatment of B-cell malignancies, and the anti-erb2 receptor antibody trastuzumab used in the treatment of breast cancer. Finally, immunostimulation may develop via modulation of pathways involved in immune system regulation. For example, the anti-CD28 monoclonal antibody TGN1412 was developed as an agonist of regulatory T-cells for treatment of T-cell-mediated chronic inflammatory diseases or leukemias. A panel was convened to discuss potential toxicities associated with immunostimulation. At the Immunotoxicology IV meeting in 2006, a panel, moderated by Dr. Robert House (Dynport Vaccine Co., Frederick, MD), included Drs. Gary Burleson (Burleson Research Technologies, Inc., Raleigh, NC), Kenneth Hastings (US FDA, Center for Drug Evaluation and Research [CDER], Rockville, MD), Barbara Mounho (Amgen, Thousand Oaks, CA), Rafael Ponce (ZymoGenetics, Inc., Seattle, WA), Mark Wing (Huntington Life Sciences, Cambridgeshire, United Kingdom), Lauren Black (Navigators Consulting, Sparks, NV) and Anne Pilaro (US FDA, CDER, Rockville, MD). This paper reviews the major identified toxicities associated with immunostimulation, including the acute phase response, cell and tissue abnormalities/injury, cytokine release/cytokine storm, tumor lysis syndrome, vascular leak, and autoimmunity that were discussed by this panel.

  20. Alcohol and cannabis: Comparing their adverse health effects and regulatory regimes.

    PubMed

    Hall, Wayne

    2016-11-28

    The claim that the adverse health effects of cannabis are much less serious than those of alcohol has been central to the case for cannabis legalisation. Regulators in US states that have legalised cannabis have adopted regulatory models based on alcohol. This paper critically examines the claim about adverse health effects and the wisdom of regulating cannabis like alcohol. First, it compares what we know about the adverse health effects of alcohol and cannabis. Second, it discusses the uncertainties about the long term health effects of sustained daily cannabis use. Third, it speculates about how the adverse health effects of cannabis may change after legalisation. Fourth, it questions the assumption that alcohol provides the best regulatory model for a legal cannabis market. Fifth, it outlines the major challenges in regulating cannabis under the liberal alcohol-like regulatory regimes now being introduced.

  1. Arsenic exposure and adverse health effects: a review of recent findings from arsenic and health studies in Matlab, Bangladesh.

    PubMed

    Yunus, Mohammad; Sohel, Nazmul; Hore, Samar Kumar; Rahman, Mahfuzar

    2011-09-01

    The recent discovery of large-scale arsenic (As) contamination of groundwater has raised much concern in Bangladesh. Reliable estimates of the magnitude of As exposure and related health problems have not been comprehensively investigated in Bangladesh. A large population-based study on As and health consequences in Matlab (AsMat) was done in Matlab field site where International Centre for Diarrhoeal Disease Research, Bangladesh has maintained a health and demographic surveillance system registering prospectively all vital events. Taking advantage of the health and demographic surveillance system and collecting data on detailed individual level As exposure using water and urine samples, AsMat investigated the morbidity and mortality associated with As exposure. Reviews of findings to date suggest the adverse effects of As exposure on the risk of skin lesions, high blood pressure, diabetes mellitus, chronic disease, and all-cause infant and adult disease mortality. Future studies of clinical endpoints will enhance our knowledge gaps and will give directions for disease prevention and mitigations.

  2. Anticipated public health consequences of global climate change.

    PubMed

    Longstreth, J

    1991-12-01

    Human activities are placing enormous pressures on the biosphere. The introduction of new chemicals and the increasing ambient levels of existing chemicals have resulted in atmospheric degradation. This paper reviews some of the adverse effects of stratospheric ozone depletion and global warming. Because the atmospheric effects of ozone depletion are fairly well characterized, quantitative risk estimates have been developed. However, because the atmospheric effects of global warming are less understood, public health problems that could be intensified by climate change are assessed qualitatively. The interactive effects of these two phenomena are also discussed.

  3. For neonates undergoing cardiac surgery does thymectomy as opposed to thymic preservation have any adverse immunological consequences?

    PubMed

    Afifi, Ahmed; Raja, Shahzad G; Pennington, Daniel J; Tsang, Victor T

    2010-09-01

    A best evidence topic in congenital cardiac surgery was written according to a structured protocol. The question addressed was whether neonatal thymectomy in patients undergoing cardiac surgery has any adverse immunological consequences. Altogether 164 papers were found using the reported search, of which nine papers represented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses were tabulated. The thymus is the major production site of T cells, whose stocks are built-up during foetal and early postnatal life. However, its function diminishes after the first years of life, and although thymic output is maintained into adulthood, the thymus mostly degenerates into fatty tissue in elderly adults. To date, there has been no general consensus with regard to the importance of this organ during childhood and adulthood. As a consequence, during cardiac surgery in neonates, partial or total thymectomy is routinely performed to enable better access to the heart and great vessels to correct congenital heart defects, suggesting that it may be dispensable during childhood and adulthood. Interestingly, current best available evidence from nine case-control studies suggests that neonatal thymectomy affects peripheral T-cell populations both in the short- as well as long-term and results in premature immunosenescence. However, the impact of these changes on the risk of infectious diseases or malignancy has not been thoroughly evaluated by any of these studies. Maintenance of a registry of patients undergoing neonatal thymectomy and further studies to assess the functional or clinical consequences of this practice would be valuable.

  4. Lifespan adversity and later adulthood telomere length in the nationally representative US Health and Retirement Study

    PubMed Central

    Gemmill, Alison; Weir, David; Adler, Nancy E.; Prather, Aric A.

    2016-01-01

    Stress over the lifespan is thought to promote accelerated aging and early disease. Telomere length is a marker of cell aging that appears to be one mediator of this relationship. Telomere length is associated with early adversity and with chronic stressors in adulthood in many studies. Although cumulative lifespan adversity should have bigger impacts than single events, it is also possible that adversity in childhood has larger effects on later life health than adult stressors, as suggested by models of biological embedding in early life. No studies have examined the individual vs. cumulative effects of childhood and adulthood adversities on adult telomere length. Here, we examined the relationship between cumulative childhood and adulthood adversity, adding up a range of severe financial, traumatic, and social exposures, as well as comparing them to each other, in relation to salivary telomere length. We examined 4,598 men and women from the US Health and Retirement Study. Single adversities tended to have nonsignificant relations with telomere length. In adjusted models, lifetime cumulative adversity predicted 6% greater odds of shorter telomere length. This result was mainly due to childhood adversity. In adjusted models for cumulative childhood adversity, the occurrence of each additional childhood event predicted 11% increased odds of having short telomeres. This result appeared mainly because of social/traumatic exposures rather than financial exposures. This study suggests that the shadow of childhood adversity may reach far into later adulthood in part through cellular aging. PMID:27698131

  5. Beyond the art of governmentality: unmasking the distributional consequences of health policies.

    PubMed

    Coyte, Peter C; Holmes, Dave

    2006-06-01

    The aim of this article is to critique health policy discourses that are taken for granted. This perspective will allow for the identification of 'exclusionary' health policies, which we define as policies that are thought to offer universal benefit, despite yielding adverse effects for significant groups of people in society. As such, policies that are said to be designed 'for all' frequently benefit only a subset of the population. Our intent is to highlight the distributional consequences of certain health policies that are largely institutionalized in contemporary society. We believe that these distributional effects are explicit representations of power in society and that institutions may provide individual 'choice' and 'freedom' that, in turn, yields separation as an outcome, a separating equilibrium. Specifically, if those who benefit from policies of partition are numerous and are to obtain significant advantage or incur limited costs, or if those who are adversely affected are scarce (or hidden), or the size of these adverse effects are small (or perceived to be minor), then partition becomes more likely as a 'legitimate', but exclusionary, instrument of public policy.

  6. Causes and consequences of early-life health.

    PubMed

    Case, Anne; Paxson, Christina

    2010-01-01

    We examine the consequences of child health for economic and health outcomes in adulthood, using height as a marker of childhood health. After reviewing previous evidence, we present a conceptual framework that highlights data limitations and methodological problems that complicate the study of this topic. We then present estimates of the associations between height and a range of outcomes--including schooling, employment, earnings, health, and cognitive ability--measured in five data sets from early to late adulthood. These results indicate that, on average, taller individuals attain higher levels of education. Height is also positively associated with better economic, health, and cognitive outcomes. These associations are only partially explained by the higher average educational attainment of taller individuals. We then use data from the National Longitudinal Survey of Youth 1979 Children and Young Adults survey to document the associations between health, cognitive development, and growth in childhood. Even among children with the same mother, taller siblings score better on cognitive tests and progress through school more quickly. Part of the differences found between siblings arises from differences in their birth weights and lengths attributable to mother's behaviors while pregnant. Taken together, these results support the hypothesis that childhood health influences health and economic status throughout adulthood.

  7. Adverse Health Problems Among Municipality Workers in Alexandria (Egypt)

    PubMed Central

    Abd El-Wahab, Ekram W.; Eassa, Safaa M.; Lotfi, Sameh E.; El Masry, Sanaa A.; Shatat, Hanan Z.; Kotkat, Amira M.

    2014-01-01

    Background: Solid waste management has emerged as an important human and environmental health issue. Municipal solid waste workers (MSWWs) are potentially exposed to a variety of occupational biohazards and safety risks. The aim of this study was to describe health practices and safety measures adopted by workers in the main municipal company in Alexandria (Egypt) as well as the pattern of the encountered work related ill health. Methods: A cross-sectional study was conducted between January and April 2013. We interviewed and evaluated 346 workers serving in about 15 different solid waste management activities regarding personal hygiene, the practice of security and health care measures and the impact of solid waste management. Results: Poor personal hygiene and self-care, inadequate protective and safety measures for potentially hazardous exposure were described. Impact of solid waste management on health of MSWWs entailed high prevalence of gastrointestinal, respiratory, skin and musculoskeletal morbidities. Occurrence of accidents and needle stick injuries amounted to 46.5% and 32.7% respectively. The risk of work related health disorders was notably higher among workers directly exposed to solid waste when compared by a group of low exposure potential particularly for diarrhea (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.2-3.8), vomiting (OR = 2.7, 95% CI = 1.1-6.6), abdominal colic (OR = 1.9, 95% CI = 1.1-3.2), dysentery (OR = 3.6, 95% CI = 1.3-10), dyspepsia (OR = 1.8, 95% CI = 1.1-3), low back/sciatic pain (OR = 3.5, 95% CI = 1.8-7), tinnitus (OR = 6.2, 95% CI = 0.3-122) and needle stick injury (OR = 3.4, 95% CI = 2.1-5.5). Conclusions: Workers exposed to solid waste exhibit significant increase in risk of ill health. Physician role and health education could be the key to assure the MSWWs health safety. PMID:24932385

  8. The epidemiology of smoking: health consequences and benefits of cessation.

    PubMed

    Fagerström, Karl

    2002-01-01

    Tobacco use is the single most important preventable health risk in the developed world, and an important cause of premature death worldwide. Smoking causes a wide range of diseases, including many types of cancer, chronic obstructive pulmonary disease, coronary heart disease, stroke, peripheral vascular disease, and peptic ulcer disease. In addition, smoking during pregnancy adversely affects fetal and neonatal growth and development. Recent decades have seen a massive expansion in tobacco use in the developing world and accelerating growth in smoking among women in the developed world. Globally, smoking-related mortality is set to rise from 3 million annually (1995 estimate) to 10 million annually by 2030, with 70% of these deaths occurring in developing countries. Many of the adverse health effects of smoking are reversible, and smoking cessation treatments represent some of the most cost effective of all healthcare interventions. Although the greatest benefit accrues from ceasing smoking when young, even quitting in middle age avoids much of the excess healthcare risk associated with smoking. In order to improve smoking cessation rates, effective behavioural and pharmacological treatments, coupled with professional counselling and advice, are required. Since smoking duration is the principal risk factor for smoking-related morbidity, the treatment goal should be early cessation and prevention of relapse.

  9. Childhood Adverse Events and Health Outcomes among Methamphetamine-Dependent Men and Women

    ERIC Educational Resources Information Center

    Messina, Nena P.; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Hunter, Jeremy; Rawson, Richard

    2008-01-01

    To describe the prevalence of childhood adverse events (CAEs) among methamphetamine-dependent men and women, and assess the relationship of cumulative CAEs to health problems. Data for 236 men and 351 women were analyzed assessing CAEs. Dependent variables included 14 self-reported health problems or psychiatric symptom domains. Mental health was…

  10. The cost of being a man: social and health consequences of Igbo masculinity.

    PubMed

    Odimegwu, Clifford; Pallikadavath, Saseendran; Adedini, Sunday

    2013-01-01

    In the bid to explain reproductive health outcomes in most developing countries, men have often been seen as the cause of the problem. However, no systematic attempt has been made to examine men's perception of their own social and health needs, including how ideologies of masculinity impact men's social and physical health. This study examines the Igbo context and shows how men understand and interpret masculinity and the consequences of this for social and health behaviours. Data from adolescent and adult Igbo men aged 15-75 were collected using both quantitative survey interviews (n = 1372) and qualitative techniques such as focus-group discussion (n = 20), in-depth interviews (n = 10) and key informant interviews (n = 10) in selected areas of south-eastern Nigeria. We collected data on gender role ideologies and sexuality issues and practices. Our analysis shows that there are social and health costs associated with adherence to masculine ideologies and a strong association between masculine ideologies and men's health, risk-taking and health-seeking behaviours in the study population. We conclude that all sexual and reproductive health programmes should include services that address the specific needs of men and those negative aspects of masculinity that tend to expose men to adverse health outcomes.

  11. Urban sprawl and you: how sprawl adversely affects worker health.

    PubMed

    Pohanka, Mary; Fitzgerald, Sheila

    2004-06-01

    Urban sprawl, once thought of as just an environmental issue, is currently gaining momentum as an emerging public health issue worthy of research and political attention. Characteristics seen in sprawling communities include increasing traffic volumes; inadequate public transportation; pedestrian unfriendly streets; and the division of businesses, shops, and homes. These characteristics can affect health in many ways. Greater air pollution contributes to higher asthma and other lung disorder rates. An increased dependence on the automobile encourages a more sedentary lifestyle and can potentially contribute to obesity. The increased danger and stress of long commutes can lead to more accidents, anxiety, and social isolation. Occupational health nurses can become involved by promoting physical activity in the workplace, creating programs for injury prevention and stress management, becoming involved in political smart growth measures, and educating and encouraging colleagues to become active in addressing this issue.

  12. ‘First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study

    PubMed Central

    Barr, B; Taylor-Robinson, D; Stuckler, D; Loopstra, R; Reeves, A; Whitehead, M

    2016-01-01

    Background In England between 2010 and 2013, just over one million recipients of the main out-of-work disability benefit had their eligibility reassessed using a new functional checklist—the Work Capability Assessment. Doctors and disability rights organisations have raised concerns that this has had an adverse effect on the mental health of claimants, but there are no population level studies exploring the health effects of this or similar policies. Method We used multivariable regression to investigate whether variation in the trend in reassessments in each of 149 local authorities in England was associated with differences in local trends in suicides, self-reported mental health problems and antidepressant prescribing rates, while adjusting for baseline conditions and trends in other factors known to influence mental ill-health. Results Each additional 10 000 people reassessed in each area was associated with an additional 6 suicides (95% CI 2 to 9), 2700 cases of reported mental health problems (95% CI 548 to 4840), and the prescribing of an additional 7020 antidepressant items (95% CI 3930 to 10100). The reassessment process was associated with the greatest increases in these adverse mental health outcomes in the most deprived areas of the country, widening health inequalities. Conclusions The programme of reassessing people on disability benefits using the Work Capability Assessment was independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing. This policy may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits. PMID:26573235

  13. 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

  14. 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.

  15. Attention-deficit/hyperactivity disorder and adverse health outcomes

    PubMed Central

    Nigg, Joel

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention–disorganization and/or hyperactivity–impulsivity. In DSM-IV, the diagnostic criteria required impairment in social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes. PMID:23298633

  16. Teen motherhood and long-term health consequences.

    PubMed

    Patel, Payal H; Sen, Bisakha

    2012-07-01

    The objective of this article is to examine the association of teen motherhood and long-term physical and mental health outcomes. The physical and mental health components (PCS and MCS) of the SF-12 Healthy Survey in the NLSY79 health module were used to assess long-term health outcomes of women who experienced teenage motherhood. Various familial, demographic, and environmental characteristics were indentified and controlled for that may have predicted teen motherhood and long-term health outcomes. The two comparison groups for teen mothers were women who experienced teen-pregnancy only and women who were engaged in unprotected sexual activity as a teenage but did not experience pregnancy. Multivariate ordinary least squares regression was used for analysis. The average PCS and MCS for teen mothers was 49.91 and 50.89, respectively. Teen mothers exhibited poorer physical health later in life compared to all women as well as the comparison groups. When controlling for age, teen mothers had significantly lower PCS and MCS scores compared to all other women. Furthermore, when controlling for familial, demographic, and environmental characteristics, teen mothers exhibited significantly lower PCS and MCS scores. When comparing teen mothers to the two comparison groups, PCS was not statistically different although MCS was significantly lower in the teen-pregnancy group. Teen motherhood does lead to poorer physical health outcomes later in life. On the other hand, poorer mental health outcomes in later life may be attributed to the unmeasured factors leading to a teen pregnancy and not teen motherhood itself. Additional research needs to be conducted on the long-term consequences of teen motherhood.

  17. Energy Drink Consumption in Europe: A Review of the Risks, Adverse Health Effects, and Policy Options to Respond

    PubMed Central

    Breda, João Joaquim; Whiting, Stephen Hugh; Encarnação, Ricardo; Norberg, Stina; Jones, Rebecca; Reinap, Marge; Jewell, Jo

    2014-01-01

    With the worldwide consumption of energy drinks increasing in recent years, concerns have been raised both in the scientific community and among the general public about the health effects of these products. Recent studies provide data on consumption patterns in Europe; however, more research is needed to determine the potential for adverse health effects related to the increasing consumption of energy drinks, particularly among young people. A review of the literature was conducted to identify published articles that examined the health risks, consequences, and policies related to energy drink consumption. The health risks associated with energy drink consumption are primarily related to their caffeine content, but more research is needed that evaluates the long-term effects of consuming common energy drink ingredients. The evidence indicating adverse health effects due to the consumption of energy drinks with alcohol is growing. The risks of heavy consumption of energy drinks among young people have largely gone unaddressed and are poised to become a significant public health problem in the future. PMID:25360435

  18. Energy drink consumption in europe: a review of the risks, adverse health effects, and policy options to respond.

    PubMed

    Breda, João Joaquim; Whiting, Stephen Hugh; Encarnação, Ricardo; Norberg, Stina; Jones, Rebecca; Reinap, Marge; Jewell, Jo

    2014-01-01

    With the worldwide consumption of energy drinks increasing in recent years, concerns have been raised both in the scientific community and among the general public about the health effects of these products. Recent studies provide data on consumption patterns in Europe; however, more research is needed to determine the potential for adverse health effects related to the increasing consumption of energy drinks, particularly among young people. A review of the literature was conducted to identify published articles that examined the health risks, consequences, and policies related to energy drink consumption. The health risks associated with energy drink consumption are primarily related to their caffeine content, but more research is needed that evaluates the long-term effects of consuming common energy drink ingredients. The evidence indicating adverse health effects due to the consumption of energy drinks with alcohol is growing. The risks of heavy consumption of energy drinks among young people have largely gone unaddressed and are poised to become a significant public health problem in the future.

  19. Adverse Effects of Methylmercury: Environmental Health Research Implications

    PubMed Central

    Grandjean, Philippe; Satoh, Hiroshi; Murata, Katsuyuki; Eto, Komyo

    2010-01-01

    Background The scientific discoveries of health risks resulting from methylmercury exposure began in 1865 describing ataxia, dysarthria, constriction of visual fields, impaired hearing, and sensory disturbance as symptoms of fatal methylmercury poisoning. Objective Our aim was to examine how knowledge and consensus on methylmercury toxicity have developed in order to identify problems of wider concern in research. Data sources and extraction We tracked key publications that reflected new insights into human methylmercury toxicity. From this evidence, we identified possible caveats of potential significance for environmental health research in general. Synthesis At first, methylmercury research was impaired by inappropriate attention to narrow case definitions and uncertain chemical speciation. It also ignored the link between ecotoxicity and human toxicity. As a result, serious delays affected the recognition of methylmercury as a cause of serious human poisonings in Minamata, Japan. Developmental neurotoxicity was first reported in 1952, but despite accumulating evidence, the vulnerability of the developing nervous system was not taken into account in risk assessment internationally until approximately 50 years later. Imprecision in exposure assessment and other forms of uncertainty tended to cause an underestimation of methylmercury toxicity and repeatedly led to calls for more research rather than prevention. Conclusions Coupled with legal and political rigidity that demanded convincing documentation before considering prevention and compensation, types of uncertainty that are common in environmental research delayed the scientific consensus and were used as an excuse for deferring corrective action. Symptoms of methylmercury toxicity, such as tunnel vision, forgetfulness, and lack of coordination, also seemed to affect environmental health research and its interpretation. PMID:20529764

  20. Mechanisms Underlying the Association Between Early-Life Adversity and Physical Health: Charting a Course for the Future.

    PubMed

    Bush, Nicole R; Lane, Richard D; McLaughlin, Katie A

    Early-life adversities (ELA) are associated with subsequent pervasive alterations across a wide range of neurobiological systems and psychosocial factors that contribute to accelerated onset of health problems and diseases. In this article, we provide an integrated perspective on recent developments in research on ELA, based on the articles published in this Special Issue of Psychosomatic Medicine. We focus on the following: 1) the distinction between specific versus general aspects of ELA with regard to the nature of exposure (e.g., physical and sexual abuse, emotional abuse or neglect, relative socioeconomic deprivation), biological and behavioral correlates of ELA, and differences across diseases; 2) the importance of timing in the critical phases of exposure to ELA; and 3) adaptive versus dysfunctional responses to ELA and their consequences for biological and behavioral risk factors for adverse health outcomes. This article concludes with outlining important new targets for research in this area, including the neurobiology of affect as a mechanism linking ELA to adverse health outcomes, and the need for large-scale longitudinal investigations of multisystem processes relevant to ELA in diverse samples, starting prenatally, continuing to late adolescence, and with long-term follow-up assessments that enable evaluation of incident disease outcomes.

  1. Adverse health effects of air pollutants in a nonsmoking population.

    PubMed

    Pope, C A

    1996-07-17

    Utah Valley has provided an interesting and unique opportunity to evaluate the health effects of respirable particulate air pollution (PM10). Residents of this valley are predominantly nonsmoking members of the Church of Jesus Christ of Latter-day Saints (Mormons). The area has moderately high average PM10 levels with periods of highly elevated PM10 concentrations due to local emissions being trapped in a stagnant air mass near the valley floor during low-level temperature inversion episodes. Due to a labor dispute, there was intermittent operation of the single largest pollution source, an old integrated steel mill. Levels of other common pollutants including sulfur dioxide, ozone, and acidic aerosol are relatively low. Studies specific to Utah Valley have observed that elevated PM10 concentrations are associated with: (1) decreased lung function; (2) increased incidence of respiratory symptoms; (3) increased school absenteeism; (4) increased respiratory hospital admissions; and (5) increased mortality, especially respiratory and cardiovascular mortality.

  2. Potential adverse health effects of genetically modified crops.

    PubMed

    Bakshi, Anita

    2003-01-01

    Genetically modified crops have the potential to eliminate hunger and starvation in millions of people, especially in developing countries because the genetic modification can produce large amounts of foods that are more nutritious. Large quantities are produced because genetically modified crops are more resistant to pests and drought. They also contain greater amounts of nutrients, such as proteins and vitamins. However, there are concerns about the safety of genetically modified crops. The concerns are that they may contain allergenic substances due to introduction of new genes into crops. Another concern is that genetic engineering often involves the use of antibiotic-resistance genes as "selectable markers" and this could lead to production of antibiotic-resistant bacterial strains that are resistant to available antibiotics. This would create a serious public health problem. The genetically modified crops might contain other toxic substances (such as enhanced amounts of heavy metals) and the crops might not be "substantially equivalent" in genome, proteome, and metabolome compared with unmodified crops. Another concern is that genetically modified crops may be less nutritious; for example, they might contain lower amounts of phytoestrogens, which protect against heart disease and cancer. The review of available literature indicates that the genetically modified crops available in the market that are intended for human consumption are generally safe; their consumption is not associated with serious health problems. However, because of potential for exposure of a large segment of human population to genetically modified foods, more research is needed to ensure that the genetically modified foods are safe for human consumption.

  3. Is there evidence that recent consolidation in the health insurance industry has adversely affected premiums?

    PubMed

    Kopit, William G

    2004-01-01

    James Robinson suggests that recent consolidation in the insurance market has been a cause of higher health insurance prices (premiums). Although the recent consolidation among health insurers and rising premiums are indisputable, it is unlikely that consolidation has had any adverse effect on premiums nationwide, and Robinson provides no data that suggest otherwise. Specifically, he does not present data showing an increase in concentration in any relevant market during the past few years, let alone any resulting increase in premiums. Health insurance consolidation in certain local markets could adversely affect premiums, but it seems clear that it is not a major national antitrust issue.

  4. 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…

  5. The Relationship between Adverse Childhood Events, Resiliency and Health among Children with Autism

    ERIC Educational Resources Information Center

    Rigles, Bethany

    2017-01-01

    Previous research has shown a negative relationship between adverse childhood events (ACEs) and health and resiliency among the general population, but has not examined these associations among children with autism. Purpose: To determine the prevalence of ACEs among children with autism and how ACEs are associated with resiliency and health.…

  6. Reducing the health consequences of opioid addiction in primary care.

    PubMed

    Bowman, Sarah; Eiserman, Julie; Beletsky, Leo; Stancliff, Sharon; Bruce, R Douglas

    2013-07-01

    Addiction to prescription opioids is prevalent in primary care settings. Increasing prescription opioid use is largely responsible for a parallel increase in overdose nationally. Many patients most at risk for addiction and overdose come into regular contact with primary care providers. Lack of routine addiction screening results in missed treatment opportunities in this setting. We reviewed the literature on screening and brief interventions for addictive disorders in primary care settings, focusing on opioid addiction. Screening and brief interventions can improve health outcomes for chronic illnesses including diabetes, hypertension, and asthma. Similarly, through the use of screening and brief interventions, patients with addiction can achieve improved health outcome. A spectrum of low-threshold care options can reduce the negative health consequences among individuals with opioid addiction. Screening in primary care coupled with short interventions, including motivational interviewing, syringe distribution, naloxone prescription for overdose prevention, and buprenorphine treatment are effective ways to manage addiction and its associated risks and improve health outcomes for individuals with opioid addiction.

  7. [Screening induced by health services: impact and consequences. Ethical issues].

    PubMed

    Segura-Benedicto, Andreu

    2006-03-01

    The main aim of screening is to identify people with an increased probability to benefit from preventive interventions, generally from secondary prevention but also from primary prevention activities. The goal is to facilitate early diagnosis and treatment in order to modify positively the prognosis (the former case), or to recognize people exposed to risk factors which increase the incidence rate of disease, and then to prevent the disease (the latter case). Good intentions are not enough to achieve good results in terms of effectiveness, safety, efficiency or equity. It is necessary to have a systematic assessment of the consequences of screening, particularly on the impact on peoples health and on the health services. Due to the diversity of types of screenings that are done, it is very difficult to estimate the net impact caused by their implementation. Moreover, the changes in the health of a population depend on many factors other than health service interventions. Thus, it is very important to determine the effectiveness and safety of the screening methods that are most frequently applied. Unfortunately, assessment of the benefits and the harm potentially caused by preventive interventions has not been done often. In Spain only a few partial assessments have been published, and they focus on the activities and the processes themselves rather than the final outcomes. Given that screening activities are carried out in health care services, and that the populations screened are mostly healthy people, the ethical issues have great importance when health policies are designed and implemented. Thus, it is recommended that screenings activities be analyzed applying the ethical principles of autonomy, benefit, safety and justice. If any screening program cannot reasonably satisfy these principles then they should be removed from the list of public health activities that are financed by public resources. In the same sense, all screening procedures offered to the

  8. [Efforts to prevent adverse events in the United States--health care risk management and a fresh perspective on adverse events prevention].

    PubMed

    Ayuzawa, J

    2001-03-01

    Not causing adverse events is never-ceasing issue in the health care field. However, the advances and greater specialization of medical technologies and the increasing number of elderly people, are all factors in the occurrence of adverse events. At the same time, greater efficiency is now demanded in the health care field, and the problem of preventing adverse events has become tougher than ever before. Given the situation, a fresh perspective on attempts to prevent adverse events may be important. One hint for such a new perspective is the health care risk management that is widely practiced in the health care field in the United States. This was introduced in the mid-1970s to counter the disputes and lawsuits at the time, but over the years the focus has shifted to the importance of prevention, and is now recognized as a means to work toward the assurance of quality of health care. Hints are also found in the suggestions related to adverse events prevention. In "To Err Is Human," published in November 1999 in the United States, includes proposals to "respect human limits in process design" and "promote effective team functioning," which are just the approaches we should adopt for a new perspective. I would also like to draw attention to the idea that there should be investigations into "developing effective mechanisms for identifying and dealing with unsafe practitioners" and the importance of "protecting voluntary reporting systems" that is mentioned. Adopting American methods unchanged to the health care system in Japan may not be appropriate, but the way of thinking and know-how from health care risk management, as well as the suggestions for adverse events prevention will provide us new perspectives on adverse events prevention, from which we should work toward a system of more efficient, and high-quality adverse events prevention.

  9. Health consequence scales for use in health impact assessments of climate change.

    PubMed

    Brown, Helen; Spickett, Jeffery

    2014-09-16

    While health impact assessment (HIA) has typically been applied to projects, plans or policies, it has significant potential with regard to strategic considerations of major health issues facing society such as climate change. Given the complexity of climate change, assessing health impacts presents new challenges that may require different approaches compared to traditional applications of HIA. This research focuses on the development of health consequence scales suited to assessing and comparing health effects associated with climate change and applied within a HIA framework. This assists in setting priorities for adaptation plans to minimize the public health impacts of climate change. The scales presented in this paper were initially developed for a HIA of climate change in Perth in 2050, but they can be applied across spatial and temporal scales. The design is based on a health effects pyramid with health measures expressed in orders of magnitude and linked to baseline population and health data. The health consequence measures are combined with a measure of likelihood to determine the level of risk associated with each health potential health impact. In addition, a simple visual framework that can be used to collate, compare and communicate the level of health risks associated with climate change has been developed.

  10. Health Consequence Scales for Use in Health Impact Assessments of Climate Change

    PubMed Central

    Brown, Helen; Spickett, Jeffery

    2014-01-01

    While health impact assessment (HIA) has typically been applied to projects, plans or policies, it has significant potential with regard to strategic considerations of major health issues facing society such as climate change. Given the complexity of climate change, assessing health impacts presents new challenges that may require different approaches compared to traditional applications of HIA. This research focuses on the development of health consequence scales suited to assessing and comparing health effects associated with climate change and applied within a HIA framework. This assists in setting priorities for adaptation plans to minimize the public health impacts of climate change. The scales presented in this paper were initially developed for a HIA of climate change in Perth in 2050, but they can be applied across spatial and temporal scales. The design is based on a health effects pyramid with health measures expressed in orders of magnitude and linked to baseline population and health data. The health consequence measures are combined with a measure of likelihood to determine the level of risk associated with each health potential health impact. In addition, a simple visual framework that can be used to collate, compare and communicate the level of health risks associated with climate change has been developed. PMID:25229697

  11. Borrowing to cope with adverse health events: liquidity constraints, insurance coverage, and unsecured debt.

    PubMed

    Babiarz, Patryk; Widdows, Richard; Yilmazer, Tansel

    2013-10-01

    This article uses data from the Health and Retirement Study for 1998-2010 to investigate whether households respond to the financial stress caused by health problems by increasing their unsecured debt. Results show both the probability of having unsecured debt and the amount of debt increase after an adverse health event among households with low financial assets, who are uninsured, or who have less generous health insurance. The effect of health problems on borrowing is caused by both medical expenditures and disruptions to the income stream. Unsecured debt seems to remain on some households' balance sheets for an extended period.

  12. 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...

  13. Stress and resource pathways connecting early socioeconomic adversity to young adults' physical health risk.

    PubMed

    Wickrama, Kandauda K A S; Lee, Tae Kyoung; O'Neal, Catherine Walker; Kwon, Josephine A

    2015-05-01

    Although research has established the impact of early stress, including stressful life contexts, and early resources, such as educational attainment, on various adolescent health outcomes, previous research has not adequately investigated "integrative models" incorporating both stress and resource mediational pathways to explain how early socioeconomic adversity impacts physical health outcomes, particularly in early life stages. Data on early childhood/adolescent stress and socioeconomic resources as well as biomarkers indicating physical health status in young adulthood were collected from 11,798 respondents (54 % female) over a 13-year period from youth participating in the National Study of Adolescent Health (Add Health). Physical health risk in young adulthood was measured using a composite index of nine regulatory biomarkers of cardiovascular and metabolic systems. Heterogeneity in stress and socioeconomic resource pathways was assessed using latent class analysis to identify clusters, or classes, of stress and socioeconomic resource trajectories. The influence of early socioeconomic adversity on young adults' physical health risk, as measured by biomarkers, was estimated, and the role of stress and socioeconomic resource trajectory classes as linking mechanisms was assessed. There was evidence for the influence of early socioeconomic adversity on young adults' physical health risk directly and indirectly through stress and socioeconomic resource trajectory classes over the early life course. These findings suggest that health models should be broadened to incorporate both stress and resource experiences simultaneously. Furthermore, these findings have prevention and intervention implications, including the importance of early socioeconomic adversity and key intervention points for "turning" the trajectories of at-risk youth.

  14. Health Monitoring and Management for Manufacturing Workers in Adverse Working Conditions.

    PubMed

    Xu, Xiaoya; Zhong, Miao; Wan, Jiafu; Yi, Minglun; Gao, Tiancheng

    2016-10-01

    In adverse working conditions, environmental parameters such as metallic dust, noise, and environmental temperature, directly affect the health condition of manufacturing workers. It is therefore important to implement health monitoring and management based on important physiological parameters (e.g., heart rate, blood pressure, and body temperature). In recent years, new technologies, such as body area networks, cloud computing, and smart clothing, have allowed the improvement of the quality of services. In this article, we first give five-layer architecture for health monitoring and management of manufacturing workers. Then, we analyze the system implementation process, including environmental data processing, physical condition monitoring and system services and management, and present the corresponding algorithms. Finally, we carry out an evaluation and analysis from the perspective of insurance and compensation for manufacturing workers in adverse working conditions. The proposed scheme will contribute to the improvement of workplace conditions, realize health monitoring and management, and protect the interests of manufacturing workers.

  15. Building an Evidence-Based Mental Health Program for Children with History of Early Adversity

    ERIC Educational Resources Information Center

    Kroupina, Maria; Vermeulen, Marlous; Moberg, Stephanie

    2015-01-01

    Adoption is a major intervention in a child's life, however internationally adopted (IA) children remain at risk for long-term neurodevelopmental and mental health issues due to the fact that most of them have a history of early adversity prior to their adoption. In the last 20 years, extensive research with this population has increased the…

  16. ENVIRONMENTAL POLLUTANTS AND ADVERSE HUMAN HEALTH EFFECTS: HAZARD IDENTIFICATION USING INTERREGION COMPARISONS

    EPA Science Inventory

    Background: Associations between adverse health effects and environmental exposures are difficult to study, because exposures may be widespread, low-dose in nature, and common throughout the study population. Therefore, individual risk-factor epidemiology may not be the right to...

  17. ARE ENVIRONMENTAL EXPOSURES TO CHLOROPHENOXY HERBICIDES ASSOCIATED WITH AN INCREASE IN ADVERSE HUMAN HEALTH EFFECTS?

    EPA Science Inventory

    Background: Associations between adverse health effects and environmental exposures are difficult to study because exposures may be widespread, low-dose in nature, and common throughout the study population. Individual risk-factor epidemiology may not be able to initially ident...

  18. Adverse Childhood Experiences (ACE) and Health-Risk Behaviors among Adults in a Developing Country Setting

    ERIC Educational Resources Information Center

    Ramiro, Laurie S.; Madrid, Bernadette J.; Brown, David W.

    2010-01-01

    Objective: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. Study population: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the…

  19. Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: a cohort study of an urban, minority sample in the U.S.

    PubMed

    Mersky, J P; Topitzes, J; Reynolds, A J

    2013-11-01

    Research has shown that adverse childhood experiences (ACEs) increase the risk of poor health-related outcomes in later life. Less is known about the consequences of ACEs in early adulthood or among diverse samples. Therefore, we investigated the impacts of differential exposure to ACEs on an urban, minority sample of young adults. Health, mental health, and substance use outcomes were examined alone and in aggregate. Potential moderating effects of sex were also explored. Data were derived from the Chicago Longitudinal Study, a panel investigation of individuals who were born in 1979 or 1980. Main-effect analyses were conducted with multivariate logistic and OLS regression. Sex differences were explored with stratified analysis, followed by tests of interaction effects with the full sample. Results confirmed that there was a robust association between ACEs and poor outcomes in early adulthood. Greater levels of adversity were associated with poorer self-rated health and life satisfaction, as well as more frequent depressive symptoms, anxiety, tobacco use, alcohol use, and marijuana use. Cumulative adversity also was associated with cumulative effects across domains. For instance, compared to individuals without an ACE, individuals exposed to multiple ACEs were more likely to have three or more poor outcomes (OR range=2.75-10.15) and four or more poor outcomes (OR range=3.93-15.18). No significant differences between males and females were detected. Given that the consequences of ACEs in early adulthood may lead to later morbidity and mortality, increased investment in programs and policies that prevent ACEs and ameliorate their impacts is warranted.

  20. Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: A cohort study of an urban, minority sample in the U.S.

    PubMed Central

    Topitzes, J.; Reynolds, A.J.

    2014-01-01

    Research has shown that adverse childhood experiences (ACEs) increase the risk of poor health-related outcomes in later life. Less is known about the consequences of ACEs in early adulthood or among diverse samples. Therefore, we investigated the impacts of differential exposure to ACEs on an urban, minority sample of young adults. Health, mental health, and substance use outcomes were examined alone and in aggregate. Potential moderating effects of sex were also explored. Data were derived from the Chicago Longitudinal Study, a panel investigation of individuals who were born in 1979 or 1980. Main-effect analyses were conducted with multivariate logistic and OLS regression. Sex differences were explored with stratified analysis, followed by tests of interaction effects with the full sample. Results confirmed that there was a robust association between ACEs and poor outcomes in early adulthood. Greater levels of adversity were associated with poorer self-rated health and life satisfaction, as well as more frequent depressive symptoms, anxiety, tobacco use, alcohol use, and marijuana use. Cumulative adversity also was associated with cumulative effects across domains. For instance, compared to individuals without an ACE, individuals exposed to multiple ACEs were more likely to have three or more poor outcomes (OR range = 2.75–10.15) and four or more poor outcomes (OR range = 3.93–15.18). No significant differences between males and females were detected. Given that the consequences of ACEs in early adulthood may lead to later morbidity and mortality, increased investment in programs and policies that prevent ACEs and ameliorate their impacts is warranted. PMID:23978575

  1. Multiple Shocks, Coping and Welfare Consequences: Natural Disasters and Health Shocks in the Indian Sundarbans

    PubMed Central

    Mazumdar, Sumit; Mazumdar, Papiya Guha; Kanjilal, Barun; Singh, Prashant Kumar

    2014-01-01

    Background Based on a household survey in Indian Sundarbans hit by tropical cyclone Aila in May 2009, this study tests for evidence and argues that health and climatic shocks are essentially linked forming a continuum and with exposure to a marginal one, coping mechanisms and welfare outcomes triggered in the response is significantly affected. Data & Methods The data for this study is based on a cross-sectional household survey carried out during June 2010. The survey was aimed to assess the impact of cyclone Aila on households and consequent coping mechanisms in three of the worst-affected blocks (a sub-district administrative unit), viz. Hingalganj, Gosaba and Patharpratima. The survey covered 809 individuals from 179 households, cross cutting age and gender. A separate module on health-seeking behaviour serves as the information source of health shocks defined as illness episodes (ambulatory or hospitalized) experienced by household members. Key findings Finding reveals that over half of the households (54%) consider that Aila has dealt a high, damaging impact on their household assets. Result further shows deterioration of health status in the period following the incidence of Aila. Finding suggests having suffered multiple shocks increases the number of adverse welfare outcomes by 55%. Whereas, suffering either from the climatic shock (33%) or the health shock (25%) alone increases such risks by a much lesser extent. The multiple-shock households face a significantly higher degree of difficulty to finance expenses arising out of health shocks, as opposed to their counterparts facing only the health shock. Further, these households are more likely to finance the expenses through informal loans and credit from acquaintances or moneylenders. Conclusion This paper presented empirical evidence on how natural and health shocks mutually reinforce their resultant impact, making coping increasingly difficult and present significant risks of welfare loss, having short

  2. Adverse Childhood Experiences and the Health of University Students in Eight Provinces of Vietnam.

    PubMed

    Tran, Quynh Anh; Dunne, Michael P; Vo, Thang Van; Luu, Ngoc Hoat

    2015-11-01

    Recent systematic reviews have emphasized the need for more research into the health and social impacts of adverse childhood experiences (ACEs) in the Asia-Pacific region. This cross-sectional study was conducted with 2099 young adult students in 8 medical universities throughout Vietnam. An anonymous, self-report questionnaire included the World Health Organization ACE-International Questionnaire and standardized measures of mental and physical health. Three quarters (76%) of the students reported at least one exposure to ACEs; 21% had 4 or more ACEs. The most commonly reported adversities were emotional abuse, physical abuse, and witnessing a household member being treated violently (42.3%, 39.9%, and 34.6%, respectively). Co-occurrence of ACEs had dose-response relationships with poor mental health, suicidal ideation, and low physical health-related quality of life. This first multisite study of ACEs among Vietnamese university students provided evidence that childhood adversity is common and is significantly linked with impaired health and well-being into the early adult years.

  3. Health consequences and health systems response to the Pacific U.S. Nuclear Weapons Testing Program.

    PubMed

    Palafox, Neal A; Riklon, Sheldon; Alik, Wilfred; Hixon, Allen L

    2007-03-01

    Between 1946 and 1958, the United States detonated 67 thermonuclear devices in the Pacific as part of their U.S. Nuclear Weapons Testing Program (USNWTP). The aggregate explosive power was equal to 7,200 Hiroshima atomic bombs. Recent documents released by the U.S. government suggest that the deleterious effects of the nuclear testing were greater and extended farther than previously known. The Republic of the Marshall Islands (RMI) government and affected communities have sought refress through diplomatic routes with the U.S. government, however, existing medical programs and financial reparations have not adequately addressed many of the health consequences of the USNWTP. Since radiation-induced cancers may have a long latency, a healthcare infrastructure is needed to address both cancer and related health issues. This article reviews the health consequences of the Pacific USNWTP and the current health systems ability to respond.

  4. Mental Health Consequences and Social Issues After the Fukushima Disaster.

    PubMed

    Maeda, Masaharu; Oe, Misari

    2017-03-01

    The Great East Japan Earthquake and subsequent nuclear power plant accident caused multidimensional and long-term effects on the mental health condition of people living in Fukushima. In this article, focusing on the influence of the nuclear disaster, we present an overview of studies regarding the psychosocial consequences of people in Fukushima. Studies revealed that the experiences of the explosions at the plant as well as the tsunami are deeply embedded in their memory, leading to posttraumatic responses. Chronic physical diseases, worries about livelihood, lost jobs, lost social ties, and concerns about compensation were also associated with posttraumatic responses. Furthermore, the radioactive fallout brought chronic anxiety regarding physical risks of radiation exposure to people, especially young mothers. People often have different opinions about the radiation risk and their own future plans, resulting in a reduction in the resilience that communities and families had before the disaster. In addition, such weakened community resilience may produce a significant increase in disaster-related suicide in Fukushima. Specific social issues, such as "radiation stigma" among the public and self-stigma among evacuees, that are never seen with other natural disasters also increased in Fukushima.

  5. Early life adversity reduces stress reactivity and enhances impulsive behavior: implications for health behaviors.

    PubMed

    Lovallo, William R

    2013-10-01

    Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor health behaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes.

  6. Surveillance of methadone-related adverse drug events using multiple public health data sources.

    PubMed

    Sims, Shannon A; Snow, Laverne A; Porucznik, Christina A

    2007-08-01

    Healthcare safety and quality surveillance is increasingly conducted by public health agencies. We describe a biomedical informatics method that uses multiple public health data sources to perform surveillance of methadone-related adverse drug events. Data from Utah medical examiner records, vital statistics, emergency department encounter administrative data and a database of controlled substances prescriptions are used to examine trends in state-wide adverse events related to methadone. From 1997 to 2004, population-adjusted methadone prescriptions increased 727%, with evidence to suggest the rise in the methadone prescription rate is for treatment of pain, not addiction therapy. During the same period of time, population adjusted, accidental methadone-related deaths in medical examiner data increased 1770%. Population adjusted methadone-related emergency department encounters rose 612% from 1997 to 2003. Our results suggest that the increase in methadone prescription rates from 1997 to 2004 was accompanied by a concurrent increase in methadone-related morbidity and mortality. Although patient data is not linked between data sources, our results demonstrate that utilizing multiple public health data sources captures more cases and provides more clinical detail than individual data sources alone. Our approach is a successful biomedical informatics approach for surveillance of adverse events and utilizes widely available public health data sources, as well as an emerging source of public health data, controlled substance prescription registries.

  7. Early life adversity reduces stress reactivity and enhances impulsive behavior: Implications for health behaviors

    PubMed Central

    Lovallo, William R.

    2012-01-01

    Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor health behaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes. PMID:23085387

  8. Are There Adverse Consequences to Being a Sibling of a Person with a Disability? A Propensity Score Analysis

    ERIC Educational Resources Information Center

    Neely-Barnes, Susan L.; Graff, J. Carolyn

    2011-01-01

    This study examined whether siblings of children with disabilities have increased mental health problems, behavioral difficulties, or greater mental health service use as compared to siblings of children without disabilities. Data come from the 2006 National Health Interview Survey. Propensity score matching was used to complete the analysis.…

  9. Lifetime Adversity Leads to Blunted Stress Axis Reactivity: Studies from the Oklahoma Family Health Patterns Project

    PubMed Central

    Lovallo, William R.; Farag, Noha H.; Sorocco, Kristen H.; Cohoon, Andrew J.; Vincent, Andrea S.

    2011-01-01

    Background Can stressful events in early life alter the response characteristics of the human stress axis? Individual differences in stress reactivity are considered potentially important in long-term health and disease, however little is known about the sources of these individual differences. We present evidence that adverse experience in childhood and adolescence can alter core components of the stress axis, including cortisol and heart rate reactivity. Methods We exposed 354 healthy young adults (196 women) to public speaking and mental arithmetic stressors in the laboratory. Stress responses were indexed by self-report, heart rate, and cortisol levels relative to measures on a nonstress control day. Subjects were grouped into those who had experienced 0, 1, or 2 or more significant adverse life events including Physical or Sexual Adversity (mugged, threatened with a weapon, experienced a break-in or robbery; or raped or sexually assaulted by a relative or nonrelative) or Emotional Adversity (separation from biological mother or father for at least 6 months prior to age 15). Results Experience of adversity predicted smaller heart rate and cortisol responses to the stressors in a dose-dependent fashion (0 > 1 > 2 or more events; (Fs = 5.79 and 8.11, ps < .004) for both men and women. This was not explained by differences in socioeconomic status, the underlying cortisol diurnal cycle, or subjective experience during the stress procedure. Conclusion The results indicate a long-term impact of stressful life experience on the reactivity of the human stress axis. PMID:22112928

  10. Adverse health effects and unhealthy behaviors among medical students using Facebook.

    PubMed

    Al-Dubai, Sami Abdo Radman; Ganasegeran, Kurubaran; Al-Shagga, Mustafa Ahmed Mahdi; Yadav, Hematram; Arokiasamy, John T

    2013-01-01

    Little is known about the relationships between adverse health effects and unhealthy behaviors among medical students using Facebook. The aim of this study was to determine the associations between adverse health effects and unhealthy behaviors with Facebook use. A cross-sectional study was conducted in a private university in Malaysia among 316 medical students. A self-administered questionnaire was used. It included questions on sociodemographics, pattern of Facebook use, social relationship, unhealthy behaviors, and health effects. Mean age was 20.5 (±2.7) years. All students had a Facebook account. The average daily Facebook surfing hours were 2.5 (±1.7). Significant associations were found between average hours of Facebook surfing and the following factors: isolation from family members and community, refusing to answer calls, musculoskeletal pain, headache, and eye irritation (P < 0.005). The average hours spent on Facebook were significantly associated with holding urination and defecation while online, surfing Facebook until midnight, and postponing, forgetting, or skipping meals (P < 0.005). The average hours spent on Facebook were associated with adverse health effects and unhealthy behaviors among medical students, as well as social isolation from the family and community.

  11. Radiation health consequences for astronauts: mechanisms, monitoring and prevention

    NASA Astrophysics Data System (ADS)

    Neyfakh, E.

    During space flights crews are exposed chronically to uneven irradiation of enhanced bioefficiency following with significant elevation for chromosomal aberrations as minimum. To protect in space rationally monitoring and preventing of health radiogenic individual primary consequences for astronauts are of high importance. Majority of Chernobyl-touched population has some common etiologic radiogenic mechanisms and radioloads with astronauts ones during long-term missions and former is able to be used well as the close ground-level model. Primary radiogenic deviations. Two radiogenic pathologies as lipoperoxic ( LP ) stress with coupled deficits for essential bioantioxidants ( BAO ) were typical for chronic low-dose Chernobyl-touched contingents. When BAO expenditure had led to their subnormal levels, radiogenic free radical chain -b ranched LP processes occurred in vivo hyperbolically. Catabolites and their free radicals of the abnormal LP cascade are known to be toxic, mutagenic / carcinogenic and teratogenic factors as such, as they are for retinol and tocopherol deficiencies. Both coupled pathogenic factors interrelated synergistically. Simultaneous dysbalances for LP and / or BAO systems were evaluated as the cause and markers for metabolic disregulations. Human LP stress was proved to be the most radiosensible known marker to mo nitor least invasively of blood microsamples in a ground lab via the developed PC Program. But for capsule conditions the best approach is assumed to be LP monitoring via skin ultraweak green-blue chemiluminescence ( CL ) caused by recombination of peroxyl radicals. CL from surfaces of organs was embedded first ( E. Neyfakh, 1964 - 71 ) to reflect their internal LP velocities in vivo and it is the non-invasive on-line simple method of the highest sensitivity, supplying with data transmissible to the ground directly. Related deviations. a) Radiogenic hypermutagenesis: LP catabolites and their free radicals are responsible for direct DNA

  12. Cost-sharing, physician utilization, and adverse selection among Medicare beneficiaries with chronic health conditions.

    PubMed

    Hoffman, Geoffrey

    2015-02-01

    Pooled data from the 2007, 2009, and 2011/2012 California Health Interview Surveys were used to compare the number of self-reported annual physician visits among 36,808 Medicare beneficiaries ≥65 in insurance groups with differential cost-sharing. Adjusted for adverse selection and a set of health covariates, Medicare fee-for-service (FFS) only beneficiaries had similar physician utilization compared with HMO enrollees but fewer visits compared with those with supplemental (1.04, p = .001) and Medicaid (1.55, p = .003) coverage. FFS only beneficiaries in very good or excellent health had fewer visits compared with those of similar health status with supplemental (1.30, p = .001) or Medicaid coverage (2.15, p = .002). For subpopulations with several chronic conditions, FFS only beneficiaries also had fewer visits compared with beneficiaries with supplemental or Medicaid coverage. Observed differences in utilization may reflect efficient and necessary physician utilization among those with chronic health needs.

  13. National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: reporting on adverse and negative actions. Final rule.

    PubMed

    2010-01-28

    This final rule revises existing regulations under sections 401 through 432 of the Health Care Quality Improvement Act of 1986, governing the National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners, to incorporate statutory requirements under section 1921 of the Social Security Act, as amended by section 5(b) of the Medicare and Medicaid Patient and Program Protection Act of 1987 (MMPPPA), and as amended by the Omnibus Budget Reconciliation Act of 1990 (OBRA). The MMPPPA, along with certain additional provisions in the OBRA, was designed to protect program beneficiaries from unfit health care practitioners, and otherwise improve the anti-fraud provisions of Medicare and State health care programs. Section 1921, the statutory authority upon which this regulatory action is based, requires each State to adopt a system of reporting to the Secretary of Health and Human Services (the Secretary) certain adverse licensure actions taken against health care practitioners and health care entities licensed or otherwise authorized by a State (or a political subdivision thereof) to provide health care services. It also requires each State to report any negative actions or findings that a State licensing authority, peer review organization, or private accreditation entity has concluded against a health care practitioner or health care entity.

  14. Identifying adverse effects of area-based health policy: An ethnographic study of a deprived neighbourhood in England.

    PubMed

    Williams, Oli

    2017-03-17

    Health interventions commonly have adverse effects. Addressing these could significantly improve health outcomes. This paper addresses an adverse effect common in the promotion of health behaviours: exacerbation of health inequalities between low- and high-socioeconomic groups. Health behaviours - particularly, physical activity - are positioned within the context of social inequality and the inequitable spatial distribution of resources. Area-based health policy that targets deprived areas is assessed for its capacity to promote health behaviours without exacerbating inequality. Data are derived from a 16-month ethnography in a deprived English neighbourhood that was the target of area-based intervention that prioritised the promotion of physical activity. Findings provide evidence of adverse intervention effects that further disadvantaged the low-socioeconomic population. Analysis demonstrates how this was ultimately the outcome of localised policy drifting away from initial commitments to equitable service access. These findings increase understanding of the processes through which adverse intervention effects arise and how they can be mitigated.

  15. The health status of women in Oaxaca: determinants and consequences.

    PubMed

    Winter, M; Morris, E W; Murphy, A D

    1993-12-01

    Survey data from a sample of 575 women from the city of Oaxaca de Juárez, Mexico, are analyzed to ascertain the effect of the receipt of job-related benefits, including health benefits, on the self-reported health status of women, their rating of the health of the members of their household, and their satisfaction with the health of the members of their household. Health status depends on the woman's age, her socioeconomic status, and the number of children she has borne. Her rating of the health of the members of her household is related to her age, her socioeconomic status, and her rating of her own health. Satisfaction with the physical health of the members of the household is a function her health, her rating of the health of her household, her age, her socioeconomic status and the number of children she has borne. The overall conclusion is that, in this study, it is socioeconomic and demographic factors that are important in determining the woman's health status, rather than the receipt of job-related benefits. That she reports good health is an important factor in her view of her family's health and her satisfaction with her own health and that of her family.

  16. Common Sleep Disorders Increase Risk of Motor Vehicle Crashes and Adverse Health Outcomes in Firefighters

    PubMed Central

    Barger, Laura K.; Rajaratnam, Shantha M.W.; Wang, Wei; O'Brien, Conor S.; Sullivan, Jason P.; Qadri, Salim; Lockley, Steven W.; Czeisler, Charles A.

    2015-01-01

    Study Objectives: Heart attacks and motor vehicle crashes are the leading causes of death in US firefighters. Given that sleep disorders are an independent risk factor for both of these, we examined the prevalence of common sleep disorders in a national sample of firefighters and their association with adverse health and safety outcomes. Methods: Firefighters (n = 6,933) from 66 US fire departments were assessed for common sleep disorders using validated screening tools, as available. Firefighters were also surveyed about health and safety, and documentation was collected for reported motor vehicle crashes. Results: A total of 37.2% of firefighters screened positive for any sleep disorder including obstructive sleep apnea (OSA), 28.4%; insomnia, 6.0%; shift work disorder, 9.1%; and restless legs syndrome, 3.4%. Compared with those who did not screen positive, firefighters who screened positive for a sleep disorder were more likely to report a motor vehicle crash (adjusted odds ratio 2.00, 95% CI 1.29–3.12, p = 0.0021) and were more likely to self-report falling asleep while driving (2.41, 2.06–2.82, p < 0.0001). Firefighters who screened positive for a sleep disorder were more likely to report having cardiovascular disease (2.37, 1.54–3.66, p < 0.0001), diabetes (1.91, 1.31–2.81, p = 0.0009), depression (3.10, 2.49–3.85, p < 0.0001), and anxiety (3.81, 2.87–5.05, p < 0.0001), and to report poorer health status (p < 0.0001) than those who did not screen positive. Adverse health and safety associations persisted when OSA and non-OSA sleep disorders were examined separately. Conclusions: Sleep disorders are prevalent in firefighters and are associated with increased risk of adverse health and safety outcomes. Future research is needed to assess the efficacy of occupational sleep disorders prevention, screening, and treatment programs in fire departments to reduce these safety and health risks. Citation: Barger LK, Rajaratnam SM, Wang W, O'Brien CS

  17. Mental Health of Elementary Schoolteachers in Southern Brazil: Working Conditions and Health Consequences.

    PubMed

    Cezar-Vaz, Marta Regina; Bonow, Clarice Alves; de Almeida, Marlise Capa Verde; Rocha, Laurelize Pereira; Borges, Anelise Miritz

    2015-01-01

    The mental health of educators is a growing problem in many countries. This study sought to identify self-reported stressful working conditions of elementary schoolteachers and the biopsychosocial consequences of those working conditions and then identify working conditions that promote well-being for teachers in the workplace. Exploratory study was done with 37 teachers. Data collection was performed using a structured interview with a questionnaire. Results show that stressful working conditions are related to inadequate salary, an excessive number of activities, and having to take work home. Biopsychosocial consequences include anxiety, stress, and sleep disorders. There was a statistically significant association between inadequate salary and anxiety (p = 0.01) and between an excessive number of activities and stress (p = 0.01). Teachers reported that a good relationship among colleagues is a working condition that promotes well-being in the workplace. The identification of stressful working conditions for teachers, the biopsychosocial consequences, and working conditions that promote well-being in the workplace are relevant to determining actions that improve the work environment and, consequently, the health of teachers.

  18. Mental Health of Elementary Schoolteachers in Southern Brazil: Working Conditions and Health Consequences

    PubMed Central

    Cezar-Vaz, Marta Regina; Bonow, Clarice Alves; de Almeida, Marlise Capa Verde; Rocha, Laurelize Pereira; Borges, Anelise Miritz

    2015-01-01

    The mental health of educators is a growing problem in many countries. This study sought to identify self-reported stressful working conditions of elementary schoolteachers and the biopsychosocial consequences of those working conditions and then identify working conditions that promote well-being for teachers in the workplace. Exploratory study was done with 37 teachers. Data collection was performed using a structured interview with a questionnaire. Results show that stressful working conditions are related to inadequate salary, an excessive number of activities, and having to take work home. Biopsychosocial consequences include anxiety, stress, and sleep disorders. There was a statistically significant association between inadequate salary and anxiety (p = 0.01) and between an excessive number of activities and stress (p = 0.01). Teachers reported that a good relationship among colleagues is a working condition that promotes well-being in the workplace. The identification of stressful working conditions for teachers, the biopsychosocial consequences, and working conditions that promote well-being in the workplace are relevant to determining actions that improve the work environment and, consequently, the health of teachers. PMID:26366433

  19. Noise monitoring and adverse health effects in residents in different functional areas of Luzhou, China.

    PubMed

    Han, Zhi-Xia; Lei, Zhang-Heng; Zhang, Chun-Lian; Xiong, Wei; Gan, Zhong-Lin; Hu, Ping; Zhang, Qing-Bi

    2015-03-01

    The purpose of the study was to investigate the noise pollution situation and the resulting adverse effect on residents' health in Luzhou, China, to provide data for noise pollution prevention policies and interventions. Four different functional areas (commercial, construction, residential, and transportation hub areas) were chosen to monitor noise level for 3 months. The survey was performed by questionnaire on the spot on randomly selected individuals; it collected data on the impact of noise on residents' health (quality of sleep, high blood pressure, subjective feeling of nervous system damage, and attention) as well as the knowledge of noise-induced health damage, the degree of adaptation to noise, and their solutions. The noise levels of residential, commercial, transportation, and construction areas exceeded the national standards (P < .001). Sleep quality, prevalence of hypertension, and attention in transportation hub areas were significantly different from those in the other 3 areas (P < .05); only 24.46% of people knew the health hazards associated with noise; 64.57% of residents have adapted to the current noise environment. Most of them have to close the doors and windows to reduce noise. The noise pollution situation in Luzhou, China, is serious, especially the traffic noise pollution. Residents pay less attention to it and adopt single measures to reduce the noise. We should work toward the prevention and control of traffic noise and improve the residents' awareness to reduce the adverse health effects of noise.

  20. The adverse effects of International Monetary Fund programs on the health and education workforce.

    PubMed

    Marphatia, Akanksha A

    2010-01-01

    Decades of underinvestment in public sectors and in teachers and health workers have adversely affected the health and educational outcomes of women. This is partly explained by a general lack of resources. However, the amount a country can spend on social sectors, including teachers and health workers, is also determined by its macroeconomic framework, which is set in agreement with the International Monetary Fund. There is now ample evidence of how IMF-imposed wage ceilings have constrained the ability of governments to hire adequate numbers of trained professionals and increase investment in social sectors. Though the IMF has recently removed wage ceilings from its basket of conditions, little change has taken place to ensure that women are better supported by macroeconomic policies or, at the least, are less adversely affected. Thus far, the IMF's neoliberal policies have either ignored gender concerns or instrumentalized equity, health, and education to support economic development. Unless macroeconomic policies are more flexible and deliberately take into account the different needs of women and men, social outcomes will continue to be poor and inequitable. Governments must pursue alternative, feminist policies that put the goals of social equity at the center of macroeconomic policy. These policies can facilitate increased investment in education and health care, which are vital measures for achieving gender equality and providing both women and men with the skills and training needed to soften the impact of the current economic crisis.

  1. Health consequences of the 'Great Recession' on the employed: evidence from an industrial cohort in aluminum manufacturing.

    PubMed

    Modrek, Sepideh; Cullen, Mark R

    2013-09-01

    While the negative effects of unemployment have been well studied, the consequences of layoffs and downsizing for those who remain employed are less well understood. This study uses human resources and health claims data from a large multi-site fully insured aluminum company to explore the health consequences of downsizing on the remaining workforce. We exploit the variation in the timing and intensity of layoff to categorize 30 plants as high or low layoff plants. Next, we select a stably employed cohort of workers with history of health insurance going back to 2006 to 1) describe the selection process into layoff and 2) explore the association between the severity of plant level layoffs and the incidence of four chronic conditions in the remaining workforce. We examine four health outcomes: incident hypertension, diabetes, asthma/COPD and depression for a cohort of approximately 13,000 employees. Results suggest that there was an increased risk of developing hypertension for all workers and an increased risk of developing diabetes for salaried workers that remain at the plants with the highest level of layoffs. The hypertension results were robust to a several specification tests. In addition, the study design selected only healthy workers, therefore our estimates are likely to be a lower bound and suggest that adverse health consequences of the 2007-2009 recession may have affected a broader proportion of the population than previously expected.

  2. Drug Abuse: The Crack Cocaine Epidemic Health Consequences and Treatment.

    DTIC Science & Technology

    1991-01-01

    Addicts agonists,2 such as bromocriptine and amantadine . Antidepressants and dopamine agonists help to alleviate the feelings of anhedonia or the... dopamine , a chemical found naturally in the brain, causing it to remain active longer than normal. This retention of dopamine changes brain activity...and dopamine I Although it has been used worldwide for over a decade without reports of important adverse effects, flupenthixol is not yet licensed

  3. Health-protective and Adverse Effects of the Apolipoprotein E ε2 Allele in Older Males

    PubMed Central

    Kulminski, Alexander M.; Ukraintseva, Svetlana V.; Arbeev, Konstantin G.; Manton, Kenneth G.; Oshima, Junko; Martin, George M.; Il'yasova, Dora; Yashin, Anatoli I.

    2009-01-01

    OBJECTIVES: To re-examine a health-protective role of the common Apolipoprotein E (APOE) polymorphism focusing on connections between the APOE ε2-containing genotypes and impairments in instrumental activities of daily living [IADL] in older (65+) males and females. To examine how these connections may be mediated by diagnosed coronary heart disease (CHD), Alzheimer's disease, colorectal cancer, macular degeneration (MD), and atherosclerosis. DESIGN: Retrospective cross-sectional study. SETTING: The unique disability-focused data from a genetic sub-sample of the 1999 National Long Term Care Survey linked with Medicare service use files. PARTICIPANTS: 1733 genotyped individuals interviewed on IADL disabilities. MEASUREMENTS: Indicators of IADL impairments, five geriatric disorders, and ε2-containing genotypes. RESULTS: The ε2/3 genotype is a major contributor to adverse associations between the ε2 allele and IADL disability in males [Odds Ratio (OR)=3.09, Confidence Interval (CI)=1.53-6.26)]. It shows, however, significant protective effects for CHD (OR=0.55, CI=0.33-0.92), while CHD is adversely associated with IADL disability (OR=2.18, CI=1.28-3.72). The presence of five diseases does not significantly alter the adverse association between ε2-containing genotypes and disability. Protective effects of the ε2/3 genotype for CHD (OR=0.52, CI=0.27-0.99) and deleterious effects for IADL (OR=3.50, CI=1.71-7.14) for males hold in multivariate models with both these factors included. No significant associations between the ε2-containing genotypes and IADL are found in females. CONCLUSIONS: The ε2 allele can play a dual role in males, protecting them against some health disorders, while promoting others. Strong adverse relationships with disability suggest that ε2-containing genotypes can be unfavorable factors for the health/well-being of aging males. PMID:18179501

  4. Geographic Variation in Public Health Spending: Correlates and Consequences

    PubMed Central

    Mays, Glen P; Smith, Sharla A

    2009-01-01

    Objectives To examine the extent of variation in public health agency spending levels across communities and over time, and to identify institutional and community correlates of this variation. Data Sources and Setting Three cross-sectional surveys of the nation's 2,900 local public health agencies conducted by the National Association of County and City Health Officials in 1993, 1997, and 2005, linked with contemporaneous information on population demographics, socioeconomic characteristics, and health resources. Study Design A longitudinal cohort design was used to analyze community-level variation and change in per-capita public health agency spending between 1993 and 2005. Multivariate regression models for panel data were used to estimate associations between spending, institutional characteristics, health resources, and population characteristics. Principal Findings The top 20 percent of communities had public health agency spending levels >13 times higher than communities in the lowest quintile, and most of this variation persisted after adjusting for differences in demographics and service mix. Local boards of health and decentralized state-local administrative structures were associated with higher spending levels and lower risks of spending reductions. Local public health agency spending was inversely associated with local-area medical spending. Conclusions The mechanisms that determine funding flows to local agencies may place some communities at a disadvantage in securing resources for public health activities. PMID:19686249

  5. Trajectories of Adverse Childhood Experiences and Self-Reported Health at Age 18

    PubMed Central

    Thompson, Richard; Flaherty, Emalee G.; English, Diana J.; Litrownik, Alan J.; Dubowitz, Howard; Kotch, Jonathan B.; Runyan, Desmond K.

    2014-01-01

    Objective Despite growing evidence of links between adverse childhood experiences (ACEs) and long-term health outcomes, there has been limited longitudinal investigation of such links in youth. The purpose of these analyses was to describe the patterns of exposure to ACEs over time and their links to youth health. Methods The current analyses used data from LONGSCAN, a prospective study of children at risk for or exposed to child maltreatment, who were followed from age 4 to age 18. The analyses focused on 802 youth with complete data. Cumulative exposure to ACEs between 4 and 16 was used to place participants in 3 trajectory-defined groups: chronic ACEs, early ACEs only, and limited ACEs. Links to self-reported age 18 health were examined using linear mixed models after controlling for earlier health status and demographics. Results The chronic ACEs group had increased self-reported health concerns and use of medical care at 18, but not poorer self-rated health status. The early ACEs only group did not significantly differ from limited ACEs on outcomes. Conclusions In addition to other negative outcomes, chronic ACEs appear to affect physical health in emerging adulthood. Interventions aimed at reducing exposure to ACEs and early mitigation of their effects may have lasting and widespread health benefits. PMID:25441654

  6. Incorporating Health and Behavioral Consequences of Child Abuse in Prevention Programs Targeting Female Adolescents.

    ERIC Educational Resources Information Center

    Buzi, Ruth S.; Weinman, Maxine L.; Smith, Peggy B.

    1998-01-01

    Examined the health and behavioral consequences of child abuse, comparing parenting and never-pregnant teens. Both groups identified major consequences of suicide, prostitution, school drop-out, crime, and substance abuse. Parenting teens expressed interest in prevention programs that would address these consequences. Recommendations for child…

  7. Potential Climate Change Health Risks from Increases in Heat Waves: Abnormal Birth Outcomes and Adverse Maternal Health Conditions.

    PubMed

    Cil, Gulcan; Cameron, Trudy Ann

    2017-02-23

    We investigate the risks presented by heat waves for adverse health conditions for babies and expectant mothers when these mothers have been exposed to heat waves during gestation or during the period just prior to conception. Rather than just birth weight and gestational age, we focus on less common metrics such as abnormal conditions in the newborn (fetal distress, reliance on a ventilator, and meconium aspiration) and adverse health conditions in the mother (pregnancy-related hypertension, uterine bleeding during pregnancy, eclampsia, and incompetent cervix). We use monthly panel data for over 3,000 U.S. counties, constructed from the confidential version of the U.S. Natality Files for 1989-2008. Our models control for sociodemographic factors and include county, month, and state-by-year fixed effects to control for unobserved spatial and timewise heterogeneity in the data. Even within the United States, where there is widespread access to air conditioning, heat waves increase the fraction of babies with abnormal conditions related to maternal stress, as well as the fraction of mothers who experience pregnancy-related adverse health conditions. The scope for these risks in developing countries is likely to be even greater.

  8. Public health consequences of terrorism on maternal-child health in New York City and Madrid.

    PubMed

    Sherrieb, Kathleen; Norris, Fran H

    2013-06-01

    Past research provides evidence for trajectories of health and wellness among individuals following disasters that follow specific pathways of resilience, resistance, recovery, or continued dysfunction. These individual responses are influenced by event type and pre-event capacities. This study was designed to utilize the trajectories of health model to determine if it translates to population health. We identified terrorist attacks that could potentially impact population health rather than only selected individuals within the areas of the attacks. We chose to examine a time series of population birth outcomes before and after the terrorist events of the New York City (NYC) World Trade Center (WTC) attacks of 2001 and the Madrid, Spain train bombings of 2004 to determine if the events affected maternal-child health of those cities and, if so, for how long. For percentages of low birth weight (LBW) and preterm births, we found no significant effects from the WTC attacks in NYC and transient but significant effects on rates of LBW and preterm births following the bombings in Madrid. We did find a significant positive and sustained effect on infant mortality rate in NYC following the WTC attacks but no similar effect in Madrid. There were no effects on any of the indicator variables in the comparison regions of New York state and the remainder of Spain. Thus, population maternal-health in New York and Madrid showed unique adverse effects after the terrorist attacks in those cities. Short-term effects on LBW and preterm birth rates in Madrid and long-term effects on infant mortality rates in NYC were found when quarterly data were analyzed from 1990 through 2008/2009. These findings raise questions about chronic changes in the population's quality of life following catastrophic terrorist attacks. Public health should be monitored and interventions designed to address chronic stress, environmental, and socioeconomic threats beyond the acute aftermath of events.

  9. Childhood Health: Trends and Consequences over the Life Course

    ERIC Educational Resources Information Center

    Delaney, Liam; Smith, James P.

    2012-01-01

    This article first documents evidence on the changing prevalence of childhood physical and mental health problems, focusing on the development of childhood health conditions in the United States. Authors Liam Delaney and James Smith present evidence on the changing prevalence of childhood chronic conditions over time using recalled data as well as…

  10. Revealing moments: formulating understandings of adverse experiences in a health appraisal interview.

    PubMed

    Beach, W A; Dixson, C N

    2001-01-01

    Analysis of a health appraisal interview reveals how an interviewer employs formulations to organize talk about a patient's medical history. When selected reportings by patient are paraphrased, a three-part formulations cycle is initiated: (1) interviewer's formulated understandings, (2) patient's confirmation, and (3) topic shift by interviewer. The reenactment of this interactional pattern promotes increasing attention to patient's adverse experiences as "root problems" underlying adult health status (e.g. molestation, obesity, depression). Creating an environment for patient's emergent disclosures is facilitated by displaying non-judgmental sensitivity to patient's stated concerns, soliciting alignment to particular reconstructions and avoidance of moving the interview forward prematurely and to issues not grounded in patient's illness circumstances. The identification and utilization of communication techniques for attending to patient's bio-psycho-social history is critical for refining understandings of empathic interviewing, enhancing diagnosis and treatment (e.g. referrals), decreasing patients' utilization of health care systems, and ultimately reducing costs for quality medical care.

  11. 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

  12. Sharing sensitive personal health information through Facebook: the unintended consequences.

    PubMed

    Househ, Mowafa

    2011-01-01

    The purpose of this paper was to explore the types of sensitive health information posted by individuals through social network media sites such as Facebook. The researcher found several instances in which individuals, who could be identified by their user profiles, posted personal and sensitive health information related to mental and genetic disorders and sexually transmitted diseases. The data suggest that Facebook users should be made aware of the potential harm that may occur when sharing sensitive health information publicly through Facebook. Ethical considerations in undertaking such research are also examined.

  13. Dating violence: mental health consequences based on type of abuse.

    PubMed

    Eshelman, Lee; Levendosky, Alytia A

    2012-01-01

    This study aims to determine the relationship between psychological, physical, and sexual abuse, and mental health symptoms. Female college students (N = 499) completed anonymous online surveys to report experiences of abuse, as well as symptoms of depression, posttraumatic stress disorder (PTSD), and physical injuries. Five groups of participants were found: no abuse; psychological abuse; physical abuse; psychological and physical abuse; and psychological, physical, and sexual abuse. The multiple abuse groups showed the highest rate of mental health symptoms. In addition, increased frequency of abuse was related to more mental health symptoms and more physical injuries.

  14. Common variants of the vitamin D binding protein gene and adverse health outcomes

    PubMed Central

    Malik, Suneil; Fu, Lei; Juras, David James; Karmali, Mohamed; Wong, Betty Y. L.; Gozdzik, Agnes

    2013-01-01

    The vitamin D binding protein (DBP) is the major plasma carrier for vitamin D and its metabolites, but it is also an actin scavenger, and is the precursor to the immunomodulatory protein, Gc-MAF. Two missense variants of the DBP gene – rs7041 encoding Asp432Glu and rs4588 encoding Thr436Lys – change the amino acid sequence and alter the protein function. They are common enough to generate population-wide constitutive differences in vitamin D status, based on assay of the serum metabolite, 25-hydroxyvitamin D (25OHD). Whether these variants also influence the role of vitamin D in an immunologic milieu is not known. However, the issue is relevant, given the immunomodulatory effects of DBP and the role of protracted innate immune-related inflammation in response to tissue injury or repeated infection. Indeed, DBP and vitamin D may jointly or independently contribute to a variety of adverse health outcomes unrelated to classical notions of their function in bone and mineral metabolism. This review summarizes the reports to date of associations between DBP variants, and various chronic and infectious diseases. The available information leads us to conclude that DBP variants are a significant and common genetic factor in some common disorders, and therefore, are worthy of closer attention. In view of the heightened interest in vitamin D as a public health target, well-designed studies that look simultaneously at vitamin D and its carrier in relation to genotypes and adverse health outcome should be encouraged. PMID:23427793

  15. Chlorinated drinking water, cancers and adverse health outcomes in Gangtok, Sikkim, India.

    PubMed

    Sharma, Rabi N; Goel, Sudha

    2007-10-01

    Long-term impacts of drinking chlorinated water on the incidence of cancers and other adverse health outcomes were assessed in a population-based cross-sectional study. The study was conducted by comparing a group exposed to chlorinated drinking water for more than thirty years with control groups with less or no exposure to chlorine. A house-to-house survey was completed to gather information on residential history, age, education, income, source and extent of treatment of water and health characteristics. All residents below thirty years of age were excluded from the database used for analyses to ensure that the groups were comparable. Fourteen cancer cases were found in the long-term exposed groups of 1085 persons and 9 cancer cases in the two control populations of 725 persons. The odds ratio for cancers (OR) was 1.05 (95% CI = 0.43-2.65) and is not statistically significant. Reciprocal or inverse odds [corrected] ratios for gastrointestinal disorders, kidney problems and skin infections were statistically significant ranging from 2.06 (95% CI = 1.01-4.17) to 2.2 (95% CI = 1.45-3.33). These OR values indicate that there is no significant association between the incidence of cancer and exposure to chlorinated water while chlorinating drinking water significantly reduced the incidence of non-carcinogenic adverse health effects like gastrointestinal diseases, skin infections, and kidney diseases.

  16. Adverse health behaviours among colorectal cancer survivors: a case study from Iran

    PubMed Central

    Aminisani, Nayyereh; Nikbakht, Hosseinali A.; Hosseinei, Seidreza R.

    2016-01-01

    Background Cancer survivors are at greater risk of developing secondary tumours, cardiovascular disease, diabetes, and osteoporosis. A part of this is because they share the similar lifestyle factors. The aim of this study was to examine the prevalence of adverse health behaviours and its determinants among colorectal survivors. Methods This cross-sectional study was conducted in Babol city located in North of Iran. The pathologic information and demographic characteristics were collected from the population based-cancer registry. Colorectal cancer (CRC) survivors between 2007–2013 were included in this study. A questionnaire includes socioeconomic status, lifestyle behaviours [smoking, physical activity (PA), fruit & vegetable consumption], and clinical factors were completed via home visit by trained interviewers. Results The majority of CRC survivors were male and were more than 50 years of age, more than half of them resided in urban areas. About 67% of survivors had at least one comorbid condition. In general, the majority of them were not meeting the recommendation for PA (89%), about 87% of them consumed less than 5 daily serving of fruit & vegetable and 14.6% of participants were smoke either cigarette or hookah. Female genders, illiteracy, comorbidities, and place of residency were the most important determinants of having adverse health behaviours. Conclusions The minority of people with CRC were not meeting the PA or 5-A-day recommendations. It is important to notify the health policy makers and to develop a comprehensive educational program to enhance the adherence to healthy lifestyle recommendation among CRC survivors. PMID:27284469

  17. Adverse Childhood Experiences and Adult Health Outcomes Among Veteran and Non-Veteran Women

    PubMed Central

    Blosnich, John R.; Dichter, Melissa E.

    2015-01-01

    Abstract Background: Women veterans represent a vulnerable population with unique health needs and disparities in access to care. One constellation of exposures related to subsequent poor health includes adverse childhood experiences (ACEs; e.g., physical and sexual child abuse), though research on impacts of ACEs among women veterans is limited. Methods: Data were drawn from the 2010 Behavioral Risk Factor Surveillance System for the 11 states that included the ACE module (n=36,485). Weighted chi-squared tests and multivariable logistic regression were used to assess the prevalence of ACEs among women veterans compared with women non-veterans and differences in the following outcomes, controlling for ACEs: social support, inadequate sleep, life satisfaction, mental distress, smoking, heavy alcohol use, obesity, diabetes, cardiovascular disease symptoms, asthma, and disability. Results: Women veterans (1.6% of the total sample) reported a higher prevalence of 7 out of 11 childhood adversities and higher mean ACE score than women non-veterans. Women veterans were more likely to be current smokers and report a disability, associations which were attenuated when controlling for ACE. Conclusions: Despite women veterans' higher prevalence of ACE, their health outcomes did not differ substantially from non-veterans. Further research is needed to understand the intersections of traumatic experiences and sources of resilience over the lifecourse among women veterans. PMID:26390379

  18. Surveillance of suspected adverse reactions to natural health products: the case of propolis.

    PubMed

    Menniti-Ippolito, Francesca; Mazzanti, Gabriela; Vitalone, Annabella; Firenzuoli, Fabio; Santuccio, Carmela

    2008-01-01

    Natural health products are promoted to the public as equally or more effective and less toxic than conventional drugs. However, some 'natural' medicines are known to have adverse effects. From April 2002 to August 2007, 18 suspected adverse reactions associated with propolis-containing products were reported to the national surveillance system of natural health products, coordinated by the Italian National Health Institute. Sixteen reports concerned allergic reactions (with dermatological or respiratory symptoms), while two concerned the digestive tract. Some of the reactions were serious: six patients were admitted to hospital or visited an emergency department and in two of these a life-threatening event was reported. In seven patients (four of whom were children), an allergic predisposition was indicated. Propolis, a resinous substance collected by honeybees from the buds of living plants, has been used for several purposes (dermatitis, laryngitis, oral ulcers) because of its wide range of suggested activities (antibacterial, antiviral, antifungal, anti-inflammatory, antioxidant and chemopreventive actions). However, propolis is also a potent sensitizer and should not be used in patients with an allergic predisposition, in particular an allergy to pollen. In Italy, products containing bee derivatives (bee pollen, royal jelly or propolis) are available to the public as food supplements. No label warning of possible adverse reactions is found on the packaging, although it is well known that atopic and asthmatic individuals may be at an increased risk of allergic reactions after using these products. The public and healthcare practitioners should be aware of the risk of allergic reactions to products derived from bees and a warning should be added to the packaging of these products.

  19. Adolescent Family Adversity and Mental Health Problems: The Role of Adaptive Self-Regulation Capacities. The TRAILS Study

    ERIC Educational Resources Information Center

    Bakker, Martin Paul; Ormel, Johan; Verhulst, Frank C.; Oldehinkel, Albertine J.

    2011-01-01

    Adolescent family adversity is a considerable adaptive challenge in an increasingly turbulent developmental period. Using data from a prospective population cohort of 2230 Dutch adolescents, we tested risk-buffering interactions between adolescent family adversity and self-regulation capacities on mental health. We used two adaptive…

  20. HEALTH AND ENVIRONMENTAL CONSEQUENCES OF THE WORLD TRADE CENTER DISASTER

    EPA Science Inventory

    The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyse...

  1. The female athlete triad: components, nutrition issues, and health consequences.

    PubMed

    Manore, Melinda M; Kam, Lynn Ciadella; Loucks, Anne B

    2007-01-01

    This paper, which was part of the International Association of Athletics Federations (IAAF) 2007 Nutritional Consensus Conference, briefly reviews the components of the female athlete triad (Triad): energy availability, menstrual status, and bone health. Each component of the Triad spans a continuum from health to disease, and female athletes can have symptoms related to each component of the Triad to different degrees. Low energy availability is the primary factor that impairs menstrual dysfunction and bone health in the Triad. We discuss nutritional issues associated with the Triad, focusing on intakes of macronutrients needed for good health, and stress fractures, the most common injury associated with the Triad. Finally, we briefly discuss screening and treatment for the Triad and the occurrence of the Triad in men.

  2. Risky Music Listening, Permanent Tinnitus and Depression, Anxiety, Thoughts about Suicide and Adverse General Health

    PubMed Central

    Vogel, Ineke; van de Looij-Jansen, Petra M.; Mieloo, Cathelijne L.; Burdorf, Alex; de Waart, Frouwkje

    2014-01-01

    Objective To estimate the extent to which exposure to music through earphones or headphones with MP3 players or at discotheques and pop/rock concerts exceeded current occupational safety standards for noise exposure, to examine the extent to which temporary and permanent hearing-related symptoms were reported, and to examine whether the experience of permanent symptoms was associated with adverse perceived general and mental health, symptoms of depression, and thoughts about suicide. Methods A total of 943 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their sociodemographics, music listening behaviors and health. Multiple logistic regression analyses were used to examine associations. Results About 60% exceeded safety standards for occupational noise exposure; about one third as a result of listening to MP3 players. About 10% of the participants experienced permanent hearing-related symptoms. Temporary hearing symptoms that occurred after using an MP3 player or going to a discotheque or pop/rock concert were associated with exposure to high-volume music. However, compared to participants not experiencing permanent hearing-related symptoms, those experiencing permanent symptoms were less often exposed to high volume music. Furthermore, they reported at least two times more often symptoms of depression, thoughts about suicide and adverse self-assessed general and mental health. Conclusions Risky music-listening behaviors continue up to at least the age of 25 years. Permanent hearing-related symptoms are associated with people’s health and wellbeing. Participants experiencing such symptoms appeared to have changed their behavior to be less risky. In order to induce behavior change before permanent and irreversible hearing-related symptoms occur, preventive measurements concerning hearing health are needed. PMID:24897078

  3. Work-related Mental Consequences: Implications of Burnout on Mental Health Status Among Health Care Providers

    PubMed Central

    Papathanasiou, Ioanna V.

    2015-01-01

    Introduction: Burnout can create problems in every aspect of individual’s’ human life. It may have an adverse effect on interpersonal and family relations and can lead to a general negative attitude towards life. Aim: The purpose of this study is to investigate whether burnout is associated with the mental health status of health care providers. Material and Methods: The sample in this study consisted of 240 health care employees. The Greek version of Maslach’s Burnout Inventory (MBI) was used for measuring burnout levels and the Greek version of the Symptoms Rating Scale for Depression and Anxiety (SRSDA) questionnaire was used to evaluate health care providers’ mental health status. Descriptive statistics were initially generated for sample characteristics. Normality was checked by the Kolmogorov-Smirnov test and data was processed with parametric tests. General linear models with MBI dimensions as independent variables and SRSDA subscales as dependent variables were used to determine the relation between burnout and mental health status. Statistics were processed with SPSS v. 17.0 (SPSS, Chicago, IL, USA). Statistical significance was set at p=0.05. Results: The average age of the sample is 40.00±7.95 years. Regarding gender the percentage of men is 21.40% (N=49) and of women is 78.60% (N=180). Overall the professional burnout of health care workers is moderate. The mean score for emotional exhaustion is 26.41, for personal accomplishment 36.70 and for depersonalization 9.81. The mean for each subscale of SRSDA is 8.23±6.79 for Depression Beck-21, 3.96±4.26 for Depression Beck-13, 4.91±4.44 for Melancholia, 6.32±4.35 for Asthenia and 6.36±4.72 for Anxiety. The results of general linear models with the MBI dimensions as independent variables and the SRSDA subscales as dependent variables are shown that emotional exhaustion and personal accomplishment are statistically correlated with all subscales of SRSDA, while depersonalization is not correlated

  4. Adverse or acceptable: negotiating access to a post-apartheid health care contract

    PubMed Central

    2014-01-01

    Background As in many fragile and post-conflict countries, South Africa’s social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Methods Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering – negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Results Although South Africa’s right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Conclusions Building health in

  5. [Epidemiological research on environmental health risks and their economic consequences].

    PubMed

    Haucke, F; Holle, R; Wichmann, H E

    2009-12-01

    In environmental health research, methods for quantitative analysis of human population studies data are gaining importance. In recent years, it has been realized that they can also provide an important link to the economic view on environmental health effects. In this review, fundamental concepts and methods from environmental epidemiology and health economics are presented and it is shown how they can be linked in order to support environmental policy decisions. In addition, the characteristics of environmental epidemiology and the role of epidemiologic studies in risk assessment are discussed. From the economic point of view, cost-of-illness studies and cost effectiveness studies are the main approaches, and we have placed special focus on methods of monetary valuation of health effects that are generally proposed in the environmental context. Two conceptually differing strategies to combine epidemiologic and economic evidence are presented: the environmental attributable fraction model as a top-down approach and the impact pathway approach which follows a bottom-up analysis strategy. Finally, two examples are used to illustrate the application of these concepts and methods: health risks caused by fine particle air pollution and their costs, and the cost-effectiveness of radon exposure reduction policies.

  6. The European ban on growth-promoting antibiotics and emerging consequences for human and animal health.

    PubMed

    Casewell, Mark; Friis, Christian; Marco, Enric; McMullin, Paul; Phillips, Ian

    2003-08-01

    Following the ban of all food animal growth-promoting antibiotics by Sweden in 1986, the European Union banned avoparcin in 1997 and bacitracin, spiramycin, tylosin and virginiamycin in 1999. Three years later, the only attributable effect in humans has been a diminution in acquired resistance in enterococci isolated from human faecal carriers. There has been an increase in human infection from vancomycin-resistant enterococci in Europe, probably related to the increased in usage of vancomycin for the treatment of methicillin-resistant staphylococci. The ban of growth promoters has, however, revealed that these agents had important prophylactic activity and their withdrawal is now associated with a deterioration in animal health, including increased diarrhoea, weight loss and mortality due to Escherichia coli and Lawsonia intracellularis in early post-weaning pigs, and clostridial necrotic enteritis in broilers. A directly attributable effect of these infections is the increase in usage of therapeutic antibiotics in food animals, including that of tetracycline, aminoglycosides, trimethoprim/sulphonamide, macrolides and lincosamides, all of which are of direct importance in human medicine. The theoretical and political benefit of the widespread ban of growth promoters needs to be more carefully weighed against the increasingly apparent adverse consequences.

  7. The health consequences of child mental health problems and parenting styles: Unintentional injuries among European schoolchildren☆,☆☆

    PubMed Central

    Keyes, Katherine M.; Susser, Ezra; Pilowsky, Daniel J.; Hamilton, Ava; Bitfoi, Adina; Goelitz, Dietmar; Kuijpers, Rowella C.W.M.; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Kovess, Viviane

    2015-01-01

    Objective Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. Methods Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past year injuries serious enough to seek medical atten tion were reported by mothers. Child mental health problems were assessed using validated measures and re ported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. Results. Children with attention deficit/hyperactivity symptoms and oppositional defant symptoms had a higher risk of injury compared to other children whether based on parent report (OR = 1.47, 95% C.I. 1.2 1.9), teacher report (OR = 1.36, 95% C.I. 1.1 1.7), or parent- and teacher-report combined (OR = 1.53, 95% C.I. 1.1 2.1). Children who self reported oppositional symptoms also had higher risk of injury (OR = 1.6, 95% C.I. 1.1 2.4). Low caring behavior of parents increased the risk of injury (OR = 1.4, 95% C.I. 1.1-1.9). Conclusion Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent child relationships and prevention as well as focused treatment for externaliz ing problems may reduce the burden of injury. PMID:25073079

  8. Adverse health effects of spousal violence among women attending Saudi Arabian primary health-care clinics.

    PubMed

    Eldoseri, H M; Tufts, K A; Zhang, Q; Fish, J N

    2014-12-17

    This study aimed to investigate the frequency of spousal violence among Saudi women and document the related health effects and injuries, as well as their attitudes to gender and violence. Structured interviews were conducted with 200 ever-married women recruited from primary-care centres in Jeddah. Nearly half of the surveyed women (44.5%) reported ever experiencing physical violence from their spouse. Although 37 women (18.5%) had received violence-related injuries, only 6.5% had reported these injuries to a health-care provider. Victims of spousal violence had poor perceptions of their overall health, and reported pain or discomfort, antidepressant use and suicidal thoughts. Women mostly disagreed with the presented justifications for wife-beating. However, the association between gender attitudes and spousal violence was not significant. The results of this study support calls for integration of education about partner violence into health-care curricula to enhance the access and quality of services.

  9. Environmental Public Health Policy for Asbestos in Schools: Unintended Consequences.

    ERIC Educational Resources Information Center

    Corn, Jacqueline Karnell

    This book explores the history of asbestos in schools and buildings and how this issue shaped the development of public health policy. It provides insight into past policy including how and why action was taken and who caused it to be taken; it also offers guidance for the scientific and regulatory communities in the future. While explaining…

  10. Ontologies to capture adverse events following immunisation (AEFI) from real world health data.

    PubMed

    Liyanage, Harshana; de Lusignan, Simon

    2014-01-01

    Immunisation is an important part of health care and adverse events following immunisation (AEFI) are relatively rare. AEFI can be detected through long term follow up of a cohort or from looking for signals from real world, routine data; from different health systems using a variety of clinical coding systems. Mapping these is a challenging aspect of integrating data across borders. Ontological representations of clinical concepts provide a method to map similar concepts, in this case AEFI across different coding systems. We describe a method using ontologies to be flag definite, probable or possible cases. We use Guillain-Barre syndrome (GBS) as an AEFI to illustrate this method, and the Brighton collaboration's case definition of GBS as the gold standard. Our method can be used to flag definite, probable or possible cases of GBS. Whilst there has been much research into the use of ontologies in immunisation these have focussed on database interrogation; where ours looks to identify varying signal strength.

  11. Psychoneuroimmunology in pregnancy: immune pathways linking stress with maternal health, adverse birth outcomes, and fetal development.

    PubMed

    Christian, Lisa M

    2012-01-01

    It is well-established that psychological stress promotes immune dysregulation in nonpregnant humans and animals. Stress promotes inflammation, impairs antibody responses to vaccination, slows wound healing, and suppresses cell-mediated immune function. Importantly, the immune system changes substantially to support healthy pregnancy, with attenuation of inflammatory responses and impairment of cell-mediated immunity. This adaptation is postulated to protect the fetus from rejection by the maternal immune system. Thus, stress-induced immune dysregulation during pregnancy has unique implications for both maternal and fetal health, particularly preterm birth. However, very limited research has examined stress-immune relationships in pregnancy. The application of psychoneuroimmunology research models to the perinatal period holds great promise for elucidating biological pathways by which stress may affect adverse pregnancy outcomes, maternal health, and fetal development.

  12. Diagnostic criteria for adverse health effects in the environs of wind turbines.

    PubMed

    McMurtry, Robert Y; Krogh, Carmen Me

    2014-10-01

    In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed.

  13. Diagnostic criteria for adverse health effects in the environs of wind turbines

    PubMed Central

    Krogh, Carmen ME

    2014-01-01

    Summary In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed. PMID:25383200

  14. Evidence Report: Risk of Crew Adverse Health Event Due to Altered Immune Response

    NASA Technical Reports Server (NTRS)

    Crucian, Brian; Sams, Clarence F.

    2013-01-01

    The Risk of Crew Adverse Health Event Due to Altered Immune Response is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. It is known that human immune function is altered in- and post-flight, but it is unclear at present if such alterations lead to increased susceptibility to disease. Reactivation of latent viruses has been documented in crewmembers, although this reactivation has not been directly correlated with immune changes or with observed diseases. As described in this report, further research is required to better characterize the relationships between altered immune response and susceptibility to disease during and after spaceflight. This is particularly important for future deep-space exploration missions.

  15. The impact of adverse events on health care costs for older adults undergoing nonelective abdominal surgery

    PubMed Central

    Bailey, Jonathan G.; Davis, Philip J.B.; Levy, Adrian R.; Molinari, Michele; Johnson, Paul M.

    2016-01-01

    Background Postoperative complications have been identified as an important and potentially preventable cause of increased hospital costs. While older adults are at increased risk of experiencing complications and other adverse events, very little research has specifically examined how these events impact inpatient costs. We sought to examine the association between postoperative complications, hospital mortality and loss of independence and direct inpatient health care costs in patients 70 years or older who underwent nonelective abdominal surgery. Methods We prospectively enrolled consecutive patients 70 years or older who underwent nonelective abdominal surgery between July 1, 2011, and Sept. 30, 2012. Detailed patient-level data were collected regarding demographics, diagnosis, treatment and outcomes. Patient-level resource tracking was used to calculate direct hospital costs (2012 $CDN). We examined the association between complications, hospital mortality and loss of independence cost using multiple linear regression. Results During the study period 212 patients underwent surgery. Overall, 51.9% of patients experienced a nonfatal complication (32.5% minor and 19.4% major), 6.6% died in hospital and 22.6% experienced a loss of independence. On multivariate analysis nonfatal complications (p < 0.001), hospital mortality (p = 0.021) and loss of independence at discharge (p < 0.001) were independently associated with health care costs. These adverse events respectively accounted for 30%, 4% and 10% of the total costs of hospital care. Conclusion Adverse events were common after abdominal surgery in older adults and accounted for 44% of overall costs. This represents a substantial opportunity for better patient outcomes and cost savings with quality improvement strategies tailored to the needs of this high-risk surgical population. PMID:26999476

  16. Adverse Childhood Experiences and Health in Adulthood in a Rural Population-Based Sample

    PubMed Central

    Iniguez, Kristen C.; Stankowski, Rachel V.

    2016-01-01

    Background Adverse childhood experiences (ACEs), including emotional abuse, substance abuse in the household, separation or divorce, physical abuse, violence between adults, mental illness in the household, sexual abuse, or incarceration of a household member, have the potential to profoundly impact health and well-being in adulthood. To assess whether previously reported relationships between ACEs and health outcomes withstand validation, we conducted a community-based ACE study with the unique capacity to link self-reported ACEs and other survey results to validated health data in an electronic medical record (EMR). Methods Information regarding ACEs and health outcomes was captured from 2013–2014 via a telephone survey of residents of the predominantly rural northern and central regions of Wisconsin and electronic abstraction of EMR data. ACE score was calculated by counting each exposure as one point. We examined the relationship between ACE score, type, and self-reported and validated health outcomes. Results A total of 800 participants completed the telephone survey. Overall, 62% reported at least one ACE and 15% reported experiencing four or more. All self-reported measures of poor health were associated with increased ACE score. EMR data were positively correlated with ACE score for increased body mass index and diagnoses of depression, anxiety, and asthma. In contrast, diagnoses of hypertension, hypercholesterolemia, myocardial infarction, and skin and other cancers were inversely related to ACE score. Emotional abuse was the most common ACE reported followed by substance abuse in the household. ACEs tended to cluster so that people who reported at least one ACE were likely to have experienced multiple ACEs. There was no clear correlation between abuse type (e.g., direct abuse vs. household dysfunction) and health outcomes. Conclusions In the first community-based study to link self-reported ACEs to comprehensive health measures documented in the medical

  17. Organophosphate pesticides exposure among farmworkers: pathways and risk of adverse health effects.

    PubMed

    Suratman, Suratman; Edwards, John William; Babina, Kateryna

    2015-01-01

    Organophosphate (OP) compounds are the most widely used pesticides with more than 100 OP compounds in use around the world. The high-intensity use of OP pesticides contributes to morbidity and mortality in farmworkers and their families through acute or chronic pesticides-related illnesses. Many factors contributing to adverse health effects have been investigated by researchers to determine pathways of OP-pesticide exposure among farmers in developed and developing countries. Factors like wind/agricultural pesticide drift, mixing and spraying pesticides, use of personal protective equipment (PPE), knowledge, perceptions, washing hands, taking a shower, wearing contaminated clothes, eating, drinking, smoking, and hot weather are common in both groups of countries. Factors including low socioeconomic status areas, workplace conditions, duration of exposure, pesticide safety training, frequency of applying pesticides, spraying against the wind, and reuse of pesticide containers for storage are specific contributors in developing countries, whereas housing conditions, social contextual factors, and mechanical equipment were specific pathways in developed countries. This paper compares existing research in environmental and behavioural exposure modifying factors and biological monitoring between developing and developed countries. The main objective of this review is to explore the current depth of understanding of exposure pathways and factors increasing the risk of exposure potentially leading to adverse health effects specific to each group of countries.

  18. Uncertainty quantification of adverse human health effects from continuously released contaminant sources in groundwater systems

    NASA Astrophysics Data System (ADS)

    Zarlenga, Antonio; de Barros, Felipe P. J.; Fiori, Aldo

    2016-10-01

    We propose a computationally efficient probabilistic modeling methodology to estimate the adverse effects on humans of exposure to contaminated groundwater. Our work is aligned with the standard suggested by the regulatory agencies and allows to propagate uncertainty from hydrogeological, toxicological and behavioral parameters to the final health risk endpoint. The problem under consideration consists of a contaminated aquifer supplying water to a population. Contamination stems from a continuous source that feeds a steady plume which constitutes the hazard source. This scenario is particularly suited for NAPL pollutants. The erratic displacement of the contaminant plume in groundwater, due to the spatial variability of hydraulic conductivity, is characterized within the Lagrangian stochastic framework which enables the complete probabilistic characterization of the contaminant concentration at an environmentally sensitive location. Following the probabilistic characterization of flow and transport, we quantify the adverse health effects on humans. The dose response assessment involves the estimation of the uncertain effects of the exposure to a given contaminant while accounting for the exposed individual's metabolism. The model integrates groundwater transport, exposure and human metabolism in a comprehensive probabilistic framework which allows the assessment of the risk probability through a novel simple analytical solution. Aside from its computational efficiency, the analytical features of the framework allows the assessment of uncertainty arising from the hydrogeological parameters.

  19. Adverse childhood experiences, health, and employment: A study of men seeking job services.

    PubMed

    Topitzes, James; Pate, David J; Berman, Nathan D; Medina-Kirchner, Christopher

    2016-11-01

    The present study explored factors associated with barriers to current employment among 199 low-income, primarily Black American men seeking job services. The study took place in an urban setting located within the upper Midwest region of the U.S., where the problem of Black male joblessness is both longstanding and widespread. Recent research suggests that Black male joblessness regionally and nationally is attributable to myriad macro- and micro-level forces. While structural-level factors such as migration of available jobs, incarceration patterns, and racism have been relatively well-studied, less is known about individual-level predictors of Black male joblessness, which are inextricably linked to macro-level or structural barriers. This study therefore examined relations between adverse childhood experiences (ACEs), health-related factors, and employment-related problems. Participants faced both specific and cumulative childhood adversities at much higher rates than men from more economically advantaged contexts. In addition, the physical, behavioral, and mental health of the study participants were, according to self-report survey results, notably worse than that of the general population or alternative samples. Finally, results indicated that exposure to ACEs may have helped to undermine the men's ability to attain current employment and that drug problems along with depression symptoms helped explain the link between ACEs and employment barriers. Theoretical and practical implications of results are explored.

  20. Exploring the relationship between childhood adversity and oral health: An anecdotal approach and integrative view.

    PubMed

    Kirkengen, Anna Luise; Lygre, Henning

    2015-08-01

    During the past two decades, increasing recognition has been given to a relationship between oral health and systemic diseases. Associated systemic conditions include cardiovascular disease, diabetes, low birth weight and preterm births, respiratory diseases, rheumatoid arthritis, obesity, osteoporosis, and, in particular among oral conditions, periodontal disease. Low-grade inflammation is a common denominator linking these disorders. Applying an anecdotal approach and an integrative view, the medical and dental histories of two women document increasing ill health subsequent to incidences of maltreatment and sexual abuse, including oral penetration, at an early age. Comprehensive oral rehabilitation was required in both cases. These cases open for medical insight with regard to their implicit patho-physiology, when integrated with current evidence from neuroscience, endocrinology, and immunology, converging in the concepts of allostasis and allostatic load. In cases such as those presented in this paper, primary care physicians (family doctors, General Practitioners) and dentists may be the first to identify an etiological pattern. This report underlines the importance of increased and enhanced multidisciplinary research cooperation among health professionals. Our hypothesis is that childhood adversity may affect all aspects of human health, including adult oral health.

  1. Food insecurity is associated with adverse health outcomes among human infants and toddlers.

    PubMed

    Cook, John T; Frank, Deborah A; Berkowitz, Carol; Black, Maureen M; Casey, Patrick H; Cutts, Diana B; Meyers, Alan F; Zaldivar, Nieves; Skalicky, Anne; Levenson, Suzette; Heeren, Tim; Nord, Mark

    2004-06-01

    The U.S. Household Food Security Scale, developed with federal support for use in national surveys, is an effective research tool. This study uses these new measures to examine associations between food insecurity and health outcomes in young children. The purpose of this study was to determine whether household food insecurity is associated with adverse health outcomes in a sentinel population ages < or = 36 mo. We conducted a multisite retrospective cohort study with cross-sectional surveys at urban medical centers in 5 states and Washington DC, August 1998-December 2001. Caregivers of 11,539 children ages < or = 36 mo were interviewed at hospital clinics and emergency departments (ED) in central cities. Outcome measures included child's health status, hospitalization history, whether child was admitted to hospital on day of ED visit (for subsample interviewed in EDs), and a composite growth-risk variable. In this sample, 21.4% of households were food insecure (6.8% with hunger). In a logistic regression, after adjusting for confounders, food-insecure children had odds of "fair or poor" health nearly twice as great [adjusted odds ratio (AOR) = 1.90, 95% CI = 1.66-2.18], and odds of being hospitalized since birth almost a third larger (AOR = 1.31, 95% CI = 1.16-1.48) than food-secure children. A dose-response relation appeared between fair/poor health status and severity of food insecurity. Effect modification occurred between Food Stamps and food insecurity; Food Stamps attenuated (but did not eliminate) associations between food insecurity and fair/poor health. Food insecurity is associated with health problems for young, low-income children. Ensuring food security may reduce health problems, including the need for hospitalizations.

  2. [Health consequences of environmental temperature and climate variations].

    PubMed

    Swynghedauw, Bernard

    2012-01-01

    Recent climate change is a consequence of the greenhouse effect and human activity, and is directly responsible for extreme events such as heatwaves (see report of the French Académie des Sciences). Human thermoregulation depends more on behavior than on biology Air conditioning and building structure play an essential role. The 2003 heatwave was not a unique event. Preventive measures reduced mortality during subsequent heatwaves. Most deaths were due to heat stroke associated with dehydration. During strenuous exercise, especially during military training, heat stroke requires specific treatment. Temperature/ global mortality and temperature/cardiovascular mortality curves are both U-shaped. Usually, global mortality increases winter and is linked to temperature. During summer, global mortality increases only when heatwaves occur. Climate change participates in the spread of infectious diseases. Nevertheless, in continental France, for the moment, climate change is not a major factor in the incidence of infectious diseases, despite the fact that several bacteria, viruses and vectors are temperature-sensitive. The situation in Reunion, French Polynesia and French Departments of America is more complicated, due to their geographic heterogeneity. Some areas are more exposed to the climatic risk and could act as a gateway for new infections and mutations. The dramatic loss of biodiversity is partly a consequence of climate change. It increases the transmissibility of some pathogens and can also potentially lead to an increase in autoimmune diseases and obesity. Climate change plays a important role in allergic diseases, through changes in the diffusion and composition of pollens. These modifications are being monitored by several observatories. Six different veterinary diseases, including several zoonoses, are of particular concern.

  3. Asian migration to Australia: food and health consequences.

    PubMed

    Wahlqvist, Mark L

    2002-01-01

    Australia's food and health patterns are inextricably and increasingly linked with Asia. Indigenous Australians arrived in the continent via Asia and have linguistic connections with people who settled in south India; there was interaction and food trade between both South-East Asia and China and northern indigenous Australians over thousands of years. After European settlement in 1788, there have been several and increasing (apart from the period of the infamous White Australian Policy following the Colonial period and Independence, with Federation, in 1901) waves of Asian migration, notably during the gold rush (Chinese), the building of the overland Telegraph (Afghans), the Colombo Plan and Asian student education in Australia from the 1950s onwards (South-Eeast Asians), and with refugees (Vietnamese and mainland Chinese), and business (late twentieth century) and progressive family reunion. Each wave has injected additional food cultural elements and caused a measure of health change for migrants and host citizens. Of principal advantage to Australia has been the progressive diversification of the food supply and associated health protection. This has increased food security and sustainability. The process of Australian eating patterns becoming Asianized is evident through market garden development (and the introduction of new foods), fresh food markets and groceries, restaurants and the development of household cooking skills (often taught by student boarders). Most of the diversification has been with grain (rice), legumes (soy), greens, root vegetables, and various 'exotic fruits'. Food acculturation with migration is generally bi-directional. Thus, for Asians in Australia, there has been a decrease in energy expenditure (and a lower plane of energy throughput), an increase in food energy density (through increased fat and sugary drink intakes), and a decrease in certain health protective foods (lentils, soy, greens) and beverages (tea). This sets the stage

  4. [Climatic changes in Scandinavia--consequences for public health].

    PubMed

    Kanestrøm, I

    1999-01-30

    Atmospheric composition and climate conditions are of great importance for health. Increasing consumption of fossil fuels ever since the industrial revolution has resulted in higher contents of greenhouse gases in the atmosphere. Primarily, this will increase the global temperature. Secondarily, it may change the patterns of precipitation and droughts. Higher extreme temperatures will have a negative effect on health. Climate changes can also change the living conditions of undesirable insects and microbes. The ozone gas in the atmosphere acts as a shield against the harmful ultraviolet radiation from the sun. Chlorofluorocarbons contribute to reduction of the ozone layer and increase ultraviolet radiation. Increased exposure of the skin to this radiation may cause damage such as sunburn and skin cancer. In order to avoid damage, it is of importance to wear protective clothing or use effective sunshades.

  5. Triumph and adversity: Exploring the complexities of consumer storytelling in mental health nursing education.

    PubMed

    Happell, Brenda; Bennetts, Wanda

    2016-12-01

    Consumer participation in the education of health professionals is increasing, particularly in mental health nursing education and storytelling remains the most frequent approach to consumer involvement. The use of story has tended to be accepted as a legitimate educational tool with limited critique or consideration of its potential consequences presented within the academic literature. A qualitative exploratory research study was undertaken with mental health nurse academics (n = 34) and consumer educators and academics (n = 12), to investigate the perceptions and experiences of mental health nurses and consumers regarding the involvement of consumers in mental health nursing education. Data were analysed thematically. Story was a major theme to emerge from consumer participants and received some attention from nurse academics. Consumers and nurses both referred to the power of story to convey the human experience of mental illness diagnosis and service use; and the vulnerability that can result from storytelling. Consumers also described: story as expectation; preparation and support; and the politics of story. All participants supported the value of storytelling in mental health nursing education. Consumers had considered the complexities in far greater detail. The ongoing value of story as an educational technique requires further research. Equally important is considering a broader range of educational roles for mental health consumers.

  6. [Sickness - disease - illness - health: Problems of global definitions and consequences].

    PubMed

    Schroeder-Kurth, Traute Marianne

    2003-01-01

    Globalization on the one side is highly wellcome as simplifying trade, communication or tourism. On the other side globalization seems to uniform cultural values, which causes anxieties and outrage in many countries. Since decades "western" medical knowledge is being transferred into the Third World. This paper begins with the problem of a worldwide understanding of terms like sickness, disease, illness and health. Results gained from investigations in the field of Medical Anthropology emphasize the importance to integrate any cultural values and symbols of the target population. Examples given to demonstrate difficulties and requirements for any transfer of western medicine into those countries. A close view into the health systems, concepts of health and disease, coping and treatment in England, France, Germany and the USA shows considerable divergences. "Western" medicine is not based on an uniform conception, but is modulated by traditional values of the nations. Any attempt to globalize "western" medicine must respect and integrate the inherited thinking pattern and medical system of a population in order to benefit the people.

  7. Public health consequences of heavy metals in dump sites.

    PubMed Central

    Clarkson, T W; Weiss, B; Cox, C

    1983-01-01

    Metals differ from most synthetic organic chemicals in that their clinical manifestations are well known and methods for their measurement in the body are generally well established. Since metals are ubiquitous, special care should be taken to identify the source, whether dump site or not. Isotopic ratios may be used for lead. Time of exposure may be highly variable so estimates will be necessary of integrated "dose-commitment." Transmission to man will follow many pathways. The contamination of children's hands and clothing by dust may be an important route. Because effects are so different, the chemical species (e.g., organic versus inorganic forms) of each metal must be identified. Exposure assessment requires identification of suitable indicator media, usually blood in the case of lead, urine with cadmium and inorganic mercury, and blood or hair with regard to methylmercury. Human head hair may have considerable potential, as it may provide a recapitulation of past exposures. The first health complaints associated with most metals are usually nonspecific. The complex social, political, and legal issues strongly indicate the need for objective tests for health effects. Most important is the identification and measurement of the critical effect, i.e., an effect that alerts the public health authorities that further exposure should cease. For example, in the case of lead, the critical effect is hematologic; with cadmium it is the presence in urine of abnormally high concentration of small molecular weight protein; and with mercury no early objective test has yet been devised. PMID:6825626

  8. Repealing Federal Health Reform: Economic and Employment Consequences for States.

    PubMed

    Ku, Leighton; Steinmetz, Erika; Brantley, Erin; Bruen, Brian

    2017-01-01

    Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans. Goal: To determine the state-by-state effect of repeal on employment and economic activity. Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal spending cuts. Findings and Conclusions: Repeal results in a $140 billion loss in federal funding for health care in 2019, leading to the loss of 2.6 million jobs (mostly in the private sector) that year across all states. A third of lost jobs are in health care, with the majority in other industries. If replacement policies are not in place, there will be a cumulative $1.5 trillion loss in gross state products and a $2.6 trillion reduction in business output from 2019 to 2023. States and health care providers will be particularly hard hit by the funding cuts.

  9. 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.

  10. Can Social Support Protect Bullied Adolescents from Adverse Outcomes? A Prospective Study on the Effects of Bullying on the Educational Achievement and Mental Health of Adolescents at Secondary Schools in East London

    ERIC Educational Resources Information Center

    Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

    2011-01-01

    This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to…

  11. Adverse inpatient outcomes during the transition to a new electronic health record system: observational study

    PubMed Central

    Barnett, Michael L; Mehrotra, Ateev

    2016-01-01

    Objective To assess the short term association of inpatient implementation of electronic health records (EHRs) with patient outcomes of mortality, readmissions, and adverse safety events. Design Observational study with difference-in-differences analysis. Setting Medicare, 2011-12. Participants Patients admitted to 17 study hospitals with a verifiable “go live” date for implementation of inpatient EHRs during 2011-12, and 399 control hospitals in the same hospital referral region. Main outcome measures All cause readmission within 30 days of discharge, all cause mortality within 30 days of admission, and adverse safety events as defined by the patient safety for selected indicators (PSI)-90 composite measure among Medicare beneficiaries admitted to one of these hospitals 90 days before and 90 days after implementation of the EHRs (n=28 235 and 26 453 admissions), compared with the control group of all contemporaneous admissions to hospitals in the same hospital referral region (n=284 632 and 276 513 admissions). Analyses were adjusted for beneficiaries’ sociodemographic and clinical characteristics. Results Before and after implementation, characteristics of admissions were similar in both study and control hospitals. Among study hospitals, unadjusted 30 day mortality (6.74% to 7.15%, P=0.06) and adverse safety event rates (10.5 to 11.4 events per 1000 admissions, P=0.34) did not significantly change after implementation of EHRs. There was an unadjusted decrease in 30 day readmission rates, from 19.9% to 19.0% post-implementation (P=0.02). In difference-in-differences analysis, however, there was no significant change in any outcome between pre-implementation and post-implementation periods (all P≥0.13). Conclusions Despite concerns that implementation of EHRs might adversely impact patient care during the acute transition period, we found no overall negative association of such implementation on short term inpatient mortality, adverse safety

  12. Global Association of Cold Spells and Adverse Health Effects: A Systematic Review and Meta-Analysis

    PubMed Central

    Ryti, Niilo R.I.; Guo, Yuming; Jaakkola, Jouni J.K.

    2015-01-01

    Background There is substantial evidence that mortality increases in low temperatures. Less is known about the role of prolonged cold periods denoted as cold spells. Objective We conducted the first systematic review and meta-analysis to summarize the evidence on the adverse health effects of cold spells in varying climates. Data sources and extraction Four databases (Ovid Medline, PubMed, Scopus, Web of Science) were searched for all years and languages available. “Cold spell” was defined as an event below a temperature threshold lasting for a minimum duration of 2 days. Of 1,527 identified articles, 26 satisfied our eligibility criteria for the systematic review, and 9 were eligible for meta-analyses. The articles were grouped by the three main study questions into Overall-effect Group, Added-effect Group, and Temperature-change-effect Group. Data synthesis Based on random-effects models in the meta-analyses, cold spells were associated with increased mortality from all or all nonaccidental causes (summary rate ratio = 1.10; 95% CI: 1.04, 1.17 based on 9 estimates from five studies), cardiovascular diseases (1.11; 95% CI: 1.03, 1.19; 12 estimates from eight studies), and respiratory diseases (1.21; 95% CI: 0.97, 1.51; 8 estimates from four studies). Estimated associations were stronger for people ≥ 65 years of age (1.06; 95% CI: 1.00, 1.12) than for people 0–64 years of age (1.01; 95% CI: 1.00, 1.03). Study-specific effect estimates from a limited number of studies suggested an increased morbidity related to cold spells, but it was not possible to quantitatively summarize the evidence. Conclusions Cold spells are associated with increased mortality rates in populations around the world. The body of evidence suggests that cold spells also have other adverse health effects. There was substantial heterogeneity among the studies, which should be taken into account in the interpretation of the results. Citation Ryti NR, Guo Y, Jaakkola JJ. 2016. Global

  13. The Health Consequences of Smoking for Women. A Report of the Surgeon General 1979.

    ERIC Educational Resources Information Center

    Pinney, John M., Ed.; And Others

    This report focuses on the evidence about the health consequences of smoking for women, and is intended to serve the public health and medical communities as a unified source of existing scientific research. The major issues about tobacco use and women's health are examined, including trends in consumption, biomedical evidence, and determinants of…

  14. Responding to the public health consequences of the Ukraine crisis: an opportunity for global health diplomacy

    PubMed Central

    Mackey, Tim K; Strathdee, Steffanie A

    2015-01-01

    Introduction Peace and stability in Eastern Europe is now at a crossroads with the rapidly deteriorating foreign policy crisis continuing to unfold in the Ukraine. However, largely overlooked in the context of other foreign policy and diplomatic priorities are the serious public health consequences for the region following the annexation of Crimea and the subsequent decision to ban opioid substitution therapy in the disputed territory. Discussion On 1 May 2014, the Republic of Crimea officially announced it would end access to opioid substitution therapy, an essential harm reduction tool recognized by international organizations and virtually all other European countries. The policy development marks a critical reversal in the region’s fight against its growing HIV epidemic and also threatens years of public health gains aimed at providing evidence-based and integrated treatment approaches to combat drug dependence and HIV. Beyond these risks, the Ukrainian conflict could also negatively impact control of other infectious diseases that are converging with HIV and injection drug use, such as multidrug-resistant tuberculosis and hepatitis C virus. The continuing conflict is also likely to have a significant negative impact on Ukraine’s fragile public health system leading to even worse population health outcomes than currently experienced by the country. Conclusions In response to this crisis, the application of global health diplomacy principles represents a possible route of advocacy to ensure that HIV prevention, humane treatment of substance using populations, and improving public health outcomes in the region are pursued among concerned international stakeholders. In order to be effective, global health diplomacy efforts must be coordinated and advocated in all forms of diplomatic engagement, including at the core, multistakeholder and informal levels and through existing channels such as the different human rights bodies of the United Nations as well as

  15. Health consequences of cricket – view from South Asia

    PubMed Central

    2013-01-01

    Although cricket has origins in the British Empire, it is followed as a religion in South Asia, probably due to the influence of the former during their rule. The sport is equally popular among all groups of the society, and is not subject to gender or age constraints. It marks the epitome of reverence and is considered a battle for self-esteem, not only for those playing, but for those watching as well. The intensity of emotional attachment with this sport renders certain public health benefits as well as drawbacks to the general masses. PMID:23890090

  16. [Health consequences of obesity in children and adolescents].

    PubMed

    Valerio, G; Licenziati, M R; Manco, M; Ambruzzi, A M; Bacchini, D; Baraldi, E; Bona, G; Bruzzi, P; Cerutti, F; Corciulo, N; Crinò, A; Franzese, A; Grugni, G; Iughetti, L; Lenta, S; Maffeis, C; Marzuillo, P; Miraglia Del Giudice, E; Morandi, A; Morino, G; Moro, B; Perrone, L; Prodam, F; Ricotti, R; Santamaria, F; Zito, E; Tanas, R

    2014-10-01

    Obesity in childhood is associated with the presence of complications that can undermine health immediately or in the long term. Several conditions, such as pulmonary or orthopedic complications are strictly associated with the severity of overweight, since they are directly associated to the mechanic stress of fat tissue on the airways or on the bones. Other conditions, such as metabolic or liver complications, although increasing with the extent of overweight, are associated with insulin resistance, which can be modulated by different other factors (ethnicity, genetics, fat distribution) and can occur in overweight children as well. No less important are psychological correlates, such as depression and stigma, which can seriously affect the health related quality of life. Pediatric services for the care of childhood obesity need to be able to screen overweight and obese children for the presence of physical and psychological complications, which can be still reversed by weight loss. This article provides pediatricians a comprehensive update on the main complications in obese children and adolescents and their treatment.

  17. Associations between Anticholinergic Burden and Adverse Health Outcomes in Parkinson Disease

    PubMed Central

    Crispo, James A. G.; Willis, Allison W.; Thibault, Dylan P.; Fortin, Yannick; Hays, Harlen D.; McNair, Douglas S.; Bjerre, Lise M.; Kohen, Dafna E.; Perez-Lloret, Santiago; Mattison, Donald R.; Krewski, Daniel

    2016-01-01

    Background Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD). The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population. Methods Using the Cerner Health Facts® database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011. Anticholinergic burden was computed using the Anticholinergic Risk Scale (ARS). Primary outcomes were associations between ARS score and diagnosis of fracture and delirium. Secondary outcomes included associations between ARS score and 30-day hospital revisits. Results Many individuals (57.8%) were prescribed non-PD medications with moderate to very strong anticholinergic potential. Individuals with the greatest ARS score (≥4) were more likely to be diagnosed with fractures (adjusted odds ratio (AOR): 1.56, 95% CI: 1.29–1.88) and delirium (AOR: 1.61, 95% CI: 1.08–2.40) relative to those with no anticholinergic burden. Similarly, inpatients with the greatest ARS score were more likely to visit the emergency department (adjusted hazard ratio (AHR): 1.32, 95% CI: 1.10–1.58) and be readmitted (AHR: 1.16, 95% CI: 1.01–1.33) within 30-days of discharge. Conclusions We found a positive association between increased anticholinergic burden and adverse outcomes among individuals with PD. Additional pharmacovigilance studies are needed to better understand risks associated with anticholinergic medication use in PD. PMID:26939130

  18. Reciprocal relations between effort-reward imbalance at work and adverse health: a three-wave panel survey.

    PubMed

    Shimazu, Akihito; de Jonge, Jan

    2009-01-01

    Siegrist's [1996. Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology, 1, 27-41.] Effort-Reward Imbalance (ERI) Model assumes that ERI at one point in time influences health at a later point in time. Empirical cross-sectional and longitudinal findings have supported the influence of ERI on adverse health. However, the ERI model does not explicitly take into account that the relation between ERI and adverse health may be also explained by reversed causal relations, or even reciprocal (bi-directional) relations in which ERI and health mutually influence each other. The present 3-wave panel study among 211 Japanese male blue-collar workers in one construction machinery company examined reciprocal relations between ERI and adverse health (i.e., psychological distress and physical complaints) with a 1-year time-lag per wave. Hypotheses were tested using structural equation modeling (Amos 7.0J). Results showed cross-lagged and causally dominant effects of ERI on both psychological distress and physical complaints after 1 year for both Time 1-Time 2 and Time 2-Time 3. In addition, cross-lagged effects of psychological distress on ERI were found after 1 year for both Time 1-Time 2 and Time 2-Time 3. These findings suggest that (perceived) ERI and employee health influence each other reciprocally rather than uni-directionally, and underline the importance of studying reversed causal effects in the relation between ERI and employee health.

  19. Pathways from Childhood Abuse and Other Adversities to Adult Health Risks: The Role of Adult Socioeconomic Conditions

    PubMed Central

    Maguire-Jack, Kathryn

    2015-01-01

    Adverse Childhood Experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N=29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks – depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions— marriage, divorce and separation, educational attainment, income and insurance status—mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15–20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact. PMID:26059537

  20. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions.

    PubMed

    Font, Sarah A; Maguire-Jack, Kathryn

    2016-01-01

    Adverse childhood experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N=29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks-depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions-marriage, divorce and separation, educational attainment, income and insurance status-mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15-20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional, and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact.

  1. [Allergies, an increasing public health problem: causes and consequences].

    PubMed

    de Weck, A

    2000-01-01

    Allergies due to IgE immunoglobulins and belonging to the atopic syndrome, such as asthma, allergic rhinitis and atopic eczema have increased in prevalence three times during the past 20-30 years in most industrialized countries. The causes of that increase are still much debated but seem to be related to multiple changes in the environment. Our recent studies on dog atopy indicate that the interaction of a dominant gene responsible for high IgE production but with variable expression, according to several environmental factors acting during infancy, could explain observations made in man. Allergic diseases have become an important portion of public health costs, amounting to approximately 200 billions French Francs in the European Community. Early and adequate care for the about 20% of allergic patients which are severely affected, as well setting up a systematic prevention policy would have a moderating influence on the increasing costs, and would achieve improvements in the quality of life of allergic patients. Appropriate measures include fostering medical and political awareness about the problem's urgency, the formation of an appropriate body of specialists and an Allergological education at all levels, as well as the definition of a screening and care providing policy taking in account existing medical structures.

  2. Leveraging the biology of adversity to address the roots of disparities in health and development.

    PubMed

    Shonkoff, Jack P

    2012-10-16

    Extensive evidence that personal experiences and environmental exposures are embedded biologically (for better or for worse) and the cumulative knowledge of more than four decades of intervention research provide a promising opportunity to mobilize evolving scientific insights to catalyze a new era of more effective early childhood policy and practice. Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers.

  3. Leveraging the biology of adversity to address the roots of disparities in health and development

    PubMed Central

    Shonkoff, Jack P.

    2012-01-01

    Extensive evidence that personal experiences and environmental exposures are embedded biologically (for better or for worse) and the cumulative knowledge of more than four decades of intervention research provide a promising opportunity to mobilize evolving scientific insights to catalyze a new era of more effective early childhood policy and practice. Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers. PMID:23045654

  4. The Yin: An adverse health perspective of nanoceria: uptake, distribution, accumulation, and mechanisms of its toxicity

    PubMed Central

    Yokel, Robert A.; Hussain, Salik; Garantziotis, Stavros; Demokritou, Philip; Castranova, Vincent; Cassee, Flemming R.

    2014-01-01

    Ce3+, which becomes more relevant as particle size decreases and the ratio of surface area to volume increases. Given its biopersistence and resulting increased toxicity with time, there is a risk that long-term exposure to low nanoceria levels may eventually lead to adverse health effects. This critical review provides recommendations for research to resolve some of the many unknowns of nanoceria’s fate and adverse effects. PMID:25243070

  5. Adverse Health Effects Associated with Living in a Former Methamphetamine Drug Laboratory - Victoria, Australia, 2015.

    PubMed

    Wright, Jackie; Kenneally, Michaela E; Edwards, John W; Walker, G Stewart

    2017-01-06

    The manufacture of methamphetamine in clandestine drug laboratories occurs in various locations, including residential houses and apartments. Unlike the controlled manufacture of chemicals and drugs, clandestine manufacture results in the uncontrolled storage, use, generation, and disposal of a wide range of chemicals and the deposit of methamphetamine drug residues on indoor surfaces (1). These residues have been found at high levels on porous and nonporous surfaces and have been shown to persist for months to years (1). Persons exposed to these environments often have poorly defined exposures and health effects. It is commonly assumed that these levels of exposure are low compared with those related to illicit drug use or therapeutic use of amphetamine-based drugs for managing behavioral issues such as attention deficit hyperactivity disorder (2). In 2015, a family that was unknowingly exposed to methamphetamine residues in a house in Australia was found to have adverse health effects and elevated methamphetamine levels in hair samples, highlighting the potential for public health risks for persons who might live in methamphetamine-contaminated dwellings. This case study highlights the importance of the identification and effective decontamination of former clandestine drug laboratories.

  6. Cytogenetic Risks and Possible Adverse Health Effects by Narcotic Substances Dependent

    PubMed Central

    Movafagh, Abolfazl; Haeri, Ali; Kolahi, Ali Asghar; Hassani-Moghadam, Hossein

    2012-01-01

    Objectives: Illicit drug abuse has crossed social, economic, and geographical borders, and remains one of the major health problems that modern society is facing worldwide. The role of multiple drug abuse as a basic for chromosome damage has been overlooked and it is important to determine its possible adverse health effects. This study aimed to compare the frequency of chromosomal damages between drug addicts and free drug controls. Methods: Cytogenetic study was obtained from 146 illicit drug-users and 200 free drug controls. Subjects were grouped into three categories depending on main drug of dependence. Results: Cytogenetic studies on cultured lymphocytes showed an increase the frequency of chromosomal damages among addicts including opiate (5.89%), heroin (7.65%), and crystal (4.9%) when compared with drug free controls (1.45%). The frequency of chromosomal abnormalities was breaks, gaps, marker, and acentric, respectively. Conclusions: Our findings are also important as they are among the first to suggest here, illicit drug addiction continue to be significant public health problems in Iran. PMID:23024848

  7. Self-Focused and Other-Focused Resiliency: Plausible Mechanisms Linking Early Family Adversity to Health Problems in College Women

    ERIC Educational Resources Information Center

    Coleman, Sulamunn R. M.; Zawadzki, Matthew J.; Heron, Kristin E.; Vartanian, Lenny R.; Smyth, Joshua M.

    2016-01-01

    Objectives: This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. Participants: Female students (N = 795) participated between October 2009 and May 2010. Methods: Participants completed self-report measures…

  8. The impact of adverse health events on consumption: Understanding the mediating effect of income transfers, wealth, and health insurance.

    PubMed

    Babiarz, Patryk; Yilmazer, Tansel

    2017-03-21

    Using data from the Panel Study of Income Dynamics for years 1999-2013, we investigate the impact of physical and mental illnesses on household consumption and financial status. In comparison to severe physical health problems, mental illnesses lead to larger decreases in labor income. Increases in public and private transfers following the onset of a mental illness do not completely offset the decline in labor income. Consequently, we find a significant decrease in consumption expenditures after the household head experiences a mental problem. On the other hand, public and private transfers and accumulated wealth offset the relatively smaller decline in labor income and enable households with severe physical problems to smooth their consumption. Health insurance helps to prevent larger drops in consumption after the onset of a mental health problem.

  9. Adverse health effects of fluoro-edenitic fibers: epidemiological evidence and public health priorities.

    PubMed

    Bruno, Caterina; Comba, Pietro; Zona, Amerigo

    2006-09-01

    Subsequent to the detection of a cluster of mesothelioma cases in the Sicilian town of Biancavilla, located at the slopes of Etna volcano, ad hoc epidemiological studies and environmental monitoring suggested an etiological role of an asbestiform fiber present in a stone quarry. The fiber was shown to constitute a new mineral species named fluoro-edenite. Fluoro-edenitic fibers were found in the materials extracted from the quarry and used in the local building industry, as well as in soils. Besides the risk of mesothelioma, residents in Biancavilla showed a significantly increased mortality from chronic obstructive pulmonary disease, which was particularly evident among women. In the light of these findings, Biancavilla was defined a site of national interest for environmental reclamation. The first preventive action involved termination of quarrying activity, covering with asphalt of roads previously paved with local soil materials, and removal of sources of dust in the urban area. Concurrent to the implementation of environmental cleanup, some specific "second generation" studies are now being designed and performed, namely morbidity surveys based on hospital discharge cards, monitoring of fibers in sputum and health surveillance in selected population groups. In this frame, special emphasis is given to the issue of communication, both to the general public and to target groups like family doctors, teachers, and media professionals. This experience could represent a useful basis for the elaboration of a strategy to approach similar environmental issues.

  10. Health surveillance under adverse ergonomics conditions--validity of a screening method adapted for the occupational health service.

    PubMed

    Jonker, Dirk; Gustafsson, Ewa; Rolander, Bo; Arvidsson, Inger; Nordander, Catarina

    2015-01-01

    A new health surveillance protocol for work-related upper-extremity musculoskeletal disorders has been validated by comparing the results with a reference protocol. The studied protocol, Health Surveillance in Adverse Ergonomics Conditions (HECO), is a new version of the reference protocol modified for application in the Occupational Health Service (OHS). The HECO protocol contains both a screening part and a diagnosing part. Sixty-three employees were examined. The screening in HECO did not miss any diagnosis found when using the reference protocol, but in comparison to the reference protocol considerable time savings could be achieved. Fair to good agreement between the protocols was obtained for one or more diagnoses in neck/shoulders (86%, k = 0.62) and elbow/hands (84%, k = 0.49). Therefore, the results obtained using the HECO protocol can be compared with a reference material collected with the reference protocol, and thus provide information of the magnitude of disorders in an examined work group. Practitioner Summary: The HECO protocol is a relatively simple physical examination protocol for identification of musculoskeletal disorders in the neck and upper extremities. The protocol is a reliable and cost-effective tool for the OHS to use for occupational health surveillance in order to detect workplaces at high risk for developing musculoskeletal disorders.

  11. Exposures of children to organophosphate pesticides and their potential adverse health effects.

    PubMed Central

    Eskenazi, B; Bradman, A; Castorina, R

    1999-01-01

    Recent studies show that young children can be exposed to pesticides during normal oral exploration of their environment and their level of dermal contact with floors and other surfaces. Children living in agricultural areas may be exposed to higher pesticide levels than other children because of pesticides tracked into their homes by household members, by pesticide drift, by breast milk from their farmworker mother, or by playing in nearby fields. Nevertheless, few studies have assessed the extent of children's pesticide exposure, and no studies have examined whether there are adverse health effects of chronic exposure. There is substantial toxicologic evidence that repeated low-level exposure to organophosphate (OP) pesticides may affect neurodevelopment and growth in developing animals. For example, animal studies have reported neurobehavorial effects such as impairment on maze performance, locomotion, and balance in neonates exposed (italic)in utero(/italic) and during early postnatal life. Possible mechanisms for these effects include inhibition of brain acetylcholinesterase, downregulation of muscarinic receptors, decreased brain DNA synthesis, and reduced brain weight in offspring. Research findings also suggest that it is biologically plausible that OP exposure may be related to respiratory disease in children through dysregulation of the autonomic nervous system. The University of California Berkeley Center for Children's Environmental Health Research is working to build a community-university partnership to study the environmental health of rural children. This Center for the Health Assessment of Mothers and Children of Salinas, or CHAMACOS in Monterey County, California, will assess (italic)in utero(/italic) and postnatal OP pesticide exposure and the relationship of exposure to neurodevelopment, growth, and symptoms of respiratory illness in children. The ultimate goal of the center is to translate research findings into a reduction of children

  12. The Development of Countermeasures for Space Radiation Induced Adverse Health Effects

    NASA Astrophysics Data System (ADS)

    Kennedy, Ann

    The Development of Countermeasures for Space Radiation Induced Adverse Health Effects Ann R. Kennedy Department of Radiation Oncology, University of Pennsylvania School of Medicine, 195 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA, United States 19104-6072 The development of countermeasures for radiation induced adverse health effects is a lengthy process, particularly when the countermeasure/drug has not yet been evaluated in human trials. One example of a drug developed from the bench to the clinic is the soybean-derived Bowman-Birk inhibitor (BBI), which has been developed as a countermeasure for radiation induced cancer. It was originally identified as a compound/drug that could prevent the radiation induced carcinogenic process in an in vitro assay system in 1975. The first observation that BBI could inhibit carcinogenesis in animals was in 1985. BBI received Investigational New Drug (IND) Status with the U.S. Food and Drug Administration (FDA) in 1992 (after several years of negotiation with the FDA about the potential IND status of the drug), and human trials began at that time. Phase I, II and III human trials utilizing BBI have been performed under several INDs with the FDA, and an ongoing Phase III trial will be ending in the very near future. Thus, the drug has been in development for 35 years at this point, and it is still not a prescription drug on the market which is available for human use. A somewhat less time-consuming process is to evaluate compounds that are on the GRAS (Generally Recognized as Safe) list. These compounds would include some over-the-counter medications, such as antioxidant vitamins utilized in human trials at the levels for which Recommended Dietary Allowances (RDAs) have been established. To determine whether GRAS substances are able to have beneficial effects on radiation induced adverse health effects, it is still likely to be a lengthy process involving many years to potentially decades of human trial work. The

  13. Human mercury exposure and adverse health effects in the Amazon: a review.

    PubMed

    Passos, Carlos J S; Mergler, Donna

    2008-01-01

    This paper examines issues of human mercury (Hg) exposure and adverse health effects throughout the Amazon region. An extensive review was conducted using bibliographic indexes as well as secondary sources. There are several sources of Hg (mining, deforestation, reservoirs), and exposure takes place through inhalation or from fish consumption. There is a wide range of exposure, with mean hair-Hg levels above 15 microg/g in several Amazonian communities, placing them among the highest reported levels in the world today. Dietary Hg intake has been estimated in the vicinity of 1-2 microg/kg/day, considerably higher than the USEPA RfD of 0.1 microg/kg/day or the World Health Organization recommendation of 0.23 microg/kg/day. Neurobehavioral deficits and, in some cases, clinical signs have been reported both for adults and children in relation to Hg exposure in several Amazonian countries. There is also some evidence of cytogenetic damage, immune alterations, and cardiovascular toxicity. Since fish provide a highly nutritious food source, there is an urgent need to find realistic and feasible solutions that will reduce exposure and toxic risk, while maintaining healthy traditional dietary habits and preserving this unique biodiversity.

  14. Adverse event detection (AED) system for continuously monitoring and evaluating structural health status

    NASA Astrophysics Data System (ADS)

    Yun, Jinsik; Ha, Dong Sam; Inman, Daniel J.; Owen, Robert B.

    2011-03-01

    Structural damage for spacecraft is mainly due to impacts such as collision of meteorites or space debris. We present a structural health monitoring (SHM) system for space applications, named Adverse Event Detection (AED), which integrates an acoustic sensor, an impedance-based SHM system, and a Lamb wave SHM system. With these three health-monitoring methods in place, we can determine the presence, location, and severity of damage. An acoustic sensor continuously monitors acoustic events, while the impedance-based and Lamb wave SHM systems are in sleep mode. If an acoustic sensor detects an impact, it activates the impedance-based SHM. The impedance-based system determines if the impact incurred damage. When damage is detected, it activates the Lamb wave SHM system to determine the severity and location of the damage. Further, since an acoustic sensor dissipates much less power than the two SHM systems and the two systems are activated only when there is an acoustic event, our system reduces overall power dissipation significantly. Our prototype system demonstrates the feasibility of the proposed concept.

  15. Lead-induced oxidative stress adversely affects health of the occupational workers.

    PubMed

    Khan, D A; Qayyum, S; Saleem, S; Khan, F A

    2008-10-01

    Lead is a persistent toxic metal and associated with impairment of various body functions in occupational workers. The main objective was to determine the lead-induced oxidative stress and adverse health effects by biochemical markers in industrial workers. One hundred and forty-eight males consisting of 87 lead-exposed industrial workers and 61 controls were included. Blood lead level (BLL) was determined on a 3010B ESA lead analyzer. Blood complete counts were done on a hematology analyzer. Biochemical markers including serum uric acid, urea, creatinine, phosphate, alanine aminotransferase (ALT), and gamma glutamyltransferase (GGT) were measured on a Selectra E auto analyzer. Serum malondialdehyde (MDA) was measured spectrophotometrically and C-reactive protein (CRP) on Immulite-1000. Results revealed that lead-exposed workers had significantly high BLLs, median (range), 29.1 (9.0-61.1) microg/dL compared with controls, 8.3 (1.0-21.7) microg/dL. Oxidative stress (MDA, GGT) and inflammatory markers (high-sensitivity CRP) were significantly increased (P < or = 0.05). Blood pressure was raised, whereas hemoglobin was decreased in exposed group (P < or = 0.002). Serum urea, uric acid, phosphate, and ALT were significantly raised in lead-exposed workers (P < or = 0.001). Serum albumin, total proteins, and glomerular filtration rate (GFR) were decreased. Blood lead showed a significant positive correlation with serum GGT (r = 0.63), MDA (r = 0.71), CRP (r = 0.75), urea (r = 0.34), creatinine (r = 0.51), and uric acid (r = 0.29) (P < or = 0.01). It is concluded that lead exposure increases oxidative stress that correlates with adverse changes in hematological, renal, and hepatic function in the occupational workers. Elevated blood lead has positive correlation with oxidative stress, inflammatory and biochemical markers that might be used to detect impairment in the body function in lead exposed workers.

  16. Does Americanization Have Adverse Effects on Health? Stress, Health Habits, and Infant Health Outcomes among Puerto Ricans.

    ERIC Educational Resources Information Center

    Landale, Nancy S.; Oropesa, R. S.; Llanes, Daniel; Gorman, Bridget K.

    1999-01-01

    Analysis of data from the Puerto Rican Maternal and Infant Health Study found that recent migrants to the U.S. mainland experienced fewer stressful life events and engaged in fewer negative health behaviors during pregnancy than U.S.-born Puerto Rican women. Recent migrants also exhibited better infant health outcomes than childhood migrants or…

  17. Adverse childhood experiences and mental health, chronic medical conditions, and development in young children

    PubMed Central

    Kerker, Bonnie D.; Zhang, Jinjin; Nadeem, Erum; Stein, Ruth E. K.; Hurlburt, Michael S.; Heneghan, Amy; Landsverk, John; Horwitz, Sarah McCue

    2015-01-01

    Objective The objective of this study was to determine the relationships between adverse childhood experiences (ACEs) and mental health, chronic medical conditions and social development among young children in the child welfare system. Methods This was a cross-sectional study, using a nationally representative sample of children investigated by child welfare (National Survey of Child and Adolescent Well-Being II) from 2008–2009. Our analysis included caregiver interviews and caseworker reports about children age 18–71 months who were not in out-of-home care (N=912). We examined the associations between ACEs and mental health (measured by the Child Behavior Checklist (CBCL)), reported chronic medical conditions, and social development (measured by the Vineland Socialization Scale), in bivariate and multivariate analyses. Results Nearly all children (98.1%) were reported to have had an ACE in their lifetime; the average number of ACEs was 3.6. For every additional reported ACE there was a 32% increased odds of having a problem score on the CBCL (Odds Ratio (OR)=1.32, 95% Confidence Interval (CI): 1.14, 1.53), and a 21% increased odds of having a chronic medical condition (OR=1.21, 95% CI: 1.05, 1.40). Among children 36–71 months, for every additional reported ACE there was a 77% increased odds of a low Vineland Socialization score (OR=1.77, 95% CI: 1.12, 2.78). Conclusion and Relevance ACEs were associated with poor early childhood mental health and chronic medical conditions, and, among children age 3–5, social development. Efforts are needed to examine whether providing early intervention to families with multiple stressors mitigates the impact of ACEs on children’s outcomes. PMID:26183001

  18. The adverse health effects of oil spills: a review of the literature and a framework for medically evaluating exposed individuals.

    PubMed

    Levy, Barry S; Nassetta, William J

    2011-01-01

    In April 2010, an explosion on an oil rig in the Gulf of Mexico killed 11 workers, injured 17 workers, and spilled an estimated 185 million gallons of crude oil into the Gulf. Adverse effects on the health of cleanup workers, fishermen, and others as well as on the ecosystem are being studied. This paper reviews published studies of the adverse health effects due to previous oil spills. Acute effects have included: respiratory, eye, and skin symptoms; headache; nausea; dizziness; and tiredness or fatigue. Chronic effects have included: psychological disorders, respiratory disorders, genotoxic effects, and endocrine abnormalities. We also present a systematic approach to evaluating individuals exposed to oil spills.

  19. Agricultural sources of contaminants of emerging concern and adverse health effects on freshwater fish

    USGS Publications Warehouse

    Tillitt, Donald E.; Buxton, Herbert T.

    2011-01-01

    Agricultural contaminants of emerging concern (CECs) are generally thought of as certain classes of chemicals associated with animal feeding and production facilities. Veterinary pharmaceuticals used in animal food production systems represent one of the largest groups of CECs. In our review, we discuss the extensive increase in use of antibiotics in animal feeding operations (AFOs) around the world. AFOs are a major consumer of antibiotics and other veterinary pharmaceuticals and over the past decade there has been growing information on the occurrence, release, and fate of CECs from animal food production operations, including the application of pharmaceutical-containing manure to agricultural fields and releases from waste lagoons. Concentrations of CECs in surface and ground water in proximity to AFOs correspond to their presence in the AFO wastes. In many cases, the environmental concentrations of agriculturally-derived CECs are below toxicity thresholds. Hormones and hormone replacement compounds are a notable exception, where chemical concentrations near AFOs can exceed concentrations known to cause adverse effects on endocrine-related functions in fish. In addition, some agricultural pesticides, once thought to be safe to non-target organisms, have demonstrated endocrine-related effects that may pose threats to fish populations in agricultural regions. That is, we have pesticides with emerging concerns, thus, the concern is emerging and not necessarily the chemical. In this light, one must consider certain agricultural pesticides to be included in the list of CECs. Even though agricultural pesticides are routinely evaluated in regulatory testing schemes which have been used for decades, the potential hazards of some pesticides have only recently been emerging. Emerging concerns of pesticides in fish include interference with hormone signaling pathways; additive (or more than additive) effects from pesticide mixtures; and adverse population-level effects at

  20. The health consequences of maquiladora work: women on the US-Mexican border.

    PubMed Central

    Guendelman, S; Silberg, M J

    1993-01-01

    OBJECTIVES. As more US companies take jobs to Mexico, complaints are growing that the assembly plants (maquiladoras) exert adverse effects on workers' health. This study assessed the health of female electronic and garment maquiladora workers, comparing them with women employed in services and non-wage earners. METHODS. A survey was administered to 480 women living in Tijuana in 1990. The sample was stratified by occupation and length of employment. Functional impediments, nervousness, depression, and sense of control were used as outcome variables, controlling for other confounders. RESULTS. Despite working longer hours, receiving lower wages, and having less decision latitude and education, maquiladora workers were not worse off than service workers. Maquiladora workers reported similar incidences of depression and lack of control over life. Electronics workers, especially, had lower incidences of nervousness and functional impediments, after controlling for other confounders. Also, maquiladora work did not add an extra health burden compared with non-wage earners. CONCLUSIONS. The adverse effects of maquiladoras previously reported may have been exaggerated. Subjective factors, including negative attitudes toward economic adversity and work dissatisfaction, were stronger predictors of health than were objective indicators. PMID:8417604

  1. [Environmental medicine in public health service--a social responsibility and its consequences].

    PubMed

    Thriene, B

    2001-02-01

    The special committee for "Environmental Medicine" established by the Federal Association of Doctors in the German Public Health Service presents its paper entitled "Environmental Medicine in the Public Health Service--A Social Responsibility and its Consequences: Propositions with regard to the situation, aims, strategies, and opportunities for action". The paper includes core ideas and responsibilities in the public health service. It aims at providing a number of guidelines for implementing "Environment and Health" ("Umwelt und Gesundheit"), an action programme by the Federal Ministry of Environmental Protection and the Ministry of Health, as well as "Health 21" ("Gesundheit 21"), the framework concept "Health for all" for the WHO's European Region. The paper also aims at initiating and facilitating steps for joint action by the Public Health Service. These theses were passed on to Mrs. Andrea Fischer, the Federal Minister of Health, during a meeting with the Board of the Association. In Germany, environment-related public health protection is well established in the Public Health Departments and state institutes/departments within the scope of public health provision and disease prevention. Typical responsibilities include environmental hygiene and environment-related medical services which have increased in importance. The range of responsibilities and its current political importance are a result of environment-related public health risks, the social situation of the population, also with regard to health issues, and the scope of responsibilities and competencies by doctors and staff in the public health departments. With the people's demands for health, quality of life and life expectancy, this need for action increases. In this paper, judicial, professional, and personal consequence are presented which arise as public health authorities assume these responsibilities.

  2. Mental Health, Sleep Quality, Drinking Motives, and Alcohol-Related Consequences: A Path-Analytic Model

    PubMed Central

    Kenney, Shannon R.; Lac, Andrew; LaBrie, Joseph W.; Hummer,, Justin F.; Pham, Andy

    2013-01-01

    Objective: Poor mental health, sleep problems, drinking motivations, and high-risk drinking are prevalent among college students. However, research designed to explicate the interrelationships among these health risk behaviors is lacking. This study was designed to assess the direct and indirect influences of poor mental health (a latent factor consisting of depression, anxiety, and stress) to alcohol use and alcohol-related consequences through the mediators of global sleep quality and drinking motives in a comprehensive model. Method: Participants were 1,044 heavy-drinking college students (66.3% female) who completed online surveys. Results: A hybrid structural equation model tested hypotheses involving relations leading from poor mental health to drinking motives and poorer global sleep quality to drinking outcomes. Results showed that poor mental health significantly predicted all four subscales of drinking motivations (social, coping, conformity, and enhancement) as well as poor sleep. Most of the drinking motives and poor sleep were found to explain alcohol use and negative alcohol consequences. Poor sleep predicted alcohol consequences, even after controlling for all other variables in the model. The hypothesized mediational pathways were examined with tests of indirect effects. Conclusions: This is the first study to assess concomitantly the relationships among three vital health-related domains (mental health, sleep behavior, and alcohol risk) in college students. Findings offer important implications for college personnel and interventionists interested in reducing alcohol risk by focusing on alleviating mental health problems and poor sleep quality. PMID:24172110

  3. Health Consequences of Long-Term Injection Heroin Use Among Aging Mexican American Men

    PubMed Central

    Torres, Luis R.; Kaplan, Charles; Valdez, Avelardo

    2012-01-01

    Objectives Research on the health consequences of long-term injection drug use (IDU) is limited. This article examines these consequences among aging, male Mexican American injecting heroin users. Concern for this group is crucial, given its health disparities and the association of IDU with disease transmission. Method Aging, male Mexican American IDUs (N = 227) were recruited through intensive outreach. Participants self-reported health status, medical and substance use history, and completed behavioral and psychometric health scales. Results are compared to Hispanic national samples. Results Participants had significantly poorer self-rated health and negative health conditions. Selected medical conditions not associated with the heroin-use lifestyle (i.e., hypertension, diabetes, arthritis) were lower relative to the comparison samples. Discussion This population has a complex profile of health consequences linked to a heroin-using lifestyle. The study concludes that routine screening of infectious diseases and medical and behavioral conditions among aging substance using populations may contribute to reducing Hispanic health disparities. PMID:21451118

  4. Assessing the interrelatedness of multiple types of adverse childhood experiences and odds for poor health in South Carolina adults.

    PubMed

    Crouch, Elizabeth; Strompolis, Melissa; Bennett, Kevin J; Morse, Melanie; Radcliff, Elizabeth

    2017-03-01

    Adverse childhood experiences (ACEs) have been linked to negative health outcomes in adulthood, but little research has been done on the effect of ACEs on the health and well-being of adults in South Carolina (SC). This study analyzed a sample of 9744 respondents who participated in the 2014 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) to examine the relationship among childhood experiences of physical, sexual, and emotional abuse, as well as witnessing household violence, on mental and physical health outcomes in adulthood among SC residents. Twenty-two percent of survey respondents reported poor general health (22.1%), and a smaller proportion reported high frequent mental distress in the past month (13.1%). Each category of childhood experiences was associated with an increase in the risk of poor general health. Individuals reporting three or more types of experiences were more likely to report poor health (aOR 2.89; 95% CI 2.86-2.92) than adults without such experiences. Respondents reporting three or more types of childhood adverse experiences were more likely to report frequent mental distress (aOR 3.29; 95% CI 3.26-3.33) compared to adults who did not report three or more types of adversity. Findings from the SC BRFSS highlight a connection between ACEs and negative health outcomes later in life. Given that results of this study also demonstrated that increased exposure to ACEs was associated with greater odds of negative health in adulthood, preventing adverse events such as experiencing abuse or witnessing domestic violence in childhood will have significant effects on later adult health.

  5. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  6. Change in Motor Function and Adverse Health Outcomes in Older African Americas

    PubMed Central

    Buchman, Aron S.; Wilson, Robert S.; Leurgans, Sue E.; Bennett, David A.; Barnes, Lisa L.

    2015-01-01

    Objective We tested whether declining motor function accelerates with age in older African Americans. Methods Eleven motor performances were assessed annually in 513 older African Americans. Results During follow-up of 5 years, linear mixed-effect models showed that motor function declined by about 0.03 units/yr (Estimate, −0.026, p<0.001); about 4% more rapidly for each additional year of age at baseline. A proportional hazard model showed that both baseline motor function level and its rate of change were independent predictors of death and incident disability (all p’s <0.001). These models showed that the additional annual amount of motor decline in 85 year old persons at baseline versus 65 year old persons was associated with a 1.5-fold higher rate of death and a 3-fold higher rate of developing Katz disability. Conclusions The rate of declining motor function accelerates with increasing age and its rate of decline predicts adverse health outcomes in older African Americans. PMID:26209439

  7. Adverse effects of cannabis on health: an update of the literature since 1996.

    PubMed

    Kalant, Harold

    2004-08-01

    Recent research has clarified a number of important questions concerning adverse effects of cannabis on health. A causal role of acute cannabis intoxication in motor vehicle and other accidents has now been shown by the presence of measurable levels of Delta(9)-tetrahydrocannabinol (THC) in the blood of injured drivers in the absence of alcohol or other drugs, by surveys of driving under the influence of cannabis, and by significantly higher accident culpability risk of drivers using cannabis. Chronic inflammatory and precancerous changes in the airways have been demonstrated in cannabis smokers, and the most recent case-control study shows an increased risk of airways cancer that is proportional to the amount of cannabis use. Several different studies indicate that the epidemiological link between cannabis use and schizophrenia probably represents a causal role of cannabis in precipitating the onset or relapse of schizophrenia. A weaker but significant link between cannabis and depression has been found in various cohort studies, but the nature of the link is not yet clear. A large body of evidence now demonstrates that cannabis dependence, both behavioral and physical, does occur in about 7-10% of regular users, and that early onset of use, and especially of weekly or daily use, is a strong predictor of future dependence. Cognitive impairments of various types are readily demonstrable during acute cannabis intoxication, but there is no suitable evidence yet available to permit a decision as to whether long-lasting or permanent functional losses can result from chronic heavy use in adults. However, a small but growing body of evidence indicates subtle but apparently permanent effects on memory, information processing, and executive functions, in the offspring of women who used cannabis during pregnancy. In total, the evidence indicates that regular heavy use of cannabis carries significant risks for the individual user and for the health care system.

  8. Adverse Effects of Androgen Deprivation Therapy: Defining the Problem and Promoting Health Among Men with Prostate Cancer

    PubMed Central

    Saylor, Philip J.; Smith, Matthew R.

    2010-01-01

    Androgen deprivation therapy (ADT) plays a central role in the management of men with locally advanced, recurrent, and metastatic prostate cancer. Because most men diagnosed with prostate cancer will die of something other than their cancer, treatment-related adverse effects are highly relevant to their long-term health. Benefits of ADT in each clinical setting must be weighed against ADT-related adverse effects. ADT is detrimental to several metabolic end points and to bone health. ADT has been prospectively shown to cause decreased lean muscle mass, increased fat mass, weight gain, increased cholesterol and triglycerides, insulin resistance, and loss of bone mineral density. In population-based analyses it has been associated with an increased incidence of diabetes, clinical fractures, and cardiovascular disease. Data-driven recommendations for managing these adverse effects are needed. Currently the authors advocate the use of adapted practice guidelines developed to prevent diabetes, fractures, and coronary heart disease in the general population. PMID:20141678

  9. Characteristics of racism and the health consequences experienced by black nursing faculty.

    PubMed

    Robinson, Ora V

    2014-01-01

    Few studies have examined the health consequences of racism experienced by Black nursing professors. A cohort of nine Black nursing professors at various academic ranks responded to a series of questions on racism, coping and intervention strategies to reduce the harmful health consequences. Findings identified behavioral characteristics of racism, resiliency factors of coping, and suggested workshops to minimize the effects of racism within the nursing profession. Implications include workshops on critical self reflection and rules of engagement. A question raised for future research "how to create a racially/ethnic inclusive and psychosocial healthy academic work environment"?

  10. Reporting of Adverse Events in Published and Unpublished Studies of Health Care Interventions: A Systematic Review

    PubMed Central

    Golder, Su; Wright, Kath

    2016-01-01

    Background We performed a systematic review to assess whether we can quantify the underreporting of adverse events (AEs) in the published medical literature documenting the results of clinical trials as compared with other nonpublished sources, and whether we can measure the impact this underreporting has on systematic reviews of adverse events. Methods and Findings Studies were identified from 15 databases (including MEDLINE and Embase) and by handsearching, reference checking, internet searches, and contacting experts. The last database searches were conducted in July 2016. There were 28 methodological evaluations that met the inclusion criteria. Of these, 9 studies compared the proportion of trials reporting adverse events by publication status. The median percentage of published documents with adverse events information was 46% compared to 95% in the corresponding unpublished documents. There was a similar pattern with unmatched studies, for which 43% of published studies contained adverse events information compared to 83% of unpublished studies. A total of 11 studies compared the numbers of adverse events in matched published and unpublished documents. The percentage of adverse events that would have been missed had each analysis relied only on the published versions varied between 43% and 100%, with a median of 64%. Within these 11 studies, 24 comparisons of named adverse events such as death, suicide, or respiratory adverse events were undertaken. In 18 of the 24 comparisons, the number of named adverse events was higher in unpublished than published documents. Additionally, 2 other studies demonstrated that there are substantially more types of adverse events reported in matched unpublished than published documents. There were 20 meta-analyses that reported the odds ratios (ORs) and/or risk ratios (RRs) for adverse events with and without unpublished data. Inclusion of unpublished data increased the precision of the pooled estimates (narrower 95

  11. A joint ERS/ATS policy statement: what constitutes an adverse health effect of air pollution? An analytical framework.

    PubMed

    Thurston, George D; Kipen, Howard; Annesi-Maesano, Isabella; Balmes, John; Brook, Robert D; Cromar, Kevin; De Matteis, Sara; Forastiere, Francesco; Forsberg, Bertil; Frampton, Mark W; Grigg, Jonathan; Heederik, Dick; Kelly, Frank J; Kuenzli, Nino; Laumbach, Robert; Peters, Annette; Rajagopalan, Sanjay T; Rich, David; Ritz, Beate; Samet, Jonathan M; Sandstrom, Thomas; Sigsgaard, Torben; Sunyer, Jordi; Brunekreef, Bert

    2017-01-01

    The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies.This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution.

  12. Toward a Case Definition of Adverse Health Effects in the Environs of Industrial Wind Turbines: Facilitating a Clinical Diagnosis

    ERIC Educational Resources Information Center

    McMurtry, Robert Y.

    2011-01-01

    Internationally, there are reports of adverse health effects (AHE) in the environs of industrial wind turbines (IWT). There was multidisciplinary confirmation of the key characteristics of the AHE at the first international symposium on AHE/IWT. The symptoms being reported are consistent internationally and are characterized by crossover findings…

  13. Using the Personal Background Preparation Survey to Identify Health Science Professions Students at Risk for Adverse Academic Events

    ERIC Educational Resources Information Center

    Johnson, Craig W.; Johnson, Ronald; McKee, John C.; Kim, Mira

    2009-01-01

    In the first predictive validity study of a diagnostic and prescriptive instrument for averting adverse academic status events (AASE) among multiple populations of diverse health science professions students, entering matriculates' personal background and preparation survey (PBPS) scores consistently significantly predicted 1st- or 2nd-year AASE.…

  14. Development of Quantitative Adverse Outcome Pathways Using Health-Protective Assumptions to Fill Data Gaps

    EPA Science Inventory

    In an adverse outcome pathway (AOP), the target site dose participates in a molecular initiating event (MIE), which in turn triggers a sequence of key events leading to an adverse outcome (AO). Quantitative AOPs (QAOP) are needed if AOP characterization is to address risk as well...

  15. Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting.

    PubMed

    Bloomrosen, Meryl; Starren, Justin; Lorenzi, Nancy M; Ash, Joan S; Patel, Vimla L; Shortliffe, Edward H

    2011-01-01

    Federal legislation (Health Information Technology for Economic and Clinical Health (HITECH) Act) has provided funds to support an unprecedented increase in health information technology (HIT) adoption for healthcare provider organizations and professionals throughout the U.S. While recognizing the promise that widespread HIT adoption and meaningful use can bring to efforts to improve the quality, safety, and efficiency of healthcare, the American Medical Informatics Association devoted its 2009 Annual Health Policy Meeting to consideration of unanticipated consequences that could result with the increased implementation of HIT. Conference participants focused on possible unintended and unanticipated, as well as undesirable, consequences of HIT implementation. They employed an input-output model to guide discussion on occurrence of these consequences in four domains: technical, human/cognitive, organizational, and fiscal/policy and regulation. The authors outline the conference's recommendations: (1) an enhanced research agenda to guide study into the causes, manifestations, and mitigation of unintended consequences resulting from HIT implementations; (2) creation of a framework to promote sharing of HIT implementation experiences and the development of best practices that minimize unintended consequences; and (3) recognition of the key role of the Federal Government in providing leadership and oversight in analyzing the effects of HIT-related implementations and policies.

  16. Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting

    PubMed Central

    Starren, Justin; Lorenzi, Nancy M; Ash, Joan S; Patel, Vimla L; Shortliffe, Edward H

    2010-01-01

    Federal legislation (Health Information Technology for Economic and Clinical Health (HITECH) Act) has provided funds to support an unprecedented increase in health information technology (HIT) adoption for healthcare provider organizations and professionals throughout the U.S. While recognizing the promise that widespread HIT adoption and meaningful use can bring to efforts to improve the quality, safety, and efficiency of healthcare, the American Medical Informatics Association devoted its 2009 Annual Health Policy Meeting to consideration of unanticipated consequences that could result with the increased implementation of HIT. Conference participants focused on possible unintended and unanticipated, as well as undesirable, consequences of HIT implementation. They employed an input–output model to guide discussion on occurrence of these consequences in four domains: technical, human/cognitive, organizational, and fiscal/policy and regulation. The authors outline the conference's recommendations: (1) an enhanced research agenda to guide study into the causes, manifestations, and mitigation of unintended consequences resulting from HIT implementations; (2) creation of a framework to promote sharing of HIT implementation experiences and the development of best practices that minimize unintended consequences; and (3) recognition of the key role of the Federal Government in providing leadership and oversight in analyzing the effects of HIT-related implementations and policies. PMID:21169620

  17. Antecedents and consequences of workplace aggression in the allied health context.

    PubMed

    Demir, Defne; Rodwell, John; Flower, Rebecca L

    2014-01-01

    Workplace aggression research has typically focused on groups in the health care industry considered to be high risk (e.g., nursing); however, aggression also occurs among other health care professional groups, such as those in allied health. This study aimed to investigate the antecedents and consequences of workplace aggression among allied health professionals. Allied health professionals working for an Australian health care organization were surveyed, with 134 (49%) responding. The largest group of allied health professionals surveyed were social workers (49%). Job demands, job control, and social support were linked to different types of aggression. Different sources of aggression were linked to various employee outcomes. The importance of considering stressors surrounding employee work conditions is highlighted.

  18. Adverse selection with a multiple choice among health insurance plans: a simulation analysis.

    PubMed

    Marquis, M S

    1992-08-01

    This study uses simulation methods to quantify the effects of adverse selection. The data used to develop the model provide information about whether families can accurately forecast their risk and whether this forecast affects the purchase of insurance coverage--key conditions for adverse selection to matter. The results suggest that adverse selection is sufficient to eliminate high-option benefit plans in multiple choice markets if insurers charge a single, experience-rated premium. Adverse selection is substantially reduced if premiums are varied according to demographic factors. Adverse selection is also restricted in supplementary insurance markets. In this market, supplementary policies are underpriced because a part of the additional benefits that purchasers can expect is a cost to the base plan and is not reflected in the supplementary premium. As a result, full supplementary coverage is attractive to both low and high risks.

  19. Acute adverse event signalling scheme using the Saskatchewan Administrative health care utilization datafiles: results for two benzodiazepines.

    PubMed

    Rawson, N S; Rawson, M J

    1999-01-01

    Linked administrative health care utilization databases offer potential benefits for postmarketing surveillance. The value of the Saskatchewan datafiles in an acute adverse event signalling scheme has been evaluated using two benzodiazepines. The first 20,000 patients dispensed lorazepam and the first 8525 patients dispensed alprazolam were followed through the datafiles over the year after their initial prescription of the relevant drug, and all medical services occurring during treatment were recorded. The most frequent adverse drug reactions to benzodiazepines are drowsiness, depression, impaired intellectual function and memory, lethargy, impaired coordination, dizziness, nausea and/or vomiting, skin rash, and respiratory disturbance. Data from our study showed that sleep disorders, depressive disorders, dizziness and/or vertigo, respiratory symptoms, esophagus and stomach disorders, and inflammatory skin conditions occurred significantly more often in the first 30 days after the initial prescription than in the succeeding six months in both drug groups, indicating that they are important adverse events. There are several limitations to the methodology; however, the results of the analysis indicate that the use of administrative health care utilization datafiles in a systematic assessment to signal potential acute adverse drug reactions is a feasible proposition, but further studies are required to assess whether events are real adverse reactions.

  20. Risk of Adverse Health and Performance Effects of Celestial Dust Exposure

    NASA Technical Reports Server (NTRS)

    Scully, Robert R.; Meyers, Valerie E.

    2015-01-01

    silica (Permissible Exposure Limit [PEL] 0.05 mg/m3) but more toxic than the nuisance dust titanium dioxide (TiO2 [PEL 5.0 mg/m3]). A PEL for episodic exposure to airborne lunar dust during a six-month stay on the lunar surface was established, in consultation with an independent, extramural panel of expert pulmonary toxicologists, at 0.3 mg/m3. The PEL provided for lunar dust is limited to the conditions and exposure specified therefore additional research remains to be accomplished with lunar dust to further address the issues of activation, address other areas of more unique lunar geology (Glotch et al., 2010; Greenhagen et al., 2010), examine potential toxicological effects of inhaled or ingested dust upon other organ systems, such cardiovascular, nervous systems, and examine effects of acute exposure to massive doses of dust such as may occur during off-nominal situations. Work to support the establishment of PELs for Martian dust and dusts of asteroids remains to be accomplished. The literature that describes health effects of exposure to toxic terrestrial dusts provides substantial basis for concern that prolonged exposure to respirable celestial dust could be detrimental to human health. Celestial bodies where a substantial portion of the dust is in the respirable range or where the dusts have large reactive surface areas or contain transition metals or volatile organics, represent greater risks of adverse effects from exposure to the dust. It is possible that in addition to adverse effects to the respiratory system, inhalation and ingestion of celestial dusts could pose risks to other systems

  1. Long-term health and socioeconomic consequences of early-life exposure to the 1959-1961 Chinese Famine.

    PubMed

    Fan, Wen; Qian, Yue

    2015-01-01

    This research investigates long-term consequences of early-life malnutrition by examining effects of the 1959-1961 Chinese Famine. Taking into account temporal and geographic variations in famine severity, we construct a difference-in-differences estimator to identify effects of early-life exposure to famine on perceived health and socioeconomic outcomes in midlife. Using a sample of 1716 adults born in 1955-1966 in rural China from a nationally representative survey-the 2005 Chinese General Social Survey-we find that the famine had adverse effects on mid-life health for males born into families where at least one parent was a Communist Party member and females regardless of parental party membership. Being born during the famine had no effects on years of education or income for either gender. Quantile regressions suggest intense mortality selection among males who had no party-affiliated parents. Our study highlights the importance of timing and contexts of life experiences in shaping health.

  2. Adverse health effects due to arsenic exposure: Modification by dietary supplementation of jaggery in mice

    SciTech Connect

    Singh, Nrashant; Kumar, D.; Lal, Kewal; Raisuddin, S.; Sahu, Anand P.

    2010-02-01

    Populations of villages of eastern India and Bangladesh and many other parts of the world are exposed to arsenic mainly through drinking water. Due to non-availability of safe drinking water they are compelled to depend on arsenic-contaminated water. Generally, poverty level is high in those areas and situation is compounded by the lack of proper nutrition. The hypothesis that the deleterious health effects of arsenic can be prevented by modification of dietary factors with the availability of an affordable and indigenous functional food jaggery (sugarcane juice) has been tested in the present study. Jaggery contains polyphenols, vitamin C, carotene and other biologically active components. Arsenic as sodium-m-arsenite at low (0.05 ppm) and high (5 ppm) doses was orally administered to Swiss male albino mice, alone and in combination with jaggery feeding (250 mg/mice), consecutively for 180 days. The serum levels of total antioxidant, glutathione peroxidase and glutathione reductase were substantially reduced in arsenic-exposed groups, while supplementation of jaggery enhanced their levels in combined treatment groups. The serum levels of interleukin-1beta, interleukin-6 and TNF-alpha were significantly increased in arsenic-exposed groups, while in the arsenic-exposed and jaggery supplemented groups their levels were normal. The comet assay in bone marrow cells showed the genotoxic effects of arsenic, whereas combination with jaggery feeding lessened the DNA damage. Histopathologically, the lung of arsenic-exposed mice showed the necrosis and degenerative changes in bronchiolar epithelium with emphysema and thickening of alveolar septa which was effectively antagonized by jaggery feeding. These results demonstrate that jaggery, a natural functional food, effectively antagonizes many of the adverse effects of arsenic.

  3. "More than skin deep": stress neurobiology and mental health consequences of racial discrimination.

    PubMed

    Berger, Maximus; Sarnyai, Zoltán

    2015-01-01

    Ethnic minority groups across the world face a complex set of adverse social and psychological challenges linked to their minority status, often involving racial discrimination. Racial discrimination is increasingly recognized as an important contributing factor to health disparities among non-dominant ethnic minorities. A growing body of literature has recognized these health disparities and has investigated the relationship between racial discrimination and poor health outcomes. Chronically elevated cortisol levels and a dysregulated hypothalamic-pituitary-adrenal (HPA) axis appear to mediate effects of racial discrimination on allostatic load and disease. Racial discrimination seems to converge on the anterior cingulate cortex (ACC) and may impair the function of the prefrontal cortex (PFC), hence showing substantial similarities to chronic social stress. This review provides a summary of recent literature on hormonal and neural effects of racial discrimination and a synthesis of potential neurobiological pathways by which discrimination affects mental health.

  4. Challenges of chronic pain management: public health consequences and considered responses.

    PubMed

    Finch, James W

    2013-01-01

    This article reviews the public health consequences of current approaches to chronic pain management, particularly those related to prescription of opioid analgesics and other controlled medications. This article also reviews factors contributing to these negative trends and discusses potential strategies for reversing them.

  5. Health Consequences of the Interaction of Our Genome with Our Environment

    EPA Science Inventory

    Health Consequences Of The Interaction Of Our Genome With Our Environment DM DeMarini, US EPA, RTP, NC 27711 Our primary exposures to potentially mutagenic agents are via the air, water, soil, combustion emissions, and food. Thus, characterizing the mutations induced by these...

  6. Do sugar-sweetened beverages cause adverse health outcomes in adults? A systematic review protocol

    PubMed Central

    2014-01-01

    Background Chronic diseases, such as cardiovascular disease and type 2 diabetes, impose significant burden to public health. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, blood glucose, and lipids, physical inactivity, excessive sedentary behaviours, overweight and obesity, and tobacco usage. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in adults is associated with adverse health outcomes and what the potential moderating factors are. Methods/Design Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case-control studies, and nested case-control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of confounding variables that should be adjusted for, we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessments. Meta-analysis will

  7. Provider and policy response to reverse the consequences of low health literacy.

    PubMed

    Bryan, Cathy

    2008-01-01

    The 2004 Institute of Medicine publication, Health Literacy: A Prescription to End Confusion, is the first comprehensive report about low health literacy and its consequences. Although affecting more than 50 percent of the adult population in the United States, low health literacy is a pervasive issue that has received little attention among policymakers and healthcare executives. Yet, strategies to increase the health literacy of patient communities are relatively inexpensive and easy to implement. Furthermore, such strategies have the potential to significantly reduce costs and improve outcomes by arming the population with information on self-management and prevention of disease. This article presents an overview of the issues surrounding low health literacy, highlights its impact on the delivery system, and discusses practical steps that healthcare providers and executives can implement to enable health literate communities.

  8. Household and community-level Adverse Childhood Experiences and adult health outcomes in a diverse urban population.

    PubMed

    Wade, Roy; Cronholm, Peter F; Fein, Joel A; Forke, Christine M; Davis, Martha B; Harkins-Schwarz, Mary; Pachter, Lee M; Bair-Merritt, Megan H

    2016-02-01

    Adverse Childhood Experiences (ACEs), which include family dysfunction and community-level stressors, negatively impact the health and well being of children throughout the life course. While several studies have examined the impact of these childhood exposures amongst racially and socially diverse populations, the contribution of ACEs in the persistence of socioeconomic disparities in health is poorly understood. To determine the association between ACEs and health outcomes amongst a sample of adults living in Philadelphia and examine the moderating effect of Socioeconomic Status (SES) on this association, we conducted a cross-sectional survey of 1,784 Philadelphia adults, ages 18 and older, using random digit dialing methodology to assess Conventional ACEs (experiences related to family dysfunction), Expanded ACEs (community-level stressors), and health outcomes. Using weighted, multivariable logistic regression analyses along with SES stratified models, we examined the relationship between ACEs and health outcomes as well as the modifying effect of current SES. High Conventional ACE scores were significantly associated with health risk behaviors, physical and mental illness, while elevated Expanded ACE scores were associated only with substance abuse history and sexually transmitted infections. ACEs did have some differential impacts on health outcomes based on SES. Given the robust impact of Conventional ACEs on health, our results support prior research highlighting the primacy of family relationships on a child's life course trajectory and the importance of interventions designed to support families. Our findings related to the modifying effect of SES may provide additional insight into the complex relationship between poverty and childhood adversity.

  9. The Effect of Work Hours on Adverse Events and Errors in Health Care

    PubMed Central

    Olds, Danielle M.; Clarke, Sean P.

    2010-01-01

    Introduction We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors. Method Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors. Results All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables. Discussion This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime. Impact on Industry Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety. PMID:20497801

  10. Theoretical arguments for the discounting of health consequences: where do we go from here?

    PubMed

    Lazaro, Angelina

    2002-01-01

    Despite the theoretical arguments presented in the literature regarding discounting over the last 25 years, no satisfactory reply has yet been offered to the question of whether health consequences have to be discounted at the same rate as monetary consequences in the economic evaluation of health programmes or interventions designed to improve health. Against this background, the main objective of this paper was to review and systemise these theoretical arguments, with the aim of determining whether any of the positions identified can be accepted without reservation. Having determined that this is not possible, we investigated the rationality of discounting in the literature and, on this basis, propose a potential way to resolve the problem. Thus, we argue that the relationship between the discount of monetary and health consequences has to be determined in an indirect manner, by reference to the relationship maintained by the individual time preference rates for health and money in the context of private and social choice. Although this proposal moves the debate into the empirical field, its advantages must be weighed against the difficulties associated with the estimation of the time preferences.

  11. Effect of Television on Obesity and Excess of Weight and Consequences of Health.

    PubMed

    Rosiek, Anna; Maciejewska, Natalia Frąckowiak; Leksowski, Krzysztof; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz

    2015-08-12

    The epidemic nature of obesity in industrialized countries is a serious health and social concern. The number of obese people has significantly increased in the past 20 years. In Poland excess weight and obesity are a serious epidemiological concern. In terms of the number of overweight people, Poland is a leader in Europe. Therefore, indicating many serious health concerns that are the natural consequences of this phenomenon has become important from the point of view of public health. This work identifies numerous diseases which are a direct consequence of obesity due to bad eating habits and lack of physical exercise among Poles. It discusses the negative effect of television and food commercials contributing to an increase in obesity, not only among adults but also among children. This is an overview forming grounds for further studies into ways of preventing the development of diseases due to obesity, both in Poland and in the world.

  12. Effect of Television on Obesity and Excess of Weight and Consequences of Health

    PubMed Central

    Rosiek, Anna; Frąckowiak Maciejewska, Natalia; Leksowski, Krzysztof; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz

    2015-01-01

    The epidemic nature of obesity in industrialized countries is a serious health and social concern. The number of obese people has significantly increased in the past 20 years. In Poland excess weight and obesity are a serious epidemiological concern. In terms of the number of overweight people, Poland is a leader in Europe. Therefore, indicating many serious health concerns that are the natural consequences of this phenomenon has become important from the point of view of public health. This work identifies numerous diseases which are a direct consequence of obesity due to bad eating habits and lack of physical exercise among Poles. It discusses the negative effect of television and food commercials contributing to an increase in obesity, not only among adults but also among children. This is an overview forming grounds for further studies into ways of preventing the development of diseases due to obesity, both in Poland and in the world. PMID:26274965

  13. Planned Repeat Cesarean Section at Term and Adverse Childhood Health Outcomes: A Record-Linkage Study

    PubMed Central

    Black, Mairead; Bhattacharya, Siladitya; Philip, Sam; Norman, Jane E.; McLernon, David J.

    2016-01-01

    Background Global cesarean section (CS) rates range from 1% to 52%, with a previous CS being the commonest indication. Labour following a previous CS carries risk of scar rupture, with potential for offspring hypoxic brain injury, leading to high rates of repeat elective CS. However, the effect of delivery by CS on long-term outcomes in children is unclear. Increasing evidence suggests that in avoiding exposure to maternal bowel flora during labour or vaginal birth, offspring delivered by CS may be adversely affected in terms of energy uptake from the gut and immune development, increasing obesity and asthma risks, respectively. This study aimed to address the evidence gap on long-term childhood outcomes following repeat CS by comparing adverse childhood health outcomes after (1) planned repeat CS and (2) unscheduled repeat CS with those that follow vaginal birth after CS (VBAC). Methods and Findings A data-linkage cohort study was performed. All second-born, term, singleton offspring delivered between 1 January 1993 and 31 December 2007 in Scotland, UK, to women with a history of CS (n = 40,145) were followed up until 31 January 2015. Outcomes assessed included obesity at age 5 y, hospitalisation with asthma, learning disability, cerebral palsy, and death. Cox regression and binary logistic regression were used as appropriate to compare outcomes following planned repeat CS (n = 17,919) and unscheduled repeat CS (n = 8,847) with those following VBAC (n = 13,379). Risk of hospitalisation with asthma was greater following both unscheduled repeat CS (3.7% versus 3.3%, adjusted hazard ratio [HR] 1.18, 95% CI 1.05–1.33) and planned repeat CS (3.6% versus 3.3%, adjusted HR 1.24, 95% CI 1.09–1.42) compared with VBAC. Learning disability and death were more common following unscheduled repeat CS compared with VBAC (3.7% versus 2.3%, adjusted odds ratio 1.64, 95% CI 1.17–2.29, and 0.5% versus 0.4%, adjusted HR 1.50, 95% CI 1.00–2.25, respectively). Risk of obesity

  14. Jobless now, sick later? Investigating the long-term consequences of involuntary job loss on health.

    PubMed

    Schröder, Mathis

    2013-03-01

    In the light of the current economic crises which in many countries lead to business closures and mass lay-offs, the consequences of job loss are important on various dimensions. They have to be investigated not only in consideration of a few years, but with a long-term perspective as well, because early life course events may prove important for later life outcomes. This paper uses data from SHARELIFE to shed light on the long-term consequences of involuntary job loss on health. The paper distinguishes between two different reasons for involuntary job loss: plant closures, which in the literature are considered to be exogenous to the individual, and lay-offs, where the causal direction of health and unemployment is ambiguous. These groups are separately compared to those who never experienced a job loss. The paper uses eleven different measures of health to assess long-term health consequences of job loss, which has to have occurred at least 25 years before the current interview. As panel data cannot be employed, a large body of variables, including childhood health and socio-economic conditions, is used to control for the initial conditions. The findings suggest that individuals with an exogenous job loss suffer in the long run: men are significantly more likely to be depressed and they have more trouble knowing the current date. Women report poorer general health and more chronic conditions and are also affected in their physical health: they are more likely to be obese or overweight, and to have any limitations in their (instrumental) activities of daily living. In the comparison group of laid-off individuals, controlling for the initial conditions reduces the effects of job loss on health - proving that controlling for childhood conditions is important.

  15. Multiple Stressors in a Top Predator Seabird: Potential Ecological Consequences of Environmental Contaminants, Population Health and Breeding Conditions.

    PubMed

    Bustnes, Jan O; Bourgeon, Sophie; Leat, Eliza H K; Magnusdóttir, Ellen; Strøm, Hallvard; Hanssen, Sveinn A; Petersen, Aevar; Olafsdóttir, Kristin; Borgå, Katrine; Gabrielsen, Geir W; Furness, Robert W

    2015-01-01

    Shetland, especially related to BDEs. This indicates stronger fitness consequences of POPs following seasons with very poor breeding conditions and/or high reproductive effort. This study suggests that the impacts of POPs may differ depending on population health and breeding conditions, and that even low concentrations of POPs could have ecological consequences during adverse circumstances. This is important with regard to risk assessment of biomagnifying contaminants in marine ecosystems.

  16. Do sugar-sweetened beverages cause adverse health outcomes in children? A systematic review protocol

    PubMed Central

    2014-01-01

    Background Cardiovascular disease and type 2 diabetes are examples of chronic diseases that impose significant morbidity and mortality in the general population worldwide. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, high blood glucose or glucose intolerance, high lipid levels, physical inactivity, excessive sedentary behaviours, and overweight/obesity. The occurrence of intermediate outcomes during childhood increases the risk of disease in adulthood. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in children is associated with adverse health outcomes and what the potential moderating factors are. Methods/Design Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case–control studies, and nested case–control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of

  17. WindVOiCe, a Self-Reporting Survey: Adverse Health Effects, Industrial Wind Turbines, and the Need for Vigilance Monitoring

    ERIC Educational Resources Information Center

    Krogh, Carmen M. E.; Gillis, Lorrie; Kouwen, Nicholas; Aramini, Jeff

    2011-01-01

    Industrial wind turbines have been operating in many parts of the globe. Anecdotal reports of perceived adverse health effects relating to industrial wind turbines have been published in the media and on the Internet. Based on these reports, indications were that some residents perceived they were experiencing adverse health effects. The purpose…

  18. Association of Antenatal Depression with Adverse Consequences for the Mother and Newborn in Rural Ghana: Findings from the DON Population-Based Cohort Study

    PubMed Central

    Weobong, Benedict; ten Asbroek, Augustinus H. A.; Soremekun, Seyi; Manu, Alexander A.; Owusu-Agyei, Seth; Prince, Martin; Kirkwood, Betty R.

    2014-01-01

    Background Whilst there is compelling evidence of an almost 2-fold increased risk of still births, and suggestive evidence of increased mortality among offspring of mothers with psychotic disorders, only three studies have addressed the role of antenatal depression (AND) on survival of the baby. We examined these associations in a large cohort of pregnant women in Ghana. Methods A Cohort study nested within 4-weekly surveillance of all women of reproductive age to identify pregnancies and collect data on births and deaths in the Kintampo Health Research Centre study area of Ghana. Women were screened for AND using the Patient Health Questionnaire (PHQ-9) to ascertain DSM-IV major or minor depression. Outcomes were adverse birth outcomes, maternal/infant morbidity, and uptake of key newborn care practices, examined using logistic regression; effect sizes reported as relative risks with 95% confidence intervals. Results 20679 (89.6%) pregnant women completed the PHQ-9. The prevalence of AND was 9.9% (n = 2032) (95% confidence interval 9.4%–10.2%). AND was associated with: prolonged labour (RR 1.25, 95% CI 1.02–1.53); peripartum complications (RR 1.11, 95% CI 1.07–1.15);postpartum complications (RR 1.27, 96% CI 1.21–1.34); non-vaginal delivery (RR 1.19, 95% CI 1.02–1.40); newborn illness (RR 1.52, 95% CI 1.16–1.99); and bed net use during pregnancy (RR 0.93, 95% CI 0.89–0.98), but not neonatal deaths, still births, low birth weight, immediate breast feeding initiation, or exclusive breastfeeding. AND was marginally associated with preterm births (RR 1.32, 95% CI 0.98–1.76). Conclusion This paper has contributed important evidence on the role of antenatal depression as a potential contributor to maternal and infant morbidity. Non-pharmacological treatments anchored on primary care delivery structures are recommended as an immediate step. We further recommend that trials are designed to assess if treating antenatal depression in conjunction with

  19. The ineffectiveness and unintended consequences of the public health war on obesity.

    PubMed

    Ramos Salas, Ximena

    2015-02-03

    The public health war on obesity has had little impact on obesity prevalence and has resulted in unintended consequences. Its ineffectiveness has been attributed to: 1) heavy focus on individual-based approaches and lack of scaled-up socio-environmental policies and programs, 2) modest effects of interventions in reducing and preventing obesity at the population level, and 3) inappropriate focus on weight rather than health. An unintended consequence of these policies and programs is excessive weight preoccupation among the population, which can lead to stigma, body dissatisfaction, dieting, disordered eating, and even death from effects of extreme dieting, anorexia, and obesity surgery complications, or from suicide that results from weight-based bullying. Future public health approaches should: a) avoid simplistic obesity messages that focus solely on individuals' responsibility for weight and health, b) focus on health outcomes rather than weight control, and c) address the complexity of obesity and target both individual-level and system-level determinants of health.

  20. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    PubMed

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided.

  1. Angry, Scared, and Unsure: Mental Health Consequences of Contaminated Water in Flint, Michigan.

    PubMed

    Cuthbertson, Courtney A; Newkirk, Cathy; Ilardo, Joan; Loveridge, Scott; Skidmore, Mark

    2016-12-01

    Natural and manmade crises impact community-level behavioral health, including mental health and substance use. This article shares findings from a larger project about community behavioral health, relevant to the ongoing water crisis in Flint, Michigan, using data from a larger study, involving monthly surveys of a panel of key informants from Genesee County. The data come from open-response questions and are analyzed as qualitative data using grounded theory techniques. Although respondents were not asked about the water issues in Flint, participants commented that the water situation was increasing stress, anxiety, and depression among the city's population. Participants thought these mental health issues would affect the entire community but would be worse among low-income, African American populations in the city. Mental health consequences were related not only to the water contamination but to distrust of public officials who are expected and have the authority to resolve the issues. The mental health effects of this public health crisis are significant and have received inadequate attention in the literature. Public health response to situations similar to the water issues in Flint should include sustained attention mental health.

  2. Adverse Health Outcomes, Perpetrator Characteristics, and Sexual Violence Victimization among U.S. Adult Males

    ERIC Educational Resources Information Center

    Choudhary, Ekta; Coben, Jeffrey; Bossarte, Robert M.

    2010-01-01

    In the United States, an estimated three million men are victims of sexual violence each year, yet the majority of existing studies have evaluated the consequences and characteristics of victimization among women alone. The result has been a gap in the existing literature examining the physical and psychological consequences of sexual assault…

  3. Probabilistic accident consequence uncertainty analysis -- Late health effects uncertainty assessment. Volume 1: Main report

    SciTech Connect

    Little, M.P.; Muirhead, C.R.; Goossens, L.H.J.; Kraan, B.C.P.; Cooke, R.M.; Harper, F.T.; Hora, S.C.

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring 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. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA late health effects models.

  4. Probabilistic accident consequence uncertainty analysis -- Early health effects uncertainty assessment. Volume 1: Main report

    SciTech Connect

    Haskin, F.E.; Harper, F.T.; Goossens, L.H.J.; Kraan, B.C.P.; Grupa, J.B.

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring 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. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA early health effects models.

  5. Probabilistic accident consequence uncertainty analysis -- Early health effects uncertainty assessment. Volume 2: Appendices

    SciTech Connect

    Haskin, F.E.; Harper, F.T.; Goossens, L.H.J.; Kraan, B.C.P.

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring 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. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA early health effects models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the panel on early health effects, (4) short biographies of the experts, and (5) the aggregated results of their responses.

  6. Probabilistic accident consequence uncertainty analysis -- Late health effects uncertain assessment. Volume 2: Appendices

    SciTech Connect

    Little, M.P.; Muirhead, C.R.; Goossens, L.H.J.; Kraan, B.C.P.; Cooke, R.M.; Harper, F.T.; Hora, S.C.

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring 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. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA late health effects models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the expert panel on late health effects, (4) short biographies of the experts, and (5) the aggregated results of their responses.

  7. Prenatal Family Adversity and Maternal Mental Health and Vulnerability to Peer Victimisation at School

    ERIC Educational Resources Information Center

    Lereya, Suzet Tanya; Wolke, Dieter

    2013-01-01

    Background: Prenatal stress has been shown to predict persistent behavioural abnormalities in offspring. Unknown is whether prenatal stress makes children more vulnerable to peer victimisation. Methods: The current study is based on the Avon Longitudinal Study of Parents and Children, a prospective community-based study. Family adversity, maternal…

  8. Physical Performance Characteristics of Assisted Living Residents and Risk for Adverse Health Outcomes

    ERIC Educational Resources Information Center

    Giuliani, Carol A.; Gruber-Baldini, Ann L.; Park, Nan S.; Schrodt, Lori A.; Rokoske, Franzi; Sloane, Philip D.; Zimmerman, Sheryl

    2008-01-01

    Purpose: Researchers know little about the physical performance ability of residential care/assisted living (RC/AL) residents and its relationship to adverse outcomes such as fracture, nursing home placement, functional decline, and death. The purposes of this article are to (a) describe the functional characteristics of RC/AL residents, (b)…

  9. Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health.

    PubMed

    Logan-Greene, Patricia; Green, Sara; Nurius, Paula S; Longhi, Dario

    2014-01-01

    Although evidence is rapidly amassing as to the damaging potential of early life adversities on physical and mental health, as yet few investigations provide comparative snapshots of these patterns across adulthood. This population-based study addresses this gap, examining the relationship of adverse childhood experiences (ACEs) to physical and mental health within a representative sample (n = 19,333) of adults, comparing the prevalence and explanatory strength of ACEs among four birth cohorts spanning ages 18-79. This assessment accounts for demographic and socioeconomic factors, as well as both direct and moderating effects of resilience resources (social/emotional support, life satisfaction, and sleep quality). Findings demonstrate (1) increasing trends of reported ACEs across younger cohorts, including time period shifts such as more prevalent family incarceration, substance abuse, and divorce, (2) significant bivariate as well as independent associations of ACEs with poor health within every cohort, controlling for multiple covariates (increasing trends in older age for physical health), and (3) robust patterns wherein resilience resources moderated ACEs, indicating buffering pathways that sustained into old age. Theoretical and practice implications for health professionals are discussed.

  10. Timing of introduction of complementary food: short- and long-term health consequences.

    PubMed

    Przyrembel, Hildegard

    2012-01-01

    Complementary food is needed when breast milk (or infant formula) alone is no longer sufficient for both nutritional and developmental reasons. The timing of its introduction, therefore, is an individual decision, although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. The new foods are intended to 'complement' ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later consequences on health. The evaluation of consequences of both early and late introduction of complementary food can neither disregard the effect of breastfeeding compared to formula feeding nor the composition or quality of the complementary food. Possible short-term health effects concern growth velocity and infections, and possible long-term effects may relate to atopic diseases, type 1 and 2 diabetes, obesity and neuromuscular development. On the basis of the currently available evidence, it is impossible to exactly determine the age when risks related to the start of complementary feeding are lowest or highest for most of these effects, with the possible exception of infections and early growth velocity. The present knowledge on undesirable health effects, however, is mainly based on observational studies, and although some mechanisms have been proposed, further prospective studies have to clarify these unsolved issues. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants.

  11. Consequences for patients of health care professionals' conscientious actions: the ban on abortions in South Australia.

    PubMed Central

    Cannold, L

    1994-01-01

    The legitimacy of the refusal of South Australian nurses to care for second trimester abortion patients on grounds of conscience is examined as a test case for a theory of permissible limits on the autonomy of health care professionals. In cases of health care professional (HCP) conscientious refusal, it is argued that a balance be struck between the HCPs' claims to autonomous action and the consequences to them of having their autonomous action restricted, and the entitlement of patients to care and the consequences for them of being refused such care. Conscientious action that results in the disruption or termination of health care services, however, is always impermissible on two grounds. Firstly, because it is at this point that the action '... invades a patient's autonomy, puts a patient at serious risk ... [and] treats a patient unjustly' (1) Secondly, because the consequences of such refusals turn them into political acts--acts of civil disobedience. It is arguable that in order for acts of civil disobedience to be legitimate, certain obligations are required of the dissenter by the community. It is concluded that the actions of the South Australian nurses, which have over the last few years both terminated and disrupted second trimester services, are morally impermissible. PMID:8083879

  12. The consequences of health service privatisation for equality and equity in health care in South Africa.

    PubMed

    Price, M

    1988-01-01

    The trend towards the privatisation of health services in South Africa reflects a growing use of private sources of finance and the growing proportion of privately owned fee-for-service providers and facilities. Fee-for-service methods of reimbursement aggravate the geographical maldistribution of personnel and facilities, and the competition for scarce personnel resources aggravates the difference in the quality of the public and private services. Thus the growth in demand for these types of providers may be expected to increase inequality of access in these two respects. The potential expansion of medical scheme coverage is shown to be limited to well under 50% of the population, leaving the majority of the population without access to private sector health care. Even for members of the medical schemes, benefits are linked to income, thus clashing with the principle of equal care for equal need. The public funds needed to overcome financial obstacles to access to private providers could be more efficiently deployed by financing publicly owned and controlled health services directly. Taxation also offers the most equitable method of financing health services. Finally, attention is drawn to the dilemma resulting from the strengthening of the private health sector; while in the short term this can offer better care to more people on a racially non-discriminatory basis, in the long term, health care for the population as a whole may become more unequal and for those dependent on the public sector it may even deteriorate.

  13. A research framework for pharmacovigilance in health social media: Identification and evaluation of patient adverse drug event reports.

    PubMed

    Liu, Xiao; Chen, Hsinchun

    2015-12-01

    Social media offer insights of patients' medical problems such as drug side effects and treatment failures. Patient reports of adverse drug events from social media have great potential to improve current practice of pharmacovigilance. However, extracting patient adverse drug event reports from social media continues to be an important challenge for health informatics research. In this study, we develop a research framework with advanced natural language processing techniques for integrated and high-performance patient reported adverse drug event extraction. The framework consists of medical entity extraction for recognizing patient discussions of drug and events, adverse drug event extraction with shortest dependency path kernel based statistical learning method and semantic filtering with information from medical knowledge bases, and report source classification to tease out noise. To evaluate the proposed framework, a series of experiments were conducted on a test bed encompassing about postings from major diabetes and heart disease forums in the United States. The results reveal that each component of the framework significantly contributes to its overall effectiveness. Our framework significantly outperforms prior work.

  14. mHealth to promote pregnancy and interconception health among African-American women at risk for adverse birth outcomes: a pilot study

    PubMed Central

    Miller, Lindsey; Isbell, Sheila; Shields, Tekesia; Worthy, Natasha; Dunlop, Anne Lang

    2015-01-01

    Background The use of mobile phone applications (mHealth) to provide health education and behavioral prompts is 1 of the 12 common mHealth functions identified by the World Health Organization as innovations to strengthen health systems. Among low-income pregnant and parenting women, health education is widely recognized as a way to improve maternal and infant health outcomes, but the efficacy of written health education materials to change knowledge and behavior for this population is questionable. mHealth prompts, in contrast, is a promising alternative. Methods A team of researchers in medicine/epidemiology, anthropology/midwifery, computer science/sensors, and community-based case management created and pilot tested a mHealth application (mHealth app) for African-American women at high risk for adverse birth outcomes. We tested the acceptability and feasibility of the interactive application among women during the reproductive stages of early and late pregnancy, postpartum, and interconception. Results Interview data from 14 women in the various reproductive stages revealed that most women found the mHealth messages helpful. Also, 62 Ob-Gyn physicians and nurses and 19 Family Medicine residents provided feedback. Women’s responses to specific messages trended down over time. Women in the postpartum phase had the highest response rate to particular text messages, followed by those in the pregnancy phase. Responses dropped off dramatically during the interconception period. About 21% of women lost their phones. Unexpected findings were that all participants already had smartphones, women wanted messages about depression, and clinicians wanted the app to link to case management for individualized medical care. Conclusions Logistical challenges to app management were limitations but are useful for consideration before scale-up. This study corroborates findings in the health literacy literature that women most at risk for adverse birth outcomes need additional

  15. OAE: The Ontology of Adverse Events

    PubMed Central

    2014-01-01

    Background A medical intervention is a medical procedure or application intended to relieve or prevent illness or injury. Examples of medical interventions include vaccination and drug administration. After a medical intervention, adverse events (AEs) may occur which lie outside the intended consequences of the intervention. The representation and analysis of AEs are critical to the improvement of public health. Description The Ontology of Adverse Events (OAE), previously named Adverse Event Ontology (AEO), is a community-driven ontology developed to standardize and integrate data relating to AEs arising subsequent to medical interventions, as well as to support computer-assisted reasoning. OAE has over 3,000 terms with unique identifiers, including terms imported from existing ontologies and more than 1,800 OAE-specific terms. In OAE, the term ‘adverse event’ denotes a pathological bodily process in a patient that occurs after a medical intervention. Causal adverse events are defined by OAE as those events that are causal consequences of a medical intervention. OAE represents various adverse events based on patient anatomic regions and clinical outcomes, including symptoms, signs, and abnormal processes. OAE has been used in the analysis of several different sorts of vaccine and drug adverse event data. For example, using the data extracted from the Vaccine Adverse Event Reporting System (VAERS), OAE was used to analyse vaccine adverse events associated with the administrations of different types of influenza vaccines. OAE has also been used to represent and classify the vaccine adverse events cited in package inserts of FDA-licensed human vaccines in the USA. Conclusion OAE is a biomedical ontology that logically defines and classifies various adverse events occurring after medical interventions. OAE has successfully been applied in several adverse event studies. The OAE ontological framework provides a platform for systematic representation and analysis of

  16. The Chernobyl Accident 20 Years On: An Assessment of the Health Consequences and the International Response

    PubMed Central

    Baverstock, Keith; Williams, Dillwyn

    2006-01-01

    Background The Chernobyl accident in 1986 caused widespread radioactive contamination and enormous concern. Twenty years later, the World Health Organization and the International Atomic Energy Authority issued a generally reassuring statement about the consequences. Accurate assessment of the consequences is important to the current debate on nuclear power. Objectives Our objectives in this study were to evaluate the health impact of the Chernobyl accident, assess the international response to the accident, and consider how to improve responses to future accidents. Discussion So far, radiation to the thyroid from radioisotopes of iodine has caused several thousand cases of thyroid cancer but very few deaths; exposed children were most susceptible. The focus on thyroid cancer has diverted attention from possible nonthyroid effects, such as mini-satellite instability, which is potentially important. The international response to the accident was inadequate and uncoordinated, and has been unjustifiably reassuring. Accurate assessment of Chernobyl’s future health effects is not currently possible in the light of dose uncertainties, current debates over radiation actions, and the lessons from the late consequences of atomic bomb exposure. Conclusions Because of the uncertainties over the dose from and the consequences of the Chernobyl accident, it is essential that investigations of its effects should be broadened and supported for the long term. Because of the problems with the international response to Chernobyl, the United Nations should initiate an independent review of the actions and assignments of the agencies concerned, with recommendations for dealing with future international-scale accidents. These should involve independent scientists and ensure cooperation rather than rivalry. PMID:16966081

  17. Health Care Costs and the Socioeconomic Consequences of Work Injuries in Brazil: A Longitudinal Study

    PubMed Central

    SANTANA, Vilma Sousa; FERNANDES DE SOUZA, Luis Eugênio Portela; PINTO, Isabela Cardoso de Matos

    2013-01-01

    Work injuries are a worldwide public health problem but little is known about their socioeconomic impact. This prospective longitudinal study estimates the direct health care costs and socioeconomic consequences of work injuries for 406 workers identified in the emergency departments of the two largest public hospitals in Salvador, Brazil, from June through September 2005. After hospital discharge workers were followed up monthly until their return to work. Most insured workers were unaware of their rights or of how to obtain insurance benefits (81.6%). Approximately half the cases suffered loss of earnings, and women were more frequently dismissed than men. The most frequently reported family consequences were: need for a family member to act as a caregiver and difficulties with daily expenses. Total costs were US$40,077.00 but individual costs varied widely, according to injury severity. Out-of-pocket costs accounted for the highest proportion of total costs (50.5%) and increased with severity (57.6%). Most out-of-pocket costs were related to transport and purchasing medicines and other wound care products. The second largest contribution (40.6%) came from the public National Health System − SUS. Employer participation was negligible. Health care funding must be discussed to alleviate the economic burden of work injuries on workers. PMID:23803496

  18. Is acculturation always adverse to Korean immigrant health in the United States?

    PubMed

    Ra, Chaelin Karen; Cho, Youngtae; Hummer, Robert A

    2013-06-01

    This study examined the association between individuals' proportion of life spent in the United States and the health status and health behaviors among Korean immigrants aged 25 and above. The analysis is stratified by level of education to test whether a higher proportion of time spent in the United States is associated with poorer health among both less educated and highly educated Korean immigrants. California health interview survey data from 2005 to 2007 were used to estimate logistic regression models of health and health behaviour among Korean immigrants, stratified by educational attainment. The health and health behaviour of less educated Korean immigrants tended to be worse among those with a higher proportion of residence in the United States. However, more highly educated Korean immigrants tended to exhibit lower odds of being unhealthy and lower odds of poor health behavior with a higher proportion of life spent in the United States. Acculturation is not always associated with poorer immigrant health outcomes. A higher proportion of life spent in the United States tends to be associated with more favorable health and health behavior among highly educated Korean immigrants.

  19. The health system consequences of agency nursing and moonlighting in South Africa.

    PubMed

    Rispel, Laetitia C; Blaauw, Duane

    2015-01-01

    Background Worldwide, there is an increased reliance on casual staff in the health sector. Recent policy attention in South Africa has focused on the interrelated challenges of agency nursing and moonlighting in the health sector. Objective This paper examines the potential health system consequences of agency nursing and moonlighting among South African nurses. Methods During 2010, a cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses providing clinical care completed a self-administered questionnaire after giving informed consent. The questionnaire obtained information on socio-demographics, involvement in agency nursing and moonlighting, and self-reported indicators of potential health system consequences of agency nursing and moonlighting. A weighted analysis was done using STATA(®) 13. Results In the survey, 40.7% of nurses reported moonlighting or working for an agency in the preceding year. Of all participants, 51.5% reported feeling too tired to work, 11.5% paid less attention to nursing work on duty, and 10.9% took sick leave when not actually sick in the preceding year. Among the moonlighters, 11.9% had taken vacation leave to do agency work or moonlighting, and 9.8% reported conflicting schedules between their primary and secondary jobs. In the bivariate analysis, moonlighting nurses were significantly more likely than non-moonlighters to take sick leave when not sick (p=0.011) and to pay less attention to nursing work on duty (p=0.035). However, in a multiple logistic regression analysis, the differences between moonlighters and non-moonlighters did not remain statistically significant after adjusting for other socio-demographic variables. Conclusion Although moonlighting did not emerge as a statistically significant predictor, the reported health system consequences are serious. A combination of strong nursing leadership, effective management, and consultation with and buy-in from front

  20. Adverse childhood experiences, depression and mental health barriers to work among low-income women.

    PubMed

    Cambron, Christopher; Gringeri, Christina; Vogel-Ferguson, Mary Beth

    2015-01-01

    Recent research has connected childhood abuse to decreased physical and mental health for low-income women in Utah. Further, mental health has established a link to employment problems. This study conducted a secondary analysis of data collected from individuals accessing public assistance to investigate the relationships among retrospective self-reports of childhood emotional, physical and sexual abuse and prospective indicators of mental health and mental health barriers to work. Logistic regression models found strong relationships between childhood abuse and increased odds of depression and mental health barriers to work. Path models highlight the relative importance of depression for those reporting mental health as the biggest barrier to work. Recommendations for social workers, public health professionals, and program administrators are provided.

  1. Insomnia and sleep apnea in midlife women: prevalence and consequences to health and functioning

    PubMed Central

    Kline, Christopher E.; Nowakowski, Sara

    2015-01-01

    Sleep disturbance is common during the menopausal transition, with numerous downstream consequences to health and functioning, including reduced quality of life, impaired mental health, and increased physical health morbidity. Insomnia affects approximately 50% of midlife women and is characterized by nocturnal symptoms of difficulties initiating or maintaining sleep (or both) and daytime symptoms that impair occupational, social, or other components of functioning. In addition, approximately 20% of midlife women develop sleep-disordered breathing during the menopausal transition. This commentary summarizes the prevalence, risk factors, and treatment options for each of these sleep disorders in midlife women, with specific focus on first-line treatments for insomnia (cognitive behavioral therapy for insomnia) and sleep-disordered breathing (continuous positive airway pressure) and unique considerations for treating sleep disorders in midlife women. Future directions are also discussed. PMID:26097736

  2. Economic and public health consequences of delayed access to medical care for migrants living with HIV in France.

    PubMed

    Guillon, Marlène; Celse, Michel; Geoffard, Pierre-Yves

    2017-03-25

    In 2013, migrants accounted for 46% of newly diagnosed cases of HIV (human immunodeficiency virus) infection in France. These populations meet with specific obstacles leading to late diagnosis and access to medical care. Delayed access to care (ATC) for HIV-infected migrants reduces their life expectancy and quality of life. Given the reduction of infectivity under antiretroviral (ARV) treatment, delayed ATC for HIV-infected migrants may also hinder the control of the HIV epidemic. The objective of this study is to measure the public health and economic consequences of delayed ATC for migrants living with HIV in France. Using a healthcare payer perspective, our model compares the lifetime averted infections and costs of early vs. late ATC for migrants living with HIV in France. Early and late ATC are defined by an entry into care with a CD4 cell count of 350 and 100/mm(3), respectively. Our results show that an early ATC is dominant, even in the worst-case scenario. In the most favorable scenario, early ATC generates an average net saving of €198,000 per patient, and prevents 0.542 secondary infection. In the worst-case scenario, early ATC generates an average net saving of €32,000 per patient, and prevents 0.299 secondary infection. These results are robust to various adverse changes in key parameters and to a definition of late ATC as an access to care at a CD4 level of 200/mm(3). In addition to individual health benefits, improving ATC for migrants living with HIV proves efficient in terms of public health and economics. These results stress the benefit of ensuring early ATC for all individuals living with HIV in France.

  3. Repressed and silent suffering: consequences of childhood sexual abuse for women's health and well-being.

    PubMed

    Sigurdardottir, Sigrun; Halldorsdottir, Sigridur

    2013-06-01

    Research results indicate that psychological trauma in childhood caused by child sexual abuse can have serious and widespread consequences for health and well-being. The purpose of this study was to examine the consequences of childhood sexual abuse for women's health and well-being. The research methodology was phenomenology. Seven women with a history of childhood sexual abuse were interviewed twice with 1-6 months interval. For all the women, the abuse started when they were between 4 and 5. All of them were repeatedly violated and traumatized ever since then and were even still being victimized at the time of the interviews. The main result of the study is that time does not heal all wounds. All the women described great repressed and silent suffering in all aspects of life, and the abuse is still seriously affecting them and their loved ones. As children, they had learning problems, experienced bullying and had unexplained physical symptoms. In adulthood, they have been suffering multiple physical and psychological symptoms: five of them have fibromyalgia; all of them have been suffering chronic and widespread pain; they have all been dealing with depression and difficulty with close connections, and they all have trouble trusting others. Because they were kids, they have been using the health service to a great extent but without adequate help. It is important for health professionals to know the symptoms and consequences of childhood sexual abuse to be able to respond to adult survivors in a supportive and caring way. More effective therapeutic measures have to be developed to decrease their suffering.

  4. Predictive validity of parent- and self-rated ADHD symptoms in adolescence on adverse socioeconomic and health outcomes.

    PubMed

    Du Rietz, Ebba; Kuja-Halkola, Ralf; Brikell, Isabell; Jangmo, Andreas; Sariaslan, Amir; Lichtenstein, Paul; Kuntsi, Jonna; Larsson, Henrik

    2017-02-10

    There is scarcity of research investigating the validity of self-report of attention deficit hyperactivity disorder (ADHD) symptoms compared to other informants, such as parents. This study aimed to compare the predictive associations of ADHD symptoms rated by parents and their children across adolescence on a range of adverse socioeconomic and health outcomes in early adulthood. Parent- and self-rated ADHD symptoms were assessed in 2960 individuals in early (13-14 years) and late adolescence (16-17 years). Logistic regression analyses were used to compare the associations between parent- and self-rated ADHD symptoms at both time points and adverse life outcomes in young adulthood obtained from Swedish national registries. Both parent- and self-ratings of ADHD symptoms were associated with increased risk for adverse outcomes, although associations of parent-ratings were more often statistically significant and were generally stronger (OR = 1.12-1.49, p < 0.05) than self-ratings (OR = 1.07-1.17, p < 0.05). After controlling for the other informant, parent-ratings of ADHD symptoms in both early and late adolescence significantly predicted academic and occupational failure, criminal convictions and traffic-related injuries, while self-ratings of ADHD symptoms only in late adolescence predicted substance use disorder and academic failure. Our findings suggest that both parent- and self-ratings of ADHD symptoms in adolescence provides valuable information on risk of future adverse socioeconomic and health outcomes, however, self-ratings are not valuable once parent-ratings have been taken into account in predicting most outcomes. Thus, clinicians and researchers should prioritize parent-ratings over self-ratings.

  5. Consequences of the North American Free Trade Agreement for health services: a perspective from Mexico.

    PubMed Central

    Frenk, J; Gómez-Dantés, O; Cruz, C; Chacón, F; Hernández, P; Freeman, P

    1994-01-01

    OBJECTIVES. The purposes of the study were to assess the potential impact of the North American Free Trade Agreement (NAFTA) on medical care in Mexico and to identify internal measures Mexico could take to increase the benefits and minimize the risks of free trade. METHODS. The dual nature of the health sector is examined; the Mexican, Canadian, and US health care systems are compared; and modes and consequences of international exchange of health services are analyzed. RESULTS. Four issues require immediate attention: accreditation of health care facilities, licensing and certification of professionals, technology assessment, and financial equity. CONCLUSIONS. NAFTA offers opportunities for positive developments in Mexico, provided risks can be anticipated and preventive measures can be taken to avoid negative impacts on the health system. Medical services, like other elements of the Mexican economy, must be modernized to respond to the demands of global competition. The Mexican National Academy of Medicine has recommended to the Mexican government (1) internal strengthening of the Mexican health care system to improve its ability to respond to the new conditions created by NAFTA and (2) a gradual process to facilitate equitable and mutually beneficial interactions among the three countries. PMID:7943476

  6. A cross-cultural longitudinal examination of the effect of cumulative adversity on the mental and physical health of older adults.

    PubMed

    Palgi, Yuval; Shrira, Amit

    2016-03-01

    Self-oriented adversity refers to traumatic events that primarily inflict the self, whereas other-oriented adversity refers to events that affect the self by primarily targeting others. The present study aimed to examine whether cultural background moderates the effects of self-oriented and other-oriented adversity on mental and physical health of older adults. Using longitudinal data from the Israeli component of the Survey of Health and Retirement, we focused on 370 Jews and 239 Arabs who reported their exposure to various adversities across the life span, and completed questionnaires regarding mental and physical health. Results showed that the effect of self-oriented adversity on health did not differ among Jews and Arabs. However, other-oriented adversity showed a stronger effect on Arabs' mental and physical health than on Jews' health. Our findings suggest that the accumulation of adverse events that affect the self by primarily targeting others may have a stronger impact in collectivist cultures than in individualist cultures.

  7. Health consequences of female genital mutilation/cutting in the Gambia, evidence into action

    PubMed Central

    2011-01-01

    Background Female Genital Mutilation/Cutting (FGM/C) is a harmful traditional practice with severe health complications, deeply rooted in many Sub-Saharan African countries. In The Gambia, the prevalence of FGM/C is 78.3% in women aged between 15 and 49 years. The objective of this study is to perform a first evaluation of the magnitude of the health consequences of FGM/C in The Gambia. Methods Data were collected on types of FGM/C and health consequences of each type of FGM/C from 871 female patients who consulted for any problem requiring a medical gynaecologic examination and who had undergone FGM/C in The Gambia. Results The prevalence of patients with different types of FGM/C were: type I, 66.2%; type II, 26.3%; and type III, 7.5%. Complications due to FGM/C were found in 299 of the 871 patients (34.3%). Even type I, the form of FGM/C of least anatomical extent, presented complications in 1 of 5 girls and women examined. Conclusion This study shows that FGM/C is still practiced in all the six regions of The Gambia, the most common form being type I, followed by type II. All forms of FGM/C, including type I, produce significantly high percentages of complications, especially infections. PMID:21967670

  8. Identification and prioritization of relationships between environmental stressor and adverse human health impacts

    EPA Science Inventory

    AbstractBackground: There are over 80,000 chemicals in commerce with little data available describing their impacts on human health. Biomonitoring surveys, such as the NHANES, offer one route to identifying possible relationships between environmental chemicals and health impacts...

  9. Building associations between markers of environmental stressors and adverse human health impacts using frequent itemset mining

    EPA Science Inventory

    Building associations between markers of exposure and effect using frequent itemset mining The human-health impact of environmental contaminant exposures is unclear. While some exposure-effect relationships are well studied, health effects are unknown for the vast majority of the...

  10. Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

    PubMed Central

    Ulrich, F.; Petermann, F.

    2016-01-01

    In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child. PMID:27904164

  11. Predictors of health practices within age-sex groups: National Survey of Personal Health Practices and Consequences, 1979.

    PubMed Central

    Rakowski, W

    1988-01-01

    Health promotion-disease prevention programs share with health behavior research the common objective of identifying population subgroups toward whom services can be targeted. For this report, six age-sex groups were examined to determine similarities and differences in the predictors of eight health practice indices. Data were from the 1979 National Survey of Personal Health Practices and Consequences. Results showed very little similarity of predictors across the three age cohorts (20-34, 35-49, 50-64), between men and women, and among the six age-sex groups. No predictor achieved significance consistently for several health practices in any of the six groups, although years of education made the best showing. The lack of overlap among predictors helps to explain why health promotion messages and recruitment strategies may not appeal to as diverse an audience as initially intended. Possible explanations for the absence of similar predictors include differences in the nature of the various practices themselves, absence of data on intentions behind a person's behavior, and the "over-determined" character of an individual person's behavior. PMID:3136496

  12. Physiological and health consequences of social status in zebrafish (Danio rerio).

    PubMed

    Filby, Amy L; Paull, Gregory C; Bartlett, Emily J; Van Look, Katrien J W; Tyler, Charles R

    2010-12-02

    Social status affects access to food, mates and shelter and has consequences for the physiology of individuals and their health status. In the zebrafish (Danio rerio), an emerging model for studies into animal behavior, the possible consequences of social hierarchy to an individual's physiology and health are unknown. To address this, in this species we assessed the effects of social interaction (for periods of 1-5days) on growth, stress, immune function and reproductive condition. Wide-ranging differences in physiology occurred between the social ranks, some of which were sex-related and time-dependent. In both sexes, dominant fish were larger than subordinates and dominant males had a higher growth rate during the trials. Subordinates had higher plasma cortisol and in males higher telencephalic corticotrophin-releasing hormone, neuropeptide y and glucocorticoid receptor gene expression. Splenic cytokine expression suggested differences in immune status between ranks in both sexes and hematocrit was elevated in subordinate males. In both sexes, dominants and subordinates differed in the expression of genes for various gonadal sex steroid receptors and steroidogenic enzymes and in dominant females the ovary was larger relative to body mass compared with in subordinates. Dominant males had higher plasma 11-ketotestosterone than subordinates and there was an increase in the number of spermatids in their testes over the duration of the study that was not seen in subordinate males. The wide-ranging physiological differences seen between dominant and subordinate zebrafish as a consequence of their social status suggest negative health impacts for subordinates after prolonged durations in those hierarchies.

  13. A Public Health Achievement Under Adversity: The Eradication of Poliomyelitis From Peru, 1991

    PubMed Central

    Cueto, Marcos

    2014-01-01

    The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America’s story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public–private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru’s Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements. PMID:25322297

  14. A public health achievement under adversity: the eradication of poliomyelitis from Peru, 1991.

    PubMed

    Sobti, Deepak; Cueto, Marcos; He, Yuan

    2014-12-01

    The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America's story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public-private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru's Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements.

  15. Adverse adolescent relationship histories and young adult health: Cumulative effects of loneliness, low parental support, relationship instability, intimate partner violence and loss

    PubMed Central

    Adam, Emma K.; Chyu, Laura; Hoyt, Lindsay; Doane, Leah D.; Boisjoly, Johanne; Duncan, Greg; Chase-Lansdale, Lindsay; McDade, Thomas W.

    2011-01-01

    Purpose To examine the associations between adverse interpersonal relationship histories experienced during adolescence and health in young adulthood in a large, nationally representative sample. Methods Using data from Waves I, II and III of the National Longitudinal Study of Adolescent Health, multiple adverse relationship experiences are examined, including high loneliness, low perceived parental support, frequent transitions in romantic relationships (relationship instability), exposure to intimate partner violence, and loss by death of important relationship figures. These histories are assessed, both individually and in a relationship risk index, as predictors of self-reported general health and depressive symptoms at Wave III (ages 18 to 27), controlling for baseline (Wave I) health and for demographic and health behavior covariates. Results Net of baseline health and covariates, each type of relationship risk (experienced between Wave I and Wave III) was related to either depression or general health at Wave III, with the strongest effects seen for exposure to intimate partner violence. In addition, a cumulative relationship risk index examining the extent to which youth experienced high levels of multiple relationship risk factors revealed that each additional adverse relationship experience increased the odds of reporting poor mental and general health at Wave III, with increases occurring in an additive manner. Conclusions Multiple types of adverse relationship experiences predicted increases in poor general health and depressive symptoms from adolescence to early adulthood. Consistent with a cumulative risk hypothesis, the more types of adverse relationship experiences a youth experienced, the worse their young adult health outcomes. PMID:21856520

  16. Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

    NASA Technical Reports Server (NTRS)

    Evans-Flynn, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra; Leveton, Lauren B.; Vessey, William

    2015-01-01

    Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk.

  17. Mental health consequences of war: a brief review of research findings

    PubMed Central

    MURTHY, R. SRINIVASA; LAKSHMINARAYANA, RASHMI

    2006-01-01

    Among the consequences of war, the impact on the mental health of the civilian population is one of the most significant. Studies of the general population show a definite increase in the incidence and prevalence of mental disorders. Women are more affected than men. Other vulnerable groups are children, the elderly and the disabled. Prevalence rates are associated with the degree of trauma, and the availability of physical and emotional support. The use of cultural and religious coping strategies is frequent in developing countries. PMID:16757987

  18. Detention of British citizens as hostages in the Gulf--health, psychological, and family consequences.

    PubMed Central

    Easton, J A; Turner, S W

    1991-01-01

    OBJECTIVE--To describe the physical, psychological, and family consequences of the detention of British subjects as hostages in Kuwait or Iraq, or both, after the invasion of Kuwait on 2 August 1990 and to investigate the relation between types of trauma experienced and these reactions. DESIGN--Postal questionnaire. SUBJECTS--381 respondents. RESULTS--Many health, social, and psychological sequelae were identified. Problems with present finance, accommodation, and work are important causes of distress. Many hostages coped well and gained self esteem. CONCLUSIONS--A minority of respondents require further support and treatment. Expatriates in risk areas should retain assets in their home country. PMID:1747642

  19. The Non-linear Health Consequences of Living in Larger Cities.

    PubMed

    Rocha, Luis E C; Thorson, Anna E; Lambiotte, Renaud

    2015-10-01

    Urbanization promotes economy, mobility, access, and availability of resources, but on the other hand, generates higher levels of pollution, violence, crime, and mental distress. The health consequences of the agglomeration of people living close together are not fully understood. Particularly, it remains unclear how variations in the population size across cities impact the health of the population. We analyze the deviations from linearity of the scaling of several health-related quantities, such as the incidence and mortality of diseases, external causes of death, wellbeing, and health care availability, in respect to the population size of cities in Brazil, Sweden, and the USA. We find that deaths by non-communicable diseases tend to be relatively less common in larger cities, whereas the per capita incidence of infectious diseases is relatively larger for increasing population size. Healthier lifestyle and availability of medical support are disproportionally higher in larger cities. The results are connected with the optimization of human and physical resources and with the non-linear effects of social networks in larger populations. An urban advantage in terms of health is not evident, and using rates as indicators to compare cities with different population sizes may be insufficient.

  20. Smoker-Free Workplace Policies: Developing a Model of Public Health Consequences of Workplace Policies Barring Employment to Smokers

    PubMed Central

    Houle, Brian; Siegel, Michael

    2009-01-01

    A marked shift in tobacco-related workplace health promotion intervention involves the adoption of policies barring employment to smokers. We discuss the potential public health consequences of these policies on those affected – smokers, their families, the surrounding community, and society at large. We find a lack of published evidence evaluating the effectiveness and consequences of these policies. By developing a model of policy effects, we outline possible unintended consequences. With such large gaps in the evidence base and the potential for deleterious consequences, we argue for increased discussion about the use of smoker-free employment policies as a public health intervention and for increased engagement of employers by the public health community in worksite health promotion. PMID:19168490

  1. Short-, Medium-, and Long-Term Consequences of Poor Infant Health: An Analysis Using Siblings and Twins

    ERIC Educational Resources Information Center

    Oreopoulos, Philip; Stabile, Mark; Walld, Randy; Roos, Leslie L.

    2008-01-01

    We use administrative data on a sample of births between 1978 and 1985 to investigate the short-, medium-, and long-term consequences of poor infant health. Our findings offer several advances to the existing literature on the effects of early infant health on subsequent health, education, and labor force attachment. First, we use a large sample…

  2. Adverse Effects of Tattoos and Piercing on Parent/Patient Confidence in Health Care Providers.

    PubMed

    Johnson, Scarlett C; Doi, Maegan L M; Yamamoto, Loren G

    2016-09-01

    First impressions based on practitioner appearance often form the basis for preliminary assumptions regarding trust, confidence, and competence, especially in situations where patients or family members do not have an established relationship with the physician. Given their growing prevalence, we strove to further investigate whether visible tattoos or piercings on a medical provider affects a patient's perception of the provider's capabilities and their trust in the care that would be provided. A survey using photographs of simulated practitioners was administered to 314 participants split between rural and urban locations. Study volunteers rated tattooed practitioners with lower confidence ratings when compared with nontattooed practitioners and reported greater degrees of discomfort with greater degrees of facial piercing. We concluded that these factors adversely affect the clinical confidence ratings of practitioners, regardless of the gender, age group, or location of participants.

  3. Understanding the organisational context for adverse events in the health services: the role of cultural censorship.

    PubMed

    Hart, E; Hazelgrove, J

    2001-12-01

    This paper responds to the current emphasis on organisational learning in the NHS as a means of improving healthcare systems and making hospitals safer places for patients. Conspiracies of silence have been identified as obstacles to organisational learning, covering error and hampering communication. In this paper we question the usefulness of the term and suggest that "cultural censorship", a concept developed by the anthropologist Robin Sherriff, provides a much needed insight into cultures of silence within the NHS. Drawing on a number of illustrations, but in particular the Ritchie inquiry into the disgraced gynaecologist Rodney Ledward, we show how the defining characteristics of cultural censorship can help us to understand how adverse events get pushed underground, only to flourish in the underside of organisational life.

  4. Understanding the organisational context for adverse events in the health services: the role of cultural censorship

    PubMed Central

    Hart, E; Hazelgrove, J

    2001-01-01

    This paper responds to the current emphasis on organisational learning in the NHS as a means of improving healthcare systems and making hospitals safer places for patients. Conspiracies of silence have been identified as obstacles to organisational learning, covering error and hampering communication. In this paper we question the usefulness of the term and suggest that "cultural censorship", a concept developed by the anthropologist Robin Sherriff, provides a much needed insight into cultures of silence within the NHS. Drawing on a number of illustrations, but in particular the Ritchie inquiry into the disgraced gynaecologist Rodney Ledward, we show how the defining characteristics of cultural censorship can help us to understand how adverse events get pushed underground, only to flourish in the underside of organisational life. Key Words: cultural censorship; organisational culture; quality improvement; patient safety PMID:11743156

  5. 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.

  6. Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health

    PubMed Central

    Houdek, Devon

    2017-01-01

    It is well recognized that bone loss accelerates in hypogonadal states, with female menopause being the classic example of sex hormones affecting the regulation of bone metabolism. Underrepresented is our knowledge of the clinical and metabolic consequences of overt male hypogonadism, as well as the more subtle age-related decline in testosterone on bone quality. While menopause and estrogen deficiency are well-known risk factors for osteoporosis in women, the effects of age-related testosterone decline in men on bone health are less well known. Much of our knowledge comes from observational studies and retrospective analysis on small groups of men with variable causes of primary or secondary hypogonadism and mild to overt testosterone deficiencies. This review aims to present the current knowledge of the consequences of adult male hypogonadism on bone metabolism. The direct and indirect effects of testosterone on bone cells will be explored as well as the important differences in male osteoporosis and assessment as compared to that in females. The clinical consequence of both primary and secondary hypogonadism, as well as testosterone decline in older males, on bone density and fracture risk in men will be summarized. Finally, the therapeutic options and their efficacy in male osteoporosis and hypogonadism will be discussed.

  7. Evidence of Coal-Fly-Ash Toxic Chemical Geoengineering in the Troposphere: Consequences for Public Health

    PubMed Central

    Herndon, J. Marvin

    2015-01-01

    The widespread, intentional and increasingly frequent chemical emplacement in the troposphere has gone unidentified and unremarked in the scientific literature for years. The author presents evidence that toxic coal combustion fly ash is the most likely aerosolized particulate sprayed by tanker-jets for geoengineering, weather-modification and climate-modification purposes and describes some of the multifold consequences on public health. Two methods are employed: (1) Comparison of 8 elements analyzed in rainwater, leached from aerosolized particulates, with corresponding elements leached into water from coal fly ash in published laboratory experiments, and (2) Comparison of 14 elements analyzed in dust collected outdoors on a high-efficiency particulate air (HEPA) filter with corresponding elements analyzed in un-leached coal fly ash material. The results show: (1) the assemblage of elements in rainwater and in the corresponding experimental leachate are essentially identical. At a 99% confidence interval, they have identical means (T-test) and identical variances (F-test); and (2) the assemblage of elements in the HEPA dust and in the corresponding average un-leached coal fly ash are likewise essentially identical. The consequences on public health are profound, including exposure to a variety of toxic heavy metals, radioactive elements, and neurologically-implicated chemically mobile aluminum released by body moisture in situ after inhalation or through transdermal induction. PMID:26270671

  8. Evidence of Coal-Fly-Ash Toxic Chemical Geoengineering in the Troposphere: Consequences for Public Health.

    PubMed

    Herndon, J Marvin

    2015-08-11

    The widespread, intentional and increasingly frequent chemical emplacement in the troposphere has gone unidentified and unremarked in the scientific literature for years. The author presents evidence that toxic coal combustion fly ash is the most likely aerosolized particulate sprayed by tanker-jets for geoengineering, weather-modification and climate-modification purposes and describes some of the multifold consequences on public health. Two methods are employed: (1) Comparison of 8 elements analyzed in rainwater, leached from aerosolized particulates, with corresponding elements leached into water from coal fly ash in published laboratory experiments, and (2) Comparison of 14 elements analyzed in dust collected outdoors on a high-efficiency particulate air (HEPA) filter with corresponding elements analyzed in un-leached coal fly ash material. The results show: (1) the assemblage of elements in rainwater and in the corresponding experimental leachate are essentially identical. At a 99% confidence interval, they have identical means (T-test) and identical variances (F-test); and (2) the assemblage of elements in the HEPA dust and in the corresponding average un-leached coal fly ash are likewise essentially identical. The consequences on public health are profound, including exposure to a variety of toxic heavy metals, radioactive elements, and neurologically-implicated chemically mobile aluminum released by body moisture in situ after inhalation or through transdermal induction.

  9. High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence

    PubMed Central

    Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

    2015-01-01

    Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases. PMID:25833341

  10. High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence.

    PubMed

    Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

    2015-06-01

    Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases.

  11. Military youth and the deployment cycle: emotional health consequences and recommendations for intervention.

    PubMed

    Esposito-Smythers, Christianne; Wolff, Jennifer; Lemmon, Keith M; Bodzy, Mary; Swenson, Rebecca R; Spirito, Anthony

    2011-08-01

    The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and reintegration periods. Despite widespread acknowledgment of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle.

  12. 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.

  13. [Suspected adverse reactions after vaccination. Results from the German Health Interview and Examination Survey for Children and Adolescents. Part 2: predictors of parental reporting of suspected adverse reactions after vaccinations].

    PubMed

    Poethko-Müller, C; Atzpodien, K; Schmitz, R; Schlaud, M

    2011-03-01

    Each method to monitor vaccine safety has strengths and limitations. Therefore, vaccine safety monitoring should rely on different types of data sources. Methods commonly rely on patient-reported adverse reactions. Little is, however, known about factors that may affect the probability with which patients report adverse reactions to vaccines. From 2003-2006, the representative National Health Interview and Examination Survey for Children and Adolescents ("Kinder- und Jugendgesundheitssurvey", KiGGS) retrospectively collected information about vaccines, vaccination dates, and suspected vaccine related adverse reactions from a total of 17,641 participants (<17 years). Poorly tolerated vaccinations were more likely reported from parents living in former West Germany compared to former East Germany (OR 1.61; 95% CI 1.08-2.39), parents of children with special health care needs (OR 1.49; 95% CI 1.08-2.04), and from parents reporting reservations against vaccinations (OR 3.29; 95% CI 2.28-4.75). Parental reporting of adverse vaccine reactions appears to be associated with parental perception and assessment of possible adverse vaccine reactions, as well as with the parents' attitude towards immunization in general.

  14. Climate change and adverse health events: community perceptions from the Tanahu district of Nepal

    NASA Astrophysics Data System (ADS)

    Mishra, Shiva Raj; Mani Bhandari, Parash; Issa, Rita; Neupane, Dinesh; Gurung, Swadesh; Khanal, Vishnu

    2015-03-01

    Nepal is a country economically dependent on climate-sensitive industries. It is highly vulnerable to the environmental, social, economic and health impacts of climate change. The objective of this study is to explore community perceptions of climate variability and human health risks. In this letter, we present a cross sectional study conducted between August 2013 and July 2014 in the Tanahu district of Nepal. Our analysis is based on 258 face-to-face interviews with household heads utilizing structured questionnaires. Over half of the respondents (54.7%) had perceived a change in climate, 53.9% had perceived an increase in temperature in the summer and 49.2% had perceived an increase in rainfall during the rainy season. Half of the respondents perceived an increase in the number of diseases during the summer, 46.5% perceived an increase during the rainy season and 48.8% during winter. Only 8.9% of the respondents felt that the government was doing enough to prevent climate change and its impact on their community. Belonging to the Janajati (indigenous) ethnic group, living in a pakki, super-pakki house and belonging to poor or mid-level income were related to higher odds of perceiving climate variability. Illiterates were less likely to perceive climate variability. Respondents living in a pakki house, super-pakki, or those who were poor were more likely to perceive health risks. Illiterates were less likely to perceive health risks.

  15. How Much Do Rural Hispanics Know about the Adverse Health Risks of Smoking?

    ERIC Educational Resources Information Center

    Butkovic, Tania; Hegde, Ramanujan S.; Hughes, Susan; Lourie, Andrea; Schafer, Sean

    2001-01-01

    Among 137 rural Hispanic Americans surveyed in central California--over half having limited English proficiency and less than a 7th-grade education--almost all knew that smoking causes lung cancer and osteoporosis, but less than half knew of smoking's other health risks. Current smokers were most likely to underestimate smoking risks. (Contains 26…

  16. Using the AHRQ PSIs to Detect Post-Discharge Adverse Events in the Veterans Health Administration

    PubMed Central

    Mull, Hillary J.; Borzecki, Ann M.; Chen, Qi; Shin, Marlena H.; Rosen, Amy K.

    2015-01-01

    Background PSIs use inpatient administrative data to flag cases with potentially preventable adverse events (AEs) attributable to hospital care. We explored how many AEs the PSIs identified in the 30 days post-discharge. Methods We ran the PSI software (version 3.1a) on VA 2003–2007 administrative data for ten recently validated PSIs. Among PSI-eligible index hospitalizations not flagged with an AE, we evaluated how many AEs occurred within 1–14 and 15–30 days post-discharge using inpatient and outpatient administrative data. Results Considering all PSI-eligible index hospitalizations, we identified 11,141 post-discharge AEs, compared to 40,578 inpatient-flagged AEs. More than 60% of post-discharge AEs were detected within 14 days of discharge. The majority of post-discharge AEs were decubitus ulcers and postoperative pulmonary embolisms or deep vein thromboses. Conclusions Extending PSI algorithms to the post-discharge period may provide a more complete picture of hospital quality. Future work should use chart review to validate post-discharge PSI events. PMID:23939485

  17. The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects.

    PubMed

    van Amsterdam, Jan; Brunt, Tibor; van den Brink, Wim

    2015-03-01

    Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB1) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis variants with relatively high levels of cannabidiol (CBD) is associated with fewer psychotic experiences. Synthetic cannabinoid receptor agonists (SCRAs) are full agonists and often more potent than THC. Moreover, in contrast to natural cannabis, SCRAs preparations contain no CBD so that these drugs may have a higher psychosis-inducing potential than cannabis. This paper reviews the general toxicity profile and the adverse effects of SCRAs with special emphasis on their psychosis-inducing risk. The review shows that, compared with the use of natural cannabis, the use of SCRAs may cause more frequent and more severe unwanted negative effects, especially in younger, inexperienced users. Psychosis and psychosis-like conditions seem to occur relatively often following the use of SCRAs, presumably due to their high potency and the absence of CBD in the preparations. Studies on the relative risk of SCRAs compared with natural cannabis to induce or evoke psychosis are urgently needed.

  18. Are food insecurity's health impacts underestimated in the U.S. population? Marginal food security also predicts adverse health outcomes in young U.S. children and mothers.

    PubMed

    Cook, John T; Black, Maureen; Chilton, Mariana; Cutts, Diana; Ettinger de Cuba, Stephanie; Heeren, Timothy C; Rose-Jacobs, Ruth; Sandel, Megan; Casey, Patrick H; Coleman, Sharon; Weiss, Ingrid; Frank, Deborah A

    2013-01-01

    This review addresses epidemiological, public health, and social policy implications of categorizing young children and their adult female caregivers in the United States as food secure when they live in households with "marginal food security," as indicated by the U.S. Household Food Security Survey Module. Existing literature shows that households in the US with marginal food security are more like food-insecure households than food-secure households. Similarities include socio-demographic characteristics, psychosocial profiles, and patterns of disease and health risk. Building on existing knowledge, we present new research on associations of marginal food security with health and developmental risks in young children (<48 mo) and health in their female caregivers. Marginal food security is positively associated with adverse health outcomes compared with food security, but the strength of the associations is weaker than that for food insecurity as usually defined in the US. Nonoverlapping CIs, when comparing odds of marginally food-secure children's fair/poor health and developmental risk and caregivers' depressive symptoms and fair/poor health with those in food-secure and -insecure families, indicate associations of marginal food security significantly and distinctly intermediate between those of food security and food insecurity. Evidence from reviewed research and the new research presented indicates that households with marginal food security should not be classified as food secure, as is the current practice, but should be reported in a separate discrete category. These findings highlight the potential underestimation of the prevalence of adverse health outcomes associated with exposure to lack of enough food for an active, healthy life in the US and indicate an even greater need for preventive action and policies to limit and reduce exposure among children and mothers.

  19. Effect of adverse childhood experiences on physical health in adulthood: Results of a study conducted in Baghdad city

    PubMed Central

    Al-Shawi, Ameel F.; Lafta, Riyadh K.

    2015-01-01

    Background: Studies have revealed a powerful relationship between adverse childhood experiences (ACEs) and physical and mental health in adulthood. Literature documents the conversion of traumatic emotional experiences in childhood into organic disease later in life. Objective: The aim was to estimate the effect of childhood experiences on the physical health of adults in Baghdad city. Subjects and Methods: A cross-sectional study was conducted from January 2013 to January 2014. The study sample was drawn from Baghdad city. Multistage sampling techniques were used in choosing 13 primary health care centers and eight colleges of three universities in Baghdad. In addition, teachers of seven primary schools and two secondary schools were chosen by a convenient method. Childhood experiences were measured by applying a modified standardized ACEs-International Questionnaire form and with questions for bonding to family and parental monitoring. Physical health assessment was measured by a modified questionnaire derived from Health Appraisal Questionnaire of Centers for Disease Control and Prevention. The questionnaire includes questions on cerebrovascular diseases, diabetes mellitus, tumor, respiratory and gastrointestinal diseases. Results: Logistic regression model showed that a higher level of bonding to family (fourth quartile) is expected to reduce the risk of chronic physical diseases by almost the half (odds ratio = 0.57) and exposure to a high level of household dysfunction and abuse (fourth quartile) is expected to increase the risk of chronic physical diseases by 81%. Conclusion: Childhood experiences play a major role in the determination of health outcomes in adulthood, and early prevention of ACEs. Encouraging strong family bonding can promote physical health in later life. PMID:25983602

  20. The Relationship between Working Conditions and Adverse Health Symptoms of Employee in Solar Greenhouse.

    PubMed

    Zhang, Min; Wang, Xiu Feng; Cui, Xiu Min; Wang, Jian; Yu, Shi Xin

    2015-02-01

    To determine the correlation between the working environment and the health status of employees in solar greenhouse, 1171 employees were surveyed. The results show the 'Greenhouse diseases' are affected by many factors. Among general uncomforts, the morbidity of the bone and joint damage is the highest and closely related to labor time and age. Planting summer squash and wax gourd more easily cause skin pruritus. Asthma-related cough, eye disease, and skin pruritus are significantly correlated with the cultivation of wax gourd. The application of inorganic fertilizer and fertigation dramatically induce the bone and joint damage. The smell of covering film greatly influence skin pruritus. Personal protection is badly scanty and normative occupational health and safety need to be completed.

  1. Adverse childhood experiences, mental health, and quality of life of Chilean girls placed in foster care: An exploratory study.

    PubMed

    Seiler, Annina; Kohler, Stefanie; Ruf-Leuschner, Martina; Landolt, Markus A

    2016-03-01

    In Latin America, little research has been conducted regarding exposure to adverse childhood experiences (ACEs), mental health, and health-related quality of life (HRQoL) among foster children. This study examined the association between ACEs and mental health, posttraumatic stress disorder (PTSD), and HRQoL in Chilean foster girls relative to age-matched Chilean family girls. Data were obtained from 27 Chilean foster girls and 27 Chilean girls ages 6 to 17 years living in family homes. Standardized self- and proxy-report measures were used. Foster girls reported more ACEs than controls in terms of familial and nonfamilial sexual abuse and both emotional and physical neglect. Girls living in foster care had a significantly higher rate of PTSD, displayed greater behavioral and emotional problems, and reported a lower HRQoL. Analysis confirmed the well-known cumulative risk hypothesis by demonstrating a significant positive association between the number of ACEs and PTSD symptom severity and a significant negative association with HRQoL. Chilean foster girls endured more ACEs that impair mental health and HRQoL than age-matched peers living with their families. These findings have implications for out-of-home care services in Latin America, highlighting the need to implement not only appropriate trauma-focused treatments but also appropriate prevention strategies.

  2. Consideration of Personal Adverse Childhood Experiences during Implementation of Trauma-Informed Care Curriculum in Graduate Health Programs

    PubMed Central

    Strait, Joshua; Bolman, Tiffany

    2017-01-01

    Context: Scientific findings of adverse childhood experiences (ACEs) and their lifelong graded relationship with leading causes of death are well established. Many health care practitioners, however, have yet to implement ACEs screening in clinical practice. Furthermore, ACEs screening and trauma-informed care (TIC) are not part of standard graduate-level training. Objective: To 1) implement trauma-informed curriculum for multiple graduate health programs, 2) determine student understanding of and willingness to address ACEs, and 3) assess the relationship between students voluntarily evaluating their individual ACE Score and their attitude toward ACEs and TIC. Design: Prospective study with pre- and postcurricular surveys (12-question digital survey administered before and after the curriculum) for 967 graduate students from 9 health professions programs at 2 campuses who received curriculum focused on ACEs and TIC. Main Outcome Measures: Students’ understanding of ACEs and TIC, their awareness of personal ACEs, and their willingness to incorporate TIC in practice. Results: Among students who voluntarily completed an ACE questionnaire, there was statistical significance in familiarity with clinical and scientific findings of the ACE Study (p < 0.001) and familiarity with TIC (p < 0.02). A significant intercampus difference in the students’ familiarity with the scientific and clinical findings of the ACE Study (p < 0.05) was found. Conclusion: Students and future health care practitioners who voluntarily assess their ACE Score are significantly more likely to understand scientific and clinical findings of the ACE Study as well as TIC. PMID:27673708

  3. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health.

    PubMed

    Garner, Andrew S; Shonkoff, Jack P

    2012-01-01

    Advances in a wide range of biological, behavioral, and social sciences are expanding our understanding of how early environmental influences (the ecology) and genetic predispositions (the biologic program) affect learning capacities, adaptive behaviors, lifelong physical and mental health, and adult productivity. A supporting technical report from the American Academy of Pediatrics (AAP) presents an integrated ecobiodevelopmental framework to assist in translating these dramatic advances in developmental science into improved health across the life span. Pediatricians are now armed with new information about the adverse effects of toxic stress on brain development, as well as a deeper understanding of the early life origins of many adult diseases. As trusted authorities in child health and development, pediatric providers must now complement the early identification of developmental concerns with a greater focus on those interventions and community investments that reduce external threats to healthy brain growth. To this end, AAP endorses a developing leadership role for the entire pediatric community-one that mobilizes the scientific expertise of both basic and clinical researchers, the family-centered care of the pediatric medical home, and the public influence of AAP and its state chapters-to catalyze fundamental change in early childhood policy and services. AAP is committed to leveraging science to inform the development of innovative strategies to reduce the precipitants of toxic stress in young children and to mitigate their negative effects on the course of development and health across the life span.

  4. Changes in occupational health problems and adverse patient reactions in orthodontics from 1987 to 2000.

    PubMed

    Jacobsen, Nils; Hensten-Pettersen, Arne

    2003-12-01

    The purpose of the present investigation was to assess the reasons for changes in occupational health problems and patient reactions to orthodontic treatment after a survey carried out in 1987. Questionnaire data on occupation-related health complaints and patient reactions over the preceding 2 years were obtained from 121 of 170 Norwegian orthodontists (71 per cent). Most health complaints were dermatoses of the hands and fingers related to the processing of acrylic removable appliances, to composite bonding materials, or gloves. A few reactions were of a respiratory or systemic nature. In total, occupation-related dermatoses were reported by 17.4 per cent (21/121) compared with 40 per cent previously. Non-dermal complaints comprised 9 per cent compared with 18.2 per cent in 1987. Patient reactions were distributed equally between intra-oral reactions affecting lips, gingiva, oral mucosa, and tongue, and dermal reactions affecting the corner of the mouth, the dorsal part of the neck, the peri-oral area, cheeks, chin or skin elsewhere. A few patients had systemic reactions. The assumed eliciting agents of intra-oral reactions were fixed metallic appliances, acrylic removable appliances, polymer brackets or composite bonding materials, or were related to elastics. Extra-oral (dermal) reactions were attributed to metallic, elastic or textile parts of the extra-oral appliances. Some reactions were verified as allergies. The percentage of patient reactions in total was estimated to be 0.3-0.4 per cent compared with 0.8-0.9 per cent in 1987. The reduction in occupation-related health complaints among orthodontists was explained by changes in previously important hygiene factors such as soaps, detergents, etc., whereas the biomaterials-related reactions persisted. The reduction in the 2 year incidence of patient reactions was associated with a marked reduction in extra-oral reactions following preventive measures such as coating metallic devices, whereas the intra

  5. Ozone exposure and systemic biomarkers: Evaluation of evidence for adverse cardiovascular health impacts.

    PubMed

    Goodman, Julie E; Prueitt, Robyn L; Sax, Sonja N; Pizzurro, Daniella M; Lynch, Heather N; Zu, Ke; Venditti, Ferdinand J

    2015-05-01

    The US Environmental Protection Agency (EPA) recently concluded that there is likely to be a causal relationship between short-term (< 30 days) ozone exposure and cardiovascular (CV) effects; however, biological mechanisms to link transient effects with chronic cardiovascular disease (CVD) have not been established. Some studies assessed changes in circulating levels of biomarkers associated with inflammation, oxidative stress, coagulation, vasoreactivity, lipidology, and glucose metabolism after ozone exposure to elucidate a biological mechanism. We conducted a weight-of-evidence (WoE) analysis to determine if there is evidence supporting an association between changes in these biomarkers and short-term ozone exposure that would indicate a biological mechanism for CVD below the ozone National Ambient Air Quality Standard (NAAQS) of 75 parts per billion (ppb). Epidemiology findings were mixed for all biomarker categories, with only a few studies reporting statistically significant changes and with no consistency in the direction of the reported effects. Controlled human exposure studies of 2 to 5 hours conducted at ozone concentrations above 75 ppb reported small elevations in biomarkers for inflammation and oxidative stress that were of uncertain clinical relevance. Experimental animal studies reported more consistent results among certain biomarkers, although these were also conducted at ozone exposures well above 75 ppb and provided limited information on ozone exposure-response relationships. Overall, the current WoE does not provide a convincing case for a causal relationship between short-term ozone exposure below the NAAQS and adverse changes in levels of biomarkers within and across categories, but, because of study limitations, they cannot not provide definitive evidence of a lack of causation.

  6. Identifying and managing adverse environmental health effects: 2. Outdoor air pollution

    PubMed Central

    Abelsohn, Alan; Stieb, David; Sanborn, Margaret D.; Weir, Erica

    2002-01-01

    AIR POLLUTION CONTRIBUTES TO PREVENTABLE ILLNESS AND DEATH. Subgroups of patients who appear to be more sensitive to the effects of air pollution include young children, the elderly and people with existing chronic cardiac and respiratory disease such as chronic obstructive pulmonary disease and asthma. It is unclear whether air pollution contributes to the development of asthma, but it does trigger asthma episodes. Physicians are in a position to identify patients at particular risk of health effects from air pollution exposure and to suggest timely and appropriate actions that these patients can take to protect themselves. A simple tool that uses the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) can help physicians take patients' environmental exposure histories to assess those who may be at risk. As public health advocates, physicians contribute to the primary prevention of illness and death related to air pollution in the population. In this article we review the origins of air pollutants, the pathophysiology of health effects, the burden of illness and the clinical implications of smog exposure using the illustrative case of an adolescent patient with asthma. PMID:12000251

  7. Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II Study, Helsinki Health Study, and the Japanese Civil Servants Study.

    PubMed

    Lallukka, Tea; Lahelma, Eero; Rahkonen, Ossi; Roos, Eva; Laaksonen, Elina; Martikainen, Pekka; Head, Jenny; Brunner, Eric; Mosdol, Annhild; Marmot, Michael; Sekine, Michikazu; Nasermoaddeli, Ali; Kagamimori, Sadanobu

    2008-04-01

    Adverse health behaviors and obesity are key determinants of major chronic diseases. Evidence on work-related determinants of these behavioral risk factors is inconclusive, and comparative studies are especially lacking. We aimed to examine the associations between job strain, working overtime, adverse health behaviors, and obesity among 45-60-year-old white-collar employees of the Whitehall II Study from London (n=3,397), Helsinki Health Study (n=6,070), and the Japanese Civil Servants Study (n=2,213). Comparable data from all three cohorts were pooled, and logistic regression analysis was used, stratified by cohort and sex. Models were adjusted for age, occupational class, and marital status. Outcomes were unhealthy food habits, physical inactivity, heavy drinking, smoking, and obesity. In London, men reporting passive work were more likely to be physically inactive. A similar association was repeated among women in Helsinki. Additionally, high job strain was associated with physical inactivity among men in London and women in Helsinki. In London, women reporting passive work were less likely to be heavy drinkers and smokers. In Japan, men working overtime reported less smoking, whereas those with high job strain were more likely to smoke. Among men in Helsinki the association between working overtime and non-smoking was also suggested, but it reached statistical significance in the age-adjusted model only. Obesity was associated with working overtime among women in London. In conclusion, job strain and working overtime had some, albeit mostly weak and inconsistent, associations with adverse health behaviors and obesity in these middle-aged white-collar employee cohorts from Britain, Finland, and Japan.

  8. The consequences for human health of stratospheric ozone depletion in association with other environmental factors.

    PubMed

    Lucas, R M; Norval, M; Neale, R E; Young, A R; de Gruijl, F R; Takizawa, Y; van der Leun, J C

    2015-01-01

    Due to the implementation of the Montreal Protocol, which has limited, and is now probably reversing, the depletion of the stratospheric ozone layer, only modest increases in solar UV-B radiation at the surface of the Earth have occurred. For many fair-skinned populations, changing behaviour with regard to exposure to the sun over the past half century - more time in the sun, less clothing cover (more skin exposed), and preference for a tan - has probably contributed more to greater levels of exposure to UV-B radiation than ozone depletion. Exposure to UV-B radiation has both adverse and beneficial effects on human health. This report focuses on an assessment of the evidence regarding these outcomes that has been published since our previous report in 2010. The skin and eyes are the organs exposed to solar UV radiation. Excessive solar irradiation causes skin cancer, including cutaneous malignant melanoma and the non-melanoma skin cancers, basal cell carcinoma and squamous cell carcinoma, and contributes to the development of other rare skin cancers such as Merkel cell carcinoma. Although the incidence of melanoma continues to increase in many countries, in some locations, primarily those with strong sun protection programmes, incidence has stabilised or decreased over the past 5 years, particularly in younger age-groups. However, the incidence of non-melanoma skin cancers is still increasing in most locations. Exposure of the skin to the sun also induces systemic immune suppression that may have adverse effects on health, such as through the reactivation of latent viral infections, but also beneficial effects through suppression of autoimmune reactivity. Solar UV-B radiation damages the eyes, causing cataracts and pterygium. UV-B irradiation of the skin is the main source of vitamin D in many geographic locations. Vitamin D plays a critical role in the maintenance of calcium homeostasis in the body; severe deficiency causes the bone diseases, rickets in children

  9. Smallpox Vaccine and Adverse Reproductive Health Outcomes in Military Service Members

    DTIC Science & Technology

    2005-01-01

    disease to bioterrorist threat. Obstet Gynecol 2002;100(1):87-93 4. Levine MM. Live-virus vaccines in pregnancy: risks and recommendations. Lancet 1974;2...vaccination and outcome of pregnancy. AJPH Nations Health 1968;58(10)1910-21. 12. Luisi M. Smallpox vaccination and pregnancy. Am J Obstet Gynecol 1977;128...Valero J, Luna S, Dominguez-Rojas V. Risk factors in miscarriage: a review. Eur J Obstet Gynecol Reprod Biol 2002;102(2):111-9 14. Ellish NJ, Saboda K

  10. Overuse of high stability antibiotics and its consequences in public and environmental health.

    PubMed

    Zdziarski, Przemysław; Simon, Krzysztof; Majda, Jacek

    2003-01-01

    In this paper the ecological aspects of widespread antibiotic consumption are described. Many practitioners, veterinarians, breeders, farmers and analysts work on the assumption that a antibiotics undergo spontaneous degradation. It is well documented that the indiscriminate use of antibiotics has led to the water contamination, selection and dissemination of antibiotic-resistant organisms, alteration of fragile ecology of the microbial ecosystems. The damages caused by the overuse of antibiotics include hospital, waterborne and foodborne infections by resistant bacteria, enteropathy (irritable bowel syndrome, antibiotic-associated diarrhea etc.), drug hypersensitivity, biosphere alteration, human and animal growth promotion, destruction of fragile interspecific competition in microbial ecosystems etc. The consequences of heavy antibiotic use for public and environmental health are difficult to assess: utilization of antibiotics from the environment and reduction of irrational use is the highest priority issue. This purpose may be accomplished by bioremediation, use of probenecid for antibiotic dosage reduction and by adoption of hospital infections methodology for control resistance in natural ecosystems.

  11. Emotional and Behavioral Consequences of Bioterrorism: Planning a Public Health Response

    PubMed Central

    Stein, Bradley D; Tanielian, Terri L; Eisenman, David P; Keyser, Donna J; Burnam, M Audrey; Pincus, Harold A

    2004-01-01

    Millions of dollars have been spent improving the public health system's bioterrorism response capabilities. Yet relatively little attention has been paid to precisely how the public will respond to bioterrorism and how emotional and behavioral responses might complicate an otherwise successful response. This article synthesizes the available evidence about the likely emotional and behavioral consequences of bioterrorism to suggest what decision makers can do now to improve that response. It examines the emotional and behavioral impact of previous “bioterrorism-like” events and summarizes interviews with experts who have responded to such events or conducted research on the effects of communitywide disasters. The article concludes by reflecting on the evidence and experts’ perspectives to suggest actions to be taken now and future policy and research priorities. PMID:15330972

  12. Adverse events and placebo effects: African scientists, HIV, and ethics in the 'global health sciences'.

    PubMed

    Crane, Johanna

    2010-12-01

    This paper builds on the growing literature in 'postcolonial technoscience' by examining how science and ethics travel in transnational HIV research. I use examples of two controversial US-funded studies of mother-to-child transmission in Africa as case studies through which to explore quandaries of difference and inequality in global health research. My aim is not to adjudicate the debates over these studies, but rather to raise some questions about transnational research, science, and ethics that often get lost in public controversies over the moral status of such trials. Using interviews conducted with American and Ugandan HIV researchers as well as relevant material published in the popular and medical press, I argue that debates over research practice and the conditions under which practices are deemed ethically legitimate or questionable reflect the challenges faced by African researchers seeking to participate in global health science. In doing so, I show how questions of scientific legitimacy and authority are played out in debates over who decides what constitutes 'the normal' in human biological research and who can legitimately 'speak for Africa' regarding the ethics of research design and practice. I conclude that researchers from'resource-poor settings' must often walk a tightrope between claims of difference from the global North and assertions of sameness, in which a claim too forceful in either direction can undermine the ethical--and thus scientific--legitimacy of their research.

  13. Children's health insurance program premiums adversely affect enrollment, especially among lower-income children.

    PubMed

    Abdus, Salam; Hudson, Julie; Hill, Steven C; Selden, Thomas M

    2014-08-01

    Both Medicaid and the Children's Health Insurance Program (CHIP), which are run by the states and funded by federal and state dollars, offer health insurance coverage for low-income children. Thirty-three states charged premiums for children at some income ranges in CHIP or Medicaid in 2013. Using data from the 1999-2010 Medical Expenditure Panel Surveys, we show that the relationship between premiums and coverage varies considerably by income level and by parental access to employer-sponsored insurance. Among children with family incomes above 150 percent of the federal poverty level, a $10 increase in monthly premiums is associated with a 1.6-percentage-point reduction in Medicaid or CHIP coverage. In this income range, the increase in uninsurance may be higher among those children whose parents lack an offer of employer-sponsored insurance than among those whose parents have such an offer. Among children with family incomes of 101-150 percent of poverty, a $10 increase in monthly premiums is associated with a 6.7-percentage-point reduction in Medicaid or CHIP coverage and a 3.3-percentage-point increase in uninsurance. In this income range, the increase in uninsurance is even larger among children whose parents lack offers of employer coverage.

  14. Biopersistence and potential adverse health impacts of fibrous nanomaterials: what have we learned from asbestos?

    PubMed

    Sanchez, Vanesa C; Pietruska, Jodie R; Miselis, Nathan R; Hurt, Robert H; Kane, Agnes B

    2009-01-01

    Human diseases associated with exposure to asbestos fibers include pleural fibrosis and plaques, pulmonary fibrosis (asbestosis), lung cancer, and diffuse malignant mesothelioma. The critical determinants of fiber bioactivity and toxicity include not only fiber dimensions, but also shape, surface reactivity, crystallinity, chemical composition, and presence of transition metals. Depending on their size and dimensions, inhaled fibers can penetrate the respiratory tract to the distal airways and into the alveolar spaces. Fibers can be cleared by several mechanisms, including the mucociliary escalator, engulfment, and removal by macrophages, or through splitting and chemical modification. Biopersistence of long asbestos fibers can lead to inflammation, granuloma formation, fibrosis, and cancer. Exposure to synthetic carbon nanomaterials, including carbon nanofibers and carbon nanotubes (CNTs), is considered a potential health hazard because of their physical similarities with asbestos fibers. Respiratory exposure to CNTs can produce an inflammatory response, diffuse interstitial fibrosis, and formation of fibrotic granulomas similar to that observed in asbestos-exposed animals and humans. Given the known cytotoxic and carcinogenic properties of asbestos fibers, toxicity of fibrous nanomaterials is a topic of intense study. The mechanisms of nanomaterial toxicity remain to be fully elucidated, but recent evidence suggests points of similarity with asbestos fibers, including a role for generation of reactive oxygen species, oxidative stress, and genotoxicity. Considering the rapid increase in production and use of fibrous nanomaterials, it is imperative to gain a thorough understanding of their biologic activity to avoid the human health catastrophe that has resulted from widespread use of asbestos fibers.

  15. Risk of Adverse Health Effects Due to Host-Microorganism Interactions

    NASA Technical Reports Server (NTRS)

    Ott, C. Mark; Oubre, Cherie; Castro, Sarah; Mehta, Satish; Pierson, Duane

    2015-01-01

    While preventive measures limit the presence of many medically significant microorganisms during spaceflight missions, microbial infection of crewmembers cannot be completely prevented. Spaceflight experiments over the past 50 years have demonstrated a unique microbial response to spaceflight culture, although the mechanisms behind those responses and their operational relevance were unclear. In 2007, the operational importance of these microbial responses was emphasized as the results of an experiment aboard STS-115 demonstrated that the enteric pathogen Salmonella enterica serovar Typhimurium (S. Typhimurium) increased in virulence in a murine model of infection. The experiment was reproduced in 2008 aboard STS-123 confirming this finding. In response to these findings, the Institute of Medicine of the National Academies recommended that NASA investigate this risk and its potential impact on the health of the crew during spaceflight. NASA assigned this risk to the Human Research Program. To better understand this risk, evidence has been collected and reported from both spaceflight analog systems and actual spaceflight. Although the performance of virulence studies during spaceflight are challenging and often impractical, additional information has been and continues to be collected to better understand the risk to crew health. Still, the uncertainty concerning the extent and severity of these alterations in host-microorganism interactions is very large and requires more investigation.

  16. Pre-operative psychological distress does not adversely affect functional or mental health gain after primary total hip arthroplasty.

    PubMed

    Hossain, Munier; Parfitt, Daniel J; Beard, David J; Darrah, Clare; Nolan, John; Murray, David W; Andrew, John G

    2011-01-01

    Preoperative psychological distress has been reported to predict poor outcome and patient dissatisfaction after total hip arthroplasty (THA). The purpose of this study was to investigate if pre-operative psychological distress was associated with adverse functional outcome after primary THR. We analysed the database of a prospective multi-centre study undertaken between January 1999 and January 2002. We recorded the Oxford Hip Score (OHS) and SF36 score preoperatively and up to five years after surgery for 1055 patients. We dichotomised the patients into the mentally distressed (Mental Health Scale score - MHS =56) and the not mentally distressed (MHS >56) groups based on their pre-operative MHS of the SF36. 762 (72.22%). Patients (595 not distressed and 167 distressed) were followed up at 5 years. Both pre and post-operative OHS and SF-36 scores were significantly worse in the distressed group (both p<0.001). However, both groups experienced statistically significant improvement in OHS and MHS, which was maximal at 1 year after surgery and was maintained over the follow up (p=0.00). There was a substantial improvement in mental distress in patients who reported mental distress prior to surgery. The results suggest that pre-operative psychological distress did not adversely compromise functional outcome gain after THA. Despite having worse absolute values both pre and post operatively, patients with mental distress did not have any less functional gain from THA as measured by improvement in OHS.

  17. Juvenile Male Rats Exposed to a Low-Dose Mixture of Twenty-Seven Environmental Chemicals Display Adverse Health Effects

    PubMed Central

    Svingen, Terje; Mandrup, Karen; Skov, Kasper; Pedersen, Mikael; Frederiksen, Hanne; Frandsen, Henrik Lauritz; Vinggaard, Anne Marie

    2016-01-01

    Humans are exposed to a large number of environmental chemicals in their daily life, many of which are readily detectable in blood or urine. It remains uncertain if these chemicals can cause adverse health effects when present together at low doses. In this study we have tested whether a mixture of 27 chemicals administered orally to juvenile male rats for three months could leave a pathophysiological footprint. The mixture contained metals, perfluorinated compounds, PCB, dioxins, pesticides, heterocyclic amines, phthalate, PAHs and others, with a combined dose of 0.16 (Low dose), 0.47 (Mid dose) or 1.6 (High dose) mg/kg bw/day. The lowest dose was designed with the aim of obtaining plasma or urine concentrations in rats at levels approaching those observed in humans. Some single congeners were administered at doses representative of combined doses for chemical groups. With this baseline, we found effects on weight, histology and gene expression in the liver, as well as changes to the blood plasma metabolome in all exposure groups, including low-dose. Additional adverse effects were observed in the higher dosed groups, including enlarged kidneys and alterations to the metabolome. No significant effects on reproductive parameters were observed. PMID:27598887

  18. Changing patterns of adolescent sexual behavior: consequences for health and development.

    PubMed

    Friedman, H L

    1992-07-01

    Sexuality is a fundamental quality of human life, important for health, happiness, individual development, and indeed for the preservation of the human race. During the dynamic period of adolescence in which the passage from childhood to maturity takes place, sexuality takes on new dimensions; feelings become more intense, relationships become more complex, and the consequences of sexual behavior are radically altered. This not only affects the behavior of young people but also of those who interact with them, their families and peers, and those who work in the health, education, youth, social welfare, and other sectors. In the contemporary world the conditions of life for many young people have also changed, and with it patterns of sexual behavior. In general, earlier puberty, later marriage, a decline in the family leading to less control and more autonomy, and intense exposure to sexual stimuli via the mass media and travel across cultural boundaries have made pre-marital adolescent sexual activity more common. This has added to traditional problems of early marriage, newer problems of early pregnancy, childbirth, and induced abortion outside of marriage, sexually transmitted diseases, and human immunodeficiency syndrome infection leading to acquired immunodeficiency syndrome. But the work of the World Health Organization (WHO), along with many others in the field, strongly suggests that given appropriate information and services, trust and equity between the sexes, young people will behave responsibly and well. In this paper some of the findings from methods developed by WHO for research, training, advocacy, and evaluation, and findings in relation to patterns and determinants of sexual and reproductive health and development will be described, and future directions suggested.

  19. Drugs and Medical Devices: Adverse Events and the Impact on Women's Health.

    PubMed

    Carey, Jennifer L; Nader, Nathalie; Chai, Peter R; Carreiro, Stephanie; Griswold, Matthew K; Boyle, Katherine L

    2017-01-01

    A large number of medications and medical devices removed from the market by the US Food and Drug Administration over the past 4 decades specifically posed greater health risks to women. This article reviews the historical background of sex and gender in clinical research policy and describes several approved drugs and devices targeted for use in women that have caused major morbidity and mortality. The intended population for the medications and devices, population affected, approval process, and the basic and legal actions taken against the medication/drug company are also discussed. It is recognized that women are still at risk for harm from unsafe medications and devices, and continued improvements in legislation that promotes inclusion of sex and gender into the design and analysis of research will improve safety for both men and women.

  20. The mental health of prisoners: a review of prevalence, adverse outcomes and interventions

    PubMed Central

    Fazel, Seena; Hayes, Adrian J; Bartellas, Katrina; Clerici, Massimo; Trestman, Robert

    2016-01-01

    There are more than 10 million prisoners worldwide, and the prevalence of all investigated mental disorders is higher than general population comparisons. Although the extent to which prison increases the incidence of mental disorders is uncertain, there is considerable evidence of low rates of identification and treatment of psychiatric disorders. Prisoners are also at increased risk of all-cause mortality, suicide, self-harm, violence, and victimization, and research has outlined some modifiable risk factors. High quality treatment trials for psychiatric disorders in prisoners have been limited. Despite this, it has been shown in trials that opiate substitution treatments reduce substance misuse relapse and possibly reoffending. The mental health needs of women and older adults in prison are distinct, and national policies should be developed to meet these. Clinical, research, and policy recommendations to improve prison mental healthcare are presented. National attempts to meet these recommendations should be annually surveyed. PMID:27426440

  1. Inactive matrix Gla protein is causally related to adverse health outcomes: a Mendelian randomization study in a Flemish population.

    PubMed

    Liu, Yan-Ping; Gu, Yu-Mei; Thijs, Lutgarde; Knapen, Marjo H J; Salvi, Erika; Citterio, Lorena; Petit, Thibault; Carpini, Simona Delli; Zhang, Zhenyu; Jacobs, Lotte; Jin, Yu; Barlassina, Cristina; Manunta, Paolo; Kuznetsova, Tatiana; Verhamme, Peter; Struijker-Boudier, Harry A; Cusi, Daniele; Vermeer, Cees; Staessen, Jan A

    2015-02-01

    Matrix Gla-protein is a vitamin K-dependent protein that strongly inhibits arterial calcification. Vitamin K deficiency leads to production of inactive nonphosphorylated and uncarboxylated matrix Gla protein (dp-ucMGP). The risk associated with dp-ucMGP in the population is unknown. In a Flemish population study, we measured circulating dp-ucMGP at baseline (1996-2011), genotyped MGP, recorded adverse health outcomes until December 31, 2012, and assessed the multivariable-adjusted associations of adverse health outcomes with dp-ucMGP. We applied a Mendelian randomization analysis using MGP genotypes as instrumental variables. Among 2318 participants, baseline dp-ucMGP averaged 3.61 μg/L. Over 14.1 years (median), 197 deaths occurred, 58 from cancer and 70 from cardiovascular disease; 85 participants experienced a coronary event. The risk of death and non-cancer mortality curvilinearly increased (P≤0.008) by 15.0% (95% confidence interval, 6.9-25.3) and by 21.5% (11.1-32.9) for a doubling of the nadir (1.43 and 0.97 μg/L, respectively). With higher dp-ucMGP, cardiovascular mortality log-linearly increased (hazard ratio for dp-ucMGP doubling, 1.14 [1.01-1.28]; P=0.027), but coronary events log-linearly decreased (0.93 [0.88-0.99]; P=0.021). dp-ucMGP levels were associated (P≤0.001) with MGP variants rs2098435, rs4236, and rs2430692. For non-cancer mortality and coronary events (P≤0.022), but not for total and cardiovascular mortality (P≥0.13), the Mendelian randomization analysis suggested causality. Higher dp-ucMGP predicts total, non-cancer and cardiovascular mortality, but lower coronary risk. For non-cancer mortality and coronary events, these associations are likely causal.

  2. Spanking and adult mental health impairment: The case for the designation of spanking as an adverse childhood experience.

    PubMed

    Afifi, Tracie O; Ford, Derek; Gershoff, Elizabeth T; Merrick, Melissa; Grogan-Kaylor, Andrew; Ports, Katie A; MacMillan, Harriet L; Holden, George W; Taylor, Catherine A; Lee, Shawna J; Peters Bennett, Robbyn

    2017-01-23

    Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N=8316, response rate=65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR)=1.37; 95% CI=1.02 to1.86), moderate to heavy drinking (AOR)=1.23; 95% CI=1.07 to 1.41), and the use of street drugs (AOR)=1.32; 95% CI=1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence.

  3. Indirect consequences of extreme weather and climate events and their associations with physical health in coastal Bangladesh: a cross-sectional study.

    PubMed

    Beier, Dominik; Brzoska, Patrick; Khan, Mobarak Hossain

    2015-01-01

    Background Bangladesh is one of the countries in the world which is most prone to natural disasters. The overall situation is expected to worsen, since extreme weather and climate events (EWCE) are likely to increase in both frequency and intensity. Indirect consequences caused in the events' aftermath widen the range of possible adverse health outcomes. Objective To assess the association of indirect consequences of EWCE and physical health. Design We used recent cross-sectional self-reported data from 16 coastal villages in Bangladesh. A total of 980 households were surveyed using a structured questionnaire. The outcome of physical health was categorized into three groups, reflecting the severity of reported diseases by the respective source of treatment as a proxy variable (hospital/clinic for severe disease, other source/no treatment for moderate disease, and no disease). The final statistical analysis was conducted using multinomial logistic regression. Results Severe diseases were significantly associated with drinking water from open sources [odds ratio (OR): 4.26, 95% confidence interval (CI): 2.25-8.09] and tube wells (OR: 2.39, 95% CI: 1.43-4.01), moderate harm by river erosion (OR: 6.24, 95% CI: 2.76-14.11), food scarcity (OR: 1.98, 95% CI: 1.16-3.40), and the perception of increased employment problems (OR: 2.19, 95% CI: 1.18-4.07). Moderate diseases were significantly associated with moderate harm by river erosion (OR: 2.65, 95% CI: 1.28-5.48) and fully experienced food scarcity (OR: 1.75, 95% CI: 1.16-2.63). For both categories, women and the elderly had higher chances for diseases. Conclusions Indirect consequences of EWCE were found to be associated with adverse health outcomes. Basic needs such as drinking water, food production, and employment opportunities are particularly likely to become threatened by EWCE and, thus, may lead to a higher likelihood of ill-health. Intervention strategies should concentrate on protection and provision of basic

  4. Indirect consequences of extreme weather and climate events and their associations with physical health in coastal Bangladesh: a cross-sectional study

    PubMed Central

    Beier, Dominik; Brzoska, Patrick; Khan, Mobarak Hossain

    2015-01-01

    Background Bangladesh is one of the countries in the world which is most prone to natural disasters. The overall situation is expected to worsen, since extreme weather and climate events (EWCE) are likely to increase in both frequency and intensity. Indirect consequences caused in the events’ aftermath widen the range of possible adverse health outcomes. Objective To assess the association of indirect consequences of EWCE and physical health. Design We used recent cross-sectional self-reported data from 16 coastal villages in Bangladesh. A total of 980 households were surveyed using a structured questionnaire. The outcome of physical health was categorized into three groups, reflecting the severity of reported diseases by the respective source of treatment as a proxy variable (hospital/clinic for severe disease, other source/no treatment for moderate disease, and no disease). The final statistical analysis was conducted using multinomial logistic regression. Results Severe diseases were significantly associated with drinking water from open sources [odds ratio (OR): 4.26, 95% confidence interval (CI): 2.25–8.09] and tube wells (OR: 2.39, 95% CI: 1.43–4.01), moderate harm by river erosion (OR: 6.24, 95% CI: 2.76–14.11), food scarcity (OR: 1.98, 95% CI: 1.16–3.40), and the perception of increased employment problems (OR: 2.19, 95% CI: 1.18–4.07). Moderate diseases were significantly associated with moderate harm by river erosion (OR: 2.65, 95% CI: 1.28–5.48) and fully experienced food scarcity (OR: 1.75, 95% CI: 1.16–2.63). For both categories, women and the elderly had higher chances for diseases. Conclusions Indirect consequences of EWCE were found to be associated with adverse health outcomes. Basic needs such as drinking water, food production, and employment opportunities are particularly likely to become threatened by EWCE and, thus, may lead to a higher likelihood of ill-health. Intervention strategies should concentrate on protection and

  5. Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

    NASA Technical Reports Server (NTRS)

    Flynn-Evans, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra

    2016-01-01

    Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk as follows: Sleep loss is apparent during spaceflight. Astronauts consistently average less sleep during spaceflight relative to on the ground. The causes of this sleep loss remain unknown, however ground-based evidence suggests that the sleep duration of astronauts is likely to lead to performance impairment and short and long-term health consequences. Further research is needed in this area in order to develop screening tools to assess individual astronaut sleep need in order to quantify the magnitude of sleep loss during spaceflight; current and planned efforts in BHP's research portfolio address this need. In addition, it is still unclear whether the conditions of spaceflight environment lead to sleep loss or whether other factors, such as work overload lead to the reduced sleep duration. Future data mining efforts and continued data collection on the ISS will help to further characterize factors contributing to sleep loss. Sleep inertia has not been evaluated during spaceflight. Ground-based studies confirm that it takes two to four hours to achieve optimal performance after waking from a sleep episode. Sleep inertia has been associated with increased accidents and reduced performance in operational environments. Sleep inertia poses considerable risk during spaceflight when emergency

  6. Cadmium exposure and consequence for the health and productivity of farmed ruminants.

    PubMed

    Lane, E A; Canty, M J; More, S J

    2015-08-01

    This paper reviews Cd exposure and consequences for the health and productivity of farmed ruminants. In farmed ruminants, Cd exposure may be associated with a number of different activities, including industrial processing, mining, and agricultural practices, and is also higher in soils in some geographic regions. Cd kidney concentrations increase with age and Cd exposure. Although Cd toxicity in farmed ruminants has been demonstrated experimentally, there are no published reports of naturally occurring Cd toxicity in farmed ruminants. Clinical signs of Cd intoxication are unlikely with a daily dietary Cd intake of less than 5 mg/kg feed, which is 5-10 times higher than the maximum permitted Cd concentration in ruminant feed in the European Union. In farmed ruminants, Cd levels in tissue are largely dependent on the Cd content of diet. However, many factors affect Cd availability, relating to soils, plants and the presence of other trace elements including Ca, Cu, Fe, Mn, Mo, Se and Zn. Experimental studies have highlighted the ability of Cd to alter trace element status, and the protective effect of good mineral status, however, there remain gaps in knowledge of the impact of these interactions on the health and productivity of farmed animals.

  7. From ultrasocial to antisocial: a role for oxytocin in the acute reinforcing effects and long-term adverse consequences of drug use?

    PubMed

    McGregor, I S; Callaghan, P D; Hunt, G E

    2008-05-01

    Addictive drugs can profoundly affect social behaviour both acutely and in the long-term. Effects range from the artificial sociability imbued by various intoxicating agents to the depressed and socially withdrawn state frequently observed in chronic drug users. Understanding such effects is of great potential significance in addiction neurobiology. In this review we focus on the 'social neuropeptide' oxytocin and its possible role in acute and long-term effects of commonly used drugs. Oxytocin regulates social affiliation and social recognition in many species and modulates anxiety, mood and aggression. Recent evidence suggests that popular party drugs such as MDMA and gamma-hydroxybutyrate (GHB) may preferentially activate brain oxytocin systems to produce their characteristic prosocial and prosexual effects. Oxytocin interacts with the mesolimbic dopamine system to facilitate sexual and social behaviour, and this oxytocin-dopamine interaction may also influence the acquisition and expression of drug-seeking behaviour. An increasing body of evidence from animal models suggests that even brief exposure to drugs such as MDMA, cannabinoids, methamphetamine and phencyclidine can cause long lasting deficits in social behaviour. We discuss preliminary evidence that these adverse effects may reflect long-term neuroadaptations in brain oxytocin systems. Laboratory studies and preliminary clinical studies also indicate that raising brain oxytocin levels may ameliorate acute drug withdrawal symptoms. It is concluded that oxytocin may play an important, yet largely unexplored, role in drug addiction. Greater understanding of this role may ultimately lead to novel therapeutics for addiction that can improve mood and facilitate the recovery of persons with drug use disorders.

  8. Adverse health effects and histological changes in white sturgeon (Acipenser transmontanus) exposed to dietary selenomethionine.

    PubMed

    Zee, Jenna; Patterson, Sarah; Gagnon, Danielle; Hecker, Markus

    2016-07-01

    It has been shown that selenium (Se) released to the aquatic environment can have devastating effects on local wildlife. White sturgeon (Acipenser transmontanus) have a life history particularly susceptible to contaminants, and their protection is of interest as they are culturally and economically important, and many populations are classified as endangered. During the present 72-d dietary study, multiple signs of decreased health and Se lethality were observed. Juvenile white sturgeon were given diets containing 1.4 μg, 5.6 μg, 22.4 μg, or 104.4 μg selenomethionine/g food (dry mass). Selenium accumulated in muscle and liver tissue in a dose-dependent manner. Edema causing exophthalmos developed within 15 d and 23 d, and lethal effects occurred in 54% and 22% of fish in the high- and medium-dose groups, respectively. Growth and hepatosomatic index were significantly lower in the high-dose group, which also had a high incidence of food avoidance. Histology of the liver revealed a dose-dependent increase in melanomacrophage aggregates and decrease of energy stores, which indicated toxicity. These results indicate that white sturgeon are susceptible to the effects of Se accumulation over relatively short time periods. This stresses the need for continued sturgeon research and studies looking into the environmental fate and regulation of released Se. Environ Toxicol Chem 2016;35:1741-1750. © 2015 SETAC.

  9. 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

  10. Planned Cesarean Delivery at Term and Adverse Outcomes in Childhood Health

    PubMed Central

    Black, Mairead; Bhattacharya, Siladitya; Philip, Sam; Norman, Jane E.; McLernon, David J.

    2016-01-01

    Importance Planned cesarean delivery comprises a significant proportion of births globally, with combined rates of planned and unscheduled cesarean delivery in a number of regions approaching 50%. Observational studies have shown that offspring born by cesarean delivery are at increased risk of ill health in childhood, but these studies have been unable to adjust for some key confounding variables. Additionally, risk of death beyond the neonatal period has not yet been reported for offspring born by planned cesarean delivery. Objective To investigate the relationship between planned cesarean delivery and offspring health problems or death in childhood. Design, Setting, and Participants Population-based data-linkage study of 321 287 term singleton first-born offspring born in Scotland, United Kingdom, between 1993 and 2007, with follow-up until February 2015. Exposures Offspring born by planned cesarean delivery in a first pregnancy were compared with offspring born by unscheduled cesarean delivery and with offspring delivered vaginally. Main Outcomes and Measures The primary outcome was asthma requiring hospital admission; secondary outcomes were salbutamol inhaler prescription at age 5 years, obesity at age 5 years, inflammatory bowel disease, type 1 diabetes, cancer, and death. Results Compared with offspring born by unscheduled cesarean delivery (n = 56 015 [17.4%]), those born by planned cesarean delivery (12 355 [3.8%]) were at no significantly different risk of asthma requiring hospital admission, salbutamol inhaler prescription at age 5 years, obesity at age 5 years, inflammatory bowel disease, cancer, or death but were at increased risk of type 1 diabetes (0.66% vs 0.44%; difference, 0.22% [95% CI, 0.13%-0.31%]; adjusted hazard ratio [HR], 1.35 [95% CI, 1.05-1.75]). In comparison with children born vaginally (n = 252 917 [78.7%]), offspring born by planned cesarean delivery were at increased risk of asthma requiring hospital admission (3.73% vs 3

  11. Human exposure to mercury: A critical assessment of the evidence of adverse health effects

    SciTech Connect

    Ratcliffe, H.E.; Swanson, G.M.; Fischer, L.J.

    1996-10-25

    The ubiquitous nature of mercury in the environment, its global atmospheric cycling, and its toxicity to humans at levels that are uncomfortably close to exposures experienced by a proportion of the population are some of the current concerns associated with this pollutant. The purpose of this review is to critically evaluate the scientific quality of published reports involving human exposures to mercury and associated health outcomes as an aid in the risk evaluation of this chemical. A comprehensive review of the scientific literature involving human exposures to mercury was performed and each publication evaluated using a defined set of criteria that are considered standards in epidemiologic and toxicologic research. Severe, sometimes fatal, effects of mercury exposure at high levels were primarily reported as case studies. The disasters in Minamata, Japan, in the 1950s and in Iraq in 1971-1972 clearly demonstrated neurologic effects associated with ingestion of methylmercury both in adults and in infants exposed in utero. The effects were convincingly Associated with methylmercury ingestion, despite limitations of the study design. Several well-conducted studies have investigated the effects of methylmercury at levels below those in the Iraq incident but have not provided clear evidence of an effect. The lower end of the dose-response curve constructed from the Iraq data therefore still needs to be confirmed. The studies of mercury exposure in the workplace were mainly of elemental or inorganic mercury, and effects that were observed at relatively low exposure levels were primarily neurologic and renal. Several studies have investigated effects associated with dental amalgam but have been rated as inconclusive because of methodologic deficiencies. In our overall evaluation, 29 of 110 occupational studies and 20 of 54 studies where exposure occurred in the natural environment provided at least suggestive evidence of an exposure-related effect. 259 refs., 4 tabs.

  12. Greater Age-Related Decline in Markers of Physical, Mental and Cognitive Health among Israeli Older Adults Exposed to Lifetime Cumulative Adversity

    PubMed Central

    Shrira, Amit

    2013-01-01

    Objectives This longitudinal investigation addressed whether and how lifetime cumulative adversity and depressive symptoms moderated age-related decline in markers of physical, mental and cognitive health. Method 1,248 older adults (mean age = 62 at Wave 1) who completed the first two waves of the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel) reported on exposure to potentially traumatic life events, depressive symptoms, and three outcomes – disability, quality of life and cognitive markers. Results Age was related to greater functional decline in outcome measures across the two waves (i.e., increase in disability and decrease in quality of life and cognitive functioning). This age-related decline became stronger as lifetime adversity increased. A three-way interaction showed that the greatest age-related functional decline in outcome measures was especially salient among those with high level of lifetime adversity and high level of depressive symptoms. Conclusion Lifetime cumulative adversity is associated with a more noticeable process of age-related dysfunction across various markers of health. Although the majority of older adults are resilient to lifetime adversity, prevention and intervention programs should be aimed at mitigating the pronounced senescence observed when adversity accumulated to a large degree, and especially when it is accompanied with high level of distress. PMID:24328416

  13. Sexual Trauma and Adverse Health and Occupational Outcomes Among Men Serving in the U.S. Military.

    PubMed

    Millegan, Jeffrey; Wang, Lawrence; LeardMann, Cynthia A; Miletich, Derek; Street, Amy E

    2016-04-01

    Although absolute counts of U.S. service men who experience sexual trauma are comparable to service women, little is known about the impact of sexual trauma on men. The association of recent sexual trauma (last 3 years) with health and occupational outcomes was investigated using longitudinal data (2004-2013) from the Millennium Cohort Study. Of 37,711 service men, 391 (1.0%) reported recent sexual harassment and 76 (0.2%) sexual assault. In multivariable models, sexual harassment or assault, respectively, was associated with poorer mental health: AOR = 1.60, 95% CI [1.22, 2.12], AOR = 4.39, 95% CI [2.40, 8.05]; posttraumatic stress disorder: AOR = 2.50, 95% CI [1.87, 3.33], AOR = 6.63, 95% CI [3.65, 12.06]; depression: AOR = 2.37, 95% CI [1.69, 3.33], AOR = 5.60, 95% CI [2.83, 11.09]; and multiple physical symptoms: AOR = 2.22, 95% CI [1.69, 2.92]; AOR = 3.57, 95% CI [1.98, 6.42], after adjustment for relevant covariates. Sexual harassment was also associated with poorer physical health: AOR = 1.68, 95% CI [1.27, 2.22]. Men who reported sexual trauma were more likely to have left military service: AOR = 1.60, 95% CI [1.14, 2.24], and be disabled/unemployed postservice: AOR = 1.76, 95% CI [1.02, 3.02]. Results suggest that sexual trauma was significantly associated with adverse health and functionality extending to postmilitary life. Findings support the need for developing better prevention strategies and services to reduce the burden of sexual trauma on service men.

  14. Costing the Morbidity and Mortality Consequences of Zoonoses Using Health-Adjusted Life Years.

    PubMed

    Jordan, H; Dunt, D; Hollingsworth, B; Firestone, S M; Burgman, M

    2016-10-01

    Governments are routinely involved in the biosecurity of agricultural and food imports and exports. This involves controlling the complex ongoing threat of the broad range of zoonoses: endemic, exotic and newly emerging. Policy-related decision-making in these areas requires accurate information and predictions concerning the effects and potential impacts of zoonotic diseases. The aim of this article was to provide information concerning the development and use of utility-based tools, specifically disability-adjusted life years (DALYs), for measuring the burden on human disease (morbidity and mortality) as a consequence of zoonotic infections. Issues and challenges to their use are also considered. Non-monetary utility approaches that are reviewed in this paper form one of a number of tools that can be used to estimate the monetary and non-monetary 'cost' of morbidity- and mortality-related consequences. Other tools derive from cost-of-illness, willingness-to-pay and multicriteria approaches. Utility-based approaches are specifically designed to capture the pain, suffering and loss of functioning associated with diseases, zoonotic and otherwise. These effects are typically complicated to define, measure and subsequently 'cost'. Utility-based measures will not be able to capture all of the effects, especially those that extend beyond the health sector. These will more normally be captured in financial terms. Along with other uncommon diseases, the quality of the relevant epidemiological data may not be adequate to support the estimation of losses in utility as a result of zoonoses. Other issues in their use have been identified. New empirical studies have shown some success in addressing these issues. Other issues await further study. It is concluded that, bearing in mind all caveats, utility-based methods are important tools in assessing the magnitude of the impacts of zoonoses in human disease. They make an important contribution to decision-making and priority

  15. 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.

  16. Adverse Childhood Experiences among American Indian/Alaska Native Children: The 2011-2012 National Survey of Children's Health

    PubMed Central

    2016-01-01

    We examined parent-reported adverse childhood experiences (ACEs) and associated outcomes among American Indian and Alaska Native (AI/AN) children aged 0–17 years from the 2011-2012 National Survey of Children's Health. Bivariate and multivariable analyses of cross-sectional data on 1,453 AI/AN children and 61,381 non-Hispanic White (NHW) children assessed race-based differences in ACEs prevalence and differences in provider-diagnosed chronic emotional and developmental conditions, health characteristics, reported child behaviors, and health services received as a function of having multiple ACEs. AI/AN children were more likely to have experienced 2+ ACEs (40.3% versus 21%), 3+ ACEs (26.8% versus 11.5%), 4+ ACEs (16.8% versus 6.2%), and 5+ ACEs (9.9% versus 3.3%) compared to NHW children. Prevalence rates for depression, anxiety, and ADHD were higher among AI/AN children with 3+ ACEs (14.4%, 7.7%, and 12.5%) compared to AI/ANs with fewer than 2 ACEs (0.4%, 1.8%, and 5.5%). School problems, grade failures, and need for medication and counseling were 2-3 times higher among AI/ANs with 3+ ACEs versus the same comparison group. Adjusted odds ratio for emotional, developmental, and behavioral difficulties among AI/AN children with 2+ ACEs was 10.3 (95% CI = 3.6–29.3). Race-based differences were largely accounted for by social and economic-related factors. PMID:27529052

  17. A cooperative reduction model for regional air pollution control in China that considers adverse health effects and pollutant reduction costs.

    PubMed

    Xie, Yujing; Zhao, Laijun; Xue, Jian; Hu, Qingmi; Xu, Xiang; Wang, Hongbo

    2016-12-15

    How to effectively control severe regional air pollution has become a focus of global concern recently. The non-cooperative reduction model (NCRM) is still the main air pollution control pattern in China, but it is both ineffective and costly, because each province must independently fight air pollution. Thus, we proposed a cooperative reduction model (CRM), with the goal of maximizing the reduction in adverse health effects (AHEs) at the lowest cost by encouraging neighboring areas to jointly control air pollution. CRM has two parts: a model of optimal pollutant removal rates using two optimization objectives (maximizing the reduction in AHEs and minimizing pollutant reduction cost) while meeting the regional pollution control targets set by the central government, and a model that allocates the cooperation benefits (i.e., health improvement and cost reduction) among the participants according to their contributions using the Shapley value method. We applied CRM to the case of sulfur dioxide (SO2) reduction in Yangtze River Delta region. Based on data from 2003 to 2013, and using mortality due to respiratory and cardiovascular diseases as the health endpoints, CRM saves 437 more lives than NCRM, amounting to 12.1% of the reduction under NCRM. CRM also reduced costs by US $65.8×10(6) compared with NCRM, which is 5.2% of the total cost of NCRM. Thus, CRM performs significantly better than NCRM. Each province obtains significant benefits from cooperation, which can motivate them to actively cooperate in the long term. A sensitivity analysis was performed to quantify the effects of parameter values on the cooperation benefits. Results shown that the CRM is not sensitive to the changes in each province's pollutant carrying capacity and the minimum pollutant removal capacity, but sensitive to the maximum pollutant reduction capacity. Moreover, higher cooperation benefits will be generated when a province's maximum pollutant reduction capacity increases.

  18. Traumatic physical health consequences of intimate partner violence against women: what is the role of community-level factors?

    PubMed Central

    2011-01-01

    Background Intimate partner violence (IPV) against women is a serious public health issue with recognizable direct health consequences. This study assessed the association between IPV and traumatic physical health consequences on women in Nigeria, given that communities exert significant influence on the individuals that are embedded within them, with the nature of influence varying between communities. Methods Cross-sectional nationally-representative data of women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey was used in this study. Multilevel logistic regression analysis was used to assess the association between IPV and several forms of physical health consequences. Results Bruises were the most common form of traumatic physical health consequences. In the adjusted models, the likelihood of sustaining bruises (OR = 1.91, 95% CI = 1.05 - 3.46), wounds (OR = 2.54, 95% CI = 1.31 - 4.95), and severe burns (OR = 3.20, 95% CI = 1.63 - 6.28) was significantly higher for women exposed to IPV compared to those not exposed to IPV. However, after adjusting for individual- and community-level factors, women with husbands/partners with controlling behavior, those with primary or no education, and those resident in communities with high tolerance for wife beating had a higher likelihood of experiencing IPV, whilst mean community-level education and women 24 years or younger were at lower likelihood of experiencing IPV. Conclusions Evidence from this study shows that exposure to IPV is associated with increased likelihood of traumatic physical consequences for women in Nigeria. Education and justification of wife beating were significant community-level factors associated with traumatic physical consequences, suggesting the importance of increasing women's levels of education and changing community norms that justify controlling behavior and IPV. PMID:22185323

  19. Heatwave Early Warning Systems and Adaptation Advice to Reduce Human Health Consequences of Heatwaves

    PubMed Central

    Lowe, Dianne; Ebi, Kristie L.; Forsberg, Bertil

    2011-01-01

    Introduction: With climate change, there has been an increase in the frequency, intensity and duration of heatwave events. In response to the devastating mortality and morbidity of recent heatwave events, many countries have introduced heatwave early warning systems (HEWS). HEWS are designed to reduce the avoidable human health consequences of heatwaves through timely notification of prevention measures to vulnerable populations. Objective: To identify the key characteristics of HEWS in European countries to help inform modification of current, and development of, new systems and plans. Methods: We searched the internet to identify HEWS policy or government documents for 33 European countries and requested information from relevant organizations. We translated the HEWS documents and extracted details on the trigger indicators, thresholds for action, notification strategies, message intermediaries, communication and dissemination strategies, prevention strategies recommended and specified target audiences. Findings and Conclusions: Twelve European countries have HEWS. Although there are many similarities among the HEWS, there also are differences in key characteristics that could inform improvements in heatwave early warning plans. PMID:22408593

  20. Cycling in São Paulo, Brazil (1997-2012): Correlates, time trends and health consequences.

    PubMed

    Sá, Thiago Hérick; Duran, Ana Clara; Tainio, Marko; Monteiro, Carlos Augusto; Woodcock, James

    2016-12-01

    The purpose of the study was to describe cyclists and cycling trips, and to explore correlates, time trends and health consequences of cycling in São Paulo, Brazil from 1997 to 2012. Cross-sectional analysis using repeated São Paulo Household Travel Surveys (HTS). At all time periods cycling was a minority travel mode in São Paulo (1174 people with cycling trips out of 214,719 people). Poisson regressions for individual correlates were estimated using the entire 2012 HTS sample. Men were six times more likely to cycle than women. We found rates of bicycle use rising over time among the richest quartile but total cycling rates dropped from 1997 to 2012 due to decreasing rates among the poor. Harms from air pollution would negate benefits from physical activity through cycling only at 1997 air pollution levels and at very high cycling levels (≥ 9 h of cycling per day). Exposure-based road injury risk decreased between 2007 and 2012, from 0.76 to 0.56 cyclist deaths per 1000 person-hours travelled. Policies to reduce spatial segregation, measures to tackle air pollution, improvements in dedicated cycling infrastructure, and integrating the bicycle with the public transport system in neighborhoods of all income levels could make cycling safer and prevent more individuals from abandoning the cycling mode in São Paulo.

  1. Human parasites in the Roman World: health consequences of conquering an empire.

    PubMed

    Mitchell, Piers D

    2017-01-01

    The archaeological evidence for parasites in the Roman era is presented in order to demonstrate the species present at that time, and highlight the health consequences for people living under Roman rule. Despite their large multi-seat public latrines with washing facilities, sewer systems, sanitation legislation, fountains and piped drinking water from aqueducts, we see the widespread presence of whipworm (Trichuris trichiura), roundworm (Ascaris lumbricoides) and Entamoeba histolytica that causes dysentery. This would suggest that the public sanitation measures were insufficient to protect the population from parasites spread by fecal contamination. Ectoparasites such as fleas, head lice, body lice, pubic lice and bed bugs were also present, and delousing combs have been found. The evidence fails to demonstrate that the Roman culture of regular bathing in the public baths reduced the prevalence of these parasites. Fish tapeworm was noted to be widely present, and was more common than in Bronze and Iron Age Europe. It is possible that the Roman enthusiasm for fermented, uncooked fish sauce (garum) may have facilitated the spread of this helminth. Roman medical practitioners such as Galen were aware of intestinal worms, explaining their existence and planning treatment using the humoural theory of the period.

  2. Chromium in the environment: an evaluation of exposure of the UK general population and possible adverse health effects.

    PubMed

    Rowbotham, A L; Levy, L S; Shuker, L K

    2000-01-01

    Chromium in the hexavalent form, Cr(VI), has long been recognized as a carcinogen and there is concern as to the effects of continuous low-level exposure to chromium both occupationally and environmentally. This review summarizes the available exposure data and known health effects and evaluates the potential risk to human health in the United Kingdom. Chromium emissions to the environment in the United Kingdom are predominantly derived from fuel combustion, waste incineration, and industrial processes. The less toxic trivalent form of chromium [Cr(III)] is dominant in most environmental compartments, and any Cr(VI), the more toxic form, that is emitted to the environment can be reduced to Cr(III). Food is a major source of exposure to chromium, and estimated daily oral intakes for infants (1 yr), children (11 yr), and adults are 33-45, 123-171, and 246-343 micrograms/person/d, respectively. Soil ingestion, particularly common in young children, can contribute to oral intake. Inhalation is a minor route of exposure for the general population. Average daily inhalation intakes in infants can range from 0.004 microgram/d for rural infants to 0.14 microgram/d for urban infants who are passively exposed to tobacco smoke, whereas adults who live in industrialized areas and smoke may take up between 2 and 12 micrograms/d. The most serious health effect associated with Cr(VI) is lung cancer, which has been associated with some occupational exposure scenarios, whereas Cr(III) is an essential nutrient with a broad safety range and low toxicity. The human body has effective detoxification mechanisms that can reduce ingested or inhaled Cr(VI) to Cr(III). In conclusion, there is no clear evidence to relate exposure to environmental levels of chromium with adverse health effects in either the general UK population or subgroups exposed to chromium around industrialized or contaminated sites. It can be expected that an improved understanding of the relevance of possible long

  3. The Effects of Collateral Consequences of Criminal Involvement on Employment, Use of Temporary Assistance for Needy Families, and Health.

    PubMed

    Sheely, Amanda; Kneipp, Shawn M

    2015-01-01

    Criminal convictions are often associated with collateral consequences that limit access to the forms of employment and social services on which disadvantaged women most frequently rely--regardless of the severity of the offense. These consequences may play an important role in perpetuating health disparities by socioeconomic status and gender. We examined the extent to which research studies to date have assessed whether a criminal conviction might influence women's health by limiting access to Temporary Assistance for Needy Families (TANF) and employment, as a secondary, or "collateral" criminal conviction-related consequence. We reviewed 434 peer-reviewed journal articles retrieved from three electronic article databases and 197 research reports from three research organizations. Two reviewers independently extracted data from each eligible article or report using a standardized coding scheme. Of the sixteen eligible studies included in the review, most were descriptive. None explored whether receiving TANF modified health outcomes, despite its potential to do so. Researchers to date have not fully examined the causal pathways that could link employment, receiving TANF, and health, especially for disadvantaged women. Future research is needed to address this gap and to understand better the potential consequences of the criminal justice system involvement on the health of this vulnerable population.

  4. Nutrient- and non-nutrient-based natural health product (NHP) use in adults with mood disorders: prevalence, characteristics and potential for exposure to adverse events

    PubMed Central

    2013-01-01

    Background To address knowledge gaps regarding natural health product (NHP) usage in mental health populations, we examined their use in adults with mood disorders, and explored the potential for adverse events. Methods Food and NHP intake was obtained from 97 adults with mood disorders. NHP data was used to compare prevalence with population norms (British Columbia Nutrition Survey; BCNS). Bivariate and regression analyses examined factors associated with NHP use. Assessment of potential adverse effects of NHP use was based on comparing nutrient intakes from food plus supplements with the Dietary Reference Intakes and by reviewing databases for reported adverse health effects. Results Two-thirds (66%; 95% CI 56 to 75) were taking at least one NHP; 58% (95% CI 47 to 68) were taking NHPs in combination with psychiatric medications. The proportion of each type of NHP used was generally higher than the BCNS (range of p’s < 0.05 to 0.0001). When intakes from food and NHP sources were combined, a small proportion exceeded any Lowest-Observed-Adverse-Effect-Levels: only for niacin (n = 17) and magnesium (n = 6), two nutrients for which the potential for adverse effects is minimal. Conversely, about 38% (95% CI 28 to 49) of the sample were taking a non-nutrient based NHP for which previous adverse events had been documented. Conclusions The prevalent use of NHPs in this population suggests that health care providers need to be knowledgeable about their characteristics. The efficacy and safety of NHPs in relation to mental health warrants further investigation. PMID:23570306

  5. Consequences of Domestic Violence on Women's Mental Health in Bosnia and Herzegovina

    PubMed Central

    Avdibegović, Esmina; Sinanović, Osman

    2006-01-01

    Psychological Symptoms (GSI) were in significant positive correlation with the frequency of psychological (r = 0.45, P<0.001), physical (r = 0.43, P<0.001), and sexual abuse (r = 0.37, P<0.001). Conclusion Domestic violence in various forms had long-term consequences on mental health of women. This should be taken into account when treating women with war-related trauma. PMID:17042065

  6. "We get what we deserve": the belief in a just world and its health consequences for Blacks.

    PubMed

    Hagiwara, Nao; Alderson, Courtney J; McCauley, Jessica M

    2015-12-01

    This study explored whether individual differences in the endorsement of the belief that the world is a just place (i.e., the just world belief) would predict individual differences in resilience/vulnerability to the negative health consequences of discrimination. One-hundred and thirty Blacks participated in a vital check and completed a computer-based questionnaire that included measures of the just world belief, perceived discrimination, physical and mental health, and the presence/absence of chronic illnesses. Endorsement of the just world belief was not associated with self-reported physical/mental health; however, it moderated the effects of perceived discrimination on the number of chronic illnesses and systolic blood pressure. These findings suggest that Blacks who believe that the world is a just place where they get what they deserve may be at a particularly higher risk for the negative health consequences of discrimination. Theoretical and clinical implications of the findings are discussed.

  7. The Consequences of Migration to the United States for Short-term Changes in the Health of Mexican Immigrants

    PubMed Central

    Goldman, Noreen; Pebley, Anne R.; Creighton, Mathew J.; Teruel, Graciela M.; Rubalcava, Luis N.; Chung, Chang

    2014-01-01

    Although many studies have attempted to examine the consequences of Mexico-U.S. migration for Mexican immigrants’ health, few have had adequate data to generate the appropriate comparisons. In this article, we use data from two waves of the Mexican Family Life Survey (MxFLS) to compare the health of current migrants from Mexico with those of earlier migrants and nonmigrants. Because the longitudinal data permit us to examine short-term changes in health status subsequent to the baseline survey for current migrants and for Mexican residents, as well as to control for the potential health selectivity of migrants, the results provide a clearer picture of the consequences of immigration for Mexican migrant health than have previous studies. Our findings demonstrate that current migrants are more likely to experience recent changes in health status—both improvements and declines—than either earlier migrants or nonmigrants. The net effect, however, is a decline in health for current migrants: compared with never migrants, the health of current migrants is much more likely to have declined in the year or two since migration and not significantly more likely to have improved. Thus, it appears that the migration process itself and/or the experiences of the immediate post-migration period detrimentally affect Mexican immigrants’ health. PMID:24788391

  8. Business oriented EU human cell and tissue product legislation will adversely impact Member States' health care systems.

    PubMed

    Pirnay, Jean-Paul; Vanderkelen, Alain; De Vos, Daniel; Draye, Jean-Pierre; Rose, Thomas; Ceulemans, Carl; Ectors, Nadine; Huys, Isabelle; Jennes, Serge; Verbeken, Gilbert

    2013-12-01

    The transplantation of conventional human cell and tissue grafts, such as heart valve replacements and skin for severely burnt patients, has saved many lives over the last decades. The late eighties saw the emergence of tissue engineering with the focus on the development of biological substitutes that restore or improve tissue function. In the nineties, at the height of the tissue engineering hype, industry incited policymakers to create a European regulatory environment, which would facilitate the emergence of a strong single market for tissue engineered products and their starting materials (human cells and tissues). In this paper we analyze the elaboration process of this new European Union (EU) human cell and tissue product regulatory regime-i.e. the EU Cell and Tissue Directives (EUCTDs) and the Advanced Therapy Medicinal Product (ATMP) Regulation and evaluate its impact on Member States' health care systems. We demonstrate that the successful lobbying on key areas of regulatory and policy processes by industry, in congruence with Europe's risk aversion and urge to promote growth and jobs, led to excessively business oriented legislation. Expensive industry oriented requirements were introduced and contentious social and ethical issues were excluded. We found indications that this new EU safety and health legislation will adversely impact Member States' health care systems; since 30 December 2012 (the end of the ATMP transitional period) there is a clear threat to the sustainability of some lifesaving and established ATMPs that were provided by public health institutions and small and medium-sized enterprises under the frame of the EUCTDs. In the light of the current economic crisis it is not clear how social security systems will cope with the inflation of costs associated with this new regulatory regime and how priorities will be set with regard to reimbursement decisions. We argue that the ATMP Regulation should urgently be revised to focus on delivering

  9. Endocrine-Disrupting Activity of Hydraulic Fracturing Chemicals and Adverse Health Outcomes After Prenatal Exposure in Male Mice.

    PubMed

    Kassotis, Christopher D; Klemp, Kara C; Vu, Danh C; Lin, Chung-Ho; Meng, Chun-Xia; Besch-Williford, Cynthia L; Pinatti, Lisa; Zoeller, R Thomas; Drobnis, Erma Z; Balise, Victoria D; Isiguzo, Chiamaka J; Williams, Michelle A; Tillitt, Donald E; Nagel, Susan C

    2015-12-01

    Oil and natural gas operations have been shown to contaminate surface and ground water with endocrine-disrupting chemicals. In the current study, we fill several gaps in our understanding of the potential environmental impacts related to this process. We measured the endocrine-disrupting activities of 24 chemicals used and/or produced by oil and gas operations for five nuclear receptors using a reporter gene assay in human endometrial cancer cells. We also quantified the concentration of 16 of these chemicals in oil and gas wastewater samples. Finally, we assessed reproductive and developmental outcomes in male C57BL/6J mice after the prenatal exposure to a mixture of these chemicals. We found that 23 commonly used oil and natural gas operation chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors, and mixtures of these chemicals can behave synergistically, additively, or antagonistically in vitro. Prenatal exposure to a mixture of 23 oil and gas operation chemicals at 3, 30, and 300 μg/kg · d caused decreased sperm counts and increased testes, body, heart, and thymus weights and increased serum testosterone in male mice, suggesting multiple organ system impacts. Our results suggest possible adverse developmental and reproductive health outcomes in humans and animals exposed to potential environmentally relevant levels of oil and gas operation chemicals.

  10. Endocrine-disrupting activity of hydraulic fracturing chemicals and adverse health outcomes after prenatal exposure in male mice

    USGS Publications Warehouse

    Kassotis, Christopher D.; Klemp, Kara C.; Vu, Danh C.; Lin, Chung-Ho; Meng, Chun-Xia; Besch-Williford, Cynthia L.; Pinatti, Lisa; Zoeller, R. Thomas; Drobnis, Erma Z.; Balise, Victoria D.; Isiguzo, Chiamaka J.; Williams, Michelle A.; Tillitt, Donald E.; Nagel, Susan C.

    2015-01-01

    Oil and natural gas operations have been shown to contaminate surface and ground water with endocrine-disrupting chemicals. In the current study, we fill several gaps in our understanding of the potential environmental impacts related to this process. We measured the endocrine-disrupting activities of 24 chemicals used and/or produced by oil and gas operations for five nuclear receptors using a reporter gene assay in human endometrial cancer cells. We also quantified the concentration of 16 of these chemicals in oil and gas wastewater samples. Finally, we assessed reproductive and developmental outcomes in male C57BL/6J mice after the prenatal exposure to a mixture of these chemicals. We found that 23 commonly used oil and natural gas operation chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors, and mixtures of these chemicals can behave synergistically, additively, or antagonistically in vitro. Prenatal exposure to a mixture of 23 oil and gas operation chemicals at 3, 30, and 300 μg/kg · d caused decreased sperm counts and increased testes, body, heart, and thymus weights and increased serum testosterone in male mice, suggesting multiple organ system impacts. Our results suggest possible adverse developmental and reproductive health outcomes in humans and animals exposed to potential environmentally relevant levels of oil and gas operation chemicals.

  11. Measures to improve dairy cow foot health: consequences for farmer income and dairy cow welfare.

    PubMed

    Bruijnis, M R N; Hogeveen, H; Stassen, E N

    2013-01-01

    Dairy farming in western countries with cubicle housing is an efficient way of dairy farming. Though, a disadvantage is the high prevalence and incidence of foot disorders (clinical and subclinical), which cause high economic losses and also seriously impair the welfare of dairy cattle. To point out the importance of reducing the amount and severity of foot disorders, advice to farmers should include information about the scale of the problem and the consequences in terms of economics and animal welfare. To provide support in making decisions on implementing intervention measures, insight into costs and benefits of different measures should be available. The objective of this study, therefore, is to provide more insight into the costs and benefits, for farmer and cow, of different intervention measures to improve dairy cow foot health. Intervention measures were modeled when they were applicable on a dairy farm with cubicle housing and when sufficient information was available in literature. Net costs were calculated as the difference between the costs of the measure and the economic benefits resulting from the measure. Welfare benefits were calculated as well. Cost-effective measures are: improving lying surface (mattress and bedding, €7 and €1/cow per year, respectively), reducing stocking density (break even) and performing additional foot trimming (€1/cow per year). Simultaneously, these measures have a relative high welfare benefit. Labor costs play an important role in the cost-effectiveness of labor-intensive measures. More insight into cost-effectiveness and welfare benefits of intervention measures can help to prioritize when choosing between intervention measures.

  12. Reported Adverse Health Effects in Children from Ingestion of Alcohol-Based Hand Sanitizers - United States, 2011-2014.

    PubMed

    Santos, Cynthia; Kieszak, Stephanie; Wang, Alice; Law, Royal; Schier, Joshua; Wolkin, Amy

    2017-03-03

    Hand sanitizers are effective and inexpensive products that can reduce microorganisms on the skin, but ingestion or improper use can be associated with health risks. Many hand sanitizers contain up to 60%-95% ethanol or isopropyl alcohol by volume, and are often combined with scents that might be appealing to young children. Recent reports have identified serious consequences, including apnea, acidosis, and coma in young children who swallowed alcohol-based (alcohol) hand sanitizer (1-3). Poison control centers collect data on intentional and unintentional exposures to hand sanitizer solutions resulting from various routes of exposure, including ingestion, inhalation, and dermal and ocular exposures. To characterize exposures of children aged ≤12 years to alcohol hand sanitizers, CDC analyzed data reported to the National Poison Data System (NPDS).* The major route of exposure to both alcohol and nonalcohol-based (nonalcohol) hand sanitizers was ingestion. The majority of intentional exposures to alcohol hand sanitizers occurred in children aged 6-12 years. Alcohol hand sanitizer exposures were associated with worse outcomes than were nonalcohol hand sanitizer exposures. Caregivers and health care providers should be aware of the potential dangers associated with hand sanitizer ingestion. Children using alcohol hand sanitizers should be supervised and these products should be kept out of reach from children when not in use.

  13. Differences in African American and White College Students' Drinking Behaviors: Consequences, Harm Reduction Strategies, and Health Information Sources

    ERIC Educational Resources Information Center

    Siebert, Darcy Clay; Wilke, Dina J.; Delva, Jorge; Smith, Michael P.; Howell, Richard L.

    2003-01-01

    The authors explored the differences between African American and White college students' drinking behaviors and their attitudes toward consequences, harm-reduction strategies, and health information sources. They collected data from a randomly selected sample of 1,110 students in a large public university to examine the effects of a high-risk…

  14. Why Should We Care about Child Labor? The Education, Labor Market, and Health Consequences of Child Labor

    ERIC Educational Resources Information Center

    Beegle, Kathleen; Dehejia, Rajeev; Gatti, Roberta

    2009-01-01

    Despite the extensive literature on the determinants of child labor, the evidence on the consequences of child labor on outcomes such as education, labor, and health is limited. We evaluate the causal effect of child labor participation among children in school on these outcomes using panel data from Vietnam and an instrumental variables strategy.…

  15. The Health Consequences of Using Smokeless Tobacco: A Report of the Advisory Committee to the Surgeon General.

    ERIC Educational Resources Information Center

    Public Health Service (DHHS), Rockville, MD.

    This report on the health consequences of smokeless tobacco contains an "Introduction, Overview, and Conclusions" section and four major chapters. Chapter 1 defines the various forms of smokeless tobacco that are used in the United States and examines data pertaining to trends in prevalence and patterns of use. Methodological…

  16. Smoking: The Health Consequences of Tobacco Use. An Annotated Bibliography with Analytical Introduction. Science and Social Responsibility Series, No. 2.

    ERIC Educational Resources Information Center

    Schmitz, Cecilia M.; Gray, Richard A.

    This volume contains an extensive introduction to the health consequences of tobacco use and extended annotations of the most important English-language monographs and articles to appear on the subject in the 1980s and 1990s arranged in classified order under select headings. The introductory analytical essay by Richard A. Gray covers: early and…

  17. Delinquency and Recidivism: A Multicohort, Matched-Control Study of the Role of Early Adverse Experiences, Mental Health Problems, and Disabilities

    ERIC Educational Resources Information Center

    Barrett, David E.; Katsiyannis, Antonis; Zhang, Dalun; Zhang, Dake

    2014-01-01

    The authors examined the role of early adverse experiences, mental health problems, and disabilities in the prediction of juvenile delinquency and recidivism, using a matched-control group design. The delinquent group comprised 99,602 youth, born between 1981 and 1988, whose cases had been processed by the South Carolina Department of Juvenile…

  18. Health Consequences of Environmental Exposures in Early Life: Coping with a Changing World in the Post-MDG Era.

    PubMed

    Suk, William; Ruchirawat, Mathuros; Stein, Renato T; Diaz-Barriga, Fernando; Carpenter, David O; Neira, Maria; Sly, Peter D

    2016-01-01

    Despite overall progress toward achieving the Millennium Development Goals, large health discrepancies persist between developed and developing countries. The world is rapidly changing and the influences of societal change and climate change will disproportionately affect the world's most vulnerable populations, thus exacerbating current inequities. Current development strategies do not adequately address these disproportionate impacts of environmental exposures. The aim of this study was to propose a new framework to address the health consequences of environmental exposures beyond 2015. This framework is transdisciplinary and precautionary. It is based on identifying social and economic determinants of health, strengthening primary health systems, and improving the health of vulnerable populations. It incorporates deliberate plans for assessment and control of avoidable environmental exposures. It sets specific, measurable targets for health and environmental improvement.

  19. Multi-Institutional Assessment of Adverse Health Outcomes Among North American Testicular Cancer Survivors After Modern Cisplatin-Based Chemotherapy.

    PubMed

    Fung, Chunkit; Sesso, Howard D; Williams, Annalynn M; Kerns, Sarah L; Monahan, Patrick; Abu Zaid, Mohammad; Feldman, Darren R; Hamilton, Robert J; Vaughn, David J; Beard, Clair J; Kollmannsberger, Christian K; Cook, Ryan; Althouse, Sandra; Ardeshir-Rouhani-Fard, Shirin; Lipshultz, Steve E; Einhorn, Lawrence H; Fossa, Sophie D; Travis, Lois B

    2017-04-10

    Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking ( P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased ( P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.

  20. Validity and Reliability of a New Measure of Nursing Experience With Unintended Consequences of Electronic Health Records.

    PubMed

    Gephart, Sheila M; Bristol, Alycia A; Dye, Judy L; Finley, Brooke A; Carrington, Jane M

    2016-10-01

    Unintended consequences of electronic health records represent undesired effects on individuals or systems, which may contradict initial goals and impact patient care. The purpose of this study was to determine the extent to which a new quantitative measure called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire (CG-UCE-Q) was valid and reliable. Then, it was used to describe acute care nurses' experience with unintended consequences of electronic health records and relate them to the professional practice environment. Acceptable content validity was achieved for two rounds of surveys with nursing informatics experts (n = 5). Then, acute care nurses (n = 144) were recruited locally and nationally to complete the survey and describe the frequency with which they encounter unintended consequences in daily work. Principal component analysis with oblique rotation was applied to evaluate construct validity. Correlational analysis with measures of the professional practice environment and workarounds was used to evaluate convergent validity. Test-retest reliability was measured in the local sample (N = 68). Explanation for 63% of the variance across six subscales (patient safety, system design, workload issues, workarounds, technology barriers, and sociotechnical impact) supported construct validity. Relationships were significant between subscales for electronic health record-related threats to patient safety and low autonomy/leadership (P < .01), poor communication about patients (P < .01), and low control over practice (P < .01). The most frequent sources of unintended consequences were increased workload, interruptions that shifted tasks from the computer, altered workflow, and the need to duplicate data entry. Convergent validity of the CG-UCE-Q was moderately supported with both the context and processes of workarounds with strong relationships identified for when nurses perceived a block and altered process to work around it

  1. Alcohol Involvement in Sexual Behaviour and Adverse Sexual Health Outcomes from 26 to 38 Years of Age

    PubMed Central

    Connor, Jennie L.; Kydd, Robyn M.; Dickson, Nigel P.

    2015-01-01

    Background Research on alcohol and sexual behaviour has focused on young adults or high-risk groups, showing alcohol use contributing to riskier sexual choices. Adults now in their late thirties have been exposed to heavier drinking norms than previously, raising questions about effects on sexual wellbeing. We examined self-reported use and consequences of alcohol in sexual contexts, and its association with usual drinking pattern at age 38, and also associations of heavy drinking occasion (HDO) frequency with number of sexual partners, sexually transmitted infections (STIs), and terminations of pregnancy (TOPs), from 26–32 and 32–38 years of age. Methods Members of the Dunedin Study birth cohort answered computer-presented questions about sexual behaviour and outcomes, and interviewer-administered alcohol consumption questions, at age 26, 32 and 38 years. Results Response level was >90% at each assessment. At 38, drinking before or during sex in the previous year was common (8.2% of men; 14.6% of women reported “usually/always”), and unwanted consequences were reported by 13.5% of men and 11.9% of women, including regretted sex or failure to use contraception or condoms. Frequent heavy drinkers were more likely to “use alcohol to make it easier to have sex” and regret partner choice, particularly women. Heavy drinking frequency was strongly associated with partner numbers for men and women at 32, but only for women at 38. Significantly higher odds of STIs amongst the heaviest drinking men, and TOPs amongst the heaviest drinking women were seen at 32–38. Conclusions Alcohol involvement in sex continues beyond young adulthood where it has been well documented, and is common at 38. Women appear to be more affected than men, and heavy drinking is associated with poorer outcomes for both. Improving sexual health and wellbeing throughout the life course needs to take account of the role of alcohol in sexual behaviour. PMID:26267272

  2. [Photodegradation of chlorpromazine, a drug-related adverse event].

    PubMed

    Chabi, Yossounon; Brahim, Kheira; Da Costa, Maryline; Caffin, Anne-Gaëlle; Camus, Gisèle; Paillet, Michel; Bohand, Xavier

    2016-04-01

    The photodegradation of an active substance during treatment is a rare drug-related adverse event which can sometimes have serious consequences. Health professionals must be aware of the specific storage and administration instructions with regard to chlorpromazine and ensure that they are respected.

  3. Poor Health Literacy in Nigeria: Causes, Consequences and Measures to improve it.

    PubMed

    Adekoya-Cole, T O; Akinmokun, O I; Enweluzo, G O; Badmus, O O; Alabi, E O

    2015-01-01

    Health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make an appropriate decisions concerning their health. It is one of the link by which the health status of individual and the health indices and statistics of our country can be improved upon. Factors influencing health literacy in Nigeria include the culture and belief system, poor and ineffective communication, lack of education and low educational level, and low socioeconomic status Low health literacy predisposes to poorer health status, poorer disease outcome, lack of understanding in the use of preventive services, frequent hospital visitations amongst others. Factors influencing health literacy must be identified and modified to help improve the health literacy level of the populace. This will invariably improve the health status of the populace with a resultant improvement in the health indices of our country. This is a call for the Government and Health Care Professionals to acknowledge low health literacy as a problem and, therefore, be willing to play their roles in tackling this problem to achieve a healthy Nation

  4. Adverse mental health outcomes associated with emotional abuse in young rural South African women: a cross-sectional study

    PubMed Central

    Jewkes, Rachel; Hoffman, Susie; Dunkle, Kristen L.; Nduna, Mzikazi; Shai, Nwabisa J.

    2013-01-01

    There is a lack of data on the prevalence of emotional abuse in youth. The aim of this study was thus to estimate the prevalence of emotional abuse in intimate partnerships among young women in rural South Africa and to measure the association between lifetime experience of emotional abuse (with and without the combined experience of physical and/or sexual abuse) and adverse health outcomes. Between 2002 and 2003, young women from 70 villages were recruited to participate in the cluster randomized controlled trial of an HIV behavioural intervention, Stepping Stones. Data was obtained through the administration of a questionnaire at baseline. Of the 1293 women who had ever been partnered, 189 (14.6%) had experienced only emotional abuse in their lifetimes. Three hundred and sixty-six women (28.3%) experienced emotional abuse with physical and/or sexual abuse in their lifetimes, and one hundred and forty-four women (11.1%) experienced physical and/or sexual abuse without emotional abuse. Hazardous drinking was associated with the experience of physical and/or sexual abuse, with (OR 6.0, 95% CI 1.0 – 36.6) and without emotional abuse (OR 5.8, 95% CI 1.1 – 29.4). Illicit drug use (OR 5.6, 95% CI 2.4 – 12.6), having depressive symptoms (OR 2.9, 95% CI 1.2 – 4.2), having psychological distress (OR 1.9, 95% CI 1.4 – 2.6), and suicidality (OR 79.0, 95% CI 17.3 – 359.6) was associated with the experience of emotional abuse with physical and/or sexual abuse. Suicidality was also strongly associated with having experienced emotional abuse alone (OR 79.5, 95% CI 16.7 – 377.4). This study showed that emotionally abused young women had a greater risk of suicidality than those experiencing no abuse and that the combined experience of emotional with physical and/or sexual abuse was strongly associated with poor mental health outcomes. PMID:21987516

  5. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy

    PubMed Central

    Olmo, Neide Regina Simões; do Nascimento Saldiva, Paulo Hilário; Braga, Alfésio Luís Ferreira; Lin, Chin An; de Paula Santos, Ubiratan; Pereira, Luiz Alberto Amador

    2011-01-01

    The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies. PMID:21655765

  6. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy.

    PubMed

    Olmo, Neide Regina Simoes; Saldiva, Paulo Hilário do Nascimento; Braga, Alfésio Luís Ferreira; Lin, Chin An; Santos, Ubiratan de Paula; Pereira, Luiz Alberto Amador

    2011-01-01

    The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies.

  7. Early Adverse Experiences and the Developing Brain

    PubMed Central

    Bick, Johanna; Nelson, Charles A

    2016-01-01

    Children exposed to various forms of adversity early in life are at increased risk for a broad range of developmental difficulties, affecting both cognitive and emotional adjustment. We review a growing body of evidence suggesting that exposure to adverse circumstances affects the developing brain in ways that increase risk for a myriad of problems. We focus on two forms of adversity, one in which children are exposed to childhood maltreatment in family environments, and another in which children are exposed to extreme psychosocial deprivation in contexts of institutional rearing. We discuss ways in which each of these experiences represent violations of species-expected caregiving conditions, thereby imposing challenges to the developing brain. We also review emerging data pointing to the effectiveness of early intervention in remediating neurodevelopmental consequences associated with maltreatment or institutional rearing. We conclude by discussing implications of this work for public health efforts and highlight important directions for the field. PMID:26334107

  8. Promoting survival: A grounded theory study of consequences of modern health practices in Ouramanat region of Iranian Kurdistan.

    PubMed

    Mohammadpur, Ahmad; Rezaei, Mehdi; Sadeghi, Rasoul

    2010-05-14

    The aim of this qualitative study is to explore the way people using modern health care perceive its consequences in Ouraman-e-Takht region of Iranian Kurdistan. Ouraman-e-Takht is a rural, highly mountainous and dry region located in the southwest Kurdistan province of Iran. Recently, modern health practices have been introduced to the region. The purpose of this study was to investigate, from the Ouramains' point of view, the impact that modern health services and practices have had on the Ouraman traditional way of life. Interview data from respondents were analyzed by using grounded theory. Promoting survival was the core category that explained the impact that modern health practices have had on the Ouraman region. The people of Ouraman interpreted modern health practices as increasing their quality of life and promoting their survival. Results are organized around this core category in a paradigm model consisting of conditions, interactions, and consequences. This model can be used to understand the impact of change from the introduction of modern health on a traditional society.

  9. Childhood Poverty: Understanding and Preventing the Adverse Impacts of a Most-Prevalent Risk to Pediatric Health and Well-Being.

    PubMed

    Schickedanz, Adam; Dreyer, Benard P; Halfon, Neal

    2015-10-01

    Poor children are at greater risk for worse health, less productivity, and harms to well-being that extend into adulthood and subsequent generations. Timing and duration of poverty matter and influence life course outcomes, especially for education, health, and lifetime productivity. This article focuses on interventions by policy advocacy and the pediatric health system, and protection of the health and well-being of families in economic hardship from disadvantages and trauma wrought by poverty. A framework is presented for child poverty prevention and its consequences for lifelong health and success on a national scale.

  10. Deep and almost unbearable suffering: consequences of childhood sexual abuse for men's health and well-being.

    PubMed

    Sigurdardottir, Sigrun; Halldorsdottir, Sigridur; Bender, Sóley S

    2012-12-01

    Previous studies indicate that childhood sexual abuse can have extensive and serious consequences. The aim of this research was to do a qualitative study of the consequences of childhood sexual abuse for Icelandic men's health and well-being. Phenomenology was the methodological approach of the study. Totally 14 interviews were conducted, two per individual, and analysed based on the Vancouver School of Phenomenology. The main results of the study showed that the men describe deep and almost unbearable suffering, affecting their entire life, of which there is no alleviation in sight. The men have lived in repressed silence most of their lives and have come close to taking their own lives. What stopped them from committing suicide was revealing to others what happened to them which set them free in a way. The men experienced fear- or rage-based shock at the time of the trauma and most of them endured the attack by dissociation, disconnecting psyche and body and have difficulties reconnecting. They had extremely difficult childhoods, living with indisposition, bullying, learning difficulties and behavioural problems. Some have, from a young age, numbed themselves with alcohol and elicit drugs. They have suffered psychologically and physically and have had relational and sexual intimacy problems. The consequences of the abuse surfaced either immediately after the shock or many years later and developed into complex post-traumatic stress disorder. Because of perceived societal prejudice, it was hard for the men to seek help. This shows the great need for professionals to be alert to the possible consequences of childhood sexual abuse in their practice to reverse the damaging consequences on their health and well-being. We conclude that living in repressed silence after a trauma, like childhood sexual abuse, can be dangerous for the health, well-being and indeed the very life of the survivor.

  11. RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

    SciTech Connect

    Yuan, Y.C.; Chen, S.Y.; Biwer, B.M.; LePoire, D.J.

    1995-11-01

    This report presents the technical details of RISKIND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, interactive program that can be run on an IBM or equivalent personal computer under the Windows{trademark} environment. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incident-free models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionuclide inventory and dose conversion factors. In addition, the flexibility of the models allows them to be used for assessing any accidental release involving radioactive materials. The RISKIND code allows for user-specified accident scenarios as well as receptor locations under various exposure conditions, thereby facilitating the estimation of radiological consequences and health risks for individuals. Median (50% probability) and typical worst-case (less than 5% probability of being exceeded) doses and health consequences from potential accidental releases can be calculated by constructing a cumulative dose/probability distribution curve for a complete matrix of site joint-wind-frequency data. These consequence results, together with the estimated probability of the entire spectrum of potential accidents, form a comprehensive, probabilistic risk assessment of a spent nuclear fuel transportation accident.

  12. Choice of organic foods is related to perceived consequences for human health and to environmentally friendly behaviour.

    PubMed

    Magnusson, Maria K; Arvola, Anne; Hursti, Ulla Kaisa Koivisto; Aberg, Lars; Sjödén, Per-Olow

    2003-04-01

    We designed a questionnaire concerned with attitudes and behaviour towards organic foods, environmentally friendly behaviour (EFB), and perceived consequences of organic food choice in terms of human health, the environment and animal welfare. It was mailed in 1998 to a random nation-wide sample of 2000 Swedish citizens, ages 18-65 years, and 1154 (58%) responded. Self-reported purchase of organic foods was most strongly related to perceived benefit for human health. Performance of EFBs such as refraining from car driving was also a good predictor of purchase frequency. The results indicate that egoistic motives are better predictors of the purchase of organic foods than are altruistic motives.

  13. Mental Health Consequences in Men Exposed to Sexual Abuse during the War in Croatia and Bosnia

    ERIC Educational Resources Information Center

    Loncar, Mladen; Henigsberg, Neven; Hrabac, Pero

    2010-01-01

    In the research project on sexual abuse of men during the war in Croatia and Bosnia and Herzegovina, detailed information from 60 victims of such crimes was gathered. The aim of the research was to define key attributes of sexual abuse of men in war as well as consequences it had on the victims. A method of structured interview was used. Also, the…

  14. Violence and its injury consequences in American movies: a public health perspective

    PubMed Central

    McArthur, D.; Peek-Asa, C.; Webb, T.; Fisher, K.; Cook, B.; Browne, N.; Kraus, J.

    2000-01-01

    Objectives—The purpose of this study was to evaluate the seriousness and frequency of violence and the degree of associated injury depicted in the 100 top grossing American films of 1994. Methods—Each scene in each film was examined for the presentation of violent actions upon persons and coded by means of a systematic context sensitive analytic scheme. Specific degrees of violence and indices of injury severity were abstracted. Only actually depicted, not implied, actions were coded, although both explicit and implied consequences were examined. Results—The median number of violent actions per film was 16, with a range from 1 to 110. Intentional violence outnumbered unintentional violence by a factor of 10. Almost 90% of violent actions showed no consequences to the recipient's body, although more than 80% of the violent actions were executed with lethal or moderate force. Fewer than 1% of violent actions were accompanied by injuries that were then medically attended. Conclusions—Violent force in American films of 1994 was overwhelmingly intentional and in four of five cases was executed at levels likely to cause significant bodily injury. Not only action films but movies of all genres contained scenes in which the intensity of the action was not matched by correspondingly severe injury consequences. Many American films, regardless of genre, tend to minimize the consequences of violence to human beings. PMID:10875668

  15. Future Directions in Childhood Adversity and Youth Psychopathology.

    PubMed

    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.

  16. Interrater agreement of two adverse drug reaction causality assessment methods: A randomised comparison of the Liverpool Adverse Drug Reaction Causality Assessment Tool and the World Health Organization-Uppsala Monitoring Centre system

    PubMed Central

    Mehta, Ushma; Rossiter, Dawn P.; Maartens, Gary; Cohen, Karen

    2017-01-01

    Introduction A new method to assess causality of suspected adverse drug reactions, the Liverpool Adverse Drug Reaction Causality Assessment Tool (LCAT), showed high interrater agreement when used by its developers. Our aim was to compare the interrater agreement achieved by LCAT to that achieved by another causality assessment method, the World Health Organization-Uppsala Monitoring Centre system for standardised case causality assessment (WHO-UMC system), in our setting. Methods Four raters independently assessed adverse drug reaction causality of 48 drug-event pairs, identified during a hospital-based survey. A randomised design ensured that no washout period was required between assessments with the two methods. We compared the methods’ interrater agreement by calculating agreement proportions, kappa statistics, and the intraclass correlation coefficient. We identified potentially problematic questions in the LCAT by comparing raters’ responses to individual questions. Results Overall unweighted kappa was 0.61 (95% CI 0.43 to 0.80) on the WHO-UMC system and 0.27 (95% CI 0.074 to 0.46) on the LCAT. Pairwise unweighted Cohen kappa ranged from 0.33 to 1.0 on the WHO-UMC system and from 0.094 to 0.71 on the LCAT. The intraclass correlation coefficient was 0.86 (95% CI 0.74 to 0.92) on the WHO-UMC system and 0.61 (95% CI 0.39 to 0.77) on the LCAT. Two LCAT questions were identified as significant points of disagreement. Discussion We were unable to replicate the high interrater agreement achieved by the LCAT developers and instead found its interrater agreement to be lower than that achieved when using the WHO-UMC system. We identified potential reasons for this and recommend priority areas for improving the LCAT. PMID:28235001

  17. Thursday’s child: The role of adverse childhood experiences in explaining mental health disparities among lesbian, gay, and bisexual U.S. adults

    PubMed Central

    Blosnich, John R.; Andersen, Judith P.

    2015-01-01

    This study examined how Adverse Childhood Experiences (ACE) may explain disparities in poor mental health between lesbian, gay, and bisexual (LGB) and heterosexual adults. Data are from three U.S. states’ 2010 Behavioral Risk Factor Surveillance System surveys (n=20,060) that included sexual orientation, ACE inventory, and mental distress. LGB status was significantly associated with mental distress (OR=1.85 [1.14–3.02]). Once incorporating ACE scores into the multiple regression analysis, LGB status was no longer associated with mental distress (OR=1.28 [0.76–2.16]). The results corroborate previous research that LGB individuals report greater prevalence of childhood adversity than their heterosexual peers, which may explain LGB adulthood health disparities. PMID:25367679

  18. Thursday's child: the role of adverse childhood experiences in explaining mental health disparities among lesbian, gay, and bisexual U.S. adults.

    PubMed

    Blosnich, John R; Andersen, Judith P

    2015-02-01

    This study examined how adverse childhood experiences (ACE) may explain disparities in poor mental health between lesbian, gay, and bisexual (LGB), and heterosexual adults. Data are from three US states' 2010 behavioral risk factor surveillance system surveys (n = 20,060) that included sexual orientation, ACE inventory, and mental distress. LGB status was significantly associated with mental distress (OR = 1.85 [1.14-3.02]). Once incorporating ACE scores into the multiple regression analysis, LGB status was no longer associated with mental distress (OR = 1.28 [0.76-2.16]). The results corroborate previous research that LGB individuals report greater prevalence of childhood adversity than their heterosexual peers, which may explain LGB adulthood health disparities.

  19. Health Consequences of Typhoon Haiyan in the Eastern Visayas Region Using a Syndromic Surveillance Database

    PubMed Central

    Salazar, Miguel Antonio; Law, Ronald; Pesigan, Arturo; Winkler, Volker

    2017-01-01

    Introduction: Typhoon Haiyan was the strongest storm recorded in Philippine history. Surveillance in Post Extreme Emergencies and Disasters (SPEED) was activated during the typhoon response. This study analyzes the health impact of different diseases during different timeframes post-disaster during Typhoon Haiyan in 2013 using a syndromic surveillance database. Methods: SPEED reports medical consultations based on 21 syndromes covering a range of conditions from three syndrome groups: communicable diseases, injuries, and non-communicable diseases (NCDs). We analyzed consultation rates for 150 days post-disaster by syndrome, syndrome group, time period, and health facility type for adults as well as for children under the age of five. Results: Communicable diseases had the highest consultation rates followed by similar rates for both injuries and NCDs. While communicable diseases were the predominant syndrome group for children, wounds and hypertension were common syndromes observed in adults. Village health centers had the most consultations amongst health facilities, but also showed the highest variability. Discussion: Children were more vulnerable to communicable diseases compared to adults. Community health centers showing consistently high consultation rates point out a need for their prioritization. The predominance of primary care conditions requires disaster managers to focus on basic health care and public health measures in community health centers that target the young, elderly and impoverished appropriate to the time period. PMID:28255519

  20. Spinal Cord Injury as a Permanent Consequence of Victimization in Random Violence: A Public Health Perspective.

    ERIC Educational Resources Information Center

    Anderson, James F.; Dyson, Laronistine; Grandison, Terry

    1998-01-01

    Traumatic spinal cord injuries resulting from criminal violence is a growing public health concern. Citing the criminal justice system's failure to reduce violence and the costs of treating injuries, a public health-education approach is advocated. Approaches to prevention, gun control, and a comprehensive family policy are discussed. (Author/EMK)

  1. Intimate Partner Violence and Physical Health Consequences: Policy and Practice Implications

    ERIC Educational Resources Information Center

    Plichta, Stacey B.

    2004-01-01

    Extensive research indicates that intimate partner violence (IPV) poses a significant risk to the physical health of women. IPV is associated with increased mortality, injury and disability, worse general health, chronic pain, substance abuse, reproductive disorders, and poorer pregnancy outcomes. IPV is also associated with an overuse of health…

  2. Research as intervention? Exploring the health and well-being of children and youth facing global adversity through participatory visual methods.

    PubMed

    D'Amico, Miranda; Denov, Myriam; Khan, Fatima; Linds, Warren; Akesson, Bree

    2016-01-01

    Global health research typically relies on the translation of knowledge (from health professionals to the community) and the dissemination of knowledge (from research results to the wider public). However, Greenhalgh and Wieringa [2011. Is it time to drop the 'knowledge translation' metaphor? A critical literature review. Journal of the Royal Society of Medicine, 104(12), 501-509. doi: 10.1258/jrsm.2011.110285 ] suggest 'that while "translation" is a widely used metaphor in medicine, it constrains how we conceptualize and study the link between knowledge and practice' (p. 501). Often the knowledge garnered from such research projects comes from health professionals rather than reflecting the lived experiences of people and communities. Likewise, there has been a gap in 'translating' and 'disseminating' the results of participatory action research projects to policymakers and medical practitioners. This paper will look at how using participatory visual methodologies in global health research with children and youth facing global adversity incorporates the multiple functions of their lived realities so that research becomes a means of intervention. Drawing from a literature review of participatory visual methods as media, content and processes of global health research, this paper raises practical, theoretical, and ethical questions that arise from research as intervention. The paper concludes by exploring what lessons emerge when participatory visual methodologies are integrated into global health research with children and youth facing global adversity.

  3. Mitigating the consequences of a health condition: The role of intra- and interhousehold assistance.

    PubMed

    Dalton, Michael; LaFave, Daniel

    2017-02-20

    The behavior of noncoresident family members motivates much of the literature on consumption smoothing, risk-sharing, and informal networks, yet little is known empirically on the topic due to a lack of data simultaneously observing multiple households in an extended family. This study utilizes genealogically linked longitudinal data to examine how extended family networks insure against financial risks from severely limiting health conditions. We find that nonhealth consumption of unmarried households declines in response to worsening health, whereas married households smooth expenditures in a way that is consistent with full insurance. Families mitigate losses by reallocating home production, drawing down home equity, holding formal health insurance, collecting social security, and receiving transfers from noncoresident relatives. We illustrate that the costs of health shocks are transmitted throughout family networks, and that noncoresident children draw down their assets and consumption when responding to a parent's health decline.

  4. [Intimate partner violence against women and physical and mental health consequences].

    PubMed

    Plazaola-Castaño, Juncal; Ruiz Pérez, Isabel

    2004-04-03

    Intimate partner violence is currently a public health issue of great relevance. The aim of this article is to present through a literature review, the physical and psychological health problems that, beyond physical injuries, can alert health care professionals of the presence of spouse abuse in their care centers. Literature consistently shows that victims of the so called domestic violence present, compared with no victims, more chronic health problems like fibromyalgia, gastrointestinal disorders like irritable bowel syndrome, and gynaecological signs including sexually transmitted diseases, as well as post-traumatic stress disorder, anxiety and depression among others. The broad range of pathologies associated with the abuse of a sexual intimate suggests that victims will attend different health care services. These could play a key role to help these women and refer them to the appropriate legal, social and/or community services.

  5. Notes from the Field: Increase in Reported Adverse Health Effects Related to Synthetic Cannabinoid Use - United States, January-May 2015.

    PubMed

    Law, Royal; Schier, Josh; Martin, Colleen; Chang, Arthur; Wolkin, Amy

    2015-06-12

    On April 6, 2015, CDC received notification of an increase in telephone calls to U.S. poison centers related to synthetic cannabinoid use. Monthly calls to all poison centers are tracked by the National Poison Data System, which reported that adverse health effects or concerns about possible adverse health effects related to synthetic cannabinoid use increased 330% from 349 in January 2015 to 1,501 in April 2015. Synthetic cannabinoids include various psychoactive chemicals or a mixture of such chemicals that are sprayed onto plant material, which is then often smoked or ingested to achieve a "high." These products are sold under a variety of names (e.g., synthetic marijuana, spice, K2, black mamba, and crazy clown) and can be sold in retail outlets as herbal products. Law enforcement agencies have regulated a number of these substances; however, manufacturers of synthetic cannabinoids frequently change the formulation to avoid detection and regulation. After the initial notification, CDC analyzed information from the National Poison Data System on reported adverse health effects related to synthetic cannabinoid use for the period January-May 2015.

  6. Emergency Responses and Health Consequences after the Fukushima Accident; Evacuation and Relocation.

    PubMed

    Hasegawa, A; Ohira, T; Maeda, M; Yasumura, S; Tanigawa, K

    2016-04-01

    The Fukushima accident was a compounding disaster following the strong earthquake and huge tsunami. The direct health effects of radiation were relatively well controlled considering the severity of the accident, not only among emergency workers but also residents. Other serious health issues include deaths during evacuation, collapse of the radiation emergency medical system, increased mortality among displaced elderly people and public healthcare issues in Fukushima residents. The Fukushima mental health and lifestyle survey disclosed that the Fukushima accident caused severe psychological distress in the residents from evacuation zones. In addition to psychiatric and mental health problems, there are lifestyle-related problems such as an increase proportion of those overweight, an increased prevalence of hypertension, diabetes mellitus and dyslipidaemia and changes in health-related behaviours among evacuees; all of which may lead to an increased cardiovascular disease risk in the future. The effects of a major nuclear accident on societies are diverse and enduring. The countermeasures should include disaster management, long-term general public health services, mental and psychological care, behavioural and societal support, in addition to efforts to mitigate the health effects attributable to radiation.

  7. Adverse events and patients’ perceived health-related quality of life at the end of multidrug-resistant tuberculosis treatment in Namibia

    PubMed Central

    Sagwa, Evans L; Ruswa, Nunurai; Mavhunga, Farai; Rennie, Timothy; Leufkens, Hubert GM; Mantel-Teeuwisse, Aukje K

    2016-01-01

    Purpose The health-related quality of life (HRQoL) of patients completing multidrug-resistant tuberculosis (MDR-TB) treatment in Namibia and whether the occurrence of adverse events influenced patients’ rating of their HRQoL was evaluated. Patients and methods A cross-sectional analytic survey of patients completing or who recently completed MDR-TB treatment was conducted. The patients rated their HRQoL using the simplified Short Form-™ (SF-8) questionnaire consisting of eight Likert-type questions. Three supplemental questions on the adverse events that the patients may have experienced during their MDR-TB treatment were also included. Scoring of HRQoL ratings was norm-based (mean =50, standard deviation =10) ranging from 20 (worst health) to 80 (best health), rather than the conventional 0–100 scores. We evaluated the internal consistency of the scale items using the Cronbach’s alpha, performed descriptive analyses, and analyzed the association between the patients’ HRQoL scores and adverse events. Results Overall, 36 patients (20 males, 56%) aged 17–54 years (median =40 years) responded to the questionnaire. The median (range) HRQoL score for the physical component summary was 58.6 (35.3–60.5), while the median score for the mental component summary was 59.3 (26.6–61.9), indicating not-so-high self-rating of health. There was good internal consistency of the scale scores, with a Cronbach’s alpha value of >0.80. In all, 32 (89%) of the 36 patients experienced at least one adverse drug event of any severity during their treatment (median events =3, range 1–6), of which none was life-threatening. The occurrence of adverse events was not related to HRQoL scores. For patients reporting zero to two events, the median (range) HRQoL score was 56.8 (44.4–56.8), while for those reporting three or more events, the median score was 55.2 (38.6–56.8); P=0.34 for difference between these scores. Conclusion Patients completing treatment for MDR-TB in

  8. 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

  9. Authentic leadership, social support and their role in workplace bullying and its mental health consequences.

    PubMed

    Warszewska-Makuch, Magdalena; Bedyńska, Sylwia; Żołnierczyk-Zreda, Dorota

    2015-01-01

    The aim of this study was to show how authentic leadership is related to social support and exposure to workplace bullying and how these variables are related to mental health. For our sample of 820 office workers employed in different Polish organizations and sectors, social support from supervisors moderated the relationship between authentic leadership and workplace bullying. Social support from co-workers moderated the relationship between workplace bullying and mental health and authentic leadership moderated the relationship between workplace bullying and mental health.

  10. The consequences of job displacement for health: moderating influences of economic conditions and educational attainment.

    PubMed

    Pearlman, Jessica

    2015-07-01

    This paper examines 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.

  11. Authentic leadership, social support and their role in workplace bullying and its mental health consequences

    PubMed Central

    Warszewska-Makuch, Magdalena; Bedyńska, Sylwia; Żołnierczyk-Zreda, Dorota

    2015-01-01

    The aim of this study was to show how authentic leadership is related to social support and exposure to workplace bullying and how these variables are related to mental health. For our sample of 820 office workers employed in different Polish organizations and sectors, social support from supervisors moderated the relationship between authentic leadership and workplace bullying. Social support from co-workers moderated the relationship between workplace bullying and mental health and authentic leadership moderated the relationship between workplace bullying and mental health. PMID:26323771

  12. Childhood adversity and frequent medical consultations.

    PubMed

    Fiddler, Maggie; Jackson, Judy; Kapur, Navneet; Wells, Adrian; Creed, Francis

    2004-01-01

    We assessed possible psychological mediators of the relationship between childhood adversity and frequent medical consultations among new outpatients at neurology, cardiology, and gastroenterology clinics. We assessed whether these differed in patients with and without organic disease that explained their symptoms. At first clinic visit we recorded Hospital Anxiety and Depression scale (HADS--anxiety and depression subscale scores), Illness Perception Questionnaire (IPQ--four subscales: consequences, cure, identity, timeline), Health Anxiety Questionnaire (total score), and Symptom Amplification Scale (total score). Subjects were divided into two groups according to whether they had experienced any type of childhood adversity using the Childhood Experience of Care and Abuse Schedule. Outcome was the (log) number of medical consultations for 12 months before and 6 months after the index clinic visits. Multiple regression analysis was used to determine mediators; this was performed separately for patients with symptoms explained and not explained by organic disease. One-hundred and twenty-nine patients (61% response) were interviewed. Fifty-two (40.3%) had experienced childhood adversity; they made a median of 16 doctor visits compared with 10 for those without adversity (adjusted P=.026). IPQ identity score (number of symptoms attributed to the illness) and HAD depression scores were significantly associated with both childhood adversity and number of medical consultations and these variables acted as mediators between childhood adversity and frequency of consultation in the multiple regression analyses. This association was limited to patients with medically unexplained symptoms and was mediated by IPQ Identity Score (number of symptoms attributed to the patient's illness) and HAD depression score. Sexual abuse and overt neglect were the adversities most closely associated with frequent consultations. In patients with medically unexplained symptoms the association

  13. Health Consequences of Weight Stigma: Implications for Obesity Prevention and Treatment.

    PubMed

    Puhl, Rebecca; Suh, Young

    2015-06-01

    Despite decades of research documenting consistent stigma and discrimination against individuals with obesity, weight stigma is rarely considered in obesity prevention and treatment efforts. In recent years, evidence has examined weight stigmatization as a unique contributor to negative health outcomes and behaviors that can promote and exacerbate obesity. This review summarizes findings from published studies within the past 4 years examining the relationship between weight stigma and maladaptive eating behaviors (binge eating and increased food consumption), physical activity, weight status (weight gain and loss and development of obesity), and physiological stress responses. Research evaluating the effects of weight stigma present in obesity-related public health campaigns is also highlighted. Evidence collectively demonstrates negative implications of stigmatization for weight-related health correlates and behaviors and suggests that addressing weight stigma in obesity prevention and treatment is warranted. Key questions for future research to further delineate the health effects of weight stigmatization are summarized.

  14. Physical Health Consequences of Interpersonal Trauma: A Systematic Review of the Role of Psychological Variables.

    PubMed

    López-Martínez, Alicia E; Serrano-Ibáñez, Elena R; Ruiz-Párraga, Gema T; Gómez-Pérez, Lydia; Ramírez-Maestre, Carmen; Esteve, Rosa

    2016-07-25

    Interpersonal forms of trauma are among the most commonly reported traumas. These types of traumas are more damaging to well-being than noninterpersonal forms. They have also been strongly associated with somatic symptoms and more general physical health problems. Nevertheless, the results of trauma studies are mixed and suggest that pathways may vary according to the stressors, mediators, and health outcomes investigated. This article presents a systematic qualitative review of published studies that have investigated interpersonal trauma, its association with physical health, and the potential role of intervening psychological variables. A systematic search was made of four psychology and health electronic databases. Of the 863 studies reviewed, 50 were preselected, 11 of which met the inclusion and methodological quality criteria. All but one study had a cross-sectional design. The findings showed that childhood trauma exposure was the most common category of interpersonal trauma addressed in the reviewed studies and that the physical health variables investigated were diverse. The psychological variables most frequently investigated in the studies were posttraumatic stress disorder, depression, dissociation, and substance abuse. Overall, the results suggest that interpersonal trauma exposure is associated with poorer physical health; however, the role of intervening psychological variables remains unclear. The limitations of the reviewed literature are discussed, and methodological recommendations are made for future research.

  15. A Heavy Burden: The Cardiovascular Health Consequences of Having a Family Member Incarcerated

    PubMed Central

    Wildeman, Christopher; Wang, Emily A.; Matusko, Niki; Jackson, James S.

    2014-01-01

    Objectives. We examined the association of family member incarceration with cardiovascular risk factors and disease by gender. Methods. We used a sample of 5470 adults aged 18 years and older in the National Survey of American Life, a 2001–2003 nationally representative cross-sectional survey of Blacks and Whites living in the United States, to examine 5 self-reported health conditions (diabetes, hypertension, heart attack or stroke, obesity, and fair or poor health). Results. Family member incarceration was associated with increased likelihood of poor health across all 5 conditions for women but not for men. In adjusted models, women with family members who were currently incarcerated had 1.44 (95% confidence interval [CI] = 1.03, 2.00), 2.53 (95% CI = 1.80, 3.55), and 1.93 (95% CI = 1.45, 2.58) times the odds of being obese, having had a heart attack or stroke, and being in fair or poor health, respectively. Conclusions. Family member incarceration has profound implications for women’s cardiovascular health and should be considered a unique risk factor that contributes to racial disparities in health. PMID:24432879

  16. Health effects model for nuclear power plant accident consequence analysis. Part I. Introduction, integration, and summary. Part II. Scientific basis for health effects models

    SciTech Connect

    Evans, J.S.; Moeller, D.W.; Cooper, D.W.

    1985-07-01

    Analysis of the radiological health effects of nuclear power plant accidents requires models for predicting early health effects, cancers and benign thyroid nodules, and genetic effects. Since the publication of the Reactor Safety Study, additional information on radiological health effects has become available. This report summarizes the efforts of a program designed to provide revised health effects models for nuclear power plant accident consequence modeling. The new models for early effects address four causes of mortality and nine categories of morbidity. The models for early effects are based upon two parameter Weibull functions. They permit evaluation of the influence of dose protraction and address the issue of variation in radiosensitivity among the population. The piecewise-linear dose-response models used in the Reactor Safety Study to predict cancers and thyroid nodules have been replaced by linear and linear-quadratic models. The new models reflect the most recently reported results of the follow-up of the survivors of the bombings of Hiroshima and Nagasaki and permit analysis of both morbidity and mortality. The new models for genetic effects allow prediction of genetic risks in each of the first five generations after an accident and include information on the relative severity of various classes of genetic effects. The uncertainty in modeloling radiological health risks is addressed by providing central, upper, and lower estimates of risks. An approach is outlined for summarizing the health consequences of nuclear power plant accidents. 298 refs., 9 figs., 49 tabs.

  17. Assessing Exposure and Health Consequences of Chemicals in Drinking Water: Current State of Knowledge and Research Needs

    PubMed Central

    Kogevinas, Manolis; Cordier, Sylvaine; Templeton, Michael R.; Vermeulen, Roel; Nuckols, John R.; Nieuwenhuijsen, Mark J.; Levallois, Patrick

    2014-01-01

    Background: Safe drinking water is essential for well-being. Although microbiological contamination remains the largest cause of water-related morbidity and mortality globally, chemicals in water supplies may also cause disease, and evidence of the human health consequences is limited or lacking for many of them. Objectives: We aimed to summarize the state of knowledge, identify gaps in understanding, and provide recommendations for epidemiological research relating to chemicals occurring in drinking water. Discussion: Assessing exposure and the health consequences of chemicals in drinking water is challenging. Exposures are typically at low concentrations, measurements in water are frequently insufficient, chemicals are present in mixtures, exposure periods are usually long, multiple exposure routes may be involved, and valid biomarkers reflecting the relevant exposure period are scarce. In addition, the magnitude of the relative risks tends to be small. Conclusions: Research should include well-designed epidemiological studies covering regions with contrasting contaminant levels and sufficient sample size; comprehensive evaluation of contaminant occurrence in combination with bioassays integrating the effect of complex mixtures; sufficient numbers of measurements in water to evaluate geographical and temporal variability; detailed information on personal habits resulting in exposure (e.g., ingestion, showering, swimming, diet); collection of biological samples to measure relevant biomarkers; and advanced statistical models to estimate exposure and relative risks, considering methods to address measurement error. Last, the incorporation of molecular markers of early biological effects and genetic susceptibility is essential to understand the mechanisms of action. There is a particular knowledge gap and need to evaluate human exposure and the risks of a wide range of emerging contaminants. Citation: Villanueva CM, Kogevinas M, Cordier S, Templeton MR, Vermeulen R

  18. Joint USNRC/EC consequence uncertainty study: The ingestion pathway, dosimetry and health effects expert judgment elicitations and results

    SciTech Connect

    Harper, F.; Goossens, L.; Abbott, M.

    1996-08-01

    The US Nuclear Regulatory Commission (USNRC) and the European Commission (EC) have conducted a formal expert judgment elicitation jointly to systematically collect the quantitative information needed to perform consequence uncertainty analyses on a broad set of commercial nuclear power plants. Information from three sets of joint US/European expert panels was collected and processed. Information from the three sets of panels was collected in the following areas: in the phenomenological areas of atmospheric dispersion and deposition, in the areas of ingestion pathways and external dosimetry, and in the areas of health effects and internal dosimetry. This exercise has demonstrated that the uncertainty for particular issues as measured by the ratio of the 95th percentile to the 5th percentile can be extremely large (orders of magnitude), or rather small (factor of two). This information has already been used by many of the experts that were involved in this process in areas other than the consequence uncertainty field. The benefit to the field of radiological consequences is just beginning as the results of this study are published and made available to the consequence community.

  19. Excessive computer game playing among Norwegian adults: self-reported consequences of playing and association with mental health problems.

    PubMed

    Wenzel, H G; Bakken, I J; Johansson, A; Götestam, K G; Øren, Anita

    2009-12-01

    Computer games are the most advanced form of gaming. For most people, the playing is an uncomplicated leisure activity; however, for a minority the gaming becomes excessive and is associated with negative consequences. The aim of the present study was to investigate computer game-playing behaviour in the general adult Norwegian population, and to explore mental health problems and self-reported consequences of playing. The survey includes 3,405 adults 16 to 74 years old (Norway 2007, response rate 35.3%). Overall, 65.5% of the respondents reported having ever played computer games (16-29 years, 93.9%; 30-39 years, 85.0%; 40-59 years, 56.2%; 60-74 years, 25.7%). Among 2,170 players, 89.8% reported playing less than 1 hr. as a daily average over the last month, 5.0% played 1-2 hr. daily, 3.1% played 2-4 hr. daily, and 2.2% reported playing > 4 hr. daily. The strongest risk factor for playing > 4 hr. daily was being an online player, followed by male gender, and single marital status. Reported negative consequences of computer game playing increased strongly with average daily playing time. Furthermore, prevalence of self-reported sleeping problems, depression, suicide ideations, anxiety, obsessions/ compulsions, and alcohol/substance abuse increased with increasing playing time. This study showed that adult populations should also be included in research on computer game-playing behaviour and its consequences.

  20. Cars, corporations, and commodities: Consequences for the social determinants of health

    PubMed Central

    Woodcock, James; Aldred, Rachel

    2008-01-01

    Social epidemiologists have drawn attention to health inequalities as avoidable and inequitable, encouraging thinking beyond proximal risk factors to the causes of the causes. However, key debates remain unresolved including the contribution of material and psychosocial pathways to health inequalities. Tools to operationalise social factors have not developed in tandem with conceptual frameworks, and research has often remained focused on the disadvantaged rather than on forces shaping population health across the distribution. Using the example of transport, we argue that closer attention to social processes (capital accumulation and motorisation) and social forms (commodity, corporation, and car) offers a way forward. Corporations tied to the car, primarily oil and vehicle manufacturers, are central to the world economy. Key drivers in establishing this hegemony are the threat of violence from motor vehicles and the creation of distance through the restructuring of place. Transport matters for epidemiology because the growth of mass car ownership is environmentally unsustainable and affects population health through a myriad of pathways. Starting from social forms and processes, rather than their embodiment as individual health outcomes and inequalities, makes visible connections between road traffic injuries, obesity, climate change, underdevelopment of oil producing countries, and the huge opportunity cost of the car economy. Methodological implications include a movement-based understanding of how place affects health and a process-orientated integration of material and psychosocial explanations that, while materially based, contests assumptions of automatic benefits from economic growth. Finally, we identify car and oil corporations as anti-health forces and suggest collaboration with them creates conflicts of interest. PMID:18291031

  1. Cars, corporations, and commodities: consequences for the social determinants of health.

    PubMed

    Woodcock, James; Aldred, Rachel

    2008-02-21

    Social epidemiologists have drawn attention to health inequalities as avoidable and inequitable, encouraging thinking beyond proximal risk factors to the causes of the causes. However, key debates remain unresolved including the contribution of material and psychosocial pathways to health inequalities. Tools to operationalise social factors have not developed in tandem with conceptual frameworks, and research has often remained focused on the disadvantaged rather than on forces shaping population health across the distribution. Using the example of transport, we argue that closer attention to social processes (capital accumulation and motorisation) and social forms (commodity, corporation, and car) offers a way forward. Corporations tied to the car, primarily oil and vehicle manufacturers, are central to the world economy. Key drivers in establishing this hegemony are the threat of violence from motor vehicles and the creation of distance through the restructuring of place. Transport matters for epidemiology because the growth of mass car ownership is environmentally unsustainable and affects population health through a myriad of pathways. Starting from social forms and processes, rather than their embodiment as individual health outcomes and inequalities, makes visible connections between road traffic injuries, obesity, climate change, underdevelopment of oil producing countries, and the huge opportunity cost of the car economy. Methodological implications include a movement-based understanding of how place affects health and a process-orientated integration of material and psychosocial explanations that, while materially based, contests assumptions of automatic benefits from economic growth. Finally, we identify car and oil corporations as anti-health forces and suggest collaboration with them creates conflicts of interest.

  2. Public health consequences of global climate change in the United States--some regions may suffer disproportionately.

    PubMed

    Longstreth, J

    1999-02-01

    Current risk assessments of the likely regional health impacts of global climate change (GCC) are hindered by two factors. First, dose-response relationships between weather parameters and many of the likely health effects have not been developed, and second, reliable estimates of future regional climates across the United States are still beyond the scope of current modeling efforts. Consequently, probabilistic risk estimates of most of the likely regional health impacts of GCC have such a high degree of uncertainty that their usefulness to health officials dealing with regional issues is very limited. With the numerous pressures on today's health care systems, it is understandable that the possible consequences of GCC have received scant attention from regional health care decision makers. Indeed, the consensus among this community appears to be that any increases in health effects associated with GCC will be easily handled by the current health care system. However, such a position may be naive as the potential exists that an unequal distribution of such effects could overwhelm some regions, whereas others may feel little or no impact. This review of the likely regional impacts of GCC has been structured as a semianalytical look at this issue of distributional effects. Because of the lack of dose-response information and reliable estimates of future regional climates, however, it takes a historical perspective. That is, it assumes that the quality and quantity of health risks a region faces under GCC will be directly related to its recent history of health risks from warm weather/climate-related diseases as well as to the size, characteristics, and distribution of the sensitive subpopulations currently residing within its borders. The approach is semiquantitative; however, it uses national data gathered on a regional level and as such should only be used to generate a hypothesis rather than test it. When applied to the United States, its outcome leads to the

  3. 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

  4. CE: Veteran Women: Mental Health-Related Consequences of Military Service.

    PubMed

    Ganzer, Christine Anne

    2016-11-01

    : The last two decades have seen increasing numbers of women entering all branches of the U.S. armed forces. Now that women in the military are no longer prohibited from holding direct combat positions, they are often exposed to traumatic events that place them at higher risk for mental health conditions. Nurses working within the Veterans Affairs (VA) system and those working in non-VA settings are likely to encounter female veterans. It's essential for all nurses to be knowledgeable about the mental health issues commonly seen in this population, and to understand the importance of screening, not only for mental health issues but also for physical conditions that may be related to service.Numerous studies have focused on the mental health effects of deployment among military men, but very few have been conducted among military women. To learn more, the literature was searched for relevant articles published between January 2005 and December 2015. The research supports the contention that both active-duty and veteran women are at increased risk for postdeployment mental health problems, including posttraumatic stress disorder, military sexual trauma, and suicide. This article discusses the relevant research; identifies gaps in the literature; and addresses the nursing practice implications, including screening.

  5. Consequences of differential residence designations for rural health policy research: the case of infant mortality.

    PubMed

    Farmer, F L; Clarke, L L; Miller, M K

    1993-01-01

    In 1991, members of the rural caucus proposed numerous bills designed to attenuate the rural-urban differences in health care delivery and health status. Implicit in the legislative process is the assumption that "rural America" differs systematically from "urban America." However, research has consistently demonstrated that there is not a single rural America but rather, those areas outside of the major metropolitan areas represent a complex mosaic of varying social and environmental settings. Rural communities differ in meaningful ways along a number of socioenvironmental parameters, and accordingly, health status indicators also differ across rural communities. Thus, health outcome statistics averaged across rural communities will often mask important disparities experienced by certain population groups. Policies based on these aggregate indicators may overlook the needs of the most disadvantaged. While a number of measures of rurality have emerged in the last decade, much of the information presented to policy-makers is either too aggregated (i.e., metropolitan-nonmetropolitan) to identify important differences across the range of communities, or it is gathered in agency-specific categories that are not comparable. The central question under examination in the current context is the possibility of distorting the picture of infant health status by aggregating the diverse rural locales of the United States. Empirical results indicate that when considering infant mortality, any rural disadvantage is contingent upon how 'rural' and 'urban' have been defined. Further, the results indicate that conclusions must be conditioned on other important sociodemographic parameters such as region of the country and race.

  6. A review of the consequences of global climate change on human health.

    PubMed

    Kim, Ki-Hyun; Kabir, Ehsanul; Ara Jahan, Shamin

    2014-01-01

    The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.

  7. Intimate partner violence in older women in Spain: prevalence, health consequences, and service utilization.

    PubMed

    Montero, Isabel; Martín-Baena, David; Escribà-Agüir, Vicenta; Ruiz-Pérez, Isabel; Vives-Cases, Carmen; Talavera, Marta

    2013-01-01

    The purpose of this study is to estimate the prevalence of lifetime intimate partner violence (IPV) in older women and to analyze its effect on women's health and Healthcare Services utilization. Women aged 55 years and over (1,676) randomly sampled from Primary Healthcare Services around Spain were included. Lifetime IPV prevalence, types, and duration were calculated. Descriptive and multivariate procedures using logistic and multiple lineal regression models were used. Of the women studied, 29.4% experienced IPV with an average duration of 21 years. Regardless of the type of IPV experienced, abused women showed significantly poorer health and higher healthcare services utilization compared to women who had never been abused. The high prevalence detected long standing duration, negative health impact, and high healthcare services utilization, calling attention to a need for increased efforts aimed at addressing IPV in older women.

  8. 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

  9. Adverse Reproductive and Developmental Health Outcomes Following Prenatal Exposure to a Hydraulic Fracturing Chemical Mixture in Female C57Bl/6 Mice.

    PubMed

    Kassotis, Christopher D; Bromfield, John J; Klemp, Kara C; Meng, Chun-Xia; Wolfe, Andrew; Zoeller, R Thomas; Balise, Victoria D; Isiguzo, Chiamaka J; Tillitt, Donald E; Nagel, Susan C

    2016-09-01

    Unconventional oil and gas operations using hydraulic fracturing can contaminate surface and groundwater with endocrine-disrupting chemicals. We have previously shown that 23 of 24 commonly used hydraulic fracturing chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors in a human endometrial cancer cell reporter gene assay and that mixtures can behave synergistically, additively, or antagonistically on these receptors. In the current study, pregnant female C57Bl/6 dams were exposed to a mixture of 23 commonly used unconventional oil and gas chemicals at approximately 3, 30, 300, and 3000 μg/kg·d, flutamide at 50 mg/kg·d, or a 0.2% ethanol control vehicle via their drinking water from gestational day 11 through birth. This prenatal exposure to oil and gas operation chemicals suppressed pituitary hormone concentrations across experimental groups (prolactin, LH, FSH, and others), increased body weights, altered uterine and ovary weights, increased heart weights and collagen deposition, disrupted folliculogenesis, and other adverse health effects. This work suggests potential adverse developmental and reproductive health outcomes in humans and animals exposed to these oil and gas operation chemicals, with adverse outcomes observed even in the lowest dose group tested, equivalent to concentrations reported in drinking water sources. These endpoints suggest potential impacts on fertility, as previously observed in the male siblings, which require careful assessment in future studies.

  10. Signalling-Dependent Adverse Health Effects of Carbon Nanoparticles Are Prevented by the Compatible Solute Mannosylglycerate (Firoin) In Vitro and In Vivo

    PubMed Central

    Kroker, Matthias; Hornstein, Tamara; Ale-Agha, Niloofar; Stöckmann, Daniel; Bilstein, Andreas; Albrecht, Catrin; Paunel-Görgülü, Adnana; Suschek, Christoph V.; Krutmann, Jean; Unfried, Klaus

    2014-01-01

    The inhalation of combustion-derived nanoparticles leads to adverse health effects in the airways. In this context the induction of membrane-coupled signalling is considered as causative for changes in tissue homeostasis and pro-inflammatory reactions. The identification of these molecular cell reactions allowed to seek for strategies which interfere with these adverse effects. In the current study, we investigated the structurally different compatible solutes mannosylglycerate (firoin) from thermophilic bacteria and ectoine from halophilic bacteria for their capability to reduce signalling pathways triggered by carbon nanoparticles in target cells in the lung. The pre-treatment of lung epithelial cells with both substances decreased the particle-specific activation of mitogen-activated protein kinases and also the endpoints proliferation and apoptosis. Firoin applied into the lungs of animals, like ectoine, led to a significant reduction of the neutrophilic lung inflammation induced by particle exposure. The pro-inflammatory effect of carbon nanoparticles on human neutrophil granulocytes ex vivo was significantly reduced by both substances via the reduction of the anti-apoptotic membrane-dependent signalling. The data of this study together with earlier studies demonstrate that two structurally non-related compatible solutes are able to prevent pathogenic reactions of the airways to carbon nanoparticles by interfering with signalling events. The findings highlight the preventive or therapeutic potential of compatible solutes for adverse health effects caused by particle exposure of the airways. PMID:25415441

  11. The Health Consequences of Smoking; A Report of the Surgeon General: 1972.

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    Six times since 1964, the Public Health Service has issued formal reviews of the scientific evidence which links cigarette smoking to disease and premature death. Each successive review, including this one, has seemed to confirm and strengthen the conclusion of the 1964 Report, that cigarettes are a major cause of death and disease. In the first…

  12. Consequences of Runaway and Thrownaway Experiences for Sexual Minority Health during the Transition to Adulthood

    ERIC Educational Resources Information Center

    Pearson, Jennifer; Thrane, Lisa; Wilkinson, Lindsey

    2017-01-01

    Sexual minority youth are more likely to run away from home or experience homelessness, leaving them at increased risk of victimization and negative health outcomes. In this study, the authors use a developmental perspective that considers both vulnerable beginnings in families and the risky trajectories that follow to explore the connections…

  13. Diabetes Treatment as "Homework": Consequences for Household Knowledge and Health Practices in Rural Uganda

    ERIC Educational Resources Information Center

    Nielsen, Jannie; Bahendeka, Silver K.; Bygbjerg, Ib C.; Meyrowitsch, Dan W.; Whyte, Susan R.

    2016-01-01

    Background: Health professionals assign diabetes patients "homework" in that they give them instructions on how to manage diabetes, recognizing that most diabetes care takes place in the home setting. We studied how homework is practiced and whether knowledge and behavioral practices related to diabetes self-management diffuse from…

  14. The Social Patterning of Work-Related Insecurity and Its Health Consequences

    ERIC Educational Resources Information Center

    Scott-Marshall, Heather

    2010-01-01

    This study examines the association between work-related insecurity and health, with a focus on how this relationship is moderated by social location (gender, age and race). Drawing on longitudinal data from a Canadian labour market survey (1999-2004) the findings show that certain groups have a higher prevalence of exposure to certain types of…

  15. Experiences of racist events are associated with negative health consequences for African American women.

    PubMed Central

    Kwate, Naa Oyo A.; Valdimarsdottir, Heiddis B.; Guevarra, Josephine S.; Bovbjerg, Dana H.

    2003-01-01

    This study investigated whether experiences of racist events were related to psychological distress, negative health behaviors, and health problems. Participants were 71 African American women (mean age 44.4) who were recruited from an urban cancer-screening clinic as part of a larger longitudinal study on familial risk of breast cancer. Participants completed three study assessments, approximately one month apart, and data were collected via self-report. Correlational analyses revealed that past year and lifetime racism were both related to psychological distress. Among smokers and drinkers, past year racism was positively correlated with number of cigarettes and drinks consumed. Lifetime racism was negatively related to perceived health, and positively related to lifetime history of physical disease and frequency of recent common colds. Analyses using a general linear model revealed that these relationships were largely unaccounted for by other variables. In addition, demographic variables such as income and education were not related to experiences of racism. The results suggest that racism can be detrimental to African American's well being and should be investigated in health disparities research. PMID:12856911

  16. Consequences of ongoing civil conflict in Somalia: evidence for public health responses.

    PubMed

    Guha-Sapir, Debarati; Ratnayake, Ruwan

    2009-08-01

    Debarati Guha-Sapir and Ruwan Ratnayake use field data to demonstrate the severe vulnerability faced by much of the Somalian population due to ongoing conflict, and call for concerted public health interventions and access to food aid especially in southern Somalia.

  17. 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.

  18. Mental health consequences in men exposed to sexual abuse during the war in Croatia and Bosnia.

    PubMed

    Loncar, Mladen; Henigsberg, Neven; Hrabac, Pero

    2010-02-01

    In the research project on sexual abuse of men during the war in Croatia and Bosnia and Herzegovina, detailed information from 60 victims of such crimes was gathered. The aim of the research was to define key attributes of sexual abuse of men in war as well as consequences it had on the victims. A method of structured interview was used. Also, the statement of each victim was recorded. Victims were exposed to physical torture of their genitals, psycho-sexual torture and physical abuse. The most common symptoms of traumatic reactions were sleep disturbances, concentration difficulties, night-mares and flashbacks, feelings of hopelessness, and different physical stress symptoms such as constant headaches, profuse sweating, and tachycardia. In addition to rape and different methods of sexual abuse, most of the victims were heavily beaten. The conclusion is made that the number of sexually abused men during the war must have been much higher than reported.

  19. Health effects models for nuclear power plant accident consequence analysis. Part 1, Introduction, integration, and summary: Revision 2

    SciTech Connect

    Evans, J.S.; Abrahmson, S.; Bender, M.A.; Boecker, B.B.; Scott, B.R.; Gilbert, E.S.

    1993-10-01

    This report is a revision of NUREG/CR-4214, Rev. 1, Part 1 (1990), Health Effects Models for Nuclear Power Plant Accident Consequence Analysis. This revision has been made to incorporate changes to the Health Effects Models recommended in two addenda to the NUREG/CR-4214, Rev. 1, Part 11, 1989 report. The first of these addenda provided recommended changes to the health effects models for low-LET radiations based on recent reports from UNSCEAR, ICRP and NAS/NRC (BEIR V). The second addendum presented changes needed to incorporate alpha-emitting radionuclides into the accident exposure source term. As in the earlier version of this report, models are provided for early and continuing effects, cancers and thyroid nodules, and genetic effects. Weibull dose-response functions are recommended for evaluating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary, and gastrointestinal syndromes are considered. Linear and linear-quadratic models are recommended for estimating the risks of seven types of cancer in adults - leukemia, bone, lung, breast, gastrointestinal, thyroid, and ``other``. For most cancers, both incidence and mortality are addressed. Five classes of genetic diseases -- dominant, x-linked, aneuploidy, unbalanced translocations, and multifactorial diseases are also considered. Data are provided that should enable analysts to consider the timing and severity of each type of health risk.

  20. Effect of the Duration Time of a Nuclear Accident on Radiological Health Consequences

    PubMed Central

    Jeong, Hyojoon; Park, Misun; Jeong, Haesun; Hwang, Wontae; Kim, Eunhan; Han, Moonhee

    2014-01-01

    This study aimed to quantify the effect of duration time of a nuclear accident on the radiation dose of a densely populated area and the resulting acute health effects. In the case of nuclear accidents, the total emissions of radioactive materials can be classified into several categories. Therefore, the release information is very important for the assessment of risk to the public. We confirmed that when the duration time of the emissions are prolonged to 7 hours, the concentrations of radioactive substances in the ambient air are reduced by 50% compared to that when the duration time of emission is one hour. This means that the risk evaluation using only the first wind direction of an accident is very conservative, so it has to be used as a screening level for the risk assessment. Furthermore, it is judged that the proper control of the emission time of a nuclear accident can minimize the health effects on residents. PMID:24619120

  1. A review on human health consequences of metals exposure to e-waste in China.

    PubMed

    Song, Qingbin; Li, Jinhui

    2015-01-01

    As the world's the largest dumping ground for e-waste, much of the population in China is exposed to heavy metals due to informal e-waste recycling processes. We reviewed recent studies on body burdens and human health effects of heavy metals from the major e-waste recycling sites in China. The results showed that the residents in the e-waste recycling sites are facing a potential higher daily intake of heavy metals. Moreover, heavy metals had entered subjects' bodies (the collected 5 tissue samples). Additionally,individual exposure to heavy metals in e-waste has also caused negative health outcomes,especially in neonates and children. We also recorded plausible outcomes associated with exposure to e wast (to heavy metals). A precautionary approach toward exposure, especially in neonates and children, therefore seems warranted.

  2. The Vitamin D Deficiency Pandemic and Consequences for Nonskeletal Health: Mechanisms of Action

    PubMed Central

    Holick, Michael F.

    2008-01-01

    Vitamin D, the sunshine vitamin, is important for childhood bone health. Over the past two decades, it is now recognized that vitamin D not only is important for calcium metabolism and maintenance of bone health throughout life, but also plays an important role in reducing risk of many chronic diseases including type I diabetes, multiple sclerosis, rheumatoid arthritis, deadly cancers, heart disease and infectious diseases. How vitamin D is able to play such an important role in health is based on observation that all tissues and cells in the body have a vitamin D receptor, and, thus, respond to its active form 1,25-dihydroxyvitamin D. However, this did not explain how living at higher latitudes and being at risk of vitamin D deficiency increased risk of these deadly diseases since it was also known that the 1,25-dihydroxyvitamin D levels are normal or even elevated when a person is vitamin D insufficient. Moreover, increased intake of vitamin D or exposure to more sunlight will not induce the kidneys to produce more 1,25-dihydroxyvitamin D. The revelation that the colon, breast, prostate, macrophages and skin among other organs have the enzymatic machinery to produce 1,25-dihydroxyvitamin D provides further insight as to how vitamin D plays such an essential role for overall health and well being. This review will put into perspective many of the new biologic actions of vitamin D and on how 1,25-dihydroxyvitamin D is able to regulate directly or indirectly more than 200 different genes that are responsible for a wide variety of biologic processes. PMID:18801384

  3. The underdevelopment of health of working America: causes, consequences and possible solutions.

    PubMed Central

    Navarro, V

    1976-01-01

    This article presents the health conditions of working America, and provides an analysis of the causes of that situation. It is postulated that the main health problems in the U.S. are due not to prevalent life styles-as the behavioralists indicate-but to the dramatic maldistribution of economic and political power in our society, with the absence of control by the majority of the U.S. population-the working and lower-middle classes-over the work process with which they are involved, the economic wealth that they produce, and the political institutions that they pay for. The production of goods and wealth as well as the political institutions of the United States are dominated and controlled by a minority of our population-the corporate and upper-middle classes. Empirical information is presented to support this postulate. In light of this explanation, it is asserted that a major public health task is to deliberately and actively contribute to the political mobilization of forces aimed at bringing about profound changes in the pattern of control of our working insitutions and of the distribution of wealth and political power, changes which seek to shift that control from the few to the many. PMID:937599

  4. RISKIND: A computer program for calculating radiological consequences and health risks from transportation of spent nuclear fuel

    SciTech Connect

    Yuan, Y.C.; Chen, S.Y.; LePoire, D.J.; Rothman, R.

    1993-02-01

    This report presents the technical details of RISIUND, a computer code designed to estimate potential radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel. RISKIND is a user-friendly, semiinteractive program that can be run on an IBM or equivalent personal computer. The program language is FORTRAN-77. Several models are included in RISKIND that have been tailored to calculate the exposure to individuals under various incident-free and accident conditions. The incidentfree models assess exposures from both gamma and neutron radiation and can account for different cask designs. The accident models include accidental release, atmospheric transport, and the environmental pathways of radionuclides from spent fuels; these models also assess health risks to individuals and the collective population. The models are supported by databases that are specific to spent nuclear fuels and include a radionudide inventory and dose conversion factors.

  5. Mental health consequences of international migration for Vietnamese Americans and the mediating effects of physical health and social networks: results from a natural experiment approach.

    PubMed

    Fu, Hongyun; VanLandingham, Mark J

    2012-05-01

    Although the existing literature on immigrant mental health is extensive, major substantive and methodological gaps remain. Substantively, there is little population-based research that focuses on the mental health consequences of migration for Vietnamese Americans. More generally, although a wide range of mental health problems among immigrants has been identified, the potential causal or mediating mechanisms underlying these problems remain elusive. This latter substantive shortcoming is related to a key methodological challenge involving the potentially confounding effects of selection on migration-related outcomes. This article addresses these challenges by employing a "natural experiment" design, involving comparisons among three population-based samples of Vietnamese immigrants, never-leavers, and returnees (N=709). Data were collected in Ho Chi Minh City and in New Orleans between 2003 and 2005. The study investigates the long-term impact of international migration on Vietnamese mental health, and the potential mediating effects of social networks and physical health on these migration-related outcomes. The results reveal both mental health advantages and disadvantages among Vietnamese immigrants relative to the two groups of Vietnamese nationals. Selection can be ruled out for some of these differences, and both social networks and physical health are found to play important explanatory roles.

  6. Health consequences of the snow disaster in Massachusetts, February 6, 1978.

    PubMed Central

    Glass, R I; O'Hare, P; Conrad, J L

    1979-01-01

    On February 6, 1978, the largest New England blizzard of the century struck eastern Massachusetts. On request, four days later, the Center for Disease Control provided epidemiologic assistance. On-site disaster assistance provided decision-makers with immediate health surveillance information useful in helping the area return to normal. No outbreaks of infectious diseases and no significant increase in the number of deaths were observed in the week following the blizzard. Some of the deaths which occurred immediately after the blizzard might have been prevented if traffic had been banned earlier. PMID:225958

  7. Toyotism in Brazil: the contrast between discourse and practice and the consequences for workers' health.

    PubMed

    Bernardo, Marcia Hespanhol; Sato, Leny

    2010-01-01

    In recent decades, a predominant discourse has emerged in the media, particularly in the business management literature, that affirms moving beyond rigid Taylorism-Fordism to a more flexible work organization model considered to be more humanized. This article presents some results of a study that analyzed the experiences of workers in two Japanese automobile plants in Brazil with respect to aspects of the organization of work that have been promoted as positive by this predominant business management discourse. The plants studied employ the Japanese production model which has served as the principal reference for the idea of increased flexibility. The ethnographic methodology used included open-ended interviews (individual and in groups), informal conversation with workers, and participation in activities promoted by the union that represented the workers interviewed. The data analyzed took into account the experience of more than 40 workers. We conclude that the consequences of the work experiences of the workers who participated in the study are mental suffering and illness, and not a more humane work environment, as many business management publications have argued.

  8. Consequences of Job Insecurity on the Psychological and Physical Health of Greek Civil Servants

    PubMed Central

    Nella, Dimitra; Panagopoulou, Efharis; Galanis, Nikiforos; Montgomery, Anthony; Benos, Alexis

    2015-01-01

    The aim of this study was to estimate the short term consequences of job insecurity associated with a newly introduced mobility framework in Greece. In specific, the study examined the impact of job insecurity on anxiety, depression, and psychosomatic and musculoskeletal symptoms, two months after the announcement of the mobility framework. In addition the study also examined the “spill over” effects of job insecurity on employees not directly affected by the mobility framework. Personal interviews using a structured questionnaire were conducted for 36 university administrative employees awaiting repositioning, 36 coworkers not at risk, and 28 administrative employees of a local hospital not at risk. Compared to both control groups the employees in the anticipation phase of labor mobility had significantly worse scores for perceived stress, anxiety, depression, positive affect, negative affect, social support, marital discord, common somatic symptoms, and frequency of musculoskeletal pain. This study highlights the immediate detrimental effects of job insecurity on the physical, psychological, and social functioning of employees. There is a need for the development of front line interventions to prevent these effects from developing into chronic conditions with considerable cost for the individual and society in general. PMID:26557687

  9. Consequences of Job Insecurity on the Psychological and Physical Health of Greek Civil Servants.

    PubMed

    Nella, Dimitra; Panagopoulou, Efharis; Galanis, Nikiforos; Montgomery, Anthony; Benos, Alexis

    2015-01-01

    The aim of this study was to estimate the short term consequences of job insecurity associated with a newly introduced mobility framework in Greece. In specific, the study examined the impact of job insecurity on anxiety, depression, and psychosomatic and musculoskeletal symptoms, two months after the announcement of the mobility framework. In addition the study also examined the "spill over" effects of job insecurity on employees not directly affected by the mobility framework. Personal interviews using a structured questionnaire were conducted for 36 university administrative employees awaiting repositioning, 36 coworkers not at risk, and 28 administrative employees of a local hospital not at risk. Compared to both control groups the employees in the anticipation phase of labor mobility had significantly worse scores for perceived stress, anxiety, depression, positive affect, negative affect, social support, marital discord, common somatic symptoms, and frequency of musculoskeletal pain. This study highlights the immediate detrimental effects of job insecurity on the physical, psychological, and social functioning of employees. There is a need for the development of front line interventions to prevent these effects from developing into chronic conditions with considerable cost for the individual and society in general.

  10. Health effects models for nuclear power plant accident consequence analysis: Low LET radiation

    SciTech Connect

    Evans, J.S. . School of Public Health)

    1990-01-01

    This report describes dose-response models intended to be used in estimating the radiological health effects of nuclear power plant accidents. Models of early and continuing effects, cancers and thyroid nodules, and genetic effects are provided. Weibull dose-response functions are recommended for evaluating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary, and gastrointestinal syndromes -- are considered. In addition, models are included for assessing the risks of several nonlethal early and continuing effects -- including prodromal vomiting and diarrhea, hypothyroidism and radiation thyroiditis, skin burns, reproductive effects, and pregnancy losses. Linear and linear-quadratic models are recommended for estimating cancer risks. Parameters are given for analyzing the risks of seven types of cancer in adults -- leukemia, bone, lung, breast, gastrointestinal, thyroid, and other.'' The category, other'' cancers, is intended to reflect the combined risks of multiple myeloma, lymphoma, and cancers of the bladder, kidney, brain, ovary, uterus and cervix. Models of childhood cancers due to in utero exposure are also developed. For most cancers, both incidence and mortality are addressed. The models of cancer risk are derived largely from information summarized in BEIR III -- with some adjustment to reflect more recent studies. 64 refs., 18 figs., 46 tabs.

  11. Causes, Consequences and Public Health Implications of Low B-Vitamin Status in Ageing

    PubMed Central

    Porter, Kirsty; Hoey, Leane; Hughes, Catherine F.; Ward, Mary; McNulty, Helene

    2016-01-01

    The potential protective roles of folate and the metabolically related B-vitamins (vitamins B12, B6 and riboflavin) in diseases of ageing are of increasing research interest. The most common cause of folate and riboflavin deficiencies in older people is low dietary intake, whereas low B12 status is primarily associated with food-bound malabsorption, while sub-optimal vitamin B6 status is attributed to increased requirements in ageing. Observational evidence links low status of folate and the related B-vitamins (and/or elevated concentrations of homocysteine) with a higher risk of degenerative diseases including cardiovascular disease (CVD), cognitive dysfunction and osteoporosis. Deficient or low status of these B-vitamins alone or in combination with genetic polymorphisms, including the common MTHFR 677 C → T polymorphism, could contribute to greater disease risk in ageing by causing perturbations in one carbon metabolism. Moreover, interventions with the relevant B-vitamins to optimise status may have beneficial effects in preventing degenerative diseases. The precise mechanisms are unknown but many have been proposed involving the role of folate and the related B-vitamins as co-factors for one-carbon transfer reactions, which are fundamental for DNA and RNA biosynthesis and the maintenance of methylation reactions. This review will examine the evidence linking folate and related B-vitamins with health and disease in ageing, associated mechanisms and public health implications. PMID:27854316

  12. Sexual violence among female undergraduates in a tertiary institution in Port Harcourt: prevalence, pattern, determinants and health consequences.

    PubMed

    Mezie-Okoye, Margaret-Mary M M M; Alamina, Folusho F

    2014-12-01

    The prevalence, pattern, determinants and health consequences of sexual violence on female undergraduates attending the University of Port Harcourt in the Niger-Delta region of Nigeria was investigated. The study was a cross-sectional study involving 413 female students, and consisted of self-administered questionnaires. Data were analysed using Epi Info v6.04d and presented as frequency tables. Associations were tested using Chi square and Odds Ratio, p < 0.05, at 95% CI. Mean age was 22.1 +/- 2.8. One hundred and ninety three (46.7%) had suffered from one form of sexual violence or the another. Fondling/grabbing of sensitive body parts was the commonest 65(33.7%) form of sexual violence. Intimate partners topped the list of perpetrators. Year of study (p=0.006, OR 0.57, CI=0.39-0.85), prior victimization (p=0.049, OR=1.52, CI = 1.00-2.30) and consensual sexual activity (p=0.001, OR=1.92, CI = 1.29-2.84) were associated with sexual violence. Depression and guilt were the major health consequences reported. Sexual violence is high at the University of Port Harcourt, which warrants targeted preventive action.

  13. Stress, Behavior and Health: Developing a Model for Predicting Post-Deployment Morbidity, Mortality and Other Adverse Outcomes

    DTIC Science & Technology

    1999-07-01

    PHYSICAL , AND MENTAL HEALTH FACTORS ASSOCIATED WITH DEPLOYMENT OF US ARMY SOLDIERS TO THE PERSIAN GULF .......................................... 59...34Demographic, physical , and mental health factors associated with deployment of US Army soldiers to the Persian Gulf," currently under review at Military...height, weight, tobacco and alcohol use, age at menarche, family cancer history, last physical exam, serum cholesterol, last mammogram, name, and

  14. Health consequences of Chernobyl: the New York Academy of Sciences publishes an antidote to the nuclear establishment's pseudo-science.

    PubMed

    Katz, Alison Rosamund

    2010-01-01

    In February 2010, the New York Academy of Sciences published the most complete and up-to-date collection of evidence, from independent, scientific sources all over the world, on the health and environmental consequences of the Chernobyl accident. For 24 years, through a high-level, internationally coordinated cover-up of the world's most serious industrial accident, the nuclear lobby has deprived the world of a unique and critically important source of scientific information. The International Atomic Energy Agency (IAEA), mouthpiece of the nuclear establishment, has coordinated the cover-up through the dissemination and imposition of crude pseudo-science. Regrettably, the World Health Organization, a U.N. agency on which the world's people rely for guidance, is subordinate to the IAEA in matters of radiation and health, has participated in the cover-up, and stands accused of non-assistance to populations in danger. The new book on Chernobyl makes available huge amounts of evidence from independent studies undertaken in the affected countries, unique and valuable data that have been ignored by the international health establishment. This comprehensive account of the full dimensions of the catastrophe reveals the shameful inadequacy of current international assistance to the affected populations. It also demonstrates, once more, that future energy options cannot include nuclear power.

  15. Evaluating and understanding fish health risks and their consequences in propagated and free-ranging fish populations

    USGS Publications Warehouse

    Moffitt, C.M.; Haukenes, A.H.; Williams, C.J.

    2005-01-01

    Fishery managers and resource conservationists are increasingly interested in understanding the fish health and disease risks of free-ranging fishes and whether propagated fishes or features and practices used at fish culture facilities pose a health risk to free-ranging populations. Disease agents are present in most both captive and all free-ranging fish populations, but the consequences and extent of infections in free-ranging populations are often difficult to measure, control, and understand. Sampling methods, protocols, and assay techniques developed to assess the health of captive populations are not as applicable for assessments of free-ranging fishes. The use of chemicals and therapeutics to control diseases and parasites in propagated fishes likely reduces the risk of introducing specific pathogens into the environment, but control measures may have localized effects on the environment surrounding fish culture facilities. To understand health risks of propagated and free ranging fishes, we must consider fish populations, culture facilities, fish releases, and their interactions within the greater geospatial features of the aquatic environment. ?? 2004 by the American Fisheries Society.

  16. 2013 Immune Risk Standing Review Panel Evidence Review for: The Risk of Crew Adverse Health Event Due to Altered Immune Response

    NASA Technical Reports Server (NTRS)

    Steinberg, Susan

    2014-01-01

    The 2013 Immune Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on February 3-4, 2014. The SRP reviewed the new Evidence Report for the Risk of Crew Adverse Health Event Due to Altered Immune Response (from here on referred to as the 2013 Immune Evidence Report), as well as the Research Plan for this Risk that is in the current version of the Human Research Program’s (HRP) Integrated Research Plan (IRP).

  17. Mental health and the psychosocial consequences of natural disasters in Asia.

    PubMed

    Udomratn, Pichet

    2008-10-01

    This article presents an overview of natural disasters in Asia, as well as mental disorders and psychosocial interventions related to disasters. Although most of the top ten worst natural disasters occurred in Asia over the past century, little is known about the mental health and psychosocial aspects. After the tsunami incident in 2004, research reports in international journals related to Asian disasters have been growing. The prevalence rate of post-traumatic stress disorder related to natural disasters is currently between 8.6% and 57.3% depending on assessment methodologies, instruments and timing. Cognitive behaviour therapy has been found to be effective with Asian survivors but needs to be adapted for cultural and local sensitivities. Further research is needed in the areas of epidemiology for mental disorders and suitable psychosocial interventions for disaster survivors in Asia.

  18. Overweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem.

    PubMed

    Williams, Ellen P; Mesidor, Marie; Winters, Karen; Dubbert, Patricia M; Wyatt, Sharon B

    2015-09-01

    This review considers a variety of perspectives on overweight and obesity (OW/obesity), including measurement and classification; prevalence and changes in prevalence in recent years; genetic, biological, medical, individual, and social correlates of OW/obesity; and treatment approaches. Despite increased attention, OW/obesity is escalating in prevalence worldwide, and the causes are exceedingly complex. A range of innovative studies, including basic research on gut microflora, dietary composition, pharmacologic interventions, and surgical procedures, is generating findings with potential for future prevention and treatment of OW/obesity. Social system changes such as school programs and the awareness of the roles of personal, family, health provider, and cultural experiences related to OW/obesity have also gained traction for vital prevention and treatment efforts over the past decade.

  19. Rate of establishing the gut microbiota in infancy has consequences for future health

    PubMed Central

    Dogra, Shaillay; Sakwinska, Olga; Soh, Shu-E; Ngom-Bru, Catherine; Brück, Wolfram M; Berger, Bernard; Brüssow, Harald; Karnani, Neerja; Lee, Yung Seng; Yap, Fabian; Chong, Yap-Seng; Godfrey, Keith M; Holbrook, Joanna D

    2015-01-01

    The gut of the human neonate is colonized rapidly after birth from an early sparse and highly distinct microbiota to a more adult-like and convergent state, within 1 to 3 years. The progression of colonizing bacterial species is non-random. During the first months of life several shifts commonly occur in the species prevalent in our guts. Although the sequential progression of these species is remarkably consistent across individuals and geographies, there is inter-individual variation in the rate of progression. Our study and others suggest that the rate is influenced by environmental factors, and influences our future health. In this article, we review our recent contribution to cataloging the developing infant gut microbiota alongside other important recent studies. We suggest testable hypotheses that arise from this synthesis. PMID:26516657

  20. The bifidogenic effect of inulin and oligofructose and its consequences for gut health.

    PubMed

    Meyer, D; Stasse-Wolthuis, M

    2009-11-01

    The bifidogenic effect of inulin and oligofructose is now well established in various studies, not only in adult participants but also in other age groups. This bifidogenic shift in the composition of the colonic microbiota is likely the basis for the impact of these prebiotic compounds on various parameters of colonic function. Mainly from animal and in vitro studies and also from some human trials, there are indications, for instance, that inulin-type fructans may reduce the production of potentially toxic metabolites and may induce important immune-mediated effects. This review discusses how these changes in the composition and activity of the colonic microbiota may affect gut health in healthy people, including in those who may experience some form of gastrointestinal discomfort.

  1. Testing the dose-response specification in epidemiology: public health and policy consequences for lead.

    PubMed

    Rothenberg, Stephen J; Rothenberg, Jesse C

    2005-09-01

    Statistical evaluation of the dose-response function in lead epidemiology is rarely attempted. Economic evaluation of health benefits of lead reduction usually assumes a linear dose-response function, regardless of the outcome measure used. We reanalyzed a previously published study, an international pooled data set combining data from seven prospective lead studies examining contemporaneous blood lead effect on IQ (intelligence quotient) of 7-year-old children (n = 1,333). We constructed alternative linear multiple regression models with linear blood lead terms (linear-linear dose response) and natural-log-transformed blood lead terms (log-linear dose response). We tested the two lead specifications for nonlinearity in the models, compared the two lead specifications for significantly better fit to the data, and examined the effects of possible residual confounding on the functional form of the dose-response relationship. We found that a log-linear lead-IQ relationship was a significantly better fit than was a linear-linear relationship for IQ (p = 0.009), with little evidence of residual confounding of included model variables. We substituted the log-linear lead-IQ effect in a previously published health benefits model and found that the economic savings due to U.S. population lead decrease between 1976 and 1999 (from 17.1 microg/dL to 2.0 microg/dL) was 2.2 times (319 billion dollars) that calculated using a linear-linear dose-response function (149 billion dollars). The Centers for Disease Control and Prevention action limit of 10 microg/dL for children fails to protect against most damage and economic cost attributable to lead exposure.

  2. Health consequences of the first Persian Gulf War on French troops.

    PubMed

    Salamon, R; Verret, C; Jutand, M A; Bégassat, M; Laoudj, F; Conso, F; Brochard, P

    2006-04-01

    Since 1993, many studies on the health of Persian Gulf War Veterans (PGWV) have been undertaken. These studies have concluded that there has been an increased mortality due to external causes, no excess of recognized diseases, and no effect on PGWV children. When compared with the non-deployed, PGWV have reported a higher frequency of infertility as well as different symptoms, but a specific Gulf War syndrome was not identified. In October 2000, the French government asked an independent working group to analyse the scientific literature on PGWV health. The group concluded that an exhaustive study of French PGWV was to be undertaken. The objectives of this study were to describe the exposures of PGWV in the operations theatre, to report on the symptoms and diseases that occurred in PGWV and their children during and after the military campaign, and to explore the possibility of a Gulf War syndrome. This exhaustive cross-sectional study, which included all civilians and troops who served in the Gulf from August 1990 to July 1991, began in January 2002. Data were collected by postal self-administered questionnaires. A standardized clinical evaluation was performed by 27 clinics of occupational diseases and nine military hospitals. Symptoms and diseases which appeared after the campaign are described. To date, among 20,261 PGWV, 5,666 participated in the study (28%). The most frequent symptoms described since the return from the Gulf were headaches (83%), neurological or psychological symptoms, and back pain. Apart from well-known symptoms associations (respiratory, neurocognitive, psychological and musculo-skeletal syndromes), no other cluster was highlighted by our analysis.

  3. Household Food Insecurity Is Associated with Adverse Mental Health Indicators and Lower Quality of Life among Koreans: Results from the Korea National Health and Nutrition Examination Survey 2012–2013

    PubMed Central

    Chung, Hye-Kyung; Kim, Oh Yoen; Kwak, So Young; Cho, Yoonsu; Lee, Kyong Won; Shin, Min-Jeong

    2016-01-01

    Food insecurity is an ongoing public health issue and contributes to mental health status. We investigated whether food insecurity is associated with inadequate nutrient intake and whether it affects mental health indicators (perceived stress/experience of depressive symptom/suicidal ideation) and quality of life (QOL) among Koreans (n = 5862, 20–64 years) using data from the Korea National Health and Nutritional Examination Survey (2012–2013). Household food security status was categorized as “food-secure household”, “food-insecure household without hunger”, and “food-insecure household with hunger”. Data on food insecurity, sociodemographic factors, nutrient intake, mental health indicators, and QOL were used. A logistic regression model was conducted to determine odds ratios (ORs) for psychological health