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Sample records for affect population health

  1. [Factors affecting access to health care institutions by the internally displaced population in Colombia].

    PubMed

    Mogollón-Pérez, Amparo Susana; Vázquez, María Luisa

    2008-04-01

    In Colombia, the on-going armed conflict causes displacement of thousands of persons that suffer its economic, social, and health consequences. Despite government regulatory efforts, displaced people still experience serious problems in securing access to health care. In order to analyze the institutional factors that affect access to health care by the internally displaced population, a qualitative, exploratory, and descriptive study was carried out by means of semi-structured individual interviews with a criterion sample of stakeholders (81). A narrative content analysis was performed, with mixed generation of categories and segmentation of data by themes and informants. Inadequate funding, providers' problems with reimbursement by insurers, and lack of clear definition as to coverage under the Social Security System in Health pose barriers to access to health care by the internally displaced population. Bureaucratic procedures, limited inter- and intra-sector coordination, and scarce available resources for public health service providers also affect access. Effective government action is required to ensure the right to health care for this population.

  2. Famine-affected, refugee, and displaced populations: recommendations for public health issues.

    PubMed

    1992-07-24

    During the past three decades, the most common emergencies affecting the health of large populations in developing countries have involved famine and forced migrations. The public health consequences of mass population displacement have been extensively documented. On some occasions, these migrations have resulted in extremely high rates of mortality, morbidity, and malnutrition. The most severe consequences of population displacement have occurred during the acute emergency phase, when relief efforts are in the early stage. During this phase, deaths--in some cases--were 60 times the crude mortality rate (CMR) among non-refugee populations in the country of origin (1). Although the quality of international disaster response efforts has steadily improved, the human cost of forced migration remains high. Since the early 1960s, most emergencies involving refugees and displaced persons have taken place in less developed countries where local resources have been insufficient for providing prompt and adequate assistance. The international community's response to the health needs of these populations has been at times inappropriate, relying on teams of foreign medical personnel with little or no training. Hospitals, clinics, and feeding centers have been set up without assessment of preliminary needs, and essential prevention programs have been neglected. More recent relief programs, however, emphasize a primary health care (PHC) approach, focusing on preventive programs such as immunization and oral rehydration therapy (ORT), promoting involvement by the refugee community in the provision of health services, and stressing more effective coordination and information gathering. The PHC approach offers long-term advantages, not only for the directly affected population, but also for the country hosting the refugees. A PHC strategy is sustainable and strengthens the national health development program.

  3. The impact of digital technology on health of populations affected by humanitarian crises: Recent innovations and current gaps.

    PubMed

    Mesmar, Sandra; Talhouk, Reem; Akik, Chaza; Olivier, Patrick; Elhajj, Imad H; Elbassuoni, Shady; Armoush, Sarah; Kalot, Joumana; Balaam, Madeline; Germani, Aline; Ghattas, Hala

    2016-11-01

    Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports, we identified 50 digital technologies used by humanitarian actors, and/or populations affected by crises. We organized them according to the stage of the humanitarian cycle that they were used in, and the health outcomes or determinants of health they affected. Digital technologies were found to facilitate communication, coordination, and collection and analysis of data, enabling timely responses in humanitarian contexts. A lack of evaluation of these technologies, a paternalistic approach to their development, and issues of privacy and equity constituted major challenges. We highlight the need to create a space for dialogue between technology designers and populations affected by humanitarian crises.

  4. Intimate Partner Violence and Its Health Impact on Disproportionately Affected Populations, Including Minorities and Impoverished Groups

    PubMed Central

    Hayashi, Hitomi; Campbell, Jacquelyn C.

    2015-01-01

    Abstract In the United States, intimate partner violence (IPV) against women disproportionately affects ethnic minorities. Further, disparities related to socioeconomic and foreign-born status impact the adverse physical and mental health outcomes as a result of IPV, further exacerbating these health consequences. This article reviews 36 U.S. studies on the physical (e.g., multiple injuries, disordered eating patterns), mental (e.g., depression, post-traumatic stress disorder), and sexual and reproductive health conditions (e.g., HIV/STIs, unintended pregnancy) resulting from IPV victimization among ethnic minority (i.e., Black/African American, Hispanic/Latina, Native American/Alaska Native, Asian American) women, some of whom are immigrants. Most studies either did not have a sufficient sample size of ethnic minority women or did not use adequate statistical techniques to examine differences among different racial/ethnic groups. Few studies focused on Native American/Alaska Native and immigrant ethnic minority women and many of the intra-ethnic group studies have confounded race/ethnicity with income and other social determinants of health. Nonetheless, of the available data, there is evidence of health inequities associated with both minority ethnicity and IPV. To appropriately respond to the health needs of these groups of women, it is necessary to consider social, cultural, structural, and political barriers (e.g., medical mistrust, historical racism and trauma, perceived discrimination, immigration status) to patient–provider communication and help-seeking behaviors related to IPV, which can influence health outcomes. This comprehensive approach will mitigate the racial/ethnic and socioeconomic disparities related to IPV and associated health outcomes and behaviors. PMID:25551432

  5. Violence Affects Physical and Mental Health Differently: The General Population Based Tromsø Study

    PubMed Central

    Friborg, Oddgeir; Emaus, Nina; Rosenvinge, Jan H.; Bilden, Unni; Olsen, Jan Abel; Pettersen, Gunn

    2015-01-01

    This general population-based study examined associations between violence and mental health, musculoskeletal pain, and early disability pension. The prevalence and consequences of good vs. poor adjustment (resilience vs. vulnerability) following encounters with violence were also examined. Data were based on the sixth wave of the “Tromsø Study” (N = 12,981; 65.7% response rate, 53.4% women, M-age = 57.5 years, SD-age = 12.7 years). Self-reported data on psychological (threats) and physical violence (beaten/kicked), mental health (anxiety/depression), musculoskeletal pain (MSP), and granting of disability pension (DP) were collected. Men suffered more violent events during childhood than women did, and vice versa during adulthood. Psychological violence implied poorer mental health and slightly more MSP than physical violence. The risk of MSP was highest for violence occurring during childhood in women and during the last year for men. A dose-response relationship between an increasing number of violent encounters and poorer health was observed. About 58% of individuals reported no negative impact of violence (hence, resilience group), whereas 42% considered themselves as more vulnerable following encounters with violence. Regression analyses indicated comparable mental health but slightly more MSP in the resilience group compared to the unexposed group, whereas the vulnerable group had significantly worse health overall and a higher risk of early granting of DP. Resilience is not an all-or-nothing matter, as physical ailments may characterize individuals adapting well following encounters with violence. PMID:26317970

  6. Female athletes: a population at risk of vitamin and mineral deficiencies affecting health and performance.

    PubMed

    McClung, James P; Gaffney-Stomberg, Erin; Lee, Jane J

    2014-10-01

    Adequate vitamin and mineral status is essential for optimal human health and performance. Female athletes could be at risk for vitamin and mineral insufficiency due to inadequate dietary intake, menstruation, and inflammatory responses to heavy physical activity. Recent studies have documented poor iron status and associated declines in both cognitive and physical performance in female athletes. Similarly, insufficient vitamin D and calcium status have been observed in female athletes, and may be associated with injuries, such as stress fracture, which may limit a female athlete's ability to participate in regular physical activity. This review will focus on recent studies detailing the prevalence of poor vitamin and mineral status in female athletes, using iron, vitamin D, and calcium as examples. Factors affecting the dietary requirement for these vitamins and minerals during physical training will be reviewed. Lastly, countermeasures for the prevention of inadequate vitamin and mineral status will be described.

  7. Layered stigma among health-care and social service providers toward key affected populations in Jamaica and The Bahamas.

    PubMed

    Rogers, S J; Tureski, K; Cushnie, A; Brown, A; Bailey, A; Palmer, Q

    2014-01-01

    While considerable research has documented stigma toward key populations affected by HIV and AIDS - men who have sex with men (MSM), sex workers (SWs) - it provided limited empirical evidence on the presence of layered stigma among health-care professionals providing services for these populations. C-Change conducted a survey among 332 staff of health-care and social service agencies in Jamaica and The Bahamas to understand the levels of stigma toward people living with HIV (PLHIV), including MSM and SWs and factors associated with stigma. While most health-care professionals responding to the survey said that PLHIV, MSM, and SWs deserved quality care, they expressed high levels of blame and negative judgments, especially toward MSM and SWs. Across a stigma assessment involving eight vignette characters, the highest levels of stigma were expressed toward PLHIV who were also MSM or SWs, followed by PLHIV, MSM, and SWs. Differences were assessed by gender, country, type of staff, type of agency, and exposure to relevant training. Findings indicate higher reported stigma among nonclinical vs. clinical staff, staff who worked in general vs. MSM/SW-friendly health facilities, and among untrained vs. training staff. This implies the need for targeted staff capacity strengthening as well as improved facility environments that are MSM/SW-friendly.

  8. The ISTSS/Rand guidelines on mental health training of primary healthcare providers for trauma-exposed populations in conflict-affected countries.

    PubMed

    Eisenman, David; Weine, Stevan; Green, Bonnie; de Jong, Joop; Rayburn, Nadine; Ventevogel, Peter; Keller, Allen; Agani, Ferid

    2006-02-01

    Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.

  9. Negative Health Comparisons Decrease Affective and Cognitive Well-Being in Older Adults. Evidence from a Population-Based Longitudinal Study in Germany

    PubMed Central

    Hajek, André; König, Hans-Helmut

    2016-01-01

    Purpose: To examine the effect of health comparisons on affective (AWB) and cognitive well-being (CWB) in older adults longitudinally. Methods: Data were derived from the third and fourth wave of the German Ageing Survey (DEAS) which is a population-based prospective cohort study of community-dwelling subjects in Germany aged 40 and above (with 8,277 observations in fixed effects regressions). Health comparisons were assessed by the question “How would you rate your health compared with other people your age” (Much better; somewhat better; the same; somewhat worse, much worse). While AWB was quantified by using the Positive and Negative Affect Schedule (PANAS), CWB was assessed by using the Satisfaction with Life Scale (SWLS). Fixed effects regressions were used to analyze the effect of health comparisons on AWB and CWB. Results: While positive health comparisons only slightly increased CWB (total sample), negative health comparisons markedly decreased CWB (total sample and women), and negative affects (women). Neither positive nor negative health comparisons affected positive affects. Conclusions: Our findings stress the importance of negative health comparisons for CWB and negative affects in women. Comparison effects are asymmetric and in most cases upwards. Consequently, designing interventions to avoid upwards health comparisons might be a fruitful approach in order to maintain AWB and CWB. PMID:27445953

  10. [Roma populations and health].

    PubMed

    Jackson, Y; Tabin, J P; Hourton, G; Bodenmann, P

    2015-03-25

    The health status of the so-called "Roma" is usually much poorer than that of neighbouring non-Roma populations with a life expectancy gap of 5-15 years. This results from prolonged exposure to adverse determinants of health and to persistent exclusion from social and political arenas. Scientific and social research has only poorly addressed the health issues of Roma and evidences are scarce. Insufficient access to public services, including to health care and non optimal clinical practices are modifiable factors. If correctly addressed, this could contribute to reduce health disparities, including in Switzerland.

  11. Respiratory symptoms increase health care consumption and affect everyday life – a cross-sectional population-based study from Finland, Estonia, and Sweden

    PubMed Central

    Axelsson, Malin; Lindberg, Anne; Kainu, Annette; Rönmark, Eva; Jansson, Sven-Arne

    2016-01-01

    Background Even though respiratory symptoms are common in the adult population, there is limited research describing their impact on everyday life and association with health care consumption. Aim The main objective of this population-based study was to estimate and compare the prevalence of respiratory symptoms among adults in Finland, Estonia, and Sweden in relation to health care consumption and to identify factors influencing health care consumption. A secondary aim was to assess to which extent the presence of respiratory symptoms affect everyday life. Method In the population-based FinEsS studies consisting of random samples of subjects aged 20 to 69 years from Finland (n=1,337), Estonia (n=1,346), and Sweden (n=1,953), data on demographics, respiratory health, and health care consumption were collected by structured interviews. Prevalence was compared and multiple logistic regression analyses were performed. Results Respiratory symptoms were significantly more common in Finland (66.0%) and Estonia (65.2%) than in Sweden (54.1%). Among subjects with respiratory symptoms, the proportion reporting outpatient care during the past year was fairly similar in the three countries, while specialist consultations were more common in Finland (19.1%), and hospitalisations more common in Estonia (15.0%). Finnish and Estonian residency, female sex, and BMI>25 increased the risk for outpatient care consumption. Wheeze and attacks of shortness of breath in the past 12 months, recurrent sputum production, and cough were associated with an increased risk for health care consumption. Increasing number of respiratory symptoms increased the risk for consuming health care. A larger proportion of subjects in Estonia and Sweden experienced their everyday life being affected by respiratory symptoms compared with subjects in Finland. Conclusion Respiratory symptoms are common in Finland, Estonia, and Sweden and contribute to a negative impact on everyday life as well as increased

  12. Dynamics of resilience in forced migration: a 1-year follow-up study of longitudinal associations with mental health in a conflict-affected, ethnic Muslim population

    PubMed Central

    Siriwardhana, Chesmal; Abas, Melanie; Siribaddana, Sisira; Sumathipala, Athula; Stewart, Robert

    2015-01-01

    Objective The concept of ‘resilience’ is of increasing interest in studies of mental health in populations facing adversity. However, lack of longitudinal data on the dynamics of resilience and non-usage of resilience-specific measurements have prevented a better understanding of resilience-mental health interactions. Hence, the present study was conducted to investigate the stability of levels of resilience and its associations with sociodemographic and mental health exposures in a conflict-affected internal-migrant population in Sri Lanka. Design A prospective follow-up study of 1 year. Setting Puttalam district of North Western province in postconflict Sri Lanka (baseline in 2011, follow-up in 2012). Participants An ethnic Muslim population internally displaced 20 years ago (in 1990) from Northern Sri Lanka, aged 18 or above and currently in the process of return migration. Measures It was hypothesised that levels of resilience would be associated with mental health outcomes. Resilience was measured on both occasions using the 14-item Resilience Scale (RS-14), social support by the Multidimensional Social Support Scale and Lubben Social Network Scale and common mental disorders by the Patient Health Questionnaire (PHQ). Results Of 450 participants interviewed at baseline in 2011, 338 (75.1%) were re-interviewed in 2012 after a 1-year follow-up. The mean resilience scores measured by RS-14 were 80.2 (95% CI 78.6 to 81.9) at baseline and 84.9 (83.5 to 86.3) at follow-up. At both time points, lower resilience was independently associated with food insecurity, lower social support availability and social isolation. At both time points, there were significant associations with common mental disorders (CMDs) in unadjusted analyses, but they only showed independence at baseline. The CMD prevalence, maintenance and incidence at follow-up was 8.3%, 28.2% and 2.2%, respectively. Conclusions In this displaced population facing a potential reduction in adversity

  13. Climate Change, Health, and Populations of Concern

    EPA Pesticide Factsheets

    This page contains communication materials that summarize key points from the U.S. Climate and Health Assessment for eight different populations that are disproportionately affected by climate change impacts.

  14. Population, nutrition and health.

    PubMed

    1982-06-01

    The World Health Organization defines health as not only the absence of disease but as a more positive state of physical, mental, and social well-being. 1 of the most important influences on health is nutrition. Millions of people throughout the world either do not get enough to eat or do not get enough of the right kinds of food. Malnutrition is the biggest single contributor to child mortality in developing countries; malnourished children have an impaired ability to fight infection and disease. Children suffering protein-energy or protein-calorie malnutrition may develop nutritional deficiency diseases such as marasmus or kwashiorkor. Some estimates indicate that 2/3 of children in developing countries suffer from protein-calorie malnutrition. Some deficiency diseases caused by a lack of 1 or more nutrients are very widespread, such as anemia, endemic goiter, and xerophthalmia. Contributing factors for malnutrition may include low purchasing power of poor families, poor harvests due to crop failure, bad weather, food spoilage, pests, or a poor distribution system, or cultural practices that prevent the full utilization of available food resources. The decline in the incidence of breastfeeding in recent decades is a major factor in the malnutrition and ill health of children. The quality of nutrition affects the development of human beings in many ways that are sometimes overlooked, such as physical growth and intellectual development. In the long run, only economic development will eliminate malnutrition by eliminating its basic causes of food availability, poverty, ignorance, and overpopulation. Breastfeeding is an important nutritional source for infants and has a contraceptive value for mothers. Improved nutrition should have beneficial effects on the costs of providing education, health services, and housing. Improving the nutritional status of small children may increase their ability to withstand disease, resulting in the survival of greater numbers of

  15. Population Health and Occupational Therapy.

    PubMed

    Braveman, Brent

    2016-01-01

    Occupational therapy practitioners play an important role in improving the health of populations through the development of occupational therapy interventions at the population level and through advocacy to address occupational participation and the multiple determinants of health. This article defines and explores population health as a concept and describes the appropriateness of occupational therapy practice in population health. Support of population health practice as evidenced in the official documents of the American Occupational Therapy Association and the relevance of population health for occupational therapy as a profession are reviewed. Recommendations and directions for the future are included related to celebration of the achievements of occupational therapy practitioners in the area of population health, changes to the Occupational Therapy Practice Framework and educational accreditation standards, and the importance of supporting, recognizing, rewarding, and valuing occupational therapy practitioners who assume roles in which direct care is not their primary function.

  16. Does health affect portfolio choice?

    PubMed

    Love, David A; Smith, Paul A

    2010-12-01

    A number of recent studies find that poor health is empirically associated with a safer portfolio allocation. It is difficult to say, however, whether this relationship is truly causal. Both health status and portfolio choice are influenced by unobserved characteristics such as risk attitudes, impatience, information, and motivation, and these unobserved factors, if not adequately controlled for, can induce significant bias in the estimates of asset demand equations. Using the 1992-2006 waves of the Health and Retirement Study, we investigate how much of the connection between health and portfolio choice is causal and how much is due to the effects of unobserved heterogeneity. Accounting for unobserved heterogeneity with fixed effects and correlated random effects models, we find that health does not appear to significantly affect portfolio choice among single households. For married households, we find a small effect (about 2-3 percentage points) from being in the lowest of five self-reported health categories.

  17. Does Positive Affect Influence Health?

    ERIC Educational Resources Information Center

    Pressman, Sarah D.; Cohen, Sheldon

    2005-01-01

    This review highlights consistent patterns in the literature associating positive affect (PA) and physical health. However, it also raises serious conceptual and methodological reservations. Evidence suggests an association of trait PA and lower morbidity and of state and trait PA and decreased symptoms and pain. Trait PA is also associated with…

  18. Nutritional Factors Affecting Mental Health

    PubMed Central

    Lim, So Young; Kim, Eun Jin; Kim, Arang; Lee, Hee Jae; Choi, Hyun Jin

    2016-01-01

    Dietary intake and nutritional status of individuals are important factors affecting mental health and the development of psychiatric disorders. Majority of scientific evidence relating to mental health focuses on depression, cognitive function, and dementia, and limited evidence is available about other psychiatric disorders including schizophrenia. As life span of human being is increasing, the more the prevalence of mental disorders is, the more attention rises. Lists of suggested nutritional components that may be beneficial for mental health are omega-3 fatty acids, phospholipids, cholesterol, niacin, folate, vitamin B6, and vitamin B12. Saturated fat and simple sugar are considered detrimental to cognitive function. Evidence on the effect of cholesterol is conflicting; however, in general, blood cholesterol levels are negatively associated with the risk of depression. Collectively, the aims of this review are to introduce known nutritional factors for mental health, and to discuss recent issues of the nutritional impact on cognitive function and healthy brain aging. PMID:27482518

  19. Perspectives on urban conditions and population health.

    PubMed

    Vlahov, David; Galea, Sandro; Gibble, Emily; Freudenberg, Nicholas

    2005-01-01

    The majority of the world's population will live in cities in the next few years and the pace of urbanization worldwide will continue to accelerate over the coming decades. While the number of megacities is projected to increase, the largest population growth is expected to be in cities of less than one million people. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living affects health, a cogent framework that enables systematic study of urban health across time and place has yet to emerge. Four alternate but complementary approaches to the study of urban health today are presented (urban health penalty, urban health advantage, urban sprawl, and an integrative urban conditions model) followed by three key questions that may help guide the study and practice of urban health in coming decades.

  20. Population properties affect inbreeding avoidance in moose.

    PubMed

    Herfindal, Ivar; Haanes, Hallvard; Røed, Knut H; Solberg, Erling J; Markussen, Stine S; Heim, Morten; Sæther, Bernt-Erik

    2014-12-01

    Mechanisms reducing inbreeding are thought to have evolved owing to fitness costs of breeding with close relatives. In small and isolated populations, or populations with skewed age- or sex distributions, mate choice becomes limited, and inbreeding avoidance mechanisms ineffective. We used a unique individual-based dataset on moose from a small island in Norway to assess whether inbreeding avoidance was related to population structure and size, expecting inbreeding avoidance to be greater in years with larger populations and even adult sex ratios. The probability that a potential mating event was realized was negatively related to the inbreeding coefficient of the potential offspring, with a stronger relationship in years with a higher proportion or number of males in the population. Thus, adult sex ratio and population size affect the degree of inbreeding avoidance. Consequently, conservation managers should aim for sex ratios that facilitate inbreeding avoidance, especially in small and isolated populations.

  1. Light on population health status.

    PubMed Central

    Beyrer, K.; Brauer, G. W.; Fliedner, T. M.; Greiner, C.; Reischl, U.

    1999-01-01

    A new approach to illustrating and analysing health status is presented which allows comparisons of various aspects of health in a population at different times and in different populations during given periods. Both quantitative and qualitative elements can be represented, the impact of interventions can be monitored, and the extent to which objectives are achieved can be assessed. The practical application of the approach is demonstrated with reference to the health profiles to Tunisia in 1966 and 1994. PMID:10083719

  2. Women's Select Health Issues in Underserved Populations.

    PubMed

    Fernandez, Luz M; Becker, Jonathan A

    2017-03-01

    The purpose of this article is to review women's health issues that affect underserved populations. Certain groups have a lack of health care resources or inability to access resources. Individuals encounter barriers to accessing health care due to socioeconomic status, transportation, intimate partner issues, and distrust of the health care system. These factors lead to health care disparities and a lack of appropriate care or quality care as it pertains to breast cancer screening, cervical cancer screening, and obtaining contraceptive care. Identifying available resources in response to community-based needs assessment is among the tools available to combat these inequalities.

  3. Does trade affect child health?

    PubMed

    Levine, David I; Rothman, Dov

    2006-05-01

    Frankel and Romer [Frankel, J., Romer, D., 1999. Does trade cause growth? American Economic Review 89 (3), 379-399] documented positive effects of geographically determined trade openness on economic growth. At the same time, critics fear that openness can lead to a "race to the bottom" that increases pollution and reduces government resources for investments in health and education. We use Frankel and Romer's gravity model of trade to examine how openness to trade affects children. Overall, we find little harm from trade, and potential benefits largely through slightly faster GDP growth.

  4. Remote sensing of environmental factors affecting health

    NASA Astrophysics Data System (ADS)

    Jovanovic, Petar

    The purpose of this paper is to present the results of research to identify, by satellite imagery, parameters of the environment affecting health on Earth. Thus, we suggest expanding the application of space technology to preventive medicine, as a new field in the peaceful uses of outer space. The scope of the study includes all parts of the environment, natural and man-made, and all kinds of protection of life: human, animal and vegetation health. The general objective is to consider and classify those factors, detectable from space, that affect or are relevant to health and may be found in the air, water, sea, soil, land, vegetation, as well as those linked to climate, industry, energy production, development works, irrigation systems, and human settlements. The special objective is the classification of environmental factors detectable from space, that are linked to communicable or chronic endemic diseases or health problems. The method of identifying the factors affecting health was the parallel study of environmental epidemiological and biological parameters. The role of environmental factors common to both human and animal populations is discussed. Conclusive findings are formulated and possible applications, both scientific and practical, in other sectors are also discussed.

  5. Soil resources area affects herbivore health.

    PubMed

    Garner, James A; Ahmad, H Anwar; Dacus, Chad M

    2011-06-01

    Soil productivity effects nutritive quality of food plants, growth of humans and animals, and reproductive health of domestic animals. Game-range surveys sometimes poorly explained variations in wildlife populations, but classification of survey data by major soil types improved effectiveness. Our study evaluates possible health effects of lower condition and reproductive rates for wild populations of Odocoileus virginianus Zimmerman (white-tailed deer) in some physiographic regions of Mississippi. We analyzed condition and reproductive data for 2400 female deer from the Mississippi Department of Wildlife, Fisheries, and Parks herd health evaluations from 1991-1998. We evaluated age, body mass (Mass), kidney mass, kidney fat mass, number of corpora lutea (CL) and fetuses, as well as fetal ages. Region affected kidney fat index (KFI), which is a body condition index, and numbers of fetuses of adults (P≤0.001). Region affected numbers of CL of adults (P≤0.002). Mass and conception date (CD) were affected (P≤0.001) by region which interacted significantly with age for Mass (P≤0.001) and CD (P<0.04). Soil region appears to be a major factor influencing physical characteristics of female deer.

  6. Population and women's health.

    PubMed

    Abernethy, V

    1994-01-01

    Explanations of cultural patterns can be found in the economic context (carrying capacity) in which they develop. Population pressure explains the abuse of women throughout history and in modern times because overpopulation leads to devaluation of women's reproductive capacity. A cultural response to overpopulation includes practices that limit the numbers of women of reproductive age. Such practices foster son preference, which results in selective abortion, female infanticide, neglect and overwork of girls, dowry deaths, and discrimination against widows. The results of these practices are manifest in sex ratios that are culturally rather than naturally controlled and in demographic facts such as the calculation that 60 million females are missing in Asia alone (and perhaps more than 100 million worldwide). Women are also removed from a reproductive setting by being kidnapped or sold into prostitution or by being forced to adopt prostitution for economic survival. In cases where survival is threatened by environmental degradation and population growth, the most harsh cultural practices will emerge to adapt the population to the resources at hand. This situation creates an ethical dilemma posed by the problem of imposing Western values on a culture that is undertaking adaptive practices to insure its very survival. Ways to help women in these situation include limiting population growth humanely through family planning, provision of paid work to women, and creation of an environment that supports a small family ideal. Prosperity itself, through modernization, sometimes causes family sizes to increase. The most important intervention appears to be the provision of paid employment outside the home for women. On the other hand, large-scale wealth transfers and liberal immigration policies simply send signals that population pressure is a regional problem that can be alleviated by the international community. Increasing immigration to developed countries will place

  7. Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus.

    PubMed

    Pottie, Kevin; Hui, Charles; Rahman, Prinon; Ingleby, David; Akl, Elie A; Russell, Grant; Ling, Li; Wickramage, Kolitha; Mosca, Davide; Brindis, Claire D

    2017-02-03

    Persons affected by migration require health systems that are responsive and adaptable to the needs of both disadvantaged migrants and non-migrant populations. The objective of this study is to support health systems for populations affected by migration.

  8. The long shadow of work—does time since labour market exit affect the association between socioeconomic position and health in a post‐working population

    PubMed Central

    Hyde, Martin; Jones, Ian Rees

    2007-01-01

    Objective To test the effect of time since labour market exit (LME) on associations between socioeconomic position (SEP) and self‐rated health. Methods Retirees from the English Longitudinal Study of Ageing (ELSA) were divided into three groups on the basis of the length of time since LME. Seven different indicators of SEP were identified: socioeconomic class, income, wealth, education, tenure, area deprivation and subjective social status. Unadjusted and mutually adjusted logistic regression analyses were performed with poor self‐rated health as the outcome. The sample consisted of 2617 men (mean (SD) age 71.69 (7.04) years) and 2619 women (71.29 (8.26) years). Results In the unadjusted analyses, patterns of association between SEP measures and health were similar for men and women. Most SEP measures were associated with poor health, although the effects were attenuated by time since LME. In the mutually adjusted analyses, wealth was found to have a strong independent effect on health among men, especially in those groups that left the labour market ⩽20 years ago,while for women subjective social status seemed to have the most important effect on health after LME. Conclusions Time since LME is an important factor to consider when studying health inequalities in a post‐working population. The effect of time since LME varies according to gender and the measures of SEP used. Further work in this area should take account of age, period and cohort effects using multiple measures of SEP and more refined measures of LME. PMID:17496263

  9. Air Pollution Affects Community Health

    ERIC Educational Resources Information Center

    Shy, Carl M.; Finklea, John F.

    1973-01-01

    Community Health and Environmental Surveillance System (CHESS), a nationwide program relating community health to environmental quality, is designed to evaluate existing environmental standards, obtain health intelligence for new standards, and document health benefits of air pollution control. (BL)

  10. [Excessive population and health].

    PubMed

    Rivera, A A

    1995-07-01

    Population density in El Salvador is among the highest in the world. In metropolitan San Salvador and the other main cities, crowding, squatter settlements, unemployment and underemployment, scarcity of basic services, squalor, and other social pathologies appear to be increasing. Overpopulation poses an enormous challenge for development. Reflection on the benefits of family planning has been delayed in El Salvador, and in the interim there have been increases in social inequality, misery, and hunger. Family planning programs have been referred to as "neo-Malthusian" and contrary to the right to life, but in fact they promote birth spacing and free selection of methods by couples, contributing to improvement in the quality of family life. Family planning allows couples to limit their offspring to those they can adequately care for emotionally and materially. People must be shown that family planning alleviates many of humanity's problems.

  11. Approaching Health Disparities from a Population Perspective: The NIH Centers for Population Health and Health Disparities

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Addressing health disparities has been a national challenge for decades. The NIH-sponsored Centers for Population Health and Health Disparities (CPHHDs) represent the first federal initiative to support transdisciplinary multilevel research on the determinants of health disparities. Using preliminar...

  12. Fitting audiology within the population health perspective.

    PubMed

    Fitzpatrick, Elizabeth; Johnston, J Cyne Topshee; Angus, Doug; Durieux-Smith, Andrée

    2006-01-01

    The population health perspective has become increasingly apparent in the medical, public health, and policy literature. This article emphasizes the value of applying the population health perspective and associated frameworks to the rehabilitative sciences and particularly to the field of audiology. Key components of the population health perspective--including the determinants of health, the importance of evidence-based practice, and the value of transdisciplinarity--are used to illustrate the relevance of population health to the field of audiology. Using these key concepts from a population health framework and examples from audiology, the adoption of a population health perspective is proposed.

  13. Crisis-Affected Populations and Tuberculosis.

    PubMed

    Zenner, Dominik

    2017-01-01

    By definition, humanitarian crises can severely affect human health, directly through violence or indirectly through breakdown of infrastructure or lack of provision for basic human needs, such as safe shelter, food, clean water, and suitable clothing. After the initial phase, these indirect effects are the most important determinants of morbidity and mortality in humanitarian emergencies, and infectious diseases are among the most significant causes of ill health. Tuberculosis (TB) incidence in humanitarian emergencies varies depending on a number of factors, including the country background epidemiology, but will be elevated compared with precrisis levels. TB morbidity and mortality are associated with access to appropriate care and medications, and will also be elevated due to barriers to access to diagnosis and appropriate treatment, including robust TB drug supplies. While reestablishment of TB control is challenging in the early phases, successful treatment programs have been previously established, and the WHO has issued guidance on establishing such successful programs. Such programs should be closely linked to other health programs and established in close collaboration with the country's national treatment program. Individuals who flee the emergency also have a higher TB risk and can face difficulties accessing care en route to or upon arrival in host countries. These barriers, often associated with treatment delays and worse outcomes, can be the result of uncertainties around legal status, other practical challenges, or lack of health care worker awareness. It is important to recognize and mitigate these barriers with an increasing number of tools now available and described.

  14. Women, health and population policies.

    PubMed

    Tuladhar, J

    1997-07-01

    Women, in Nepal, suffer from low levels of literacy, limited access to health care, and widespread poverty. This article describes the health status of Nepalese women, major interventions, and constraints. Nepalese women face 10 major critical health issues. Women have little choice in determining marriage partners, number of children, or family planning (FP). Women's status is measured by the number of sons. Women's security is tied to the childbearing capacity. Women lack property rights and access to independent resources. Clause 9 of the Law permits men to remarry and leave their wives destitute: if the woman is incurably mentally ill; if the woman has an infectious, incurable venereal disease; if the woman is an invalid; if the woman is infertile after 10 years of marriage; or if the woman is living separate and taking her share of ANSA. The 6th 5-Year Plan offered the integration of FP within other development programs. Population policy included, for the first time, women's programs. Four major women-oriented strategies were included in the 1984 National Population Strategy: 1) the encouragement of women's employment through training and job opportunities in health, education, and agricultural industries; 2) provision of institutional support that accommodates women's needs; 3) integration of women's development within Integrated Development Projects; and 4) distribution of appropriate technology. Future actions should focus on reproductive health, FP for adolescents and men, women's control of their own fertility, and the education of the girl child.

  15. Indigenous populations health protection: A Canadian perspective

    PubMed Central

    2012-01-01

    The disproportionate effects of the 2009 H1N1 pandemic on many Canadian Aboriginal communities have drawn attention to the vulnerability of these communities in terms of health outcomes in the face of emerging and reemerging infectious diseases. Exploring the particular challenges facing these communities is essential to improving public health planning. In alignment with the objectives of the Pandemic Influenza Outbreak Research Modelling (Pan-InfORM) team, a Canadian public health workshop was held at the Centre for Disease Modelling (CDM) to: (i) evaluate post-pandemic research findings; (ii) identify existing gaps in knowledge that have yet to be addressed through ongoing research and collaborative activities; and (iii) build upon existing partnerships within the research community to forge new collaborative links with Aboriginal health organizations. The workshop achieved its objectives in identifying main research findings and emerging information post pandemic, and highlighting key challenges that pose significant impediments to the health protection and promotion of Canadian Aboriginal populations. The health challenges faced by Canadian indigenous populations are unique and complex, and can only be addressed through active engagement with affected communities. The academic research community will need to develop a new interdisciplinary framework, building upon concepts from ‘Communities of Practice’, to ensure that the research priorities are identified and targeted, and the outcomes are translated into the context of community health to improve policy and practice. PMID:23256553

  16. Psychedelics and Mental Health: A Population Study

    PubMed Central

    Krebs, Teri S.; Johansen, Pål-Ørjan

    2013-01-01

    Background The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline. Objective To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population. Method Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale), mental health treatment (inpatient, outpatient, medication, needed but did not receive), symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis), and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events. Results 21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems. Conclusion We did not find use of psychedelics to be an independent risk factor for mental health problems. PMID:23976938

  17. Signaling pathways affecting skeletal health.

    PubMed

    Marie, Pierre J

    2012-09-01

    Skeletal health is dependent on the balance between bone resorption and formation during bone remodeling. Multiple signaling pathways play essential roles in the maintenance of skeletal integrity by positively or negatively regulating bone cells. During the last years, significant advances have been made in our understanding of the essential signaling pathways that regulate bone cell commitment, differentiation and survival. New signaling anabolic pathways triggered by parathyroid hormone, local growth factors, Wnt signaling, and calcium sensing receptor have been identified. Novel signals induced by interactions between bone cells-matrix (integrins), osteoblasts/osteocytes (cadherins, connexins), and osteoblasts/osteoclast (ephrins, Wnt-RhoA, semaphorins) have been discovered. Recent studies revealed the key pathways (MAPK, PI3K/Akt) that critically control bone cells and skeletal mass. This review summarizes the most recent knowledge on the major signaling pathways that control bone cells, and their potential impact on the development of therapeutic strategies to improve human bone health.

  18. Energy Systems and Population Health

    SciTech Connect

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    to rural and urban health facilities allows increased delivery and coverage of 3 various health services and interventions such as tests and treatments, better storage of medicine and vaccines, disinfection of medical equipment by boiling or radiation, and more frequent and efficient health system encounters through mobile clinics or longer working hours; and so on. In fact, while the dominant view of development-energy-health linkages has been that improvements in energy and health are outcomes of the socioeconomic development process (e.g., the ''energy ladder'' framework discussed below), it has even been argued that access to higher quality energy sources and technologies can initiate a chain of demographic, health, and development outcomes by changing the household structure and socioeconomic relationships. For example, in addition to increased opportunities for food and income production, reduced infant mortality as a result of transition to cleaner fuels or increased coverage of vaccination with availability of refrigerators in rural clinics may initiate a process of ''demographic transition'' to low-mortality and low-fertility populations (14). Such a transition has historically been followed with further improvements in maternal and child health and increased female participation in the labor markets and other economic activities.

  19. Health status of vulnerable populations.

    PubMed

    Aday, L A

    1994-01-01

    The notion of risk underlying the concept of vulnerability implies that everyone is potentially vulnerable (or at risk), that is, there is always a chance of developing health problems. The risk is, however, greater for those with the least social status, social capital, and human capital resources to either prevent or ameliorate the origins and consequences of poor physical, psychological, or social health. The completeness and accuracy of information on the health status of the vulnerable populations examined here varies substantially across groups. Methodological work is needed to derive standardized definitions of terms, specify the content and timing for collecting information for minimum basic data sets, and develop uniform standards for evaluating and reporting data quality on the health status of vulnerable populations. The variety of indicators of vulnerable populations examined indicates that during the decade of the 1980s the incidence of serious physical, psychological, and/or social needs increased (at worst) and was unameliorated (at best) for millions of Americans. AIDS emerged as a new and deadly threat from a handful of cases classified as Gay-Related Immune Deficiency in the early part of the 1980s to what now may be over a million Americans who are HIV-positive. The number of homeless has increased an average of 20% a year to estimates now ranging up to one million men, women, or children homeless on any given night to twice that number who may be homeless sometime during the year. Over seven million people immigrated to the United States during the period from 1981 to 1990--an increasing proportion of whom are refugees carrying with them the physical, psychological, and social wounds of war. The number of children abused by family members or other intimates has burgeoned to an estimated 1.6 to 1.7 million per year, and with the greater use of firearms, intentional acts of violence towards oneself or others are becoming increasingly deadly in

  20. Transforming Health Professionals into Population Health Change Agents

    PubMed Central

    Naccarella, Lucio; Butterworth, Iain; Moore, Timothy

    2016-01-01

    Background With the recognition that professional education has not kept pace with the challenges facing the health and human service system, there has been a move to transformative education and learning professional development designed to expand the number of enlightened and empowered change agents with the competence to implement changes at an individual, organisation and systems level. Design and Methods Since 2010, the Department of Health and Human Services in Victoria, Australia, in collaboration with The University of Melbourne’s School of Population and Global Health, has delivered seven population health short courses aimed to catalyse participants’ transformation into population health change agents. This paper presents key learnings from a combination of evaluation data from six population health short courses using a transformative learning framework from a 2010 independent international commission for health professionals that was designed to support the goals of transformative and interdependent health professionals. Participatory realist evaluation approaches and qualitative methods were used. Results Evaluation findings reveal that there were mixed outcomes in facilitating participants’ implementation of population health approaches, and their transformation into population health agents upon their return to their workplaces. Core enablers, barriers and requirements, at individual, organisational and system levels influence the capability of participants to implement population health approaches. The iterative and systemic evolution of the population health short courses, from a one off event to a program of inter-dependent modules, demonstrates sustained commitment by the short course developers and organisers to the promotion of transformative population health learning outcomes. Conclusions To leverage this commitment, recognising that professional development is not an event but part of an ongoing transformative process, suggestions to

  1. Pregnancy persistently affects memory T cell populations.

    PubMed

    Kieffer, Tom E C; Faas, Marijke M; Scherjon, Sicco A; Prins, Jelmer R

    2017-02-01

    Pregnancy is an immune challenge to the maternal immune system. The effects of pregnancy on maternal immunity and particularly on memory T cells during and after pregnancy are not fully known. This observational study aims to show the short term and the long term effects of pregnancy on the constitution, size and activation status of peripheral human memory T-lymphocyte populations. Effector memory (EM) and central memory (CM) T-lymphocytes were analyzed using flow cytometry of peripheral blood from 14 nulligravid, 12 primigravid and 15 parous women that were on average 18 months postpartum. The short term effects were shown by the significantly higher CD4+ EM cell and activated CD4+ memory cell proportions in primigravid women compared to nulligravid women. The persistent effects found in this study were the significantly higher proportions of CD4+ EM, CD4+ CM and activated memory T cells in parous women compared to nulligravid women. In contrast to CD4+ cells, activation status of CD8+ memory cells did not differ between the groups. This study shows that pregnancy persistently affects the pre-pregnancy CD4+ memory cell pool in human peripheral blood. During pregnancy, CD4+ T-lymphocytes might differentiate into EM cells followed by persistent higher proportions of CD4+ CM and EM cells postpartum. The persistent effects of pregnancy on memory T cells found in this study support the hypothesis that memory T cells are generated during pregnancy and that these cells could be involved in the lower complication risks in multiparous pregnancies in humans.

  2. Stigma, status, and population health

    PubMed Central

    Phelan, Jo C.; Lucas, Jeffrey W.; Ridgeway, Cecilia L.; Taylor, Catherine J.

    2014-01-01

    Stigma and status are the major concepts in two important sociological traditions that describe related processes but that have developed in isolation. Although both approaches have great promise for understanding and improving population health, this promise has not been realized. In this paper, we consider the applicability of status characteristics theory (SCT) to the problem of stigma with the goal of better understanding social systemic aspects of stigma and their health consequences. To this end, we identify common and divergent features of status and stigma processes. In both, labels that are differentially valued produce unequal outcomes in resources via culturally shared expectations associated with the labels; macro-level inequalities are enacted in micro-level interactions, which in turn reinforce macro-level inequalities; and status is a key variable. Status and stigma processes also differ: Higher- and lower-status states (e.g., male and female) are both considered normal, whereas stigmatized characteristics (e.g., mental illness) are not; interactions between status groups are guided by “social ordering schemas” that provide mutually agreed-upon hierarchies and interaction patterns (e.g., men assert themselves while women defer), whereas interactions between “normals” and stigmatized individuals are not so guided and consequently involve uncertainty and strain; and social rejection is key to stigma but not status processes. Our juxtaposition of status and stigma processes reveals close parallels between stigmatization and status processes that contribute to systematic stratification by major social groupings, such as race, gender, and SES. These parallels make salient that stigma is not only an interpersonal or intrapersonal process but also a macro-level process and raise the possibility of considering stigma as a dimension of social stratification. As such, stigma’s impact on health should be scrutinized with the same intensity as that of

  3. Political economy and population health: is Australia exceptional?

    PubMed Central

    Boxall, Anne-marie; Short, Stephanie D

    2006-01-01

    Background It is accepted knowledge that social and economic conditions – like education and income – affect population health. What remains uncertain is whether the degree of inequality in these conditions influences population health and if so, how. Some researchers who argue that inequalities are important, say there is a relationship between political economy, inequality and population health. Their evidence comes from comparative studies showing that countries with neo-liberal political economies generally have poorer population health outcomes than those with social or Christian democratic political economies. According to these researchers, neo-liberal political economies adopt labour market and welfare state policies that lead to greater levels of inequality and poorer population health outcomes for us all. Discussion Australia has experienced considerable social and economic reforms over the last 20 years, with both major political parties increasingly adopting neo-liberal policies. Despite these reforms, population health outcomes are amongst the best in the world. Summary Australia appears to contest theories suggesting a link between political economy and population health. To progress our understanding, researchers need to concentrate on policy areas outside health – such as welfare, economics and industrial relations. We need to do longitudinal studies on how reforms in these areas affect levels of social and economic inequality, as well population health. We need to draw on social scientific methods, especially concerning case selection, to advance our understanding of casual relationships in policy studies. It is important to find out if, and why, Australia has resisted the affects of neo-liberalism on population health so we ensure our high standards are maintained in the future. PMID:16737549

  4. Gender, health and population policy.

    PubMed

    Postel, E

    1992-01-01

    Indonesia is an international showpiece of successful population control. The number of desired acceptors of family planning is fixed by a coordinating board in cooperation with international advisers including the World Bank. More than 95% of the actual acceptors or users of contraceptives are women rather than couples. Numerical targets are set for districts, subdistricts, villages and hamlets; and local administrators are charged with the execution of the program. Ambitious village or district leaders use a variety of incentives and disincentives to comply with these directives issued by superiors. "2 children is enough" is the slogan on ubiquitous posters in the archipelago. A woman who is pregnant for a 3rd time may face scorn in her village. Although family planning has succeeded in averting births, maternal mortality rates in Indonesia are among the highest in the world. 55% of Indonesian women suffer from anaemia, particularly pregnant or breast feeding women. In principle there is free choice of contraceptives, but effective means such as hormonal implants, IUDs, and sterilization are promoted instead of pills and barrier methods. Thus, a program originally designed to be sensitive to community concerns runs the risk of becoming an oppressive system. Under the rhetoric of human development the quality of family planning services should be improved, the status of women raised by better education and more employment opportunities, no discrimination, and better health services. The aim of United Nations Population Fund (UNFPA) is to extend modern family planning services to 567 million couples, 59% of all married women of reproductive age, by the age 2000. The contraceptive needs of unmarried women have been ignored again, while the plight of unmarried pregnant women has probably increased by increasing violence and wars.

  5. Health policy approaches to population health: the limits of medicalization.

    PubMed

    Lantz, Paula M; Lichtenstein, Richard L; Pollack, Harold A

    2007-01-01

    Because of a strong tendency to "medicalize" health status problems and to assume that their primary solution involves medical care, policymakers often focus on increased financial and geographic access to personal health services in policies aimed at populations that are vulnerable to poor health. This approach has produced real public health gains, but it has neglected key social and economic causes of health vulnerability and disparities. Although access to care is a necessary component of population health, concerted policy action in income security, education, housing, nutrition/food security, and the environment is also critical in efforts to improve health among socially disadvantaged populations.

  6. How Resource Phenology Affects Consumer Population Dynamics.

    PubMed

    Bewick, Sharon; Cantrell, R Stephen; Cosner, Chris; Fagan, William F

    2016-02-01

    Climate change drives uneven phenology shifts across taxa, and this can result in changes to the phenological match between interacting species. Shifts in the relative phenology of partner species are well documented, but few studies have addressed the effects of such changes on population dynamics. To explore this, we develop a phenologically explicit model describing consumer-resource interactions. Focusing on scenarios for univoltine insects, we show how changes in resource phenology can be reinterpreted as transformations in the year-to-year recursion relationships defining consumer population dynamics. This perspective provides a straightforward path for interpreting the long-term population consequences of phenology change. Specifically, by relating the outcome of phenological shifts to species traits governing recursion relationships (e.g., consumer fecundity or competitive scenario), we demonstrate how changes in relative phenology can force systems into different dynamical regimes, with major implications for resource management, conservation, and other areas of applied dynamics.

  7. Social Determinants of Population Health: A Systems Sciences Approach

    PubMed Central

    Fink, David S.; Keyes, Katherine M.; Cerdá, Magdalena

    2016-01-01

    Population distributions of health emerge from the complex interplay of health-related factors at multiple levels, from the biological to the societal level. Individuals are aggregated within social networks, affected by their locations, and influenced differently across time. From aggregations of individuals, group properties can emerge, including some exposures that are ubiquitous within populations but variant across populations. By combining a focus on social determinants of health with a conceptual framework for understanding how genetics, biology, behavior, psychology, society, and environment interact, a systems science approach can inform our understanding of the underlying causes of the unequal distribution of health across generations and populations, and can help us identify promising approaches to reduce such inequalities. In this paper, we discuss how systems science approaches have already made several substantive and methodological contributions to the study of population health from a social epidemiology perspective. PMID:27642548

  8. Global health burden and needs of transgender populations: a review.

    PubMed

    Reisner, Sari L; Poteat, Tonia; Keatley, JoAnne; Cabral, Mauro; Mothopeng, Tampose; Dunham, Emilia; Holland, Claire E; Max, Ryan; Baral, Stefan D

    2016-07-23

    Transgender people are a diverse population affected by a range of negative health indicators across high-income, middle-income, and low-income settings. Studies consistently document a high prevalence of adverse health outcomes in this population, including HIV and other sexually transmitted infections, mental health distress, and substance use and abuse. However, many other health areas remain understudied, population-based representative samples and longitudinal studies are few, and routine surveillance efforts for transgender population health are scarce. The absence of survey items with which to identify transgender respondents in general surveys often restricts the availability of data with which to estimate the magnitude of health inequities and characterise the population-level health of transgender people globally. Despite the limitations, there are sufficient data highlighting the unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people. To mitigate these risks and foster resilience, a comprehensive approach is needed that includes gender affirmation as a public health framework, improved health systems and access to health care informed by high quality data, and effective partnerships with local transgender communities to ensure responsiveness of and cultural specificity in programming. Consideration of transgender health underscores the need to explicitly consider sex and gender pathways in epidemiological research and public health surveillance more broadly.

  9. The population health approach in historical perspective.

    PubMed

    Szreter, Simon

    2003-03-01

    The origin of the population health approach is an historic debate over the relationship between economic growth and human health. In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued. The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a "neoliberal" agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of "global" economic growth.

  10. The Population Health Approach in Historical Perspective

    PubMed Central

    Szreter, Simon

    2003-01-01

    The origin of the population health approach is an historic debate over the relationship between economic growth and human health. In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued. The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a “neoliberal” agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of “global” economic growth. PMID:12604486

  11. Achieving Population Health in Accountable Care Organizations

    PubMed Central

    Walker, Deborah Klein

    2013-01-01

    Although “population health” is one of the Institute for Healthcare Improvement’s Triple Aim goals, its relationship to accountable care organizations (ACOs) remains ill-defined and lacks clarity as to how the clinical delivery system intersects with the public health system. Although defining population health as “panel” management seems to be the default definition, we called for a broader “community health” definition that could improve relationships between clinical delivery and public health systems and health outcomes for communities. We discussed this broader definition and offered recommendations for linking ACOs with the public health system toward improving health for patients and their communities. PMID:23678910

  12. Population Education in Health: Some Sample Lessons.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and Oceania.

    This manual for home economics teachers contains eight sample lessons on health issues related to population growth. Among the topics treated are nutrition, family health, communicable diseases, causes of high mortality, and community health services. Lessons are designed for lower primary through high school students. A scope and sequence chart…

  13. Seven Foundational Principles of Population Health Policy.

    PubMed

    Bhattacharya, Dru; Bhatt, Jay

    2017-02-13

    In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately translated into formal policies or practices among the key stakeholders in population health. These principles are meant to empower stakeholders-whether it is the planner or the practitioner, the decision maker or the dedicated caregiver-and inform the development of practical tools, research, and education.

  14. Slum health: Diseases of neglected populations

    PubMed Central

    Riley, Lee W; Ko, Albert I; Unger, Alon; Reis, Mitermayer G

    2007-01-01

    Background Urban slums, like refugee communities, comprise a social cluster that engenders a distinct set of health problems. With 1 billion people currently estimated to live in such communities, this neglected population has become a major reservoir for a wide spectrum of health conditions that the formal health sector must deal with. Discussion Unlike what occurs with refugee populations, the formal health sector becomes aware of the health problems of slum populations relatively late in the course of their illnesses. As such, the formal health sector inevitably deals with the severe and end-stage complications of these diseases at a substantially greater cost than what it costs to manage non-slum community populations. Because of the informal nature of slum settlements, and cultural, social, and behavioral factors unique to the slum populations, little is known about the spectrum, burden, and determinants of illnesses in these communities that give rise to these complications, especially of those diseases that are chronic but preventable. In this article, we discuss observations made in one slum community of 58,000 people in Salvador, the third largest city in Brazil, to highlight the existence of a spectrum and burden of chronic illnesses not likely to be detected by the formal sector health services until they result in complications or death. Lack of health-related data from slums could lead to inappropriate and unrealistic allocation of health care resources by the public and private providers. Similar misassumptions and misallocations are likely to exist in other nations with large urban slum populations. Summary Continued neglect of ever-expanding urban slum populations in the world could inevitably lead to greater expenditure and diversion of health care resources to the management of end-stage complications of diseases that are preventable. A new approach to health assessment and characterization of social-cluster determinants of health in urban slums

  15. Population Health Measurement: Applying Performance Measurement Concepts in Population Health Settings

    PubMed Central

    Stoto, Michael A.

    2014-01-01

    Introduction: Whether the focus of population-health improvement efforts, the measurement of health outcomes, risk factors, and interventions to improve them are central to achieving collective impact in the population health perspective. And because of the importance of a shared measurement system, appropriate measures can help to ensure the accountability of and ultimately integrate the efforts of public health, the health care delivery sector, and other public and private entities in the community to improve population health. Yet despite its importance, population health measurement efforts in the United States are poorly developed and uncoordinated. Collaborative Measurement Development: To achieve the potential of the population health perspective, public health officials, health system leaders, and others must work together to develop sets of population health measures that are suitable for different purposes yet are harmonized so that together they can help to improve a community’s health. This begins with clearly defining the purpose of a set of measures, distinguishing between outcomes for which all share responsibility and actions to improve health for which the health care sector, public health agencies, and others should be held accountable. Framework for Population Health Measurement: Depending on the purpose of the analysis, then, measurement systems should clearly specify what to measure—in particular the population served (the denominator), what the critical health dimensions are in a measurement framework, and how the measures can be used to ensure accountability. Building on a clear understanding of the purpose and dimensions of population health that must be measured, developers can then choose specific measures using existing data or developing new data sources if necessary, with established validity, reliability, and other scientific characteristics. Rather than indiscriminately choosing among the proliferating data streams, this

  16. Factors affecting outdoor exposure in winter: population-based study

    NASA Astrophysics Data System (ADS)

    Mäkinen, Tiina M.; Raatikka, Veli-Pekka; Rytkönen, Mika; Jokelainen, Jari; Rintamäki, Hannu; Ruuhela, Reija; Näyhä, Simo; Hassi, Juhani

    2006-09-01

    The extent of outdoor exposure during winter and factors affecting it were examined in a cross-sectional population study in Finland. Men and women aged 25-74 years from the National FINRISK 2002 sub-study ( n=6,591) were queried about their average weekly occupational, leisure-time and total cold exposure during the past winter. The effects of gender, age, area of residence, occupation, ambient temperature, self-rated health, physical activity and education on cold exposure were analysed. The self-reported median total cold exposure time was 7 h/week (8 h men, 6 h women),<1 h/week (2 h men, 0 h women) at work, 4 h/week (5 h men, 4 h women) during leisure time and 1 h/week (1 h men, 1.5 h women) while commuting to work. Factors associated with increased occupational cold exposure among men were: being employed in agriculture, forestry and industry/mining/construction or related occupations, being less educated and being aged 55-64 years. Factors associated with increased leisure-time cold exposure among men were: employment in industry/mining/construction or related occupations, being a pensioner or unemployed, reporting at least average health, being physically active and having college or vocational education. Among women, being a housewife, pensioner or unemployed and engaged in physical activity increased leisure-time cold exposure, and young women were more exposed than older ones. Self-rated health was positively associated with leisure time cold exposure in men and only to a minor extent in women. In conclusion, the subjects reported spending 4% of their total time under cold exposure, most of it (71%) during leisure time. Both occupational and leisure-time cold exposure is greater among men than women.

  17. Environmental Risk to Health of the Population

    ERIC Educational Resources Information Center

    Anopchenko, Tatiana Y.; Murzin, Anton D.; Kandrashina, Elena A.; Kosyakova, Inessa V.; Surnina, Olga E.

    2016-01-01

    Researches of the last years in the field of ecological epidemiology and the analysis of risk for health allow to claim with confidence that the polluted environment is one of the important factors defining changes of a state of health of the population. Expert opinions on the scale of this influence differ considerably now. These estimations vary…

  18. Communicating health information to disadvantaged populations.

    PubMed

    Beacom, Amanda M; Newman, Sandra J

    2010-01-01

    Interest in the communication of health information among disadvantaged populations has increased in recent years with the shift from a model of patient-provider communication to one of a more empowered healthcare consumer; with the use of new communication technologies that increase the number of channels through which health information may be accessed; and with the steadily increasing number of people without health insurance. Three separate research literatures contribute to our current understanding of this issue. In the medicine and public health literature, disparities in health access and outcomes among socioeconomic, ethnic, and racial groups are now well documented. In the information sciences literature, scholars note that on a continuum of health information behaviors, ranging from information avoidance and nonseeking to active seeking, nonseeking behaviors are associated with disadvantaged populations. In the communication literature, enthusiasm over the technology-driven growth of online health information seeking is tempered by evidence supporting the knowledge gap hypothesis, which indicates that as potential access to health information increases, systematic gaps in health knowledge also increase as groups with higher socioeconomic status acquire this information at a faster rate than those with lower socioeconomic status. A number of diverse strategies show promise in reducing information and health disparities, including those that focus on technology, such as programs to increase computer and Internet access, skills, and comprehension; those that focus on interpersonal communication, such as the community health worker model; and those that focus on mass media channels, such as entertainment education.

  19. Climate change, food, water and population health in China.

    PubMed

    Tong, Shilu; Berry, Helen L; Ebi, Kristie; Bambrick, Hilary; Hu, Wenbiao; Green, Donna; Hanna, Elizabeth; Wang, Zhiqiang; Butler, Colin D

    2016-10-01

    Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially - although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources - e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change - e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases - are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change.

  20. Oral health beliefs in diverse populations.

    PubMed

    Nakazono, T T; Davidson, P L; Andersen, R M

    1997-05-01

    Using data from population-based samples of adults participating in the ICS-II USA study, and using principal components analysis, we constructed oral health belief measures corresponding to the Health Belief Model (HBM) dimensions. Tests of validity and reliability were performed. Scales measuring perceived benefit of preventive practices and seriousness of oral disease had the highest validity and reliability. We used multiple regression analysis to examine sociodemographic predictors of perceived benefits of preventive practices. Race-ethnicity and age cohort were significant predictors among Baltimore and San Antonio adults. White adults and middle-aged persons in both research locations were more likely to believe in the benefit of preventive practices. Female gender, higher educational attainment, and better self-rated health were significant indicators of more positive oral health beliefs in every research location. Results also characterize persons who place lower value on preventive practices (i.e., males, less-educated persons, and those reporting poorer self-rated health). The design of effective dental public health messages and outreach efforts requires an analysis of the individual's health orientation and the factors influencing oral health beliefs. Oral health education interventions designed to improve health beliefs should contain an evaluation component for assessing the impact of education on health practices and oral health status.

  1. The Health Care Institution, Population Health and Black Lives.

    PubMed

    King, Christopher J; Redwood, Yanique

    2016-05-01

    The ongoing existence of institutionalized racism and discriminatory practices in various systems (education, criminal justice, housing, employment) serve as root causes of poor health in Blacks Lives. Furthermore, these unjust social structures and their complex interplay result in inefficient utilization of health services and reactive or futile interactions with medical providers. Collectively, these factors contribute to racial disparities in health and treatment represents a significant portion of the nation's health care expenditures. In order for health care systems to optimize population health goals, racism must be recognized as a determinant of health. As anchor institutions in their respective communities, we offer hospitals and health systems a conceptual framework to address the issue within internal and external constructs.

  2. Boundary Spanning Leadership Practices for Population Health.

    PubMed

    Shirey, Maria R; White-Williams, Connie

    2015-09-01

    This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. In this article, the authors discuss boundary spanning leadership practices for achieving the Triple Aim of simultaneously improving the health of populations, improving the patient experience, and reducing per-capita cost of health care. Drawing on experience with an existing population-focused heart failure clinic borne of an academic-practice partnership, the authors discuss boundary spanning leadership practices aimed at achieving the Triple Aim concept and its intended design.

  3. Matching taxpayer funding to population health needs.

    PubMed

    Hanna, Michael

    2015-04-10

    In an era of economic recession and budget cutbacks,Americans may be curious to know how the government is distributing their taxes for medical research, relative to their health needs. Previous reports recommended that the National Institutes of Health (NIH) allocate funding proportional to the burden-of-illness from diseases and conditions. But the most recent publicly available data on burden-of-illness and NIH funding show that infectious diseases are still overfunded relative to their health burden on the American population, especially HIV/AIDS. By contrast, several lifestyle/environmental health conditions are still underfunded, including importantly: chronic obstructive pulmonary disease, lung cancer, stroke, heart disease, depression, violence, and road injury. NIH's allocation of research funding is often disproportionate to the current health needs of the American people. Greater decision-making involvement of Congress and the public would be helpful, if Americans want their taxes spent fairly on the illnesses that actually burden their health.

  4. Emerging health issues: the widening challenge for population health promotion.

    PubMed

    McMichael, Anthony J; Butler, Colin D

    2006-12-01

    The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability--maintenance of the Earth's ecological and geophysical systems--is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the

  5. Predicting when climate-driven phenotypic change affects population dynamics.

    PubMed

    McLean, Nina; Lawson, Callum R; Leech, Dave I; van de Pol, Martijn

    2016-06-01

    Species' responses to climate change are variable and diverse, yet our understanding of how different responses (e.g. physiological, behavioural, demographic) relate and how they affect the parameters most relevant for conservation (e.g. population persistence) is lacking. Despite this, studies that observe changes in one type of response typically assume that effects on population dynamics will occur, perhaps fallaciously. We use a hierarchical framework to explain and test when impacts of climate on traits (e.g. phenology) affect demographic rates (e.g. reproduction) and in turn population dynamics. Using this conceptual framework, we distinguish four mechanisms that can prevent lower-level responses from impacting population dynamics. Testable hypotheses were identified from the literature that suggest life-history and ecological characteristics which could predict when these mechanisms are likely to be important. A quantitative example on birds illustrates how, even with limited data and without fully-parameterized population models, new insights can be gained; differences among species in the impacts of climate-driven phenological changes on population growth were not explained by the number of broods or density dependence. Our approach helps to predict the types of species in which climate sensitivities of phenotypic traits have strong demographic and population consequences, which is crucial for conservation prioritization of data-deficient species.

  6. Rate of language evolution is affected by population size.

    PubMed

    Bromham, Lindell; Hua, Xia; Fitzpatrick, Thomas G; Greenhill, Simon J

    2015-02-17

    The effect of population size on patterns and rates of language evolution is controversial. Do languages with larger speaker populations change faster due to a greater capacity for innovation, or do smaller populations change faster due to more efficient diffusion of innovations? Do smaller populations suffer greater loss of language elements through founder effects or drift, or do languages with more speakers lose features due to a process of simplification? Revealing the influence of population size on the tempo and mode of language evolution not only will clarify underlying mechanisms of language change but also has practical implications for the way that language data are used to reconstruct the history of human cultures. Here, we provide, to our knowledge, the first empirical, statistically robust test of the influence of population size on rates of language evolution, controlling for the evolutionary history of the populations and formally comparing the fit of different models of language evolution. We compare rates of gain and loss of cognate words for basic vocabulary in Polynesian languages, an ideal test case with a well-defined history. We demonstrate that larger populations have higher rates of gain of new words whereas smaller populations have higher rates of word loss. These results show that demographic factors can influence rates of language evolution and that rates of gain and loss are affected differently. These findings are strikingly consistent with general predictions of evolutionary models.

  7. 78 FR 20646 - National Committee on Vital and Health Statistics, Population Health Subcommittee: Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... HUMAN SERVICES National Committee on Vital and Health Statistics, Population Health Subcommittee... Statistics (NCVHS), Subcommittees on Population Health and Privacy, Confidentiality & Security. Time and Date... meeting is to provide an opportunity for the Population Health and Privacy, Confidentiality and...

  8. Purchasing population health: aligning financial incentives to improve health outcomes.

    PubMed Central

    Kindig, D A

    1998-01-01

    OBJECTIVE: To review the concept of population health, including its definition, measurement, and determinants, and to suggest an approach for aligning financial incentives toward this goal. DATA SOURCE, STUDY DESIGN, DATA EXTRACTION. Literature review, policy analysis PRINCIPAL FINDINGS: The article presents the argument that a major reason for our slow progress toward health outcome improvement is that there is no operational definition of population health and that financial incentives are not aligned to this goal. Current attempts at process measures as indicators of quality or outcome are not adequate for the task. It is suggested that some measure of health-adjusted life expectancy be adopted for this purpose, and that integrated delivery systems and other agents responsible for nonmedical determinants be rewarded for improvement in this measure. This will require the development of an investment portfolio across the determinants of health based on relative marginal return to health, with horizontal integration strategies across sectoral boundaries. A 20-year three-phase development strategy is proposed, including components of research and acceptance, integrated health system implementation, and cross-sectoral integration. CONCLUSIONS: The U.S. healthcare system is a $1 trillion industry without a definition of its product. Until population outcome measures are developed and rewarded for, we will not solve the twenty-first century challenge of maximizing health outcome improvement for the resources available. Images Figure 1 PMID:9618669

  9. Population health: challenges for science and society.

    PubMed

    Mechanic, David

    2007-09-01

    The emphasis on risk factor intervention at the individual level has predominated in efforts to reduce mortality and promote health. Interest in social and other nonmedical interventions, particularly socioeconomic status (SES) influences, has increased in recent years. This article focuses on the interaction of social structure and socioeconomic status with other influences in complex pathways to affect health, and their contribution to health disparities. It examines both social class as an explanation of health differences and competing hypotheses concerning prenatal and early nutrition and cognitive capacity. Although education is associated with income, wealth, occupation, and other SES indicators and may not be the most important SES determinant, it influences a variety of pathways to health outcomes and offers strategic leverage for intervention because of social and political consensus on its value beyond health.

  10. Health Law 2015: Individuals and Populations.

    PubMed

    Jacobson, Peter D; Dahlen, Rachel

    2016-08-16

    In this article, we assess two particular trends in judicial doctrine that are likely to emerge in the post-ACA era. The first trend is the inevitable emergence of enterprise medical liability (EML) that will supplant tort law's unstable attempt to apportion liability between physicians and institutions. Arguments favoring EML in health law date back to the early 1980s. But health care's ongoing consolidation suggests that the time has arrived for courts or state legislatures to develop legal doctrine that more closely resembles the ways in which health care is now delivered. This would result in a more appropriate allocation of liability to the institutional level. The second judicial trend will be the convergence of health law and public health law concepts. Because the ACA arguably stimulates closer engagement between health systems and public health departments, health systems will have greater responsibility for keeping their communities healthy along with obligations for individual patient care (i.e., individuals and populations). If so, courts will need to incorporate elements from health law and public health law in resolving disputes.

  11. FACTORS ADVERSELY AFFECTING AMPHIBIAN POPULATIONS IN THE US

    EPA Science Inventory

    Factors known or suspected to be adversely affecting native amphibian populations in the US were identified using information from species accounts written in a standardized format by multiple authors in a forthcoming book. Specific adverse factors were identified for 53 (58%) of...

  12. How health affects small business in South Africa.

    PubMed

    Chao, Li-Wei; Pauly, Mark V

    2007-03-01

    Preventable and treatable diseases have taken a devastating human and economic toll on many developing countries. That economic toll is likely to be underestimated because most studies focus on productivity losses in the formal, or large-firm, sector; yet, a large portion of the population of developing countries works in the informal sector in very small businesses, either as an owner-worker or as an employee. It is plausible that ill health might affect small businesses most severely, possibly putting the entire business at risk. This Issue Brief summarizes a three-year study that tracks small businesses in Durban, South Africa, and investigates the connection between the owner's health and business growth, survival, or closure. The results bolster the economic case for investing resources in the prevention and treatment of disease in developing countries.

  13. Can coyotes affect deer populations in Southeastern North America?

    SciTech Connect

    Kilgo, J., C.; Ray, H., Scott; Ruth, Charles; Miller, Karl, V.

    2010-07-01

    ABSTRACT The coyote (Canis latrans) is a recent addition to the fauna of eastern North America, and in many areas coyote populations have been established for only a decade or two. Although coyotes are known predators of white-tailed deer (Odocoileus virginianus) in their historic range, effects this new predator may have on eastern deer populations have received little attention. We speculated that in the southeastern United States, coyotes may be affecting deer recruitment, and we present 5 lines of evidence that suggest this possibility. First, the statewide deer population in South Carolina has declined coincident with the establishment and increase in the coyote population. Second, data sets from the Savannah River Site (SRS) in South Carolina indicate a new mortality source affecting the deer population concurrent with the increase in coyotes. Third, an index of deer recruitment at SRS declined during the period of increase in coyotes. Fourth, food habits data from SRS indicate that fawns are an important food item for coyotes during summer. Finally, recent research from Alabama documented significant coyote predation on fawns there. Although this evidence does not establish cause and effect between coyotes and observed declines in deer recruitment, we argue that additional research should proactively address this topic in the region. We identified several important questions on the nature of the deer–coyote relationship in the East.

  14. Theory's role in shaping behavioral health research for population health.

    PubMed

    King, Abby C

    2015-11-26

    The careful application of theory often is used in the behavioral health field to enhance our understanding of how the world currently works. But theory also can help us visualize what the world can become, particularly through its potential impacts on population-wide health. Applying a multi-level ecological perspective can help in expanding the field's focus upward toward the population at large. While ecological frameworks have become increasingly popular, arguably such perspectives have fallen short of their potential to actively bridge conceptual constructs and, by extension, intervention approaches, across different levels of population impact. Theoretical and conceptual perspectives that explicitly span levels of impact offer arguably the greatest potential for achieving scientific insights that may in turn produce the largest population health effects. Examples of such "bridging" approaches include theories and models that span behavioral + micro-environment, behavioral + social/cultural, and social + physical environment constructs. Several recommendations are presented related to opportunities for leveraging theories to attain the greatest impact in the population health science field. These include applying the evidence obtained from person-level theories to inform methods for positively impacting the behaviors of community gatekeepers and decision-makers for greater population change and reach; leveraging the potential of residents as "citizen scientists"--a resource for enacting behavioral health changes at the individual, environmental, and policy levels; using empirical observations and theory in equal parts to build more robust, relevant, and solution-oriented behavior change programs; exploring moderators and mediators of change at levels of impact that go beyond the individual; and considering the circumstances in which applying conceptual methods that embrace a "complexity" as opposed to "causality" perspective may lead to more

  15. The health of Arctic populations: Does cold matter?

    PubMed

    Young, T Kue; Mäkinen, Tiina M

    2010-01-01

    The objective of the study was to examine whether cold climate is associated with poorer health in diverse Arctic populations. With climate change increasingly affecting the Arctic, the association between climate and population health status is of public health significance. The mean January and July temperatures were determined for 27 Arctic regions based on weather station data for the period 1961-1990 and their association with a variety of health outcomes assessed by correlation and multiple linear regression analyses. Mean January temperature was inversely associated with infant and perinatal mortality rate, age-standardized mortality rate from respiratory diseases, and age-specific fertility rate for teens and directly associated with life expectancy at birth in both males and females, independent of a variety of socioeconomic, demographic, and health care factors. Mean July temperature was also associated with infant mortality and mortality from respiratory diseases, and with total fertility rate. For every 10 degrees C increase in mean January temperature, the life expectancy at birth among males increased by about 6 years and infant mortality rate decreased by about 4 deaths/1,000 livebirths. Cold climate is significantly associated with higher mortality and fertility in Arctic populations and should be recognized in public health planning.

  16. Structural Factors Affecting Health Examination Behavioral Intention.

    PubMed

    Huang, Hui-Ting; Kuo, Yu-Ming; Wang, Shiang-Ru; Wang, Chia-Fen; Tsai, Chung-Hung

    2016-04-01

    Disease screening instruments used for secondary prevention can facilitate early determination and treatment of pathogenic factors, effectively reducing disease incidence, mortality rates, and health complications. Therefore, people should be encouraged to receive health examinations for discovering potential pathogenic factors before symptoms occur. Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan. In total, 388 effective questionnaires were analyzed through structural model analysis. Consequently, this study yielded four crucial findings: (1) The established extended health belief model could effectively predict health examination behavioral intention; (2) Self-efficacy was the factor that most strongly influenced health examination behavioral intention, followed by health knowledge; (3) Self-efficacy substantially influenced perceived benefits and perceived barriers; (4) Health knowledge and social support indirectly influenced health examination behavioral intention. The preceding results can effectively increase the acceptance and use of health examination services among the public, thereby facilitating early diagnosis and treatment and ultimately reducing disease and mortality rates.

  17. Structural Factors Affecting Health Examination Behavioral Intention

    PubMed Central

    Huang, Hui-Ting; Kuo, Yu-Ming; Wang, Shiang-Ru; Wang, Chia-Fen; Tsai, Chung-Hung

    2016-01-01

    Disease screening instruments used for secondary prevention can facilitate early determination and treatment of pathogenic factors, effectively reducing disease incidence, mortality rates, and health complications. Therefore, people should be encouraged to receive health examinations for discovering potential pathogenic factors before symptoms occur. Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan. In total, 388 effective questionnaires were analyzed through structural model analysis. Consequently, this study yielded four crucial findings: (1) The established extended health belief model could effectively predict health examination behavioral intention; (2) Self-efficacy was the factor that most strongly influenced health examination behavioral intention, followed by health knowledge; (3) Self-efficacy substantially influenced perceived benefits and perceived barriers; (4) Health knowledge and social support indirectly influenced health examination behavioral intention. The preceding results can effectively increase the acceptance and use of health examination services among the public, thereby facilitating early diagnosis and treatment and ultimately reducing disease and mortality rates. PMID:27043606

  18. [Health care expenditures and the aging population].

    PubMed

    Felder, S

    2012-05-01

    The impact of a longer life on future health care expenditures will be quite moderate because of the high costs of dying and the compression of mortality in old age. If not age per se but proximity to death determines the bulk of expenditures, a shift in the mortality risk to higher ages will not significantly affect lifetime health care expenditures, as death occurs only once in every life. A calculation of the demographic effect on health care expenditures in Germany up until 2050 that explicitly accounts for costs in the last years of life leads to a significantly lower demographic impact on per-capita expenditures than a calculation based on crude age-specific health expenditures.

  19. Maximizing the benefits of antiretroviral therapy for key affected populations

    PubMed Central

    Grubb, Ian R; Beckham, Sarah W; Kazatchkine, Michel; Thomas, Ruth M; Albers, Eliot R; Cabral, Mauro; Lange, Joep; Vella, Stefano; Kurian, Manoj; Beyrer, Chris

    2014-01-01

    Introduction Scientific research has demonstrated the clinical benefits of earlier initiation of antiretroviral treatment (ART), and that ART can markedly reduce HIV transmission to sexual partners. Ensuring universal access to ART for those who need it has long been a core principle of the HIV response, and extending the benefits of ART to key populations is critical to increasing the impact of ART and the overall effectiveness of the HIV response. However, this can only be achieved through coordinated efforts to address political, social, legal and economic barriers that key populations face in accessing HIV services. Discussion Recent analyses show that HIV prevalence levels among key populations are far higher than among the general population, and they experience a range of biological and behavioural factors, and social, legal and economic barriers that increase their vulnerability to HIV and have resulted in alarmingly low ART coverage. World Health Organization 2014 consolidated guidance on HIV among key populations offers the potential for increased access to ART by key populations, following the same principles as for the general adult population. However, it should not be assumed that key populations will achieve greater access to ART unless stigma, discrimination and punitive laws, policies and practices that limit access to ART and other HIV interventions in many countries are addressed. Conclusions Rights-based approaches and investments in critical enablers, such as supportive legal and policy environments, are essential to enable wider access to ART and other HIV interventions for key populations. The primary objective of ART should always be to treat the person living with HIV; prevention is an important, additional benefit. ART should be provided only with informed consent. The preventive benefits of treatment must not be used as a pretext for failure to provide other necessary HIV programming for key populations, including comprehensive harm

  20. Distributing shared savings for population health management.

    PubMed

    Averill, Richard F; Goldfield, Norbert; Hughes, John S

    2014-04-01

    Lessons from outcomes-based fee-for-service payment models that can be applied to population health management models include the following: Focus on outcomes, not processes. Limit the number of outcomes measures used. Ensure that the amount distributed is substantial enough to motivate behavior change. Communicate results clearly and transparently. Ensure that the financial consequence of poor performance is proportional to the cost increase it generates. Focus on reducing the rate of excess preventable outcomes.

  1. Local Health Department Collaborative Capacity to Improve Population Health.

    PubMed

    Rodriguez, Hector P; McCullough, Jeffrey Mac; Hsuan, Charleen

    2014-10-01

    Local health departments (LHDs) can more effectively develop and strengthen community health partnerships when leaders focus on building partnership collaborative capacity (PCC), including a multisector infrastructure for population health improvement. Using the 2008 National Association of County and City Health Officials (NACCHO) Profile survey, we constructed an overall measure of LHD PCC comprised of the five dimensions: outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. We conducted a series of regression analyses to examine the extent to which LHD characteristics and contextual factors were related to PCC. The most developed PCC dimension was vision-focus balance, while infrastructure development and community linkages were the least developed. In multivariate analyses, LHDs that were locally governed (rather than governed by the state), LHDs without local boards of health, and LHDs providing a wider range of clinical services had greater overall PCC. LHDs serving counties with higher uninsurance rates had lower overall PCC. LHDs with lower per capita expenditures had less developed partnership infrastructure. LHD discontinuation of clinical services may result in an erosion of collaborative capacity unless LHD partnerships also shift their foci from services delivery to population health improvement.

  2. Population coding of affect across stimuli, modalities and individuals

    PubMed Central

    Chikazoe, Junichi; Lee, Daniel H.; Kriegeskorte, Nikolaus; Anderson, Adam K.

    2014-01-01

    It remains unclear how the brain represents external objective sensory events alongside our internal subjective impressions of them—affect. Representational mapping of population level activity evoked by complex scenes and basic tastes uncovered a neural code supporting a continuous axis of pleasant-to-unpleasant valence. This valence code was distinct from low-level physical and high-level object properties. While ventral temporal and anterior insular cortices supported valence codes specific to vision and taste, both the medial and lateral orbitofrontal cortices (OFC), maintained a valence code independent of sensory origin. Further only the OFC code could classify experienced affect across participants. The entire valence spectrum is represented as a collective pattern in regional neural activity as sensory-specific and abstract codes, whereby the subjective quality of affect can be objectively quantified across stimuli, modalities, and people. PMID:24952643

  3. Adult height, nutrition, and population health

    PubMed Central

    Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George

    2016-01-01

    In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence. PMID:26928678

  4. Population health diagnosis with an ecohealth approach

    PubMed Central

    Arenas-Monreal, Luz; Cortez-Lugo, Marlene; Parada-Toro, Irene; Pacheco-Magaña, Lilian E; Magaña-Valladares, Laura

    2015-01-01

    OBJECTIVE To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico. METHODS Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems. RESULTS The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated. CONCLUSIONS With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population. PMID:26538099

  5. Adult height, nutrition, and population health.

    PubMed

    Perkins, Jessica M; Subramanian, S V; Davey Smith, George; Özaltin, Emre

    2016-03-01

    In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence.

  6. Communities of solution: partnerships for population health.

    PubMed

    Griswold, Kim S; Lesko, Sarah E; Westfall, John M

    2013-01-01

    Communities of solution (COSs) are the key principle for improving population health. The 1967 Folsom Report explains that the COS concept arose from the recognition that complex political and administrative structures often hinder problem solving by creating barriers to communication and compromise. A 2012 reexamination of the Folsom Report resurrects the idea of the COS and presents 13 grand challenges that define the critical links among community, public health, and primary care and call for ongoing demonstrations of COSs grounded in patient-centered care. In this issue, examples of COSs from around the country demonstrate core principles and propose visions of the future. Essential themes of each COS are the crossing of "jurisdictional boundaries," community-led or -oriented initiatives, measurement of outcomes, and creating durable connections with public health.

  7. Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus

    PubMed Central

    Pottie, Kevin; Hui, Charles; Rahman, Prinon; Ingleby, David; Akl, Elie A.; Russell, Grant; Ling, Li; Wickramage, Kolitha; Mosca, Davide; Brindis, Claire D.

    2017-01-01

    Persons affected by migration require health systems that are responsive and adaptable to the needs of both disadvantaged migrants and non-migrant populations. The objective of this study is to support health systems for populations affected by migration. Materials and Methods: An international Delphi consensus process was used to identify policy approaches to improve health systems for populations affected by migration. Participants were leading migrant health experts from Americas, Europe, Middle East, Asia, and Australasia. We calculated average ranking scores and qualitatively analyzed open-ended questions. Results: Participants identified the following key areas as priorities for policy development: health inequities, system discrimination, migrant related health data, disadvantaged migrant sub-groups, and considerations for disadvantaged non-migrant populations. Highly ranked items to improve health systems were: Health Equity Impact Assessment, evidence based guidelines, and the International Organization for Migration annual reports. Discussion: Policy makers need tools, data and resources to address health systems challenges. Policies need to avoid preventable deaths of migrants and barriers to basic health services. PMID:28165380

  8. Ambient air pollution and population health: overview.

    PubMed

    Krewski, Daniel; Rainham, Daniel

    2007-02-01

    In November 2003 approximately 200 researchers, stakeholders, and policymakers from more than 40 countries gathered to discuss the science and policy implications of air pollution and human health as part of the AIRNET/NERAM Strategies for Clean Air and Health initiative. The purpose of this paper is to review the more than 35 research posters presented at the conference, including exposure, toxicological, and epidemiological studies of air pollution. Collectively, these papers support previous evidence that both short- and long-term exposures to particulate air pollution have adverse population health impacts, including effects on children. Cellular studies also suggest that air pollution can cause mutagenic and oxidative effects, raising concerns about carcinogenicity and cellular regeneration. Studies of biomarkers, such as Clara-cell proteins and lymphocyte damage assessment, provide further evidence of air pollution effects at the cellular level. Other studies have focused on improvements to measurement and sources of air pollution. These studies suggest that particle mass rather than particle composition may be a more useful indicator of potential human health risk. It is well known that emissions from transportation sources are a major contributor to ambient air pollution in large urban centres. Epidemiologic researchers are able to reduce bias due to misclassification and improve exposure assessment models by allocating air pollution exposure according to distance from traffic sources or land-use patterns. The close association between traffic patterns and air pollution concentrations provides a potential basis for the development of transport policies and regulations with population health improvements as a primary objective. The results of the research presented here present opportunities and challenges for the development of policies for improvements to air quality and human health. However, there remains the challenge of how best to achieve these

  9. How the Neanderthal in Your Genes Affects Your Health

    MedlinePlus

    ... medlineplus.gov/news/fullstory_163749.html How the Neanderthal in Your Genes Affects Your Health The DNA ... 23, 2017 THURSDAY, Feb. 23, 2017 (HealthDay News) -- Neanderthals were wiped out about 40,000 years ago, ...

  10. The Relationship of Health Aid to Population Health Improvements

    PubMed Central

    Bendavid, Eran; Bhattacharya, Jay

    2016-01-01

    Importance Foreign aid to the health sector is an important component of all health spending in many developing countries. The relationship between health aid and changes in population health among aid recipients remains unknown. Objective To quantify the relationship between health aid and changes in life expectancy and under-5 mortality among aid recipient nations. Design Cross-country panel data analysis of the relationship between longitudinal measures of health aid, life expectancy, and under-5 mortality. Using difference models for longitudinal data with fixed effects for countries and years, we estimate the unique relationship between health aid and changes in life expectancy and under-5 mortality, controlling for gross domestic product per capita, urbanization, and total fertility rate. Setting and participants 140 aid-recipient countries between 1974 and 2010. Main Exposures and Outcomes and Measures The main exposure is the annual amount of development assistance directed to the health sector in constant 2010 US dollars; the principal outcomes are the improvements in under-5 mortality and life expectancy in in the period following aid receipt. Results We find that between 1974 and 2010, life expectancy increased by 0.24 months faster (95% CI 0.02-0.46, p=0.03) and under-5 mortality declined by 0.14 per 1,000 live births faster (95% CI 0.02-0.26, p=0.02) with each 1% increase in health aid. We also find that the association between health aid and health improvements has been strengthening over time, with the closest association between 2000 and 2010. We find that health improvements associated with health aid are measurable for 3-5 years after aid disbursement. These findings imply that an increase of $1 billion in health aid could be associated with 364,800 (95% CI 98,400-630,000) fewer under-5 deaths. Conclusions Foreign aid to the health sector is related to increasing life expectancy and declining under-5 mortality. The returns to aid appear to last

  11. Health Complaints, Stress, and Distress: Exploring the Central Role of Negative Affectivity.

    ERIC Educational Resources Information Center

    Watson, David; Pennebaker, James W.

    1989-01-01

    Studies involving several population types (300 college students and 222 adults) and an assessment of related research examined assumptions that stress adversely affects physical health. Results indicate that self-report measures tend to overestimate the true association between stress and health due to the existence of negative affectivity…

  12. Measurement in Veterans Affairs Health Services Research: Veterans as a Special Population

    PubMed Central

    Morgan, Robert O; Teal, Cayla R; Reddy, Siddharta G; Ford, Marvella E; Ashton, Carol M

    2005-01-01

    Objective To introduce this supplemental issue on measurement within health services research by using the population of U.S. veterans as an illustrative example of population and system influences on measurement quality. Principal Findings Measurement quality may be affected by differences in demographic characteristics, illness burden, psychological health, cultural identity, or health care setting. The U.S. veteran population and the VA health system represent a microcosm in which a broad range of measurement issues can be assessed. Conclusions Measurement is the foundation on which health decisions are made. Poor measurement quality can affect both the quality of health care decisions and decisions about health care policy. The accompanying articles in this issue highlight a subset of measurement issues that have applicability to the broad community of health services research. It is our hope that they stimulate a broad discussion of the measurement challenges posed by conducting “state-of-the-art” health services research. PMID:16178996

  13. Climate change, food, water and population health in China

    PubMed Central

    Berry, Helen L; Ebi, Kristie; Bambrick, Hilary; Hu, Wenbiao; Green, Donna; Hanna, Elizabeth; Wang, Zhiqiang; Butler, Colin D

    2016-01-01

    Abstract Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change’s most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially – although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources – e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change – e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases – are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population’s resilience to the risks of climate variability and change. PMID:27843166

  14. Population density affects sex ratio variation in red deer.

    PubMed

    Kruuk, L E; Clutton-Brock, T H; Albon, S D; Pemberton, J M; Guinness, F E

    1999-06-03

    Many mammal populations show significant deviations from an equal sex ratio at birth, but these effects are notoriously inconsistent. This may be because more than one mechanism affects the sex ratio and the action of these mechanisms depends on environmental conditions. Here we show that the adaptive relationship between maternal dominance and offspring sex ratio previously demonstrated in red deer (Cervus elaphus), where dominant females produced more males, disappeared at high population density. The proportion of males born each year declined with increasing population density and with winter rainfall, both of which are environmental variables associated with nutritional stress during pregnancy. These changes in the sex ratio corresponded to reductions in fecundity, suggesting that they were caused by differential fetal loss. In contrast, the earlier association with maternal dominance is presumed to have been generated pre-implantation. The effects of one source of variation superseded the other within about two generations. Comparison with other ungulate studies indicates that positive associations between maternal quality and the proportion of male offspring born have only been documented in populations below carrying capacity.

  15. Arsenic in Drinking Water in Bangladesh: Factors Affecting Child Health

    PubMed Central

    Aziz, Sonia N.; Aziz, Khwaja M. S.; Boyle, Kevin J.

    2014-01-01

    The focus of this paper is to present an empirical model of factors affecting child health by observing actions households take to avoid exposure to arsenic in drinking water. Millions of Bangladeshis face multiple health hazards from high levels of arsenic in drinking water. Safe water sources are either expensive or difficult to access, affecting people’s individuals’ time available for work and ultimately affecting the health of household members. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, parental actions linking child health outcomes is used in the empirical model. Empirical results suggest that child health is significantly affected by the age and gender of the household water procurer. Adults with a high degree of concern for children’s health risk from arsenic contamination, and who actively mitigate their arsenic contaminated water have a positive effect on child health. PMID:24982854

  16. Forced movements of population and health hazards in tropical Africa.

    PubMed

    Prothero, R M

    1994-08-01

    Significant interactions between disease and population mobility have been demonstrated in tropical Africa in recent decades. Problems arising are greater than in the past. During the last two decades forced movements have become important. These are associated with refugees, coerced resettlement and victims of environmental catastrophe. The health hazards associated with them are reviewed from medical and social science literature for North East Africa (refugees and resettlement) and for West Africa (pastoralists affected by drought). Political, social and economic settings are of importance but tend to receive only limited attention. There is need for more social science input in studying and ameliorating problems arising from health hazards associated with and exacerbated by forced movements of population.

  17. Health care reform, behavioral health, and the criminal justice population.

    PubMed

    Cuellar, Alison Evans; Cheema, Jehanzeb

    2014-10-01

    The 2010 Patient Protection and Affordable Care Act (ACA) has a number of important features for individuals who are involved with the criminal justice system. Among the most important changes is the expansion of Medicaid to more adults. The current study estimates that 10% of the total Medicaid expansion could include individuals who have experienced recent incarceration. The ACA also emphasizes the importance of mental health and substance abuse benefits, potentially changing the landscape of behavioral health treatment providers willing to serve criminal justice populations. Finally, it seeks to promote coordinated care delivery. New care delivery and appropriate funding models are needed to address the behavioral health and other chronic conditions experienced by those in criminal justice and to coordinate care within the complex structure of the justice system itself.

  18. Positive affect and psychosocial processes related to health.

    PubMed

    Steptoe, Andrew; O'Donnell, Katie; Marmot, Michael; Wardle, Jane

    2008-05-01

    Positive affect is associated with longevity and favourable physiological function. We tested the hypothesis that positive affect is related to health-protective psychosocial characteristics independently of negative affect and socio-economic status. Both positive and negative affect were measured by aggregating momentary samples collected repeatedly over 1 day, and health-related psychosocial factors were assessed by questionnaire in a sample of 716 men and women aged 58-72 years. Positive affect was associated with greater social connectedness, emotional and practical support, optimism and adaptive coping responses, and lower depression, independently of age, gender, household income, paid employment, smoking status, and negative affect. Negative affect was independently associated with negative relationships, greater exposure to chronic stress, depressed mood, pessimism, and avoidant coping. Positive affect may be beneficial for health outcomes in part because it is a component of a profile of protective psychosocial characteristics.

  19. Changing Population Health Policy: A Model for Identifying Health Needs and Recommendations to Improve Health Status.

    PubMed

    Schroeder, Shawnda M

    2016-06-01

    In the spring of 2014, the North Dakota Center for Rural Health (CRH) was tasked with completing an objective assessment of the state oral health environment. This included an assessment of oral health status, review of workforce needs, evaluation of current oral health programs, and policy recommendations to ameliorate identified oral health needs. The report was prepared for the North Dakota Legislative Health Services Interim Committee. This article highlights a research method developed and employed to identify current population health status and policy recommendations through statewide collaboration, transparent process, and objective analyses, regardless of the health specialty of focus. Evidenced-based decision making in health policy requires more than presentation of data. It requires input from the population or community utilizing or struggling to gain access to the given health service. It is now understood that health services researchers must employ a variety of research methods, include end users in the research process, tailor presentation of the findings for the appropriate audience, and include the population of study in the research, allowing them to provide recommended solutions when possible. Although the effort to be described focused specifically on oral health in North Dakota, the methodologies used to answer the research questions could, and are encouraged to, be employed in other states with regard to other specialty health disciplines and population health studies. The study sought to answer 3 questions: (1) What is the population health need?; (2) What is already being done?; and (3) What are the recommendations to improve population health? (Population Health Management 2016;19:216-223).

  20. Discrimination, work and health in immigrant populations in Spain.

    PubMed

    Agudelo-Suárez, Andrés; Gil-González, Diana; Ronda-Pérez, Elena; Porthé, Victoria; Paramio-Pérez, Gema; García, Ana M; Garí, Aitana

    2009-05-01

    One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. A qualitative study was performed by means of 84 interviews and 12 focus groups held with immigrant workers in five cities in Spain receiving a large influx of immigrants (Madrid, Barcelona, Valencia, Alicante and Huelva), covering representative immigrant communities in Spain (Romanians, Moroccans, Ecuadorians, Colombians and Sub-Saharan Africans). Discourse narrative content analysis was performed using pre-established categories and gradually incorporating other emerging categories from the immigrant interviewees themselves. The participants reported instances of discrimination in their community and working life, characterised by experiences of racism, mistreatment and precarious working conditions in comparison to the Spanish-born population. They also talked about limitations in terms of accessible occupations (mainly construction, the hotel and restaurant trade, domestic service and agriculture), and described major difficulties accessing other types of work (for example public administration). They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual

  1. May organic pollutants affect fish populations in the North Sea?

    PubMed

    Hylland, Ketil; Beyer, Jonny; Berntssen, Marc; Klungsøyr, Jarle; Lang, Thomas; Balk, Lennart

    2006-01-08

    The North Sea is a highly productive area with large fish populations that have been extensively harvested over the past century. North Sea fisheries remain important to the surrounding countries despite declining fish stocks over the past decades. The main reason for declining fish stocks is nearly certainly overfishing, but other environmental pressures also affect fish populations, such as eutrophication, climate change, and exposure to metals and organic pollutants, including polyaromatic hydrocarbons (PAHs), alkylphenols, and organochlorine compounds. There are three main sources of organic pollutants in the North Sea: atmospheric, land-based sources, and inputs from offshore gas and oil installations. All three sources contribute to elevated concentrations of organic pollutants in the North Sea compared to the Norwegian Sea. There is evidence that chlorinated organic contaminants were present in sufficiently high concentrations in the southern North Sea two decades ago, to alter embryonal development in fish. The results from extensive, long-term monitoring programs show that some diseases decreased whereas other increased in the southern North Sea and that, among other factors, contaminants may play a role in the temporal changes recorded in disease prevalence. Recent studies demonstrated that components in offshore effluents may affect fish reproduction and that tissues of fish near oil rigs are structurally different to tissues of fish from reference areas. Data on effluents from offshore activities have recently become available through an international workshop (BECPELAG) and follow-up studies.

  2. New health physics perspectives affecting instrumentation technology

    SciTech Connect

    Vallario, E.

    1983-06-01

    Measurements obtained from health physics instrumentation are basic to the radiation control process and are used by management to assure that radiation exposures are kept within limits specified by national-international authorities. Because of this inseparable relationship, health physics instrumentation must be keyed on a continuing basis to changes in radiation exposure standards. In the last five years, there have been dramatic changes to the basic radiation protection standards. These changes should be evaluated in the context of the need for corresponding changes in instrumentation technology. At the time these assessments are made, care must be exercised to assure that radiation protection standards are not dictated by inadequate state-of-the-art technology. It is imperative that the development pathway to be followed be properly structured. This is particularly true for ''critical'' instrumentation standards i.e., those standards directly related to the determination of the radiation status of the worker, public, and their environment.

  3. Types of provincial structure and population health.

    PubMed

    Young, Frank W; Rodriguez, Eunice

    2005-01-01

    This paper explores the potential of using large administrative units for studies of population health within a country. The objective is to illustrate a new way of defining structural dimensions and to use them in examining variation in life expectancy rates. We use data from the 50 provinces of Spain as a case study. A factor analysis of organizational items such as schools, hotels and medical personnel is employed to define and generate "collective" measures for well-known provincial types, in this case: urban, commercial, industrial and tourist provinces. The scores derived from the factor analysis are then used in a regression model to predict life expectancy. The City-centered and Commercial provinces showed positive correlations with life expectancy while those for the Tourist provinces were negative. The industrial type was nonsignificant. Explanations of these correlations are proposed and the advantages and disadvantages of this exploratory technique are reviewed. The use of this technique for generating an overview of social organization and population health is discussed.

  4. The Impact of Disasters on Populations With Health and Health Care Disparities

    PubMed Central

    Davis, Jennifer R.; Wilson, Sacoby; Brock-Martin, Amy; Glover, Saundra; Svendsen, Erik R.

    2010-01-01

    Context A disaster is indiscriminate in whom it affects. Limited research has shown that the poor and medically underserved, especially in rural areas, bear an inequitable amount of the burden. Objective To review the literature on the combined effects of a disaster and living in an area with existing health or health care disparities on a community’s health, access to health resources, and quality of life. Methods We performed a systematic literature review using the following search terms: disaster, health disparities, health care disparities, medically underserved, and rural. Our inclusion criteria were peer-reviewed, US studies that discussed the delayed or persistent health effects of disasters in medically underserved areas. Results There has been extensive research published on disasters, health disparities, health care disparities, and medically underserved populations individually, but not collectively. Conclusions The current literature does not capture the strain of health and health care disparities before and after a disaster in medically underserved communities. Future disaster studies and policies should account for differences in health profiles and access to care before and after a disaster. PMID:20389193

  5. FastStats: Health of Asian or Pacific Islander Population

    MedlinePlus

    ... States, 2015, table 49 [PDF - 9.8 MB] Health insurance coverage for Asian population Percent of persons under 65 years without health insurance coverage: 7.5% Source: Summary Health Statistics Tables ...

  6. How energy policies affect public health.

    PubMed Central

    Romm, J J; Ervin, C A

    1996-01-01

    The connection between energy policy and increased levels of respiratory and cardiopulmonary disease has become clearer in the past few years. People living in cities with high levels of pollution have a higher risk of mortality than those living in less polluted cities. The pollutants most directly linked to increased morbidity and mortality include ozone, particulates, carbon monoxide, sulfur dioxide, volatile organic compounds, and oxides of nitrogen. Energy-related emissions generate the vast majority of these polluting chemicals. Technologies to prevent pollution in the transportation, manufacturing, building, and utility sectors can significantly reduce these emissions while reducing the energy bills of consumers and businesses. In short, clean energy technologies represent a very cost-effective investment in public health. Some 72% of the Federal government's investment in the research, development, and demonstration of pollution prevention technologies is made by the Department of Energy, with the largest share provided by the Office of Energy Efficiency and Renewable Energy. This article will examine the connections between air pollution and health problems and will discuss what the Department of Energy is doing to prevent air pollution now and in the future. Images p390-a p391-a p392-a p393-a p394-a p395-a p396-a p397-a PMID:8837627

  7. Ambient air pollution, climate change, and population health in China.

    PubMed

    Kan, Haidong; Chen, Renjie; Tong, Shilu

    2012-07-01

    As the largest developing country, China has been changing rapidly over the last three decades and its economic expansion is largely driven by the use of fossil fuels, which leads to a dramatic increase in emissions of both ambient air pollutants and greenhouse gases (GHGs). China is now facing the worst air pollution problem in the world, and is also the largest emitter of carbon dioxide. A number of epidemiological studies on air pollution and population health have been conducted in China, using time-series, case-crossover, cross-sectional, cohort, panel or intervention designs. The increased health risks observed among Chinese population are somewhat lower in magnitude, per amount of pollution, than the risks found in developed countries. However, the importance of these increased health risks is greater than that in North America or Europe, because the levels of air pollution in China are very high in general and Chinese population accounts for more than one fourth of the world's totals. Meanwhile, evidence is mounting that climate change has already affected human health directly and indirectly in China, including mortality from extreme weather events; changes in air and water quality; and changes in the ecology of infectious diseases. If China acts to reduce the combustion of fossil fuels and the resultant air pollution, it will reap not only the health benefits associated with improvement of air quality but also the reduced GHG emissions. Consideration of the health impact of air pollution and climate change can help the Chinese government move forward towards sustainable development with appropriate urgency.

  8. Oak Ridge Health Studies Phase 1 report, Volume 2: Part C, Dose Reconstruction Feasibility Study. Tasks 5: A summary of information concerning historical locations and activities of populations potentially affected by releases from the Oak Ridge Reservation

    SciTech Connect

    DaMassa, C.L.; Widner, T.E.

    1993-09-01

    A significant number of information sources have been identified that are relevant to historical locations and activities of populations potentially affected by releases from the Oak Ridge Reservation. The information that has been reviewed as part of this Task 5 investigation has shown that numerous residences and farms have historically been present near the ORR boundary and that a variety of land uses and recreational activities have been practiced. Based on this information alone, it would appear that many routes of off-site exposure could have been plausible. Most of the available published information addresses demographic and land use data on a regional or county-wide basis over fairly broad time periods. The information sources that are most readily available do not support direct evaluation of potential exposure pathways at specific geographic locations near the Oak Ridge facilities at specific points in time. A number of information sources have been identified that can provide demography and land use information more specific to locations and time periods that are identified to be of interest. Examples of data sources in this category include individual USGS topographic maps, aerial photographs, lowest-level census tract data, and interviews with long-time local residents. However, specific release events and periods of interest should be identified prior to attempts to collect more specific demographic or land use information for actual dose reconstruction.

  9. The model of fungal population dynamics affected by nystatin

    NASA Astrophysics Data System (ADS)

    Voychuk, Sergei I.; Gromozova, Elena N.; Sadovskiy, Mikhail G.

    Fungal diseases are acute problems of the up-to-day medicine. Significant increase of resistance of microorganisms to the medically used antibiotics and a lack of new effective drugs follows in a growth of dosage of existing chemicals to solve the problem. Quite often such approach results in side effects on humans. Detailed study of fungi-antibiotic dynamics can identify new mechanisms and bring new ideas to overcome the microbial resistance with a lower dosage of antibiotics. In this study, the dynamics of the microbial population under antibiotic treatment was investigated. The effects of nystatin on the population of Saccharomyces cerevisiae yeasts were used as a model system. Nystatin effects were investigated both in liquid and solid media by viability tests. Dependence of nystatin action on osmotic gradient was evaluated in NaCl solutions. Influences of glucose and yeast extract were additionally analyzed. A "stepwise" pattern of the cell death caused by nystatin was the most intriguing. This pattern manifested in periodical changes of the stages of cell death against stages of resistance to the antibiotic. The mathematical model was proposed to describe cell-antibiotic interactions and nystatin viability effects in the liquid medium. The model implies that antibiotic ability to cause a cells death is significantly affected by the intracellular compounds, which came out of cells after their osmotic barriers were damaged

  10. Environment and Host Affects Arbuscular Mycorrhiza Fungi (AMF) Population

    PubMed Central

    Rahim, Norahizah Abd; Jais, Hasnah Md; Hassan, Hasnuri Mat

    2016-01-01

    The association of arbuscular mycorrhiza fungi (AMF) and roots undoubtedly gives positive advantages to the host plant. However, heavily fertilised soil such as in oil palm plantation, inhibit the growth of mycorrhiza. Thus, the aim of this research is to distinguish and quantify the availability of AMF population and propagules at different sites of an oil palm plantation by Most Probable Number (MPN) assay. In addition, root infection method was employed to observe host compatibility through the propagation of AMF using two different types of hosts, monocotyledon (Echinochloa cruss-galli) and dicotyledon (Vigna radiata). Three different locations at an oil palm plantation were chosen for sampling. Each location was represented by a distinctive soil series, and were further divided into two sites, that is canopy and midway area. Midway site had a greater population of AMF compared to canopy. The result showed that different environments affect the availability of AMF in the soil. Higher number of AMF infection observed in monocotyledon host suggests that the fibrous root system provide a better association with mycorrhiza. PMID:27965735

  11. Health in the hot zone - How could global warming affect humans?

    SciTech Connect

    Monastersky, R.

    1996-04-06

    A soon-to-be-released report from the World Health Organization examines the health effects of global warming, calling climate change one of the largest public health challenges for the upcoming century. The issue extends beyond tropical illness: deaths caused directly by heat, dwindling agricultural yields etc. could all affect human health. This article looks at the following health related effects and gives an overview of the scientific information available on each: temperature and mortality; tropical trouble, including vecorborne diseases and increase in susceptable populations; and waterborne problems such as cholera, harmful algal bloomes, food shortages.

  12. Positive affect, negative affect, stress, and social support as mediators of the forgiveness-health relationship.

    PubMed

    Green, Michelle; Decourville, Nancy; Sadava, Stanley

    2012-01-01

    Structural equation modeling was used to test a model in which positive affect, negative affect, perceived stress, and social support were hypothesized to mediate the relationship between forgiveness and mental and physical health. Six hundred and twenty-three undergraduates completed a battery of self-report measures. Results of the analyses indicated that the forgiveness-health relation was mediated by positive affect, negative affect, stress, and the interrelationship between negative affect and stress. There was limited support for social support and the interrelationship between positive affect and social support as mediators. The results suggested that the relationship between forgiveness and health is mediated rather than direct. Implications and directions for future research are discussed.

  13. Population health in New Zealand 2000–2013: From determinants of health to targets

    PubMed Central

    Kenealy, Timothy W; Schmidt-Busby, Jacqueline IG; Rea, Harold H

    2015-01-01

    Objective: To determine how ‘population health’ has been understood in practice and policy and has influenced health system restructuring in New Zealand since 2000. Methods: Interviews in 2007–2008 with managers, clinicians, government policy advisors and academics were undertaken to explore the relationships between population health, determinants of health, and health system restructuring. This was augmented by a review of major government health policies from 2009 to 2013 to establish which notions of population health were reflected. Results: Population health shifted from a broad notion of health determinants to focus on a small number of quantifiable health targets driven by financial incentives. Meantime, an emphasis on ‘quality and safety’ impeded population health activities. District Health Board programmes to identify high risk individuals, by disease or hospital service utilisation, diverted attention from broader population health outcomes. District Health Boards were not held accountable for integrating a population health approach in service planning and did not initiate or lead intersectoral work. Community consultation was limited. Primary Health Organisations, although mandated to address population health, typically aligned with the small-business model of general practice making service integration difficult to achieve. In policy, ‘population health’ dropped from favour in the mid-2000s, although many documents, outside the health sector, carried forward these values. Conclusion: A progressively narrower focus on a small number of health targets and on organisational processes undermined earlier policy intentions and health system restructuring that sought to improve broader population health outcomes. PMID:26770767

  14. Population Health Considerations for Pediatric Asthma: Findings from the 2011-2012 California Health Interview Survey.

    PubMed

    Shaikh, Ulfat; Byrd, Robert S

    2016-04-01

    Childhood asthma is a prevalent and costly chronic condition. Optimal management enables secondary and tertiary prevention. The goal was to identify population health considerations for pediatric asthma in California to inform the development of quality improvement interventions. California Health Interview Survey 2011-2012 is a random-digit dial telephone survey conducted in 5 languages. It includes 44,000 households from all 58 counties in California. This study assessed factors related to symptom control and health care use in children ages 2-11 years with asthma. An estimated 492,385 (9.6%) of children in California currently have asthma. Urban and rural residents face comparable asthma disease burdens. School-age male children as well as Asian and African American children are disproportionately affected. Asthma causes significant morbidity, with poorer health status, high utilization of emergency care, and the need for daily medication use. Only 38% of children with asthma have a recent asthma management plan. Half of all children with asthma did not receive influenza immunization in the past year, although this reflects the overall low rate of influenza vaccination. Parents of children with asthma frequently utilize the Internet for health information and communication with their child's health care provider. Children with asthma in California face several population-level challenges, including poor health status, low influenza vaccination rates, high use of emergency care, and suboptimal use of health literacy tools. Focusing on improved care coordination and preventive care for high-risk groups is especially urgent given the expansion of public health insurance and impending shortages in the primary care workforce. (Population Health Management 2016;19:145-151).

  15. Mind/Body Connection: How Your Emotions Affect Your Health

    MedlinePlus

    ... body. Relaxation methods, such as meditation, listening to music, listening to guided imagery CD's or mp3's, yoga, ... Article >>Mental HealthPostpartum Depression (PPD)Postpartum depression affects women after childbirth. It includes feelings of sadness, loneliness, ...

  16. Health Insurance Coverage: 2000. Consumer Income. Current Population Reports.

    ERIC Educational Resources Information Center

    Mills, Robert J.

    This report uses data from the U.S. Census Bureau's March 2001 Current Population Survey to examine health insurance coverage. The number and percentage of people covered by employment-based health insurance rose significantly in 2000, driving the overall increase in health insurance coverage. Among the entire population age 18-64 years, workers…

  17. COULD ETHINYL ESTRADIOL AFFECT THE POPULATION BIOLOGY OF CUNNER, TAUTOGOLABRUS ADSPERSUS

    EPA Science Inventory

    Endocrine disrupting chemicals in the environment may disturb the population dynamics of wildlife by affecting reproductive output and embryonic development of organisms. This study used a population model to evaluate whether ethinyl estradiol (EE2 could affect cunner Tautogolabr...

  18. The relationship between health expenditures and the age structure of the population in OECD countries.

    PubMed

    O'Connell, J M

    1996-01-01

    The purpose of this study was to analyse national health expenditures of OECD countries relative to their age structures. Using econometric techniques designed to analyse cross-sectional time series data, the ageing of the population was found to affect health spending in several countries while having no effect in others. In addition, the effect of income on health spending was lower than that generally reported in the literature. These findings suggest that unobserved country-specific factors play a major role in determining the amount of resources allocated to health services in a country. Such factors also determine if the ageing of the population with increased health spending.

  19. In-home behavioral health case management: an integrated model for high-risk populations.

    PubMed

    Theis, Gerald A; Kozlowski, Deirdre; Behrens, Jenna

    2006-01-01

    The escalating health care costs attributed to high-risk populations have fueled a need for a proactive approach to deal with people affected by complex mental health issues that often coexist with chronic medical conditions. Through an in-home behavioral health case management (CM) program, patients with mental illnesses (some with coexisting medical conditions) receive integrated medical and mental health services through a disease-management approach that has proven effective in treating high-risk patients.

  20. Commentary: improving the health of neglected populations in Latin America.

    PubMed

    Franco-Paredes, Carlos; Jones, Danielle; Rodríguez-Morales, Alfonso J; Santos-Preciado, José Ignacio

    2007-01-23

    Neglected diseases encompass a group of pathologies that disproportionally affect resource-constrained areas of the world. In tropical and subtropical areas in Latin America, the vicious cycle of poverty, disease and underdevelopment is widespread. The burden of disease associated to neglected diseases in this region is mainly expressed through diseases such as malaria, dengue, intestinal parasitic infections, Chagas' disease, and many others. These maladies have burdened Latin America throughout centuries and have directly influenced their ability to develop and become competitive societies in the current climate of globalization. Therefore, the need for a new paradigm that integrates various public health policies, programs, and a strategy with the collaboration of all responsible sectors is long overdue. In this regard, innovative approaches are required to ensure the availability of low-cost, simple, sustainable, and locally acceptable strategies to improve the health of neglected populations to prevent, control, and potentially eliminate neglected diseases. Improving the health of these forgotten populations will place them in an environment more conducive to development and will likely contribute significantly to the achievement of the Millennium Development Goals in this area of the globe.

  1. How Does Tele-Mental Health Affect Group Therapy Process? Secondary Analysis of a Noninferiority Trial

    ERIC Educational Resources Information Center

    Greene, Carolyn J.; Morland, Leslie A.; Macdonald, Alexandra; Frueh, B. Christopher; Grubbs, Kathleen M.; Rosen, Craig S.

    2010-01-01

    Objective: Video teleconferencing (VTC) is used for mental health treatment delivery to geographically remote, underserved populations. However, few studies have examined how VTC affects individual or group psychotherapy processes. This study compares process variables such as therapeutic alliance and attrition among participants receiving anger…

  2. Design Factors Affect User Experience for Different Cultural Populations

    ERIC Educational Resources Information Center

    Chu, Sauman

    2016-01-01

    With increasing changes in our demographic populations and new immigrants settling in the US, there is an increasing need for visual communications that address the diversity of our populations. This paper draws from the results of the researcher's several past research and teaching projects that worked with different cultural populations. These…

  3. Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity.

    PubMed

    Bauer, Greta R

    2014-06-01

    Intersectionality theory, developed to address the non-additivity of effects of sex/gender and race/ethnicity but extendable to other domains, allows for the potential to study health and disease at different intersections of identity, social position, processes of oppression or privilege, and policies or institutional practices. Intersectionality has the potential to enrich population health research through improved validity and greater attention to both heterogeneity of effects and causal processes producing health inequalities. Moreover, intersectional population health research may serve to both test and generate new theories. Nevertheless, its implementation within health research to date has been primarily through qualitative research. In this paper, challenges to incorporation of intersectionality into population health research are identified or expanded upon. These include: 1) confusion of quantitative terms used metaphorically in theoretical work with similar-sounding statistical methods; 2) the question of whether all intersectional positions are of equal value, or even of sufficient value for study; 3) distinguishing between intersecting identities, social positions, processes, and policies or other structural factors; 4) reflecting embodiment in how processes of oppression and privilege are measured and analysed; 5) understanding and utilizing appropriate scale for interactions in regression models; 6) structuring interaction or risk modification to best convey effects, and; 7) avoiding assumptions of equidistance or single level in the design of analyses. Addressing these challenges throughout the processes of conceptualizing and planning research and in conducting analyses has the potential to improve researchers' ability to more specifically document inequalities at varying intersectional positions, and to study the potential individual- and group-level causes that may drive these observed inequalities. A greater and more thoughtful incorporation

  4. Population Health Research: Early Description of the Organizational Shift Toward Population Health Management and Defining a Vision for Leadership.

    PubMed

    Caldararo, Kristi L; Nash, David B

    2017-03-06

    As health care delivery systems adapt to the changing marketplace, many struggle to define a clear strategy that will prove successful in managing the health of entire populations. The federal government continues to put increasing pressure on organizations to shift away from the traditional way of delivering episodic care and move toward managing populations as a whole-before, during, and after a patient presents in a health care facility. Private payers have begun to follow suit as risk-based payer contracts and bundled payment models become increasingly popular. For organizations to adequately influence the health outcomes of a population, they must be responsible for more than just a patient's medical care. They must partner with the community to create a strategy that encompasses the psychosocial and environmental factors that contribute to one's health. Although health care leaders know this industry transformation is imminent, there is minimal research that shares best practices in regard to designing and implementing a successful population health management strategy. Interviews were conducted with leadership from 10 organizations in order to understand the strategic approach taken by delivery systems and health care institutions that view population health as a key aspect of their overall mission. Responses were recorded and outlined in a detailed response grid. The objective is to provide a qualitative overview of how industry leaders are currently responding to population health. Additionally, common themes and recommendations are presented to serve as guidance for other health care organizations that are at the start of their journey toward population health management.

  5. Teaching nurses to focus on the health needs of populations: a Master's Degree Program in Population Health Nursing.

    PubMed

    Frisch, Noreen Cavan; George, Valerie; Govoni, Amy L; Jennings-Sanders, Andrea; McCahon, Cheryl P

    2003-01-01

    Responding to the mandate to prepare nurses for practice in population-based healthcare, the faculty at Cleveland State University (CSU) developed a unique Master of Science in Nursing program to prepare Population Health Nurse Experts. The program prepares nurses to examine the health status of populations and to design, implement, and evaluate nursing interventions accounting for the varied factors impacting on the health of a defined group. The speciality of population health nursing is practiced by nurses who can use population sciences (epidemiology, demography, population projections, and population behavioral theories) along with post-baccalaureate nursing competencies to work with defined populations across care environments. The authors discuss a curriculum that prepares nurses for this emerging speciality.

  6. Positive affect and psychobiological processes relevant to health.

    PubMed

    Steptoe, Andrew; Dockray, Samantha; Wardle, Jane

    2009-12-01

    Empirical evidence suggests that there are marked associations between positive psychological states and health outcomes, including reduced cardiovascular disease risk and increased resistance to infection. These observations have stimulated the investigation of behavioral and biological processes that might mediate protective effects. Evidence linking positive affect with health behaviors has been mixed, though recent cross-cultural research has documented associations with exercising regularly, not smoking, and prudent diet. At the biological level, cortisol output has been consistently shown to be lower among individuals reporting positive affect, and favorable associations with heart rate, blood pressure, and inflammatory markers such as interleukin-6 have also been described. Importantly, these relationships are independent of negative affect and depressed mood, suggesting that positive affect may have distinctive biological correlates that can benefit health. At the same time, positive affect is associated with protective psychosocial factors such as greater social connectedness, perceived social support, optimism, and preference for adaptive coping responses. Positive affect may be part of a broader profile of psychosocial resilience that reduces risk of adverse physical health outcomes.

  7. Influenza prevention and population health management.

    PubMed

    Kuhn, Alyce

    2008-10-01

    Modifiable health risk factors can be improved through effective health promotion and disease management efforts, such as vaccinations. Employers must understand that employee illness is related to not only medical and pharmaceutical costs, but to productivity costs as well.

  8. Health Literacy Skills in Rural and Urban Populations

    ERIC Educational Resources Information Center

    Zahnd, Whitney E.; Scaife, Steven L.; Francis, Mark L.

    2009-01-01

    Objective: To determine whether health literacy is lower in rural populations. Method: We analyzed health, prose, document, and quantitative literacy from the National Assessment of Adult Literacy study. Metropolitan Statistical Area designated participants as rural or urban. Results: Rural populations had lower literacy levels for all literacy…

  9. Minority Populations in Minnesota: A Health Status Report.

    ERIC Educational Resources Information Center

    Minnesota State Dept. of Health, Minneapolis. Center for Health Statistics.

    The social, economic, and health status advances experienced by Minnesota's White population have eluded significant numbers of the State's Black and Indian populations. This report contains statistical data and analyses of the health status of minorities in Minnesota. The information is meant to contribute to an intensified effort to improve the…

  10. Moving the Dial to Advance Population Health Equity in New York City Asian American Populations

    PubMed Central

    Trinh-Shevrin, Chau; Kwon, Simona C.; Nadkarni, Smiti Kapadia; Islam, Nadia S.

    2015-01-01

    The shift toward a health equity framework for eliminating the health disparities burden of racial/ethnic minority populations has moved away from a disease-focused model to a social determinants framework that aims to achieve the highest attainment of health for all. The New York University Center for the Study of Asian American Health (CSAAH) has identified core themes and strategies for advancing population health equity for Asian American populations in New York City that are rooted in the following: social determinants of health; multisectoral, community-engaged approaches; leveraging community assets; improved disaggregated data collection and access to care; and building sustainability through community leadership and infrastructure-building activities. We describe the strategies CSAAH employed to move the dial on population health equity. PMID:25905858

  11. [Population policies and reproductive health in Paraguay

    PubMed

    Simancas; Zúñiga

    1998-03-30

    The population's high growth rate, age profile, and geographical distribution have aroused increasing public concern in Paraguay. The country is involved in a moderate demographic transition, compatible with the consequences of modernity and the uneven rate of both social and economic changes. Reduction of mortality and the persistence of high birth rate patterns result in an age structure that consolidates demographic growth, with an increased focus on the dependent population. In the late 1960s the need for a systematic approach to population problems was perceived within the framework of economic planning. National governments had, and currently have, an ambivalent perception of this issue, since population growth is simply considered a positive factor. This concept results from an economic view of the consequences of a reduced domestic market in absolute terms. The lack of a Development Plan, the management deficit, and the shortage of training leave doubts as to the establishment of organically connected policies or programs concerning population.

  12. Factors affecting levels of genetic diversity in natural populations.

    PubMed Central

    Amos, W; Harwood, J

    1998-01-01

    Genetic variability is the clay of evolution, providing the base material on which adaptation and speciation depend. It is often assumed that most interspecific differences in variability are due primarily to population size effects, with bottlenecked populations carrying less variability than those of stable size. However, we show that population bottlenecks are unlikely to be the only factor, even in classic case studies such as the northern elephant seal and the cheetah, where genetic polymorphism is virtually absent. Instead, we suggest that the low levels of variability observed in endangered populations are more likely to result from a combination of publication biases, which tend to inflate the level of variability which is considered 'normal', and inbreeding effects, which may hasten loss of variability due to drift. To account for species with large population sizes but low variability we advance three hypotheses. First, it is known that certain metapopulation structures can result in effective population sizes far below the census size. Second, there is increasing evidence that heterozygous sites mutate more frequently than equivalent homozygous sites, plausibly because mismatch repair between homologous chromosomes during meiosis provides extra opportunities to mutate. Such a mechanism would undermine the simple relationship between heterozygosity and effective population size. Third, the fact that related species that differ greatly in variability implies that large amounts of variability can be gained or lost rapidly. We argue that such cases are best explained by rapid loss through a genome-wide selective sweep, and suggest a mechanism by which this could come about, based on forced changes to a control gene inducing coevolution in the genes it controls. Our model, based on meiotic drive in mammals, but easily extended to other systems, would tend to facilitate population isolation by generating molecular incompatabilities. Circumstances can even be

  13. Bees brought to their knees: Microbes affecting honey bee health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The biology and health of the honey bee, Apis mellifera, has been of interest to human societies since the advent of beekeeping. Descriptive scientific research on pathogens affecting honey bees have been published for nearly a century, but it wasn’t until the recent outbreak of heavy colony losses...

  14. Does Sex Education Affect Adolescent Sexual Behaviors and Health?

    ERIC Educational Resources Information Center

    Sabia, Joseph J.

    2006-01-01

    This study examines whether offering sex education to young teenagers affects several measures of adolescent sexual behavior and health: virginity status, contraceptive use, frequency of intercourse, likelihood of pregnancy, and probability of contracting a sexually transmitted disease. Using data from the National Longitudinal Study of Adolescent…

  15. Anemic loonie begins to affect health care sector

    PubMed Central

    Mullens, A

    1998-01-01

    Although most news surrounding the declining dollar has concentrated on its impact on Canadian shoppers, economists say it is bound to affect the financially strapped health care system too. They point out that many of the good purchased by Canadian hospitals come from the US, and the weak loonie means their price will rise. PMID:9757181

  16. Factors Affecting the Technology Readiness of Health Professionals

    ERIC Educational Resources Information Center

    Myers, Stephanie E.

    2010-01-01

    Federal government policies are promoting diffusion of technologies into the healthcare system. If health professionals reject the new technologies planned for the healthcare system, it could result in costly failures, delays, and workforce problems. There is a lack of knowledge about factors that affect technology readiness (TR), defined as the…

  17. Trends Affecting the U.S. Health Care System. Health Planning Information Series.

    ERIC Educational Resources Information Center

    Cerf, Carol

    This integrated review of national trends affecting the health care system is primarily intended to facilitate the planning efforts of health care providers and consumers, Government agencies, medical school administrators, health insurers, and companies in the medical market. It may also be useful to educators as a textbook to give their students…

  18. POPULATION HEALTH AND THE RISE OF CONSUMERISM.

    PubMed

    2015-09-01

    Earlier this summer, we convened a panel of health care executives and industry experts to consider how hospitals can balance the demands of high-value, more efficient care with the emergence of the savvy health care consumer. Their insights and words of advice are eye-opening.

  19. Factors Affecting Healthful Eating Among Touring Popular Musicians and Singers.

    PubMed

    Cizek, Erin; Kelly, Patrick; Kress, Kathleen; Mattfeldt-Beman, Mildred

    2016-06-01

    Maintaining good health is essential for touring musicians and singers. The stressful demands of touring may impact food choices, leading to detrimental effects on health and performance. This exploratory pilot study aimed to assess factors affecting healthful eating of touring musicians and singers. A 46-item survey was used to assess food- and nutrition-related attitudes, knowledge and behaviors, and environmental factors, as well as lifestyle, musical background, and demographic data. Participants (n=35) were recruited from a musicians' assistance foundation as well as touring musical theater productions and a music festival. Results indicate that touring musicians and singers had positive attitudes regarding healthful foods. Of 35 respondents, 80.0% indicated eating healthful food was important to them. Respondents reported feeling confident selecting (76.5%) and preparing (82.4%) healthful foods; however, they showed uncertainty when determining if carbohydrate-containing foods should be consumed or avoided. Respondents indicated environmental factors including availability and cost of healthy food options and tour schedules limited access to healthful foods. Venues (73.5%), fast food restaurants (67.6%), and airports (64.7%) were the most frequently identified locations in need of offering more healthful food choices. Respondents (52.9%) indicated more support from others while touring would help them make healthier food choices. More research is needed to develop mobile wellness programs as well as performance-based nutrition guidelines for musicians and singers that address the unique demands associated with touring.

  20. Real estate planning for population health.

    PubMed

    McHugh, Margie

    2014-11-01

    Factors that health systems should consider when performing strategic assessments of their portfolios of ambulatory facilities include: Inventory. Location Facility condition. Service mix. Space use and capacity. Occupancy metrics. Strategic and economic opportunities.

  1. Medical or health geography? Populations, peoples and places.

    PubMed

    Rosenberg, M W

    1998-09-01

    While medical geography has grown eclectic to the point where a growing number of medical geographers prefer the terms health geographer, health geography, or the geography of health, schisms have nonetheless developed between Mayer et al. and those who have urged medical geographers to seek new epistemologies. Lost in this debate is the rapid and considerable growth of research by medical and health geographers. The author first reviews recent research on the mapping and modeling of diseases, then examines the literature on the access, delivery, and planning of health services. He then considers the debate over medical geography versus a geography of health. Opportunities are identified where medical, health, and population geographers can productively collaborate. Sharing many of the same theoretical and methodological strengths, weaknesses, and frustrations, medical, health, and population geographers need to work together toward creating inclusive geographies.

  2. Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial

    PubMed Central

    Ruggiero, Kenneth J.; Price, Matthew; Adams, Zachary; Stauffacher, Kirstin; McCauley, Jenna; Danielson, Carla Kmett; Knapp, Rebecca; Hanson, Rochelle F.; Davidson, Tatiana M.; Amstadter, Ananda B.; Carpenter, Matthew J.; Saunders, Benjamin E.; Kilpatrick, Dean G.; Resnick, Heidi S.

    2015-01-01

    Objective To assess the efficacy of Bounce Back Now (BBN), a modular, web-based intervention for disaster-affected adolescents and their parents. Method A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study web portal irrespective of mental health status at baseline. Families who accessed the web portal were assigned randomly to 3 groups: (1) BBN, which featured modules for adolescents and parents targeting adolescents’ mental health symptoms; (2) BBN plus additional modules targeting parents’ mental health symptoms; or (3) assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression. Results Nearly 50% of families accessed the web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B=−0.24, SE=0.08, p<.01) and depressive symptoms (B=−0.23, SE=0.09, p<.01). Post-hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental vs. control conditions at 12-month follow-up (PTSD: B=−0.36, SE=0.19, p=.06; depressive symptoms: B=−0.42, SE=0.19, p=0.03). A time × condition interaction also was found favoring the BBN vs. BBN + parent self-help condition for PTSD symptoms (B=0.30, SE=0.12, p=.02), but not depressive symptoms (B=0.12, SE=0.12, p=.33). Conclusion Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters. PMID:26299292

  3. Racial and Ethnic Health Disparities in Incarcerated Populations.

    PubMed

    Borysova, Meghan E; Mitchell, Ojmarrh; Sultan, Dawood H; Williams, Arthur R

    2012-01-01

    Alarming disparities in population health and wellness in the United States have led to multidisciplinary research efforts to create health equity. Identifying disparities, elucidating the etiological bases of disparities, and implementing solutions to eliminate disparities are part of the U.S. national health agenda. Racial and ethnic disparities have been identified throughout the cancer control continuum, in cardiovascular disease, diabetes and a multitude of other conditions. The causes of disparities are complex, condition specific, and conjectured to result from combinations of biological and socio-behavioral factors. Racial and ethnic health disparities within the vast incarcerated communities have been excluded from most studies, yet are of significant ethical and fiscal concern to inmates, governing bodies, and non-incarcerated communities into which inmates return. Importantly, research on racial and ethnic disparities in this unique population may shed light on the relative etiologies of health disparities and solutions for creating health equity throughout the general population in the United States.

  4. South Asian populations in Canada: migration and mental health

    PubMed Central

    2014-01-01

    Background South Asian populations are the largest visible minority group in Canada; however, there is very little information on the mental health of these populations. The objective of this study was to determine the prevalence rates and characteristics of mental health outcomes for South Asian first-generation immigrant and second-generation Canadian-born populations. Methods The Canadian Community Health Survey (CCHS) 2011 was used to calculate the estimated prevalence rates of the following mental health outcomes: mood disorders, anxiety disorders, fair-poor self-perceived mental health status, and extremely stressful life stress. The characteristics associated with these four mental health outcomes were determined through multivariate logistic regression analysis of merged CCHS 2007–2011 data. Results South Asian Canadian-born (3.5%, 95% CI 3.4-3.6%) and South Asian immigrant populations (3.5%, 95% CI 3.5-3.5%) did not vary significantly in estimated prevalence rates of mood disorders. However, South Asian immigrants experienced higher estimated prevalence rates of diagnosed anxiety disorders (3.4%, 95% CI 3.4-3.5 vs. 1.1%, 95% CI 1.1-1.1%) and self-reported extremely stressful life stress (2.6%, 95% CI 2.6-2.7% vs. 2.4%, 95% CI 2.3-2.4%) compared to their Canadian-born counterparts. Lastly, South Asian Canadian-born populations had a higher estimated prevalence rate of poor-fair self-perceived mental health status (4.4%, 95% CI 4.3-4.5%) compared to their immigrant counterparts (3.4%, 95% CI 3.3-3.4%). Different profiles of mental health determinants emerged for South Asian Canadian-born and immigrant populations. Female gender, having no children under the age of 12 in the household, food insecurity, poor-fair self-rated health status, being a current smoker, immigrating to Canada before adulthood, and taking the CCHS survey in either English or French was associated with greater risk of negative mental health outcomes for South Asian immigrant

  5. Alterations in psychosocial health of people affected by asbestos poisoning

    PubMed Central

    Clemente, Miguel; Reig-Botella, Adela; Prados, Juan Carlos

    2015-01-01

    OBJECTIVE To analyze the state of psychosocial and mental health of professionals affected by asbestos. METHODS A cross-sectional study was conducted with 110 professionals working in the Ferrolterra region of Spain, who were affected by asbestos poisoning. This group was compared with a group of 70 shipyard workers with no manifestation of work-related diseases. All the participants were male with a mean age of 67 years. This study was conducted in 2013, between January and June, and used the SCL-90 questionnaire by Derogatis as its primary measure for research. This questionnaire consists of 9 variables that measure psychosomatic symptoms. In addition, an overall index of psychosomatic gravity was calculated. The participants were also asked two questions concerning their overall perception of feeling good. Data were analyzed by ANOVA and logistic regression. RESULTS Participants affected by asbestos poisoning showed high occurrence rates of psychological health variables such as somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and global severity index. CONCLUSIONS Social interaction as a differentiating factor between workers affected by work-related chronic syndromes as compared to healthy participants will possibly aid in the development of intervention programs by improving the social network of affected individuals. PMID:25902564

  6. Environmental exposures that affect the endocrine system: public health implications.

    PubMed

    DeRosa, C; Richter, P; Pohl, H; Jones, D E

    1998-01-01

    In recent years much attention has been focused on the potential for a wide range of xenobiotic chemicals to interact with and disrupt the endocrine systems of animal and human populations. An overview of the chemicals that have been implicated as endocrine disruptors is presented. The ubiquity in the environment and associated body burdens of these chemicals in human populations are described. Potential mechanisms of action are reviewed, including the role of specific intracellular receptors and their interactions with endogenous and exogenous materials. The subsequent upregulation or downregulation of physiological processes at critical stages of development is discussed. The potential for joint toxic action and interaction of chemical mixtures is also discussed. The acknowledged role of wildlife populations as sentinels of potential human health effects is reviewed, and the weight of evidence for the role and impact of endocrine disruptors is presented. The implications of exposure to endocrine-disrupting chemicals for human health are reviewed, with special emphasis on the potential for transgenerational effects in at-risk populations. Recommendations for future research include the development of (1) structural activity and in vivo and in vitro functional toxicology methods to screen chemicals for their endocrine-disrupting ability, (2) biomarkers of exposure and effect, and (3) in situ sentinel systems.

  7. Public policies and the problematic USA population health profile.

    PubMed

    Raphael, Dennis

    2007-11-01

    International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that the USA presents one of the worst population health profiles and public policy environments in support of health among wealthy developed nations - a result of systemic inequities in income, influence, and power - the USA public health gaze is firmly - and narrowly - focused on issues of access to health care, racial and ethnic disparities in healthcare, and individual behavioral risk factors. Reasons for the USA's neglect of structural and public policy issues are explored and Ten Tips for American Public Health Researchers and Workers are presented.

  8. Persons With Disabilities as an Unrecognized Health Disparity Population

    PubMed Central

    Walker, Deborah Klein; Correa-De-Araujo, Rosaly

    2015-01-01

    Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness. PMID:25689212

  9. Persons with disabilities as an unrecognized health disparity population.

    PubMed

    Krahn, Gloria L; Walker, Deborah Klein; Correa-De-Araujo, Rosaly

    2015-04-01

    Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness.

  10. Nutrition, Population, and Health: Some Implications for Policy

    ERIC Educational Resources Information Center

    Winikoff, Beverly

    1978-01-01

    A discussion of the relationships, both biological and behavioral, among nutrition, population, and health in relation to government policy. Special emphasis is given to breast feeding and child survival. (BB)

  11. Promoting global population health while constraining the environmental footprint.

    PubMed

    McMichael, A J; Butler, C D

    2011-01-01

    Populations today face increasing health risks from human-induced regional and global environmental changes and resultant ecological nonsustainability. Localized environmental degradation that has long accompanied population growth, industrialization, and rising consumerism has now acquired a global and often systemic dimension (e.g., climate change, disrupted nitrogen cycling, biodiversity loss). Thus, the economic intensification and technological advances that previously contributed to health gains have now expanded such that humanity's environmental (and ecological) footprint jeopardizes global population health. International data show, in general, a positive correlation of a population's health with level of affluence and size of per-person footprint. Yet, beyond a modest threshold, larger footprints afford negligible health gain and may impair health (e.g., via the rise of obesity). Furthermore, some lower-income countries have attained high levels of health. Many changes now needed to promote ecological (and social) sustainability will benefit local health. Continued improvement of global health could thus coexist with an equitably shared global environmental footprint.

  12. Factors Affecting Tooth Retention among Adult Population of Dharwad District, India

    PubMed Central

    Inamdar, Nurul Ameen; Prasad, K V V

    2016-01-01

    Introduction Oral health in relation to general health is influen-ced by the retention of teeth. Understanding factors affecting tooth retention will help health and social policy-makers to translate the knowledge on tooth retention into action programs for improving oral health of the people and hence enhance tooth retention. Aim The aim of the present study was to determine the factors affecting tooth retention among adult population of Dharwad district, India. Materials and Methods A cross-sectional survey of 1100 subjects (616 urban and 484 rural) residing in Dharwad district, Karnataka, India, was conducted. Self-designed questionnaire was prepared and data were collected on socio-demographic factors, oral hygiene practices, diet practices, adverse oral habits and frequency of dental visits by the interview method and clinical examination. Statistical analysis was carried out by applying one way analysis of variance (ANOVA), unpaired t-test and backward stepwise multiple regression. Karl Pearson’s correlation coefficient was used to test the correlation between the two quantitative variables. Results A total of 66.72% subjects retained all 28 teeth and mean number of teeth retained by the study subjects were 25.33 (90.46%). There was gradual reduction in tooth retention with increase in age. Males (95.8%) compared to females (94.07%), unmarried (98.8%) than married subjects (93.3%) and subjects with intermediate or post high school diploma (97.5%) than those who were illiterate (89.5%) and other low educational level study subjects retained more teeth. Further mean values of tooth retention for other socio demographic factors i.e., occupation, income and family size were not statistically significant (p≤0.05). In addition, subjects using tooth brush (96.6%) and tooth paste (96.6%) for cleaning the teeth, subjects practicing mixed diet (96.6%) and subjects who never visited the dentist (96.5%) in their lifetime showed statistically significant greater tooth

  13. Stigma as a Fundamental Cause of Population Health Inequalities

    PubMed Central

    Phelan, Jo C.

    2013-01-01

    Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health. PMID:23488505

  14. Affective Forecasting: An Unrecognized Challenge in Making Serious Health Decisions

    PubMed Central

    Arnold, Robert M.

    2008-01-01

    Patients facing medical decisions that will impact quality of life make assumptions about how they will adjust emotionally to living with health declines and disability. Despite abundant research on decision-making, we have no direct research on how accurately patients envision their future well-being and how this influences their decisions. Outside medicine, psychological research on “affective forecasting” consistently shows that people poorly predict their future ability to adapt to adversity. This finding is important for medicine, since many serious health decisions hinge on quality-of-life judgments. We describe three specific mechanisms for affective forecasting errors that may influence health decisions: focalism, in which people focus more on what will change than on what will stay the same; immune neglect, in which they fail to envision how their own coping skills will lessen their unhappiness; and failure to predict adaptation, in which people fail to envision shifts in what they value. We discuss emotional and social factors that interact with these cognitive biases. We describe how caregivers can recognize these biases in the clinical setting and suggest interventions to help patients recognize and address affective forecasting errors. PMID:18665428

  15. 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.

  16. Dental Health Problems of the Geriatric Population

    PubMed Central

    Dummett, Clifton O.

    1979-01-01

    A topic seldom considered and even more rarely discussed among the dental components of the health professions is presented. The dentist's preoccupation with hosts of dental treatment problems has left little time for considering the perplexities of aging, critical illness, or dying or dead patient's relatives. Community dentistry has now forced upon our consciousness the fact that perhaps the subject is one which must not be avoided, if we are to fulfill completely our professional obligations to the public. PMID:423295

  17. 40 CFR 230.75 - Actions affecting plant and animal populations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Actions affecting plant and animal... Actions To Minimize Adverse Effects § 230.75 Actions affecting plant and animal populations. Minimization of adverse effects on populations of plants and animals can be achieved by: (a) Avoiding changes...

  18. 40 CFR 230.75 - Actions affecting plant and animal populations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Actions affecting plant and animal... Actions To Minimize Adverse Effects § 230.75 Actions affecting plant and animal populations. Minimization of adverse effects on populations of plants and animals can be achieved by: (a) Avoiding changes...

  19. 40 CFR 230.75 - Actions affecting plant and animal populations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Actions affecting plant and animal... Actions To Minimize Adverse Effects § 230.75 Actions affecting plant and animal populations. Minimization of adverse effects on populations of plants and animals can be achieved by: (a) Avoiding changes...

  20. 40 CFR 230.75 - Actions affecting plant and animal populations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Actions affecting plant and animal... Actions To Minimize Adverse Effects § 230.75 Actions affecting plant and animal populations. Minimization of adverse effects on populations of plants and animals can be achieved by: (a) Avoiding changes...

  1. 40 CFR 230.75 - Actions affecting plant and animal populations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Actions affecting plant and animal... Actions To Minimize Adverse Effects § 230.75 Actions affecting plant and animal populations. Minimization of adverse effects on populations of plants and animals can be achieved by: (a) Avoiding changes...

  2. Latin America: native populations affected by early onset periodontal disease.

    PubMed

    Nowzari, Hessam; Botero, Javier Enrique

    2011-06-01

    Millions of individuals are affected by early onset periodontal disease in Latin America, a continent that includes more than 20 countries. The decision-makers claim that the disease is not commonly encountered. In 2009, 280,919 authorized immigrants were registered in the United States versus 5,460,000 unauthorized (2,600,000 in California). The objective of the present article is to raise awareness about the high prevalence of the disease among Latin Americans and the good prognosis of preventive measures associated with minimal financial cost.

  3. Is climate change affecting wolf populations in the high Arctic?

    USGS Publications Warehouse

    Mech, L.D.

    2004-01-01

    Gobal climate change may affect wolves in Canada's High Arctic (80?? N) acting through three trophic levels (vegetation, herbivores, and wolves). A wolf pack dependent on muskoxen and arctic hares in the Eureka area of Ellesmere Island denned and produced pups most years from at least 1986 through 1997. However, when summer snow covered vegetation in 1997 and 2000 for the first time since records were kept, halving the herbivore nutrition-replenishment period, muskox and hare numbers dropped drastically, and the area stopped supporting denning wolves through 2003. The unusual weather triggering these events was consistent with global-climate-change phenomena. ?? 2004 Kluwer Academic Publishers.

  4. Is climate change affecting wolf populations in the high Arctic?

    USGS Publications Warehouse

    Mech, L.D.

    2004-01-01

    Global climate change may affect wolves in Canada's High Arctic (80DG N) acting through three trophic levels (vegetation, herbivores, and wolves). A wolf pack dependent on muskoxen and arctic hares in the Eureka area of Ellesmere Island denned and produced pups most years from at least 1986 through 1997. However when summer snow covered vegetation in 1997 and 2000 for the first time since records were kept, halving the herbivore nutrition-replenishment period, muskox and hare numbers dropped drastically, and the area stopped supporting denning wolves through 2003. The unusual weather triggering these events was consistent with global-climate-change phenomena.

  5. Racial-Ethnic Variation in Mental Health Service Utilization Among People with a Major Affective Disorder and a Criminal History.

    PubMed

    Lee, Sungkyu; Matejkowski, Jason; Han, Woojae

    2017-01-01

    Using a nationally representative sample, this study examined the extent to which the utilization of various mental health services was associated with racial-ethnic identity among people with major affective disorders who have a criminal history. Approximately 33.7 % of the sample received any type of mental health services in a given year. Multivariate models indicated that married Blacks and Latinos were less likely to use specialty mental health care than their white counterparts. To provide equitable mental health treatment for vulnerable subgroups of this population, mental health professionals should account for the heterogeneity of mental health care in diverse cultural contexts.

  6. Factors affecting minority population proximity to hazardous facilities

    SciTech Connect

    Nieves, L.A.; Nieves, A.L. |

    1995-04-01

    Disproportionate exposure of minority groups to environmental hazards has been attributed to ``environmental racism`` by some authors, without systematic investigation of the factors underlying this exposure pattern. This study examines regional differences in the proximity of African-Americans, Hispanics, Asians, and non-Hispanic Whites to a broad range of facility types and explores the effects of urban and income factors. A statistically significant inverse relationship is found between the percentage of non-Hispanic Whites and virtually all facility categories in all regions. Except for Hispanics in the South, all such associations for minority groups show a direct relationship, though some are nonsignificant. The geographic concentration of facilities is more closely tied to urbanization than to economic factors. Controlling for both urban and economic factors, minority population concentration is still a significant explanatory variable for some facility types in some regions. This finding is most consistent for African-Americans.

  7. Air Pollution and Health: Emerging Information on Susceptible Populations

    EPA Science Inventory

    Outdoor air pollution poses risks to human health in communities around the world, and research on populations who are most susceptible continues to reveal new insights. Human susceptibility to adverse health effects from exposure to air pollution can be related to underlying dis...

  8. Teaching Population Health: A Competency Map Approach to Education

    PubMed Central

    Kaprielian, Victoria S.; Silberberg, Mina; McDonald, Mary Anne; Koo, Denise; Hull, Sharon K.; Murphy, Gwen; Tran, Anh N.; Sheline, Barbara L.; Halstater, Brian; Martinez-Bianchi, Viviana; Weigle, Nancy J.; de Oliveira, Justine Strand; Sangvai, Devdutta; Copeland, Joyce; Tilson, Hugh H.; Scutchfield, F. Douglas; Michener, J. Lloyd

    2013-01-01

    A 2012 Institute of Medicine report is the latest in the growing number of calls to incorporate a population health approach in health professionals’ training. Over the last decade, Duke University, particularly its Department of Community and Family Medicine, has been heavily involved with community partners in Durham, North Carolina to improve the local community’s health. Based on these initiatives, a group of interprofessional faculty began tackling the need to fill the curriculum gap to train future health professionals in public health practice, community engagement, critical thinking, and team skills to improve population health effectively in Durham and elsewhere. The Department of Community and Family Medicine has spent years in care delivery redesign and curriculum experimentation, design, and evaluation to distinguish the skills trainees and faculty need for population health improvement and to integrate them into educational programs. These clinical and educational experiences have led to a set of competencies that form an organizational framework for curricular planning and training. This framework delineates which learning objectives are appropriate and necessary for each learning level, from novice through expert, across multiple disciplines and domains. The resulting competency map has guided Duke’s efforts to develop, implement, and assess training in population health for learners and faculty. In this article, the authors describe the competency map development process as well as examples of its application and evaluation at Duke and limitations to its use with the hope that other institutions will apply it in different settings. PMID:23524919

  9. Occupational Health and Sleep Issues in Underserved Populations.

    PubMed

    Kalliny, Medhat; McKenzie, Judith Green

    2017-03-01

    Sleep disorders and occupational hazards, injuries, and illnesses impact an individual's overall health. In the United States, substantial racial, ethnic, and socioeconomic disparities exist in sleep and occupational health. Primary care physicians working in underserved communities should be aware of this disparity and target these higher-risk populations for focused evaluation and intervention.

  10. FAMILY AND MENTAL HEALTH PROBLEMS IN A DEAF POPULATION.

    ERIC Educational Resources Information Center

    RAINER, JOHN D., ED.; AND OTHERS

    THE FINAL REPORT OF THE MENTAL HEALTH PROJECT FOR THE DEAF IS PRESENTED. FOLLOWING AN EXPLANATION OF THE PROJECT AND ITS PROCEDURES AND AN HISTORICAL REVIEW OF SPECIAL EDUCATION AND MENTAL HEALTH SERVICES ARE REPORTS (BY INDIVIDUAL AUTHORS) OF THE RESEARCH PROGRAM WITHIN THE NEW YORK STATE DEAF POPULATION, THE REPORTS CONSIDER (1) METHODOLOGICAL…

  11. Pesticide exposures and respiratory health in general populations.

    PubMed

    Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan

    2017-01-01

    Human exposures to pesticides can occur in the workplace, in the household and through the ambient environment. While several articles have reviewed the impact of pesticide exposures on human respiratory health in occupational settings, to the best of our knowledge, this article is the first one to review published studies on the association between pesticide exposures and human respiratory health in the general populations. In this article, we critically reviewed evidences up to date studying the associations between non-occupational pesticide exposures and respiratory health in general populations. This article also highlighted questions arising from these studies, including our recent analyses using the data from the Canadian Health Measures Survey (CHMS), for future research. We found few studies have addressed the impact of environmental pesticide exposures on respiratory health, especially on lung function, in general populations. In the studies using the data from CHMS Cycle 1, exposures to OP insecticides, pyrethroid insecticides, and the organochlorine pesticide DDT were associated with impaired lung function in the Canadian general population, but no significant associations were observed for the herbicide 2,4-D. Future research should focus on the potential age-specific and pesticide-specific effect on respiratory health in the general population, and repeated longitudinal study design is critical for assessing the temporal variations in pesticide exposures. Research findings from current studies of non-occupational pesticide exposures and their health impact in general population will help to improve the role of regulatory policies in mitigating pesticide-related public health problems, and thereafter providing greater benefit to the general population.

  12. Assessing Health Issues in States with Large Minority Populations.

    PubMed

    Long, Michelle; Menifield, Charles E; Fletcher, Audwin B

    2015-09-01

    Health care spending is often addressed in discussions of budgeting and deficits in the United States. It is important to many Americans that funds allocated for health care spending be allocated and spent in the most efficient and effective manner, leading to improved health outcomes, particularly for underserved populations. Many studies address health care spending, but few address the issue of spending as it relates to societal well-being, or certain health outcomes that adversely impact communities. This study seeks to expand the available literature by analyzing data from national sources at the state level.

  13. Built Environment and Elderly Population Health: A Comprehensive Literature Review

    PubMed Central

    Garin, Noe; Olaya, Beatriz; Miret, Marta; Ayuso-Mateos, Jose Luis; Power, Michael; Bucciarelli, Paola; Haro, Josep Maria

    2014-01-01

    Global population aging over recent years has been linked to poorer health outcomes and higher healthcare expenditure. Policies focusing on healthy aging are currently being developed but a complete understanding of health determinants is needed to guide these efforts. The built environment and other external factors have been added to the International Classification of Functioning as important determinants of health and disability. Although the relationship between the built environment and health has been widely examined in working age adults, research focusing on elderly people is relatively recent. In this review, we provide a comprehensive synthesis of the evidence on the built environment and health in the elderly. PMID:25356084

  14. Suicide Prevention Strategies for Improving Population Health.

    PubMed

    Wilcox, Holly C; Wyman, Peter A

    2016-04-01

    Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means.

  15. Priorities of health policy: cost shifting or population health

    PubMed Central

    Richardson, Jeff RJ

    2005-01-01

    Background This paper is an edited version of an invited paper submitted to the Australian Health Care Summit on 17–19 August 2003. It comments upon the policies which have dominated recent debate and contrasts their importance with the importance of five issues which have received relatively little attention. Methods Policy is usually a response to identified problems and the paper examines the nature and size of the problems which heave led to recent policy initiatives. These are contrasted with the magnitude and potential cost effectiveness policies to address the problems in five areas of comparative neglect. Results It is argued that recent and proposed changes to the financing and delivery of health services in Australia have focused upon issues of relatively minor significance while failing to address adequately major inequities and system deficiencies. Conclusion There is a need for an independent review of the health system with the terms of reference focusing attention upon large system-wide failures. PMID:15679895

  16. Source population characteristics affect heterosis following genetic rescue of fragmented plant populations

    PubMed Central

    Pickup, M.; Field, D. L.; Rowell, D. M.; Young, A. G.

    2013-01-01

    Understanding the relative importance of heterosis and outbreeding depression over multiple generations is a key question in evolutionary biology and is essential for identifying appropriate genetic sources for population and ecosystem restoration. Here we use 2455 experimental crosses between 12 population pairs of the rare perennial plant Rutidosis leptorrhynchoides (Asteraceae) to investigate the multi-generational (F1, F2, F3) fitness outcomes of inter-population hybridization. We detected no evidence of outbreeding depression, with inter-population hybrids and backcrosses showing either similar fitness or significant heterosis for fitness components across the three generations. Variation in heterosis among population pairs was best explained by characteristics of the foreign source or home population, and was greatest when the source population was large, with high genetic diversity and low inbreeding, and the home population was small and inbred. Our results indicate that the primary consideration for maximizing progeny fitness following population augmentation or restoration is the use of seed from large, genetically diverse populations. PMID:23173202

  17. Politics, welfare regimes, and population health: controversies and evidence.

    PubMed

    Muntaner, Carles; Borrell, Carme; Ng, Edwin; Chung, Haejoo; Espelt, Albert; Rodriguez-Sanz, Maica; Benach, Joan; O'Campo, Patricia

    2011-09-01

    In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research.

  18. Insights into Population Health Management Through Disease Diagnoses Networks

    PubMed Central

    Feldman, Keith; Stiglic, Gregor; Dasgupta, Dipanwita; Kricheff, Mark; Obradovic, Zoran; Chawla, Nitesh V.

    2016-01-01

    The increasing availability of electronic health care records has provided remarkable progress in the field of population health. In particular the identification of disease risk factors has flourished under the surge of available data. Researchers can now access patient data across a broad range of demographics and geographic locations. Utilizing this Big healthcare data researchers have been able to empirically identify specific high-risk conditions found within differing populations. However to date the majority of studies approached the issue from the top down, focusing on the prevalence of specific diseases within a population. Through our work we demonstrate the power of addressing this issue bottom-up by identifying specifically which diseases are higher-risk for a specific population. In this work we demonstrate that network-based analysis can present a foundation to identify pairs of diagnoses that differentiate across population segments. We provide a case study highlighting differences between high and low income individuals in the United States. This work is particularly valuable when addressing population health management within resource-constrained environments such as community health programs where it can be used to provide insight and resource planning into targeted care for the population served. PMID:27461860

  19. [Health status and access to health services by the population of L'Aquila (Abruzzo Region, Italy) six years after the earthquake].

    PubMed

    Altobelli, Emma; Vittorini, Pierpaolo; Leuter, Cinzia; Bianchini, Valeria; Angelone, Anna Maria; Aloisio, Federica; Cofini, Vincenza; Zazzara, Francesca; Di Orio, Ferdinando

    2016-01-01

    Natural disasters, such as the earthquake that occurred in the province of L'Aquila in central Italy, in 2009, generally increase the demand for healthcare. A survey was conducted to assess perception of health status an d use of health services in a sample of L'Aquila's resident population, five years after the event, and in a comparison population consisting of a sample of the resident population of Avezzano, a town in the same region, not affected by the earthquake. No differences were found in perception of health status between the two populations. Both groups reported difficulties in accessing specialized healthcare and rehabilitation services.

  20. 76 FR 20867 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage...

  1. 75 FR 79330 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas is...

  2. 76 FR 39062 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Medically Underserved Populations and Health Professional Shortage Areas is to establish criteria and...

  3. 76 FR 12307 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-07

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage...

  4. 76 FR 10825 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-28

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

  5. 75 FR 79329 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

  6. 75 FR 67303 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-02

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Designation of Medically Underserved Populations and Health Professional Shortage Areas is to establish...

  7. 76 FR 50442 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas is...

  8. 76 FR 53377 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and... Medically Underserved Populations and Health Professional Shortage Areas is to establish criteria and...

  9. A critical discussion of the benefits of e-health in population-level dental research.

    PubMed

    Lam, Raymond; Kruger, Estie; Tennant, Marc

    2013-01-01

    Population-level research is an essential area of health with the potential to affect quality of life and the broader economy. There are excellent epidemiological studies that have improved health services, but traditional research requires a considerable investment. Although electronic technology has changed the practice of many industries with improved efficiency, its application to health is relatively new. Termed 'e-health', this emerging area has been defined by the World Health Organization as the use of information technology to support many aspects of health such as in administration and scientific information. However, not all professionals are convinced of its use. This paper presents a novel application of this emerging area to describe the benefit in data collation and research to support one of the most pressing issues in public health: oral health and policy. Using the Chronic Disease Dental Scheme as an example, a critical discussion of its benefit to population-level research is presented. The Chronic Disease Dental Scheme method of electronic administration has been shown to enhance research and to complement existing progress in health data linkage. e-Health is an invaluable tool for population-level dental research.

  10. Implementation science and its application to population health.

    PubMed

    Lobb, Rebecca; Colditz, Graham A

    2013-01-01

    Implementation science studies the use of strategies to adapt and use evidence-based interventions in targeted settings (e.g., schools, workplaces, health care facilities, public health departments) to sustain improvements to population health. This nascent field of research is in the early stages of developing theories of implementation and evaluating the properties of measures. Stakeholder engagement, effectiveness studies, research synthesis, and mathematical modeling are some of the methods used by implementation scientists to identify strategies to embed evidence-based interventions in clinical and public health programs. However, for implementation science to reach its full potential to improve population health the existing paradigm for how scientists create evidence, prioritize publications, and synthesize research needs to shift toward greater stakeholder input and improved reporting on external validity. This shift will improve the relevance of the research that is produced and provide information that will help guide decision makers in their selection of research-tested interventions.

  11. A critical examination of summary measures of population health.

    PubMed Central

    Murray, C. J.; Salomon, J. A.; Mathers, C.

    2000-01-01

    In the past decade, interest has been rising in the development, calculation and use of summary measures of population health, which combine information on mortality and non-fatal health outcomes. This paper reviews the issues and challenges in the design and application of summary measures and presents a framework for evaluating different alternatives. Summary measures have a variety of uses, including comparisons of health in different populations and assessments of the relative contributions of different diseases, injuries and risk factors to the total disease burden in a population. Summary measures may be divided into two broad families: health expectancies and health gaps. Within each family, there are many different possible measures, but they share a number of inputs, including information on mortality, non-fatal health outcomes, and health state valuations. Other critical points include calculation methods and a range of conceptual and methodological issues regarding the definition, measurement and valuation of health states. This paper considers a set of basic criteria and desirable properties that may lead to rejection of certain summary measures and the development of new ones. Despite the extensive developmental agenda that remains, applications of summary measures cannot await the final resolution of all methodological issues, so they should focus on those measures that satisfy as many basic criteria and desirable properties as possible. PMID:10994282

  12. Improving health literacy in community populations: a review of progress.

    PubMed

    Nutbeam, Don; McGill, Bronwyn; Premkumar, Pav

    2017-03-28

    Governments around the world have adopted national policies and programs to improve health literacy. This paper examines progress in the development of evidence to support these policies from interventions to improve health literacy among community populations. Our review found only a limited number of studies (n=7) that met the criteria for inclusion, with many more influenced by the concept of health literacy but not using it in the design and evaluation. Those included were diverse in setting, population and intended outcomes. All included educational strategies to develop functional health literacy, and a majority designed to improve interactive or critical health literacy skills. Several papers were excluded because they described a protocol for an intervention, but not results, indicating that our review may be early in a cycle of activity in community intervention research. The review methodology may not have captured all relevant studies, but it provides a clear message that the academic interest and attractive rhetoric surrounding health literacy needs to be tested more systematically through intervention experimentation in a wide range of populations using valid and reliable measurement tools. The distinctive influence of the concept of health literacy on the purpose and methodologies of health education and communication is not reflected in many reported interventions at present. Evidence to support the implementation of national policies and programs, and the intervention tools required by community practitioners are not emerging as quickly as needed. This should be addressed as a matter of priority by research funding agencies.

  13. [The inequality of health services for the uninsured population in Mexico].

    PubMed

    Miranda-Ocampo, R; Salvatierra-Izaba, B; Vivanco-Cedeño, B; Alvarez-Lucas, C; Lezana-Fernández, M A

    1993-01-01

    In order to assess the coverage of health services for non-insured population receiving health care from the Ministry of Health (SSA), a cross-sectional study was developed. With official statistics of SSA and data from the XI General Census of Population and Housing (1990), ratios of coverage and mortality rates in hospitals were assessed. The data were processed through simple analysis. In addition, states were stratified by groups according to poverty indicators obtained through a factorial analysis with the method of multiple components. The results showed that a polarized health economy for the non-insured population in Mexico is the cause of complex difficulties in the health care provision. The low financial resources affect the distribution of health care services in the states. Seventy-six per cent of the non-insured population is concentrated in those states with the highest levels of poverty, with a potential coverage of only 34.2 per cent and just 63.4 per cent of potential population use. The coverage of health care services in the states with lower poverty indicators is 1.9 times that of the states with higher poverty indicators. It was also observed that hospital mortality rate among children less than one year old was 1.7 times higher in poor regions. In general, the health services coverage is low. Therefore, it is necessary to expand the access to health care and improve the quality of services as well as life conditions of the population in the states with the highest poverty indicators. If this occurs, it will be possible to close the gap in order to build a better National Health System.

  14. Predicting individual affect of health interventions to reduce HPV prevalence.

    PubMed

    Corley, Courtney D; Mihalcea, Rada; Mikler, Armin R; Sanfilippo, Antonio P

    2011-01-01

    Recently, human papilloma virus (HPV) has been implicated to cause several throat and oral cancers and HPV is established to cause most cervical cancers. A human papilloma virus vaccine has been proven successful to reduce infection incidence in FDA clinical trials, and it is currently available in the USA. Current intervention policy targets adolescent females for vaccination; however, the expansion of suggested guidelines may extend to other age groups and males as well. This research takes a first step toward automatically predicting personal beliefs, regarding health intervention, on the spread of disease. Using linguistic or statistical approaches, sentiment analysis determines a text's affective content. Self-reported HPV vaccination beliefs published in web and social media are analyzed for affect polarity and leveraged as knowledge inputs to epidemic models. With this in mind, we have developed a discrete-time model to facilitate predicting impact on the reduction of HPV prevalence due to arbitrary age- and gender-targeted vaccination schemes.

  15. Predicting Individual Affect of Health Interventions to Reduce HPV Prevalence

    SciTech Connect

    Corley, Courtney D.; Mihalcea, Rada; Mikler, Armin R.; Sanfilippo, Antonio P.

    2011-04-01

    Recently, human papilloma virus has been implicated to cause several throat and oral cancers and hpv is established to cause most cervical cancers. A human papilloma virus vaccine has been proven successful to reduce infection incidence in FDA clinical trials and it is currently available in the United States. Current intervention policy targets adolescent females for vaccination; however, the expansion of suggested guidelines may extend to other age groups and males as well. This research takes a first step towards automatically predicting personal beliefs, regarding health intervention, on the spread of disease. Using linguistic or statistical approaches, sentiment analysis determines a texts affective content. Self-reported HPV vaccination beliefs published in web and social media are analyzed for affect polarity and leveraged as knowledge inputs to epidemic models. With this in mind, we have developed a discrete-time model to facilitate predicting impact on the reduction of HPV prevalence due to arbitrary age and gender targeted vaccination schemes.

  16. The Hub Population Health System: distributed ad hoc queries and alerts.

    PubMed

    Buck, Michael D; Anane, Sheila; Taverna, John; Amirfar, Sam; Stubbs-Dame, Remle; Singer, Jesse

    2012-06-01

    The Hub Population Health System enables the creation and distribution of queries for aggregate count information, clinical decision support alerts at the point-of-care for patients who meet specified conditions, and secure messages sent directly to provider electronic health record (EHR) inboxes. Using a metronidazole medication recall, the New York City Department of Health was able to determine the number of affected patients and message providers, and distribute an alert to participating practices. As of September 2011, the system is live in 400 practices and within a year will have over 532 practices with 2500 providers, representing over 2.5 million New Yorkers. The Hub can help public health experts to evaluate population health and quality improvement activities throughout the ambulatory care network. Multiple EHR vendors are building these features in partnership with the department's regional extension center in anticipation of new meaningful use requirements.

  17. Determinants of Trust in Health Care in an Older Population

    PubMed Central

    Guerrero, Natalie; Mendes de Leon, Carlos F.; Evans, Denis A.; Jacobs, Elizabeth A.

    2014-01-01

    Background Compared with non-Hispanic white patients, minority patients tend to have less trust in the health care system and its providers. It is not clear what contributes to this disparity. Objectives To explore differences in socio-demographic and psychological correlates of institutional trust in health care in an aging population of African Americans and non-Hispanic whites. Design Cross-sectional survey data from the longitudinal Chicago Health and Aging Project. Setting Population-based study of three communities in the Chicago area Participants The sample included 2,284 African Americans and 1,354 non-Hispanic whites with a mean age of 79.3 years. Measurements Demographic factors, socio-economic status, health care access, cynical hostility, perceived discrimination, depression, and institutional trust in health care. Results African Americans reported substantially lower health care trust than non-Hispanic whites (p<0.001). After adjustment for demographic variables and socioeconomic status, only race (p<0.001) and age (p<0.01) were significantly associated with health care trust scores. The association between race and health care trust was slightly attenuated after adjusting for cynical hostility, depressive symptoms, and perceived discrimination (p<0.001). Each of these variables was negatively associated with health care trust, and together these accounted for about 15% of racial differences in health care trust. Conclusion Psychological factors, not demographic characteristics, socioeconomic status, or health care factors appear to contribute the most to disparities in health care trust between African Americans as compare to non-Hispanic whites in this older population. PMID:25752478

  18. Difference in health inequity between two population groups due to a social determinant of health.

    PubMed

    Moonesinghe, Ramal; Bouye, Karen; Penman-Aguilar, Ana

    2014-12-01

    The World Health Organization defines social determinants of health as "complex, integrated, and overlapping social structures and economic systems" that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference in prevalence of the risk factor in the two populations. The difference in health inequity could be larger than the difference in health outcomes between the two populations in some situations. Compared to health disparities which are typically measured and monitored using absolute or relative disparities of health outcomes, the methods presented in this manuscript provide a different, yet complementary, picture because they parse out the contributions of unfair and avoidable risk factors.

  19. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations.

    PubMed

    Massetti, Greta M; Ragan, Kathleen R; Thomas, Cheryll C; Ryerson, A Blythe

    Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer.

  20. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations.

    PubMed

    Massetti, Greta M; Ragan, Kathleen R; Thomas, Cheryll C; Ryerson, A Blythe

    2015-10-20

    Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer.

  1. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations

    PubMed Central

    Massetti, Greta M.; Ragan, Kathleen R.; Thomas, Cheryll C.; Ryerson, A. Blythe

    2015-01-01

    Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer. PMID:26566532

  2. Foreclosure and Health in Southern Europe: Results from the Platform for People Affected by Mortgages.

    PubMed

    Vásquez-Vera, Hugo; Rodríguez-Sanz, Maica; Palència, Laia; Borrell, Carme

    2016-04-01

    Housing instability has been shown to be related to poorer health outcomes in various studies, mainly in the USA and UK. Affected individuals are more prone to psychiatric (e.g., major depression, anxiety) and physical disorders (e.g., hypertension). This situation has deteriorated with the onset of the economic crisis. One of the most affected countries is Spain, which has high rates of foreclosure and eviction that continue to rise. In response, a civil movement, The Platform for People Affected by Mortgages (PAH), works to provide solutions to its members affected by foreclosure and advocates for the right to decent housing. The aims of this study ware to describe and compare the health status of PAH members from Catalonia to a sample of the general population and to analyze the association between health status and mortgage status, foreclosure stage, and other socioeconomic variables, among members of the PAH. We conducted a cross-sectional study using a self-administered online questionnaire (2014) administered to 905 PAH members in Catalonia (>18 years; 559 women and 346 men). Results were compared with health indicators from The Health Survey of Catalonia 2013 (n = 4830). The dependent variables were poor mental health (GHQ 12 ≥ 3), and poor self-reported health (fair or poor). All analyses were stratified by sex. We computed age-standardized prevalence and prevalence ratios of poor mental and self-reported health in both samples. We also analyzed health outcomes among PAH members according to mortgage status (mortgage holders or guarantors), stage of foreclosure, and other socioeconomic variables by computing prevalence ratios from robust Poisson regression models. The prevalence of poor mental health among PAH members was 90.6 % in women and 84.4 % in men, and 15.5 and 10.2 % in the general population, respectively. The prevalence of poor self-reported health was 55.6 % in women and 39.4 % in men from the PAH, and 19.2 and 16.1 % in the general

  3. Patient safety is not enough: targeting quality improvements to optimize the health of the population.

    PubMed

    Woolf, Steven H

    2004-01-06

    Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

  4. Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review

    PubMed Central

    Cyril, Sheila; Smith, Ben J.; Possamai-Inesedy, Alphia; Renzaho, Andre M. N.

    2015-01-01

    Background Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. Design The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. Results Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. Conclusions The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way

  5. Beyond Books: Public Libraries As Partners For Population Health.

    PubMed

    Morgan, Anna U; Dupuis, Roxanne; D'Alonzo, Bernadette; Johnson, Andria; Graves, Amy; Brooks, Kiahana L; McClintock, Autumn; Klusaritz, Heather; Bogner, Hillary; Long, Judith A; Grande, David; Cannuscio, Carolyn C

    2016-11-01

    Public libraries are not usually included in discussions about improving population health. They are, however, well positioned to be partners in building a culture of health through programming that addresses the social determinants of health. The Healthy Library Initiative, a partnership between the University of Pennsylvania and the Free Library of Philadelphia (the public library system that serves the city), has undertaken such efforts in Philadelphia. In this article we report findings from an assessment of how ten highly subscribed programs address the social determinants of health, as well as results of interviews with community residents and library staff. Of the 5.8 million in-person Free Library visits in 2015, 500,000 included attendance at specialized programs that addressed multiple health determinants, such as housing and literacy. Library staff provided intensive support to vulnerable populations including homeless people, people with mental illness and substance use, recent immigrants, and children and families suffering from trauma. We found that public libraries are trusted institutions that have broad population reach and untapped potential to improve population health.

  6. Exploring Health Implications of Disparities Associated with Food Insecurity Among Low-Income Populations.

    PubMed

    Canales, Mary K; Coffey, Nancy; Moore, Emily

    2015-09-01

    A focus group process, conducted by a community-academic partnership, qualitatively assessed food insecurity perspectives of parents and community staff assisting families with food assistance. Food insecurity was reported to affect all aspects of their life, increasing stress and reducing coping abilities. The Agency for Healthcare Research and Quality encourages research with priority populations, including low-income populations. This research supports the body of knowledge correlating relationships between poverty, food insecurity, and chronic health conditions. Perspectives of food-insecure people are often missing from policy and advocacy interventions. Nurses can use lessons learned and recommendations from this research to address food-insecurity-related health disparities.

  7. Why sustainable population growth is a key to climate change and public health equity.

    PubMed

    Howat, Peter; Stoneham, Melissa

    2011-12-01

    Australia's population could reach 42 million by 2050. This rapid population growth, if unabated, will have significant social, public health and environmental implications. On the one hand, it is a major driver of climate change and environmental degradation; on the other it is likely to be a major contributor to growing social and health issues including a decline in quality of life for many residents. Disadvantaged and vulnerable groups will be most affected. The environmental, social and health-related issues include: pressure on the limited arable land in Australia; increased volumes of industrial and domestic waste; inadequate essential services; traffic congestion; lack of affordable housing; declining mental health; increased obesity problems; and inadequate aged care services. Many of these factors are related to the aggravation of climate change and health inequities. It is critical that the Australian Government develops a sustainable population plan with stabilisation of population growth as an option. The plan needs to ensure adequate hospitals and healthcare services, education facilities, road infrastructure, sustainable transport options, water quality and quantity, utilities and other amenities that are already severely overburdened in Australian cities. There is a need for a guarantee that affordable housing will be available and priority be given to training young people and Indigenous people for employment. This paper presents evidence to support the need for the stabilisation of population growth as one of the most significant measures to control climate change as well as to improve public health equity.

  8. Lessons from San Francisco: health impact assessments have advanced political conditions for improving population health.

    PubMed

    Bhatia, Rajiv; Corburn, Jason

    2011-12-01

    Health impact assessment is a structured decision support tool used to systematically characterize the anticipated health effects, both adverse and beneficial, of societal decisions. In San Francisco, the use of health impact assessments has not only produced evidence to inform health policy decision making but has also contributed to the political conditions needed to achieve optimal population health. Health impact assessments have helped increase public awareness of the determinants of health, routine monitoring of these determinants, cooperation among institutions, health-protective laws and regulations, and organizational networks for health advocacy and accountability. Drawing on more than a decade of local experience, we identify the direct and indirect effects of the assessments on the politics of governance as well as on health. We demonstrate that health impact assessment is both an analytic tool and a process that helps build the social institutions that can improve health.

  9. Quantifying Burden of Disease to Measure Population Health in Korea

    PubMed Central

    2016-01-01

    Quantitative assessments of the health status of a population are essential to make decisions and set priorities in the field of public health. Changing epidemiologic patterns increase the demand for comprehensive estimates of population health across the full health spectrum, including non-communicable diseases and injuries. Burden of disease (BoD) analysis has helped meet this need. With the success of the Global Burden of Disease (GBD) Study, the BoD technique has become predominantly associated with the GBD approach and its methodology using disability-adjusted life year (DALY) has been rapidly disseminated and generally accepted over the last several years. The first Korean BoD study using the DALY metric was presented in 2002. Various BoD studies have since been conducted, but the DALY concept has remained primarily academic and has not yet been actively utilized in the health policy arena. Here, we review the DALY metric and population-based Korean BoD studies using national health data, with the intent of increasing the understanding of their value and their potential role in strengthening future assessments of the Korean population’s health status. PMID:27775246

  10. Psychosocial biomarker research: integrating social, emotional and economic factors into population studies of aging and health.

    PubMed

    Steptoe, Andrew

    2011-04-01

    There are complex reciprocal relationships between health and social, emotional and economic factors in aging populations. Social and affective neurosciences are rapidly developing an understanding of the mechanisms underlying these phenomena using sophisticated behavioural, neuroimaging and psychophysiological methods. These techniques are often complex and expensive, so are generally used in relatively small selected samples rather than in large-scale cohort studies. However, an understanding of the significance of these processes in health and well-being depends on integrating findings from social and affective neuroscience into population-level studies. The aim of this article is to describe how a population perspective on the determinants of health and well-being in old age articulates with the agenda of social, affective and economic neuroscience, particularly through the application of psychosocial biomarker research. Social and affective neuroscience and epidemiological approaches provide complementary research strategies for understanding the mechanisms linking social, emotional and economic factors with health risk. This will be illustrated primarily from findings from two studies conducted at University College London, the Whitehall II Study and the English Longitudinal Study of Ageing.

  11. Flipping the classroom to teach population health: Increasing the relevance.

    PubMed

    Simpson, Vicki; Richards, Elizabeth

    2015-05-01

    In recent years, there have been multiple calls to enhance the population health and health promotion aspects of nursing programs. Further impetus has been provided by passage of the Affordable Care Act in 2010 with its focus on prevention. The need to develop students who can critically think and apply knowledge learned is crucial to the development of nurses who can integrate and apply the concepts of population-focused practice in society and a healthcare system undergoing transformation. This coupled with the ever changing needs of learners requires a different approach to content delivery and presentation. Flipped classroom courses, with an online component, offer the flexibility and technology desired by current undergraduate students. The use of a flipped classroom approach to re-design a population health course in a Midwestern nursing program resulted in stronger course evaluations from students and reflected better student understanding of the relevance of such content in a nursing curriculum.

  12. Demography, vulnerabilities and right to health to Brazilian prison population.

    PubMed

    Soares, Marden Marques; Bueno, Paula Michele Martins Gomes

    2016-06-01

    This study investigates the latest research on the profile of the Brazilian prison population, its demography and current laws and regulations. It aims in the direction of ensuring the human right to health. Brazilian prison system is a complex universe in which state and federal criminal contexts keep more than 607,000 people in custody. This population is composed of 75% of young and black people, 67% poorly educated and 41% are pre-trial detainees, living in overcrowded prisons and architecturally vandalized, with population growth of around 575% in 24 years, making this environment a major focus of production of diseases. The prison becomes the object of differentiated intervention by public bodies linked to the executive and the judiciary - it is worth remarking that the data show the high level of inequalities and health vulnerabilities among the prison population, whose needs involve a set of cross-sector of transverse public policies actions towards penal execution.

  13. Policy challenges in addressing racial disparities and improving population health.

    PubMed

    Mechanic, David

    2005-01-01

    Socioeconomic status fundamentally affects most health and disease outcomes, but black Americans are doubly disadvantaged by low status, discrimination, and residential segregation. Improving health and removing disparities are essential goals, but some efforts that improve the health of blacks in important ways also increase black-white disparity ratios. People with more information, influence, resources, and social networks may be better able to take advantage of new technologies and scientific developments, initially increasing disparities. Better health and reduced mortality should be the key policy criteria, but these criteria should be linked with consideration of careful targeting to level the playing field and close disparities.

  14. Population risk factors and trends in health care and public policy.

    PubMed

    Haughton, Betsy; Stang, Jamie

    2012-03-01

    Many factors affect the current and future practice of dietetics in the United States. This article provides an overview of the most important population risk factors and trends in health care and public policy that are anticipated to affect the current dietetics workforce and future of dietetics training and practice. It concludes with an overview of the state of the current workforce, highlighting the opportunities and challenges it will face in the future. Demographic shifts in the age and racial/ethnic composition of the US population will be a major determinant of future the dietetics profession because a growing population of older adults with chronic health conditions will require additional medical nutrition therapy services. Dietetics practitioners will work with an increasingly diverse population, which will require the ability to adapt existing programs and services to culturally diverse individuals and communities. Economic factors will affect not only the type, quantity, and quality of food available in homes, but also how health care is delivered, influencing future roles of registered dietitians (RDs) and dietetic technicians, registered (DTRs). As health care services consume a larger percentage of federal and corporate expenditures, health care agencies will continue to look for ways to reduce costs. Health promotion and disease prevention efforts will likely play a larger role in health care services, thus creating many opportunities for RDs and DTRs in preventive care and wellness. Increasingly, dietetics services will be provided in more diverse settings, such as worksites, community health centers, and home-care agencies. To address population-based health care and nutrition priorities effectively, dietetics practice will need to focus on appropriate evidence-based intervention approaches and targets. The workforce needs to be skilled in the delivery of culturally competent interventions across the lifespan, for all population groups, and

  15. Perceived health in the Portuguese population aged ≥ 35

    PubMed Central

    de Figueiredo, João Paulo; Cardoso, Salvador Massano

    2014-01-01

    OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001), with chronic disease (p < 0.0001), who consumed < 3 meals per day (p ≤ 0.01), who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence) and with different areas of life satisfaction. CONCLUSIONS Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over health attitudes and

  16. Developing comprehensive health care for an underserved population.

    PubMed

    Penprase, Barbara

    2006-01-01

    An especially vulnerable population is the disadvantaged and underserved older adult population residing in urban communities. This article describes a hospital-sponsored program in an urban community developed to improve access to health promotion and chronic disease control services for older adults. As part of the newly designed service, the hospital also sought to change its image from simply that of a "hospital" to that of a "community setting" dedicated to serving the comprehensive needs of older adults.

  17. Health risk and promotion behaviors in refugee populations.

    PubMed

    Barnes, Donelle M; Harrison, Cara; Heneghan, Richard

    2004-08-01

    Refugees resettling in the U.S. are generally low-income and underserved by health promotion interventions. To begin to address refugee health promotion issues, this study describes health behaviors of newly arrived (less than 90 days) adult refugees in the U.S. The methods used were retrospective description of clients from one refugee health screening program. The sample consisted of adult refugees (n=591), men and women, from Cuba, Bosnia, Vietnam, Kosovo, Iran, Iraq, and other countries. Rates of overweight were highest among Bosnians and lowest among Vietnamese. Cubans reported the most physical activity and Kosovars the least. Rates of smoking were highest among Bosnians and lowest among Cubans. Older refugees were more overweight and reported less physical activity and more smoking than younger adults. In some cases, different refugee groups have similar health promotion needs, while in others needs differ. This baseline descriptive data supports calls for further health promotion research and interventions in refugee populations.

  18. Do Canadian Civil Servants Care About the Health of Populations?

    PubMed Central

    Lavis, John N.; Ross, Suzanne E.; Stoddart, Gregory L.; Hohenadel, Joanne M.; McLeod, Christopher B.; Evans, Robert G.

    2003-01-01

    Objectives. This article describes Canadian civil servants’ awareness of, attitudes toward, and self-reported use of ideas about the determinants of health. Methods. Federal and provincial civil servants in departments of finance, labor, social services, and health were surveyed. Results. With civil servants in finance departments a notable exception, most Canadian civil servants see the health of populations as a relevant outcome for their sectors. Many (65%) report that ideas about the determinants of health have already influenced policymaking in their sector, but most (83%) say they need more information about the health consequences of the policy alternatives their departments face. Conclusions. Civil servants should consider developing accountability structures for health and researchers should consider producing and transferring more policy-relevant research. PMID:12660214

  19. Effective health risk communication about pandemic influenza for vulnerable populations.

    PubMed

    Vaughan, Elaine; Tinker, Timothy

    2009-10-01

    The consequences of pandemic influenza for vulnerable populations will depend partly on the effectiveness of health risk communications. Strategic planning should fully consider how life circumstances, cultural values, and perspectives on risk influence behavior during a pandemic. We summarize recent scientific evidence on communication challenges and examine how sociocultural, economic, psychological, and health factors can jeopardize or facilitate public health interventions that require a cooperative public. If ignored, current communication gaps for vulnerable populations could result in unequal protection across society during an influenza pandemic. We offer insights on communication preparedness gleaned from scientific studies and the deliberations of public health experts at a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008.

  20. Translating evidence into population health improvement: strategies and barriers.

    PubMed

    Woolf, Steven H; Purnell, Jason Q; Simon, Sarah M; Zimmerman, Emily B; Camberos, Gabriela J; Haley, Amber; Fields, Robert P

    2015-03-18

    Among the challenges facing research translation-the effort to move evidence into policy and practice-is that key questions chosen by investigators and funders may not always align with the information priorities of decision makers, nor are the findings always presented in a form that is useful for or relevant to the decisions at hand. This disconnect is a problem particularly for population health, where the change agents who can make the biggest difference in improving health behaviors and social and environmental conditions are generally nonscientists outside of the health professions. To persuade an audience that does not read scientific journals, strong science may not be enough to elicit change. Achieving influence in population health often requires four ingredients for success: research that is responsive to user needs, an understanding of the decision-making environment, effective stakeholder engagement, and strategic communication. This article reviews the principles and provides examples from a national and local initiative.

  1. Implications of Big Data Analytics on Population Health Management.

    PubMed

    Bradley, Paul S

    2013-09-01

    As healthcare providers transition to outcome-based reimbursements, it is imperative that they make the transition to population health management to stay viable. Providers already have big data assets in the form of electronic health records and financial billing system. Integrating these disparate sources together in patient-centered datasets provides the foundation for probabilistic modeling of their patient populations. These models are the core technology to compute and track the health and financial risk status of the patient population being served. We show how the probabilistic formulation allows for straightforward, early identification of a change in health and risk status. Knowing when a patient is likely to shift to a less healthy, higher risk category allows the provider to intervene to avert or delay the shift. These automated, proactive alerts are critical in maintaining and improving the health of a population of patients. We discuss results of leveraging these models with an urban healthcare provider to track and monitor type 2 diabetes patients. When intervention outcome data are available, data mining and predictive modeling technology are primed to recommend the best type of intervention (prescriptions, physical therapy, discharge protocols, etc.) with the best likely outcome.

  2. The Interaction between Selection, Demography and Selfing and How It Affects Population Viability

    PubMed Central

    Awad, Diala Abu; Gallina, Sophie; Bonamy, Cyrille; Billiard, Sylvain

    2014-01-01

    Population extinction due to the accumulation of deleterious mutations has only been considered to occur at small population sizes, large sexual populations being expected to efficiently purge these mutations. However, little is known about how the mutation load generated by segregating mutations affects population size and, eventually, population extinction. We propose a simple analytical model that takes into account both the demographic and genetic evolution of populations, linking population size, density dependence, the mutation load, and self-fertilisation. Analytical predictions were found to be relatively good predictors of population size and probability of population viability when verified using an explicit individual based stochastic model. We show that initially large populations do not always reach mutation-selection balance and can go extinct due to the accumulation of segregating deleterious mutations. Population survival depends not only on the relative fitness and demographic stochasticity, but also on the interaction between the two. When deleterious mutations are recessive, self-fertilisation affects viability non-monotonically and genomic cold-spots could favour the viability of outcrossing populations. PMID:24465911

  3. Financial impact of population health management programs: reevaluating the literature.

    PubMed

    Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven

    2012-06-01

    Although many employers offer some components of worksite-based population health management (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies.

  4. Location of odor sources and the affected population in Imperial County, California

    SciTech Connect

    Hahn, J.L.

    1981-08-01

    This report is divided into four sections. The first two sections contain general background information on Imperial County. The third section is a general discussion of odor sources in Imperial County, and the fourth maps the specific odor sources, the expected areas of perception, and the affected populations. this mapping is done for the Imperial Valley and each of the four Imperial County KGRA's (Known Geothermal Resource Areas) where odor from the development of the geothermal energy may affect population.

  5. Maryland's Special Populations Cancer Network: cancer health disparities reduction model.

    PubMed

    Baquet, Claudia R; Mack, Kelly M; Bramble, Joy; DeShields, Mary; Datcher, Delores; Savoy, Mervin; Hummel, Kery; Mishra, Shiraz I; Brooks, Sandra E; Boykin-Brown, Stephanie

    2005-05-01

    Cancer in Maryland is a serious health concern for minority and underserved populations in rural and urban areas. This report describes the National Cancer Institute (NCI) supported Maryland Special Populations Cancer Network (MSPN), a community-academic partnership. The MSPN's priority populations include African Americans, Native Americans, and other medically underserved residents of rural and urban areas. The MSPN has established a community infrastructure through formal collaborations with several community partners located in Baltimore City, the rural Eastern Shore, and Southern and Western Maryland, and among the Piscataway Conoy Tribe and the other 27 Native American Tribes in Maryland. Key partners also include the University of Maryland Eastern Shore and the University of Maryland Statewide Health Network. The MSPN has implemented innovative and successful programs in cancer health disparities research, outreach, and training; clinical trials education, health disparities policy, and resource leveraging. The MSPN addresses the goal of the NCI and the Department of Health and Human Services (DHHS) to reduce and eventually eliminate cancer health disparities. Community-academic partnerships are the foundation of this successful network.

  6. Health Literacy in Taiwan: A Population-Based Study.

    PubMed

    Duong, Van Tuyen; Lin, I-Feng; Sorensen, Kristine; Pelikan, Jürgen M; Van Den Broucke, Stephan; Lin, Ying-Chin; Chang, Peter Wushou

    2015-11-01

    Data on health literacy (HL) in the population is limited for Asian countries. This study aimed to test the validity of the Mandarin version of the European Health Literacy Survey Questionnaire (HLS-EU-Q) for use in the general public in Taiwan. Multistage stratification random sampling resulted in a sample of 2989 people aged 15 years and above. The HLS-EU-Q was validated by confirmatory factor analysis with excellent model data fit indices. The general HL of the Taiwanese population was 34.4 ± 6.6 on a scale of 50. Multivariate regression analysis showed that higher general HL is significantly associated with the higher ability to pay for medication, higher self-perceived social status, higher frequency of watching health-related TV, and community involvement but associated with younger age. HL is also associated with health status, health behaviors, and health care accessibility and use. The HLS-EU-Q was found to be a useful tool to assess HL and its associated factors in the general population.

  7. Rational use of electronic health records for diabetes population management.

    PubMed

    Eggleston, Emma M; Klompas, Michael

    2014-04-01

    Population management is increasingly invoked as an approach to improve the quality and value of diabetes care. Recent emphasis is driven by increased focus on both costs and measures of care as the US moves from fee for service to payment models in which providers are responsible for costs incurred, and outcomes achieved, for their entire patient population. The capacity of electronic health records (EHRs) to create patient registries, apply analytic tools, and facilitate provider- and patient-level interventions has allowed rapid evolution in the scope of population management initiatives. However, findings on the efficacy of these efforts for diabetes are mixed, and work remains to achieve the full potential of an-EHR based population approach. Here we seek to clarify definitions and key domains, provide an overview of evidence for EHR-based diabetes population management, and recommend future directions for applying the considerable power of EHRs to diabetes care and prevention.

  8. Getting from here to there: health IT needs for population health.

    PubMed

    Vest, Joshua R; Harle, Christopher A; Schleyer, Titus; Dixon, Brian E; Grannis, Shaun J; Halverson, Paul K; Menachemi, Nir

    2016-12-01

    The United States' decade-long transition from a paper- to technology-based information infrastructure has always been recognized as an initial step-a laying of the foundation-for future changes to the delivery of care. An increasingly important focal area for improvement is population health. Numerous policies and programs now require healthcare organizations to manage the risks, outcomes, utilization, and health of entire groups of individuals. Nonetheless, current health information technology (IT) systems are not ready to support population health improvements effectively and efficiently. Existing health IT systems were designed for organizations that are structurally, operationally, and culturally focused on individual care delivery, rather than improving health for a population. Opportunities exist to align health IT resources and population health management strategies to fill the gaps among technological capabilities, use and the emerging demands of population health. To realize this alignment, healthcare leaders must think differently about the types of data their organizations need, the types of partners with whom they share information, and how they can leverage new information and partnerships for evidence-based action.

  9. Disadvantaged populations in maternal health in China who and why?

    PubMed Central

    Yuan, Beibei; Qian, Xu; Thomsen, Sarah

    2013-01-01

    Background China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. Methods We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. Results In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Conclusions Inequity in maternal health continues to be an

  10. Disadvantaged populations in maternal health in China who and why?

    PubMed

    Yuan, Beibei; Qian, Xu; Thomsen, Sarah

    2013-01-01

    Background China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. Methods We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. Results In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Conclusions Inequity in maternal health continues to be an

  11. Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days

    PubMed Central

    Slabaugh, S. Lane; Shah, Mona; Zack, Matthew; Cordier, Tristan; Havens, Eric; Davidson, Evan; Miao, Michael; Prewitt, Todd; Jia, Haomiao

    2017-01-01

    Abstract Measuring population health with morbidity and mortality data, often collected at the site of care, fails to capture the individual's perspective on health and well-being. Because health happens outside the walls of medical facilities, a holistic and singular measure of health that can easily be captured for an entire population could aid in understanding the well-being of communities. This paper postulates that Healthy Days, a health-related quality of life measure developed and validated by the Centers for Disease Control and Prevention, is an ideal survey instrument to advance population health. A systematic literature review was conducted and revealed a strong evidence base using Healthy Days with significant correlations to chronic disease conditions. Building on the literature base and experience, methods for analyzing Healthy Days data are discussed, including stratified sampling techniques, statistical measures to account for variance, and modeling techniques for skewed distributions. Using such analytic techniques, Healthy Days has been used extensively in national health surveillance. As the health care system faces increasing costs and constrained resources, the Healthy Days survey instrument can be used to inform public policies and allocate health service resources. Because Healthy Days captures broad dimensions of health from the individual's perspective, it is a simple way to holistically measure the health and well-being of a population and its trend over time. Expanded use of Healthy Days can aid population health managers and contribute to the understanding of the broader determinants of the nation's and individual community's health and aid in evaluating progress toward health goals. PMID:27031869

  12. Query Health: standards-based, cross-platform population health surveillance

    PubMed Central

    Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

    2014-01-01

    Objective Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Materials and methods Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. Results We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. Discussions This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Conclusions Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. PMID:24699371

  13. Habitat stability and predation pressure affect temperament behaviours in populations of three-spined sticklebacks.

    PubMed

    Brydges, Nichola M; Colegrave, Nick; Heathcote, Robert J P; Braithwaite, Victoria A

    2008-03-01

    1. There is growing interest in the causes and consequences of animal temperaments. Temperament behaviours often have heritable components, but ecological variables can also affect them. Numerous variables are likely to differ between habitats, and these may interact to influence temperament behaviours. 2. Temperament behaviours may be correlated within populations (behavioural syndromes), although the underlying causes of such correlations are currently unclear. 3. We analysed three different temperament behaviours and learning ability in three-spined sticklebacks, Gasterosteus aculeatus, to determine how different ecological variables influence them both within and between populations. We selected populations from four ponds and four rivers that varied naturally in their exposure to predators. 4. High-predation river populations were significantly less bold than a high-predation pond and low-predation river populations, and low-predation pond populations were significantly less bold than a high-predation pond population. Within populations, temperament behaviours were correlated in one high-predation river population only. 5. These results suggest that multiple ecological factors can interact to affect temperament behaviours between populations, and also correlations in those behaviours within populations.

  14. When bad moods may not be so bad: Valuing negative affect is associated with weakened affect-health links.

    PubMed

    Luong, Gloria; Wrzus, Cornelia; Wagner, Gert G; Riediger, Michaela

    2016-04-01

    Bad moods are considered "bad" not only because they may be aversive experiences in and of themselves, but also because they are associated with poorer psychosocial functioning and health. We propose that people differ in their negative affect valuation (NAV; the extent to which negative affective states are valued as pleasant, useful/helpful, appropriate, and meaningful experiences) and that affect-health links are moderated by NAV. These predictions were tested in a life span sample of 365 participants ranging from 14-88 years of age using reports of momentary negative affect and physical well-being (via experience sampling) and assessments of NAV and psychosocial and physical functioning (via computer-assisted personal interviews and behavioral measures of hand grip strength). Our study demonstrated that the more individuals valued negative affect, the less pronounced (and sometimes even nonexistent) were the associations between everyday experiences of negative affect and a variety of indicators of poorer psychosocial functioning (i.e., emotional health problems, social integration) and physical health (i.e., number of health conditions, health complaints, hand grip strength, momentary physical well-being). Exploratory analyses revealed that valuing positive affect was not associated with the analogous moderating effects as NAV. These findings suggest that it may be particularly important to consider NAV in models of affect-health links.

  15. Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa.

    PubMed

    Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W

    2017-04-01

    Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

  16. Increasing access by priority populations to Australian sexual health clinics.

    PubMed

    Ali, Hammad; Donovan, Basil; Fairley, Christopher K; Chen, Marcus Y; O'Connor, Catherine C; Grulich, Andrew E; McNulty, Anna; Ryder, Nathan; Hellard, Margaret E; Guy, Rebecca J

    2013-10-01

    Data from a network of 35 Australian sexual health clinics, in geographically diverse locations, showed that the number and proportion of patients from priority populations (ie, young people, men who have sex with men, indigenous people, and female sex workers) increased significantly between 2004 and 2011.

  17. Epidemiological Sociology and the Social Shaping of Population Health

    ERIC Educational Resources Information Center

    Link, Bruce G.

    2008-01-01

    When biomedical knowledge and technology create the capacity for humans to avoid disease and circumvent early death, sociological factors become more, not less important for population health. The transformation of disease causation from cruel fate, accident, and bad luck to circumstances that are under some degree of human control facilitates a…

  18. Older Women: A Population at Risk for Mental Health Problems.

    ERIC Educational Resources Information Center

    Wisniewski, Wendy; Cohen, Donna

    The expanding population of older women relative to older men or the "feminization of aging" is a significant demographic trend with important implications for the future. Older women are at risk for extended years of widowhood, living alone, institutionalization, poverty, and mental health problems. Although the dementias of late life appear to…

  19. Too much sitting: the population health science of sedentary behavior.

    PubMed

    Owen, Neville; Healy, Geneviève N; Matthews, Charles E; Dunstan, David W

    2010-07-01

    Even when adults meet physical activity guidelines, sitting for prolonged periods can compromise metabolic health. Television (TV) time and objective measurement studies show deleterious associations, and breaking up sedentary time is beneficial. Sitting time, TV time, and time sitting in automobiles increase premature mortality risk. Further evidence from prospective studies, intervention trials, and population-based behavioral studies is required.

  20. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    PubMed

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

    2014-04-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

  1. Focus on coal power station installations and population health.

    PubMed

    Valenti, Marco; Masedu, Francesco; Tiberti, Sergio

    2011-01-01

    Damage to health associated with emissions from coal power stations can vary greatly from one location to another depending on the size of the plant, location and the characteristics of the population. Population-based studies conducted by independent groups in different locations around the world show effects on health in populations at higher risk, but failed to definitely demonstrate direct effects on morbidity and mortality, to be exclusively attributed to the presence of active power stations. However, evidence on the role of micropollutants from power station activities suggests that a complete and thorough analysis should be made on the environmental cycle. Therefore danger should in any case be assessed as carefully as possible while assuming, at most, that all micropollutants may come into direct contact with man through the various potential pathways throughout their entire lifetime, regardless of the factors that reduce their presence.

  2. Population expansion and individual age affect endoparasite richness and diversity in a recolonising large carnivore population

    PubMed Central

    Lesniak, Ines; Heckmann, Ilja; Heitlinger, Emanuel; Szentiks, Claudia A.; Nowak, Carsten; Harms, Verena; Jarausch, Anne; Reinhardt, Ilka; Kluth, Gesa; Hofer, Heribert; Krone, Oliver

    2017-01-01

    The recent recolonisation of the Central European lowland (CEL) by the grey wolf (Canis lupus) provides an excellent opportunity to study the effect of founder events on endoparasite diversity. Which role do prey and predator populations play in the re-establishment of endoparasite life cycles? Which intrinsic and extrinsic factors control individual endoparasite diversity in an expanding host population? In 53 individually known CEL wolves sampled in Germany, we revealed a community of four cestode, eight nematode, one trematode and 12 potential Sarcocystis species through molecular genetic techniques. Infections with zoonotic Echinococcus multilocularis, Trichinella britovi and T. spiralis occurred as single cases. Per capita endoparasite species richness and diversity significantly increased with population size and changed with age, whereas sex, microsatellite heterozygosity, and geographic origin had no effect. Tapeworm abundance (Taenia spp.) was significantly higher in immigrants than natives. Metacestode prevalence was slightly higher in ungulates from wolf territories than from control areas elsewhere. Even though alternative canid definitive hosts might also play a role within the investigated parasite life cycles, our findings indicate that (1) immigrated wolves increase parasite diversity in German packs, and (2) prevalence of wolf-associated parasites had declined during wolf absence and has now risen during recolonisation. PMID:28128348

  3. Population expansion and individual age affect endoparasite richness and diversity in a recolonising large carnivore population

    NASA Astrophysics Data System (ADS)

    Lesniak, Ines; Heckmann, Ilja; Heitlinger, Emanuel; Szentiks, Claudia A.; Nowak, Carsten; Harms, Verena; Jarausch, Anne; Reinhardt, Ilka; Kluth, Gesa; Hofer, Heribert; Krone, Oliver

    2017-01-01

    The recent recolonisation of the Central European lowland (CEL) by the grey wolf (Canis lupus) provides an excellent opportunity to study the effect of founder events on endoparasite diversity. Which role do prey and predator populations play in the re-establishment of endoparasite life cycles? Which intrinsic and extrinsic factors control individual endoparasite diversity in an expanding host population? In 53 individually known CEL wolves sampled in Germany, we revealed a community of four cestode, eight nematode, one trematode and 12 potential Sarcocystis species through molecular genetic techniques. Infections with zoonotic Echinococcus multilocularis, Trichinella britovi and T. spiralis occurred as single cases. Per capita endoparasite species richness and diversity significantly increased with population size and changed with age, whereas sex, microsatellite heterozygosity, and geographic origin had no effect. Tapeworm abundance (Taenia spp.) was significantly higher in immigrants than natives. Metacestode prevalence was slightly higher in ungulates from wolf territories than from control areas elsewhere. Even though alternative canid definitive hosts might also play a role within the investigated parasite life cycles, our findings indicate that (1) immigrated wolves increase parasite diversity in German packs, and (2) prevalence of wolf-associated parasites had declined during wolf absence and has now risen during recolonisation.

  4. Population expansion and individual age affect endoparasite richness and diversity in a recolonising large carnivore population.

    PubMed

    Lesniak, Ines; Heckmann, Ilja; Heitlinger, Emanuel; Szentiks, Claudia A; Nowak, Carsten; Harms, Verena; Jarausch, Anne; Reinhardt, Ilka; Kluth, Gesa; Hofer, Heribert; Krone, Oliver

    2017-01-27

    The recent recolonisation of the Central European lowland (CEL) by the grey wolf (Canis lupus) provides an excellent opportunity to study the effect of founder events on endoparasite diversity. Which role do prey and predator populations play in the re-establishment of endoparasite life cycles? Which intrinsic and extrinsic factors control individual endoparasite diversity in an expanding host population? In 53 individually known CEL wolves sampled in Germany, we revealed a community of four cestode, eight nematode, one trematode and 12 potential Sarcocystis species through molecular genetic techniques. Infections with zoonotic Echinococcus multilocularis, Trichinella britovi and T. spiralis occurred as single cases. Per capita endoparasite species richness and diversity significantly increased with population size and changed with age, whereas sex, microsatellite heterozygosity, and geographic origin had no effect. Tapeworm abundance (Taenia spp.) was significantly higher in immigrants than natives. Metacestode prevalence was slightly higher in ungulates from wolf territories than from control areas elsewhere. Even though alternative canid definitive hosts might also play a role within the investigated parasite life cycles, our findings indicate that (1) immigrated wolves increase parasite diversity in German packs, and (2) prevalence of wolf-associated parasites had declined during wolf absence and has now risen during recolonisation.

  5. Oral health promotion for our ageing Australian population.

    PubMed

    Chalmers, J M

    2003-03-01

    The ageing Australian population living in the new millennium has dental needs that are very different and more complex than those experienced by previous older adult cohorts during the twentieth century. A summary of the oral health status of older Australians is presented, together with a review of the important relationships between general health and oral health. The key to maintaining and improving older adults' oral health status is the use of oral health promotion strategies that focus not only on dental characteristics, but also on the life characteristics of older adults, and on their quality of life issues. Traditionally, there has been very limited geriatric oral health promotion, with several myths contributing to this situation. Contemporary geriatric oral health promotion in the new millenium has an evidence-based and planned approach. It encompasses not only the treatment of oral diseases and conditions, but has an increased focus on the prevention of oral diseases and conditions to enhance oral health status and older adults' quality of life. Using the Ottawa Charter and a functional dependence classification, a geriatric oral health promotion matrix is presented, using a specific example of Australian residential care.

  6. Mental health promotion: concepts and strategies for reaching the population.

    PubMed

    Jané-Llopis, Eva

    2007-12-01

    There have been many attempts to define mental health promotion. To date, there is no consensus in the field as to what it entails. While some understand it as a holistic concept including intervening at structural, societal and political levels to positively influence mental health, others conceptualise it basically as strategies with an individual focus to improve personal competencies. Many of these differences are related to the distinct understanding of the concepts of mental well-being and positive mental health. The lack of clarity on the boundaries of mental health promotion has divided professionals and is a missed opportunity, as momentum is moving mental health promotion on to political agendas. In Europe, two important milestones for mental health, the WHO Ministerial Conference and the EC Green Paper on Mental Health, have moved mental health promotion into the political landscape, recognising positive mental health and mental well-being as fundamental to the quality of life and productivity of Europeans and a contributor to sustainable development. Although proven efficacious, ad hoc implementation of mental health promotion programs alone is not sufficient to ensure improvement of the population's mental health. Co-ordinated action that includes efficient ways to deliver such interventions in a sustainable way is essential. Two such delivery mechanisms in the search for efficiency are discussed in this paper: a) identifying co-occurrence of mental and physical health problems in order to include mental health promotion components into existing health promotion interventions; and, b) supporting the inclusion of mental health indicators into sound public policy options in order to prove that efficacious policies in labour, education, environment, etc, also bring about positive mental health outcomes. To support the current interest to bring about positive mental health it is essential that evaluation of existing initiatives is put in place, as well as

  7. [The impact of the economic crisis on the health and healthcare of the immigrant population. SESPAS report 2014].

    PubMed

    Vázquez, María Luisa; Vargas, Ingrid; Aller, Marta-Beatriz

    2014-06-01

    Despite the economic crisis, the immigrant population of Spain continues to be high, with 5.7 million persons (11.4%). This population, whose health needs are similar to those of the general population, is more vulnerable due to their exposure to worse social determinants (living and working conditions together with a higher risk of exclusion from social services). In this article, we analyze how the economic crisis affects or can affect the health of the immigrant population in Spain by examining distinct population-specific or institutional factors that influence the effects of the crisis and the available data. The available evidence is limited, but several effects can be identified: firstly, some social determinants, such as higher unemployment rates and worse working conditions, have deteriorated, which can be expected to lead to a worsening of health status. These consequences have already been described for mental health or have been estimated for infectious diseases. Secondly, political decisions have had a direct impact, excluding-with some exceptions-undocumented immigrants from the right to health care. Finally, the lower priority given to adapting health services to the specific characteristics of the immigrant population (most of whom are documented) together with the introduction of new barriers, has hampered or will hamper access to health care. As a result, the economic crisis can be expected to have a greater impact on the immigrant population.

  8. The free health care initiative: how has it affected health workers in Sierra Leone?

    PubMed Central

    Witter, Sophie; Wurie, Haja; Bertone, Maria Paola

    2016-01-01

    There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers. Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and technical resources, can galvanize systemic changes. In this regard, the story of Sierra Leone differs from many countries introducing fee exemptions, where fee exemption has been a stand-alone programme, unconnected to wider health system reforms. The challenge will be sustaining the momentum and the attention to delivering results as the FHCI ceases to be an initiative and becomes just ‘business as normal’. The health system in Sierra Leone was fragile and conflict-affected prior to the FHCI and still faces significant challenges, both in human resources for health and more widely, as vividly evidenced by the current Ebola crisis. PMID:25797469

  9. Reforming health care financing in Bulgaria: the population perspective.

    PubMed

    Balabanova, Dina; McKee, Martin

    2004-02-01

    Health financing reform in Bulgaria has been characterised by lack of political consensus on reform direction, economic shocks, and, since 1998, steps towards social insurance. As in other eastern European countries, the reform has been driven by an imperative to embrace new ideas modelled on systems elsewhere, but with little attention to whether these reflect popular values. This study explores underlying values, such as views on the role of the state and solidarity, attitudes to, and understanding of compulsory and voluntary insurance, and co-payments. The study identifies general principles (equity, transparency) considered important by the population and practical aspects of implementation of reform. Data were obtained from a representative survey (n=1547) and from 58 in-depth interviews and 6 focus groups with users and health professionals, conducted in 1997 before the actual reform of the health financing system in Bulgaria. A majority supports significant state involvement in health care financing, ranging from providing safety net for the poor, through co-subsidising or regulating the social insurance system, to providing state-financed universal free care (half of all respondents). Collectivist values in Bulgaria remain strong, with support for free access to services regardless of income, age, or health status and progressive funding. There is strong support (especially among the well off) for a social insurance system based on the principle of solidarity and accountability rather than the former tax-based model. The preferred health insurance fund was autonomous, state regulated, financing only health care, and offering optional membership. Voluntary insurance and, less so, co-payments were acceptable if limited to selected services and better off groups. In conclusion, a health financing system under public control that fits well with values and population preferences is likely to improve compliance and be more sustainable. Universal health insurance

  10. FastStats: Health of Black or African American non-Hispanic Population

    MedlinePlus

    ... Health of Black or African American non-Hispanic Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

  11. Air pollution and population health: a global challenge.

    PubMed

    Chen, Bingheng; Kan, Haidong

    2008-03-01

    "Air pollution and population health" is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still at relatively high levels, though the levels have been gradually decreasing or have remained stable during rapid economic development. In recent years, several hundred epidemiological studies have emerged showing adverse health effects associated with short-term and long-term exposure to air pollutants. Time-series studies conducted in Asian cities also showed similar health effects on mortality associated with exposure to particulate matter (PM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)) and ozone (O(3)) to those explored in Europe and North America. The World Health Organization (WHO) published the "WHO Air Quality Guidelines (AQGs), Global Update" in 2006. These updated AQGs provide much stricter guidelines for PM, NO(2), SO(2) and O(3). Considering that current air pollution levels are much higher than the WHO-recommended AQGs, interim targets for these four air pollutants are also recommended for member states, especially for developing countries in setting their country-specific air quality standards. In conclusion, ambient air pollution is a health hazard. It is more important in Asian developing countries within the context of pollution level and population density. Improving air quality has substantial, measurable and important public health benefits.

  12. Interdisciplinarity and Systems Science to Improve Population Health

    PubMed Central

    Mabry, Patricia L.; Olster, Deborah H.; Morgan, Glen D.; Abrams, David B.

    2008-01-01

    Fueled by the rapid pace of discovery, humankind's ability to understand the ultimate causes of preventable common disease burdens and to identify solutions is now reaching a revolutionary tipping point. Achieving optimal health and well-being for all members of society lies as much in the understanding of the factors identified by the behavioral, social, and public health sciences as by the biological ones. Accumulating advances in mathematical modeling, informatics, imaging, sensor technology, and communication tools have stimulated several converging trends in science: an emerging understanding of epigenomic regulation; dramatic successes in achieving population health-behavior changes; and improved scientific rigor in behavioral, social, and economic sciences. Fostering stronger interdisciplinary partnerships to bring together the behavioral–social–ecologic models of multilevel “causes of the causes” and the molecular, cellular, and, ultimately, physiological bases of health and disease will facilitate breakthroughs to improve the public's health. The strategic vision of the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH) is rooted in a collaborative approach to addressing the complex and multidimensional issues that challenge the public's health. This paper describes OBSSR's four key programmatic directions (next-generation basic science, interdisciplinary research, systems science, and a problem-based focus for population impact) to illustrate how interdisciplinary and transdisciplinary perspectives can foster the vertical integration of research among biological, behavioral, social, and population levels of analysis over the lifespan and across generations. Interdisciplinary and multilevel approaches are critical both to the OBSSR's mission of integrating behavioral and social sciences more fully into the NIH scientific enterprise and to the overall NIH mission of utilizing science in the pursuit

  13. External built residential environment characteristics that affect mental health of adults.

    PubMed

    Ochodo, Charles; Ndetei, D M; Moturi, W N; Otieno, J O

    2014-10-01

    External built residential environment characteristics include aspects of building design such as types of walls, doors and windows, green spaces, density of houses per unit area, and waste disposal facilities. Neighborhoods that are characterized by poor quality external built environment can contribute to psychosocial stress and increase the likelihood of mental health disorders. This study investigated the relationship between characteristics of external built residential environment and mental health disorders in selected residences of Nakuru Municipality, Kenya. External built residential environment characteristics were investigated for 544 residents living in different residential areas that were categorized by their socioeconomic status. Medically validated interview schedules were used to determine mental health of residents in the respective neighborhoods. The relationship between characteristics of the external built residential environment and mental health of residents was determined by multivariable logistic regression analyses and chi-square tests. The results show that walling materials used on buildings, density of dwelling units, state of street lighting, types of doors, states of roofs, and states of windows are some built external residential environment characteristics that affect mental health of adult males and females. Urban residential areas that are characterized by poor quality external built environment substantially expose the population to daily stressors and inconveniences that increase the likelihood of developing mental health disorders.

  14. Self-rated health and ethnicity: focus on indigenous populations

    PubMed Central

    Bombak, Andrea E.; Bruce, Sharon G.

    2012-01-01

    Objectives Self-rated health (SRH) is a commonly used measure in surveys to assess general health status or health-related quality of life. Differences have been detected in how different ethnic groups and nationalities interpret the SRH measure and assess their health. This review summarizes the research conducted on SRH within and between ethnic groups, with a focus on indigenous groups. Study design and methods A search of published academic literature on SRH and ethnicity, including a comprehensive review of all relevant indigenous research, was conducted using PubMed and summarized. Results A wide variety of research on SRH within ethnic groups has been undertaken. SRH typically serves as an outcome measure. Minority respondents generally rated their health worse than the dominant population. Numerous culturally-specific determinants of SRH have been identified. Cross-national and cross-ethnicity comparisons of the associations of SRH have been conducted to assess the validity of SRH. While SRH is a valid measure within a variety of ethnicities, differences in how SRH is assessed by ethnicities have been detected. Research in indigenous groups remains generally under-represented in the SRH literature. Conclusions These results suggest that different ethnic groups and nationalities vary in SRH evaluations, interpretation of the SRH measure, and referents employed in rating health. To effectively assess and redress health disparities and establish culturally-relevant and effective health interventions, a greater understanding of SRH is required, particularly among indigenous groups, in which little research has been conducted. PMID:22663937

  15. International Health

    MedlinePlus

    ... create refugee populations with immediate and long-term health problems. Some of the major diseases currently affecting ... also an international problem which can affect people's health. Many countries and health organizations are working together ...

  16. Genetics in population health science: strategies and opportunities.

    PubMed

    Belsky, Daniel W; Moffitt, Terrie E; Caspi, Avshalom

    2013-10-01

    Translational research is needed to leverage discoveries from the frontiers of genome science to improve public health. So far, public health researchers have largely ignored genetic discoveries, and geneticists have ignored important aspects of population health science. This mutual neglect should end. In this article, we discuss 3 areas where public health researchers can help to advance translation: (1) risk assessment: investigate genetic profiles as components in composite risk assessments; (2) targeted intervention: conduct life-course longitudinal studies to understand when genetic risks manifest in development and whether intervention during sensitive periods can have lasting effects; and (3) improved understanding of environmental causation: collaborate with geneticists on gene-environment interaction research. We illustrate with examples from our own research on obesity and smoking.

  17. Health status of the Pakistani population: a health profile and comparison with the United States.

    PubMed Central

    Pappas, G; Akhtar, T; Gergen, P J; Hadden, W C; Khan, A Q

    2001-01-01

    OBJECTIVES: The health status of the Pakistani population was compared with that of the US population to provide a better understanding of the health problems in a developing nation and shed light on the dynamics of selected diseases. METHODS: Results from the National Health Survey of Pakistan (n = 18,315) and the US National Health and Nutrition Examination Survey (n = 31,311) were compared. Standardized and comparable methods were used in both surveys. RESULTS: Indicators of undernutrition among children were high throughout Pakistan. Among adults, there were urban-rural differences and economic gradients in indicators of undernutrition and risk factors for heart disease and cancer. In comparison with the US population, the Pakistani population has a higher rate of undernutrition, a lower rate of high cholesterol, and an approximately equal rate of high blood pressure. CONCLUSIONS: There are major inequalities in health within Pakistan and between Pakistan and the United States. Standardized national health examination survey methodology can be used to monitor health status and plan health transition policy in developing countries. PMID:11189831

  18. Recombination affects accumulation of damaging and disease-associated mutations in human populations.

    PubMed

    Hussin, Julie G; Hodgkinson, Alan; Idaghdour, Youssef; Grenier, Jean-Christophe; Goulet, Jean-Philippe; Gbeha, Elias; Hip-Ki, Elodie; Awadalla, Philip

    2015-04-01

    Many decades of theory have demonstrated that, in non-recombining systems, slightly deleterious mutations accumulate non-reversibly, potentially driving the extinction of many asexual species. Non-recombining chromosomes in sexual organisms are thought to have degenerated in a similar fashion; however, it is not clear the extent to which damaging mutations accumulate along chromosomes with highly variable rates of crossing over. Using high-coverage sequencing data from over 1,400 individuals in the 1000 Genomes and CARTaGENE projects, we show that recombination rate modulates the distribution of putatively deleterious variants across the entire human genome. Exons in regions of low recombination are significantly enriched for deleterious and disease-associated variants, a signature varying in strength across worldwide human populations with different demographic histories. Regions with low recombination rates are enriched for highly conserved genes with essential cellular functions and show an excess of mutations with demonstrated effects on health, a phenomenon likely affecting disease susceptibility in humans.

  19. Population health needs beyond ratifying the Kyoto Protocol: a look at occupational deprivation.

    PubMed

    Pereira, R B

    2008-01-01

    The dramatic impact of climate change is physically and economically affecting the world, a consequence of neglecting scientific information known since the 1960s and 1970s. International discussion has focused on the needs of the physical environment and general health concerns (such addressing greenhouse gas production and population health issues); however, little acknowledgement has yet been made of local human issues, such as the effect of climate change on the mental health of those in rural communities. This commentary takes an occupational science perspective to describe new ways of classifying potential mental health problems associated with climate change and its impact on the rural environment. It challenges policy makers to take a proactive approach to addressing the current impacts of climate change on the future mental health of individuals in rural communities.

  20. [The federal health expenditure on the uninsured population: Mexico 1980-1995].

    PubMed

    Lara, A; Gómez-Dantés, O; Urdapilleta, O; Bravo, M L

    1997-01-01

    In the last fifteen years Mexico suffered several economic crisis which have negatively affected public expenditure in social welfare and, as a consequence, public expenditure in health. This paper discusses the relationship between the adjustment policies adopted to confront these crisis and public expenditure in health care for the non-insured population, as well as the regional distribution of this expenditure. In part one, the evolution of general public expenditure, public expenditure in social welfare, and public expenditure in health between 1980 and 1995 is described. In part two, the distribution of public health expenditure for the non-insured population among the five regions in which the country was divided by the National Health Survey II is discussed. The main conclusion of this paper is that, between 1980 and 1995, the public expenditure gaps that have existed for a long time in Mexico among regions remained unchanged. These gaps basically affect the southern states of the country, are not related to health needs, and may deepen in view of the new relative cuts in public expenditure in social welfare announced by the new administration.

  1. Life and health satisfaction in the adult population of Iran

    PubMed Central

    2016-01-01

    OBJECTIVES Increasing interest has emerged in the use of subjective well-being as a development indicator and for the evaluation of public policies. The aim of this study was to assess life and health satisfaction and their determinants in the adult population of Iran. METHODS We conducted a survey of a sample of 3,150 adults at least 18 years of age in Tehran, the capital of Iran. The subjects were selected using a stratified random sampling method, and they were interviewed face-to-face at their usual residence by trained interviewers. Life satisfaction was used as a measure of subjective well-being. We used ordinary least square regression models to assess the associations of life and health satisfaction with socio-demographic variables. RESULTS On a 0-10 scale, the mean (standard deviation) scores for life and health satisfaction were 6.93 (2.54) and 7.18 (1.97), respectively. The average score for life satisfaction in females was 0.52 points higher than in males. A U-shaped relationship was found between age and life satisfaction, with respondents 35 to 44 years of age having the lowest average level of life satisfaction. Satisfaction with life and health among divorced respondents was significantly lower than among never-married and married participants. The scores for life satisfaction in respondents who rated their health status as poor were 3.83 points lower than in those who rated their health status as excellent. CONCLUSIONS The majority of the population of Tehran was satisfied with their life and health. Self-rated health status had the greatest impact on life satisfaction. PMID:27809456

  2. The affective response to health-related information and its relationship to health anxiety: an ambulatory approach.

    PubMed

    Jasper, Fabian; Hiller, Wolfgang; Berking, Matthias; Rommel, Thilo; Witthöft, Michael

    2015-01-01

    Affective reactions to health-related information play a central role in health anxiety. Therefore, using ambulatory assessment, we analysed the time course of negative affect in a control group (CG, n = 60) which only rated their negative affect and an experimental group (EG, n = 97) which also rated the presence of somatic symptoms (e.g., back pain). By means of mixed regression models, we observed a decline of negative affect following the symptom self-ratings in the EG and a stable affect in the CG. The decline of negative affect was not moderated by the degree of health anxiety. Our findings might indicate that evaluating one's health status leads to a general reduction of negative affect in healthy individuals. The results of the study are in line with a bidirectional symptom perception model and underline the crucial role of affect regulation in the processing of health-related information.

  3. Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting

    PubMed Central

    Skoufalos, Alexis; Medalia, Alice; Fendrick, A. Mark

    2016-01-01

    Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting Janice L. Clarke, RN, Alexis Skoufalos, EdD, Alice Medalia, PhD, and A. Mark Fendrick, MD Editorial: A Call to Action: David B. Nash, MD, MBA   S-2 Overview: Depression and the Population Health Imperative   S-3 Promoting Awareness of the Issues and Opportunities for Improvement   S-5 Cognitive Dysfunction in Affective Disorders   S-5 Critical Role of Employers in Improving Health Outcomes for Employees with Depression   S-6 Closing the Behavioral Health Professional and Process Gaps   S-6 Achieving the Triple Aim for Patients with Depressive Disorders   S-6 Improving the Experience of Care for Patients with Depression   S-6 Improving Quality of Care and Health Outcomes for Patients with Depression   S-7 Changing the Cost of Care Discussion from How Much to How Well   S-8 Panel Insights and Recommendations   S-9 Conclusion   S-10 PMID:27636743

  4. Ethnic discrimination and health: the relationship between experienced ethnic discrimination and multiple health domains in Norway's rural Sami population

    PubMed Central

    Hansen, Ketil Lenert

    2015-01-01

    Objective Self-reported ethnic discrimination has been associated with a range of health outcomes. This study builds on previous efforts to investigate the prevalence of self-reported ethnic discrimination in the indigenous (Sami) population, and how such discrimination may be associated with key health indicators. Study design The study relies on data from the 2003/2004 (n=4,389) population-based study of adults (aged 36–79 years) in 24 rural municipalities of Central and North Norway (the SAMINOR study). Self-reported ethnic discrimination was measured using the question: “Have you ever experienced discrimination due to your ethnic background?” Health indicators included questions regarding cardiovascular disease, diabetes, chronic muscle pain, metabolic syndrome and obesity. Logistic regression was applied to examine the relationship between self-reported ethnic discrimination and health outcomes. Results The study finds that for Sami people living in minority areas, self-reported ethnic discrimination is associated with all the negative health indicators included in the study. Conclusion We conclude that ethnic discrimination affects a wide range of health outcomes. Our findings highlight the importance of ensuring freedom from discrimination for the Sami people of Norway. PMID:25683064

  5. The health status of minority populations in the United States.

    PubMed

    Nickens, H W

    1991-07-01

    There is increasing national recognition that while our nation's health care system is the most expensive in the world, the health care status of Americans overall ranks poorly compared with other Western, industrialized nations. In the United States we tend to look at minority-majority variations of health status, as well as the variations of many other indicators by race or ethnicity, because race and ethnicity are particularly important components of our society. In general, health status indicators of minority Americans are worse than those of whites. In some locales, death rates of minority Americans are comparable to those of Third World nations. At the same time, minority Americans make up a rapidly increasing proportion of the nation's population and work force. Our baseline national data on some minority groups, however, currently are inadequate to detect shifts in health status. Finally, the rapidly expanding problem of the acquired immunodeficiency syndrome among some minority populations provides both an imperative and an opportunity to learn how model prevention programs should be designed and executed.

  6. [Use of social marketing in population health programs (literature review)].

    PubMed

    Kholmogorova, G T; Gladysheva, N V

    1991-01-01

    At present health education programmes abroad make wide use of social marketing strategy. Unlike commercial marketing whose purpose is competition and struggle for the expansion of commodity markets, social marketing is aimed at disseminating certain ideas or introducing certain practices, using largely the technological base and strategy of commercial marketing. The authors give 8 fundamental principles of social marketing (consumer orientation, the theory of barter, the analysis of audience and segmentation, special surveys to detect the orientation of population, the choice of channels for information transmission application of "marketing mixture", control of ongoing programme and marketing management). Application fields of social marketing in public health are discussed.

  7. Public health departments and accountable care organizations: finding common ground in population health.

    PubMed

    Ingram, Richard; Scutchfield, F Douglas; Costich, Julia F

    2015-05-01

    We examined areas of potential collaboration between accountable care organizations and public health agencies, as well as perceived barriers and facilitators. We interviewed 9 key informants on 4 topics: advantages of public health agency involvement in accountable care organizations; services public health agencies could provide; practical, cultural, and legal barriers to accountable care organization-public health agency involvement; and business models that facilitate accountable care organization-public health agency collaboration. Public health agencies could help accountable care organizations partner with community organizations and reach vulnerable patients, provide population-based services and surveillance data, and promote policies that improve member health. Barriers include accountable care organizations' need for short-term financial yield, limited public health agency technical and financial capacity, and the absence of a financial model.

  8. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership

    PubMed Central

    2013-01-01

    Background Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women’s Hospital. Description of intervention The PHIT Partnership’s health systems support aligns with the World Health Organization’s six health systems building blocks. HSS activities focus across all levels of the health system — community, health center, hospital, and district leadership — to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. Evaluation design The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted

  9. Neighborhood deprivation affects children's mental health: environmental risks identified in a genetic design.

    PubMed

    Caspi, A; Taylor, A; Moffitt, T E; Plomin, R

    2000-07-01

    The possibility that neighborhood conditions affect children's development has captured much attention because of its implications for prevention. But does growing up in deprived neighborhoods matter above and beyond a genetic liability to behavior problems, if genetically vulnerable families tend to concentrate in poor neighborhoods? A nationwide study of 2-year-old twins shows that children in deprived neighborhoods were at increased risk for emotional and behavioral problems over and above any genetic liability. Environmental factors shared by members of a family accounted for 20% of the population variation in children's behavior problems, and neighborhood deprivation accounted for 5% of this family-wide environmental effect. The results suggest that the link between poor neighborhoods and children's mental health may be a true environmental effect, and demonstrate that genetic designs are environmentally informative and can be used to identify modifiable risk factors for promoting child health.

  10. Can Electronic Health Records Be Used for Population Health Surveillance? Validating Population Health Metrics Against Established Survey Data

    PubMed Central

    McVeigh, Katharine H.; Newton-Dame, Remle; Chan, Pui Ying; Thorpe, Lorna E.; Schreibstein, Lauren; Tatem, Kathleen S.; Chernov, Claudia; Lurie-Moroni, Elizabeth; Perlman, Sharon E.

    2016-01-01

    Introduction: Electronic health records (EHRs) offer potential for population health surveillance but EHR-based surveillance measures require validation prior to use. We assessed the validity of obesity, smoking, depression, and influenza vaccination indicators from a new EHR surveillance system, the New York City (NYC) Macroscope. This report is the second in a 3-part series describing the development and validation of the NYC Macroscope. The first report describes in detail the infrastructure underlying the NYC Macroscope; design decisions that were made to maximize data quality; characteristics of the population sampled; completeness of data collected; and lessons learned from doing this work. This second report, which addresses concerns related to sampling bias and data quality, describes the methods used to evaluate the validity and robustness of NYC Macroscope prevalence estimates; presents validation results for estimates of obesity, smoking, depression and influenza vaccination; and discusses the implications of our findings for NYC and for other jurisdictions embarking on similar work. The third report applies the same validation methods described in this report to metabolic outcomes, including the prevalence, treatment and control of diabetes, hypertension and hyperlipidemia. Methods: NYC Macroscope prevalence estimates, overall and stratified by sex and age group, were compared to reference survey estimates for adult New Yorkers who reported visiting a doctor in the past year. Agreement was evaluated against 5 a priori criteria. Sensitivity and specificity were assessed by examining individual EHR records in a subsample of 48 survey participants. Results: Among adult New Yorkers in care, the NYC Macroscope prevalence estimate for smoking (15.2%) fell between estimates from NYC HANES (17.7 %) and CHS (14.9%) and met all 5 a priori criteria. The NYC Macroscope obesity prevalence estimate (27.8%) also fell between the NYC HANES (31.3%) and CHS (24

  11. [Mental health in older adults: major neurocognitive, affective, and sleep disorders].

    PubMed

    Tello-Rodríguez, Tania; Alarcón, Renato D; Vizcarra-Escobar, Darwin

    2016-06-01

    Numerous biological, psychological, and social factors influence the mental health of elderly individuals to varying degrees. Apart from components related to the normal aging process and the co-occurrence of various medical conditions, events such as the death of a loved one, retirement, or disability significantly contribute to a variety of mental and emotional problems in this stage of the life cycle. The most frequent problems affect the neurocognitive, emotional, and oneiric spheres. Major neurocognitive disorders reduce one's overall performance and, thus, increase their need for close care. Affective disorders may be exacerbated by the lack of family support and decreased social interactions, which may lead to significant isolation result in suicidal behavior. The increased frequency of sleep disorders such as insomnia and daytime sleepiness and specific disorders such as obstructive apnea significantly alter the quality of life of this population.

  12. [Health problems in the population of a dispensary in Cienfuegas].

    PubMed

    Mederos Collazo, C; Salabarría Díaz, N; Ramírez Martínez, R

    1995-01-01

    A study was performed on the entire population served by the medical office #36 from the teaching area V of Cienfuegos municipality with the aim of determining the main health problems and the effectiveness of measures designed to eliminate or improve such problems. Among the principal results are: the incorporation of elderly subjects to "Grandparents Clubs", the reduction of smoking and an improvement of sanitary education, although certain difficulties are still present regarding the latter due to increased intestinal parasitic infections.

  13. Genetic diversity affects the strength of population regulation in a marine fish.

    PubMed

    Johnson, D W; Freiwald, J; Bernardi, G

    2016-03-01

    Variation is an essential feature of biological populations, yet much of ecological theory treats individuals as though they are identical. This simplifying assumption is often justified by the perception that variation among individuals does not have significant effects on the dynamics of whole populations. However, this perception may be skewed by a historic focus on studying single populations. A true evaluation of the extent to which among-individual variation affects the dynamics of populations requires the study of multiple populations. In this study, we examined variation in the dynamics of populations of a live-bearing, marine fish (black surfperch; Embiotoca jacksoni). In collaboration with an organization of citizen scientists (Reef Check California), we were able to examine the dynamics of eight populations that were distributed throughout approximately 700 km of coastline, a distance that encompasses much of this species' range. We hypothesized that genetic variation within a local population would be related to the intensity of competition and to the strength of population regulation. To test this hypothesis, we examined whether genetic diversity (measured by the diversity of mitochondrial DNA haplotypes) was related to the strength of population regulation. Low-diversity populations experienced strong density dependence in population growth rates and population sizes were regulated much more tightly than they were in high-diversity populations. Mechanisms that contributed to this pattern include links between genetic diversity, habitat use, and spatial crowding. On average, low-diversity populations used less of the available habitat and exhibited greater spatial clustering (and more intense competition) for a given level of density (measured at the scale of the reef). Although the populations we studied also varied with respect to exogenous characteristics (habitat complexity, densities of predators, and interspecific competitors), none of these

  14. City planning and population health: a global challenge.

    PubMed

    Giles-Corti, Billie; Vernez-Moudon, Anne; Reis, Rodrigo; Turrell, Gavin; Dannenberg, Andrew L; Badland, Hannah; Foster, Sarah; Lowe, Melanie; Sallis, James F; Stevenson, Mark; Owen, Neville

    2016-12-10

    Significant global health challenges are being confronted in the 21st century, prompting calls to rethink approaches to disease prevention. A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation. This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are destination accessibility, equitable distribution of employment across cities, managing demand by reducing the availability and increasing the cost of parking, designing pedestrian-friendly and cycling-friendly movement networks, achieving optimum levels of residential density, reducing distance to public transport, and enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport). Together, these interventions will create healthier and more sustainable compact cities that reduce the environmental, social, and behavioural risk factors that affect lifestyle choices, levels of traffic, environmental pollution, noise, and crime. The health sector, including health ministers, must lead in advocating for integrated multisector city planning that prioritises health, sustainability, and liveability outcomes, particularly in rapidly changing low-income and middle-income countries. We recommend establishing a set of indicators to benchmark and monitor progress towards achievement of more compact cities that promote health and reduce health inequities.

  15. A shift from exploitation to interference competition with increasing density affects population and community dynamics.

    PubMed

    Holdridge, Erica M; Cuellar-Gempeler, Catalina; terHorst, Casey P

    2016-08-01

    Intraspecific competition influences population and community dynamics and occurs via two mechanisms. Exploitative competition is an indirect effect that occurs through use of a shared resource and depends on resource availability. Interference competition occurs by obstructing access to a resource and may not depend on resource availability. Our study tested whether the strength of interference competition changes with protozoa population density. We grew experimental microcosms of protozoa and bacteria under different combinations of protozoan density and basal resource availability. We then solved a dynamic predator-prey model for parameters of the functional response using population growth rates measured in our experiment. As population density increased, competition shifted from exploitation to interference, and competition was less dependent on resource levels. Surprisingly, the effect of resources was weakest when competition was the most intense. We found that at low population densities, competition was largely exploitative and resource availability had a large effect on population growth rates, but the effect of resources was much weaker at high densities. This shift in competitive mechanism could have implications for interspecific competition, trophic interactions, community diversity, and natural selection. We also tested whether this shift in the mechanism of competition with protozoa density affected the structure of the bacterial prey community. We found that both resources and protozoa density affected the structure of the bacterial prey community, suggesting that competitive mechanism may also affect trophic interactions.

  16. Reproductive health, population growth, economic development and environmental change.

    PubMed

    Lincoln, D W

    1993-01-01

    World population will increase by 1000 million, or by 20%, within 10 years. Ninety-five per cent of this increase will occur in the South, in areas that are already economically, environmentally and politically fragile. Morbidity and mortality associated with reproduction will be greater in the current decade than in any period in human history. Annually, 40-60 million pregnancies will be terminated and 5-10 million children will die within one year of birth. AIDS-related infections, e.g. tuberculosis, will undermine health care in Africa (and elsewhere) and in places AIDS-related deaths will decimate the work-force. The growth in population and associated morbidity will inhibit global economic development and spawn new problems. The key issues are migration, the spread of disease, the supply of water and the degradation of land, and fiscal policies with respect to family planning, pharmaceuticals and Third-World debt. Full education, particularly of women, and more effective family planning in the South have the power to unlock the problem. Failure will see the developed countries, with their 800 million population, swamped by the health, economic and environmental problems of the South, with its projected population of 5400 million people for the year 2000.

  17. Gender differences in health information behaviour: a Finnish population-based survey.

    PubMed

    Ek, Stefan

    2015-09-01

    Narrowing the gaps in health outcomes, including those between men and women, has been a pronounced goal on the agenda of the Finnish health authorities since the mid-1980s. But still there is a huge gap in favour of women when it comes to life expectancy at birth. People's health information behaviour, that is how people seek, obtain, evaluate, categorize and use relevant health-related information to perform desired health behaviours, is a critical prerequisite to appropriate and consistent performances of these behaviours. With respect to gender, it has been noted that men often are unwilling and lack the motivation to engage with health-related information. The purpose of this study was to investigate how gender affects health information behaviour in the Finnish population aged 18-65 years. The survey data were collected via a questionnaire which was posted to a representative cross section consisting of 1500 Finnish citizens. The statistical analysis consists of ANOVA F-tests and Fisher's exact tests. The results show that women were more interested in and reported much more active seeking of health-related information, paid more attention to potential worldwide pandemics and were much more attentive as to how the goods they purchase in everyday life affect their health than men did. Women also reported receiving far more informal health-related information from close family members, other kin and friends/workmates than men did. Thus, to succeed in public health promotion and interventions the measures taken should be much more sensitive to the gender gap in health information behaviour.

  18. Oral health status of a population with multiple sclerosis

    PubMed Central

    Martínez-Pérez, Eva M.; Miegimolle-Herrero, Mónica; Planells-del-Pozo, Paloma

    2012-01-01

    Objective: To determine the oral treatment needs of a sample of patients diagnosed with multiple sclerosis in the Community of Madrid (Spain). Patients and methods: A cross-sectional epidemiological study was carried out with a sample of 64 patients who were aged 25 to 77 years. They were distributed into homogeneous age groups: < 46 years, 46-54 years and > 54 years. In order to evaluate the oral health status and treatment requirements, the parameters and guidelines of the WHO were used. Results: The prevalence of caries was 100%, or very close in all three groups. As age increased, the morbidity rate decreased, but the mortality rate increased considerably. On analyzing gingival health, 65% of patients had calculus, 5% bleeding and 30% were healthy. Conclusions: The DMFT index found provided data that was, in general, very similar to that of the general population in Spain. However, the gingival health status found demonstrated that the population of multiple sclerosis patients requires specific assistance. Key words: Multiple sclerosis, oral health, dentures. PMID:22143682

  19. Reducing Suicide Rates: Need for Public Health and Population Interventions

    PubMed Central

    Jacob, K. S.

    2016-01-01

    Recent studies from India have challenged the fact that the majority of the people who die by suicide have severe mental illness; they have demonstrated its frequent links to environmental stress, social, cultural, economic, and political correlates. Suicide, a complex phenomenon, is a final common pathway for a variety of causal etiologies. Nevertheless, psychiatry continues to argue for curative solutions based on the reductionistic biomedical model, rather than support public health measures to manage the larger sociocultural, economic, and political context. While psychiatry and curative medicine help many people in distress, specific mental health interventions are unlikely to impact secular trends in the rates of suicide. The reduction of population rates of suicide requires a range of public health measures. PMID:28031584

  20. Message Design Strategies to Raise Public Awareness of Social Determinants of Health and Population Health Disparities

    PubMed Central

    Niederdeppe, Jeff; Bu, Q Lisa; Borah, Porismita; Kindig, David A; Robert, Stephanie A

    2008-01-01

    Context Raising public awareness of the importance of social determinants of health (SDH) and health disparities presents formidable communication challenges. Methods This article reviews three message strategies that could be used to raise awareness of SDH and health disparities: message framing, narratives, and visual imagery. Findings Although few studies have directly tested message strategies for raising awareness of SDH and health disparities, the accumulated evidence from other domains suggests that population health advocates should frame messages to acknowledge a role for individual decisions about behavior but emphasize SDH. These messages might use narratives to provide examples of individuals facing structural barriers (unsafe working conditions, neighborhood safety concerns, lack of civic opportunities) in efforts to avoid poverty, unemployment, racial discrimination, and other social determinants. Evocative visual images that invite generalizations, suggest causal interpretations, highlight contrasts, and create analogies could accompany these narratives. These narratives and images should not distract attention from SDH and population health disparities, activate negative stereotypes, or provoke counterproductive emotional responses directed at the source of the message. Conclusions The field of communication science offers valuable insights into ways that population health advocates and researchers might develop better messages to shape public opinion and debate about the social conditions that shape the health and well-being of populations. The time has arrived to begin thinking systematically about issues in communicating about SDH and health disparities. This article offers a broad framework for these efforts and concludes with an agenda for future research to refine message strategies to raise awareness of SDH and health disparities. PMID:18798887

  1. National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors.

    PubMed

    Schatz, Bruce R

    2015-12-01

    At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.

  2. National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors

    PubMed Central

    Schatz, Bruce R.

    2015-01-01

    Abstract At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics. PMID:26858915

  3. What Health Issues or Conditions Affect Women Differently Than Men?

    MedlinePlus

    ... to have treatment to control their cholesterol levels. Mental health Women are more likely to show signs of ... men are. Depression is the most common women’s mental health problem, 5 and more women than men are ...

  4. Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

    PubMed Central

    Kuate Defo, Barthélémy

    2014-01-01

    Background Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains

  5. A guide to scaling up population health interventions.

    PubMed

    Milat, Andrew J; Newson, Robyn; King, Lesley; Rissel, Chris; Wolfenden, Luke; Bauman, Adrian; Redman, Sally; Giffin, Michael

    2016-01-28

    The 'how to' of scaling up public health interventions for maximum reach and outcomes is receiving greater attention; however, there remains a paucity of practical tools to guide those actively involved in scaling up processes in high-income countries. To fill this gap, the New South Wales Ministry of Health developed Increasing the scale of population health interventions: a guide (2014). The guide was informed by a systematic review of scaling up models and methods, and a two-round Delphi process with a sample of senior policy makers, practitioners and researchers actively involved in scaling up processes. Although it is a practical guide to assist health policy makers, health practitioners and others responsible for scaling up effective population health interventions, it can also be used by researchers in the design of research studies that are potentially suitable for scaling up, particularly where research-practice collaborations are involved. The guide is divided into four steps: step 1, 'scalability assessment', aims to determine if an intervention is scalable; step 2, 'developing a scale up plan', aims to develop a practical and workable scaling up plan that can be used to convince stakeholders there is a compelling case for action. Step 3, 'preparing for scale up', aims to identify ways of securing resources needed for going to scale, operating at scale, and building a foundation of legitimacy and support to sustain the scaling up effort through the implementation stage; and step 4, 'scaling up the intervention', involves putting the plan developed in step 2 into place. Although the guide is written as though the user is starting from the point of assessing the scalability of an intervention, later steps can be used by those already involved in scaling up to review their implementation processes. The guide is not intended to be prescriptive. Its purpose is to help policy makers, practitioners, researchers and other decision makers decide on appropriate

  6. Land use, transport, and population health: estimating the health benefits of compact cities.

    PubMed

    Stevenson, Mark; Thompson, Jason; de Sá, Thiago Hérick; Ewing, Reid; Mohan, Dinesh; McClure, Rod; Roberts, Ian; Tiwari, Geetam; Giles-Corti, Billie; Sun, Xiaoduan; Wallace, Mark; Woodcock, James

    2016-12-10

    Using a health impact assessment framework, we estimated the population health effects arising from alternative land-use and transport policy initiatives in six cities. Land-use changes were modelled to reflect a compact city in which land-use density and diversity were increased and distances to public transport were reduced to produce low motorised mobility, namely a modal shift from private motor vehicles to walking, cycling, and public transport. The modelled compact city scenario resulted in health gains for all cities (for diabetes, cardiovascular disease, and respiratory disease) with overall health gains of 420-826 disability-adjusted life-years (DALYs) per 100 000 population. However, for moderate to highly motorised cities, such as Melbourne, London, and Boston, the compact city scenario predicted a small increase in road trauma for cyclists and pedestrians (health loss of between 34 and 41 DALYs per 100 000 population). The findings suggest that government policies need to actively pursue land-use elements-particularly a focus towards compact cities-that support a modal shift away from private motor vehicles towards walking, cycling, and low-emission public transport. At the same time, these policies need to ensure the provision of safe walking and cycling infrastructure. The findings highlight the opportunities for policy makers to positively influence the overall health of city populations.

  7. Is health determined by genetic code or zip code? Measuring the health of groups and improving population health.

    PubMed

    Slade-Sawyer, Penelope

    2014-01-01

    Maintaining the optimal health of all North Carolinians is integral to the overall well-being of the state. It is not enough to have policies, initiatives, and reforms created and led by experts in health and health care. To move towards a culture that appreciates and promotes optimal population health, we also need assistance from other arenas. Data continue to suggest that domains such as education, housing, and income may be just as important, if not more important, than determinants that are usually associated with health outcomes. Thus North Carolina's leaders, professionals, and policy makers need to adopt shared responsibility for our population's health by taking a health-in-all-policies stance. Research to expand our understanding of individual and group actions that contribute to health outcomes, collaboration of partners across diverse sectors to implement evidence-based initiatives, and creative thinking and planning for future workforce needs are a few important actions. Together, these efforts can help to shift our long-standing focus on "disease care" to an upstream approach that ultimately reduces health care burdens and improves population health.

  8. Multiple dietary supplements do not affect metabolic and cardiovascular health

    PubMed Central

    Holloszy, John O.; Fontana, Luigi

    2014-01-01

    Dietary supplements are widely used for health purposes. However, little is known about the metabolic and cardiovascular effects of combinations of popular over-the-counter supplements, each of which has been shown to have anti-oxidant, anti-inflammatory and pro-longevity properties in cell culture or animal studies. This study was a 6-month randomized, single-blind controlled trial, in which 56 non-obese (BMI 21.0-29.9 kg/m2) men and women, aged 38 to 55 yr, were assigned to a dietary supplement (SUP) group or control (CON) group, with a 6-month follow-up. The SUP group took 10 dietary supplements each day (100 mg of resveratrol, a complex of 800 mg each of green, black, and white tea extract, 250 mg of pomegranate extract, 650 mg of quercetin, 500 mg of acetyl-l-carnitine, 600 mg of lipoic acid, 900 mg of curcumin, 1 g of sesamin, 1.7 g of cinnamon bark extract, and 1.0 g fish oil). Both the SUP and CON groups took a daily multivitamin/mineral supplement. The main outcome measures were arterial stiffness, endothelial function, biomarkers of inflammation and oxidative stress, and cardiometabolic risk factors. Twenty-four weeks of daily supplementation with 10 dietary supplements did not affect arterial stiffness or endothelial function in nonobese individuals. These compounds also did not alter body fat measured by DEXA, blood pressure, plasma lipids, glucose, insulin, IGF-1, and markers of inflammation and oxidative stress. In summary, supplementation with a combination of popular dietary supplements has no cardiovascular or metabolic effects in non-obese relatively healthy individuals. PMID:24659610

  9. Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

    PubMed Central

    Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J.; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton “Mickey”; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B.; Strelnick, A. Hal; Wallerstein, Nina

    2014-01-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public’s health and reducing health disparities, the CTSA Consortium’s Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy’s application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

  10. Strategies for expanding health insurance coverage in vulnerable populations

    PubMed Central

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-01-01

    Background Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. Objectives To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. www.thecochranelibrary.com (searched 2 November 2012), PubMed (searched 1 November 2012), EMBASE (searched 6 July 2012), Global Health (searched 6 July 2012), IBSS (searched 6 July 2012), WHO Library Database (WHOLIS) (searched 1 November 2012), IDEAS (searched 1 November 2012), ISI-Proceedings (searched 1 November 2012),OpenGrey (changed from OpenSIGLE) (searched 1 November 2012), African Index Medicus (searched 1 November 2012), BLDS (searched 1 November 2012), Econlit (searched 1 November 2012), ELDIS (searched 1 November 2012), ERIC (searched 1 November 2012), HERDIN NeON Database (searched 1 November 2012), IndMED (searched 1 November 2012), JSTOR (searched 1 November 2012), LILACS(searched 1 November 2012), NTIS (searched 1 November 2012), PAIS (searched 6 July 2012), Popline (searched 1 November 2012), ProQuest Dissertation &Theses Database (searched 1 November 2012), PsycINFO (searched 6 July 2012), SSRN (searched 1 November 2012), Thai Index Medicus (searched 1 November 2012), World Bank (searched 2 November 2012), WanFang (searched 3 November 2012), China National Knowledge Infrastructure (CHKD-CNKI) (searched 2 November 2012). In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via Web of Science to find other potentially relevant studies. Selection criteria Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA

  11. Recruitment of Minority and Underserved Populations in the United States: The Centers for Population Health & Health Disparities Experience

    PubMed Central

    Paskett, Electra D.; Reeves, Katherine W.; McLaughlin, John M.; Katz, Mira L.; McAlearney, Ann Scheck; Ruffin, Mack T.; Halbert, Chanita Hughes; Merete, Cristina; Davis, Faith; Gehlert, Sarah

    2008-01-01

    Objective The recruitment of minority and underserved individuals to research studies is often problematic. The purpose of this study was to describe the recruitment experiences of projects that actively recruited minority and underserved populations as part of The Centers for Population Health and Health Disparities (CPHHD) initiative. Methods Principal investigators and research staff from 17 research projects at eight institutions across the United States were surveyed about their recruitment experiences. Investigators reported the study purpose and design, recruitment methods employed, recruitment progress, problems or challenges to recruitment, strategies used to address these problems, and difficulties resulting from Institutional Review Board (IRB) or Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements. Additionally, information was collected about participant burden and compensation. Burden was classified on a three-level scale. Recruitment results were reported as of March 31, 2007. Results Recruitment attainment ranged from 52% to 184% of the participant recruitment goals. Commonly reported recruitment problems included administrative issues, and difficulties with establishing community partnerships and contacting potential participants. Long study questionnaires, extended follow-up, and narrow eligibility criteria were also problematic. The majority of projects reported difficulties with IRB approvals, though few reported issues related to HIPAA requirements. Attempted solutions to recruitment problems varied across Centers and included using multiple recruitment sites and sources and culturally appropriate invitations to participate. Participant burden and compensation varied widely across the projects, however, accrual appeared to be inversely associated with the amount of participant burden for each project. Conclusion Recruitment of minority and underserved populations to clinical trials is necessary to increase study

  12. Private Health Care Coverage in the Brazilian population, according to the 2013 Brazilian National Health Survey.

    PubMed

    Malta, Deborah Carvalho; Stopa, Sheila Rizzato; Pereira, Cimar Azeredo; Szwarcwald, Célia Landmann; Oliveira, Martha; Reis, Arthur Chioro Dos

    2017-01-01

    This study aims to present the percentages of the Brazilian population holding health insurance plans, itemized by social-demographic characteristics, based on the data of the National Health Survey carried out in 2013, and to compare this information with the administrative data of the National Supplementary Health Agency for the same year. Data from the National Health Survey, and from the Beneficiaries Information System of the National Health Agency for the year 2013, were used. The percentage of people having a health plan was described according to stratification for: all of Brazil, urban/rural, Brazilian official Regions, Brazilian States and state capitals, gender, age group, level of schooling, position in the workforce, ethnic classification, and self-assessed state of health. Results include the following: The percentage of people saying they had some health plan in Brazil was 27.9% (CI 95%: 27.1-28.8). A significant difference was found relating to level of schooling - the percentage being highest for those who stated they had complete secondary education (68.8% CI 95%: 67.2-70.4) and for those who said they were currently in work (32.5% CI 95%: 31.5-33.5). The increase in health plan coverage in the Brazilian population reflects the improvement of the suply of employment and the growth in the country's economy.

  13. Determinants of self-perceived changes in health status among pre- and early-retirement populations.

    PubMed

    Choi, Namkee G

    2003-01-01

    Using data from the 1992 and 1994 waves of the Health and Retirement Study (HRS), this study described reasons reported by pre- and early-retirement populations for perceived changes in global health status over a 2-year period. It then analyzed the association between self-perceptions of change and the actual changes in objective health conditions, controlling for demographics, emotional health status, and the changes in work status and health-affecting habits. The results were compared to the determinants of self-ratings of health at wave 2. Existing or increasing impairments in functional abilities were found to contribute to self-perceptions of decline. However, a diagnosis of new chronic disease and the experience of a major medical event per se did not universally contribute to self-perception of decline. The relationship between cross-sectional self-ratings of health and objective health conditions was more straightforward. Self-perception of improvement among people with serious health problems most likely owed to medical interventions and improvement in symptoms, the most frequently mentioned reasons for perceived improvement, and reflected the subjects' selective optimization and resiliency.

  14. Cognitive and Affective Dimensions in Health Related Education. Proceedings of a Conference (Gainesville, Florida, January 1974).

    ERIC Educational Resources Information Center

    Morgan, Margaret K., Ed.; And Others

    Ten papers dealing with various aspects of cognitive and affective dimensions of the allied health student are presented. They are: "A Review of Research on Cognitive and Affective Dimensions of Education for the Health Related Professions" by Margaret K. Morgan, "Methodological Problems in the Study of Affective and Cognitive…

  15. Recommendations for the Use of ICT in Elderly Populations with Affective Disorders

    PubMed Central

    Gros, Auriane; Bensamoun, David; Manera, Valeria; Fabre, Roxane; Zacconi-Cauvin, Anne-Marie; Thummler, Susanne; Benoit, Michel; Robert, Philippe; David, Renaud

    2016-01-01

    Objective: Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia. PMID:27877126

  16. Recommendations for the Use of ICT in Elderly Populations with Affective Disorders.

    PubMed

    Gros, Auriane; Bensamoun, David; Manera, Valeria; Fabre, Roxane; Zacconi-Cauvin, Anne-Marie; Thummler, Susanne; Benoit, Michel; Robert, Philippe; David, Renaud

    2016-01-01

    Objective: Affective disorders are frequently encountered among elderly populations, and the use of information and communication technologies (ICT) could provide an added value for their recognition and assessment in addition to current clinical methods. The diversity and lack of consensus in the emerging field of ICTs is however a strong limitation for their global use in daily practice. The aim of the present article is to provide recommendations for the use of ICTs for the assessment and management of affective disorders among elderly populations with or without dementia. Methods: A Delphi panel was organized to gather recommendations from experts in the domain. A set of initial general questions for the use of ICT in affective disorders was used to guide the discussion of the expert panel and to analyze the Strengths, Weaknesses, Opportunities, and Threats (SWOT) of employing ICT in elderly populations with affective disorders. Based on the results collected from this first round, a web survey was sent to local general practitioners (GPs) and to all interns in psychiatry in France. Results: The results of the first round revealed that ICT may offer very useful tools for practitioners involved in the diagnosis and management of affective disorders. However, the results of the web survey showed the interest to explain better to current and upcoming practitioners the utility of ICT especially for people living with dementia.

  17. Can ocean acidification affect population dynamics of the barnacle Semibalanus balanoides at its southern range edge?

    PubMed

    Findlay, Helen S; Burrows, Michael T; Kendall, Michael A; Spicer, John I; Widdicombe, Stephen

    2010-10-01

    The global ocean and atmosphere are warming. There is increasing evidence suggesting that, in addition to other environmental factors, climate change is affecting species distributions and local population dynamics. Additionally, as a consequence of the growing levels of atmospheric carbon dioxide (CO2), the oceans are taking up increasing amounts of this CO2, causing ocean pH to decrease (ocean acidification). The relative impacts of ocean acidification on population dynamics have yet to be investigated, despite many studies indicating that there will be at least a sublethal impact on many marine organisms, particularly key calcifying organisms. Using empirical data, we forced a barnacle (Semibalanus balanoides) population model to investigate the relative influence of sea surface temperature (SST) and ocean acidification on a population nearing the southern limit of its geographic distribution. Hindcast models were compared to observational data from Cellar Beach (southwestern United Kingdom). Results indicate that a declining pH trend (-0.0017 unit/yr), indicative of ocean acidification over the past 50 years, does not cause an observable impact on the population abundance relative to changes caused by fluctuations in temperature. Below the critical temperature (here T(crit) = 13.1 degrees C), pH has a more significant affect on population dynamics at this southern range edge. However, above this value, SST has the overriding influence. At lower SST, a decrease in pH (according to the National Bureau of Standards, pHNBs) from 8.2 to 7.8 can significantly decrease the population abundance. The lethal impacts of ocean acidification observed in experiments on early life stages reduce cumulative survival by approximately 25%, which again will significantly alter the population level at this southern limit. Furthermore, forecast predictions from this model suggest that combined acidification and warming cause this local population to die out 10 years earlier than

  18. Possibilities of detecting health effects by studies of populations exposed to chemicals from waste disposal sites.

    PubMed

    Buffler, P A; Crane, M; Key, M M

    1985-10-01

    Factors affecting the design of an epidemiologic study assessing possible health effects from chemical waste disposal sites are reviewed. Such epidemiologic studies will most likely be prompted either by a known release of chemicals into the environment around the site, or by an unusual disease cluster in a population near the site. In the latter situation, a method for evaluating the health effects is needed, and one possible approach is discussed. In the former situation, it may not be obvious what health outcomes are relevant. Reported associations between health effects and chemicals in humans were reviewed. Studies from the occupational and environmental literature were classified by chemical and target organ affected and presented in tabular form. No attempt was made to critically evaluate the quality of evidence for each health effect, although bibliographic documentation was provided where possible. Episodes of chemical contamination of food, drinking water and other media were also reviewed and presented in a separate table. The organ sites likely to be affected by toxic chemicals from waste disposal sites depend heavily on the route of exposure and the dose that is received. Ingestion is the most frequently reported route of exposure in episodes of environmental contamination. These have affected the hepatic, renal, hematopoietic, reproductive, and central nervous systems. The type and severity of effects were dose-dependent. Direct skin contact is important in the occupational environment where dermal and central nervous system effects have been reported but seems less likely as a route of exposure for populations around waste disposal sites. Inhalation, unless at relative high concentrations or as a result of fire, is unlikely to be important, although hematopoietic, reproductive, and central nervous system effects have been reported in occupational studies.

  19. Possibilities of detecting health effects by studies of populations exposed to chemicals from waste disposal sites.

    PubMed Central

    Buffler, P A; Crane, M; Key, M M

    1985-01-01

    Factors affecting the design of an epidemiologic study assessing possible health effects from chemical waste disposal sites are reviewed. Such epidemiologic studies will most likely be prompted either by a known release of chemicals into the environment around the site, or by an unusual disease cluster in a population near the site. In the latter situation, a method for evaluating the health effects is needed, and one possible approach is discussed. In the former situation, it may not be obvious what health outcomes are relevant. Reported associations between health effects and chemicals in humans were reviewed. Studies from the occupational and environmental literature were classified by chemical and target organ affected and presented in tabular form. No attempt was made to critically evaluate the quality of evidence for each health effect, although bibliographic documentation was provided where possible. Episodes of chemical contamination of food, drinking water and other media were also reviewed and presented in a separate table. The organ sites likely to be affected by toxic chemicals from waste disposal sites depend heavily on the route of exposure and the dose that is received. Ingestion is the most frequently reported route of exposure in episodes of environmental contamination. These have affected the hepatic, renal, hematopoietic, reproductive, and central nervous systems. The type and severity of effects were dose-dependent. Direct skin contact is important in the occupational environment where dermal and central nervous system effects have been reported but seems less likely as a route of exposure for populations around waste disposal sites. Inhalation, unless at relative high concentrations or as a result of fire, is unlikely to be important, although hematopoietic, reproductive, and central nervous system effects have been reported in occupational studies. PMID:3910420

  20. The role of nursing in governmentality, biopower and population health: family health nursing.

    PubMed

    Thompson, Lee

    2008-03-01

    The shift in health care focus towards an emphasis on population health gains via health promotion is now well established. One of the strategies that has been promoted as a means of better addressing the shortcomings in delivering health care that attends more specifically to preventative and promotion activities has been the description and piloting of a new nursing role, the family health nurse. This paper examines the ways in which this new nursing role is enmeshed in practices of governmentality and biopower. The role has the potential to elicit 'health gain' by means of the highly interventive nature of parts of the role. But this very intensity also raises questions about the ways in which coercive power and individual liberties are negotiated.

  1. Does distrust in providers affect health-care utilization in China?

    PubMed Central

    Duckett, Jane; Hunt, Kate; Munro, Neil; Sutton, Matt

    2016-01-01

    How trust affects health-care utilization is not well-understood, especially in low- and middle-income countries. This article focuses on China, a middle-income country where low trust in health-care settings has become a prominent issue, but actual levels of distrust and their implications for utilization are unknown. We conducted a nationally representative survey of the Chinese population (November 2012 to January 2013), which resulted in a sample of 3680 adult men and women. Respondents rated their trust in different types of health-care providers. Using multivariate logistic and negative binomial regression models, we estimated the association between distrust in clinics and respondents’ hospital visits in the last year; whether they had sought hospital treatment first for two common symptoms (headache, cold) in the last 2 months; and whether they said they would go first to a hospital if they had a minor or major illness. We analysed these associations before and after adjusting for performance evaluations of clinics and hospitals, controlling for sex, age, education, income, insurance status, household registration and self-assessed health. We found that distrust in hospitals is low, but distrust in clinics is high and strongly associated with increased hospital utilization, especially for minor symptoms and illnesses. Further research is needed to understand the reasons for distrust in clinics because its effects are not fully accounted for by poor evaluations of their competence. PMID:27117483

  2. Landscape context affects genetic diversity at a much larger spatial extent than population abundance.

    PubMed

    Jackson, Nathan D; Fahrig, Lenore

    2014-04-01

    Regional landscape context influences the fate of local populations, yet the spatial extent of this influence (called the "scale of effect") is difficult to predict. Thus, a major problem for conservation management is to understand the factors governing the scale of effect such that landscape structure surrounding a focal area is measured and managed at the biologically relevant spatial scale. One unresolved question is whether and how scale of effect may depend on the population response measured (e.g., abundance vs. presence/absence). If scales of effect differ across population outcomes of a given species, management based on one outcome may compromise another, further complicating conservation decision making. Here we used an individual-based simulation model to investigate how scales of effect of landscapes that vary in the amount and fragmentation of habitat differ among three population responses (local abundance, presence/absence, and genetic diversity). We also explored how the population response measured affects the relative importance of habitat amount and fragmentation in shaping local populations, and how dispersal distance mediates the magnitude and spatial scale of these effects. We found that the spatial scale most strongly influencing local populations depended on the outcome measured and was predicted to be small for abundance, medium-sized for presence/absence, and large for genetic diversity. Increasing spatial scales likely resulted from increasing temporal scales over which outcomes were regulated (with local genetic diversity being regulated over the largest number of generations). Thus, multiple generations of dispersal and gene flow linked local population patterns to regional population size. The effects of habitat amount dominated the effects of fragmentation for all three outcomes. Increased dispersal distance strongly reduced abundance, but not presence/absence or genetic diversity. Our results suggest that managing protected species

  3. A spatial decision support tool for estimating population catchments to aid rural and remote health service allocation planning.

    PubMed

    Schuurman, Nadine; Randall, Ellen; Berube, Myriam

    2011-12-01

    There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote areas. Using this tool, health-care planners can model multiple scenarios to determine the optimal location for health services, as well as the number of people served in each instance.

  4. Amplifying diffusion of health information in low-literate populations through adult education health literacy classes.

    PubMed

    Freedman, Ariela M; Miner, Kathleen R; Echt, Katharina V; Parker, Ruth; Cooper, Hannah L F

    2011-01-01

    Over the next decade, as literacy rates are predicted to decline, the health care sector faces increasing challenges to effective communication with low-literate groups. Considering the rising costs of health care and the forthcoming changes in the American health care system, it is imperative to find nontraditional avenues through which to impart health knowledge and functional skills. This article draws on classroom observations and qualitative interviews with 21 students and 3 teachers in an adult education health literacy class to explore the efficacy of using adult education courses to teach functional health literacy skills to low-literate populations. Data were analyzed using a combination of thematic and content analyses. Results describe the motivation of students to share information within the classroom and with friends and family outside the classroom. This article also provides several recommendations to help ensure accuracy of diffused information both within and outside of the classroom. Ultimately, this study suggests that the adult education system is in a prime position to impart functional health literacy skills to low-literate populations in the classroom. Significantly, this study demonstrates that adult education students themselves may be a powerful vehicle for health communication beyond the walls of the classroom.

  5. Global research neglect of population-based approaches to smoking cessation: time for a more rigorous science of population health interventions.

    PubMed

    Lawrence, David; Mitrou, Francis; Zubrick, Stephen R

    2011-09-01

    It has been argued that the preponderance of studies into individual smoking cessation therapies seems grossly out of proportion to the number of people who use these therapies to quit smoking, and that this imbalance is due to factors such as the role of the pharmaceutical industry in funding research and a general bias towards individual- rather than population-based approaches to medical and health problems. We believe that there are other significant factors that affect the balance of research in smoking cessation, such as the higher standards of evidence required to justify the implementation of individual medical therapies compared with population-based interventions. We argue that research practitioners in the area of population tobacco control are well placed to address this imbalance by setting more rigorous standards of evidence for population health interventions. This could be achieved by setting aside a small proportion of funds from population health and advocacy activities to invest in studying their effectiveness. We believe that this would potentially return information of sufficient value to justify increasing overall population investment beyond the cost of the additional research component. Additional benefits would be gained from increased research in this area, such as better understanding of how to translate tobacco control initiatives to developing countries with high smoking rates, and how to target disadvantaged and marginalized populations more effectively in developed countries that continue to have high rates of smoking and low rates of smoking cessation, despite the existence of broad population-based strategies.

  6. 76 FR 61294 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... Populations and Health Professional Shortage Areas; Notice of Meeting AGENCY: Health Resources and Services... meeting of the Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and...: The purpose of the Negotiated Rulemaking Committee on Designation of Medically Underserved...

  7. Globalisation: what is it and how does it affect health?

    PubMed

    Lee, Kelley

    2004-02-16

    The term "globalisation" tends to be misused and overused. We need greater clarity in our understanding of the globalisation process, including the distinct changes involved and their relation to human health. The health impacts of globalisation are simultaneously positive and negative, varying according to factors such as geographical location, sex, age, ethnic origin, education level, and socioeconomic status. Globalisation is not an unstoppable force. Our key challenge is to create socially and environmentally sustainable forms of globalisation that provide the greatest benefits and least costs, shared more equitably than is currently the case. The health community must engage more directly in current research and policy debates on globalisation and encourage values that promote human health. At the same time, those at the helm of globalisation processes must recognise that attending to health impacts will strengthen the long-term sustainability of globalisation.

  8. The impact of an integrated population health enhancement and disease management program on employee health risk, health conditions, and productivity.

    PubMed

    Loeppke, Ron; Nicholson, Sean; Taitel, Michael; Sweeney, Matthew; Haufle, Vince; Kessler, Ronald C

    2008-12-01

    This study evaluated the impact of an integrated population health enhancement program on employee health risks, health conditions, and productivity. Specifically, we analyzed changes in these measures among a cohort of 543 employees who completed a health risk assessment in both 2003 and 2005. We compared these findings with 2 different sets of employees who were not offered health enhancement programming. We found that the DIRECTV cohort showed a significant reduction in health risks after exposure to the program. Relative to a matched comparison group, the proportion of low-risk employees at DIRECTV in 2005 was 8.2 percentage points higher; the proportion of medium-risk employees was 7.1 percentage points lower; and the proportion of high-risk employees was 1.1 percentage points lower (p < 0.001). The most noticeable changes in health risk were a reduction in the proportion of employees with high cholesterol; an improvement in diet; a reduction of heavy drinking; management of high blood pressure; improved stress management; increased exercise; fewer smokers; and a drop in obesity rates. We also found that a majority of employees who improved their risk levels from 2003 to 2005 maintained their gains in 2006. Employees who improved their risks levels also demonstrated relative improvement in absenteeism. Overall, this study provides additional evidence that integrated population health enhancement positively impacts employees' health risk and productivity; it also reinforces the view that "good health is good business."

  9. Conceptualising population health: from mechanistic thinking to complexity science.

    PubMed

    Jayasinghe, Saroj

    2011-01-20

    The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS). The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.

  10. The role of affect in consumer evaluation of health care services.

    PubMed

    Ng, Sandy; Russell-Bennett, Rebekah

    2015-01-01

    Health care services are typically consumed out of necessity, typically to recover from illness. While the consumption of health care services can be emotional given that consumers experience fear, hope, relief, and joy, surprisingly, there is little research on the role of consumer affect in health care consumption. We propose that consumer affect is a heuristic cue that drives evaluation of health care services. Drawing from cognitive appraisal theory and affect-as-information theory, this article tests a research model (N = 492) that investigates consumer affect resulting from service performance on subsequent service outcomes.

  11. Transdisciplinary cardiovascular and cancer health disparities training: experiences of the centers for population health and health disparities.

    PubMed

    Golden, Sherita Hill; Ferketich, Amy; Boyington, Josephine; Dugan, Sheila; Garroutte, Eva; Kaufmann, Peter G; Krok, Jessica; Kuo, Alice; Ortega, Alexander N; Purnell, Tanjala; Srinivasan, Shobha

    2015-07-01

    The Centers for Population Health and Health Disparities program promotes multilevel and multifactorial health equity research and the building of research teams that are transdisciplinary. We summarized 5 areas of scientific training for empowering the next generation of health disparities investigators with research methods and skills that are needed to solve disparities and inequalities in cancer and cardiovascular disease. These areas include social epidemiology, multilevel modeling, health care systems or health care delivery, community-based participatory research, and implementation science. We reviewed the acquisition of the skill sets described in the training components; these skill sets will position trainees to become leaders capable of effecting significant change because they provide tools that can be used to address the complexities of issues that promote health disparities.

  12. Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education

    PubMed Central

    PHELPS, CHARLES; RAPPUOLI, RINO; LEVIN, SCOTT; SHORTLIFFE, EDWARD; COLWELL, RITA

    2016-01-01

    Policy Points: Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning.Public health agencies’ current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost‐effectiveness.As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost‐effectiveness analyses widely recommended and used for public health planning.Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Context Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost‐effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Methods Our work employed a multicriteria systems analysis approach—specifically, multiattribute utility theory—to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost‐effectiveness analysis approach. Findings (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost‐effectiveness analysis. (2) More sophisticated systems‐level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become

  13. A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India

    PubMed Central

    2014-01-01

    Background Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Methods Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Results Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. Conclusion This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated

  14. Factors affecting allied health faculty job satisfaction: a literature review.

    PubMed

    Romig, Barbara; O'Sullivan Maillet, Julie; Denmark, Robert M

    2011-01-01

    Evidence in the literature suggests job satisfaction can make a difference in keeping qualified workers on the job, but little research has been conducted focusing specifically on allied health faculty. In order to attract and retain top quality faculty, colleges and universities should understand the variables impacting faculty satisfaction and develop a plan to enhance satisfaction. An integrative literature review (CINHAL, ERIC, Journal of Allied Health, Chronicle of Higher Education, Research in Higher Education, and current books on job satisfaction) of faculty job satisfaction and dissatisfaction produced a variety of publications presenting the key determinants of job satisfaction by allied health faculty in the United States. The purpose of the analysis was to examine the various factors that influence job satisfaction, especially by allied health faculty, in institutions of higher education in the U.S. The procedure used for this analysis consisted of reviewing allied health and higher education faculty studies to identify factors influencing job satisfaction, research questions, sample size reported, instruments used for measurement of job satisfaction, and job satisfaction results. While the theoretical models of allied health and higher education faculty job satisfaction exist separately in the literature, their remarkable similarities permit the prospect of a contemporary framework of the essential components of job satisfaction. Potential opportunities for continuing research on the personal and professional variables impacting job satisfaction of allied health faculty and similar disciplines are presented.

  15. 75 FR 54349 - Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-07

    ... Designation of Medically Underserved Populations and Health Professional Shortage Areas; Notice of Meeting In... Underserved Populations and Health Professional Shortage Areas. Date and time: September 22, 2010, 9:30 a.m... Designation of Medically Underserved Populations and Health Professional Shortage Areas is to establish...

  16. Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

    PubMed Central

    Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

    2011-01-01

    Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

  17. Gene actions of QTLs affecting several agronomic traits resolved in a recombinant inbred rice population and two testcross populations.

    PubMed

    Mei, H W; Luo, L J; Ying, C S; Wang, Y P; Yu, X Q; Guo, L B; Paterson, A H; Li, Z K

    2003-06-01

    To understand the types of gene action controlling seven quantitative traits in rice, QTL mapping was performed to dissect the main effect (M-QTLs) and digenic epistatic (E-QTLs) QTLs responsible for the trait performance of 254 recombinant inbred lines (RILs) of "Lemont/Teqing", and two testcross (TC) F(1) populations derived from these RILs. The correlation analyses reveal a general pattern, i.e. trait heritability in the RILs was negatively correlated to trait heterosis in the TC hybrids. A large number of M-QTLs and E-QTLs affecting seven traits, including heading date (HD), plant height (PH), flag leaf length (FLL), flag leaf width (FLW), panicle length (PL), spikelet number per panicle (SN) and spikelet fertility (SF), were identified and could be classified into two predominant groups, additive QTLs detected primarily in the RILs, and overdominant QTLs identified exclusively in the TC populations. There is little overlap between QTLs identified in the RILs and in the TC populations. This result implied that additive gene action is largely independent from non-additive gene action in the genetic control of quantitative traits of rice. The detected E-QTLs collectively explained a much greater portion of the total phenotypic variation than the M-QTLs, supporting prior findings that epistasis has played an important role in the genetic control of quantitative traits in rice. The implications of these results to the development of inbred and hybrid cultivars were discussed.

  18. SOCIOECONOMIC, CULTURAL, AND BEHAVIORAL FACTORS AFFECTING HISPANIC HEALTH OUTCOMES

    PubMed Central

    MORALES, LEO S.; LARA, MARIELENA; KINGTON, RAYNARD S.; VALDEZ, ROBERT O.; ESCARCE, JOSÉ J.

    2006-01-01

    Evidence suggests that social and economic factors are important determinants of health. Yet, despite higher poverty rates, less education, and worse access to health care, health outcomes of many Hispanics living in the United States today are equal to, or better than, those of non-Hispanic whites. This paradox is described in the literature as the epidemiological paradox or Hispanic health paradox. In this paper, the authors selectively review data and research supporting the existence of the epidemiological paradox. They find substantial support for the existence of the epidemiological paradox, particularly among Mexican Americans. Census undercounts of Hispanics, misclassification of Hispanic deaths, and emigration of Hispanics do not fully account for the epidemiological paradox. Identifying protective factors underlying the epidemiological paradox, while improving access to care and the economic conditions among Hispanics, are important research and policy implications of this review. PMID:12407964

  19. Socioeconomic, cultural, and behavioral factors affecting Hispanic health outcomes.

    PubMed

    Morales, Leo S; Lara, Marielena; Kington, Raynard S; Valdez, Robert O; Escarce, José J

    2002-11-01

    Evidence suggests that social and economic factors are important determinants of health. Yet, despite higher porverty rates, less education, and worse access to health care, health outcomes of many Hispanics living in the United States today are equal to, or better than, those of non-Hispanic whites. This paradox is described in the literature as the epidemiological paradox or Hispanic health paradox. In this paper, the authors selectively review data and research supporting the existence of the epidemiological paradox. They find substantial support for the existence of the epidemiological paradox, particularly among Mexican Americans. Census undercounts of Hispanics, misclassification of Hispanic deaths, and emigration of Hispanics do not fully account for the epidemiological paradox. Identifying protective factors underlying the epidemiological paradox, while improving access to care and the economic conditions among Hispanics, are important research and policy implications of this review.

  20. Population health improvement: a community health business model that engages partners in all sectors.

    PubMed

    Kindig, David A; Isham, George

    2014-01-01

    Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

  1. Ecological interactions affecting population-level responses to chemical stress in Mesocyclops leuckarti.

    PubMed

    Kulkarni, Devdutt; Hommen, Udo; Schäffer, Andreas; Preuss, Thomas G

    2014-10-01

    Higher tiers of ecological risk assessment (ERA) consider population and community-level endpoints. At the population level, the phenomenon of density dependence is one of the most important ecological processes that influence population dynamics. In this study, we investigated how different mechanisms of density dependence would influence population-level ERA of the cyclopoid copepod Mesocyclops leuckarti under toxicant exposure. We used a combined approach of laboratory experiments and individual-based modelling. An individual-based model was developed for M. leuckarti to simulate population dynamics under triphenyltin exposure based on individual-level ecological and toxicological data from laboratory experiments. The study primarily aimed to-(1) determine which life-cycle processes, based on feeding strategies, are most significant in determining density dependence (2) explore how these mechanisms of density dependence affect extrapolation from individual-level effects to the population level under toxicant exposure. Model simulations showed that cannibalism of nauplii that were already stressed by TPT exposure contributed to synergistic effects of biotic and abiotic factors and led to a twofold stress being exerted on the nauplii, thereby resulting in a higher population vulnerability compared to the scenario without cannibalism. Our results suggest that in population-level risk assessment, it is easy to underestimate toxicity unless underlying ecological interactions including mechanisms of population-level density regulation are considered. This study is an example of how a combined approach of experiments and mechanistic modelling can lead to a thorough understanding of ecological processes in ecotoxicology and enable a more realistic ERA.

  2. Stochasticity and determinism: how density-independent and density-dependent processes affect population variability.

    PubMed

    Ohlberger, Jan; Rogers, Lauren A; Stenseth, Nils Chr

    2014-01-01

    A persistent debate in population ecology concerns the relative importance of environmental stochasticity and density dependence in determining variability in adult year-class strength, which contributes to future reproduction as well as potential yield in exploited populations. Apart from the strength of the processes, the timing of density regulation may affect how stochastic variation, for instance through climate, translates into changes in adult abundance. In this study, we develop a life-cycle model for the population dynamics of a large marine fish population, Northeast Arctic cod, to disentangle the effects of density-independent and density-dependent processes on early life-stages, and to quantify the strength of compensatory density dependence in the population. The model incorporates information from scientific surveys and commercial harvest, and dynamically links multiple effects of intrinsic and extrinsic factors on all life-stages, from eggs to spawners. Using a state-space approach we account for observation error and stochasticity in the population dynamics. Our findings highlight the importance of density-dependent survival in juveniles, indicating that this period of the life cycle largely determines the compensatory capacity of the population. Density regulation at the juvenile life-stage dampens the impact of stochastic processes operating earlier in life such as environmental impacts on the production of eggs and climate-dependent survival of larvae. The timing of stochastic versus regulatory processes thus plays a crucial role in determining variability in adult abundance. Quantifying the contribution of environmental stochasticity and compensatory mechanisms in determining population abundance is essential for assessing population responses to climate change and exploitation by humans.

  3. Personalised Medicine: A New Approach to Improving Health in Indigenous Australian Populations.

    PubMed

    Rae, Kym M; Grimson, Steve; Pringle, Kirsty G

    2017-01-06

    Personalised medicine is a newly emerging field with much to offer to all populations in improved clinical treatment options. Since the 1970s, clinicians and researchers have all been working towards improving the health of Indigenous Australians. However, there has been little research on the impact of genetics on Indigenous health, how genetic and environmental factors interact to contribute to poor health in Indigenous people, and how genetic factors specific to Indigenous people affect their responses to particular treatments. This short review highlights the urgent need for more genetic studies specific to Indigenous people in order to provide more appropriate care and to improve health outcomes. This paper explores why genetic work with Indigenous communities has been limited, how personalised medicine could benefit Indigenous communities, and highlights a number of specific instances in which personalised medicine has been critical for improving morbidity and mortality in other high-risk groups. In order to take the next step in advancing the health of Indigenous peoples, targeted research into the genetic factors behind chronic diseases is critically needed. This research may allow clinicians a better understanding of how genetic factors interact with environmental factors to influence an Indigenous Australian's individual risk of disease, prognosis, and response to therapies. It is hoped that this knowledge will produce clinical interventions that will help deliver clearly targeted, more appropriate care to this at-risk population.

  4. Mental health status of vulnerable tsunami-affected communities: a survey in Aceh Province, Indonesia.

    PubMed

    Souza, Renato; Bernatsky, Sasha; Reyes, Rosalie; de Jong, Kaz

    2007-06-01

    The authors determined the prevalence of severe emotional distress and depressive symptoms using the Hopkins Symptoms Checklist-25 (HSCL; Derogatis, Lipman, Rickels, Uhlenhuth, & Covi, 1974) in tsunami-affected communities that had experienced armed conflict arising from the ongoing independence movement in Aceh Province, Indonesia. We also evaluated determinants of severe emotional distress. The data were collected for the purposes of a mental health assessment. In our sample (N = 262), 83.6% demonstrated severe emotional distress, and 77.1% demonstrated depressive symptoms. In multivariate regression models, severe emotional distress was positively associated with the number of tsunami-related deaths among household members. Our data suggests a need for effective interventions in this vulnerable population.

  5. Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

    PubMed

    Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie

    2016-12-01

    Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations.

  6. Dental care and children with special health care needs: a population-based perspective.

    PubMed

    Lewis, Charlotte W

    2009-01-01

    This paper grew out of a project reviewing progress in children's oral health after Oral Health in America: A Report of the Surgeon General was published in 2000. It includes a summary of advances in national surveillance of children with special health care needs (CSHCN), and presents more recent data on unmet dental care need among CSHCN. To that end, we used the 2006 National Survey of Children with Special Health Care Needs to determine the prevalence of unmet dental care need among CSHCN and to compare this within subgroups of CSHCN, as well as to children without special health care needs, and to results from the previous iteration of this survey. Dental care remains the most frequently cited unmet health need for CSHCN. More CSHCN had unmet needs for nonpreventive than preventive dental care. CSHCN who are teens, poorer, uninsured, had insurance lapses, or are more severely affected by their condition had higher adjusted odds of unmet dental care needs. CSHCN who were both low income and severely affected had 13.4 times the adjusted odds of unmet dental care need. In summary, CSHCN are more likely to be insured and to receive preventive dental care at equal or higher rates than children without special health care needs. Nevertheless, CSHCN, particularly lower income and severely affected, are more likely to report unmet dental care need compared with unaffected children. Despite advances in knowledge about dental care among CSHCN, unanswered questions remain. Recommendations are provided toward obtaining additional data and facilitating dental care access for this vulnerable population.

  7. [Factors affecting the attitude of the Czech population towards induced abortion].

    PubMed

    Weiss, P; Zvĕrina, J

    1998-10-01

    Based on an anonymous questionnaire survey of a representative population group above 15 years of age in the Czech Republic (862 men and 857 women) the authors investigated also sociodemographic factors affecting attitudes of the Czech population to induced abortions. The findings suggest that attitudes of men and women to induced abortions do not differ essentially in any of the investigated criteria. The size of domicile does not affect the attitudes substantially. The most restrictive views are expressed by respondents of the oldest age group (above 60 years) and respondents of the youngest age group (15-17 years). The liberal attitude to induced abortions increases with the educational level. Religious belief has a marked effect on restrictive attitudes to abortions, nevertheless among catholic subjects only 7% male and female respondents expressed refused induced abortions unequivocally.

  8. Ecological context and metapopulation dynamics affect sex-ratio variation among dioecious plant populations

    PubMed Central

    Field, David L.; Pickup, Melinda; Barrett, Spencer C. H.

    2013-01-01

    Background and Aims Populations of dioecious flowering plants commonly exhibit heterogeneity in sex ratios and deviations from the equilibrium expectation of equal numbers of females and males. Yet the role of ecological and demographic factors in contributing towards biased sex ratios is currently not well understood. Methods Species-level studies from the literature were analysed to investigate ecological correlates of among-population sex-ratio variation and metapopulation models and empirical data were used to explore the influence of demography and non-equilibrium conditions on flowering sex ratios. Key Results The survey revealed significant among-population heterogeneity in sex ratios and this was related to the degree of sampling effort. For some species, sex-ratio bias was associated with the proportion of non-reproductive individuals, with greater male bias in populations with a lower proportion of individuals that were flowering. Male-biased ratios were also found at higher altitudes and latitudes, and in more xeric sites. Simulations and empirical data indicated that clonal species exhibited greater heterogeneity in sex ratios than non-clonal species as a result of their slower approach to equilibrium. The simulations also indicated the importance of interactions between reproductive mode and founder effects, with greater departures from equilibrium in clonal populations with fewer founding individuals. Conclusions The results indicate that sex-based differences in costs of reproduction and non-equilibrium conditions can each play important roles in affecting flowering sex ratios in populations of dioecious plants. PMID:23444124

  9. Population structure of Columbia spotted frogs (Rana luteiventris) is strongly affected by the landscape

    USGS Publications Warehouse

    Funk, W.C.; Blouin, M.S.; Corn, P.S.; Maxell, B.A.; Pilliod, D.S.; Amish, S.; Allendorf, F.W.

    2005-01-01

    Landscape features such as mountains, rivers, and ecological gradients may strongly affect patterns of dispersal and gene flow among populations and thereby shape population dynamics and evolutionary trajectories. The landscape may have a particularly strong effect on patterns of dispersal and gene flow in amphibians because amphibians are thought to have poor dispersal abilities. We examined genetic variation at six microsatellite loci in Columbia spotted frogs (Rana luteiventris) from 28 breeding ponds in western Montana and Idaho, USA, in order to investigate the effects of landscape structure on patterns of gene flow. We were particularly interested in addressing three questions: (i) do ridges act as barriers to gene flow? (ii) is gene flow restricted between low and high elevation ponds? (iii) does a pond equal a 'randomly mating population' (a deme)? We found that mountain ridges and elevational differences were associated with increased genetic differentiation among sites, suggesting that gene flow is restricted by ridges and elevation in this species. We also found that populations of Columbia spotted frogs generally include more than a single pond except for very isolated ponds. There was also evidence for surprisingly high levels of gene flow among low elevation sites separated by large distances. Moreover, genetic variation within populations was strongly negatively correlated with elevation, suggesting effective population sizes are much smaller at high elevation than at low elevation. Our results show that landscape features have a profound effect on patterns of genetic variation in Columbia spotted frogs.

  10. Legal issues affecting confidentiality and informed consent in reproductive health.

    PubMed

    Rockett, L R

    2000-01-01

    The law governing confidentiality and informed consent has acquired unique characteristics in the area of reproductive health, as a consequence of both the establishment of a constitutional right to privacy in reproductive health matters and the reaction of those politically and morally opposed to the exercise of that right. The primary issues have involved: 1) the right of minors to receive reproductive health services without parental consent, which remains a political battleground; 2) laws requiring physicians to provide information to pregnant patients that is intended, not to inform them of the risks and benefits of the procedure, but to discourage them from obtaining abortions; 3) coerced and prohibited sterilizations; 4) court-ordered contraception and procedures to protect the fetus; and 5) restrictions on counseling about abortion, contraception, sterilization, and other reproductive health services authorized by state conscience or noncompliance clauses that shield such restrictions from the usual ethical, medical, and legal rules governing informed consent. The last area is of profound significance to the ability of women to make informed decisions about their reproductive health options. In the current economic environment, which fuels mergers and acquisitions involving sectarian and nonsectarian institutions, women are increasingly being put at risk as a result of such restrictions.

  11. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    PubMed Central

    Juarez, Paul D.; Matthews-Juarez, Patricia; Hood, Darryl B.; Im, Wansoo; Levine, Robert S.; Kilbourne, Barbara J.; Langston, Michael A.; Al-Hamdan, Mohammad Z.; Crosson, William L.; Estes, Maurice G.; Estes, Sue M.; Agboto, Vincent K.; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y.

    2014-01-01

    The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training. PMID:25514145

  12. The public health exposome: a population-based, exposure science approach to health disparities research.

    PubMed

    Juarez, Paul D; Matthews-Juarez, Patricia; Hood, Darryl B; Im, Wansoo; Levine, Robert S; Kilbourne, Barbara J; Langston, Michael A; Al-Hamdan, Mohammad Z; Crosson, William L; Estes, Maurice G; Estes, Sue M; Agboto, Vincent K; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y

    2014-12-01

    The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures "get under the skin". The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.

  13. Population ageing in developed and developing regions: implications for health policy.

    PubMed

    Lloyd-Sherlock, P

    2000-09-01

    Population ageing is now recognised as a global issue of increasing importance, and has many implications for health care and other areas of social policy. However, these issues remain relatively under-researched, particularly in poorer countries, and there is a dearth of specific policy initiatives at the international level. For example, the 1994 International Conference on Population and Development agreed to 15 key principles for future policy, but none of these even make indirect mention of the aged (International Conference on Population and Development, 1995, Documents. Programme of action of the 1994 International Conference on Population and Development. Population and Development Review, 21(2), 437-461). This paper seeks to highlight some of the key issues arising from population ageing. It begins with a brief overview of international trends in demographic ageing, and considers the health needs of different groups of older people. It sketches out some implications for policy, paying particular attention to the financing and organisation of health services. The final part of the paper contains a discussion about how older people have been affected by, and have adapted to, processes of social, economic and political change. Given the wide scope of these concerns, it is not possible to discuss any issue in detail, and the paper does not claim to give the subject matter a comprehensive or global treatment. It must be stressed that patterns of ageing and their implications for policy are highly complex and variable, and, as such, great care should be taken in generalising between the experiences of different groups of older people, and between different settings.

  14. Social capital, health behaviours and health: a population-based associational study

    PubMed Central

    2013-01-01

    Background Social capital is associated with health behaviours and health. Our objective was to explore how different dimensions of social capital and health-related behaviours are associated, and whether health behaviours mediate this association between social capital and self-rated health and psychological well-being. Methods We used data from the Health 2000 Survey (n=8028) of the adult population in Finland. The response rate varied between 87% (interview) and 77% (the last self-administered questionnaire). Due to item non-response, missing values were replaced using multiple imputation. The associations between three dimensions of social capital (social support, social participation and networks, trust and reciprocity) and five health behaviours (smoking, alcohol use, physical activity, vegetable consumption, sleep) were examined by using logistic regression and controlling for age, gender, education, income and living arrangements. The possible mediating role of health behaviours in the association between social capital and self-rated health and psychological well-being was also analysed with a logistic regression model. Results Social participation and networks were associated with all of the health behaviours. High levels of trust and reciprocity were associated with non-smoking and adequate duration of sleep, and high levels of social support with adequate duration of sleep and daily consumption of vegetables. Social support and trust and reciprocity were independently associated with self-rated health and psychological well-being. Part of the association between social participation and networks and health was explained by physical activity. Conclusions Irrespective of their social status, people with higher levels of social capital – especially in terms of social participation and networks – engage in healthier behaviours and feel healthier both physically and psychologically. PMID:23805881

  15. Identifying environmental health priorities in underserved populations: a study of rural versus urban communities

    PubMed Central

    Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.

    2013-01-01

    Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study

  16. Socioeconomic factors affecting marriage, divorce and birth rates in a Japanese population.

    PubMed

    Uchida, E; Araki, S; Murata, K

    1993-10-01

    The effects of low income, urbanisation and young age population on age-adjusted rates of first marriage, divorce and live birth among the Japanese population in 46 prefectures were analysed by stepwise regression for 1970 and for 1975. During this period, Japanese society experienced a drastic change from long-lasting economic growth to serious recession in 1973. In both 1970 and 1975, the first marriage rate for females was inversely related to low income and the divorce rates for both males and females were positively related to low income. The live birth rate was significantly related to low income, urbanisation and young age population only in 1975. The first marriage rate for females and the divorce rates for both sexes increased significantly but the first marriage rate for males and live birth rate significantly decreased between 1970 and 1975. These findings suggest that low income was the essential factor affecting first marriage for females and divorce for males and females.

  17. Population variation affects interactions between two California salt marsh plant species more than precipitation.

    PubMed

    Noto, Akana E; Shurin, Jonathan B

    2016-02-01

    Species that occur along broad environmental gradients often vary in phenotypic traits that make them better adapted to local conditions. Variation in species interactions across gradients could therefore be due to either phenotypic differences among populations or environmental conditions that shift the balance between competition and facilitation. To understand how the environment (precipitation) and variation among populations affect species interactions, we conducted a common garden experiment using two common salt marsh plant species, Salicornia pacifica and Jaumea carnosa, from six salt marshes along the California coast encompassing a large precipitation gradient. Plants were grown alone or with an individual of the opposite species from the same site and exposed to one of three precipitation regimes. J. carnosa was negatively affected in the presence of S. pacifica, while S. pacifica was facilitated by J. carnosa. The strength of these interactions varied by site of origin but not by precipitation treatment. These results suggest that phenotypic variation among populations can affect interaction strength more than environment, despite a threefold difference in precipitation. Geographic intraspecific variation may therefore play an important role in determining the strength of interactions in communities.

  18. How to evaluate population management? Transforming the Care Continuum Alliance population health guide toward a broadly applicable analytical framework.

    PubMed

    Struijs, Jeroen N; Drewes, Hanneke W; Heijink, Richard; Baan, Caroline A

    2015-04-01

    Many countries face the persistent twin challenge of providing high-quality care while keeping health systems affordable and accessible. As a result, the interest for more efficient strategies to stimulate population health is increasing. A possible successful strategy is population management (PM). PM strives to address health needs for the population at-risk and the chronically ill at all points along the health continuum by integrating services across health care, prevention, social care and welfare. The Care Continuum Alliance (CCA) population health guide, which recently changed their name in Population Health Alliance (PHA) provides a useful instrument for implementing and evaluating such innovative approaches. This framework is developed for PM specifically and describes the core elements of the PM-concept on the basis of six subsequent interrelated steps. The aim of this article is to transform the CCA framework into an analytical framework. Quantitative methods are refined and we operationalized a set of indicators to measure the impact of PM in terms of the Triple Aim (population health, quality of care and cost per capita). Additionally, we added a qualitative part to gain insight into the implementation process of PM. This resulted in a broadly applicable analytical framework based on a mixed-methods approach. In the coming years, the analytical framework will be applied within the Dutch Monitor Population Management to derive transferable 'lessons learned' and to methodologically underpin the concept of PM.

  19. Skin blood perfusion and oxygenation colour affect perceived human health.

    PubMed

    Stephen, Ian D; Coetzee, Vinet; Law Smith, Miriam; Perrett, David I

    2009-01-01

    Skin blood perfusion and oxygenation depends upon cardiovascular, hormonal and circulatory health in humans and provides socio-sexual signals of underlying physiology, dominance and reproductive status in some primates. We allowed participants to manipulate colour calibrated facial photographs along empirically-measured oxygenated and deoxygenated blood colour axes both separately and simultaneously, to optimise healthy appearance. Participants increased skin blood colour, particularly oxygenated, above basal levels to optimise healthy appearance. We show, therefore, that skin blood perfusion and oxygenation influence perceived health in a way that may be important to mate choice.

  20. Temporal behaviour profiles of Mus musculus in nature are affected by population activity.

    PubMed

    Robbers, Yuri; Koster, Eva A S; Krijbolder, Doortje I; Ruijs, Amanda; van Berloo, Sander; Meijer, Johanna H

    2015-02-01

    Animals have circadian clocks that govern their activity pattern, resulting in 24h rhythms in physiology and behaviour. Under laboratory conditions, light is the major external signal that affects temporal patterns in behaviour, and Mus musculus is strictly nocturnal in its behaviour. In the present study we questioned whether under natural conditions, environmental factors other than light affect the temporal profile of mice. In order to test this, we investigated the activity patterns of free-ranging M. musculus in a natural habitat, using sensors and a camera integrated into a recording unit that the mice could freely enter and leave. Our data show that mice have seasonal fluctuations in activity duration (6.7±0.82 h in summer, 11.3±1.80 h in winter). Furthermore, although primarily nocturnal, wild mice also exhibit daytime activity from spring until late autumn. A multivariate analysis revealed that the major factor correlating with increased daytime activity was population activity, defined as the number of visits to the recording site. Day length had a small but significant effect. Further analysis revealed that the relative population activity (compared to the past couple of days) is a better predictor of daytime activity than absolute population activity. Light intensity and temperature did not have a significant effect on daytime activity. The amount of variance explained by external factors is 51.9%, leaving surprisingly little unexplained variance that might be attributed to the internal clock. Our data further indicate that mice determine population activity by comparing a given night with the preceding 2-7 nights, a time frame suggesting a role for olfactory cues. We conclude that relative population activity is a major factor controlling the temporal activity patterns of M. musculus in an unrestricted natural population.

  1. Does a Personalized Health Portal for Diabetes Retinal Imaging Positively Affect Motivational Readiness to Change

    DTIC Science & Technology

    2010-11-01

    term complications related to diabetes include diabetic eye disease, nerve damage ( neuropathy ), heart disease, stroke, kidney failure, and peripheral ...TITLE: Does a Personalized Health Portal for Diabetes Retinal Imaging Positively Affect Motivational Readiness to Change PRINCIPAL...SUBTITLE Does a Personalized Health Portal for Diabetes Retinal Imaging 5a. CONTRACT NUMBER W81XWH-09-2-0166 Positively Affect Motivational

  2. Using Electronic Health Records for Population Health Research: A Review of Methods and Applications.

    PubMed

    Casey, Joan A; Schwartz, Brian S; Stewart, Walter F; Adler, Nancy E

    2016-01-01

    The use and functionality of electronic health records (EHRs) have increased rapidly in the past decade. Although the primary purpose of EHRs is clinical, researchers have used them to conduct epidemiologic investigations, ranging from cross-sectional studies within a given hospital to longitudinal studies on geographically distributed patients. Herein, we describe EHRs, examine their use in population health research, and compare them with traditional epidemiologic methods. We describe diverse research applications that benefit from the large sample sizes and generalizable patient populations afforded by EHRs. These have included reevaluation of prior findings, a range of diseases and subgroups, environmental and social epidemiology, stigmatized conditions, predictive modeling, and evaluation of natural experiments. Although studies using primary data collection methods may have more reliable data and better population retention, EHR-based studies are less expensive and require less time to complete. Future EHR epidemiology with enhanced collection of social/behavior measures, linkage with vital records, and integration of emerging technologies such as personal sensing could improve clinical care and population health.

  3. Identifying radiation-induced survivorship syndromes affecting bowel health in a cohort of gynecological cancer survivors

    PubMed Central

    Steineck, Gunnar; Skokic, Viktor; Bull, Cecilia; Alevronta, Eleftheria; Dunberger, Gail; Bergmark, Karin; Wilderäng, Ulrica; Oh, Jung Hun; Deasy, Joseph O.; Jörnsten, Rebecka

    2017-01-01

    Background During radiotherapy unwanted radiation to normal tissue surrounding the tumor triggers survivorship diseases; we lack a nosology for radiation-induced survivorship diseases that decrease bowel health and we do not know which symptoms are related to which diseases. Methods Gynecological-cancer survivors were followed-up two to 15 years after having undergone radiotherapy; they reported in a postal questionnaire the frequency of 28 different symptoms related to bowel health. Population-based controls gave the same information. With a modified factor analysis, we determined the optimal number of factors, factor loadings for each symptom, factor-specific factor-loading cutoffs and factor scores. Results Altogether data from 623 survivors and 344 population-based controls were analyzed. Six factors best explain the correlation structure of the symptoms; for five of these a statistically significant difference (P< 0.001, Mann-Whitney U test) was found between survivors and controls concerning factor score quantiles. Taken together these five factors explain 42 percent of the variance of the symptoms. We interpreted these five factors as radiation-induced syndromes that may reflect distinct survivorship diseases. We obtained the following frequencies, defined as survivors having a factor loading above the 95 percent percentile of the controls, urgency syndrome (190 of 623, 30 percent), leakage syndrome (164 of 623, 26 percent), excessive gas discharge (93 of 623, 15 percent), excessive mucus discharge (102 of 623, 16 percent) and blood discharge (63 of 623, 10 percent). Conclusion Late effects of radiotherapy include five syndromes affecting bowel health; studying them and identifying the underlying survivorship diseases, instead of the approximately 30 long-term symptoms they produce, will simplify the search for prevention, alleviation and elimination. PMID:28158314

  4. Unbelievable?! Theistic/Epistemological Viewpoint Affects Religion-Health Relationship.

    PubMed

    Speed, David

    2017-02-01

    Research suggests that Religion/Spirituality promotes a variety of positive health outcomes. However, despite reporting lower levels of Religion/Spirituality, non-believers report comparable levels of health to believers. The current study tested the hypothesis that Religion/Spirituality does not have a uniform effect on health for all persons, and tested theological/epistemological categories as moderators. Using the 2012 and 2014 General Social Survey (N = 2670), the relationship between Religion/Spirituality and happiness and self-rated health was investigated. Results indicated that Gnostic Theists experienced Religion/Spirituality more positively than their peers did; Agnostic Theists experienced Religion/Spirituality less positively than their peers did; and Negative Atheists experienced Religion/Spirituality less positively than their peers did. These findings suggested that Religion/Spirituality is not associated with salutary effects for all persons, and that whether a person believes in god(s) and how confident he/she was in god(s)' existence, influenced his/her experience with Religion/Spirituality.

  5. Factors Affecting Canadian Teachers' Willingness to Teach Sexual Health Education

    ERIC Educational Resources Information Center

    Cohen, Jacqueline N.; Byers, E. Sandra; Sears, Heather A.

    2012-01-01

    Non-specialist teachers in Canada are increasingly required to teach sexual health topics. However, research suggests that they do not always do so willingly. This study examined the associations between the characteristics of non-specialist elementary and middle school teachers (n = 294) in Canadian schools and their willingness to provide sexual…

  6. Financial Health of Child Care Facilities Affects Quality of Care.

    ERIC Educational Resources Information Center

    Brower, Mary R.; Sull, Theresa M.

    2003-01-01

    Contends that child care facility owners, boards of directors, staff, and parents need to focus on financial management, as poor financial health compromises the quality of care for children. Specifically addresses the issues of: (1) concern for providing high quality child care; (2) the connection between quality and money; and (3) strengthening…

  7. How Does Bullying Affect Health and Well-Being?

    MedlinePlus

    ... mental health problems, headaches, and problems adjusting to school. 2 Bullying also can cause long-term damage to self-esteem. 3 Children and adolescents who are bullies are at increased risk for substance use, academic problems, and violence to others later in life. 2 Those who ...

  8. Lineage Affect Similarity and Health of Older Family Members.

    ERIC Educational Resources Information Center

    Troll, Lillian E.

    Interviews with same-sex adult members of three-generation family lines can dramatize similarities and differences by age and generation in ways of thinking and feeling. An analysis of interviews with 157 families examined the health of the grandparent, the happiness of each of the three generational representatives, and family salience. Twelve…

  9. Adolescents' health behaviors and obesity: Does race affect this epidemic?

    PubMed Central

    Shelley, Mack C.; Hausafus, Cheryl O.

    2010-01-01

    This study explores the influence of health behaviors and individual attributes on adolescent overweight and obesity using data from Wave II (Add Health). Structural equation model/path analysis using maximum likelihood estimation was utilized to analyze the relationships of health behaviors and attributes with obesity. Results of the model reveal that the causal paths (adolescents' attributes and health behaviors) for overweight and obesity were different for African American and Caucasian adolescents. Generally, African Americans were more susceptible to overweight and obesity than Caucasians. Although increasing levels of vigorous physical activities lowers the risk for obesity among African American and Caucasian adolescents alike, low family SES and being sedentary were associated with overweight and obesity among Caucasians. No significant associations were found among African Americans. Increased hours of sleep at night relate positively with obesity among African Americans. These findings suggest important elements in the consideration of race in developing effective intervention and prevention approaches for curbing the obesity epidemic among U.S. adolescents. PMID:21286412

  10. Understanding Locally, Culturally, and Contextually Relevant Mental Health Problems among Rwandan Children and Adolescents Affected by HIV/AIDS

    PubMed Central

    Betancourt, Theresa Stichick; Rubin-Smith, Julia E.; Beardslee, William R.; Stulac, Sara N.; Fayida, Ildephonse; Safren, Steven

    2011-01-01

    In assessing the mental health of HIV/AIDS-affected children and adolescents in Sub-Saharan Africa, researchers often employ mental health measures developed in other settings. However, measures derived from standard Western psychiatric criteria are frequently based on conceptual models of illness or terminology that may or may not be an appropriate for diverse populations. Understanding local perceptions of mental health problems can aid in the selection or creation of appropriate measures. This study used qualitative methodologies (Free Listing [FL], Key Informant [KI] interviews, and Clinician Interviews [C-KIs]) to understand local perceptions of mental health problems facing HIV/AIDS-affected youth in Rwinkwavu, Rwanda. Several syndrome terms were identified by participants: agahinda kenshi, kwiheba, guhangayika, ihahamuka, umushiha and uburara. While these local syndromes share some similarities with Western mood, anxiety, and conduct disorders, they also contain important culture-specific features and gradations of severity. Our findings underscore the importance of understanding local manifestations of mental health syndromes when conducting mental health assessments and when planning interventions for HIV/AIDS-affected children and adolescents in diverse settings. PMID:21271393

  11. The Use of Social Media for Health Promotion in Hispanic Populations: A Scoping Systematic Review

    PubMed Central

    Hudnut-Beumler, Julia; Po'e, Eli

    2016-01-01

    Background The Internet is an increasingly popular platform for public health interventions due to its distinct ability to communicate with, engage, and educate communities. Given the widespread use of the Internet, these interventions could be a means of equalizing access to information to address health disparities in minority populations, such as Hispanics. Hispanics are disproportionately affected by poor health outcomes, including obesity, diabetes, and human immunodeficiency virus/acquired immune deficiency syndrome. Although underserved and underrepresented, Hispanics are among the leading users of social media in the United States. Previous reviews have examined the use of social media in public health efforts, but, to our knowledge, none have focused on the Hispanic population. Objective To conduct a scoping systematic review of the published literature to capture the ways social media has been used in health interventions aimed at Hispanic populations and identify gaps in existing knowledge to provide recommendations for future research. Methods We performed a systematic review of the literature related to social media, public health, and Hispanics using the PubMed, PsycINFO, and EMBASE databases to locate peer-reviewed studies published between January 1, 2010, and December 31, 2015. Each article was reviewed for the following inclusion criteria: social media as a main component of study methodology or content; public health topic; majority Hispanic/Latino study population; English or Spanish language; and original research study. Relevant data were extracted from articles meeting inclusion criteria including publication year, location, study design, social media platform, use of social media, target population, and public health topic. Results Of the 267 articles retrieved, a total of 27 unique articles met inclusion criteria. All were published in 2012 or later. The most common study design was a cross-sectional survey, which was featured in 10 of the

  12. [Status of health and oral health of the elderly population in Lebanon].

    PubMed

    Osta, N El; Hennequin, M; Osta, L El; Naaman, N Bou Abboud; Geahchan, N; Tubert-Jeannin, S

    2015-08-27

    Lebanon is in demographic transition as more people reach increasingly older age; 10% of the population in Lebanon is elderly. The incidence of chronic diseases and oral diseases increases significantly with age. However, 55% of the elderly have no health insurance and 82% have no dental insurance. Both noncommunicable diseases (NCDs) and oral diseases are a major health burden in the country and share the same risk factors. The WHO strategy for prevention and control of noncommunicable diseases should therefore be a new approach for the prevention and control of dental diseases among Lebanese elderly. This paper aims to increase the awareness of the medical community in Lebanon about the interrelationship between general and oral health in the elderly and concludes with the need for the Ministry of Health to develop policies and national action plans against NCDs to reduce not only mortality from NCDs but also morbidity from oral diseases.

  13. Supporting mental health in South African HIV-affected communities: primary health care professionals’ understandings and responses

    PubMed Central

    Burgess, Rochelle Ann

    2015-01-01

    How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients’ distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoning mental health needs in resource-poor HIV-affected settings. Whilst a minority of studies have begun to explore interventions to target this group of women, there is a dearth of studies that explore the broader contexts that will likely shape service outcomes, such as health sector dynamics and competing definitions of mental ill-health. This study reports on an in-depth case study of primary mental health services in a rural HIV-affected community in Northern KwaZulu-Natal. Health professionals identified as the frontline staff working within the primary mental health care model (n = 14) were interviewed. Grounded thematic analysis of interview data highlighted that practitioners employed a critical and socially anchored framework for understanding their patients’ needs. Poverty, gender and family relationships were identified as intersecting factors driving HIV-affected patients’ mental distress. In a divergence from existing evidence, practitioner efforts to act on their understandings of patient needs prioritized social responses over biomedical ones. To achieve this whilst working within a primary mental health care model, practitioners employed a series of modifications to services to increase their ability to target the sociostructural realities facing HIV-affected women with mental health issues. This article suggests that beyond attention to the crucial issues of funding and human resources that face primary mental health care, attention must also be paid to promoting the development of policies that provide practitioners with increased and more consistent opportunities to address the complex social realities that frame the mental

  14. Supporting mental health in South African HIV-affected communities: primary health care professionals' understandings and responses.

    PubMed

    Burgess, Rochelle Ann

    2015-09-01

    How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients' distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoning mental health needs in resource-poor HIV-affected settings. Whilst a minority of studies have begun to explore interventions to target this group of women, there is a dearth of studies that explore the broader contexts that will likely shape service outcomes, such as health sector dynamics and competing definitions of mental ill-health. This study reports on an in-depth case study of primary mental health services in a rural HIV-affected community in Northern KwaZulu-Natal. Health professionals identified as the frontline staff working within the primary mental health care model (n = 14) were interviewed. Grounded thematic analysis of interview data highlighted that practitioners employed a critical and socially anchored framework for understanding their patients' needs. Poverty, gender and family relationships were identified as intersecting factors driving HIV-affected patients' mental distress. In a divergence from existing evidence, practitioner efforts to act on their understandings of patient needs prioritized social responses over biomedical ones. To achieve this whilst working within a primary mental health care model, practitioners employed a series of modifications to services to increase their ability to target the sociostructural realities facing HIV-affected women with mental health issues. This article suggests that beyond attention to the crucial issues of funding and human resources that face primary mental health care, attention must also be paid to promoting the development of policies that provide practitioners with increased and more consistent opportunities to address the complex social realities that frame the mental distress

  15. Seagrass colonization: Knock-on effects on zoobenthic community, populations and individual health

    NASA Astrophysics Data System (ADS)

    Tu Do, V.; de Montaudouin, Xavier; Lavesque, Nicolas; Blanchet, Hugues; Guyard, Hervé

    2011-12-01

    This study provided evidence that Zostera noltii presence affects macrofauna community structure independently from median sediment grain-size and that the notion of ecosystem health is rather subjective: in the present case, we recorded "good health" in terms of seagrass development, "no impact" in terms of macrobenthic biotic indices and "negative effect" for a given key-population. The occurrence and development of a Z. noltii seagrass bed was surveyed at Banc d'Arguin, Arcachon Bay (France), to estimate the modification of the macrozoobenthic community and of the dynamics of a key-population for the local ecosystem, - the cockle Cerastoderma edule. Even though median grain-size of the sediment decreased only at the very end of the survey, i.e. when seagrass totally invaded the area, most of the macrofauna community characteristics (such as abundance and biomass) increased as soon as Z. noltii patches appeared. The structure of the macrofauna community also immediately diverged between sand and seagrass habitats, without however modifying the tested biotic indices (BENTIX, BOPA, AMBI). The health of the cockle population (growth, abundance, recruitment) was impacted by seagrass development. Related parasite communities slowly diverged between habitats, with more parasites in the cockles from seagrass areas. However, the number of parasites per cockle was always insufficient to alter cockle fitness.

  16. State Constitutional Commitment to Health and Health Care and Population Health Outcomes: Evidence From Historical US Data

    PubMed Central

    2015-01-01

    Objectives. I investigated whether the introduction of health and health care provisions in US state constitutions can make health systems more equitable and improve health outcomes by urging state policymakers and administrative agencies to uphold their human rights obligations at state level. Methods. I constructed a panel of infant mortality rates from 50 US states over the period 1929 through 2000 to examine their association with the timing and details of introducing a constitutional right to health and health care provisions. Results. The introduction of a stronger constitutional commitment that obligates state legislature to provide health care was associated with a subsequent reduction in the infant mortality rate of approximately 7.8%. The introduction of provisions explicitly targeting the poor was also associated with a reduction in the infant mortality rate of 6.5%. These health benefits are primarily evident in non-White populations. Conclusions. This empirical result supports Elizabeth Leonard’s view that although state constitutional rights have been poorly enforced through the judiciary, a constitutional expression of health care duties has fueled the political and social process, ultimately allowing states to identify the best way to address citizens’ health inequality concerns. PMID:25905857

  17. The dynamics of health in wild field vole populations: a haematological perspective.

    PubMed

    Beldomenico, Pablo M; Telfer, Sandra; Gebert, Stephanie; Lukomski, Lukasz; Bennett, Malcolm; Begon, Michael

    2008-09-01

    1. Pathogens have been proposed as potentially important drivers of population dynamics, but while a few studies have investigated the impact of specific pathogens, the wealth of information provided by general indices of health has hardly been exploited. By evaluating haematological parameters in wild populations, our knowledge of the dynamics of health and infection may be better understood. 2. Here, haematological dynamics in natural populations of field voles are investigated to determine environmental and host factors associated with indicators of inflammatory response (counts of monocytes and neutrophils) and of condition: measures of immunological investment (lymphocyte counts) and aerobic capacity (red blood cell counts). 3. Individuals from three field vole populations were sampled monthly for 2 years. Comparisons with individuals kept under controlled conditions facilitated interpretation of field data. Mixed effects models were developed for each cell type to evaluate separately the effects of various factors on post-juvenile voles and mature breeding females. 4. There were three well-characterized 'physiological' seasons. The immunological investment appeared lowest in winter (lowest lymphocyte counts), but red blood cells were at their highest levels and indices of inflammatory response at their lowest. Spring was characterized by a fall in red blood cell counts and peaks in indicators of inflammatory response. During the course of summer-autumn, red blood cell counts recovered, the immunological investment increased and the indicators of inflammatory response decreased. 5. Poor body condition appeared to affect the inflammatory response (lower neutrophil and monocyte peaks) and the immunological investment (lower lymphocyte counts), providing evidence that the capacity to fight infection is dependent upon host condition. 6. Breeding early in the year was most likely in females in better condition (high lymphocyte and red blood cell counts). 7. All the

  18. The dynamics of health in wild field vole populations: a haematological perspective

    PubMed Central

    Beldomenico, Pablo M.; Telfer, Sandra; Gebert, Stephanie; Lukomski, Lukasz; Bennett, Malcolm; Begon, Michael

    2010-01-01

    Summary Pathogens have been proposed as potentially important drivers of population dynamics, but while a few studies have investigated the impact of specific pathogens, the wealth of information provided by general indices of health has hardly been exploited. By evaluating haematological parameters in wild populations, our knowledge of the dynamics of health and infection may be better understood. Here, haematological dynamics in natural populations of field voles are investigated to determine environmental and host factors associated with indicators of inflammatory response (counts of monocytes and neutrophils) and of condition: measures of immunological investment (lymphocyte counts) and aerobic capacity (red blood cell counts). Individuals from three field vole populations were sampled monthly for 2 years. Comparisons with individuals kept under controlled conditions facilitated interpretation of field data. Mixed effects models were developed for each cell type to evaluate separately the effects of various factors on post-juvenile voles and mature breeding females. There were three well-characterized ‘physiological’ seasons. The immunological investment appeared lowest in winter (lowest lymphocyte counts), but red blood cells were at their highest levels and indices of inflammatory response at their lowest. Spring was characterized by a fall in red blood cell counts and peaks in indicators of inflammatory response. During the course of summer—autumn, red blood cell counts recovered, the immunological investment increased and the indicators of inflammatory response decreased. Poor body condition appeared to affect the inflammatory response (lower neutrophil and monocyte peaks) and the immunological investment (lower lymphocyte counts), providing evidence that the capacity to fight infection is dependent upon host condition. Breeding early in the year was most likely in females in better condition (high lymphocyte and red blood cell counts). All the

  19. Population sex-ratio affecting behavior and physiology of overwintering bank voles (Myodes glareolus).

    PubMed

    Sipari, Saana; Haapakoski, Marko; Klemme, Ines; Palme, Rupert; Sundell, Janne; Ylönen, Hannu

    2016-05-15

    Many boreal rodents are territorial during the breeding season but during winter become social and aggregate for more energy efficient thermoregulation. Communal winter nesting and social interactions are considered to play an important role for the winter survival of these species, yet the topic is relatively little explored. Females are suggested to be the initiators of winter aggregations and sometimes reported to survive better than males. This could be due to the higher social tolerance observed in overwintering females than males. Hormonal status could also affect winter behavior and survival. For instance, chronic stress can have a negative effect on survival, whereas high gonadal hormone levels, such as testosterone, often induce aggressive behavior. To test if the winter survival of females in a boreal rodent is better than that of males, and to assess the role of females in the winter aggregations, we generated bank vole (Myodes glareolus) populations of three different sex ratios (male-biased, female-biased and even density) under semi-natural conditions. We monitored survival, spatial behavior and hormonal status (stress and testosterone) during two winter months. We observed no significant differences in survival between the sexes or among populations with differing sex-ratios. The degree of movement area overlap was used as an indicator of social tolerance and potential communal nesting. Individuals in male biased populations showed a tendency to be solitary, whereas in female biased populations there was an indication of winter aggregation. Females living in male-biased populations had higher stress levels than the females from the other populations. The female-biased sex-ratio induced winter breeding and elevated testosterone levels in males. Thus, our results suggest that the sex-ratio of the overwintering population can lead to divergent overwintering strategies in bank voles.

  20. Population preferences for health care in liberia: insights for rebuilding a health system.

    PubMed

    Kruk, Margaret E; Rockers, Peter C; Tornorlah Varpilah, S; Macauley, Rose

    2011-12-01

    OBJECTIVE. To quantify the influence of health system attributes, particularly quality of care, on preferences for health clinics in Liberia, a country with a high burden of disease that is rebuilding its health system after 14 years of civil war. DATA SOURCES/STUDY SETTING. Informed by focus group discussions, a discrete choice experiment (DCE) was designed to assess preferences for structure and process of care at health clinics. The DCE was fielded in rural, northern Liberia as part of a 2008 population-based survey on health care utilization. DATA COLLECTION. The survey response rate was 98 percent with DCE data available for 1,431 respondents. Mixed logit models were used to estimate the influence of six attributes on choice of hypothetical clinics for a future illness. PRINCIPAL FINDINGS. Participants' choice of clinic was most influenced by provision of a thorough physical exam and consistent availability of medicines. Respectful treatment and government (versus NGO) management marginally increased utility, whereas waiting time was not significant. CONCLUSIONS. Liberians value technical quality of care over convenience, courtesy, and public management in selecting clinics for curative care. This suggests that investments in improved competence of providers and availability of medicines may increase population utilization of essential services as well as promote better clinical outcomes.

  1. Population Preferences for Health Care in Liberia: Insights for Rebuilding a Health System

    PubMed Central

    Kruk, Margaret E; Rockers, Peter C; Tornorlah Varpilah, S; Macauley, Rose

    2011-01-01

    Objective To quantify the influence of health system attributes, particularly quality of care, on preferences for health clinics in Liberia, a country with a high burden of disease that is rebuilding its health system after 14 years of civil war. Data Sources/Study Setting Informed by focus group discussions, a discrete choice experiment (DCE) was designed to assess preferences for structure and process of care at health clinics. The DCE was fielded in rural, northern Liberia as part of a 2008 population-based survey on health care utilization. Data Collection The survey response rate was 98 percent with DCE data available for 1,431 respondents. Mixed logit models were used to estimate the influence of six attributes on choice of hypothetical clinics for a future illness. Principal Findings Participants' choice of clinic was most influenced by provision of a thorough physical exam and consistent availability of medicines. Respectful treatment and government (versus NGO) management marginally increased utility, whereas waiting time was not significant. Conclusions Liberians value technical quality of care over convenience, courtesy, and public management in selecting clinics for curative care. This suggests that investments in improved competence of providers and availability of medicines may increase population utilization of essential services as well as promote better clinical outcomes. PMID:21517835

  2. Bees brought to their knees: microbes affecting honey bee health.

    PubMed

    Evans, Jay D; Schwarz, Ryan S

    2011-12-01

    The biology and health of the honey bee Apis mellifera has been of interest to human societies for centuries. Research on honey bee health is surging, in part due to new tools and the arrival of colony-collapse disorder (CCD), an unsolved decline in bees from parts of the United States, Europe, and Asia. Although a clear understanding of what causes CCD has yet to emerge, these efforts have led to new microbial discoveries and avenues to improve our understanding of bees and the challenges they face. Here we review the known honey bee microbes and highlight areas of both active and lagging research. Detailed studies of honey bee-pathogen dynamics will help efforts to keep this important pollinator healthy and will give general insights into both beneficial and harmful microbes confronting insect colonies.

  3. Storytelling: A Qualitative Tool to Promote Health Among Vulnerable Populations.

    PubMed

    Palacios, Janelle F; Salem, Benissa; Hodge, Felicia Schanche; Albarrán, Cyndi R; Anaebere, Ann; Hayes-Bautista, Teodocia Maria

    2015-09-01

    Storytelling is a basic cultural phenomenon that has recently been recognized as a valuable method for collecting research data and developing multidisciplinary interventions. The purpose of this article is to present a collection of nursing scholarship wherein the concept of storytelling, underpinned by cultural phenomena, is explored for data collection and intervention. A conceptual analysis of storytelling reveals key variables. Following a brief review of current research focused on storytelling used within health care, three case studies among three vulnerable populations (American Indian teen mothers, American Indian cancer survivors, and African American women at risk for HIV/AIDS) demonstrate the uses of storytelling for data collection and intervention. Implications for transcultural nursing regarding storytelling are discussed.

  4. [Medical and biologic monitoring of Aral region population health].

    PubMed

    Mutaihan, Zh M; Ibrayeva, L K; Batyrbekova, L S; Aleshina, N Yu; Smagulova, B Zh; Abitayev, D S; Atshabarova, S Sh

    2015-01-01

    The article covers data on health state in dwellers of Shiely settlement in Kyzylorda region, evaluation of therapeutic morbidity by organ systems among the examined population. Findings are that 92% of the examinees are assigned to a morbid group, according to medical and biologic studies. As per nosology classes: first place was occupied by urogenital diseases, second place--by digestive diseases, third place--by blood and hemogenesis disorders. Comparative analysis by sex revealed no differences in first two rank places (urogenital diseases in males 78.7%, in females - 77.2%; digestive diseases--72.3% and 74.4% respectively), third place was occupied by circulatory diseases (15.7%) in males and by blood and hemogenesis disorders (26.4%) in females.

  5. 29 CFR 1960.19 - Other Federal agency standards affecting occupational safety and health.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... safety and health. 1960.19 Section 1960.19 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... EMPLOYEE OCCUPATIONAL SAFETY AND HEALTH PROGRAMS AND RELATED MATTERS Standards § 1960.19 Other Federal agency standards affecting occupational safety and health. (a) Where employees of different...

  6. Health evaluation of a pronghorn antelope population in Oregon.

    PubMed

    Dunbar, M R; Velarde, R; Gregg, M A; Bray, M

    1999-07-01

    During 1996 and 1997, the U.S. Fish and Wildlife Service conducted a study to determine the cause(s) of population decline and low survival of pronghorn antelope (Antilocapra americana) fawns on Hart Mountain National Antelope Refuge (HMNAR) located in southeastern Oregon (USA). As part of that study, blood, fecal, and tissue samples from 104 neonatal fawns, 40 adult does, and nine adult male pronghorns were collected to conduct a health evaluation of the population. Physiological parameters related to nutrition and/or disease were studied. No abnormalities were found in the complete blood cell counts of adults (n = 40) or fawns (n = 44 to 67). Serum total protein and blood urea nitrogen (BUN) levels were lower compared to other pronghorn populations. Does had mean BUN values significantly lower (P < 0.001) in December 1996 than March 1997. Serum copper (Cu) levels in does (range 0.39 to 0.74 ppm) were considered marginal when compared to domestic animals and other wild ungulates. Fawns had low (0.28 ppm) Cu levels at birth and reached the does' marginal values in about 3 days. Whole blood, serum and liver selenium (Se) levels were considered marginal to low in most segments of the pronghorn population. However, serum levels of vitamin E (range 1.98 to 3.27 microg/ml), as determined from the does captured in March, were apparently sufficient to offset any signs of Se deficiency. No clinical signs of Cu or Se deficiency were observed. Fifty-five of 87 dead fawns were necropsied. Trauma, due to predation by coyotes (Canis latrans), accounted for 62% of the mortality during mid-May to mid-July of each year. Other causes included predation by golden eagles (Aquila chrysaetos) (4%), dystocia (2%), septicemic pasteurellosis (4%), starvation (5%), and unknown (23%). Adult females were tested for serum neutralizing antibodies to Brucella spp. (n = 20, negative), Leptospira interrogans (n = 20, negative), bluetongue virus (n = 20, 35% positive), epizootic hemorrhagic

  7. Health evaluation of a pronghorn antelope population in Oregon

    USGS Publications Warehouse

    Dunbar, M.R.; Velarde, R.; Gregg, M.A.; Bray, M.

    1999-01-01

    During 1996 and 1997, the U.S. Fish and Wildlife Service conducted a study to determine the cause(s) of population decline and low survival of pronghorn antelope (Antilocapra americana) fawns on Hart Mountain National Antelope Refuge (HMNAR) located in southeastern Oregon (USA). As part of that study, blood, fecal, and tissue samples from 104 neonatal fawns, 40 adult does, and nine adult male pronghorns were collected to conduct a health evaluation of the population. Physiological parameters related to nutrition and/or disease were studied. No abnormalities were found in the complete blood cell counts of adults (n = 40) or fawns (n = 44 to 67). Serum total protein and blood urea nitrogen (BUN) levels were lower compared to other pronghorn populations. Does had mean BUN values significantly lower (P < 0.001) in December 1996 than March 1997. Serum copper (Cu) levels in does (range 0.39 to 0.74 ppm) were considered marginal when compared to domestic animals and other wild ungulates. Fawns had low (0.28 ppm) Cu levels at birth and reached the does' marginal values in about 3 days Whole blood, serum and liver selenium (Se) levels were considered marginal to low in most segments of the pronghorn population. However, serum levels of vitamin E (range 1.98 to 3.27 ??g/ml), as determined from the does captured in March, were apparently sufficient to offset any signs of Se deficiency. No clinical signs of Cu or Se deficiency were observed. Fifty-five of 87 dead fawns were necropsied. Trauma, due to predation by coyotes (Canis latrans), accounted for 62% of the mortality during mid-May to mid-July of each year. Other causes included predation by golden eagles (Aquila chrysaetos) (4%), dystocia (2%), septicemic pasteurellosis (4%), starvation (5%), and unknown (23%). Adult females were tested for serum neutralizing antibodies to Brucella spp. (n = 20, negative), Leptospira interrogans (n = 20, negative), bluetongue virus (n = 20, 35% positive), epizootic hemorrhagic disease

  8. Analysis of knowledge of the general population and health professionals on organ donation after cardiac death

    PubMed Central

    Bedenko, Ramon Correa; Nisihara, Renato; Yokoi, Douglas Shun; Candido, Vinícius de Mello; Galina, Ismael; Moriguchi, Rafael Massayuki; Ceulemans, Nico; Salvalaggio, Paolo

    2016-01-01

    Objective To evaluate the knowledge and acceptance of the public and professionals working in intensive care units regarding organ donation after cardiac death. Methods The three hospitals with the most brain death notifications in Curitiba were selected, and two groups of respondents were established for application of the same questionnaire: the general public (i.e., visitors of patients in intensive care units) and health professionals working in the same intensive care unit. The questionnaire contained questions concerning demographics, intention to donate organs and knowledge of current legislation regarding brain death and donation after cardiac death. Results In total, 543 questionnaires were collected, including 442 from family members and 101 from health professionals. There was a predominance of women and Catholics in both groups. More females intended to donate. Health professionals performed better in the knowledge comparison. The intention to donate organs was significantly higher in the health professionals group (p = 0.01). There was no significant difference in the intention to donate in terms of education level or income. There was a greater acceptance of donation after uncontrolled cardiac death among Catholics than among evangelicals (p < 0.001). Conclusion Most of the general population intended to donate, with greater intentions expressed by females. Education and income did not affect the decision. The type of transplant that used a donation after uncontrolled cardiac death was not well accepted in the study population, indicating the need for more clarification for its use in our setting. PMID:27626950

  9. Is active commuting the answer to population health?

    PubMed

    Shephard, Roy J

    2008-01-01

    This brief review examines whether active commuting is an effective method of controlling the current obesity epidemic and enhancing the cardiovascular health of the population. Of the many potential methods of active commuting, walking and cycling are the usual choices. Children and adolescents prefer cycling, but for adults issues of safety, cycle storage and company dress codes make walking the preferred option, particularly in North American cities, where urban design and weather conditions often do not favour cycling. Active transportation is more frequent in some European countries with dedicated cycle and pedestrian paths, but in most developed societies, active transportation has declined in recent years.Attempts to increase walking behaviour in the sedentary population have had only limited success to date. A weekly gross energy expenditure of at least 4 MJ is recommended to reduce all-cause and cardiovascular mortality. This can be achieved by walking 1.9 km in 22 minutes twice per day, 5 days per week, or by cycling at 16 km/h for 11 minutes twice per day, 5 days per week. When engaged in level walking, the intensity of effort may be adequate for cardiovascular benefit in older adults, but in fit young workers, it is necessary to either increase the pace or choose a hilly route in order to induce cardio-respiratory benefit; in contrast, cycling is likely to provide an adequate cardiovascular stimulus even for young adults.Empirical data to date have yielded mixed results: a reduced all-cause and cardiovascular mortality has been observed more frequently in cyclists than in walkers, and more frequently in women and older men than in young active commuters. More information is needed concerning the typical weekly dose of activity provided by active commuting, and the impact of such commuting on overall attitudes towards physical activity. It is also necessary to find better methods of involving the sedentary population, through both counselling and changes

  10. Public Health Consequences on Vulnerable Populations from Acute Chemical Releases

    PubMed Central

    Ruckart, Perri Zeitz; Orr, Maureen F.

    2008-01-01

    Data from a large, multi-state surveillance system on acute chemical releases were analyzed to describe the type of events that are potentially affecting vulnerable populations (children, elderly and hospitalized patients) in order to better prevent and plan for these types of incidents in the future. During 2003–2005, there were 231 events where vulnerable populations were within ¼ mile of the event and the area of impact was greater than 200 feet from the facility/point of release. Most events occurred on a weekday during times when day care centers or schools were likely to be in session. Equipment failure and human error caused a majority of the releases. Agencies involved in preparing for and responding to chemical emergencies should work with hospitals, nursing homes, day care centers, and schools to develop policies and procedures for initiating appropriate protective measures and managing the medical needs of patients. Chemical emergency response drills should involve the entire community to protect those that may be more susceptible to harm. PMID:21572842

  11. Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

    PubMed Central

    2013-01-01

    Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA   S-2 Introduction   S-2 Benign Prostatic Hyperplasia (BPH)   S-3 • Overview   S-3• Current BPH Treatment Paradigm   S-4• BPH Continuum of Care: Bladder Health   S-5 New Treatment Option for BPH   S-5 • The UroLift® System   S-6• Positioning of UroLift® in BPH Treatment Paradigm   S-7 New Value Proposition   S-8 • Addressing Bladder Health: Breaking the Cycle   S-8• Cost Benefit Analysis: The Big Picture   S-8 Patient and Family Engagement   S-10 Summary   S-11 PMID:22823180

  12. Probiotics and prebiotics and health in ageing populations.

    PubMed

    Duncan, Sylvia H; Flint, Harry J

    2013-05-01

    In healthy adults microbial communities that colonise different regions of the human colon contribute nutrients and energy to the host via the fermentation of non-digestible dietary components in the large intestine. A delicate balance of microbial species is required to maintain healthy metabolism and immune function. Disturbance in this microbial balance can have negative consequences for health resulting in elevated inflammation and infection, that are contributory factors in diabetes and cancer. There is a growing awareness that the microbial balance in the colon may become increasingly perturbed with aging and therefore hasten the onset of certain diseases. Societal and dietary factors influence microbial community composition both in the short and long term in the elderly (>65 years old) whilst immunosenescence may also be linked to a perturbed distal gut microbiota and frailty in the elderly. Significant progress has been made in defining some of the dominant members of the microbial community in the healthy large intestine and in identifying their roles in metabolism. There is therefore an urgent need for better awareness of the impact of diet, prebiotic and probiotic strategies in driving human colonic microbial composition in order to understand the possibilities for maintaining healthy gut function and well-being in an increasingly elderly population. Here we review gut microbial changes associated with aging and how diet, prebiotics and probiotics may modulate the gut microbiota to maintain health in the elderly.

  13. Antimicrobial Stewardship for a Geriatric Behavioral Health Population

    PubMed Central

    Ellis, Kristen; Rubal-Peace, Georgina; Chang, Victoria; Liang, Eva; Wong, Nicolas; Campbell, Stephanie

    2016-01-01

    Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit. PMID:27025523

  14. Conceptual evaluation of population health surveillance programs: method and example.

    PubMed

    El Allaki, Farouk; Bigras-Poulin, Michel; Ravel, André

    2013-03-01

    Veterinary and public health surveillance programs can be evaluated to assess and improve the planning, implementation and effectiveness of these programs. Guidelines, protocols and methods have been developed for such evaluation. In general, they focus on a limited set of attributes (e.g., sensitivity and simplicity), that are assessed quantitatively whenever possible, otherwise qualitatively. Despite efforts at standardization, replication by different evaluators is difficult, making evaluation outcomes open to interpretation. This ultimately limits the usefulness of surveillance evaluations. At the same time, the growing demand to prove freedom from disease or pathogen, and the Sanitary and Phytosanitary Agreement and the International Health Regulations require stronger surveillance programs. We developed a method for evaluating veterinary and public health surveillance programs that is detailed, structured, transparent and based on surveillance concepts that are part of all types of surveillance programs. The proposed conceptual evaluation method comprises four steps: (1) text analysis, (2) extraction of the surveillance conceptual model, (3) comparison of the extracted surveillance conceptual model to a theoretical standard, and (4) validation interview with a surveillance program designer. This conceptual evaluation method was applied in 2005 to C-EnterNet, a new Canadian zoonotic disease surveillance program that encompasses laboratory based surveillance of enteric diseases in humans and active surveillance of the pathogens in food, water, and livestock. The theoretical standard used for evaluating C-EnterNet was a relevant existing structure called the "Population Health Surveillance Theory". Five out of 152 surveillance concepts were absent in the design of C-EnterNet. However, all of the surveillance concept relationships found in C-EnterNet were valid. The proposed method can be used to improve the design and documentation of surveillance programs. It

  15. Tracking Official Development Assistance for Reproductive Health in Conflict-Affected Countries

    PubMed Central

    Patel, Preeti; Roberts, Bayard; Guy, Samantha; Lee-Jones, Louise; Conteh, Lesong

    2009-01-01

    Background Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006. Methods and Findings The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US$20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US$509.3 million (2.4%) was allocated to reproductive health. This represents an annual average of US$1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. Conclusions This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict. PMID:19513098

  16. How will health reform affect demand for RNs?

    PubMed

    Spetz, Joanne

    2014-01-01

    The U.S. Bureau of Labor Statistics forecasts demand for registered nurses (RNs) will result in 3.5 million nursing jobs by 2020, marking a 26% increase over 10 years. RN employment is expected to grow most rapidly in outpatient settings--particularly physician offices--and home health care. The Affordable Care Act will likely impact the places where RNs work, and the skills they need to be successful in these settings. RNs will be expected to serve as care coordinators, case managers, patient educators, and chronic care specialists. RNs with strong skills will be in high demand in the labor market.

  17. Defining Population Health Vulnerability Following an Extreme Weather Event in an Urban Pacific Island Environment: Honiara, Solomon Islands.

    PubMed

    Natuzzi, Eileen S; Joshua, Cynthia; Shortus, Matthew; Reubin, Reginald; Dalipanda, Tenneth; Ferran, Karen; Aumua, Audrey; Brodine, Stephanie

    2016-08-03

    Extreme weather events are common and increasing in intensity in the southwestern Pacific region. Health impacts from cyclones and tropical storms cause acute injuries and infectious disease outbreaks. Defining population vulnerability to extreme weather events by examining a recent flood in Honiara, Solomon Islands, can help stakeholders and policymakers adapt development to reduce future threats. The acute and subacute health impacts following the April 2014 floods were defined using data obtained from hospitals and clinics, the Ministry of Health and in-country World Health Organization office in Honiara. Geographical information system (GIS) was used to assess morbidity and mortality, and vulnerability of the health system infrastructure and households in Honiara. The April flash floods were responsible for 21 acute deaths, 33 injuries, and a diarrhea outbreak that affected 8,584 people with 10 pediatric deaths. A GIS vulnerability assessment of the location of the health system infrastructure and households relative to rivers and the coastline identified 75% of the health infrastructure and over 29% of Honiara's population as vulnerable to future hydrological events. Honiara, Solomon Islands, is a rapidly growing, highly vulnerable urban Pacific Island environment. Evaluation of the mortality and morbidity from the April 2014 floods as well as the infectious disease outbreaks that followed allows public health specialists and policy makers to understand the health system and populations vulnerability to future shocks. Understanding the negative impacts natural disaster have on people living in urban Pacific environments will help the government as well as development partners in crafting resilient adaptation development.

  18. Chronic Ischemic Heart Disease Affects Health Related Quality of Life

    PubMed Central

    Goreishi, Abolfazl; Shajari, Zahra; Mohammadi, Zeinab

    2012-01-01

    Background Chronic diseases endanger not only physical health but also psychological and social health of patient. Thus, evaluation of such patients for psychological treatment decisions is very important. Method This is a descriptive study that was performed with 50 chronic patients (ischemic heart disease) selected from Valiasr and Mousavi at cardiac wards in Zanjan Province. They were given three types of questionnaire: demographic, WHOQOL, and Zung depression and anxiety index. The information was statically analyzed by frequency chart, central indexes, dispersion, Chi-Square and t tests, Pearson’s correlation index (P < 0.05). Results The average of quality of life in all patients were calculated as was respectively 12.19, 11.98, 12.08, and 12.4 in physical, psychological, social and environmental domains respectively, 68 percent of total number of the patients had various degrees of anxiety and 78 percent of them had various degrees of depression. There was a significant relationship between the life quality average in all domains and anxiety intensity and depression intensity (P < 0.05) and there was a significant relationship between life quality average in all domains and income (P < 0.05). Conclusion As the level of depression and anxiety goes up, quality of life decreases pointing out that they have a reverse relationship. Depression and anxiety are one of the most significant factors of quality of life among other variables. Regarding specific conditions of the treatment, it is necessary to pay special attention to psychological aspects.

  19. Social capital, anticipated ethnic discrimination and self-reported psychological health: a population-based study.

    PubMed

    Lindström, Martin

    2008-01-01

    This study investigates the association between anticipated ethnic discrimination and self-reported psychological health, taking generalized trust in other people into consideration. The 2004 Public Health Survey in Skåne, Sweden, is a cross-sectional postal questionnaire study including a total of 27,757 respondents aged 18-80 with a 59% response rate. Multivariate analyses of anticipated discrimination and self-reported psychological health were performed using logistic regressions in order to investigate the importance of possible confounders (age, country of origin, education and horizontal trust). Poor psychological health was reported by 13.0% of men and 18.9% of women, and 44.8% and 44.7%, respectively, reported that 50% or more of employers would discriminate according to race, colour of skin, religion, or cultural background. Respondents in younger age groups, born abroad, with high education, low trust and high levels of self-reported anticipated discrimination, had significantly higher levels of poor self-reported psychological health. There was a significant association between anticipated discrimination and low horizontal trust. After multiple adjustments for age, country of origin and education, the addition of trust in the model reduced the odds ratio of poor self-reported psychological health in the "most employers" category from 1.8 (1.4-2.1) to 1.5 (1.3-1.9) among men and from 2.2 (1.8-2.6) to 1.8 (1.5-2.2) among women. Generalized trust in other people may be a confounder of the association between anticipated discrimination and poor psychological health. Anticipated discrimination may have effects on the mental health of not only the affected minorities, but also on the mental health of the general population.

  20. Factors Affecting Mental Health of Local Staff Working in the Vanni Region, Sri Lanka

    PubMed Central

    Cardozo, Barbara Lopes; Crawford, Carol; Petit, Pilar; Ghitis, Frida; Sivilli, Teresa I.; Scholte, Willem F.; Ager, Alastair; Eriksson, Cynthia

    2016-01-01

    In the aftermath of the civil war that extended from 1983–2009, humanitarian organizations provided aid to the conflict-affected population of the Vanni region in northern Sri Lanka. In August, 2010, a needs assessment was conducted to determine the mental-health status of Sri Lankan national humanitarian aid staff working in conditions of stress and hardship, and consider contextual and organizational characteristics influencing such status. A total of 398 staff members from nine organizations working in the Vanni area participated in the survey, which assessed stress, work characteristics, social support, coping styles, and symptoms of psychological distress. Exposure to traumatic, chronic, and secondary stressors was common. Nineteen percent of the population met criteria for posttraumatic stress disorder (PTSD), 53% of participants reported elevated anxiety symptoms, and 58% reported elevated depression symptoms. Those reporting high levels of support from their organizations were less likely to suffer depression and PTSD symptoms than those reporting lower levels of staff support (OR =.23, p < .001) and (OR =.26, p < .001), respectively. Participants who were age 55 or older were significantly less likely to suffer anxiety symptoms than those who were between 15 and 34 years of age (OR =.13, p = .011). Having experienced travel difficulties was significantly associated with more anxiety symptoms (OR = 3.35, p < .001). It was recommended that organizations provide stress-management training and increase support to their staff. PMID:27099648

  1. Interoception beyond homeostasis: affect, cognition and mental health

    PubMed Central

    Tsakiris, Manos; Critchley, Hugo

    2016-01-01

    Interoception refers to the sensing of the internal state of one's body. Interoception is distinct from the processing of sensory information concerning external (non-self) stimuli (e.g. vision, hearing, touch and smell) and is the afferent axis to internal (autonomic and hormonal) physiological control. However, the impact of interoception extends beyond homeostatic/allostatic reflexes: it is proposed to be fundamental to motivation, emotion (affective feelings and behaviours), social cognition and self-awareness. This view is supported by a growing body of experimental evidence that links peripheral physiological states to mental processes. Within this framework, the representation of self is constructed from early development through continuous integrative representation of biological data from the body, to form the basis for those aspects of conscious awareness grounded on the subjective sense of being a unique individual. This theme issue of the Philosophical Transactions of the Royal Society B draws together state-of-the-art knowledge concerning theoretical, experimental and clinical facets of interoception with the emphasis on cognitive and affective neuroscience. The multidisciplinary and cross-disciplinary perspectives represented in this theme issue disseminate and entrench knowledge about interoception across the scientific community and provide a reference for the conceptualization and further study of interoception across behavioural sciences. PMID:28080961

  2. MISR Satellite Observations of Aerosol Types Affecting Human Health

    NASA Astrophysics Data System (ADS)

    Kalashnikova, O. V.; Franklin, M.; Garay, M. J.; Diner, D. J.

    2015-12-01

    Ground-based observations of pollutants and concentrations of particulate matter (PM), that includes small particles designated PM2.5 and dust-dominated PM10, are the gold standard in studies of environmental impacts on human health. However, because monitoring stations are costly, they typically provide only limited spatial coverage, especially in rural and remote areas. We will demonstrate how data from the Multi-angle Imaging SpectroRadiometer (MISR) instrument that has been flying on NASA's Terra Earth Observing System satellite since early 2000 can be used to provide estimates of surface PM types. The current MISR operational aerosol retrieval uses a combination of multi-spectral and multi-angle data to retrieve aerosol optical depth (AOD) and particle property information (including dust AOD) globally at 17.6 km spatial resolution. Using the same algorithm with data collected in all 36-channels at 275 m resolution (Local Mode), which is available over greater Los Angeles area, and also was activated during 2013 DISCOVER-AQ California field campaign, high-resolution 4.4 km aerosol retrievals were performed in addition to the standard 17.6 km retrievals. The 4.4 km spatial resolution of the PM information data is fine enough to be able to resolve local differences in PM loading that may be important for understanding regional health effects of pollution in the region. In particular, we demonstrate that MISR high-resolution AOD retrievals are in better agreement with ground-based aerosol observations and reveal more details about the aerosol spatial variability compared to the MISR standard 17.6 km product. Then we will discuss techniques and show examples of the application of high-resolution MISR data to provide estimates of surface PM for the greater Los Angeles area in 2008 and for California San Joaquin Valley during the 2013 DISCOVER-AQ field campaign. Finally, we will discuss future NASA instruments that will provide new information allowing for better

  3. Genomewide Scan for Affective Disorder Susceptibility Loci in Families of a Northern Swedish Isolated Population

    PubMed Central

    Venken, Tine; Claes, Stephan; Sluijs, Samuël; Paterson, Andrew D.; van Duijn, Cornelia; Adolfsson, Rolf; Del-Favero, Jurgen; Van Broeckhoven, Christine

    2005-01-01

    We analyzed nine multigenerational families with ascertained affective spectrum disorders in northern Sweden's geographically isolated population of Västerbotten. This northern Swedish population, which originated from a limited number of early settlers ∼8,000 years ago, is genetically more homogeneous than outbred populations. In a genomewide linkage analysis, we identified three chromosomal loci with multipoint LOD scores (MPLOD) ⩾2 at 9q31.1-q34.1 (MPLOD 3.24), 6q22.2-q24.2 (MPLOD 2.48), and 2q33-q36 (MPLOD 2.26) under a recessive affected-only model. Follow-up genotyping with application of a 2-cM density simple-tandem-repeat (STR) map confirmed linkage at 9q31.1-q34.1 (MPLOD 3.22), 6q23-q24 (MPLOD 3.25), and 2q33-q36 (MPLOD 2.2). In an initial analysis aimed at identification of the underlying susceptibility genes, we focused our attention on the 9q locus. We fine mapped this region at a 200-kb STR density, with the result of an MPLOD of 3.70. Genealogical studies showed that three families linked to chromosome 9q descended from common founder couples ∼10 generations ago. In this ∼10-generation pedigree, a common ancestral haplotype was inherited by the patients, which reduced the 9q candidate region to 1.6 Mb. Further, the shared haplotype was observed in 4.2% of patients with bipolar disorder with alternating episodes of depression and mania, but it was not observed in control individuals in a patient-control sample from the Västerbotten isolate. These results suggest a susceptibility locus on 9q31-q33 for affective disorder in this common ancestral region. PMID:15614721

  4. The Effects of Daily Co-Occurrence of Affect on Older Adults’ Reactivity to Health Stressors

    PubMed Central

    Ramsey, Jennifer L.; Neupert, Shevaun D.; Mroczek, Daniel K.; Spiro, Avron

    2015-01-01

    Objectives The present study examined age differences among older adults in the daily co-occurrence of affect and its potential role in buffering the negative effects of health stressors. Design Participants were from the Veterans Affairs Normative Aging Study (NAS) and included 249 young-old adults (age = 60–79 years, M=71.6) and 64 old-old adults (age = 80–89, M = 82.9) who completed questionnaires assessing stressors, physical health symptoms, and positive and negative affect on eight consecutive days. Results An independent samples t-test showed young-old and old-old adults did not significantly differ in their mean levels of daily co-occurrence of affect. The between-person relationships among stressors, health, and daily co-occurrence of affect revealed that neither stressors nor health were significantly related to daily co-occurrence of affect. However, results from a multilevel model revealed a three-way cross-level interaction (Health Stressor X Age Group X Co-Occurrence of Affect) where old-old adults with higher levels of co-occurrence of affect were less emotionally reactive to health stressors than young-old adults. Conclusion These findings provide support for the assertion that co-occurrence of affect functions in an adaptive capacity and highlight the importance of examining domain specific stressors. PMID:26518259

  5. Gender-related differences in lifestyle may affect health status.

    PubMed

    Varì, Rosaria; Scazzocchio, Beatrice; D'Amore, Antonio; Giovannini, Claudio; Gessani, Sandra; Masella, Roberta

    2016-01-01

    Consistent epidemiological and clinical evidence strongly indicates that chronic non-communicable diseases are largely associated with four lifestyle risk factors: inadequate diet, physical inactivity, tobacco use, and excessive alcohol use. Notably, obesity, a worldwide-growing pathological condition determined by the combination between inadequate diet and insufficient physical activity, is now considered a main risk factor for most chronic diseases. Dietary habits and physical activity are strongly influenced by gender attitudes and behaviors that promote different patterns of healthy or unhealthy lifestyles among women and men. Furthermore, different roles and unequal relations between genders strongly interact with differences in social and economic aspects as well as cultural and societal environment. Because of the complex network of factors involved in determining the risk for chronic diseases, it has been promoting a systemic approach that, by integrating sex and gender analysis, explores how sex-specific biological factors and gender-related social factors can interact to influence the health status.

  6. Deficits in facial affect recognition among antisocial populations: a meta-analysis.

    PubMed

    Marsh, Abigail A; Blair, R J R

    2008-01-01

    Individuals with disorders marked by antisocial behavior frequently show deficits in recognizing displays of facial affect. Antisociality may be associated with specific deficits in identifying fearful expressions, which would implicate dysfunction in neural structures that subserve fearful expression processing. A meta-analysis of 20 studies was conducted to assess: (a) if antisocial populations show any consistent deficits in recognizing six emotional expressions; (b) beyond any generalized impairment, whether specific fear recognition deficits are apparent; and (c) if deficits in fear recognition are a function of task difficulty. Results show a robust link between antisocial behavior and specific deficits in recognizing fearful expressions. This impairment cannot be attributed solely to task difficulty. These results suggest dysfunction among antisocial individuals in specified neural substrates, namely the amygdala, involved in processing fearful facial affect.

  7. Design of the New York City Macroscope: Innovations in Population Health Surveillance Using Electronic Health Records

    PubMed Central

    Newton-Dame, Remle; McVeigh, Katharine H.; Schreibstein, Lauren; Perlman, Sharon; Lurie-Moroni, Elizabeth; Jacobson, Laura; Greene, Carolyn; Snell, Elisabeth; Thorpe, Lorna E.

    2016-01-01

    Introduction: Electronic health records (EHRs) have the potential to offer real-time, inexpensive standardized health data about chronic health conditions. Despite rapid expansion, EHR data evaluations for chronic disease surveillance have been limited. We present design and methods for the New York City (NYC) Macroscope, an EHR-based chronic disease surveillance system. This methods report is the first in a three part series describing the development and validation of the NYC Macroscope. This report describes in detail the infrastructure underlying the NYC Macroscope; indicator definitions; design decisions that were made to maximize data quality; characteristics of the population sampled; completeness of data collected; and lessons learned from doing this work. The second report describes the methods used to evaluate the validity and robustness of NYC Macroscope prevalence estimates; presents validation results for estimates of obesity, smoking, depression and influenza vaccination; and discusses the implications of our findings for NYC and for other jurisdictions embarking on similar work. The third report applies the same validation methods to metabolic outcomes, including the prevalence, treatment and control of diabetes, hypertension and hyperlipidemia. Methods: We designed the NYC Macroscope for comparison to a local “gold standard,” the 2013–14 NYC Health and Nutrition Examination Survey, and the telephonic 2013 Community Health Survey. NYC Macroscope indicators covered prevalence, treatment, and control of diabetes, hypertension, and hyperlipidemia; and prevalence of influenza vaccination, obesity, depression and smoking. Indicators were stratified by age, sex, and neighborhood poverty, and weighted to the in-care NYC population and limited to primary care patients. Indicator queries were distributed to a virtual network of primary care practices; 392 practices and 716,076 adult patients were retained in the final sample. Findings: The NYC

  8. Maternal health issues and cardio-metabolic outcomes in the offspring: a focus on Indigenous populations.

    PubMed

    Wicklow, Brandy A; Sellers, Elizabeth A C

    2015-01-01

    Non-communicable diseases (NCDs) including diabetes, obesity and cardiovascular disease are the leading causes of death worldwide. Indigenous populations are disproportionally affected. In an effort to halt the increasing disease burden, the mechanisms underlying the increasing rate of NCDs are an important area of study. Recent evidence has focused on the perinatal period as an influential period impacting the future cardio-metabolic health of the offspring. This concept has been defined as metabolic foetal programming and supports the importance of the developmental origins of health and disease in research and clinical practice, specifically in prevention efforts to protect future generations from NCDs. An understanding of the underlying mechanisms involved is not clear as of yet. However, an understanding of these mechanisms is imperative in order to plan effective intervention strategies. As much of the discussion below is gleaned from large epidemiological studies and animal studies, further research with prospective cohorts is necessary.

  9. The mental health of populations directly and indirectly exposed to violent conflict in Indonesia

    PubMed Central

    2010-01-01

    Background Large disasters affect people who live both near and far from the areas in which they occur. The mental health impact is expected to be similar to a ripple effect, where the risk of mental health consequences generally decreases with increasing distance from the disaster center. However, we have not been able to identify studies of the ripple effect of man-made disaster on mental health in low-income countries. Objectives The objective was to examine the hypothesis of a ripple effect on the mental health consequences in populations exposed to man-made disasters in a developing country context, through a comparison of two different populations living in different proximities from the center of disaster in Mollucas. Methods Cross-sectional longitudinal data were collected from 510 Internally Displaced Persons (IDPs) living in Ambon, who were directly exposed to the violence, and non-IDPs living in remote villages in Mollucas, Indonesia, who had never been directly exposed to violence in Mollucas. Data were collected during home visits and statistical comparisons were conducted by using chi square tests, t-test and logistic regression. Results There was significantly more psychological distress "caseness" in IDPs than non-IDPs. The mental health consequences of the violent conflict in Ambon supported the ripple effect hypothesis as displacement status appears to be a strong risk factor for distress, both as a main effect and interaction effect. Significantly higher percentages of IDPs experienced traumatic events than non-IDPs in all six event types reported. Conclusions This study indicates that the conflict had an impact on mental health and economic conditions far beyond the area where the actual violent events took place, in a diminishing pattern in line with the hypothesis of a ripple effect. PMID:20673322

  10. Thermoregulatory behaviour affects prevalence of chytrid fungal infection in a wild population of Panamanian golden frogs

    PubMed Central

    Richards-Zawacki, Corinne L.

    2010-01-01

    Predicting how climate change will affect disease dynamics requires an understanding of how the environment affects host–pathogen interactions. For amphibians, global declines and extinctions have been linked to a pathogenic chytrid fungus, Batrachochytrium dendrobatidis. Using a combination of body temperature measurements and disease assays conducted before and after the arrival of B. dendrobatidis, this study tested the hypothesis that body temperature affects the prevalence of infection in a wild population of Panamanian golden frogs (Atelopus zeteki). The timing of first detection of the fungus was consistent with that of a wave of epidemic infections spreading south and eastward through Central America. During the epidemic, many golden frogs modified their thermoregulatory behaviour, raising body temperatures above their normal set point. Odds of infection decreased with increasing body temperature, demonstrating that even slight environmental or behavioural changes have the potential to affect an individual's vulnerability to infection. The thermal dependency of the relationship between B. dendrobatidis and its amphibian hosts demonstrates how the progression of an epidemic can be influenced by complex interactions between host and pathogen phenotypes and the environments in which they are found. PMID:19864287

  11. Thermoregulatory behaviour affects prevalence of chytrid fungal infection in a wild population of Panamanian golden frogs.

    PubMed

    Richards-Zawacki, Corinne L

    2010-02-22

    Predicting how climate change will affect disease dynamics requires an understanding of how the environment affects host-pathogen interactions. For amphibians, global declines and extinctions have been linked to a pathogenic chytrid fungus, Batrachochytrium dendrobatidis. Using a combination of body temperature measurements and disease assays conducted before and after the arrival of B. dendrobatidis, this study tested the hypothesis that body temperature affects the prevalence of infection in a wild population of Panamanian golden frogs (Atelopus zeteki). The timing of first detection of the fungus was consistent with that of a wave of epidemic infections spreading south and eastward through Central America. During the epidemic, many golden frogs modified their thermoregulatory behaviour, raising body temperatures above their normal set point. Odds of infection decreased with increasing body temperature, demonstrating that even slight environmental or behavioural changes have the potential to affect an individual's vulnerability to infection. The thermal dependency of the relationship between B. dendrobatidis and its amphibian hosts demonstrates how the progression of an epidemic can be influenced by complex interactions between host and pathogen phenotypes and the environments in which they are found.

  12. Focusing National Institutes of Health HIV/AIDS research for maximum population impact.

    PubMed

    Walensky, Rochelle P; Auerbach, Judith D

    2015-03-15

    Progress in advancing research on the pathophysiology, prevention, treatment, and impact of human immunodeficiency virus (HIV) is threatened by the decaying purchasing power of National Institutes of Health (NIH) dollars. A working group of the NIH Office of AIDS Research Advisory Council was charged by the NIH Director with developing a focused and concise blueprint to guide the use of limited funding over the next few years. Science priorities outlined by the working group and reported here are intended to maximally address individuals, groups, and settings most affected by the epidemic, and to redress shortcomings in realizing population-level HIV prevention, treatment, and eradication goals. Optimizing these priorities requires that traditional silos--defined by topic focus and by scientific discipline--be dissolved and that structural issues affecting the pipeline of new investigators and the ability of the Office of AIDS Research to fulfill its role of steward of the NIH HIV/AIDS research program be directly addressed.

  13. Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey

    PubMed Central

    Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija

    2016-01-01

    Background: The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. Aims: To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Study Design: Cross-sectional study. Methods: This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households – 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05. Results: Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16–1.51), unemployment (1.36; 1.18–1.56), single status (1.34; 1.23–1.45), and Wealth Index middle class (1.20; 1.08–1.32) or poor (1.33; 1.21–1.47) were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59–0.89). Single (1.50; 1.26–1.78), unemployed (1.39; 1.07–1.80) and inactive respondents (1.42; 1.10–1.83) had a higher odds of chronic anxiety or depression than married

  14. Health expectancy calculations: a novel approach to studying population health in Bulgaria.

    PubMed Central

    Mutafova, M.; van de Water, H. P.; Perenboom, R. J.; Boshuizen, H. C.; Maleshkov, C.

    1997-01-01

    The measurement of life expectancy in terms of either good or poor health is a novel approach to studying the health of the population in Bulgaria. The pilot study reported here-carried out among people aged > or = 60 years in a middle-sized Bulgarian town-was designed to obtain information on the years of functional restrictions expected among the elderly. In accordance with the answers to a series of questions (recommended by WHO), subjects were categorized as disabled, handicapped, or having different states of perceived health. The indicators "disability-free life expectancy", "handicap-free life expectancy" and "healthy life expectancy" (based on self-perceived health) were calculated according to Sullivan's method. The results show, for example, that 8.0 of the 16.0 years that men aged 60 years may expect to live, on average, will be free of disability. For men aged 80 years the figures are 1.3 of 5.5 years. For women at 60 years and 80 years the results are 7.3 and 0.5 disability-free years of 19.2 and 7.3 expected life years, respectively. Similar results were found for handicap-free life expectancies and healthy life expectancies. At all ages, the proportion of life in a condition free of disability, free of handicap, or in perceived good health is substantially lower for women than for men. Women may expect to live longer, but a greater proportion of their life will be spent in poor health. The approach presented here for measuring the health status of the elderly may be helpful as an aid to planning medical and social care and for the development of public health policies. PMID:9185367

  15. UK Food Standards Agency Optimal Nutrition Status Workshop: environmental factors that affect bone health throughout life.

    PubMed

    Burns, Lynn; Ashwell, Margaret; Berry, Jacqueline; Bolton-Smith, Caroline; Cassidy, Aedin; Dunnigan, Matthew; Khaw, Kay Tee; Macdonald, Helen; New, Susan; Prentice, Ann; Powell, Jonathan; Reeve, Jonathan; Robins, Simon; Teucher, Birgit

    2003-06-01

    The UK Food Standards Agency (FSA) convened a group of expert scientists to discuss and review UK FSA- and Department of Health-funded research on diet and bone health. This research focused on the lifestyle factors that are amenable to change and may significantly affect bone health and the risk of osteoporotic fracture. The potential benefits of fruits and vegetables, meat, Ca, vitamins D and K and phyto-oestrogens were presented and discussed. Other lifestyle factors were also discussed, particularly the effect of physical activity and possible gene-nutrient interactions affecting bone health.

  16. Proactive Population Health Management in the Context of a Regional Health Information Exchange Using Standards-Based Decision Support

    PubMed Central

    Lobach, David F.; Kawamoto, Kensaku; Anstrom, Kevin J.; Kooy, Kevin R.; Eisenstein, Eric L.; Silvey, Garry M.; Willis, Janese M.; Johnson, Frederick; Simo, Jessica

    2007-01-01

    The clinic-based healthcare model does not deliver high quality, cost-effective care to populations of patients. Despite public perception that aggressive investment in information technology will lead to improvements in the safety and quality of healthcare delivery, there is little evidence that health information technology can be used to promote population-based health management. This paper describes the use of a standards-based clinical decision support system to facilitate proactive population health management using data from a regional health information exchange (HIE) network. The initial release of this system was designed to detect ten sentinel health events related to hospitalization, emergency department (ED) utilization, and care coordination in a population of 36,000 individuals. In an analysis of 11,899 continuously enrolled patients from a single county over a six-month period, 2,285 unique patients experienced 7,226 sentinel health events. The most common events were ED utilization for low severity conditions (2,546), two or more missed appointments within a 60-day period (1,728), ED encounters for patients with asthma (1,220), and three or more ED encounters within 90 days (731). Logistic regression analysis identified patients aged 19–64 as the population most likely to have sentinel health events. In addition to presenting data demonstrating the feasibility of population health management in the context of an HIE, this paper also includes lessons learned from the development, implementation, and operational support of the population health management system. PMID:18693881

  17. Community violence and mental health among Iraqi women, a population-based study

    PubMed Central

    Al-Nuaimi, Maha A.

    2013-01-01

    Background: The recent events in Iraq following the 2003 war render Iraq as a country with a high level of all types of violence. Exposure to violence, as a witness or a victim, is related to a number of longer term emotional, behavioral and social problems. Objectives: To investigate the impact of witnessing and experiencing community violence and tragedy as a factor contributing to mental health disorders among Iraqi women in the city of Mosul. Methods: A population-based cross-sectional study of 500 women were selected by a multi-stage random sampling technique. Four catchment areas of primary health centers of Mosul city were selected. Community violence with nine commonly associated social, economic, emotional, physical and mental health symptoms were recorded by questionnaire. Results: The study revealed that all the participating women had a history of exposure to at least one type of community violence within the last twelve months. A mainstream consequence of exposure to community violence was transportation difficulties, loss of husband's job, and family displacement. More than half of the women were classified as having severe emotional disturbances that may evolve to mental health problems in future. Conclusion: Women are bearing the consequences of the violence in Iraq. National commitment and action needs to be taken to curb the violence which is hugely affecting the people of Iraq. Treatment programs targeted at promoting emotional resilience may be effective at preventing mental health problems. PMID:25003060

  18. Population dynamics of dechlorinators and factors affecting the level and products of PCB dechlorination in sediments

    SciTech Connect

    Kim, J.S.; Sokol, R.C.; Liu, X.; Bethoney, C.M.; Rhee, G.Y.

    1996-12-31

    Microbial dechlorination of polychlorinated biphenyls (PCBs) often stops although a significant number of removable chlorines remain. To determine the reason for the cessation, we investigated the limitation of organic carbon, PCB bioavailability, and inhibition by metabolic products. Enrichment with carbon sources did not induce additional chlorination, indicating the plateau was not due to depletion of organic carbon. The bioavailability was not limiting, since a subcritical micelle concentration of the surfactant, which enhanced desorption without inhibiting dechlorinating microorganisms, failed to lower the plateau. Neither was it due to accumulation of metabolites, since no additional dechlorination was detected when plateau sediments were incubated with fresh medium. Similarly, dechlorination was not inhibited in freshly spiked sediment slurries. Dechlorination ended up at the same level with nearly identical congener profiles, regardless of treatment. These results indicate that cessation of dechlorination was due to the accumulation of daughter congeners, which cannot be used as electron acceptors by microbes. To determine whether the decreasing availability affected the microorganisms, we determined the population dynamics of dechlorinators using the most probable number technique. The growth dynamics of the dechlorinators mirrored the time course of dechlorination. It started when the population increased by two orders of magnitude. Once dechlorination stopped the dechlorinating population also began to decrease. When dechlorinators were inoculated into PCB-free sediments, the population decreased over time. The decrease of the population as dechlorination ceased confirms that the diminishing availability of congeners was the reason for the incomplete dechlorination. Recent findings have shown that a second phase of dechlorination of certain congeners can occur after a long lag. 45 refs., 8 figs.

  19. Herbivory Differentially Affects Plant Fitness in Three Populations of the Perennial Herb Lythrum salicaria along a Latitudinal Gradient.

    PubMed

    Lehndal, Lina; Ågren, Jon

    2015-01-01

    Herbivory can negatively and selectively affect plant fitness by reducing growth, survival and reproductive output, thereby influencing plant population dynamics and evolution. Latitudinal variation in intensity of herbivory is common, but the extent to which it translates into corresponding variation in effects on plant performance is still poorly known. We tested the hypothesis that variation in the fitness-consequences of herbivory mirror differences in intensity of herbivory among three natural populations of the perennial herb Lythrum salicaria along a latitudinal gradient from southern to northernmost Sweden. We documented intensity of herbivory and examined its effect on survival, growth and reproductive output over two years by experimentally removing herbivores with insecticide. The intensity of herbivory and the effects of herbivory on plant fitness were strongest in the southern population, intermediate in the central population and weakest in the northern population. The mean proportion of the leaf area removed ranged from 11% in the southern to 3% in the northern population. Herbivore removal increased plant height 1.5-fold in the southern and 1.2-fold in the central population, the proportion plants flowering 4-fold in the southern and 2-fold in the central population, and seed production per flower 1.6-fold in the southern and 1.2-fold in the central population, but did not affect plant fitness in the northern population. Herbivore removal thus affected the relative fecundity of plants in the three populations: In the control, seed output per plant was 8.6 times higher in the northern population compared to the southern population, whereas after herbivore removal it was 2.5 times higher in the southern population. The results demonstrate that native herbivores may strongly affect the demographic structure of L. salicaria populations and thereby shape geographic patterns of seed production. They further suggest that the strength of herbivore

  20. Cancer among circumpolar populations: an emerging public health concern

    PubMed Central

    Young, T. Kue; Kelly, Janet J.; Friborg, Jeppe; Soininen, Leena; Wong, Kai O.

    2016-01-01

    Objectives To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups – Inuit, Athabaskan Indians and Sami. Methods Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the “world average” rates as reported in the GLOBOCAN database were used. Findings Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000–2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a “Circumpolar Inuit” group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer. PMID:26765259

  1. Cancer among circumpolar populations: an emerging public health concern.

    PubMed

    Young, T Kue; Kelly, Janet J; Friborg, Jeppe; Soininen, Leena; Wong, Kai O

    2016-01-01

    Objectives To determine and compare the incidence of cancer among the 8 Arctic States and their northern regions, with special focus on 3 cross-national indigenous groups - Inuit, Athabaskan Indians and Sami. Methods Data were extracted from national and regional statistical agencies and cancer registries, with direct age-standardization of rates to the world standard population. For comparison, the "world average" rates as reported in the GLOBOCAN database were used. Findings Age-standardized incidence rates by cancer sites were computed for the 8 Arctic States and 20 of their northern regions, averaged over the decade 2000-2009. Cancer of the lung and colon/rectum in both sexes are the commonest in most populations. We combined the Inuit from Alaska, Northwest Territories, Nunavut and Greenland into a "Circumpolar Inuit" group and tracked cancer trends over four 5-year periods from 1989 to 2008. There has been marked increase in lung, colorectal and female breast cancers, while cervical cancer has declined. Compared to the GLOBOCAN world average, Inuit are at extreme high risk for lung and colorectal cancer, and also certain rare cancers such as nasopharyngeal cancer. Athabaskans (from Alaska and Northwest Territories) share some similarities with the Inuit but they are at higher risk for prostate and breast cancer relative to the world average. Among the Sami, published data from 3 cohorts in Norway, Sweden and Finland show generally lower risk of cancer than non-Sami. Conclusions Cancer among certain indigenous people in the Arctic is an increasing public health concern, especially lung and colorectal cancer.

  2. Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

    PubMed Central

    Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M.; Weinick, Robin M.; Woods, Dulani; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade. PMID:28083423

  3. Effects of Type of Health Insurance Coverage on Colorectal Cancer Survival in Puerto Rico: A Population-Based Study

    PubMed Central

    Ortiz-Ortiz, Karen J.; Ramírez-García, Roberto; Cruz-Correa, Marcia; Ríos-González, Moraima Y.; Ortiz, Ana Patricia

    2014-01-01

    Colorectal cancer represents a major health problem and an important economic burden in Puerto Rico. In the 1990's, the Commonwealth of Puerto Rico implemented a health care reform through the privatization of the public health system. The goal was to ensure access to health services, eliminate disparities for medically indigent citizens and provide special coverage for high-risk conditions such as cancer. This study estimates the 5-year relative survival rate of colorectal cancer and the relative excess risk of death in Puerto Rico for 2004–2005, by type of health insurance coverage; Government Health Plan vs. Non-Government Health Plan. Colorectal cancer in advanced stages was more common in Government Health Plan patients compared with Non-Government Health Plan patients (44.29% vs. 40.24 had regional extent and 13.58% versus 10.42% had distant involvement, respectively). Government Health Plan patients in the 50–64 (RR = 6.59; CI: 2.85–15.24) and ≥65 (RR = 2.4; CI: 1.72–4.04) age-groups had the greater excess risk of death compared with Non-Government Health Plan patients. Further studies evaluating the interplay of access to health services and the barriers affecting the Government Health Plan population are warranted. PMID:24796444

  4. Oral impacts affecting daily performance in a low dental disease Thai population.

    PubMed

    Adulyanon, S; Vourapukjaru, J; Sheiham, A

    1996-12-01

    The aim of the study was to measure incidence of oral impacts on daily performances and their related features in a low dental disease population. 501 people aged 35-44 years in 16 rural villages in Ban Phang district, Khon Kaen, Thailand, were interviewed about oral impacts on nine physical, psychological and social aspects of performance during the past 6 months, and then had an oral examination. The clinical and behavioural data showed that the sample had low caries (DMFT = 2.7) and a low utilization of dental services. 73.6% of all subjects had at least one daily performance affected by an oral impact. The highest incidence of performances affected were Eating (49.7%), Emotional stability (46.5%) and Smiling (26.1%). Eating, Emotional stability and Cleaning teeth performances had a high frequency or long duration of impacts, but a low severity. The low frequency performances; Physical activities, Major role activity and Sleeping were rated as high severity. Pain and discomfort were mainly perceived as the causes of impacts (40.1%) for almost every performance except Smiling. Toothache was the major causal oral condition (32.7%) of almost all aspects of performance. It was concluded that this low caries people have as high an incidence of oral impacts as industrialized, high dental disease populations. Frequency and severity presented the paradoxical effect on different performances and should both be taken into account for overall estimation of impacts.

  5. Socio-economic factors affect mortality in 47,XYY syndrome-A comparison with the background population and Klinefelter syndrome.

    PubMed

    Stochholm, Kirstine; Juul, Svend; Gravholt, Claus Højbjerg

    2012-10-01

    Mortality among males with 47,XYY is increased due to a host of conditions and diseases. Clinical studies have suggested a poorer educational level and social adaptation among 47,XYY persons. We wanted to study the socio-economic profile in 47,XYY persons and the impact on mortality. We conducted a register study using several Danish nationwide registries. 206 47,XYY men and 20,078 controls from the background population and 1,049 controls with Klinefelter syndrome were included. Information concerning marital status, fatherhood, education, income, and retirement were obtained. Compared to the background population, 47,XYY men had fewer partnerships, were less likely to become fathers, had lower income and educational level, and retired at an earlier age. The mortality among 47,XYY men was significantly increased with a hazard ratio (HR) of 3.6 (95% confidence interval: 2.6-5.1). Adjusting for marital and educational status reduced this HR to 2.7. Compared to Klinefelter syndrome, 47,XYY had significantly fewer partnerships, were more likely to become fathers, but had lower income. Mortality among 47,XYY men was increased compared with Klinefelter syndrome with a HR of 1.36. The results show a severely inferior outcome in all investigated socio-economic parameters compared to the background population and an affected profile compared with Klinefelter syndrome, even though the population in Denmark has equal and free access to health care and education. We conclude that 47,XYY is often associated with a poorer socio-economic profile, which partly explains the increased mortality.

  6. [The scientometric analysis of dissertation studies in the field of specialty public health and health care concerning children population].

    PubMed

    Albitskiy, V S; Ustinova, N V; Antonova, Ye V

    2014-01-01

    The article considers trends and priority directions of research studies of the field of public health and health care of children population. The interpretative content analysis was applied to study dissertations in the field of public health and health care in 1991-2012. The sampling included 4194 units of information. The first stage of study established that problems of children population are considered in 14.8% dissertations defended on the mentioned specialty. The next stage the categories of content-analysis were examined. They were divided on the following axes: axis I "Main problem of study", axis II "Localization of study", axis III "Examined age groups", axis IV "Distribution of studies on gender of examined contingent", axis V "Examined contingent", axis VI "Additional medical specialty". It is established that in dissertations on public health and health care of children population on axis I prevails organizational subject matter (27.2%). The health condition of various contingents of children population (16.8%), preventive aspects of pediatrics (12.2%), examination of particular conditions/diseases/classes of diseases (10.8%) are fixed as priority directions. In the most dissertations the regional character of studies is presented (98.2%). The prevailing age group in studies is the adolescent group (19.9%). The inter-disciplinary relationships of dissertations on problems of public health and health care of children population are revealed with such specialties as "Pediatrics" (16.2%), "Obstetrics and gynecology" (3.8%) and "Hygiene" (3.4%). With consideration for recognition of health promotion and optimization of health care of children population as priority directions of public health policy amount of research studies in this field is to be admitted as inadequate. With purpose of optimization of scientific knowledge and development of system of medical social care to children population it is needed to promote research studies of problems of

  7. [Risk for health in population of Krasnoyarsk territory conditioned by food products contaminated by heavy metals].

    PubMed

    Vasilovskiĭ, A M

    2009-01-01

    Monitoring of nutrition structure in Krasnoyarsk territory population showed that the consumption rate of major food products is not stable and changes from year. The current situation provokes worsening of population health and growth diseases.

  8. Histopathology of Growth Anomaly Affecting the Coral, Montipora capitata: Implications on Biological Functions and Population Viability

    PubMed Central

    Burns, John H. R.; Takabayashi, Misaki

    2011-01-01

    Growth anomalies (GAs) affect the coral, Montipora capitata, at Wai'ōpae, southeast Hawai'i Island. Our histopathological analysis of this disease revealed that the GA tissue undergoes changes which compromise anatomical machinery for biological functions such as defense, feeding, digestion, and reproduction. GA tissue exhibited significant reductions in density of ova (66.1–93.7%), symbiotic dinoflagellates (38.8–67.5%), mesenterial filaments (11.2–29.0%), and nematocytes (28.8–46.0%). Hyperplasia of the basal body wall but no abnormal levels of necrosis and algal or fungal invasion was found in GA tissue. Skeletal density along the basal body wall was significantly reduced in GAs compared to healthy or unaffected sections. The reductions in density of the above histological features in GA tissue were collated with disease severity data to quantify the impact of this disease at the colony and population level. Resulting calculations showed this disease reduces the fecundity of M. capitata colonies at Wai'ōpae by 0.7–49.6%, depending on GA severity, and the overall population fecundity by 2.41±0.29%. In sum, GA in this M. capitata population reduces the coral's critical biological functions and increases susceptibility to erosion, clearly defining itself as a disease and an ecological threat. PMID:22205976

  9. Local divergence of thermal reaction norms among amphibian populations is affected by pond temperature variation.

    PubMed

    Richter-Boix, Alex; Katzenberger, Marco; Duarte, Helder; Quintela, María; Tejedo, Miguel; Laurila, Anssi

    2015-08-01

    Although temperature variation is known to cause large-scale adaptive divergence, its potential role as a selective factor over microgeographic scales is less well-understood. Here, we investigated how variation in breeding pond temperature affects divergence in multiple physiological (thermal performance curve and critical thermal maximum [CTmax]) and life-history (thermal developmental reaction norms) traits in a network of Rana arvalis populations. The results supported adaptive responses to face two main constraints limiting the evolution of thermal adaptation. First, we found support for the faster-slower model, indicating an adaptive response to compensate for the thermodynamic constraint of low temperatures in colder environments. Second, we found evidence for the generalist-specialist trade-off with populations from colder and less thermally variable environments exhibiting a specialist phenotype performing at higher rates but over a narrower range of temperatures. By contrast, the local optimal temperature for locomotor performance and CTmax did not match either mean or maximum pond temperatures. These results highlight the complexity of the adaptive multiple-trait thermal responses in natural populations, and the role of local thermal variation as a selective force driving diversity in life-history and physiological traits in the presence of gene flow.

  10. The Saskatchewan rural health study: an application of a population health framework to understand respiratory health outcomes

    PubMed Central

    2012-01-01

    Background Respiratory disease can impose a significant burden on the health of rural populations. The Saskatchewan Rural Health Study (SRHS) is a new large prospective cohort study of ages 6 and over currently being conducted in farming and non-farming communities to evaluate potential health determinants associated with respiratory outcomes in rural populations. In this article, we describe the rationale and methodology for the adult component. The study is being conducted over 5 years (2009–15) in two phases, baseline and longitudinal. The baseline survey consists of two components, adults and children. The adult component consists of a questionnaire-based evaluation of individual and contextual factors of importance to respiratory health in two sub populations (a Farm Cohort and a Small Town Cohort) of rural families in Saskatchewan Rural Municipalities (RMs). Clinical studies of lung function and allergy tests are being conducted on selected sub-samples of the two cohorts based on the positive response to the last question on the baseline questionnaire: “Would you be willing to be contacted about having breathing and/or allergy tests at a nearby location?”. We adopted existing population health theory to evaluate individual factors, contextual factors, and principal covariates on the outcomes of chronic bronchitis, chronic obstructive pulmonary disease, asthma and obstructive sleep apnea. Findings Of the RMs selected to participate, 32 (89%) out of 36 RMs and 15 (94%) out of 16 small towns within the RMs agreed to participate. Using the mail out survey method developed by Dillman, we obtained completed questionnaires from 4264 households (8261 individuals). We obtained lung function measurements on 1609 adults, allergy skin test information on 1615 adults; both measurements were available on 1549 adults. We observed differences between farm and non-farm rural residents with respect to individual, contextual factors and covariates. Discussion There are

  11. Creating health connections for vulnerable working populations: Goodwill North Central Wisconsin's Circles of Good Care Model.

    PubMed

    Weiss, Marjorie D

    2011-12-01

    Worker health is influenced by workplace, work processes, and workmates. This case study shows it is possible to create health connections for vulnerable working populations through health and wellness coaching. The health and safety of team members has been improved by providing on-site health coaching linked to mental and emotional well-being, as well as financial security. By leveraging the collective efficacy of the workplace, more vulnerable populations can become better health care consumers, with increased self-efficacy in promoting their own health and wellness and that of their families.

  12. Longitudinal population-based studies of affective disorders: Where to from here?

    PubMed Central

    Beard, John R; Galea, Sandro; Vlahov, David

    2008-01-01

    Background Longitudinal, population-based, research is important if we are to better characterize the lifetime patterns and determinants of affective disorders. While studies of this type are becoming increasingly prevalent, there has been little discussion about the limitations of the methods commonly used. Methods Discussion paper including a brief review of key prospective population-based studies as the basis for a critical appraisal of current approaches. Results We identified a number of common methodological weaknesses that restrict the potential of longitudinal research to characterize the diversity, prognosis, and determinants of affective disorders over time. Most studies using comprehensive diagnostic instruments have either been of relatively brief duration, or have suffered from long periods between waves. Most etiologic research has focused on first onset diagnoses, although these may be relatively uncommon after early adulthood and the burden of mental disorders falls more heavily on individuals with recurring disorders. Analysis has tended to be based on changes in diagnostic status rather than anges in symptom levels, limiting study power. Diagnoses have generally been treated as homogeneous entities and few studies have explored whether diagnostic subtypes such as atypical depression vary in their etiology or prognosis. Little research has considered whether there are distinct trajectories of symptoms over time and most has focused on individual disorders such as depression, rather than considering the relationship over time between symptoms of different affective disorders. There has also been limited longitudinal research on factors in the physical or social environment that may influence the onset, recurrence or chronicity of symptoms. Conclusion Many important, and in some respects quite basic, questions remain about the trajectory of depression and anxiety disorders over the life course and the factors that influence their incidence

  13. Assessing future expectations and the two-dimensional model of affect in an Italian population.

    PubMed

    Corno, Giulia; Molinari, Guadalupe; Baños, Rosa Maria

    2017-03-01

    Future-directed thinking has been described as part of two underlying systems that integrate dimensions of affect, motivational systems, orientation to the future, and future expectations, which are initiated at the cognitive, affective, biological, behavioral, and motivational levels. The main aim of the present study is to test the two underlying frameworks model and explore future expectations in a general Italian-speaking population (N=345). Therefore, the second aim of the present paper is to confirm the factorial structure of the Subjective Probability Task (SPT; MacLeod et al., 1996), a questionnaire designed to assess specific positive and negative orientations towards the future. Results showed that the SPT has good psychometric properties and it is a reliable instrument to assess future-directed thinking. Moreover, our findings confirmed the role of future expectancies as cognitive correlates of depression and anxiety. Differently from previous studies (Clark and Watson, 1991; MacLeod et al., 1996), our results did not confirm that depression was characterized by low positive affect. We believe this paper contributes to the understanding of future expectancies and their relation with anxiety and depression, and will help to expand the availability of an instrument to assess future directed thinking.

  14. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations

    PubMed Central

    Gallagher, Jason M.; Rauri, Sachin; Tillema, Juliana O.; Pronk, Nicolaas P.; Knudson, Susan M.

    2016-01-01

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public’s Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public’s Health: Investing in a Healthier Future, For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public’s Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement. PMID:27390075

  15. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations.

    PubMed

    Kottke, Thomas E; Gallagher, Jason M; Rauri, Sachin; Tillema, Juliana O; Pronk, Nicolaas P; Knudson, Susan M

    2016-07-07

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public's Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public's Health: Investing in a Healthier Future, For the Public's Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public's Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement.

  16. Adherence to antiretroviral therapy and treatment outcomes among conflict-affected and forcibly displaced populations: a systematic review

    PubMed Central

    2012-01-01

    Background Optimal adherence to highly active antiretroviral therapy (HAART) is required to promote viral suppression and to prevent disease progression and mortality. Forcibly displaced and conflict-affected populations may face challenges succeeding on HAART. We performed a systematic review of the literature on adherence to HAART and treatment outcomes in these groups, including refugees and internally-displaced persons (IDPs), assessed the quality of the evidence and suggest a future research program. Methods Medline, Embase, and Global Health databases for 1995–2011 were searched using the Ovid platform. A backward citation review of subsequent work that had cited the Ovid results was performed using the Web of Science database. ReliefWeb and Médecins Sans Frontières (MSF) websites were searched for additional grey literature. Results and conclusion We screened 297 records and identified 17 reports covering 15 quantitative and two qualitative studies from 13 countries. Three-quarters (11/15) of the quantitative studies were retrospective studies based on chart review; five studies included <100 clients. Adherence or treatment outcomes were reported in resettled refugees, conflict-affected persons, internally-displaced persons (IDPs), and combinations of refugees, IDPs and other foreign-born persons. The reviewed reports showed promise for conflict-affected and forcibly-displaced populations; the range of optimal adherence prevalence reported was 87–99.5%. Treatment outcomes, measured using virological, immunological and mortality estimates, were good in relation to non-affected groups. Given the diversity of settings where forcibly-displaced and conflict-affected persons access ART, further studies on adherence and treatment outcomes are needed to support scale-up and provide evidence-based justifications for inclusion of these vulnerable groups in national treatment plans. Future studies and program evaluations should focus on systematic monitoring of

  17. Have historical climate changes affected Gentoo penguin (Pygoscelis papua) populations in Antarctica?

    PubMed

    Peña M, Fabiola; Poulin, Elie; Dantas, Gisele P M; González-Acuña, Daniel; Petry, Maria Virginia; Vianna, Juliana A

    2014-01-01

    The West Antarctic Peninsula (WAP) has been suffering an increase in its atmospheric temperature during the last 50 years, mainly associated with global warming. This increment of temperature trend associated with changes in sea-ice dynamics has an impact on organisms, affecting their phenology, physiology and distribution range. For instance, rapid demographic changes in Pygoscelis penguins have been reported over the last 50 years in WAP, resulting in population expansion of sub-Antarctic Gentoo penguin (P. papua) and retreat of Antarctic Adelie penguin (P. adeliae). Current global warming has been mainly associated with human activities; however these climate trends are framed in a historical context of climate changes, particularly during the Pleistocene, characterized by an alternation between glacial and interglacial periods. During the last maximal glacial (LGM∼21,000 BP) the ice sheet cover reached its maximum extension on the West Antarctic Peninsula (WAP), causing local extinction of Antarctic taxa, migration to lower latitudes and/or survival in glacial refugia. We studied the HRVI of mtDNA and the nuclear intron βfibint7 of 150 individuals of the WAP to understand the demographic history and population structure of P. papua. We found high genetic diversity, reduced population genetic structure and a signature of population expansion estimated around 13,000 BP, much before the first paleocolony fossil records (∼1,100 BP). Our results suggest that the species may have survived in peri-Antarctic refugia such as South Georgia and North Sandwich islands and recolonized the Antarctic Peninsula and South Shetland Islands after the ice sheet retreat.

  18. Health Education Research and Practice Literature on Hispanic Health Issues: Have We Lost Sight of the Largest Minority Population?

    PubMed

    Price, James H; Khubchandani, Jagdish

    2016-03-01

    Hispanics constitute the largest racial/ethnic minority population in the United States and are the fastest growing segment of the population. Knowledge about health needs and practices, effective health promotion programs, and health policy making for Hispanics has the potential to improve population health outcomes for this group. Continued research and practice literature will aid in accomplishing these objectives. However, little is known about the extent of health education-related literature available on Hispanic health issues. In this review, we analyzed research and practice publications in all health education-related journals to assess the volume of articles published on Hispanic health issues. We found that the portion of journal articles devoted to Hispanic health issues varied widely among the journals and that there was a very limited emphasis on Hispanic health-related issues. Journal editors and editorial board members may need to be more proactive in soliciting manuscripts on Hispanic health, and our practitioners may have to improve their professional skills and cultural competence in order to work with Hispanic populations to produce research and practice literature that is of adequate quantity and quality to help improve Hispanics' health.

  19. Components of Population Vulnerability and Their Relationship With Climate-Sensitive Health Threats.

    PubMed

    English, P B; Richardson, M J

    2016-03-01

    Climate change is increasingly being framed as risks that will impact the poorest and most vulnerable communities among us. This has led to more efforts to estimate climate change risks across populations and in the context of human health and health equity. We describe the public health dimensions of climate vulnerability-exposure, population sensitivity, and adaptive capacity-and explore how these dimensions can modify population health impacts and their distribution. An overview of health disparities associated with specific climate risks is presented, and we offer potential solutions grounded in equitable urban development and improved characterization of climate vulnerabilities.

  20. The Impact of the Nurses’ Health Study on Population Health: Prevention, Translation, and Control

    PubMed Central

    Philpott, Sydney E.; Hankinson, Susan E.

    2016-01-01

    Objectives. To summarize the overall impact of the Nurses’ Health Study (NHS) over the past 40 years on the health of populations through its contributions on prevention, translation, and control. Methods. We performed a narrative review of the findings of the NHS, NHS II, and NHS3 between 1976 and 2016. Results. The NHS has generated significant findings about the associations between (1) smoking and type 2 diabetes, cardiovascular diseases, colorectal and pancreatic cancer, psoriasis, multiple sclerosis, and eye diseases; (2) physical activity and cardiovascular diseases, breast cancer, psoriasis, and neurodegeneration; (3) obesity and cardiovascular diseases, numerous cancer sites, psoriasis, multiple sclerosis, kidney stones, and eye diseases; (4) oral contraceptives and cardiovascular disease, melanoma, and breast, colorectal, and ovarian cancer; (5) hormone therapy and cardiovascular diseases, breast and endometrial cancer, and neurodegeneration; (6) endogenous hormones and breast cancer; (7) dietary factors and type 2 diabetes, cardiovascular diseases, breast and pancreatic cancer, non-Hodgkin’s lymphoma, neurodegeneration, multiple sclerosis, kidney stones, and eye diseases; and (8) sleep and shift work and chronic diseases. Conclusions. The NHS findings have influenced public health policy and practice both locally and globally to improve women’s health. PMID:27459441

  1. Access and Completion of a Web-Based Treatment in a Population-Based Sample of Tornado-Affected Adolescents

    PubMed Central

    Price, Matthew; Yuen, Erica; Davidson, Tatiana M.; Hubel, Grace; Ruggiero, Kenneth J.

    2015-01-01

    Although web-based treatments have significant potential to assess and treat difficult to reach populations, such as trauma-exposed adolescents, the extent that such treatments are accessed and used is unclear. The present study evaluated the proportion of adolescents who accessed and completed a web-based treatment for post-disaster mental health symptoms. Correlates of access and completion were examined. A sample of 2,000 adolescents living in tornado-affected communities was assessed via structured telephone interview and invited to a web-based treatment. The modular treatment addressed symptoms of PTSD, depression, and alcohol and tobacco use. Participants were randomized to experimental or control conditions after accessing the site. Overall access for the intervention was 35.8%. Module completion for those who accessed ranged from 52.8% to 85.6%. Adolescents with parents who used the Internet to obtain health-related information were more likely to access the treatment. Adolescent males were less likely to access the treatment. Future work is needed to identify strategies to further increase the reach of web-based treatments to provide clinical services in a post-disaster context. PMID:25622071

  2. Access and completion of a Web-based treatment in a population-based sample of tornado-affected adolescents.

    PubMed

    Price, Matthew; Yuen, Erica K; Davidson, Tatiana M; Hubel, Grace; Ruggiero, Kenneth J

    2015-08-01

    Although Web-based treatments have significant potential to assess and treat difficult-to-reach populations, such as trauma-exposed adolescents, the extent that such treatments are accessed and used is unclear. The present study evaluated the proportion of adolescents who accessed and completed a Web-based treatment for postdisaster mental health symptoms. Correlates of access and completion were examined. A sample of 2,000 adolescents living in tornado-affected communities was assessed via structured telephone interview and invited to a Web-based treatment. The modular treatment addressed symptoms of posttraumatic stress disorder, depression, and alcohol and tobacco use. Participants were randomized to experimental or control conditions after accessing the site. Overall access for the intervention was 35.8%. Module completion for those who accessed ranged from 52.8% to 85.6%. Adolescents with parents who used the Internet to obtain health-related information were more likely to access the treatment. Adolescent males were less likely to access the treatment. Future work is needed to identify strategies to further increase the reach of Web-based treatments to provide clinical services in a postdisaster context.

  3. The Effect of Acute Exercise on Affect and Arousal in Inpatient Mental Health Consumers.

    PubMed

    Stanton, Robert; Reaburn, Peter; Happell, Brenda

    2016-09-01

    Acute exercise performed at a self-selected intensity improves affect and may improve long-term adherence. Similarly, in people with severe depression, acute aerobic exercise performed at self-selected intensity improves affect and arousal. However, the relationship between changes in affect and arousal and perceived exercise intensity in people with mental illness has not been evaluated. Affect and arousal were assessed immediately prior to, and immediately following, a group exercise program performed at a self-selected intensity in 40 inpatient mental health consumers who received a diagnosis of anxiety or bipolar or depressive disorders. Exercise intensity was assessed immediately after exercise. Postexercise affect was significantly improved for people with bipolar and depressive disorders but not for people with anxiety disorders. For the group as a whole, results showed a significant curvilinear relationship between ratings of perceived exertion and postexercise affect. These data will inform the development and delivery of future exercise interventions for inpatient mental health consumers.

  4. Creating incentives to move upstream: developing a diversified portfolio of population health measures within payment and health care reform.

    PubMed

    Auerbach, John

    2015-03-01

    I examined the feasibility of developing a balanced portfolio of population health measures that would be useful within the current deliberations about health care and payment reform. My commentary acknowledges that an obstacle to the selection of population health metrics is the differing definitions of population health. Rather than choosing between these definitions, I identified five categories of indicators, ranging from traditional clinical care prevention interventions to those that measure investment in community-level nonclinical services, that in various combinations might yield the most promising results. I offer concrete examples of markers in each of the categories and show that there is a growing number of individuals eager to receive concrete recommendations and implement population health pilot programs.

  5. Creating Incentives to Move Upstream: Developing a Diversified Portfolio of Population Health Measures Within Payment and Health Care Reform

    PubMed Central

    2015-01-01

    I examined the feasibility of developing a balanced portfolio of population health measures that would be useful within the current deliberations about health care and payment reform. My commentary acknowledges that an obstacle to the selection of population health metrics is the differing definitions of population health. Rather than choosing between these definitions, I identified five categories of indicators, ranging from traditional clinical care prevention interventions to those that measure investment in community-level nonclinical services, that in various combinations might yield the most promising results. I offer concrete examples of markers in each of the categories and show that there is a growing number of individuals eager to receive concrete recommendations and implement population health pilot programs. PMID:25602896

  6. Integrating collaborative population health projects into a medical student curriculum at Stanford.

    PubMed

    Chamberlain, Lisa J; Wang, N Ewen; Ho, Evelyn T; Banchoff, Ann W; Braddock, Clarence H; Gesundheit, Neil

    2008-04-01

    The authors describe the population health curriculum at the Stanford University School of Medicine from 2003 to 2007 that includes a requirement for first-year medical students to engage in community-based population health projects. The new curriculum in population health comprises classroom and experiential teaching methods. Population health projects, a key component of the curriculum, are described and classified by topic and topic area (e.g., health education; health services) and the intended outcome of the intervention (e.g., establishing new policies; advocacy). During the past four years, 344 students have entered the curriculum and have participated in 68 population health projects. The projects were determined both by students' interests and community needs, and they represented diverse topics: 51% of the 68 projects addressed topics in the area of disease prevention and health promotion; 28% addressed health care access; 15% addressed health services; 4% addressed emergency preparedness; and 1% addressed ethical issues in health. Each project had one of three targets for intervention: community capacity building, establishing policies and engaging in advocacy, and bringing about change or improvement in an aspect of the health care system. Projects represented diverse stages in the evolution of a community-campus partnership, from needs assessment to planning, implementation, and evaluation of project outcomes. Experience to date shows that classroom-based sessions and experiential learning in the area of population health can be successfully integrated in a medical school curriculum. When contextualized in a population health curriculum, population health projects can provide future physicians with an experiential counterpart to their classroom learning.

  7. Climate change affects key nitrogen-fixing bacterial populations on coral reefs.

    PubMed

    Santos, Henrique F; Carmo, Flávia L; Duarte, Gustavo; Dini-Andreote, Francisco; Castro, Clovis B; Rosado, Alexandre S; van Elsas, Jan Dirk; Peixoto, Raquel S

    2014-11-01

    Coral reefs are at serious risk due to events associated with global climate change. Elevated ocean temperatures have unpredictable consequences for the ocean's biogeochemical cycles. The nitrogen cycle is driven by complex microbial transformations, including nitrogen fixation. This study investigated the effects of increased seawater temperature on bacteria able to fix nitrogen (diazotrophs) that live in association with the mussid coral Mussismilia harttii. Consistent increases in diazotroph abundances and diversities were found at increased temperatures. Moreover, gradual shifts in the dominance of particular diazotroph populations occurred as temperature increased, indicating a potential future scenario of climate change. The temperature-sensitive diazotrophs may provide useful bioindicators of the effects of thermal stress on coral reef health, allowing the impact of thermal anomalies to be monitored. In addition, our findings support the development of research on different strategies to improve the fitness of corals during events of thermal stress, such as augmentation with specific diazotrophs.

  8. Climate change affects key nitrogen-fixing bacterial populations on coral reefs

    PubMed Central

    Santos, Henrique F; Carmo, Flávia L; Duarte, Gustavo; Dini-Andreote, Francisco; Castro, Clovis B; Rosado, Alexandre S; van Elsas, Jan Dirk; Peixoto, Raquel S

    2014-01-01

    Coral reefs are at serious risk due to events associated with global climate change. Elevated ocean temperatures have unpredictable consequences for the ocean's biogeochemical cycles. The nitrogen cycle is driven by complex microbial transformations, including nitrogen fixation. This study investigated the effects of increased seawater temperature on bacteria able to fix nitrogen (diazotrophs) that live in association with the mussid coral Mussismilia harttii. Consistent increases in diazotroph abundances and diversities were found at increased temperatures. Moreover, gradual shifts in the dominance of particular diazotroph populations occurred as temperature increased, indicating a potential future scenario of climate change. The temperature-sensitive diazotrophs may provide useful bioindicators of the effects of thermal stress on coral reef health, allowing the impact of thermal anomalies to be monitored. In addition, our findings support the development of research on different strategies to improve the fitness of corals during events of thermal stress, such as augmentation with specific diazotrophs. PMID:24830827

  9. The protective function of personal growth initiative among a genocide-affected population in Rwanda.

    PubMed

    Blackie, Laura E R; Jayawickreme, Eranda; Forgeard, Marie J C; Jayawickreme, Nuwan

    2015-07-01

    The aim of the current study was to investigate the extent to which individual differences in personal growth initiative (PGI) were associated with lower reports of functional impairment of daily activities among a genocide-affected population in Rwanda. PGI measures an individual's motivation to develop as a person and the extent to which he or she is active in setting goals that work toward achieving self-improvement. We found that PGI was negatively associated with functional impairment when controlling for depression, posttraumatic stress disorder, and other demographic factors. Our results suggest that PGI may constitute an important mindset for facilitating adaptive functioning in the aftermath of adversity and in the midst of psychological distress, and as such they might have practical applications for the development of intervention programs.

  10. Health and Illness in a Connected World: How Might Sharing Experiences on the Internet Affect People's Health?

    PubMed Central

    Ziebland, Sue; Wyke, Sally

    2012-01-01

    Context The use of the Internet for peer-to-peer connection has been one of its most dramatic and transformational features. Yet this is a new field with no agreement on a theoretical and methodological basis. The scientific base underpinning this activity needs strengthening, especially given the explosion of web resources that feature experiences posted by patients themselves. This review informs a National Institute for Health Research (NIHR) (UK) research program on the impact of online patients’ accounts of their experiences with health and health care, which includes the development and validation of a new e-health impact questionnaire. Methods We drew on realist review methods to conduct a conceptual review of literature in the social and health sciences. We developed a matrix to summarize the results, which we then distilled from a wide and diverse reading of the literature. We continued reading until we reached data saturation and then further refined the results after testing them with expert colleagues and a public user panel. Findings We identified seven domains through which online patients’ experiences could affect health. Each has the potential for positive and negative impacts. Five of the identified domains (finding information, feeling supported, maintaining relationships with others, affecting behavior, and experiencing health services) are relatively well rehearsed, while two (learning to tell the story and visualizing disease) are less acknowledged but important features of online resources. Conclusions The value of first-person accounts, the appeal and memorability of stories, and the need to make contact with peers all strongly suggest that reading and hearing others’ accounts of their own experiences of health and illnesss will remain a key feature of e-health. The act of participating in the creation of health information (e.g., through blogging and contributing to social networking on health topics) also influences patients

  11. Importance of Health and Social Care Research into Gender and Sexual Minority Populations in Nepal.

    PubMed

    Regmi, Pramod R; van Teijlingen, Edwin

    2015-11-01

    Despite progressive legislative developments and increased visibility of sexual and gender minority populations in the general population, mass media often report that this population face a wide range of discrimination and inequalities. LGBT (lesbian, gay, and bisexual, and transgender) populations have not been considered as priority research populations in Nepal. Research in other geographical settings has shown an increased risk of poor mental health, violence, and suicide and higher rates of smoking, as well as alcohol and drugs use among LGBT populations. They are also risk for lifestyle-related illness such as cancer, diabetes, and heart diseases. Currently, in Nepal, there is a lack of understanding of health and well-being, social exclusion, stigma, and discrimination as experienced by these populations. Good-quality public health research can help design and implement targeted interventions to the sexual and gender minority populations of Nepal.

  12. The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations

    PubMed Central

    Chan, Lenny L. S.; Fouts, Michelle M.; Murphy, Elizabeth J.

    2017-01-01

    Widespread electronic health record (EHR) implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1) the adoption of RxNorm; (2) standardized naming and picklist options for high alert medications such as insulin; (3) the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4) enhanced bidirectional communication with pharmacy partners; and (5) informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations. PMID:28197420

  13. Exploring health professionals' perspectives on factors affecting Iranian hospital efficiency and suggestions for improvement.

    PubMed

    Afzali, Hossein Haji Ali; Moss, John R; Mahmood, Mohammad Afzal

    2011-01-01

    While numerous studies have been undertaken in many developed countries and in a few developing countries, there has so far been no systematic attempt to identify factors affecting efficiency in the Iranian hospitals. This study was designed to elicit the perspectives of a group of health professionals and managers so as to analyse factors affecting the efficiency of hospitals owned by the Iranian Social Security Organization (SSO), which is the second largest institutional source of hospital care in that country. This study also aimed to identify actions that would improve efficiency. Using purposive sampling (to identify key informants), interviews with seventeen health professionals and hospital managers involved in the SSO health system were conducted. The respondents identified a number of organizational factors affecting efficiency, particularly the hospital budgeting and payment system used to fund physicians, and the lack of the managerial skills needed to manage complex facilities such as hospitals. The interviewees stressed the necessity for reforms of the regulatory framework to improve efficiency. A few participants recommended the concept of a funder-provider split. The results of this exploratory study have provided meaningful insight into Iranian health professionals views of factors affecting efficiency, and of possible remedial actions. It is expected that the findings will provide guidance for health policy makers and hospital managers in the Iranian SSO to analyse factors affecting efficiency and to identify remedial actions to improve efficiency. Hospitals in other developing countries may be affected by similar factors.

  14. How do demographic transitions and public health policies affect patients with Parkinson’s disease in Brazil?

    PubMed Central

    Bovolenta, Tânia M; Felicio, Andre C

    2017-01-01

    Brazil is currently experiencing a significant demographic transition characterized by a decrease in fertility rates and an exponential increase in the number of elderly citizens, which presents a special challenge for the health care professionals. More than other portions of the population, the elderly are most commonly affected by chronic diseases such as Parkinson’s disease. Policymakers contend that Brazil is reasonably well-prepared regarding elderly health care, with policies that aim to ensure the quality of life and the well-being of this portion of the population. However, what happens in practice falls short of what the Brazilian Constitution sets forth. Specifically, there is a clear contradiction between what the law recognizes as being a citizen’s rights and the implementation of guidelines. Because health financing in Brazil remains relatively low, the civil society tries to fill in the gaps as much as possible in the treatment of elderly patients suffering from chronic diseases such as Parkinson’s disease. In this review, we outline the current legislation in Brazil regarding the elderly and in particular, patients with Parkinson’s disease, in the context of a rapidly aging population. PMID:28182156

  15. Does childhood cancer affect parental divorce rates? A population-based study.

    PubMed

    Syse, Astri; Loge, Jon H; Lyngstad, Torkild H

    2010-02-10

    PURPOSE Cancer in children may profoundly affect parents' personal relationships in terms of psychological stress and an increased care burden. This could hypothetically elevate divorce rates. Few studies on divorce occurrence exist, so the effect of childhood cancers on parental divorce rates was explored. PATIENTS AND METHODS Data on the entire Norwegian married population, age 17 to 69 years, with children age 0 to 20 years in 1974 to 2001 (N = 977,928 couples) were retrieved from the Cancer Registry, the Central Population Register, the Directorate of Taxes, and population censuses. Divorce rates for 4,590 couples who were parenting a child with cancer were compared with those of otherwise similar couples by discrete-time hazard regression models. Results Cancer in a child was not associated with an increased risk of parental divorce overall. An increased divorce rate was observed with Wilms tumor (odds ratio [OR], 1.52) but not with any of the other common childhood cancers. The child's age at diagnosis, time elapsed from diagnosis, and death from cancer did not influence divorce rates significantly. Increased divorce rates were observed for couples in whom the mothers had an education greater than high school level (OR, 1.16); the risk was particularly high shortly after diagnosis, for CNS cancers and Wilms tumors, for couples with children 0 to 9 years of age at diagnosis, and after a child's death. CONCLUSION This large, registry-based study shows that cancer in children is not associated with an increased parental divorce rate, except with Wilms tumors. Couples in whom the wife is highly educated appear to face increased divorce rates after a child's cancer, and this may warrant additional study.

  16. Historically black medical schools: addressing the minority health professional pipeline and the public mission of care for vulnerable populations.

    PubMed

    Norris, Keith C; Baker, Richard S; Taylor, Robert; Montgomery-Rice, Valerie; Higginbotham, Eve J; Riley, Wayne J; Maupin, John; Drew-Ivie, Sylvia; Reede, Joan Y; Gibbons, Gary

    2009-09-01

    Substantial changes in not only access to care, cost, and quality of care, but also health professions education are needed to ensure effective national healthcare reform. Since the actionable determinants of health such as personal beliefs and behaviors, socioeconomic factors, and the environment disproportionately affect the poor (and often racial/ethnic minorities), many have suggested that focusing efforts on this population will both directly and indirectly improve the overall health of the nation. Key to the success of such strategies are the ongoing efforts by historically black medical schools (HBMSs) as well as other minority serving medical and health professional schools, who produce a disproportionate percentage of the high-quality and diverse health professionals that are dedicated to maintaining the health of an increasingly diverse nation. Despite their public mission, HBMSs receive limited public support threatening their ability to not only meet the increasing minority health workforce needs but to even sustain their existing contributions. Substantial changes in health education policy and funding are needed to ensure HBMSs as well as other minority-serving medical and health professional schools can continue to produce the diverse, high-quality health professional workforce necessary to maintain the health of an increasingly diverse nation. We explore several model initiatives including focused partnerships with legislative and business leaders that are urgently needed to ensure the ability of HBMSs to maintain their legacy of providing compassionate, quality care to the communities in greatest need.

  17. Public health impact of dietary phosphorus excess on bone and cardiovascular health in the general population.

    PubMed

    Calvo, Mona S; Uribarri, Jaime

    2013-07-01

    This review explores the potential adverse impact of the increasing phosphorus content in the American diet on renal, cardiovascular, and bone health of the general population. Increasingly, studies show that phosphorus intakes in excess of the nutrient needs of a healthy population may significantly disrupt the hormonal regulation of phosphate, calcium, and vitamin D, which contributes to disordered mineral metabolism, vascular calcification, impaired kidney function, and bone loss. Moreover, large epidemiologic studies suggest that mild elevations of serum phosphate within the normal range are associated with cardiovascular disease (CVD) risk in healthy populations without evidence of kidney disease. However, few studies linked high dietary phosphorus intake to mild changes in serum phosphate because of the nature of the study design and inaccuracies in the nutrient composition databases. Although phosphorus is an essential nutrient, in excess it could be linked to tissue damage by a variety of mechanisms involved in the endocrine regulation of extracellular phosphate, specifically the secretion and action of fibroblast growth factor 23 and parathyroid hormone. Disordered regulation of these hormones by high dietary phosphorus may be key factors contributing to renal failure, CVD, and osteoporosis. Although systematically underestimated in national surveys, phosphorus intake seemingly continues to increase as a result of the growing consumption of highly processed foods, especially restaurant meals, fast foods, and convenience foods. The increased cumulative use of ingredients containing phosphorus in food processing merits further study given what is now being shown about the potential toxicity of phosphorus intake when it exceeds nutrient needs.

  18. Intra Amniotic Administration of Raffinose and Stachyose Affects the Intestinal Brush Border Functionality and Alters Gut Microflora Populations

    PubMed Central

    Pacifici, Sarina; Song, Jaehong; Zhang, Cathy; Wang, Qiaoye; Glahn, Raymond P.; Kolba, Nikolai; Tako, Elad

    2017-01-01

    This study investigates the effectiveness of two types of prebiotics—stachyose and raffinose—which are present in staple food crops that are widely consumed in regions where dietary Fe deficiency is a health concern. The hypothesis is that these prebiotics will improve Fe status, intestinal functionality, and increase health-promoting bacterial populations in vivo (Gallus gallus). By using the intra-amniotic administration procedure, prebiotic treatment solutions were injected in ovo (day 17 of embryonic incubation) with varying concentrations of a 1.0 mL pure raffinose or stachyose in 18 MΩ H2O. Four treatment groups (50, 100 mg·mL−1 raffinose or stachyose) and two controls (18 MΩ H2O and non-injected) were utilized. At hatch the cecum, small intestine, liver, and blood were collected for assessment of the relative abundance of the gut microflora, relative expression of Fe-related genes and brush border membrane functional genes, hepatic ferritin levels, and hemoglobin levels, respectively. The prebiotic treatments increased the relative expression of brush border membrane functionality proteins (p < 0.05), decreased the relative expression of Fe-related proteins (p < 0.05), and increased villus surface area. Raffinose and stachyose increased the relative abundance of probiotics (p < 0.05), and decreased that of pathogenic bacteria. Raffinose and stachyose beneficially affected the gut microflora, Fe bioavailability, and brush border membrane functionality. Our investigations have led to a greater understanding of these prebiotics’ effects on intestinal health and mineral metabolism. PMID:28335485

  19. A systematic review of population health interventions and Scheduled Tribes in India

    PubMed Central

    2010-01-01

    Background Despite India's recent economic growth, health and human development indicators of Scheduled Tribes (ST) or Adivasi (India's indigenous populations) lag behind national averages. The aim of this review was to identify the public health interventions or components of these interventions that are effective in reducing morbidity or mortality rates and reducing risks of ill health among ST populations in India, in order to inform policy and to identify important research gaps. Methods We systematically searched and assessed peer-reviewed literature on evaluations or intervention studies of a population health intervention undertaken with an ST population or in a tribal area, with a population health outcome(s), and involving primary data collection. Results The evidence compiled in this review revealed three issues that promote effective public health interventions with STs: (1) to develop and implement interventions that are low-cost, give rapid results and can be easily administered, (2): a multi-pronged approach, and (3): involve ST populations in the intervention. Conclusion While there is a growing body of knowledge on the health needs of STs, there is a paucity of data on how we can address these needs. We provide suggestions on how to undertake future population health intervention research with ST populations and offer priority research avenues that will help to address our knowledge gap in this area. PMID:20659344

  20. Income Inequality and Health Status in the United States: Evidence from the Current Population Survey.

    ERIC Educational Resources Information Center

    Mellor, Jennifer M.; Milyo, Jeffrey

    2002-01-01

    Current Population Survey data on self-reported health status and income for the general population and those in poverty were analyzed. No consistent association was found between income inequality and individual health status. Previous findings of such an association were attributed to ecological fallacy or failure to control for individual…

  1. An information theory based framework for the measurement of population health.

    PubMed

    Nesson, Erik T; Robinson, Joshua J

    2015-04-01

    This paper proposes a new framework for the measurement of population health and the ranking of the health of different geographies. Since population health is a latent variable, studies which measure and rank the health of different geographies must aggregate observable health attributes into one summary measure. We show that the methods used in nearly all the literature to date implicitly assume that all attributes are infinitely substitutable. Our method, based on the measurement of multidimensional welfare and inequality, minimizes the entropic distance between the summary measure of population health and the distribution of the underlying attributes. This summary function coincides with the constant elasticity of substitution and Cobb-Douglas production functions and naturally allows different assumptions regarding attribute substitutability or complementarity. To compare methodologies, we examine a well-known ranking of the population health of U.S. states, America's Health Rankings. We find that states' rankings are somewhat sensitive to changes in the weight given to each attribute, but very sensitive to changes in aggregation methodology. Our results have broad implications for well-known health rankings such as the 2000 World Health Report, as well as other measurements of population and individual health levels and the measurement and decomposition of health inequality.

  2. Healthy nature healthy people: 'contact with nature' as an upstream health promotion intervention for populations.

    PubMed

    Maller, Cecily; Townsend, Mardie; Pryor, Anita; Brown, Peter; St Leger, Lawrence

    2006-03-01

    Whilst urban-dwelling individuals who seek out parks and gardens appear to intuitively understand the personal health and well-being benefits arising from 'contact with nature', public health strategies are yet to maximize the untapped resource nature provides, including the benefits of nature contact as an upstream health promotion intervention for populations. This paper presents a summary of empirical, theoretical and anecdotal evidence drawn from a literature review of the human health benefits of contact with nature. Initial findings indicate that nature plays a vital role in human health and well-being, and that parks and nature reserves play a significant role by providing access to nature for individuals. Implications suggest contact with nature may provide an effective population-wide strategy in prevention of mental ill health, with potential application for sub-populations, communities and individuals at higher risk of ill health. Recommendations include further investigation of 'contact with nature' in population health, and examination of the benefits of nature-based interventions. To maximize use of 'contact with nature' in the health promotion of populations, collaborative strategies between researchers and primary health, social services, urban planning and environmental management sectors are required. This approach offers not only an augmentation of existing health promotion and prevention activities, but provides the basis for a socio-ecological approach to public health that incorporates environmental sustainability.

  3. Mental health of carers of children affected by HIV attending community-based programmes in South Africa and Malawi

    PubMed Central

    Skeen, Sarah; Tomlinson, Mark; Macedo, Ana; Croome, Natasha; Sherr, Lorraine

    2015-01-01

    training and supervision of staff at CBOs for children affected by HIV, and the inclusion of CBOs in broader efforts to improve population mental health outcomes. PMID:24766642

  4. Strange but common bedfellows: the relationship between humanitarians and the military in developing psychosocial interventions for civilian populations affected by armed conflict.

    PubMed

    Kienzler, Hanna; Pedersen, Duncan

    2012-07-01

    This essay analyses how the relationships between Cold War and post-Cold War politics, military psychiatry, humanitarian aid and mental health interventions in war and post-war contexts have transformed over time. It focuses on the restrictions imposed on humanitarian interventions and aid during the Cold War; the politics leading to the transfer of the PTSD diagnosis and its treatment from the military to civilian populations; humanitarian intervention campaigns in the post-Cold War era; and the development of psychosocial intervention programs and standards of care for civilian populations affected by armed conflict. Viewing these developments in their broader historical, political and social contexts reveals the politics behind mental health interventions conducted in countries and populations affected by warfare. In such militarized contexts, the work of NGOs providing assistance to people suffering from trauma-related health problems is far from neutral as it depends on the support of the military and plays an important role in the shaping of international politics and humanitarian aid programs.

  5. Population health and the hardcore smoker: Geoffrey Rose revisited.

    PubMed

    Chaiton, Michael O; Cohen, Joanna E; Frank, John

    2008-09-01

    The "hardening hypothesis" suggests that as smoking prevalence decreases, lighter smokers will quit first, leaving more "hardcore" smokers in the population. At a population level, however, the weight of evidence suggests that no hardening is occurring. By understanding the lessons from Geoffrey Rose's model of population-level risk factor change, we argue that the hardening of the smoking population is not inevitable. The Rose model predicts that the effect of policy interventions, and changes in social norms, can shift the population-level risk distribution for continuing to be a smoker, making it more likely that all smokers will quit. This analysis also suggests that further reductions in smoking prevalence will not come without further changes in the underlying--and largely cultural--root causes of smoking in a population.

  6. Perfluorocarbons and Gilbert syndrome (phenotype) in the C8 Health Study Population

    SciTech Connect

    Fan, Hongmin; Ducatman, Alan; Zhang, Jianjun

    2014-11-15

    Background: Gilbert syndrome (GS) is an inherited defect of bilirubin conjugation, most commonly caused by a gene mutation for the enzyme UGT1A. GS is known to affect the metabolism and excretion of drugs and xenobiotics. Perfluorocarbon compounds (PFCs) are bio-persistent environmental contaminants that affect metabolic regulation. In this study, we examined the associations of GS phenotype and serum PFCs in the C8 Health Study Population. Materials and methods: Using 2005–2006 data from a large PFC-exposure population survey, we compared serum PFCs concentrations between GS and non GS clinical phenotypes, in a cross sectional design, adjusting for standard risk factors, including age, BMI, smoking status, socioeconomic status and gender. Results: Among 10 PFC compounds considered, only perfluorohexanoic acid (PFHxA) was seen at a significantly higher concentration in GS men and women. Conclusion: PFHxA exposure may be associated with GS. Our findings do not support increased exposure in GS for other PFCs. - Highlights: • Most serum PFCs are not associated with clinically evident Gilbert syndrome. • However, serum perfluorohexanoic acid is positively associated. • The investigation addresses the clinical presentation, not the genetic mutation.

  7. How Do Health Policies Affect My Health?: A Performance Task for High School

    ERIC Educational Resources Information Center

    Wycoff-Horn, Marcie R.; Caravella, Tracy J.

    2011-01-01

    It is well known that chronic diseases are the most common, costly, and preventable of all health issues in the United States. Chronic diseases continue to be a major health concern. Of the top 10 leading causes of mortality, 7 are identified as chronic. More recently, the prevalence of these chronic conditions has increased among the adolescent…

  8. Winter fawn survival in black-tailed deer populations affected by hair loss syndrome.

    PubMed

    Bender, Louis C; Hall, P Briggs

    2004-07-01

    Overwinter fawn mortality associated with hair loss syndrome (HLS) is anecdotally thought to be important in declines of Columbian black-tailed deer (Odocoileus hemionus columbianus) populations in Washington and Oregon (USA). We determined prevalence of HLS in black-tailed deer, September and April fawn:doe ratios, and minimum overwinter survival rates of fawns for selected game management units (GMUs) in western Washington from 1999 to 2001. Prevalence of HLS ranged from 6% to 74% in fawns and 4% to 33% in does. Minimum fawn survival ranged from 0.56 to 0.83 and was unrelated to prevalence of HLS in either does (r=0.005, P=0.991) or fawns (r=-0.215, P=0.608). The prevalence of HLS in either does or fawns was also unrelated to either fall fawn:doe ratios (HLS does: r=-0.132, P=0.779; HLS fawns: r=0.130, P=0.760) or spring fawn:doe ratios (HLS does: r=-0.173, P=0.711; HLS fawns: r=-0.020, P=0.963). However, the prevalence of HLS in does and fawns was strongly related (r=0.942, P=0.002), and GMUs with high prevalence of HLS had lower deer population densities (fawns: r=-0.752, P=0.031; does: r=-0.813, P=0.026). Increased overwinter mortality of fawns because of HLS was not supported by our data. Decreased production of fawns, increased summer mortality of fawns, or both were seen in six of eight study GMU-year combinations. Observed rates of productivity and minimum fawn survival were inadequate to maintain population size in five of eight study GMU-year combinations, assuming an annual doe survival rate of 0.75. The influence of deer condition and population health on adult survival, fawn production, preweaning fawn survival, parasitism, and prevalence of HLS in both fawns and adults need to be clarified to identify what factors are limiting black-tailed deer productivity.

  9. Socio-Economic and Health Status of Leprosy Affected Person: A Study in Jharkhand.

    PubMed

    Majumder, N

    2015-01-01

    The study has been conducted in the Potka Block of East Singhbhum district of the state of Jharkhand. The district is mainly dominated by indigenous tribes, such as, Santhal, Munda, Ho, Bhumiz, Kharia, and Sabar. The unit of analysis of the study was an individual. The objectives were to: a) Understand the socio-economic and health status of LAP, b) Know the health seeking behavior and problems faced by the LAP, c) Assess the utilization of the programs related to Leprosy eradication in the study area and d), Suggest various measures for improving the socio-economic and health status of LAP. Fifty Leprosy affected persons (LAP) from the Potka block; comprising of 20% of LAP of that area have been selected as the study sample by using the method of Multi-Stage Random Sampling, with equal representation of men and women. The LAPs included leprosy patients, leprosy treated people and their family members. 39/50 (78%) of the respondents are illiterates and only 3/11 (6%) among the literate population have crossed matriculation and above. This seems to have resulted in the respondent's low level of awareness about the disease, resulting in delayed treatment. 14/25 (56%) percent of female and 13/25 (52%) of male respondents are considered untouchable by their natal families, thus forced to stay in congested leprosy colonies resulting in other social and health related issues. It was observed that leprosy cured children,and also children of LAP are being denied admission iany school, due to the social stigma attached to it. 27/50 (54%)of leprosy patients and leprosy cured people (mostly with visible deformities) were found to practice begging as their sole means of livelihood. Many LAPs are also engaged in cultivation and small scale business particularly among the rural population. An amount of gender disparity was also observed in the employment pattern among the LAPs. Among the, respondents 15/25 (60%) of the females are beggars as compared to 12/25 (48%) of the male

  10. Right to sexual and reproductive health in new population policies of Iran.

    PubMed

    Kokabisaghi, Fatemeh

    2017-02-24

    Sexual and reproductive health services in Iran are influenced by population policies. Willingness of Iranian policy makers to control the population's growth rate resulted in the provision of countrywide family planning services and contraceptives from 1990 to 2013. Now policy makers favour population growth because of a statistically significant decline in the fertility rate and ageing of the population. New population policies contain incentives for higher fertility and limitations on family planning services. Some elements of these policies contradict standards of international human rights treaties including prohibition against retrogressive measures and limitations on sexual and reproductive health services. These policies may jeopardize individual and public health. Iran should immediately revoke these laws and policies and progressively improve people's enjoyment of their right to sexual and reproductive health. The country's population policies should focus on encouraging people to have higher fertility by providing financial and social support to parents and future children.

  11. Thomas McKeown, Meet Fidel Castro: Physicians, Population Health and the Cuban Paradox.

    PubMed

    Evans, Robert G

    2008-05-01

    About 40 years ago, Thomas McKeown demonstrated that the historic decline in the great killer diseases owed little or nothing to progress in medicine. A generation of research on population health followed, highlighting the large social gradients in health within populations. These vary greatly across societies, but appear largely unrelated to medical care. Medicine was acknowledged as "powerful, but within limits"; the major determinants of health lie elsewhere. We may have missed something. Cuba has achieved "first world" population health status despite a minimal economic base. Far from marginalizing medicine, Cuba has by far the world's largest physician workforce. But doctors' roles are significantly expanded. The system seems to work.

  12. Meeting the ONCHIT population health mandate: a proposed model for security in selective transportable distributed environments.

    PubMed

    Lorence, Daniel; Chin, John; Richards, Michael

    2010-08-01

    Goal Two of the US ONCHIT Plan focuses on enabling the use of electronic health information for critical health improvement activities that promote the health of targeted communities, and the US population as a whole. Because of the focus on communities and populations, the activities under this second goal differ fundamentally from those of the first goal, which focus on the care of individuals. Proposed here is a model for health information management in such population-based environments, which allows selective access and use of information, and maintains transportability while ensuring security and confidentiality.

  13. Historical and anthropogenic factors affecting the population genetic structure of Ontario's inland lake populations of Walleye (Sander vitreus).

    PubMed

    Walter, Ryan P; Cena, Christopher J; Morgan, George E; Heath, Daniel D

    2012-01-01

    Populations existing in formerly glaciated areas often display composite historical and contemporary patterns of genetic structure. For Canadian freshwater fishes, population genetic structure is largely reflective of dispersal from glacial refugia and isolation within drainage basins across a range of scales. Enhancement of sport fisheries via hatchery stocking programs and other means has the potential to alter signatures of natural evolutionary processes. Using 11 microsatellite loci genotyped from 2182 individuals, we analyzed the genetic structure of 46 inland lake walleye (Sander vitreus) populations spanning five major drainage basins within the province of Ontario, Canada. Population genetic analyses coupled with genotype assignment allowed us to: 1) characterize broad- and fine-scale genetic structure among Ontario walleye populations; and 2) determine if the observed population divergence is primarily due to natural or historical processes, or recent anthropogenic events. The partitioning of genetic variation revealed higher genetic divergence among lakes than among drainage basins or proposed ancestries-indicative of relatively high isolation among lakes, study-wide. Walleye genotypes were clustered into three major groups, likely reflective of Missourian, Mississippian, and Atlantic glacial refugial ancestry. Despite detectable genetic signatures indicative of anthropogenic influences, province-wide spatial genetic structure remains consistent with the hypothesis of dispersal from distinct glacial refugia and subsequent isolation of lakes within primary drainage basins. Our results provide a novel example of minimal impacts from fishery enhancement to the broad-scale genetic structure of inland fish populations.

  14. Affect and Self-Rated Health: A Dynamic Approach with Older Adults

    PubMed Central

    Segerstrom, Suzanne C.

    2015-01-01

    Objective Self-rated health (SRH) predicts mortality above and beyond objective health risks and as such comprises an important aspect of health. Established contributors to self-rated health include affect, age, and disease, but neither their dynamic nor their synergistic contributions to SRH have been comprehensively tested. Methods The present study employed older adults (N = 150; M age = 75 years) and a longitudinal design with 6-month waves over up to 5 years. Positive and negative affect (PA, NA), chronic disease, and SRH were assessed at each wave. Results In multilevel models with single predictors, older age, more chronic disease, and higher NA predicted worse SRH, whereas higher PA predicted better SRH. Affect predicted SRH both between and within people. In multilevel models with interactions between affect and age or disease, individual differences in NA predicted worse SRH primarily in older people. Within people, changes in NA were associated with changes in SRH, but more so in younger than in older people. Within people, changes in PA were associated with changes in SRH, but only when health was better than usual. Conclusions There were both dynamic and synergistic relationships between affect and SRH that could only emerge in a multilevel, multivariable design. In the case of NA, between-person, trait NA had the opposite relationship to SRH and age compared with within-person, state NA. Which component of this relationship predicts mortality is an important question for future research. PMID:23914813

  15. Population Health Measurement at Centers for Medicare & Medicaid Services: Bridging the Gap Between Public Health and Clinical Quality.

    PubMed

    Kassler, William J; Howerton, Mollie; Thompson, Alice; Cope, Elizabeth; Alley, Dawn E; Sanghavi, Darshak

    2016-10-05

    As Medicare and Medicaid increasingly shift to alternative payment models focused on population-based payments, there is an urgent need to develop measures of population health that can drive health improvement. In response, an assessment and design project established a framework for developing population health measures from a payer perspective, conducted environmental scans of existing measures and available data infrastructure, and conducted a gap analysis informing measure development and infrastructure needs. The work, summarized here, makes recommendations for creating a set of core measures, demonstrates some of the key challenges in applying a traditional quality measure development framework to population health, and complements recent efforts by the National Academy of Medicine and others with a focus on a payer perspective.

  16. [Effects of population aging on health care expenditure: myths and facts].

    PubMed

    Casado Marín, D

    2001-01-01

    Over the last 30 years, the elderly population of developed countries has shown an unprecedented increase. This process has raised alarm about the future affordability of health care systems. In this context, we consider the effects of population aging on health care expenditure within a process involving several elements: the increasing number of elderly persons, variations in the health status of the elderly and the evolution of the cost of medical treatment. The main conclusion is that only a small part of the increase in expenditure is due to population aging. Furthermore, because the average health status of the elderly has improved with greater longevity, we suggest that most of the increase in health care expenditure can be attributed to the evolution of non-demographic factors. Such as health services utilization, treatment cost and the development of new medical technology. Unlike populations aging, these factors can be subjected to future regulation and consequently, can to a large extent be controlled.

  17. Population health promotion 2.0: An eco-social approach to public health in the Anthropocene.

    PubMed

    Hancock, Trevor

    2015-07-08

    Humanity is both an animal species that evolved within and is dependent upon natural ecosystems and a social animal that exists within the social systems we have created. Our health is dependent upon both these systems - natural and social - functioning well, and indeed upon their interactions. Yet our approach to improving the health of the population over the past few decades has been largely, if not exclusively, focused on the social determinants of health. A recent Canadian Public Health Association (CPHA) Discussion Document and the technical report on which it is based seek to strike a more balanced approach. First, they document the dramatic and rapid global ecological changes that humans have created and argue that they are a significant threat to the health of the population in the 21st century. Second, they identify the underlying social, cultural and economic forces that are driving these changes. Third, they argue that we need to take an eco-social approach in population health promotion, recognizing the interactions between the ecological and social determinants of health. Such an approach could be considered to be 'Population health promotion 2.0', and it has profound implications for the practice of public health.

  18. Density but not climate affects the population growth rate of guanacos ( Lama guanicoe) (Artiodactyla, Camelidae)

    PubMed Central

    Zubillaga, María; Skewes, Oscar; Soto, Nicolás; Rabinovich, Jorge E

    2014-01-01

    We analyzed the effects of population density and climatic variables on the rate of population growth in the guanaco ( Lama guanicoe), a wild camelid species in South America. We used a time series of 36 years (1977-2012) of population sampling in Tierra del Fuego, Chile. Individuals were grouped in three age-classes: newborns, juveniles, and adults; for each year a female population transition matrix was constructed, and the population growth rate (λ) was estimated for each year as the matrix highest positive eigenvalue. We applied a regression analysis with finite population growth rate (λ) as dependent variable, and total guanaco population, sheep population, annual mean precipitation, and winter mean temperature as independent variables, with and without time lags. The effect of guanaco population size was statistically significant, but the effects of the sheep population and the climatic variables on guanaco population growth rate were not statistically significant. PMID:25187878

  19. Politics and population health: Testing the impact of electoral democracy.

    PubMed

    Patterson, Andrew C; Veenstra, Gerry

    2016-07-01

    This study addresses questions of whether and why electoral democracies have better health than other nations. After devising a replicable approach to missing data, we compare political, economic, and health-related data for 168 nations collected annually from 1960 through 2010. Regression models estimate that electoral democracies have 11 years of longer life expectancy on average and 62.5% lower rates of infant mortality. The association with life expectancy reduces markedly after controlling for GDP, while a combination of factors may explain the democratic advantage in infant health. Results suggest that income inequality associates independently with both health outcomes but does not mediate their associations with democracy.

  20. Age and Gender Affect the Composition of Fungal Population of the Human Gastrointestinal Tract

    PubMed Central

    Strati, Francesco; Di Paola, Monica; Stefanini, Irene; Albanese, Davide; Rizzetto, Lisa; Lionetti, Paolo; Calabrò, Antonio; Jousson, Olivier; Donati, Claudio; Cavalieri, Duccio; De Filippo, Carlotta

    2016-01-01

    The fungal component of the human gut microbiota has been neglected for long time due to the low relative abundance of fungi with respect to bacteria, and only recently few reports have explored its composition and dynamics in health or disease. The application of metagenomics methods to the full understanding of fungal communities is currently limited by the under representation of fungal DNA with respect to the bacterial one, as well as by the limited ability to discriminate passengers from colonizers. Here, we investigated the gut mycobiota of a cohort of healthy subjects in order to reduce the gap of knowledge concerning fungal intestinal communities in the healthy status further screening for phenotypical traits that could reflect fungi adaptation to the host. We studied the fecal fungal populations of 111 healthy subjects by means of cultivation on fungal selective media and by amplicon-based ITS1 metagenomics analysis on a subset of 57 individuals. We then characterized the isolated fungi for their tolerance to gastrointestinal (GI) tract-like challenges and their susceptibility to antifungals. A total of 34 different fungal species were isolated showing several phenotypic characteristics associated with intestinal environment such as tolerance to body temperature (37°C), to acidic and oxidative stress, and to bile salts exposure. We found a high frequency of azoles resistance in fungal isolates, with potential and significant clinical impact. Analyses of fungal communities revealed that the human gut mycobiota differs in function of individuals' life stage in a gender-related fashion. The combination of metagenomics and fungal cultivation allowed an in-depth understanding of the fungal intestinal community structure associated to the healthy status and the commensalism-related traits of isolated fungi. We further discussed comparatively the results of sequencing and cultivation to critically evaluate the application of metagenomics-based approaches to

  1. The use of tumors in wild populations of fish to assess ecosystem health

    USGS Publications Warehouse

    Baumann, Paul C.

    1992-01-01

    Evidence has linked toxicants in aquatic systems with cancer in fish and population level effects on species. Thus some types of tumors may be useful monitors of ecosystem health, at least as affected by genotoxins and promoters. However, tumors caused by purely genetic mechanisms or by virus would not be good indicators. Only neoplasms which have chemicals as a portion of their etiology (either as initiators or promoters) would be useful in assessing ecosystem health. Lesions which may fit these criteria include liver neoplasms (both biliary and hepatic) and skin lesions in a variety of primarily benthic fishes, and neural lesions in various drum species and in butterfly fish species. Two studies purporting to demonstrate a lack of tumors in fish from polluted areas have been reexamined and found either to have insufficient data on vulnerable species or to actually support a tumor-pollution linkage. Thus certain lesions in vulnerable species or species groups may serve as a mechanism to assess one facet of ecosystem health.

  2. Representation, Exemplification, and Risk: Resonance of Tobacco Graphic Health Warnings Across Diverse Populations.

    PubMed

    Bigman, Cabral A; Nagler, Rebekah H; Viswanath, K

    2016-08-01

    As countries implement Article 11 of the World Health Organization (WHO) Framework Convention on Tobacco Control, graphic warning labels that use images of people and their body parts to illustrate the consequences of smoking are being added to cigarette packs. According to exemplification theory, these case examples-exemplars-can shape perceptions about risk and may resonate differently among demographic subpopulations. Drawing on data from eight focus groups (N = 63) with smokers and nonsmokers from vulnerable populations, this qualitative study explores whether people considered exemplars in their reactions to and evaluations of U.S. graphic health warning labels initially proposed by the Food and Drug Administration. Participants made reference to prior and concurrent mass media messages and exemplars during the focus groups and used demographic cues in making sense of the images on the warning labels. Participants were particularly sensitive to age of the exemplars and how it might affect label effectiveness and beliefs about smoking. Race and socioeconomic status also were salient for some participants. We recommend that exemplars and exemplification be considered when selecting and evaluating graphic health warnings for tobacco labels and associated media campaigns.

  3. Seasonal variation in affective and other clinical symptoms among high-risk families for bipolar disorders in an Arctic population

    PubMed Central

    Pirkola, Sami; Eriksen, Heidi A.; Partonen, Timo; Kieseppä, Tuula; Veijola, Juha; Jääskeläinen, Erika; Mylläri-Figuerola, Eeva-Maija; Salo, Paula M.; Paunio, Tiina

    2015-01-01

    Background In bipolar disorder (BD), seasonality of symptoms is common and disturbances in circadian rhythms have been reported. Objectives We identified high-penetrance families in a geographically restricted area in Northern Fennoscandia and studied the seasonal variation of clinical symptoms among BD subjects and their healthy relatives. Design We explored the clinical characteristics of subjects living in Northern Fennoscandia, with extreme annual variation in daylight. Among known indigenous high-risk families for BD, we compared the affected ones (N=16) with their healthy relatives (N=15), and also included 18 healthy non-related controls from the same geographical area. Seasonal fluctuation in clinical measures was followed up at the 4 most demarcated photoperiodic time points of the annual cycle: around the summer solstice and autumn equinox in 2013, the winter solstice in 2013/2014, and the spring equinox in 2014. In the baseline, lifetime manic symptoms [Mood Disorder Questionnaire (MDQ)] and morningness–eveningness questionnaire type (MEQ) were registered, whereas in the follow-up, depressive [Beck Depression Inventory (BDI)] and distress [General Health Questionnaire (GHQ-12)] symptoms and alcohol consumption and sleep were recorded. Results Possibly indicative or statistically significant differences in symptoms between the affected subjects and their healthy relatives were the BDI winter (13.3 vs. 2.6, t=−2.51, p=0.022) and spring scores (12.6 vs. 3.2, t=−1.97, p=0.063) and GHQ winter (4.2 vs. 0.82, t=−2.08, p=0.052) and spring scores (3.8 vs. 0.82, t=−1.97, p=0.063). Scores were higher among the affected subjects, exceeding a possibly diagnostic threshold (10 and 3) at all the time points, and without the notable seasonality which was observed among the healthy relatives. In the overall population, MDQ and MEQ scores had an inverse correlation (−0.384, significant at 0.016), indicating increased lifetime manic behaviour among “the night

  4. A comparison of the health status and health care utilization patterns between foreigners and the national population in Spain: new evidence from the Spanish National Health Survey.

    PubMed

    Hernández-Quevedo, Cristina; Jiménez-Rubio, Dolores

    2009-08-01

    The increasing proportion of immigrants in Spanish society is placing pressure on the National Health Care System to accommodate the needs of this population group while keeping costs under control. In the year 2000, a law was approved in Spain according to which all people, regardless of their nationality, are entitled to use health care services under the same conditions as Spanish citizens, provided that they are registered in the local population census. However, empirical evidence about differences in health status and health care utilization between the immigrant and the Spanish population is insufficient. This paper uses the 2003 and 2006 Spanish National Health Surveys to explore the existence of inequalities in health and in the access to health services for the immigrant population living in Spain, relative to that of Spaniards. Our results show that there are different patterns in the level of health and the medical care use between the national and the foreign population in Spain: while immigrants' self-reported health relative to that of the Spanish population depends upon individual nationality, all immigrants, regardless of their nationality, seem to face barriers of entry to specialized care. Further research is needed to understand the nature of these barriers in order to design more effective health policies.

  5. Do Wealth Shocks Affect Health? New Evidence from the Housing Boom

    PubMed Central

    Fichera, Eleonora

    2016-01-01

    Abstract We exploit large exogenous changes in housing wealth to examine the impact of wealth gains and losses on individual health. In UK household, panel data house price increases, which endow owners with greater wealth, lower the likelihood of home owners exhibiting a range of non‐chronic health conditions and improve their self‐assessed health with no effect on their psychological health. These effects are not transitory and persist over a 10‐year period. Using a range of fixed effects models, we provide robust evidence that these results are not biased by reverse causality or omitted factors. For owners' wealth gains affect labour supply and leisure choices indicating that house price increases allow individuals to reduce intensity of work with commensurate health benefits. © 2016 The Authors. Health Economics Published by John Wiley & Sons, Ltd. PMID:27870303

  6. A framework for guiding health literacy research in populations with universal access to healthcare.

    PubMed

    Weld, Konstantine Keian; Padden, Diane; Ramsey, Gloria; Garmon Bibb, Sandra C

    2008-01-01

    At least one third of the US population suffers from limited health literacy, which has been linked to poorer health status, higher costs, and individuals who are socioeconomically disadvantaged. However, research and the development of theoretical frameworks to study health literacy have only recently begun to occur. The purpose of this article is to describe theoretical frameworks that have either been used or may be used to guide health literacy research and to identify implications for nursing research and practice related to an adaptation of a health literacy framework developed specifically for conducting research in populations with universal access to healthcare.

  7. Taming Malaria: A New Health Model for the Indigenous Populations in Brazil.

    ERIC Educational Resources Information Center

    Martins, Leda Leitao

    1999-01-01

    In the late 1980s, a gold rush in Roraima state, Brazil, had devastating effects on the health of indigenous populations. Since then, a new health system emerged combining the assets of nongovernmental organizations, government agencies, and Native peoples such as the Macuxi. Community-chosen indigenous health workers and microscope technicians…