Sample records for future general population

  1. Strategies for Development of Palliative Care From the Perspectives of General Population and Health Care Professionals: A Japanese Outreach Palliative Care Trial of Integrated Regional Model Study.

    PubMed

    Yoshida, Saran; Miyashita, Mitsunori; Morita, Tatsuya; Akizuki, Nobuya; Akiyama, Miki; Shirahige, Yutaka; Ichikawa, Takayuki; Eguchi, Kenji

    2015-09-01

    This study primarily aimed to identify future actions required to promote palliative care in Japan. The future actions regarded as effective by the general population were "improve physicians' skill in palliative care" (61%), "create a counseling center for cancer" (61%), and "improve nurses' skill in palliative care" (60%). In contrast, future actions regarded as effective by the health care professionals were "set up a Web site that provides information about cancer" (72%), "promote consultation with specialists in palliative care" (71%), and "open an outpatient department specializing in palliative care" (70%). The results suggest (1) development and maintenance of settings; (2) enhancement of palliative care education and training programs for health care providers; and (3) improvement in distributing information about cancer and regional palliative care resources to the general population. © The Author(s) 2014.

  2. 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. Copyright © 2016. Published by Elsevier B.V.

  3. Initial report of the osteogenesis imperfecta adult natural history initiative.

    PubMed

    Tosi, Laura L; Oetgen, Matthew E; Floor, Marianne K; Huber, Mary Beth; Kennelly, Ann M; McCarter, Robert J; Rak, Melanie F; Simmonds, Barbara J; Simpson, Melissa D; Tucker, Carole A; McKiernan, Fergus E

    2015-11-14

    A better understanding of the natural history of osteogenesis imperfecta (OI) in adulthood should improve health care for patients with this rare condition. The Osteogenesis Imperfecta Foundation established the Adult Natural History Initiative (ANHI) in 2010 to give voice to the health concerns of the adult OI community and to begin to address existing knowledge gaps for this condition. Using a web-based platform, 959 adults with self-reported OI, representing a wide range of self-reported disease severity, reported symptoms and health conditions, estimated the impact of these concerns on present and future health-related quality of life (QoL) and completed a Patient-Reported Outcomes Measurement Information System (PROMIS®) survey of health issues. Adults with OI report lower general physical health status (p < .0001), exhibit a higher prevalence of auditory (58% of sample versus 2-16% of normalized population) and musculoskeletal (64% of sample versus 1-3% of normalized population) concerns than the general population, but report generally similar mental health status. Musculoskeletal, auditory, pulmonary, endocrine, and gastrointestinal issues are particular future health-related QoL concerns for these adults. Numerous other statistically significant differences exist among adults with OI as well as between adults with OI and the referent PROMIS® population, but the clinical significance of these differences is uncertain. Adults with OI report lower general health status but are otherwise more similar to the general population than might have been expected. While reassuring, further analysis of the extensive OI-ANHI databank should help identify areas of unique clinical concern and for future research. The OI-ANHI survey experience supports an internet-based strategy for successful patient-centered outcomes research in rare disease populations.

  4. Population, Resources, Environment: An Uncertain Future.

    ERIC Educational Resources Information Center

    Repetto, Robert

    1987-01-01

    The links between population growth, resource use, and environmental quality are too complex to permit straightforward generalizations about causal relationships. However, rapid population growth has increased the number of poor people in developing countries, thus contributing to the degradation of the environment and the renewable resources of…

  5. The relationship of brachial-ankle pulse wave velocity to future cardiovascular disease events in the general Japanese population: the Takashima Study.

    PubMed

    Takashima, N; Turin, T C; Matsui, K; Rumana, N; Nakamura, Y; Kadota, A; Saito, Y; Sugihara, H; Morita, Y; Ichikawa, M; Hirose, K; Kawakani, K; Hamajima, N; Miura, K; Ueshima, H; Kita, Y

    2014-05-01

    Brachial-ankle pulse wave velocity (baPWV) is a non-invasive measure of arterial stiffness obtained using an automated system. Although baPWVs have been widely used as a non-invasive marker for evaluation of arterial stiffness, evidence for the prognostic value of baPWV in the general population is scarce. In this study, we assessed the association between baPWV and future cardiovascular disease (CVD) incidence in a Japanese population. From 2002 to 2009, baPWV was measured in a total of 4164 men and women without a history of CVD, and they were followed up until the end of 2009 with a median follow-up period of 6.5 years. Hazard ratios (HRs) for CVD incidence according to baPWV levels were calculated using a Cox proportional hazards model adjusted for potential confounding factors, including seated or supine blood pressure (BP). During the follow-up period, we observed 40 incident cases of CVD. In multivariable-adjusted model, baPWV as a continuous variable was not significantly associated with future CVD risk after adjustment for supine BP. However, compared with lower baPWV category (<18 m s(-1)), higher baPWV (< or = 18.0 m s(-1)) was significantly associated with an increased CVD risk (HR: 2.70, 95% confidence interval: 1.18-6.19). Higher baPWV (< or = 18.0 m s(-1)) would be an independent predictor of future CVD event in the general Japanese population.

  6. Investing in Early Career General Staff

    ERIC Educational Resources Information Center

    Graham, Carroll

    2009-01-01

    With the greying of the Australian population, it has been widely recognised that active career development for early career academics is essential to the future capacities of universities (Hugo, Daysh, Morris & Rudd, 2004). However, the same has not been acknowledged for general staff, despite general staff comprising more than 50% of staff…

  7. IFLA General Conference, 1987. Division of Libraries Serving the General Public. Libraries Serving Disadvantaged Persons Section. Library Services to Multicultural Populations Section. Papers.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    Eleven of the 15 papers in this collection discuss library services for disadvantaged persons; the remaining four papers are concerned with services to multicultural populations. The papers from the Section of Libraries Serving Disadvantaged Persons appear first in this list: (1) "The Development and Future of Easy Readers for Adults in the UK"…

  8. Population ageing and dental care.

    PubMed

    Harford, Jane

    2009-04-01

    Population ageing is a fact in both developed and developing countries. The concern about population ageing largely arises from the combination of a greater number of older people requiring greater amounts of healthcare services and pensions, and relatively fewer people working to pay for them. Oral health and dental care are important aspects of health and health care. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Traditionally, economic studies of ageing have focused on the fiscal implications of ageing, projecting the increased burden on health and welfare services that accompanies ageing. It assumed that ageing is the major driver of recent changes and those past trends will simply be amplified by faster population ageing in the future. Less work has been done to understand other past drivers of increased healthcare spending and their implications for the future. The conclusion of these reports is usually that population ageing is unaffordable with current policy settings. They have proposed policies to deal with population ageing which focused on increasing workforce participation and worker productivity to increase the tax base and reducing entitlements. However, the affordability question is as much political as a numerical. There are no clearly articulated criteria for affordability and little opportunity for public discourse about what citizens are willing to pay in taxes to support an ageing population. While the reports do not necessarily reflect public opinion, they will certainly shape it. Predicting the future for oral health is more fraught than for general health, as oral health is in the midst of an epidemiological transition from high rates of edentulism and tooth loss to low rates. Changes in the pattern of dental expenditure in the past do not mirror the experience of rapid increases in per capita expenditure on older age groups as regards general health. Dentistry's marginal status means that less work has been done to understand the future consequences of these changes and how they will interact with population ageing. Further than this though, we need to understand why the future might look as these projections suggest, so that we may look at ways that it can be shaped.

  9. Characteristics of Hyperacusis in the General Population

    PubMed Central

    Paulin, Johan; Andersson, Linus; Nordin, Steven

    2016-01-01

    There is a need for better understanding of various characteristics in hyperacusis in the general population. The objectives of the present study were to investigate individuals in the general population with hyperacusis regarding demographics, lifestyle, perceived general health and hearing ability, hyperacusis-specific characteristics and behavior, and comorbidity. Using data from a large-scale population-based questionnaire study, we investigated individuals with physician-diagnosed (n=66) and self-reported (n=313) hyperacusis in comparison to individuals without hyperacusis (n=2995). High age, female sex, and high education were associated with hyperacusis, and that trying to avoid sound sources, being able to affect the sound environment, and having sough medical attention were common reactions and behaviors. Posttraumatic stress disorder, chronic fatigue syndrome, generalized anxiety disorder, depression, exhaustion, fibromyalgia, irritable bowel syndrome, migraine, hearing impairment, tinnitus, and back/joint/muscle disorders were comorbid with hyperacusis. The results provide ground for future study of these characteristic features being risk factors for development of hyperacusis and/or consequences of hyperacusis. PMID:27569405

  10. Modeled response of the West Nile virus vector Culex quinquefasciatus to changing climate using the dynamic mosquito simulation model

    NASA Astrophysics Data System (ADS)

    Morin, Cory W.; Comrie, Andrew C.

    2010-09-01

    Climate can strongly influence the population dynamics of disease vectors and is consequently a key component of disease ecology. Future climate change and variability may alter the location and seasonality of many disease vectors, possibly increasing the risk of disease transmission to humans. The mosquito species Culex quinquefasciatus is a concern across the southern United States because of its role as a West Nile virus vector and its affinity for urban environments. Using established relationships between atmospheric variables (temperature and precipitation) and mosquito development, we have created the Dynamic Mosquito Simulation Model (DyMSiM) to simulate Cx. quinquefasciatus population dynamics. The model is driven with climate data and validated against mosquito count data from Pasco County, Florida and Coachella Valley, California. Using 1-week and 2-week filters, mosquito trap data are reproduced well by the model ( P < 0.0001). Dry environments in southern California produce different mosquito population trends than moist locations in Florida. Florida and California mosquito populations are generally temperature-limited in winter. In California, locations are water-limited through much of the year. Using future climate projection data generated by the National Center for Atmospheric Research CCSM3 general circulation model, we applied temperature and precipitation offsets to the climate data at each location to evaluate mosquito population sensitivity to possible future climate conditions. We found that temperature and precipitation shifts act interdependently to cause remarkable changes in modeled mosquito population dynamics. Impacts include a summer population decline from drying in California due to loss of immature mosquito habitats, and in Florida a decrease in late-season mosquito populations due to drier late summer conditions.

  11. Network Models: An Underutilized Tool in Wildlife Epidemiology?

    PubMed Central

    Craft, Meggan E.; Caillaud, Damien

    2011-01-01

    Although the approach of contact network epidemiology has been increasing in popularity for studying transmission of infectious diseases in human populations, it has generally been an underutilized approach for investigating disease outbreaks in wildlife populations. In this paper we explore the differences between the type of data that can be collected on human and wildlife populations, provide an update on recent advances that have been made in wildlife epidemiology by using a network approach, and discuss why networks might have been underutilized and why networks could and should be used more in the future. We conclude with ideas for future directions and a call for field biologists and network modelers to engage in more cross-disciplinary collaboration. PMID:21527981

  12. Patients living with disabilities: The need for high-quality primary care.

    PubMed

    Lofters, Aisha; Guilcher, Sara; Maulkhan, Niraj; Milligan, James; Lee, Joseph

    2016-08-01

    To compare the potential risk factors for lower-quality primary care, the potential markers of unmet needs in primary care, and the willingness to participate in future research among primary care patients with versus without physical disabilities. A waiting room survey using a convenience sample. A family health team (FHT) in Kitchener-Waterloo, Ont, with a designated Mobility Clinic. A total of 40 patients seen at the FHT Mobility Clinic and 80 patients from the general patient population of the same FHT. Socioeconomic status and social capital, number of self-reported emergency department visits and hospitalizations in the preceding year, and willingness of the patients in the 2 groups to participate in future research studies. Patients from the Mobility Clinic were more than twice as likely to be receiving benefits or social assistance (75.0% vs 32.1%, P < .001), were twice as likely to report an annual household income of less than $40000 (58.6% vs 29.2%, P = .006), and were more likely to report their health status to be fair or poor (42.5% vs 16.2%, P = .002). Half of Mobility Clinic patients had visited the emergency department at least once in the preceding year, compared with 29.7% in the general patient population (P = .027). When asked if they would be willing to provide their health card number in the future so that it could be linked to health care data for research, 82.5% of Mobility Clinic patients agreed versus 55.0% of those in the general patient population (P = .004). In this study, patients with disabilities were at a social disadvantage compared with their peers without disabilities and were more likely to use the emergency department, suggesting that they had unmet health needs. Future research should continue to explore this patient population and to investigate if an interprofessional primary health care team approach focused on patients with disabilities can help to increase quality of care. Copyright© the College of Family Physicians of Canada.

  13. [Promising Future in General Internal Medicine for the Next Generation of Physicians].

    PubMed

    Allenbach, Victoria Perpinias; Rozsnyai, Zsofia; Streit, Sven

    2018-06-01

    Promising Future in General Internal Medicine for the Next Generation of Physicians Abstract. We are facing a lack of specialists in general internal medicine in general practitioners' practices as well as in hospitals, while at the same time the population ages and usually displays several chronic diseases (multimorbidity). Thanks to more university places, an improved job description for general internal medicine and new further education offers (curricula), interest in general internal medicine increased again, as surveys of students indicate. The young generation of family doctors and generalists in hospitals wishes flexible working conditions in order to reconcile work, family and spare time in the best possible way. Working atmosphere and colleagues have a high priority. These wishes must now be incorporated into attractive further training with flexible curricula and mentoring offers so that young talents can successfully be promoted.

  14. U.S. truck driver anthropometric study and multivariate anthropometric models for cab designs.

    PubMed

    Guan, Jinhua; Hsiao, Hongwei; Bradtmiller, Bruce; Kau, Tsui-Ying; Reed, Matthew R; Jahns, Steven K; Loczi, Josef; Hardee, H Lenora; Piamonte, Dominic Paul T

    2012-10-01

    This study presents data from a large-scale anthropometric study of U.S. truck drivers and the multivariate anthropometric models developed for the design of next-generation truck cabs. Up-to-date anthropometric information of the U.S. truck driver population is needed for the design of safe and ergonomically efficient truck cabs. We collected 35 anthropometric dimensions for 1,950 truck drivers (1,779 males and 171 females) across the continental United States using a sampling plan designed to capture the appropriate ethnic, gender, and age distributions of the truck driver population. Truck drivers are heavier than the U.S.general population, with a difference in mean body weight of 13.5 kg for males and 15.4 kg for females. They are also different in physique from the U.S. general population. In addition, the current truck drivers are heavier and different in physique compared to their counterparts of 25 to 30 years ago. The data obtained in this study provide more accurate anthropometric information for cab designs than do the current U.S. general population data or truck driver data collected 25 to 30 years ago. Multivariate anthropometric models, spanning 95% of the current truck driver population on the basis of a set of 12 anthropometric measurements, have been developed to facilitate future cab designs. The up-to-date truck driver anthropometric data and multivariate anthropometric models will benefit the design of future truck cabs which, in turn, will help promote the safety and health of the U.S. truck drivers.

  15. Environmental Assessment: The Development of a Borrow Source Cape Canaveral Air Force Station to Provide Material for Future Emergency Renourishment Projects Patrick Air Force Base

    DTIC Science & Technology

    2007-07-01

    donor and recipient site description, date, turtle ID, morphometrics, sex , general health, etc.). These reports will be kept on file in the CCAFS 45...target species captured, weather conditions, lost or missing traps, and moon phase. If population data is being collected, sex , age, and reproductive...typical of other beach mice as well (Rave and Holler 1992). Sex ratios in beach mouse populations are generally 1:1 (Extine 1980; Rave and Holler

  16. Gambling Disorder in Veterans: A Review of the Literature and Implications for Future Research.

    PubMed

    Levy, Lauren; Tracy, J Kathleen

    2018-02-09

    To review the scientific literature examining gambling behavior in military veterans in order to summarize factors associated with gambling behavior in this population. Database searches were employed to identify articles specifically examining gambling behavior in military veterans. Cumulative search results identified 52 articles (1983-2017) examining gambling behavior in veteran populations. Articles generally fell into one or more of the following categories: prevalence, psychological profiles and psychiatric comorbidities, treatment evaluations, measurement, and genetic contributions to gambling disorder. Results from reviewed articles are presented and implications for future research discussed. Research to date has provided an excellent foundation to inform potential screening, intervention and research activities going forward. The authors suggest that a public health approach to future research endeavors would strengthen the evidence base regarding gambling in veteran populations and better inform strategies for screening, prevention and treatment.

  17. Losing your edge: climate change and the conservation value of range-edge populations.

    PubMed

    Rehm, Evan M; Olivas, Paulo; Stroud, James; Feeley, Kenneth J

    2015-10-01

    Populations occurring at species' range edges can be locally adapted to unique environmental conditions. From a species' perspective, range-edge environments generally have higher severity and frequency of extreme climatic events relative to the range core. Under future climates, extreme climatic events are predicted to become increasingly important in defining species' distributions. Therefore, range-edge genotypes that are better adapted to extreme climates relative to core populations may be essential to species' persistence during periods of rapid climate change. We use relatively simple conceptual models to highlight the importance of locally adapted range-edge populations (leading and trailing edges) for determining the ability of species to persist under future climates. Using trees as an example, we show how locally adapted populations at species' range edges may expand under future climate change and become more common relative to range-core populations. We also highlight how large-scale habitat destruction occurring in some geographic areas where many species range edge converge, such as biome boundaries and ecotones (e.g., the arc of deforestation along the rainforest-cerrado ecotone in the southern Amazonia), can have major implications for global biodiversity. As climate changes, range-edge populations will play key roles in helping species to maintain or expand their geographic distributions. The loss of these locally adapted range-edge populations through anthropogenic disturbance is therefore hypothesized to reduce the ability of species to persist in the face of rapid future climate change.

  18. Anxiety and depression in cardiac patients: age differences and comparisons with the general population.

    PubMed

    Hinz, Andreas; Kittel, Jörg; Karoff, Marthin; Daig, Isolde

    2011-01-01

    Anxiety and depression are often found in cardiac patients, but also in the general population. Therefore, evaluation of these symptoms in patients requires a comparison with norm values. The purpose of this study was to explore differences between cardiac patients and the general population in age dependency of anxiety and depression, and to discuss possible reasons for these differences. A sample of German cardiac patients (n = 2,696) and a sample of the German general population (n = 2,037) were tested using the Hospital Anxiety and Depression Scale (HADS). While we confirmed a linear age trend of anxiety and depression in the general population, we observed an inverted U-shaped age dependency in the patient sample. Young patients are especially affected by anxiety and depression. Five items of the HADS that mainly contributed to the age differences were identified. Formal characteristics of these 5 items could not explain the age differences. Concerning the meaning of the items, however, most of the items refer to worrying about the future. The relatively low rates of anxiety and depression in older patients (compared with the general population) indicate that adaptation processes took place, which should be taken into account in studies concerning the psychological status of patients. Young patients need special attention when dealing with mental distress. Copyright © 2011 S. Karger AG, Basel.

  19. Design and Evaluation of a One-Semester General Chemistry Course for Undergraduate Life Science Majors

    ERIC Educational Resources Information Center

    Schnoebelen, Carly; Towns, Marcy H.; Chmielewski, Jean; Hrycyna, Christine A.

    2018-01-01

    The chemistry curriculum for undergraduate life science majors at Purdue University has been transformed to better meet the needs of this student population and prepare them for future success. The curriculum, called the 1-2-1 curriculum, includes four consecutive and integrated semesters of instruction in general chemistry, organic chemistry, and…

  20. Generalizing the Network Scale-Up Method: A New Estimator for the Size of Hidden Populations*

    PubMed Central

    Feehan, Dennis M.; Salganik, Matthew J.

    2018-01-01

    The network scale-up method enables researchers to estimate the size of hidden populations, such as drug injectors and sex workers, using sampled social network data. The basic scale-up estimator offers advantages over other size estimation techniques, but it depends on problematic modeling assumptions. We propose a new generalized scale-up estimator that can be used in settings with non-random social mixing and imperfect awareness about membership in the hidden population. Further, the new estimator can be used when data are collected via complex sample designs and from incomplete sampling frames. However, the generalized scale-up estimator also requires data from two samples: one from the frame population and one from the hidden population. In some situations these data from the hidden population can be collected by adding a small number of questions to already planned studies. For other situations, we develop interpretable adjustment factors that can be applied to the basic scale-up estimator. We conclude with practical recommendations for the design and analysis of future studies. PMID:29375167

  1. Do we have to choose between feeding the human population and conserving nature? Modelling the global dependence of people on ecosystem services.

    PubMed

    Cazalis, Victor; Loreau, Michel; Henderson, Kirsten

    2018-09-01

    The ability of the human population to continue growing depends strongly on the ecosystem services provided by nature. Nature, however, is becoming more and more degraded as the number of individuals increases, which could potentially threaten the future well-being of the human population. We use a dynamic model to conceptualise links between the global proportion of natural habitats and human demography, through four categories of ecosystem services (provisioning, regulating, cultural recreational and informational) to investigate the common future of nature and humanity in terms of size and well-being. Our model shows that there is generally a trade-off between the quality of life and human population size and identifies four short-term scenarios, corresponding to three long-term steady states of the model. First, human population could experience declines if nature becomes too degraded and regulating services diminish; second the majority of the population could be in a famine state, where the population continues to grow with minimal food provision. Between these scenarios, a desirable future scenario emerges from the model. It occurs if humans convert enough land to feed all the population, while maintaining biodiversity and ecosystem services. Finally, we find a fourth scenario, which combines famine and a decline in the population because of an overexploitation of land leading to a decrease in food production. Human demography is embedded in natural dynamics; the two factors should be considered together if we are to identify a desirable future for both nature and humans. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Applying landscape genomic tools to forest management and restoration of Hawaiian koa (Acacia koa) in a changing environment.

    PubMed

    Gugger, Paul F; Liang, Christina T; Sork, Victoria L; Hodgskiss, Paul; Wright, Jessica W

    2018-02-01

    Identifying and quantifying the importance of environmental variables in structuring population genetic variation can help inform management decisions for conservation, restoration, or reforestation purposes, in both current and future environmental conditions. Landscape genomics offers a powerful approach for understanding the environmental factors that currently associate with genetic variation, and given those associations, where populations may be most vulnerable under future environmental change. Here, we applied genotyping by sequencing to generate over 11,000 single nucleotide polymorphisms from 311 trees and then used nonlinear, multivariate environmental association methods to examine spatial genetic structure and its association with environmental variation in an ecologically and economically important tree species endemic to Hawaii, Acacia koa . Admixture and principal components analyses showed that trees from different islands are genetically distinct in general, with the exception of some genotypes that match other islands, likely as the result of recent translocations. Gradient forest and generalized dissimilarity models both revealed a strong association between genetic structure and mean annual rainfall. Utilizing a model for projected future climate on the island of Hawaii, we show that predicted changes in rainfall patterns may result in genetic offset, such that trees no longer may be genetically matched to their environment. These findings indicate that knowledge of current and future rainfall gradients can provide valuable information for the conservation of existing populations and also help refine seed transfer guidelines for reforestation or replanting of koa throughout the state.

  3. Dietary Sodium Consumption Predicts Future Blood Pressure and Incident Hypertension in the Japanese Normotensive General Population

    PubMed Central

    Takase, Hiroyuki; Sugiura, Tomonori; Kimura, Genjiro; Ohte, Nobuyuki; Dohi, Yasuaki

    2015-01-01

    Background Although there is a close relationship between dietary sodium and hypertension, the concept that persons with relatively high dietary sodium are at increased risk of developing hypertension compared with those with relatively low dietary sodium has not been studied intensively in a cohort. Methods and Results We conducted an observational study to investigate whether dietary sodium intake predicts future blood pressure and the onset of hypertension in the general population. Individual sodium intake was estimated by calculating 24-hour urinary sodium excretion from spot urine in 4523 normotensive participants who visited our hospital for a health checkup. After a baseline examination, they were followed for a median of 1143 days, with the end point being development of hypertension. During the follow-up period, hypertension developed in 1027 participants (22.7%). The risk of developing hypertension was higher in those with higher rather than lower sodium intake (hazard ratio 1.25, 95% CI 1.04 to 1.50). In multivariate Cox proportional hazards regression analysis, baseline sodium intake and the yearly change in sodium intake during the follow-up period (as continuous variables) correlated with the incidence of hypertension. Furthermore, both the yearly increase in sodium intake and baseline sodium intake showed significant correlations with the yearly increase in systolic blood pressure in multivariate regression analysis after adjustment for possible risk factors. Conclusions Both relatively high levels of dietary sodium intake and gradual increases in dietary sodium are associated with future increases in blood pressure and the incidence of hypertension in the Japanese general population. PMID:26224048

  4. Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population.

    PubMed

    Barth, Swaantje; Haas, Johannes-Peter; Schlichtiger, Jenny; Molz, Johannes; Bisdorff, Betty; Michels, Hartmut; Hügle, Boris; Radon, Katja

    2016-01-01

    Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models. Sixty-two percent of the study population was female; age range was 18-73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55-58%; general population 28%; 26-29%) and the anxiety/depression dimension (28%; 27-29% vs. 4%; 4-5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability. HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future.

  5. Future Supply of Pediatric Surgeons: Analytical Study of the Current and Projected Supply of Pediatric Surgeons in the Context of a Rapidly Changing Process for Specialty and Subspecialty Training.

    PubMed

    Ricketts, Thomas C; Adamson, William T; Fraher, Erin P; Knapton, Andy; Geiger, James D; Abdullah, Fizan; Klein, Michael D

    2017-03-01

    To describe the future supply and demand for pediatric surgeons using a physician supply model to determine what the future supply of pediatric surgeons will be over the next decade and a half and to compare that projected supply with potential indicators of demand and the growth of other subspecialties. Anticipating the supply of physicians and surgeons in the future has met with varying levels of success. However, there remains a need to anticipate supply given the rapid growth of specialty and subspecialty fellowships. This analysis is intended to support decision making on the size of future fellowships in pediatric surgery. The model used in the study is an adaptation of the FutureDocs physician supply and need tool developed to anticipate future supply and need for all physician specialties. Data from national inventories of physicians by specialty, age, sex, activity, and location are combined with data from residency and fellowship programs and accrediting bodies in an agent-based or microsimulation projection model that considers movement into and among specialties. Exits from practice and the geographic distribution of physician and the patient population are also included in the model. Three scenarios for the annual entry into pediatric surgery fellowships (28, 34, and 56) are modeled and their effects on supply through 2030 are presented. The FutureDocs model predicts a very rapid growth of the supply of surgeons who treat pediatric patients-including general pediatric surgeon and focused subspecialties. The supply of all pediatric surgeons will grow relatively rapidly through 2030 under current conditions. That growth is much faster than the rate of growth of the pediatric population. The volume of complex surgical cases will likely match this population growth rate meaning there will be many more surgeons trained for those procedures. The current entry rate into pediatric surgery fellowships (34 per year) will result in a slowing of growth after 2025, a rate of 56 will generate a continued growth through 2030 with a likely plateau after 2035. The rate of entry into pediatric surgery will continue to exceed population growth through 2030 under two likely scenarios. The very rapid anticipated growth in focused pediatric subspecialties will likely prove challenging to surgeons wishing to maintain their skills with complex cases as a larger and more diverse group of surgeons will also seek to care for many of the conditions and patients which the general pediatric surgeons and general surgeons now see. This means controlling the numbers of pediatric surgery fellowships in a way that recognizes problems with distribution, the volume of cases available to maintain proficiency, and the dynamics of retirement and shifts into other specialty practice.

  6. Projection of invertebrate populations in the headwater streams of a temperate catchment under a changing climate.

    PubMed

    Nukazawa, Kei; Arai, Ryosuke; Kazama, So; Takemon, Yasuhiro

    2018-06-14

    Climate change places considerable stress on riverine ecosystems by altering flow regimes and increasing water temperature. This study evaluated how water temperature increases under climate change scenarios will affect stream invertebrates in pristine headwater streams. The studied headwater-stream sites were distributed within a temperate catchment of Japan and had similar hydraulic-geographical conditions, but were subject to varying temperature conditions due to altitudinal differences (100 to 850 m). We adopted eight general circulation models (GCMs) to project air temperature under conservative (RCP2.6), intermediate (RCP4.5), and extreme climate scenarios (RCP8.5) during the near (2031-2050) and far (2081-2100) future. Using the water temperature of headwater streams computed by a distributed hydrological-thermal model as a predictor variable, we projected the population density of stream invertebrates in the future scenarios based on generalized linear models. The mean decrease in the temporally averaged population density of Plecoptera was 61.3% among the GCMs, even under RCP2.6 in the near future, whereas density deteriorated even further (90.7%) under RCP8.5 in the far future. Trichoptera density was also projected to greatly deteriorate under RCP8.5 in the far future. We defined taxa that exhibited temperature-sensitive declines under climate change as cold stenotherms and found that most Plecoptera taxa were cold stenotherms in comparison to other orders. Specifically, the taxonomic families that only distribute in Palearctic realm (e.g., Megarcys ochracea and Scopura longa) were selectively assigned, suggesting that Plecoptera family with its restricted distribution in the Palearctic might be a sensitive indicator of climate change. Plecoptera and Trichoptera populations in the headwaters are expected/anticipated to decrease over the considerable geographical range of the catchment, even under the RCP2.6 in the near future. Given headwater invertebrates play important roles in streams, such as contributing to watershed productivity, our results provide useful information for managing streams at the catchment-level. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. High intra-specific variation in avian body condition responses to climate limits generalisation across species

    PubMed Central

    van der Jeugd, Henk P.; van de Pol, Martijn

    2018-01-01

    It is generally assumed that populations of a species will have similar responses to climate change, and thereby that a single value of sensitivity will reflect species-specific responses. However, this assumption is rarely systematically tested. High intraspecific variation will have consequences for identifying species- or population-level traits that can predict differences in sensitivity, which in turn can affect the reliability of projections of future climate change impacts. We investigate avian body condition responses to changes in six climatic variables and how consistent and generalisable these responses are both across and within species, using 21 years of data from 46 common passerines across 80 Dutch sites. We show that body condition decreases with warmer spring/early summer temperatures and increases with higher humidity, but other climate variables do not show consistent trends across species. In the future, body condition is projected to decrease by 2050, mainly driven by temperature effects. Strikingly, populations of the same species generally responded just as differently as populations of different species implying that a single species signal is not meaningful. Consequently, species-level traits did not explain interspecific differences in sensitivities, rather population-level traits were more important. The absence of a clear species signal in body condition responses implies that generalisation and identifying species for conservation prioritisation is problematic, which sharply contrasts conclusions of previous studies on the climate sensitivity of phenology. PMID:29466460

  8. 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. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  9. Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population

    PubMed Central

    Barth, Swaantje; Haas, Johannes-Peter; Schlichtiger, Jenny; Molz, Johannes; Bisdorff, Betty; Michels, Hartmut; Hügle, Boris; Radon, Katja

    2016-01-01

    Objective Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. Methods In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models. Results Sixty-two percent of the study population was female; age range was 18–73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55–58%; general population 28%; 26–29%) and the anxiety/depression dimension (28%; 27–29% vs. 4%; 4–5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability. Conclusions HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future. PMID:27115139

  10. Dietary Sodium Consumption Predicts Future Blood Pressure and Incident Hypertension in the Japanese Normotensive General Population.

    PubMed

    Takase, Hiroyuki; Sugiura, Tomonori; Kimura, Genjiro; Ohte, Nobuyuki; Dohi, Yasuaki

    2015-07-29

    Although there is a close relationship between dietary sodium and hypertension, the concept that persons with relatively high dietary sodium are at increased risk of developing hypertension compared with those with relatively low dietary sodium has not been studied intensively in a cohort. We conducted an observational study to investigate whether dietary sodium intake predicts future blood pressure and the onset of hypertension in the general population. Individual sodium intake was estimated by calculating 24-hour urinary sodium excretion from spot urine in 4523 normotensive participants who visited our hospital for a health checkup. After a baseline examination, they were followed for a median of 1143 days, with the end point being development of hypertension. During the follow-up period, hypertension developed in 1027 participants (22.7%). The risk of developing hypertension was higher in those with higher rather than lower sodium intake (hazard ratio 1.25, 95% CI 1.04 to 1.50). In multivariate Cox proportional hazards regression analysis, baseline sodium intake and the yearly change in sodium intake during the follow-up period (as continuous variables) correlated with the incidence of hypertension. Furthermore, both the yearly increase in sodium intake and baseline sodium intake showed significant correlations with the yearly increase in systolic blood pressure in multivariate regression analysis after adjustment for possible risk factors. Both relatively high levels of dietary sodium intake and gradual increases in dietary sodium are associated with future increases in blood pressure and the incidence of hypertension in the Japanese general population. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  11. Identifying Chronic Conditions and Other Selected Factors That Motivate Physical Activity in World Senior Games Participants and the General Population

    PubMed Central

    Bowen, Elise; Hager, Ron L.

    2015-01-01

    This study assesses chronic disease or disease-related conditions as motivators of physical activity. It also compares these and other motivators of physical activity between Senior Games participants (SGPs) and the general population. Analyses are based on an anonymous cross-sectional survey conducted among 666 SGPs and 177 individuals from the general population. SGPs experienced better general health and less obesity, diabetes, and depression, as well as an average of 14.7 more years of regular physical activity (p < .0001), 130.8 more minutes per week of aerobic activity (p < .0001), and 42.7 more minutes of anaerobic activity per week (p < .0001). Among those previously told they had diabetes, high blood pressure, high cholesterol, or depression, 74.2%, 72.2%, 70.4%, and 60.6%, respectively, said that it motivated them to increase their physical activity. Percentages were similar between SGPs and the general population. SGPs were more likely motivated to be physically active to improve physical and mental health in the present, to prevent physical and cognitive decline in the future, and to increase social opportunities. The Senior Games reinforces extrinsic motivators to positively influence intrinsic promoters such as skill development, satisfaction of learning, enjoyment, and fun. PMID:28138459

  12. Identifying Chronic Conditions and Other Selected Factors That Motivate Physical Activity in World Senior Games Participants and the General Population.

    PubMed

    Merrill, Ray M; Bowen, Elise; Hager, Ron L

    2015-01-01

    This study assesses chronic disease or disease-related conditions as motivators of physical activity. It also compares these and other motivators of physical activity between Senior Games participants (SGPs) and the general population. Analyses are based on an anonymous cross-sectional survey conducted among 666 SGPs and 177 individuals from the general population. SGPs experienced better general health and less obesity, diabetes, and depression, as well as an average of 14.7 more years of regular physical activity ( p < .0001), 130.8 more minutes per week of aerobic activity ( p < .0001), and 42.7 more minutes of anaerobic activity per week ( p < .0001). Among those previously told they had diabetes, high blood pressure, high cholesterol, or depression, 74.2%, 72.2%, 70.4%, and 60.6%, respectively, said that it motivated them to increase their physical activity. Percentages were similar between SGPs and the general population. SGPs were more likely motivated to be physically active to improve physical and mental health in the present, to prevent physical and cognitive decline in the future, and to increase social opportunities. The Senior Games reinforces extrinsic motivators to positively influence intrinsic promoters such as skill development, satisfaction of learning, enjoyment, and fun.

  13. Migratory bird hunter opinions regarding potential management strategies for controlling light goose populations

    USGS Publications Warehouse

    Dinges, Andrew J.; Webb, Elisabeth B.; Vrtiska, Mark P.; Nilon, Charles H.; Wilhelm Stanis, Sonja A.

    2014-01-01

    We expanded the Nebraska Light Goose Conservation Order (LGCO) harvest survey (NE, USA) in spring 2012 to assess migratory bird hunter opinions regarding future management strategies for controlling light goose populations. Although hunters strongly agreed that population control of light geese was an important wildlife management issue, they were generally unsupportive of wildlife officials using forms of direct control methods to control light goose populations. Respondents who indicated participation in the 2012 LGCO were also less supportive of any form of direct control compared with migratory bird hunters who did not participate in the LGCO. When presented with alternative methods by wildlife officials for future light goose population control, respondents were most supportive of wildlife agencies selectively shooting light geese on migration and wintering areas and least supportive of wildlife officials using bait with approved chemicals to euthanize light geese. A clear understanding of public perception of various potential direct-control options will likely assist wildlife biologists in making informed decisions on how to proceed with population control of light geese.

  14. Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: role of comorbid conditions and race.

    PubMed

    Sisk, Jane E; Whang, William; Butler, Jay C; Sneller, Vishnu-Priya; Whitney, Cynthia G

    2003-06-17

    Guidelines are increasingly recommending preventive services starting at 50 years of age, and policymakers are considering such a recommendation for pneumococcal polysaccharide vaccination. The finding that pneumococcal vaccination is cost-saving for people 65 years of age or older raises the question of the vaccination's implications for other older adults, especially black people, whose disease incidence exceeds that of nonblack people, and those with high-risk conditions. To assess the implications of vaccinating black and nonblack people 50 through 64 years of age against invasive pneumococcal disease. Cost-effectiveness analysis. Published literature for vaccination effectiveness and cost estimates; data on disease incidence and case-fatality rates from the Centers for Disease Control and Prevention. Hypothetical cohort 50 through 64 years of age with the 1995 U.S. age distribution. Lifetime. Societal. Pneumococcal polysaccharide vaccination compared with no vaccination. Incremental medical costs and health effects, in quality-adjusted life-years per vaccinee. Vaccination saved medical costs and improved health among high-risk black people (27.55 dollars savings per vaccinee) and nonblack people (5.92 dollars savings per vaccinee), excluding survivors' future costs. For low-risk black and nonblack people and the overall general population, vaccination cost 2477 dollars, 8195 dollars, and 3434 dollars, respectively, to gain 1 year of healthy life. Excluding survivors' future costs, in the general immunocompetent population, cost per quality-adjusted life-year in global worst-case results ranged from 21 513 dollars for black people to 68 871 dollars for nonblack people; in the high-risk population, cost ranged from 11 548 dollars for black people to 39 000 dollars for nonblack people. In the global best case, vaccination was cost-saving for black and nonblack people in the general immunocompetent and high-risk populations, excluding survivors' future costs. The cost-effectiveness range was narrower in probabilistic sensitivity analyses, with 95% probabilistic intervals ranging from cost-saving to 1594 dollars for black people and from cost-saving to 12 273 dollars for nonblack people in the general immunocompetent population. Costs per quality-adjusted life-year for low-risk people with case-fatality rates from 1998 were 2477 dollars for black people and 8195 dollars for nonblack people, excluding survivors' medical costs. These results support the current recommendation to vaccinate high-risk people and provide useful information for considering extending the recommendation to the general population 50 through 64 years of age. Lack of evidence about the effectiveness of revaccination for people 65 years of age or older, when disease risks are higher, argues for further research to guide vaccination policy.

  15. An aging population and growing disease burden will require a large and specialized health care workforce by 2025.

    PubMed

    Dall, Timothy M; Gallo, Paul D; Chakrabarti, Ritasree; West, Terry; Semilla, April P; Storm, Michael V

    2013-11-01

    As the US population ages, the increasing prevalence of chronic disease and complex medical conditions will have profound implications for the future health care system. We projected future prevalence of selected diseases and health risk factors to model future demand for health care services for each person in a representative sample of the current and projected future population. Based on changing demographic characteristics and expanded medical coverage under the Affordable Care Act, we project that the demand for adult primary care services will grow by approximately 14 percent between 2013 and 2025. Vascular surgery has the highest projected demand growth (31 percent), followed by cardiology (20 percent) and neurological surgery, radiology, and general surgery (each 18 percent). Market indicators such as long wait times to obtain appointments suggest that the current supply of many specialists throughout the United States is inadequate to meet the current demand. Failure to train sufficient numbers and the correct mix of specialists could exacerbate already long wait times for appointments, reduce access to care for some of the nation's most vulnerable patients, and reduce patients' quality of life.

  16. PRELIMINARY DATABASE DEVELOPMENT IN TARGET DIETARY SAMPLES AND COMPOSITE DIET SAMPLES

    EPA Science Inventory

    Food may surpass drinking water as the major source of ingestion of total elemental arsenic for the general population. For this reason, accurate assessments of inorganic arsenic intake via food are needed to provide estimates for dietary exposure within future epidemiology stud...

  17. 40 CFR 35.2116 - Collection system.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2116 Collection system... adequately treat such collected wastewater and where the bulk (generally two-thirds) of the expected flow (flow from existing plus future residential users) will be from the resident population on October 18...

  18. Accrediting Graduate Medical Education in Psychiatry: Past, Present, and Future.

    PubMed

    Johnson, Toni; John, Nadyah Janine; Lang, Michael; Shelton, P G

    2017-06-01

    The current terminology, goals, and general competency framework systematically utilized in the education of residents regardless of specialty is almost unrecognizable and quite foreign to those who trained before 2010. For example, the clinical and professional expectations for physicians-in-training have been placed onto a developmental framework of milestones. The expectations required during training have been expanded to include leadership and team participation skills, proficiency in the use of information technology, systems-based knowledge including respect of resources and cost of care, patient safety, quality improvement, population health and sensitivity to diversity for both individual and populations of patients. With these additions to physician training, the Accreditation Council for Graduate Medical Education (ACGME) hopes to remain accountable to the social contract between medicine and the public. With a focus on psychiatric practice, this article provides a general background and overview of the major overhaul of the accreditation process and educational goals for graduate medical education and briefly highlights possibilities for the future.

  19. [Which infectious diseases should be prioritized in educating Japanese population?].

    PubMed

    Horiguchi, Itsuko; Kishiwagi, Tomoko; Marui, Eiji

    2008-03-01

    We studied which infections would be prioritized in educating the general population of Japan. Subjects were 25 physicians and veterinarians in charge of infection control in infections control divisions of local and national governments. We conducted a questionnaire using the Delphi method. Based on (1) epidemiological and clinical characteristics, (2) knowledge level, awareness, and behavior of general population and healthcare professionals, and (3) social background and coping skills we selected 24 diseases for prioritization Tuberculosis was first, followed by influenza, HIV/AIDS, enterohemorrhagic Escherichia coli infection (O157), and genital chlamydial infection. Three animal-derived infections ranked in the top 10. We have not yet found which the priority of infections should be prioritized in educating the general population on infections. Although our findings are too few to make any generations about, several studies back the reasons why diseases were singled out in our study. Given the fact that most high-ranked infections have ever been educated, education thus far appears to have been highly ineffective way, meaning that more effective ways of education on infection must be found in future.

  20. Developmental Outcomes of Foster Children: A Meta-Analytic Comparison With Children From the General Population and Children at Risk Who Remained at Home.

    PubMed

    Goemans, Anouk; van Geel, Mitch; van Beem, Merel; Vedder, Paul

    2016-08-01

    Foster care is often preferred to other placement options for children in the child welfare system. However, it is not clear how the developmental outcomes of foster children relate to children in other living arrangements. In this study, a series of meta-analyses are performed to compare the cognitive, adaptive, and behavioral functioning of children placed in foster care (n = 2,305) with children at risk who remained with their biological parents (n = 4,335) and children from the general population (n = 4,971). A systematic literature search in PsycINFO, Medline, ERIC, and ProQuest identified 31 studies suitable for inclusion (N = 11,611). Results showed that foster children had generally lower levels of functioning than children from the general population. No clear differences were found between foster children and children at risk who remained at home, but both groups experienced developmental problems. Improving the quality of foster care and future research to identify which children are best served by either foster care or in-home services are recommended. © The Author(s) 2016.

  1. U.S. Food and Fiber - Abundance or Austerity?

    ERIC Educational Resources Information Center

    Resources for the Future, 1984

    1984-01-01

    Examines the future of United States agriculture, with primary reference to the next two decades and a more general assessment to the year 2020. Major areas considered include population and economic growth, food and agricultural policies, and the long-term productive capacity of U.S. agriculture. (JN)

  2. Consumer acceptance and travel behavior : impacts of automated vehicles : final report.

    DOT National Transportation Integrated Search

    2016-01-01

    This study provides a glimpse into the not-too-distant future by asking people in the general population how they would respond to the availability of self-driving vehicles, which might be on Texas roadways within a few years. Some elements of the te...

  3. Using Survival Analysis to Improve Estimates of Life Year Gains in Policy Evaluations.

    PubMed

    Meacock, Rachel; Sutton, Matt; Kristensen, Søren Rud; Harrison, Mark

    2017-05-01

    Policy evaluations taking a lifetime horizon have converted estimated changes in short-term mortality to expected life year gains using general population life expectancy. However, the life expectancy of the affected patients may differ from the general population. In trials, survival models are commonly used to extrapolate life year gains. The objective was to demonstrate the feasibility and materiality of using parametric survival models to extrapolate future survival in health care policy evaluations. We used our previous cost-effectiveness analysis of a pay-for-performance program as a motivating example. We first used the cohort of patients admitted prior to the program to compare 3 methods for estimating remaining life expectancy. We then used a difference-in-differences framework to estimate the life year gains associated with the program using general population life expectancy and survival models. Patient-level data from Hospital Episode Statistics was utilized for patients admitted to hospitals in England for pneumonia between 1 April 2007 and 31 March 2008 and between 1 April 2009 and 31 March 2010, and linked to death records for the period from 1 April 2007 to 31 March 2011. In our cohort of patients, using parametric survival models rather than general population life expectancy figures reduced the estimated mean life years remaining by 30% (9.19 v. 13.15 years, respectively). However, the estimated mean life year gains associated with the program are larger using survival models (0.380 years) compared to using general population life expectancy (0.154 years). Using general population life expectancy to estimate the impact of health care policies can overestimate life expectancy but underestimate the impact of policies on life year gains. Using a longer follow-up period improved the accuracy of estimated survival and program impact considerably.

  4. Attitudes to Mental Illness and Its Demographic Correlates among General Population in Singapore.

    PubMed

    Yuan, Qi; Abdin, Edimansyah; Picco, Louisa; Vaingankar, Janhavi Ajit; Shahwan, Shazana; Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Shafie, Saleha; Tay, Jenny; Chong, Siow Ann; Subramaniam, Mythily

    2016-01-01

    Public attitudes to mental illness could influence how the public interact with, provide opportunities for, and help people with mental illness. This study aims to explore the underlying factors of the Attitudes to Mental Illness questionnaire among the general population in Singapore and the socio-demographic correlates of each factor. From March 2014 to April 2015, a nation-wide cross-sectional survey on mental health literacy with 3,006 participants was conducted in Singapore. Factor analysis revealed a 4-factor structure for the Attitudes to Mental Illness questionnaire among the Singapore general population, namely social distancing, tolerance/support for community care, social restrictiveness, and prejudice and misconception. Older age, male gender, lower education and socio-economic status were associated with more negative attitudes towards the mentally ill. Chinese showed more negative attitudes than Indians and Malays (except for prejudice and misconception). There is a need for culture-specific interventions, and the associated factors identified in this study should be considered for future attitude campaigns.

  5. Encopresis, soiling and constipation in children and adults with developmental disability.

    PubMed

    Matson, Johnny L; LoVullo, Santino V

    2009-01-01

    Children and adults with developmental disabilities are more likely to evince encopresis, soiling and constipation than the general population. This set of related behaviors can produce a great deal of stress and can be a major restriction in independent living. This paper provides a review of the current state of knowledge on the prevalence, etiology, assessment and treatment of this co-occurring set of disorders. These problems are more common in persons with developmental disabilities then the general population. Furthermore, classical and operant treatment methods appear to be the best supported interventions for most cases. Strengths and weaknesses of the current research base are discussed along with potential avenues for future research.

  6. Advanced rural skills training - the value of an addiction medicine rotation.

    PubMed

    Allan, Julaine

    2011-11-01

    General practitioners are ideally placed to address drug and alcohol problems in the Australian population. Lack of adequate undergraduate and postgraduate training has been suggested as a key barrier limiting their involvement in addiction medicine. This article describes the establishment and operations of an advanced rural skills training program at the Lyndon Community - a rural drug and alcohol treatment organisation in New South Wales. An addiction medicine rotation offers general practice registrars the opportunity to develop skills and experience in psychosocial interventions as well as physical and mental health issues common in the treatment population. Registrars participating in the Lyndon Community program perceived that the training period had influenced and enhanced their future practice.

  7. Prevalence of Behavioural and Psychological Symptoms of Dementia in Individuals with Learning Disabilities.

    PubMed

    Devshi, Rajal; Shaw, Sarah; Elliott-King, Jordan; Hogervorst, Eef; Hiremath, Avinash; Velayudhan, Latha; Kumar, Satheesh; Baillon, Sarah; Bandelow, Stephan

    2015-12-02

    A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of dementia regardless of its subtype Research has indicated that there is a high prevalence of BPSD in the general dementia population. There are limited studies, which investigate the prevalence of BPSD within individuals who have learning disabilities and dementia. Findings suggest BPSDs are present within individuals with learning disabilities and dementia. Future research should use updated tools for investigating the prevalence of BPSD within individuals with learning disabilities and dementia.

  8. Hyperphagia: current concepts and future directions proceedings of the 2nd international conference on hyperphagia

    USDA-ARS?s Scientific Manuscript database

    Hyperphagia is a central feature of inherited disorders (e.g., Prader-Willi Syndrome) in which obesity is a primary phenotypic component. Hyperphagia may also contribute to obesity as observed in the general population, thus raising the potential importance of common underlying mechanisms and treatm...

  9. General Economic and Demographic Background and Projections for Indiana Library Services.

    ERIC Educational Resources Information Center

    Foust, James D.; Tower, Carl B.

    Before future library needs can be estimated, economic and demographic variables that influence the demand for library services must be projected and estimating equations relating library needs to economic and demographic parameters developed. This study considers the size, location and age-sex characteristics of Indiana's current population and…

  10. Mindfulness-Based Interventions for Older Adults: A Review of the Effects on Physical and Emotional Well-being

    PubMed Central

    Geiger, Paul J.; Boggero, Ian A.; Brake, C. Alex; Caldera, Carolina A.; Combs, Hannah L.; Peters, Jessica R.; Baer, Ruth A.

    2015-01-01

    This comprehensive review examined the effects of mindfulness-based interventions on the physical and emotional wellbeing of older adults, a rapidly growing segment of the general population. Search procedures yielded 15 treatment outcome studies meeting inclusion criteria. Support was found for the feasibility and acceptability of mindfulness-based interventions with older adults. Physical and emotional wellbeing outcome variables offered mixed support for the use of mindfulness-based interventions with older adults. Potential explanations of mixed findings may include methodological flaws, study limitations, and inconsistent modifications of protocols. These are discussed in detail and future avenues of research are discussed, emphasizing the need to incorporate geriatric populations into future mindfulness-based empirical research. PMID:27200109

  11. Shifting foundations and metrics for golden-cheeked warbler recovery

    USGS Publications Warehouse

    Hatfield, Jeff S.; Weckerly, Floyd W.; Duarte, Adam

    2012-01-01

    Using the golden-cheeked warbler (Setophaga chrysoparia) as a case study, this paper discusses what lessons can be learned from the process of the emergency listing and subsequent development of the recovery plan. Are the metrics for recovery in the current warbler plan appropriate, including population size and distribution (recovery units), migration corridors, and wintering habitat? In other words, what happened, what can we learn, and what should happen (in general) in the future for development of such plans? We discuss the number of recovery units required for species persistence and estimate the number of male warblers in protected areas across the breeding range of the species, using newly published density estimates. We also discuss future monitoring strategies to estimate warbler population trends and dispersal rates.

  12. Past, present, and future of a freshwater fish metapopulation in a threatened landscape.

    PubMed

    Vera-Escalona, Iván; Senthivasan, Shreeram; Habit, Evelyn; Ruzzante, Daniel E

    2018-02-12

    It is well documented that hydropower plants can affect the dynamics of fish populations through landscape alterations and the creation of new barriers. Less emphasis has been placed on the examination of the genetic consequences for fish populations of the construction of dams. The relatively few studies that focus on genetics often do not consider colonization history and even fewer tend to use this information for conservation purposes. As a case study, we used a 3-pronged approach to study the influence of historical processes, contemporary landscape features, and potential future anthropogenic changes in landscape on the genetic diversity of a fish metapopulation. Our goal was to identify the metapopulation's main attributes, detect priority areas for conservation, and assess the consequences of the construction of hydropower plants for the persistence of the metapopulation. We used microsatellite markers and coalescent approaches to examine historical colonization processes, traditional population genetics, and simulations of future populations under alternate scenarios of population size reduction and gene flow. Historical gene flow appeared to have declined relatively recently and contemporary populations appeared highly susceptible to changes in landscape. Gene flow is critical for population persistence. We found that hydropower plants could lead to a rapid reduction in number of alleles and to population extirpation 50-80 years after their construction. More generally, our 3-pronged approach for the analyses of empirical genetic data can provide policy makers with information on the potential impacts of landscape changes and thus lead to more robust conservation efforts. © 2018 Society for Conservation Biology.

  13. Twenty-year trends in the Ohio generalist physician workforce.

    PubMed

    Williams, P T

    1998-12-01

    Many factors contribute to the variations seen in physician workforce projections, including assumptions about attrition, new physician entry, and geographic requirements. Our study offers data for bench-marking future research into this complex issue. At 5-year intervals starting in 1975, data were collected for each Ohio county by local physician census takers. Total Ohio family physician rates per population did not increase appreciably during the 20-year period. A decrease in the number of allopathic family physicians was balanced by an increase in the number of osteopathic family physicians, many of whom were graduates of the state's first osteopathic medical school, which graduated its first class in 1980. Rates of general internists and general pediatricians increased. In 1975, the percentage of physicians older than 59 years was higher for family physicians than for general internists and general pediatricians. By 1995, this disparity in age distribution had greatly decreased. Rural family physician rates per 100,000 population decreased, and urban rates increased, while both urban and rural rates increased for general internists and general pediatricians. Variations in accounting for clinical time used for non-generalist clinical and nonclinical activities may explain a large part of the difference between generalist head count and full-time equivalency (FTE) study results; together these activities can be said to make up a "fourth compartment" contributing to improper specialty designation. The decrease in the percentage of family physicians older than 59 years indicates that the future supply of practicing family physicians is not in jeopardy. The rural family physician workforce is decreasing, while the general internist and general pediatrician rural workforce is increasing, but the total rural workforce is still well below the urban workforce. Neither component of the rural workforce appears to have stabilized.

  14. Sleep quality and covariates as predictors of pain intensity among the general population in rural China.

    PubMed

    Liu, Xiao-Kun; Xiao, Shui-Yuan; Zhou, Liang; Hu, Mi; Zhou, Wei; Liu, Hui-Ming

    2018-01-01

    The aims of this study were to investigate the distribution of sleep quality and its relationship with the prevalence of pain among rural Chinese people and to explore the association between sleep quality and pain intensity among the general population in real-life settings. This cross-sectional survey included a total of 2052 adults from rural areas in Liuyang, Hunan Province, recruited through random multistage sampling. The distributions of sleep quality and pain prevalence among the participants over a 4-week period were described. Because of multicollinearity among variables, the influence of self-rated sleep quality and psychosocial covariates on pain intensity was explored using a ridge regression model. The data showed that participants reporting all categories of sleep quality experienced some degree of pain. Sleep quality, along with physical and mental health, was a negative predictor of pain intensity among the general population. Symptoms of depression positively predicted pain intensity. Poor sleep quality increased pain intensity among the participants. Both previous research and the present data suggest that improving sleep quality may significantly decrease pain intensity in the general population. The relationship between sleep and pain may be bidirectional. This finding also suggests that treatment for sleep disorders and insomnia should be addressed in future efforts to alleviate pain intensity.

  15. [Which zoonoses should the general population be more awareness of ? Qualitative research targeted at veterinarians].

    PubMed

    Horiguchi, Itsuko; Ishikawa, Naoko; Feng, Qiaolian; Kigawa, Mika; Marui, Eiji

    2011-09-01

    The purpose of this study was to determine which zoonoses should the general population be more aware of. We conducted qualitative research (Delphi method) on thirty veterinarians who were selected from the whole country. Twenty-four diseases were selected. The reasons for their selection were classified into three categories: "Amount of knowledge, attitude and behavior", "Clinicoepidemiologic characteristics" and "Social characteristics". More than half of the top ten zoonoses are those that are not transmitted from humans to humans, with rabies in the first place, avian influenza (with its high pathogenicity) in the second place and psittacosis in the third place. From the top ten diseases, it is considered that the prevention of animal-to-human transmission should be emphasized. In addition, from the reasons for the selection, it is suggested that it is necessary to review social characteristics, such as the inadequacy of quarantine and the insufficiencies of legal systems. As for the zoonoses that are transmitted from humans to humans, it will be indispensable in the future to widely spread information on zoonoses and enlighten the general population about them. It is thought that this survey can be a basis for selecting a zoonosis that should be given priority in enlightening the general population.

  16. Contrasted demographic responses facing future climate change in Southern Ocean seabirds.

    PubMed

    Barbraud, Christophe; Rivalan, Philippe; Inchausti, Pablo; Nevoux, Marie; Rolland, Virginie; Weimerskirch, Henri

    2011-01-01

    1. Recent climate change has affected a wide range of species, but predicting population responses to projected climate change using population dynamics theory and models remains challenging, and very few attempts have been made. The Southern Ocean sea surface temperature and sea ice extent are projected to warm and shrink as concentrations of atmospheric greenhouse gases increase, and several top predator species are affected by fluctuations in these oceanographic variables. 2. We compared and projected the population responses of three seabird species living in sub-tropical, sub-Antarctic and Antarctic biomes to predicted climate change over the next 50 years. Using stochastic population models we combined long-term demographic datasets and projections of sea surface temperature and sea ice extent for three different IPCC emission scenarios (from most to least severe: A1B, A2, B1) from general circulation models of Earth's climate. 3. We found that climate mostly affected the probability to breed successfully, and in one case adult survival. Interestingly, frequent nonlinear relationships in demographic responses to climate were detected. Models forced by future predicted climatic change provided contrasted population responses depending on the species considered. The northernmost distributed species was predicted to be little affected by a future warming of the Southern Ocean, whereas steep declines were projected for the more southerly distributed species due to sea surface temperature warming and decrease in sea ice extent. For the most southerly distributed species, the A1B and B1 emission scenarios were respectively the most and less damaging. For the two other species, population responses were similar for all emission scenarios. 4. This is among the first attempts to study the demographic responses for several populations with contrasted environmental conditions, which illustrates that investigating the effects of climate change on core population dynamics is feasible for different populations using a common methodological framework. Our approach was limited to single populations and have neglected population settlement in new favourable habitats or changes in inter-specific relations as a potential response to future climate change. Predictions may be enhanced by merging demographic population models and climatic envelope models. © 2010 The Authors. Journal compilation © 2010 British Ecological Society.

  17. Intraspecific niche models for ponderosa pine (Pinus ponderosa) suggest potential variability in population-level response to climate change.

    PubMed

    Maguire, Kaitlin C; Shinneman, Douglas J; Potter, Kevin M; Hipkins, Valerie D

    2018-03-14

    Unique responses to climate change can occur across intraspecific levels, resulting in individualistic adaptation or movement patterns among populations within a given species. Thus, the need to model potential responses among genetically distinct populations within a species is increasingly recognized. However, predictive models of future distributions are regularly fit at the species level, often because intraspecific variation is unknown or is identified only within limited sample locations. In this study, we considered the role of intraspecific variation to shape the geographic distribution of ponderosa pine (Pinus ponderosa), an ecologically and economically important tree species in North America. Morphological and genetic variation across the distribution of ponderosa pine suggest the need to model intraspecific populations: the two varieties (var. ponderosa and var. scopulorum) and several haplotype groups within each variety have been shown to occupy unique climatic niches, suggesting populations have distinct evolutionary lineages adapted to different environmental conditions. We utilized a recently-available, geographically-widespread dataset of intraspecific variation (haplotypes) for ponderosa pine and a recently-devised lineage distance modeling approach to derive additional, likely intraspecific occurrence locations. We confirmed the relative uniqueness of each haplotype-climate relationship using a niche-overlap analysis, and developed ecological niche models (ENMs) to project the distribution for two varieties and eight haplotypes under future climate forecasts. Future projections of haplotype niche distributions generally revealed greater potential range loss than predicted for the varieties. This difference may reflect intraspecific responses of distinct evolutionary lineages. However, directional trends are generally consistent across intraspecific levels, and include a loss of distributional area and an upward shift in elevation. Our results demonstrate the utility in modeling intraspecific response to changing climate and they inform management and conservation strategies, by identifying haplotypes and geographic areas that may be most at risk, or most secure, under projected climate change.

  18. Intraspecific niche models for ponderosa pine (Pinus ponderosa) suggest potential variability in population-level response to climate change

    USGS Publications Warehouse

    Maguire, Kaitlin C.; Shinneman, Douglas; Potter, Kevin M.; Hipkins, Valerie D.

    2018-01-01

    Unique responses to climate change can occur across intraspecific levels, resulting in individualistic adaptation or movement patterns among populations within a given species. Thus, the need to model potential responses among genetically distinct populations within a species is increasingly recognized. However, predictive models of future distributions are regularly fit at the species level, often because intraspecific variation is unknown or is identified only within limited sample locations. In this study, we considered the role of intraspecific variation to shape the geographic distribution of ponderosa pine (Pinus ponderosa), an ecologically and economically important tree species in North America. Morphological and genetic variation across the distribution of ponderosa pine suggest the need to model intraspecific populations: the two varieties (var. ponderosa and var. scopulorum) and several haplotype groups within each variety have been shown to occupy unique climatic niches, suggesting populations have distinct evolutionary lineages adapted to different environmental conditions. We utilized a recently-available, geographically-widespread dataset of intraspecific variation (haplotypes) for ponderosa pine and a recently-devised lineage distance modeling approach to derive additional, likely intraspecific occurrence locations. We confirmed the relative uniqueness of each haplotype-climate relationship using a niche-overlap analysis, and developed ecological niche models (ENMs) to project the distribution for two varieties and eight haplotypes under future climate forecasts. Future projections of haplotype niche distributions generally revealed greater potential range loss than predicted for the varieties. This difference may reflect intraspecific responses of distinct evolutionary lineages. However, directional trends are generally consistent across intraspecific levels, and include a loss of distributional area and an upward shift in elevation. Our results demonstrate the utility in modeling intraspecific response to changing climate and they inform management and conservation strategies, by identifying haplotypes and geographic areas that may be most at risk, or most secure, under projected climate change.

  19. Projection of temperature-related mortality due to cardiovascular disease in beijing under different climate change, population, and adaptation scenarios.

    PubMed

    Zhang, Boya; Li, Guoxing; Ma, Yue; Pan, Xiaochuan

    2018-04-01

    Human health faces unprecedented challenges caused by climate change. Thus, studies of the effect of temperature change on total mortality have been conducted in numerous countries. However, few of those studies focused on temperature-related mortality due to cardiovascular disease (CVD) or considered future population changes and adaptation to climate change. We present herein a projection of temperature-related mortality due to CVD under different climate change, population, and adaptation scenarios in Beijing, a megacity in China. To this end, 19 global circulation models (GCMs), 3 representative concentration pathways (RCPs), 3 socioeconomic pathways, together with generalized linear models and distributed lag non-linear models, were used to project future temperature-related CVD mortality during periods centered around the years 2050 and 2070. The number of temperature-related CVD deaths in Beijing is projected to increase by 3.5-10.2% under different RCP scenarios compared with that during the baseline period. Using the same GCM, the future daily maximum temperatures projected using the RCP2.6, RCP4.5, and RCP8.5 scenarios showed a gradually increasing trend. When population change is considered, the annual rate of increase in temperature-related CVD deaths was up to fivefold greater than that under no-population-change scenarios. The decrease in the number of cold-related deaths did not compensate for the increase in that of heat-related deaths, leading to a general increase in the number of temperature-related deaths due to CVD in Beijing. In addition, adaptation to climate change may enhance rather than ameliorate the effect of climate change, as the increase in cold-related CVD mortality greater than the decrease in heat-related CVD mortality in the adaptation scenarios will result in an increase in the total number of temperature-related CVD mortalities. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. A Sensitivity Study on the Effectiveness of Active Debris Removal in LEO

    NASA Technical Reports Server (NTRS)

    Liou, J. C.; Johnson, Nicholas L.

    2007-01-01

    The near-Earth orbital debris population will continue to increase in the future due to ongoing space activities, on-orbit explosions, and accidental collisions among resident space objects. Commonly adopted mitigation measures, such as limiting postmission orbital lifetimes of satellites to less than 25 years, will slow down the population growth, but may be insufficient to stabilize the environment. The nature of the growth, in the low Earth orbit (LEO) region, is further demonstrated by a recent study where no future space launches were conducted in the environment projection simulations. The results indicate that, even with no new launches, the LEO debris population would remain relatively constant for only the next 50 years. Beyond that, the debris population would begin to increase noticeably, due to the production of collisional debris. Therefore, to better limit the growth of future debris population to protect the environment, remediation option, i.e., removing existing large and massive objects from orbit, needs to be considered. This paper does not intend to address the technical or economical issues for active debris removal. Rather, the objective is to provide a sensitivity study to quantify the effectiveness of various remediation options. A removal criterion based upon mass and collision probability is developed to rank objects at the beginning of each projection year. This study includes simulations with removal rates ranging from 2 to 20 objects per year, starting in the year 2020. The outcome of each simulation is analyzed, and compared with others. The summary of the study serves as a general guideline for future debris removal consideration.

  1. Demographic controls of future global fire risk

    NASA Astrophysics Data System (ADS)

    Knorr, W.; Arneth, A.; Jiang, L.

    2016-08-01

    Wildfires are an important component of terrestrial ecosystem ecology but also a major natural hazard to societies, and their frequency and spatial distribution must be better understood. At a given location, risk from wildfire is associated with the annual fraction of burned area, which is expected to increase in response to climate warming. Until recently, however, only a few global studies of future fire have considered the effects of other important global environmental change factors such as atmospheric CO2 levels and human activities, and how these influence fires in different regions. Here, we contrast the impact of climate change and increasing atmospheric CO2 content on burned area with that of demographic dynamics, using ensembles of climate simulations combined with historical and projected population changes under different socio-economic development pathways for 1901-2100. Historically, humans notably suppressed wildfires. For future scenarios, global burned area will continue to decline under a moderate emissions scenario, except for low population growth and fast urbanization, but start to increase again from around mid-century under high greenhouse gas emissions. Contrary to common perception, we find that human exposure to wildfires increases in the future mainly owing to projected population growth in areas with frequent wildfires, rather than by a general increase in burned area.

  2. Bacterial computing with engineered populations.

    PubMed

    Amos, Martyn; Axmann, Ilka Maria; Blüthgen, Nils; de la Cruz, Fernando; Jaramillo, Alfonso; Rodriguez-Paton, Alfonso; Simmel, Friedrich

    2015-07-28

    We describe strategies for the construction of bacterial computing platforms by describing a number of results from the recently completed bacterial computing with engineered populations project. In general, the implementation of such systems requires a framework containing various components such as intracellular circuits, single cell input/output and cell-cell interfacing, as well as extensive analysis. In this overview paper, we describe our approach to each of these, and suggest possible areas for future research. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  3. Mutational jackpot events generate effective frequency-dependent selection in adapting populations

    NASA Astrophysics Data System (ADS)

    Hallatschek, Oskar

    The site-frequency spectrum is one the most easily measurable quantities that characterize the genetic diversity of a population. While most neutral models predict that site frequency spectra should decay with increasing frequency, a high-frequency uptick has been reported in many populations. Anomalies in the high-frequency tail are particularly unsettling because the highest frequencies can be measured with greatest accuracy. Here, we show that an uptick in the spectrum of neutral mutations generally arises when mutant frequencies are dominated by rare jackpot events, mutational events with large descendant numbers. This leads to an effective pattern of frequency-dependent selection (or unstable internal equilibrium at one half frequency) that causes an accumulation of high-frequency polymorphic sites. We reproduce the known uptick occurring for recurrent hitchhiking (genetic draft) as well as rapid adaptation, and (in the future) generalize the shape of the high-frequency tail to other scenarios that are dominated by jackpot events, such as frequent range expansions. We also tackle (in the future) the inverse approach to use the high-frequency uptick for learning about the tail of the offspring number distribution. Positively selected alleles need to surpass, typically, an u NSF Career Award (PoLS), NIH NIGMS R01, Simons Foundation.

  4. Parenting stress among caregivers of children with chronic illness: a systematic review.

    PubMed

    Cousino, Melissa K; Hazen, Rebecca A

    2013-09-01

    To critically review, analyze, and synthesize the literature on parenting stress among caregivers of children with asthma, cancer, cystic fibrosis, diabetes, epilepsy, juvenile rheumatoid arthritis, and/or sickle cell disease. Method PsychInfo, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature were searched according to inclusion criteria. Meta-analysis of 13 studies and qualitative analysis of 96 studies was conducted. Results Caregivers of children with chronic illness reported significantly greater general parenting stress than caregivers of healthy children (d = .40; p = ≤.0001). Qualitative analysis revealed that greater general parenting stress was associated with greater parental responsibility for treatment management and was unrelated to illness duration and severity across illness populations. Greater parenting stress was associated with poorer psychological adjustment in caregivers and children with chronic illness. Conclusion Parenting stress is an important target for future intervention. General and illness-specific measures of parenting stress should be used in future studies.

  5. Quality of life profile of general Vietnamese population using EQ-5D-5L.

    PubMed

    Nguyen, Long Hoang; Tran, Bach Xuan; Hoang Le, Quynh Ngoc; Tran, Tung Thanh; Latkin, Carl A

    2017-10-11

    Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors. A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates. Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases). Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.

  6. A Review of Intervention Programs to Prevent and Treat Behavioral Problems in Young Children with Developmental Disabilities

    PubMed Central

    Petrenko, Christie L. M.

    2013-01-01

    Children with developmental disabilities are at higher risk for internalizing and externalizing behavioral problems than children in the general population. Effective prevention and treatment programs are necessary to reduce the burden of behavioral problems in this population. The current review identified 17 controlled trials of nine intervention programs for young children with developmental disabilities, with parent training the most common type of intervention in this population. Nearly all studies demonstrated medium to large intervention effects on child behavior post-intervention. Preliminary evidence suggests interventions developed for the general population can be effective for children with developmental disabilities and their families. A greater emphasis on the prevention of behavior problems in young children with developmental disabilities prior to the onset of significant symptoms or clinical disorders is needed. Multi-component interventions may be more efficacious for child behavior problems and yield greater benefits for parent and family adjustment. Recommendations for future research directions are provided. PMID:24222982

  7. Potential future scenarios for Australia's native biodiversity given on-going increases in human population.

    PubMed

    Pepper, D A; Lada, Hania; Thomson, James R; Bakar, K Shuvo; Lake, P S; Mac Nally, Ralph

    2017-01-15

    Most natural assets, including native biodiversity (our focus), are under increasing threat from direct (loss of habitat, hunting) and indirect (climate change) human actions. Most human impacts arise from increasing human populations coupled with rises in per capita resource use. The rates of change of human actions generally outpace those to which the biota can respond or adapt. If we are to maintain native biodiversity, then we must develop ways to envisage how the biota may be affected over the next several decades to guide management and policy responses. We consider the future for Australia's native biodiversity in the context of two assumptions. First, the human population in Australia will be 40million by 2050, which has been mooted by federal government agencies. Second, greenhouse gas emissions will track the highest rates considered by the Intergovernmental Panel on Climate Change. The scenarios are based on major drivers of change, which were constructed from seven key drivers of change pertinent to native biodiversity. Five scenarios deal with differing distributions of the human population driven by uncertainties in climate change and in the human responses to climate change. Other scenarios are governed largely by global change and explore different rates of resource use, unprecedented rates of technological change, capabilities and societal values. A narrative for each scenario is provided. The set of scenarios spans a wide range of possible future paths for Australia, with different implications for the future of native biodiversity. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Educating for the Future: Baseline Estimates of Minnesota's Educational Attainment

    ERIC Educational Resources Information Center

    Fergus, Meredith; Williams-Wyche, Shaun; Brower, Susan; Egbert, Andi

    2016-01-01

    In 2015, the Minnesota Legislature enacted legislation setting a target that 70 percent of Minnesota adults age 25 to 44 will have attained a postsecondary certificate or degree by 2025, both for the general population and by racial/ethnic subgroups. This report fulfills the mandated reporting pursuant to Minnesota's educational attainment goal,…

  9. Demographic Challenges in America's Future.

    ERIC Educational Resources Information Center

    Butz, William P.; And Others

    This document examines trends in the United States population since World War II, and projects a scenario of how demographic and economic phenomena may evolve over the next several decades. The report is divided into five sections. Section 1 introduces the volume and discusses generally some of the effects of the nation's transition to zero…

  10. Singing Ability, Musical Self-Concept, and Future Music Participation

    ERIC Educational Resources Information Center

    Demorest, Steven M.; Kelley, Jamey; Pfordresher, Peter Q.

    2017-01-01

    Research on adults who identify as "tone deaf" suggest that their poor musical self-concept is shaped by a view of themselves as nonsingers even when their perceptual skills and singing ability are not significantly worse than the general population. Many of these adults self-selected out of further participation as children but…

  11. The Future of Campus Recreation: Time for a Different Administrative Home?

    ERIC Educational Resources Information Center

    Milton, Paul R.; Roth, Lisa; Fisher, Wesley

    2011-01-01

    At the beginning of the 20th Century, collegiate campus recreation programs were moved from student controlled entities and placed under the supervision of academic or athletic departments (Milton, 2008a). As such programs grew and became more popular among the general student populations on America's college campuses, administrative oversight was…

  12. Individual and social discounting in a viscous population.

    PubMed

    Sozou, Peter D

    2009-08-22

    Social discounting in economics involves applying a diminishing weight to community-wide benefits or costs into the future. It impacts on public policy decisions involving future positive or negative effects, but there is no consensus on the correct basis for determining the social discount rate. This study presents an evolutionary biological framework for social discounting. How an organism should value future benefits to its local community is governed by the extent to which members of the community in the future are likely to be its kin. Trade-offs between immediate and delayed benefits to an individual or to its community are analysed for a modelled patch-structured iteroparous population with limited dispersal. It is shown that the social discount rate is generally lower than the individual (private) discount rate. The difference in the two rates is most pronounced, in ratio terms, when the dispersal level is low and the hazard rate for patch destruction is much smaller than the individual mortality rate. When decisions involve enforced collective action rather than individuals acting independently, social investment increases but the social discount rate remains the same.

  13. Efficacy and the Strength of Evidence of U.S. Alcohol Control Policies

    PubMed Central

    Nelson, Toben F.; Xuan, Ziming; Babor, Thomas; Brewer, Robert D.; Chaloupka, Frank J.; Gruenewald, Paul; Holder, Harold; Klitzner, Michael; Mosher, James; Ramirez, Rebecca L.; Reynolds, Robert; Toomey, Traci L.; Naimi, Timothy S.

    2013-01-01

    Background Public policy can limit alcohol consumption and its associated harms, but no direct comparison of the relative efficacy of alcohol control policies exists for the U.S. Purpose To identify alcohol control policies and develop quantitative ratings of their efficacy and strength of evidence. Methods In 2010, a Delphi panel of ten U.S. alcohol policy experts identified and rated the efficacy of alcohol control policies for reducing binge drinking and alcohol-impaired driving among both the general population and youth, and the strength of evidence informing the efficacy of each policy. The policies were nominated based on scientific evidence and potential for public health impact. Analysis was conducted in 2010–2012. Results Panelists identified and rated 47 policies. Policies limiting price received the highest ratings, with alcohol taxes receiving the highest ratings for all four outcomes. Highly rated policies for reducing binge drinking and alcohol-impaired driving in the general population were also highly rated among youth, although several policies were rated more highly for youth compared with the general population. Policy efficacy ratings for the general population and youth were positively correlated for reducing both binge drinking (r = 0.50) and alcohol-impaired driving (r = 0.45). The correlation between efficacy ratings for reducing binge drinking and alcohol-impaired driving was strong for the general population (r = 0.88) and for youth (r = 0.85). Efficacy ratings were positively correlated with strength-of-evidence ratings. Conclusions Comparative policy ratings can help characterize the alcohol policy environment, inform policy discussions, and identify future research needs. PMID:23790985

  14. Health requirements for advanced coal extraction systems

    NASA Technical Reports Server (NTRS)

    Zimmerman, W. F.

    1980-01-01

    Health requirements were developed as long range goals for future advanced coal extraction systems which would be introduced into the market in the year 2000. The goal of the requirements is that underground coal miners work in an environment that is as close as possible to the working conditions of the general population, that they do not exceed mortality and morbidity rates resulting from lung diseases that are comparable to those of the general population, and that their working conditions comply as closely as possible to those of other industries as specified by OSHA regulations. A brief technique for evaluating whether proposed advanced systems meet these safety requirements is presented, as well as a discussion of the costs of respiratory disability compensation.

  15. Prevalence of Behavioural and Psychological Symptoms of Dementia in Individuals with Learning Disabilities

    PubMed Central

    Devshi, Rajal; Shaw, Sarah; Elliott-King, Jordan; Hogervorst, Eef; Hiremath, Avinash; Velayudhan, Latha; Kumar, Satheesh; Baillon, Sarah; Bandelow, Stephan

    2015-01-01

    A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of dementia regardless of its subtype Research has indicated that there is a high prevalence of BPSD in the general dementia population. There are limited studies, which investigate the prevalence of BPSD within individuals who have learning disabilities and dementia. Findings suggest BPSDs are present within individuals with learning disabilities and dementia. Future research should use updated tools for investigating the prevalence of BPSD within individuals with learning disabilities and dementia. PMID:26854171

  16. Thyroid cancer incidence among active duty U.S. military personnel, 1990-2004

    PubMed Central

    Enewold, Lindsey R.; Zhou, Jing; Devesa, Susan S.; de Gonzalez, Amy Berrington; Anderson, William F.; Zahm, Shelia H.; Stojadinovic, Alexander; Peoples, George E.; Marrogi, Aizenhawar J.; Potter, John F.; McGlynn, Katherine A.; Zhu, Kangmin

    2011-01-01

    BACKGROUND Increases in thyroid papillary carcinoma incidence rates have largely been attributed to heightened medical surveillance and improved diagnostics. We examined papillary carcinoma incidence in an equal-access healthcare system by demographics, which are related to incidence. METHODS Incidence rates during 1990-2004 among white and black individuals aged 20-49 years in the military and the general U.S. population were compared using data from the Department of Defense’s Automated Central Tumor Registry and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER-9) program. RESULTS Incidence was significantly higher in the military than in the general population among white women [incidence rate ratio (IRR)=1.42, 95% 95% confidence interval (CI)=1.25-1.61], black women (IRR=2.31, 95% CI=1.70-2.99), and black men (IRR=1.69, 95% CI=1.10-2.50). Among whites, differences between the two populations were confined to rates of localized tumors (women: IRR=1.73, 95% CI=1.47-2.00; men: IRR=1.51, 95% CI=1.30-1.75), which may partially be due to variation in staging classification. Among white women, rates were significantly higher in the military regardless of tumor size, and rates rose significantly over time both for tumors ≤2 cm (military: IRR=1.64, 95% CI=1.18-2.28; general population: IRR=1.55, 95% CI=1.45-1.66) and >2 cm (military: IRR=1.74, 95% CI=1.07-2.81; general population: IRR=1.48, 95% CI=1.27-1.72). Among white men, rates increased significantly only in the general population. Incidence also varied by military service branch. CONCLUSIONS Heightened medical surveillance does not appear to fully explain the differences between the two populations or the temporal increases in either population. IMPACT These findings suggest the importance of future research into thyroid cancer etiology. PMID:21914838

  17. Predicting the genetic consequences of future climate change: The power of coupling spatial demography, the coalescent, and historical landscape changes.

    PubMed

    Brown, Jason L; Weber, Jennifer J; Alvarado-Serrano, Diego F; Hickerson, Michael J; Franks, Steven J; Carnaval, Ana C

    2016-01-01

    Climate change is a widely accepted threat to biodiversity. Species distribution models (SDMs) are used to forecast whether and how species distributions may track these changes. Yet, SDMs generally fail to account for genetic and demographic processes, limiting population-level inferences. We still do not understand how predicted environmental shifts will impact the spatial distribution of genetic diversity within taxa. We propose a novel method that predicts spatially explicit genetic and demographic landscapes of populations under future climatic conditions. We use carefully parameterized SDMs as estimates of the spatial distribution of suitable habitats and landscape dispersal permeability under present-day, past, and future conditions. We use empirical genetic data and approximate Bayesian computation to estimate unknown demographic parameters. Finally, we employ these parameters to simulate realistic and complex models of responses to future environmental shifts. We contrast parameterized models under current and future landscapes to quantify the expected magnitude of change. We implement this framework on neutral genetic data available from Penstemon deustus. Our results predict that future climate change will result in geographically widespread declines in genetic diversity in this species. The extent of reduction will heavily depend on the continuity of population networks and deme sizes. To our knowledge, this is the first study to provide spatially explicit predictions of within-species genetic diversity using climatic, demographic, and genetic data. Our approach accounts for climatic, geographic, and biological complexity. This framework is promising for understanding evolutionary consequences of climate change, and guiding conservation planning. © 2016 Botanical Society of America.

  18. Attitudes to Mental Illness and Its Demographic Correlates among General Population in Singapore

    PubMed Central

    Yuan, Qi; Abdin, Edimansyah; Picco, Louisa; Vaingankar, Janhavi Ajit; Shahwan, Shazana; Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Shafie, Saleha; Tay, Jenny; Chong, Siow Ann; Subramaniam, Mythily

    2016-01-01

    Background Public attitudes to mental illness could influence how the public interact with, provide opportunities for, and help people with mental illness. Aims This study aims to explore the underlying factors of the Attitudes to Mental Illness questionnaire among the general population in Singapore and the socio-demographic correlates of each factor. Methods From March 2014 to April 2015, a nation-wide cross-sectional survey on mental health literacy with 3,006 participants was conducted in Singapore. Results Factor analysis revealed a 4-factor structure for the Attitudes to Mental Illness questionnaire among the Singapore general population, namely social distancing, tolerance/support for community care, social restrictiveness, and prejudice and misconception. Older age, male gender, lower education and socio-economic status were associated with more negative attitudes towards the mentally ill. Chinese showed more negative attitudes than Indians and Malays (except for prejudice and misconception). Conclusions There is a need for culture-specific interventions, and the associated factors identified in this study should be considered for future attitude campaigns. PMID:27893796

  19. Multimorbidity prevalence and patterns across socioeconomic determinants: a cross-sectional survey.

    PubMed

    Agborsangaya, Calypse B; Lau, Darren; Lahtinen, Markus; Cooke, Tim; Johnson, Jeffrey A

    2012-03-19

    Studies on the prevalence of multimorbidity, defined as having two or more chronic conditions, have predominantly focused on the elderly. We estimated the prevalence and specific patterns of multimorbidity across different adult age groups. Furthermore, we examined the associations of multimorbidity with socio-demographic factors. Using data from the Health Quality Council of Alberta (HQCA) 2010 Patient Experience Survey, the prevalence of self reported multimorbidity was assessed by telephone interview among a sample of 5010 adults (18 years and over) from the general population. Logistic regression analyses were performed to determine the association between a range of socio-demographic factors and multimorbidity. The overall age- and sex-standardized prevalence of multimorbidity was 19.0% in the surveyed general population. Of those with multimorbidity, 70.2% were aged less than 65 years. The most common pairing of chronic conditions was chronic pain and arthritis. Age, sex, income and family structure were independently associated with multimorbidity. Multimorbidity is a common occurrence in the general adult population, and is not limited to the elderly. Future prevention programs and practice guidelines should take into account the common patterns of multimorbidity.

  20. Development of conceptual ecological models linking management of the Missouri River to pallid sturgeon population dynamics

    USGS Publications Warehouse

    Jacobson, Robert B.; Parsley, Michael J.; Annis, Mandy L.; Colvin, Michael E.; Welker, Timothy L.; James, Daniel A.

    2015-01-01

    This report documents the process of developing and refining conceptual ecological models (CEMs) for linking river management to pallid sturgeon (Scaphirhynchus albus) population dynamics in the Missouri River. The refined CEMs are being used in the Missouri River Pallid Sturgeon Effects Analysis to organize, document, and formalize an understanding of pallid sturgeon population responses to past and future management alternatives. The general form of the CEMs, represented by a population-level model and component life-stage models, was determined in workshops held in the summer of 2013. Subsequently, the Missouri River Pallid Sturgeon Effects Analysis team designed a general hierarchical structure for the component models, refined the graphical structure, and reconciled variation among the components and between models developed for the upper river (Upper Missouri & Yellowstone Rivers) and the lower river (Missouri River downstream from Gavins Point Dam). Importance scores attributed to the relations between primary biotic characteristics and survival were used to define a candidate set of working dominant hypotheses about pallid sturgeon population dynamics. These CEMs are intended to guide research and adaptive-management actions to benefit pallid sturgeon populations in the Missouri River.

  1. Climate, CO2 and human population impacts on global wildfire emissions

    NASA Astrophysics Data System (ADS)

    Knorr, W.; Jiang, L.; Arneth, A.

    2016-01-01

    Wildfires are by far the largest contributor to global biomass burning and constitute a large global source of atmospheric traces gases and aerosols. Such emissions have a considerable impact on air quality and constitute a major health hazard. Biomass burning also influences the radiative balance of the atmosphere and is thus not only of societal, but also of significant scientific interest. There is a common perception that climate change will lead to an increase in emissions as hot and dry weather events that promote wildfire will become more common. However, even though a few studies have found that the inclusion of CO2 fertilisation of photosynthesis and changes in human population patterns will tend to somewhat lower predictions of future wildfire emissions, no such study has included full ensemble ranges of both climate predictions and population projections, including the effect of different degrees of urbanisation.

    Here, we present a series of 124 simulations with the LPJ-GUESS-SIMFIRE global dynamic vegetation-wildfire model, including a semi-empirical formulation for the prediction of burned area based on fire weather, fuel continuity and human population density. The simulations use Climate Model Intercomparison Project 5 (CMIP5) climate predictions from eight Earth system models. These were combined with two Representative Concentration Pathways (RCPs) and five scenarios of future human population density based on the series of Shared Socioeconomic Pathways (SSPs) to assess the sensitivity of emissions to the effect of climate, CO2 and humans. In addition, two alternative parameterisations of the semi-empirical burned-area model were applied. Contrary to previous work, we find no clear future trend of global wildfire emissions for the moderate emissions and climate change scenario based on the RCP 4.5. Only historical population change introduces a decline by around 15 % since 1900. Future emissions could either increase for low population growth and fast urbanisation, or continue to decline for high population growth and slow urbanisation. Only for high future climate change (RCP8.5), wildfire emissions start to rise again after ca. 2020 but are unlikely to reach the levels of 1900 by the end of the 21st century. We find that climate warming will generally increase the risk of fire, but that this is only one of several equally important factors driving future levels of wildfire emissions, which include population change, CO2 fertilisation causing woody thickening, increased productivity and fuel load and faster litter turnover in a warmer climate.

  2. Expansion of HIV/AIDS in China: Lessons from Yunnan Province

    PubMed Central

    Xiao, Yan; Kristensen, Sibylle; Sun, Jiangping; Lu, Lin; Vermund, Sten H.

    2009-01-01

    In this article we systematically and critically review the Chinese and English language literature on human immunodeficiency virus (HIV)-related studies in Yunnan Province, Southwestern China. Yunnan Province had the first Chinese HIV outbreak and is still the worst affected area in the nation. Since 1989, HIV infection has extended from injecting drug users into the general population through sexual transmission. Since the economic reform of the 1980s, changed social norms and increased migration have spawned increases in HIV-related risk behaviors such as drug use and commercial sex work. A smaller size of “bridge” populations and lower sexual contact rates between persons in “bridge” and general populations may explain the slower expansion of the HIV epidemic in Yunnan compared to nearby Southeast Asian nations. In 2004, women in antenatal care had a 0.38% HIV prevalence province wide, although >1% infection rates are seen in those counties with high injection drug rates. Patterns of drug trafficking have spread the unusual recombinant HIV subtypes first seen in Yunnan to far-flung regions of China. Increased efforts of Yunnan’s HIV control program are correlated with an improved general HIV awareness, but risk behaviors continue at worrisome rates. Future efforts should focus on changing risk behaviors, including harm reduction and condom promotion, especially among the “bridge” groups. The resurgence of commercial sex work in Yunnan, and the high frequency of workers migrating into provinces far from home and family are all sociocultural factors of considerable importance for future HIV and sexually transmitted disease control in China. PMID:17107739

  3. Factors Contributing to the Self-Reported Prevalence of Multiple Chemical Sensitivity in Public Facility Workers and the General Population of Korea.

    PubMed

    Heo, Yong; Kim, Sang-Hoon; Lee, Seok-Ki; Kim, Hyoung-Ah

    Multiple chemical sensitivity (MCS), an acquired disorder with multiple recurrent symptoms, has been studied for its association with diverse environmental factors. The present study investigated the factors associated with the self-reported prevalence of MCS in public facility workers and the general population in Korea. The Quick Environmental Exposure Sensitivity Inventory (QEESI) questionnaire was obtained from public facility workers (N=530) and the general population (N=500) to determine the prevalence of MCS and the degree of its risk. Information about demographic characteristics, subjective perceptions of sick building syndrome or sick house syndrome or allergy (SBS/SHS/Allergy), and certain home- or workplace-related events were also obtained. There was not a statistical difference between the public facility workers and the general population in the QEESI scores. The overall prevalence of MCS was 14.4% and there was no statistical difference between the two groups. Regarding the overall degree of risk of MCS, 21.8% of the study subjects were categorized as "very suggestive", and there was no significant difference between the two groups. Gender and the subjective perception of SBS/SHS/Allergy significantly affected the prevalence of MCS and the MCS risk criteria. Considering the absence of diagnostic criteria and/or treatment methods for MCS in Korea, these results can be utilized in establishing future strategies to manage MCS.

  4. A sex-specific comparison of major depressive disorder symptomatology in the canadian forces and the general population.

    PubMed

    Erickson, Julie; Kinley, D Jolene; Bolton, James M; Zamorski, Mark A; Enns, Murray W; Sareen, Jitender

    2014-07-01

    To compare major depressive disorder (MDD) symptomatology within men and women in a large, representative sample of Canadian military personnel and civilians. We used the Canadian Community Health Survey: Mental Health and Well-Being (Cycle 1.2 and Canadian Forces Supplement) (n = 36 984 and n = 8441, respectively) to compare past-year MDD symptomatology among military and civilian women, and military and civilian men. Logistic regression models were used to determine differences in the types of depressive symptoms endorsed in each group. Men in the military with MDD were at lower odds than men in the general population to endorse numerous symptoms of depression, such as hopelessness (adjusted odds ratio [AOR] 0.44; 99% CI 0.23 to 0.83) and inability to cope (AOR 0.53; 99% CI 0.31 to 0.92). Military women with MDD were at lower odds of thinking about their death (AOR 0.52; 99% CI 0.32 to 0.86), relative to women with MDD in the general population. Different MDD symptomatology among males and females in the military, compared with those in the general population, may reflect selection effects (for example, personality characteristics and patterns of comorbidity) or occupational experiences unique to military personnel. Future research examining the mechanisms behind MDD symptomatology in military personnel and civilians is required.

  5. A Sex-Specific Comparison of Major Depressive Disorder Symptomatology in the Canadian Forces and the General Population

    PubMed Central

    Erickson, Julie; Kinley, D Jolene; Bolton, James M; Zamorski, Mark A; Enns, Murray W; Sareen, Jitender

    2014-01-01

    Objective: To compare major depressive disorder (MDD) symptomatology within men and women in a large, representative sample of Canadian military personnel and civilians. Method: We used the Canadian Community Health Survey: Mental Health and Well-Being (Cycle 1.2 and Canadian Forces Supplement) (n = 36 984 and n = 8441, respectively) to compare past-year MDD symptomatology among military and civilian women, and military and civilian men. Logistic regression models were used to determine differences in the types of depressive symptoms endorsed in each group. Results: Men in the military with MDD were at lower odds than men in the general population to endorse numerous symptoms of depression, such as hopelessness (adjusted odds ratio [AOR] 0.44; 99% CI 0.23 to 0.83) and inability to cope (AOR 0.53; 99% CI 0.31 to 0.92). Military women with MDD were at lower odds of thinking about their death (AOR 0.52; 99% CI 0.32 to 0.86), relative to women with MDD in the general population. Conclusion: Different MDD symptomatology among males and females in the military, compared with those in the general population, may reflect selection effects (for example, personality characteristics and patterns of comorbidity) or occupational experiences unique to military personnel. Future research examining the mechanisms behind MDD symptomatology in military personnel and civilians is required. PMID:25007423

  6. Exercise and mental health: a review.

    PubMed

    Glenister, D

    1996-02-01

    With the advent of programmes to raise the level of fitness in the general population, and alliances between primary health care and community leisure services, the potential of exercise in promoting mental as well as physical health deserves investigation. In contrast to USA and continental Europe, there is a paucity of British research studies systematically exploring the mental health benefits of exercise. The recent rapid growth of exercise prescription among general practitioners presents an opportunity for future research. This review of eleven randomised control trials (RCTs) suggests a causal relationship between exercise and mental health based upon studies in various settings. The methodological difficulties associated with randomised control trials of psycho-social interventions are discussed. The value of future randomised control trials which incorporate examination of perceived acceptability and health economics is indicated.

  7. Genetic structure of muskellunge in the Great Lakes region and the effects of supplementation on genetic integrity of wild populations

    USGS Publications Warehouse

    Turnquist, Keith N.; Larson, Wesley; Farrell, John M.; Hanchin, P.A.; Kapuscinski, Kevin L.; Miller, Loren M.; Scribner, Kim T.; Wilson, Chris C.; Sloss, Brian L.

    2017-01-01

    Muskellunge (Esox masquinongy) are important apex predators that support numerous recreational fisheries throughout the Great Lakes region. Declines in muskellunge abundance from historical overharvest and environmental degradation have threatened the viability of many populations and prompted significant restoration efforts that often include stocking. The goal of our study was to investigate contemporary population structure and genetic diversity in 42 populations of muskellunge sampled across the Great Lakes region to inform future management and supplementation practices. We genotyped 1896 muskellunge (N = 10–123/population) at 13 microsatellite loci. The greatest genetic variation was between populations of Great Lakes origin and populations of Northern (inland) origin, with both groups also exhibiting significant substructure (overall FST = 0.23). Genetic structure was generally correlated with geography; however, we only found marginal evidence of isolation by distance, likely due to high genetic differentiation among proximate populations. Measures of genetic diversity were moderate across most populations, but some populations displayed low diversity consistent with small population sizes or historical bottlenecks. Many of the populations studied displayed evidence of historic introductions and supplemental stocking, including the presence of individuals with primarily non-native ancestry as well as interlineage hybrids. Our results suggest that the historic population structure of muskellunge is largely intact across the Great Lakes region, but also that stocking practices have altered this structure to some degree. We suggest that future supplementation practices use local sources where possible, and incorporate genetic tools including broodstock screening to ensure that non-native muskellunge are not used to supplement wild populations.

  8. Distribution of Salivary Testosterone in Men and Women in a British General Population-Based Sample: The Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

    PubMed Central

    Clifton, Soazig; Tanton, Clare; Macdowall, Wendy; Copas, Andrew J.; Lee, David; Field, Nigel; Mitchell, Kirstin R.; Sonnenberg, Pam; Bancroft, John; Mercer, Cath H.; Johnson, Anne M.; Wellings, Kaye; Wu, Frederick C. W.

    2017-01-01

    Introduction: Measurement of salivary testosterone (Sal-T) to assess androgen status offers important potential advantages in epidemiological research. The utility of the method depends on the interpretation of the results against robustly determined population distributions, which are currently lacking. Aim: To determine age-specific Sal-T population distributions for men and women. Methods: Morning saliva samples were obtained from participants in the third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey of the British general population. Sal-T was measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Linear and quantile regression analyses were used to determine the age-specific 2.5th and 97.5th percentiles for the general population (1675 men and 2453 women) and the population with health exclusions (1145 men and 1276 women). Results: In the general population, the mean Sal-T level in men decreased from 322.6 pmol/L at 18 years of age to 153.9 pmol/L at 69 years of age. In women, the decrease in the geometric mean Sal-T level was from 39.8 pmol/L at 18 years of age to 19.5 pmol/L at 74 years of age. The annual decrease varied with age, with an average of 1.0% to 1.4% in men and 1.3% to 1.5% in women. For women, the 2.5th percentile fell below the detection limit (<6.5 pmol/L) from age 52 years onward. The mean Sal-T level was approximately 6 times greater in men than in women, and this remained constant over the age range. The Sal-T level was lowest for men and highest for women in the summer. The results were similar for the general population with exclusions. Conclusions: To our knowledge, this is the first study to describe the sex- and age-specific distributions for Sal-T in a large representative population using a specific and sensitive LC-MS/MS technique. The present data can inform future population research by facilitating the interpretation of Sal-T results as a marker of androgen status. PMID:29264442

  9. Archived DNA reveals fisheries and climate induced collapse of a major fishery.

    PubMed

    Bonanomi, Sara; Pellissier, Loïc; Therkildsen, Nina Overgaard; Hedeholm, Rasmus Berg; Retzel, Anja; Meldrup, Dorte; Olsen, Steffen Malskær; Nielsen, Anders; Pampoulie, Christophe; Hemmer-Hansen, Jakob; Wisz, Mary Susanne; Grønkjær, Peter; Nielsen, Einar Eg

    2015-10-22

    Fishing and climate change impact the demography of marine fishes, but it is generally ignored that many species are made up of genetically distinct locally adapted populations that may show idiosyncratic responses to environmental and anthropogenic pressures. Here, we track 80 years of Atlantic cod (Gadus morhua) population dynamics in West Greenland using DNA from archived otoliths in combination with fish population and niche based modeling. We document how the interacting effects of climate change and high fishing pressure lead to dramatic spatiotemporal changes in the proportions and abundance of different genetic populations, and eventually drove the cod fishery to a collapse in the early 1970s. Our results highlight the relevance of fisheries management at the level of genetic populations under future scenarios of climate change.

  10. Archived DNA reveals fisheries and climate induced collapse of a major fishery

    PubMed Central

    Bonanomi, Sara; Pellissier, Loïc; Therkildsen, Nina Overgaard; Hedeholm, Rasmus Berg; Retzel, Anja; Meldrup, Dorte; Olsen, Steffen Malskær; Nielsen, Anders; Pampoulie, Christophe; Hemmer-Hansen, Jakob; Wisz, Mary Susanne; Grønkjær, Peter; Nielsen, Einar Eg

    2015-01-01

    Fishing and climate change impact the demography of marine fishes, but it is generally ignored that many species are made up of genetically distinct locally adapted populations that may show idiosyncratic responses to environmental and anthropogenic pressures. Here, we track 80 years of Atlantic cod (Gadus morhua) population dynamics in West Greenland using DNA from archived otoliths in combination with fish population and niche based modeling. We document how the interacting effects of climate change and high fishing pressure lead to dramatic spatiotemporal changes in the proportions and abundance of different genetic populations, and eventually drove the cod fishery to a collapse in the early 1970s. Our results highlight the relevance of fisheries management at the level of genetic populations under future scenarios of climate change. PMID:26489934

  11. Archived DNA reveals fisheries and climate induced collapse of a major fishery

    NASA Astrophysics Data System (ADS)

    Bonanomi, Sara; Pellissier, Loïc; Therkildsen, Nina Overgaard; Hedeholm, Rasmus Berg; Retzel, Anja; Meldrup, Dorte; Olsen, Steffen Malskær; Nielsen, Anders; Pampoulie, Christophe; Hemmer-Hansen, Jakob; Wisz, Mary Susanne; Grønkjær, Peter; Nielsen, Einar Eg

    2015-10-01

    Fishing and climate change impact the demography of marine fishes, but it is generally ignored that many species are made up of genetically distinct locally adapted populations that may show idiosyncratic responses to environmental and anthropogenic pressures. Here, we track 80 years of Atlantic cod (Gadus morhua) population dynamics in West Greenland using DNA from archived otoliths in combination with fish population and niche based modeling. We document how the interacting effects of climate change and high fishing pressure lead to dramatic spatiotemporal changes in the proportions and abundance of different genetic populations, and eventually drove the cod fishery to a collapse in the early 1970s. Our results highlight the relevance of fisheries management at the level of genetic populations under future scenarios of climate change.

  12. [Perspectives and challenges to guarantee training and renewal in general internal medicine].

    PubMed

    Waeber, G; Cornuz, J; Gaspoz, J-M; Pécoud, A; Perrier, A

    2009-01-28

    Training new doctors in general internal medicine represents a challenge. This requires to define future needs, which result from interest that are not necessarily convergent between patients, doctors, insurers and politicians. Problems related to medical demography in Switzerland, with the ageing of the population, the increase in health care costs and the place of Switzerland within the European Community require the implementation of specific objectives to train new physicians in general internal medicine. The success of these opportunities depends on social factors, political choices and choices from physician's association. In this article we will approach these challenges by formulating some proposals--nonexhaustive--in order to guarantee sufficient renewal in general internal medicine.

  13. The future of the welfare state: crisis myths and crisis realities.

    PubMed

    Castles, Francis G

    2002-01-01

    Accounts of the future of the welfare state are often presented in crisis terms. Some commentators identify globalization as a force that has already led to a major retreat by the state and is likely to lead to further downsizing of the public sector. Others see the future burden of an aging population as creating huge public expenditure pressures that can be countered only by increased parsimony in most areas of spending. Although both crisis scenarios contain elements of truth, analysis of recent public expenditure trends shows that both are substantially exaggerated as general representations of likely developments over the next two or three decades. However, unnoticed by most commentators, a real, longer-term crisis is beginning to make itself felt. This crisis arises, in part, from the demographic impact of a cultural transformation in the labor market, in progress for several decades. Extreme scenarios of possible consequences over the next 50 to 100 years include population implosion, mass migration, increasingly dangerous eruptions of right-wing populism, and, possibly, territorial conflict between developed and underdeveloped nations. This is not a crisis of the welfare state but rather a crisis for which the welfare state may be an essential part of the answer. The only way Western societies can lessen the future impact of the ongoing cultural transformation of the labor market is through the redesign of welfare state institutions to confront these new challenges.

  14. Plasma Free Amino Acid Profiles Predict Four-Year Risk of Developing Diabetes, Metabolic Syndrome, Dyslipidemia, and Hypertension in Japanese Population

    PubMed Central

    Yamakado, Minoru; Nagao, Kenji; Imaizumi, Akira; Tani, Mizuki; Toda, Akiko; Tanaka, Takayuki; Jinzu, Hiroko; Miyano, Hiroshi; Yamamoto, Hiroshi; Daimon, Takashi; Horimoto, Katsuhisa; Ishizaka, Yuko

    2015-01-01

    Plasma free amino acid (PFAA) profile is highlighted in its association with visceral obesity and hyperinsulinemia, and future diabetes. Indeed PFAA profiling potentially can evaluate individuals’ future risks of developing lifestyle-related diseases, in addition to diabetes. However, few studies have been performed especially in Asian populations, about the optimal combination of PFAAs for evaluating health risks. We quantified PFAA levels in 3,701 Japanese subjects, and determined visceral fat area (VFA) and two-hour post-challenge insulin (Ins120 min) values in 865 and 1,160 subjects, respectively. Then, models between PFAA levels and the VFA or Ins120 min values were constructed by multiple linear regression analysis with variable selection. Finally, a cohort study of 2,984 subjects to examine capabilities of the obtained models for predicting four-year risk of developing new-onset lifestyle-related diseases was conducted. The correlation coefficients of the obtained PFAA models against VFA or Ins120 min were higher than single PFAA level. Our models work well for future risk prediction. Even after adjusting for commonly accepted multiple risk factors, these models can predict future development of diabetes, metabolic syndrome, and dyslipidemia. PFAA profiles confer independent and differing contributions to increasing the lifestyle-related disease risks in addition to the currently known factors in a general Japanese population. PMID:26156880

  15. Identification of population substructure among Jews using STR markers and dependence on reference populations included.

    PubMed

    Listman, Jennifer B; Hasin, Deborah; Kranzler, Henry R; Malison, Robert T; Mutirangura, Apiwat; Sughondhabirom, Atapol; Aharonovich, Efrat; Spivak, Baruch; Gelernter, Joel

    2010-06-14

    Detecting population substructure is a critical issue for association studies of health behaviors and other traits. Whether inherent in the population or an artifact of marker choice, determining aspects of a population's genetic history as potential sources of substructure can aid in design of future genetic studies. Jewish populations, among which association studies are often conducted, have a known history of migrations. As a necessary step in understanding population structure to conduct valid association studies of health behaviors among Israeli Jews, we investigated genetic signatures of this history and quantified substructure to facilitate future investigations of these phenotypes in this population. Using 32 autosomal STR markers and the program STRUCTURE, we differentiated between Ashkenazi (AJ, N = 135) and non-Ashkenazi (NAJ, N = 226) Jewish populations in the form of Northern and Southern geographic genetic components (AJ north 73%, south 23%, NAJ north 33%, south 60%). The ability to detect substructure within these closely related populations using a small STR panel was contingent on including additional samples representing major continental populations in the analyses. Although clustering programs such as STRUCTURE are designed to assign proportions of ancestry to individuals without reference population information, when Jewish samples were analyzed in the absence of proxy parental populations, substructure within Jews was not detected. Generally, for samples with a given grandparental country of birth, STRUCTURE assignment values to Northern, Southern, African and Asian clusters agreed with mitochondrial DNA and Y-chromosomal data from previous studies as well as historical records of migration and intermarriage.

  16. Identification of population substructure among Jews using STR markers and dependence on reference populations included

    PubMed Central

    2010-01-01

    Background Detecting population substructure is a critical issue for association studies of health behaviors and other traits. Whether inherent in the population or an artifact of marker choice, determining aspects of a population's genetic history as potential sources of substructure can aid in design of future genetic studies. Jewish populations, among which association studies are often conducted, have a known history of migrations. As a necessary step in understanding population structure to conduct valid association studies of health behaviors among Israeli Jews, we investigated genetic signatures of this history and quantified substructure to facilitate future investigations of these phenotypes in this population. Results Using 32 autosomal STR markers and the program STRUCTURE, we differentiated between Ashkenazi (AJ, N = 135) and non-Ashkenazi (NAJ, N = 226) Jewish populations in the form of Northern and Southern geographic genetic components (AJ north 73%, south 23%, NAJ north 33%, south 60%). The ability to detect substructure within these closely related populations using a small STR panel was contingent on including additional samples representing major continental populations in the analyses. Conclusions Although clustering programs such as STRUCTURE are designed to assign proportions of ancestry to individuals without reference population information, when Jewish samples were analyzed in the absence of proxy parental populations, substructure within Jews was not detected. Generally, for samples with a given grandparental country of birth, STRUCTURE assignment values to Northern, Southern, African and Asian clusters agreed with mitochondrial DNA and Y-chromosomal data from previous studies as well as historical records of migration and intermarriage. PMID:20546593

  17. National surveys of military personnel, nursing students, and the public: drivers of military nursing careers.

    PubMed

    Donelan, Karen; Romano, Carol; Buerhaus, Peter; DesRoches, Catherine; Applebaum, Sandra; Ward, Johanna Rm; Schoneboom, Bruce A; Hinshaw, Ada Sue

    2014-05-01

    The U.S. health care system is facing a projected nursing shortage of unprecedented magnitude. Although military nursing services recently have been able to meet their nursing recruitment quotas, national studies have predicted a long-term nursing shortage that may affect future recruitment for the Nurse Corps of the three military services. Data are needed to plan for recruitment incentives and the impact of those incentives on targeted populations of likely future nurses. Data are drawn from three online surveys conducted in 2011-2012, including surveys of 1,302 Army, Navy, and Air Force personnel serving on major military bases, 914 nursing students at colleges with entry Bachelor of Science in Nursing programs located nearby major military bases, and a qualitative survey of 1,200 young adults, age 18-39, in the general public. The three populations are different in several demographic characteristics. We explored perceptions of military careers, nursing careers and barriers, and incentives to pursue military nursing careers in all populations. Perceptions differ among the groups. The results of this study may help to inform strategies for reaching out to specific populations with targeted messages that focus on barriers and facilitators relevant to each to successfully recruit a diverse Nurse Corps for the future. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  18. [Effects on female healthcare workers of the ministry of health campaign against tobacco smoking.

    PubMed

    La Torre, Giuseppe; Guastamacchia, Sergio; Barbagallo, Alfio; Mannocci, Alice

    2017-11-01

    Smoking prevalence among health care workers is higher in comparison with general population and the prevalence of women who smoke is higher than among men. In the prevention strategies the multimedia campaign may be a positive impact on the fight against tobacco. Objective. The aim of the study was to assess the impact of the last Italian campaign against smoking (Il fumo fammale) in the health care women workers. A cross-sectional study was conducted in Latium and Sicily (Italy) in 2015, through an interview on memories and impressions about the spots and after a new vision of the spot and eventually other comments. 357 individuals entered the study, 204 female health care workers and 153 from the general population. The female health care workers were more skeptical than the general population. The impressions aroused in the healthcare workers versus the general population were: sadness (OR=2.96;IC95%:1.17-7.49), indifference (OR=5.57;IC95%:2.43-12.77); while a cue to reflect was more considered from general population than health care workers (OR=0.13;IC95%:0.07-0.23). The female professionals health referred the main characteristics of the spot as no original, no impactful, no persuasive and boring too. In conclusion the multimedia campaign to fight against the smoking should be useful, but the psico-behavioural factors have applied and considered when it is implemented; to reduce the tobacco consumption in the healthcare workers can make them an example for the people of healthy life styles and they are a start up of prevention mechanism too. Furthermore it is important to consider the healthcare professional's opinions for future healthy communications and multimedia campaign on tobacco harm. Copyright© by Aracne Editrice, Roma, Italy.

  19. Grip Strength Is Associated With Cognitive Performance in Schizophrenia and the General Population: A UK Biobank Study of 476559 Participants.

    PubMed

    Firth, Joseph; Stubbs, Brendon; Vancampfort, Davy; Firth, Josh A; Large, Matthew; Rosenbaum, Simon; Hallgren, Mats; Ward, Philip B; Sarris, Jerome; Yung, Alison R

    2018-06-06

    Handgrip strength may provide an easily-administered marker of cognitive functional status. However, further population-scale research examining relationships between grip strength and cognitive performance across multiple domains is needed. Additionally, relationships between grip strength and cognitive functioning in people with schizophrenia, who frequently experience cognitive deficits, has yet to be explored. Baseline data from the UK Biobank (2007-2010) was analyzed; including 475397 individuals from the general population, and 1162 individuals with schizophrenia. Linear mixed models and generalized linear mixed models were used to assess the relationship between grip strength and 5 cognitive domains (visual memory, reaction time, reasoning, prospective memory, and number memory), controlling for age, gender, bodyweight, education, and geographical region. In the general population, maximal grip strength was positively and significantly related to visual memory (coefficient [coeff] = -0.1601, standard error [SE] = 0.003), reaction time (coeff = -0.0346, SE = 0.0004), reasoning (coeff = 0.2304, SE = 0.0079), number memory (coeff = 0.1616, SE = 0.0092), and prospective memory (coeff = 0.3486, SE = 0.0092: all P < .001). In the schizophrenia sample, grip strength was strongly related to visual memory (coeff = -0.155, SE = 0.042, P < .001) and reaction time (coeff = -0.049, SE = 0.009, P < .001), while prospective memory approached statistical significance (coeff = 0.233, SE = 0.132, P = .078), and no statistically significant association was found with number memory and reasoning (P > .1). Grip strength is significantly associated with cognitive functioning in the general population and individuals with schizophrenia, particularly for working memory and processing speed. Future research should establish directionality, examine if grip strength also predicts functional and physical health outcomes in schizophrenia, and determine whether interventions which improve muscular strength impact on cognitive and real-world functioning.

  20. Prevalence of food sensitization and probable food allergy among adults in India: the EuroPrevall INCO study.

    PubMed

    Mahesh, P A; Wong, Gary W K; Ogorodova, L; Potts, J; Leung, T F; Fedorova, O; Holla, Amrutha D; Fernandez-Rivas, M; Clare Mills, E N; Kummeling, I; Versteeg, S A; van Ree, R; Yazdanbakhsh, M; Burney, P

    2016-07-01

    Data are lacking regarding the prevalence of food sensitization and probable food allergy among general population in India. We report the prevalence of sensitization and probable food allergy to 24 common foods among adults from general population in Karnataka, South India. The study was conducted in two stages: a screening study and a case-control study. A total of 11 791 adults in age group 20-54 were randomly sampled from general population in South India and answered a screening questionnaire. A total of 588 subjects (236 cases and 352 controls) participated in the case-control study involving a detailed questionnaire and specific IgE estimation for 24 common foods. A high level of sensitization (26.5%) was observed for most of the foods in the general population, higher than that observed among adults in Europe, except for those foods that cross-react with birch pollen. Most of the sensitization was observed in subjects who had total IgE above the median IgE level. A high level of cross-reactivity was observed among different pollens and foods and among foods. The prevalence of probable food allergy (self-reports of adverse symptoms after the consumption of food and specific IgE to the same food) was 1.2%, which was mainly accounted for cow's milk (0.5%) and apple (0.5%). Very high levels of sensitization were observed for most foods, including those not commonly consumed in the general population. For the levels of sensitization, the prevalence of probable food allergy was low. This disassociation needs to be further explored in future studies. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. HSV-2 serology can be predictive of HIV epidemic potential and hidden sexual-risk behavior in the Middle East and North Africa

    PubMed Central

    Abu-Raddad, Laith J.; Schiffer, Joshua T.; Ashley, Rhoda; Mumtaz, Ghina; Alsallaq, Ramzi A.; Akala, Francisca Ayodeji; Semini, Iris; Riedner, Gabriele; Wilson, David

    2013-01-01

    Background HIV prevalence is low in the Middle East and North Africa (MENA) region, though the risk or potential for further spread in the future is not well understood. Behavioral surveys are limited in this region and when available have serious limitations in assessing the risk of HIV acquisition. We demonstrate the potential use of herpes simplex virus-2 (HSV-2) seroprevalence as a marker for HIV risk within MENA. Methods We designed a mathematical model to assess whether HSV-2 prevalence can be predictive of future HIV spread. We also conducted a systematic literature review of HSV-2 seroprevalence studies within MENA. Results We found that HSV-2 prevalence data are rather limited in this region. Prevalence is typically low among the general population but high in established core groups prone to sexually transmitted infections such as men who have sex with men and female sex workers. Our model predicts that if HSV-2 prevalence is low and stable, then the risk of future HIV epidemics is low. However, expanding or high HSV-2 prevalence (greater than about 20%), implies a risk for a considerable HIV epidemic. Based on available HSV-2 prevalence data, it is not likely that the general population in MENA is experiencing or will experience such a considerable HIV epidemic. Nevertheless, the risk for concentrated HIV epidemics among several high-risk core groups is high. Conclusions HSV-2 prevalence surveys provide a useful mechanism for identifying and corroborating populations at risk for HIV within MENA. HSV-2 serology offers an effective tool for probing hidden risk behaviors in a region where quality behavioral data are limited. PMID:21352788

  2. Climate, CO2, and demographic impacts on global wildfire emissions

    NASA Astrophysics Data System (ADS)

    Knorr, W.; Jiang, L.; Arneth, A.

    2015-09-01

    Wildfires are by far the largest contributor to global biomass burning and constitute a large global source of atmospheric traces gases and aerosols. Such emissions have a considerable impact on air quality and constitute a major health hazard. Biomass burning also influences the radiative balance of the atmosphere and is thus not only of societal, but also of significant scientific interest. There is a common perception that climate change will lead to an increase in emissions as hot and dry weather events that promote wildfire will become more common. However, even though a few studies have found that the inclusion of CO2 fertilization of photosynthesis and changes in human population patterns will tend to somewhat lower predictions of future wildfire emissions, no such study has included full ensemble ranges of both climate predictions and population projections, including the effect of different degrees of urbanisation. Here, we present a series of 124 simulations with the LPJ-GUESS-SIMFIRE global dynamic vegetation - wildfire model, including a semi-empirical formulation for the prediction of burned area based on fire weather, fuel continuity and human population density. The simulations comprise Climate Model Intercomparison Project 5 (CMIP5) climate predictions from eight Earth system models using two Representative Concentration Pathways (RCPs) and five scenarios of future human population density based on the series of Shared Socioeconomic Pathways (SSPs), sensitivity tests for the effect of climate and CO2, as well as a sensitivity analysis using two alternative parameterisations of the semi-empirical burned-area model. Contrary to previous work, we find no clear future trend of global wildfire emissions for the moderate emissions and climate change scenario based on the RCP 4.5. Only historical population change introduces a decline by around 15 % since 1900. Future emissions could either increase for low population growth and fast urbanisation, or continue to decline for high population growth and slow urbanisation. Only for high future climate change (RCP8.5), wildfire emissions start to rise again after ca. 2020 but are unlikely to reach the levels of 1900 by the end of the 21st century. We find that climate warming will generally increase the risk of fire, but that this is only one of several equally important factors driving future levels of wildfire emissions, which include population change, CO2 fertilisation causing woody thickening, increased productivity and fuel load, and faster litter turnover in a warmer climate.

  3. Assessing uncertainties in global cropland futures using a conditional probabilistic modelling framework

    NASA Astrophysics Data System (ADS)

    Engström, Kerstin; Olin, Stefan; Rounsevell, Mark D. A.; Brogaard, Sara; van Vuuren, Detlef P.; Alexander, Peter; Murray-Rust, Dave; Arneth, Almut

    2016-11-01

    We present a modelling framework to simulate probabilistic futures of global cropland areas that are conditional on the SSP (shared socio-economic pathway) scenarios. Simulations are based on the Parsimonious Land Use Model (PLUM) linked with the global dynamic vegetation model LPJ-GUESS (Lund-Potsdam-Jena General Ecosystem Simulator) using socio-economic data from the SSPs and climate data from the RCPs (representative concentration pathways). The simulated range of global cropland is 893-2380 Mha in 2100 (± 1 standard deviation), with the main uncertainties arising from differences in the socio-economic conditions prescribed by the SSP scenarios and the assumptions that underpin the translation of qualitative SSP storylines into quantitative model input parameters. Uncertainties in the assumptions for population growth, technological change and cropland degradation were found to be the most important for global cropland, while uncertainty in food consumption had less influence on the results. The uncertainties arising from climate variability and the differences between climate change scenarios do not strongly affect the range of global cropland futures. Some overlap occurred across all of the conditional probabilistic futures, except for those based on SSP3. We conclude that completely different socio-economic and climate change futures, although sharing low to medium population development, can result in very similar cropland areas on the aggregated global scale.

  4. Genetic diversity is related to climatic variation and vulnerability in threatened bull trout

    USGS Publications Warehouse

    Kovach, Ryan; Muhlfeld, Clint C.; Wade, Alisa A.; Hand, Brian K.; Whited, Diane C.; DeHaan, Patrick W.; Al-Chokhachy, Robert K.; Luikart, Gordon

    2015-01-01

    Understanding how climatic variation influences ecological and evolutionary processes is crucial for informed conservation decision-making. Nevertheless, few studies have measured how climatic variation influences genetic diversity within populations or how genetic diversity is distributed across space relative to future climatic stress. Here, we tested whether patterns of genetic diversity (allelic richness) were related to climatic variation and habitat features in 130 bull trout (Salvelinus confluentus) populations from 24 watersheds (i.e., ~4–7th order river subbasins) across the Columbia River Basin, USA. We then determined whether bull trout genetic diversity was related to climate vulnerability at the watershed scale, which we quantified on the basis of exposure to future climatic conditions (projected scenarios for the 2040s) and existing habitat complexity. We found a strong gradient in genetic diversity in bull trout populations across the Columbia River Basin, where populations located in the most upstream headwater areas had the greatest genetic diversity. After accounting for spatial patterns with linear mixed models, allelic richness in bull trout populations was positively related to habitat patch size and complexity, and negatively related to maximum summer temperature and the frequency of winter flooding. These relationships strongly suggest that climatic variation influences evolutionary processes in this threatened species and that genetic diversity will likely decrease due to future climate change. Vulnerability at a watershed scale was negatively correlated with average genetic diversity (r = −0.77;P < 0.001); watersheds containing populations with lower average genetic diversity generally had the lowest habitat complexity, warmest stream temperatures, and greatest frequency of winter flooding. Together, these findings have important conservation implications for bull trout and other imperiled species. Genetic diversity is already depressed where climatic vulnerability is highest; it will likely erode further in the very places where diversity may be most needed for future persistence.

  5. Prevalence Comparison of Past-year Mental Disorders and Suicidal Behaviours in the Canadian Armed Forces and the Canadian General Population

    PubMed Central

    Zamorski, Mark A.; Boulos, David; Garber, Bryan G.

    2016-01-01

    Objective: Military personnel in Canada and elsewhere have been found to have higher rates of certain mental disorders relative to their corresponding general populations. However, published Canadian data have only adjusted for age and sex differences between the populations. Additional differences in the sociodemographic composition, labour force characteristics, and childhood trauma exposure in the populations could be driving these prevalence differences. Our objective is to compare the prevalence of past-year mental disorders and suicidal behaviours in the Canadian Armed Forces Regular Force with the rates in a representative, matched sample of Canadians in the general population (CGP). Methods: Data sources were the 2013 Canadian Forces Mental Health Survey and the 2012 Canadian Community Health Survey–Mental Health. CGP sample was restricted to match the age range, employment status, and history of chronic conditions of Regular Force personnel. An iterative proportional fitting method was used to approximate the marginal distribution of sociodemographic and childhood trauma variables in both samples. Results: Relative to the matched CGP, Regular Force personnel had significantly higher rates of past-year major depressive episode, generalized anxiety disorder, and suicide ideation. However, lower rates of alcohol use disorder were seen in Regular Force personnel relative to the matched CGP sample. Conclusions: Factors other than differences in sociodemographic composition and history of childhood trauma account for the excess burden of mental disorders and suicidal behaviours in the Canadian Armed Forces. Explanations to explore in future research include occupational trauma, selection effects, and differences in the context of administration of the 2 surveys. PMID:27270741

  6. Attitudes among the general Austrian population towards neonatal euthanasia: a survey.

    PubMed

    Goldnagl, Lena; Freidl, Wolfgang; Stronegger, Willibald J

    2014-10-07

    The Groningen Protocol aims at providing guidance in end-of-life decision-making for severely impaired newborns. Since its publication in 2005 many bioethicists and health care professionals have written articles in response. However, only very little is known about the opinion among the general population on this subject. The aim of this study was to present the general attitude towards neonatal euthanasia (NE) among the Austrian population and the factors associated with the respondents' opinion. A cross-sectional study was conducted among the general Austrian population. Computer-assisted telephone interviews were performed with 1,000 interviewees aged 16 years and older. Binary logistic regression was performed in order to determine factors that are independently associated with the respondents' opinion about neonatal euthanasia. While 63.6% of the participants rejected the idea of neonatal euthanasia for severely impaired newborns, 36.4% opted either in favor or were undecided. Regression analysis has shown the respondents' educational level (p = 0.005) and experience in the care of terminally ill persons (p = 0.001) to be factors that are positively associated with the rejection of neonatal euthanasia, whereas a higher age was associated with a lower degree of rejection (p = 0.021). We found that the majority of the Austrian population rejects the idea of neonatal euthanasia for severely impaired newborns. However, given the increasing levels of rejection of NE among the younger generations and among people with a higher educational level, it cannot be precluded that the rejection rate might in future increase even further, rather than decrease.

  7. Stroke Symptoms as a Predictor of Future Hospitalization

    PubMed Central

    Howard, Virginia J.; Safford, Monika M.; Allen, Shauntice; Judd, Suzanne E.; Rhodes, J. David; Kleindorfer, Dawn O.; Soliman, Elsayed Z.; Meschia, James F.; Howard, George

    2015-01-01

    BACKGROUND Stroke symptoms in the general adult population are common and associated with stroke risk factors, lower physical and mental functioning, impaired cognitive status, and future stroke. Our objective was to determine the association of stroke symptoms with self-reported hospitalization or emergency department (ED) visit. METHODS Lifetime history of stroke symptoms (sudden weakness, numbness, unilateral or general loss of vision, loss of ability to communicate or understand) was assessed at baseline in a national, population-based, longitudinal cohort study of 30,239 blacks and whites, ≥ 45 years, enrolled 2003–2007. Self-reported hospitalization or ED visit and reason were collected during follow-up through March 2013. The symptom-hospitalization association was assessed by proportional hazards analysis in persons stroke/TIA-free at baseline (27,126) with adjustment for sociodemographics and further adjustment for risk factors. RESULTS One or more stroke symptoms were reported by 4,758 (17.5%). After adjustment for sociodemographics, stroke symptoms were most strongly associated with greater risk of hospitalization/ED for cardiovascular disease (HR = 1.87; 95% CI: 1.78 – 1.96), stroke (HR = 1.69; 95% CI: 1.55 – 1.85), and any reason (HR = 1.39; 95% CI: 1.34 – 1.44). These associations remained significant and only modestly reduced after risk factor adjustment. CONCLUSIONS Stroke symptoms are a marker for future hospitalization and ED visit not only for stroke but for cardiovascular disease in general. Findings suggest a role for stroke symptom assessment as a novel and simple approach for identifying individuals at high risk for cardiovascular disease including stroke in whom preventive strategies could be implemented. PMID:26774871

  8. Stroke Symptoms as a Predictor of Future Hospitalization.

    PubMed

    Howard, Virginia J; Safford, Monika M; Allen, Shauntice; Judd, Suzanne E; Rhodes, J David; Kleindorfer, Dawn O; Soliman, Elsayed Z; Meschia, James F; Howard, George

    2016-03-01

    Stroke symptoms in the general adult population are common and associated with stroke risk factors, lower physical and mental functioning, impaired cognitive status, and future stroke. Our objective was to determine the association of stroke symptoms with self-reported hospitalization or emergency department (ED) visit. Lifetime history of stroke symptoms (sudden weakness, numbness, unilateral or general loss of vision, loss of ability to communicate or understand) was assessed at baseline in a national, population-based, longitudinal cohort study of 30,239 blacks and whites younger than 45 years, enrolled from 2003 to 2007. Self-reported hospitalization or ED visit and reason were collected during follow-up through March 2013. The symptom-hospitalization association was assessed by proportional hazards analysis in persons who were stroke/transient ischemic attack-free at baseline (27,126) with adjustment for sociodemographics and further adjustment for risk factors. One or more stroke symptoms were reported by 4758 (17.5%). After adjustment for sociodemographics, stroke symptoms were most strongly associated with greater risk of hospitalization/ED for cardiovascular disease (CVD) (hazard ratio [HR] = 1.87, 95% confidence interval [CI]: 1.78-1.96), stroke (HR = 1.69, 95% CI: 1.55-1.85), and any reason (HR = 1.39, 95% CI: 1.34-1.44). These associations remained significant and only modestly reduced after risk factor adjustment. Stroke symptoms are a marker for future hospitalization and ED visit not only for stroke but also for CVD in general. Findings suggest a role for stroke symptom assessment as a novel and simple approach for identifying individuals at high risk for CVD including stroke in whom preventive strategies could be implemented. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. Assessing the prevalence of non-medical prescription opioid use in the Canadian general adult population: evidence of large variation depending on survey questions used

    PubMed Central

    2013-01-01

    Background Morbidity and mortality related to Prescription Opioid Analgesics (POAs) have been rising sharply in North America. Non-Medical Prescription Opioid Use (NMPOU) in the general population is a key indicator of POA-related harm, yet the role of question item design for best NMPOU prevalence estimates in general population surveys is unclear, and existing NMPOU survey data for Canada are limited. Methods We tested the impact of different NMPOU question items by comparing an item in the 2008 and 2009 (N = 2,017) samples of the CAMH Monitor surveys – an Ontario adult general population survey – with a newly developed item used in the 2010 (N = 2,015) samples of the Centre for Addiction and Mental Health (CAMH) Monitor surveys. To control for a potential difference in the population demographics between surveys, we adjusted for gender, age, region, income, prescription opioid use, cigarette smoking, weekly binge drinking, cannabis use in the past three months, and psychological distress in our analyses. Results The prevalence of NMPOU as measured by the 2008 and 2009 CAMH monitor (2.0% [95% CI: 1.2% to 2.8%]) was significantly different when compared to the prevalence of NMPOU as measured by the 2010 CAMH monitor (7.7% [95% CI: 6.3% to 9.2%]) (p < 0.001). This difference was also found when stratifying our analysis by sex (p < 0.001) and when adjusting for all potential confounding covariates. Conclusion It is highly unlikely that the extensive NMPOU prevalence differences observed from the different survey items reflect an actual increase of NMPOU or changes in NMPOU determinants, but rather point to measurement effects. It appears that we currently do not have accurate estimates of NMPOU in the Canadian general population, even though these estimates are needed to guide and implement targeted interventions. Given the current substantial morbidity and mortality impact of NMPOU, there is an urgent need to systematically develop, validate and standardize NMPOU items for future general population surveys in Canada. PMID:23286378

  10. Predicting body temperature and activity of adult Polyommatus icarus using neural network models under current and projected climate scenarios.

    PubMed

    Howe, P D; Bryant, S R; Shreeve, T G

    2007-10-01

    We use field observations in two geographic regions within the British Isles and regression and neural network models to examine the relationship between microhabitat use, thoracic temperatures and activity in a widespread lycaenid butterfly, Polyommatus icarus. We also make predictions for future activity under climate change scenarios. Individuals from a univoltine northern population initiated flight with significantly lower thoracic temperatures than individuals from a bivoltine southern population. Activity is dependent on body temperature and neural network models of body temperature are better at predicting body temperature than generalized linear models. Neural network models of activity with a sole input of predicted body temperature (using weather and microclimate variables) are good predictors of observed activity and were better predictors than generalized linear models. By modelling activity under climate change scenarios for 2080 we predict differences in activity in relation to both regional differences of climate change and differing body temperature requirements for activity in different populations. Under average conditions for low-emission scenarios there will be little change in the activity of individuals from central-southern Britain and a reduction in northwest Scotland from 2003 activity levels. Under high-emission scenarios, flight-dependent activity in northwest Scotland will increase the greatest, despite smaller predicted increases in temperature and decreases in cloud cover. We suggest that neural network models are an effective way of predicting future activity in changing climates for microhabitat-specialist butterflies and that regional differences in the thermoregulatory response of populations will have profound effects on how they respond to climate change.

  11. Finite land, infinite futures? Sustainable options on a fixed land base.

    Treesearch

    Sally Duncan

    2001-01-01

    The United States is expected to add around 120 million, an additional 40 percent, to its population in the next 50 years and personal incomes are generally projected to rise. This will inevitably intensify land use pressures. Between 1992 and 1997, USDA's National Resource Inventory estimated that 2.2 million acres of rural land were developed each year, with...

  12. Outlook for Mississippi Alluvial Valley forests: a subregional report from the Southern Forest Futures Project

    Treesearch

    Emile S. Gardiner

    2015-01-01

    The Mississippi Alluvial Valley, which can be broadly subdivided into the Holocene Deposits section and the Deltaic Plain section, is a 24.9-million-acre area generally approximating the alluvial floodplain and delta of the lower Mississippi River. Its robust agricultural economy is maintained by a largely rural population, and recreational resources draw high...

  13. Conservation planning and accomplishments for protection of Cerulean Warbler (Setophaga cerulea) nonbreeding habitat

    Treesearch

    Benjamin Skolnik; David Wiedenfeld; Randy Dettmers; Constantino Aucca; Lina Daza; Heidy Valle; Francisco Sornoza; Javier Robayo; David Diaz; Jane Fitzgerald; Daniel Lebbin; Paul B. Hamel

    2012-01-01

    Vital to the work of the Cerulean Warbler Technical Group has been the collaboration among members to evaluate population status and coordinate planning for future activities, principally in conservation implementation. Two plans have been produced, one a general strategy for the conservation and management of the species over its entire range, and a more restricted...

  14. Disability in U. S. Medical Education: Disparities, Programmes and Future Directions

    ERIC Educational Resources Information Center

    Santoro, Jonathan D.; Yedla, Manisha; Lazzareschi, Daniel V.; Whitgob, Emily E.

    2017-01-01

    As of 2010, 19% of the US population lives with a disability, and with the average lifespan of persons with disability increasing, this number is expected to rise. This has prompted the identification of a need for disability-based education by the US Institute of Medicine, the Surgeon General of the United States, the Association of American…

  15. Paid Support Workers for Adults with Intellectual Disabilities; Their Current Knowledge of Hearing Loss and Future Training Needs

    ERIC Educational Resources Information Center

    McShea, Lynzee; Fulton, John; Hayes, Catherine

    2016-01-01

    Background: People with intellectual disabilities are more likely to have hearing loss than the general population. For those unable to self-advocate, the responsibility of detection and management falls to their caregivers. Methods: This is the first cycle of a project using action research methodology to improve services. Twenty care workers…

  16. Psychometric Properties of the Spanish Version of the Broad Autism Phenotype Questionnaire: Strengths, Weaknesses, and Future Improvements

    ERIC Educational Resources Information Center

    Godoy-Giménez, Marta; González-Rodríguez, Antonio; Cañadas, Fernando; Estévez, Angeles F.; Sayans-Jiménez, Pablo

    2018-01-01

    The Broad autism phenotype (BAP) refers to a set of subclinical behavioural characteristics qualitatively similar to those presented in Autism spectrum disorders (ASDs). The BAP questionnaire (BAPQ) has been widely used to assess the BAP both in relatives of ASD people and within the general population. The current study presents the first Spanish…

  17. Cigarette Smoking among Medical Students in China and Modifiable Risk Factors for Smoking Prevention

    ERIC Educational Resources Information Center

    Chen, Xinguang; Tang, Xiaolan; Stanton, Bonita; Li, Hanwu; Chen, Weiqing

    2012-01-01

    Purpose: The reduction of tobacco use among medical students is a potentially powerful strategy to reduce tobacco use among future health professionals, who in turn, can have significant impact on tobacco use among patients as well as the general population in China. The goal of this study is to update information on the prevalence of cigarette…

  18. We All Share One Planet: Comparative Case Studies in Education for Sustainable Development in India

    ERIC Educational Resources Information Center

    Arribas Layton, Lucas

    2013-01-01

    A combination of factors including Global Climate Change, population growth, depletion of natural resources, and degradation of the environment have contributed to a general consensus concerning the need for man to amend his relation with the earth in order to perpetuate the survival and well-being of future generations of human beings. An…

  19. The relationship between victimization and mental health functioning in homeless youth and adults.

    PubMed

    Rattelade, Stephanie; Farrell, Susan; Aubry, Tim; Klodawsky, Fran

    2014-06-01

    This study examined the relationship between victimization and mental health functioning in homeless individuals. Homeless populations experience higher levels of victimization than the general population, which in turn have a detrimental effect on their mental health. A sample of 304 homeless adults and youth completed one-on-one interviews, answering questions on mental health, past victimization, and recent victimization experiences. A hierarchical linear regression showed that experiences of childhood sexual abuse predicted lower mental health functioning after controlling for the sex and age of individuals. The study findings are applicable to current support programs for victims in the homeless population and are relevant to future research on homelessness and victimization.

  20. Projecting the future of an alpine ungulate under climate change scenarios.

    PubMed

    White, Kevin S; Gregovich, David P; Levi, Taal

    2018-03-01

    Climate change represents a primary threat to species persistence and biodiversity at a global scale. Cold adapted alpine species are especially sensitive to climate change and can offer key "early warning signs" about deleterious effects of predicted change. Among mountain ungulates, survival, a key determinant of demographic performance, may be influenced by future climate in complex, and possibly opposing ways. Demographic data collected from 447 mountain goats in 10 coastal Alaska, USA, populations over a 37-year time span indicated that survival is highest during low snowfall winters and cool summers. However, general circulation models (GCMs) predict future increase in summer temperature and decline in winter snowfall. To disentangle how these opposing climate-driven effects influence mountain goat populations, we developed an age-structured population model to project mountain goat population trajectories for 10 different GCM/emissions scenarios relevant for coastal Alaska. Projected increases in summer temperature had stronger negative effects on population trajectories than the positive demographic effects of reduced winter snowfall. In 5 of the 10 GCM/representative concentration pathway (RCP) scenarios, the net effect of projected climate change was extinction over a 70-year time window (2015-2085); smaller initial populations were more likely to go extinct faster than larger populations. Using a resource selection modeling approach, we determined that distributional shifts to higher elevation (i.e., "thermoneutral") summer range was unlikely to be a viable behavioral adaptation strategy; due to the conical shape of mountains, summer range was expected to decline by 17%-86% for 7 of the 10 GCM/RCP scenarios. Projected declines of mountain goat populations are driven by climate-linked bottom-up mechanisms and may have wide ranging implications for alpine ecosystems. These analyses elucidate how projected climate change can negatively alter population dynamics of a sentinel alpine species and provide insight into how demographic modeling can be used to assess risk to species persistence. © 2017 John Wiley & Sons Ltd.

  1. Applying Nyquist's method for stability determination to solar wind observations

    NASA Astrophysics Data System (ADS)

    Klein, Kristopher G.; Kasper, Justin C.; Korreck, K. E.; Stevens, Michael L.

    2017-10-01

    The role instabilities play in governing the evolution of solar and astrophysical plasmas is a matter of considerable scientific interest. The large number of sources of free energy accessible to such nearly collisionless plasmas makes general modeling of unstable behavior, accounting for the temperatures, densities, anisotropies, and relative drifts of a large number of populations, analytically difficult. We therefore seek a general method of stability determination that may be automated for future analysis of solar wind observations. This work describes an efficient application of the Nyquist instability method to the Vlasov dispersion relation appropriate for hot, collisionless, magnetized plasmas, including the solar wind. The algorithm recovers the familiar proton temperature anisotropy instabilities, as well as instabilities that had been previously identified using fits extracted from in situ observations in Gary et al. (2016). Future proposed applications of this method are discussed.

  2. Stochastic analysis of future vehicle populations

    DOT National Transportation Integrated Search

    1979-05-01

    The purpose of this study was to build a stochastic model of future vehicle populations. Such a model can be used to investigate the uncertainties inherent in Future Vehicle Populations. The model, which is called the Future Automobile Population Sto...

  3. Simulated bat populations erode when exposed to climate change projections for western North America

    PubMed Central

    Adams, Rick A.

    2017-01-01

    Recent research has demonstrated that temperature and precipitation conditions correlate with successful reproduction in some insectivorous bat species that live in arid and semiarid regions, and that hot and dry conditions correlate with reduced lactation and reproductive output by females of some species. However, the potential long-term impacts of climate-induced reproductive declines on bat populations in western North America are not well understood. We combined results from long-term field monitoring and experiments in our study area with information on vital rates to develop stochastic age-structured population dynamics models and analyzed how simulated fringed myotis (Myotis thysanodes) populations changed under projected future climate conditions in our study area near Boulder, Colorado (Boulder Models) and throughout western North America (General Models). Each simulation consisted of an initial population of 2,000 females and an approximately stable age distribution at the beginning of the simulation. We allowed each population to be influenced by the mean annual temperature and annual precipitation for our study area and a generalized range-wide model projected through year 2086, for each of four carbon emission scenarios (representative concentration pathways RCP2.6, RCP4.5, RCP6.0, RCP8.5). Each population simulation was repeated 10,000 times. Of the 8 Boulder Model simulations, 1 increased (+29.10%), 3 stayed approximately stable (+2.45%, +0.05%, -0.03%), and 4 simulations decreased substantially (-44.10%, -44.70%, -44.95%, -78.85%). All General Model simulations for western North America decreased by >90% (-93.75%, -96.70%, -96.70%, -98.75%). These results suggest that a changing climate in western North America has the potential to quickly erode some forest bat populations including species of conservation concern, such as fringed myotis. PMID:28686737

  4. Prevalence of systolic inter-arm differences in blood pressure for different primary care populations: systematic review and meta-analysis.

    PubMed

    Clark, Christopher E; Taylor, Rod S; Shore, Angela C; Campbell, John L

    2016-11-01

    Various prevalence figures have been reported for inter-arm differences in blood pressure (IAD); variation may be explained by differing population vascular risk and by measurement method. To review the literature to derive robust estimates of IAD prevalence relevant to community populations. Systematic review and meta-analysis. MEDLINE, Embase, and CINAHL were searched for cross-sectional studies likely to represent general or primary care populations, reporting prevalence of IAD and employing a simultaneous method of measurement. Using study-level data, pooled estimates of mean prevalence of systolic IADs were calculated and compared using a random effects model. Eighty IAD studies were identified. Sixteen met inclusion criteria: pooled estimates of prevalence for systolic IAD ≥10 mmHg were 11.2% (95% confidence interval [CI] = 9.1 to 13.6) in hypertension, 7.4% (95% CI = 5.8 to 9.2) in diabetes, and 3.6% (95% CI = 2.3 to 5.0) for a general adult population (P<0.001 for subgroup differences). Differences persisted for higher cut-off values. Prevalences were lower for East Asian than for Western populations and were overestimated by sequential measurement where this could be compared with simultaneous measurement within studies (relative risk for IAD: 2.9 [95% CI = 2.1 to 4.1]). Studies with higher mean absolute systolic pressures had higher prevalences for a systolic IAD ≥10 mmHg (P = 0.04). Prevalences of IADs rise in relation to underlying cardiovascular comorbidities of the population studied, and are overestimated threefold when sequential measurement is used. Population-specific variation in prevalences of IAD should be taken into account in delivering clinical care and in planning future studies. © British Journal of General Practice 2016.

  5. Simulated bat populations erode when exposed to climate change projections for western North America.

    PubMed

    Hayes, Mark A; Adams, Rick A

    2017-01-01

    Recent research has demonstrated that temperature and precipitation conditions correlate with successful reproduction in some insectivorous bat species that live in arid and semiarid regions, and that hot and dry conditions correlate with reduced lactation and reproductive output by females of some species. However, the potential long-term impacts of climate-induced reproductive declines on bat populations in western North America are not well understood. We combined results from long-term field monitoring and experiments in our study area with information on vital rates to develop stochastic age-structured population dynamics models and analyzed how simulated fringed myotis (Myotis thysanodes) populations changed under projected future climate conditions in our study area near Boulder, Colorado (Boulder Models) and throughout western North America (General Models). Each simulation consisted of an initial population of 2,000 females and an approximately stable age distribution at the beginning of the simulation. We allowed each population to be influenced by the mean annual temperature and annual precipitation for our study area and a generalized range-wide model projected through year 2086, for each of four carbon emission scenarios (representative concentration pathways RCP2.6, RCP4.5, RCP6.0, RCP8.5). Each population simulation was repeated 10,000 times. Of the 8 Boulder Model simulations, 1 increased (+29.10%), 3 stayed approximately stable (+2.45%, +0.05%, -0.03%), and 4 simulations decreased substantially (-44.10%, -44.70%, -44.95%, -78.85%). All General Model simulations for western North America decreased by >90% (-93.75%, -96.70%, -96.70%, -98.75%). These results suggest that a changing climate in western North America has the potential to quickly erode some forest bat populations including species of conservation concern, such as fringed myotis.

  6. Major depressive disorder following terrorist attacks: A systematic review of prevalence, course and correlates

    PubMed Central

    2011-01-01

    Background Terrorist attacks are traumatic events that may result in a wide range of psychological disorders for people exposed. This review aimed to systematically assess the current evidence on major depressive disorder (MDD) after terrorist attacks. Methods A systematic review was performed. Studies included assessed the impact of human-made, intentional, terrorist attacks in direct victims and/or persons in general population and evaluated MDD based on diagnostic criteria. Results A total of 567 reports were identified, 11 of which were eligible for this review: 6 carried out with direct victims, 4 with persons in general population, and 1 with victims and general population. The reviewed literature suggests that the risk of MDD ranges between 20 and 30% in direct victims and between 4 and 10% in the general population in the first few months after terrorist attacks. Characteristics that tend to increase risk of MDD after a terrorist attack are female gender, having experienced more stressful situations before or after the attack, peritraumatic reactions during the attack, loss of psychosocial resources, and low social support. The course of MDD after terrorist attacks is less clear due to the scarcity of longitudinal studies. Conclusions Methodological limitations in the literature of this field are considered and potentially important areas for future research such as the assessment of the course of MDD, the study of correlates of MDD or the comorbidity between MDD and other mental health problems are discussed. PMID:21627850

  7. [Parent-child agreement in the health related quality of life (HRQOL) of children with attention-deficit/hyperactivity disorder (ADHD): a longitudinal study].

    PubMed

    Rajmil, L; Estrada, M D; Herdman, M; Serra-Sutton, V; Tebé, C; Izaguirre, J; Alda, J A; Alonso, J; Riley, A W; Forrest, C B; Starfield, B

    2009-06-01

    To assess parent-child agreement on changes over a short-term period of time in the HRQOL of children treated for ADHD over a short period of time, and to compare child and parent ratings of children with ADHD with general population norms. Prospective study in children 6-12 years old with ADHD. Children and parents completed the Spanish versions of the Child Health and Illness Profile-Child Edition (CHIP-CE) before and after 8 weeks of treatment. CHIP-PE scores at both visits were compared using paired t tests and effect sizes (ES), intra-class correlation coefficients (ICC), and scatter plots. Child and parent ratings were compared with CHIP-CE scores for a general population sample. Thirty-one children and parents were included in the analysis. The highest change between the first and the follow-up visit was on the Risk Avoidance domain both children and parents (effect size [ES]=0.24 and 0.40, respectively). The ICC ranged from 0.44 (Satisfaction) to 0.01 (Risk avoidance). Child self-ratings were close to general population values. All domains of the parent version presented standardized means below the reference values at the baseline visit and closer to the general population norm after treatment. This study found poor parent-child agreement and suggests that both ratings should be collected in future studies on the impact of ADHD and treatment effectiveness.

  8. Mental health of survivors of 1984 Bhopal disaster: A continuing challenge

    PubMed Central

    Murthy, R. Srinivasa

    2014-01-01

    Bhopal disaster is an important milestone in Indian Industrial Psychiatry. The disaster was not only the biggest industrial disaster but also one in which complex forces have joined hands to demy the mental health needs of the population. Though the biggest general population epidemiological study over 5 years was carried out to understand the mental health impact of the disaster, the findings of this study did not get reflected in mental health care for the population. Furthermore, the needed longitudinal studies and evaluation of the interventions were not undertaken. There was no sharing of information with the survivors about the impact of the disaster on their health and well-being and sharing of skills for self-care. A result of these factors is the extreme degree of dissatisfaction in the population. Looking back, it would have met the needs of the Bhopal population, if the mental health services were community based and reaching the population, rather than the clinic-based approaches, there was a wide range of services, especially rehabilitation, continuous research into the changing mental health needs of the population and the effectiveness of interventions and most importantly, there was a continuous dialogue with the population and sharing of information with the general population. These are the tasks for the immediate future to reorganize the focus of mental health initiatives in Bhopal. Many lessons can be learnt from the Bhopal disaster and the continuing tragedy for the population. PMID:25788796

  9. Comparing Climate Change and Species Invasions as Drivers of Coldwater Fish Population Extirpations

    PubMed Central

    Sharma, Sapna; Vander Zanden, M. Jake; Magnuson, John J.; Lyons, John

    2011-01-01

    Species are influenced by multiple environmental stressors acting simultaneously. Our objective was to compare the expected effects of climate change and invasion of non-indigenous rainbow smelt (Osmerus mordax) on cisco (Coregonus artedii) population extirpations at a regional level. We assembled a database of over 13,000 lakes in Wisconsin, USA, summarising fish occurrence, lake morphology, water chemistry, and climate. We used A1, A2, and B1 scenarios from the Intergovernmental Panel on Climate Change (IPCC) of future temperature conditions for 15 general circulation models in 2046–2065 and 2081–2100 totalling 78 projections. Logistic regression indicated that cisco tended to occur in cooler, larger, and deeper lakes. Depending upon the amount of warming, 25–70% of cisco populations are predicted to be extirpated by 2100. In addition, cisco are influenced by the invasion of rainbow smelt, which prey on young cisco. Projecting current estimates of rainbow smelt spread and impact into the future will result in the extirpation of about 1% of cisco populations by 2100 in Wisconsin. Overall, the effect of climate change is expected to overshadow that of species invasion as a driver of coldwater fish population extirpations. Our results highlight the potentially dominant role of climate change as a driver of biotic change. PMID:21860661

  10. Comparing climate change and species invasions as drivers of coldwater fish population extirpations.

    PubMed

    Sharma, Sapna; Vander Zanden, M Jake; Magnuson, John J; Lyons, John

    2011-01-01

    Species are influenced by multiple environmental stressors acting simultaneously. Our objective was to compare the expected effects of climate change and invasion of non-indigenous rainbow smelt (Osmerus mordax) on cisco (Coregonus artedii) population extirpations at a regional level. We assembled a database of over 13,000 lakes in Wisconsin, USA, summarising fish occurrence, lake morphology, water chemistry, and climate. We used A1, A2, and B1 scenarios from the Intergovernmental Panel on Climate Change (IPCC) of future temperature conditions for 15 general circulation models in 2046-2065 and 2081-2100 totalling 78 projections. Logistic regression indicated that cisco tended to occur in cooler, larger, and deeper lakes. Depending upon the amount of warming, 25-70% of cisco populations are predicted to be extirpated by 2100. In addition, cisco are influenced by the invasion of rainbow smelt, which prey on young cisco. Projecting current estimates of rainbow smelt spread and impact into the future will result in the extirpation of about 1% of cisco populations by 2100 in Wisconsin. Overall, the effect of climate change is expected to overshadow that of species invasion as a driver of coldwater fish population extirpations. Our results highlight the potentially dominant role of climate change as a driver of biotic change.

  11. Enhancing health care professionals' and trainees' knowledge of physical activity guidelines for adults with and without SCI.

    PubMed

    Shirazipour, Celina H; Tomasone, Jennifer R; Martin Ginis, Kathleen A

    2018-01-11

    Health care providers (HCPs) are preferred sources of physical activity (PA) information; however, minimal research has explored HCPs' knowledge of spinal cord injury (SCI) PA guidelines, and no research has examined HCP trainees' PA guideline knowledge. The current study explored HCPs' and trainees' initial knowledge of PA guidelines for both adults with SCI and the general population, and the utility of an event-based intervention for improving this knowledge. Participants (HCPs n = 129; trainees n = 573) reported guideline knowledge for both sets of guidelines (SCI and general population) immediately after, one-month, and six-months following the intervention. Frequencies determined guideline knowledge at each timepoint, while chi-squared tests examined differences in knowledge of both guidelines, as well as knowledge differences in the short- and long-term. Results demonstrated that HCPs and trainees lack knowledge of PA guidelines, particularly guidelines for adults with SCI. The results further suggest that a single event-based intervention is not effective for improving long-term guideline knowledge. Suggestions are made for future research with the aim of improving interventions that target HCP and HCP trainees' long-term guideline knowledge for adults with SCI and the general population.

  12. U.S. population policy.

    PubMed

    Piotrow, P T

    1993-06-01

    Some of the history and special features of the US population assistance program administered by USAID are recounted. Future predictions are also made for funding and new directions for the US population assistance program and environmental issues. The topics addressed were part of a talk given in 1992 at a meeting of the Council on Population Education held in Tokyo. Credit is given to Japan for its contribution to family planning (FP) efforts by setting an example of reducing population size within a decade and providing financial support internationally. Japan's example so impressed General William H. Draper, Jr. that he worked for the establishment of the USAID and the UN Population Fund, and funding for the International Planned Parenthood Federation. He encouraged Japanese officials to provide support for international population and (FP) programs. Currently, the US provides $350 million in population assistance. Encouragement was given for Japan to increase its international commitment of $80 million and to contribute to the Johns Hopkins University William H. Draper, Jr., fellowship fund for graduate students from developing countries to study modern health communication. The special features of the US population assistance program were identified as follows: 1) high funding levels, 2) availability of FP services, 3) adequate contraceptive supplies, 4) availability of professional population staff, and 5) an emphasis on data and evaluation. The single most important element of the USAID program is the reliance on private, nongovernmental organizations (NGOs), which can establish flexible, independent, innovative and cost- effective programs. Predictions for the future were that the US Congress would expand overseas population assistance. Domestic policy will have priority, and the future will depend on who occupies the key policy positions at the State Department and USAID. THere will be more emphasis on free political elections, on humanitarian issues, and on environmental issues. New directions will be to increase funding, reduce restrictions on population assistance, increase support for NGOs, expand FP communication programs, improve the quality of FP services, increase distribution of condoms, and increase coordination among donors. The enter educate approach to promoting FP is described.

  13. [Airport related air pollution and health effects].

    PubMed

    Iavicoli, Ivo; Fontana, Luca; Ancona, Carla; Forastiere, Francesco

    2014-01-01

    Airport is an extremely complex emission source of airborne pollutants that can have a significant impact on the environment. Indeed, several airborne chemicals emitted during airport activities may significantly get worse air quality and increase exposure level of both airport workers and general population living nearby the airports. In recent years airport traffic has increased and consequently several studies investigated the association between airport-related air pollution and occurrence of adverse health effects, particularly on respiratory system, in exposed workers and general population resident nearby. In this context, we carried out a critical evaluation of the studies that investigated this correlation in order to obtain a deeper knowledge of this issue and to identify the future research needs. Results show that the evidence of association between airport-related air pollution and health effects on workers and residents is still limited.

  14. Mortality from contact-related epidemics among indigenous populations in Greater Amazonia

    PubMed Central

    Walker, Robert S.; Sattenspiel, Lisa; Hill, Kim R.

    2015-01-01

    European expansion and contact with indigenous populations led to catastrophic depopulation primarily through the introduction of novel infectious diseases to which native peoples had limited exposure and immunity. In the Amazon Basin such contacts continue to occur with more than 50 isolated indigenous societies likely to make further contacts with the outside world in the near future. Ethnohistorical accounts are useful for quantifying trends in the severity and frequency of epidemics through time and may provide insight into the likely demographic consequences of future contacts. Here we compile information for 117 epidemics that affected 59 different indigenous societies in Greater Amazonia and caused over 11,000 deaths between 1875 and 2008, mostly (75%) from measles, influenza, and malaria. Results show that mortality rates from epidemics decline exponentially through time and, independently, with time since peaceful contact. The frequency of documented epidemics also decreases with time since contact. While previous work on virgin soil epidemics generally emphasizes the calamity of contacts, we focus instead on improvements through time. The prospects for better survivorship during future contacts are good provided modern health care procedures are implemented immediately. PMID:26354026

  15. Vulnerability Reduction Needed to Maintain Current Burdens of Heat-Related Mortality in a Changing Climate-Magnitude and Determinants.

    PubMed

    Åström, Christofer; Åström, Daniel Oudin; Andersson, Camilla; Ebi, Kristie L; Forsberg, Bertil

    2017-07-07

    The health burden from heatwaves is expected to increase with rising global mean temperatures and more extreme heat events over the coming decades. Health-related effects from extreme heat are more common in elderly populations. The population of Europe is rapidly aging, which will increase the health effects of future temperatures. In this study, we estimate the magnitude of adaptation needed to lower vulnerability to heat in order to prevent an increase in heat-related deaths in the 2050s; this is the Adaptive Risk Reduction (ARR) needed. Temperature projections under Representative Concentration Pathway (RCP) 4.5 and RCP 8.5 from 18 climate models were coupled with gridded population data and exposure-response relationships from a European multi-city study on heat-related mortality. In the 2050s, the ARR for the general population is 53.5%, based on temperature projections under RCP 4.5. For the population above 65 years in Southern Europe, the ARR is projected to be 45.9% in a future with an unchanged climate and 74.7% with climate change under RCP 4.5. The ARRs were higher under RCP 8.5. Whichever emission scenario is followed or population projection assumed, Europe will need to adapt to a great degree to maintain heat-related mortality at present levels, which are themselves unacceptably high, posing an even greater challenge.

  16. Vulnerability Reduction Needed to Maintain Current Burdens of Heat-Related Mortality in a Changing Climate—Magnitude and Determinants

    PubMed Central

    Åström, Christofer; Oudin Åström, Daniel; Andersson, Camilla; L. Ebi, Kristie; Forsberg, Bertil

    2017-01-01

    The health burden from heatwaves is expected to increase with rising global mean temperatures and more extreme heat events over the coming decades. Health-related effects from extreme heat are more common in elderly populations. The population of Europe is rapidly aging, which will increase the health effects of future temperatures. In this study, we estimate the magnitude of adaptation needed to lower vulnerability to heat in order to prevent an increase in heat-related deaths in the 2050s; this is the Adaptive Risk Reduction (ARR) needed. Temperature projections under Representative Concentration Pathway (RCP) 4.5 and RCP 8.5 from 18 climate models were coupled with gridded population data and exposure-response relationships from a European multi-city study on heat-related mortality. In the 2050s, the ARR for the general population is 53.5%, based on temperature projections under RCP 4.5. For the population above 65 years in Southern Europe, the ARR is projected to be 45.9% in a future with an unchanged climate and 74.7% with climate change under RCP 4.5. The ARRs were higher under RCP 8.5. Whichever emission scenario is followed or population projection assumed, Europe will need to adapt to a great degree to maintain heat-related mortality at present levels, which are themselves unacceptably high, posing an even greater challenge. PMID:28686197

  17. New parsimonious simulation methods and tools to assess future food and environmental security of farm populations

    PubMed Central

    Antle, John M.; Stoorvogel, Jetse J.; Valdivia, Roberto O.

    2014-01-01

    This article presents conceptual and empirical foundations for new parsimonious simulation models that are being used to assess future food and environmental security of farm populations. The conceptual framework integrates key features of the biophysical and economic processes on which the farming systems are based. The approach represents a methodological advance by coupling important behavioural processes, for example, self-selection in adaptive responses to technological and environmental change, with aggregate processes, such as changes in market supply and demand conditions or environmental conditions as climate. Suitable biophysical and economic data are a critical limiting factor in modelling these complex systems, particularly for the characterization of out-of-sample counterfactuals in ex ante analyses. Parsimonious, population-based simulation methods are described that exploit available observational, experimental, modelled and expert data. The analysis makes use of a new scenario design concept called representative agricultural pathways. A case study illustrates how these methods can be used to assess food and environmental security. The concluding section addresses generalizations of parametric forms and linkages of regional models to global models. PMID:24535388

  18. New parsimonious simulation methods and tools to assess future food and environmental security of farm populations.

    PubMed

    Antle, John M; Stoorvogel, Jetse J; Valdivia, Roberto O

    2014-04-05

    This article presents conceptual and empirical foundations for new parsimonious simulation models that are being used to assess future food and environmental security of farm populations. The conceptual framework integrates key features of the biophysical and economic processes on which the farming systems are based. The approach represents a methodological advance by coupling important behavioural processes, for example, self-selection in adaptive responses to technological and environmental change, with aggregate processes, such as changes in market supply and demand conditions or environmental conditions as climate. Suitable biophysical and economic data are a critical limiting factor in modelling these complex systems, particularly for the characterization of out-of-sample counterfactuals in ex ante analyses. Parsimonious, population-based simulation methods are described that exploit available observational, experimental, modelled and expert data. The analysis makes use of a new scenario design concept called representative agricultural pathways. A case study illustrates how these methods can be used to assess food and environmental security. The concluding section addresses generalizations of parametric forms and linkages of regional models to global models.

  19. Will human populations be limited by food?

    NASA Astrophysics Data System (ADS)

    Warren, S. G.

    2016-12-01

    Historical examples of demographic change, in China, Italy, Nigeria, Utah, the Philippines, and elsewhere, together with simple mathematics and biological principles, show that stabilizing world population before it is limited by food supply will be more difficult than is generally appreciated. United Nations population projections are based on a logical fallacy in that they assume, in spite of the absence of necessary negative feedbacks, that all nations will converge rapidly to replacement-level fertility and thereafter remain at that level. The benign projections that have resulted from this assumption may have hindered efforts to make availability of birth-control a priority in development-aid. Education of women and provision of contraceptives have caused dramatic reductions in fertility, but many groups, including some that are well-educated, maintain high fertility. Small groups with persistent high fertility can grow to supplant low-fertility groups, resulting in continued growth of the total population. The global average fertility rate could rise even if each country's fertility rate is falling. In some low-fertility European countries where deaths exceed births, the population continues to grow because of immigration. Producing more than two offspring is normal for all animal species with stable populations, because their populations are limited by resources or predation rather than birth control. It may therefore be appropriate to view the growth of human population as the result not of excess fertility but rather of excess food. Even if the fertility rate is maintained far in excess of 2, the population cannot grow if food is limiting. Without the agricultural advances of the 20thcentury, world population could not have grown as it did from 1.7 billion in 1900 to 6 billion in 2000. The food supply may be enhanced in the future by genetic engineering and other innovations, but it may be limited by water shortage, climate change, pollution, and energy shortage. The efficiency of agriculture may be diminished by breakdown of social infrastructure. References: S.G. Warren, 2015: Can human populations be stabilized? Earth's Future 3, 82-94, doi:10.1002/2014EF000275 S.G. Warren, 2016: Reply to comment, Earth's Future 4, 18-19, doi:10.1002/2015EF000341

  20. Global Burden of HIV among Men Who Engage in Transactional Sex: A Systematic Review and Meta-Analysis

    PubMed Central

    Oldenburg, Catherine E.; Perez-Brumer, Amaya G.; Reisner, Sari L.; Mattie, Jason; Bärnighausen, Till; Mayer, Kenneth H.; Mimiaga, Matthew J.

    2014-01-01

    Background Men who engage in transactional sex, the exchange of sex for money, goods, or other items of value, are thought to be at increased risk of HIV, but there have been no systematic attempts to characterize HIV burden in this population. We undertook a systematic review and meta-analysis to quantify the burden in this population compared with that of men in the general population to better inform future HIV prevention efforts. Methods We searched seven electronic databases, national surveillance reports, and conference abstracts for studies of men who engage in transactional sex published between 2004–2013. Random effects meta-analysis was used to determine pooled HIV prevalence and prevalence ratios (PR) for the difference in HIV prevalence among men who engage in transactional sex as compared to general population men. Findings Of 66 studies included representing 31,924 men who had engaged in transactional sex in 28 countries, pooled biological assay-confirmed HIV prevalence was 10.5% (95% CI = 9.4 to 11.5%). The highest pooled HIV prevalence was in Sub-Saharan Africa (31.5%, 95% CI = 21.6 to 41.5%), followed by Latin America (19.3%, 95% CI = 15.5 to 23.1%), North America (16.6%, 95% CI = 3.7 to 29.5%), and Europe (12.2%, 95% CI = 6.0 to 17.2%). Men who engaged in transactional sex had an elevated burden of HIV compared to the general male population (PR = 20.7, 95% CI = 16.8 to 25.5). Conclusions The global burden of HIV is disproportionately high among men who engage in transactional sex compared with the general male population. There is an urgent need to include this population in systematic surveillance as well as to scale-up access to quality HIV prevention programs. PMID:25068720

  1. Hypertriglyceridemic waist might be an alternative to metabolic syndrome for predicting future diabetes mellitus.

    PubMed

    He, Sen; Zheng, Yi; Shu, Yan; He, Jiyun; Wang, Yong; Chen, Xiaoping

    2013-01-01

    In some cross-sectional studies, hypertriglyceridemic waist (HTGW) has been recommended as an alternative to metabolic syndrome (MetS) for screening individuals at high risk for diabetes mellitus (DM). However, little information is about the predictive power of HTGW for future DM. The aims of the study were to assess the DM predictive power of HTGW compared with MetS based on the follow-up data over 15 years collected from a general Chinese population. And Findings: The data were collected in 1992 and then again in 2007 from the same group of 687 individuals without DM in 1992. For the whole population (n =687), multivariate analysis showed presence of HTGW was associated with a 4.1-fold (95%CI: 2.4-7.0, p < 0.001) increased risk and presence of MetS was associated with a 3.7-fold (95%CI: 2.2-6.2, p < 0.001) increased risk for future DM. For the population without elevated fasting plasma glucose (n = 650), multivariate analysis showed presence of HTGW was associated with a 3.9-fold (95%CI: 2.2-7.0, p < 0.001) increased risk and presence of MetS was associated with a 3.7-fold (95%CI: 2.1-6.6, p < 0.001) increased risk for future DM. HTGW could predict future DM independently, and the predictive power was similar to MetS. HTGW might be an alternative to MetS for predicting future DM. For simpler and fewer components, HTGW might be more practical than MetS, and it might be recommended in most clinical practices. This finding might be more useful for the individuals who only have elevated WC and TG. Although these individuals are without MetS, they are still at high risk for future DM, similarly to the individuals with MetS.

  2. Conduct of a personal radiofrequency electromagnetic field measurement study: proposed study protocol.

    PubMed

    Röösli, Martin; Frei, Patrizia; Bolte, John; Neubauer, Georg; Cardis, Elisabeth; Feychting, Maria; Gajsek, Peter; Heinrich, Sabine; Joseph, Wout; Mann, Simon; Martens, Luc; Mohler, Evelyn; Parslow, Roger C; Poulsen, Aslak Harbo; Radon, Katja; Schüz, Joachim; Thuroczy, György; Viel, Jean-François; Vrijheid, Martine

    2010-05-20

    The development of new wireless communication technologies that emit radio frequency electromagnetic fields (RF-EMF) is ongoing, but little is known about the RF-EMF exposure distribution in the general population. Previous attempts to measure personal exposure to RF-EMF have used different measurement protocols and analysis methods making comparisons between exposure situations across different study populations very difficult. As a result, observed differences in exposure levels between study populations may not reflect real exposure differences but may be in part, or wholly due to methodological differences. The aim of this paper is to develop a study protocol for future personal RF-EMF exposure studies based on experience drawn from previous research. Using the current knowledge base, we propose procedures for the measurement of personal exposure to RF-EMF, data collection, data management and analysis, and methods for the selection and instruction of study participants. We have identified two basic types of personal RF-EMF measurement studies: population surveys and microenvironmental measurements. In the case of a population survey, the unit of observation is the individual and a randomly selected representative sample of the population is needed to obtain reliable results. For microenvironmental measurements, study participants are selected in order to represent typical behaviours in different microenvironments. These two study types require different methods and procedures. Applying our proposed common core procedures in future personal measurement studies will allow direct comparisons of personal RF-EMF exposures in different populations and study areas.

  3. Conduct of a personal radiofrequency electromagnetic field measurement study: proposed study protocol

    PubMed Central

    2010-01-01

    Background The development of new wireless communication technologies that emit radio frequency electromagnetic fields (RF-EMF) is ongoing, but little is known about the RF-EMF exposure distribution in the general population. Previous attempts to measure personal exposure to RF-EMF have used different measurement protocols and analysis methods making comparisons between exposure situations across different study populations very difficult. As a result, observed differences in exposure levels between study populations may not reflect real exposure differences but may be in part, or wholly due to methodological differences. Methods The aim of this paper is to develop a study protocol for future personal RF-EMF exposure studies based on experience drawn from previous research. Using the current knowledge base, we propose procedures for the measurement of personal exposure to RF-EMF, data collection, data management and analysis, and methods for the selection and instruction of study participants. Results We have identified two basic types of personal RF-EMF measurement studies: population surveys and microenvironmental measurements. In the case of a population survey, the unit of observation is the individual and a randomly selected representative sample of the population is needed to obtain reliable results. For microenvironmental measurements, study participants are selected in order to represent typical behaviours in different microenvironments. These two study types require different methods and procedures. Conclusion Applying our proposed common core procedures in future personal measurement studies will allow direct comparisons of personal RF-EMF exposures in different populations and study areas. PMID:20487532

  4. Population dynamics in the presence of quasispecies effects and changing environments

    NASA Astrophysics Data System (ADS)

    Forster, Robert Burke

    2006-12-01

    This thesis explores how natural selection acts on organisms such as viruses that have either highly error-prone reproduction or face variable environmental conditions or both. By modeling population dynamics under these conditions, we gain a better understanding of the selective forces at work, both in our simulations and hopefully also in real organisms. With an understanding of the important factors in natural selection we can forecast not only the immediate fate of an existing population but also in what directions such a population might evolve in the future. We demonstrate that the concept of a quasispecies is relevant to evolution in a neutral fitness landscape. Motivated by RNA viruses such as HIV, we use RNA secondary structure as our model system and find that quasispecies effects arise both rapidly and in realistically small populations. We discover that the evolutionary effects of neutral drift, punctuated equilibrium and the selection for mutational robustness extend to the concept of a quasispecies. In our study of periodic environments, we consider the tradeoffs faced by quasispecies in adapting to environmental change. We develop an analytical model to predict whether evolution favors short-term or long-term adaptation and validate our model through simulation. Our results bear directly on the population dynamics of viruses such as West Nile that alternate between two host species. More generally, we discover that a selective pressure exists under these conditions to fuse or split genes with complementary environmental functions. Lastly, we study the general effects of frequency-dependent selection on two strains competing in a periodic environment. Under very general assumptions, we prove that stable coexistence rather than extinction is the likely outcome. The population dynamics of this system may be as simple as stable equilibrium or as complex as deterministic chaos.

  5. HIV and AIDS in Bangladesh

    PubMed Central

    Azim, Tasnim; Khan, Sharful Islam; Haseen, Fariha; Huq, Nafisa Lira; Henning, Lars; Pervez, Md. Moshtaq; Chowdhury, Mahbub Elahi; Sarafian, Isabelle

    2008-01-01

    Bangladesh initiated an early response to the HIV epidemic starting in the mid-1980s. Since then, the res-ponse has been enhanced considerably, and many HIV-prevention interventions among the most at-risk populations and the general youth are being undertaken. Alongside prevention activities, gathering of data has been a key activity fostered by both the Government and individual development partners. This paper reviews available sources of data, including routine surveillance (HIV and behavioural among most at-risk populations), general population surveys, and various research studies with the aim to understand the dynamics of the HIV epidemic in Bangladesh. Available data show that the HIV epidemic is still at relatively low levels and is concentrated mainly among injecting drug users (IDUs) in Dhaka city. In addition, when the passively-reported cases were analyzed, another population group that appears to be especially vulnerable is migrant workers who leave their families and travel abroad for work. However, all sources of data confirm that risk behaviours that make individuals vulnerable to HIV are high—this is apparent within most at-risk populations and the general population (adult males and youth males and females). Based on the current activities and the sources of data, modelling exercises of the future of the HIV epidemic in Dhaka suggest that, if interventions are not enhanced further, Bangladesh is likely to start with an IDU-driven epidemic, similar to other neighbouring countries, which will then move to other population groups, including sex workers, males who have sex with males, clients of sex workers, and ultimately their families. This review reiterates the often repeated message that if Bangladesh wants to be an example of how to avert an HIV epidemic, it needs to act now using evidence-based programming. PMID:18831227

  6. Evaluation of the general public's knowledge, views and practices relating to appropriate antibiotic use in Qatar.

    PubMed

    Moienzadeh, Atefeh; Massoud, Tasnim; Black, Emily

    2017-04-01

    Studies completed internationally have demonstrated an alarming number of patients believed antibiotics are indicated in the treatment of viral infections and other self-limited illnesses. Evaluation of patient practices relating to antibiotics have also demonstrated inappropriate use. Antibiotic misuse by patients and practitioners has been identified as a factor in the development of resistance. Current knowledge, views and practices relating to antibiotic use in Qatar is unknown. The primary objective of this study was to evaluate the general population's current antimicrobial knowledge, views and practices in Qatar. This study was designed as a self-administered cross-sectional survey. Eligible participants were residents of Qatar who were over the age of 18 and spoke English or Arabic. The questionnaire was developed based on previously published literature and objectives of this study. Data were collected at community pharmacies in Doha, Qatar. The majority of participants (95.8%) had taken antibiotics in the past. The median knowledge score of the study population was 4/8. Misconceptions relating to use of antibiotics for treatment of viral infections were common. Inappropriate use as evident by hoarding of antibiotics for future use and sharing antibiotics with family or friends was also identified in this study population. Community pharmacists in Qatar have an opportunity to improve knowledge of the general population regarding appropriate indications of antibiotics and risk of resistance with inappropriate use. © 2015 Royal Pharmaceutical Society.

  7. Past and ongoing shifts in Joshua tree distribution support future modeled range contraction

    USGS Publications Warehouse

    Cole, Kenneth L.; Ironside, Kirsten; Eischeid, Jon K.; Garfin, Gregg; Duffy, Phil; Toney, Chris

    2011-01-01

    The future distribution of the Joshua tree (Yucca brevifolia) is projected by combining a geostatistical analysis of 20th-century climates over its current range, future modeled climates, and paleoecological data showing its response to a past similar climate change. As climate rapidly warmed ;11 700 years ago, the range of Joshua tree contracted, leaving only the populations near what had been its northernmost limit. Its ability to spread northward into new suitable habitats after this time may have been inhibited by the somewhat earlier extinction of megafaunal dispersers, especially the Shasta ground sloth. We applied a model of climate suitability for Joshua tree, developed from its 20th-century range and climates, to future climates modeled through a set of six individual general circulation models (GCM) and one suite of 22 models for the late 21st century. All distribution data, observed climate data, and future GCM results were scaled to spatial grids of ;1 km and ;4 km in order to facilitate application within this topographically complex region. All of the models project the future elimination of Joshua tree throughout most of the southern portions of its current range. Although estimates of future monthly precipitation differ between the models, these changes are outweighed by large increases in temperature common to all the models. Only a few populations within the current range are predicted to be sustainable. Several models project significant potential future expansion into new areas beyond the current range, but the species' Historical and current rates of dispersal would seem to prevent natural expansion into these new areas. Several areas are predicted to be potential sites for relocation/ assisted migration. This project demonstrates how information from paleoecology and modern ecology can be integrated in order to understand ongoing processes and future distributions.

  8. German Anxiety Barometer—Clinical and Everyday-Life Anxieties in the General Population

    PubMed Central

    Adolph, Dirk; Schneider, Silvia; Margraf, Jürgen

    2016-01-01

    The objective of this study was to test a time-efficient screening instrument to assess clinically relevant and everyday-life (e.g., economic, political, personal) anxieties. Furthermore, factors influencing these anxieties, correlations between clinical and everyday anxieties and, for the first time, anxiety during different stages of life were assessed in a representative sample of the general population (N = 2229). Around 30% of the respondents manifested at least one disorder-specific key symptom within 1 year (women > men), 8% reported severe anxiety symptoms. Two thirds of respondents reported minor everyday anxieties and 5% were strongly impaired, whereby persons with severe clinical symptoms were more frequently affected. A variety of potential influencing factors could be identified. These include, in addition to socioeconomic status, gender, general health, risk-taking, and leisure behavior, also some up to now little investigated possible protective factors, such as everyday-life mental activity. The observed effects are rather small, which, however, given the heterogeneity of the general population seems plausible. Although the correlative design of the study does not allow direct causal conclusions, it can, however, serve as a starting point for experimental intervention studies in the future. Together with time series from repeated representative surveys, we expect these data to provide a better understanding of the processes that underlie everyday-life and clinical anxieties. PMID:27667977

  9. Admixture analysis of the diagnostic subtypes of social anxiety disorder: implications for the DSM-V.

    PubMed

    Aderka, Idan M; Nickerson, Angela; Hofmann, Stefan G

    2012-06-01

    Much controversy exists regarding diagnostic subtypes of social anxiety disorder (SAD). The present study used admixture analysis to examine whether individuals with generalized and nongeneralized SAD belong to the same or different populations of origin. This can inform diagnostic subtyping of SAD in the forthcoming DSM-V. Treatment-seeking individuals with generalized SAD (n = 154) and nongeneralized SAD (n = 48) completed a battery of questionnaires. Based on participants' responses to the Liebowitz Social Anxiety Scale (LSAS), we estimated log likelihood and chi-square goodness-of-fit for models with 1, 2, 3, or 4 populations of origin, and compared models using forward stepwise estimation and maximum likelihood ratio tests. Admixture analyses suggested that the two diagnostic subtypes of SAD belong to the same underlying population of origin. In addition, observable differences in depression, general anxiety, and comorbidity were no longer significant when controlling for social anxiety severity. Our sample was recruited in the U.S. and was a treatment-seeking sample. Future studies should examine whether our results generalize to different cultures, and community samples. Support for qualitative differences between SAD subtypes was not found. Rather, our findings support the notion that the diagnostic subtypes of SAD differ quantitatively, and that SAD exists on a continuum of severity. This finding informs diagnostic subtyping of SAD in the forthcoming DSM-V. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Projecting pest population dynamics under global warming: the combined effect of inter- and intra-annual variations.

    PubMed

    Zidon, Royi; Tsueda, Hirotsugu; Morin, Efrat; Morin, Shai

    2016-06-01

    The typical short generation length of insects makes their population dynamics highly sensitive not only to mean annual temperatures but also to their intra-annual variations. To consider the combined effect of both thermal factors under global warming, we propose a modeling framework that links general circulation models (GCMs) with a stochastic weather generator and population dynamics models to predict species population responses to inter- and intra-annual temperature changes. This framework was utilized to explore future changes in populations of Bemisia tabaci, an invasive insect pest-species that affects multiple agricultural systems in the Mediterranean region. We considered three locations representing different pest status and climatic conditions: Montpellier (France), Seville (Spain), and Beit-Jamal (Israel). We produced ensembles of local daily temperature realizations representing current and future (mid-21st century) climatic conditions under two emission scenarios for the three locations. Our simulations predicted a significant increase in the average number of annual generations and in population size, and a significant lengthening of the growing season in all three locations. A negative effect was found only in Seville for the summer season, where future temperatures lead to a reduction in population size. High variability in population size was observed between years with similar annual mean temperatures, suggesting a strong effect of intra-annual temperature variation. Critical periods were from late spring to late summer in Montpellier and from late winter to early summer in Seville and Beit-Jamal. Although our analysis suggested that earlier seasonal activity does not necessarily lead to increased populations load unless an additional generation is produced, it is highly likely that the insect will become a significant pest of open-fields at Mediterranean latitudes above 40° during the next 50 years. Our simulations also implied that current predictions based on mean temperature anomalies are relatively conservative and it is better to apply stochastic tools to resolve complex responses to climate change while taking natural variability into account. In summary, we propose a modeling framework capable of determining distinct intra-annual temperature patterns leading to large or small population sizes, for pest risk assessment and management planning of both natural and agricultural ecosystems.

  11. Prevalence and Associated Factors of Depression in General Population of Korea: Results from the Korea National Health and Nutrition Examination Survey, 2014

    PubMed Central

    2017-01-01

    Depressive disorder is a common mental illness and remains a major cause of morbidity worldwide. The present study, a cross-sectional, nationwide, population-based survey assessed the prevalence of depression in the general population of Korea through a random sampling of the non-institutionalized population for the Korea National Health and Nutrition Examination Survey (KNHANES) VI. The Patient Health Questionnaire (PHQ)-9 was first introduced into the KNHANES to detect depression. The point prevalence of depression (PHQ score of 10 or higher) was 6.7% (95% confidence interval [CI], 5.7–7.6) in 4,949 subjects. Based on the analysis using the diagnostic algorithm of the PHQ-9, the prevalence of major depressive disorder was 2.7% (95% CI, 2.2–3.3). Multiple logistic regression analysis, after adjusting the sociodemographic variables, also showed that the factors associated with depression were perceived stress and health status. This study reported for the first time that the point prevalence of depression screened using the PHQ-9 in this nationwide survey of the Korean population was similar to that of the western countries. As the KNHANES to detect depression is conducted biennially, further studies on the accumulated data are expected in the future. PMID:28960042

  12. Evolutionary responses of native plant species to invasive plants: a review.

    PubMed

    Oduor, Ayub M O

    2013-12-01

    Strong competition from invasive plant species often leads to declines in abundances and may, in certain cases, cause localized extinctions of native plant species. Nevertheless, studies have shown that certain populations of native plant species can co-exist with invasive plant species,suggesting the possibility of adaptive evolutionary responses of those populations to the invasive plants. Empirical inference of evolutionary responses of the native plant species to invasive plants has involved experiments comparing two conspecific groups of native plants for differences in expression of growth/reproductive traits: populations that have experienced competition from the invasive plant species (i.e. experienced natives) versus populations with no known history of interactions with the invasive plant species (i.e. naıve natives). Here, I employ a meta-analysis to obtain a general pattern of inferred evolutionary responses of native plant species from 53 such studies. In general, the experienced natives had significantly higher growth/reproductive performances than naıve natives, when grown with or without competition from invasive plants.While the current results indicate that certain populations of native plant species could potentially adapt evolutionarily to invasive plant species, the ecological and evolutionary mechanisms that probably underlie such evolutionary responses remain unexplored and should be the focus of future studies.

  13. Temporal variation in airborne microbial populations and microbially-derived allergens in a tropical urban landscape

    NASA Astrophysics Data System (ADS)

    Woo, Anthony C.; Brar, Manreetpal S.; Chan, Yuki; Lau, Maggie C. Y.; Leung, Frederick C. C.; Scott, James A.; Vrijmoed, Lilian L. P.; Zawar-Reza, Peyman; Pointing, Stephen B.

    2013-08-01

    The microbial component of outdoor aerosols was assessed along a gradient of urban development from inner-city to rural in the seasonal-tropical metropolis of Hong Kong. Sampling over a continuous one-year period was conducted, with molecular analyses to characterize bacterial and eukaryal microbial populations, immuno-assays to detect microbially-derived allergens and extensive environmental and meteorological observations. The data revealed bio-aerosol populations were not significantly impacted by the level of urban development as measured by anthropogenic pollutants and human population levels, but instead exhibited a strong seasonal trend related to general climatic variables. We applied back-trajectory analysis to establish sources of air masses and this allowed further explanation of urban bio-aerosols largely in terms of summer-marine and winter-continental origins. We also evaluated bio-aerosols for the potential to detect human health threats. Many samples supported bacterial and fungal phylotypes indicative of known pathogenic taxa, together with common indicators of human presence. The occurrence of allergenic endotoxins and beta-glucans generally tracked trends in microbial populations, with levels known to induce symptoms detected during summer months when microbial loading was higher. This strengthens calls for bio-aerosols to be considered in future risk assessments and surveillance of air quality, along with existing chemical and particulate indices.

  14. Future Directions: Advances and Implications of Virtual Environments Designed for Pain Management

    PubMed Central

    Soomro, Ahmad; Riva, Giuseppe; Wiederhold, Mark D.

    2014-01-01

    Abstract Pain symptoms have been addressed with a variety of therapeutic measures in the past, but as we look to the future, we begin encountering new options for patient care and individual health and well-being. Recent studies indicate that computer-generated graphic environments—virtual reality (VR)—can offer effective cognitive distractions for individuals suffering from pain arising from a variety of physical and psychological illnesses. Studies also indicate the effectiveness of VR for both chronic and acute pain conditions. Future possibilities for VR to address pain-related concerns include such diverse groups as military personnel, space exploration teams, the general labor force, and our ever increasing elderly population. VR also shows promise to help in such areas as drug abuse, at-home treatments, and athletic injuries. PMID:24892206

  15. Future directions: advances and implications of virtual environments designed for pain management.

    PubMed

    Wiederhold, Brenda K; Soomro, Ahmad; Riva, Giuseppe; Wiederhold, Mark D

    2014-06-01

    Pain symptoms have been addressed with a variety of therapeutic measures in the past, but as we look to the future, we begin encountering new options for patient care and individual health and well-being. Recent studies indicate that computer-generated graphic environments--virtual reality (VR)--can offer effective cognitive distractions for individuals suffering from pain arising from a variety of physical and psychological illnesses. Studies also indicate the effectiveness of VR for both chronic and acute pain conditions. Future possibilities for VR to address pain-related concerns include such diverse groups as military personnel, space exploration teams, the general labor force, and our ever increasing elderly population. VR also shows promise to help in such areas as drug abuse, at-home treatments, and athletic injuries.

  16. Basic symptoms in the general population and in psychotic and non-psychotic psychiatric adolescents.

    PubMed

    Meng, Heiner; Schimmelmann, Benno Graf; Koch, Eginhard; Bailey, Barbara; Parzer, Peter; Günter, Michael; Mohler, Beat; Kunz, Natalia; Schulte-Markwort, Michael; Felder, Wilhelm; Zollinger, Rudolf; Bürgin, Dieter; Resch, Franz

    2009-06-01

    Cognitive-perceptive 'basic symptoms' are used complementary to ultra-high-risk criteria in order to predict onset of psychosis in the pre-psychotic phase. The aim was to investigate the prevalence of a broad selection of 'basic symptoms' in a representative general adolescent population sample (GPS; N=96) and to compare it with adolescents first admitted for early onset psychosis (EOP; N=87) or non-psychotic psychiatric disorders (NP; N=137). Subjects were assessed with the Bonn Scale for the Assessment of Basic Symptoms (BSABS). Prevalence of at least one 'basic symptom' and mean numbers were compared across the three groups. Logistic regression was used to predict group membership by BSABS subscales; risk ratios were calculated to identify 'basic symptoms' which best discriminated between groups. The prevalence of at least any one 'basic symptom' was 30.2% in GPS compared to 81% in NP and 96.5% in EOP. Correct classification of EOP when compared to GPS was high (94.0%) and lower when compared to NP (78.6%). Cognitive symptoms discriminated best between EOP and NP. Alike other prodromal- and psychotic-like experiences, 'basic symptoms' are prevalent in the general adolescent population, yet at a lower rate compared to EOP and NP. The usage of 'at least one basic symptom' as a screening criterion for youth at risk of developing a psychotic disorder is not recommended in the general population or in unselected psychiatrically ill adolescents. However, particularly cognitive 'basic symptoms' may be a valuable criteria to be included in future 'at risk' studies in adolescents.

  17. The Regional Assistance Mission to the Solomon Islands

    DTIC Science & Technology

    2011-06-01

    Solomon Islands (RAMSI) or a robust platform for lessons learned. Rather, it offers a general introduction to the country and an overview of a...fragile and conflict- affected countries such as the Solomon Islands are more relevant to future U.S. commitments than the plethora of lessons...New Guinea. With a population of approximately 560,000, the country has a diverse cultural mix across dr. andrew Leith currently resides in the

  18. How people with serious mental illness use smartphones, mobile apps, and social media.

    PubMed

    Naslund, John A; Aschbrenner, Kelly A; Bartels, Stephen J

    2016-12-01

    Research shows that people with serious mental illness are increasingly using mobile devices. Less is known about how these individuals use their mobile devices or whether they access social media. We surveyed individuals with serious mental illness to explore their use of these technologies. Individuals with serious mental illness engaged in lifestyle interventions through community mental health centers completed a survey about their use of mobile and online technologies. Responses were compared with data from the general population. Among respondents (n = 70), 93% owned cellphones, 78% used text messaging, 50% owned smartphones, and 71% used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media. Technology use was comparable to the general population, though smartphone ownership was lower. These findings can inform future interventions that fully leverage this group's use of popular digital technologies. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. How People with Serious Mental Illness Use Smartphones, Mobile Apps, and Social Media

    PubMed Central

    Naslund, John A.; Aschbrenner, Kelly A.; Bartels, Stephen J.

    2016-01-01

    Objective Research shows that people with serious mental illness are increasingly using mobile devices. Less is known about how these individuals use their mobile devices or whether they access social media. We surveyed individuals with serious mental illness to explore their use of these technologies. Methods Individuals with serious mental illness engaged in lifestyle interventions through community mental health centers completed a survey about their use of mobile and online technologies. Responses were compared to data from the general population. Results Among respondents (n=70), 93% owned cellphones, 78% used text messaging, 50% owned smartphones, and 71% used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media. Technology use was comparable to the general population, though smartphone ownership was lower. Conclusions and Implications for Practice These findings can inform future interventions that fully leverage this group’s use of popular digital technologies. PMID:27845533

  20. Feederism: an exaggeration of a normative mate selection preference?

    PubMed

    Terry, Lesley L; Suschinsky, Kelly D; Lalumière, Martin L; Vasey, Paul L

    2012-02-01

    Quinsey and Lalumière (1995) suggested that some, if not most, paraphilias are exaggerated manifestations of more normative and functional mate selection preferences. The present study tested whether Feederism, a fat fetish focused on erotic eating, feeding, and gaining weight, is an exaggeration of a sexual arousal pattern commonly seen in the general population. Thirty participants (15 men and 15 women) recruited from the general population were assessed using penile plethysmography and vaginal photoplethysmography, respectively. None of the participants were self-identified Feeders or Feedees. Participants were shown sexual, neutral, and feeding still images while listening to audio recordings of sexual, neutral, and feeding stories. Participants did not genitally respond to feeding stimuli. However, both men and women subjectively rated feeding stimuli as more sexually arousing than neutral stimuli. We discuss the discordance between physiological and self-reported sexual arousal in the context of sex differences in sexual concordance and implications for future research.

  1. Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices.

    PubMed

    Roy, Nelson; Merrill, Ray M; Thibeault, Susan; Gray, Steven D; Smith, Elaine M

    2004-06-01

    To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah (n1 = 1,243 teachers and n2 = 1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p <.05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and had reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p <.05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices.

  2. Measurement properties of tools used to assess suicidality in autistic and general population adults: A systematic review.

    PubMed

    Cassidy, S A; Bradley, L; Bowen, E; Wigham, S; Rodgers, J

    2018-05-05

    Adults diagnosed with autism are at significantly increased risk of suicidal thoughts, suicidal behaviours and dying by suicide. However, it is unclear whether any validated tools are currently available to effectively assess suicidality in autistic adults in research and clinical practice. This is crucial for understanding and preventing premature death by suicide in this vulnerable group. This two stage systematic review therefore aimed to identify tools used to assess suicidality in autistic and general population adults, evaluate these tools for their appropriateness and measurement properties, and make recommendations for appropriate selection of suicidality assessment tools in research and clinical practice. Three databases were searched (PsycInfo, Medline and Web of Knowledge). Four frequently used suicidality assessment tools were identified, and subsequently rated for quality of the evidence in support of their measurement properties using the COSMIN checklist. Despite studies having explored suicidality in autistic adults, none had utilised a validated tool. Overall, there was lack of evidence in support of suicidality risk assessments successfully predicting future suicide attempts. We recommend adaptations to current suicidality assessment tools and priorities for future research, in order to better conceptualise suicidality and its measurement in autism. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Labor Market Integration of People with Disabilities: Results from the Swiss Spinal Cord Injury Cohort Study

    PubMed Central

    Post, Marcel W. M.; Fekete, Christine; Trezzini, Bruno; Brinkhof, Martin W. G.

    2016-01-01

    Objectives We aimed to describe labor market participation (LMP) of persons with spinal cord injury (SCI) in Switzerland, to examine potential determinants of LMP, and to compare LMP between SCI and the general population. Methods We analyzed data from 1458 participants of employable age from the cross-sectional community survey of the Swiss Spinal Cord Injury Cohort Study. Data on LMP of the Swiss general population were obtained from the Swiss Federal Statistical Office. Factors associated with employment status as well as the amount of work performed in terms of full-time equivalent (FTE) were examined with regression techniques. Results 53.4% of the participants were employed at the time of the study. Adjusted odds of being employed were increased for males (OR = 1.73, 95% CI 1.33–2.25) and participants with paraplegia (OR = 1.78, 95% CI 1.40–2.27). The likelihood of being employed showed a significant concave relationship with age, peaking at age 40. The relation of LMP with education was s-shaped, while LMP was linearly related to time since injury. On average, employment rates were 30% lower than in the general population. Males with tetraplegia aged between 40 and 54 showed the greatest difference. From the 771 employed persons, the majority (81.7%) worked part-time with a median of 50% FTE (IRQ: 40%-80%). Men, those with younger age, higher education, incomplete lesions, and non-traumatic etiology showed significantly increased odds of working more hours per week. Significantly more people worked part-time than in the general population with the greatest difference found for males with tetraplegia aged between 40 and 54. Conclusions LMP of persons with SCI is comparatively high in Switzerland. LMP after SCI is, however, considerably lower than in the general population. Future research needs to show whether the reduced LMP in SCI reflects individual capacity adjustment, contextual constraints on higher LMP or both. PMID:27875566

  4. Labor Market Integration of People with Disabilities: Results from the Swiss Spinal Cord Injury Cohort Study.

    PubMed

    Reinhardt, Jan D; Post, Marcel W M; Fekete, Christine; Trezzini, Bruno; Brinkhof, Martin W G

    2016-01-01

    We aimed to describe labor market participation (LMP) of persons with spinal cord injury (SCI) in Switzerland, to examine potential determinants of LMP, and to compare LMP between SCI and the general population. We analyzed data from 1458 participants of employable age from the cross-sectional community survey of the Swiss Spinal Cord Injury Cohort Study. Data on LMP of the Swiss general population were obtained from the Swiss Federal Statistical Office. Factors associated with employment status as well as the amount of work performed in terms of full-time equivalent (FTE) were examined with regression techniques. 53.4% of the participants were employed at the time of the study. Adjusted odds of being employed were increased for males (OR = 1.73, 95% CI 1.33-2.25) and participants with paraplegia (OR = 1.78, 95% CI 1.40-2.27). The likelihood of being employed showed a significant concave relationship with age, peaking at age 40. The relation of LMP with education was s-shaped, while LMP was linearly related to time since injury. On average, employment rates were 30% lower than in the general population. Males with tetraplegia aged between 40 and 54 showed the greatest difference. From the 771 employed persons, the majority (81.7%) worked part-time with a median of 50% FTE (IRQ: 40%-80%). Men, those with younger age, higher education, incomplete lesions, and non-traumatic etiology showed significantly increased odds of working more hours per week. Significantly more people worked part-time than in the general population with the greatest difference found for males with tetraplegia aged between 40 and 54. LMP of persons with SCI is comparatively high in Switzerland. LMP after SCI is, however, considerably lower than in the general population. Future research needs to show whether the reduced LMP in SCI reflects individual capacity adjustment, contextual constraints on higher LMP or both.

  5. [Demographic aging and participation of the elderly in the financing of health and social expenses].

    PubMed

    Rochon, M

    1999-01-01

    The classical indicators typically used to understand the consequences of population aging upon the ability to finance social services fail to consider the active participation of older individuals. But such participation and contribution is not negligible in countries where the financing of social programs is mainly assured through governments¿ general funds. This paper considers the actual and future importance of the participation of the elderly in funding public expenditures in Quebec, Canada. Specifically, the author attempts to determine the contribution of the elderly to the public financing of health and social expenditures taking into account overall government revenues, how that contribution will change over time and which related factors could be influenced, and up to what point can this contribution offset the projected growth in the financial burden of countries caused by an aging population. Governments¿ revenue sources and indexes related to people¿s contributions are discussed with regard to taxation on consumption and income. The contribution of the elderly to the financing of public expenditures is then considered, followed by sections on the contribution of the elderly to government revenues and the financing of social expenses, and future trends in the contribution. Demographic and health factors such as the population¿s health status and the aging of the active population also affect expenditure trends and the ability of a population to finance them.

  6. Social Support and HIV-related Risk Behaviors: A Systematic Review of the Global Literature

    PubMed Central

    Li, Xiaoming; Stanton, Bonita

    2013-01-01

    Existing empirical evidence has well documented the role of social support in both physical and psychological well-being among various populations. In the context of HIV prevention, the rapid increase of studies on social support merits a systematic review to synthesize the current global literature on association between social support and HIV-related risk behaviors. The current review reveals a complex picture of this relationship across diverse populations. Existing studies indicate that higher levels of social support are related to fewer HIV-related risk behaviors among female sex workers and people living with HIV/AIDS and heterosexual adults in general. However, influences of social support on HIV-related risk behaviors are inconsistent within drug users, men who have sex with men and adolescents. These variations in findings may be attributed to different measurement of social support in different studies, specific context of social support for diverse population, or various characteristics of the social networks the study population obtained support from. Future studies are needed to explore the mechanism of how social support affects HIV-related risk behaviors. HIV prevention intervention efforts need to focus on the positive effect of social support for various vulnerable and at-risk populations. Future efforts also need to incorporate necessary structure change and utilize technical innovation in order to maximize the protective role of social support in HIV risk prevention or reduction. PMID:23921582

  7. What factors can be protective for both self-rated oral health and general health?

    PubMed

    Ekbäck, Gunnar; Persson, Carina; Lindén-Boström, Margareta

    2015-01-01

    The aim of this study was to analyze if the same protective factors are significant for both self-rated health and oral health. It was hypothesized that these factors should be the same. The material is based on a population sample of 17 113 women and men aged 18-84 years in one county in central Sweden.The response rate was 61%. The data were collected through a postal questionnaire "Life and Health" in 2008. The questionnaire comprised of 149 questions and was divided into a number of areas, e.g. socioeconomic conditions, quality of life, social relations, lifestyle, and health. To analyze the strength of the protective factors whilst taking into account the relationships between the various independent variables, multivariate analyses were conducted using binary multiple logistic regression. The outcome measures with the strongest association to general health is belonging to the age group 18-34 years, positive faith in the future, good sleeping pattern and to be employed/self-employed/retired. The outcomes with the strongest association to oral health are good finances, belonging to the age group 18-34 years, to be born in Sweden and positive faith in the future. Conclusions. This study shows that, in general, the same protective factors are significant for both self-rated health and self-rated oral health, making it possible to use the same approach to strengthen both general health and oral health. One important outcome, not often considered, is having positive faith in the future. It is a task for the health care system to strengthen people's faith in the future, partly through a very high quality care when needed, but also through active health promotion that increases the chances of a healthy life, both from a public health perspective as from an oral health perspective.

  8. Is a HIV vaccine a viable option and at what price? An economic evaluation of adding HIV vaccination into existing prevention programs in Thailand.

    PubMed

    Leelahavarong, Pattara; Teerawattananon, Yot; Werayingyong, Pitsaphun; Akaleephan, Chutima; Premsri, Nakorn; Namwat, Chawetsan; Peerapatanapokin, Wiwat; Tangcharoensathien, Viroj

    2011-07-05

    This study aims to determine the maximum price at which HIV vaccination is cost-effective in the Thai healthcare setting. It also aims to identify the relative importance of vaccine characteristics and risk behavior changes among vaccine recipients to determine how they affect this cost-effectiveness. A semi-Markov model was developed to estimate the costs and health outcomes of HIV prevention programs combined with HIV vaccination in comparison to the existing HIV prevention programs without vaccination. The estimation was based on a lifetime horizon period (99 years) and used the government perspective. The analysis focused on both the general population and specific high-risk population groups. The maximum price of cost-effective vaccination was defined by using threshold analysis; one-way and probabilistic sensitivity analyses were performed. The study employed an expected value of perfect information (EVPI) analysis to determine the relative importance of parameters and to prioritize future studies. The most expensive HIV vaccination which is cost-effective when given to the general population was 12,000 Thai baht (US$1 = 34 Thai baht in 2009). This vaccination came with 70% vaccine efficacy and lifetime protection as long as risk behavior was unchanged post-vaccination. The vaccine would be considered cost-ineffective at any price if it demonstrated low efficacy (30%) and if post-vaccination risk behavior increased by 10% or more, especially among the high-risk population groups. The incremental cost-effectiveness ratios were the most sensitive to change in post-vaccination risk behavior, followed by vaccine efficacy and duration of protection. The EVPI indicated the need to quantify vaccine efficacy, changed post-vaccination risk behavior, and the costs of vaccination programs. The approach used in this study differentiated it from other economic evaluations and can be applied for the economic evaluation of other health interventions not available in healthcare systems. This study is important not only for researchers conducting future HIV vaccine research but also for policy decision makers who, in the future, will consider vaccine adoption.

  9. The brave new world of older patients: preparing general practice training for an ageing population.

    PubMed

    Bonney, Andrew; Phillipson, Lyn; Jones, Sandra C; Hall, Julie; Sharma, Rashmi

    2015-11-01

    Develop and pilot test evidence-based resources for general practice training practices to enhance older patients' (65+ years) interactions with General Practice Registrars (GPRs). In Australia, general practice trainees, referred to as GPRs, see fewer older patients and patients with chronic conditions than doctors who have completed their specialist GP training. This reduces learning opportunities for GPRs in the management of these important patient groups. Therefore, developing effective strategies to improve GPR-older patient interaction is critical to primary care training, to meet the current and future needs of an ageing population. Adopting a social marketing approach, GPR practice resources were developed to address knowledge and attitudinal barriers at the practice and patient level to improve older patient comfort, and willingness to engage, with GPR care. Two focus groups with older patients (n=18) and interviews with staff of training practices (n=12) were utilised to pre-test resources. Amended resources were pilot tested and evaluated in a naturalistic GPR training practice setting using a structured patient questionnaire (n=44). Pilot evaluation suggests improved comfort and willingness of older patients to interact with GPRs. In all, 54% of survey participants indicated they would be more likely to make an appointment with a Registrar in the future as a result of exposure to the resources. In all, 40% of patients would feel comfortable having a GPR manage a complex or chronic condition, which compares favourably with 28% of similarly aged patients in previous research. The use of tailored, engaging and informative GPR resources for older patients and practice staff may be an important contributor to addressing the growing problem of ensuring GPRs are adequately engaged in treating older patients. The adoption of a social marketing framework was instrumental in enhancing the acceptance and effectiveness of this intervention.

  10. [Adherence to the Mediterranean diet of future teachers].

    PubMed

    Egeda Manzanera, José Manuel; Rodrigo Vega, Maximiliano

    2014-08-01

    The Spanish university population is vulnerable in their eating habits for various reasons. This would in many cases the abandonment of a traditional Mediterranean diet. To determine the adherence to the Mediterranean diet (adm) of a university population of future Teachers and analyze various factos that may condition its nutritional quality. Distribution Kidmed test to a sample of 212 university aged between 21 and 24. The Kidmed index (0-12) indicate whether the ADM was low (0 to 3), medium (4-7) or high (8 to 12). Each respondent was recorded age, weight, height and body mass index, and weekly physical activity. For comparison of the data was used Chi square test, the Mann Whitney test and ANOVA factor using SPSS 15. 15.1% had a low Kidmed index, 60.4% intermediate and 24.5% higher. The difference between the different levels of ADM is due to the consumption of fruits and vegetables (p < 0.05) mainly. Among the degrees of ADM and nutritional status (BMI) were not significantly different. The differences between those students who perform physical activity (66%) and no (34%) over the Kidmed index (< 0.05), were due primarily to breakfast consumed more cereals and cereal and pastries least). 75.5% of future Teachers needed improved ADM. In general, enhance a quality breakfast and minimum daily physical activity would be two core aspects in improving habits. It would be appropriate to provide nutritional education campaigns for this population and especially considering their future social role as educators. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  11. Environmental exposures to metals in Native communities and implications for child development: basis for the Navajo birth cohort study.

    PubMed

    Lewis, Johnnye; Gonzales, Melissa; Burnette, Courtney; Benally, Malcolm; Seanez, Paula; Shuey, Christopher; Nez, Helen; Nez, Christopher; Nez, Seraphina

    2015-01-01

    Two disparate statistics often cited for the Western United States raise concern about risks for developmental disabilities in Native American children. First, 13 of the states with the highest percentage of Native American population are located in the Western United States (U.S. Census Bureau, 2012 ). Second, more than 161,000 abandoned hard-rock mines are located in 12 Western states (General Accounting Office, 2014 ). Moreover, numerous studies have linked low-level metals exposure with birth defects and developmental delays. Concern has emerged among tribal populations that metals exposure from abandoned mines might threaten development of future generations.

  12. Biomarkers of Mercury Exposure in the Amazon

    PubMed Central

    de Castro, Nathália Santos Serrão; Lima, Marcelo de Oliveira

    2014-01-01

    Mercury exposure in the Amazon has been studied since the 1980s decade and the assessment of human mercury exposure in the Amazon is difficult given that the natural occurrence of this metal is high and the concentration of mercury in biological samples of this population exceeds the standardized value of normality established by WHO. Few studies have focused on the discovery of mercury biomarkers in the region's population. In this way, some studies have used genetics as well as immunological and cytogenetic tools in order to find a molecular biomarker for assessing the toxicological effect of mercury in the Amazonian population. Most of those studies focused attention on the relation between mercury exposure and autoimmunity and, because of that, they will be discussed in more detail. Here we introduce the general aspects involved with each biomarker that was studied in the region in order to contextualize the reader and add information about the Amazonian life style and health that may be considered for future studies. We hope that, in the future, the toxicological studies in this field use high technological tools, such as the next generation sequencing and proteomics skills, in order to comprehend basic questions regarding the metabolic route of mercury in populations that are under constant exposure, such as in the Amazon. PMID:24895619

  13. Demographic models and IPCC climate projections predict the decline of an emperor penguin population.

    PubMed

    Jenouvrier, Stéphanie; Caswell, Hal; Barbraud, Christophe; Holland, Marika; Stroeve, Julienne; Weimerskirch, Henri

    2009-02-10

    Studies have reported important effects of recent climate change on Antarctic species, but there has been to our knowledge no attempt to explicitly link those results to forecasted population responses to climate change. Antarctic sea ice extent (SIE) is projected to shrink as concentrations of atmospheric greenhouse gases (GHGs) increase, and emperor penguins (Aptenodytes forsteri) are extremely sensitive to these changes because they use sea ice as a breeding, foraging and molting habitat. We project emperor penguin population responses to future sea ice changes, using a stochastic population model that combines a unique long-term demographic dataset (1962-2005) from a colony in Terre Adélie, Antarctica and projections of SIE from General Circulation Models (GCM) of Earth's climate included in the most recent Intergovernmental Panel on Climate Change (IPCC) assessment report. We show that the increased frequency of warm events associated with projected decreases in SIE will reduce the population viability. The probability of quasi-extinction (a decline of 95% or more) is at least 36% by 2100. The median population size is projected to decline from approximately 6,000 to approximately 400 breeding pairs over this period. To avoid extinction, emperor penguins will have to adapt, migrate or change the timing of their growth stages. However, given the future projected increases in GHGs and its effect on Antarctic climate, evolution or migration seem unlikely for such long lived species at the remote southern end of the Earth.

  14. Demographic models and IPCC climate projections predict the decline of an emperor penguin population

    PubMed Central

    Jenouvrier, Stéphanie; Caswell, Hal; Barbraud, Christophe; Holland, Marika; Strœve, Julienne; Weimerskirch, Henri

    2009-01-01

    Studies have reported important effects of recent climate change on Antarctic species, but there has been to our knowledge no attempt to explicitly link those results to forecasted population responses to climate change. Antarctic sea ice extent (SIE) is projected to shrink as concentrations of atmospheric greenhouse gases (GHGs) increase, and emperor penguins (Aptenodytes forsteri) are extremely sensitive to these changes because they use sea ice as a breeding, foraging and molting habitat. We project emperor penguin population responses to future sea ice changes, using a stochastic population model that combines a unique long-term demographic dataset (1962–2005) from a colony in Terre Adélie, Antarctica and projections of SIE from General Circulation Models (GCM) of Earth's climate included in the most recent Intergovernmental Panel on Climate Change (IPCC) assessment report. We show that the increased frequency of warm events associated with projected decreases in SIE will reduce the population viability. The probability of quasi-extinction (a decline of 95% or more) is at least 36% by 2100. The median population size is projected to decline from ≈6,000 to ≈400 breeding pairs over this period. To avoid extinction, emperor penguins will have to adapt, migrate or change the timing of their growth stages. However, given the future projected increases in GHGs and its effect on Antarctic climate, evolution or migration seem unlikely for such long lived species at the remote southern end of the Earth. PMID:19171908

  15. Tuberculosis incidence in prisons: a systematic review.

    PubMed

    Baussano, Iacopo; Williams, Brian G; Nunn, Paul; Beggiato, Marta; Fedeli, Ugo; Scano, Fabio

    2010-12-21

    Transmission of tuberculosis (TB) in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI) and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF%) to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR) for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8) and 23.0 (IQR: 11.7-36.1), respectively. The median estimated fraction (PAF%) of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9%) and 6.3% (IQR: 2.7%-17.2%) in high- and middle/low-income countries, respectively. The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.

  16. History of suicide attempts in adults with Asperger syndrome.

    PubMed

    Paquette-Smith, Melissa; Weiss, Jonathan; Lunsky, Yona

    2014-01-01

    Individuals with Asperger syndrome (AS) may be at higher risk for attempting suicide compared to the general population. This study examines the issue of suicidality in adults with AS. An online survey was completed by 50 adults from across Ontario. The sample was dichotomized into individuals who had attempted suicide (n = 18) and those who had not (n = 32). We examined the relationship between predictor variables and previous attempts, and compared the services that both groups are currently receiving. Over 35% of individuals with AS reported that they had attempted suicide in the past. Individuals who attempted suicide were more likely to have a history of depression and self-reported more severe autism symptomatology. Those with and without a suicidal history did not differ in terms of the services they were currently receiving. This study looks at predictors retrospectively and cannot ascertain how long ago the attempt was made. Although efforts were made to obtain a representative sample, there is the possibility that the individuals surveyed may be more or less distressed than the general population with AS. The suicide attempt rate in our sample is much higher than the 4.6% lifetime prevalence seen in the general population. These findings highlight a need for more specialized services to help prevent future attempts and to support this vulnerable group.

  17. Gardening is beneficial for adult mental health: Scottish Health Survey, 2012-2013.

    PubMed

    Shiue, Ivy

    2016-07-01

    Gardening has been reported as being beneficial for mental well-being for vulnerable populations since 2000. However, little is known concerning its role in the general population. Therefore, the aim of the present study was to investigate the relationship of gardening and mental health in adults in a countrywide and population-based setting. Data was retrieved from and analysed in the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, gardening engagement, and adult mental health by General Health Questionnaire was obtained by household interview. Statistical analyses including chi-square test, t-test and survey-weighted logistic and multi-nominal regression modelling were performed. Of 9709 Scottish adults aged 16-99, 5 531 (57.0%) people did not do any gardening or building work in the last four weeks. A total of 888 (9.2%) people reported poor self-rated health. Gardening was associated with adult mental health in people both with or without heart conditions including ability to concentrate, feeling playing a useful part in things, feeling capable of making decisions, thinking of self as worthless, feeling reasonably happy, etc. General adults with or without heart conditions could benefit from engaging with gardening or building work. Future public health programmes promoting such activity should be encouraged in order to optimise adult mental health.

  18. [Family Health Teams in Ontario: Ideas for Germany from a Canadian Primary Care Model].

    PubMed

    Ulrich, Lisa-R; Pham, Thuy-Nga Tia; Gerlach, Ferdinand M; Erler, Antje

    2017-07-11

    The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners. In 2014, the German Advisory Council on the Assessment of Developments in the Health Care System highlighted the importance of regional, integrated care with community-based primary care centres at its core, providing comprehensive, population-based, patient-centred primary care with adequate access to general practitioners for a given geographical area. Such centres exist already in Ontario, Canada; within Family Health Teams (FHT), family physicians work hand-in-hand with pharmacists, nurses, nurse practitioners, social workers, and other allied health professionals. In this article, the Canadian model of FHT will be introduced and we will discuss which components could be adapted to suit the German primary care system. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Texas dentists' attitudes toward the Dental Medicaid program.

    PubMed

    Blackwelder, Aaron; Shulman, Jay D

    2007-01-01

    The purpose of this study was to report the attitudes of Texas dentists toward the Dental Medicaid program. A self-administered survey was mailed to all pediatric dentists and a random sample of general dentists. Surveys from 347 (69%) of 500 dentists (171 of 295 general dentists [58%] and 169 of 205 pediatric dentists [82%]) were returned. 57% of pediatric dentists and 29% of general dentists (P<.0001) treated at least 1 Medicaid patient in the past year. The major areas of dissatisfaction were: (1) broken appointments; (2) low reimbursement levels; and (3) patient noncompliance. This mirrors results from studies in Iowa, Louisiana, Ohio, Washington, and California. Both pediatric and general practitioners identified the following barriers to core for the Medicaid population: (1) low dental IQ; (2) few providers; and (3) no transportation. The major areas of dissatisfaction included both programmatic and patient-related factors. Attributes of the system (eg, lower reimbursement levels) are more modifiable than attributes of the patient population (eg, patient noncompliance and low dental IQ). Underfunding of dental Medicaid is endemic to all states studied in the literature. Providers, legislators, and government programs should target the programmatic problems with future efforts and funding.

  20. Resource development in otolaryngology-head and neck surgery: an analysis on patient education resource development.

    PubMed

    Goldfarb, Jeremy; Gupta, Vishaal; Sampson, Heather; Chiodo, Albino

    2014-01-01

    There is a need for educational tools in the consenting process of otolaryngology-head and neck procedures. A development strategy for the creation of educational tools in otolaryngology-head and neck surgery, particularly pamphlets on the peri-operative period in an adenotonsillectomy, is described. A participatory design approach, which engages key stakeholders in the development of an educational tool, is used. Pamphlets were created through a review of traditional and grey literature and then reviewed by a community expert in the field. The pamphlets were then reviewed by an interdisciplinary team including educational experts, and finally by less vulnerable members of the target population. Questionnaires evaluating the pamphlets' content, layout, style, and general qualitative features were included. The pamphlets yielded high ratings across all domains regardless of patient population. General feedback was provided by a non-vulnerable patient population and final pamphlets were drafted. By using a participatory design model, the pamphlets are written at an appropriate educational level to incorporate a broad audience. Furthermore, this methodology can be used in future resource development of educational tools.

  1. Resource development in otolaryngology-head and neck surgery: an analysis on patient education resource development

    PubMed Central

    2014-01-01

    Background There is a need for educational tools in the consenting process of otolaryngology-head and neck procedures. A development strategy for the creation of educational tools in otolaryngology-head and neck surgery, particularly pamphlets on the peri-operative period in an adenotonsillectomy, is described. Methods A participatory design approach, which engages key stakeholders in the development of an educational tool, is used. Pamphlets were created through a review of traditional and grey literature and then reviewed by a community expert in the field. The pamphlets were then reviewed by an interdisciplinary team including educational experts, and finally by less vulnerable members of the target population. Questionnaires evaluating the pamphlets’ content, layout, style, and general qualitative features were included. Results The pamphlets yielded high ratings across all domains regardless of patient population. General feedback was provided by a non-vulnerable patient population and final pamphlets were drafted. Conclusions By using a participatory design model, the pamphlets are written at an appropriate educational level to incorporate a broad audience. Furthermore, this methodology can be used in future resource development of educational tools. PMID:25022351

  2. Relation between age and carotid artery intima-medial thickness: a systematic review.

    PubMed

    van den Munckhof, Inge C L; Jones, Helen; Hopman, Maria T E; de Graaf, Jacqueline; Nyakayiru, Jean; van Dijk, Bart; Eijsvogels, Thijs M H; Thijssen, Dick H J

    2018-05-12

    Carotid artery intima-medial thickness (cIMT) represents a popular measure of atherosclerosis and is predictive of future cardiovascular and cerebrovascular events. Although older age is associated with a higher cIMT, little is known about whether this increase in cIMT follows a linear relationship with age or it is affected under influence of cardiovascular diseases (CVD) or CVD risk factors. We hypothesize that the relationship between cIMT and age is nonlinear and is affected by CVD or risk factors. A systematic review of studies that examined cIMT in the general population and human populations free from CVD/risk factors was undertaken. The literature search was conducted in PubMed, Scopus, and Web of Science. Seventeen studies with 32 unique study populations, involving 10,124 healthy individuals free from CVD risk factors, were included. Furthermore, 58 studies with 115 unique study populations were included, involving 65,774 individuals from the general population (with and without CVD risk factors). A strong positive association was evident between age and cIMT in the healthy population, demonstrating a gradual, linear increase in cIMT that did not differ between age decades (r = 0.91, P < 0.001). Although populations with individuals with CVD demonstrated a higher cIMT compared to populations free of CVD, a linear relation between age and cIMT was also present in this population. Our data suggest that cIMT is strongly and linearly related to age. This linear relationship was not affected by CVD or risk factors. © 2018 Wiley Periodicals, Inc.

  3. Time Frame and Justice Motive: Future Perspective Moderates the Adaptive Function of General Belief in a Just World

    PubMed Central

    Wu, Michael Shengtao; Sutton, Robbie M.; Yan, Xiaodan; Zhou, Chan; Chen, Yiwen; Zhu, Zhuohong; Han, Buxin

    2013-01-01

    Background The human ability to envision the future, that is, to take a future perspective (FP), plays a key role in the justice motive and its function in transcending disadvantages and misfortunes. The present research investigated whether individual (Study 1) and situational (Study 2) differences in FP moderated the association of general belief in a just world (GBJW) with psychological resilience. Methodology/Principal Findings We investigated FP, GBJW, and resilience in sample of adolescents (n = 223) and disaster survivors (n = 218) in China. In Study 1, adolescents revealed stronger GBJW than PBJW, and GBJW uniquely predicted resilience in the daily lives of those with high FP (but not those with low FP). In Study 2, natural priming of FP (vs. no FP) facilitated the association of GBJW with resilience after disaster. Conclusions/Significance Supporting predictions, participants endorsed GBJW more strongly than PBJW. Further, GBJW interacted with FP in both studies, such that there was an association between GBJW and resilience at high but not low levels of FP. The results corroborate recent findings suggesting that GBJW may be more psychologically adaptive than PBJW among some populations. They also confirm that focusing on the future is an important aspect of the adaptive function of just-world beliefs. PMID:24312235

  4. General practitioner workforce planning: assessment of four policy directions.

    PubMed

    Teljeur, Conor; Thomas, Stephen; O'Kelly, Fergus D; O'Dowd, Tom

    2010-06-02

    Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible interventions to address future shortages. Demand was estimated by applying GP visit rates by age and sex to national population projections. Supply was modelled using a range of parameters derived from two national surveys of GPs. A stochastic modelling approach was adopted to determine the probable future supply of GPs. Four policy interventions were tested: increasing vocational training places; recruiting GPs from abroad; incentivising later retirement; increasing nurse substitution to enable practice nurses to deliver more services. Relative to most other European countries, Ireland has few GPs per capita. Ireland has an ageing population and demand is estimated to increase by 19% by 2021. Without intervention, the supply of GPs will be 5.7% less than required in 2021. Increasing training places will enable supply to meet demand but only after 2019. Recruiting GPs from overseas will enable supply to meet demand continuously if the number recruited is approximately 0.8 per cent of the current workforce per annum. Later retirement has only a short-term impact. Nurse substitution can enable supply to meet demand but only if large numbers of practice nurses are recruited and allowed to deliver a wide range of GP services. A significant shortfall in GP supply is predicted for Ireland unless recruitment is increased. The shortfall will have numerous knock-on effects including price increases, longer waiting lists and an increased burden on hospitals. Increasing training places will not provide an adequate response to future shortages. Foreign recruitment has ethical considerations but may provide a rapid and effective response. Increased nurse substitution appears to offer the best long-term prospects of addressing GP shortages and presents the opportunity to reshape general practice to meet the demands of the future.

  5. The Prevalence of E-Cigarette Use in a Sample of U.S. Air Force Recruits

    PubMed Central

    Little, Melissa A.; Derefinko, Karen J.; Colvin, Lauren; Ebbert, Jon O.; Bursac, Zoran; Talcott, Gerald W.; Richey, Phyllis A.; Klesges, Robert C.

    2015-01-01

    Introduction The prevalence of electronic cigarette (e-cigarette) use is increasing markedly in the general population. Yet, remarkably little research exists to examine these ongoing trends in at-risk populations, and nothing is known about the prevalence of e-cigarette use among military personnel. The purpose of the current study is to provide recent (2013–2014) data on the prevalence of regular e-cigarette use in a population of recruits prior to their entry into the U.S. military. Methods The study utilized a cross-sectional assessment of e-cigarette and other tobacco and nicotine–containing product (TNCP) use in 2013–2014 among 10,043 U.S. Air Force (USAF) recruits in Technical Training. Chi-square tests, the Cochran–Armitage test for trend, and logistic regression models tested differences and trends across time for e-cigarette use. Results The rate of e-cigarette use among recruits was 5.2%, which doubled (3% to 6.5%, p<0.0001) across a 1-year period. E-cigarette use was associated with increased odds of all measured TNCPs, as well as dual and poly use (all p<0.0001). Conclusions Rates of e-cigarette use are slightly higher in young USAF recruits than in the general population, and e-cigarette users are likely to be using other TNCPs in tandem. Although additional work is needed to understand the reasons for this concomitant use, this is a necessary first step to understanding e-cigarette use prevalence in military populations. Historic trends suggest that, like general populations, e-cigarette use is on the rise for those entering the USAF and should be monitored to inform future prevention programming. PMID:25896193

  6. Head Trauma with or without Mild Brain Injury Increases the Risk of Future Traumatic Death: A Controlled Prospective 15-Year Follow-Up Study.

    PubMed

    Vaaramo, Kalle; Puljula, Jussi; Tetri, Sami; Juvela, Seppo; Hillbom, Matti

    2015-10-15

    Patients who have recovered from traumatic brain injury (TBI) show an increased risk of premature death. To investigate long-term mortality rates in a population admitted to the hospital for head injury (HI), we conducted a population-based prospective case-control, record-linkage study, All subjects who were living in Northern Ostrobothnia, and who were admitted to Oulu University Hospital in 1999 because of HI (n=737), and 2196 controls matched by age, gender, and residence randomly drawn from the population of Northern Ostrobothnia were included. Death rate and causes of death in HI subjects during 15 years of follow-up was compared with the general population controls. The crude mortality rates were 56.9, 18.6, and 23.8% for subjects having moderate-to-severe traumatic brain injury (TBI), mild TBI, and head injury without TBI, respectively. The corresponding approximate annual mortality rates were 6.7%, 1.4%, and 1.9%. All types of index HI predicted a significant risk of traumatic death in the future. Subjects who had HI without TBI had an increased risk of both death from all causes (hazard ratio 2.00; 95% confidence interval 1.57-2.55) and intentional or unintentional traumatic death (4.01, 2.20-7.30), compared with controls. The main founding was that even HI without TBI carries an increased risk of future traumatic death. The reason for this remains unknown and further studies are needed. To prevent such premature deaths, post-traumatic therapy should include an interview focusing on lifestyle factors.

  7. A cross-sectional examination of the physical fitness and selected health attributes of recreational all-terrain vehicle riders and off-road motorcyclists.

    PubMed

    Burr, Jamie F; Jamnik, Veronica; Gledhill, Norman

    2010-11-01

    The aims of this study were: (1) to characterize selected fitness and health attributes of two types of habitual recreational off-road vehicle riders - off-road motorcyclists and all-terrain vehicle riders; (2) to explore differences among riders in terms of vehicle type, age, and gender; and (3) to compare the fitness and health of riders to population norms and clinical health standards. Canadian off-road riders (n = 141) of both sexes aged 16 years and over were recruited through local and national off-road riding organizations. Anthropometry, fitness, and health measures of off-road motorcycle and all-terrain vehicle riders were compared with population norms, health standards, and physical activity guidelines. Off-road motorcycle riders had above average aerobic fitness (79th percentile), while all-terrain vehicle riders were lower than average (40th percentile). All riders had a healthy blood lipid profile and a low incidence of the metabolic syndrome (12.9%) compared with members of the general population. Off-road motorcycle riders had healthier body composition and fitness than all-terrain vehicle riders; however, the body composition of off-road motorcycle riders was no healthier than that of the general population and all-terrain vehicle riders were worse than the general population. Off-road motorcycle riders had healthier anthropometry and fitness than all-terrain vehicle riders and thus fewer health risk factors for future disease, demonstrating that the physiological profiles of off-road riders are dependent on vehicle type.

  8. Statistical dynamics of regional populations and economies

    NASA Astrophysics Data System (ADS)

    Huo, Jie; Wang, Xu-Ming; Hao, Rui; Wang, Peng

    Quantitative analysis of human behavior and social development is becoming a hot spot of some interdisciplinary studies. A statistical analysis on the population and GDP of 150 cities in China from 1990 to 2013 is conducted. The result indicates the cumulative probability distribution of the populations and that of the GDPs obeying the shifted power law, respectively. In order to understand these characteristics, a generalized Langevin equation describing variation of population is proposed, which is based on the correlations between population and GDP as well as the random fluctuations of the related factors. The equation is transformed into the Fokker-Plank equation to express the evolution of population distribution. The general solution demonstrates a transition of the distribution from the normal Gaussian distribution to a shifted power law, which suggests a critical point of time at which the transition takes place. The shifted power law distribution in the supercritical situation is qualitatively in accordance with the practical result. The distribution of the GDPs is derived from the well-known Cobb-Douglas production function. The result presents a change, in supercritical situation, from a shifted power law to the Gaussian distribution. This is a surprising result-the regional GDP distribution of our world will be the Gaussian distribution one day in the future. The discussions based on the changing trend of economic growth suggest it will be true. Therefore, these theoretical attempts may draw a historical picture of our society in the aspects of population and economy.

  9. Spatio-temporal dynamics of a fish predator: Density-dependent and hydrographic effects on Baltic Sea cod population

    PubMed Central

    Bartolino, Valerio; Tian, Huidong; Bergström, Ulf; Jounela, Pekka; Aro, Eero; Dieterich, Christian; Meier, H. E. Markus; Cardinale, Massimiliano; Bland, Barbara

    2017-01-01

    Understanding the mechanisms of spatial population dynamics is crucial for the successful management of exploited species and ecosystems. However, the underlying mechanisms of spatial distribution are generally complex due to the concurrent forcing of both density-dependent species interactions and density-independent environmental factors. Despite the high economic value and central ecological importance of cod in the Baltic Sea, the drivers of its spatio-temporal population dynamics have not been analytically investigated so far. In this paper, we used an extensive trawl survey dataset in combination with environmental data to investigate the spatial dynamics of the distribution of the Eastern Baltic cod during the past three decades using Generalized Additive Models. The results showed that adult cod distribution was mainly affected by cod population size, and to a minor degree by small-scale hydrological factors and the extent of suitable reproductive areas. As population size decreases, the cod population concentrates to the southern part of the Baltic Sea, where the preferred more marine environment conditions are encountered. Using the fitted models, we predicted the Baltic cod distribution back to the 1970s and a temporal index of cod spatial occupation was developed. Our study will contribute to the management and conservation of this important resource and of the ecosystem where it occurs, by showing the forces shaping its spatial distribution and therefore the potential response of the population to future exploitation and environmental changes. PMID:28207804

  10. Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.

    PubMed

    Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

    2015-09-01

    Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement.

  11. Aging in Hong Kong: the institutional population.

    PubMed

    Woo, Jean; Chau, Patsy P H

    2009-09-01

    The Hong Kong population is aging rapidly, such that there are concerns about residential care adequacy in terms of number of places as well as quality of care. A total of 1820 residents living in a representative sample of residential care facilities were surveyed. The survey showed a substantial proportion with cognitive dysfunction, mood problems, communication and vision problems, chronic disabling diseases, impairment in activities of daily living, and undernutrition. Programs of activities and rehabilitation were generally unavailable. Those in for-profit facilities had a worse profile. An approximate estimation of numbers of staff required based on case mix revealed considerable understaffing among the for-profit facilities. Issues of quality of care would be all the more important with anticipated future increase in the institutional population of older people.

  12. Stakeholder assessment of comparative effectiveness research needs for Medicaid populations

    PubMed Central

    Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

    2015-01-01

    Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement. PMID:26388438

  13. Culture History and Population Heterogeneity as Determinants of Bacterial Adaptation: the Adaptomics of a Single Environmental Transition

    PubMed Central

    Ryall, Ben; Eydallin, Gustavo

    2012-01-01

    Summary: Diversity in adaptive responses is common within species and populations, especially when the heterogeneity of the frequently large populations found in environments is considered. By focusing on events in a single clonal population undergoing a single transition, we discuss how environmental cues and changes in growth rate initiate a multiplicity of adaptive pathways. Adaptation is a comprehensive process, and stochastic, regulatory, epigenetic, and mutational changes can contribute to fitness and overlap in timing and frequency. We identify culture history as a major determinant of both regulatory adaptations and microevolutionary change. Population history before a transition determines heterogeneities due to errors in translation, stochastic differences in regulation, the presence of aged, damaged, cheating, or dormant cells, and variations in intracellular metabolite or regulator concentrations. It matters whether bacteria come from dense, slow-growing, stressed, or structured states. Genotypic adaptations are history dependent due to variations in mutation supply, contingency gene changes, phase variation, lateral gene transfer, and genome amplifications. Phenotypic adaptations underpin genotypic changes in situations such as stress-induced mutagenesis or prophage induction or in biofilms to give a continuum of adaptive possibilities. Evolutionary selection additionally provides diverse adaptive outcomes in a single transition and generally does not result in single fitter types. The totality of heterogeneities in an adapting population increases the chance that at least some individuals meet immediate or future challenges. However, heterogeneity complicates the adaptomics of single transitions, and we propose that subpopulations will need to be integrated into future population biology and systems biology predictions of bacterial behavior. PMID:22933562

  14. [Demography and age-dependency in ophthalmic diseases].

    PubMed

    Wolfram, C

    2015-01-01

    This article explains key terms in demography and describes current and future changes in the composition of the German population. The ratio of older persons is greatly increasing as age groups from higher birth rates are growing older and as the life expectancy continues to rise particularly for older age groups. Ophthalmology is highly affected by these societal changes as eye diseases particularly affect the elderly. The prevalence of blindness and low vision is increasing in the older population even though this increase is being overlapped by a general reduction in the risk of blindness. Up to more than 30% more age-related eye diseases are expected in the population by the year 2030, which will lead to an additional roughly 7.7 million ophthalmic consultations in the population of more than 60 years of age. The healthcare units need to be adjusted to the rising demand for ophthalmic care.

  15. Design of a Multisite Study Assessing the Impact of Tic Disorders on Individuals, Families, and Communities.

    PubMed

    Augustine, E F; Adams, H R; Bitsko, R H; van Wijngaarden, E; Claussen, A H; Thatcher, A; Hanks, C E; Lewin, A B; O'Connor, T G; Vierhile, A; Danielson, M L; Kurlan, R; Murphy, T K; Mink, J W

    2017-03-01

    Tic disorders, including Tourette syndrome, are complex, multisymptom diseases, yet the impact of these disorders on affected children, families, and communities is not well understood. To improve the understanding of the impacts of Tourette syndrome, two research groups conducted independent cross-sectional studies using qualitative and quantitative measures. They focused on similar themes, but distinct scientific objectives, and the sites collaborated to align methods of independent research proposals with the aim of increasing the analyzable sample size. Site 1 (University of Rochester) was a Pediatric Neurology referral center. Site 2 (University of South Florida) was a Child Psychiatry referral center. A total of 205 children with tic disorders were enrolled from both studies. The University of Rochester also enrolled 100 control children in order to clearly isolate impacts of Tourette syndrome distinct from those occurring in the general population. The majority of children with tic disorders (n = 191, 93.1%) had Tourette syndrome, the primary population targeted for these studies. Children with Tourette syndrome were similar across sites in terms of tic severity and the occurrence of comorbid conditions. The occurrence of psychiatric comorbidities in the control group was comparable with that in the general pediatric population of the United States, making this a well-justified comparison group. Through collaboration, two sites conducting independent research developed convergent research methods to enable pooling of data, and by extension increased power, for future analyses. This method of collaboration is a novel model for future epidemiological research of tic disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The Presidential Address 2013: Promoting Enthusiasm, Imparting Knowledge! Science for the General Population and Science for Future Researchers Must All Start in the School Curriculum

    ERIC Educational Resources Information Center

    Rees, Martin

    2013-01-01

    This article provides a transcript of the Presidential Address delivered by Martin Rees, Lord Rees of Ludlow, to the Association for Science Education (ASE) Annual Conference at the University of Reading, January 2013. The address is divided into five sections under the following headings: (1) Three Reasons Why the ASE's Mission Is So Important;…

  17. Psychological and psychosocial interventions for refugee children resettled in high-income countries.

    PubMed

    Fazel, M

    2018-04-01

    Large numbers of refugee children are arriving in high-income countries. The evidence to date suggests that they have mental health needs that are higher than for the general population and that these are exacerbated by the numbers of traumatic events they have experienced and the post-migration stressors they continue to be exposed to. The importance of a thorough and thoughtful assessment is discussed. Treatments of note are described for post-traumatic stress disorder, family functioning, general mental health problems and school environments. Future opportunities to operationalise outcome measures, develop multimodal interventions and utilise implementation science methodology are considered.

  18. Interarm blood pressure difference and target organ damage in the general population.

    PubMed

    Johansson, Jouni K; Puukka, Pauli J; Jula, Antti M

    2014-02-01

    The objective of the study was to investigate interarm differences of blood pressure (BP) and its determinants, and to clarify whether both arms are equally good in assessing BP and target organ damage in the general population. We studied a representative sample of Finnish adult population with 484 study participants, ages 25-74 years. BP was measured twice by an oscillometric monitor simultaneously on both arms. Study participants underwent a clinical examination including measurements of serum lipids, glucose and indicators of target organ damage. BP was 2.3/0.2 mmHg higher on right than on left arm (P < 0.001/P = 0.15 for SBP/DBP differences). SBP and DBP measured on right and left arms correlated equally with left ventricular mass index (LVMI), interventricular septal thickness (IVST), posterior wall thickness (PWT), pulse wave velocity (PWV) and albuminuria. Higher SBP level was an independent determinant of both greater systolic and diastolic interarm BP difference. Exaggerated absolute diastolic interarm BP difference (>5 mmHg) was associated with higher BMI, arm circumference, LVMI, IVST and PWT, whereas exaggerated absolute systolic interarm BP difference (>10 mmHg) was not associated with any clinical variables. There was only a small difference in BP between arms in a healthy general population. Both arms are equally good determinants of target organ damage. BP should be measured at least once on both arms and prefer the arm with higher BP readings in the future BP measurements.

  19. Collective behaviour, uncertainty and environmental change.

    PubMed

    Bentley, R Alexander; O'Brien, Michael J

    2015-11-28

    A central aspect of cultural evolutionary theory concerns how human groups respond to environmental change. Although we are painting with a broad brush, it is fair to say that prior to the twenty-first century, adaptation often happened gradually over multiple human generations, through a combination of individual and social learning, cumulative cultural evolution and demographic shifts. The result was a generally resilient and sustainable population. In the twenty-first century, however, considerable change happens within small portions of a human generation, on a vastly larger range of geographical and population scales and involving a greater degree of horizontal learning. As a way of gauging the complexity of societal response to environmental change in a globalized future, we discuss several theoretical tools for understanding how human groups adapt to uncertainty. We use our analysis to estimate the limits of predictability of future societal change, in the belief that knowing when to hedge bets is better than relying on a false sense of predictability. © 2015 The Author(s).

  20. Hyperphagia: current concepts and future directions proceedings of the 2nd international conference on hyperphagia.

    PubMed

    Heymsfield, Steven B; Avena, Nicole M; Baier, Leslie; Brantley, Phillip; Bray, George A; Burnett, Lisa C; Butler, Merlin G; Driscoll, Daniel J; Egli, Dieter; Elmquist, Joel; Forster, Janice L; Goldstone, Anthony P; Gourash, Linda M; Greenway, Frank L; Han, Joan C; Kane, James G; Leibel, Rudolph L; Loos, Ruth J F; Scheimann, Ann O; Roth, Christian L; Seeley, Randy J; Sheffield, Val; Tauber, Maïthé; Vaisse, Christian; Wang, Liheng; Waterland, Robert A; Wevrick, Rachel; Yanovski, Jack A; Zinn, Andrew R

    2014-02-01

    Hyperphagia is a central feature of inherited disorders (e.g., Prader-Willi Syndrome) in which obesity is a primary phenotypic component. Hyperphagia may also contribute to obesity as observed in the general population, thus raising the potential importance of common underlying mechanisms and treatments. Substantial gaps in understanding the molecular basis of inherited hyperphagia syndromes are present as are a lack of mechanistic of mechanistic targets that can serve as a basis for pharmacologic and behavioral treatments. International conference with 28 experts, including scientists and caregivers, providing presentations, panel discussions, and debates. The reviewed collective research and clinical experience provides a critical body of new and novel information on hyperphagia at levels ranging from molecular to population. Gaps in understanding and tools needed for additional research were identified. This report documents the full scope of important topics reviewed at a comprehensive international meeting devoted to the topic of hyperphagia and identifies key areas for future funding and research. Copyright © 2013 The Obesity Society.

  1. Hyperphagia: Current Concepts and Future Directions Proceedings of the 2nd International Conference on Hyperphagia

    PubMed Central

    Heymsfield, Steven B.; Avena, Nicole M.; Baier, Leslie; Brantley, Phillip; Bray, George A.; Burnett, Lisa C.; Butler, Merlin G.; Driscoll, Daniel J.; Egli, Dieter; Elmquist, Joel; Forster, Janice L.; Goldstone, Anthony P.; Gourash, Linda M.; Greenway, Frank L.; Han, Joan C.; Kane, James G.; Leibel, Rudolph L.; Loos, Ruth J.F.; Scheimann, Ann O.; Roth, Christian L.; Seeley, Randy J.; Sheffield, Val; Tauber, Maïthé; Vaisse, Christian; Wang, Liheng; Waterland, Robert A.; Wevrick, Rachel; Yanovski, Jack A.; Zinn, Andrew R.

    2014-01-01

    Objective Hyperphagia is a central feature of inherited disorders (e.g., Prader–Willi Syndrome) in which obesity is a primary phenotypic component. Hyperphagia may also contribute to obesity as observed in the general population, thus raising the potential importance of common underlying mechanisms and treatments. Substantial gaps in understanding the molecular basis of inherited hyperphagia syndromes are present as are a lack of mechanistic of mechanistic targets that can serve as a basis for pharmacologic and behavioral treatments. Design and Methods International conference with 28 experts, including scientists and caregivers, providing presentations, panel discussions, and debates. Results The reviewed collective research and clinical experience provides a critical body of new and novel information on hyperphagia at levels ranging from molecular to population. Gaps in understanding and tools needed for additional research were identified. Conclusions This report documents the full scope of important topics reviewed at a comprehensive international meeting devoted to the topic of hyperphagia and identifies key areas for future funding and research. PMID:24574081

  2. Does Specification Matter? Experiments with Simple Multiregional Probabilistic Population Projections

    PubMed Central

    Raymer, James; Abel, Guy J.; Rogers, Andrei

    2012-01-01

    Population projection models that introduce uncertainty are a growing subset of projection models in general. In this paper, we focus on the importance of decisions made with regard to the model specifications adopted. We compare the forecasts and prediction intervals associated with four simple regional population projection models: an overall growth rate model, a component model with net migration, a component model with in-migration and out-migration rates, and a multiregional model with destination-specific out-migration rates. Vector autoregressive models are used to forecast future rates of growth, birth, death, net migration, in-migration and out-migration, and destination-specific out-migration for the North, Midlands and South regions in England. They are also used to forecast different international migration measures. The base data represent a time series of annual data provided by the Office for National Statistics from 1976 to 2008. The results illustrate how both the forecasted subpopulation totals and the corresponding prediction intervals differ for the multiregional model in comparison to other simpler models, as well as for different assumptions about international migration. The paper ends end with a discussion of our results and possible directions for future research. PMID:23236221

  3. Heart failure as a general pandemic in Asia.

    PubMed

    Shimokawa, Hiroaki; Miura, Masanobu; Nochioka, Kotaro; Sakata, Yasuhiko

    2015-09-01

    Heart failure (HF) is an epidemic in healthcare worldwide, including Asia. It appears that HF will become more serious in the near future, with the epidemiological transition and ageing of the population. However, in contrast to Western countries, information on HF epidemiology is still limited in Asia, particularly in South Asia. In this review, we will briefly summarize available information regarding the current and future burden of HF in Asia, which indicates the importance of both primary prevention of underlying diseases of HF and secondary prevention, including management of ischaemic HF, HF with preserved EF, and HF in the elderly. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  4. Impaired reading comprehension and mathematical abilities in male adolescents with average or above general intellectual abilities are associated with comorbid and future psychopathology.

    PubMed

    Weiser, Mark; Reichenberg, Abraham; Rabinowitz, Jonathan; Nahon, Daniella; Kravitz, Efrat; Lubin, Gad; Knobler, Haim Y; Davidson, Michael; Noy, Shlomo

    2007-11-01

    Research indicates that persons with learning disorders often suffer from psychopathology. We assessed current and future psychopathology in male adolescents with discrete impairments in reading comprehension (IRC) or arithmetic abilities (IAA) but with average or above-average general intellectual abilities. Subjects were a population-based cohort of 174,994 male adolescents screened by the Israeli Draft Board with average or above-average intellectual abilities but with low scores (8.6th and 10th lowest percentile respectively) on reading or arithmetic tests. They were compared with adolescents who scored in the 10th percentile and above on these tests (comparison group). Relative to the comparison group, male adolescents with IRC, IAA, or IRC and IAA (0.69%), had poorer scores on most behavioral assessments and higher prevalence of current psychopathology: 4.2% (comparison group), 8.0% (IRC), 7.0% (IAA), and 9.8% (IRC and IAA). Adolescents with IRC were also at increased risk for later hospitalization for schizophrenia (hazard ratios = 1.8, 95% confidence interval: 1.3-2.6). Male adolescents with average and above-average general intellectual abilities but with IRC or IAA are more likely to have current and future psychopathology. Impairments in intellectual functioning and abnormal behaviors leading to mental illnesses may share common neurobiological substrates. The results support screening male adolescents with learning disorders for psychopathology.

  5. Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?

    PubMed Central

    Taylor, Donald H; Esmail, Aneez

    1999-01-01

    Objectives To determine the number and geographical distribution of general practitioners in the NHS who qualified medically in South Asia and to project their numbers as they retire. Design Retrospective analysis of yearly data and projection of future trends. Setting England and Wales. Subjects General practitioners who qualified medically in the countries of Bangladesh, India, Pakistan, and Sri Lanka and who were practising in the NHS on 1 October 1992. Main outcome measures Proportion and age of general practitioners who qualified in South Asia by health authority; the Benzeval and Judge measure of population need at the health authority level. Results 4192 of 25 333 (16.5%) of all unrestricted general practitioners practising full time on 1 October 1992 qualified in South Asian medical schools. The proportion varied by health authority from 0.007% to 56.5%. Roughly two thirds who were practising in 1992 will have retired by 2007; in some health authorities this will represent a loss of one in four general practitioners. The practices that these doctors will leave seem to be in relatively deprived areas as measured by deprivation payments and a health authority measure of population need. Conclusion Many general practitioners who qualified in South Asian medical schools will retire within the next decade. The impact will vary greatly by health authority. Those health authorities with the greatest number of such doctors are in some of the most deprived areas in the United Kingdom and have experienced the most difficulty in filling vacancies. Various responses will be required by workforce planners to mitigate the impact of these retirements. Key messagesCurrently, one in six general practitioners practising full time in the NHS qualified medically in a South Asian medical school; two thirds are likely to retire by 2007It is unlikely that doctors who qualify in South Asia will be a source of general practice recruitment in the futureThe posts from which South Asian qualifiers are retiring may be more difficult to fill because they are often in practices in areas of higher needThere is extreme variation in the proportion of total general practitioners who are South Asian qualifiers; flexibility for policy responses should be maintained PMID:9924060

  6. Human immunodeficiency virus (HIV) prevention education in Singapore: challenges for the future.

    PubMed

    Wong, Mee Lian; Sen, Priya; Wong, Christina M; Tjahjadi, Sylvia; Govender, Mandy; Koh, Ting Ting; Yusof, Zarina; Chew, Ling; Tan, Avin; K, Vijaya

    2012-12-01

    We reviewed the current human immunodeficiency virus (HIV) prevention education programmes in Singapore, discussed the challenges faced and proposed prevention education interventions for the future. Education programmes on HIV prevention have shown some success as seen by reduced visits to sex workers among the general adult population and a marked increase in condom use among brothel-based sex workers. However, we still face many challenges such as low awareness of HIV preventive strategies and high prevalence of HIV stigma in the general population. Voluntary HIV testing and condom use remain low among the priority groups such as men who have sex with men (MSM) and heterosexual men who buy sex. Casual sex has increased markedly from 1.1% in 1989 to 17.4% in 2007 among heterosexuals in Singapore, with the majority (84%) practising unprotected sex. Sex workers have moved from brothels to entertainment venues where sex work is mostly hidden with lack of access to sexually transmitted infections (STIs)/ HIV prevention education and treatment programmes. Education programmes promoting early voluntary testing is hampered because of poor access, high cost and stigma towards people living with HIV. It remains a challenge to promote abstinence and consistent condom use in casual and steady sexual relationships among heterosexuals and MSM. New ways to promote condom use by using a positive appeal about its pleasure enhancing effects rather than the traditional disease-oriented approach should be explored. Education programmes promoting early voluntary testing and acceptance of HIV-infected persons should be scaled up and integrated into the general preventive health services.

  7. Monitoring trends in bat populations of the United States and territories: Problems and prospects

    USGS Publications Warehouse

    O'Shea, T.J.; Bogan, M. A.

    2003-01-01

    Bats are ecologically and economically important mammals. The life histories of bats (particularly their low reproductive rates and the need for some species to gather in large aggregations at limited numbers of roosting sites) make their populations vulnerable to declines. Many of the species of bats in the United States (U.S.) and territories are categorized as endangered or threatened, have been candidates for such categories, or are considered species of concern. The importance and vulnerability of bat populations makes monitoring trends in their populations a goal for their future management. However, scientifically rigorous monitoring of bat populations requires well-planned, statistically defensible efforts. This volume reports findings of an expert workshop held to examine the topic of monitoring populations of bats. The workshop participants included leading experts in sampling and analysis of wildlife populations, as well as experts in the biology and conservation of bats. Findings are reported in this volume under two sections. Part I of the report presents contributed papers that provide overviews of past and current efforts at monitoring trends in populations of bats in the U.S. and territories. These papers consider current techniques and problems, and summarize what is known about the status and trends in populations of selected groups of bats. The contributed papers in Part I also include a description of the monitoring program developed for bat populations in the United Kingdom, a critique of monitoring programs in wildlife in general with recommendations for survey and sampling strategies, and a compilation and analysis of existing data on trends in bats of the U.S. and territories. Efforts directed at monitoring bat populations are piecemeal and have shortcomings. In Part II of the report, the workshop participants provide critical analyses of these problems and develop recommendations for improving methods, defining objectives and priorities, gaining mandates, and enhancing information exchange to facilitate future efforts for monitoring trends in U.S. bat populations.

  8. A method for the dynamic management of genetic variability in dairy cattle

    PubMed Central

    Colleau, Jean-Jacques; Moureaux, Sophie; Briend, Michèle; Bechu, Jérôme

    2004-01-01

    According to the general approach developed in this paper, dynamic management of genetic variability in selected populations of dairy cattle is carried out for three simultaneous purposes: procreation of young bulls to be further progeny-tested, use of service bulls already selected and approval of recently progeny-tested bulls for use. At each step, the objective is to minimize the average pairwise relationship coefficient in the future population born from programmed matings and the existing population. As a common constraint, the average estimated breeding value of the new population, for a selection goal including many important traits, is set to a desired value. For the procreation of young bulls, breeding costs are additionally constrained. Optimization is fully analytical and directly considers matings. Corresponding algorithms are presented in detail. The efficiency of these procedures was tested on the current Norman population. Comparisons between optimized and real matings, clearly showed that optimization would have saved substantial genetic variability without reducing short-term genetic gains. PMID:15231230

  9. Future climate stimulates population out-breaks by relaxing constraints on reproduction.

    PubMed

    Heldt, Katherine A; Connell, Sean D; Anderson, Kathryn; Russell, Bayden D; Munguia, Pablo

    2016-09-14

    When conditions are stressful, reproduction and population growth are reduced, but when favourable, reproduction and population size can boom. Theory suggests climate change is an increasingly stressful environment, predicting extinctions or decreased abundances. However, if favourable conditions align, such as an increase in resources or release from competition and predation, future climate can fuel population growth. Tests of such population growth models and the mechanisms by which they are enabled are rare. We tested whether intergenerational increases in population size might be facilitated by adjustments in reproductive success to favourable environmental conditions in a large-scale mesocosm experiment. Herbivorous amphipod populations responded to future climate by increasing 20 fold, suggesting that future climate might relax environmental constraints on fecundity. We then assessed whether future climate reduces variation in mating success, boosting population fecundity and size. The proportion of gravid females doubled, and variance in phenotypic variation of male secondary sexual characters (i.e. gnathopods) was significantly reduced. While future climate can enhance individual growth and survival, it may also reduce constraints on mechanisms of reproduction such that enhanced intra-generational productivity and reproductive success transfers to subsequent generations. Where both intra and intergenerational production is enhanced, population sizes might boom.

  10. The Workforce Task Force report: clinical implications for neurology.

    PubMed

    Freeman, William D; Vatz, Kenneth A; Griggs, Robert C; Pedley, Timothy

    2013-07-30

    The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient access exist due to looming concerns about further Medicare reimbursement cuts. This uncertainty is set against a backdrop of Congressional volatility on a variety of issues, including the repeal of the sustainable growth rate for physician reimbursement. The impact of these US health care changes on the neurology workforce, future increasing demands, reimbursement, and alternative health care delivery models including accountable care organizations, nonphysician providers such as nurse practitioners and physician assistants, and teleneurology for both stroke and general neurology are discussed. The data lead to the conclusion that neurologists will need to play an even larger role in caring for the aging US population by 2025. We propose solutions to increase the availability of neurologic services in the future and provide other ways of meeting the anticipated increased demand for neurologic care.

  11. The Workforce Task Force Report

    PubMed Central

    Vatz, Kenneth A.; Griggs, Robert C.; Pedley, Timothy

    2013-01-01

    The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient access exist due to looming concerns about further Medicare reimbursement cuts. This uncertainty is set against a backdrop of Congressional volatility on a variety of issues, including the repeal of the sustainable growth rate for physician reimbursement. The impact of these US health care changes on the neurology workforce, future increasing demands, reimbursement, and alternative health care delivery models including accountable care organizations, nonphysician providers such as nurse practitioners and physician assistants, and teleneurology for both stroke and general neurology are discussed. The data lead to the conclusion that neurologists will need to play an even larger role in caring for the aging US population by 2025. We propose solutions to increase the availability of neurologic services in the future and provide other ways of meeting the anticipated increased demand for neurologic care. PMID:23783750

  12. Preventing HIV infection: educating the general public.

    PubMed

    Kroger, F

    1991-01-01

    This essay discusses the rationale for targeting HIV prevention programs to the general public, as opposed to focusing strictly on high-risk populations. The author first considers varying definitions of the term "general public," then explains the goal of general public education programs. Additionally, the author lays down the theoretical foundations of general audience education programs and weights related research findings. Finally, he offers recommendations for future practice. Noting the complex socioecological elements involved in health behavior, the author argues in favor of a broad definition for the general public. This broad outlook allows programs to still target high-risk population while not bypassing low-risk persons, who are sometimes treated as irrelevant because they do not contribute to excess morbidity or mortality. When it comes to HIV educational programs for the general public, their goals should be to instruct the public on how the virus is transmitted, to allay unfounded fears, and to increase the level of support for AIDS prevention and control. Such a program would require a theoretical basis drawn from multiple sources: health education, health communication, clinical and social psychology, and social marketing. The author concludes by proving recommendations designed to reinforce existing programs: 1) strengthen efforts to ensure that all people are educated about HIV and to encourage people to treat AIDS patients with compassion; 2) continue to explore for the most effective communication channels; 3) strengthen the communication infrastructure for those who are disenfranchised from health education; and 4) strengthen evaluation efforts of health communication programs.

  13. Sex, race, and age distributions of mean aortic wall thickness in a multiethnic population-based sample.

    PubMed

    Rosero, Eric B; Peshock, Ronald M; Khera, Amit; Clagett, Patrick; Lo, Hao; Timaran, Carlos H

    2011-04-01

    Reference values and age-related changes of the wall thickness of the abdominal aorta have not been described in the general population. We characterized age-, race-, and gender-specific distributions, and yearly rates of change of mean aortic wall thickness (MAWT), and associations between MAWT and cardiovascular risk factors in a multi-ethnic population-based probability sample. Magnetic resonance imaging measurements of MAWT were performed on 2466 free-living white, black, and Hispanic adult subjects. MAWT race/ethnicity- and gender-specific percentile values across age were estimated using regression analyses. MAWT was greater in men than in women and increased linearly with age in all the groups and across all the percentiles. Hispanic women had the thinnest and black men the thickest aortas. Black men had the highest and white women the lowest age-related MAWT increase. Age, gender, ethnicity, smoking status, systolic blood pressure, low-density lipoprotein-cholesterol levels, high-density lipoprotein-cholesterol levels, and fasting glucose levels were independent predictors of MAWT. Age, gender, and racial/ethnic differences in MAWT distributions exist in the general population. Such differences should be considered in future investigations assessing aortic atherosclerosis and the effects of anti-atherosclerotic therapies. Published by Mosby, Inc.

  14. Lifestyle Health Behaviors of Nurses and Midwives: The 'Fit for the Future' Study.

    PubMed

    Perry, Lin; Xu, Xiaoyue; Gallagher, Robyn; Nicholls, Rachel; Sibbritt, David; Duffield, Christine

    2018-05-09

    Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014⁻2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25⁻34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required.

  15. Dietary patterns and physical activity in people with schizophrenia and increased waist circumference.

    PubMed

    Jakobsen, Ane Storch; Speyer, Helene; Nørgaard, Hans Christian Brix; Karlsen, Mette; Hjorthøj, Carsten; Krogh, Jesper; Mors, Ole; Nordentoft, Merete; Toft, Ulla

    2018-03-16

    People with severe mental disorders die 10-25years earlier than people in the Western background population, mainly due to lifestyle related diseases, with cardiovascular disease (CVD) being the most frequent cause of death. Major contributors to this excess morbidity and mortality are unhealthy lifestyle factors including tobacco smoking, unhealthy eating habits and lower levels of physical activity. The aim of this study was to investigate the dietary habits and levels of physical activity in people with schizophrenia spectrum disorders and overweight and to compare the results with the current recommendations and with results from the general Danish population. We interviewed a sample of 428 people with schizophrenia spectrum disorders and increased waist circumference enrolled in the CHANGE trial using a Food Frequency Questionnaire (FFQ) and a 24h recall interview, a Physical Activity Scale (PAS), scale for assessment of positive and negative symptoms (SAPS and SANS, respectively), Brief Assessment of Cognition in Schizophrenia (BACS) and Global Assessment of Functioning (GAF). We compared with information on dietary intake and physical activity in the general Danish population from the Danish National Survey of Dietary Habits and Physical Activity in 2011-2013 (DANSDA). The CHANGE participants reported a very low energy intake and their distribution of nutrients (i.e. fat, protein and carbohydrates) harmonized with the recommendations from the Danish Health Authorities, and were similar to the latest report on the dietary habits in the Danish general population. However, the intake of saturated fat, sugar and alcohol exceed the recommended amounts and the corresponding intake in the general population. The intake of fiber, vegetables and fruit and fish were insufficient and also less than in the general population. The overall estimated quality of the dietary habits was poor, only 10.7% of the participants had healthy dietary patterns, and the quality was poorer than in the general population. Even with a very liberal definition of the term "homecooked", only 62% of the participants had taken any part in the preparation of their food. The level of physical activity was low and only one fifth of the participants complied with the recommendations of min. 30min daily moderate-to-vigorous activity. Half of the CHANGE participants were smokers, compared to 17% in the general population. Negative symptoms were significantly associated with poorer dietary quality and less physical activity, whereas no such significant associations were found for cognition, positive symptoms or antipsychotic medication. Even when accounting for some error from recall - and social desirability bias, the findings point in the direction that the average energy intake in obese people with schizophrenia spectrum disorders is not exceeding that of the general population, and that overweight may to some degree be a result of physical inactivity and metabolic adverse effects of antipsychotic medication. The physical activity level is low and the rate of tobacco smoking is high, and our results suggest that negative symptoms play a significant role. Future research should focus on bringing about lifestyle changes in this fragile population in order to reduce the excess risk of CVD and mortality. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. AEDT: A new concept for ecological dynamics in the ever-changing world.

    PubMed

    Chesson, Peter

    2017-05-01

    The important concept of equilibrium has always been controversial in ecology, but a new, more general concept, an asymptotic environmentally determined trajectory (AEDT), overcomes many concerns with equilibrium by realistically incorporating long-term climate change while retaining much of the predictive power of a stable equilibrium. A population or ecological community is predicted to approach its AEDT, which is a function of time reflecting environmental history and biology. The AEDT invokes familiar questions and predictions but in a more realistic context in which consideration of past environments and a future changing profoundly due to human influence becomes possible. Strong applications are also predicted in population genetics, evolution, earth sciences, and economics.

  17. Adaptive harvest management of North American waterfowl populations: a brief history and future prospects

    USGS Publications Warehouse

    Nichols, J.D.; Runge, M.C.; Johnson, F.A.; Williams, B.K.

    2007-01-01

    Since 1995, the US Fish and Wildlife Service has used an adaptive approach to the management of sport harvest of mid-continent Mallard ducks (Anas platyrhynchos) in North America. This approach differs from many current approaches to conservation and management in requiring close collaboration between managers and scientists. Key elements of this process are objectives, alternative management actions, models permitting prediction of system responses, and a monitoring program. The iterative process produces optimal management decisions and leads to reduction in uncertainty about response of populations to management. This general approach to management has a number of desirable features and is recommended for use in many other programs of management and conservation.

  18. What is the strength of evidence for heart failure disease-management programs?

    PubMed

    Clark, Alexander M; Savard, Lori A; Thompson, David R

    2009-07-28

    Heart failure (HF) disease-management programs are increasingly common. However, some large and recent trials of programs have not reported positive findings. There have also been parallel recent advances in reporting standards and theory around complex nonpharmacological interventions. These developments compel reconsideration in this Viewpoint of how research into HF-management programs should be evaluated, the quality, specificity, and usefulness of this evidence, and the recommendations for future research. Addressing the main determinants of intervention effectiveness by using the PICO (Patient, Intervention, Comparison, and Outcome) approach and the recent CONSORT (Consolidated Standards of Reporting Trials) statement on nonpharmacological trials, we will argue that in both current trials and meta-analyses, interventions and comparisons are not sufficiently well described; that complex programs have been excessively oversimplified; and that potentially salient differences in programs, populations, and settings are not incorporated into analyses. In preference to more general meta-analyses of programs, adequate descriptions are first needed of populations, interventions, comparisons, and outcomes in past and future trials. This could be achieved via a systematic survey of study authors based on the CONSORT statement. These more detailed data on studies should be incorporated into future meta-analyses of comparable trials and used with other techniques such as patient-based outcomes data and meta-regression. Although trials and meta-analyses continue to have potential to generate useful evidence, a more specific evidence base is needed to support the development of effective programs for different populations and settings.

  19. U.S. Military Engineering Assistance to Peru: Doing Things Right

    DTIC Science & Technology

    1992-06-05

    this effort; I am indebted to them always. Thanks and admiration to LTC Mike Ritchie who sent very useful information and to General de Brigada Adridn...12-13. One might note that this data comes from the Peruvian Hinister1o de Trabajo, or Employment Ministry. 15 economically active population...characteristic branches of government and Constitution in the near future. As Alexis de Toqueville said eloquently, "For a bad government, the worst time is

  20. Moyamoya angiopathy in Europe: the beginnings in Zurich, practical lessons learned, increasing awareness and future perspectives.

    PubMed

    Khan, N; Yonekawa, Y

    2008-01-01

    The number of patients, especially children, diagnosed with Moyamoya angiopathy and being referred to us for treatment from all across Europe, has increased over the last few years. An increase in awareness of the occurrence of stroke in children in the general and medical population might be the main cause of this phenomenon. Increasing awareness does not happen "spontaneously" nor does it manifest overnight! It requires regular platforms of communication between the general population and amongst the different medical specialists mainly neurologists, paediatric neurologists, neuropsychologists, neuroradiologists, neurorehabilitation specialists, nursing staff and neurosurgeons. Presently we were lucky to conduct the first Moyamoya Symposium ever to be conducted at a European-Japanese level with participation of specialists of this particular field from across Europe and Japan. Ever since the first child with Moyamoya was managed at the University hospital in Zurich some 7 years ago the number of patients referred to us from all across Europe increased rapidly. The importance of interdisciplinary communication, trust and support amongst specialists and increasing the awareness of the disease among the patients, medical personnel was and remains to be just as important as making the correct diagnosis and treatment of choice in these patients. We present the lessons we learned during these previous years and look into the future perspectives that require our further and urgent attention.

  1. Future Cognitive Ability: US IQ Prediction until 2060 Based on NAEP.

    PubMed

    Rindermann, Heiner; Pichelmann, Stefan

    2015-01-01

    The US National Assessment of Educational Progress (NAEP) measures cognitive competences in reading and mathematics of US students (last 2012 survey N = 50,000). The long-term development based on results from 1971 to 2012 allows a prediction of future cognitive trends. For predicting US averages also demographic trends have to be considered. The largest groups' (White) average of 1978/80 was set at M = 100 and SD = 15 and was used as a benchmark. Based on two past NAEP development periods for 17-year-old students, 1978/80 to 2012 (more optimistic) and 1992 to 2012 (more pessimistic), and demographic projections from the US Census Bureau, cognitive trends until 2060 for the entire age cohort and ethnic groups were estimated. Estimated population averages for 2060 are 103 (optimistic) or 102 (pessimistic). The average rise per decade is dec = 0.76 or 0.45 IQ points. White-Black and White-Hispanic gaps are declining by half, Asian-White gaps treble. The catch-up of minorities (their faster ability growth) contributes around 2 IQ to the general rise of 3 IQ; however, their larger demographic increase reduces the general rise at about the similar amount (-1.4 IQ). Because minorities with faster ability growth also rise in their population proportion the interactive term is positive (around 1 IQ). Consequences for economic and societal development are discussed.

  2. Future Cognitive Ability: US IQ Prediction until 2060 Based on NAEP

    PubMed Central

    2015-01-01

    The US National Assessment of Educational Progress (NAEP) measures cognitive competences in reading and mathematics of US students (last 2012 survey N = 50,000). The long-term development based on results from 1971 to 2012 allows a prediction of future cognitive trends. For predicting US averages also demographic trends have to be considered. The largest groups’ (White) average of 1978/80 was set at M = 100 and SD = 15 and was used as a benchmark. Based on two past NAEP development periods for 17-year-old students, 1978/80 to 2012 (more optimistic) and 1992 to 2012 (more pessimistic), and demographic projections from the US Census Bureau, cognitive trends until 2060 for the entire age cohort and ethnic groups were estimated. Estimated population averages for 2060 are 103 (optimistic) or 102 (pessimistic). The average rise per decade is dec = 0.76 or 0.45 IQ points. White-Black and White-Hispanic gaps are declining by half, Asian-White gaps treble. The catch-up of minorities (their faster ability growth) contributes around 2 IQ to the general rise of 3 IQ; however, their larger demographic increase reduces the general rise at about the similar amount (-1.4 IQ). Because minorities with faster ability growth also rise in their population proportion the interactive term is positive (around 1 IQ). Consequences for economic and societal development are discussed. PMID:26460731

  3. Young physicians and the Finnish welfare state.

    PubMed

    Saarinen, Arttu

    2009-01-01

    This article aims to focus on how young physicians in general and different subpopulations, in particular, see the role of the welfare state. The author seeks to compare young physicians' opinions with those of older physicians, a similar age group in the general population and all physicians. A random sample was picked from the Finnish Medical Association register (n = 1,092). Data were analysed using descriptive statistics and multinomial logistic regression analysis. Results show that young physicians--when compared with an overall population of the same age, with physicians overall, or with older physicians--are more critical of the degree of social security currently offered. Young physicians also want to give more responsibility to the private sector than do older physicians. On the other hand, young physicians are not very critical of healthcare system functionality. All in all, young physicians' opinions about the welfare state are not particularly radical. Results indicate that physicians' opinions about the welfare state will not change dramatically in the near future. Views on social security, healthcare system functionality and the role of the private sector correlate best with political orientation. There are some studies about physicians' attitudes towards the welfare state, but the opinions of young physicians have not been studied in countries with large social security systems. The paper addresses this gap because it is important to study young physicians' opinions because future services will be structured on them.

  4. Discrimination, domestic violence, abuse, and other adverse life events in people with epilepsy: Population-based study to assess the burden of these events and their contribution to psychopathology.

    PubMed

    Nimmo-Smith, Victoria; Brugha, Traolach S; Kerr, Michael P; McManus, Sally; Rai, Dheeraj

    2016-11-01

    To quantify the experience of discrimination, domestic violence, abuse, and other stressful life events in people with epilepsy in comparison with the general population and people with other chronic conditions. To assess whether any excess relative burden of these adversities could explain the higher rates of depression in people with epilepsy. The Adult Psychiatric Morbidity Survey 2007 used comprehensive interviews with 7,403 individuals living in private residences in England. Doctor-diagnosed epilepsy and other chronic conditions were established by self-report. Discrimination, domestic violence, physical and sexual abuse, and other stressful life events were assessed using computerized self-completion and a face-to-face interview, respectively. People with epilepsy were sevenfold more likely to have reported experiencing discrimination due to health problems (adjusted odds ratio [OR] 7.1; 95% confidence interval [CI] 3.1-16.3), than the general population without epilepsy. This estimate was substantially greater in people with epilepsy than for people with other chronic conditions. People with epilepsy also had greater odds of experiencing domestic violence and sexual abuse than the general population, although these associations were also found in people with other chronic conditions. There was less evidence of an association between epilepsy and a history of physical abuse or having a greater burden of other stressful life events. In exploratory analyses, assuming they lie on the causal pathway, discrimination, domestic violence, and sexual abuse explained 42.7% of the total effect of the relationship between epilepsy and depression or anxiety disorders. People with epilepsy can face a range of psychosocial adversities and extensively report feeling discriminated against as compared to the general population. In addition, if confirmed in longitudinal studies, the results suggest that these psychosocial adversities may have a significant role in the development of psychiatric comorbidity and may be targets for future interventions. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  5. Life expectancy of colon, breast, and testicular cancer patients: an analysis of US-SEER population-based data.

    PubMed

    Capocaccia, R; Gatta, G; Dal Maso, L

    2015-06-01

    Cancer survivorship is an increasingly important issue in cancer control. Life expectancy of patients diagnosed with breast, colon, and testicular cancers, stratified by age at diagnosis and time since diagnosis, is provided as an indicator to evaluate future mortality risks and health care needs of cancer survivors. The standard period life table methodology was applied to estimate excess mortality risk for cancer patients diagnosed in 1985-2011 from SEER registries and mortality data of the general US population. The sensitivity of life expectancy estimates on different assumptions was evaluated. Younger patients with colon cancer showed wider differences in life expectancy compared with that of the general population (11.2 years in women and 10.7 in men at age 45-49 years) than older patients (6.3 and 5.8 at age 60-64 years, respectively). Life expectancy progressively increases in patients surviving the first years, up to 4 years from diagnosis, and then starts to decrease again, approaching that of the general population. For breast cancer, the initial drop in life expectancy is less marked, and again with wider differences in younger patients, varying from 8.7 at age 40-44 years to 2.4 at ages 70-74 years. After diagnosis, life expectancy still decreases with time, but less than that in the general population, slowly approaching that of cancer-free women. Life expectancy of men diagnosed with testicular cancer at age 30 years is estimated as 45.2 years, 2 years less than cancer-free men of the same age. The difference becomes 1.3 years for patients surviving the first year, and then slowly approaches zero with increasing survival time. Life expectancy provides meaningful information on cancer patients, and can help in assessing when a cancer survivor can be considered as cured. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  6. The future of the New Zealand plastic surgery workforce.

    PubMed

    Adams, Brandon M; Klaassen, Michael F; Tan, Swee T

    2013-04-05

    The New Zealand (NZ) plastic and reconstructive surgery (PRS) workforce provides reconstructive plastic surgery (RPS) public services from six centres. There has been little analysis on whether the workforce is adequate to meet the needs of the NZ population currently or in the future. This study analysed the current workforce, its distribution and future requirements. PRS manpower data, workforce activities, population statistics, and population modelling were analysed to determine current needs and predict future needs for the PRS workforce. The NZ PRS workforce is compared with international benchmarks. Regional variation of the workforce was analysed with respect to the population's access to PRS services. Future supply of specialist plastic surgeons is analysed. NZ has a lower number of plastic surgeons per capita than comparable countries. The current NZ PRS workforce is mal-distributed. Areas of current and emerging future need are identified. The current workforce mal-distribution will worsen with future population growth and distribution. Up to 60% of the NZ population will be at risk of inadequate access to PRS services by 2027. Development of PRS services must be coordinated to ensure that equitable and sustainable services are available throughout NZ. Strategies for ensuring satisfactory future workforce are discussed.

  7. [Cardiovascular risk and cardiovascular events in the general population of the sanitary area of Toledo. RICARTO Study].

    PubMed

    Rodríguez-Roca, G C; Rodríguez-Padial, L; Alonso-Moreno, F J; Segura-Fragoso, A; Villarín-Castro, A; Rodríguez-García, M L; Menchén-Herreros, A; Rojas-Martelo, G A; Fernández-Conde, J A; Artigao-Rodenas, L M; Carbayo-Herencia, J A; Escobar-Cervantes, C; Hernández-Moreno, J; Fernández-Martín, J

    2018-03-01

    The main aim of this study is to ascertain the prevalence of cardiovascular risk factors (CVRF), target organ damage (TOD), cardiovascular disease (CVD), as well as life habits (physical exercise, alcohol consumption, and Mediterranean diet) in the population of a Health Area in Toledo, Spain, to assess cardiovascular risk (CVR). Epidemiological and observational study that will analyse a sample from the general population aged 18 years or older, randomly selected from a database of health cards, and stratified by age and gender. Clinical history, physical examination, and complementary tests will be performed. Aliquots of whole blood and serum samples will be stored at a temperature of-85°C to evaluate future genetic studies. CVR will be estimated by using SCORE project scales calibrated for Spanish population and the Framingham Heart Study scale. When the estimated sample size has been achieved and after a minimum follow-up of 5 years, a final visit will performed in which CVRF, TOD, CVD, CVRF control, and fatal and non-fatal outcomes will be evaluated. The RICARTO study is aimed to assess the prevalence of the main CVRF, TOD and CVD in order to determine the CVR in the general population of a health area of Toledo. An analysis will be repeated on the final sample after at least 5 years of follow-up to ascertain the incidence of CV outcomes and the temporal trends of life style, as well as the prevalence of CVRF, TOD, and CVD. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Increased genetic variation and evolutionary potential drive the success of an invasive grass.

    PubMed

    Lavergne, Sébastien; Molofsky, Jane

    2007-03-06

    Despite the increasing biological and economic impacts of invasive species, little is known about the evolutionary mechanisms that favor geographic range expansion and evolution of invasiveness in introduced species. Here, we focus on the invasive wetland grass Phalaris arundinacea L. and document the evolutionary consequences that resulted from multiple and uncontrolled introductions into North America of genetic material native to different European regions. Continental-scale genetic variation occurring in reed canarygrass' European range has been reshuffled and recombined within North American introduced populations, giving rise to a number of novel genotypes. This process alleviated genetic bottlenecks throughout reed canarygrass' introduced range, including in peripheral populations, where depletion of genetic diversity is expected and is observed in the native range. Moreover, reed canarygrass had higher genetic diversity and heritable phenotypic variation in its invasive range relative to its native range. The resulting high evolutionary potential of invasive populations allowed for rapid selection of genotypes with higher vegetative colonization ability and phenotypic plasticity. Our results show that repeated introductions of a single species may inadvertently create harmful invaders with high adaptive potential. Such invasive species may be able to evolve in response to changing climate, allowing them to have increasing impact on native communities and ecosystems in the future. More generally, multiple immigration events may thus trigger future adaptation and geographic spread of a species population by preventing genetic bottlenecks and generating genetic novelties through recombination.

  9. Current and Future Effects of Climate Change on Montane Amphibians

    NASA Astrophysics Data System (ADS)

    Corn, S.

    2002-05-01

    Breeding phenology of amphibians in inextricably linked to weather, and change in the timing of breeding resulting from climate change may have consequences for the fitness of individuals and may affect persistence of amphibian populations. Amphibians in some north temperate locations have been observed to breed earlier in recent years in response to warmer spring temperatures, but this is not a universal phenomenon. In mountain populations, phenology is influenced by snow deposition as much as temperature. A trend towards earlier breeding, associated with increasing El Niño frequency, may be occurring in the Cascade Mountains in Oregon, but only at lower elevations. There is no evidence for changes in the dates of breeding activity by amphibians in the Rocky Mountains. Too few amphibian species have been studied, and those for which data exist have been studied for too brief a span of years to allow general conclusions about the effects of climate change. However, regardless of whether climate change has contributed to current amphibian declines, changes in temperature and the extent and duration of snow cover predicted for the next century will have increasingly severe consequences for the persistence of some species. Additional observations from amphibian populations, and spatial and temporal modeling of climate variables are needed to generate predictions of past and future breeding phenology, and the effects on amphibian population dynamics.

  10. Anticipatory Reward Processing in Addicted Populations: A Focus on the Monetary Incentive Delay Task

    PubMed Central

    Balodis, Iris M.; Potenza, Marc N.

    2014-01-01

    Advances in brain imaging techniques have allowed neurobiological research to temporally analyze signals coding for the anticipation of rewards. In addicted populations, both hypo- and hyper-responsiveness of brain regions (e.g., ventral striatum) implicated in drug effects and reward system processing have been reported during anticipation of generalized reward. Here, we discuss the current state of knowledge of reward processing in addictive disorders from a widely used and validated task: the Monetary Incentive Delay Task (MIDT). The current paper constrains review to those studies applying the MIDT in addicted and at-risk adult populations, with a focus on anticipatory processing and striatal regions activated during task performance, as well as the relationship of these regions with individual difference (e.g., impulsivity) and treatment outcome variables. We further review drug influences in challenge studies as a means to examine acute influences on reward processing in abstinent, recreationally using and addicted populations. Here, we discuss that generalized reward processing in addicted and at-risk populations is often characterized by divergent anticipatory signaling in the ventral striatum. Although methodological/task variations may underlie some discrepant findings, anticipatory signaling in the ventral striatum may also be influenced by smoking status, drug metabolites and treatment status in addicted populations. Divergent results across abstinent, recreationally using and addicted populations demonstrate complexities in interpreting findings. Future studies will benefit from focusing on characterizing how impulsivity and other addiction-related features relate to anticipatory striatal signaling over time. Additionally, identifying how anticipatory signals recover/adjust following protracted abstinence will be important in understanding recovery processes. PMID:25481621

  11. Robust Decision Making to Support Water Quality Climate Adaptation: a Case Study in the Chesapeake Bay Watershed

    NASA Astrophysics Data System (ADS)

    Fischbach, J. R.; Lempert, R. J.; Molina-Perez, E.

    2017-12-01

    The U.S. Environmental Protection Agency (USEPA), together with state and local partners, develops watershed implementation plans designed to meet water quality standards. Climate uncertainty, along with uncertainty about future land use changes or the performance of water quality best management practices (BMPs), may make it difficult for these implementation plans to meet water quality goals. In this effort, we explored how decision making under deep uncertainty (DMDU) methods such as Robust Decision Making (RDM) could help USEPA and its partners develop implementation plans that are more robust to future uncertainty. The study focuses on one part of the Chesapeake Bay watershed, the Patuxent River, which is 2,479 sq km in area, highly urbanized, and has a rapidly growing population. We simulated the contribution of stormwater contaminants from the Patuxent to the overall Total Maximum Daily Load (TMDL) for the Chesapeake Bay under multiple scenarios reflecting climate and other uncertainties. Contaminants considered included nitrogen, phosphorus, and sediment loads. The assessment included a large set of scenario simulations using the USEPA Chesapeake Bay Program's Phase V watershed model. Uncertainties represented in the analysis included 18 downscaled climate projections (based on 6 general circulation models and 3 emissions pathways), 12 land use scenarios with different population projections and development patterns, and alternative assumptions about BMP performance standards and efficiencies associated with different suites of stormwater BMPs. Finally, we developed cost estimates for each of the performance standards and compared cost to TMDL performance as a key tradeoff for future water quality management decisions. In this talk, we describe how this research can help inform climate-related decision support at USEPA's Chesapeake Bay Program, and more generally how RDM and other DMDU methods can support improved water quality management under climate uncertainty.

  12. Hepatitis C serosorting among people who inject drugs in rural Puerto Rico.

    PubMed

    Duncan, Ian; Curtis, Ric; Reyes, Juan Carlos; Abadie, Roberto; Khan, Bilal; Dombrowski, Kirk

    2017-06-01

    Due to the high cost of treatment, preventative measures to limit Hepatitis C (HCV) transmission among people who inject drugs (PWID) are encouraged by many public health officials. A key one of these is serosorting, where PWID select risk partners based on concordant HCV status. Research on the general U.S. population by Smith et al. (2013) found that knowledge of one's own HCV status facilitated serosorting behaviors among PWID, such that respondents with knowledge of their own status were more likely to ask potential partners about their status prior to sharing risk. Our objective was to see if this held true in rural Puerto Rico. We replicate this study using a sample of PWID in rural Puerto Rico to draw comparisons. We used respondent driven sampling to survey 315 participants, and have a final analytic sample of 154. The survey was heavily modeled after the National HIV Behavioral Survey, which was the dataset used by the previous researchers. We found that among PWID in rural Puerto Rico, unlike in the general population, knowledge of one's own HCV status had no significant effect on the selection of one's most recent injection partner, based on his/her HCV status. We conclude that PWID in rural Puerto Rico differ from the general U.S. population when it comes to serosorting behaviors, and that these differences should be taken into account in future outreaches and intervention strategies.

  13. Substitution and Complementarity of Alcohol and Cannabis: A Review of the Literature.

    PubMed

    Subbaraman, Meenakshi Sabina

    2016-09-18

    Whether alcohol and cannabis are used as substitutes or complements remains debated, and findings across various disciplines have not been synthesized to date. This article is a first step towards organizing the interdisciplinary literature on alcohol and cannabis substitution and complementarity. Electronic searches were performed using PubMed and ISI Web of Knowledge. Behavioral studies of humans with "alcohol" (or "ethanol") and "cannabis" (or "marijuana") and "complement(*)" (or "substitut(*)") in the title or as a keyword were considered. Studies were organized according to sample characteristics (youth, general population, clinical and community-based). These groups were not set a priori, but were informed by the literature review process. Of the 39 studies reviewed, 16 support substitution, ten support complementarity, 12 support neither and one supports both. Results from studies of youth suggest that youth may reduce alcohol in more liberal cannabis environments (substitute), but reduce cannabis in more stringent alcohol environments (complement). Results from the general population suggest that substitution of cannabis for alcohol may occur under more lenient cannabis policies, though cannabis-related laws may affect alcohol use differently across genders and racial groups. Alcohol and cannabis act as both substitutes and complements. Policies aimed at one substance may inadvertently affect consumption of other substances. Future studies should collect fine-grained longitudinal, prospective data from the general population and subgroups of interest, especially in locations likely to legalize cannabis.

  14. Distinct relationships between social aptitude and dimensions of manic-like symptoms in youth.

    PubMed

    Benarous, Xavier; Mikita, Nina; Goodman, Robert; Stringaris, Argyris

    2016-08-01

    Difficulties with interpersonal relationships have been reported in children and adolescents with manic symptoms, even if they do not fulfil criteria for a manic episode. The role of social aptitude (SA) in youths with manic symptoms has never been examined in the general population. Moreover, no study has examined whether SA is differentially associated with dimensions of manic symptoms. We hypothesised that youth with predominantly undercontrol manic symptoms (characterised by irritability) would show lower levels of SA; conversely, youth with predominantly exuberant symptoms would show better than average social skills. Our sample comprised 5325 participants from the 2004 British Child and Adolescent Mental Health Survey (B-CAMHS04), mean age 10.3 years, SD = 3.3, 48 % girls. Manic symptoms were assessed with the Development and Wellbeing Assessment by interviewing parents and young people. Children and adolescents with manic symptoms had a lower SA score, compared to the general population by parent report, but not by self-report. SA score was higher in youths with predominantly exuberant manic symptoms compared to the general population; whereas the youths with predominantly undercontrol manic symptoms had lower SA scores by parent and self-report. Our results provide further evidence for the distinction between exuberant and undercontrol manic symptoms and highlight the need to focus on SA in future research.

  15. International migration beyond gravity: A statistical model for use in population projections

    PubMed Central

    Cohen, Joel E.; Roig, Marta; Reuman, Daniel C.; GoGwilt, Cai

    2008-01-01

    International migration will play an increasing role in the demographic future of most nations if fertility continues to decline globally. We developed an algorithm to project future numbers of international migrants from any country or region to any other. The proposed generalized linear model (GLM) used geographic and demographic independent variables only (the population and area of origins and destinations of migrants, the distance between origin and destination, the calendar year, and indicator variables to quantify nonrandom characteristics of individual countries). The dependent variable, yearly numbers of migrants, was quantified by 43653 reports from 11 countries of migration from 228 origins and to 195 destinations during 1960–2004. The final GLM based on all data was selected by the Bayesian information criterion. The number of migrants per year from origin to destination was proportional to (population of origin)0.86(area of origin)−0.21(population of destination)0.36(distance)−0.97, multiplied by functions of year and country-specific indicator variables. The number of emigrants from an origin depended on both its population and its population density. For a variable initial year and a fixed terminal year 2004, the parameter estimates appeared stable. Multiple R2, the fraction of variation in log numbers of migrants accounted for by the starting model, improved gradually with recentness of the data: R2 = 0.57 for data from 1960 to 2004, R2 = 0.59 for 1985–2004, R2 = 0.61 for 1995–2004, and R2 = 0.64 for 2000–2004. The migration estimates generated by the model may be embedded in deterministic or stochastic population projections. PMID:18824693

  16. The light pollution as a surrogate for urban population of the US cities

    NASA Astrophysics Data System (ADS)

    Operti, Felipe G.; Oliveira, Erneson A.; Carmona, Humberto A.; Machado, Javam C.; Andrade, José S.

    2018-02-01

    We show that the definition of the city boundaries can have a dramatic influence on the scaling behavior of the night-time light (NTL) as a function of population (POP) in the US. Precisely, our results show that the arbitrary geopolitical definition based on the Metropolitan/Consolidated Metropolitan Statistical Areas (MSA/CMSA) leads to a sublinear power-law growth of NTL with POP. On the other hand, when cities are defined according to a more natural agglomeration criteria, namely, the City Clustering Algorithm (CCA), an isometric relation emerges between NTL and population. This discrepancy is compatible with results from previous works showing that the scaling behaviors of various urban indicators with population can be substantially different for distinct definitions of city boundaries. Moreover, considering the CCA definition as more adequate than the MSA/CMSA one because the former does not violate the expected extensivity between land population and area of their generated clusters, we conclude that, without loss of generality, the CCA measures of light pollution and population could be interchangeably utilized in future studies.

  17. Household water demand and welfare loss for future Europe

    NASA Astrophysics Data System (ADS)

    Bernhard, Jeroen; Reynaud, Arnaud; Lanzanova, Denis; de Roo, Ad

    2015-04-01

    Matching the availability of water to its demand in Europe is a major challenge for the future due to expected economic and demographic developments and climate change. This means there is a growing need to estimate future water demand and to optimize the water allocation to all end users to counteract welfare loss. At the European scale it is currently not possible to assess the impact of social and economic changes on future water demand or to prioritize water allocation amongst different sectors based on economic damage without extensive use of assumptions and generalizations. Indeed, our review of existing regional optimization models for Europe reveals that the social-economic component of the water use system needs to be improved by complementing them with detailed water use estimates and cost/benefit functions in order to determine the optimal situation. Our study contributes to closing this knowledge gap for the European household sector by quantifying future water demand and the effect of water pricing, as well as providing a method for the calculation of monetary damage due to unmet demand at the highest spatial resolution possible. We used a water demand function approach in which household water consumption depends upon some exogenous drivers including water price, household income, population and household characteristics and climate conditions. For each European country, the annual water consumption per capita was calculated at regional level (NUTS3) and subsequently disaggregated to five kilometer grid level based on a population density map. In order to produce estimates of water demand, the evolution of the explanatory variables of the water demand functions and population density map were simulated until 2050 based on related variables such as GDP and demographic projections. The results of this study will be integrated into the JRC hydro-economic modelling framework for an assessment of the Water-Agriculture-Energy-Ecosystems Nexus.

  18. The implications of regional and national demographic projections for future GMS costs in Ireland through to 2026.

    PubMed

    Conway, Aisling; Kenneally, Martin; Woods, Noel; Thummel, Andreas; Ryan, Marie

    2014-10-21

    As the health services in Ireland have become more resource-constrained, pressure has increased to reduce public spending on community drug schemes such as General Medical Services (GMS) drug prescribing and to understand current and future trends in prescribing. The GMS scheme covers approximately 37% of the Irish population in 2011 and entitles them, inter alia, to free prescription drugs and appliances. This paper projects the effects of future changes in population, coverage, claims rates and average claims cost on GMS costs in Ireland. Data on GMS coverage, claims rates and average cost per claim are drawn from the Primary Care Reimbursement Service (PCRS) and combined with Central Statistics Office (CSO) (Regional and National Population Projections through to 2026). A Monte Carlo Model is used to simulate the effects of demographic change (by region, age, gender, coverage, claims rates and average claims cost) will have on GMS prescribing costs in 2016, 2021 and 2026 under different scenarios. The Population of Ireland is projected to grow by 32% between 2007 and 2026 and by 96% for the over 70s. The Eastern region is estimated to grow by 3% over the lifetime of the projections at the expense of most other regions. The Monte Carlo simulations project that females will be a bigger driver of GMS costs than males. Midlands region will be the most expensive of the eight old health board regions. Those aged 70 and over and children under 11 will be significant drivers of GMS costs with the impending demographic changes. Overall GMS medicines costs are projected to rise to €1.9bn by 2026. Ireland's population will experience rapid growth over the next decade. Population growth coupled with an aging population will result in an increase in coverage rates, thus the projected increase in overall prescribing costs. Our projections and simulations map the likely evolution of GMS cost, given existing policies and demographic trends. These costs can be contained by government policy initiatives.

  19. Simulated effects of recruitment variability, exploitation, and reduced habitat area on the muskellunge population in Shoepack Lake, Voyageurs National Park, Minnesota

    USGS Publications Warehouse

    Frohnauer, N.K.; Pierce, C.L.; Kallemeyn, L.W.

    2007-01-01

    The genetically unique population of muskellunge Esox masquinongy inhabiting Shoepack Lake in Voyageurs National Park, Minnesota, is potentially at risk for loss of genetic variability and long-term viability. Shoepack Lake has been subject to dramatic surface area changes from the construction of an outlet dam by beavers Castor canadensis and its subsequent failure. We simulated the long-term dynamics of this population in response to recruitment variation, increased exploitation, and reduced habitat area. We then estimated the effective population size of the simulated population and evaluated potential threats to long-term viability, based on which we recommend management actions to help preserve the long-term viability of the population. Simulations based on the population size and habitat area at the beginning of a companion study resulted in an effective population size that was generally above the threshold level for risk of loss of genetic variability, except when fishing mortality was increased. Simulations based on the reduced habitat area after the beaver dam failure and our assumption of a proportional reduction in population size resulted in an effective population size that was generally below the threshold level for risk of loss of genetic variability. Our results identified two potential threats to the long-term viability of the Shoepack Lake muskellunge population, reduction in habitat area and exploitation. Increased exploitation can be prevented through traditional fishery management approaches such as the adoption of no-kill, barbless hook, and limited entry regulations. Maintenance of the greatest possible habitat area and prevention of future habitat area reductions will require maintenance of the outlet dam built by beavers. Our study should enhance the long-term viability of the Shoepack Lake muskellunge population and illustrates a useful approach for other unique populations. ?? Copyright by the American Fisheries Society 2007.

  20. Ultrasonographic measurements of subclinical carotid atherosclerosis in prediction of ischemic stroke.

    PubMed

    Mathiesen, E B; Johnsen, S H

    2009-01-01

    Carotid intima-media thickness (IMT) and plaque measurements are widely used to quantify atherosclerosis and assess the risk of future stroke, and are used as surrogate endpoints for clinical disease. In recent years, it has become clear that carotid IMT and plaque reflect biologically and genetically different aspects of the atherosclerotic process, and are differentially related to risk factors and cardiovascular disease. Plaques are focal manifestations of atherosclerosis while increased IMT represents mainly hypertensive medial hypertrophy. Several prospective studies have showed that IMT and plaque measurements, such as total plaque area and plaque number, are predictive of future stroke. Plaque echogenicity predicts future stroke independent of plaque size. The contribution of IMT and plaque measurements in individual stroke risk prediction in the general population seems to be limited, but may be useful as a tool for individual stratification of high-risk patients.

  1. Numerical solution of a logistic growth model for a population with Allee effect considering fuzzy initial values and fuzzy parameters

    NASA Astrophysics Data System (ADS)

    Amarti, Z.; Nurkholipah, N. S.; Anggriani, N.; Supriatna, A. K.

    2018-03-01

    Predicting the future of population number is among the important factors that affect the consideration in preparing a good management for the population. This has been done by various known method, one among them is by developing a mathematical model describing the growth of the population. The model usually takes form in a differential equation or a system of differential equations, depending on the complexity of the underlying properties of the population. The most widely used growth models currently are those having a sigmoid solution of time series, including the Verhulst logistic equation and the Gompertz equation. In this paper we consider the Allee effect of the Verhulst’s logistic population model. The Allee effect is a phenomenon in biology showing a high correlation between population size or density and the mean individual fitness of the population. The method used to derive the solution is the Runge-Kutta numerical scheme, since it is in general regarded as one among the good numerical scheme which is relatively easy to implement. Further exploration is done via the fuzzy theoretical approach to accommodate the impreciseness of the initial values and parameters in the model.

  2. The water balance questionnaire: design, reliability and validity of a questionnaire to evaluate water balance in the general population.

    PubMed

    Malisova, Olga; Bountziouka, Vassiliki; Panagiotakos, Demosthenes B; Zampelas, Antonis; Kapsokefalou, Maria

    2012-03-01

    There is a need to develop a questionnaire as a research tool for the evaluation of water balance in the general population. The water balance questionnaire (WBQ) was designed to evaluate water intake from fluid and solid foods and drinking water, and water loss from urine, faeces and sweat at sedentary conditions and physical activity. For validation purposes, the WBQ was administrated in 40 apparently healthy participants aged 22-57 years (37.5% males). Hydration indices in urine (24 h volume, osmolality, specific gravity, pH, colour) were measured through established procedures. Furthermore, the questionnaire was administered twice to 175 subjects to evaluate its reliability. Kendall's τ-b and the Bland and Altman method were used to assess the questionnaire's validity and reliability. The proposed WBQ to assess water balance in healthy individuals was found to be valid and reliable, and it could thus be a useful tool in future projects that aim to evaluate water balance.

  3. Vitamin D: Current Guidelines and Future Outlook.

    PubMed

    Pilz, Stefan; Trummer, Christian; Pandis, Marlene; Schwetz, Verena; Aberer, Felix; Grübler, Martin; Verheyen, Nicolas; Tomaschitz, Andreas; März, Winfried

    2018-02-01

    Vitamin D is of public health interest because its deficiency is common and is associated with musculoskeletal diseases, as well as extraskeletal diseases, such as cancer, cardiovascular diseases, and infections. Several health authorities have reviewed the existing literature and published nutritional vitamin D guidelines for the general population. There was a wide consensus that serum 25-hydroxyvitamin D [25(OH)D] concentration should be used to assess vitamin D status and intake, and that musculoskeletal, and not extraskeletal, effects of vitamin D should be the basis for nutritional vitamin D guidelines. Recommended target levels for 25(OH)D range from 25 to 50 nmol/l (10 to 20 ng/ml), corresponding to a vitamin D intake of 400 to 800 International Units (10 to 20 μg) per day. It is of concern that significant sections of the general population do not meet these recommended vitamin D levels. This definitely requires action from a public health perspective. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  4. Development of a Computerized Adaptive Test for Anxiety Based on the Dutch-Flemish Version of the PROMIS Item Bank.

    PubMed

    Flens, Gerard; Smits, Niels; Terwee, Caroline B; Dekker, Joost; Huijbrechts, Irma; Spinhoven, Philip; de Beurs, Edwin

    2017-12-01

    We used the Dutch-Flemish version of the USA PROMIS adult V1.0 item bank for Anxiety as input for developing a computerized adaptive test (CAT) to measure the entire latent anxiety continuum. First, psychometric analysis of a combined clinical and general population sample ( N = 2,010) showed that the 29-item bank has psychometric properties that are required for a CAT administration. Second, a post hoc CAT simulation showed efficient and highly precise measurement, with an average number of 8.64 items for the clinical sample, and 9.48 items for the general population sample. Furthermore, the accuracy of our CAT version was highly similar to that of the full item bank administration, both in final score estimates and in distinguishing clinical subjects from persons without a mental health disorder. We discuss the future directions and limitations of CAT development with the Dutch-Flemish version of the PROMIS Anxiety item bank.

  5. Risk Behaviors for HIV and HCV Infection Among People Who Inject Drugs in Hai Phong, Viet Nam, 2014.

    PubMed

    Duong, Huong Thi; Jarlais, Don Des; Khuat, Oanh Hai Thi; Arasteh, Kamyar; Feelemyer, Jonathan; Khue, Pham Minh; Giang, Hoang Thi; Laureillard, Didier; Hai, Vinh Vu; Vallo, Roselyne; Michel, Laurent; Moles, Jean Pierre; Nagot, Nicolas

    2017-06-13

    We examined the potential for HIV and hepatitis C (HCV) transmission across persons who inject drugs (PWID), men-who-have-sex-with-men (MSM) and female commercial sex workers (CSW) PWID and the potential for sexual transmission of HIV from PWID to the general population in Hai Phong, Viet Nam. Using respondent driven and convenience sampling we recruited 603 participants in 2014. All participants used heroin; 24% used non-injected methamphetamine. HIV prevalence was 25%; HCV prevalence was 67%. HIV infection was associated with HCV prevalence and both infections were associated with length of injecting career. Reported injecting risk behaviors were low; unsafe sexual behavior was high among MSM-PWID and CSW-PWID. There is strong possibility of sexual transmission to primary partners facilitated by methamphetamine use. We would suggest future HIV prevention programs utilize multiple interventions including "treatment as prevention" to potential sexual transmission of HIV among MSM and CSW-PWID and from PWID to the general population.

  6. Mortality in epilepsy.

    PubMed

    Hitiris, Nikolas; Mohanraj, Rajiv; Norrie, John; Brodie, Martin J

    2007-05-01

    All studies report an increased mortality risk for people with epilepsy compared with the general population. Population-based studies have demonstrated that the increased mortality is often related to the cause of the epilepsy. Common etiologies include neoplasia, cerebrovascular disease, and pneumonia. Deaths in selected cohorts, such as sudden unexpected death in epilepsy (SUDEP), status epilepticus (SE), suicides, and accidents are more frequently epilepsy-related. SUDEP is a particular cause for concern in younger people, and whether and when SUDEP should be discussed with patients with epilepsy remain problematic issues. Risk factors for SUDEP include generalized tonic-clonic seizures, increased seizure frequency, concomitant learning disability, and antiepileptic drug polypharmacy. The overall incidence of SE may be increasing, although case fatality rates remain constant. Mortality is frequently secondary to acute symptomatic disorders. Poor compliance with treatment in patients with epilepsy accounts for a small proportion of deaths from SE. The incidence of suicide is increased, particularly for individuals with epilepsy and comorbid psychiatric conditions. Late mortality figures in patients undergoing epilepsy surgery vary and are likely to reflect differences in case selection. Future studies of mortality should be prospective and follow agreed guidelines to better quantify risk and causation in individual populations.

  7. The influence of coarse-scale environmental features on current and predicted future distributions of narrow-range endemic crayfish populations

    USGS Publications Warehouse

    Dyer, Joseph J.; Brewer, Shannon K.; Worthington, Thomas A.; Bergey, Elizabeth A.

    2013-01-01

    1.A major limitation to effective management of narrow-range crayfish populations is the paucity of information on the spatial distribution of crayfish species and a general understanding of the interacting environmental variables that drive current and future potential distributional patterns. 2.Maximum Entropy Species Distribution Modeling Software (MaxEnt) was used to predict the current and future potential distributions of four endemic crayfish species in the Ouachita Mountains. Current distributions were modelled using climate, geology, soils, land use, landform and flow variables thought to be important to lotic crayfish. Potential changes in the distribution were forecast by using models trained on current conditions and projecting onto the landscape predicted under climate-change scenarios. 3.The modelled distribution of the four species closely resembled the perceived distribution of each species but also predicted populations in streams and catchments where they had not previously been collected. Soils, elevation and winter precipitation and temperature most strongly related to current distributions and represented 6587% of the predictive power of the models. Model accuracy was high for all models, and model predictions of new populations were verified through additional field sampling. 4.Current models created using two spatial resolutions (1 and 4.5km2) showed that fine-resolution data more accurately represented current distributions. For three of the four species, the 1-km2 resolution models resulted in more conservative predictions. However, the modelled distributional extent of Orconectes leptogonopodus was similar regardless of data resolution. Field validations indicated 1-km2 resolution models were more accurate than 4.5-km2 resolution models. 5.Future projected (4.5-km2 resolution models) model distributions indicated three of the four endemic species would have truncated ranges with low occurrence probabilities under the low-emission scenario, whereas two of four species would be severely restricted in range under moderatehigh emissions. Discrepancies in the two emission scenarios probably relate to the exclusion of behavioural adaptations from species-distribution models. 6.These model predictions illustrate possible impacts of climate change on narrow-range endemic crayfish populations. The predictions do not account for biotic interactions, migration, local habitat conditions or species adaptation. However, we identified the constraining landscape features acting on these populations that provide a framework for addressing habitat needs at a fine scale and developing targeted and systematic monitoring programmes.

  8. Potential future impact of a partially effective HIV vaccine in a southern African setting.

    PubMed

    Phillips, Andrew N; Cambiano, Valentina; Nakagawa, Fumiyo; Ford, Deborah; Lundgren, Jens D; Roset-Bahmanyar, Edith; Roman, François; Van Effelterre, Thierry

    2014-01-01

    It is important for public health and within the HIV vaccine development field to understand the potential population level impact of an HIV vaccine of partial efficacy--both in preventing infection and in reducing viral load in vaccinated individuals who become infected--in the context of a realistic future implementation scenario in resource limited settings. An individual level model of HIV transmission, progression and the effect of antiretroviral therapy was used to predict the outcome to 2060 of introduction in 2025 of a partially effective vaccine with various combinations of efficacy characteristics, in the context of continued ART roll-out in southern Africa. In the context of our base case epidemic (in 2015 HIV prevalence 28% and incidence 1.7 per 100 person years), a vaccine with only 30% preventative efficacy could make a substantial difference in the rate with which HIV incidence declines; the impact on incidence in relative terms is projected to increase over time, with a projected 67% lower HIV incidence in 2060 compared with no vaccine introduction. The projected mean decline in the general adult population death rate 2040-2060 is 11%. A vaccine with no prevention efficacy but which reduces viral load by 1 log is predicted to result in a modest (14%) reduction in HIV incidence and an 8% reduction in death rate in the general adult population (mean 2040-2060). These effects were broadly similar in multivariable uncertainty analysis. Introduction of a partially effective preventive HIV vaccine would make a substantial long-term impact on HIV epidemics in southern Africa, in addition to the effects of ART. Development of an HIV vaccine, even of relatively low apparent efficacy at the individual level, remains a critical global public health goal.

  9. Historic and forecasted population and land-cover change in eastern North Carolina, 1992-2030

    USGS Publications Warehouse

    Claggett, Peter; Hearn,, Paul P.; Donato, David I.

    2015-01-01

    The Southeast Regional Partnership for Planning and Sustainability (SERPPAS) was formed in 2005 as a partnership between the Department of Defense (DOD) and State and Federal agencies to promote better collaboration in making resource-use decisions. In support of this goal, the U.S. Geological Survey (USGS) conducted a study to evaluate historic population growth and land-cover change, and to model future change, for the 13-county SERPPAS study area in southeastern North Carolina (fig. 1). Improved understanding of trends in land-cover change and the ability to forecast land-cover change that is consistent with these trends will be a key component of efforts to accommodate local military-mission imperatives while also promoting sustainable economic growth throughout the 13-county study area. The study had three principal objectives:    1.  Evaluate historic changes in population and land cover for the period 1992–2006 using both previously existing as well as newly generated land-cover data.    2.  Develop models to forecast future change in land cover using the data gathered in objective 1 in conjunction with ancillary data on the suitability of the various sub-areas within the study area for low- and high-intensity urban development.    3.  Deliver these results—including an executive-level briefing and a USGS technical report—to DOD, other project cooperators, and local counties in hard-copy and digital formats and via the Web through a map-based data viewer. This report provides a general overview of the study and is intended for general distribution to non-technical audiences.

  10. Anticipating changes to future connectivity within a network of marine protected areas.

    PubMed

    Coleman, Melinda A; Cetina-Heredia, Paulina; Roughan, Moninya; Feng, Ming; van Sebille, Erik; Kelaher, Brendan P

    2017-09-01

    Continental boundary currents are projected to be altered under future scenarios of climate change. As these currents often influence dispersal and connectivity among populations of many marine organisms, changes to boundary currents may have dramatic implications for population persistence. Networks of marine protected areas (MPAs) often aim to maintain connectivity, but anticipation of the scale and extent of climatic impacts on connectivity are required to achieve this critical conservation goal in a future of climate change. For two key marine species (kelp and sea urchins), we use oceanographic modelling to predict how continental boundary currents are likely to change connectivity among a network of MPAs spanning over 1000 km of coastline off the coast of eastern Australia. Overall change in predicted connectivity among pairs of MPAs within the network did not change significantly over and above temporal variation within climatic scenarios, highlighting the need for future studies to incorporate temporal variation in dispersal to robustly anticipate likely change. However, the intricacies of connectivity between different pairs of MPAs were noteworthy. For kelp, poleward connectivity among pairs of MPAs tended to increase in the future, whereas equatorward connectivity tended to decrease. In contrast, for sea urchins, connectivity among pairs of MPAs generally decreased in both directions. Self-seeding within higher-latitude MPAs tended to increase, and the role of low-latitude MPAs as a sink for urchins changed significantly in contrasting ways. These projected changes have the potential to alter important genetic parameters with implications for adaptation and ecosystem vulnerability to climate change. Considering such changes, in the context of managing and designing MPA networks, may ensure that conservation goals are achieved into the future. © 2017 The Authors. Global Change Biology Published by John Wiley & Sons Ltd.

  11. Epidemiology of Postherpetic Neuralgia in Korea: An Electronic Population Health Insurance System Based Study.

    PubMed

    Hong, Myong-Joo; Kim, Yeon-Dong; Cheong, Yong-Kwan; Park, Seon-Jeong; Choi, Seung-Won; Hong, Hyon-Joo

    2016-04-01

    Postherpetic neuralgia (PHN) is a disease entity defined as persistent pain after the acute pain of herpes zoster gradually resolves. It is associated with impaired daily activities, resulting in reduced quality of life. General epidemiological data on PHN is necessary for the effective management. However, data on the epidemiology of PHN in Korea is lacking. The aim of this study was to evaluate the epidemiological features of PHN in the general population.We used population-based medical data for 51,448,491 subscribers to the Health Insurance Service in the year of 2013 to analyze of PHN epidemiology in Korea, such as the incidence, regional distribution, seasonal variation, and healthcare resource utilization. Total number of patients and medical cost on PHN were analyzed from 2009 to 2013.Findings indicate that the incidence of PHN in Korea was 2.5 per 1000 person-years, which was strongly correlated with age and sex. There were no differences in seasonal variation or regional distribution. The medical cost increased steadily over the study period. When admitted to general hospitals, patients with PHN were mainly managed in the dermatology and anesthesiology departments.The incidence and prevalence rates of PHN in Koreans appear to be considerably higher compared to those in western populations, while the sex and age predisposition was similar. Considering that the pain associated with PHN can have a marked impact on a patient's quality of life resulting in a medicosocial economic burden, anesthesiology physicians have an important role in primary care in Korea. Future research on the cost-effectiveness of the management of PHN is needed.

  12. Prevalence of systolic inter-arm differences in blood pressure for different primary care populations: systematic review and meta-analysis

    PubMed Central

    Clark, Christopher E; Taylor, Rod S; Shore, Angela C; Campbell, John L

    2016-01-01

    Background Various prevalence figures have been reported for inter-arm differences in blood pressure (IAD); variation may be explained by differing population vascular risk and by measurement method. Aim To review the literature to derive robust estimates of IAD prevalence relevant to community populations. Design and setting Systematic review and meta-analysis. Method MEDLINE, Embase, and CINAHL were searched for cross-sectional studies likely to represent general or primary care populations, reporting prevalence of IAD and employing a simultaneous method of measurement. Using study-level data, pooled estimates of mean prevalence of systolic IADs were calculated and compared using a random effects model. Results Eighty IAD studies were identified. Sixteen met inclusion criteria: pooled estimates of prevalence for systolic IAD ≥10 mmHg were 11.2% (95% confidence interval [CI] = 9.1 to 13.6) in hypertension, 7.4% (95% CI = 5.8 to 9.2) in diabetes, and 3.6% (95% CI = 2.3 to 5.0) for a general adult population (P<0.001 for subgroup differences). Differences persisted for higher cut-off values. Prevalences were lower for East Asian than for Western populations and were overestimated by sequential measurement where this could be compared with simultaneous measurement within studies (relative risk for IAD: 2.9 [95% CI = 2.1 to 4.1]). Studies with higher mean absolute systolic pressures had higher prevalences for a systolic IAD ≥10 mmHg (P = 0.04). Conclusion Prevalences of IADs rise in relation to underlying cardiovascular comorbidities of the population studied, and are overestimated threefold when sequential measurement is used. Population-specific variation in prevalences of IAD should be taken into account in delivering clinical care and in planning future studies. PMID:27789511

  13. Change-in-ratio methods for estimating population size

    USGS Publications Warehouse

    Udevitz, Mark S.; Pollock, Kenneth H.; McCullough, Dale R.; Barrett, Reginald H.

    2002-01-01

    Change-in-ratio (CIR) methods can provide an effective, low cost approach for estimating the size of wildlife populations. They rely on being able to observe changes in proportions of population subclasses that result from the removal of a known number of individuals from the population. These methods were first introduced in the 1940’s to estimate the size of populations with 2 subclasses under the assumption of equal subclass encounter probabilities. Over the next 40 years, closed population CIR models were developed to consider additional subclasses and use additional sampling periods. Models with assumptions about how encounter probabilities vary over time, rather than between subclasses, also received some attention. Recently, all of these CIR models have been shown to be special cases of a more general model. Under the general model, information from additional samples can be used to test assumptions about the encounter probabilities and to provide estimates of subclass sizes under relaxations of these assumptions. These developments have greatly extended the applicability of the methods. CIR methods are attractive because they do not require the marking of individuals, and subclass proportions often can be estimated with relatively simple sampling procedures. However, CIR methods require a carefully monitored removal of individuals from the population, and the estimates will be of poor quality unless the removals induce substantial changes in subclass proportions. In this paper, we review the state of the art for closed population estimation with CIR methods. Our emphasis is on the assumptions of CIR methods and on identifying situations where these methods are likely to be effective. We also identify some important areas for future CIR research.

  14. Disparities in Infectious Disease Hospitalizations for American Indian/Alaska Native People

    PubMed Central

    Holman, Robert C.; Folkema, Arianne M.; Singleton, Rosalyn J.; Redd, John T.; Christensen, Krista Y.; Steiner, Claudia A.; Schonberger, Lawrence B.; Hennessy, Thomas W.; Cheek, James E.

    2011-01-01

    Objectives We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people. Methods We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998–2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey. Results The ID hospitalization rate for AI/AN people declined during the study period. The 2004–2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory--tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%). Conclusions Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities. PMID:21800745

  15. Measuring masculinity in research on men of color: findings and future directions.

    PubMed

    Griffith, Derek M; Gunter, Katie; Watkins, Daphne C

    2012-05-01

    The purpose of this study was to examine the association between masculinity and the health of US men of color aged 18 years and older. We identified 22 population-based studies that included a measure of masculinity and a measure of health behavior, mental health, or physical health. The associations between masculinity and health were complex and varied by construct and health outcome, though they generally were significant in the hypothesized directions. Future research should explore the centrality of masculinity versus other identities and characteristics, how the relationship between masculinity and health varies by health outcome, and the identification of the conceptions and aspects of masculinity that are most relevant to and associated with specific health behaviors and health outcomes.

  16. Measuring Masculinity in Research on Men of Color: Findings and Future Directions

    PubMed Central

    Gunter, Katie; Watkins, Daphne C.

    2012-01-01

    The purpose of this study was to examine the association between masculinity and the health of US men of color aged 18 years and older. We identified 22 population-based studies that included a measure of masculinity and a measure of health behavior, mental health, or physical health. The associations between masculinity and health were complex and varied by construct and health outcome, though they generally were significant in the hypothesized directions. Future research should explore the centrality of masculinity versus other identities and characteristics, how the relationship between masculinity and health varies by health outcome, and the identification of the conceptions and aspects of masculinity that are most relevant to and associated with specific health behaviors and health outcomes. PMID:22401519

  17. Systematic Reviews of Mechanisms for Financing Family Planning: Findings, Implications, and Future Agenda.

    PubMed

    Lissner, Craig L; Ali, Moazzam

    2016-12-01

    The article describes an international collaboration that systematically reviewed the evidence on financing mechanisms for family planning/contraception, assessed the strength of and summarized the evidence, identified research gaps, and proposed a new research agenda to address the gaps. The review found that the evidence base is weak owing to the paucity of studies, diversity in findings, and variations in intervention, study design, and outcome measures. Of more than 17,000 papers reviewed only 38 met the eligibility criteria. A number of general recommendations on the directions and areas of future research can be drawn. There is a strong need for more robust study designs on the effectiveness of financial incentives in family planning. © 2016 The Population Council, Inc.

  18. Future Estimation of Convenience Living Facilities Withdrawal due to Population Decline all Over Japan from 2010 TO 2040 - Focus on Supermarkets, Convenience Stores and Drugstores

    NASA Astrophysics Data System (ADS)

    Nishimoto, Yuka; Akiyama, Yuki; Shibasaki, Ryosuke

    2016-06-01

    Population explosion is considered to be one of the most crucial problems in the world. However, in Japan, the opposite problem: population decline has become serious now. Japanese population is estimated to decrease by twenty millions in 2040. This negative situation will cause to increase areas where many residents cannot make a daily living all over Japan because many convenience living facilities such as supermarkets, convenience stores and drugstores will be difficult to maintain their market area population due to future population decline. In our research, we used point data of convenience living facilities developed by address geocoding of digital telephone directory and point data of future population projection developed by distribution of Japanese official population projection data proportionally among the building volume of digital residential map, which can monitor building volumes all over Japan. In conclusion, we estimated that various convenience living facilities in Japan will shrink and close by population decline in near future. In particular, it is cleared that approximately 14.7% of supermarkets will be possible to withdraw all over Japan by 2040. In addition, it is cleared that over 40% of supermarkets in some countryside prefectures will be possible to withdraw by 2040. Thus, we estimated future distributions of convenience living facilities that cannot maintain their market area population due to future population decline. Moreover, we estimated the number of people that they will become inconvenience in buying fresh foods.

  19. Infectious disease at gluten introduction and risk of childhood diabetes mellitus.

    PubMed

    Welander, Adina; Montgomery, Scott M; Ludvigsson, Johnny; Ludvigsson, Jonas F

    2014-08-01

    To investigate the risk of future diabetes mellitus type 1 (T1D) in children who suffered from infection at time of gluten introduction. Population-based prospective study. Parents filled out a diary at home. We hereby obtained data on date of gluten introduction, breastfeeding duration, and infections in 9414 children born in the southeast of Sweden from October 1, 1997, through October 1, 1999 (the All Babies in Southeast Sweden cohort). The Cox proportional hazards model was used to investigate the risk of future T1D until February 1, 2012, among children with infection at time of gluten introduction. Forty-six children (0.5%) developed T1D and were compared with 9368 reference children from the general population. Some 10 of 46 children with later T1D had an infection at time of gluten introduction (22%) compared with 2520 reference children (27%, P=.43). Later T1D was not associated with age at end of breastfeeding, age at any infection, or age at gluten introduction. Breastfeeding at time of gluten introduction was not protective against future T1D (hazard ratio 1.2; 95% CI, 0.5-2.7). In our final model, when we adjusted for age at gluten introduction, age at infection, and breastfeeding duration, infection at time of gluten introduction did not influence the risk of future T1D (hazard ratio 0.8; 95% CI, 0.3-1.6). Infection at time of gluten introduction is not a major risk factor for future T1D in nonselected children. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Modelling the Future Hydroclimatology of the Lower Fraser River and its Impacts on the Spawning Migration Survival of Sockeye Salmon

    NASA Technical Reports Server (NTRS)

    Hague, M. J.; Ferrari, M. R.; Miller, J. R.; Patterson, D. A.; Russell, G. L.; Farrell, A.P.; Hinch, S. G.

    2010-01-01

    Short episodic high temperature events can be lethal for migrating adult Pacific salmon (Oncorhynchus spp.). We downscaled temperatures for the Fraser River, British Columbia to evaluate the impact of climate warming on the frequency of exceeding thermal thresholds associated with salmon migratory success. Alarmingly, a modest 1.0 C increase in average summer water temperature over 100 years (1981-2000 to 2081-2100) tripled the number of days per year exceeding critical salmonid thermal thresholds (i.e. 19.0 C). Refined thresholds for two populations (Gates Creek and Weaver Creek) of sockeye salmon (Oncorhynchus nerka) were defined using physiological constraint models based on aerobic scope. While extreme temperatures leading to complete aerobic collapse remained unlikely under our warming scenario, both populations were increasingly forced to migrate upriver at reduced levels of aerobic performance (e.g. in 80% of future simulations, => 90% of salmon encountered temperatures exceeding population specific thermal optima for maximum aerobic scope; T(sub opt)) = 16.3 C for Gates Creek and T(sub sopt)=14.5 C for Weaver Creek). Assuming recent changes to river entry timing persist, we also predicted dramatic increases in the probability of freshwater mortality for Weaver Creek salmon due to reductions in aerobic, and general physiological, performance (e.g. in 42% of future simulations =>50% of Weaver Creek fish exceeded temperature thresholds associated with 0 - 60% of maximum aerobic scope). Potential for adaptation via directional selection on run-timing was more evident for the Weaver Creek population. Early entry Weaver Creek fish experienced 25% (range: 15 - 31%) more suboptimal temperatures than late entrants, compared with an 8% difference (range: 0 - 17%) between early and late Gates Creek fish. Our results emphasize the need to consider daily temperature variability in association with population-specific differences in behaviour and physiological constraints when forecasting impacts of climate change on migratory survival of aquatic species.

  1. The projected public health and economic impact of vitamin D fortified dairy products for fracture prevention in France.

    PubMed

    Hiligsmann, Mickael; Reginster, Jean-Yves

    2018-04-01

    There is a paucity of research that projects the public health and economic impact of healthcare interventions in the future. In this study, we aimed to estimate the public health and economic impact of vitamin D fortified dairy products for the years 2020, 2030, 2040, 2050 and 2060. We used a previously validated Markov microsimulation model that was designed to assess the public health and economic impact of dairy products for fracture prevention in the French general population aged over 60 years in the year 2015. The expected benefit (in terms of fractures prevented) of the recommended intake of dairy products compared to the absence of appropriate intake is expected to increase by 63% in 2040 and by 85% in 2060. The cost per quality-adjusted life years gained of the appropriate intake of dairy products is expected to decrease from €58,244 in 2015 to €42,616 in 2060. The potential public health and economic benefits of vitamin D fortified dairy products is expected to substantially increase in the future, especially in the population aged over 80 years. Decision makers should be aware of the current and future potential benefits of dairy products to protect bone fractures.

  2. Climate change impact assessment on food security in Indonesia

    NASA Astrophysics Data System (ADS)

    Ettema, Janneke; Aldrian, Edvin; de Bie, Kees; Jetten, Victor; Mannaerts, Chris

    2013-04-01

    As Indonesia is the world's fourth most populous country, food security is a persistent challenge. The potential impact of future climate change on the agricultural sector needs to be addressed in order to allow early implementation of mitigation strategies. The complex island topography and local sea-land-air interactions cannot adequately be represented in large scale General Climate Models (GCMs) nor visualized by TRMM. Downscaling is needed. Using meteorological observations and a simple statistical downscaling tool, local future projections are derived from state-of-the-art, large-scale GCM scenarios, provided by the CMIP5 project. To support the agriculture sector, providing information on especially rainfall and temperature variability is essential. Agricultural production forecast is influenced by several rain and temperature factors, such as rainy and dry season onset, offset and length, but also by daily and monthly minimum and maximum temperatures and its rainfall amount. A simple and advanced crop model will be used to address the sensitivity of different crops to temperature and rainfall variability, present-day and future. As case study area, Java Island is chosen as it is fourth largest island in Indonesia but contains more than half of the nation's population and dominates it politically and economically. The objective is to identify regions at agricultural risk due to changing patterns in precipitation and temperature.

  3. Development of Cell Models as a Basis for Bioreactor Design for Genetically Modified Bacteria

    DTIC Science & Technology

    1986-10-30

    of future behavior based on specifying the current state vector . Generally a total population greater than 10,000 is sufficient to allow treatment of...specifying the current state vector (essentially values for all variables in the model). Deterministic models become increasingly valid as the number of...host I A) and therein PARASItIS converts the host’s biomaterial or activities into its own + A and B are in physical contact. SYMBIOSIS (or perhaps Oi

  4. Preliminary investigations of the winter ecology of Long-billed Curlews in coastal Texas

    USGS Publications Warehouse

    Woodin, Marc C.; Skoruppa, Mary Kay; Edwardson, Jeremy W.; Austin, Jane E.

    2012-01-01

    Results from this 1-year pilot study yielded an intriguing combination of findings that warrant further investigation. Observations include reduced numbers of roosting birds along the Texas coast during dry conditions, highly dynamic use of nocturnal roost sites, use of widely divergent habitat types for foraging, low body mass of most captured birds, and apparent fidelity to general feeding areas. Future investigations of this eastern winter population of curlews would benefit from larger sample sizes and monitoring of individual birds.

  5. Dietary fiber and protein: nutritional therapy in chronic kidney disease and beyond.

    PubMed

    Evenepoel, Pieter; Meijers, Björn K

    2012-02-01

    The health benefits of dietary fiber in the general population are increasingly recognized. Krishnamurthy et al. provide compelling evidence that chronic kidney disease (CKD) further augments these benefits. CKD, besides a microinflammatory state, is a state of increased proteolytic fermentation. Both these harmful conditions are exacerbated by dietary protein and reversed by dietary fiber. Future nutrition guidelines should consider recommending a higher consumption of dietary fiber or potassium-free alternatives such as prebiotics in CKD patients.

  6. Suicide Among Soldiers: A Review of Psychosocial Risk and Protective Factors

    PubMed Central

    Nock, Matthew K.; Deming, Charlene A.; Fullerton, Carol S.; Gilman, Stephen E.; Goldenberg, Matthew; Kessler, Ronald C.; McCarroll, James E.; McLaughlin, Katie A.; Peterson, Christopher; Schoenbaum, Michael; Stanley, Barbara; Ursano, Robert J.

    2014-01-01

    Suicide is difficult to predict and prevent and remains a leading cause of death worldwide. Although soldiers historically have had a suicide rate well below that of the general population, the suicide rate among members of the U.S. Army has increased markedly over the past several years and now exceeds that of the general population. This paper reviews psychosocial factors known to be associated with the increased risk of suicidal behavior in general and describes how some of these factors may be especially important in understanding suicide among soldiers. Moving forward, the prevention of suicide requires additional research aimed at: (a) better describing when, where, and among whom suicidal behavior occurs, (b) using exploratory studies to discover new risk and protective factors, (c) developing new methods of predicting suicidal behavior that synthesize information about modifiable risk and protective factors from multiple domains, and (d) understanding the mechanisms and pathways through which suicidal behavior develops. Although the scope and severity of this problem is daunting, the increasing attention and dedication to this issue by the Armed Forces, scientists, and society provide hope for our ability to better predict and prevent these tragic outcomes in the future. PMID:23631542

  7. Planning for Serious Illness by the General Public: A Population-Based Survey

    PubMed Central

    Quinlan, Elizabeth; Venne, Rosemary; Hunter, Paulette; Surtees, Doug

    2013-01-01

    Background. While rates of advance care documentation amongst the general public remain low, there is increasing recognition of the value of informal planning to address patient preferences in serious illness. Objectives. To determine the associations between personal attributes and formal and informal planning for serious illness across age groups. Methods. This population-based, online survey was conducted in Saskatchewan, Canada, in April, 2012, using a nonclinical sample of 827 adults ranging from 18 to 88 years of age and representative of age, sex, and regional distribution of the province. Associations between key predictor variables and planning for serious illness were assessed using binary logistic regression. Results. While 16.6% of respondents had completed a written living will or advance care plan, half reported having conversations about their treatment wishes or states of health in which they would find it unacceptable to live. Lawyers were the most frequently cited source of assistance for those who had prepared advance care plans. Personal experiences with funeral planning significantly increased the likelihood of activities designed to plan for serious illness. Conclusions. Strategies designed to increase the rate of planning for future serious illness amongst the general public must account for personal readiness. PMID:25025030

  8. Integral projection models for finite populations in a stochastic environment.

    PubMed

    Vindenes, Yngvild; Engen, Steinar; Saether, Bernt-Erik

    2011-05-01

    Continuous types of population structure occur when continuous variables such as body size or habitat quality affect the vital parameters of individuals. These structures can give rise to complex population dynamics and interact with environmental conditions. Here we present a model for continuously structured populations with finite size, including both demographic and environmental stochasticity in the dynamics. Using recent methods developed for discrete age-structured models we derive the demographic and environmental variance of the population growth as functions of a continuous state variable. These two parameters, together with the expected population growth rate, are used to define a one-dimensional diffusion approximation of the population dynamics. Thus, a substantial reduction in complexity is achieved as the dynamics of the complex structured model can be described by only three population parameters. We provide methods for numerical calculation of the model parameters and demonstrate the accuracy of the diffusion approximation by computer simulation of specific examples. The general modeling framework makes it possible to analyze and predict future dynamics and extinction risk of populations with various types of structure, and to explore consequences of changes in demography caused by, e.g., climate change or different management decisions. Our results are especially relevant for small populations that are often of conservation concern.

  9. Unpredictable food supply modifies costs of reproduction and hampers individual optimization.

    PubMed

    Török, János; Hegyi, Gergely; Tóth, László; Könczey, Réka

    2004-11-01

    Investment into the current reproductive attempt is thought to be at the expense of survival and/or future reproduction. Individuals are therefore expected to adjust their decisions to their physiological state and predictable aspects of environmental quality. The main predictions of the individual optimization hypothesis for bird clutch sizes are: (1) an increase in the number of recruits with an increasing number of eggs in natural broods, with no corresponding impairment of parental survival or future reproduction, and (2) a decrease in the fitness of parents in response to both negative and positive brood size manipulation, as a result of a low number of recruits, poor future reproduction of parents, or both. We analysed environmental influences on costs and optimization of reproduction on 6 years of natural and experimentally manipulated broods in a Central European population of the collared flycatcher. Based on dramatic differences in caterpillar availability, we classified breeding seasons as average and rich food years. The categorization was substantiated by the majority of present and future fitness components of adults and offspring. Neither observational nor experimental data supported the individual optimization hypothesis, in contrast to a Scandinavian population of the species. The quality of fledglings deteriorated, and the number of recruits did not increase with natural clutch size. Manipulation revealed significant costs of reproduction to female parents in terms of future reproductive potential. However, the influence of manipulation on recruitment was linear, with no significant polynomial effect. The number of recruits increased with manipulation in rich food years and tended to decrease in average years, so control broods did not recruit more young than manipulated broods in any of the year types. This indicates that females did not optimize their clutch size, and that they generally laid fewer eggs than optimal in rich food years. Mean yearly clutch size did not follow food availability, which suggests that females cannot predict food supply of the brood-rearing period at the beginning of the season. This lack of information on future food conditions seems to prevent them from accurately estimating their optimal clutch size for each season. Our results suggest that individual optimization may not be a general pattern even within a species, and alternative mechanisms are needed to explain clutch size variation.

  10. Assessing environmental attitudes and concerns about a contaminated site in a densely populated suburban environment.

    PubMed

    Burger, Joanna

    2005-02-01

    Considerable attention has been devoted to the concerns and perceptions of people residing around contaminated facilities, both brownfields in urban areas and others located in remote and lightly populated areas. This paper examines the concerns of recreationists and sportsmen residing near the Department of Energy's (DOE) Brookhaven National Laboratory, in central Long Island, one of the most densely populated regions in the United States, where tourism is of prime importance. On an open-ended question, the greatest concern was pollution, followed by environmental health as a global concern, and human health as a concern for Brookhaven. Accidents/spills, loss of public health, and loss of ecological health were rated highest among a list of concerns, and change in property values was rated lowest. When asked to rank seven concerns, protecting human health was ranked the highest, and economic interests were ranked the lowest. For future land use at Brookhaven, recreational uses were rated the highest, while building houses and factories, and storage of nuclear material were rated the lowest. These data can be used by managers, decision and policy makers, and the general public to assess and manage local and regional environmental concerns and to consider future land uses for decommissioned lands, such as those at Brookhaven.

  11. Concepts and tools for predictive modeling of microbial dynamics.

    PubMed

    Bernaerts, Kristel; Dens, Els; Vereecken, Karen; Geeraerd, Annemie H; Standaert, Arnout R; Devlieghere, Frank; Debevere, Johan; Van Impe, Jan F

    2004-09-01

    Description of microbial cell (population) behavior as influenced by dynamically changing environmental conditions intrinsically needs dynamic mathematical models. In the past, major effort has been put into the modeling of microbial growth and inactivation within a constant environment (static models). In the early 1990s, differential equation models (dynamic models) were introduced in the field of predictive microbiology. Here, we present a general dynamic model-building concept describing microbial evolution under dynamic conditions. Starting from an elementary model building block, the model structure can be gradually complexified to incorporate increasing numbers of influencing factors. Based on two case studies, the fundamentals of both macroscopic (population) and microscopic (individual) modeling approaches are revisited. These illustrations deal with the modeling of (i) microbial lag under variable temperature conditions and (ii) interspecies microbial interactions mediated by lactic acid production (product inhibition). Current and future research trends should address the need for (i) more specific measurements at the cell and/or population level, (ii) measurements under dynamic conditions, and (iii) more comprehensive (mechanistically inspired) model structures. In the context of quantitative microbial risk assessment, complexity of the mathematical model must be kept under control. An important challenge for the future is determination of a satisfactory trade-off between predictive power and manageability of predictive microbiology models.

  12. Nutrition and Health in Amphibian Husbandry

    PubMed Central

    Ferrie, Gina M.; Alford, Vance C.; Atkinson, Jim; Baitchman, Eric; Barber, Diane; Blaner, William S.; Crawshaw, Graham; Daneault, Andy; Dierenfeld, Ellen; Finke, Mark; Fleming, Greg; Gagliardo, Ron; Hoffman, Eric A.; Karasov, William; Klasing, Kirk; Koutsos, Elizabeth; Lankton, Julia; Lavin, Shana R.; Lentini, Andrew; Livingston, Shannon; Lock, Brad; Mason, Tom; McComb, Alejandra; Morris, Cheryl; Pessier, Allan P.; Olea-Popelka, Francisco; Probst, Tom; Rodriguez, Carlos; Schad, Kristine; Semmen, Kent; Sincage, Jamie; Stamper, M. Andrew; Steinmetz, Jason; Sullivan, Kathleen; Terrell, Scott; Wertan, Nina; Wheaton, Catharine J.; Wilson, Brad; Valdes, Eduardo V.

    2015-01-01

    Amphibian biology is intricate, and there are many inter-related factors that need to be understood before establishing successful Conservation Breeding Programs (CBPs). Nutritional needs of amphibians are highly integrated with disease and their husbandry needs, and the diversity of developmental stages, natural habitats, and feeding strategies result in many different recommendations for proper care and feeding. This review identifies several areas where there is substantial room for improvement in maintaining healthy ex situ amphibian populations specifically in the areas of obtaining and utilizing natural history data for both amphibians and their dietary items, achieving more appropriate environmental parameters, understanding stress and hormone production, and promoting better physical and population health. Using a scientific or research framework to answer questions about disease, nutrition, husbandry, genetics, and endocrinology of ex situ amphibians will improve specialists’ understanding of the needs of these species. In general, there is a lack of baseline data and comparative information for most basic aspects of amphibian biology as well as standardized laboratory approaches. Instituting a formalized research approach in multiple scientific disciplines will be beneficial not only to the management of current ex situ populations, but also in moving forward with future conservation and reintroduction projects. This overview of gaps in knowledge concerning ex situ amphibian care should serve as a foundation for much needed future research in these areas. PMID:25296396

  13. 'Just another incentive scheme': a qualitative interview study of a local pay-for-performance scheme for primary care.

    PubMed

    Hackett, Julia; Glidewell, Liz; West, Robert; Carder, Paul; Doran, Tim; Foy, Robbie

    2014-10-25

    A range of policy initiatives have addressed inequalities in healthcare and health outcomes. Local pay-for-performance schemes for primary care have been advocated as means of enhancing clinical ownership of the quality agenda and better targeting local need compared with national schemes such as the UK Quality and Outcomes Framework (QOF). We investigated whether professionals' experience of a local scheme in one English National Health Service (NHS) former primary care trust (PCT) differed from that of the national QOF in relation to the goal of reducing inequalities. We conducted retrospective semi-structured interviews with primary care professionals implementing the scheme and those involved in its development. We purposively sampled practices with varying levels of population socio-economic deprivation and achievement. Interviews explored perceptions of the scheme and indicators, likely mechanisms of influence on practice, perceived benefits and harms, and how future schemes could be improved. We used a framework approach to analysis. Thirty-eight professionals from 16 general practices and six professionals involved in developing local indicators participated. Our findings cover four themes: ownership, credibility of the indicators, influences on behaviour, and exacerbated tensions. We found little evidence that the scheme engendered any distinctive sense of ownership or experiences different from the national scheme. Although the indicators and their evidence base were seldom actively questioned, doubts were expressed about their focus on health promotion given that eventual benefits relied upon patient action and availability of local resources. Whilst practices serving more affluent populations reported status and patient benefit as motivators for participating in the scheme, those serving more deprived populations highlighted financial reward. The scheme exacerbated tensions between patient and professional consultation agendas, general practitioners benefitting directly from incentives and nurses who did much of the work, and practices serving more and less affluent populations which faced different challenges in achieving targets. The contentious nature of pay-for-performance was not necessarily reduced by local adaptation. Those developing future schemes should consider differential rewards and supportive resources for practices serving more deprived populations, and employing a wider range of levers to promote professional understanding and ownership of indicators.

  14. Population, Education, and Children's Futures. Fastback 150.

    ERIC Educational Resources Information Center

    Bjork, Robert M.; Fraser, Stewart E.

    This monograph discusses world population problems, examines the underlying concepts and issues in population education, and looks at the future. The monograph begins by describing an attempt at population education in a village of India. Eight guiding concepts that are considered to be essential for population educators are then discussed. These…

  15. Applicability of the Newtonian gravity concept inventory to introductory college physics classes

    NASA Astrophysics Data System (ADS)

    Williamson, Kathryn; Prather, Edward E.; Willoughby, Shannon

    2016-06-01

    The study described here extends the applicability of the Newtonian Gravity Concept Inventory (NGCI) to college algebra-based physics classes, beyond the general education astronomy courses for which it was originally developed. The four conceptual domains probed by the NGCI (Directionality, Force Law, Independence of Other Forces, and Threshold) are well suited for investigating students' reasoning about gravity in both populations, making the NGCI a highly versatile instrument. Classical test theory statistical analysis with physics student responses pre-instruction (N = 1,392) and post-instruction (N = 929) from eight colleges and universities across the United States indicate that the NGCI is composed of items with appropriate difficulty and discrimination and is reliable for this population. Also, expert review and student interviews support the NGCI's validity for the physics population. Emergent similarities and differences in how physics students reason about gravity compared to astronomy students are discussed, as well as future directions for analyzing the instrument's item parameters across both populations.

  16. Prevalence of Hypertension and Associated Risk Factors in Western Alaska Native People: The Western Alaska Tribal Collaborative for Health (WATCH) Study.

    PubMed

    Jolly, Stacey E; Koller, Kathryn R; Metzger, Jesse S; Day, Gretchen M; Silverman, Angela; Hopkins, Scarlett E; Austin, Melissa A; Boden-Albala, Bernadette; Ebbesson, Sven O E; Boyer, Bert B; Howard, Barbara V; Umans, Jason G

    2015-10-01

    Hypertension is a common chronic disease and a key risk factor in the development of cardiovascular disease. The Western Alaska Tribal Collaborative for Health study consolidates baseline data from four major cohorts residing in the Norton Sound and Yukon-Kuskokwim regions of western Alaska. This consolidated cohort affords an opportunity for a systematic analysis of high blood pressure and its correlates in a unique population with high stroke rates over a wide age range. While the prevalence of hypertension among western Alaska Native people (30%, age-standardized) is slightly less than that of the US general population (33%), cardiovascular disease is a leading cause of mortality in this rural population. The authors found that improvement is needed in hypertension awareness as about two thirds (64%) of patients reported awareness and only 39% with hypertension were controlled on medication. Future analyses assessing risk and protective factors for incident hypertension in this population are indicated. © 2015 Wiley Periodicals, Inc.

  17. The Value of Information for Populations in Varying Environments

    NASA Astrophysics Data System (ADS)

    Rivoire, Olivier; Leibler, Stanislas

    2011-04-01

    The notion of information pervades informal descriptions of biological systems, but formal treatments face the problem of defining a quantitative measure of information rooted in a concept of fitness, which is itself an elusive notion. Here, we present a model of population dynamics where this problem is amenable to a mathematical analysis. In the limit where any information about future environmental variations is common to the members of the population, our model is equivalent to known models of financial investment. In this case, the population can be interpreted as a portfolio of financial assets and previous analyses have shown that a key quantity of Shannon's communication theory, the mutual information, sets a fundamental limit on the value of information. We show that this bound can be violated when accounting for features that are irrelevant in finance but inherent to biological systems, such as the stochasticity present at the individual level. This leads us to generalize the measures of uncertainty and information usually encountered in information theory.

  18. Prevalence of Hypertension and Associated Risk Factors in Western Alaska Native People: The Western Alaska Tribal Collaborative for Health (WATCH) Study

    PubMed Central

    Jolly, Stacey E.; Koller, Kathryn R.; Metzger, Jesse S.; Day, Gretchen M.; Silverman, Angela; Hopkins, Scarlett E.; Austin, Melissa A.; Boden-Albala, Bernadette; Ebbesson, Sven O.E.; Boyer, Bert B.; Howard, Barbara V.; Umans, Jason G.

    2014-01-01

    Hypertension is a common chronic disease and a key risk factor in the development of cardiovascular disease. The Western Alaska Tribal Collaborative for Health Study consolidates baseline data from four major cohorts residing in the Norton Sound and Yukon-Kuskokwim regions of western Alaska. This consolidated cohort affords an opportunity for a systematic analysis of high blood pressure and its correlates in a unique population that has high stroke rates over a wide age range. While the prevalence of hypertension among western Alaska Native people (30%, age-standardized) is slightly less than that of the U.S. general population (33%), cardiovascular disease is a leading cause of mortality in this rural population. We found that improvement is needed in hypertension awareness as about two-thirds (64%) reported awareness and only 39% with hypertension were controlled on medication. Future analyses assessing risk and protective factors for incident hypertension in this population are indicated. PMID:25644577

  19. Estimating Historical Eastern North Pacific Blue Whale Catches Using Spatial Calling Patterns

    PubMed Central

    Monnahan, Cole C.; Branch, Trevor A.; Stafford, Kathleen M.; Ivashchenko, Yulia V.; Oleson, Erin M.

    2014-01-01

    Blue whales (Balaenoptera musculus) were exploited extensively around the world and remain endangered. In the North Pacific their population structure is unclear and current status unknown, with the exception of a well-studied eastern North Pacific (ENP) population. Despite existing abundance estimates for the ENP population, it is difficult to estimate pre-exploitation abundance levels and gauge their recovery because historical catches of the ENP population are difficult to separate from catches of other populations in the North Pacific. We collated previously unreported Soviet catches and combined these with known catches to form the most current estimates of North Pacific blue whale catches. We split these conflated catches using recorded acoustic calls from throughout the North Pacific, the knowledge that the ENP population produces a different call than blue whales in the western North Pacific (WNP). The catches were split by estimating spatiotemporal occurrence of blue whales with generalized additive models fitted to acoustic call patterns, which predict the probability a catch belonged to the ENP population based on the proportion of calls of each population recorded by latitude, longitude, and month. When applied to the conflated historical catches, which totaled 9,773, we estimate that ENP blue whale catches totaled 3,411 (95% range 2,593 to 4,114) from 1905–1971, and amounted to 35% (95% range 27% to 42%) of all catches in the North Pacific. Thus most catches in the North Pacific were for WNP blue whales, totaling 6,362 (95% range 5,659 to 7,180). The uncertainty in the acoustic data influence the results substantially more than uncertainty in catch locations and dates, but the results are fairly insensitive to the ecological assumptions made in the analysis. The results of this study provide information for future studies investigating the recovery of these populations and the impact of continuing and future sources of anthropogenic mortality. PMID:24892427

  20. Estimating historical eastern North Pacific blue whale catches using spatial calling patterns.

    PubMed

    Monnahan, Cole C; Branch, Trevor A; Stafford, Kathleen M; Ivashchenko, Yulia V; Oleson, Erin M

    2014-01-01

    Blue whales (Balaenoptera musculus) were exploited extensively around the world and remain endangered. In the North Pacific their population structure is unclear and current status unknown, with the exception of a well-studied eastern North Pacific (ENP) population. Despite existing abundance estimates for the ENP population, it is difficult to estimate pre-exploitation abundance levels and gauge their recovery because historical catches of the ENP population are difficult to separate from catches of other populations in the North Pacific. We collated previously unreported Soviet catches and combined these with known catches to form the most current estimates of North Pacific blue whale catches. We split these conflated catches using recorded acoustic calls from throughout the North Pacific, the knowledge that the ENP population produces a different call than blue whales in the western North Pacific (WNP). The catches were split by estimating spatiotemporal occurrence of blue whales with generalized additive models fitted to acoustic call patterns, which predict the probability a catch belonged to the ENP population based on the proportion of calls of each population recorded by latitude, longitude, and month. When applied to the conflated historical catches, which totaled 9,773, we estimate that ENP blue whale catches totaled 3,411 (95% range 2,593 to 4,114) from 1905-1971, and amounted to 35% (95% range 27% to 42%) of all catches in the North Pacific. Thus most catches in the North Pacific were for WNP blue whales, totaling 6,362 (95% range 5,659 to 7,180). The uncertainty in the acoustic data influence the results substantially more than uncertainty in catch locations and dates, but the results are fairly insensitive to the ecological assumptions made in the analysis. The results of this study provide information for future studies investigating the recovery of these populations and the impact of continuing and future sources of anthropogenic mortality.

  1. Chronic Generalized Harassment during College: Influences on Alcohol and Drug Use

    PubMed Central

    McGinley, Meredith; Rospenda, Kathleen M.; Liu, Li; Richman, Judith A.

    2015-01-01

    The experience of chronic generalized harassment from others can have a deleterious impact on individuals over time. Specifically, coping resources may be taxed, resulting in the use of avoidant coping strategies such substance use. However, little is known about the experience of chronic generalized harassment (e.g., verbal hostility, manipulation by others, exclusion from important events) and its impact on substance use in collegiate populations. In the current study, we examined the latent growth of generalized harassment across the transition from high school to college, whether this growth was heterogeneous, and the relationships between latent generalized harassment classifications and substance use. Incoming freshmen students (N = 2890; 58% female; 53% White) at eight colleges in Illinois completed a web survey at four points: fall 2011 (baseline), spring 2012 (T1), fall 2012 (T2), and fall 2013 (T3). Students were required to be at least 18 years old at baseline, and were compensated with online gift certificates. Two-part Latent Class Growth Analysis (LCGA) was implemented in order to examine heterogeneous growth over time. The results supported a two-class solution (infrequent and chronic classes) for generalized harassment. Growth in harassment was characterized by a decrease from baseline through college entry, with a recovery in rates by T3. Members of the chronically harassed class had greater mean generalized harassment over time, and were less likely to report zero instances of harassment experiences. As hypothesized, membership in the chronic class predicted future binge drinking, drinking to intoxication, problems due to alcohol use, and cigarette use, but not marijuana use. Future interventions should focus on providing college students with resources to help cope with distress stemming from persistent generalized harassment from peers, faculty, and other individuals in higher-education settings. PMID:26081935

  2. Chronic Generalized Harassment During College: Influences on Alcohol and Drug Use.

    PubMed

    McGinley, Meredith; Rospenda, Kathleen M; Liu, Li; Richman, Judith A

    2015-10-01

    The experience of chronic generalized harassment from others can have a deleterious impact on individuals over time. Specifically, coping resources may be taxed, resulting in the use of avoidant coping strategies such as substance use. However, little is known about the experience of chronic generalized harassment (e.g., verbal hostility, manipulation by others, exclusion from important events) and its impact on substance use in collegiate populations. In the current study, we examined the latent growth of generalized harassment across the transition from high school to college, whether this growth was heterogeneous, and the relationships between latent generalized harassment classifications and substance use. Incoming freshmen students (N = 2890; 58% female; 53% white) at eight colleges in Illinois completed a web survey at five points: fall 2011 (baseline), spring 2012 (T1), fall 2012 (T2), fall 2013 (T3) and fall 2014 (T4). Students were required to be at least 18 years old at baseline, and were compensated with online gift certificates. Two-part latent class growth analysis was implemented in order to examine heterogeneous growth over time. The results supported a two-class solution (infrequent and chronic classes) for generalized harassment. Growth in harassment was characterized by a decrease from baseline through college entry, with a recovery in rates by T3. Members of the chronically harassed class had greater mean generalized harassment over time, and were less likely to report zero instances of harassment experiences. As hypothesized, membership in the chronic class predicted future binge drinking, drinking to intoxication, problems due to alcohol use, and cigarette use, but not marijuana use. Future interventions should focus on providing college students with resources to help cope with distress stemming from persistent generalized harassment from peers, faculty, and other individuals in higher-education settings.

  3. Determinants of favourable opinions about euthanasia in a sample of French physicians.

    PubMed

    Dany, Lionel; Baumstarck, Karine; Dudoit, Eric; Duffaud, Florence; Auquier, Pascal; Salas, Sébastien

    2015-11-05

    The question whether euthanasia should be legalised has led to substantial public debate in France. The objective of this study in a sample of French physicians was to establish the potential determinants of a favourable opinion about euthanasia in general and when faced with a specific situation as embodied in the Humbert affair. The study was a cross-sectional survey investigating two different samples of medical doctors: (1) those specialised in palliative care and affiliated to the French Society for Patient Accompaniment and Palliative Care; (2) medical interns (medical doctors in training course) in a French medical university (Marseille). A questionnaire was sent (email) to each voluntary participant including sociodemographics, professional status, mention of believing in God, and opinion about euthanasia (the question was designed to assess the general opinion about euthanasia and the opinion about a specific case, the Vincent Humbert' case (a man who was rendered quadriplegic, blind, and mute after an accident and has requested euthanasia). A total of 413 physicians participated in the research (participation rate: 48.5%). Less than half of the population were favourable to euthanasia in general and almost two-thirds of the population were favourable to Vincent Humbert's request for euthanasia. Based on the multivariate analysis, individuals believing in God and being a medical intern were significant independent factors linked to having a favourable opinion about euthanasia in general and about the Vincent Humbert's request. There is still no study in France on the development of opinion about euthanasia and its impact. The issue goes beyond the strictly professional sphere and involves broader socio-political stakes. These stakes do not necessarily take into account medical practices and experiences or the desires of end-of-life patients. The professional upheaval that the future French legal framework will doubtlessly trigger will require further research. The professional upheaval that the future French legal framework will doubtlessly trigger will require further research.

  4. Career choices of medical students: a national survey of 1780 students.

    PubMed

    Lefevre, Jérémie H; Roupret, Morgan; Kerneis, Solen; Karila, Laurent

    2010-06-01

    OBJECTIVES Many factors influence the career specialty decisions made by medical students. The aim of this study was to broaden consideration of the determinants of specialty choice in a large population of medical students in their sixth year of study. METHODS A total of 2588 students distributed across all of the 39 medical schools in France participated in a National Practice Examination in December 2008, after which an electronic questionnaire was administered. Study criteria were: population characteristics; demographics, and motivation for and drawbacks to medical specialty choice. RESULTS A total of 1780 students (1111 women, 62%) responded to the questionnaire (69% response rate). The mean age of respondents was 23.8 years (22-35 years). Of these, 1555 students (87%) stated their preferred medical specialty. Surgical and medical specialties were the two specialties selected most frequently by students (n = 729, 47%). General practice was chosen by 20%. Gender influenced the choice of specialty: 88% of future paediatricians, 82% of gynaecologists and 77% of general practitioners (GPs) were women (p < 0.05). Main motivating factors included interesting diseases, opportunities for private practice and patient contact. Main drawbacks limiting the choice of other specialties were poor quality of life, an exclusively hospital-based career and loss of patient contact. Gender was the criterion most associated with significant differences in factors of motivation for or discouragement from a career. Patient contact and opportunities for private practice were significantly highlighted by future GPs compared with students opting for the medical or surgical specialties (p < 0.0001). CONCLUSIONS Students' career choices regarding specialties or general practice result from the interplay among several factors. Career interest in general practice is particularly low. Initiatives to address the factors affecting student career choices regarding less favoured specialties and to deal with the growing feminisation of the profession, which will lead to irreversible changes in clinical practice, are required.

  5. Increased utilisation of primary healthcare in persons exposed to severe stress in prenatal life: a national population-based study in Denmark.

    PubMed

    Li, Jiong; Yang, Hu; Guldin, Mai-Britt; Vedsted, Peter; Vestergaard, Mogens

    2015-01-08

    Recent studies have suggested that stress in a pregnant mother may affect the future health of the unborn child negatively. An excellent proxy for health problems is the use of healthcare resources. Using nationwide data, we examined whether persons born to mothers who lost a close relative during pregnancy have more contacts to general practice. Population-based cohort study. Denmark. We included all children born in Denmark from 1973 to 2002 (N=2 032 528). Exposure of prenatal stress was defined as maternal bereavement by the death of a close relative during the antenatal period. The outcome of interest was contact with general practice between 2003 and 2009 when the participants were between 1 and 35 years of age. Poisson regression was used to assess the association between exposure and outcome. Contacts to general practitioner. Overall, persons exposed to prenatal stress had 2% more GP contacts than those not exposed, primarily due to increased utilisation of healthcare services during late adolescence and early adulthood. The exposed persons born to mothers who had lost a spouse had a higher risk (relative risk (RR) 1.12, 95% CI 1.10 to 1.14) and so did those born to mothers who had lost a close relative due to unexpected death (RR 1.06, 95% CI 1.05 to 1.06). Exposed persons had more contacts to general practice in daytime and more psychometric tests, talk therapies and C reactive protein tests than unexposed persons. Prenatal stress following maternal bereavement was associated with a slightly increased utilisation of primary healthcare, mainly due to increased healthcare needs related to mental health and infections. Understanding how stress during pregnancy influences the future health of the child is an important aspect of prenatal care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Assessing the Generalizability of Randomized Trial Results to Target Populations

    PubMed Central

    Stuart, Elizabeth A.; Bradshaw, Catherine P.; Leaf, Philip J.

    2014-01-01

    Recent years have seen increasing interest in and attention to evidence-based practices, where the “evidence” generally comes from well-conducted randomized trials. However, while those trials yield accurate estimates of the effect of the intervention for the participants in the trial (known as “internal validity”), they do not always yield relevant information about the effects in a particular target population (known as “external validity”). This may be due to a lack of specification of a target population when designing the trial, difficulties recruiting a sample that is representative of a pre-specified target population, or to interest in considering a target population somewhat different from the population directly targeted by the trial. This paper first provides an overview of existing design and analysis methods for assessing and enhancing the ability of a randomized trial to estimate treatment effects in a target population. It then provides a case study using one particular method, which weights the subjects in a randomized trial to match the population on a set of observed characteristics. The case study uses data from a randomized trial of School-wide Positive Behavioral Interventions and Supports (PBIS); our interest is in generalizing the results to the state of Maryland. In the case of PBIS, after weighting, estimated effects in the target population were similar to those observed in the randomized trial. The paper illustrates that statistical methods can be used to assess and enhance the external validity of randomized trials, making the results more applicable to policy and clinical questions. However, there are also many open research questions; future research should focus on questions of treatment effect heterogeneity and further developing these methods for enhancing external validity. Researchers should think carefully about the external validity of randomized trials and be cautious about extrapolating results to specific populations unless they are confident of the similarity between the trial sample and that target population. PMID:25307417

  7. Assessing the generalizability of randomized trial results to target populations.

    PubMed

    Stuart, Elizabeth A; Bradshaw, Catherine P; Leaf, Philip J

    2015-04-01

    Recent years have seen increasing interest in and attention to evidence-based practices, where the "evidence" generally comes from well-conducted randomized trials. However, while those trials yield accurate estimates of the effect of the intervention for the participants in the trial (known as "internal validity"), they do not always yield relevant information about the effects in a particular target population (known as "external validity"). This may be due to a lack of specification of a target population when designing the trial, difficulties recruiting a sample that is representative of a prespecified target population, or to interest in considering a target population somewhat different from the population directly targeted by the trial. This paper first provides an overview of existing design and analysis methods for assessing and enhancing the ability of a randomized trial to estimate treatment effects in a target population. It then provides a case study using one particular method, which weights the subjects in a randomized trial to match the population on a set of observed characteristics. The case study uses data from a randomized trial of school-wide positive behavioral interventions and supports (PBIS); our interest is in generalizing the results to the state of Maryland. In the case of PBIS, after weighting, estimated effects in the target population were similar to those observed in the randomized trial. The paper illustrates that statistical methods can be used to assess and enhance the external validity of randomized trials, making the results more applicable to policy and clinical questions. However, there are also many open research questions; future research should focus on questions of treatment effect heterogeneity and further developing these methods for enhancing external validity. Researchers should think carefully about the external validity of randomized trials and be cautious about extrapolating results to specific populations unless they are confident of the similarity between the trial sample and that target population.

  8. Cholesterol in preteen children of parents with premature coronary disease.

    PubMed

    Gross, H; Caplan, C

    1978-03-01

    A pediatric population at high risk for the development of coronary artery disease has been identified. Using a simple and inexpensive protocol, serum cholesterol determinations were performed on 50 children 12 years old and younger. These children were taken from 28 families in which one parent had suffered a myocardial infarction before the age of 50. Eight of the 50 children were found to have significant elevation of serum cholesterol. This was an incidence of 16%--twice that of the general pediatric population. Subjects with both adverse genetic and metabolic backgrounds need to be identified in this simple way. Preventive and therapeutic measures in such children may alter in the future the serious morbidity and mortality of coronary artery disease.

  9. Safe sleep practices and sudden infant death syndrome risk reduction: NICU and well-baby nursery graduates.

    PubMed

    Fowler, Aja J; Evans, Patricia W; Etchegaray, Jason M; Ottenbacher, Allison; Arnold, Cody

    2013-11-01

    Our primary objective was to compare parents of infants cared for in newborn intensive care units (NICUs) and infants cared for in well-baby ("general") nurseries with regard to knowledge and practice of safe sleep practices/sudden infant death syndrome risk reduction measures and guidelines. Our secondary objective was to obtain qualitative data regarding reasons for noncompliance in both populations. Sixty participants (30 from each population) completed our survey measuring safe sleep knowledge and practice. Parents of NICU infants reported using 2 safe sleep practices-(a) always placing baby in crib to sleep and (b) always placing baby on back to sleep-significantly more frequently than parents of well infants. Additional findings and implications for future studies are discussed.

  10. A preliminary investigation of risks for adverse outcomes of relationship seeking on social network sites (SNS): a descriptive study of women over 50 seeking relationships on MySpace in Hillsborough County, Florida.

    PubMed

    Vandeweerd, Carla; Corvin, Jaime; Coulter, Martha; Perkins, Elizabeth; Telford, Robin; Yalcin, Ali; Myers, Jaime; Yegidis, Bonnie

    2014-01-01

    In contrast to younger populations, little attention has been paid to the increase in seniors using Internet-based venues to find relationships and the potential risk for adverse outcomes this poses. This study examined data collected via an online survey from 45 ethnically diverse women aged 50+ "seeking relationships" on MySpace. The majority of women reported a relationship with someone they met online (85%). They also reported experiencing adverse events including financial exploitation (40%), threats (55%), and physical harm (38%) by someone they met online at levels greater than traditional relationship seeking in the general population. Directions for future research are explored.

  11. Some comments on the World Energy Conference (WEC) energy demand model

    NASA Astrophysics Data System (ADS)

    Brandell, L.

    1982-04-01

    The WEC model, relating the energy demand for a region in a year to gross national product (GNP), aggregated energy prices and elasticity constants, is generalized. The changes that result from the assumption that the elasticity factors are not constant are examined. The resulting differential equation contains the variables energy demand per capita and GNP per capita for the region considered. The effect of time lag in energy demand and the influence of the population growth rate are also included in the model. No projections of the future energy demand were made, but model sensitiveness to the modifications were studied. Time lag effects and population growth effects can raise the projected energy demand for a region by 10% or more.

  12. Motor control in a Drosophila taste circuit

    PubMed Central

    Gordon, Michael D.; Scott, Kristin

    2009-01-01

    Tastes elicit innate behaviors critical for directing animals to ingest nutritious substances and reject toxic compounds, but the neural basis of these behaviors is not understood. Here, we use a neural silencing screen to identify neurons required for a simple Drosophila taste behavior, and characterize a neural population that controls a specific subprogram of this behavior. By silencing and activating subsets of the defined cell population, we identify the neurons involved in the taste behavior as a pair of motor neurons located in the subesophageal ganglion (SOG). The motor neurons are activated by sugar stimulation of gustatory neurons and inhibited by bitter compounds; however, experiments utilizing split-GFP detect no direct connections between the motor neurons and primary sensory neurons, indicating that further study will be necessary to elucidate the circuitry bridging these populations. Combined, these results provide a general strategy and a valuable starting point for future taste circuit analysis. PMID:19217375

  13. Mining Electronic Health Records Data: Domestic Violence and Adverse Health Effects.

    PubMed

    Karakurt, Gunnur; Patel, Vishal; Whiting, Kathleen; Koyutürk, Mehmet

    2017-01-01

    Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims. The Domestic abuse population contained 5870 patients, while the Non-Domestic Abuse population contained 14,315,140 patients. Explorys provides National Big Data from the entire USA. Statistical analysis identified 2429 terms as significantly more prevalent among victims of domestic abuse, compared to the general population. These terms were classified into broad categories, including acute injury, chronic conditions, substance abuse, mental health, disorders, gynecological and pregnancy related problems.

  14. Mental health issues in unaccompanied refugee minors

    PubMed Central

    Huemer, Julia; Karnik, Niranjan S; Voelkl-Kernstock, Sabine; Granditsch, Elisabeth; Dervic, Kanita; Friedrich, Max H; Steiner, Hans

    2009-01-01

    Previous studies about unaccompanied refugee minors (URMs) showed that they are a highly vulnerable group who have greater psychiatric morbidity than the general population. This review focuses on mental health issues among URMs. Articles in databases PsycINFO, Medline and PubMed from 1998 to 2008 addressing this topic were reviewed. The literature had a considerable emphasis on the assessment of PTSD symptoms. Results revealed higher levels of PTSD symptoms in comparison to the norm populations and accompanied refugee minors. In several studies, age and female gender predicted or influenced PTSD symptoms. The existing literature only permits limited conclusions on this very hard to reach population. Future research should include the analysis of long-term outcomes, stress management and a more thorough analysis of the whole range of psychopathology. Additionally, the development of culturally sensitive norms and standardized measures for diverse ethnic groups is of great importance. PMID:19341468

  15. A cross-cultural comparison of population gambling patterns and regulatory frameworks: France and Québec.

    PubMed

    Kairouz, Sylvia; Paradis, Catherine; Nadeau, Louise; Tovar, Marie-Line; Pousset, Maud

    2016-12-01

    Few empirical studies have examined the relationships between differing regulatory approaches and patterns of gambling behaviors. This article reports on a correlational cross-cultural comparison of differences in the regulatory approaches and gambling behavior among general adult populations in France and Québec, Canada. We drew data from two large population surveys conducted in France and Québec (N=27 653 and N=11 888, respectively). We found diverging and converging aspects of government regulatory policies. Statistical analyses demonstrated significantly higher participation rates and prevalence of 'assiduous gamblers' in Québec. In France, among assiduous gamblers, the proportion of moderate-risk and probable pathological gamblers is significantly higher. Future research should examine environmental conditions and varying gambling offerings, as well as gambling regulation, to determine their potential influence on gambling behaviors.

  16. Wealth Transmission and Inequality Among Hunter-Gatherers

    PubMed Central

    Hill, Kim; Marlowe, Frank; Nolin, David; Wiessner, Polly; Gurven, Michael; Bowles, Samuel; Mulder, Monique Borgerhoff; Hertz, Tom; Bell, Adrian

    2010-01-01

    We report quantitative estimates of intergenerational transmission and population-wide inequality for wealth measures in a set of hunter-gatherer populations. Wealth is defined broadly as factors that contribute to individual or household well-being, ranging from embodied forms such as weight and hunting success to material forms such household goods, as well as relational wealth in exchange partners. Intergenerational wealth transmission is low to moderate in these populations, but is still expected to have measurable influence on an individual’s life chances. Wealth inequality (measured with Gini coefficients) is moderate for most wealth types, matching what qualitative ethnographic research has generally indicated (if not the stereotype of hunter-gatherers as extreme egalitarians). We discuss some plausible mechanisms for these patterns, and suggest ways in which future research could resolve questions about the role of wealth in hunter-gatherer social and economic life. PMID:21151711

  17. Terrestrial basking sea turtles are responding to spatio-temporal sea surface temperature patterns.

    PubMed

    Van Houtan, Kyle S; Halley, John M; Marks, Wendy

    2015-01-01

    Naturalists as early as Darwin observed terrestrial basking in green turtles (Chelonia mydas), but the distribution and environmental influences of this behaviour are poorly understood. Here, we examined 6 years of daily basking surveys in Hawaii and compared them with the phenology of local sea surface temperatures (SST). Data and models indicated basking peaks when SST is coolest, and we found this timeline consistent with bone stress markings. Next, we assessed the decadal SST profiles for the 11 global green turtle populations. Basking generally occurs when winter SST falls below 23°C. From 1990 to 2014, the SST for these populations warmed an average 0.04°C yr(-1) (range 0.01-0.09°C yr(-1)); roughly three times the observed global average over this period. Owing to projected future warming at basking sites, we estimated terrestrial basking in green turtles may cease globally by 2100. To predict and manage for future climate change, we encourage a more detailed understanding for how climate influences organismal biology. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  18. Terrestrial basking sea turtles are responding to spatio-temporal sea surface temperature patterns

    PubMed Central

    Van Houtan, Kyle S.; Halley, John M.; Marks, Wendy

    2015-01-01

    Naturalists as early as Darwin observed terrestrial basking in green turtles (Chelonia mydas), but the distribution and environmental influences of this behaviour are poorly understood. Here, we examined 6 years of daily basking surveys in Hawaii and compared them with the phenology of local sea surface temperatures (SST). Data and models indicated basking peaks when SST is coolest, and we found this timeline consistent with bone stress markings. Next, we assessed the decadal SST profiles for the 11 global green turtle populations. Basking generally occurs when winter SST falls below 23°C. From 1990 to 2014, the SST for these populations warmed an average 0.04°C yr−1 (range 0.01–0.09°C yr−1); roughly three times the observed global average over this period. Owing to projected future warming at basking sites, we estimated terrestrial basking in green turtles may cease globally by 2100. To predict and manage for future climate change, we encourage a more detailed understanding for how climate influences organismal biology. PMID:25589483

  19. The accuracy of climate models' simulated season lengths and the effectiveness of grid scale correction factors

    DOE PAGES

    Winterhalter, Wade E.

    2011-09-01

    Global climate change is expected to impact biological populations through a variety of mechanisms including increases in the length of their growing season. Climate models are useful tools for predicting how season length might change in the future. However, the accuracy of these models tends to be rather low at regional geographic scales. Here, I determined the ability of several atmosphere and ocean general circulating models (AOGCMs) to accurately simulate historical season lengths for a temperate ectotherm across the continental United States. I also evaluated the effectiveness of regional-scale correction factors to improve the accuracy of these models. I foundmore » that both the accuracy of simulated season lengths and the effectiveness of the correction factors to improve the model's accuracy varied geographically and across models. These results suggest that regional specific correction factors do not always adequately remove potential discrepancies between simulated and historically observed environmental parameters. As such, an explicit evaluation of the correction factors' effectiveness should be included in future studies of global climate change's impact on biological populations.« less

  20. Effects of business-as-usual anthropogenic emissions on air quality

    NASA Astrophysics Data System (ADS)

    Pozzer, A.; Zimmermann, P.; Doering, U. M.; van Aardenne, J.; Tost, H.; Dentener, F.; Janssens-Maenhout, G.; Lelieveld, J.

    2012-08-01

    The atmospheric chemistry general circulation model EMAC has been used to estimate the impact of anthropogenic emission changes on global and regional air quality in recent and future years (2005, 2010, 2025 and 2050). The emission scenario assumes that population and economic growth largely determine energy and food consumption and consequent pollution sources with the current technologies ("business as usual"). This scenario is chosen to show the effects of not implementing legislation to prevent additional climate change and growing air pollution, other than what is in place for the base year 2005, representing a pessimistic (but plausible) future. By comparing with recent observations, it is shown that the model reproduces the main features of regional air pollution distributions though with some imprecisions inherent to the coarse horizontal resolution (~100 km) and simplified bottom-up emission input. To identify possible future hot spots of poor air quality, a multi pollutant index (MPI), suited for global model output, has been applied. It appears that East and South Asia and the Middle East represent such hotspots due to very high pollutant concentrations, while a general increase of MPIs is observed in all populated regions in the Northern Hemisphere. In East Asia a range of pollutant gases and fine particulate matter (PM2.5) is projected to reach very high levels from 2005 onward, while in South Asia air pollution, including ozone, will grow rapidly towards the middle of the century. Around the Persian Gulf, where natural PM2.5 concentrations are already high (desert dust), ozone levels are expected to increase strongly. The population weighted MPI (PW-MPI), which combines demographic and pollutant concentration projections, shows that a rapidly increasing number of people worldwide will experience reduced air quality during the first half of the 21st century. Following this business as usual scenario, it is projected that air quality for the global average citizen in 2050 would be almost comparable to that for the average citizen in East Asia in the year 2005, which underscores the need to pursue emission reductions.

  1. Establishing endangered species recovery criteria using predictive simulation modeling

    USGS Publications Warehouse

    McGowan, Conor P.; Catlin, Daniel H.; Shaffer, Terry L.; Gratto-Trevor, Cheri L.; Aron, Carol

    2014-01-01

    Listing a species under the Endangered Species Act (ESA) and developing a recovery plan requires U.S. Fish and Wildlife Service to establish specific and measurable criteria for delisting. Generally, species are listed because they face (or are perceived to face) elevated risk of extinction due to issues such as habitat loss, invasive species, or other factors. Recovery plans identify recovery criteria that reduce extinction risk to an acceptable level. It logically follows that the recovery criteria, the defined conditions for removing a species from ESA protections, need to be closely related to extinction risk. Extinction probability is a population parameter estimated with a model that uses current demographic information to project the population into the future over a number of replicates, calculating the proportion of replicated populations that go extinct. We simulated extinction probabilities of piping plovers in the Great Plains and estimated the relationship between extinction probability and various demographic parameters. We tested the fit of regression models linking initial abundance, productivity, or population growth rate to extinction risk, and then, using the regression parameter estimates, determined the conditions required to reduce extinction probability to some pre-defined acceptable threshold. Binomial regression models with mean population growth rate and the natural log of initial abundance were the best predictors of extinction probability 50 years into the future. For example, based on our regression models, an initial abundance of approximately 2400 females with an expected mean population growth rate of 1.0 will limit extinction risk for piping plovers in the Great Plains to less than 0.048. Our method provides a straightforward way of developing specific and measurable recovery criteria linked directly to the core issue of extinction risk. Published by Elsevier Ltd.

  2. User Experience Evaluation of a Smoking Cessation App in People With Serious Mental Illness

    PubMed Central

    Rizo, Javier; Kientz, Julie A.; McDonell, Michael G.; Ries, Richard K.; Sobel, Kiley

    2016-01-01

    Introduction: Smoking rates among people with serious mental illness are 3 to 4 times higher than the general population, yet currently there are no smoking cessation apps specifically designed to address this need. We report the results of a User Experience (UX) evaluation of a National Cancer Institute smoking cessation app, QuitPal, and provide user centered design data that can be used to tailor smoking cessation apps for this population. Methods: Two hundred forty hours of field experience with QuitPal, 10 hours of recorded interviews and task performances, usage logs and a self-reported usability scale, informed the results of our study. Participants were five individuals recruited from a community mental health clinic with a reported serious mental illness history. Performance, self-reports, usage logs and interview data were triangulated to identify critical usability errors and UX themes emerging from this population. Results: Data suggests QuitPal has below average levels of usability, elevated time on task performances and required considerable amounts of guidance. UX themes provided critical information to tailor smoking cessation apps for this population, such as the importance of breaking down “cessation” into smaller steps and use of a reward system. Conclusions: This is the first study to examine the UX of a smoking cessation app among people with serious mental illness. Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for this highly nicotine dependent yet under-served population. Implications: Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for people with serious mental illness, a highly nicotine dependent yet under-served population. PMID:26581430

  3. Genotyping by sequencing resolves shallow population structure to inform conservation of Chinook salmon (Oncorhynchus tshawytscha)

    PubMed Central

    Larson, Wesley A; Seeb, Lisa W; Everett, Meredith V; Waples, Ryan K; Templin, William D; Seeb, James E

    2014-01-01

    Recent advances in population genomics have made it possible to detect previously unidentified structure, obtain more accurate estimates of demographic parameters, and explore adaptive divergence, potentially revolutionizing the way genetic data are used to manage wild populations. Here, we identified 10 944 single-nucleotide polymorphisms using restriction-site-associated DNA (RAD) sequencing to explore population structure, demography, and adaptive divergence in five populations of Chinook salmon (Oncorhynchus tshawytscha) from western Alaska. Patterns of population structure were similar to those of past studies, but our ability to assign individuals back to their region of origin was greatly improved (>90% accuracy for all populations). We also calculated effective size with and without removing physically linked loci identified from a linkage map, a novel method for nonmodel organisms. Estimates of effective size were generally above 1000 and were biased downward when physically linked loci were not removed. Outlier tests based on genetic differentiation identified 733 loci and three genomic regions under putative selection. These markers and genomic regions are excellent candidates for future research and can be used to create high-resolution panels for genetic monitoring and population assignment. This work demonstrates the utility of genomic data to inform conservation in highly exploited species with shallow population structure. PMID:24665338

  4. Socio-Economic Instability and the Scaling of Energy Use with Population Size

    PubMed Central

    DeLong, John P.; Burger, Oskar

    2015-01-01

    The size of the human population is relevant to the development of a sustainable world, yet the forces setting growth or declines in the human population are poorly understood. Generally, population growth rates depend on whether new individuals compete for the same energy (leading to Malthusian or density-dependent growth) or help to generate new energy (leading to exponential and super-exponential growth). It has been hypothesized that exponential and super-exponential growth in humans has resulted from carrying capacity, which is in part determined by energy availability, keeping pace with or exceeding the rate of population growth. We evaluated the relationship between energy use and population size for countries with long records of both and the world as a whole to assess whether energy yields are consistent with the idea of an increasing carrying capacity. We find that on average energy use has indeed kept pace with population size over long time periods. We also show, however, that the energy-population scaling exponent plummets during, and its temporal variability increases preceding, periods of social, political, technological, and environmental change. We suggest that efforts to increase the reliability of future energy yields may be essential for stabilizing both population growth and the global socio-economic system. PMID:26091499

  5. Socio-Economic Instability and the Scaling of Energy Use with Population Size.

    PubMed

    DeLong, John P; Burger, Oskar

    2015-01-01

    The size of the human population is relevant to the development of a sustainable world, yet the forces setting growth or declines in the human population are poorly understood. Generally, population growth rates depend on whether new individuals compete for the same energy (leading to Malthusian or density-dependent growth) or help to generate new energy (leading to exponential and super-exponential growth). It has been hypothesized that exponential and super-exponential growth in humans has resulted from carrying capacity, which is in part determined by energy availability, keeping pace with or exceeding the rate of population growth. We evaluated the relationship between energy use and population size for countries with long records of both and the world as a whole to assess whether energy yields are consistent with the idea of an increasing carrying capacity. We find that on average energy use has indeed kept pace with population size over long time periods. We also show, however, that the energy-population scaling exponent plummets during, and its temporal variability increases preceding, periods of social, political, technological, and environmental change. We suggest that efforts to increase the reliability of future energy yields may be essential for stabilizing both population growth and the global socio-economic system.

  6. [Population density, age distribution and urbanisation as factors influencing the frequency of home visits--an analysis for Mecklenburg-West Pomerania].

    PubMed

    Heymann, R; Weitmann, K; Weiss, S; Thierfelder, D; Flessa, S; Hoffmann, W

    2009-07-01

    This study examines and compares the frequency of home visits by general practitioners in regions with a lower population density and regions with a higher population density. The discussion centres on the hypothesis whether the number of home visits in rural and remote areas with a low population density is, in fact, higher than in urbanised areas with a higher population density. The average age of the population has been considered in both cases. The communities of Mecklenburg West-Pomerania were aggregated into postal code regions. The analysis is based on these postal code regions. The average frequency of home visits per 100 inhabitants/km2 has been calculated via a bivariate, linear regression model with the population density and the average age for the postal code region as independent variables. The results are based on billing data of the year 2006 as provided by the Association of Statutory Health Insurance Physicians of Mecklenburg-Western Pomerania. In a second step a variable which clustered the postal codes of urbanised areas was added to a multivariate model. The hypothesis of a negative correlation between the frequency of home visits and the population density of the areas examined cannot be confirmed for Mecklenburg-Western Pomerania. Following the dichotomisation of the postal code regions into sparsely and densely populated areas, only the very sparsely populated postal code regions (less than 100 inhabitants/km2) show a tendency towards a higher frequency of home visits. Overall, the frequency of home visits in sparsely populated postal code regions is 28.9% higher than in the densely populated postal code regions (more than 100 inhabitants/km2), although the number of general practitioners is approximately the same in both groups. In part this association seems to be confirmed by a positive correlation between the average age in the individual postal code regions and the number of home visits carried out in the area. As calculated on the basis of the data at hand, only the very sparsely populated areas with a still gradually decreasing population show a tendency towards a higher frequency of home visits. According to the data of 2006, the number of home visits remains high in sparsely populated areas. It may increase in the near future as the number of general practitioners in these areas will gradually decrease while the number of immobile and older inhabitants will increase.

  7. Rapid urbanization and the growing threat of violence and conflict: a 21st century crisis.

    PubMed

    Patel, Ronak B; Burkle, Frederick M

    2012-04-01

    As the global population is concentrated into complex environments, rapid urbanization increases the threat of conflict and insecurity. Many fast-growing cities create conditions of significant disparities in standards of living, which set up a natural environment for conflict over resources. As urban slums become a haven for criminal elements, youth gangs, and the arms trade, they also create insecurity for much of the population. Specific populations, such as women, migrants, and refugees, bear the brunt of this lack of security, with significant impacts on their livelihoods, health, and access to basic services. This lack of security and violence also has great costs to the general population, both economic and social. Cities have increasingly become the battlefield of recent conflicts as they serve as the seats of power and gateways to resources. International agencies, non-governmental organizations, and policy-makers must act to stem this tide of growing urban insecurity. Protecting urban populations and preventing future conflict will require better urban planning, investment in livelihood programs for youth, cooperation with local communities, enhanced policing, and strengthening the capacity of judicial systems.

  8. The basic principles of migration health: Population mobility and gaps in disease prevalence

    PubMed Central

    Gushulak, Brian D; MacPherson, Douglas W

    2006-01-01

    Currently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented. PMID:16674820

  9. Biofield therapies: helpful or full of hype? A best evidence synthesis.

    PubMed

    Jain, Shamini; Mills, Paul J

    2010-03-01

    Biofield therapies (such as Reiki, therapeutic touch, and healing touch) are complementary medicine modalities that remain controversial and are utilized by a significant number of patients, with little information regarding their efficacy. This systematic review examines 66 clinical studies with a variety of biofield therapies in different patient populations. We conducted a quality assessment as well as a best evidence synthesis approach to examine evidence for biofield therapies in relevant outcomes for different clinical populations. Studies overall are of medium quality, and generally meet minimum standards for validity of inferences. Biofield therapies show strong evidence for reducing pain intensity in pain populations, and moderate evidence for reducing pain intensity hospitalized and cancer populations. There is moderate evidence for decreasing negative behavioral symptoms in dementia and moderate evidence for decreasing anxiety for hospitalized populations. There is equivocal evidence for biofield therapies' effects on fatigue and quality of life for cancer patients, as well as for comprehensive pain outcomes and affect in pain patients, and for decreasing anxiety in cardiovascular patients. There is a need for further high-quality studies in this area. Implications and future research directions are discussed.

  10. Anticipatory reward processing in addicted populations: a focus on the monetary incentive delay task.

    PubMed

    Balodis, Iris M; Potenza, Marc N

    2015-03-01

    Advances in brain imaging techniques have allowed neurobiological research to temporally analyze signals coding for the anticipation of reward. In addicted populations, both hyporesponsiveness and hyperresponsiveness of brain regions (e.g., ventral striatum) implicated in drug effects and reward system processing have been reported during anticipation of generalized reward. We discuss the current state of knowledge of reward processing in addictive disorders from a widely used and validated task: the monetary incentive delay task. Only studies applying the monetary incentive delay task in addicted and at-risk adult populations are reviewed, with a focus on anticipatory processing and striatal regions activated during task performance as well as the relationship of these regions with individual difference (e.g., impulsivity) and treatment outcome variables. We further review drug influences in challenge studies as a means to examine acute influences on reward processing in abstinent, recreationally using, and addicted populations. Generalized reward processing in addicted and at-risk populations is often characterized by divergent anticipatory signaling in the ventral striatum. Although methodologic and task variations may underlie some discrepant findings, anticipatory signaling in the ventral striatum may also be influenced by smoking status, drug metabolites, and treatment status in addicted populations. Divergent results across abstinent, recreationally using, and addicted populations demonstrate complexities in interpreting findings. Future studies would benefit from focusing on characterizing how impulsivity and other addiction-related features relate to anticipatory striatal signaling over time. Additionally, identifying how anticipatory signals recover or adjust after protracted abstinence will be important in understanding recovery processes. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  11. Public attitudes to the storage of blood left over from routine general practice tests and its use in research.

    PubMed

    Treweek, Shaun; Doney, Alex; Leiman, David

    2009-01-01

    There is increasing international interest in DNA biobanks but relatively little evidence concerning appropriate recruitment methods for these repositories of genetic information linked to patient-specific phenotypic data. To this end, our study aimed to investigate the attitudes of members of the public recruited through general practices to the donation and storage of blood left over from routine clinical tests in general practice. A questionnaire was mailed to 2600 individuals randomly selected from two general practice patient lists in Dundee, Scotland. Using a 7-point Likert scale, respondents rated their attitudes toward DNA biobanks in general, and procurement of blood samples specifically. Overall, 841 (34%) of 2471 delivered questionnaires were returned. Compared with patients on the practice lists, respondents were older and more likely to be women. A majority of respondents (61%) were unequivocally positive about storing blood left over from routine tests. Despite general support for this collection method, when asked about open-ended consent, respondents expressed concern about future uses. Respondents' increasing age and level of deprivation had significant adverse effects on attitudes towards making leftover routine biological samples available for research (P = 0.013 and P = 0.034, respectively). The study had three main limitations: there was a low response rate (34%) such that respondents were not entirely respresentative of the survey population; some respondents had difficulty with the questionnaire; and the study was somewhat underpowered for some comparisons. Despite its limitations, this first survey of a general practice population suggests that the majority would be willing to consider giving open-ended consent for the use of blood left over from routine clinical tests in general practice to be stored and used later for medical research.

  12. Increased genetic variation and evolutionary potential drive the success of an invasive grass

    PubMed Central

    Lavergne, Sébastien; Molofsky, Jane

    2007-01-01

    Despite the increasing biological and economic impacts of invasive species, little is known about the evolutionary mechanisms that favor geographic range expansion and evolution of invasiveness in introduced species. Here, we focus on the invasive wetland grass Phalaris arundinacea L. and document the evolutionary consequences that resulted from multiple and uncontrolled introductions into North America of genetic material native to different European regions. Continental-scale genetic variation occurring in reed canarygrass' European range has been reshuffled and recombined within North American introduced populations, giving rise to a number of novel genotypes. This process alleviated genetic bottlenecks throughout reed canarygrass' introduced range, including in peripheral populations, where depletion of genetic diversity is expected and is observed in the native range. Moreover, reed canarygrass had higher genetic diversity and heritable phenotypic variation in its invasive range relative to its native range. The resulting high evolutionary potential of invasive populations allowed for rapid selection of genotypes with higher vegetative colonization ability and phenotypic plasticity. Our results show that repeated introductions of a single species may inadvertently create harmful invaders with high adaptive potential. Such invasive species may be able to evolve in response to changing climate, allowing them to have increasing impact on native communities and ecosystems in the future. More generally, multiple immigration events may thus trigger future adaptation and geographic spread of a species population by preventing genetic bottlenecks and generating genetic novelties through recombination. PMID:17360447

  13. Sex differences in DSM-IV posttraumatic stress disorder symptoms expression using item response theory: A population-based study.

    PubMed

    Rivollier, Fabrice; Peyre, Hugo; Hoertel, Nicolas; Blanco, Carlos; Limosin, Frédéric; Delorme, Richard

    2015-11-15

    Whether there are systematic sex differences in posttraumatic stress disorder (PTSD) symptom expression remains debated. Using methods based on item response theory (IRT), we aimed at examining differences in the likelihood of reporting DSM-IV symptoms of PTSD between women and men, while stratifying for major trauma type and equating for PTSD severity. We compared data from women and men in a large nationally representative adult sample, the National Epidemiologic Survey on Alcohol and Related Conditions. Analyses were conducted in the full population sample of individuals who met the DSM-IV criterion A (n=23,860) and in subsamples according to trauma types. The clinical presentation of the 17 DSM-IV PTSD symptoms in the general population did not substantially differ in women and men in the full population and by trauma type after equating for levels of PTSD severity. The only exception was the symptom "foreshortened future", which was more likely endorsed by men at equivalent levels of PTSD severity. The retrospective nature of the assessment of PTSD symptoms could have led to recall bias. Our sample size was too small to draw conclusions among individuals who experienced war-related traumas. Our findings suggest that the clinical presentation of PTSD does not differ substantially between women and men. We also provide additional psychometric support to the exclusion of the symptom "foreshortened future" from the diagnostic criteria for PTSD in the DSM-5. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Integrating the molecular and the population approaches to dementia research to help guide the future development of appropriate therapeutics.

    PubMed

    Hunter, Sally; Brayne, Carol

    2014-04-15

    Dementia research over the last 50 years has expanded enormously and has greater international interest now than at any time in history. A variety of scientific approaches have been brought to bear on this complex disorder in which the syndrome of clinical features is its defining importance in societal terms. Little has emerged in terms of tangible benefits for people with dementia to date other than a hugely increased awareness at societal and governmental levels. One of the drivers for the increase in focus has been epidemiological evidence, which has provided background numbers for the justification of resources for dementia research. However it can be argued that this justification did not take into account the true meaning of the population evidence, drawing instead on preconceptions which were, at the time, the widely accepted interpretations of earlier evidence. Current evidence, along with the lack of single therapeutic successes, suggests that a clearer analysis is required which not only examines the value and applicability of existing knowledge, most particularly its generation and generalizability, but also where future investment should go for most likely benefit of populations. This includes a hard look at the pre-occupation of societies with single therapies, their place in the context of prevention more generally, particularly within aging populations, and how evidence is generated on likely impacts and their timeframes. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Parenting a Child with Phenylketonuria: An Investigation into the Factors That Contribute to Parental Distress.

    PubMed

    Ambler, Olivia; Medford, Emma; Hare, Dougal J

    2018-04-20

    Phenylketonuria (PKU) is an inherited metabolic condition that can lead to the onset of intellectual disabilities if not strictly managed through a low-protein diet. Parents are responsible for supervising their child's treatment for PKU, which may impact on their experience of distress. This cross-sectional study aimed to identify the factors that contribute to distress in parents who care for a child with PKU, distinct from parents in the general population. Thirty-eight parents of children and adolescents with PKU and 32 parents in the general population completed the questionnaires measuring parental psychological resilience, child behaviour problems, perceived social support and distress. Parents of children with PKU also completed measures of their child's care dependency and behaviour related to developmental and intellectual disabilities. The findings revealed no statistically significant differences in distress between the groups, but parents of children with PKU reported more child behaviour problems. Multiple regression analysis identified that parental psychological resilience and child anxious behaviour explained 35% of the variance in distress for parents of children with PKU. By comparison, parental psychological resilience and generic child behaviour only accounted for 19% of the variance in distress for parents in the general population. This has implications for developing interventions in clinical settings that aim to reduce parents' distress by enhancing their psychological resilience and supporting them to manage child behaviour difficulties, particularly anxious behaviour. Future research should include larger, more diverse samples and use longitudinal study designs.

  16. Substitution and complementarity of alcohol and cannabis: A review of the literature

    PubMed Central

    2016-01-01

    Background Whether alcohol and cannabis are used as substitutes or complements remains debated, and findings across various disciplines have not been synthesized to date. Objective This paper is a first step towards organizing the interdisciplinary literature on alcohol and cannabis substitution and complementarity. Method Electronic searches were performed using PubMed and ISI Web of Knowledge. Behavioral studies of humans with ‘alcohol’ (or ‘ethanol’) and ‘cannabis’ (or ‘marijuana”) and ‘complement*’ (or ‘substitut*’) in the title or as a keyword were considered. Studies were organized according to sample characteristics (youth, general population, clinical and community-based). These groups were not set a priori, but were informed by the literature review process. Results Of the 39 studies reviewed, 16 support substitution, ten support complementarity, 12 support neither and one supports both. Results from studies of youth suggest that youth may reduce alcohol in more liberal cannabis environments (substitute), but reduce cannabis in more stringent alcohol environments (complement). Results from the general population suggest that substitution of cannabis for alcohol may occur under more lenient cannabis policies, though cannabis-related laws may affect alcohol use differently across genders and racial groups. Conclusions Alcohol and cannabis act as both substitutes and complements. Policies aimed at one substance may inadvertently affect consumption of other substances. Future studies should collect fine-grained longitudinal, prospective data from the general population and subgroups of interest, especially in locations likely to legalize cannabis. PMID:27249324

  17. Future in psychopathology research.

    PubMed

    Heckers, Stephan

    2014-03-01

    Psychopathology research has focused either on the analysis of the mental state in the here and now or on the synthesis of mental status abnormalities with biological markers and outcome data. These two schools of psychopathology, the analytic and the synthetic, make contrasting assumptions, take different approaches, and pursue divergent goals. Analytic psychopathology favors the individual person and unique biography, whereas synthetic psychopathology abstracts from the single case and generalizes to the population level. The dimension of time, especially the prediction of future outcomes, is viewed differently by these two schools. Here I outline how Carpenter's proposal of strong inference and theory testing in psychopathology research can be used to test the value of analytic and synthetic psychopathology. The emerging field of personalized psychiatry can clarify the relevance of psychopathology for contemporary research in psychiatry.

  18. Locally adaptive, spatially explicit projection of US population for 2030 and 2050.

    PubMed

    McKee, Jacob J; Rose, Amy N; Bright, Edward A; Huynh, Timmy; Bhaduri, Budhendra L

    2015-02-03

    Localized adverse events, including natural hazards, epidemiological events, and human conflict, underscore the criticality of quantifying and mapping current population. Building on the spatial interpolation technique previously developed for high-resolution population distribution data (LandScan Global and LandScan USA), we have constructed an empirically informed spatial distribution of projected population of the contiguous United States for 2030 and 2050, depicting one of many possible population futures. Whereas most current large-scale, spatially explicit population projections typically rely on a population gravity model to determine areas of future growth, our projection model departs from these by accounting for multiple components that affect population distribution. Modeled variables, which included land cover, slope, distances to larger cities, and a moving average of current population, were locally adaptive and geographically varying. The resulting weighted surface was used to determine which areas had the greatest likelihood for future population change. Population projections of county level numbers were developed using a modified version of the US Census's projection methodology, with the US Census's official projection as the benchmark. Applications of our model include incorporating multiple various scenario-driven events to produce a range of spatially explicit population futures for suitability modeling, service area planning for governmental agencies, consequence assessment, mitigation planning and implementation, and assessment of spatially vulnerable populations.

  19. A comparison of knowledge of diabetes mellitus between patients with diabetes and healthy adults: a survey from north Malaysia.

    PubMed

    Yun, Lai Shin; Hassan, Yahaya; Aziz, Noorizan Abd; Awaisu, Ahmed; Ghazali, Rozina

    2007-12-01

    The primary objective of this study was to assess and compare the knowledge of diabetes mellitus possessed by patients with diabetes and healthy adult volunteers in Penang, Malaysia. A cross-sectional study was conducted from 20 February 2006 to 31 March 2006. We randomly selected 120 patients with diabetes mellitus from a diabetic clinic at the General Hospital Penang, Malaysia and 120 healthy adults at a shopping complex in Penang. Each participant was interviewed face-to-face by a pharmacist using a validated questionnaire, and they were required to answer a total of 30 questions concerning knowledge about diabetes mellitus using Yes, No or Unsure as the only response. The results showed that patients with diabetes mellitus were significantly more knowledgeable than the healthy volunteers about risk factors, symptoms, chronic complications, treatment and self-management, and monitoring parameters. Educational level was the best predictive factor for diabetes mellitus and public awareness. Knowledge about diabetes mellitus should be improved among the general population. This study has major implications for the design of an educational programme for diabetics and a health promotion programme as a primary prevention measure for the healthy population in general, and especially for those at high risk. The results could be useful in the design of future studies for evaluating patients' and the general public's knowledge about diabetes mellitus.

  20. Using mass media and the Internet as tools to diagnose hepatitis C infections in the general population.

    PubMed

    Zuure, Freke R; Davidovich, Udi; Coutinho, Roel A; Kok, Gerjo; Hoebe, Christian J P A; van den Hoek, Anneke; Jansen, Peter L M; van Leeuwen-Gilbert, Paula; Verheuvel, Nicole C; Weegink, Christine J; Prins, Maria

    2011-03-01

    Many individuals with hepatitis C virus (HCV) infection are undiagnosed. This study describes the development and the use and outcomes of a mass media campaign, combined with an Internet risk assessment and an Internet-mediated blood-testing procedure for HCV to identify individuals infected with HCV in the general population. From April 2007 to December 2008, individuals in HCV risk groups were referred to an online, previously validated risk-assessment questionnaire at www.heptest.nl. Individuals at risk could download a referral letter for a free, anonymous HCV blood test in a nonclinical setting. Test results could be obtained online, 1 week later, using a personal log-in code. Anti-HCV-positive participants were requested to visit the Public Health Service for confirmation and RNA testing. Chronically HCV-infected individuals were referred for treatment. Data were analyzed in 2009-2010. The website attracted 40,902 visitors. Of the 9653 who completed the questionnaire, 2553 were at risk for HCV (26.4%). Main reported risk factors were a blood transfusion prior to 1992 and noninjecting drug use. Of the 1480 eligible for the blood test, 420 opted for testing (28%). HCV antibodies were detected in 3.6% (n=15, 95% CI=2.1%, 5.7%); of the 12 with a chronic HCV infection, six began treatment. Internet-mediated risk-based testing for HCV has proved to be a feasible and effective strategy to identify undiagnosed HCV infection in the general population. All HCV-infected individuals belonged to hard-to-reach populations. Test uptake was 28%, which is high for an online project that includes blood testing. Because Internet-mediated testing is low-cost, this strategy holds promise for future screening. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Estimating the health consequences of flight attendant work: comparing flight attendant health to the general population in a cross-sectional study.

    PubMed

    McNeely, Eileen; Mordukhovich, Irina; Tideman, Samuel; Gale, Sara; Coull, Brent

    2018-03-23

    Flight attendants are an understudied occupational group, despite undergoing a wide and unique range of adverse job-related exposures. In our study, we aimed to characterize the health profile of cabin crew relative to the U.S. general population. In 2014-2015, we surveyed participants of the Harvard Flight Attendant Health Study. We compared the prevalence of their health conditions to a contemporaneous cohort in the National Health and Nutrition Examination Survey (NHANES 2013-2014) using age-weighted standardized prevalence ratios (SPRs). We also analyzed associations between job tenure and selected health outcomes, using logistic regression and adjusting for potential confounders. Compared to the NHANES population (n = 2729), flight attendants (n = 5366) had a higher prevalence of female reproductive cancers (SPR = 1.66, 95% CI: 1.18-2.33), cancers at all sites (SPR = 2.15, 95% CI: 1.73-2.67 among females), as well as sleep disorders, fatigue, and depression, with SPRs ranging between 1.98 and 5.57 depending on gender and the specific condition examined. In contrast, we observed a decreased prevalence of cardiac and respiratory outcomes among flight crew relative to NHANES. Health conditions that increased with longer job tenure were sleep disorders, anxiety/depression, alcohol abuse, any cancer, peripheral artery disease, sinusitis, foot surgery, infertility, and several perinatal outcomes. We observed higher rates of specific adverse health outcomes in U.S. flight attendants compared to the general population, as well as associations between longer tenure and health conditions, which should be interpreted in light of recall bias and a cross-sectional design. Future longitudinal studies should evaluate specific exposure-disease associations among flight crew.

  2. Capability and dependency in the Newcastle 85+ cohort study. Projections of future care needs.

    PubMed

    Jagger, Carol; Collerton, Joanna C; Davies, Karen; Kingston, Andrew; Robinson, Louise A; Eccles, Martin P; von Zglinicki, Thomas; Martin-Ruiz, Carmen; James, Oliver F W; Kirkwood, Tom B L; Bond, John

    2011-05-04

    Little is known of the capabilities of the oldest old, the fastest growing age group in the population. We aimed to estimate capability and dependency in a cohort of 85 year olds and to project future demand for care. Structured interviews at age 85 with 841 people born in 1921 and living in Newcastle and North Tyneside, UK who were permanently registered with participating general practices. Measures of capability included were self-reported activities of daily living (ADL), timed up and go test (TUG), standardised mini-mental state examination (SMMSE), and assessment of urinary continence in order to classify interval-need dependency. To project future demand for care the proportion needing 24-hour care was applied to the 2008 England and Wales population projections of those aged 80 years and over by gender. Of participants, 62% (522/841) were women, 77% (651/841) lived in standard housing, 13% (106/841) in sheltered housing and 10% (84/841) in a care home. Overall, 20% (165/841) reported no difficulty with any of the ADLs. Men were more capable in performing ADLs and more independent than women. TUG validated self-reported ADLs. When classified by 'interval of need' 41% (332/810) were independent, 39% (317/810) required help less often than daily, 12% (94/810) required help at regular times of the day and 8% (67/810) required 24-hour care. Of care-home residents, 94% (77/82) required daily help or 24-hour care. Future need for 24-hour care for people aged 80 years or over in England and Wales is projected to increase by 82% from 2010 to 2030 with a demand for 630,000 care-home places by 2030. This analysis highlights the diversity of capability and levels of dependency in this cohort. A remarkably high proportion remain independent, particularly men. However a significant proportion of this population require 24-hour care at home or in care homes. Projections for the next 20 years suggest substantial increases in the number requiring 24-hour care due to population ageing and a proportionate increase in demand for care-home places unless innovative health and social care interventions are found.

  3. [The general methodological approaches identifying strategic positions in developing healthy lifestyle of population].

    PubMed

    Dorofeev, S B; Babenko, A I

    2017-01-01

    The article deals with analysis of national and international publications concerning methodological aspects of elaborating systematic approach to healthy life-style of population. This scope of inquiry plays a key role in development of human capital. The costs related to healthy life-style are to be considered as personal investment into future income due to physical incrementation of human capital. The definitions of healthy life-style, its categories and supportive factors are to be considered in the process of development of strategies and programs of healthy lifestyle. The implementation of particular strategies entails application of comprehensive information and educational programs meant for various categories of population. Therefore, different motivation techniques are to be considered for children, adolescents, able-bodied population, the elderly. This approach is to be resulted in establishing particular responsibility for national government, territorial administrations, health care administrations, employers and population itself. The necessity of complex legislative measures is emphasized. The recent social hygienic studies were focused mostly on particular aspects of development of healthy life-style of population. Hence, the demand for long term exploration of development of organizational and functional models implementing medical preventive measures on the basis of comprehensive information analysis using statistical, sociological and professional expertise.

  4. ‘Not taken in by media hype’: how potential donors, recipients and members of the general public perceive stem cell research

    PubMed Central

    Peddie, V.L.; Porter, M.; Counsell, C.; Caie, L.; Pearson, D.; Bhattacharya, S.

    2009-01-01

    BACKGROUND Views of embryo donors, scientists and members of the general public on embryonic stem cell research (eSCR) have been widely reported. Less is known about views of potential beneficiaries of stem cell therapy and the influence of media ‘hype’ on perceptions of eSCR among different groups of stakeholders. This study aimed to examine the perceptions of members of the general public as well as two patient groups likely to benefit from eSCR and to explore the role of the media in shaping these views. METHODS A qualitative study carried out in Aberdeen, Scotland included 15 people living with Parkinson’s disease (PD), 15 people living with diabetes mellitus (DM), 15 couples with infertility and 21 members of the general public who volunteered for the study. Interview transcripts were analysed thematically using grounded theory. RESULTS The two patient groups likely to benefit from eSCR in the future differed in their knowledge (mainly gained from the media) and understanding of eSCR. Those living with PD were older, more debilitated and better informed than those with DM who showed limited interest in potential future benefits of eSCR. Infertile couples learnt about eSCR from health professionals who explained the process of embryo donation to them, and had sought no further information. Most of the general public had accessed information on eSCR and believed themselves to be more discerning than others because of their objectivity, intelligence and ‘scientific awareness’. Although, the media and internet were primary sources of information for all except couples with infertility, members of all four groups claimed not to be taken in by the media ‘hype’ surrounding eSCR. CONCLUSIONS Those who expected to benefit from eSCR in the future as well as members of the general public differ in their susceptibility to media ‘hype’, while believing that they are not taken in by exaggerated claims of benefits. As respondents were a selected group who were not drawn from a representative sample, the findings cannot be generalized to a wider population. PMID:19168873

  5. Crime Victimization in Adults With Severe Mental Illness

    PubMed Central

    Teplin, Linda A.; McClelland, Gary M.; Abram, Karen M.; Weiner, Dana A.

    2006-01-01

    Context Since deinstitutionalization, most persons with severe mental illness (SMI) now live in the community, where they are at great risk for crime victimization. Objectives To determine the prevalence and incidence of crime victimization among persons with SMI by sex, race/ethnicity, and age, and to compare rates with general population data (the National Crime Victimization Survey), controlling for income and demographic differences between the samples. Design Epidemiologic study of persons in treatment. Independent master’s-level clinical research interviewers administered the National Crime Victimization Survey to randomly selected patients sampled from 16 randomly selected mental health agencies. Setting Sixteen agencies providing outpatient, day, and residential treatment to persons with SMI in Chicago, Ill. Participants Randomly selected, stratified sample of 936 patients aged 18 or older (483 men, 453 women) who were African American (n = 329), non-Hispanic white (n = 321), Hispanic (n = 270), or other race/ethnicity (n = 22). The comparison group comprised 32449 participants in the National Crime Victimization Survey. Main Outcome Measure National Crime Victimization Survey, developed by the Bureau of Justice Statistics. Results More than one quarter of persons with SMI had been victims of a violent crime in the past year, a rate more than 11 times higher than the general population rates even after controlling for demographic differences between the 2 samples (P<.001). The annual incidence of violent crime in the SMI sample (168.2 incidents per 1000 persons) is more than 4 times higher than the general population rates (39.9 incidents per 1000 persons) (P<.001). Depending on the type of violent crime (rape/sexual assault, robbery, assault, and their subcategories), prevalence was 6 to 23 times greater among persons with SMI than among the general population. Conclusions Crime victimization is a major public health problem among persons with SMI who are treated in the community. We recommend directions for future research, propose modifications in public policy, and suggest how the mental health system can respond to reduce victimization and its consequences. PMID:16061769

  6. Crime victimization in adults with severe mental illness: comparison with the National Crime Victimization Survey.

    PubMed

    Teplin, Linda A; McClelland, Gary M; Abram, Karen M; Weiner, Dana A

    2005-08-01

    Since deinstitutionalization, most persons with severe mental illness (SMI) now live in the community, where they are at great risk for crime victimization. To determine the prevalence and incidence of crime victimization among persons with SMI by sex, race/ethnicity, and age, and to compare rates with general population data (the National Crime Victimization Survey), controlling for income and demographic differences between the samples. Epidemiologic study of persons in treatment. Independent master's-level clinical research interviewers administered the National Crime Victimization Survey to randomly selected patients sampled from 16 randomly selected mental health agencies. Sixteen agencies providing outpatient, day, and residential treatment to persons with SMI in Chicago, Ill. Randomly selected, stratified sample of 936 patients aged 18 or older (483 men, 453 women) who were African American (n = 329), non-Hispanic white (n = 321), Hispanic (n = 270), or other race/ethnicity (n = 22). The comparison group comprised 32 449 participants in the National Crime Victimization Survey. National Crime Victimization Survey, developed by the Bureau of Justice Statistics. More than one quarter of persons with SMI had been victims of a violent crime in the past year, a rate more than 11 times higher than the general population rates even after controlling for demographic differences between the 2 samples (P<.001). The annual incidence of violent crime in the SMI sample (168.2 incidents per 1000 persons) is more than 4 times higher than the general population rates (39.9 incidents per 1000 persons) (P<.001). Depending on the type of violent crime (rape/sexual assault, robbery, assault, and their subcategories), prevalence was 6 to 23 times greater among persons with SMI than among the general population. Crime victimization is a major public health problem among persons with SMI who are treated in the community. We recommend directions for future research, propose modifications in public policy, and suggest how the mental health system can respond to reduce victimization and its consequences.

  7. Impaired health-related quality of life in Addison's disease--impact of replacement therapy, comorbidities and socio-economic factors.

    PubMed

    Kluger, Nicolas; Matikainen, Niina; Sintonen, Harri; Ranki, Annamari; Roine, Risto P; Schalin-Jäntti, Camilla

    2014-10-01

    Patients with Addison's disease (AD) on conventional replacement therapy have impaired health-related quality of life (HRQoL). It is possible that lower hydrocortisone (HC) doses recommended by current guidelines could restore HRQoL. We compared HRQoL in AD patients treated according to current HC recommendations to that of the age- and gender-standardized general population. We assessed HRQoL in a cross-sectional setting with the 15D instrument in a Finnish AD cohort (n = 107) and compared the results with those of a large sample of general population (n = 5671). We examined possible predictors of HRQoL in AD. Within the patient group, HRQoL was also assessed by SF-36. Mean HC dose was 22 mg/d, corresponding to 12 ± 4 mg/m2. HRQoL was impaired in AD compared with the general population (15D score; 0·853 vs 0·918, P < 0·001). Within single 15D dimensions, discomfort and symptoms, vitality and sexual activity were most affected. Stepwise regression analysis demonstrated that Patient's Association membership (P = 0·02), female gender (P < 0·01), presence of other autoimmune or inflammatory comorbidity (P < 0·02), lower education (P < 0·02) and longer disease duration (P < 0·05) independently predicted impaired HRQoL, whereas replacement regimens, autoimmune-related comorbidities, total number of comorbidities or level of healthcare follow-up did not. In AD, HRQoL was impaired also as assessed by SF-36. HRQoL is significantly impaired in AD compared with the general population despite use of recommended HC doses. Patient's Association membership was the most significant predictor of impaired HRQoL. This finding should be explored in more detail in the future. © 2014 John Wiley & Sons Ltd.

  8. Descriptive epidemiology of stigma against depression in a general population sample in Alberta.

    PubMed

    Cook, Trevor M; Wang, Jianli

    2010-04-19

    Mental health illnesses, such as depression, are responsible for a growing disease burden worldwide. Unfortunately, effective treatment is often impeded by stigmatizing attitudes of other individuals, which have been found to lead to a number of negative consequences including reduced help-seeking behavior and increased social distance. Despite the high prevalence of depression in Canada, little research has been conducted to examine stigma against depression in the Canadian general population. Such information is crucial to understanding the current state of stigmatizing attitudes in the Canadian communities, and framing future stigma reduction initiatives. The objectives of this study were to estimate the percentages of various stigmatizing attitudes toward depression in a general population sample and to compare the percentages by demographics and socioeconomic characteristics. We conducted a cross-sectional telephone survey in Alberta, Canada, between February and June 2006. Random digit dialing was used to recruit participants who were aged 18-74 years old (n = 3047). Participants were presented a case vignette describing a depressed individual, and responded to a 9-item Personal Stigma questionnaire. The percentages of stigmatizing attitudes were estimated and compared by demographic and socioeconomic variables. Among the participants, 45.9% endorsed that depressed individuals were unpredictable and 21.9% held the view that people with depression were dangerous. Significant differences in stigmatizing attitudes were found by gender, age, education, and immigration status. A greater proportion of men than women held stigmatizing views on each stigma item. No consistent trend emerged by age in stigma against depression. Participants with higher levels of education reported less stigmatizing attitudes than those with less education. Participants who were not born in Canada were more likely to hold stigmatizing attitudes than those who were born in Canada. In the general population, stigmatizing attitudes towards depression differ by demographic characteristics. Men, those with less education and immigrants should be the targets of stigma reduction campaigns.

  9. A prediction algorithm for first onset of major depression in the general population: development and validation.

    PubMed

    Wang, JianLi; Sareen, Jitender; Patten, Scott; Bolton, James; Schmitz, Norbert; Birney, Arden

    2014-05-01

    Prediction algorithms are useful for making clinical decisions and for population health planning. However, such prediction algorithms for first onset of major depression do not exist. The objective of this study was to develop and validate a prediction algorithm for first onset of major depression in the general population. Longitudinal study design with approximate 3-year follow-up. The study was based on data from a nationally representative sample of the US general population. A total of 28 059 individuals who participated in Waves 1 and 2 of the US National Epidemiologic Survey on Alcohol and Related Conditions and who had not had major depression at Wave 1 were included. The prediction algorithm was developed using logistic regression modelling in 21 813 participants from three census regions. The algorithm was validated in participants from the 4th census region (n=6246). Major depression occurred since Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-diagnostic and statistical manual for mental disorders IV. A prediction algorithm containing 17 unique risk factors was developed. The algorithm had good discriminative power (C statistics=0.7538, 95% CI 0.7378 to 0.7699) and excellent calibration (F-adjusted test=1.00, p=0.448) with the weighted data. In the validation sample, the algorithm had a C statistic of 0.7259 and excellent calibration (Hosmer-Lemeshow χ(2)=3.41, p=0.906). The developed prediction algorithm has good discrimination and calibration capacity. It can be used by clinicians, mental health policy-makers and service planners and the general public to predict future risk of having major depression. The application of the algorithm may lead to increased personalisation of treatment, better clinical decisions and more optimal mental health service planning.

  10. Migration in Deltas: An Integrated Analysis

    NASA Astrophysics Data System (ADS)

    Nicholls, Robert J.; Hutton, Craig W.; Lazar, Attila; Adger, W. Neil; Allan, Andrew; Arto, Inaki; Vincent, Katharine; Rahman, Munsur; Salehin, Mashfiqus; Sugata, Hazra; Ghosh, Tuhin; Codjoe, Sam; Appeaning-Addo, Kwasi

    2017-04-01

    Deltas and low-lying coastal regions have long been perceived as vulnerable to global sea-level rise, with the potential for mass displacement of exposed populations. The assumption of mass displacement of populations in deltas requires a comprehensive reassessment in the light of present and future migration in deltas, including the potential role of adaptation to influence these decisions. At present, deltas are subject to multiple drivers of environmental change and often have high population densities as they are accessible and productive ecosystems. Climate change, catchment management, subsidence and land cover change drive environmental change across all deltas. Populations in deltas are also highly mobile, with significant urbanization trends and the growth of large cities and mega-cities within or adjacent to deltas across Asia and Africa. Such migration is driven primarily by economic opportunity, yet environmental change in general, and climate change in particular, are likely to play an increasing direct and indirect role in future migration trends. The policy challenges centre on the role of migration within regional adaptation strategies to climate change; the protection of vulnerable populations; and the future of urban settlements within deltas. This paper reviews current knowledge on migration and adaptation to environmental change to discern specific issues pertinent to delta regions. It develops a new integrated methodology to assess present and future migration in deltas using the Volta delta in Ghana, Mahanadi delta in India and Ganges-Brahmaputra-Meghna delta across India and Bangladesh. The integrated method focuses on: biophysical changes and spatial distribution of vulnerability; demographic changes and migration decision-making using multiple methods and data; macro-economic trends and scenarios in the deltas; and the policies and governance structures that constrain and enable adaptation. The analysis is facilitated by a range of consistent scenarios from global to delta scales, developed in consultation with major stakeholders. Initial results suggest that migration decision-making strongly interacts with diverse measures for adaptation of land, water and agricultural management. A key normative challenge is to identify the parameters of successful migration and adaptation across delta regions, to inform policy analysis and formulation. Key words: Deltas, sea-level rise, migration and adaptation Acknowledgement: DECCMA (Deltas, Vulnerability & Climate Change: Migration & Adaptation) project is part of the Collaborative ADAPTATION Research Initiative in Africa and Asia (CARIAA), with financial support from the UK Government's Department for International Development (DFID) and the International Development Research Centre (IDRC), Canada.

  11. An overview of the prison population and the general health status of prisoners.

    PubMed

    Heidari, E; Dickinson, C; Dickson, C; Newton, T

    2014-07-11

    This article is the first in a series of four, which explore the oral and dental health of male prisoners in the United Kingdom. The series comprises: an overview of the general and oral health status of male prisoners, a discussion on how multi-disciplinary team working can be used to benefit the care of patients in prison environments and a description of the future planning of dental services for male prisoners. The oral health of prisoners is linked to their general health status, due in part to the presence of common risk factors such as smoking, drinking alcohol and in some cases use of recreational drugs, poor dietary and poor oral hygiene habits. Barriers to healthcare services can all have an effect on oral disease in this group. This paper highlights some of the common medical problems that oral healthcare providers face when treating prisoners in male UK prison establishments.

  12. Gender differences in health-related quality of life in patients undergoing coronary angiography.

    PubMed

    Gijsberts, Crystel M; Agostoni, Pierfrancesco; Hoefer, Imo E; Asselbergs, Folkert W; Pasterkamp, Gerard; Nathoe, Hendrik; Appelman, Yolande E; de Kleijn, Dominique P V; den Ruijter, Hester M

    2015-01-01

    Health-related quality of life (HRQOL) reflects the general well-being of individuals. In patients with coronary artery disease (CAD), HRQOL is compromised. Female patients with CAD have been reported to have lower HRQOL. In this study, we investigate gender differences in HRQOL and in associations of patient characteristics with HRQOL in patients with coronary angiography (CAG). We cross-sectionally analysed patients from the Utrecht Coronary Biobank undergoing CAG. All patients filled in an HRQOL questionnaire (RAND-36 and EuroQoL) on inclusion. RAND-36 and EuroQoL HRQOL measures were compared between the genders across indications for CAG, CAD severity and treatment of CAD. RAND-36 HRQOL measures were compared with the general Dutch population. Additionally, we assessed interactions of gender with patient characteristics in their association with HRQOL (EuroQoL). We included 1421 patients (1020 men and 401 women) with a mean age of 65 in our analysis. Women reported lower HRQOL measures than men (mean EuroQoL self-rated health grade 6.84±1.49 in men, 6.46±1.40 in women, p<0.001). The reduction in RAND-36 HRQOL as compared with the general Dutch population was larger in women than in men. From regression analysis, we found that diabetes, a history of cardiovascular disease and symptoms of shortness of breath determined HRQOL (EuroQoL) more strongly in men than in women. Women reported lower HRQOL than men throughout all indications for CAG and regardless of CAD severity or treatment. As compared with the general population, the reduction in HRQOL was more extreme in women than in men. Evident gender differences were found in determinants of HRQOL in patients undergoing CAG, which deserve attention in future research. NCT02304744 (clinicaltrials.gov).

  13. Commonality of Risk Factors for Mothers' Poor Oral Health and General Health: Baseline Analysis of a Population-Based Birth Cohort Study.

    PubMed

    Ha, Diep H; Spencer, A John; Thomson, W Murray; Scott, Jane A; Do, Loc G

    2018-04-01

    Objective The association between and commonality of risk factors for poor self-rated oral health (SROH) and general health (SRGH) among new mothers has not been reported. The purpose of this paper is to assess the commonality of risk factors for poor SROH and SRGH, and self-reported obesity and dental pain, among a population-based sample of new mothers in Australia. It also investigated health conditions affecting new mothers' general health. Methods Data collected at baseline of a population-based birth cohort was used. Mothers of newborns in Adelaide were approached to participate. Mothers completed a questionnaire collecting data on socioeconomic status (SES), health behaviours, dental pain, SROH, self-reported height and weight and SRGH. Analysis was conducted sequentially from bivariate to multivariable regression to estimate prevalence rate (PR) of reporting poor/fair SROH and SRGH. Results of the 1895 new mothers, some 21 and 6% rated their SROH and SRGH as poor/fair respectively. Dental pain was associated with low income and smoking status, while being obese was associated with low SES, low education and infrequent tooth brushing. SROH and SRGH was associated with low SES, smoking, and dental pain. SROH was also associated with SRGH [PR: 3.06 (2.42-3.88)]. Conclusion for practice There was a commonality of factors associated with self-rated oral health and general health. Strong associations between OH and GH were also observed. Given the importance of maternal health for future generations, there would be long-term societal benefit from addressing common risk factors for OH and GH in integrated programs.

  14. It Isn’t All Just Fun and Games: Collegiate Participation in Extracurricular Activities and Risk for Generalized and Sexual Harassment, Psychological Distress, and Alcohol Use

    PubMed Central

    McGinley, Meredith; Rospenda, Kathleen M.; Liu, Li; Richman, Judith A.

    2016-01-01

    Collegiate extracurricular activities, despite their benefits, may place students at an increased risk for experiencing harassment. This study utilizes multiple waves of data from an online longitudinal survey to examine how participation in college activities (intramural sports, fraternities/sororities, school clubs) relates to experiences of sexual and generalized harassment and outcomes (psychological distress, heavy alcohol use) among undergraduates (N = 1852, 58.6% female, 57.4% White) in the Midwestern United States. Activity participation was related to harassment, but the pattern depended on the activity, harassment type, and sex. Fraternity/sorority involvement was associated with generalized harassment, whereas school club involvement was linked to both generalized and sexual harassment. Female intramural athletes were at an increased risk to experience both harassment types. In addition to direct relations, activity participation was indirectly linked to future psychological distress (depression, anxiety) and heavy alcohol use via harassment. Implications for intervention with this college student population are discussed. PMID:27771523

  15. The importance of the different kinds of energy sources for energy future of Turkey

    NASA Astrophysics Data System (ADS)

    Kaplan, Yusuf Alper; Aladağ, Canan

    2016-11-01

    Nowadays, the need of energy has been increasing day by day with the population growth and the advancements of technology. In this study, the current state of nuclear, wind and solar energy on the worldwide has been generally investigated. The general assessments have been made based on Turkey's energy potential and the evaluation situation of this potential. The current political structures of countries are generally assessed and under this policy, the last situation and the latest implemented innovations are given. Turkey's energy demand is constantly increasing and Turkey is a country that needs to energy imports. This is a need for new energy sources to meet the growing need for energy. Nuclear, wind and solar energy are the new sources of energy to the fore in our country recently. In this study is given general information on the usage of energy sources of making and some deficiencies were been emphasized by political considerations in this regard.

  16. Concomitant use of the matrix strategy and the mand-model procedure in teaching graphic symbol combinations.

    PubMed

    Nigam, Ravi; Schlosser, Ralf W; Lloyd, Lyle L

    2006-09-01

    Matrix strategies employing parts of speech arranged in systematic language matrices and milieu language teaching strategies have been successfully used to teach word combining skills to children who have cognitive disabilities and some functional speech. The present study investigated the acquisition and generalized production of two-term semantic relationships in a new population using new types of symbols. Three children with cognitive disabilities and little or no functional speech were taught to combine graphic symbols. The matrix strategy and the mand-model procedure were used concomitantly as intervention procedures. A multiple probe design across sets of action-object combinations with generalization probes of untrained combinations was used to teach the production of graphic symbol combinations. Results indicated that two of the three children learned the early syntactic-semantic rule of combining action-object symbols and demonstrated generalization to untrained action-object combinations and generalization across trainers. The results and future directions for research are discussed.

  17. A Comparison of Cambodian-American Adolescent Substance Use Behavior to National and Local Norms

    PubMed Central

    Pedersen, Eric R.; Marshall, Grant N.; Schell, Terry L.; Wong, Eunice C.; Berthold, S. Megan; Hambarsoomian, Katrin

    2014-01-01

    This study was designed to compare rates of alcohol, marijuana, and cigarette use in Cambodian-American adolescents with norms from nationally- and regionally-representative peers. Substance use data from 439 10th grade Cambodian-American adolescents in Long Beach, California were compared to grade- and gender-matched nationally representative data from the Monitoring the Future study and data from the California Healthy Kids Survey of students within the same school district. Overall, the Cambodian-American youth were less likely than nationally- and regionally-representative youth to use alcohol, marijuana, and cigarettes. Specifically, relative to estimates obtained for the general population and students attending school in the same school district, Cambodian-American youth were significantly less likely to use alcohol and marijuana. Cambodian-American youth were also less likely than youth in the general population to smoke cigarettes, but did not differ statistically from youth within their same school district. As a group, Cambodian-American youth may not be at especially high risk for substance use. As is the case with virtually all populations, some individuals within the Cambodian-American group are likely to have more difficulty than others with substance use concerns. Thus, additional research is needed to identify factors that might help to identify high users with potential service needs. PMID:25128638

  18. NT-proBNP is superior to BNP for predicting first cardiovascular events in the general population: the Heinz Nixdorf Recall Study.

    PubMed

    Kara, Kaffer; Lehmann, Nils; Neumann, Till; Kälsch, Hagen; Möhlenkamp, Stefan; Dykun, Iryna; Broecker-Preuss, Martina; Pundt, Noreen; Moebus, Susanne; Jöckel, Karl-Heinz; Erbel, Raimund; Mahabadi, Amir A

    2015-03-15

    B-type natriuretic peptide (BNP) as well as N-terminal-proBNP (NT-proBNP) are associated with cardiac events in the general population. Yet, data from the general population comparing both peptides for their prognostic value is lacking. Participants from the population-based Heinz-Nixdorf-Recall-study without cardiovascular diseases were included. Associations of BNP and NT-proBNP with incident cardiovascular events (incident myocardial infarction, stroke, or cardiovascular death) were assessed using Cox regression; prognostic value was addressed using Harrell's c statistic. From overall 3589 subjects (mean age: 59.3 ± 7.7 yrs, 52.5% female), 235 subjects developed a cardiovascular event during 8.9 ± 2.2 yrs of follow-up. In regression analysis both natriuretic peptides were associated with incident cardiovascular events, independent of traditional risk factors (hazard ratio (HR) per unit increase on log-scale (95% CI): NT-proBNP: 1.60 (1.39; 1.84); BNP: 1.37 (1.19; 1.58), p<0.0001 respectively). Specifically looking at subjects <60 yrs only NT-proBNP, was linked with events (HR (95% CI): 1.59 (1.19; 2.13) for NT-proBNP, p=0.0019; HR: 1.25 (0.94; 1.65) for BNP, p=0.12, after adjustment for age and gender). Similar results were observed for females (HR (95% CI) 1.65 (1.28; 2.12), p=0.0001 for NT-proBNP, and 1.24 (0.96; 1.61), p=0.10 for BNP after adjustment for age). Adding NT-proBNP/BNP to traditional risk factors increased the prognostic value, with effects being stronger for NT-proBNP (Harrell's c, 0.724 to 0.741, p=0.034) as compared to BNP (0.724 to 0.732, p=0.20). Both, NT-proBNP and BNP are associated with future cardiovascular events in the general population. However, when both are available, NT-proBNP seems to be superior due to its higher prognostic value, especially in younger subjects and females. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Human semen quality in the new millennium: a prospective cross-sectional population-based study of 4867 men

    PubMed Central

    Joensen, Ulla Nordström; Jensen, Tina Kold; Jensen, Martin Blomberg; Almstrup, Kristian; Olesen, Inge Ahlmann; Juul, Anders; Andersson, Anna-Maria; Carlsen, Elisabeth; Petersen, Jørgen Holm; Toppari, Jorma; Skakkebæk, Niels E

    2012-01-01

    Objectives Considerable interest and controversy over a possible decline in semen quality during the 20th century raised concern that semen quality could have reached a critically low level where it might affect human reproduction. The authors therefore initiated a study to assess reproductive health in men from the general population and to monitor changes in semen quality over time. Design Cross-sectional study of men from the general Danish population. Inclusion criteria were place of residence in the Copenhagen area, and both the man and his mother being born and raised in Denmark. Men with severe or chronic diseases were not included. Setting Danish one-centre study. Participants 4867 men, median age 19 years, included from 1996 to 2010. Outcome measures Semen volume, sperm concentration, total sperm count, sperm motility and sperm morphology. Results Only 23% of participants had optimal sperm concentration and sperm morphology. Comparing with historic data of men attending a Copenhagen infertility clinic in the 1940s and men who recently became fathers, these two groups had significantly better semen quality than our study group from the general population. Over the 15 years, median sperm concentration increased from 43 to 48 million/ml (p=0.02) and total sperm count from 132 to 151 million (p=0.001). The median percentage of motile spermatozoa and abnormal spermatozoa were 68% and 93%, and did not change during the study period. Conclusions This large prospective study of semen quality among young men of the general population showed an increasing trend in sperm concentration and total sperm count. However, only one in four men had optimal semen quality. In addition, one in four will most likely face a prolonged waiting time to pregnancy if they in the future want to father a child and another 15% are at risk of the need of fertility treatment. Thus, reduced semen quality seems so frequent that it may impair the fertility rates and further increase the demand for assisted reproduction. PMID:22761286

  20. Systematic review of prognostic prediction models for acute kidney injury (AKI) in general hospital populations.

    PubMed

    Hodgson, Luke Eliot; Sarnowski, Alexander; Roderick, Paul J; Dimitrov, Borislav D; Venn, Richard M; Forni, Lui G

    2017-09-27

    Critically appraise prediction models for hospital-acquired acute kidney injury (HA-AKI) in general populations. Systematic review. Medline, Embase and Web of Science until November 2016. Studies describing development of a multivariable model for predicting HA-AKI in non-specialised adult hospital populations. Published guidance followed for data extraction reporting and appraisal. 14 046 references were screened. Of 53 HA-AKI prediction models, 11 met inclusion criteria (general medicine and/or surgery populations, 474 478 patient episodes) and five externally validated. The most common predictors were age (n=9 models), diabetes (5), admission serum creatinine (SCr) (5), chronic kidney disease (CKD) (4), drugs (diuretics (4) and/or ACE inhibitors/angiotensin-receptor blockers (3)), bicarbonate and heart failure (4 models each). Heterogeneity was identified for outcome definition. Deficiencies in reporting included handling of predictors, missing data and sample size. Admission SCr was frequently taken to represent baseline renal function. Most models were considered at high risk of bias. Area under the receiver operating characteristic curves to predict HA-AKI ranged 0.71-0.80 in derivation (reported in 8/11 studies), 0.66-0.80 for internal validation studies (n=7) and 0.65-0.71 in five external validations. For calibration, the Hosmer-Lemeshow test or a calibration plot was provided in 4/11 derivations, 3/11 internal and 3/5 external validations. A minority of the models allow easy bedside calculation and potential electronic automation. No impact analysis studies were found. AKI prediction models may help address shortcomings in risk assessment; however, in general hospital populations, few have external validation. Similar predictors reflect an elderly demographic with chronic comorbidities. Reporting deficiencies mirrors prediction research more broadly, with handling of SCr (baseline function and use as a predictor) a concern. Future research should focus on validation, exploration of electronic linkage and impact analysis. The latter could combine a prediction model with AKI alerting to address prevention and early recognition of evolving AKI. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Mortality Rates Among Substance Use Disorder Participants in Clinical Trials: Pooled Analysis of Twenty-Two Clinical Trials Within the National Drug Abuse Treatment Clinical Trials Network.

    PubMed

    Lindblad, Robert; Hu, Lian; Oden, Neal; Wakim, Paul; Rosa, Carmen; VanVeldhuisen, Paul

    2016-11-01

    Most substance use disorders (SUD) treatment clinical trials are too short and small to reliably estimate the incidence of rare events like death. The aim of this study is to estimate the overall mortality rates among a SUD treatment-seeking population by pooling participants from multiple clinical trials conducted through the National Institute on Drug Abuse (NIDA)-sponsored National Drug Abuse Treatment Clinical Trials Network (CTN). Drug and or alcohol users (N=9866) who sought treatment and participated in one of the twenty-two CTN trials. Data were collected through randomized clinical trials in national community treatment programs for SUD. Pooled analysis was performed to assess age- and gender-standardized mortality rate(s) (SM rate(s)), and mortality ratio(s) (SM ratio(s)) of CTN trial participants compared to the U.S. general population. The age- and gender-SM rate among CTN trials participants was 1403 (95% CI: 862-2074) per 100,000 person years (PY) compared to 542 (95% CI: 541-543) per 100,000 PY among the U.S. general population in 2005. By gender, age-adjusted SM ratio for female CTN trial participants was over five times (SM ratio=5.35, 95% CI: 3.31-8.19)), and for male CTN trial participants, it was over three times (SM ratio=3.39, 95% CI: 2.25-4.90) higher than their gender comparable peers in the U.S. general population. Age and gender-standardized mortality rates and ratios among NIDA CTN SUD treatment-seeking clinical trial participants are higher than the age and gender comparable U.S. general population. The overall mortality rates of CTN trial participants are similar to in-treatment mortality reported in large U.S. and non-U.S. cohorts of opioid users. Future analysis with additional CTN trial participants and risk times will improve the stability of estimates, especially within subgroups based on primary substance of abuse. These SUD mortality rates can be used to facilitate safety monitoring within SUD clinical trials. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Glycoconjugate Vaccines: The Regulatory Framework.

    PubMed

    Jones, Christopher

    2015-01-01

    Most vaccines, including the currently available glycoconjugate vaccines, are administered to healthy infants, to prevent future disease. The safety of a prospective vaccine is a key prerequisite for approval. Undesired side effects would not only have the potential to damage the individual infant but also lead to a loss of confidence in the respective vaccine-or vaccines in general-on a population level. Thus, regulatory requirements, particularly with regard to safety, are extremely rigorous. This chapter highlights regulatory aspects on carbohydrate-based vaccines with an emphasis on analytical approaches to ensure the consistent quality of successive manufacturing lots.

  3. Universal Preventive Interventions for Children in the Context of Disasters and Terrorism

    PubMed Central

    Pfefferbaum, Betty; Varma, Vandana; Nitiéma, Pascal; Newman, Elana

    2014-01-01

    Synopsis This review addresses universal disaster and terrorism services and preventive interventions delivered to children pre and post event. The paper describes the organization and structure of services used to meet the needs of children in the general population (practice applications), examines screening and intervention approaches (tools for practice), and suggests future directions for the field. A literature search identified 17 empirical studies which were analyzed to examine timing and setting of intervention delivery, providers, conditions addressed and outcomes, and intervention approaches and components. PMID:24656585

  4. Satellite broadcasting and communications in the Asia-Pacific region

    NASA Astrophysics Data System (ADS)

    Bonzon, S.

    1985-12-01

    Against the general context of worldwide developments in satellite communications and broadcasting, and the recent ORB'85 Conference, this paper assesses the future for satellite communication and broadcasting in the Asia-Pacific region. While most attention focusses on satellite developments for the industrialized world, the Asia-Pacific region is expected to play an increasingly significant role, and the needs of its population will be satisfied by development of satellite communications and broadcasting systems. Particular emphasis is placed in this paper on the broadcasting aspects, and their relationship to cultural and economic development.

  5. Scientific Literacy for the 21st Century (SL-21)

    NASA Technical Reports Server (NTRS)

    Brown, Robert W.

    1989-01-01

    A proposal called, 'Scientific Literacy for the 21st Century (SL-21)', has been introduced, suggesting ways in which NASA may work to increase scientific literacy in the U.S. The future need for an adequate supply of scientists and engineers for the space program is discussed. The principles of the SL-21 proposal are outlined. The program would emphasize education in the fields of space technologies and earth and planetary sciences. The educational elements of the proposal for teachers, students, universities, and the general adult population are described.

  6. Personalized Cancer Medicine: Molecular Diagnostics, Predictive biomarkers, and Drug Resistance

    PubMed Central

    Gonzalez de Castro, D; Clarke, P A; Al-Lazikani, B; Workman, P

    2013-01-01

    The progressive elucidation of the molecular pathogenesis of cancer has fueled the rational development of targeted drugs for patient populations stratified by genetic characteristics. Here we discuss general challenges relating to molecular diagnostics and describe predictive biomarkers for personalized cancer medicine. We also highlight resistance mechanisms for epidermal growth factor receptor (EGFR) kinase inhibitors in lung cancer. We envisage a future requiring the use of longitudinal genome sequencing and other omics technologies alongside combinatorial treatment to overcome cellular and molecular heterogeneity and prevent resistance caused by clonal evolution. PMID:23361103

  7. Accomplishments in 2007 in the treatment of advanced colorectal cancer.

    PubMed

    Goldberg, Richard M; Carrato, Alfredo

    2008-05-01

    Overview of the Disease IncidencePrognosis Prognostic or Predictive FactorsCurrent General Therapy Standards and Regional Variations STANDARDS IN THE US AND EUROPE: Combination Therapy Plus a Biologic FOCUS and CAIRO 1: Serial Single Agents vs. Combination TherapyStop-and-Go StrategyLimited Availability of Biologics in Some RegionsAccomplishments During the Year TherapyWhat Needs To Be Done Controversies and Disagreements BOND-2 and PACCE: Chemotherapy + Bevacizumab + Cetuximab or PanitumumabSpecial Populations (Elderly and Poor Performance Status)Future Directions Comments on ResearchObstacles to Progress.

  8. Accomplishments in 2007 in the Treatment of Advanced Colorectal Cancer

    PubMed Central

    Carrato, Alfredo

    2008-01-01

    Overview of the Disease IncidencePrognosis Prognostic or Predictive FactorsCurrent General Therapy Standards and Regional Variations Standards in the US and Europe: Combination Therapy Plus a Biologic FOCUS and CAIRO 1: Serial Single Agents vs. Combination TherapyStop-and-Go StrategyLimited Availability of Biologics in Some RegionsAccomplishments During the Year TherapyWhat Needs To Be Done Controversies and Disagreements BOND-2 and PACCE: Chemotherapy + Bevacizumab + Cetuximab or PanitumumabSpecial Populations (Elderly and Poor Performance Status)Future Directions Comments on ResearchObstacles to Progress PMID:19352463

  9. Dimensions of global population projections: what do we know about future population trends and structures?

    PubMed Central

    Lutz, Wolfgang; KC, Samir

    2010-01-01

    The total size of the world population is likely to increase from its current 7 billion to 8–10 billion by 2050. This uncertainty is because of unknown future fertility and mortality trends in different parts of the world. But the young age structure of the population and the fact that in much of Africa and Western Asia, fertility is still very high makes an increase by at least one more billion almost certain. Virtually, all the increase will happen in the developing world. For the second half of the century, population stabilization and the onset of a decline are likely. In addition to the future size of the population, its distribution by age, sex, level of educational attainment and place of residence are of specific importance for studying future food security. The paper provides a detailed discussion of different relevant dimensions in population projections and an evaluation of the methods and assumptions used in current global population projections and in particular those produced by the United Nations and by IIASA. PMID:20713384

  10. Depressive symptoms, depression proneness, and outcome expectancies for cigarette smoking.

    PubMed

    Friedman-Wheeler, Dara G; Ahrens, Anthony H; Haaga, David A F; McIntosh, Elizabeth; Thorndike, Frances P

    2007-08-01

    The high rates of cigarette smoking among depressed persons may be partially explained by increased positive expectancies for cigarette smoking among this population. In view of theoretical and empirical work on depressed people's negative views of the future, though, it would be expected that depressed smokers would hold particularly negative expectancies about the effects of cigarette smoking. The two current studies examined the relations between depression and smoking outcome expectancies in (a) a general population of adult regular smokers and (b) adult smokers seeking to quit smoking. Depressive symptoms and depression proneness both showed significant positive correlations with positive expectancies for cigarette smoking. Several positive correlations with negative expectancies also emerged. Thus, experiencing depressive symptoms may serve to amplify both favorable and unfavorable expectancies about the effects of smoking.

  11. On the Economics of Space Colonisation

    NASA Astrophysics Data System (ADS)

    King, D. J.

    An economic model of the future colonisation of Mars is developed, which, for simplicity, is assumed to be a one-off transplantation of capital and population to Mars. The model demonstrates that compound growth of output and population, and diminishing natural resources on Earth eventually create sufficiently intense economic pressures that the colonisation of Mars (and by implication of space generally) confers a net economic benefit on humanity. The model illustrates that the colonisation of space is likely to occur because economic forces will ultimately compel it to occur. The model is highly counter-intuitive because it has traditionally been believed by many that the colonisation of space could only be done at a net economic cost to humanity and would not result in a net economic benefit to mankind.

  12. Recent considerations in the use of recombinant interferon gamma for biological therapy of atopic dermatitis.

    PubMed

    Brar, Kanwaljit; Leung, Donald Y M

    2016-01-01

    Atopic dermatitis (AD) is the most common inflammatory skin disease in the general population. There are different endophenotypes of AD that likely have a unique immune and molecular basis, such as those who are predisposed to eczema herpeticum, or Staphylococcus aureus infections. In this review, we highlight the endophenotypes of AD where reduced interferon gamma expression may be playing a role. Additionally, we review the potential role of recombinant interferon gamma therapy in the treatment of atopic dermatitis and the particular phenotypes that may benefit from this treatment. Recombinant interferon gamma treatment will likely benefit the pediatric population with AD, as well as those with susceptibilities for skin infections. Future studies are needed to elucidate whether IFN-γ may reduce the prevalence of skin infection in AD.

  13. [Opinions, perceptions and description of cannabis amongst future health educators in training in France].

    PubMed

    Berger, Dominique; Courty, Pascal

    2007-01-01

    In France, the number of cannabis users has doubled over the last ten years. The groups most affected are 18-25 year old adults in higher education. This study involved 300 persons currently undergoing core health education training (79 teachers, 135 nurses and 86 social workers). As health educators in training, they were subject to the completion of an adapted version of the EROPP survey (Exploring the Representations, Opinions and Perceptions of Psychotropic Drugs). Results were compared with those of a French survey of the general population undertaken in 2002. Differences between the study and the control groups, and between the different types of students, were analysed using the Chi-square test. Cannabis users were also compared with non-users. The results show an over-consumption of cannabis in the study group compared to the general population, especially in men, both in terms of experimentation and current use. The specificities of each group are analysed and the results discussed in light of the study group's potential role in health education.

  14. Auditory Verbal Hallucinations in Persons With and Without a Need for Care

    PubMed Central

    Johns, Louise C.; Kompus, Kristiina; Connell, Melissa; Humpston, Clara; Lincoln, Tania M.; Longden, Eleanor; Preti, Antonio; Alderson-Day, Ben; Badcock, Johanna C.; Cella, Matteo; Fernyhough, Charles; McCarthy-Jones, Simon; Peters, Emmanuelle; Raballo, Andrea; Scott, James; Siddi, Sara; Sommer, Iris E.; Larøi, Frank

    2014-01-01

    Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various clinical disorders. AVH also occur in individuals from the general population who have no identifiable psychiatric or neurological diagnoses. This article reviews research on AVH in nonclinical individuals and provides a cross-disciplinary view of the clinical relevance of these experiences in defining the risk of mental illness and need for care. Prevalence rates of AVH vary according to measurement tool and indicate a continuum of experience in the general population. Cross-sectional comparisons of individuals with AVH with and without need for care reveal similarities in phenomenology and some underlying mechanisms but also highlight key differences in emotional valence of AVH, appraisals, and behavioral response. Longitudinal studies suggest that AVH are an antecedent of clinical disorders when combined with negative emotional states, specific cognitive difficulties and poor coping, plus family history of psychosis, and environmental exposures such as childhood adversity. However, their predictive value for specific psychiatric disorders is not entirely clear. The theoretical and clinical implications of the reviewed findings are discussed, together with directions for future research. PMID:24936085

  15. Our "increasingly mobile society"? The curious persistence of a false belief.

    PubMed

    Wolf, Douglas A; Longino, Charles F

    2005-02-01

    We call attention to the widespread belief that the United States is an "increasingly mobile society," despite the fact that overall mobility has generally declined since about 1950, and interstate mobility has generally not increased during the same period. We review and extend past research documenting these mobility trends. We describe population-level mobility for people of all ages as well as for several adult age groups, using published data from the U.S. Current Population Survey. We use simple regression methods to estimate the size and significance of mobility trends. Overall mobility rates have declined for individuals of all ages and among all age groups. The largest average annual declines occur for 20- to 29-year-olds, although the rate of decline for those aged 65 and older is also large. Interstate mobility has declined slightly or remained constant, except among adults between 45 and 64 years old. Although there may be good reasons to worry about the future of family care provided to elderly individuals, increased geographic mobility does not appear to be one of them. We speculate on reasons why the false belief persists.

  16. Health and morbidity survey, Seychelles, 1956-57

    PubMed Central

    Spitz, A. J. W.

    1960-01-01

    Adequate knowledge of existing health and morbidity conditions is the basis for all planning of future health services. For this reason, a health and morbidity survey of the population of the Seychelles was carried out in 1956-57 under the joint auspices of the Seychelles Government and the World Health Organization. Statistical sampling methods were used and the information was obtained by the household interview method. Health, morbidity and relevant demographic data were thus disclosed for the first time for Seychelles. Basic information was obtained on: general morbidity of the population, including dental and nutritional status, malnutrition, incidence of intestinal diseases and other easily diagnosable conditions; growth and weight curves of children up to the age of 16; haemoglobin levels; erythrocyte sedimentation rates; general living conditions such as housing and overcrowding, social status and latrine arrangements; the connexion of soil pollution with the incidence of amoebiasis and helminthiasis; and lastly, the incidence of the sickle cell trait, eosinophilia and positive serological reactions to the Chediak test (for manifest or latent syphilis). The findings are presented with a minimum of remarks and interpretation. PMID:13833401

  17. Overview of Emerging Contaminants and Associated Human Health Effects

    PubMed Central

    Lei, Meng; Zhang, Lun; Lei, Jianjun; Zong, Liang; Li, Jiahui; Wu, Zheng; Wang, Zheng

    2015-01-01

    In recent decades, because of significant progress in the analysis and detection of trace pollutants, emerging contaminants have been discovered and quantified in living beings and diverse environmental substances; however, the adverse effects of environmental exposure on the general population are largely unknown. This review summarizes the conclusions of the comprehensive epidemic literature and representative case reports relevant to emerging contaminants and the human body to address concerns about potential harmful health effects in the general population. The most prevalent emerging contaminants include perfluorinated compounds, water disinfection byproducts, gasoline additives, manufactured nanomaterials, human and veterinary pharmaceuticals, and UV-filters. Rare but statistically meaningful connections have been reported for a number of contaminants and cancer and reproductive risks. Because of contradictions in the outcomes of some investigations and the limited number of articles, no significant conclusions regarding the relationship between adverse effects on humans and extents of exposure can be drawn at this time. Here, we report that the current evidence is not conclusive and comprehensive and suggest prospective cohort studies in the future to evaluate the associations between human health outcomes and emerging environmental contaminants. PMID:26713315

  18. Disproportionate Minority Contact.

    PubMed

    Fix, Rebecca L; Cyperski, Melissa A; Burkhart, Barry R

    2017-04-01

    The overrepresentation of racial/ethnic minorities within the criminal justice system relative to their population percentage, a phenomenon termed disproportionate minority contact, has been examined within general adult and adolescent offender populations; yet few studies have tested whether this phenomenon extends to juvenile sexual offenders (JSOs). In addition, few studies have examined whether offender race/ethnicity influences registration and notification requirements, which JSOs are subject to in some U.S. states. The present study assessed for disproportionate minority contact among general delinquent offenders and JSOs, meaning it aimed to test whether the criminal justice system treats those accused of sexual and non-sexual offenses differently by racial/ethnic group. Furthermore, racial/ethnic group differences in risk, legal classification, and sexual offending were examined for JSOs. Results indicated disproportionate minority contact was present among juveniles with non-sexual offenses and JSOs in Alabama. In addition, offense category and risk scores differed between African American and European American JSOs. Finally, registration classifications were predicted by offending characteristics, but not race/ethnicity. Implications and future directions regarding disproportionate minority contact among JSOs and social and legal policy affecting JSOs are discussed.

  19. The use of climate information to estimate future mortality from high ambient temperature: A systematic literature review.

    PubMed

    Sanderson, Michael; Arbuthnott, Katherine; Kovats, Sari; Hajat, Shakoor; Falloon, Pete

    2017-01-01

    Heat related mortality is of great concern for public health, and estimates of future mortality under a warming climate are important for planning of resources and possible adaptation measures. Papers providing projections of future heat-related mortality were critically reviewed with a focus on the use of climate model data. Some best practice guidelines are proposed for future research. The electronic databases Web of Science and PubMed/Medline were searched for papers containing a quantitative estimate of future heat-related mortality. The search was limited to papers published in English in peer-reviewed journals up to the end of March 2017. Reference lists of relevant papers and the citing literature were also examined. The wide range of locations studied and climate data used prevented a meta-analysis. A total of 608 articles were identified after removal of duplicate entries, of which 63 were found to contain a quantitative estimate of future mortality from hot days or heat waves. A wide range of mortality models and climate model data have been used to estimate future mortality. Temperatures in the climate simulations used in these studies were projected to increase. Consequently, all the papers indicated that mortality from high temperatures would increase under a warming climate. The spread in projections of future climate by models adds substantial uncertainty to estimates of future heat-related mortality. However, many studies either did not consider this source of uncertainty, or only used results from a small number of climate models. Other studies showed that uncertainty from changes in populations and demographics, and the methods for adaptation to warmer temperatures were at least as important as climate model uncertainty. Some inconsistencies in the use of climate data (for example, using global mean temperature changes instead of changes for specific locations) and interpretation of the effects on mortality were apparent. Some factors which have not been considered when estimating future mortality are summarised. Most studies have used climate data generated using scenarios with medium and high emissions of greenhouse gases. More estimates of future mortality using climate information from the mitigation scenario RCP2.6 are needed, as this scenario is the only one under which the Paris Agreement to limit global warming to 2°C or less could be realised. Many of the methods used to combine modelled data with local climate observations are simplistic. Quantile-based methods might offer an improved approach, especially for temperatures at the ends of the distributions. The modelling of adaptation to warmer temperatures in mortality models is generally arbitrary and simplistic, and more research is needed to better quantify adaptation. Only a small number of studies included possible changes in population and demographics in their estimates of future mortality, meaning many estimates of mortality could be biased low. Uncertainty originating from establishing a mortality baseline, climate projections, adaptation and population changes is important and should be considered when estimating future mortality.

  20. Rebuttal of "Polar bear population forecasts: a public-policy forecasting audit"

    USGS Publications Warehouse

    Amstrup, Steven C.; Caswell, Hal; DeWeaver, Eric; Stirling, Ian; Douglas, David C.; Marcot, Bruce G.; Hunter, Christine M.

    2009-01-01

    Observed declines in the Arctic sea ice have resulted in a variety of negative effects on polar bears (Ursus maritimus). Projections for additional future declines in sea ice resulted in a proposal to list polar bears as a threatened species under the United States Endangered Species Act. To provide information for the Department of the Interior's listing-decision process, the US Geological Survey (USGS) produced a series of nine research reports evaluating the present and future status of polar bears throughout their range. In response, Armstrong et al. [Armstrong, J. S., K. C. Green, W. Soon. 2008. Polar bear population forecasts: A public-policy forecasting audit. Interfaces 38(5) 382–405], which we will refer to as AGS, performed an audit of two of these nine reports. AGS claimed that the general circulation models upon which the USGS reports relied were not valid forecasting tools, that USGS researchers were not objective or lacked independence from policy decisions, that they did not utilize all available information in constructing their forecasts, and that they violated numerous principles of forecasting espoused by AGS. AGS (p. 382) concluded that the two USGS reports were "unscientific and inconsequential to decision makers." We evaluate the AGS audit and show how AGS are mistaken or misleading on every claim. We provide evidence that general circulation models are useful in forecasting future climate conditions and that corporate and government leaders are relying on these models to do so. We clarify the strict independence of the USGS from the listing decision. We show that the allegations of failure to follow the principles of forecasting espoused by AGS are either incorrect or are based on misconceptions about the Arctic environment, polar bear biology, or statistical and mathematical methods. We conclude by showing that the AGS principles of forecasting are too ambiguous and subjective to be used as a reliable basis for auditing scientific investigations. In summary, we show that the AGS audit offers no valid criticism of the USGS conclusion that global warming poses a serious threat to the future welfare of polar bears and that it only serves to distract from reasoned public-policy debate.

  1. Inferring population-level contact heterogeneity from common epidemic data

    PubMed Central

    Stack, J. Conrad; Bansal, Shweta; Kumar, V. S. Anil; Grenfell, Bryan

    2013-01-01

    Models of infectious disease spread that incorporate contact heterogeneity through contact networks are an important tool for epidemiologists studying disease dynamics and assessing intervention strategies. One of the challenges of contact network epidemiology has been the difficulty of collecting individual and population-level data needed to develop an accurate representation of the underlying host population's contact structure. In this study, we evaluate the utility of common epidemiological measures (R0, epidemic peak size, duration and final size) for inferring the degree of heterogeneity in a population's unobserved contact structure through a Bayesian approach. We test the method using ground truth data and find that some of these epidemiological metrics are effective at classifying contact heterogeneity. The classification is also consistent across pathogen transmission probabilities, and so can be applied even when this characteristic is unknown. In particular, the reproductive number, R0, turns out to be a poor classifier of the degree heterogeneity, while, unexpectedly, final epidemic size is a powerful predictor of network structure across the range of heterogeneity. We also evaluate our framework on empirical epidemiological data from past and recent outbreaks to demonstrate its application in practice and to gather insights about the relevance of particular contact structures for both specific systems and general classes of infectious disease. We thus introduce a simple approach that can shed light on the unobserved connectivity of a host population given epidemic data. Our study has the potential to inform future data-collection efforts and study design by driving our understanding of germane epidemic measures, and highlights a general inferential approach to learning about host contact structure in contemporary or historic populations of humans and animals. PMID:23034353

  2. The importance of within-year repeated counts and the influence of scale on long-term monitoring of sage-grouse

    USGS Publications Warehouse

    Fedy, B.C.; Aldridge, Cameron L.

    2011-01-01

    Long-term population monitoring is the cornerstone of animal conservation and management. The accuracy and precision of models developed using monitoring data can be influenced by the protocols guiding data collection. The greater sage-grouse (Centrocercus urophasianus) is a species of concern that has been monitored over decades, primarily, by counting the number of males that attend lek (breeding) sites. These lek count data have been used to assess long-term population trends and for multiple mechanistic studies. However, some studies have questioned the efficacy of lek counts to accurately identify population trends. In response, monitoring protocols were changed to have a goal of counting lek sites multiple times within a season. We assessed the influence of this change in monitoring protocols on model accuracy and precision applying generalized additive models to describe trends over time. We found that at large spatial scales including >50 leks, the absence of repeated counts within a year did not significantly alter population trend estimates or interpretation. Increasing sample size decreased the model confidence intervals. We developed a population trend model for Wyoming greater sage-grouse from 1965 to 2008, identifying significant changes in the population indices and capturing the cyclic nature of this species. Most sage-grouse declines in Wyoming occurred between 1965 and the 1990s and lek count numbers generally increased from the mid-1990s to 2008. Our results validate the combination of monitoring data collected under different protocols in past and future studies-provided those studies are addressing large-scale questions. We suggest that a larger sample of individual leks is preferable to multiple counts of a smaller sample of leks. ?? 2011 The Wildlife Society.

  3. Organochlorine pesticides and polychlorinated biphenyls in fin whales (Balaenoptera physalus) from the Gulf of California.

    PubMed

    Niño-Torres, Carlos Alberto; Zenteno-Savín, Tania; Gardner, Susan C; Urbán R, Jorge

    2010-08-01

    The present study reports unique data on concentrations of several classes of organochlorine pesticides and polychlorinated biphenyls in blubber biopsies from healthy living fin whales (Balaenoptera physalus) from the Gulf of California, Mexico, one of the most isolated and unstudied population in the world. OC levels in this population were generally lower than levels reported in fin whales from other regions. The rank order of OCs were SigmaDDTs (range from 300 to 2400 ng g(-1) lw) > SigmaPCBs (range from 40 to 290 ng g(-1) lw) > SigmaHCHs (range from or = SigmaCHLORs (from < LOQ to 100 ng g(-1) lw). The most abundant OC pesticide measured was the DDT metabolite, p,p'-DDE. The PCBs 138, 153, and 180 were the most abundant PCBs congeners found in the fin whales samples. Males had significant higher concentrations of SigmaOC, SigmaDDTs and SigmaPCBs than females (P < 0.05), although the p,p'-DDE/SigmaDDTs ratios were similar between the sexes. Although the OC concentrations found in this population were generally below the levels that would be expected to cause deleterious health effects, the maximum values observed (2700 ng g(-1) lw) in some animals were higher than those associated with reproductive effects in whales. Given the small population size and highly isolated characteristics of Gulf of California fin whales, health effects in individuals could readily translate into population-level effects. Future research on this topic will be necessary to better understand the role that these compounds may have on the health of this population.

  4. [United Nations world population prize to Dr. Halfdan Mahler. Acceptance speech].

    PubMed

    Mahler, H

    1995-06-01

    The professional achievements of Halfdan Mahler, for which he was awarded the 1995 UN World Population Prize, are summarized, and Dr. Mahler's acceptance speech is presented. Dr. Mahler worked for reproductive health and sustainable development during his six years as secretary general of the IPPF. Under his leadership, the IPPF established world standards for family planning and reproductive health. Dr. Mahler also guided creation and implementation of the long-term IPPF strategic plan, Vision 2000. During his tenure as director general of the World Health Organization from 1973 to 1988, he established the special program of education, development, and training for research in human reproduction. Dr. Mahler's acceptance speech sketched a world of the future in which women control their reproductive lives and enjoy equality with men in work and at home, where adolescents understand and control their sexuality, where all children are desired and cared for, and where hard work brings success even in the poorest population sectors. The challenges of achieving this vision are enormous. The world's population will have doubled to 10 billion, and tensions and inequities will persist. But if the vision is not fulfilled, the present population will triple to 15 billion and competition for every kind of resource will be intolerable. In order to succeed, the rights to free and informed reproductive decision making must be guaranteed for every couple. Harmful practices that violate the right to autonomous reproductive decision making, such as early marriage or female genital mutilation, must be eliminated. Governments must commit themselves to educating and providing resources to women so that they can exercise their rights. Family planning services must be extended to the poor and marginal population sectors that still are denied access, and to adolescents who are at risk of unwanted pregnancy and disease.

  5. Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study.

    PubMed

    Nair, Uma S; Jordan, Jeremy S; Funk, Daniel; Gavin, Kristin; Tibbetts, Erica; Collins, Bradley N

    2016-05-01

    Female inmate populations in the United States tend to be overweight, physically inactive, experience high stress, and have a history of nicotine and other drug dependence. Thus, they bear an elevated risk of cardiovascular (CV) disease than the general population. However, few evidence-based health interventions exist for this population. This study will test proof of concept, feasibility, and potential efficacy of a multiple health behavior change intervention that integrates CV-health promotion education delivered during a physical activity (PA) program (indoor cycling) tailored to this population. This study uses a quasi-experimental 2-group design with two measurement time-points: baseline and 8-week end of treatment. N=120 incarcerated women (18-59years of age) who are medically cleared for participation in PA will be enrolled. Indoor cycling instructors will be trained to deliver five health education topics over an 8-week period during twice-weekly cycling classes. Topics match the American Heart Association recommendations for CV health: (a) nutrition, (b) PA promotion, (c) weight management, (d) stress management, and (e) smoking cessation and relapse prevention. Modes of intervention include instructor advice, written materials and audio/video clips reviewed during class. CV-related and mental health measures will be assessed at both time-points. Results will guide a full scale efficacy study. Future research in this area has potential to impact the health of female inmates, a high-risk population. Moreover, this multiple health behavior change intervention model represents a community approach to health promotion that could generalize to other underserved populations who may benefit most from similar intervention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Using simulation to improve wildlife surveys: Wintering mallards in Mississippi, USA

    USGS Publications Warehouse

    Pearse, A.T.; Reinecke, K.J.; Dinsmore, S.J.; Kaminski, R.M.

    2009-01-01

    Wildlife conservation plans generally require reliable data about population abundance and density. Aerial surveys often can provide these data; however, associated costs necessitate designing and conducting surveys efficiently. We developed methods to simulate population distributions of mallards (Anas platyrhynchos) wintering in western Mississippi, USA, by combining bird observations from three previous strip-transect surveys and habitat data from three sets of satellite images representing conditions when surveys were conducted. For each simulated population distribution, we compared 12 primary survey designs and two secondary design options by using coefficients of variation (CV) of population indices as the primary criterion for assessing survey performance. In all, 3 of the 12 primary designs provided the best precision (CV???11.7%) and performed equally well (WR08082E1d.gif diff???0.6%). Features of the designs that provided the largest gains in precision were optimal allocation of sample effort among strata and configuring the study area into five rather than four strata, to more precisely estimate mallard indices in areas of consistently high density. Of the two secondary design options, we found including a second observer to double the size of strip transects increased precision or decreased costs, whereas ratio estimation using auxiliary habitat data from satellite images did not increase precision appreciably. We recommend future surveys of mallard populations in our study area use the strata we developed, optimally allocate samples among strata, employ PPS or EPS sampling, and include two observers when qualified staff are available. More generally, the methods we developed to simulate population distributions from prior survey data provide a cost-effective method to assess performance of alternative wildlife surveys critical to informing management decisions, and could be extended to account for effects of detectability on estimates of true abundance. ?? 2009 CSIRO.

  7. Competitive regulation of plant allometry and a generalized model for the plant self-thinning process.

    PubMed

    Wang, Gang; Yuan, Jianli; Wang, Xizhi; Xiao, Sa; Huang, Wenbing

    2004-11-01

    Taking into account the individual growth form (allometry) in a plant population and the effects of intraspecific competition on allometry under the population self-thinning condition, and adopting Ogawa's allometric equation 1/y = 1/axb + 1/c as the expression of complex allometry, the generalized model describing the change mode of r (the self-thinning exponential in the self-thinning equation, log M = K + log N, where M is mean plant mass, K is constant, and N is population density) was constructed. Meanwhile, with reference to the changing process of population density to survival curve type B, the exponential, r, was calculated using the software MATHEMATICA 4.0. The results of the numerical simulation show that (1) the value of the self-thinning exponential, r, is mainly determined by allometric parameters; it is most sensitive to change of b of the three allometric parameters, and a and c take second place; (2) the exponential, r, changes continuously from about -3 to the asymptote -1; the slope of -3/2 is a transient value in the population self-thinning process; (3) it is not a 'law' that the slope of the self-thinning trajectory equals or approaches -3/2, and the long-running dispute in ecological research over whether or not the exponential, r, equals -3/2 is meaningless. So future studies on the plant self-thinning process should focus on investigating how plant neighbor competition affects the phenotypic plasticity of plant individuals, what the relationship between the allometry mode and the self-thinning trajectory of plant population is and, in the light of evolution, how plants have adapted to competition pressure by plastic individual growth.

  8. The Climate-Population Nexus in the East African Horn: Emerging Degradation Trends in Rangeland and Pastoral Livelihood Zones

    NASA Astrophysics Data System (ADS)

    Pricope, N. G.; Husak, G. J.; Funk, C. C.; Lopez-Carr, D.

    2014-12-01

    Increasing climate variability and extreme weather conditions along with declining trends in both rainfall and temperature represent major risk factors affecting agricultural production and food security in many regions of the world. We identify regions where significant rainfall decrease from 1979-2011 over the entire continent of Africa couples with significant human population density increase. The rangelands of Ethiopia, Kenya, and Somalia in the East African Horn remain one of the world's most food insecure regions, yet have significantly increasing human populations predominantly dependent on pastoralist and agro-pastoralist livelihoods. Vegetation in this region is characterized by a variable mosaic of land covers, generally dominated by grasslands necessary for agro-pastoralism, interspersed by woody vegetation. Recent assessments indicate that widespread degradation is occurring, adversely impacting fragile ecosystems and human livelihoods. Using two underutilized MODIS products, we observe significant changes in vegetation patterns and productivity over the last decade all across the East African Horn. We observe significant vegetation browning trends in areas experiencing drying precipitation trends in addition to increasing population pressures. We also found that the drying precipitation trends only partially statistically explain the vegetation browning trends, further indicating that other factors such as population pressures and land use changes are responsible for the observed declining vegetation health. Furthermore, we show that the general vegetation browning trends persist even during years with normal rainfall conditions such as 2012, indicating potential long-term degradation of rangelands on which approximately 10 million people depend. These findings have serious implications for current and future regional food security monitoring and forecasting as well as for mitigation and adaptation strategies in a region where population is expected to continue increasing against a backdrop of drying climate trends.

  9. Out-of-pocket costs for cancer survivors between 5 and 10 years from diagnosis: an Italian population-based study.

    PubMed

    Baili, Paolo; Di Salvo, Francesca; de Lorenzo, Francesco; Maietta, Francesco; Pinto, Carmine; Rizzotto, Vera; Vicentini, Massimo; Rossi, Paolo Giorgi; Tumino, Rosario; Rollo, Patrizia Concetta; Tagliabue, Giovanna; Contiero, Paolo; Candela, Pina; Scuderi, Tiziana; Iannelli, Elisabetta; Cascinu, Stefano; Aurora, Fulvio; Agresti, Roberto; Turco, Alberto; Sant, Milena; Meneghini, Elisabetta; Micheli, Andrea

    2016-05-01

    To illustrate the out-of-pocket (OOP) costs incurred by a population-based group of patients from 5 to 10 years since their cancer diagnosis in a country with a nationwide public health system. Interviews on OOP costs to a sample of 5-10 year prevalent cases randomly extracted from four population-based cancer registries (CRs), two in the north and two in the south of Italy. The patients' general practitioners (GPs) gave assurance about the patient's physical and psychological condition for the interview. A zero-inflated negative binomial model was used to analyze OOP cost determinants. Two hundred six cancer patients were interviewed (48 % of the original sample). On average, a patient in the north spent €69 monthly, against €244 in the south. The main differences are for transport, room, and board (TRB) to reach the hospital and/or the cancer specialist (north €0; south €119). Everywhere, OOP costs without TRB costs were higher for patients with a low quality of life. Despite the limited participation, our study sample's characteristics are similar to those of the Italian cancer prevalence population, allowing us to generalize the results. The higher OOP costs in the south may be due to the scarcity of oncologic structures, obliging patients to seek assistance far from their residence. Implications for cancer survivors Cancer survivors need descriptive studies to show realistic data about their status. Future Italian and European descriptive studies on cancer survivorship should be based on population CRs and involve GPs in order to approach the patient at best.

  10. The composition of human cortical allograft bone derived from FDA/AATB-screened donors.

    PubMed

    Pietrzak, William S; Woodell-May, Jennifer

    2005-07-01

    Allograft human bone is an integral part of the surgeons' armamentarium and will continue to be for the near future. The intraoperative handling and/or mechanical properties are critical to its function. These properties are significantly influenced by the composition and the structure of the bone, which varies from donor to donor. Published studies of human bone composition use bone derived from a population that may differ from the population of qualified donors from which allograft bone is derived and may not well represent the pool of clinical allograft bone. This study investigated the cortical bone composition from 20 donors (males and females, 17 to 65 years of age) that had passed the US Food and Drug Administration and American Association of Tissue Banks screening procedures for donor qualification. As such, this represents a subset of the general population. The analysis yielded the following composition: mineral (ash) = 67.0% +/- 1.3% (w/w); matrix (predominantly type I collagen and other proteins) = 31.9% +/- 1.1% (w/w); and lipid (hexane extractables) = 1.1% +/- 1.5% (w/w). In general, these results were well within the ranges specified in the literature, with the significance being the demonstration of low variability within the study population. No age or gender compositional dependency was evident in this series, possibly as a result of the relatively homogenous population, which may have limited the ability to observe trends. Visually, the bone powders ranged from nearly white to red-brown. The more intense colors appeared to be associated with greater lipid content, perhaps indicating the presence of residual oxidized lipids.

  11. Egg donation, surrogate mothering, and cloning: attitudes of men and women in Germany based on a representative survey.

    PubMed

    Stöbel-Richter, Yve; Goldschmidt, Susanne; Brähler, Elmar; Weidner, Kerstin; Beutel, Manfred

    2009-07-01

    To determine opinions and attitudes of the German general population toward the treatment methods of reproductive medicine: egg donation, surrogate mothering, and reproductive cloning. Representative survey. German general population: face-to-face interviews at home with 2,110 persons, aged 18-50 years. Patients were not included. No interventions took place. Approval and disapproval of treatment methods of reproductive medicine and preimplantation genetic diagnosis were assessed by questionnaires regarding medical, age, reasons, or general. Overall, the diverse treatment methods of reproductive medicine found comparable rates of approval and disapproval. Legalization of egg donation was approved by a slight majority (50.8%), particularly for medical reasons (35.9%). Surrogate mothering found lower overall rates of approval (43.7%), 28.5% supported an admission for medical reasons. Reproductive cloning was rejected by the vast majority (82.9%). Attitudes to reproductive medicine were affected by age and the individual reproductive experiences. New techniques in reproductive medicine and their development provide hope and health promises for affected couples but also entail long-term risks and ethical issues. Balancing the individual's right to a reproductive autonomy and choice and ethical standards will constitute a future challenge for society. Results demonstrate considerable uncertainty and information deficits in the community.

  12. Estimating the impact of reducing violence against female sex workers on HIV epidemics in Kenya and Ukraine: a policy modeling exercise.

    PubMed

    Decker, Michele R; Wirtz, Andrea L; Pretorius, Carel; Sherman, Susan G; Sweat, Michael D; Baral, Stefan D; Beyrer, Chris; Kerrigan, Deanna L

    2013-02-01

    Female sex workers (FSWs) worldwide suffer disproportionate burdens of HIV and gender-based violence. Despite evidence linking these threats, little is known about the potential HIV epidemic impact of reducing abuse. The Goals model approximated the impact of reducing violence against FSWs on HIV epidemics in Ukraine and Kenya, measured by reductions in new infections among FSWs and adults. Cumulative infections averted over a 5-year period, in which violence declined was calculated, relative to a status quo with no reduction. Projections held HIV interventions constant at baseline levels; subsequently, scenarios adjusted for planned expansion of antiretroviral therapy (ART) coverage. An approximate 25% reduction in incident HIV infections among FSWs was observed when physical or sexual violence was reduced; cumulative infections averted were 21,200 and 4700 in Kenya and Ukraine, respectively. Similar percent reductions were observed assuming ART coverage expansion, with approximately 18,200 and 4400 infections averted among FSWs in Kenya and Ukraine. New infections were also averted in the general population. Reducing violence against FSWs appears to impart significant reductions in new infections among FSWs and in the general adult population in both generalized and concentrated epidemics. Limitations provide direction to improve the precision of future estimates. © 2013 John Wiley & Sons A/S.

  13. Cohort profile: the Comparative Outcomes And Service Utilization Trends (COAST) Study among people living with and without HIV in British Columbia, Canada

    PubMed Central

    Hull, Mark W; Salters, Kate; Samji, Hasina; Cescon, Angela; Sereda, Paul; Lima, Viviane D; Nosyk, Bohdan; Whitehurst, David G T; Lear, Scott A; Montaner, Julio S G; Hogg, Robert S

    2018-01-01

    Purpose The Comparative Outcomes And Service Utilization Trends (COAST) Study in British Columbia (BC), Canada, was designed to evaluate the determinants of health outcomes and health care services use among people living with HIV (PLHIV) as they age in the period following the introduction of combination antiretroviral therapy (cART). The study also assesses how age-associated comorbidities and health care use among PLHIV may differ from those observed in the general population. Participants COAST was established through a data linkage between two provincial data sources: The BC Centre for Excellence in HIV/AIDS Drug Treatment Program, which centrally manages cART dispensation across BC and contains prospectively collected data on demographic, immunological, virological, cART use and other clinical information for all known PLHIV in BC; and Population Data BC, a provincial data repository that holds individual event-level, longitudinal data for all 4.6 million BC residents. COAST participants include 13 907 HIV-positive adults (≥19 years of age) and a 10% random sample inclusive of 516 340 adults from the general population followed from 1996 to 2013. Findings to date For all participants, linked individual-level data include information on demographics, health service use (eg, inpatient care, outpatient care and prescription medication dispensations), mortality, and HIV diagnostic and clinical data. Publications from COAST have demonstrated the significant mortality reductions and dramatic changes in the causes of death among PLHIV from 1996 to 2012, differences in the amount of time spent in a healthy state by HIV status, and high levels of injury and mood disorder diagnosis among PLHIV compared with the general population. Future plans To capture the dynamic nature of population health parameters, regular data updates and a refresh of the data linkage are planned to occur every 2 years, providing the basis for planned analysis to examine age-associated comorbidities and patterns of health service use over time. PMID:29331972

  14. Labour market participation and sick leave among patients diagnosed with myasthenia gravis in Denmark 1997-2011: a Danish nationwide cohort study.

    PubMed

    Frost, Asger; Svendsen, Marie Louise; Rahbek, Jes; Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther; Lund, Thomas

    2016-11-17

    To examine labour market participation and long-term sick leave following a diagnosis with myasthenia gravis (MG) compared with the general Danish population and for specific subgroups of MG patients. A nationwide matched cohort study from 1997 to 2011 using data from population-based medical and social registries. The study includes 330 MG patients aged 18 to 65 years old identified from hospital diagnoses and dispensed prescriptions, and twenty references from the Danish population matching each MG patient on age, gender, and profession. Main outcome measures are labour market participation (yes/no) and long-term sick leave ≥9 weeks (yes/no) with follow-up at 1- and 2 years after the time of MG diagnosis or match. Based on complete person-level information on all public transfer payments in Denmark, persons having no labour market participation are defined as individuals receiving social benefits for severely reduced workability, flexijob, and disability pension. MG is consistently associated with higher odds of having no labour market participation and long-term sick leave compared with the general Danish population (no labour market participation & ≥9 weeks sick leave at 2-year follow-up, adjusted OR (95% CI): 5.76 (4.13 to 8.04) & 8.60 (6.60 to 11.23)). Among MG patients, females and patients treated with both acetylcholinesterase inhibitors and immunosuppression have higher odds of lost labour market participation and long-term sick leave. This study suggests that MG patients have almost 6 times higher odds of no labour market participation and almost 9 times higher odds of long-term sick leave 2 years after diagnosis compared with the general Danish population. In particular female MG patients and patients treated with both acetylcholinesterase and immunosuppression have high odds of a negative labour market outcome. Future research should focus on predictors in workplace and labour market policy of labour market participation among MG patients.

  15. [Health care financing: is it enough and appropriate?].

    PubMed

    Puig-Junoy, Jaume

    2006-03-01

    The object of this short paper is to present the results of Spanish public health care expenditures projections until 2013 according to the expected impact of the main demographic and technological health cost drivers. Future annual health expenditures are estimated using a simple method based on the decomposition of the past main growth factors in two scenarios. The main cost drivers considered were the following: demography, which includes the increasing number of people and the impact of population ageing; the increase in the price of health care inputs above the general price level; and the impact of changes in medical practice related with expanding medical technology. In 2013, public health care expenditure may be around 5.7% and 6% of gross domestic product (GDP); that is, at least, between 0.24 and 0.53 additional GDP points will be spent on public health care. The main factor responsible for the future expenditure increase will continue to be the increase in the average health service intensity, followed by demographic factors. In the base-case scenario, public expenditure increase until 2013 will be compatible with a real 2.5% annual increase in consumption of non-health goods and services. In order to finance the future costs, the Spanish population will have to devote to public health expenditure less than 7% of income increase until 2013. Despite being important, the expected Spanish GDP growth until 2013 may be enough to finance the increase in public health expenditure as a result of the impact of demographic changes. Expanding medical technology is expected to continue being the main driver of future costs.

  16. Mapping, Bayesian Geostatistical Analysis and Spatial Prediction of Lymphatic Filariasis Prevalence in Africa

    PubMed Central

    Slater, Hannah; Michael, Edwin

    2013-01-01

    There is increasing interest to control or eradicate the major neglected tropical diseases. Accurate modelling of the geographic distributions of parasitic infections will be crucial to this endeavour. We used 664 community level infection prevalence data collated from the published literature in conjunction with eight environmental variables, altitude and population density, and a multivariate Bayesian generalized linear spatial model that allows explicit accounting for spatial autocorrelation and incorporation of uncertainty in input data and model parameters, to construct the first spatially-explicit map describing LF prevalence distribution in Africa. We also ran the best-fit model against predictions made by the HADCM3 and CCCMA climate models for 2050 to predict the likely distributions of LF under future climate and population changes. We show that LF prevalence is strongly influenced by spatial autocorrelation between locations but is only weakly associated with environmental covariates. Infection prevalence, however, is found to be related to variations in population density. All associations with key environmental/demographic variables appear to be complex and non-linear. LF prevalence is predicted to be highly heterogenous across Africa, with high prevalences (>20%) estimated to occur primarily along coastal West and East Africa, and lowest prevalences predicted for the central part of the continent. Error maps, however, indicate a need for further surveys to overcome problems with data scarcity in the latter and other regions. Analysis of future changes in prevalence indicates that population growth rather than climate change per se will represent the dominant factor in the predicted increase/decrease and spread of LF on the continent. We indicate that these results could play an important role in aiding the development of strategies that are best able to achieve the goals of parasite elimination locally and globally in a manner that may also account for the effects of future climate change on parasitic infection. PMID:23951194

  17. Shifting species interactions in terrestrial dryland ecosystems under altered water availability and climate change

    USGS Publications Warehouse

    McCluney, Kevin E.; Belnap, Jayne; Collins, Scott L.; González, Angélica L.; Hagen, Elizabeth M.; Holland, J. Nathaniel; Kotler, Burt P.; Maestre, Fernando T.; Smith, Stanley D.; Wolf, Blair O.

    2012-01-01

    Species interactions play key roles in linking the responses of populations, communities, and ecosystems to environmental change. For instance, species interactions are an important determinant of the complexity of changes in trophic biomass with variation in resources. Water resources are a major driver of terrestrial ecology and climate change is expected to greatly alter the distribution of this critical resource. While previous studies have documented strong effects of global environmental change on species interactions in general, responses can vary from region to region. Dryland ecosystems occupy more than one-third of the Earth's land mass, are greatly affected by changes in water availability, and are predicted to be hotspots of climate change. Thus, it is imperative to understand the effects of environmental change on these globally significant ecosystems. Here, we review studies of the responses of population-level plant-plant, plant-herbivore, and predator-prey interactions to changes in water availability in dryland environments in order to develop new hypotheses and predictions to guide future research. To help explain patterns of interaction outcomes, we developed a conceptual model that views interaction outcomes as shifting between (1) competition and facilitation (plant-plant), (2) herbivory, neutralism, or mutualism (plant-herbivore), or (3) neutralism and predation (predator-prey), as water availability crosses physiological, behavioural, or population-density thresholds. We link our conceptual model to hypothetical scenarios of current and future water availability to make testable predictions about the influence of changes in water availability on species interactions. We also examine potential implications of our conceptual model for the relative importance of top-down effects and the linearity of patterns of change in trophic biomass with changes in water availability. Finally, we highlight key research needs and some possible broader impacts of our findings. Overall, we hope to stimulate and guide future research that links changes in water availability to patterns of species interactions and the dynamics of populations and communities in dryland ecosystems.

  18. Identifying the Transgender Population in the Medicare Program

    PubMed Central

    Proctor, Kimberly; Haffer, Samuel C.; Ewald, Erin; Hodge, Carla; James, Cara V.

    2016-01-01

    Abstract Purpose: To identify and describe the transgender population in the Medicare program using administrative data. Methods: Using a combination of International Classification of Diseases ninth edition (ICD-9) codes relating to transsexualism and gender identity disorder, we analyzed 100% of the 2013 Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service (FFS) “final action” claims from both institutional and noninstitutional providers (∼1 billion claims) to identify individuals who may be transgender Medicare beneficiaries. To confirm, we developed and applied a multistage validation process. Results: Four thousand ninety-eight transgender beneficiaries were identified, of which ∼90% had confirmatory diagnoses, billing codes, or evidence of a hormone prescription. In general, the racial, ethnic, and geographic distribution of the Medicare transgender population tends to reflect the broader Medicare population. However, age, original entitlement status, and disease burden of the transgender population appear substantially different. Conclusions: Using a variety of claims information, ranging from claims history to additional diagnoses, billing modifiers, and hormone prescriptions, we demonstrate that administrative data provide a valuable resource for identifying a lower bound of the Medicare transgender population. In addition, we provide a baseline description of the diversity and disease burden of the population and a framework for future research. PMID:28861539

  19. Nutrition and health in amphibian husbandry.

    PubMed

    Ferrie, Gina M; Alford, Vance C; Atkinson, Jim; Baitchman, Eric; Barber, Diane; Blaner, William S; Crawshaw, Graham; Daneault, Andy; Dierenfeld, Ellen; Finke, Mark; Fleming, Greg; Gagliardo, Ron; Hoffman, Eric A; Karasov, William; Klasing, Kirk; Koutsos, Elizabeth; Lankton, Julia; Lavin, Shana R; Lentini, Andrew; Livingston, Shannon; Lock, Brad; Mason, Tom; McComb, Alejandra; Morris, Cheryl; Pessier, Allan P; Olea-Popelka, Francisco; Probst, Tom; Rodriguez, Carlos; Schad, Kristine; Semmen, Kent; Sincage, Jamie; Stamper, M Andrew; Steinmetz, Jason; Sullivan, Kathleen; Terrell, Scott; Wertan, Nina; Wheaton, Catharine J; Wilson, Brad; Valdes, Eduardo V

    2014-01-01

    Amphibian biology is intricate, and there are many inter-related factors that need to be understood before establishing successful Conservation Breeding Programs (CBPs). Nutritional needs of amphibians are highly integrated with disease and their husbandry needs, and the diversity of developmental stages, natural habitats, and feeding strategies result in many different recommendations for proper care and feeding. This review identifies several areas where there is substantial room for improvement in maintaining healthy ex situ amphibian populations specifically in the areas of obtaining and utilizing natural history data for both amphibians and their dietary items, achieving more appropriate environmental parameters, understanding stress and hormone production, and promoting better physical and population health. Using a scientific or research framework to answer questions about disease, nutrition, husbandry, genetics, and endocrinology of ex situ amphibians will improve specialists' understanding of the needs of these species. In general, there is a lack of baseline data and comparative information for most basic aspects of amphibian biology as well as standardized laboratory approaches. Instituting a formalized research approach in multiple scientific disciplines will be beneficial not only to the management of current ex situ populations, but also in moving forward with future conservation and reintroduction projects. This overview of gaps in knowledge concerning ex situ amphibian care should serve as a foundation for much needed future research in these areas. © 2014 Wiley Periodicals, Inc.

  20. Museum specimen data reveal emergence of a plant disease may be linked to increases in the insect vector population.

    PubMed

    Zeilinger, Adam R; Rapacciuolo, Giovanni; Turek, Daniel; Oboyski, Peter T; Almeida, Rodrigo P P; Roderick, George K

    2017-09-01

    The emergence rate of new plant diseases is increasing due to novel introductions, climate change, and changes in vector populations, posing risks to agricultural sustainability. Assessing and managing future disease risks depends on understanding the causes of contemporary and historical emergence events. Since the mid-1990s, potato growers in the western United States, Mexico, and Central America have experienced severe yield loss from Zebra Chip disease and have responded by increasing insecticide use to suppress populations of the insect vector, the potato psyllid, Bactericera cockerelli (Hemiptera: Triozidae). Despite the severe nature of Zebra Chip outbreaks, the causes of emergence remain unknown. We tested the hypotheses that (1) B. cockerelli occupancy has increased over the last century in California and (2) such increases are related to climate change, specifically warmer winters. We compiled a data set of 87,000 museum specimen occurrence records across the order Hemiptera collected between 1900 and 2014. We then analyzed changes in B. cockerelli distribution using a hierarchical occupancy model using changes in background species lists to correct for collecting effort. We found evidence that B. cockerelli occupancy has increased over the last century. However, these changes appear to be unrelated to climate changes, at least at the scale of our analysis. To the extent that species occupancy is related to abundance, our analysis provides the first quantitative support for the hypothesis that B. cockerelli population abundance has increased, but further work is needed to link B. cockerelli population dynamics to Zebra Chip epidemics. Finally, we demonstrate how this historical macro-ecological approach provides a general framework for comparative risk assessment of future pest and insect vector outbreaks. © 2017 by the Ecological Society of America.

  1. The shaping of genetic variation in edge-of-range populations under past and future climate change

    PubMed Central

    Razgour, Orly; Juste, Javier; Ibáñez, Carlos; Kiefer, Andreas; Rebelo, Hugo; Puechmaille, Sébastien J; Arlettaz, Raphael; Burke, Terry; Dawson, Deborah A; Beaumont, Mark; Jones, Gareth; Wiens, John

    2013-01-01

    With rates of climate change exceeding the rate at which many species are able to shift their range or adapt, it is important to understand how future changes are likely to affect biodiversity at all levels of organisation. Understanding past responses and extent of niche conservatism in climatic tolerance can help predict future consequences. We use an integrated approach to determine the genetic consequences of past and future climate changes on a bat species, Plecotus austriacus. Glacial refugia predicted by palaeo-modelling match those identified from analyses of extant genetic diversity and model-based inference of demographic history. Former refugial populations currently contain disproportionately high genetic diversity, but niche conservatism, shifts in suitable areas and barriers to migration mean that these hotspots of genetic diversity are under threat from future climate change. Evidence of population decline despite recent northward migration highlights the need to conserve leading-edge populations for spearheading future range shifts. PMID:23890483

  2. Exploring Agricultural Livelihood Transitions with an Agent-Based Virtual Laboratory: Global Forces to Local Decision-Making

    PubMed Central

    Magliocca, Nicholas R.; Brown, Daniel G.; Ellis, Erle C.

    2013-01-01

    Rural populations are undergoing rapid changes in both their livelihoods and land uses, with associated impacts on ecosystems, global biogeochemistry, and climate change. A primary challenge is, thus, to explain these shifts in terms of the actors and processes operating within a variety of land systems in order to understand how land users might respond locally to future changes in broader-scale environmental and economic conditions. Using ‘induced intensification’ theory as a benchmark, we develop a generalized agent-based model to investigate mechanistic explanations of relationships between agricultural intensity and population density, environmental suitability, and market influence. Land-use and livelihood decisions modeled from basic micro-economic theories generated spatial and temporal patterns of agricultural intensification consistent with predictions of induced intensification theory. Further, agent actions in response to conditions beyond those described by induced intensification theory were explored, revealing that interactions among environmental constraints, population pressure, and market influence may produce transitions to multiple livelihood regimes of varying market integration. The result is new hypotheses that could modify and enrich understanding of the classic relationship between agricultural intensity and population density. The strength of this agent-based model and the experimental results is the generalized form of the decision-making processes underlying land-use and livelihood transitions, creating the prospect of a virtual laboratory for systematically generating hypotheses of how agent decisions and interactions relate to observed land-use and livelihood patterns across diverse land systems. PMID:24039892

  3. Sizing firefighters: method and implications.

    PubMed

    Hsiao, Hongwei; Whitestone, Jennifer; Kau, Tsui-Ying; Whisler, Richard; Routley, J Gordon; Wilbur, Michael

    2014-08-01

    This article reports new anthropometric information of U.S. firefighters for fire apparatus design applications (Study 1) and presents a data method to assist in firefighter anthropometric data usage for research-to-practice propositions (Study 2). Up-to-date anthropometric information of the U.S. firefighter population is needed for updating ergonomic and safety specifications for fire apparatus. A stratified sampling plan of three-age by three-race/ethnicity combinations was used to collect anthropometric data of 863 male and 88 female firefighters across the U.S. regions; 71 anthropometric dimensions were measured (Study I). Differences among original, weighted, and normality transformed data from Study 1 were compared to allowable observer errors (Study 2). On average, male firefighters were 9.8 kg heavier and female firefighters were 29 mm taller than their counterparts in the general U.S. population. They also have larger upper-body builds than those of the general U.S. population. The data in weighted, unweighted, and normality transformed modes were compatible among each other with a few exceptions. The data obtained in this study provide the first available U.S. national firefighter anthropometric information for fire apparatus designs. The data represent the demographic characteristics of the current firefighter population and, except for a few dimensions, can be directly employed into fire apparatus design applications without major weighting or nonnormality concerns. The up-to-date firefighter anthropometric data and data method will benefit the design of future fire apparatus and protective equipment, such as seats, body restraints, cabs, gloves, and bunker gear.

  4. [Design of the general population study NEMESIS-2: Netherlands Mental Health Survey and Incidence Study-2].

    PubMed

    de Graaf, Ron; Ten Have, Margreet; van Dorsselaer, Saskia

    2012-01-01

    The longitudinal epidemiological population study NEMESIS-2 (Netherlands Mental Health Survey and Incidence Study-2) replicates the first study conducted from 1996 to 1999, and expands it by adding new subjects such as impulse-control disorders. To describe the aims and design of nemesis-2, particularly of its first round of measurements, to provide up-to-date figures on prevalence, incidence, course and consequences of mental disorders and associated factors, and to study trends in the mental health of the population aged 18-64 years and the use these people make of psychiatric services. Face-to-face interviews were conducted (November 2007-July 2009) by means of the Composite International Diagnostic Interview 3.0. The response was 65.1% (n = 6646). Respondents were reasonably representative for the population, but young persons were somewhat underrepresented. Two follow-up rounds of measurements are planned with three-year intervals between the rounds. The second round of measurements began in November 2010. A qualitatively good dataset was built up. This will allow several mental health topics to be studied in the future.

  5. Migration of a telehealth program to a e-education health program

    NASA Astrophysics Data System (ADS)

    Gomez, A.; Montano, L. F.; Amaro, L.; Aleman, B.

    It's presented the result of the experience of Telehealth in Mexico, inside a National program, in one Public Health Institution, which along nine years of using, has been fulfilled a retrospective and prospective analysis of future application, emphasising on the specification of characteristics of the application sites, with impact measures: Cost/Opportunity , Cost/Benefit , and Cost/Efficiency . Anticipating inversion and reorganization of the net when being convenient, as well as situate the distance medical attention, beyond the institutional technologic platforms. A fanlight of possibilities is already opened to e-education programs that support the preventive medicine, the self-care, and the distance medical education in all medical attention levels, enlarging it covering not only to doctors, paramedical and nurses but also to general population, making it more equable and covering the minorities like rural population, handicaps, and indigene population overall in development ways countries and identifying the impact measurements in the evaluation of the enabling given to; doctors, teachers, students and open population. Also is proposed a Latin American E-Education Net for Health.

  6. Visceral Adiposity Index: An Indicator of Adipose Tissue Dysfunction

    PubMed Central

    2014-01-01

    The Visceral Adiposity Index (VAI) has recently proven to be an indicator of adipose distribution and function that indirectly expresses cardiometabolic risk. In addition, VAI has been proposed as a useful tool for early detection of a condition of cardiometabolic risk before it develops into an overt metabolic syndrome. The application of the VAI in particular populations of patients (women with polycystic ovary syndrome, patients with acromegaly, patients with NAFLD/NASH, patients with HCV hepatitis, patients with type 2 diabetes, and general population) has produced interesting results, which have led to the hypothesis that the VAI could be considered a marker of adipose tissue dysfunction. Unfortunately, in some cases, on the same patient population, there is conflicting evidence. We think that this could be mainly due to a lack of knowledge of the application limits of the index, on the part of various authors, and to having applied the VAI in non-Caucasian populations. Future prospective studies could certainly better define the possible usefulness of the VAI as a predictor of cardiometabolic risk. PMID:24829577

  7. Wing geometry of Phlebotomus stantoni and Sergentomyia hodgsoni from different geographical locations in Thailand.

    PubMed

    Sumruayphol, Suchada; Chittsamart, Boonruam; Polseela, Raxsina; Sriwichai, Patchara; Samung, Yudthana; Apiwathnasorn, Chamnarn; Dujardin, Jean-Pierre

    2017-01-01

    Geographic populations of the two main sandflies genera present in Thailand were studied for species and population identification. Size and shape of Phlebotomus stantoni and Sergentomyia hodgsoni from different island and mainland locations were examined by landmark-based geometric morphometrics. Intraspecific and interspecific wing comparison was carried out based on 12 anatomical landmarks. The wing centroid size of P. stantoni was generally larger than that of S. hodgsoni. Within both species, wings from the continent were significantly larger than those from island populations. Size variation could be significant between geographic locations, but could also overlap between genera. The wing venation geometry showed non-overlapping differences between two species. The within-species variation of geometric shape between different geographical locations was highly significant, but it could not interfere with the interspecies difference. The lack of species overlapping in shape, and the high discrimination between geographic populations, make geometric shape a promising character for future taxonomic and epidemiological studies. Copyright © 2016 Académie des sciences. Published by Elsevier SAS. All rights reserved.

  8. Are online gamblers more at risk than offline gamblers?

    PubMed

    Kairouz, Sylvia; Paradis, Catherine; Nadeau, Louise

    2012-03-01

    To characterize and compare sociodemographic profiles, game-play patterns, and level of addictive behaviors among adults who gamble online and those who do not, and to examine if, at the population level, online gambling is associated with more risky behaviors than offline gambling. Respondents were 8,456 offline gamblers and 111 online gamblers who participated in a population-based survey conducted in the province of Québec, in 2009. The study sample is representative of adult general population. There is an unequal distribution of online gambling in the population. A disproportionate number of men, young people, and students say they participate in online gambling. Poker players are overrepresented among online gamblers and gambling behaviors tend to be more excessive on the Internet. Compared with offline gamblers, online gamblers report more co-occurring risky behaviors, namely alcohol and cannabis use. Those who gamble online appear to be more at risk for gambling-related problems, but the present findings alone cannot be used as evidence for that conclusion. Future research designs could combine longitudinal data collection and multilevel analyses to provide more insight into the causal mechanisms associated with online gambling.

  9. U.S. Population Growth: Prospects and Policy.

    ERIC Educational Resources Information Center

    McFalls, Joseph A., Jr.; And Others

    1984-01-01

    The Commission on Population Growth and the American Future concluded that zero population growth (ZPG) is in the best interest of the United States. To achieve ZPG in the future, the United States must keep fertility and net immigration relatively low. Practical problems are discussed. (RM)

  10. [Analysis and design structure of an aging society].

    PubMed

    Fujimasa, Iwao

    2012-01-01

    On observing present Japanese society, we can find deep gaps between the present system and its probable future. One of the gaps may be due to the misconception that future societal make up is not definite. The aim of the current study was to investigate a future societal structure and to develop methods of adding a timed dimension policy to the societal structure. This is named "A theory of structuralism economics". We developed 3 societal structure projection engines and applied a system of dynamics language to estimate the future total population of Japan. The Japan total population reached a maximum in 2005, and thereafter depopulation begun. The populations in the younger working age group (from 25 to 54 years old) and those in the elderly working age group (from 55 to 84 years old) became almost equal in 2010. As economic growth rate depends upon an increase in the working population, the increase in national income rate of Japan approached over 10% per year between 1950 to 1970. The increased working age population of the same period exceeded 2.5% annually. However, after 2005 depopulation began in Japan. In future, national income will decrease proportional to the working age population, but personal national income will hold almost unchanged. We propose a new strategy for future society structure. The working age should be extended by 10 years. Labor power will come to exceed 60% of the population and will thereafter become stable.

  11. Territorial problems relating to the structure of employment in terms of sex.

    PubMed

    Kotliar, A

    1971-10-01

    Future development plans in Russia should take into account the fact that the employment opportunities which exist in a specific geographical area will exert an influence on the sex ratios in the population of that area, and the sex ratios, in turn, will affect reproductive capacity of that population. When development schemes, in a particular region, create a demand primarily for a type of labor traditionally associated with only one sex, the demographic structure will adjust to this demand. For example, in Kameshkovo, light industry predominates and generally women fulfill the labor requirements in this type of enterprise. The labor demand for women has resulted in a disproportionate sex ratio in the community; there are 154 women/100 men. Sometimes the demographic structure will resist the pressures created by the labor demands and individuals will, instead of migrating, seek employment in fields traditionally associated with the opposite sex. In cities located in the Vladimir and Ivanovo regions textile industries, traditionally associated with a female labor force, predominant, and these textile industries employ a higher proportion of men than textile industries located in other regions. In areas where heavy industry predominates, the number of men employed exceeds the number of employed women, and wages are high enough so that only one spouse must work; women may then devote more time to family matters and this is reflected in the higher birth rates associated with these areas. In areas where light industry predominates, more women are employed and wages are lower. Generally both spouses must work and as a result birth rates are lower. Future development plans should attempt to create an equal demand for the labor of both sexes. Ideal sex ratios for the population and for the labor force were calculated. Tables depict 1) % of employed workers by sex for selected cities and industries; 2) proportion of women employed, birth rate, and natural increases by territorial units; 3) sex ratios in the labor force and the population by type of industry for 7 regions; and 4) size of city by sex ratio.

  12. Association between narcotic use and anabolic-androgenic steroid use among American adolescents.

    PubMed

    Denham, Bryan E

    2009-01-01

    Drawing on the data gathered in the 2006 Monitoring the Future study of American youth, the present research examines associations between use of narcotics and use of anabolic-androgenic steroids (AASs) among high-school seniors (n = 2,489). With independent measures and controls including sex, race, media exposure, socializing with friends, participation in recreational and school-sponsored sports, perceptions of drug use among professional athletes, and perceptions of steroid use among close friends, binary logistic regression analyses revealed significant associations between AAS use and the use of alcohol, crack cocaine, Vicodin, gamma-hydroxybutyrate (GHB), Ketamine, and Rohypnol. While use of both AASs and the narcotic drugs generally did not eclipse 5% of the sample, the numbers extend to many thousands in larger populations. Implications for health practitioners and recommendations for future research are offered. The study's limitations are noted.

  13. Annual Research Review: Understudied populations within the autism spectrum – current trends and future directions in neuroimaging research

    PubMed Central

    Jack, Allison; Pelphrey, Kevin

    2017-01-01

    Background Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental conditions that vary in both etiology and phenotypic expression. Expressions of ASD characterized by a more severe phenotype, including autism with intellectual disability (ASD+ID), autism with a history of developmental regression (ASD+R), and minimally verbal autism (ASD+MV) are understudied generally, and especially in the domain of neuroimaging. However, neuroimaging methods are a potentially powerful tool for understanding the etiology of these ASD subtypes. Scope and Methodology This review evaluates existing neuroimaging research on ASD+MV, ASD+ID, and ASD+R, identified by a search of the literature using the PubMed database, and discusses methodological, theoretical, and practical considerations for future research involving neuroimaging assessment of these populations. Findings There is a paucity of neuroimaging research on ASD+ID, ASD+MV, and ASD+R, and what findings do exist are often contradictory, or so sparse as to be ungeneralizable. We suggest that while greater sample sizes and more studies are necessary, more important would be a paradigm shift toward multimodal (e.g., imaging genetics) approaches that allow for the characterization of heterogeneity within etiologically diverse samples. PMID:28102566

  14. Regional and seasonal response of a West Nile virus vector to climate change.

    PubMed

    Morin, Cory W; Comrie, Andrew C

    2013-09-24

    Climate change will affect the abundance and seasonality of West Nile virus (WNV) vectors, altering the risk of virus transmission to humans. Using downscaled general circulation model output, we calculate a WNV vector's response to climate change across the southern United States using process-based modeling. In the eastern United States, Culex quinquefasciatus response to projected climate change displays a latitudinal and elevational gradient. Projected summer population depressions as a result of increased immature mortality and habitat drying are most severe in the south and almost absent further north; extended spring and fall survival is ubiquitous. Much of California also exhibits a bimodal pattern. Projected onset of mosquito season is delayed in the southwestern United States because of extremely dry and hot spring and summers; however, increased temperature and late summer and fall rains extend the mosquito season. These results are unique in being a broad-scale calculation of the projected impacts of climate change on a WNV vector. The results show that, despite projected widespread future warming, the future seasonal response of C. quinquefasciatus populations across the southern United States will not be homogeneous, and will depend on specific combinations of local and regional conditions.

  15. A Systematic Review of Isometric Lingual Strength-Training Programs in Adults With and Without Dysphagia.

    PubMed

    McKenna, Victoria S; Zhang, Bin; Haines, Morgan B; Kelchner, Lisa N

    2017-05-17

    This systematic review summarizes the effects of isometric lingual strength training on lingual strength and swallow function in adult populations. Furthermore, it evaluates the designs of the reviewed studies and identifies areas of future research in isometric lingual strength training for dysphagia remediation. A comprehensive literature search of 3 databases and additional backward citation search identified 10 studies for inclusion in the review. The review reports and discusses the isometric-exercise intervention protocols, pre- and postintervention lingual-pressure data (maximum peak pressures and lingual-palatal pressures during swallowing), and oropharyngeal swallowing measures such as penetration-aspiration scales, oropharyngeal residue and duration, lingual volumes, and quality-of-life assessments. Studies reported gains in maximum peak lingual pressures following isometric lingual strength training for both healthy adults and select groups of individuals with dysphagia. However, due to the variability in study designs, it remains unclear whether strength gains generalize to swallow function. Although isometric lingual strength training is a promising intervention for oropharyngeal dysphagia, the current literature is too variable to confidently report specific therapeutic benefits. Future investigations should target homogenous patient populations and use randomized controlled trials to determine the efficacy of this treatment for individuals with dysphagia.

  16. A cross-sectional, randomized cluster sample survey of household vulnerability to extreme heat among slum dwellers in ahmedabad, india.

    PubMed

    Tran, Kathy V; Azhar, Gulrez S; Nair, Rajesh; Knowlton, Kim; Jaiswal, Anjali; Sheffield, Perry; Mavalankar, Dileep; Hess, Jeremy

    2013-06-18

    Extreme heat is a significant public health concern in India; extreme heat hazards are projected to increase in frequency and severity with climate change. Few of the factors driving population heat vulnerability are documented, though poverty is a presumed risk factor. To facilitate public health preparedness, an assessment of factors affecting vulnerability among slum dwellers was conducted in summer 2011 in Ahmedabad, Gujarat, India. Indicators of heat exposure, susceptibility to heat illness, and adaptive capacity, all of which feed into heat vulnerability, was assessed through a cross-sectional household survey using randomized multistage cluster sampling. Associations between heat-related morbidity and vulnerability factors were identified using multivariate logistic regression with generalized estimating equations to account for clustering effects. Age, preexisting medical conditions, work location, and access to health information and resources were associated with self-reported heat illness. Several of these variables were unique to this study. As sociodemographics, occupational heat exposure, and access to resources were shown to increase vulnerability, future interventions (e.g., health education) might target specific populations among Ahmedabad urban slum dwellers to reduce vulnerability to extreme heat. Surveillance and evaluations of future interventions may also be worthwhile.

  17. Climate Change and the Neglected Tropical Diseases.

    PubMed

    Booth, Mark

    2018-01-01

    Climate change is expected to impact across every domain of society, including health. The majority of the world's population is susceptible to pathological, infectious disease whose life cycles are sensitive to environmental factors across different physical phases including air, water and soil. Nearly all so-called neglected tropical diseases (NTDs) fall into this category, meaning that future geographic patterns of transmission of dozens of infections are likely to be affected by climate change over the short (seasonal), medium (annual) and long (decadal) term. This review offers an introduction into the terms and processes deployed in modelling climate change and reviews the state of the art in terms of research into how climate change may affect future transmission of NTDs. The 34 infections included in this chapter are drawn from the WHO NTD list and the WHO blueprint list of priority diseases. For the majority of infections, some evidence is available of which environmental factors contribute to the population biology of parasites, vectors and zoonotic hosts. There is a general paucity of published research on the potential effects of decadal climate change, with some exceptions, mainly in vector-borne diseases. © 2018 Elsevier Ltd All rights reserved.

  18. Adaptation of human skin color in various populations.

    PubMed

    Deng, Lian; Xu, Shuhua

    2018-01-01

    Skin color is a well-recognized adaptive trait and has been studied extensively in humans. Understanding the genetic basis of adaptation of skin color in various populations has many implications in human evolution and medicine. Impressive progress has been made recently to identify genes associated with skin color variation in a wide range of geographical and temporal populations. In this review, we discuss what is currently known about the genetics of skin color variation. We enumerated several cases of skin color adaptation in global modern humans and archaic hominins, and illustrated why, when, and how skin color adaptation occurred in different populations. Finally, we provided a summary of the candidate loci associated with pigmentation, which could be a valuable reference for further evolutionary and medical studies. Previous studies generally indicated a complex genetic mechanism underlying the skin color variation, expanding our understanding of the role of population demographic history and natural selection in shaping genetic and phenotypic diversity in humans. Future work is needed to dissect the genetic architecture of skin color adaptation in numerous ethnic minority groups around the world, which remains relatively obscure compared with that of major continental groups, and to unravel the exact genetic basis of skin color adaptation.

  19. Population Pharmacokinetic Model for Cancer Chemoprevention With Sulindac in Healthy Subjects

    PubMed Central

    Berg, Alexander K.; Mandrekar, Sumithra J.; Ziegler, Katie L. Allen; Carlson, Elsa C.; Szabo, Eva; Ames, Mathew M.; Boring, Daniel; Limburg, Paul J.; Reid, Joel M.

    2014-01-01

    Sulindac is a prescription-based non-steroidal anti-inflammatory drug (NSAID) that continues to be actively investigated as a candidate cancer chemoprevention agent. To further current understanding of sulindac bioavailability, metabolism, and disposition, we developed a population pharmacokinetic model for the parent compound and its active metabolites, sulindac sulfide, and exisulind. This analysis was based on data from 24 healthy subjects who participated in a bioequivalence study comparing two formulations of sulindac. The complex disposition of sulindac and its metabolites was described by a seven-compartment model featuring enterohepatic recirculation and is the first reported population pharmacokinetic model for sulindac. The derived model was used to explore effects of clinical variables on sulindac pharmacokinetics and revealed that body weight, creatinine clearance, and gender were significantly correlated with pharmacokinetic parameters. Moreover, the model quantifies the relative bioavailability of the sulindac formulations and illustrates the utility of population pharmacokinetics in bioequivalence assessment. This novel population pharmacokinetic model provides new insights regarding the factors that may affect the pharmacokinetics of sulindac and the exisulind and sulindac sulfide metabolites in generally healthy subjects, which have implications for future chemoprevention trial design for this widely available agent. PMID:23436338

  20. Evaluating the chlamydia and gonorrhoea screening program in the Humanitarian Entrant Health Service, Western Australia.

    PubMed

    Hoad, Veronica C; Thambiran, Aesen

    2012-07-02

    To document the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in the refugee population settling in Western Australia from 1 January 2006 to 31 December 2009 and make recommendations for future screening for chlamydia and gonorrhoea in the refugee population. A prevalence and quality assurance study of 2610 refugees aged 15 years and older who attended the Humanitarian Entrant Health Service in Western Australia and were screened for chlamydia and gonorrhoea. Demographic details and results of C. trachomatis and N. gonorrhoeae tests on first void urine. The prevalence of chlamydia was found to be 0.8% (n = 21) in the refugee population. No gonorrhoea infections were detected. The prevalence of chlamydia was low (0.19%-1.23%) when analysed by sex, ethnicity or age and was considerably lower than other subpopulations considered high risk in Australia. The low prevalence rates of chlamydia and gonorrhoea found in the refugee population suggest that current screening guidelines should be updated. We recommend screening all refugees who are sexually active up to age 39 years, taking into account an appropriate sexual history; otherwise, screening guidelines should be as for the general Australian population.

  1. The Experience of Learning Meditation and Mind/Body Practices in the COPD Population.

    PubMed

    Chan, Roxane Raffin; Lehto, Rebecca H

    2016-01-01

    Persons with Chronic Obstructive Pulmonary Disease (COPD) exhibit high levels of comorbid anxiety that severely worsens their sensation of dyspnea and is associated with high levels of avoidance of essential activities resulting in an increase morbidity and mortality. Increasing meditation and mind/body practices have been shown to decrease anxiety, and improve intrapersonal and interpersonal relationships in general populations, however, results of studies in the COPD population have been mixed. Understanding how persons with COPD experience learning meditation and mind/body skills would aid future meditation-focused mind/body intervention design. A mixed-method study of a community based meditation-focused mind/body intervention for persons with COPD. Reflective journaling, phone exit interviews and survey measures: chronic disease respiratory questionnaire, and Anxiety Sensitivity 3 questionnaire. Eight weekly one hour meditation-focused mind/body classes that taught concentration and insight meditation skills along with mind/body exercises that facilitated increased body and emotional awareness. Out of 41 participants, 32 (73%) contributed detailed experience about learning and practicing meditation and mind/body practices that distilled into four themes, barriers to practice, learning style, emotional processing, and benefits of practice. Of those 32 participants 21 (73%) identified improvement in physical or emotional symptoms. Overall, 13 (40%) participants provided details regarding how they adapted specific meditation skills into daily life to improve emotional function and lessen dyspnea. Anxiety sensitivity to social situations was associated with a lack of participation. Lessons learned for larger scale application to future meditation and mind/body intervention design for chronic illness populations such as COPD are identified. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. High HIV prevalence among men who have sex with men in Nigeria: implications for combination prevention.

    PubMed

    Vu, Lung; Adebajo, Sylvia; Tun, Waimar; Sheehy, Meredith; Karlyn, Andrew; Njab, Jean; Azeez, Aderemi; Ahonsi, Babatunde

    2013-06-01

    This study provides population-based estimates of HIV prevalence and factors associated with HIV infection among men who have sex with men (MSM) in 3 large cities in Nigeria. We aimed to increase the knowledge base of the evolving HIV epidemic among MSM, highlight risk factors that may fuel the epidemic, and inform future HIV prevention packages. A total of 712 MSM, aged 18 years and older, living in Abuja, Ibadan, and Lagos were recruited using respondent-driven sampling. Participants completed a behavioral questionnaire and tested for HIV. Population-based estimates were obtained using RDSAT software. Factors associated with HIV infection were ascertained using multiple logistic regression adjusting for RDSAT individualized weights. A high proportion of MSM reported high-risk behaviors, including unprotected anal sex with men (30-50%), unprotected vaginal sex with women (40%), bisexual behavior (30-45%), and never been tested for HIV (40-55%). The population-based estimates of HIV among MSM in the 3 cities were 34.9%, 11.3%, and 15.2%, respectively. In Abuja, HIV was significantly associated with unprotected sex and transactional sex. In Ibadan, HIV was significantly associated with unprotected sex and self-identified bisexual. In Lagos, HIV was significantly associated with the older age. HIV prevalence among MSM in the 3 cities was 4-10 times higher than the general population prevalence and was behaviorally linked. In response to a complex set of risks and disadvantages that put African MSM at a greater risk of HIV infection, future interventions targeting MSM should focus on a comprehensive approach that combines behavioral, biomedical, and structural interventions.

  3. Projecting county-level populations under three future scenarios: a technical document supporting the Forest Service 2010 RPA Assessment

    Treesearch

    Stanley J. Zarnoch; H. Ken Cordell; Carter J. Betz

    2010-01-01

    County-level population projections from 2010 to 2060 are developed under three national population growth scenarios for reporting in the 2010 Renewable Resources Planning Act (RPA) Assessment. These population growth scenarios are tied to global futures scenarios defined by the Intergovernmental Panel on Climate Change (IPCC), a program within the United Nations...

  4. Future population of atomic bomb survivors in Nagasaki.

    PubMed

    Yokota, Kenichi; Mine, Mariko; Shibata, Yoshisada

    2013-01-01

    The Nagasaki University Atomic Bomb Survivor Database, which was established in 1978 for elucidating the long-term health effects of the atomic bombing, has registered since 1970 about 120,000 atomic bomb survivors with a history of residence in Nagasaki city. Since the number of atomic bomb survivors has steadily been decreasing, prediction of future population is important for planning future epidemiologic studies, and we tried to predict the population of atomic bomb survivors in Nagasaki city from 2008 to 2030. In addition, we evaluated our estimated population comparing with the actual number from 2008 to 2011.

  5. Assessing DSM-IV symptoms of panic attack in the general population: an item response analysis.

    PubMed

    Sunderland, Matthew; Hobbs, Megan J; Andrews, Gavin; Craske, Michelle G

    2012-12-20

    Unexpected panic attacks may represent a non-specific risk factor for future depression and anxiety disorders. The examination of panic symptoms and associated latent severity levels may lead to improvements in the identification, prevention, and treatment of panic attacks and subsequent psychopathology for 'at risk' individuals in the general population. The current study utilised item response theory to assess the DSM-IV symptoms of panic in relation to the latent severity level of the panic attack construct in a sample of 5913 respondents from the National Epidemiologic Survey on Alcohol and Related conditions. Additionally, differential item functioning (DIF) was assessed to determine if each symptom of panic targets the same level of latent severity between different sociodemographic groups (male/female, young/old). Symptoms indexing 'choking', 'fear of dying', and 'tingling/numbness' are some of the more severe symptoms of panic whilst 'heart racing', 'short of breath', 'tremble/shake', 'dizzy/faint', and 'perspire' are some of the least severe symptoms. Significant levels of DIF were detected in the 'perspire' symptom between males and females and the 'fear of dying' symptom between young and old respondents. The current study was limited to examining cross-sectional data from respondents who had experienced at least one panic attack across their lifetime. The findings of the current study provide additional information regarding panic symptoms in the general population that may enable researchers and clinicians to further refine the detection of 'at-risk' individuals who experience threshold and sub-threshold levels of panic. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Cardiovascular risk assessment of South Asian populations in religious and community settings: a qualitative study.

    PubMed

    Eastwood, Sophie V; Rait, Greta; Bhattacharyya, Mimi; Nair, Devaki R; Walters, Kate

    2013-08-01

    Cardiovascular disease (CVD) is a leading cause of mortality, and South Asian groups experience worse outcomes than the general population in the UK. Regular screening for CVD risk factors is recommended, but we do not know the best settings in which to deliver this for ethnically diverse populations. Health promotion in religious and community settings may reduce inequalities in access to cardiovascular preventative health care. To use stakeholders' and attendees' experiences to explore the feasibility and potential impact of cardiovascular risk assessment targeting South Asian groups at religious and community venues and how health checks in these settings might compare with general practice assessments. Qualitative semi-structured interviews were used. The settings were two Hindu temples, one mosque and one Bangladeshi community centre in central and north-west London. Twenty-four participants (12 stakeholders and 12 attendees) were purposively selected for interview. Interviews were recorded and transcribed verbatim. Themes from the data were generated using thematic framework analysis. All attendees reported positive experiences of the assessments. All reported making lifestyle changes after the check, particularly to diet and exercise. Barriers to lifestyle change, e.g. resistance to change from family members, were identified. Advantages of implementing assessments in religious and community settings compared with general practice included accessibility and community encouragement. Disadvantages included reduced privacy, organizational difficulties and lack of follow-up care. Cardiovascular risk assessment in religious and community settings has the potential to trigger lifestyle change in younger participants. These venues should be considered for future health promotional activities.

  7. Epidemiology of Postherpetic Neuralgia in Korea

    PubMed Central

    Hong, Myong-Joo; Kim, Yeon-Dong; Cheong, Yong-Kwan; Park, Seon-Jeong; Choi, Seung-Won; Hong, Hyon-Joo

    2016-01-01

    Abstract Postherpetic neuralgia (PHN) is a disease entity defined as persistent pain after the acute pain of herpes zoster gradually resolves. It is associated with impaired daily activities, resulting in reduced quality of life. General epidemiological data on PHN is necessary for the effective management. However, data on the epidemiology of PHN in Korea is lacking. The aim of this study was to evaluate the epidemiological features of PHN in the general population. We used population-based medical data for 51,448,491 subscribers to the Health Insurance Service in the year of 2013 to analyze of PHN epidemiology in Korea, such as the incidence, regional distribution, seasonal variation, and healthcare resource utilization. Total number of patients and medical cost on PHN were analyzed from 2009 to 2013. Findings indicate that the incidence of PHN in Korea was 2.5 per 1000 person-years, which was strongly correlated with age and sex. There were no differences in seasonal variation or regional distribution. The medical cost increased steadily over the study period. When admitted to general hospitals, patients with PHN were mainly managed in the dermatology and anesthesiology departments. The incidence and prevalence rates of PHN in Koreans appear to be considerably higher compared to those in western populations, while the sex and age predisposition was similar. Considering that the pain associated with PHN can have a marked impact on a patient's quality of life resulting in a medicosocial economic burden, anesthesiology physicians have an important role in primary care in Korea. Future research on the cost-effectiveness of the management of PHN is needed. PMID:27057902

  8. Effects of climate change on an emperor penguin population: analysis of coupled demographic and climate models.

    PubMed

    Jenouvrier, Stéphanie; Holland, Marika; Stroeve, Julienne; Barbraud, Christophe; Weimerskirch, Henri; Serreze, Mark; Caswell, Hal

    2012-09-01

    Sea ice conditions in the Antarctic affect the life cycle of the emperor penguin (Aptenodytes forsteri). We present a population projection for the emperor penguin population of Terre Adélie, Antarctica, by linking demographic models (stage-structured, seasonal, nonlinear, two-sex matrix population models) to sea ice forecasts from an ensemble of IPCC climate models. Based on maximum likelihood capture-mark-recapture analysis, we find that seasonal sea ice concentration anomalies (SICa ) affect adult survival and breeding success. Demographic models show that both deterministic and stochastic population growth rates are maximized at intermediate values of annual SICa , because neither the complete absence of sea ice, nor heavy and persistent sea ice, would provide satisfactory conditions for the emperor penguin. We show that under some conditions the stochastic growth rate is positively affected by the variance in SICa . We identify an ensemble of five general circulation climate models whose output closely matches the historical record of sea ice concentration in Terre Adélie. The output of this ensemble is used to produce stochastic forecasts of SICa , which in turn drive the population model. Uncertainty is included by incorporating multiple climate models and by a parametric bootstrap procedure that includes parameter uncertainty due to both model selection and estimation error. The median of these simulations predicts a decline of the Terre Adélie emperor penguin population of 81% by the year 2100. We find a 43% chance of an even greater decline, of 90% or more. The uncertainty in population projections reflects large differences among climate models in their forecasts of future sea ice conditions. One such model predicts population increases over much of the century, but overall, the ensemble of models predicts that population declines are far more likely than population increases. We conclude that climate change is a significant risk for the emperor penguin. Our analytical approach, in which demographic models are linked to IPCC climate models, is powerful and generally applicable to other species and systems. © 2012 Blackwell Publishing Ltd.

  9. Documenting and explaining the HIV decline in east Zimbabwe: the Manicaland General Population Cohort

    PubMed Central

    Gregson, Simon; Mugurungi, Owen; Eaton, Jeffrey; Takaruza, Albert; Rhead, Rebecca; Maswera, Rufurwokuda; Mutsvangwa, Junior; Mayini, Justin; Skovdal, Morten; Schaefer, Robin; Hallett, Timothy; Sherr, Lorraine; Munyati, Shungu; Mason, Peter; Campbell, Catherine; Garnett, Geoffrey P; Nyamukapa, Constance Anesu

    2017-01-01

    Purpose The Manicaland cohort was established to provide robust scientific data on HIV prevalence and incidence, patterns of sexual risk behaviour and the demographic impact of HIV in a sub-Saharan African population subject to a generalised HIV epidemic. The aims were later broadened to include provision of data on the coverage and effectiveness of national HIV control programmes including antiretroviral therapy (ART). Participants General population open cohort located in 12 sites in Manicaland, east Zimbabwe, representing 4 major socioeconomic strata (small towns, agricultural estates, roadside settlements and subsistence farming areas). 9,109 of 11,453 (79.5%) eligible adults (men 17-54 years; women 15–44 years) were recruited in a phased household census between July 1998 and January 2000. Five rounds of follow-up of the prospective household census and the open cohort were conducted at 2-year or 3-year intervals between July 2001 and November 2013. Follow-up rates among surviving residents ranged between 77.0% (over 3 years) and 96.4% (2 years). Findings to date HIV prevalence was 25.1% at baseline and had a substantial demographic impact with 10-fold higher mortality in HIV-infected adults than in uninfected adults and a reduction in the growth rate in the worst affected areas (towns) from 2.9% to 1.0%pa. HIV infection rates have been highest in young adults with earlier commencement of sexual activity and in those with older sexual partners and larger numbers of lifetime partners. HIV prevalence has since fallen to 15.8% and HIV incidence has also declined from 2.1% (1998-2003) to 0.63% (2009-2013) largely due to reduced sexual risk behaviour. HIV-associated mortality fell substantially after 2009 with increased availability of ART. Future plans We plan to extend the cohort to measure the effects on the epidemic of current and future HIV prevention and treatment programmes. Proposals for access to these data and for collaboration are welcome. PMID:28988165

  10. Forecasting consequences of changing sea ice availability for Pacific walruses

    USGS Publications Warehouse

    Udevitz, Mark S.; Jay, Chadwick V.; Taylor, Rebecca; Fischbach, Anthony S.; Beatty, William S.; Noren, Shawn R.

    2017-01-01

    The accelerating rate of anthropogenic alteration and disturbance of environments has increased the need for forecasting effects of environmental change on fish and wildlife populations. Models linking projections of environmental change with behavioral responses and bioenergetic effects can provide a basis for these forecasts. There is particular interest in forecasting effects of projected reductions in sea ice availability on Pacific walruses (Odobenus rosmarus divergens). Declining extent of summer sea ice in the Chukchi Sea has caused Pacific walruses to increase use of coastal haulouts and decrease use of more productive offshore feeding areas. Such climate-induced changes in distribution and behavior could ultimately affect the status of the population. We developed behavioral models to relate changes in sea ice availability to adult female walrus movements and activity levels, and adapted previously developed bioenergetics models to relate those activity levels to energy requirements and the ability to meet those requirements. We then linked these models to general circulation model projections of future ice availability to forecast autumn body condition for female walruses during mid- and late-century time periods. Our results suggest that as sea ice becomes less available in the Chukchi Sea, female walruses will spend more time in the southwestern region of that sea, less time resting, and less time foraging. Median forecasted autumn body masses were 7–12% lower in future scenarios than during recent times, but posterior distributions broadly overlapped and median forecasted seasonal mass losses (15–34%) were comparable to seasonal mass losses routinely experienced by other pinnipeds. These seasonal reductions in body condition would be unlikely to result in demographic effects, but if walruses were unable to rebuild endogenous reserves while wintering in the Bering Sea, cumulative effects could have implications for reproduction and survival, ultimately affecting the status of the Pacific walrus population. Our approach provides a general framework for forecasting consequences of the broad range of environmental changes and anthropogenic disturbances that may affect bioenergetics through behavioral responses or changes in prey availability.

  11. Understanding population and individual risk assessment: the case of polychlorinated biphenyls.

    PubMed

    Shields, Peter G

    2006-05-01

    Decisions about how to improve or protect the public health can be, and sometimes necessarily are, made on imprecise science. The regulation of potential human carcinogens in the environment entails a population-risk assessment process intended to reduce risks to less than one additional cancer in 100,000 or 1,000,000 persons. These risk assessment processes, however, may be miscommunicated or misinterpreted in the context of individual cancer risks by scientists, regulators, the lay media, and the public. This commentary will review methods for establishing a causal relationship between carcinogen exposures and cancer risk. It will use the case of polychlorinated biphenyls (PCB) as an example of how to place scientific data into the context of human exposure and cancer risk. PCBs are widespread environmental contaminants and most people have detectable levels of PCBs in their bodies. The primary source for exposure in the general population is through the diet. PCBs are carcinogens in experimental animal models, but how this information can be extrapolated to human risk remains uncertain. PCB experimental studies provide data that are used to regulate and control human exposure, although the epidemiologic evidence fails to establish PCBs as human carcinogens. Thus, what is used for population-risk assessment may not be appropriate for individual-risk assessment or concluding that a causal relationship exists between PCB exposure and cancer risk. The hazards from a carcinogen designated by regulatory and review agencies as a "probable" human carcinogen is often misunderstood out of context about the magnitude of the risk and in what settings. How scientists communicate their results in scientific articles can strongly influence how others interpret their data. Misunderstandings from both the use of regulatory and review-agency opinions and the conclusions espoused by scientists occur in the media, among private physicians counseling their patients about cancer risk, and in the legal settings where plaintiffs seek compensation for exposure and alleged harm (or future harm). This can lead to false conclusions about what caused a cancer in a specific patient, undue anxiety about future cancer risk, inappropriate cancer screening, and attendant increased morbidity due to increased uses of the medical system and complication rates from medical procedures. The communication of research findings by scientists must be presented with caution, resisting the temptation to extrapolate, inappropriately, research data to the general population.

  12. Mining Electronic Health Records Data: Domestic Violence and Adverse Health Effects

    PubMed Central

    Karakurt, Gunnur; Patel, Vishal; Whiting, Kathleen; Koyutürk, Mehmet

    2016-01-01

    Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims. The Domestic abuse population contained 5870 patients, while the Non-Domestic Abuse population contained 14,315,140 patients. Explorys provides National Big Data from the entire USA. Statistical analysis identified 2429 terms as significantly more prevalent among victims of domestic abuse, compared to the general population. These terms were classified into broad categories, including acute injury, chronic conditions, substance abuse, mental health, disorders, gynecological and pregnancy related problems. PMID:28435184

  13. 'Fair innings' in the face of ageing and demographic change.

    PubMed

    Hazra, Nisha C; Gulliford, Martin C; Rudisill, Caroline

    2018-04-01

    There are now 125 million people aged 80 years and over worldwide, projected by the United Nations to grow threefold by 2050. While increases in life expectancy and rapid increases in the older-age population are considered positive developments, the consequential future health care burden represents a leading concern for health services. We revisit Williams' 'fair innings' argument from 1997, in light of technological and demographic changes, and challenge the notion that greater longevity may impose an unfair burden on younger generations. We discuss perspectives on the equity-efficiency trade-off in terms of their implications for the growing over-80 population, as well as society in general. This includes questioning the comparison of treatment cost-effectiveness in younger vs. older populations when using quality-adjusted life years and the transience of life expectancies over generations. While recognising that there will never be a clear consensus regarding societal value judgements, we present empirical evidence on the very elderly that lends support to a stronger anti-ageist stance given current increases in longevity.

  14. Enhancement of cognitive and neural functions through complex reasoning training: evidence from normal and clinical populations

    PubMed Central

    Chapman, Sandra B.; Mudar, Raksha A.

    2014-01-01

    Public awareness of cognitive health is fairly recent compared to physical health. Growing evidence suggests that cognitive training offers promise in augmenting cognitive brain performance in normal and clinical populations. Targeting higher-order cognitive functions, such as reasoning in particular, may promote generalized cognitive changes necessary for supporting the complexities of daily life. This data-driven perspective highlights cognitive and brain changes measured in randomized clinical trials that trained gist reasoning strategies in populations ranging from teenagers to healthy older adults, individuals with brain injury to those at-risk for Alzheimer's disease. The evidence presented across studies support the potential for Gist reasoning training to strengthen cognitive performance in trained and untrained domains and to engage more efficient communication across widespread neural networks that support higher-order cognition. The meaningful benefits of Gist training provide compelling motivation to examine optimal dose for sustained benefits as well as to explore additive benefits of meditation, physical exercise, and/or improved sleep in future studies. PMID:24808834

  15. Multimodel inference to quantify the relative importance of abiotic factors in the population dynamics of marine zooplankton

    NASA Astrophysics Data System (ADS)

    Everaert, Gert; Deschutter, Yana; De Troch, Marleen; Janssen, Colin R.; De Schamphelaere, Karel

    2018-05-01

    The effect of multiple stressors on marine ecosystems remains poorly understood and most of the knowledge available is related to phytoplankton. To partly address this knowledge gap, we tested if combining multimodel inference with generalized additive modelling could quantify the relative contribution of environmental variables on the population dynamics of a zooplankton species in the Belgian part of the North Sea. Hence, we have quantified the relative contribution of oceanographic variables (e.g. water temperature, salinity, nutrient concentrations, and chlorophyll a concentrations) and anthropogenic chemicals (i.e. polychlorinated biphenyls) to the density of Acartia clausi. We found that models with water temperature and chlorophyll a concentration explained ca. 73% of the population density of the marine copepod. Multimodel inference in combination with regression-based models are a generic way to disentangle and quantify multiple stressor-induced changes in marine ecosystems. Future-oriented simulations of copepod densities suggested increased copepod densities under predicted environmental changes.

  16. Toward youth self-report of health and quality of life in population monitoring.

    PubMed

    Topolski, Tari D; Edwards, Todd C; Patrick, Donald L

    2004-01-01

    This paper addresses population monitoring of youth health and quality of life, including the concepts used, methodological and practical criteria for indicators, and existing surveys and measures. Current population surveys of youth generally focus on poor health, such as disability or health-risk behaviors. Although these are important end points, indicators of illness or risk do not reflect the health or life perspective of the majority of youth who do not experience health problems. The measures used to monitor youth health should be appropriate and sensitive to future needs and capture the perspectives of youths. Two potential concepts for this "scorecard" are self-perceived health and quality of life, which have been shown to be useful in adults. For youth, the quality of life framework seems particularly relevant as it incorporates both positive and negative aspects of health and well-being and also captures salient aspects of health other than physical health, such as sense of self, social relationships, environment and culture, and life satisfaction.

  17. Normative neurocognitive data for National Football League players: an initial compendium.

    PubMed

    Solomon, Gary S; Lovell, Mark R; Casson, Ira R; Viano, David C

    2015-03-01

    The use of clinical neuropsychological tests in the evaluation of National Football League (NFL) players has been ongoing for more than two decades. Prior research has demonstrated that the NFL population may perform differently than the general population on standard paper and pencil neuropsychological tests. Given the increased interest in the longitudinal and long-term assessment of neurocognitive functioning in this group of athletes, we reviewed the published neuropsychological literature in an attempt to compile an initial compendium of available normative data on paper and pencil as well as computerized neuropsychological tests for this group of football players. Thirteen published studies met the inclusion criteria, and the results are presented by athlete status (active vs. retired) and classified by neuropsychological domain. Suggestions for potential core batteries with this population are discussed, as are directions for future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Vulnerable Population Challenges in the Transformation of Cancer Care.

    PubMed

    Meneses, Karen; Landier, Wendy; Dionne-Odom, J Nicholas

    2016-05-01

    To consider current trends and future strategies that will bring about change in cancer care delivery for vulnerable populations. Institute of Medicine reports, literature review, clinical practice observations and experiences. Vulnerable populations are older adults, both minorities and the underserved, children, and individuals at end of life. These groups pose unique challenges that require health system changes and innovative nursing models to assure access to patient-centered care in the future. In the future, attention to the needs of vulnerable populations, the growing aging cancer population and the improved outcomes in the pediatric and adolescent cancer population will all require new nursing services and models of care. System changes where nursing roles are critical to support the transition to earlier palliative care are projected. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [Prevalence of psychiatric and substance use disorders among three generations of migrants: Results from French population cohort].

    PubMed

    Guardia, D; Salleron, J; Roelandt, J-L; Vaiva, G

    2017-10-01

    Mental health of migrant populations has become a major public health issue since these populations more often suffer from mental health problems than host populations. The influence of the migration process on the emergence of these disorders and its impact on future generations is uncertain. This study provides an estimate of the prevalence of mental disorders among three generations of migration. The study was conducted in the general population by the French Collaborating Center of the World Health Organization, in France, on a sample of 37,063 people aged 18 and older. The subjects interviewed were selected by a quota sampling method and, thus, were representative of the general population in the 47 study sites in France. This method develops a sample of subjects with the same characteristics as the general population on predefined issues, such as age, sex, educational level and socioprofessional category. The designation of migrant status was based on the country of birth of the subject, the subject's parents and the subject's grandparents. We defined a migrant as first generation (a subject born abroad; n=1911), second generation (at least one parent born abroad; n=4147), or third generation (at least one grandparent born abroad; n=3763) of migrants. The diagnostic tool used was the Mini International Neuropsychiatric Interview (MINI). The MINI is a brief structured diagnostic interview developed by psychiatrists for ICD-10 and DSM-IVTR psychiatric disorders in the general population. The comparisons by generation of migrants were performed by chi-square test for qualitative variables and by an analysis of variance for quantitative variables. The same tests were used to compare the presence of mental disorders according to the characteristics of the population. Factors with a P-value less than 0.2 were entered in a multivariable logistic regression to assess the relationship between the generation of migrants and the presence of mental disorders, adjusting for the confounding factors. Thirty-eight per cent of migrant subjects have psychological difficulties, versus 30 % in the host population. These results are observed on three successive generations of migrants. Migration status increases risk of depressive disorders (OR=1.555), bipolar disorder (OR=1.597, CI=1.146-2.227), post-traumatic stress disorder (OR=1.615), substance abuse (OR=2.522) and alcohol abuse (OR=1.524), and drug dependence (OR=2.116). This risk is maintained at the second and third generation. The migration process affects mental health of population regardless of socioeconomic status or geographic origin. The consideration of migration and generation of migration shows a specific psychopathological risk profile. This is related to the joint action of a migratory past and precarious socioeconomic situation. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  20. Factors leading to different viability predictions for a grizzly bear data set

    USGS Publications Warehouse

    Mills, L.S.; Hayes, S.G.; Wisdom, M.J.; Citta, J.; Mattson, D.J.; Murphy, K.

    1996-01-01

    Population viability analysis programs are being used increasingly in research and management applications, but there has not been a systematic study of the congruence of different program predictions based on a single data set. We performed such an analysis using four population viability analysis computer programs: GAPPS, INMAT, RAMAS/AGE, and VORTEX. The standardized demographic rates used in all programs were generalized from hypothetical increasing and decreasing grizzly bear (Ursus arctos horribilis) populations. Idiosyncracies of input format for each program led to minor differences in intrinsic growth rates that translated into striking differences in estimates of extinction rates and expected population size. In contrast, the addition of demographic stochasticity, environmental stochasticity, and inbreeding costs caused only a small divergence in viability predictions. But, the addition of density dependence caused large deviations between the programs despite our best attempts to use the same density-dependent functions. Population viability programs differ in how density dependence is incorporated, and the necessary functions are difficult to parameterize accurately. Thus, we recommend that unless data clearly suggest a particular density-dependent model, predictions based on population viability analysis should include at least one scenario without density dependence. Further, we describe output metrics that may differ between programs; development of future software could benefit from standardized input and output formats across different programs.

  1. Population pressures in Latin America. [Updated reprint].

    PubMed

    Merrick, T W

    1991-04-01

    This publication examines the main demographic changes in Latin America since World War II, and considers their social and economic impact on the region. The paper looks at the following demographic trends: population growth, fertility, death rate, internal migration, international migration, and age structure. It also examines other factors such as marriage and family structure, and employment and education. Furthermore, the publication provides a discussion of the relationship between population growth and economic development from both a neo-Malthusian and Structuralist view. Finally, the paper considers the region's current population policies and future population prospects. From 1950-65, annual population growth averaged 2.8%, which decreased moderately to 2.4% from 1965-85. The report identified 3 population growth patterns in the region: 1) countries which experienced early and gradual declines in birth and death rates and generally lower population growth rates (the group includes Argentina, Cuba, Uruguay, with Chile and Panama also closely fitting the description); 2) countries which underwent rapid declines in birth rate during the 1950s and which began experiencing declines in the birth rate after 1960 (Brazil, Colombia, Costa Rica, the Dominican Republic, Mexico, Paraguay, and Venezuela, with Ecuador and Peru as borderline cases); and 3) countries which didn't begin to experience declines in mortality rates until relatively late and which lag behind in fertility declines (Bolivia, Haiti, El Salvador, Guatemala, Honduras, and Nicaragua). Although population growth has slowed and will continue to fall, UN projections do not expect the population to stabilize until late in the 21st Century.

  2. Implementation of Ultraviolet Radiation Safety Measures for Outdoor Workers.

    PubMed

    Maguire, Erin; Spurr, Alison

    Ultraviolet radiation (UVR) poses a major risk for outdoor workers, putting them at greater risk for skin cancer. In the general population, the incidence of both melanoma and nonmelanoma skin cancers is increasing. It is estimated that 90% of skin cancers in Canada are directly attributable to UVR exposure, making this cancer largely preventable with the appropriate precautions. A scoping review was conducted on the barriers and facilitators to UVR safety in outdoor workers to elucidate why these precautions are not in use currently. We discuss these results according to the Hierarchy of Controls as a means to outline effective and feasible prevention strategies for outdoor workers. In doing so, this review may be used to inform the design of future workplace interventions for UVR safety in outdoor workers to decrease the risk of skin cancer in this vulnerable population.

  3. Cybervictimization of Young People With an Intellectual or Developmental Disability: Risks Specific to Sexual Solicitation.

    PubMed

    Normand, Claude L; Sallafranque-St-Louis, François

    2016-03-01

    Studies demonstrate that youth are vulnerable to online sexual solicitation. However, no study has estimated this risk for youth diagnosed with an intellectual or developmental disability (IDD). A literature review of the risk factors associated with online sexual solicitation in youths was done using electronic databases, such as PsychInFO, ERIC, MEDLINE and Scopus. Fifty-seven published papers were found relevant. However, only two pertained to the population with IDD. Sexual and physical abuse, social isolation, loneliness, depression, and chatting were found to increase the risk of being prey to sexual solicitation on the Internet. Many of these risk factors are even more prevalent in youth with IDD than in the general population. Recommendations are made for future research to help understand and prevent sexual cybersolicitation. © 2015 John Wiley & Sons Ltd.

  4. From Hofmann to the Haight Ashbury, and into the future: the past and potential of lysergic acid diethlyamide.

    PubMed

    Smith, David E; Raswyck, Glenn E; Davidson, Leigh Dickerson

    2014-01-01

    Since the discovery of its psychedelic properties in 1943, lysergic acid diethylamide (LSD) has been explored by psychiatric/therapeutic researchers, military/intelligence agencies, and a significant portion of the general population. Promising early research was halted by LSD's placement as a Schedule I drug in the early 1970s. The U.S. Army and CIA dropped their research after finding it unreliable for their purposes. NSDUH estimates that more than 22 million (9.1% of the population) have used LSD at least once in their lives. Recently, researchers have been investigating the therapeutic use of LSD and other psychedelics for end-of-life anxiety, post-traumatic stress disorder (PTSD), cancer, and addiction treatment. Adverse psychedelic reactions can be managed using talkdown techniques developed and in use since the 1960s.

  5. Migration in the context of vulnerability and adaptation to climate change: insights from analogues

    PubMed Central

    McLeman, Robert A.; Hunter, Lori M.

    2011-01-01

    Migration is one of the variety of ways by which human populations adapt to environmental changes. The study of migration in the context of anthropogenic climate change is often approached using the concept of vulnerability and its key functional elements: exposure, system sensitivity, and adaptive capacity. This article explores the interaction of climate change and vulnerability through review of case studies of dry-season migration in the West African Sahel, hurricane-related population displacements in the Caribbean basin, winter migration of ‘snowbirds’ to the US Sun-belt, and 1930s drought migration on the North American Great Plains. These examples are then used as analogues for identifying general causal, temporal, and spatial dimensions of climate migration, along with potential considerations for policy-making and future research needs. PMID:22022342

  6. Adverse Childhood Experiences in a Post-bariatric Surgery Psychiatric Inpatient Sample.

    PubMed

    Fink, Kathryn; Ross, Colin A

    2017-12-01

    Sixty-three inpatients in a psychiatric hospital who had previously undergone bariatric surgery were interviewed by the hospital dietitian. The purpose of the study was to determine the frequency of adverse childhood experiences in this population. Participants completed the Adverse Childhood Experiences (ACE) Scale. The average score on the ACE was 5.4 (3.3); 76% of participants reported childhood emotional neglect, 70% childhood verbal abuse, and 64% childhood sexual abuse; only two participants reported no adverse childhood experiences. The participants in the study reported high levels of adverse childhood experiences compared to the general population, which is consistent with prior literature on rates of childhood trauma in post-bariatric surgery patients. The role of adverse childhood experiences in post-bariatric surgery adaptation should be investigated in future research, including in prospective studies.

  7. Safety of Reiki Therapy for Newborns at Risk for Neonatal Abstinence Syndrome

    PubMed Central

    Wright-Esber, Sandra; Zupancic, Julie; Gargiulo, Deb; Woodall, Patricia

    2018-01-01

    The incidence of opioid abuse and subsequent drug withdrawal is exponentially on the rise in the United States for many populations including newborns who are born to drug-addicted mothers. These newborns often exhibit symptoms of neonatal abstinence syndrome (NAS) within 24 to 72 hours of birth. Treatment of NAS includes monitoring of withdrawal symptoms, managing physiological parameters, and the use of supportive and pharmacologic treatments. Although a few randomized controlled trials exist, studies on supportive intervention are generally limited by small sample sizes, case study reports, expert opinions, and descriptive design. Few studies address the safety of Reiki for newborns at risk for NAS using neonatal parameters. This pilot study addresses feasibility and demonstrates that Reiki is safe when administered to this high-risk population. Considerations for future studies are discussed. PMID:29315084

  8. A systematic review of recent research on adolescent religiosity/spirituality and mental health.

    PubMed

    Wong, Y Joel; Rew, Lynn; Slaikeu, Kristina D

    2006-01-01

    There is accumulating evidence that religiosity/spirituality (R/S) are important correlates of mental health in adult populations. However, the associations between R/S and mental heath in adolescent populations have not been systematically studied. The purpose of this article is to report on a systematic review of recent research on the relationships between adolescent R/S and mental health. Twenty articles between 1998 and 2004 were reviewed. Most studies (90%) showed that higher levels of R/S were associated with better mental health in adolescents. Institutional and existential dimensions of R/S had the most robust relationships with mental health. The relationships between R/S and mental health were generally stronger or more unique for males and older adolescents than for females and younger adolescents. Recommendations for future research and implications for mental health nursing are discussed.

  9. Assessing recent and near-future changes in Southern California's groundwater storage from the perspective of regional climate modeling

    NASA Astrophysics Data System (ADS)

    De Sales, F.; Rother, D.

    2017-12-01

    Current climate change assessments project an increase in temperature throughout the western U.S. over the next century, while precipitation is projected to decrease in the Southwest. These assessments are based mainly on coarse spatial resolution general circulation model (GCM) simulations, which do not include groundwater (soil and aquifer) storage projections. However, water availability is a regionally variable resource and climate change impacts on groundwater distribution will probably differ regionally across the southwestern U.S. We have implemented a coupled atmosphere-biosphere-aquifer regional modelling system (WRF/SSiB2/SIMGM) to generate recent (2005-2017) and near-future (2018-2030) high-resolution groundwater projections for Southern California. These projections are obtained by dynamic downscaling data from the Global Operation Analysis (recent) and the NCAR Community Earth System Model CMIP5 global projections (near future), which supported the Intergovernmental Panel on Climate Change 5th Assessment Report. Near-future simulations include three representative concentration pathway (RCP) scenarios namely, RCP4.5, RCP6, and RCP8.5. The model can reasonably simulate the recent changes in Southern California's groundwater as indicated by a comparison to terrestrial water storage obtained from the Gravity Recovery and Climate Experiment dataset. In particular, the 2011-2017 drought is simulated well with total groundwater storages declining throughout the period, especially along the western portion of the domain, which includes the high-populated areas of western Los Angeles, San Diego, Ventura and Orange counties. In general, the near-future simulations show a decline in groundwater storage for the region. The largest changes are observed with the RCP8.5 emission pathway, towards to southeastern tier of the study area. In addition to groundwater, this downscaling experiment also generates high-resolution precipitation and temperature estimates, which can help policy makers in the development of strategies to alleviate potential water resource deficiencies in California in the near future.

  10. Engaging the oldest old in research: lessons from the Newcastle 85+ study.

    PubMed

    Davies, Karen; Collerton, Joanna C; Jagger, Carol; Bond, John; Barker, Sally A H; Edwards, June; Hughes, Joan; Hunt, Judith M; Robinson, Louise

    2010-09-17

    Those aged 85 and over, the oldest old, are now the fastest growing sector of the population. Information on their health is essential to inform future planning; however, there is a paucity of up-to-date information on the oldest old, who are often excluded from research. The aim of the Newcastle 85+ Study is to investigate the health of a cohort of 85-year-olds from a biological, medical and psychosocial perspective. This paper describes the methods employed for the successful recruitment, retention and evaluation of this cohort. Participants were all individuals born in 1921 and registered with a participating general practice in Newcastle and North Tyneside, UK. Involvement comprised detailed health assessments, by a nurse, in their usual place of residence and/or review of their general practice medical records. Of the 1453 individuals eligible to participate, 72% (n = 1042) were recruited; 59% (n = 851) consented to both health assessment and review of general practice records. Key factors for successful involvement included protected time to engage with family and other key gatekeepers, minimising participant burden, through for example home based assessment, and flexibility of approach. Cognitive impairment is a significant issue; due consideration should be given to the ethical and legal issues of capacity and consent. Interim withdrawal rates at phase 2 (18 month post baseline), show 88 out of 854 participants (10%) had withdrawn with approval for continued use of data and materials and a further 2 participants (0.2%) had withdrawn and requested that all data be destroyed. Attrition due to death of participants within this same time frame was 135 (16%). Our recruitment rates were good and compared favourably with other similar UK and international longitudinal studies of the oldest old. The challenges of and successful strategies for involving, recruiting and retaining the oldest old in research, including those in institutions, are described to facilitate adequate representation of this growing population in future research into ageing.

  11. Cost-effectiveness analysis of HPV vaccination: comparing the general population with socially vulnerable individuals.

    PubMed

    Han, Kyu-Tae; Kim, Sun Jung; Lee, Seo Yoon; Park, Eun-Cheol

    2014-01-01

    After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

  12. Genetic maladaptation of coastal Douglas-fir seedlings to future climates

    Treesearch

    Brad St. Clair;  Glenn T. Howe

    2007-01-01

    Climates are expected to warm considerably over the next century, resulting in expectations that plant populations will not be adapted to future climates.We estimated the risk of maladaptation of current populations of coastal Douglas-fir (Pseudotsuga menziesii var. menziesii) to future climates as the proportion of nonoverlap between two normal...

  13. User Experience Evaluation of a Smoking Cessation App in People With Serious Mental Illness.

    PubMed

    Vilardaga, Roger; Rizo, Javier; Kientz, Julie A; McDonell, Michael G; Ries, Richard K; Sobel, Kiley

    2016-05-01

    Smoking rates among people with serious mental illness are 3 to 4 times higher than the general population, yet currently there are no smoking cessation apps specifically designed to address this need. We report the results of a User Experience (UX) evaluation of a National Cancer Institute smoking cessation app, QuitPal, and provide user centered design data that can be used to tailor smoking cessation apps for this population. Two hundred forty hours of field experience with QuitPal, 10 hours of recorded interviews and task performances, usage logs and a self-reported usability scale, informed the results of our study. Participants were five individuals recruited from a community mental health clinic with a reported serious mental illness history. Performance, self-reports, usage logs and interview data were triangulated to identify critical usability errors and UX themes emerging from this population. Data suggests QuitPal has below average levels of usability, elevated time on task performances and required considerable amounts of guidance. UX themes provided critical information to tailor smoking cessation apps for this population, such as the importance of breaking down "cessation" into smaller steps and use of a reward system. This is the first study to examine the UX of a smoking cessation app among people with serious mental illness. Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for this highly nicotine dependent yet under-served population. Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for people with serious mental illness, a highly nicotine dependent yet under-served population. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Time to Evolve? Potential Evolutionary Responses of Fraser River Sockeye Salmon to Climate Change and Effects on Persistence

    PubMed Central

    Reed, Thomas E.; Schindler, Daniel E.; Hague, Merran J.; Patterson, David A.; Meir, Eli; Waples, Robin S.; Hinch, Scott G.

    2011-01-01

    Evolutionary adaptation affects demographic resilience to climate change but few studies have attempted to project changes in selective pressures or quantify impacts of trait responses on population dynamics and extinction risk. We used a novel individual-based model to explore potential evolutionary changes in migration timing and the consequences for population persistence in sockeye salmon Oncorhynchus nerka in the Fraser River, Canada, under scenarios of future climate warming. Adult sockeye salmon are highly sensitive to increases in water temperature during their arduous upriver migration, raising concerns about the fate of these ecologically, culturally, and commercially important fish in a warmer future. Our results suggest that evolution of upriver migration timing could allow these salmon to avoid increasingly frequent stressful temperatures, with the odds of population persistence increasing in proportion to the trait heritability and phenotypic variance. With a simulated 2°C increase in average summer river temperatures by 2100, adult migration timing from the ocean to the river advanced by ∼10 days when the heritability was 0.5, while the risk of quasi-extinction was only 17% of that faced by populations with zero evolutionary potential (i.e., heritability fixed at zero). The rates of evolution required to maintain persistence under simulated scenarios of moderate to rapid warming are plausible based on estimated heritabilities and rates of microevolution of timing traits in salmon and related species, although further empirical work is required to assess potential genetic and ecophysiological constraints on phenological adaptation. These results highlight the benefits to salmon management of maintaining evolutionary potential within populations, in addition to conserving key habitats and minimizing additional stressors where possible, as a means to build resilience to ongoing climate change. More generally, they demonstrate the importance and feasibility of considering evolutionary processes, in addition to ecology and demography, when projecting population responses to environmental change. PMID:21738573

  15. Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

    PubMed

    Hyseni, Lirije; Elliot-Green, Alex; Lloyd-Williams, Ffion; Kypridemos, Chris; O'Flaherty, Martin; McGill, Rory; Orton, Lois; Bromley, Helen; Cappuccio, Francesco P; Capewell, Simon

    2017-01-01

    Non-communicable disease (NCD) prevention strategies now prioritise four major risk factors: food, tobacco, alcohol and physical activity. Dietary salt intake remains much higher than recommended, increasing blood pressure, cardiovascular disease and stomach cancer. Substantial reductions in salt intake are therefore urgently needed. However, the debate continues about the most effective approaches. To inform future prevention programmes, we systematically reviewed the evidence on the effectiveness of possible salt reduction interventions. We further compared "downstream, agentic" approaches targeting individuals with "upstream, structural" policy-based population strategies. We searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy focussing on the effectiveness of population interventions to reduce salt intake. Retrieved papers were independently screened, appraised and graded for quality by two researchers. To facilitate comparisons between the interventions, the extracted data were categorised using nine stages along the agentic/structural continuum, from "downstream": dietary counselling (for individuals, worksites or communities), through media campaigns, nutrition labelling, voluntary and mandatory reformulation, to the most "upstream" regulatory and fiscal interventions, and comprehensive strategies involving multiple components. After screening 2,526 candidate papers, 70 were included in this systematic review (49 empirical studies and 21 modelling studies). Some papers described several interventions. Quality was variable. Multi-component strategies involving both upstream and downstream interventions, generally achieved the biggest reductions in salt consumption across an entire population, most notably 4g/day in Finland and Japan, 3g/day in Turkey and 1.3g/day recently in the UK. Mandatory reformulation alone could achieve a reduction of approximately 1.45g/day (three separate studies), followed by voluntary reformulation (-0.8g/day), school interventions (-0.7g/day), short term dietary advice (-0.6g/day) and nutrition labelling (-0.4g/day), but each with a wide range. Tax and community based counselling could, each typically reduce salt intake by 0.3g/day, whilst even smaller population benefits were derived from health education media campaigns (-0.1g/day). Worksite interventions achieved an increase in intake (+0.5g/day), however, with a very wide range. Long term dietary advice could achieve a -2g/day reduction under optimal research trial conditions; however, smaller reductions might be anticipated in unselected individuals. Comprehensive strategies involving multiple components (reformulation, food labelling and media campaigns) and "upstream" population-wide policies such as mandatory reformulation generally appear to achieve larger reductions in population-wide salt consumption than "downstream", individually focussed interventions. This 'effectiveness hierarchy' might deserve greater emphasis in future NCD prevention strategies.

  16. Prevalence of Psychiatric Disorders among the Rural Geriatric Population: A Pilot Study in Karnataka, India

    PubMed Central

    Nair, Sreejith S.; Raghunath, Pooja; Nair, Sreekanth S.

    2015-01-01

    Background: Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India. Methods: This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software. Results: We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196) as compared to males who had a prevalence of 42.4% (72 out of 170). The most common psychiatric disorder was depression (21.9%), and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of affected individuals in 80+ age group. Conclusion: Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly. A system that ensures comprehensive health care will have to be developed for this purpose as part of our future efforts. PMID:29138712

  17. Prevalence of Psychiatric Disorders among the Rural Geriatric Population: A Pilot Study in Karnataka, India.

    PubMed

    Nair, Sreejith S; Raghunath, Pooja; Nair, Sreekanth S

    2015-01-01

    Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India. This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software. We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196) as compared to males who had a prevalence of 42.4% (72 out of 170). The most common psychiatric disorder was depression (21.9%), and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of affected individuals in 80+ age group. Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly. A system that ensures comprehensive health care will have to be developed for this purpose as part of our future efforts.

  18. General practitioners’ views of clinically led commissioning: cross-sectional survey in England

    PubMed Central

    Moran, Valerie; Checkland, Kath; Coleman, Anna; Spooner, Sharon; Gibson, Jonathan; Sutton, Matt

    2017-01-01

    Objectives Involving general practitioners (GPs) in the commissioning/purchasing of services has been an important element in English health policy for many years. The Health and Social Care Act 2012 handed responsibility for commissioning of the majority of care for local populations to GP-led Clinical Commissioning Groups (CCGs). In this paper, we explore GP attitudes to involvement in commissioning and future intentions for engagement. Design and setting Survey of a random sample of GPs across England in 2015. Method The Eighth National GP Worklife Survey was distributed to GPs in spring 2015. Responses were received from 2611 respondents (response rate = 46%). We compared responses across different GP characteristics and conducted two sample tests of proportions to identify statistically significant differences in responses across groups. We also used multivariate logistic regression to identify the characteristics associated with wanting a formal CCG role in the future. Results While GPs generally agree that they can add value to aspects of commissioning, only a minority feel that this is an important part of their role. Many current leaders intend to quit in the next 5 years, and there is limited appetite among those not currently in a formal role to take up such a role in the future. CCGs were set up as ‘membership organisations’ but only a minority of respondents reported feeling that they had ‘ownership’ of their local CCG and these were often GPs with formal CCG roles. However, respondents generally agree that the CCG has a legitimate role in influencing the work that they do. Conclusion CCGs need to engage in active succession planning to find the next generation of GP leaders. GPs believe that CCGs have a legitimate role in influencing their work, suggesting that there may be scope for CCGs to involve GPs more fully in roles short of formal leadership. PMID:28596217

  19. General practitioners' views of clinically led commissioning: cross-sectional survey in England.

    PubMed

    Moran, Valerie; Checkland, Kath; Coleman, Anna; Spooner, Sharon; Gibson, Jonathan; Sutton, Matt

    2017-06-08

    Involving general practitioners (GPs) in the commissioning/purchasing of services has been an important element in English health policy for many years. The Health and Social Care Act 2012 handed responsibility for commissioning of the majority of care for local populations to GP-led Clinical Commissioning Groups (CCGs). In this paper, we explore GP attitudes to involvement in commissioning and future intentions for engagement. Survey of a random sample of GPs across England in 2015. The Eighth National GP Worklife Survey was distributed to GPs in spring 2015. Responses were received from 2611 respondents (response rate = 46%). We compared responses across different GP characteristics and conducted two sample tests of proportions to identify statistically significant differences in responses across groups. We also used multivariate logistic regression to identify the characteristics associated with wanting a formal CCG role in the future. While GPs generally agree that they can add value to aspects of commissioning, only a minority feel that this is an important part of their role. Many current leaders intend to quit in the next 5 years, and there is limited appetite among those not currently in a formal role to take up such a role in the future. CCGs were set up as 'membership organisations' but only a minority of respondents reported feeling that they had 'ownership' of their local CCG and these were often GPs with formal CCG roles. However, respondents generally agree that the CCG has a legitimate role in influencing the work that they do. CCGs need to engage in active succession planning to find the next generation of GP leaders. GPs believe that CCGs have a legitimate role in influencing their work, suggesting that there may be scope for CCGs to involve GPs more fully in roles short of formal leadership. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Histologic types of gastric cancer among migrants from the former Soviet Union and the general population in Germany: what kind of prevention do we need?

    PubMed

    Jaehn, Philipp; Holleczek, Bernd; Becher, Heiko; Winkler, Volker

    2016-08-01

    The incidence of gastric cancer (GC) is high among migrants from Eastern Europe and Asia, but a detailed picture of disease characteristics is missing. Our study examined the incidence of histologic types among resettlers from the former Soviet Union and the general population in Germany to draw conclusions on risk factors and possible prevention strategies. Between 1990 and 2009, all GC diagnoses among a cohort of 18 619 resettlers residing in the Saarland were identified in the Saarland Cancer Registry database. Age-standardized incidence rates (ASRs) of the entire Saarland population and standardized incidence ratios (SIRs) of resettlers compared with the Saarland population were calculated for types according to Laurén. In addition, ASRs and SIRs were modeled using Poisson's regression to investigate time trends. The ASR of intestinal GC in the Saarland population decreased over time, whereas the ASR of diffuse GC remained unchanged. Resettlers' incidence of intestinal GC was elevated among men [SIR: 3.04, 95% confidence interval (CI): 2.05-4.50] and women (SIR: 2.78, 95% CI: 1.61-4.79), whereas diffuse GC was elevated only among women (SIR: 1.98, 95% CI: 1.07-3.69). No time trends for SIRs could be observed in regression analysis. Different trends of diffuse GC incidence in Germany and the USA underline the importance of environmental risk factors. The continuously elevated risk of GC among male resettlers is probably associated with risk factors affecting exclusively the intestinal type such as a low intake of fruit and vegetables and heavy alcohol consumption. Future prevention programs for resettlers should include dietary measures.

  1. Modernization is Associated with Intensive Breastfeeding Patterns in the Bolivian Amazon

    PubMed Central

    Veile, Amanda; Martin, Melanie; McAllister, Lisa

    2014-01-01

    For many traditional, non-industrialized populations, intensive and prolonged breastfeeding buffers infant health against poverty, poor sanitation, and limited health care. Due to novel influences on local economies, values, and beliefs, the traditional and largely beneficial breastfeeding patterns of such populations may be changing to the detriment of infant health. To assess if and why such changes are occurring in a traditional breastfeeding population, we document breastfeeding patterns in the Bolivian Tsimane, a forager-horticulturalist population in the early stages of modernization. Three predictions are developed and tested to evaluate the general hypothesis that modernizing influences encourage less intensive breastfeeding in the Tsimane: 1) Tsimane mothers in regions of higher infant mortality will practice more intensive BF; 2) Tsimane mothers who are located closer to a local market town will practice more intensive BF; and 3) Older Tsimane mothers will practice more intensive BF. Predictions were tested using a series of maternal interviews (from 2003-2011, n=215) and observations of mother-infant dyads (from 2002-2007, n=133). Tsimane breastfeeding patterns were generally intensive: 72% of mothers reported initiating BF within a few hours of birth, mean (± SD) age of CF introduction was 4.1±2.0 months, and mean (± SD) weaning age was 19.2±7.3 months. There was, however, intra-population variation in several dimensions of breastfeeding (initiation, frequency, duration, and complementary feeding). Contrary to our predictions, breastfeeding was most intensive in the most modernized Tsimane villages, and maternal age was not a significant predictor of breastfeeding patterns. Regional differences accounted for variation in most dimensions of breastfeeding (initiation, frequency, and complementary feeding). Future research should therefore identify constraints on breastfeeding in the less modernized Tsimane regions, and examine the formation of maternal beliefs regarding infant feeding. PMID:24444850

  2. Breeding biology of the blue-gray noddy

    USGS Publications Warehouse

    Rauson, M.J.; Harrison, C.S.; Clapp, R.B.

    1984-01-01

    Blue-gray Noddies, the smallest marine terns, are similar in many respects to all tropical terns in Hawaii: single-egg clutches are laid, growth and development take about 7 weeks, breeding is colonial. Its small size results in eggs that comprise over 27% of adult body weight, compared to 15-20% for most marine terns (Langham 1983). Blue-gray Noddies are widespread in the tropical Pacific, but populations are generally small. This may be the result of its inshore feeding habits and the fact that it is a resident species (Diamond 1978). However, populations in the Hawaiian Archipelago are probably limited by the availability of suitable nest sites in cliffs or rocky outcrops, not food supplies..... Food habits in Hawaii confirm the unique dependence of this species on sea-striders but consumption may be seasonal Blue-gray Noddies take the smallest prey of any seabird in Hawaii and may feed on a lower trophic level..... The Hawaiian population is apparently heavier and produces larger eggs than Blue-gray Noddies elsewhere in the Pacific. This conforms with the general proposition that Hawaiian seabirds are larger than those in the central Pacific (Harrison et al. 1983). The Hawaiian population also has a more predictable breeding season than those farther south.This may be due to a greater seasonality of food supply, but the factors that control the timing of breeding are not clear. There does not appear to be any competition for nest sites with other seabirds.....Our information on growth and development will enable future investigators to estimate the ages of chicks during brief visits to Blue-gray Noddy colonies. This will facilitate programs that are designed to monitor the basic health of seabird populations and to detect changes from baseline that may result from human activities or oceanographic conditions.

  3. Access all areas? An area-level analysis of accessibility to general practice and community pharmacy services in England by urbanity and social deprivation

    PubMed Central

    Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare

    2015-01-01

    Objectives (1) To determine the percentage of the population in England that has access to a general practitioner (GP) premises within a 20 min walk (the accessibility); (2) explore the relationship between the walking distance to a GP premises and urbanity and social deprivation and (3) compare accessibility of a GP premises to that of a community pharmacy—and how this may vary by urbanity and social deprivation. Design This area-level analysis spatial study used postcodes for all GP premises and community pharmacies in England. Each postcode was assigned to a population lookup table and Lower Super Output Area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe, or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score 2010). Primary outcome measure Living within a 20 min walk of a GP premises. Results Overall, 84.8% of the population is estimated to live within a 20 min walk of a GP premises: 81.2% in the most affluent areas, 98.2% in the most deprived areas, 94.2% in urban and 19.4% in rural areas. This is consistently lower when compared with the population living within a 20 min walk of a community pharmacy. Conclusions Our study shows that the vast majority of the population live within a 20 min walk of a GP premises, with higher proportions in the most deprived areas—a positive primary care law. However, more people live within a 20 min walk of a community pharmacy compared with a GP premises, and this potentially has implications for the commissioning of future services from these healthcare providers in England. PMID:25956762

  4. The acoustic repertoire of the Atlantic Forest Rocket Frog and its consequences for taxonomy and conservation (Allobates, Aromobatidae)

    PubMed Central

    Forti, Lucas Rodriguez; da Silva, Thaís Renata Ávila; Toledo, Luís Felipe

    2017-01-01

    Abstract The use of acoustic signals is a common characteristic of most anuran species to mediate intraspecific communication. Besides many social purposes, one of the main functions of these signals is species recognition. For this reason, this phenotypic trait is normally applied to taxonomy or to construct evolutionary relationship hypotheses. Here the acoustic repertoire of five populations of the genus Allobates from the Brazilian Atlantic Forest are presented for the first time, on a vulnerable to extinction Neotropical taxon. The description of males’ advertisement and aggressive calls and a female call emitted in a courtship context are presented. In addition, the advertisement calls of individuals from distinct geographical regions were compared. Differences in frequency range and note duration may imply in taxonomic rearrangements of these populations, once considered distinct species, and more recently, proposed as a single species, Allobates olfersioides. Calls of the male from the state of Rio de Janeiro do not overlap spectrally with calls of males from northern populations, while the shorter notes emitted by males from Alagoas also distinguishes this population from the remaining southern populations. Therefore, it is likely that at least two of the junior synonyms should be revalidated. Similarities among male advertisement and female calls are generally reported in other anuran species; these calls may have evolved from a preexisting vocalization common to both sexes. Male aggressive calls were different from both the male advertisement and female calls, since it was composed by a longer and multi-pulsed note. Aggressive and advertisement calls generally have similar dominant frequencies, but they have temporal distinctions. Such patterns were corroborated with the Atlantic Forest Rocket Frogs. These findings may support future research addressing the taxonomy of the group, behavioral evolution, and amphibian conservation. PMID:29133990

  5. The acoustic repertoire of the Atlantic Forest Rocket Frog and its consequences for taxonomy and conservation (Allobates, Aromobatidae).

    PubMed

    Forti, Lucas Rodriguez; da Silva, Thaís Renata Ávila; Toledo, Luís Felipe

    2017-01-01

    The use of acoustic signals is a common characteristic of most anuran species to mediate intraspecific communication. Besides many social purposes, one of the main functions of these signals is species recognition. For this reason, this phenotypic trait is normally applied to taxonomy or to construct evolutionary relationship hypotheses. Here the acoustic repertoire of five populations of the genus Allobates from the Brazilian Atlantic Forest are presented for the first time, on a vulnerable to extinction Neotropical taxon. The description of males' advertisement and aggressive calls and a female call emitted in a courtship context are presented. In addition, the advertisement calls of individuals from distinct geographical regions were compared. Differences in frequency range and note duration may imply in taxonomic rearrangements of these populations, once considered distinct species, and more recently, proposed as a single species, Allobates olfersioides . Calls of the male from the state of Rio de Janeiro do not overlap spectrally with calls of males from northern populations, while the shorter notes emitted by males from Alagoas also distinguishes this population from the remaining southern populations. Therefore, it is likely that at least two of the junior synonyms should be revalidated. Similarities among male advertisement and female calls are generally reported in other anuran species; these calls may have evolved from a preexisting vocalization common to both sexes. Male aggressive calls were different from both the male advertisement and female calls, since it was composed by a longer and multi-pulsed note. Aggressive and advertisement calls generally have similar dominant frequencies, but they have temporal distinctions. Such patterns were corroborated with the Atlantic Forest Rocket Frogs. These findings may support future research addressing the taxonomy of the group, behavioral evolution, and amphibian conservation.

  6. Prevalence of sexually transmitted infections and the sexual behavior of elderly people presenting to health examination centers in Korea.

    PubMed

    Choe, Hyun-Sop; Lee, Seung-Ju; Kim, Chul Sung; Cho, Yong-Hyun

    2011-08-01

    Sexually transmitted infections are diseases provoking a great social and economic burden as well as health-related problems, and with the aging of society and the extension of life expectancy sexually transmitted infections in the elderly have drawn more attention these days. For the management of sexually transmitted infections in this population, basic epidemiological data need to be established. In this study, 1,804 persons from the general population aged over 60 years visiting health examination centers were tested for syphilis, gonorrhea, and chlamydia, and interviewed about the patterns of sexual behavior of elderly people through questionnaires. The prevalence rates of syphilis, gonorrhea, and chlamydia recorded were 0.222% (4/1804), 0 (none), and 0.776% (14/1804), respectively. The results of the survey showed that the sexual life of the elderly people was currently active, and the sexual behavior of chlamydia patients was distinguished in some characteristics from that of the general participants. Political management to prevent sexually transmitted infections needs to be continued in elderly people as it is in other age groups. More detailed follow-up studies are necessary to determine the incidence and prevalence rates of the diseases in the elderly population in future, and the results of this study are considered to be useful as basic data for such studies.

  7. Early death in active professional athletes: Trends and causes.

    PubMed

    Lemez, S; Wattie, N; Baker, J

    2016-05-01

    The objective of the study was to examine mortality trends and causes of death among professional athletes from the four major sports in North America who died during their playing careers. 205 deceased athletes who were registered as active when they died from the National Basketball Association (NBA), National Football League (NFL), National Hockey League (NHL), and Major League Baseball (MLB) were examined. Results were compared with the Canadian and U.S. general population. The leading causes of death in players reflected the leading causes of death in the Canadian and U.S. general population (i.e., car accidents). Descriptively, NFL and NBA players had a higher likelihood of dying in a car accident (OR 1.75, 95% CI: 0.91-3.36) compared with NHL and MLB players. In addition, NFL and NBA players had a significantly higher likelihood of dying from a cardiac-related illness (OR 4.44, 95% CI: 1.59-12.43). Mortality trends were disproportionate to team size. Overall, death in active athletes is low. Out of 53 400 athletes who have historically played in the four leagues, only 205 died while active (0.38%). Future examinations into the trends and causes of mortality in elite athlete populations will create a better understanding of health-related risks in elite sport. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Insight into the number of pre-malignancies and malignancies of the skin in a hospital population in the Netherlands.

    PubMed

    van Rijsingen, Margit; Seubring, Inge; Maessen-Visch, Birgitte; Lavrijsen, Sjan; van Bergen, Bert; Groenewoud, Johannes; Gerritsen, Marie-Jeanne

    2015-01-01

    Skin cancer incidence is rising, placing a burden on healthcare systems worldwide. This problem may even be more extensive than expected, since registration of (pre)malignancies of the skin is poor. To provide insight into the numbers of (pre)malignancies in patients with actinic keratosis (AK) or basal cell carcinoma (BCC) in 2 university and 2 general hospitals. The types and numbers of previous tumours and of tumours during a two-year follow-up were collected from 574 patients. Mean time between the first diagnosed (pre)malignancy and time of inclusion was 6.6 years. Overall, 60% had multiple types of (pre)malignancies. In BCC patients, 61% had multiple BCCs, in patients with squamous cell carcinoma (SCC), 40% had multiple SCCs. The combination 'BCC and SCC' occurred in 10%, 'BCC and AK' in 47%, 'SCC and AK' in 14%. High numbers of patients with multiple (pre)malignancies were found in this patient population in university and general hospitals, which may well reflect the Dutch hospital population. We conclude that skin cancer patients are more extensively affected than was expected up till now. Consequently, the management of skin cancer may be in need of adaptation in near future and the question arises whether dermatologists have the capacity for providing care for all these patients.

  9. The use of climate information to estimate future mortality from high ambient temperature: A systematic literature review

    PubMed Central

    Arbuthnott, Katherine; Kovats, Sari; Hajat, Shakoor; Falloon, Pete

    2017-01-01

    Background and objectives Heat related mortality is of great concern for public health, and estimates of future mortality under a warming climate are important for planning of resources and possible adaptation measures. Papers providing projections of future heat-related mortality were critically reviewed with a focus on the use of climate model data. Some best practice guidelines are proposed for future research. Methods The electronic databases Web of Science and PubMed/Medline were searched for papers containing a quantitative estimate of future heat-related mortality. The search was limited to papers published in English in peer-reviewed journals up to the end of March 2017. Reference lists of relevant papers and the citing literature were also examined. The wide range of locations studied and climate data used prevented a meta-analysis. Results A total of 608 articles were identified after removal of duplicate entries, of which 63 were found to contain a quantitative estimate of future mortality from hot days or heat waves. A wide range of mortality models and climate model data have been used to estimate future mortality. Temperatures in the climate simulations used in these studies were projected to increase. Consequently, all the papers indicated that mortality from high temperatures would increase under a warming climate. The spread in projections of future climate by models adds substantial uncertainty to estimates of future heat-related mortality. However, many studies either did not consider this source of uncertainty, or only used results from a small number of climate models. Other studies showed that uncertainty from changes in populations and demographics, and the methods for adaptation to warmer temperatures were at least as important as climate model uncertainty. Some inconsistencies in the use of climate data (for example, using global mean temperature changes instead of changes for specific locations) and interpretation of the effects on mortality were apparent. Some factors which have not been considered when estimating future mortality are summarised. Conclusions Most studies have used climate data generated using scenarios with medium and high emissions of greenhouse gases. More estimates of future mortality using climate information from the mitigation scenario RCP2.6 are needed, as this scenario is the only one under which the Paris Agreement to limit global warming to 2°C or less could be realised. Many of the methods used to combine modelled data with local climate observations are simplistic. Quantile-based methods might offer an improved approach, especially for temperatures at the ends of the distributions. The modelling of adaptation to warmer temperatures in mortality models is generally arbitrary and simplistic, and more research is needed to better quantify adaptation. Only a small number of studies included possible changes in population and demographics in their estimates of future mortality, meaning many estimates of mortality could be biased low. Uncertainty originating from establishing a mortality baseline, climate projections, adaptation and population changes is important and should be considered when estimating future mortality. PMID:28686743

  10. Universal preventive interventions for children in the context of disasters and terrorism.

    PubMed

    Pfefferbaum, Betty; Varma, Vandana; Nitiéma, Pascal; Newman, Elana

    2014-04-01

    This review addresses universal disaster and terrorism services and preventive interventions delivered to children before and after an event. The article describes the organization and structure of services used to meet the needs of children in the general population (practice applications), examines screening and intervention approaches (tools for practice), and suggests future directions for the field. A literature search identified 17 empirical studies that were analyzed to examine the timing and setting of intervention delivery, providers, conditions addressed and outcomes, and intervention approaches and components. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Motivation: What have we learned and what is still missing?

    PubMed

    Studer, B; Knecht, S

    2016-01-01

    This final chapter deliberates three overarching topics and conclusions of the research presented in this volume: the endurance of the concept of extrinsic vs intrinsic motivation, the importance of considering subjective costs of activities when aiming to understand and enhance motivation, and current knowledge of the neurobiological underpinnings of motivation. Furthermore, three topics for future motivation research are outlined, namely the assessment and determinants of intrinsic benefits, the reconciliation of activity-specific motivation models with generalized motivation impairments in clinical populations, and the motivational dynamics of groups. © 2016 Elsevier B.V. All rights reserved.

  12. Advancing Risk Assessment through the Application of Systems Toxicology

    PubMed Central

    Sauer, John Michael; Kleensang, André; Peitsch, Manuel C.; Hayes, A. Wallace

    2016-01-01

    Risk assessment is the process of quantifying the probability of a harmful effect to individuals or populations from human activities. Mechanistic approaches to risk assessment have been generally referred to as systems toxicology. Systems toxicology makes use of advanced analytical and computational tools to integrate classical toxicology and quantitative analysis of large networks of molecular and functional changes occurring across multiple levels of biological organization. Three presentations including two case studies involving both in vitro and in vivo approaches described the current state of systems toxicology and the potential for its future application in chemical risk assessment. PMID:26977253

  13. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dodds, J.; Lin, C.D.

    Teenagers in the U.S., U.S.S.R., Eastern Europe, Western Europe, and New Zealand have consistently rated death of a parent and nuclear war as their greatest concerns about the future. In the present study, however, Chinese teenagers rated overpopulation and environmental pollution as their greatest concerns; these were usually rated quite low by teenagers in other countries. While still of concern to Chinese teenagers, nuclear war seemed more remote to them than it did to U.S. and U.S.S.R. teenagers and therefore more survivable. Speculation is offered as to how teenagers' concerns reflect those of a country's general population.

  14. [What is researched in Spain on childhood accidents and poisonings? A descriptive study of the last 11 years].

    PubMed

    Abad Pérez, I; Colmenar Revuelta, J; Gascón Pérez, E; Colmenar Revuelta, C

    1987-04-01

    Situation of research done in childhood accidents an accidental poisoning in Spain must be known to plan future studies. Authors studied 131 publications obtained from IME (Indice Medico Español) data bank (1974-1984). Only 62 of them were epidemiological studies or reviews. Most of them were based on hospital data. Authors were mainly pediatricians who lived in big cities and had articles published in pediatric journals. They conclude that there are few studies on epidemiology of accidents in general populations and on how to prevent them.

  15. Implementing Evidence-Based Practices for People With Schizophrenia

    PubMed Central

    Drake, Robert E.; Bond, Gary R.; Essock, Susan M.

    2009-01-01

    Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions. PMID:19491315

  16. Potential Impacts Related to the Air Training Command Realignments. Institutional Characteristics, Transportation, Civilian Community Utilities, Land Use for Craig AFB, Alabama, Webb AFB, Texas, Columbus AFB, Mississippi, Laughlin AFB, Texas, Reese AFB, Texas, Vance AFB, Oklahoma

    DTIC Science & Technology

    1976-12-30

    response and 70.4 percent civilian response, extend to 100 percent population, 1975; Counity Census Data, General Social =0 Economic Characteristics. 25...transportation problems exist and the alternative action is not txpected to disturb the situation in the future. 86 On-Base (AFERN 4.4.1.3) No major problema of...values could increase in specific residential areas that are perceived as meeting certain economic and social needs where current 7acancies are minimal

  17. Evolutionary and ecological forces influencing population diversification in Bornean montane passerines.

    PubMed

    Chua, Vivien L; Smith, Brian Tilston; Burner, Ryan C; Rahman, Mustafa Abdul; Lakim, Maklarin; Prawiradilaga, Dewi M; Moyle, Robert G; Sheldon, Frederick H

    2017-08-01

    The mountains of Borneo are well known for their high endemicity and historical role in preserving Southeast Asian rainforest biodiversity, but the diversification of populations inhabiting these mountains is poorly studied. Here we examine the genetic structure of 12 Bornean montane passerines by comparing complete mtDNA ND2 gene sequences of populations spanning the island. Maximum likelihood and Bayesian phylogenetic trees and haplotype networks are examined for common patterns that might signal important historical events or boundaries to dispersal. Morphological and ecological characteristics of each species are also examined using phylogenetic generalized least-squares (PGLS) for correlation with population structure. Populations in only four of the 12 species are subdivided into distinct clades or haplotype groups. Although this subdivision occurred at about the same time in each species (ca. 0.6-0.7Ma), the spatial positioning of the genetic break differs among the species. In two species, northeastern populations are genetically divergent from populations elsewhere on the island. In the other two species, populations in the main Bornean mountain chain, including the northeast, are distinct from those on two isolated peaks in northwestern Borneo. We suggest different historical forces played a role in shaping these two distributions, despite commonality in timing. PGLS analysis showed that only a single characteristic-hand-wing index-is correlated with population structure. Birds with longer wings, and hence potentially more dispersal power, have less population structure. To understand historical forces influencing montane population structure on Borneo, future studies must compare populations across the entirety of Sundaland. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Predicting the Future Impact of Droughts on Ungulate Populations in Arid and Semi-Arid Environments

    PubMed Central

    Duncan, Clare; Chauvenet, Aliénor L. M.; McRae, Louise M.; Pettorelli, Nathalie

    2012-01-01

    Droughts can have a severe impact on the dynamics of animal populations, particularly in semi-arid and arid environments where herbivore populations are strongly limited by resource availability. Increased drought intensity under projected climate change scenarios can be expected to reduce the viability of such populations, yet this impact has seldom been quantified. In this study, we aim to fill this gap and assess how the predicted worsening of droughts over the 21st century is likely to impact the population dynamics of twelve ungulate species occurring in arid and semi-arid habitats. Our results provide support to the hypotheses that more sedentary, grazing and mixed feeding species will be put at high risk from future increases in drought intensity, suggesting that management intervention under these conditions should be targeted towards species possessing these traits. Predictive population models for all sedentary, grazing or mixed feeding species in our study show that their probability of extinction dramatically increases under future emissions scenarios, and that this extinction risk is greater for smaller populations than larger ones. Our study highlights the importance of quantifying the current and future impacts of increasing extreme natural events on populations and species in order to improve our ability to mitigate predicted biodiversity loss under climate change. PMID:23284700

  19. Postdoctoral education in dentistry: preparing dental practitioners to meet the oral health needs of America in the 21st century.

    PubMed

    Glassman, P; Meyerowitz, C

    1999-08-01

    There has been increasing interest in the organization and accreditation of Postdoctoral General Dentistry Programs (PGD). In addition, numerous national organizations have called for increases in the number of first postdoctoral year (PGY-1) positions and programs. At the same time there has been a movement to incorporate concepts of competency-based education into dental education programs in order to stress the outcomes of education rather then the process. These movements have coincided with an increased recognition that dental education will be affected by the changing demographics of our population, the emerging trends in health care delivery and financing, and the need for an increase in the number of primary care providers in dentistry, trained at an advanced level, who are capable of caring for an increasingly socially diverse and medically complex population in our country in the next century. This paper reviews the history of postdoctoral education programs in dentistry and medicine with a focus on PGD education, describes the changing health care environment in which future dental professionals will practice, and relates the dental postdoctoral experience to that in medicine. A strategy is presented for the dental profession to prepare dental practitioners with the competencies needed for the future and to create enough training opportunities to prepare these practitioners to care for the oral health needs of the nation. This proposal calls for a "National Consensus Development Conference on the Future of Postdoctoral Primary Care Education in Dentistry". This conference would define the strategies necessary to prepare dental practitioners with the competencies needed for the future and develop approaches to create enough training opportunities to prepare these practitioners to care for the oral health needs of the nation.

  20. Is the Relationship between Common Mental Disorder and Adiposity Bidirectional? Prospective Analyses of a UK General Population-Based Study.

    PubMed

    Fezeu, Léopold K; Batty, G David; Batty, David G; Gale, Catharine R; Kivimaki, Mika; Hercberg, Serge; Czernichow, Sebastien

    2015-01-01

    The direction of the association between mental health and adiposity is poorly understood. Our objective was to empirically examine this link in a UK study. This is a prospective cohort study of 3 388 people (men) aged ≥ 18 years at study induction who participated in both the UK Health and Lifestyle Survey at baseline (HALS-1, 1984/1985) and the re-survey (HALS-2, 1991/1992). At both survey examinations, body mass index, waist circumference and self-reported common mental disorder (the 30-item General Health Questionnaire, GHQ) were measured. Logistic regression models were used to compute odds ratios (OR) and accompanying 95% confidence intervals (CI) for the associations between (1) baseline common mental disorder (QHQ score > 4) and subsequent general and abdominal obesity and (2) baseline general and abdominal obesity and re-survey common mental disorders. After controlling for a range of covariates, participants with common mental disorder at baseline experienced greater odds of subsequently becoming overweight (women, OR: 1.30, 1.03 - 1.64; men, 1.05, 0.81 - 1.38) and obese (women, 1.26, 0.82 - 1.94; men, OR: 2.10, 1.23 - 3.55) than those who were free of common mental disorder. Similarly, having baseline common mental health disorder was also related to a greater risk of developing moderate (1.57, 1.21 - 2.04) and severe (1.48, 1.09 - 2.01) abdominal obesity (women only). Baseline general or abdominal obesity was not associated with the risk of future common mental disorder. These findings of the present study suggest that the direction of association between common mental disorders and adiposity is from common mental disorder to increased future risk of adiposity as opposed to the converse.

  1. Population modeling for pesticide risk assessment of threatened species-A case study of a terrestrial plant, Boltonia decurrens.

    PubMed

    Schmolke, Amelie; Brain, Richard; Thorbek, Pernille; Perkins, Daniel; Forbes, Valery

    2017-02-01

    Although population models are recognized as necessary tools in the ecological risk assessment of pesticides, particularly for species listed under the Endangered Species Act, their application in this context is currently limited to very few cases. The authors developed a detailed, individual-based population model for a threatened plant species, the decurrent false aster (Boltonia decurrens), for application in pesticide risk assessment. Floods and competition with other plant species are known factors that drive the species' population dynamics and were included in the model approach. The authors use the model to compare the population-level effects of 5 toxicity surrogates applied to B. decurrens under varying environmental conditions. The model results suggest that the environmental conditions under which herbicide applications occur may have a higher impact on populations than organism-level sensitivities to an herbicide within a realistic range. Indirect effects may be as important as the direct effects of herbicide applications by shifting competition strength if competing species have different sensitivities to the herbicide. The model approach provides a case study for population-level risk assessments of listed species. Population-level effects of herbicides can be assessed in a realistic and species-specific context, and uncertainties can be addressed explicitly. The authors discuss how their approach can inform the future development and application of modeling for population-level risk assessments of listed species, and ecological risk assessment in general. Environ Toxicol Chem 2017;36:480-491. © 2016 SETAC. © 2016 SETAC.

  2. Capability and dependency in the Newcastle 85+ cohort study. Projections of future care needs

    PubMed Central

    2011-01-01

    Background Little is known of the capabilities of the oldest old, the fastest growing age group in the population. We aimed to estimate capability and dependency in a cohort of 85 year olds and to project future demand for care. Methods Structured interviews at age 85 with 841 people born in 1921 and living in Newcastle and North Tyneside, UK who were permanently registered with participating general practices. Measures of capability included were self-reported activities of daily living (ADL), timed up and go test (TUG), standardised mini-mental state examination (SMMSE), and assessment of urinary continence in order to classify interval-need dependency. To project future demand for care the proportion needing 24-hour care was applied to the 2008 England and Wales population projections of those aged 80 years and over by gender. Results Of participants, 62% (522/841) were women, 77% (651/841) lived in standard housing, 13% (106/841) in sheltered housing and 10% (84/841) in a care home. Overall, 20% (165/841) reported no difficulty with any of the ADLs. Men were more capable in performing ADLs and more independent than women. TUG validated self-reported ADLs. When classified by 'interval of need' 41% (332/810) were independent, 39% (317/810) required help less often than daily, 12% (94/810) required help at regular times of the day and 8% (67/810) required 24-hour care. Of care-home residents, 94% (77/82) required daily help or 24-hour care. Future need for 24-hour care for people aged 80 years or over in England and Wales is projected to increase by 82% from 2010 to 2030 with a demand for 630,000 care-home places by 2030. Conclusions This analysis highlights the diversity of capability and levels of dependency in this cohort. A remarkably high proportion remain independent, particularly men. However a significant proportion of this population require 24-hour care at home or in care homes. Projections for the next 20 years suggest substantial increases in the number requiring 24-hour care due to population ageing and a proportionate increase in demand for care-home places unless innovative health and social care interventions are found. PMID:21542901

  3. It isn't all just fun and games: Collegiate participation in extracurricular activities and risk for generalized and sexual harassment, psychological distress, and alcohol use.

    PubMed

    McGinley, Meredith; Rospenda, Kathleen M; Liu, Li; Richman, Judith A

    2016-12-01

    Collegiate extracurricular activities, despite their benefits, may place students at an increased risk for experiencing harassment. This study utilizes multiple waves of data from an online longitudinal survey to examine how participation in college activities (intramural sports, fraternities/sororities, school clubs) relates to experiences of sexual and generalized harassment and outcomes (psychological distress, heavy alcohol use) among undergraduates (N = 1852, 58.6% female, 57.4% White) in the Midwestern United States. Activity participation was related to harassment, but the pattern depended on the activity, harassment type, and sex. Fraternity/sorority involvement was associated with generalized harassment, whereas school club involvement was linked to both generalized and sexual harassment. Female intramural athletes were at an increased risk to experience both harassment types. In addition to direct relations, activity participation was indirectly linked to future psychological distress (depression, anxiety) and heavy alcohol use via harassment. Implications for intervention with this college student population are discussed. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  4. Neurofeedback as supplementary training for optimizing athletes' performance: A systematic review with implications for future research.

    PubMed

    Mirifar, Arash; Beckmann, Jürgen; Ehrlenspiel, Felix

    2017-04-01

    Self-regulation plays an important role in enhancing human performance. Neurofeedback is a promising noninvasive approach for modifying human brain oscillation and can be utilized in developing skills for self-regulation of brain activity. So far, the effectiveness of neurofeedback has been evaluated with regard to not only its application in clinical populations but also the enhancement of performance in general. However, reviews of the application of neurofeedback training in the sports domain are absent, although this application goes back to 1991, when it was first applied in archery. Sport scientists have shown an increasing interest in this topic in recent years. This article provides an overview of empirical studies examining the effects of neurofeedback in sports and evaluates these studies against cardinal and methodological criteria. Furthermore, it includes guidelines and suggestions for future evaluations of neurofeedback training in sports. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The concept of treatment-free remission in chronic myeloid leukemia

    PubMed Central

    Saußele, S; Richter, J; Hochhaus, A; Mahon, F-X

    2016-01-01

    The advent of tyrosine kinase inhibitors (TKI) into the management of patients with chronic myeloid leukemia (CML) has profoundly improved prognosis. Survival of responders is approaching that of the general population but lifelong treatment is still recommended. In several trials, TKI treatment has been stopped successfully in approximately half of the patients with deep molecular response. This has prompted the development of a new concept in the evaluation of CML patients known as ‘treatment-free remission'. The future in CML treatment will be to define criteria for the safe and most promising discontinuation of TKI on one hand, and, on the other, to increase the number of patients available for such an attempt. Until safe criteria have been defined, discontinuation of therapy is still experimental and should be restricted to clinical trials or registries. This review will provide an overview of current knowledge as well as an outlook on future challenges. PMID:27133824

  6. Development and validation of the coping with terror scale.

    PubMed

    Stein, Nathan R; Schorr, Yonit; Litz, Brett T; King, Lynda A; King, Daniel W; Solomon, Zahava; Horesh, Danny

    2013-10-01

    Terrorism creates lingering anxiety about future attacks. In prior terror research, the conceptualization and measurement of coping behaviors were constrained by the use of existing coping scales that index reactions to daily hassles and demands. The authors created and validated the Coping with Terror Scale to fill the measurement gap. The authors emphasized content validity, leveraging the knowledge of terror experts and groups of Israelis. A multistep approach involved construct definition and item generation, trimming and refining the measure, exploring the factor structure underlying item responses, and garnering evidence for reliability and validity. The final scale comprised six factors that were generally consistent with the authors' original construct specifications. Scores on items linked to these factors demonstrate good reliability and validity. Future studies using the Coping with Terror Scale with other populations facing terrorist threats are needed to test its ability to predict resilience, functional impairment, and psychological distress.

  7. Workshops of the Sixth International Brain–Computer Interface Meeting: brain–computer interfaces past, present, and future

    PubMed Central

    Huggins, Jane E.; Guger, Christoph; Ziat, Mounia; Zander, Thorsten O.; Taylor, Denise; Tangermann, Michael; Soria-Frisch, Aureli; Simeral, John; Scherer, Reinhold; Rupp, Rüdiger; Ruffini, Giulio; Robinson, Douglas K. R.; Ramsey, Nick F.; Nijholt, Anton; Müller-Putz, Gernot; McFarland, Dennis J.; Mattia, Donatella; Lance, Brent J.; Kindermans, Pieter-Jan; Iturrate, Iñaki; Herff, Christian; Gupta, Disha; Do, An H.; Collinger, Jennifer L.; Chavarriaga, Ricardo; Chase, Steven M.; Bleichner, Martin G.; Batista, Aaron; Anderson, Charles W.; Aarnoutse, Erik J.

    2017-01-01

    The Sixth International Brain–Computer Interface (BCI) Meeting was held 30 May–3 June 2016 at the Asilomar Conference Grounds, Pacific Grove, California, USA. The conference included 28 workshops covering topics in BCI and brain–machine interface research. Topics included BCI for specific populations or applications, advancing BCI research through use of specific signals or technological advances, and translational and commercial issues to bring both implanted and non-invasive BCIs to market. BCI research is growing and expanding in the breadth of its applications, the depth of knowledge it can produce, and the practical benefit it can provide both for those with physical impairments and the general public. Here we provide summaries of each workshop, illustrating the breadth and depth of BCI research and highlighting important issues and calls for action to support future research and development. PMID:29152523

  8. Workshops of the Sixth International Brain-Computer Interface Meeting: brain-computer interfaces past, present, and future.

    PubMed

    Huggins, Jane E; Guger, Christoph; Ziat, Mounia; Zander, Thorsten O; Taylor, Denise; Tangermann, Michael; Soria-Frisch, Aureli; Simeral, John; Scherer, Reinhold; Rupp, Rüdiger; Ruffini, Giulio; Robinson, Douglas K R; Ramsey, Nick F; Nijholt, Anton; Müller-Putz, Gernot; McFarland, Dennis J; Mattia, Donatella; Lance, Brent J; Kindermans, Pieter-Jan; Iturrate, Iñaki; Herff, Christian; Gupta, Disha; Do, An H; Collinger, Jennifer L; Chavarriaga, Ricardo; Chase, Steven M; Bleichner, Martin G; Batista, Aaron; Anderson, Charles W; Aarnoutse, Erik J

    2017-01-01

    The Sixth International Brain-Computer Interface (BCI) Meeting was held 30 May-3 June 2016 at the Asilomar Conference Grounds, Pacific Grove, California, USA. The conference included 28 workshops covering topics in BCI and brain-machine interface research. Topics included BCI for specific populations or applications, advancing BCI research through use of specific signals or technological advances, and translational and commercial issues to bring both implanted and non-invasive BCIs to market. BCI research is growing and expanding in the breadth of its applications, the depth of knowledge it can produce, and the practical benefit it can provide both for those with physical impairments and the general public. Here we provide summaries of each workshop, illustrating the breadth and depth of BCI research and highlighting important issues and calls for action to support future research and development.

  9. Anthropogenic warming exacerbates European soil moisture droughts

    NASA Astrophysics Data System (ADS)

    Samaniego, L.; Thober, S.; Kumar, R.; Wanders, N.; Rakovec, O.; Pan, M.; Zink, M.; Sheffield, J.; Wood, E. F.; Marx, A.

    2018-05-01

    Anthropogenic warming is anticipated to increase soil moisture drought in the future. However, projections are accompanied by large uncertainty due to varying estimates of future warming. Here, using an ensemble of hydrological and land-surface models, forced with bias-corrected downscaled general circulation model output, we estimate the impacts of 1-3 K global mean temperature increases on soil moisture droughts in Europe. Compared to the 1.5 K Paris target, an increase of 3 K—which represents current projected temperature change—is found to increase drought area by 40% (±24%), affecting up to 42% (±22%) more of the population. Furthermore, an event similar to the 2003 drought is shown to become twice as frequent; thus, due to their increased occurrence, events of this magnitude will no longer be classified as extreme. In the absence of effective mitigation, Europe will therefore face unprecedented increases in soil moisture drought, presenting new challenges for adaptation across the continent.

  10. The contribution of glacier melt to streamflow

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schaner, Neil; Voisin, Nathalie; Nijssen, Bart

    2012-09-13

    Ongoing and projected future changes in glacier extent and water storage globally have lead to concerns about the implications for water supplies. However, the current magnitude of glacier contributions to river runoff is not well known, nor is the population at risk to future glacier changes. We estimate an upper bound on glacier melt contribution to seasonal streamflow by computing the energy balance of glaciers globally. Melt water quantities are computed as a fraction of total streamflow simulated using a hydrology model and the melt fraction is tracked down the stream network. In general, our estimates of the glacier meltmore » contribution to streamflow are lower than previously published values. Nonetheless, we find that globally an estimated 225 (36) million people live in river basins where maximum seasonal glacier melt contributes at least 10% (25%) of streamflow, mostly in the High Asia region.« less

  11. Genetic variability in the Florida manatee (Trichechus manatus)

    USGS Publications Warehouse

    McClenaghan, Leroy R.; O'Shea, Thomas J.

    1988-01-01

    Tissue was obtained from 59 manatee (Trichechus manatus) carcasses salvaged from 20 counties in Florida. Allozyme phenotypes at 24 structural loci were determined by gel electrophoresis. Averages for the proportion of polymorphic loci and mean heterozygosity were 0.300 (range, 0.167-0.417) and 0.050 (range, 0.028-0.063), respectively. These estimates are equivalent to or higher than those generally reported for other species of marine mammals and do not support the hypothesis that body size and heterozygosity in mammals are related inversely. Among-region gene diversity accounted for only 4% of the total diversity. High rates of gene flow probably account for genetic homogeneity across regions. An F-statistic analysis revealed a general tendency toward excess homozygosity within regions. Management efforts to prevent future reductions in population size that would erode existing genic diversity should continue.

  12. Associations between causal attributions and personal stigmatizing attitudes in untreated persons with current mental health problems.

    PubMed

    Stolzenburg, Susanne; Freitag, Simone; Schmidt, Silke; Schomerus, Georg

    2018-02-01

    Past research has shown that among the general public, certain causal explanations like biomedical causes are associated with stronger desire for social distance from persons with mental illness. Aim of this study was to find out how different causal attributions of persons with untreated mental health problems regarding their own complaints are associated with stigmatizing attitudes, anticipated self-stigma when seeking help and perceived stigma-stress. Altogether, 207 untreated persons with a current depressive syndrome were interviewed. Biomedical causes, but also belief in childhood trauma or unhealthy behavior as a cause of the problem, were associated with stronger personal stigma and with more stigma-stress. Similarities and differences to findings among the general population and implications for future research are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Internet and social media for health-related information and communication in health care: preferences of the Dutch general population.

    PubMed

    Van de Belt, Tom H; Engelen, Lucien J L P G; Berben, Sivera A A; Teerenstra, Steven; Samsom, Melvin; Schoonhoven, Lisette

    2013-10-02

    Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7%), closely followed by information provided by health care professionals (71.1%). Approximately one-third (32.3%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5%) and symptoms (59.7%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4%), and 21.2% would like to communicate via a webcam. The Internet is the main source of health-related information for the Dutch population. One in 4 persons wants to communicate with their physician via social media channels and it is expected that this number will further increase. Health care providers should explore new ways of communicating online and should facilitate ways for patients to connect with them. Future research should aim at comparing different patient groups and diseases, describing best practices, and determining cost-effectiveness.

  14. Internet and Social Media For Health-Related Information and Communication in Health Care: Preferences of the Dutch General Population

    PubMed Central

    Engelen, Lucien JLPG; Berben, Sivera AA; Teerenstra, Steven; Samsom, Melvin; Schoonhoven, Lisette

    2013-01-01

    Background Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. Objective To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. Methods A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. Results The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7%), closely followed by information provided by health care professionals (71.1%). Approximately one-third (32.3%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5%) and symptoms (59.7%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4%), and 21.2% would like to communicate via a webcam. Conclusions The Internet is the main source of health-related information for the Dutch population. One in 4 persons wants to communicate with their physician via social media channels and it is expected that this number will further increase. Health care providers should explore new ways of communicating online and should facilitate ways for patients to connect with them. Future research should aim at comparing different patient groups and diseases, describing best practices, and determining cost-effectiveness. PMID:24088272

  15. Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden

    PubMed Central

    Gilham, Clare; Rake, Christine; Burdett, Garry; Nicholson, Andrew G; Davison, Leslie; Franchini, Angelo; Carpenter, James; Hodgson, John; Darnton, Andrew; Peto, Julian

    2016-01-01

    Background We have conducted a population-based study of pleural mesothelioma patients with occupational histories and measured asbestos lung burdens in occupationally exposed workers and in the general population. The relationship between lung burden and risk, particularly at environmental exposure levels, will enable future mesothelioma rates in people born after 1965 who never installed asbestos to be predicted from their asbestos lung burdens. Methods Following personal interview asbestos fibres longer than 5 µm were counted by transmission electron microscopy in lung samples obtained from 133 patients with mesothelioma and 262 patients with lung cancer. ORs for mesothelioma were converted to lifetime risks. Results Lifetime mesothelioma risk is approximately 0.02% per 1000 amphibole fibres per gram of dry lung tissue over a more than 100-fold range, from 1 to 4 in the most heavily exposed building workers to less than 1 in 500 in most of the population. The asbestos fibres counted were amosite (75%), crocidolite (18%), other amphiboles (5%) and chrysotile (2%). Conclusions The approximate linearity of the dose–response together with lung burden measurements in younger people will provide reasonably reliable predictions of future mesothelioma rates in those born since 1965 whose risks cannot yet be seen in national rates. Burdens in those born more recently will indicate the continuing occupational and environmental hazards under current asbestos control regulations. Our results confirm the major contribution of amosite to UK mesothelioma incidence and the substantial contribution of non-occupational exposure, particularly in women. PMID:26715106

  16. Review of child maltreatment in immigrant and refugee families.

    PubMed

    LeBrun, Annie; Hassan, Ghayda; Boivin, Mylène; Fraser, Sarah-Louise; Dufour, Sarah; Lavergne, Chantal

    2016-03-14

    Study results on child maltreatment based on general population samples cannot be extrapolated with confidence to vulnerable immigrant or refugee families because of the specific characteristics and needs of these families. The aims of this paper are 1) to conduct an evidence review of the prevalence, risk factors and protective factors for child maltreatment in immigrant and refugee populations, and 2) to integrate the evidence in an analytical ecosystemic framework that would guide future research. We used a 14-step process based on guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Canadian Collaboration for Immigrant and Refugee Health. We searched major databases from "the oldest date available to July 2014". The eligibility criteria for paper selection included qualitative or quantitative methodologies; papers written in English or French; papers that describe, assess or review prevalence, risk and protection factors for child maltreatment; and a studied population of immigrants or refugees. Twenty-four articles met the criteria for eligibility. The results do not provide evidence that immigrant or refugee children are at higher risk of child maltreatment. However, recently settled immigrants and refugees experience specific risk factors related to their immigration status and to the challenges of settlement in a new country, which may result in high risk of maltreatment. Future research must incorporate more immigrant and refugee samples as well as examine, within an ecosystemic framework, the interaction between migratory and cultural factors with regard to the prevalence, consequences and treatment of child maltreatment for the targeted groups.

  17. A Review of Our Roots: Blacks in Gerontology

    PubMed Central

    Brown, Candace S.; Baker, Tamara A.; Mingo, Chivon A.; Harden, J. Taylor; Whitfield, Keith; Aiken-Morgan, Adrienne T.; Phillips, Karon L.; Washington, Tiffany

    2014-01-01

    The historical underpinnings in the field of gerontology rest on the contributions of scholars across a myriad of racial and ethnic backgrounds. With the increasing diversity of the adult population, there is a need to increase the number of researchers who study older adults from diverse racial and ethnic populations in general and Black elderly people in particular. Furthermore, it is important to document the participation of Black older adults in our earliest and continuing research efforts. Understanding the historical context and the foundational influence of Black scholars in this field is critical. To realize its humble beginnings, one must become aware of the contributions by Black scholars who have a vested interest in the aging process. With universal similarities and unique differences among older adults, there is a need to acknowledge the past and current scholarship of those who study the aging processes of Blacks while marveling over the future possibilities. The purpose of this review is to elucidate the legacy and current contributions, philosophies, and research of Black scholars in the field of gerontology. In addition, exploration of the theoretical and conceptual frameworks used to establish national and organizational initiatives is reviewed. The impetus in initiating and continuing this work requires a “knowledge of our roots” while moving into the future. It is important to learn the history and significance of Black scholars in gerontology, the contributions of older Blacks, and appreciate the resiliency and marveled life course of this unique population. PMID:24022695

  18. Creating the Future of Evidence-Based Nutrition Recommendations: Case Studies from Lipid Research123

    PubMed Central

    Dwyer, Johanna T; Rubin, Kristin H; Psota, Tricia L; Liska, DeAnn J; Montain, Scott J

    2016-01-01

    Strategic translational research is designed to address research gaps that answer specific guidance questions. It provides translational value with respect to nutrition guidance and regulatory and public policy. The relevance and the quality of evidence both matter in translational research. For example, design decisions regarding population, intervention, comparator, and outcome criteria affect whether or not high-quality studies are considered relevant to specific guidance questions and are therefore included as evidence within the context of systematic review frameworks used by authoritative food and health organizations. The process used in systematic reviews, developed by the USDA for its Nutrition Evidence Library, is described. An eating pattern and cardiovascular disease (CVD) evidence review is provided as an example, and factors that differentiated the studies considered relevant and included in that evidence base from those that were excluded are noted. Case studies on ω-3 (n–3) fatty acids (FAs) and industrial trans-FAs illustrate key factors vital to relevance and translational impact, including choice of a relevant population (e.g., healthy, at risk, or diseased subjects; general population or high-performance soldiers); dose and form of the intervention (e.g., food or supplement); use of relevant comparators (e.g., technically feasible and realistic); and measures for both exposure and outcomes (e.g., inflammatory markers or CVD endpoints). Specific recommendations are provided to help increase the impact of nutrition research on future dietary guidance, policy, and regulatory issues, particularly in the area of lipids. PMID:27422509

  19. Lifestyle and dietary habits of an obese pregnant cohort.

    PubMed

    Lindsay, Karen L; Heneghan, Clara; McNulty, Breige; Brennan, Lorraine; McAuliffe, Fionnuala M

    2015-01-01

    Obese pregnant women are the focus of numerous dietary and lifestyle intervention studies, however there is a paucity of literature examining the habitual dietary and lifestyle habits of this population. This paper aims to assess maternal dietary and lifestyle habits in an obese cohort, in order to identify priority areas to be addressed in future studies and in clinical practice. This prospective observational study recruited 100 pregnant women with a body mass index 30.0-39.9 kg/m(2) from routine antenatal clinics. Dietary intakes were assessed using a 3-day food diary and a structured lifestyle questionnaire assessed physical activity levels, smoking and alcohol habits and wellbeing. Macronutrient intakes as a percentage of total energy were not compliant to healthy eating guidelines with an inadequate intake of carbohydrate and excess intake of saturated fat. Compliance to recommended intakes of calcium, iron, folate and vitamin D was poor from diet alone. The consumption of energy dense food groups high in fat and sugar was greater than for published pregnant populations and the general female non-pregnant population. One-third of women reported engaging in weekly physical activity that would comply with recommendations for pregnant women while 25 % reported low mood status indicating potential depression. High intakes of energy-dense processed foods and poor compliance to micronutrient recommendations are critical dietary issues of concern among obese pregnant women. Low mood is a barrier to motivation for changing behaviour which would also need to be addressed in future lifestyle intervention studies.

  20. Attitudes and stereotypes regarding older women and HIV risk.

    PubMed

    Beaulaurier, Richard; Fortuna, Karen; Lind, Danielle; Emlet, Charles A

    2014-01-01

    Persons aged 50 years and over will soon disproportionately represent the future of the HIV/AIDS epidemic. It is estimated that by 2015 older adults will represent 50% of persons living with HIV in the United States. Despite the HIV/AIDS growing population among older adults, attitudes, beliefs, and stereotypes toward older adults that exist in general society have affected HIV prevention, education, and care. Specifically, ageist attitudes about the sexuality of older adults in general and older women in particular, low clinical HIV suspicion among healthcare providers, lack of knowledge about risk among older women, and differentials in power related to negotiating sexual practices all lead to heightened concerns for the prevention, identification, and treatment of HIV disease in mature women. This article examines common attitudes, beliefs, and stereotypes that exist within general society as well as health and social service providers that place older women at a disadvantage when it comes to HIV prevention, education, and treatment.

  1. Comparing Self-Concept Among Youth Currently Receiving Inpatient Versus Outpatient Mental Health Services

    PubMed Central

    Choi, Chris; Ferro, Mark A.

    2018-01-01

    Objective This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Method Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children’s Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. Results The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=−.26; p=.035). Conclusions Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged. PMID:29375635

  2. Comparing Self-Concept Among Youth Currently Receiving Inpatient Versus Outpatient Mental Health Services.

    PubMed

    Choi, Chris; Ferro, Mark A

    2018-01-01

    This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children's Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=-.26; p=.035). Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged.

  3. Comparing Self-Concept Among Youth Currently Receiving Inpatient Versus Outpatient Mental Health Services

    PubMed Central

    Choi, Chris; Ferro, Mark A.

    2018-01-01

    Objective This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Method Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children’s Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. Results The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=−.26; p=.035). Conclusions Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged. PMID:29399020

  4. Young people have their say: What makes a youth-friendly general practice?

    PubMed

    Turner, Laura; Spencer, Leah; Strugnell, Jack; Di Tommaso, Isabel; Tate, Magella; Allen, Penny; Cheek, Colleen; Cooper, Jane; Chang, Julian

    The health of young people can be considered an indicator of the health of Australia's future population. To improve access to healthcare, the perspectives of adolescents on the design and delivery of services need to be championed. The objective of this study was to identify what young people in north-west Tasmania value when seeking healthcare at general practices. The study was conducted at a single high school in rural Tasmania. Students aged 16-18 years were invited to participate in an electronic survey seeking their views and preferences for presenting to their general practitioner (GP). One hundred and fifty-five students, with a mean age of 17 years, were surveyed. GPs were the usual healthcare providers for 98.4% of participants, and 86% stated that they would like to discuss mental health, substance use and sexual health with their GP. GPs can improve access to care for young people through good communications skills and treating young people as young adults.

  5. Towards More Comprehensive Projections of Urban Heat-Related Mortality: Estimates for New York City Under Multiple Population, Adaptation, and Climate Scenarios

    NASA Technical Reports Server (NTRS)

    Petkova, Elisaveta P.; Vink, Jan K.; Horton, Radley M.; Gasparrini, Antonio; Bader, Daniel A.; Francis, Joe D.; Kinney, Patrick L.

    2016-01-01

    High temperatures have substantial impacts on mortality and, with growing concerns about climate change, numerous studies have developed projections of future heat-related deaths around the world. Projections of temperature-related mortality are often limited by insufficient information necessary to formulate hypotheses about population sensitivity to high temperatures and future demographics. This study has derived projections of temperature-related mortality in New York City by taking into account future patterns of adaptation or demographic change, both of which can have profound influences on future health burdens. We adopt a novel approach to modeling heat adaptation by incorporating an analysis of the observed population response to heat in New York City over the course of eight decades. This approach projects heat-related mortality until the end of the 21st century based on observed trends in adaptation over a substantial portion of the 20th century. In addition, we incorporate a range of new scenarios for population change until the end of the 21st century. We then estimate future heat-related deaths in New York City by combining the changing temperature-mortality relationship and population scenarios with downscaled temperature projections from the 33 global climate models (GCMs) and two Representative Concentration Pathways (RCPs).The median number of projected annual heat-related deaths across the 33 GCMs varied greatly by RCP and adaptation and population change scenario, ranging from 167 to 3331 in the 2080s compared to 638 heat-related deaths annually between 2000 and 2006.These findings provide a more complete picture of the range of potential future heat-related mortality risks across the 21st century in New York, and highlight the importance of both demographic change and adaptation responses in modifying future risks.

  6. Development of a Questionnaire to Measure the Attitudes of Laypeople, Physicians, and Psychotherapists Toward Telemedicine in Mental Health.

    PubMed

    Tonn, Peter; Reuter, Silja Christin; Kuchler, Isabelle; Reinke, Britta; Hinkelmann, Lena; Stöckigt, Saskia; Siemoneit, Hanna; Schulze, Nina

    2017-10-03

    In the field of psychiatry and psychotherapy, there are now a growing number of Web-based interventions, mobile phone apps, or treatments that are available via remote transmission screen worldwide. Many of these interventions have been shown to be effective in studies but still find little use in everyday therapeutic work. However, it is important that attitude and expectation toward this treatment are generally examined, because these factors have an important effect on the efficacy of the treatment. To measure the general attitude of the users and prescribers toward telemedicine, which may include, for instance, Web-based interventions or interventions through mobile phone apps, there are a small number of extensive tests. The results of studies based on small groups of patients have been published too, but there is no useful short screening tool to give an insight into the general population's attitude. We have developed a screening instrument that examines such attitude through a few graded questions. This study aimed to explore the Attitude toward Telemedicine in Psychiatry and Psychotherapy (ATiPP) and to evaluate the results of general population and some subgroups. In a three-step process, the questionnaire, which is available in three versions (laypeople, physicians, and psychologists), was developed. Afterwards, it was evaluated by four groups: population-representative laypeople, outpatients in different faculties, physicians, and psychotherapists. The results were evaluated from a total of 1554 questionnaires. The sample population included 1000 laypeople, 455 outpatients, 62 physicians, and 37 psychotherapists. The reliability of all three versions of the questionnaire seemed good, as indicated by the Cronbach alpha values of .849 (the laypeople group), .80 (the outpatients' group), .827 (the physicians' group), and .855 (the psychotherapists' group). The ATiPP was found to be useful and reliable for measuring the attitudes toward the Web-based interventions in psychiatry and psychotherapy and should be used in different studies in this field in the future to evaluate and reflect the attitude of the participants. ©Peter Tonn, Silja Christin Reuter, Isabelle Kuchler, Britta Reinke, Lena Hinkelmann, Saskia Stöckigt, Hanna Siemoneit, Nina Schulze. Originally published in JMIR Mental Health (http://mental.jmir.org), 03.10.2017.

  7. Footedness Is Associated with Self-reported Sporting Performance and Motor Abilities in the General Population

    PubMed Central

    Tran, Ulrich S.; Voracek, Martin

    2016-01-01

    Left-handers may have strategic advantages over right-handers in interactive sports and innate superior abilities that are beneficial for sports. Previous studies relied on differing criteria for handedness classification and mostly did not investigate mixed preferences and footedness. Footedness appears to be less influenced by external and societal factors than handedness. Utilizing latent class analysis and structural equation modeling, we investigated in a series of studies (total N > 15300) associations of handedness and footedness with self-reported sporting performance and motor abilities in the general population. Using a discovery and a replication sample (ns = 7658 and 5062), Study 1 revealed replicable beneficial effects of mixed-footedness and left-footedness in team sports, martial arts and fencing, dancing, skiing, and swimming. Study 2 (n = 2592) showed that footedness for unskilled bipedal movement tasks, but not for skilled unipedal tasks, was beneficial for sporting performance. Mixed- and left-footedness had effects on motor abilities that were consistent with published results on better brain interhemispheric communication, but also akin to testosterone-induced effects regarding flexibility, strength, and endurance. Laterality effects were only small. Possible neural and hormonal bases of observed effects need to be examined in future studies. PMID:27559326

  8. Sexual health risk among dance drug users: cross-sectional comparisons with nationally representative data.

    PubMed

    Mitcheson, Luke; McCambridge, Jim; Byrne, Angela; Hunt, Neil; Winstock, Adam

    2008-08-01

    To describe the sexual behaviour and related risk of a sample of dance drug users and compare this with data from the UK National Survey of Sexual Attitudes and Lifestyles 2000 survey. Cross-sectional purposive sampling using both self-completion postal and web-based questionnaires. This sample of dance drug users are more sexually active and have more concurrent partners than the general population. Rates of anal or vaginal sex within the last year without condom use are high and of concern (men 80 per cent; women 90 per cent). These dance drug users appear also to have higher lifetime prevalence of sexually transmitted infections than the general population and are also more likely to have ever attended a sexual health clinic. Clubbing and dance drug use, as part of a socially active lifestyle, is associated with elevated and pronounced sexual health risk. Future epidemiological studies of sexual health risk should incorporate investigation of both clubbing and recreational drug use in order to confirm the representativeness of these observations. Clubbers should be considered a target for dedicated sexual health promotion interventions, which may also be combined with interventions targeting drug and alcohol use.

  9. A meta-analysis of 25 years of mood-creativity research: hedonic tone, activation, or regulatory focus?

    PubMed

    Baas, Matthijs; De Dreu, Carsten K W; Nijstad, Bernard A

    2008-11-01

    This meta-analysis synthesized 102 effect sizes reflecting the relation between specific moods and creativity. Effect sizes overall revealed that positive moods produce more creativity than mood-neutral controls (r= .15), but no significant differences between negative moods and mood-neutral controls (r= -.03) or between positive and negative moods (r= .04) were observed. Creativity is enhanced most by positive mood states that are activating and associated with an approach motivation and promotion focus (e.g., happiness), rather than those that are deactivating and associated with an avoidance motivation and prevention focus (e.g., relaxed). Negative, deactivating moods with an approach motivation and a promotion focus (e.g., sadness) were not associated with creativity, but negative, activating moods with an avoidance motivation and a prevention focus (fear, anxiety) were associated with lower creativity, especially when assessed as cognitive flexibility. With a few exceptions, these results generalized across experimental and correlational designs, populations (students vs. general adult population), and facet of creativity (e.g., fluency, flexibility, originality, eureka/insight). The authors discuss theoretical implications and highlight avenues for future research on specific moods, creativity, and their relationships.

  10. The evolution of bacterial resistance against bacteriophages in the horse chestnut phyllosphere is general across both space and time.

    PubMed

    Koskella, Britt; Parr, Nicole

    2015-08-19

    Insight to the spatial and temporal scales of coevolution is key to predicting the outcome of host-parasite interactions and spread of disease. For bacteria infecting long-lived hosts, selection to overcome host defences is just one factor shaping the course of evolution; populations will also be competing with other microbial species and will themselves be facing infection by bacteriophage viruses. Here, we examine the temporal and spatial patterns of bacterial adaptation against natural phage populations from within leaves of horse chestnut trees. Using a time-shift experiment with both sympatric and allopatric phages from either contemporary or earlier points in the season, we demonstrate that bacterial resistance is higher against phages from the past, regardless of spatial sympatry or how much earlier in the season phages were collected. Similarly, we show that future bacterial hosts are more resistant to both sympatric and allopatric phages than contemporary bacterial hosts. Together, our results suggest the evolution of relatively general bacterial resistance against phages in nature and are contrasting to previously observed patterns of phage adaptation to bacteria from the same tree hosts over the same time frame, indicating a potential asymmetry in coevolutionary dynamics.

  11. The evolution of bacterial resistance against bacteriophages in the horse chestnut phyllosphere is general across both space and time

    PubMed Central

    Koskella, Britt; Parr, Nicole

    2015-01-01

    Insight to the spatial and temporal scales of coevolution is key to predicting the outcome of host–parasite interactions and spread of disease. For bacteria infecting long-lived hosts, selection to overcome host defences is just one factor shaping the course of evolution; populations will also be competing with other microbial species and will themselves be facing infection by bacteriophage viruses. Here, we examine the temporal and spatial patterns of bacterial adaptation against natural phage populations from within leaves of horse chestnut trees. Using a time-shift experiment with both sympatric and allopatric phages from either contemporary or earlier points in the season, we demonstrate that bacterial resistance is higher against phages from the past, regardless of spatial sympatry or how much earlier in the season phages were collected. Similarly, we show that future bacterial hosts are more resistant to both sympatric and allopatric phages than contemporary bacterial hosts. Together, our results suggest the evolution of relatively general bacterial resistance against phages in nature and are contrasting to previously observed patterns of phage adaptation to bacteria from the same tree hosts over the same time frame, indicating a potential asymmetry in coevolutionary dynamics. PMID:26150663

  12. Abnormal Pain Modulation in Patients with Spatially Distributed Chronic Pain: Fibromyalgia

    PubMed Central

    Staud, Roland

    2009-01-01

    Many chronic pain syndromes including fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, migraine headache, chronic back pain, and complex regional pain syndrome are associated with hypersensitivity to painful stimuli and with reduced endogenous pain inhibition. These findings suggest that modulation of pain-related information may be related to the onset and/or maintenance of chronic pain. Although pain sensitivity and pain inhibition are normally distributed in the general population, they are not useful as reliable predictors of future pain. The combination of heightened pain sensitivity and reduced pain-inhibition, however, appears to predispose individuals to greater risk for increased acute clinical pain (e.g., postoperative pain). It is unknown at this time whether such pain processing abnormalities may also place individuals at increased risk for chronic pain. Psychophysical methods, including heat sensory and pressure pain testing have become increasingly available and can be used for the evaluation of pain sensitivity and pain inhibition. However, long-term prospective studies in the general population are lacking which could yield insight into the role of heightened pain sensitivity and pain disinhibition for the development of chronic pain disorders like fibromyalgia. PMID:19647141

  13. An epidemiological study of rotator cuff pathology using The Health Improvement Network database.

    PubMed

    White, J J E; Titchener, A G; Fakis, A; Tambe, A A; Hubbard, R B; Clark, D I

    2014-03-01

    Little is known about the incidence of rotator cuff pathology or its demographic associations in the general population. We undertook a large epidemiological study of rotator cuff pathology in the United Kingdom using The Health Improvement Network (THIN) database. The incidence of rotator cuff pathology was 87 per 100,000 person-years. It was more common in women than in men (90 cases per 100,000 person-years in women and 83 per 100,000 person-years in men; p < 0.001). The highest incidence of 198 per 100,000 person-years was found in those aged between 55 and 59 years. The regional distribution of incidence demonstrated an even spread across 13 UK health authorities except Wales, where the incidence was significantly higher (122 per 100,000 person-years; p < 0.001). The lowest socioeconomic group had the highest incidence (98 per 100,000 person-years). The incidence has risen fourfold since 1987 and as of 2006 shows no signs of plateauing. This study represents the largest general population study of rotator cuff pathology reported to date. The results obtained provide an enhanced appreciation of the epidemiology of rotator cuff pathology and may help to direct future upper limb orthopaedic services.

  14. Psychological distress and the role of significant others in a population of gay/bisexual men in the era of HIV.

    PubMed

    Britton, P J; Zarski, J J; Hobfoll, S E

    1993-01-01

    This study, based on The Conservation of Resources Theory (COR), explores the relationship between social resources and psychological distress, as reported by gay/bisexual men who are at varying degrees of risk for HIV. This study involves theory-based stress research, and adds to the body of literature that addresses social support and gay men. Specific emphasis was placed on the process of social support by significant others in relationship to the devastating impact HIV has on the gay/bisexual community. The investigators employed an ex-post facto design that was guided by past and present theoretical and empirical data, and by specific research hypotheses. The findings suggest that facets of social support appear to be interactively related to the perceived threat of HIV in predicting distress. In general, this study supports COR theory in that resources were related to the experience of psychological distress, yet it emphasizes that the relationship between support and gay men is complex, and thus generalizations from findings based on research with the majority culture may not apply to a population of gay/bisexual men. Implications for future research are also provided.

  15. Sizing Firefighters: Method and Implications

    PubMed Central

    Hsiao, Hongwei; Whitestone, Jennifer; Kau, Tsui-Ying; Whisler, Richard; Routley, J. Gordon; Wilbur, Michael

    2015-01-01

    Objective This article reports new anthropometric information of U.S. firefighters for fire apparatus design applications (Study 1) and presents a data method to assist in firefighter anthropometric data usage for research-to-practice propositions (Study 2). Background Up-to-date anthropometric information of the U.S. firefighter population is needed for updating ergonomic and safety specifications for fire apparatus. Method A stratified sampling plan of three-age by three-race/ethnicity combinations was used to collect anthropometric data of 863 male and 88 female firefighters across the U.S. regions; 71 anthropometric dimensions were measured (Study 1). Differences among original, weighted, and normality transformed data from Study 1 were compared to allowable observer errors (Study 2). Results On average, male firefighters were 9.8 kg heavier and female firefighters were 29 mm taller than their counterparts in the general U.S. population. They also have larger upper-body builds than those of the general U.S. population. The data in weighted, unweighted, and normality transformed modes were compatible among each other with a few exceptions. Conclusion The data obtained in this study provide the first available U.S. national firefighter anthropometric information for fire apparatus designs. The data represent the demographic characteristics of the current firefighter population and, except for a few dimensions, can be directly employed into fire apparatus design applications without major weighting or nonnormality concerns. Application The up-to-date firefighter anthropometric data and data method will benefit the design of future fire apparatus and protective equipment, such as seats, body restraints, cabs, gloves, and bunker gear. PMID:25141595

  16. The work role functioning questionnaire 2.0 (Dutch version): examination of its reliability, validity and responsiveness in the general working population.

    PubMed

    Abma, Femke I; van der Klink, Jac J L; Bültmann, Ute

    2013-03-01

    The promotion of a sustainable, healthy and productive working life attracts more and more attention. Recently the Work Role Functioning Questionnaire (WRFQ) has been cross-culturally translated and adapted to Dutch. This questionnaire aims to measure the health-related work functioning of workers with health problems. The aim of this study is to evaluate the reliability, validity (including five new items) and responsiveness of the WRFQ 2.0 in the working population. A longitudinal study was conducted among workers. The reliability (internal consistency, test-retest reliability, measurement error), validity (structural validity-factor analysis, construct validity by means of hypotheses testing) and responsiveness of the WRFQ 2.0 were evaluated. A total of N = 553 workers completed the survey. The final WRFQ 2.0 has four subscales and showed very good internal consistency, moderate test-retest reliability, good construct validity and moderate responsiveness in the working population. The WRFQ was able to distinguish between groups with different levels of mental health, physical health, fatigue and need for recovery. A moderate correlation was found between WRFQ and related constructs respectively work ability and work productivity. A weak relationship was found with general self-rated health, work engagement and work involvement. The WRFQ 2.0 is a reliable and valid instrument to measure health-related work functioning in the working population. Further validation in larger samples is recommended, especially for test-retest reliability, responsiveness and the questionnaire's ability to predict the future course of health-related work functioning.

  17. Rheumatology in the community of Madrid: current availability of rheumatologists and future needs using a predictive model.

    PubMed

    Lázaro y De Mercado, Pablo; Blasco Bravo, Antonio Javier; Lázaro y De Mercado, Ignacio; Castañeda, Santos; López Robledillo, Juan Carlos

    2013-01-01

    To: 1) describe the distribution of the public sector rheumatologists; 2) identify variables on which the workload in Rheumatology depends; and 3) build a predictive model on the need of rheumatologists for the next 10 years, in the Community of Madrid (CM). The information was obtained through structured questionnaires sent to all services/units of Rheumatology of public hospitals in the CM. The population figures, current and forecasted, were obtained from the National Statistics Institute. A predictive model was built based on information about the current and foreseeable supply, current and foreseeable demand, and the assumptions and criteria used to match supply with demand. The underlying uncertainty in the model was assessed by sensitivity analysis. In the CM in 2011 there were 150 staff rheumatologists and 49 residents in 27 centers, which is equivalent to one rheumatologist for every 33,280 inhabitants in the general population, and one for every 4,996 inhabitants over 65 years. To keep the level of assistance of 2011 in 2021 in the general population, it would be necessary to train more residents or hire more rheumatologists in scenarios of demand higher than 15%. However, to keep the level of assistance in the population over 65 years of age it would be necessary to train more residents or hire more specialists even without increased demand. The model developed may be very useful for planning, with the CM policy makers, the needs of human resources in Rheumatology in the coming years. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  18. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications.

    PubMed

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-06-01

    Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young's questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. More than 79.9% of students reported their general health good and very good. The student's mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. The good SRH of medical students was higher than general population but in health faculty' students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH.

  19. Mortality Rates among Substance Use Disorder Participants in Clinical Trials: Pooled Analysis of Twenty-two Clinical Trials within the National Drug Abuse Treatment Clinical Trials Network

    PubMed Central

    Lindblad, Robert; Hu, Lian; Oden, Neal; Wakim, Paul; Rosa, Carmen; VanVeldhuisen, Paul

    2016-01-01

    Background Most substance use disorders (SUD) treatment clinical trials are too short and small to reliably estimate the incidence of rare events like death. Objective The aim of this study is to estimate the overall mortality rates among a SUD treatment-seeking population by pooling participants from multiple clinical trials conducted through the National Institute on Drug Abuse (NIDA)-sponsored National Drug Abuse Treatment Clinical Trials Network (CTN). Participants Drug and or alcohol users (N=9,866) who sought treatment and participated in one of the twenty-two CTN trials. Measurements Data were collected through randomized clinical trials in national community treatment programs (CTPs) for SUD. Pooled analysis was performed to assess age- and gender-standardized mortality rate(s) (SM rate(s)), and mortality ratio(s) (SM ratio(s)) of CTN trial participants compared to the U.S. general population. We also assessed if there were differences in mortality rates across different types of substance of abuse. Results The age- and gender-SM rate among CTN trials participants was 1403 (95% CI: 862-2074) per 100,000 person years (PY) compared to 542 (95% CI: 541-543) per 100,000 PY among the U.S. general population in 2005. By gender, age-adjusted SM ratio for female CTN trial participants was over five times (SM ratio=5.35, 95% CI: 3.31-8.19)), and for male CTN trial participants was over three times (SM ratio=3.39, 95% CI: 2.25-4.90) higher than their gender comparable peers in the U.S. general population. Conclusions Age and gender-standardized mortality rates and ratios among NIDA CTN SUD treatment-seeking clinical trial participants are higher than the age and gender comparable U.S. general population. The overall mortality rates of CTN trial participants are similar to in-treatment mortality reported in large U.S. and non-U.S. cohorts of opioid users. Future analysis with additional CTN trial participants and risk times will improve the stability of estimates, especially within subgroups based on primary substance of abuse. These SUD mortality rates can be used to facilitate safety monitoring within SUD clinical trials. PMID:27692192

  20. Assessment of public knowledge about the scope of practice of vascular surgeons.

    PubMed

    Farber, Alik; Long, Brandon M; Lauterbach, Stephen R; Bohannon, Todd; Siegal, Carolyn L

    2010-03-01

    During the past decade, there has been a sharp increase in the number of vascular procedures performed in the United States. Due to the increase in the size of the aging population, this trend is predicted to continue. Despite this, general public knowledge about vascular surgery appears low. This gap may significantly affect the success of vascular surgery as a specialty. To objectively define knowledge about vascular surgery, we administered a questionnaire to both a sample of the general population and medical students. The Vascular Surgery Knowledge Questionnaire (VSQ), a 58-item multiple choice survey, was designed to assess knowledge about the field of vascular surgery, including types of procedures commonly performed, presenting illnesses, training, and financial compensation. VSQ was tested for reliability and validity. It was administered to a sample of the general population (GP) and first year medical students (MS) via a random digit dial telephone survey and a paper-based survey, respectively. VSQ Score was derived by calculating the percent of questions from the 38-item, non-demographic part of the questionnaire answered correctly and expressed in numerical form. The maximum score possible was 100. Statistical analysis was used to assess differences in VSQ scores. Two hundred GP and 160 MS subjects completed the questionnaire. The mean VSQ score for GP and MS groups was 54 and 67 (P < .01), respectively. Forty-one percent of the GP group received a score of less than 50. Only 50% of the GP and 51% of MS cohorts agreed with the statement that vascular surgeons perform procedures on all blood vessels with the exception of the heart and brain. Just 24% of the GP group agreed with the statement that vascular surgeons treat patients with wounds that do not heal. Finally, only half of the GP group agreed that vascular surgeons treat patients with abdominal aortic aneurysms. The GP cohort significantly underestimated the average length of postgraduate training (five years) to become a vascular surgeon. Level of education, income, and residence in the Western states significantly correlated with higher scores. General population subjects who admitted to knowing a vascular surgeon received similar scores to those who did not (58 vs. 53, P >.05). These findings support our hypothesis that there is a significant knowledge deficit among both the general population and medical students about the field of vascular surgery. This has protean implications for the future of our specialty and public health in the United States.

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