Air Pollution Exposure Model for Individuals (EMI) in Health Studies

EPA Science Inventory

In health studies, traffic-related air pollution is associated with adverse respiratory effects. Due to cost and participant burden of personal measurements, health studies often estimate exposures using local ambient air monitors. Since outdoor levels do not necessarily reflect ...

Climate change & infectious diseases in India: implications for health care providers.

PubMed

Dhara, V Ramana; Schramm, Paul J; Luber, George

2013-12-01

Climate change has the potential to influence the earth's biological systems, however, its effects on human health are not well defined. Developing nations with limited resources are expected to face a host of health effects due to climate change, including vector-borne and water-borne diseases such as malaria, cholera, and dengue. This article reviews common and prevalent infectious diseases in India, their links to climate change, and how health care providers might discuss preventive health care strategies with their patients.

Climate change & infectious diseases in India: Implications for health care providers

PubMed Central

Dhara, V. Ramana; Schramm, Paul J.; Luber, George

2013-01-01

Climate change has the potential to influence the earth's biological systems, however, its effects on human health are not well defined. Developing nations with limited resources are expected to face a host of health effects due to climate change, including vector-borne and water-borne diseases such as malaria, cholera, and dengue. This article reviews common and prevalent infectious diseases in India, their links to climate change, and how health care providers might discuss preventive health care strategies with their patients. PMID:24521625

Sources of Discrimination and Their Associations With Health in Sexual Minority Adults.

PubMed

Figueroa, Wilson S; Zoccola, Peggy M

2016-06-01

Health disparities exist between sexual minorities and heterosexuals. These health disparities may be due to stressful social situations and environments that are created by discrimination. The current study recruited 277 sexual minorities to complete an online survey to examine the effects of discrimination on health. Discrimination from family and friends, compared to non-family and friends, was found to be more strongly associated with poorer health. This effect was partially statistically mediated by perceived stress reactivity. Findings from this study highlight the importance of distinguishing between different sources of discrimination when examining the effect of discrimination on health in sexual minority adults.

Effect of unaffordable medical need on distress level of family member: analyses of 1997-2013 United States National Health Interview Surveys.

PubMed

Chih, Hui Jun; Liang, Wenbin

2017-09-02

Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels. Data of a total of 262,843 participants were obtained from 17 waves (1997-2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost. Among participants without family members who experienced unmet needs for medical care due to cost, risks of having 'moderate' (score of 5-12) or 'serious' (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having 'moderate' or 'serious' level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of 'moderate' and 'serious', as compared to 'normal' level of psychological distress, were 1.58 (95% confidence interval: 1.47-1.69) and 2.09 (95% confidence interval: 1.78-2.45) if one's family members experienced unmet medical needs. Unmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013-2020.

A health hierarchy of effects model: a synthesis of advertising and health hierarchy conceptualizations.

PubMed

Rouse, R A

1991-01-01

Work by both advertising and health researchers has independently yielded hierarchy of effects models which can be used to predict campaign success. Unfortunately, however, previous work has been criticized as "common sense" approaches which are more "assumed" than "proven." This analysis argues that much of the problem is due to the lack of precision often associated with over-simplified "uni-dimensional" models. Instead, this perspective synthesized a "two-dimensional" health hierarchy of effects model and outlines a pragmatic strategy for campaign measurement.

Transcriptome profiling reveals bisphenol A alternatives activate estrogen receptor alpha in human breast cancer cells

EPA Science Inventory

Plasticizers with estrogenic activity, such as bisphenol A (BPA), have potential adverse health effects in humans. Due to mounting evidence of these health effects, BPA is being phased out and replaced by other bisphenol variants in “BPA-free” products. We have compared estrogeni...

Caffeine: implications of recent research for clinical practice.

PubMed

Wells, Susan J

1984-07-01

Caffeine is a central nervous system stimulant that has come under increasing scrutiny due to its effects on the health and mental health of those who consume it. This article summarizes the physiological effects of caffeine, reviews recent research on behavioral and mood changes associated with consumption, and discusses clinical implications for the mental health professional. Data on caffeine consumption and principal sources of caffeine are outlined.

Effects of abandoned arsenic mine on water resources pollution in north west of iran.

PubMed

Hajalilou, Behzad; Mosaferi, Mohammad; Khaleghi, Fazel; Jadidi, Sakineh; Vosugh, Bahram; Fatehifar, Esmail

2011-01-01

Pollution due to mining activities could have an important role in health and welfare of people who are living in mining area. When mining operation finishes, environ-ment of mining area can be influenced by related pollution e.g. heavy metals emission to wa-ter resources. The present study was aimed to evaluate Valiloo abandoned arsenic mine ef-fects on drinking water resources quality and possible health effects on the residents of min-ing area in the North West of Iran. Water samples and some limited composite wheat samples in downstream of min-ing area were collected. Water samples were analyzed for chemical parameters according to standard methods. For determination of arsenic in water samples, Graphite Furnace Atomic Absorption Spectrometric Method (GFAAS) and for wheat samples X - Ray Fluorescence (XRF) and Inductively Coupled Plasma Method (ICP) were used. Information about possible health effects due to exposure to arsenic was collected through interviews in studied villages and health center of Herris City. The highest concentrations of arsenic were measured near the mine (as high as 2000 µg/L in Valiloo mine opening water). With increasing distance from the mine, concentration was decreased. Arsenic was not detectable in any of wheat samples. Fortunately, no health effects had been reported between residents of studied area due to exposure to arsenic. Valiloo abandoned arsenic mine has caused release of arsenic to the around en-vironment of the mine, so arsenic concentration has been increased in the groundwater and also downstream river that requires proper measures to mitigate spread of arsenic.

Role of the Occupational Physician in Corporate Management of Health Risks: An Important Aspect of Corporate Social Responsibility (CSR).

PubMed

Sugita, Minoru; Miyakawa, Michiko

2016-01-01

There are various risks involved in corporate activities conducted both within and outside the corporation. Among these, health risks are very important and should be managed effectively as an integral part of corporate social responsibility (CSR). A corporation is responsible for health impairments caused by its activities and suffers great moral and economic loss when they occur. It is essential that corporate management takes proper preventive measures against such risks. Occupational physicians possess substantial knowledge of health risks in corporations. In this study, we examine the role of occupational physicians in the management of corporate health risks. Information was obtained from articles in print and on the Internet. Health risks due to corporate activities involve not only the employees of the corporation but also individuals outside the corporation. Each corporation should effectively use available resources to manage health risks. Occupational physicians are one such valuable resource. However, many corporations do not actively involve occupational physicians in health risk management. According to a current Japanese law, health risks for employees in corporations are managed by occupational physicians, but in general, health risks outside corporations are not. The 1984 Bhopal Disaster in India is an example in which physicians of the corporation were only minimally, if at all, involved in assessing and treating impaired health outside the corporation. The role of occupational physicians should be expanded to include management of health risks outside the corporation. This places a greater burden on the physicians and they must make the effort to train in many academic fields in order to better understand the entire context of health risks due to corporate activities. Some occupational physicians may be hesitant to take on such added responsibilities. Some corporations may not recognize the overall health risks due to its activities and do not understand the merit of occupational physicians working with the management to decrease health risks. However, an occupational physician is an important member of the corporation, so he/she must be involved in the management of health risks not only within the corporation itself, but also outside the corporation from the viewpoint of CSR. Effective management of health risks due to corporate activities should be widely discussed among occupational physicians, business entrepreneurs and managers of the division in charge of corporate health risk management as well as stakeholders. The authors propose expanding the role of occupational physicians to actively manage health risks not only inside but also outside the corporations.

Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE

PubMed Central

Kumar, Kaushalendra; Singh, Ashish; Kumar, Santosh; Ram, Faujdar; Singh, Abhishek; Ram, Usha; Negin, Joel; Kowal, Paul R.

2015-01-01

Background and Objectives The provision of affordable health care is generally considered a fundamental goal of a welfare state. In addition to its role in maintaining and improving the health status of individuals and households, it impacts the economic prosperity of a society through its positive effects on labor productivity. Given this context, this paper assesses socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India, two of the fastest growing economies of the world. Data and Methods The paper uses data from the World Health Organisation’s Study on Global Ageing and Adult Health (WHO SAGE), and Bivariate as well as Multivariate analyses for investigating the socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India. Results and Conclusions Annually, about 7% and 8% of the population in China and India, respectively, fall in poverty due to OOPHE. Also, the percentage shortfall in income for the population from poverty line due to OOPHE is 2% in China and 1.3% in India. Further, findings from the multivariate analysis indicate that lower wealth status and inpatient as well as outpatient care increase the odds of falling below poverty line significantly (with the extent much higher in the case of in-patient care) due to OOPHE in both China and India. In addition, having at least an under-5 child in the household, living in rural areas and having a household head with no formal education increases the odds of falling below poverty line significantly (compared to a head with college level education) due to OOPHE in China; whereas having at least an under-5 child, not having health insurance and residing in rural areas increases the odds of becoming poor significantly due to OOPHE in India. PMID:26270049

Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE.

PubMed

Kumar, Kaushalendra; Singh, Ashish; Kumar, Santosh; Ram, Faujdar; Singh, Abhishek; Ram, Usha; Negin, Joel; Kowal, Paul R

2015-01-01

The provision of affordable health care is generally considered a fundamental goal of a welfare state. In addition to its role in maintaining and improving the health status of individuals and households, it impacts the economic prosperity of a society through its positive effects on labor productivity. Given this context, this paper assesses socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India, two of the fastest growing economies of the world. The paper uses data from the World Health Organisation's Study on Global Ageing and Adult Health (WHO SAGE), and Bivariate as well as Multivariate analyses for investigating the socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India. Annually, about 7% and 8% of the population in China and India, respectively, fall in poverty due to OOPHE. Also, the percentage shortfall in income for the population from poverty line due to OOPHE is 2% in China and 1.3% in India. Further, findings from the multivariate analysis indicate that lower wealth status and inpatient as well as outpatient care increase the odds of falling below poverty line significantly (with the extent much higher in the case of in-patient care) due to OOPHE in both China and India. In addition, having at least an under-5 child in the household, living in rural areas and having a household head with no formal education increases the odds of falling below poverty line significantly (compared to a head with college level education) due to OOPHE in China; whereas having at least an under-5 child, not having health insurance and residing in rural areas increases the odds of becoming poor significantly due to OOPHE in India.

Effects of urbanization and climate change on stream health in north-central Texas

USDA-ARS?s Scientific Manuscript database

Estimation of stream health involves the analysis of changes in aquatic species, riparian vegetation, micro-invertebrates, and channel degradation due to hydrologic changes occurring from anthropogenic activities. In this study, we quantified stream health changes arising from urbanization and clim...

Reactive indoor air chemistry and health-A workshop summary.

PubMed

Wells, J R; Schoemaecker, C; Carslaw, N; Waring, M S; Ham, J E; Nelissen, I; Wolkoff, P

2017-11-01

The chemical composition of indoor air changes due to the reactive nature of the indoor environment. Historically, only the stable parent compounds were investigated due to their ease of measurement by conventional methods. Today, however, scientists can better characterize oxidation products (gas and particulate-phase) formed by indoor chemistry. An understanding of occupant exposure can be developed through the investigation of indoor oxidants, the use of derivatization techniques, atmospheric pressure detection, the development of real-time technologies, and improved complex modeling techniques. Moreover, the connection between exposure and health effects is now receiving more attention from the research community. Nevertheless, a need still exists for improved understanding of the possible link between indoor air chemistry and observed acute or chronic health effects and long-term effects such as work-related asthma. Published by Elsevier GmbH.

Socioeconomic disparities and health: impacts and pathways.

PubMed

Kondo, Naoki

2012-01-01

Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997-98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society.

Spatial & temporal variations of PM10 and particle number concentrations in urban air.

PubMed

Johansson, Christer; Norman, Michael; Gidhagen, Lars

2007-04-01

The size of particles in urban air varies over four orders of magnitude (from 0.001 microm to 10 microm in diameter). In many cities only particle mass concentrations (PM10, i.e. particles <10 microm diameter) is measured. In this paper we analyze how differences in emissions, background concentrations and meteorology affect the temporal and spatial distribution of PM10 and total particle number concentrations (PNC) based on measurements and dispersion modeling in Stockholm, Sweden. PNC at densely trafficked kerbside locations are dominated by ultrafine particles (<0.1 microm diameter) due to vehicle exhaust emissions as verified by high correlation with NOx. But PNC contribute only marginally to PM10, due to the small size of exhaust particles. Instead wear of the road surface is an important factor for the highest PM10 concentrations observed. In Stockholm, road wear increases drastically due to the use of studded tires and traction sand on streets during winter; up to 90% of the locally emitted PM10 may be due to road abrasion. PM10 emissions and concentrations, but not PNC, at kerbside are controlled by road moisture. Annual mean urban background PM10 levels are relatively uniformly distributed over the city, due to the importance of long range transport. For PNC local sources often dominate the concentrations resulting in large temporal and spatial gradients in the concentrations. Despite these differences in the origin of PM10 and PNC, the spatial gradients of annual mean concentrations due to local sources are of equal magnitude due to the common source, namely traffic. Thus, people in different areas experiencing a factor of 2 different annual PM10 exposure due to local sources will also experience a factor of 2 different exposure in terms of PNC. This implies that health impact studies based solely on spatial differences in annual exposure to PM10 may not separate differences in health effects due to ultrafine and coarse particles. On the other hand, health effect assessments based on time series exposure analysis of PM10 and PNC, should be able to observe differences in health effects of ultrafine particles versus coarse particles.

Important exposure controls for protection against antineoplastic agents: Highlights for oncology health care workers.

PubMed

Alehashem, Maryam; Baniasadi, Shadi

2018-01-01

A great number of antineoplastic drugs (ANPDs) are used globally in cancer treatment. Due to their adverse health effects, occupational exposure to ANPDs is considered a potential health risk to health care workers. The current study aimed to evaluate safe-handling practices of ANPDs, exposure controls, and adverse health implications for health care providers exposed to ANDPs. Prevention measures, including engineering, administrative, and work practice controls, as well as personal protective equipment (PPE), were recorded daily through a questionnaire for six weeks. Acute adverse health effects experienced by health care workers were also documented. The implemented exposure controls for preparation, administration, cleaning, and waste disposal were not in accordance with the safe handling guidelines. Central nervous system disorders (26.33%) were the most frequent acute adverse effects reported by health care workers. A significant correlation was found between the number of experienced adverse effects and handling characteristics, including the number of preparations (r = 0.38, p < 0.05), dose, and the number of prepared drugs (r = 0.46, p < 0.01 and 0.39, p < 0.05), and working hours in different locations of oncology setting for six weeks (preparation room: r = 0.38, P < 0.05, treatment room: r = 0.46, P < 0.01, patient room: r = 0.63, P < 0.01, and station: r = 0.68, P < 0.01). Due to inadequate control measures, oncology health care workers were in danger of exposure to ANPDs and experienced acute adverse health effects. Implementation of appropriate exposure controls is required to prevent occupational exposure to ANPDs.

Assessment of health and economic effects by PM2.5 pollution in Beijing: a combined exposure-response and computable general equilibrium analysis.

PubMed

Wang, Guizhi; Gu, SaiJu; Chen, Jibo; Wu, Xianhua; Yu, Jun

2016-12-01

Assessment of the health and economic impacts of PM2.5 pollution is of great importance for urban air pollution prevention and control. In this study, we evaluate the damage of PM2.5 pollution using Beijing as an example. First, we use exposure-response functions to estimate the adverse health effects due to PM2.5 pollution. Then, the corresponding labour loss and excess medical expenditure are computed as two conducting variables. Finally, different from the conventional valuation methods, this paper introduces the two conducting variables into the computable general equilibrium (CGE) model to assess the impacts on sectors and the whole economic system caused by PM2.5 pollution. The results show that, substantial health effects of the residents in Beijing from PM2.5 pollution occurred in 2013, including 20,043 premature deaths and about one million other related medical cases. Correspondingly, using the 2010 social accounting data, Beijing gross domestic product loss due to the health impact of PM2.5 pollution is estimated as 1286.97 (95% CI: 488.58-1936.33) million RMB. This demonstrates that PM2.5 pollution not only has adverse health effects, but also brings huge economic loss.

Avenanthramides, unique polyphenols of oats with potential health effects

USDA-ARS?s Scientific Manuscript database

Oats in addition to being a good source of carbohydrate energy in food and animal feed are considered a grain with several health benefits. It is a grain with a well-accepted healthy heart effect due to its soluble fiber b-glucan content, which reduces blood cholesterol. For a long time, the oat bat...

Adolescent Health Implications of New Age Technology.

PubMed

Jacobson, Cara; Bailin, Alexandra; Milanaik, Ruth; Adesman, Andrew

2016-02-01

This article examines the health implications of new age technology use among adolescents. As Internet prevalence has increased, researchers have found evidence of potential negative health consequences on adolescents. Internet addiction has become a serious issue. Pornography is now easily accessible to youth and studies have related pornography with several negative health effects. Cyberbullying has become a large problem as new age technologies have created a new and easy outlet for adolescents to bully one another. These technologies are related to increased morbidity and mortality, such as suicides due to cyberbullying and motor vehicle deaths due to texting while driving. Copyright © 2016 Elsevier Inc. All rights reserved.

The Potential of Social Media and Internet-Based Data in Preventing and Fighting Infectious Diseases: From Internet to Twitter.

PubMed

Al-Surimi, Khaled; Khalifa, Mohammed; Bahkali, Salwa; El-Metwally, Ashraf; Househ, Mowafa

2017-01-01

Health threats due to infectious diseases used to be a major public health concerns around the globe till mid of twentieth century when effective public health interventions helped in eradicating a number of infectious diseases around the world. Over the past 15 years, there has been a rise in the number of emerging and reemerging infectious diseases being reported such as the Acute Respiratory Syndrome (SARS) in 2002, HINI in 2009, Middle East Respiratory Syndrome (MERS) in 2012, Ebola in 2014, and Zika in 2016. These emerging viral infectious diseases have led to serious public health concerns leading to death and causing fear and anxiety among the public. More importantly, at the moment, the prevention and control of viral infectious diseases is difficult due to a lack of effective vaccines. Thus having real-time reporting tools are paramount to alert relevant public health surveillance systems and authorities about taking the right and necessary actions to control and minimize the potential harmful effects of viral infectious diseases. Social media and Internet-based data can play a major role in real-time reporting to empower active public health surveillance systems for controlling and fighting infectious diseases.

Biological Effects of Nonionizing Electromagnetic Radiation. Volume IV. Number 3.

DTIC Science & Technology

1980-03-01

lines that produce EMR. perimental evidence on human health effects due to electromagnetic field exposures from high-voltage transmission lines is...1311, Mrch YOW that a permissible occupational exposure level to The biologic effects of electromagnetic fields on MW and RF radiation of 500 PW/cm 2...along with the principal physical param- eters of exposure . 6402 REGULATING POSSIBLE HEALTH EFFECTS FROM AC TRANSMISSION LINE ELECTROMAGNETIC FIELDS

Addressing Health Inequities: Coronary Heart Disease Training within Learning Disabilities Services

ERIC Educational Resources Information Center

Holly, Deirdre; Sharp, John

2014-01-01

People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…

Cannabis vaping and public health--some comments on relevance and implications.

PubMed

Fischer, Benedikt; Russell, Cayley; Tyndall, Mark W

2015-11-01

Cannabis-vaping entails relevant but probably varied effects for public health: it may reduce certain cannabis use-related health risks, but entice cannabis-naive individuals into use due to "cleaner" imagery. Improved evidence is needed to guide informed and differentiated policies for cannabis-vaping, which emphasizes the urgent need for public health-based cannabis regulation.

Job loss, retirement and the mental health of older Americans.

PubMed

Mandal, Bidisha; Roe, Brian

2008-12-01

Millions of older individuals cope with physical limitations, cognitive changes, and various losses such as bereavement that are commonly associated with aging. Given increased vulnerability to various health problems during aging, work displacement might exacerbate these due to additional distress and to possible changes in medical coverage. Older Americans are of increasing interest to researchers and policymakers due to the sheer size of the Baby Boom cohort, which is approaching retirement age, and due to the general decline in job security in the U.S. labor market. This research compares and contrasts the effect of involuntary job loss and retirement on the mental health of older Americans. Furthermore, it examines the impact of re-employment on the depressive symptoms. There are two fundamental empirical challenges in isolating the effect of employment status on mental health. The first is to control for unobserved heterogeneity--all latent factors that could impact mental health so as to establish the correct magnitude of the effect of employment status. The second challenge is to verify the direction of causality. First difference models are used to control for latent effects and a two-stage least squares regression is used to account for reverse causality. We find that involuntary job loss worsens mental health, and re-employment recaptures the past mental health status. Retirement is found to improve mental health of older Americans. With the use of longitudinal data from the Health and Retirement Study surveys and the adoption of proper measures to control for the possibility of reverse causality, this study provides strong evidence of elevating depressive symptoms with involuntary job displacement even after controlling for other late-life events. Women suffer from greater distress levels than men after job loss due to business closure or lay-off. However, women also exhibit better psychological well-being than men following retirement. The present study is the first to report that the re-employment of involuntary job-loss sufferers leads to a recapturing of past mental health status. Additionally, we find that re-entering the labor force is psychologically beneficial to retirees as well. It is well established that out-of-pocket expenditures on all forms of health care for seniors with self-diagnosed depression significantly exceeds expenditures for seniors with other common ailments such as hypertension and arthritis in the U.S. Thus, our research suggests that re-employment of older Americans displaced from the labor force will be cost-effective with regard to personal mental health outcomes. That re-employment of involuntary job loss sufferers leads to a recapturing of past mental health status illuminates one potential policy trade off - increased resources dedicated to job training and placement for older U.S. workers could reap benefits with regard to reduced private and public mental health expenditures. Further research could more clearly assess the degree to which the mental health benefits of employment among older Americans would warrant the expansion of job training and employment programs aimed at this group.

Dietary fiber and digestive health in children.

PubMed

Korczak, Renee; Kamil, Alison; Fleige, Lisa; Donovan, Sharon M; Slavin, Joanne L

2017-04-01

Digestive health is an expanding area in nutrition research due to the interest in how food components such as fiber affect gastrointestinal tolerance, stool form, defecation frequency, transit time, and gut microbial composition and metabolic activity. In children, however, digestive health studies that intervene with dietary fiber are limited due to legal and ethical concerns. To better understand if fiber improves digestive health in children, a literature review was conducted to answer the following research question: What are the effect(s) of fiber-containing foods and/or supplements on digestive health outcomes in children? A search of the PubMed database identified a total of 12 studies that fit the inclusion criteria established for this review. Most of the evidence in children shows beneficial effects of partially hydrolyzed guar gum, glucomannan, and bran on digestive health outcomes; however, the existing evidence is not conclusive. Furthermore, limited data exists on the effect of whole-grain sources of dietary fiber, such as oats. Additional well-designed intervention trials are needed to determine whether outcomes of digestive health such as stool form, gastrointestinal tolerance, and stool frequency are improved by increasing the fiber content of children's diets with whole-grain sources. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Soy and gut microbiota: interaction and implication for human health

USDA-ARS?s Scientific Manuscript database

Soy (Glycine max) is a major commodity in the U.S. and soy foods are gaining popularity due to its reported health promoting effects. In the past two decades, soy and soy bioactive components have been studied for their health promoting/disease preventing activities and potential mechanism of action...

Managing an epidemic: Zika interventions and community responses in Belize.

PubMed

Gray, Deven; Mishtal, Joanna

2018-05-07

Implementing effective health interventions in recent epidemics has been difficult due to the potentially global nature of their spread and sociocultural dynamics, raising questions concerning how to develop culturally-appropriate preventive measures, and how these health threats are understood locally. In Belize, health policy makers have only been marginally effective in managing infections and mosquito vectors, and Zika has been declared endemic in certain regions, particularly on the island of Caye Caulker. Based on ethnographic research conducted primarily in 2017, we examine how perspectives of Zika-related health consequences are shaped, and how state interventions to manage Zika are understood. We argue that despite its declared endemic status, Zika is not perceived as a true health concern for community members due to numerous neoliberal structural challenges. Moreover, the state's restrictive form of reproductive governance which limits family planning services is forcing individuals to weigh conflicting conceptions of health consequences. This also contributes to an ambiguous healthcare environment for health practitioners, giving them an unclear picture of the scope of Zika as a public health concern. We also consider how critical medical anthropology and feminist analytical approaches are useful in exploring these questions and contributing to understandings of the health impacts of Zika.

Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African-American men with HIV.

PubMed

Bogart, Laura M; Wagner, Glenn J; Galvan, Frank H; Klein, David J

2010-10-01

African-Americans show worse HIV disease outcomes compared to Whites. Health disparities may be aggravated by discrimination, which is associated with worse health and maladaptive health behaviors. We examined longitudinal effects of discrimination on antiretroviral treatment adherence among 152 HIV-positive Black men who have sex with men. We measured adherence and discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation at baseline and monthly for 6 months. Hierarchical repeated-measures models tested longitudinal effects of each discrimination type on adherence. Over 6 months, participants took 60% of prescribed medications on average; substantial percentages experienced discrimination (HIV-serostatus, 38%; race/ethnicity, 40%; and sexual orientation, 33%). Greater discrimination due to all three characteristics was significantly bivariately associated with lower adherence (all p's < 0.05). In the multivariate model, only racial discrimination was significant (p < 0.05). Efforts to improve HIV treatment adherence should consider the context of multiple stigmas, especially racism.

A review of the consequences of global climate change on human health.

PubMed

Kim, Ki-Hyun; Kabir, Ehsanul; Ara Jahan, Shamin

2014-01-01

The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.

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

PubMed

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

2015-08-12

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

Education policies and health inequalities: evidence from changes in the distribution of Body Mass Index in France, 1981-2003.

PubMed

Etile, Fabrice

2014-03-01

This paper contributes to the debate over the effectiveness of education policies in reducing overall health inequalities as compared to public health actions directed at the less-educated. Recentered Influence Function (RIF) regressions are used to decompose the contribution of education to the changing distribution of Body Mass Index (BMI) in France, between 1981 and 2003, into a composition effect (the shift in population education due to a massive educational expansion), and a structure effect (a changing educational gradient in BMI). Educational expansion has reduced overall BMI inequality by 3.4% for women and 2.3% for men. However, the structure effect on its own has produced a 10.9% increase in overall inequality for women, due to a steeper education gradient starting from the second quartile of the distribution. This structure effect on overall inequality is also large (7.6%) for men, albeit insignificant as it remains concentrated in the last decile. Educational expansion policies can thus reduce overall BMI inequalities; but attention must still be paid to the BMI gradient in education even for policies addressing overall rather than socioeconomic health inequalities. Copyright © 2013 Elsevier B.V. All rights reserved.

Examination of the Physical and Social Environments and Their Effect on Health Promotion Program Participation, Self Initiated Physical Activity and Nutrition Choices among University Employees

ERIC Educational Resources Information Center

Leininger, Lisa Janzen

2011-01-01

The worksite can be an effective arena to elicit health behavior change. Worksite health promotion programs now exist in 90% of all companies with more than 50 employees. These programs have become prevalent due to the high rates of obesity and lifestyle related diseases that are present in the United States. The purpose of this study was to…

The effect of physician supply on health status: Canadian evidence.

PubMed

Piérard, Emmanuelle

2014-10-01

We estimate the relationship between per capita supply of physicians, both general practitioners and specialists, and health status of Canadians. We use data from the Canadian National Population Health Survey and the Canadian Institute for Health Information. Two measures of quality of life, self-assessed health status and the Health Utility Index, are explored. Random effects ordered probits are used to model self-assessed health status, and quantile regressions are used for the Health Utility Index. A higher supply of general practitioners is correlated with better health outcomes as measured by both measures of health status, albeit for different age groups, and it is correlated with a higher HUI for some individuals who report having a chronic condition. A higher supply of specialists is correlated with worse health outcomes for the HUI for some individuals. It is possible that a higher supply of general practitioners increases the likelihood of diagnosing and treating health conditions in a timely manner and that this in turn affects health status. Specialists, due to the nature of their expertise could affect negatively health, both through the use of riskier procedures and due to their clientele being in relatively worse health. Based on our findings, we therefore would recommend maintaining a robust supply and distribution of GPs across Canada. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Workplace health promotion: a meta-analysis of effectiveness.

PubMed

Rongen, Anne; Robroek, Suzan J W; van Lenthe, Frank J; Burdorf, Alex

2013-04-01

An unhealthy lifestyle may contribute to ill health, absence due to sickness, productivity loss at work, and reduced ability to work. Workplace health promotion programs (WHPPs) aim to improve lifestyle and consequently improve health, work ability, and work productivity. However, systematic reviews on intervention studies have reported small effects, and the overall evaluation of effectiveness of WHPPs is hampered by a large heterogeneity in interventions and study populations. This systematic review aims to investigate the influence of population, study and intervention characteristics, and study quality on the effectiveness of workplace health promotion programs. A systematic literature search was conducted identifying RCTs, published before June 2012, evaluating the effect of a WHPP aimed at smoking cessation, physical activity, healthy nutrition, and/or obesity on self-perceived health, work absence due to sickness, work productivity, or work ability. Studies were included in the meta-analyses if quantitative information was present to calculate an effect size (ES). A meta-analysis, stratified meta-analyses, and meta-regression analyses were performed in Spring 2012 using Comprehensive Meta-analysis software 2.0 and PAWS 17.0.2. In 18 studies describing 21 interventions, the overall effect of a WHPP was small (ES=0.24, 95% CI=0.14, 0.34). The effectiveness of a WHPP was larger in younger populations, in interventions with weekly contacts, and in studies in which the control group received no health promotion. A 2.6-fold lower effectiveness was observed for studies performing an intention-to-treat analysis and a 1.7-fold lower effectiveness for studies controlling for confounders. Studies of poor methodologic quality reported a 2.9-fold higher effect size of the WHPP. The effectiveness of a WHPP is partly determined by intervention characteristics and statistical analysis. High-quality RCTs reported lower effect sizes. It is important to determine the effectiveness of WHPPs in RCTs of high quality. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Recommendations to mitigate against human health risks incurred due to energetic particle irradiation beyond low earth orbit/BLEO

NASA Astrophysics Data System (ADS)

McKenna-Lawlor, Susan; Bhardwaj, Anil; Ferrari, Franco; Kuznetsov, Nikolay; Lal, Ajay K.; Li, Yinghui; Nagamatsu, Aiko; Nymmik, Rikho; Panasyuk, Michael; Petrov, Vladislav; Reitz, Günther; Pinsky, Lawrence; Shukor, Muszaphar (Sheikh); Singhvi, Ashok K.; Straube, Ulrich; Tomi, Leena; Lawrence, Townsend

2015-04-01

An account is provided of the main sources of energetic particle radiation in interplanetary space (Galactic Cosmic Radiation and Solar Energetic Particles) and career dose limits presently utilized by NASA to mitigate against the cancer and non-cancer effects potentially incurred by astronauts due to irradiation by these components are presented. Certain gaps in knowledge that presently militate against mounting viable human exploration in deep space due to the inherent health risks are identified and recommendations made as to how these gaps might be closed within a framework of global international cooperation.

The evolution of health status and chronic conditions in Catalonia, 1994-2006: the paradox of health revisited using the Blinder - Oaxaca decomposition.

PubMed

García-Altés, Anna; Pinilla, Jaime; Ortún, Vicente

2011-05-23

The paradox of health refers to the improvement in objective measures of health and the increase in the reported prevalence of chronic conditions. The objective of this paper is to test the paradox of health in Catalonia from 1994 to 2006. Longitudinal cross-sectional study using the Catalonia Health Interview Survey of 1994 and 2006. The approach used was the three-fold Blinder - Oaxaca decomposition, separating the part of the differential in mean visual analogue scale value (VAS) due to group differences in the predictors (prevalence effect), due to differences in the coefficients (severity effect), and an interaction term. Variables included were the VAS value, education level, labour status, marital status, all common chronic conditions over the two cross-sections, and a variable for non-common chronic conditions and other conditions. Sample weights have been applied. Results show that there is an increase in mean VAS for men aged 15-44, and a decrease in mean VAS for women aged 65-74 and 75 and more. The increase in mean VAS for men aged 15-44 could be explained by a decrease in the severity effect, which offsets the increase in the prevalence effect. The decrease in mean VAS for women aged 65-74 and 75 and more could be explained by an increase in the prevalence effect, which does not offset the decrease in the severity effect. The results of the present analysis corroborate the paradox of health hypothesis for the population of Catalonia, and highlight the need to be careful when measuring population health over time, as well as their usefulness to detect population's perceptions.

The evolution of health status and chronic conditions in Catalonia, 1994-2006: the paradox of health revisited using the Blinder - Oaxaca decomposition

PubMed Central

2011-01-01

Background The paradox of health refers to the improvement in objective measures of health and the increase in the reported prevalence of chronic conditions. The objective of this paper is to test the paradox of health in Catalonia from 1994 to 2006. Methods Longitudinal cross-sectional study using the Catalonia Health Interview Survey of 1994 and 2006. The approach used was the three-fold Blinder - Oaxaca decomposition, separating the part of the differential in mean visual analogue scale value (VAS) due to group differences in the predictors (prevalence effect), due to differences in the coefficients (severity effect), and an interaction term. Variables included were the VAS value, education level, labour status, marital status, all common chronic conditions over the two cross-sections, and a variable for non-common chronic conditions and other conditions. Sample weights have been applied. Results Results show that there is an increase in mean VAS for men aged 15-44, and a decrease in mean VAS for women aged 65-74 and 75 and more. The increase in mean VAS for men aged 15-44 could be explained by a decrease in the severity effect, which offsets the increase in the prevalence effect. The decrease in mean VAS for women aged 65-74 and 75 and more could be explained by an increase in the prevalence effect, which does not offset the decrease in the severity effect. Conclusions The results of the present analysis corroborate the paradox of health hypothesis for the population of Catalonia, and highlight the need to be careful when measuring population health over time, as well as their usefulness to detect population's perceptions. PMID:21605384

Assessment of annoyance due to urban road traffic noise combined with tramway noise.

PubMed

Klein, A; Marquis-Favre, C; Champelovier, P

2017-01-01

Due to the expansion of urban areas, an increasing number of residents are exposed to combined community noise sources. Studies show that the exposure to transportation noise significantly affects health and well-being. Noise annoyance is one of these adverse health effects. Up to now, annoyance due to transportation noise is mostly assessed considering single noise exposure situations neglecting the effects of potential interactions between noise sources. In this study, perceptual phenomena involved in noise annoyance due to combined urban road traffic and tramway noises are assessed in laboratory conditions with imaginary and simulated contexts. The urban road traffic was composed of light vehicles, heavy vehicles, buses, and powered-two-wheelers in different driving conditions. The tramway traffic corresponded to tramways in in-curve operating configurations. It could be shown that the road traffic and tramway traffic partial annoyance responses were influenced by each other. Throughout the experiments the strongest component effect prevailed but secondary phenomena could also be observed. Considering the perceptual phenomena highlighted in the analysis, it is shown that total noise annoyance due to the combined noises can be most adequately predicted by the strongest component model. This result was obtained by calculating partial annoyance responses due to urban road and tramway traffic.

5 CFR 890.806 - When can former spouses change enrollment or reenroll and what are the effective dates?

Code of Federal Regulations, 2014 CFR

2014-01-01

... § 890.804 loses coverage under another enrollment under this part or under another group health benefits... federally-sponsored health benefits program; (3) Loss of coverage due to the termination of membership in an... OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH...

5 CFR 890.806 - When can former spouses change enrollment or reenroll and what are the effective dates?

Code of Federal Regulations, 2013 CFR

2013-01-01

... § 890.804 loses coverage under another enrollment under this part or under another group health benefits... federally-sponsored health benefits program; (3) Loss of coverage due to the termination of membership in an... OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH...

5 CFR 890.806 - When can former spouses change enrollment or reenroll and what are the effective dates?

Code of Federal Regulations, 2011 CFR

2011-01-01

... § 890.804 loses coverage under another enrollment under this part or under another group health benefits... federally-sponsored health benefits program; (3) Loss of coverage due to the termination of membership in an... OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH...

Understanding the Importance of Relationships: Perspective of Children with Intellectual Disabilities, Their Parents, and Nurses in Canada

ERIC Educational Resources Information Center

Aston, Megan; Breau, Lynn; MacLeod, Emily

2014-01-01

Effective and therapeutic relationships between health care providers and clients are important elements for positive health outcomes. Children with intellectual disabilities (IDs) and their parents face unique challenges in establishing relationships with health care providers due to social and institutional stigma and stereotypes associated with…

Comparative quantification of health risks: Conceptual framework and methodological issues

PubMed Central

Murray, Christopher JL; Ezzati, Majid; Lopez, Alan D; Rodgers, Anthony; Vander Hoorn, Stephen

2003-01-01

Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty. PMID:12780936

Serious gaming: A tool to educate health care providers about domestic violence.

PubMed

Mason, Robin; Turner, Linda

2018-05-10

Due to many adverse health effects, victims of domestic violence are frequently seen in the health care system. Yet, health care providers may lack the training to assist them. Online curricula can be an effective instructional tool. Our competency-based, serious video game, Responding to Domestic Violence in Clinical Settings, was designed to address health care providers' knowledge gaps through 17 modules, each a half hour in length. Nearly 9,000 participants completed at least one module; nursing students completed the most modules, approximately five hours of instruction. This serious video game-based curriculum is useful in helping health providers and students learn about Domestic Violence.

Nuts and Human Health Outcomes: A Systematic Review

PubMed Central

de Souza, Rávila Graziany Machado; Schincaglia, Raquel Machado; Pimentel, Gustavo Duarte

2017-01-01

There has been increasing interest in nuts and their outcome regarding human health. The consumption of nuts is frequently associated with reduction in risk factors for chronic diseases. Although nuts are high calorie foods, several studies have reported beneficial effects after nut consumption, due to fatty acid profiles, vegetable proteins, fibers, vitamins, minerals, carotenoids, and phytosterols with potential antioxidant action. However, the current findings about the benefits of nut consumption on human health have not yet been clearly discussed. This review highlights the effects of nut consumption on the context of human health. PMID:29207471

Health impacts due to personal exposure to fine particles caused by insulation of residential buildings in Europe

NASA Astrophysics Data System (ADS)

Gens, Alexandra; Hurley, J. Fintan; Tuomisto, Jouni T.; Friedrich, Rainer

2014-02-01

The insulation of residential buildings affects human exposure to fine particles. According to current EU guidelines, insulation is regulated for energy saving reasons. As buildings become tighter, the air exchange rate is reduced and, thus, the indoor concentration of pollutants is increased if there are significant indoor sources. While usually the effects of heat insulation and increase of the air-tightness of buildings on greenhouse gas emissions are highlighted, the negative impacts on human health due to higher indoor concentrations are not addressed. Thus, we investigated these impacts using scenarios in three European countries, i. e. Czech Republic, Switzerland and Greece. The assessment was based on modelling the human exposure to fine particles originating from sources of particles within outdoor and indoor air, including environmental tobacco smoke. Exposure response relationships were derived to link (adverse) health effects to the exposure. Furthermore, probable values for the parameters influencing the infiltration of fine particles into residential buildings were modelled. Results show that the insulation and increase of the air-tightness of residential buildings leads to an overall increase of the mean population exposure - and consequently adverse health effects - in all considered countries (ranging for health effects from 0.4% in Czech Republic to 11.8% in Greece for 100% insulated buildings) due to an accumulation of particles indoors, especially from environmental tobacco smoke. Considering only the emission reductions in outdoor air (omitting changes in infiltration parameters) leads to a decrease of adverse health effects. This study highlights the importance of ensuring a sufficient air exchange rate when insulating buildings, e. g. by prescribing heat ventilation and air conditioning systems in new buildings and information campaigns on good airing practice in renovated buildings. It also shows that assessing policy measures based on the exposure may provide different recommendations compared to an assessment based on only the outdoor air concentration.

Annoyance and Worry in a Petrochemical Industrial Area—Prevalence, Time Trends and Risk Indicators

PubMed Central

Axelsson, Gösta; Stockfelt, Leo; Andersson, Eva; Gidlof-Gunnarsson, Anita; Sallsten, Gerd; Barregard, Lars

2013-01-01

In 1992, 1998, and 2006, questionnaires were sent to stratified samples of residents aged 18–75 years living near petrochemical industries (n = 600–800 people on each occasion) and in a control area (n = 200–1,000). The aims were to estimate the long-term prevalence and change over time of annoyance caused by industrial odour, industrial noise, and worries about possible health effects, and to identify risk indicators. In 2006, 20% were annoyed by industrial odour, 27% by industrial noise (1–4% in the control area), and 40–50% were worried about health effects or industrial accidents (10–20% in the control area). Multiple logistic regression analyses revealed significantly lower prevalence of odour annoyance in 1998 and 2006 than in 1992, while industrial noise annoyance increased significantly over time. The prevalence of worry remained constant. Risk of odour annoyance increased with female sex, worry of health effects, annoyance by motor vehicle exhausts and industrial noise. Industrial noise annoyance was associated with traffic noise annoyance and worry of health effects of traffic. Health-risk worry due to industrial air pollution was associated with female sex, having children, annoyance due to dust/soot in the air, and worry of traffic air pollution. PMID:23552810

Adverse Psychiatric Effects Associated with Herbal Weight-Loss Products

PubMed Central

Coviello, Marialuce; Francesconi, Marta; Hough, Christina M.; De Stefano, Gianfranco; Bolzan Mariotti Posocco, Flaminia; Minichino, Amedeo; Corazza, Ornella

2015-01-01

Obesity and overeating are among the most prevalent health concerns worldwide and individuals are increasingly using performance and image-enhancing drugs (PIEDs) as an easy and fast way to control their weight. Among these, herbal weight-loss products (HWLPs) often attract users due to their health claims, assumed safety, easy availability, affordable price, extensive marketing, and the perceived lack of need for professional oversight. Reports suggest that certain HWLPs may lead to onset or exacerbation of psychiatric disturbances. Here we review the available evidence on psychiatric adverse effects of HWLPs due to their intrinsic toxicity and potential for interaction with psychiatric medications. PMID:26457296

The effect of perceived discrimination on the health of immigrant workers in Spain

PubMed Central

2011-01-01

Background Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators. Methods A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %). Results 73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status. Conclusions Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society. PMID:21849020

The effect of perceived discrimination on the health of immigrant workers in Spain.

PubMed

Agudelo-Suárez, Andrés A; Ronda-Pérez, Elena; Gil-González, Diana; Vives-Cases, Carmen; García, Ana M; Ruiz-Frutos, Carlos; Felt, Emily; Benavides, Fernando G

2011-08-17

Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators. A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %). 73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status. Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.

The Effects of HMO Penetration on Preventable Hospitalizations

PubMed Central

Zhan, Chunliu; Miller, Marlene R; Wong, Herbert; Meyer, Gregg S

2004-01-01

Objective To examine the effects of health maintenance organization (HMO) penetration on preventable hospitalizations. Data Source Hospital inpatient discharge abstracts for 932 urban counties in 22 states from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID), hospital data from American Hospital Association (AHA) annual survey, and population characteristics and health care capacity data from Health Resources and Services Administration (HRSA) Area Resource File (ARF) for 1998. Methods Preventable hospitalizations due to 14 ambulatory care sensitive conditions were identified using the Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators. Multiple regressions were used to determine the association between preventable hospitalizations and HMO penetration while controlling for demographic and socioeconomic characteristics and health care capacity of the counties. Principal Findings A 10 percent increase in HMO penetration was associated with a 3.8 percent decrease in preventable hospitalizations (95 percent confidence interval, 2.0 percent–5.6 percent). Advanced age, female gender, poor health, poverty, more hospital beds, and fewer primary care physicians per capita were significantly associated with more preventable hospitalizations. Conclusions Our study suggests that HMO penetration has significant effects in reducing preventable hospitalizations due to some ambulatory care sensitive conditions. PMID:15032958

Global comparative healthcare effectiveness research: evaluating sustainable programmes in low & middle resource settings.

PubMed

Balkrishnan, Rajesh; Chang, Jongwha; Patel, Isha; Yang, Fang; Merajver, Sofia D

2013-03-01

The need to focus healthcare expenditures on innovative and sustainable health systems that efficiently use existing effective therapies are the major drivers stimulating Comparative Effectiveness Research (CER) across the globe. Lack of adequate access and high cost of essential medicines and technologies in many countries increases morbidity and mortality and cost of care that forces people and families into poverty due to disability and out-of-pocket expenses. This review illustrates the potential of value-added global health care comparative effectiveness research in shaping health systems and health care delivery paradigms in the "global south". Enabling the development of effective CER systems globally paves the way for tangible local and regional definitions of equity in health care because CER fosters the sharing of critical assets, resources, skills, and capabilities and the development of collaborative of multi-sectorial frameworks to improve health outcomes and metrics globally.

Climate change and health: impacts, vulnerability, adaptation and mitigation.

PubMed

Kjellstrom, Tord; Weaver, Haylee J

2009-01-01

Global climate change is progressing and health impacts have been observed in a number of countries, including Australia. The main health impacts will be due to direct heat exposure, extreme weather, air pollution, reduced local food production, food- and vectorborne infectious diseases and mental stress. The issue is one of major public health importance. Adaptation to reduce the effects of climate change involves many different sectors to minimise negative health outcomes. Wide-scale mitigation is also required, in order to reduce the effects of climate change. In addition, future urban design must be modified to mitigate and adapt to the effects of climate change. Strategies for mitigation and adaptation can create co-benefits for both individual and community health, by reducing non-climate-related health hazard exposures and by encouraging health promoting behaviours and lifestyles.

Does health affect portfolio choice?

PubMed

Love, David A; Smith, Paul A

2010-12-01

A number of recent studies find that poor health is empirically associated with a safer portfolio allocation. It is difficult to say, however, whether this relationship is truly causal. Both health status and portfolio choice are influenced by unobserved characteristics such as risk attitudes, impatience, information, and motivation, and these unobserved factors, if not adequately controlled for, can induce significant bias in the estimates of asset demand equations. Using the 1992-2006 waves of the Health and Retirement Study, we investigate how much of the connection between health and portfolio choice is causal and how much is due to the effects of unobserved heterogeneity. Accounting for unobserved heterogeneity with fixed effects and correlated random effects models, we find that health does not appear to significantly affect portfolio choice among single households. For married households, we find a small effect (about 2-3 percentage points) from being in the lowest of five self-reported health categories. Copyright © 2009 John Wiley & Sons, Ltd.

Understanding how environmental enhancement and conservation activities may benefit health and wellbeing: a systematic review.

PubMed

Lovell, Rebecca; Husk, Kerryn; Cooper, Chris; Stahl-Timmins, Will; Garside, Ruth

2015-09-07

Action taken to enhance or conserve outdoor environments may benefit health and wellbeing through the process of participation but also through improving the environment. There is interest, amongst both health and environmental organisations, in using such activities as health promotion interventions. The objective of this systematic review was to investigate the health and wellbeing impacts of participation in environmental enhancement and conservation activities and to understand how these activities may be beneficial, to whom and in what circumstances or contexts. A theory-led mixed-method systematic review was used to assess evidence of effect and to identify pathways to change (protocol: http://onlinelibrary.wiley.com/doi/ 10.1002/14651858.CD010351/full ). Due to the multi-disciplinary, dispersed and disparate body of evidence an extensive multi-stage search strategy was devised and undertaken. Twenty-seven databases and multiple sources of grey literature were searched and over 200 relevant organisations were contacted. The heterogenous evidence was synthesised using a narrative approach and a conceptual model was developed to illustrate the mechanisms of effect. Due to the limited nature of the evidence additional higher order evidence was sought to assess the plausibility of the proposed mechanisms of effect through which health and wellbeing may accrue. The majority of the quantitative evidence (13 studies; all poor quality and lower-order study designs) was inconclusive, though a small number of positive and negative associations were observed. The qualitative evidence (13 studies; 10 poor quality, 3 good) indicated that the activities were perceived to have value to health and wellbeing through a number of key mechanisms; including exposure to natural environments, achievement, enjoyment and social contact. Additional high level evidence indicated that these pathways were plausible. Despite interest in the use of environmental enhancement activities as a health intervention there is currently little direct evidence of effect, this is primarily due to a lack of robust study designs. Further rigorous research is needed to understand the potential of the activities to benefit health and environment.

Plastic and Human Health: A Micro Issue?

PubMed

Wright, Stephanie L; Kelly, Frank J

2017-06-20

Microplastics are a pollutant of environmental concern. Their presence in food destined for human consumption and in air samples has been reported. Thus, microplastic exposure via diet or inhalation could occur, the human health effects of which are unknown. The current review article draws upon cross-disciplinary scientific literature to discuss and evaluate the potential human health impacts of microplastics and outlines urgent areas for future research. Key literature up to September 2016 relating to accumulation, particle toxicity, and chemical and microbial contaminants was critically examined. Although microplastics and human health is an emerging field, complementary existing fields indicate potential particle, chemical and microbial hazards. If inhaled or ingested, microplastics may accumulate and exert localized particle toxicity by inducing or enhancing an immune response. Chemical toxicity could occur due to the localized leaching of component monomers, endogenous additives, and adsorbed environmental pollutants. Chronic exposure is anticipated to be of greater concern due to the accumulative effect that could occur. This is expected to be dose-dependent, and a robust evidence-base of exposure levels is currently lacking. Although there is potential for microplastics to impact human health, assessing current exposure levels and burdens is key. This information will guide future research into the potential mechanisms of toxicity and hence therein possible health effects.

Effects of urban tree canopy loss on land surface temperature magnitude and timing

Treesearch

Arthur Elmes; John Rogan; Christopher Williams; Samuel Ratick; David Nowak; Deborah Martin

2017-01-01

Urban Tree Canopy (UTC) plays an important role in moderating the Surface Urban Heat Island (SUHI) effect, which poses threats to human health due to substantially increased temperatures relative to rural areas. UTC coverage is associated with reduced urban temperatures, and therefore benefits both human health and reducing energy use in cities. Measurement of this...

The use of cell phone and insight into its potential human health impacts.

PubMed

Kim, Ki-Hyun; Kabir, Ehsanul; Jahan, Shamin Ara

2016-04-01

The rapid evolution of mobile phone technology has raised public concern about its possible association with adverse health effects. Given the huge number of mobile phone users at present days, even simple adverse health effects could have major implications. This article reviews the present knowledge concerning the health effects stemming from the use of cellular phones by emphasizing adverse biological effects, epidemiological issues, and indirect health effects. A line of epidemiological evidence suggests that there is no concrete association between mobile phone radiation and cancer. The evidence regarding the occurrence of cancer due to exposure to the radio frequency energy of mobile phones is nonetheless conflicting. Consequently, long-term research in this field is necessary to account for the vital issue of this scientific research to the public in a meaningful way.

Flow, stock, and impact assessment of refrigerants in the Japanese household air conditioner sector.

PubMed

Xue, Mianqiang; Kojima, Naoya; Machimura, Takashi; Tokai, Akihiro

2017-05-15

Refrigerants provide society with great benefits while have the potential to cause adverse effects on the environment and human health. The present study estimated time-dependent flows and stocks and assessed the effects of refrigerants (R-22, R-410a, and R-32) in household air conditioners in Japan. It was found that stock of R-22 and R-410a peaked at 49,147t in 2000 and 55,994t in 2017, respectively. The largest flow of R-22 and R-410a to waste phase occurred at 3417t/yr. in 2005 and 4011t/yr. in 2023, respectively. The total global warming potential (GWP) due to refrigerant emissions increased from 3.6kt CO 2 eq. in 1952 to 6999kt CO 2 eq. in 2019, and then decreased to 5314kt CO 2 eq. in 2030. The ozone depletion potential (ODP) peaked at 141t CFC-11 eq. in 2002. When substituting R-410a for R-22, the ODP decreased 50% while the GDP increased 8%. When substituting R-32 for R-410a, there was no effect on the ODP while the GDP decreased 6%. The human health damage due to the global warming effect of refrigerant emission was much higher than that due to the ozone depleting effect. The refrigerant emission in use and waste management phases dominated the human health damage. The dynamic estimation not only allows us to evaluate the performance of past policies but also supports the future sustainable management associated with the health effects of refrigerants. Copyright © 2017 Elsevier B.V. All rights reserved.

Pathway-based monitoring of biological effects at Great Lakes sites (Presntation)

EPA Science Inventory

The Great Lakes region suffers from degradation of water and environmental quality due to release of chemicals of emerging concern. Critical issues remain in delisting Areas of Concern (AOC) including determining sources of chemicals causing fish health impacts, relating health ...

Unemployment transitions and self-rated health in Europe: A longitudinal analysis of EU-SILC from 2008 to 2011.

PubMed

Tøge, Anne Grete; Blekesaune, Morten

2015-10-01

The Great Recession of 2008 has led to elevated unemployment in Europe and thereby revitalised the question of causal health effects of unemployment. This article applies fixed effects regression models to longitudinal panel data drawn from the European Union Statistics on Income and Living Conditions for 28 European countries from 2008 to 2011, in order to investigate changes in self-rated health around the event of becoming unemployed. The results show that the correlation between unemployment and health is partly due to a decrease in self-rated health as people enter unemployment. Such health changes vary by country of domicile, and by individual age; older workers have a steeper decline than younger workers. Health changes after the unemployment spell reveal no indication of adverse health effects of unemployment duration. Overall, this study indicates some adverse health effects of unemployment in Europe--predominantly among older workers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Arsenic residue in the products and by-products of chicken and ducks: a possible concern of avian health and environmental hazard to the population in West Bengal, India.

PubMed

Rana, Tanmoy; Bera, Asit Kumar; Mondal, Dipak Kumar; Das, Subhashree; Bhattacharya, Debasis; Samanta, Srikanta; Pan, Diganta; Das, Subrata Kumar

2014-07-01

Arsenicosis caused due to drinking of arsenic contaminated ground water is a major environmental health hazard throughout the world. We evaluated the ecotoxicological effect of arsenic on chicken and duck in an arsenic endemic zone. The concentration of arsenic was higher in chicken and duck feed and their by-products than that in the respective samples of control area. Arsenic concentration in the eggs of both chicken and duck was higher than that in the respective samples of control area. Thus, we concluded that arsenic enters into food chain through the intake of contaminated eggs. Furthermore, adverse health effect of arsenic on avian population is due to the alteration in haematobiochemical indices. © The Author(s) 2012.

Cognitive decline impairs financial and health literacy among community-based older persons without dementia

PubMed Central

Boyle, Patricia A.; Yu, Lei; Wilson, Robert S.; Segawa, Eisuke; Buchman, Aron S.; Bennett, David A.

2013-01-01

Literacy is an important determinant of health and well-being across the lifespan but is critical in aging, when many influential health and financial decisions are made. Prior studies suggest that older persons exhibit lower literacy than younger persons, particularly in the domains of financial and health literacy, but the reasons why remain unknown. The objectives of this study were to: a) examine pathways linking diverse resources (i.e., education, word knowledge, cognitive function, and decision making style) to health and financial literacy among older persons and determine the extent to which the relation of age with literacy represents a direct effect versus an indirect effect due to decrements in specific cognitive functions (i.e., executive functions and episodic memory), and b) test the hypothesis that declines in executive function and episodic memory are associated with lower literacy among older persons without dementia. 645 community-based older persons without dementia underwent detailed assessments of diverse resources, including education, word knowledge, cognitive function (i.e., executive function, episodic memory) and decision making style (i.e., risk aversion), and completed a measure of literacy that included items similar to those assessed in the Health and Retirement Study, such as numeracy, financial concepts such as compound inflation and knowledge of stocks and bonds, and important health concepts such as understanding of drug risk and Medicare Part D. Path analysis revealed a strong effect of age on literacy, with about half of the effect of age on literacy due to decrements in executive functions and episodic memory. In addition, executive function had an indirect effect on literacy via decision making style (i.e., risk aversion), and education and word knowledge had independent effects on literacy. Finally, among (n=447) persons with repeated cognitive assessments available for up to 14 years, regression analysis supported the association of multiple resources with literacy; moreover, more rapid declines in executive function and episodic memory over an average of 6.4 years prior to the literacy assessment predicted lower literacy scores (p’s<0.02), but rate of decline in word knowledge did not. These findings suggest that diverse individual resources contribute to financial and health literacy and lower literacy in old age is partially due to declines in executive function and episodic memory. PMID:23957225

Cognitive decline impairs financial and health literacy among community-based older persons without dementia.

PubMed

Boyle, Patricia A; Yu, Lei; Wilson, Robert S; Segawa, Eisuke; Buchman, Aron S; Bennett, David A

2013-09-01

Literacy is an important determinant of health and well-being across the life span but is critical in aging, when many influential health and financial decisions are made. Prior studies suggest that older persons exhibit lower literacy than younger persons, particularly in the domains of financial and health literacy, but the reasons why remain unknown. The objectives of this study were to: (a) examine pathways linking diverse resources (i.e., education, word knowledge, cognitive function, and decision making style) to health and financial literacy among older persons and determine the extent to which the relation of age with literacy represents a direct effect versus an indirect effect due to decrements in specific cognitive functions (i.e., executive functions and episodic memory); and (b) test the hypothesis that declines in executive function and episodic memory are associated with lower literacy among older persons without dementia. Six-hundred and forty-five community-based older persons without dementia underwent detailed assessments of diverse resources, including education, word knowledge, cognitive function (i.e., executive function, episodic memory) and decision making style (i.e., risk aversion), and completed a measure of literacy that included items similar to those used in the Health and Retirement Study, such as numeracy, financial concepts such as compound inflation and knowledge of stocks and bonds, and important health concepts such as understanding of drug risk and Medicare Part D. Path analysis revealed a strong effect of age on literacy, with about half of the effect of age on literacy due to decrements in executive functions and episodic memory. In addition, executive function had an indirect effect on literacy via decision making style (i.e., risk aversion), and education and word knowledge had independent effects on literacy. Finally, among (n = 447) persons with repeated cognitive assessments available for up to 14 years, regression analysis supported the association of multiple resources with literacy; moreover, more rapid declines in executive function and episodic memory over an average of 6.4 years prior to the literacy assessment predicted lower literacy scores (ps < 0.02), but rate of decline in word knowledge did not. These findings suggest that diverse individual resources contribute to financial and health literacy and lower literacy in old age is partially due to declines in executive function and episodic memory.

Toxicological effects of polychlorinated biphenyls (PCBs) on freshwater turtles in the United States.

PubMed

Ming-Ch'eng Adams, Clare Isabel; Baker, Joel E; Kjellerup, Birthe V

2016-07-01

Prediction of vertebrate health effects originating from persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs) has remained a challenge for decades thus making the identification of bioindicators difficult. POPs are predominantly present in soil and sediment, where they adhere to particles due to their hydrophobic characteristics. Animals inhabiting soil and sediment can be exposed to PCBs via dermal exposure while others may obtain PCBs through contaminated trophic interaction. Freshwater turtles can serve as bioindicators due to their strong site fidelity, longevity and varied diet. Previous research observed the health effects of PCBs on turtles such as decreased bone mass, changed sexual development and decreased immune responses through studying both contaminated sites along with laboratory experimentation. Higher deformity rates in juveniles, increased mortality and slower growth have also been observed. Toxicological effects of PCBs vary between species of freshwater turtles and depend on the concertation and configuration of PCB congeners. Evaluation of ecotoxicological effects of PCBs in non-endangered turtles could provide important knowledge about the health effects of endangered turtle species thus inform the design of remediation strategies. In this review, the PCB presence in freshwater turtle habitats and the ecotoxicological effects were investigated with the aim of utilizing the health status to identify areas of focus for freshwater turtle conservation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development, Application and Assessment of a Taxonomy for Characterizing International Environmental Problems

DTIC Science & Technology

1990-01-01

Population at risk 3579 NOTES. No one in the U.S. is effected ( health effects ) by a food shortage due to a drought 8. Land area at risk 1 3 5 Q 9 NOTES: Amount...adequately captures the characteristics most people are concerned with--human health , ecological effects , and welfare--for these problems. Because of...reasons as in India: Pure Food (10) is included because of the effects of pesticides, while Animal Habitat (9) and Stock of Wildlife (23) are included

Roadside vegetation design characteristics that can improve local, near road air quality

EPA Science Inventory

As public health concerns have increased due to the rising number of studies linking adverse health effects with exposures to traffic-related pollution near large roadways, interest in methods to mitigate these exposures have also increased. Several studies have investigated the...

Pathway-based monitoring of biological effects at Great Lakes sites

EPA Science Inventory

The Great Lakes region suffers from degradation of water and environmental quality due to release of chemicals of emerging concern (CEC) that may threaten near shore health. Critical issues remain in delisting AOC including determining sources of chemicals causing fish health im...

Cranberries and their bioactive constituents in human health

USDA-ARS?s Scientific Manuscript database

Recent observational and clinical studies have raised interest in the potential health effects of cranberry consumption, an association that appears due to the phytochemical content of this fruit. The profile of cranberry bioactives is distinct from other berry fruit, being rich in A-type proanthocy...

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

PubMed Central

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

2015-01-01

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

Let's Move Together: A Randomized Trial of the Impact of Family Health History on Encouragement and Co-Engagement in Physical Activity of Mexican-Origin Parents and Their Children

ERIC Educational Resources Information Center

de Heer, Hendrik Dirk; de la Haye, Kayla; Skapinsky, Kaley; Goergen, Andrea F.; Wilkinson, Anna V.; Koehly, Laura M.

2017-01-01

Background: Due to shared health behaviors and disease risk, families may be more effective targets for health promotion. This study assessed whether providing family health history (FHH)-based risk information for heart disease and diabetes affected encouragement to engage in physical activity (PA) and healthy weight (HW) maintenance and…

Change Abstract Title

NASA Astrophysics Data System (ADS)

Rudich, Y.

2017-12-01

Investigating possible health effects of transported and resuspended dusts People in regions such as the Eastern Mediterranean are often exposed to high levels of both transported desert dust and to resuspended urban dust. Due to warming and drying trends, the frequency and intensity of dust storms have increased in the Eastern Mediterranean over the last decades. High exposure to particulate matter is a known risk factor to the exposed population, but the detailed understanding of how these dusts affect health remain elusive. In this talk I will describe aspects of how dust may impact health. First, transport of bacteria by desert dust, its effects on the local microbiome and dependence on the source region will be described. Then, we will describe the biological effects due to presence of biological components on dust. Finally, we will discuss how metals from brake and tire wear in resuspended urban dust affect oxidative stress and inflammation, and lead to oxidative damage in lung tissues. The significance of these findings in light of recent measurements from the global SPARATN network will be presented.

The Potential for PTSD, Substance Use, and HIV Risk Behavior among Adolescents Exposed to Hurricane Katrina

PubMed Central

WAGNER, KARLA D.; BRIEF, DEBORAH J.; VIELHAUER, MELANIE J.; SUSSMAN, STEVE; KEANE, TERENCE M.; MALOW, ROBERT

2014-01-01

Adverse psychosocial outcomes can be anticipated among youth exposed to Hurricane Katrina. Adolescents are particularly vulnerable to the consequences of this natural disaster and may suffer lasting consequences in the form of psychological morbidity and the development of negative health behaviors due to their exposure. We review existing literature on the effects of exposure to natural disasters and similar traumas on youth and, where data on youth are unavailable, on adults. The effect of natural disasters is discussed in terms of risk for three negative health outcomes that are of particular concern due to their potential to cause long-term morbidity: post-traumatic stress disorder, substance use disorder, and HIV-risk behavior. Where available, data from studies of the effects of Hurricane Katrina are included. PMID:19895305

Women with epilepsy: clinically relevant issues

PubMed Central

Bangar, Santosh; Shastri, Abhishek; El-Sayeh, Hany; Cavanna, Andrea E.

2016-01-01

Summary Women with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population. PMID:27678205

The Household Health Spending and Impoverishment: Findings from the Households Survey in Shiraz, Iran.

PubMed

Khammarnia, M; Keshtkaran, A; Kavosi, Z; Hayati, R

2014-08-01

The present study aimed to investigate the households' impoverishment due to the healthcare costs in Shiraz in 2012. In this household's survey, 800 households were studied in Shiraz. The study sample was selected using stratified and cluster sampling in the urban and rural areas, respectively. The information was collected using the household section of the World Health Survey questionnaire. In order to determine impoverishment due to health spending, at first, the households' food-based poverty line (subsistence expenditure) was measured. Then, households' health expenditure was subtracted from their total expenditure and if the obtained value was lower than the households' food-based poverty line, the households was considered to be impoverished due to health expenditures. The collected data were entered into the SPSS (version 16) statistical software and analyzed using descriptive statistic, Chi-square test, and logistic regression in backward method. The study results showed that 7.1% of the households (CI: 0.071 ± 0.018) were impoverished because of healthcare expenditures. Besides, the households in the first quintile were more likely to be faced with poverty compared to those in the other quintiles (p < 0.05). Being covered by health insurance did not affect the protection from poverty due to health costs. Moreover, the participants living in rural areas were faced with poverty more than those living in urban areas (p < 0.05). It seems that health expenditure can be an economic shock for household in Shiraz and through spending on health a household may fall into poverty. As insurance had no effect on impoverishment, it implies that change in health insurance plans and ways of health financing is necessary.

The effect of unemployment on self-reported health and mental health in Greece from 2008 to 2013: a longitudinal study before and during the financial crisis.

PubMed

Drydakis, Nick

2015-03-01

The current study uses six annual waves of the Longitudinal Labor Market Study (LLMS) covering the 2008-2013 period to obtain longitudinal estimations suggesting statistically significant negative effects from unemployment on self-reported health and mental health in Greece. The specifications suggest that unemployment results in lower health and the deterioration of mental health during the 2008-2009 period compared with the 2010-2013 period, i.e., a period in which the country's unemployment doubled as a consequence of the financial crisis. Unemployment seems to be more detrimental to health/mental health in periods of high unemployment, suggesting that the unemployment crisis in Greece is more devastating as it concerns more people. Importantly, in all specifications, comparable qualitative patterns are found by controlling for unemployment due to firm closure, which allows us to minimize potential bias due to unemployment-health related reverse causality. Moreover, in all cases, women are more negatively affected by unemployment in relation to their health and mental health statuses than are men. Greece has been more deeply affected by the financial crisis than any other EU country, and this study contributes by offering estimates for before and during the financial crisis and considering causality issues. Because health and mental health indicators increase more rapidly in a context of higher surrounding unemployment, policy action must place greater emphasis on unemployment reduction and supporting women's employment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Measuring the effect of workplace health promotion interventions on "presenteeism": a potential role for biomarkers.

PubMed

Yamamoto, Shelby; Loerbroks, Adrian; Terris, Darcey D

2009-05-01

Health promotion activities to improve employee health to reduce health care costs and increase productivity are of particular importance for organizations and society. The evaluation of employee health and health promotion programs has typically focused on absenteeism, disability and increasingly, "presenteeism", which refers to an employee's presence at work with reduced performance due to illness. Existing psychometric measures of presenteeism may be subject to the effects of recall bias as they typically rely on questionnaires. Biomarkers such as heart rate variability and salivary cortisol can provide additional objective measures of illness and stress. Combining such physiologic measures of stress with assessments of presenteeism may offer a more comprehensive way to assess workplace productivity when developing health promotion programs.

Health economics--concepts and conceptual problems.

PubMed

Satpathy, S K; Bansal, R D

1982-01-01

Awareness of the economic manifestation of health and diseases and the limited resources allocated to health care services has brought to the focus a new discipline - health economics. Cost accounting, cost benefit, cost effectiveness methods etc. are increasingly becoming an integral part of the health management and evaluation of health programmes. Various concepts and problems relating to health economics are discussed in the present paper. More efforts should be made to conduct health economic studies in hospitals and health centres by which the process of standardisation of the concepts, would be easier. Health economics should also find its due place in the medical curriculum.

Healthy and Ready to Learn: Effects of a School-Based Public Health Insurance Outreach Program for Kindergarten-Aged Children

ERIC Educational Resources Information Center

Jenkins, Jade Marcus

2018-01-01

Background: Rates of child insurance coverage have increased due to expansions in public programs, but many eligible children remain uninsured. Uninsured children are less likely to receive preventative care, which leads to poorer health and achievement in the long term. This study is an evaluation of a school-based health insurance outreach…

Using a Health Message with a Testimonial to Motivate Colon Cancer Screening: Associations with Perceived Identification and Vividness

ERIC Educational Resources Information Center

Dillard, Amanda J.; Main, Jackie L.

2013-01-01

Research suggests that testimonials, or first-person narratives, influence health behavior and health-related decision making, but few studies have examined conceptual factors that may be responsible for these effects. In the current study, older adults who were due for colorectal cancer screening read a message about screening that included a…

Curcumin: A Review of Its' Effects on Human Health.

PubMed

Hewlings, Susan J; Kalman, Douglas S

2017-10-22

Turmeric, a spice that has long been recognized for its medicinal properties, has received interest from both the medical/scientific world and from culinary enthusiasts, as it is the major source of the polyphenol curcumin. It aids in the management of oxidative and inflammatory conditions, metabolic syndrome, arthritis, anxiety, and hyperlipidemia. It may also help in the management of exercise-induced inflammation and muscle soreness, thus enhancing recovery and performance in active people. In addition, a relatively low dose of the complex can provide health benefits for people that do not have diagnosed health conditions. Most of these benefits can be attributed to its antioxidant and anti-inflammatory effects. Ingesting curcumin by itself does not lead to the associated health benefits due to its poor bioavailability, which appears to be primarily due to poor absorption, rapid metabolism, and rapid elimination. There are several components that can increase bioavailability. For example, piperine is the major active component of black pepper and, when combined in a complex with curcumin, has been shown to increase bioavailability by 2000%. Curcumin combined with enhancing agents provides multiple health benefits. The purpose of this review is to provide a brief overview of the plethora of research regarding the health benefits of curcumin.

Measuring production loss due to health and work environment problems: construct validity and implications.

PubMed

Karlsson, Malin Lohela; Bergström, Gunnar; Björklund, Christina; Hagberg, Jan; Jensen, Irene

2013-12-01

The aim was to validate two measures of production loss, health-related and work environment-related production loss, concerning their associations with health status and work environment factors. Validity was assessed by evaluating the construct validity. Health problems related and work environment-related problems (or factors) were included in separate analyses and evaluated regarding the significant difference in proportion of explained variation (R) of production loss. health problems production loss was not found to fulfill the criteria for convergent validity in this study; however, the measure of work environment-related production loss did fulfill the criteria that were set up. The measure of work environment-related production loss can be used to screen for production loss due to work environment problems as well as an outcome measure when evaluating the effect of organizational interventions.

Nitrate and nitrite in the diet: how to assess their benefit and risk for human health.

PubMed

Habermeyer, Michael; Roth, Angelika; Guth, Sabine; Diel, Patrick; Engel, Karl-Heinz; Epe, Bernd; Fürst, Peter; Heinz, Volker; Humpf, Hans-Ulrich; Joost, Hans-Georg; Knorr, Dietrich; de Kok, Theo; Kulling, Sabine; Lampen, Alfonso; Marko, Doris; Rechkemmer, Gerhard; Rietjens, Ivonne; Stadler, Richard H; Vieths, Stefan; Vogel, Rudi; Steinberg, Pablo; Eisenbrand, Gerhard

2015-01-01

Nitrate is a natural constituent of the human diet and an approved food additive. It can be partially converted to nitrogen monoxide, which induces vasodilation and thereby decreases blood pressure. This effect is associated with a reduced risk regarding cardiovascular disease, myocardial infarction, and stroke. Moreover, dietary nitrate has been associated with beneficial effects in patients with gastric ulcer, renal failure, or metabolic syndrome. Recent studies indicate that such beneficial health effects due to dietary nitrate may be achievable at intake levels resulting from the daily consumption of nitrate-rich vegetables. N-nitroso compounds are endogenously formed in humans. However, their relevance for human health has not been adequately explored up to now. Nitrate and nitrite are per se not carcinogenic, but under conditions that result in endogenous nitrosation, it cannot be excluded that ingested nitrate and nitrite may lead to an increased cancer risk and may probably be carcinogenic to humans. In this review, the known beneficial and detrimental health effects related to dietary nitrate/nitrite intake are described and the identified gaps in knowledge as well as the research needs required to perform a reliable benefit/risk assessment in terms of long-term human health consequences due to dietary nitrate/nitrite intake are presented. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Health and societal effects from exposure to fragranced consumer products.

PubMed

Steinemann, Anne

2017-03-01

Fragranced consumer products-such as air fresheners, cleaning supplies, and personal care products- pervade society. This study investigated the occurrence and types of adverse effects associated with exposure to fragranced products in Australia, and opportunities for prevention. Data were collected in June 2016 using an on-line survey with a representative national sample ( n  = 1098). Overall, 33% of Australians report health problems, such as migraine headaches and asthma attacks, when exposed to fragranced products. Of these health effects, more than half (17.1%) could be considered disabling under the Australian Disability Discrimination Act. Additionally, 7.7% of Australians have lost workdays or a job due to illness from fragranced product exposure in the workplace, 16.4% reported health problems when exposed to air fresheners or deodorizers, 15.3% from being in a room after it was cleaned with scented products, and 16.7% would enter but then leave a business as quickly as possible due to fragranced products. About twice as many respondents would prefer that workplaces, health care facilities and professionals, hotels, and airplanes were fragrance-free rather than fragranced. While 73.7% were not aware that fragranced products, even ones called green and organic, emitted hazardous air pollutants, 56.3% would not continue to use a product if they knew it did. This is the first study in Australia to assess the extent of adverse effects associated with exposure to common fragranced products. It provides compelling evidence for the importance and value of reducing fragranced product exposure in order to reduce and prevent adverse health effects and costs.

Trauma and posttraumatic stress disorder in women with chronic pelvic pain.

PubMed

Meltzer-Brody, Samantha; Leserman, Jane; Zolnoun, Denniz; Steege, John; Green, Emily; Teich, Alice

2007-04-01

To examine the effect of abuse history, other major trauma, and posttraumatic stress disorder (PTSD) on medical symptoms and health-related daily functioning in women with chronic pelvic pain. We administered a questionnaire to 713 consecutive women seen in a referral-based pelvic pain clinic. We found that 46.8% reported having either a sexual or physical abuse history. A total of 31.3% had a positive screen for PTSD. Using regression and path analysis, controlling for demographic variables, we found that a trauma history was associated with worse daily physical functioning due to poor health (P<.001), more medical symptoms (P<.001), more lifetime surgeries (P<.001), more days spent in bed (P<.001), and more dysfunction due to pain (P<.001). Furthermore, a positive screen for PTSD was highly related to most measures of poor health status (P<.001) and somewhat explained the trauma-related poor health status. The association of trauma with poor health may be due in part to the development of PTSD resulting from trauma. These findings demonstrate the importance of screening for trauma and PTSD in women with chronic pelvic pain. II.

40 CFR 264.601 - Environmental performance standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... other vegetation; (8) The potential for health risks caused by human exposure to waste constituents; and... effects on human health or the environment due to migration of waste constituents in surface water, or... human exposure to waste constituents; and (11) The potential for damage to domestic animals, wildlife...

40 CFR 264.601 - Environmental performance standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... other vegetation; (8) The potential for health risks caused by human exposure to waste constituents; and... effects on human health or the environment due to migration of waste constituents in surface water, or... human exposure to waste constituents; and (11) The potential for damage to domestic animals, wildlife...

40 CFR 264.601 - Environmental performance standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... other vegetation; (8) The potential for health risks caused by human exposure to waste constituents; and... effects on human health or the environment due to migration of waste constituents in surface water, or... human exposure to waste constituents; and (11) The potential for damage to domestic animals, wildlife...

Climate change impacts on human health over Europe through its effect on air quality.

PubMed

Doherty, Ruth M; Heal, Mathew R; O'Connor, Fiona M

2017-12-05

This review examines the current literature on the effects of future emissions and climate change on particulate matter (PM) and O 3 air quality and on the consequent health impacts, with a focus on Europe. There is considerable literature on the effects of climate change on O 3 but fewer studies on the effects of climate change on PM concentrations. Under the latest Intergovernmental Panel on Climate Change (IPCC) 5th assessment report (AR5) Representative Concentration Pathways (RCPs), background O 3 entering Europe is expected to decrease under most scenarios due to higher water vapour concentrations in a warmer climate. However, under the extreme pathway RCP8.5 higher (more than double) methane (CH 4 ) abundances lead to increases in background O 3 that offset the O 3 decrease due to climate change especially for the 2100 period. Regionally, in polluted areas with high levels of nitrogen oxides (NO x ), elevated surface temperatures and humidities yield increases in surface O 3 - termed the O 3 climate penalty - especially in southern Europe. The O 3 response is larger for metrics that represent the higher end of the O 3 distribution, such as daily maximum O 3 . Future changes in PM concentrations due to climate change are much less certain, although several recent studies also suggest a PM climate penalty due to high temperatures and humidity and reduced precipitation in northern mid-latitude land regions in 2100.A larger number of studies have examined both future climate and emissions changes under the RCP scenarios. Under these pathways the impact of emission changes on air quality out to the 2050s will be larger than that due to climate change, because of large reductions in emissions of O 3 and PM pollutant precursor emissions and the more limited climate change response itself. Climate change will also affect climate extreme events such as heatwaves. Air pollution episodes are associated with stagnation events and sometimes heat waves. Air quality during the 2003 heatwave over Europe has been examined in numerous studies and mechanisms for enhancing O 3 have been identified.There are few studies on health effects associated with climate change impacts alone on air quality, but these report higher O 3 -related health burdens in polluted populated regions and greater PM 2.5 health burdens in these emission regions. Studies that examine the combined impacts of climate change and anthropogenic emissions change under the RCP scenarios report reductions in global and European premature O 3 -respiratory related and PM mortalities arising from the large decreases in precursor emissions. Under RCP 8.5 the large increase in CH 4 leads to global and European excess O 3 -respiratory related mortalities in 2100. For future health effects, besides uncertainty in future O 3 and particularly PM concentrations, there is also uncertainty in risk estimates such as effect modification by temperature on pollutant-response relationships and potential future adaptation that would alter exposure risk.

Frequent job change and associated health.

PubMed

Metcalfe, Chris; Davey Smith, George; Sterne, Jonathan A C; Heslop, Pauline; Macleod, John; Hart, Carole

2003-01-01

The contemporary labour market is widely regarded as having become more "flexible". It is proposed that such flexibility is a characteristic of employment histories which will have effects on psychosocial status, health-related behaviour, and physical health. Recent increases in flexibility are unlikely to have accumulated over sufficient portions of individual employment histories for any effect on health to be apparent, but a "preview" of these effects may be gained from study of older cohorts. This cross-sectional study is based on data collected in the early 1970s from 5399 men and 945 women in paid work, recruited from 27 workplaces in the west of Scotland. A flexible employment history was defined as one encompassing a large number of changes between jobs. Perceived psychological stress, health behaviour (cigarette smoking, alcohol consumption, physical exercise), physiology (diastolic blood pressure, body mass index, forced expiratory volume, plasma cholesterol concentration) and current health (angina, myocardial ischaemia) were assessed. Those individuals who reported having experienced frequent job change were more likely to smoke, consume greater amounts of alcohol, and perhaps to exercise less. Similar findings were observed in both males and females, and for different age and socio-economic groups. We found no suggestion that this association was due to higher levels of psychosocial stress, and the expected consequences for health were not observed. Interpretation of these findings is not straightforward due to an uncertain direction of causation, and a possible selection bias. However, the observed relationship between frequent job changing and a higher incidence of health risk behaviours, in the absence of a relationship with poorer health, invites further research.

Impact of Physical Activity and Body Mass Index in Cardiovascular and Musculoskeletal Health: A Review.

PubMed

Chughtai, Morad; Gwam, Chukwuweike U; Mohamed, Nequesha; Khlopas, Anton; Sodhi, Nipun; Sultan, Assem A; Bhave, Anil; Mont, Michael A

2017-12-22

Due to an increasing elderly population coupled with a growing obesity epidemic, there has been an increased prevalence in cardiovascular and musculoskeletal diseases. This has led to an increased burden in healthcare expenditures, now estimated to be over 17.8% of gross domestic product. As a result, physical activity has been increasingly encouraged due to its potential prophylactic effects on health. Recent reports have demonstrated a relationship between physical activity and body mass index (BMI) on cardiovascular and musculoskeletal health. However, the effect of the combination of the two have not been reported. Therefore, the purpose of this review was to assess the effect of various levels of physical activity on: 1) cardiovascular disease risk; and 2) the development of musculoskeletal disease (osteoarthritis [OA]) when accounting for various levels of BMIs. A total of 143 abstracts were identified for cardiovascular health and 55 abstracts for musculoskeletal health. Upon review, 11 reports were included for final evaluation. Despite patient BMI, physical activity was associated with a decreased risk of cardiovascular events. Additionally, moderate levels of physical activity were demonstrated to be protective against the development of OA; however, the levels of physical activity necessary to be beneficial were not fully elucidated. This suggests that the prophylactic effects of physical activity were maintained despite patient BMI. Future studies are needed to explore the appropriate levels of physical activity for optimal effectiveness when stratifying by patient BMI.

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

PubMed

Levy, Barry S; Nassetta, William J

2011-01-01

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

The Impact of Coffee on Health.

PubMed

Nieber, Karen

2017-11-01

Coffee is one of the most popular and widely consumed beverages worldwide due to its stimulating effects on the central nervous system as well as its taste and aroma. Coffee is a complex mixture of more than 800 volatile compounds whereas caffeine and chlorogenic acids are the most common compounds. During the last years, coffee has progressively moved to a less negative position on health due to its better-known pharmacology. Caffeine, e.g., in a cup of coffee, appears to exert most of its effects through an antagonism of the adenosine receptors. Novel approaches in epidemiological studies and experimental researches suggest that coffee consumption may help to prevent several chronic diseases, including type 2 diabetes mellitus and liver disease. Most prospective cohort studies have not found coffee consumption to be associated with a significantly increased cardiovascular disease risk. There is also evidence that decaffeinated coffee may, in some respect, have similar benefits as regular coffee, indicating that besides caffeine other components contribute to the health protecting effects. For adults consuming moderate amounts of coffee (3 - 4 cups/d providing 300 - 400 mg/d of caffeine), there is little evidence of health risks and some evidence of health benefits. This review provides up-to-date information about coffee on health. Topics addressed include the cardiovascular system, liver diseases, and diabetes as well as gastrointestinal disorders. Georg Thieme Verlag KG Stuttgart · New York.

Defining and targeting health disparities in chronic obstructive pulmonary disease

PubMed Central

Pleasants, Roy A; Riley, Isaretta L; Mannino, David M

2016-01-01

The global burden of chronic obstructive pulmonary disease (COPD) continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES) due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF) exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and etiologies, it is also associated with worsened COPD health outcomes. Effective interventions in these people are needed to decrease these disparities. Efforts that may help lessen these health inequities in low SES include 1) better surveillance targeting diagnosed and undiagnosed COPD in disadvantaged people, 2) educating the public and those involved in health care provision about the disease, 3) improving access to cost-effective and affordable health care, and 4) markedly increasing the efforts to prevent disease through smoking cessation, minimizing use and exposure to BF, and decreasing occupational exposures. COPD is considered to be one the most preventable major causes of death from a chronic disease in the world; therefore, effective interventions could have a major impact on reducing the global burden of the disease, especially in socioeconomically disadvantaged populations. PMID:27785005

Is retirement beneficial for mental health? Antidepressant use before and after retirement

PubMed Central

Oksanen, Tuula; Vahtera, Jussi; Westerlund, Hugo; Pentti, Jaana; Sjösten, Noora; Virtanen, Marianna; Kawachi, Ichiro; Kivimäki, Mika

2011-01-01

Background Recent studies based on self-reported data suggest that retirement may have beneficial effects on mental health, but studies using objective endpoints remain scarce. This study examines longitudinally the changes in antidepressant medication use across the 9 years spanning the transition to retirement. Methods Participants were Finnish public-sector employees: 7138 retired at statutory retirement age (76% women, mean age 61.2 years), 1238 retired early due to mental health issues (78% women, mean age 52.0 years), and 2643 retired due to physical health issues(72% women, mean age 55.4 years). Purchase of antidepressant medication four years prior to and four years after retirement year were based on comprehensive national pharmacy records in 1994-2005. Results One year before retirement, the use of antidepressants was 4% among those who would retire at statutory age, 61% among those who would retire due to mental health issues, and 14% among those who would retire due to physical health issues. Retirement-related changes in antidepressant use depended on the reason for retirement. Among old-age retirees, antidepressant medication use decreased during the transition period (age- and calendar-year-adjusted prevalence ratio for antidepressant use 1 year after vs. 1 year before retirement = 0.77 [95% confidence interval = 0.68 – 0.88]). Among those whose main reason for disability pension was mental health issues or physical health issues, there was an increasing trend in antidepressant use prior to retirement and, for mental health retirements, a decrease after retirement. Conclusions Trajectories of recorded purchases of antidepressant medication are consistent with the hypothesis that retirement is beneficial for mental health. PMID:21502864

Toxicological effects of nanoparticles from photocopiers

NASA Astrophysics Data System (ADS)

Khatri, Madhu

Nanotechnology is expanding rapidly and its fast-track to commercialization offering highly promising products and materials. Various physical, chemical and biological processes also results in unintentional generation of nanoparticles (NPs) leading to much higher concentrations at certain workplaces. Thus, human exposures to NPs from anthropogenic sources have increased dramatically in the past few decades. Recently, concerns have been expressed about the potential risks to human health occurring due to NP exposures in various workplaces. Although, a few recent studies have shown that the workplace exposure to NPs has the potential to cause serious human health problems such as pulmonary and related cardiovascular diseases, yet the evidence to establish their association is still lacking. This is partly due to lack of easily accessible settings with continuous NP exposures and the unavailability of sufficiently large cohorts of exposed workers. High volume photocopy (PC) centers are common and are generally operated by a permanent staff. It is now well known that laser printers and photocopiers emit NPs. We have observed that photocopiers emit significantly more NPs than laser printers and that the copy center environments had more than 20 times elevated NP levels over the background. It is evident that a significant fraction of airborne NPs get deposited in the alveolar and nasal cavity regions. Therefore, photocopy centers not only offer an opportunity to study response pattern in workers who are chronically exposed to NPs, but also to test and develop necessary methodologies to link exposures to engineered NPs and early health effects. In this study, early human health effects associated with acute NP exposure were studied. This was done by exposing a few health subjects to PC center environment for a short duration and measuring inflammatory and oxidative stress biomarkers in their nasal lavage and urine samples in response to such exposure. Additionally, potential in-vitro cytotoxicity and induction of cytokines of the collected NP generated during photocopying was studied. Furthermore, airborne fine PM collected from copy center was evaluated for their capability to induce in-vitro cytotoxicity and induction of cytokines. The research addresses one major knowledge gap between possible adverse effects on human health caused due to NP exposure. Additionally, this would help develop useful biomarkers for such exposures. These biomarkers could then assists in early detection of such effects and can potentially be used to assess human health risk from exposures to such NPs and device effective interventions if needed.

Possible health effects of caffeinated coffee consumption on Alzheimer's disease and cardiovascular disease.

PubMed

You, Dong-Chul; Kim, Young-Soon; Ha, Ae-Wha; Lee, Yu-Na; Kim, Soo-Min; Kim, Chun-Heum; Lee, Seung-Ha; Choi, Dalwoong; Lee, Jae-Min

2011-03-01

Coffee has been known to have both beneficial and harmful effects upon health. Coffee is one of the most widely consumed beverages, worldwide. Dementia/Alzheimer's disease (AD) and cardiovascular disease (CVD) are public health problems that are rapidly increasing in the aging population. Due to the high consumption of coffee, even small effects on an individual's health could have a large effect on public health.The aim of this review article is to provide an overview of previously published studies of coffee consumption on health. Herein, we focus on epidemiological and experimental findings to investigate whether coffee-drinking habits, and/or the quantity of coffee consumption, have any relationship to CVD, dementia/AD, and other chronic diseases. Although the underlying mechanisms are not fully understood, when comparing coffee drinkers with non-drinkers, moderate doses of caffeine showed protective effects against CVD and AD. We hypothesized that caffeine may be a novel therapy to treat CVD and dementia/AD.

Extreme heat in India and anthropogenic climate change

NASA Astrophysics Data System (ADS)

van Oldenborgh, Geert Jan; Philip, Sjoukje; Kew, Sarah; van Weele, Michiel; Uhe, Peter; Otto, Friederike; Singh, Roop; Pai, Indrani; Cullen, Heidi; AchutaRao, Krishna

2018-01-01

On 19 May 2016 the afternoon temperature reached 51.0 °C in Phalodi in the northwest of India - a new record for the highest observed maximum temperature in India. The previous year, a widely reported very lethal heat wave occurred in the southeast, in Andhra Pradesh and Telangana, killing thousands of people. In both cases it was widely assumed that the probability and severity of heat waves in India are increasing due to global warming, as they do in other parts of the world. However, we do not find positive trends in the highest maximum temperature of the year in most of India since the 1970s (except spurious trends due to missing data). Decadal variability cannot explain this, but both increased air pollution with aerosols blocking sunlight and increased irrigation leading to evaporative cooling have counteracted the effect of greenhouse gases up to now. Current climate models do not represent these processes well and hence cannot be used to attribute heat waves in this area. The health effects of heat are often described better by a combination of temperature and humidity, such as a heat index or wet bulb temperature. Due to the increase in humidity from irrigation and higher sea surface temperatures (SSTs), these indices have increased over the last decades even when extreme temperatures have not. The extreme air pollution also exacerbates the health impacts of heat. From these factors it follows that, from a health impact point of view, the severity of heat waves has increased in India. For the next decades we expect the trend due to global warming to continue but the surface cooling effect of aerosols to diminish as air quality controls are implemented. The expansion of irrigation will likely continue, though at a slower pace, mitigating this trend somewhat. Humidity will probably continue to rise. The combination will result in a strong rise in the temperature of heat waves. The high humidity will make health effects worse, whereas decreased air pollution would decrease the impacts.

Potential benefits of chewing gum for the delivery of oral therapeutics and its possible role in oral healthcare.

PubMed

Wessel, Stefan W; van der Mei, Henny C; Maitra, Amarnath; Dodds, Michael W J; Busscher, Henk J

2016-10-01

Over the years, chewing gum has developed from a candy towards an oral health-promoting nutraceutical. This review summarizes evidence for the oral health benefits of chewing gum, emphasizing identification of active ingredients in gum that facilitate prevention and removal of oral biofilm. Chewing of sugar-free gum yields oral health benefits that include clearance of food debris, reduction in oral dryness, increase of biofilm pH and remineralization of enamel. These basic effects of chewing gum are attributed to increased mastication and salivation. Active ingredients incorporated in chewing gums aim to expand these effects to inhibition of extrinsic tooth stain and calculus formation, enhanced enamel remineralization, reduction of the numbers of bacteria in saliva and amount of oral biofilm, neutralization of biofilm pH, and reduction of volatile sulfur compounds. Evidence for oral-health benefits of chewing gum additives is hard to obtain due to their relatively low concentrations and rapid wash-out. Clinical effects of gum additives are overshadowed by effects of increased mastication and salivation due to the chewing of gum and require daily chewing of gum for prolonged periods of time. Future studies on active ingredients should focus on specifically targeting pathogenic bacteria, whilst leaving the healthy microbiome unaffected.

The impact of conditional cash transfers on child health in low- and middle-income countries: a systematic review.

PubMed

Owusu-Addo, Ebenezer; Cross, Ruth

2014-08-01

The review aimed to assess the effectiveness of conditional cash transfers (CCTs) in improving child health in low- and middle-income countries. Seven electronic databases were searched for papers: MEDLINE, EMBASE, PubMed, PsychINFO, BIOSIS Previews, Academic Search Complete, and CSA Sociological Abstracts. The included studies comprised of randomised controlled trials and controlled before-and-after studies evaluating the impact of CCTs on child health. Due to the substantial heterogeneity of the studies, a narrative synthesis was conducted on the extracted data. Sixteen studies predominantly from Latin American countries met the inclusion criteria. The outcomes reported by the studies in relation to CCTs' effectiveness in improving child health were reduction in morbidity risk, improvement in nutritional outcomes, health services utilisation, and immunisation coverage. The review suggests that to a large extent, CCTs are effective in improving child health by addressing child health determinants such as access to health care, child and maternal nutrition, morbidity risk, immunisation coverage, and household poverty in developing countries particularly middle-income countries. Of importance to both policy and practice, it appears that CCTs require effective functioning of health care systems to effectively promote child health.

Managerial leadership is associated with employee stress, health, and sickness absence independently of the demand-control-support model.

PubMed

Westerlund, Hugo; Nyberg, Anna; Bernin, Peggy; Hyde, Martin; Oxenstierna, Gabriel; Jäppinen, Paavo; Väänänen, Ari; Theorell, Töres

2010-01-01

Research on health effects of managerial leadership has only taken established work environment factors into account to a limited extent. We therefore investigated the associations between a measure of Attentive Managerial Leadership (AML), and perceived stress, age-relative self-rated health, and sickness absence due to overstrain/fatigue, adjusting for the dimensions of the Demand-Control-Support model. Blue- and white-collar workers from Finland, Germany and Sweden employed in a multi-national forest industry company (N=12,622). Cross-sectional data on leadership and health from a company-wide survey analysed with logistic regression in different subgroups. AML was associated with perceived stress, age-relative self-rated health, and sickness absence due to overstrain/fatigue after controlling for the Demand-Control-Support model. Lack of AML was significantly associated with a high stress level in all subgroups (OR=1.68-2.67). Associations with age-relative self-rated health and sickness absence due to overstrain/fatigue were weaker, but still significant, and in the expected direction for several of the subgroups studied, suggesting an association between lack of AML and negative health consequences. The study indicates that managerial leadership is associated with employee stress, health, and sickness absence independently of the Demand-Control-Support model and should be considered in future studies of health consequences for employees, and in work environment interventions.

A Proof-of-Concept Approach for Quantifying Multi-Pollutant Health Impacts Using the Open-Source BenMAP-CE Software Program

EPA Science Inventory

Background Air pollution risk assessments often employ effect coefficients from epidemiologic studies to quantify the public health impact of changes in air quality. Partly due to data and methodological limitations, epidemiologic studies have traditionally characterized the heal...

Permissive Parenting and Mental Health in College Students: Mediating Effects of Academic Entitlement

ERIC Educational Resources Information Center

Barton, Alison L.; Hirsch, Jameson K.

2016-01-01

Objective: Student mental health may suffer due to unreasonable expectations associated with academic entitlement; permissive parenting may be one source of these expectations. The authors examined the role of academic entitlement as a mediator of the relationship between permissive parenting and psychological functioning. Participants:…

Plant health and global change--some implications for landscape management.

PubMed

Pautasso, Marco; Dehnen-Schmutz, Katharina; Holdenrieder, Ottmar; Pietravalle, Stéphane; Salama, Nabeil; Jeger, Mike J; Lange, Eckart; Hehl-Lange, Sigrid

2010-11-01

Global change (climate change together with other worldwide anthropogenic processes such as increasing trade, air pollution and urbanization) will affect plant health at the genetic, individual, population and landscape level. Direct effects include ecosystem stress due to natural resources shortage or imbalance. Indirect effects include (i) an increased frequency of natural detrimental phenomena, (ii) an increased pressure due to already present pests and diseases, (iii) the introduction of new invasive species either as a result of an improved suitability of the climatic conditions or as a result of increased trade, and (iv) the human response to global change. In this review, we provide an overview of recent studies on terrestrial plant health in the presence of global change factors. We summarize the links between climate change and some key issues in plant health, including tree mortality, changes in wildfire regimes, biological invasions and the role of genetic diversity for ecosystem resilience. Prediction and management of global change effects are complicated by interactions between globalization, climate and invasive plants and/or pathogens. We summarize practical guidelines for landscape management and draw general conclusions from an expanding body of literature. © 2010 The Authors. Biological Reviews © 2010 Cambridge Philosophical Society.

Disability-adjusted life years and economic cost assessment of the health effects related to PM2.5 and PM10 pollution in Mumbai and Delhi, in India from 1991 to 2015.

PubMed

Maji, Kamal Jyoti; Dikshit, Anil Kumar; Deshpande, Ashok

2017-02-01

Particulate air pollution is becoming a serious public health concern in urban cities in India due to air pollution-related health effects associated with disability-adjusted life years (DALYs) and economic loss. To obtain the quantitative result of health impact of particulate matter (PM) in most populated Mumbai City and most polluted Delhi City in India, an epidemiology-based exposure-response function has been used to calculate the attributable number of mortality and morbidity cases from 1991 to 2015 in a 5-year interval and the subsequent DALYs, and economic cost is estimated of the health damage based on unit values of the health outcomes. Here, we report the attributable number of mortality due to PM 10 in Mumbai and Delhi increased to 32,014 and 48,651 in 2015 compared with 19,291 and 19,716 in year 1995. And annual average mortality due to PM 2.5 in Mumbai and Delhi was 10,880 and 10,900. Premature cerebrovascular disease (CEV), ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes are about 35.3, 33.3, and 22.9% of PM 2.5 -attributable mortalities. Total DALYs due to PM10 increased from 0.34 million to 0.51 million in Mumbai and 0.34 million to 0.75 million in Delhi from average year 1995 to 2015. Among all health outcomes, mortality and chronic bronchitis shared about 95% of the total DALYs. Due to PM 10 , the estimated total economic cost at constant price year 2005 US$ increased from 2680.87 million to 4269.60 million for Mumbai City and 2714.10 million to 6394.74 million for Delhi City, from 1995 to 2015, and the total amount accounting about 1.01% of India's gross domestic product (GDP). A crucial presumption is that in 2030, PM 10 levels would have to decline by 44% (Mumbai) and 67% (Delhi) absolutely to maintain the same health outcomes in year 2015 levels. The results will help policy makers from pollution control board for further cost-benefit analyses of air pollution management programs in Mumbai and Delhi.

IS THE LINK BETWEEN HEALTH AND WEALTH CONSIDERED IN DECISION MAKING? RESULTS FROM A QUALITATIVE STUDY.

PubMed

Garau, Martina; Shah, Koonal Kirit; Sharma, Priya; Towse, Adrian

2015-01-01

The aim of this study was to explore whether wealth effects of health interventions, including productivity gains and savings in other sectors, are considered in resource allocations by health technology assessment (HTA) agencies and government departments. To analyze reasons for including, or not including, wealth effects. Semi-structured interviews with decision makers and academic experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden, and the United Kingdom). There is evidence suggesting that health interventions can produce economic gains for patients and national economies. However, we found that the link between health and wealth does not influence decision making in any country with the exception of Sweden. This is due to a combination of factors, including system fragmentation, methodological issues, and the economic recession forcing national governments to focus on short-term measures. In countries with established HTA processes and methods allowing, in principle, the inclusion of wider effects in exceptional cases or secondary analyses, it might be possible to overcome the methodological and practical barriers and see a more systematic consideration of wealth effect in decision making. This would be consistent with principles of efficient priority setting. Barriers for the consideration of wealth effects in government decision making are more fundamental, due to an enduring separation of budgets within the public sector and current financial pressures. However, governments should consider all relevant effects from public investments, including healthcare, even when benefits can only be captured in the medium- and long-term. This will ensure that resources are allocated where they bring the best returns.

Health effects of employment: a systematic review of prospective studies.

PubMed

van der Noordt, Maaike; IJzelenberg, Helma; Droomers, Mariël; Proper, Karin I

2014-10-01

The purpose of this review was to systematically summarise the literature on the health effects of employment. A search for prospective studies investigating the effect of employment on health was executed in several electronic databases, and references of selected publications were checked. Subsequently, the methodological quality of each study was assessed by predefined criteria. To draw conclusions about the health effect of employment, a best evidence synthesis was used, and if possible, data were pooled. 33 prospective studies were included, of which 23 were of high quality. Strong evidence was found for a protective effect of employment on depression and general mental health. Pooled effect sizes showed favourable effects on depression (OR=0.52; 95% CI 0.33 to 0.83) and psychological distress (OR=0.79; 95% CI 0.72 to 0.86). Insufficient evidence was found for general health, physical health and mortality due to lack of studies or inconsistent findings. This systematic review indicates that employment is beneficial for health, particularly for depression and general mental health. There is a need for more research on the effects of employment on specific physical health effects and mortality to fill the knowledge gaps. 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.

Benchmarking Controlled Trial--a novel concept covering all observational effectiveness studies.

PubMed

Malmivaara, Antti

2015-06-01

The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals.

Persecution Experiences and Mental Health of LGBT Asylum Seekers.

PubMed

Hopkinson, Rebecca A; Keatley, Eva; Glaeser, Elizabeth; Erickson-Schroth, Laura; Fattal, Omar; Nicholson Sullivan, Melba

2017-01-01

Asylum seekers are a unique population, particularly those who have endured persecution for their sexual orientation or gender identity. Little data exist about the specific experiences and needs of asylum seekers persecuted due to lesbian, gay, bisexual, or transgender (LGBT) identity. Quantitative data were gathered regarding demographics, persecution histories, and mental health of 61 clients from a torture survivors program in New York City who reported persecution due to LGBT identity. Thirty-five clients persecuted due to their LGBT identity were matched by country of origin and sex with clients persecuted for other reasons to explore how persecution and symptoms may differ for LGBT clients. LGBT asylum seekers have a higher incidence of sexual violence, persecution occurring during childhood, persecution by family members, and suicidal ideation. Understanding the type of persecution experiences and how these influence mental health outcomes is an essential step toward designing and delivering effective treatments.

Mindfulness Meditation for Adolescent Stress and Well-Being: A Systematic Review of the Literature with Implications for School Health Programs

ERIC Educational Resources Information Center

Erbe, Ryan; Lohrmann, David

2015-01-01

Stress poses one of the biggest threats to the health and well-being of young people. Adolescents are especially vulnerable to the negative effects of stress due to developmental factors. Recently, Mindfulness Meditation (MM) programs have been implemented into both clinical and school-based settings to reduce stress and promote the health of…

The effect of ill health and socioeconomic status on labor force exit and re-employment: a prospective study with ten years follow-up in the Netherlands.

PubMed

Schuring, Merel; Robroek, Suzan J W; Otten, Ferdy W J; Arts, Coos H; Burdorf, Alex

2013-03-01

The aim of this study was to investigate the effect of ill health and socioeconomic status on labor force exit due to unemployment, early retirement, disability pension, or becoming economically inactive. A secondary objective was to investigate the effect of ill health and socioeconomic status on return to work. A representative sample of the Dutch working population (N=15 152) was selected for a prospective study with ten years follow-up (93 917 person-years). Perceived health and individual and household characteristics were measured at baseline with the Permanent Quality of Life Survey (POLS) during 1999-2002. Statistics Netherlands ascertained employment status monthly from January 1999 to December 2008. Cox proportional hazards analyses were used to determine the factors that predicted labor force exit and return to work. Ill health increased the likelihood of labor force exit into unemployment [hazard ratio (HR) 1.89], disability pension (HR 6.39), and early retirement (HR 1.20), but was not a determinant of becoming economically inactive (HR 1.07). Workers with low socioeconomic status were, even after adjusting for ill health, more likely to leave the labor force due to unemployment, disability pension, and economic inactivity. Workers with ill health at baseline were less likely to return to work after unemployment (HR 0.75) or disability pension (HR 0.62). Socioeconomic status did not influence re-employment. Ill health is an important determinant for entering and maintaining paid employment. Workers with lower education were at increased risk for health-based selection out of paid employment. Policies to improve labor force participation, especially among low socioeconomic level workers, should protect workers with health problems against exclusion from the labor force.

Community health workers can improve male involvement in maternal health: evidence from rural Tanzania.

PubMed

August, Furaha; Pembe, Andrea B; Mpembeni, Rose; Axemo, Pia; Darj, Elisabeth

2016-01-01

Male involvement in maternal health is recommended as one of the interventions to improve maternal and newborn health. There have been challenges in realising this action, partly due to the position of men in society and partly due to health system challenges in accommodating men. The aim of this study was therefore to evaluate the effect of Home Based Life Saving Skills training by community health workers on improving male involvement in maternal health in terms of knowledge of danger signs, joint decision-making, birth preparedness, and escorting wives to antenatal and delivery care in a rural community in Tanzania. A community-based intervention consisting of educating the community in Home Based Life Saving Skills by community health workers was implemented using one district as the intervention district and another as comparison district. A pre-/post-intervention using quasi-experimental design was used to evaluate the effect of Home Based Life Saving Skills training on male involvement and place of delivery for their partners. The effect of the intervention was determined using difference in differences analysis between the intervention and comparison data at baseline and end line. The results show there was improvement in male involvement (39.2% vs. 80.9%) with a net intervention effect of 41.1% (confidence interval [CI]: 28.5-53.8; p <0.0001). There was improvement in the knowledge of danger signs during pregnancy, childbirth, and postpartum periods. The proportion of men accompanying their wives to antenatal and delivery also improved. Shared decision-making for place of delivery improved markedly (46.8% vs. 86.7%), showing a net effect of 38.5% (CI: 28.0-49.1; p <0.0001). Although facility delivery for spouses of the participants improved in the intervention district, this did not show statistical significance when compared to the comparison district with a net intervention effect of 12.2% (95% CI: -2.8-27.1: p=0.103). This community-based intervention employing community health workers to educate the community in the Home Based Life Saving Skills programme is both feasible and effective in improving male involvement in maternal healthcare.

On the health effects of transported and resuspended dusts

NASA Astrophysics Data System (ADS)

Rudich, Yinon

2017-04-01

In the Mediterranean area people are often exposed to high levels of both transported mineral dust and to resuspended urban dust. High exposure to particulate matter is a known risk factor to exposed population, but the detailed understanding of how these dusts affect health remain elusive. In this talk I will describe two aspects of how dust may impact health. First, transport of bacteria by desert dust and its effects on the local microbiome will be described. Then, we will describe the biological effects due to exposing water soluble extracts of fresh and aged dust particles from the Israeli Negev Desert to alveolar macrophages.

Equity during an economic crisis: financing of the Argentine health system.

PubMed

Cavagnero, Eleonora; Bilger, Marcel

2010-07-01

This article analyses the redistributive effect caused by health financing and the distribution of healthcare utilization in Argentina before and during the severe 2001/2002 economic crisis. Both dramatically changed during this period: the redistributive effect became much more positive and utilization shifted from pro-poor to pro-rich. This clearly demonstrates that when utilization is contingent on financing, changes can occur rapidly; and that an integrated approach is required when monitoring equity. From a policy perspective, the Argentine health system appears vulnerable to economic downturns mainly due to high reliance on out-of-pocket payments and the strong link between health insurance and employment.

Born at the right time? Childhood health and the business cycle.

PubMed

Angelini, Viola; Mierau, Jochen O

2014-05-01

We analyze the relationship between the state of the business cycle at birth and childhood health. We use a retrospective survey on self-reported childhood health for ten Western European countries and combine it with historically and internationally comparable data on the Gross Domestic Product. We validate the self-reported data by comparing them to realized illness spells. We find a positive relationship between being born in a recession and childhood health. This relationship is not driven by selection effects due to heightened infant mortality during recessions. Placebo regressions indicate that the observed effect is not spurious. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

An economic assessment of the health effects and crop yield losses caused by air pollution in mainland China.

PubMed

Miao, Weijie; Huang, Xin; Song, Yu

2017-06-01

Air pollution is severe in China, and pollutants such as PM 2.5 and surface O 3 may cause major damage to human health and crops, respectively. Few studies have considered the health effects of PM 2.5 or the loss of crop yields due to surface O 3 using model-simulated air pollution data in China. We used gridded outputs from the WRF-Chem model, high resolution population data, and crop yield data to evaluate the effects on human health and crop yield in mainland China. Our results showed that outdoor PM 2.5 pollution was responsible for 1.70-1.99 million cases of all-cause mortality in 2006. The economic costs of these health effects were estimated to be 151.1-176.9 billion USD, of which 90% were attributed to mortality. The estimated crop yield losses for wheat, rice, maize, and soybean were approximately 9, 4.6, 0.44, and 0.34 million tons, respectively, resulting in economic losses of 3.4 billion USD. The total economic losses due to ambient air pollution were estimated to be 154.5-180.3 billion USD, accounting for approximately 5.7%-6.6% of the total GDP of China in 2006. Our results show that both population health and staple crop yields in China have been significantly affected by exposure to air pollution. Measures should be taken to reduce emissions, improve air quality, and mitigate the economic loss. Copyright © 2016. Published by Elsevier B.V.

Did Health Care Reform Help Kentucky Address Disparities in Coverage and Access to Care among the Poor?

PubMed

Benitez, Joseph A; Adams, E Kathleen; Seiber, Eric E

2018-06-01

To evaluate the impact of Kentucky's full rollout of the Affordable Care Act on disparities in access to care due to poverty. Restricted version of the Behavioral Risk Factor Surveillance System (BRFSS) for Kentucky and years 2011-2015. We use a difference-in-differences framework to compare trends before and after implementation of the Affordable Care Act (ACA) in health insurance coverage, several access measures, and health care utilization for residents in higher versus lower poverty ZIP codes. Much of the reduction in Kentucky's uninsured rate appears driven by large uptakes in coverage from areas with higher concentrations of poverty. Residents in high-poverty communities experienced larger reductions, 8 percentage points (pp) in uninsured status and 7.5 pp in reporting unmet needs due to costs, than residents of lower poverty areas. These effects helped remove pre-ACA disparities in uninsured rates across these areas. Because we observe positive effects on coverage and reductions in financial barriers to care among those from poorer communities, our findings suggest that expanding Medicaid helps address the health care needs of the impoverished. © Health Research and Educational Trust.

Can cash transfers improve determinants of maternal mortality? Evidence from the household and community programs in Indonesia.

PubMed

Kusuma, Dian; Cohen, Jessica; McConnell, Margaret; Berman, Peter

2016-08-01

Despite global efforts in maternal health, 303,000 maternal deaths still occurred globally in 2015. One explanation is a considerable inequality in maternal mortality and the sources such as nutritional status and health utilization. One strategy to fight health inequality due to poverty is conditional cash transfer (CCT). Taking advantage of two large clustered-randomized trials in Indonesia from 2007 to 2009, this paper provides evidence on the effects of household cash transfers (PKH) and community cash transfers (Generasi) on determinants of maternal mortality. The sample sizes are 14,000 households for PKH and 12,000 households for Generasi. After two years of implementation, difference-in-differences (DID) analyses show that the two programs can improve determinants of maternal mortality with Generasi provides positive impact in some aspects of determinants, but PKH does not. Generasi improves maternal health knowledge, reduces financial barriers to accessing health services and improves utilization of health services, increases utilization among higher-risk women, improves posyandu equipment, and increases nutritional intake. As for PKH, evidence shows its strongest effects only on utilization of health services. Both programs, however, are unlikely to have a large effect on maternal mortality due to design and implementation issues that might significantly reduce program effectiveness. While the programs improved utilization, they did so at community-based facilities not equipped with emergency obstetric care. In the midst of popularity of household cash transfer, our results show that community cash transfer offers a viable policy alternative to improve the determinants of maternal mortality by allowing more flexibility in activities and at lower cost by monitoring at community level. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evidence-based health promotion: applying it in practice.

PubMed

Wong, M L

2002-09-01

In health promotion, we should use interventions established by evidence to be effective in improving the health of the community. This paper reviews the concepts, evaluation and use of evidence in health promotion. A literature search of evidence-based health promotion and evaluation of health promotion was conducted using Medline, Social Science Citation Index (SSCI), PsycLIT and evidence-based web sites on health promotion, health education and community preventive services. Recent issues of key journals on health promotion, health education and public health were also hand-searched. The concept of evidence in health promotion interventions is complex due to its multidimensional nature. Evidence of effectiveness in health promotion is assessed by combining quantitative data on effect change in outcome measures and qualitative data on process evaluation of health promotion activities. Limitations to the use of randomised trials in community-based health promotion interventions include ethical and logistic problems in maintaining randomisation of subjects over long periods, absence of experimental conditions in the real-world setting, contamination of control subjects and the multidimensional nature of health promotion interventions. Randomised controlled trials should be used to evaluate the effectiveness of most health education and behavioural interventions in clinical settings. When such trials are not feasible as in community-based health promotion interventions, quasi-experimental designs provide strong evidence. Multiple methods are needed to assess evidence of effectiveness of health promotion programmes. Appropriate practice of evidence-based health promotion requires consideration of quality of available evidence, local values and prevailing resources.

Exotic forest insects and residential property values

Treesearch

Thomas P. Holmes; Elizabeth A. Murphy; Kathleen P. Bell

2006-01-01

This paper presents a case study of the economic damages to homeowners in a northern New Jersey community due to an exotic forest insect-the hemlock woolly adelgid. Hedonic property value methods are used to estimate the effect of hemlock health on property values. A statistically significant relationship between hemlock health and residential property values is...

Application of a large electronic health record database to study effects of air quality on mortality in a heart failure population

EPA Science Inventory

Background: Electronic health records (EHRs) are now a ubiquitous component of the US healthcare system and are attractive for secondary data analysis as they contain detailed and longitudinal clinical records on potentially millions of individuals. However, due to their relative...

A simulation study to determine the attenuation and bias in health risk estimates due to exposure measurement error in bi-pollutant models

EPA Science Inventory

To understand the combined health effects of exposure to ambient air pollutant mixtures, it is becoming more common to include multiple pollutants in epidemiologic models. However, the complex spatial and temporal pattern of ambient pollutant concentrations and related exposures ...

The Health Consequences of Relocation among the Aged in the Community.

ERIC Educational Resources Information Center

Ferraro, Kenneth F.

1983-01-01

Utilized longitudinal data from a national sample of older people to examine how moving affects health. Findings indicated that moving adversely affects older people, whether the move is voluntary or involuntary. The benign effects of moving into senior housing facilities may be due to physical and social supports. (Author/JAC)

International Implications of Lead Poisoning in School Aged Children

ERIC Educational Resources Information Center

Schultz, Susan M.

2016-01-01

The United States and the World Health Organization have worked to decrease lead exposure in children, but despite these efforts lead poisoning continues to exist in industrialized and developing countries. Prevention is the only way to preclude the health, academic and behavioral problems that occur due to the effects of lead. Public awareness…

Immunology of bovine tuberculosis: Perspectives on one health approaches and defining correlates of protection versus infection

USDA-ARS?s Scientific Manuscript database

Tuberculosis (TB), primarily due to Mycobacterium tuberculosis in humans and Mycobacterium bovis in cattle, is an exemplary model of the One Health Concept. The human TB vaccine, M. bovis bacille Calmette-Guerin (BCG), was first proven effective in cattle prior to use in humans. Recent experimental ...

Counselors and Workplace Wellness Programs: A Conceptual Model

ERIC Educational Resources Information Center

Saliba, Yvette; Barden, Sejal

2017-01-01

Occupational stress is a top source of stress for over 65% of Americans due to extended hours in the workplace. Recent changes in health care have encouraged employers to build workplace wellness programs to improve physical and mental health for employees to mitigate the effects of occupational stress. Wellness programs focus on either disease…

PROJECT 2: THE ROLE OF OXIDATIVE STRESS IN PM-INDUCED ADVERSE HEALTH EFFECTS

EPA Science Inventory

We expect that due to the presence of redox cycling chemicals, ambient PM induce a series of pro-oxidative and pro-inflammatory effects which enhance asthma and atherosclerosis. We expect that these effects will be related to particle dose, size, source, composition, and seas...

Contraceptive use among migrant women with a history of induced abortion in Finland.

PubMed

Väisänen, Heini; Koponen, Päivikki; Gissler, Mika; Kontula, Osmo

2018-06-25

Women's contraceptive choices may change after an induced abortion, due to contraceptive counselling or a behavioural change prompted by the experience. The effect may vary between women; sociocultural background, for example, may affect their subsequent reproductive choices. We examined whether women's current contraceptive use was differently associated with a history of induced abortion among immigrant groups in Finland (Russian, Kurdish and Somali) and the general Finnish population. We analysed data from two surveys, the Migrant Health and Wellbeing study and the Health 2011 study, linked to the Finnish register of induced abortions. Propensity score weighted logistic regression was used to analyse the data. The likelihood of using contraceptives after an abortion varied depending on women's sociocultural background. A history of induced abortion increased contraceptive use among all groups, except Russian women, in whom there was no effect. The effect was particularly strong for Kurdish women. Sociocultural background was an important determinant of post-abortion contraceptive use. Some immigrants may struggle to navigate the Finnish health care system due to language or literacy issues. Attention should be paid to improving access to family planning among these groups.

Neurophysiological symptoms and aspartame: What is the connection?

PubMed

Choudhary, Arbind Kumar; Lee, Yeong Yeh

2018-06-01

Aspartame (α-aspartyl-l-phenylalanine-o-methyl ester), an artificial sweetener, has been linked to behavioral and cognitive problems. Possible neurophysiological symptoms include learning problems, headache, seizure, migraines, irritable moods, anxiety, depression, and insomnia. The consumption of aspartame, unlike dietary protein, can elevate the levels of phenylalanine and aspartic acid in the brain. These compounds can inhibit the synthesis and release of neurotransmitters, dopamine, norepinephrine, and serotonin, which are known regulators of neurophysiological activity. Aspartame acts as a chemical stressor by elevating plasma cortisol levels and causing the production of excess free radicals. High cortisol levels and excess free radicals may increase the brains vulnerability to oxidative stress which may have adverse effects on neurobehavioral health. We reviewed studies linking neurophysiological symptoms to aspartame usage and conclude that aspartame may be responsible for adverse neurobehavioral health outcomes. Aspartame consumption needs to be approached with caution due to the possible effects on neurobehavioral health. Whether aspartame and its metabolites are safe for general consumption is still debatable due to a lack of consistent data. More research evaluating the neurobehavioral effects of aspartame are required.

Cause and effect: the linkage between the health information seeking behavior and the online environment--a review.

PubMed

Bratucu, R; Gheorghe, I R; Purcarea, R M; Gheorghe, C M; Popa Velea, O; Purcarea, V L

2014-09-15

Today, health care consumers are taking more control over their health care problems, investing more time in finding and getting information as well as looking for proper methods in order to investigate more closely the health care information received from their physicians. Unfortunately, in health care consumers' views, the trustworthiness of health authorities and institutions has declined in the last years. So, consumers have found a new solution to their health problems, that is, the Internet. Recently, studies revealed that consumers seeking for health information have more options to look for data in comparison to the methods used a few years ago. Therefore, due to the available technology, consumers have more outlets to search for information. For instance, the Internet is a source that has revolutionized the way consumers seek data due its customized methods of assessing both quantitative and qualitative information which may be achieved with minimal effort and low costs, offering at the same time, several advantages such as making the decision process more efficient.

Cause and effect: the linkage between the health information seeking behavior and the online environment- a review

PubMed Central

Bratucu, R; Gheorghe, IR; Purcarea, RM; Gheorghe, CM; Popa Velea, O; Purcarea, VL

2014-01-01

Abstract Today, health care consumers are taking more control over their health care problems, investing more time in finding and getting information as well as looking for proper methods in order to investigate more closely the health care information received from their physicians. Unfortunately, in health care consumers’ views, the trustworthiness of health authorities and institutions has declined in the last years. So, consumers have found a new solution to their health problems, that is, the Internet. Recently, studies revealed that consumers seeking for health information have more options to look for data in comparison to the methods used a few years ago. Therefore, due to the available technology, consumers have more outlets to search for information. For instance, the Internet is a source that has revolutionized the way consumers seek data due its customized methods of assessing both quantitative and qualitative information which may be achieved with minimal effort and low costs, offering at the same time, several advantages such as making the decision process more efficient. PMID:25408746

[Impact of cigarette packages warning labels in relation to tobacco-smoking dependence and motivation to quit].

PubMed

Mannocci, Alice; Antici, Daniele; Boccia, Antonio; La Torre, Giuseppe

2012-01-01

the principal aim was to assess the impact of health warnings on cigarette packages in Italy, the reduction of daily number of cigarette smoked, in relationship to the tobacco-smoking dependence and motivation to quit. The second aim was to compare the impact of text warnings versus graphi depictions. cross-sectional study (survey). the study was conducted through interviews to an opportunistic sample of smokers.The subject enrolled were adult smokers (years ≥ 18), living in the province of Rome. Data were collected in two outpatient clinics located in Morlupo and Rome. Interviews were administered in the waiting rooms, to patients or to their relatives/ helpers. The survey was conducted in June-September 2010. The sample size (266 participants) was computed using a power of 80%, a confidence level of 95%, an expected frequency of smokers with a low motivation to quit who reduced number of cigarettes due to warnings of 15%, and a frequency of smokers with a higher motivation to quit who reduced number of cigarettes due to warnings of 30%. the effect of the health warnings used in Italy on smoking reduction was measured with the following self-reported items: "Are you or have you been influenced by the health warnings on cigarettes packages (in relation to the daily number of cigarettes smoked)?"; "Have you changed your smoking habits due to the warnings (for example: don't smoking after a coffee.)?"; "Have you ever stopped smoking due to the warnings?" The effect of labels that used shock images on cigarette boxes was measured using followed self-reported questions: "If shocking images were used on cigarette boxes, would they have greater effect than simple warning text currently used?"; "If your favourite cigarettes brand decide to change the look of its cigarette boxes with shocking images on smoking health damages, would you be driven to change it?" thanks to the health warnings, 95% of the 270 participants were informed on smoking damages, 14% (34 smokers) reduced the number cigarettes per day, and 5% (12 smokers) attempted to quit. Forty-five percent of smokers did not know the real impact of light cigarettes on their health, and 49% decided to smoke light cigarettes after having read the warnings. Women were more susceptible to immediate consequences of smoking (appearance of wrinkles; p<0.001), and were more prone to switch to light cigarettes (p=0.002). Smoking dependence, computed with Fagerstrom's test, showed significant differences by age groups (higher in smokers aged 30-45 years; p=0.001), and in smokers who were not interested to deepen knowledge of smoking effects (p=0.009). Individuals more motivated to quit were younger smokers (p=0.012). Smokers aged ≥ 45 years (OR=2.54; 95%CI 1.05-6.17), more motivated to quit (OR=2.92; 95%CI 1.17-7.30), those who reported they do not like the smoking smell on their own clothes (OR=3.6; 95%CI 1.4-9.0), those who reported warning messages are important (OR=4.93; 95%CI 1.55-15.71), those who changed their own smoking behavior due the warnings (OR=3.31; 95%CI 1.10-9.99) were more likely to reduce daily number of cigarettes due the health warnings. Forty-seven percent thought that health warnings with text and images could have a higher impact in comparison to text-only warnings. Moreover, women were more motivated to change cigarette brand if a brand should introduce pictorial warnings (OR=2.54; 95%CI 1.41-4.56). our study showed some positive effects of the introduction of health warnings on cigarette packages. In fact, almost all were informed on tobacco effects, 14% of them reduced the amount of daily smoking, and 5% attempted to quit. Many smokers still believe that switching to lighter cigarettes (e.g. those with less nicotine and tar contents) reduces smoking-related diseases. More than 50% of smokers recognized the importance of health warnings in communicating health risks of smoking, while women were more impressed than men by shocking pictorial warnings.

Caring for mom and neglecting yourself? The health effects of caring for an elderly parent.

PubMed

Coe, Norma B; Van Houtven, Courtney Harold

2009-09-01

We examine the physical and mental health effects of providing care to an elderly mother on the adult child caregiver. We address the endogeneity of the selection in and out of caregiving using an instrumental variable approach, using the death of the care recipient and sibling characteristics. We also carefully control for baseline health and work status of the adult child. We explore flexible specifications, such as Arellano-Bond estimation techniques. Continued caregiving over time increases depressive symptoms and decreases self-rated health for married women and married men. In addition, the increase in depressive symptoms is persistent for married women. While depressive symptoms for single men and women are not affected by continued caregiving, there is evidence of increased incidence of heart conditions for single men, and that these effects are persistent. Robustness checks indicate that these health changes can be directly attributable to caregiving behavior, and not due to a direct effect of the death of the mother. The initial onset of caregiving has modest immediate negative effects on depressive symptoms for married women and no immediate effects on physical health. Negative physical health effects emerge 2 years later, however, suggesting that there are delayed effects on health that would be missed with a short recall period. Initial caregiving does not affect health of married men.

Effects of modifying water environments on water supply and human health

NASA Astrophysics Data System (ADS)

Takizawa, S.; Nguyen, H. T.; Takeda, T.; Tran, N. T.

2008-12-01

Due to increasing population and per-capita water demand, demands for water are increasing in many parts of the world. Consequently, overuse of limited water resources leaves only small amounts of water in rivers and is bringing about rapid drawdown of groundwater tables. Water resources are affected by human activities such as excessive inputs of nutrients and other contaminants, agriculture and aquaculture expansions, and many development activities. The combined effects of modifying the water environments, both in terms of quantity and quality, on water supply and human health are presented in the paper with some examples from the Asian countries. In rural and sub-urban areas in Bangladesh and Vietnam, for example, the traditional way of obtaining surface water from ponds had been replaced by taking groundwaters to avert the microbial health risks that had arisen from contamination by human wastes. Such a change of water sources, however, has brought about human health impact caused by arsenic on a massive scale. In Thailand, the industrial development has driven the residents to get groundwater leaden with very high fluoride. Monitoring the urine fluoride levels reveal the risk of drinking fluoride-laden groundwaters. Rivers are also affected by extensive exploitation such as sand mining. As a result, turbidity changes abruptly after a heavy rainfall. In cities, due to shrinking water resources they have to take poor quality waters from contaminated sources. Algal blooms are seen in many reservoirs and lakes due to increasing levels of nutrients. Hence, it is likely that algal toxins may enter the water supply systems. Because most of the water treatment plants are not designed to remove those known and unknown contaminants, it is estimated that quite a large number of people are now under the threat of the public health "gtime bomb,"h which may one day bring about mass-scale health problems. In order to mitigate the negative impacts of modifying the water environments on human health, we have to develop tools to assess and predict such impacts. This paper presents methodologies to assess the current status of water resources degradation and resultant effects on human health are discussed based on some case studies.

Catastrophic health expenditure and impoverishment in Mongolia.

PubMed

Dorjdagva, Javkhlanbayar; Batbaatar, Enkhjargal; Svensson, Mikael; Dorjsuren, Bayarsaikhan; Kauhanen, Jussi

2016-07-11

The social health insurance coverage is relatively high in Mongolia; however, escalation of out-of-pocket payments for health care, which reached 41 % of the total health expenditure in 2011, is a policy concern. The aim of this study is to analyse the incidence of catastrophic health expenditures and to measure the rate of impoverishment from health care payments under the social health insurance scheme in Mongolia. We used the data from the Household Socio-Economic Survey 2012, conducted by the National Statistical Office of Mongolia. Catastrophic health expenditures are defined an excess of out-of-pocket payments for health care at the various thresholds for household total expenditure (capacity to pay). For an estimate of the impoverishment effect, the national and The Wold Bank poverty lines are used. About 5.5 % of total households suffered from catastrophic health expenditures, when the threshold is 10 % of the total household expenditure. At the threshold of 40 % of capacity to pay, 1.1 % of the total household incurred catastrophic health expenditures. About 20,000 people were forced into poverty due to paying for health care. Despite the high coverage of social health insurance, a significant proportion of the population incurred catastrophic health expenditures and was forced into poverty due to out-of-pocket payments for health care.

Mobile phone radiation health risk controversy: the reliability and sufficiency of science behind the safety standards.

PubMed

Leszczynski, Dariusz; Xu, Zhengping

2010-01-27

There is ongoing discussion whether the mobile phone radiation causes any health effects. The International Commission on Non-Ionizing Radiation Protection, the International Committee on Electromagnetic Safety and the World Health Organization are assuring that there is no proven health risk and that the present safety limits protect all mobile phone users. However, based on the available scientific evidence, the situation is not as clear. The majority of the evidence comes from in vitro laboratory studies and is of very limited use for determining health risk. Animal toxicology studies are inadequate because it is not possible to "overdose" microwave radiation, as it is done with chemical agents, due to simultaneous induction of heating side-effects. There is a lack of human volunteer studies that would, in unbiased way, demonstrate whether human body responds at all to mobile phone radiation. Finally, the epidemiological evidence is insufficient due to, among others, selection and misclassification bias and the low sensitivity of this approach in detection of health risk within the population. This indicates that the presently available scientific evidence is insufficient to prove reliability of the current safety standards. Therefore, we recommend to use precaution when dealing with mobile phones and, whenever possible and feasible, to limit body exposure to this radiation. Continuation of the research on mobile phone radiation effects is needed in order to improve the basis and the reliability of the safety standards.

Mobile phone radiation health risk controversy: the reliability and sufficiency of science behind the safety standards

PubMed Central

2010-01-01

There is ongoing discussion whether the mobile phone radiation causes any health effects. The International Commission on Non-Ionizing Radiation Protection, the International Committee on Electromagnetic Safety and the World Health Organization are assuring that there is no proven health risk and that the present safety limits protect all mobile phone users. However, based on the available scientific evidence, the situation is not as clear. The majority of the evidence comes from in vitro laboratory studies and is of very limited use for determining health risk. Animal toxicology studies are inadequate because it is not possible to "overdose" microwave radiation, as it is done with chemical agents, due to simultaneous induction of heating side-effects. There is a lack of human volunteer studies that would, in unbiased way, demonstrate whether human body responds at all to mobile phone radiation. Finally, the epidemiological evidence is insufficient due to, among others, selection and misclassification bias and the low sensitivity of this approach in detection of health risk within the population. This indicates that the presently available scientific evidence is insufficient to prove reliability of the current safety standards. Therefore, we recommend to use precaution when dealing with mobile phones and, whenever possible and feasible, to limit body exposure to this radiation. Continuation of the research on mobile phone radiation effects is needed in order to improve the basis and the reliability of the safety standards. PMID:20205835

Investment in online self-evaluation tests: A theoretical approach.

PubMed

de Gara, Francesco; Gallo, William T; Bisson, Jonathan I; Endrass, Jerome; Vetter, Stefan

2008-04-15

Large-scale traumatic events may burden any affected public health system with consequential charges. One major post-disaster, expense factor emerges form early psychological interventions and subsequent, posttraumatic mental health care. Due to the constant increase in mental health care costs, also post-disaster public mental health requires best possible, cost-effective care systems. Screening and monitoring the affected population might be one such area to optimize the charges. This paper analyzes the potential cost-effectiveness of monitoring a psychologically traumatized population and to motivate individuals at risk to seek early treatment. As basis for our model served Grossman's health production function, which was modified according to fundamental concepts of cost-benefit analyzes, to match the basic conditions of online monitoring strategies. We then introduce some fundamental concepts of cost-benefit analysis. When performing cost-benefit analyses, policy makers have to consider both direct costs (caused by treatment) and indirect costs (due to non-productivity). Considering both costs sources we find that the use of Internet-based psychometric screening instruments may reduce the duration of future treatment, psychological burden and treatment costs. The identification of individuals at risk for PTSD following a disaster may help organizations prevent both the human and the economic costs of this disease. Consequently future research on mental health issues should put more emphasis on the importance of monitoring to detect early PTSD and focus the most effective resources within early treatment and morbidity prevention.

Cervical cancer screening in Bulgaria--past and present experience.

PubMed

Valerianova, Zdravka; Panayotova, Yulia; Amati, Camilla; Baili, Paolo

2010-01-01

In Bulgaria the previously (1970-1985) existing population based cervical cancer screening was replaced in the early 1990s with an opportunistic model due to political and socioeconomic reasons. As a result, in the last 20 years, cervical cancer incidence and mortality rates steady increased. The objective of the EUROCHIP project in Bulgaria was to evaluate the readiness of the health system as well as health providers' attitudes to implementation in the country of a population based screening program for cervical cancer. Using a structured questionnaire, a convenience sample of medical specialists representing different actors involved in cervical cancer prevention, treatment, financing and policy were interviewed. The majority of interviewed practitioners worried that organization and implementation of an effective population-based cervical cancer screening program is not possible in the current unstable health system. A nostalgic attitude to the cervical cancer screening, performed in the past and pessimistic view on the capability of the current health system to cope are strong. As main barriers to implementation of an effective program were pointed financial and organizational ones. Motivation for gynecologists to perform smear test should include better information, organization and payment. Medical specialists in Bulgaria are aware of the alarming rates of cervical cancer incidence and mortality in the country. However, due to the insufficient communication and interaction between policy makers and front-line health care staff, they do not have enough information on the ongoing programs. Absence of health policy regarding screening is considered as main barrier for implementation of an effective screening program.

AIDS care: why and how should industry respond?

PubMed

Smart, R

2000-01-01

This article reports the AIDS care response of industries to the rising AIDS epidemic in South Africa. It has been reported that during 1993-99 the rate of hospital bed occupancy doubled to over 8/1000 and that 50% of ill-health retirements in 1998 were due to AIDS. Important issues to be considered by industries are the medical separation due to ill health, poor health care services. The focus of HIV/AIDS care should be on the patient, family, care giver, community, and health services, and must be based on the principles of decentralization and integration of sustainable and cost-effective HIV/AIDS services. The development of a care package must be based on six dimensions; namely, appropriateness, acceptability, accessibility, effectiveness, efficiency, and equity. On the other hand, identification of indicators in relation to the components of the care package must include support groups and networks of people living with HIV; the provision of home-based care; responsiveness of the health system; the existence and application of clinical guidelines; and the effectiveness of referrals. Any organization with a commitment in providing care should establish a Care Task Team to develop a care strategy. It should focus on who can have access to the care, what the care consists of, and who will cover the cost. In addition, a review of the existing HIV/AIDS services must be done to identify shortfalls and highlight priority gaps.

Social determinants of health--a comparative study of Bosnian adolescents in different cultural contexts.

PubMed

Sujoldzić, Anita; Peternel, Lana; Kulenović, Tarik; Terzić, Rifet

2006-12-01

This study investigated the effects of sociocultural contexts on health and the psychological well-being of immigrant adolescents, aged 15 to 18 years, originally from Bosnia and Herzegovina and now living as displaced persons either in Bosnia, or immigrants in Croatia and Austria. The study addresses the social determinants of health with a specific focus on five factors in the social environment that might have an influence on health status: gender, socio-economic status (SES), perceived discrimination and exposure to violence, social support and religious commitment. Dependent variables included self-rated health, a count of self-reported objective health problems and a range of indices of psychological well-being (somatic stress, anxiety, depression and self-esteem). The purpose of the study was to examine whether social risk factors have an effect on health, which factors mediate these effects on self-rated health and to assess whether these effects differ by gender Results indicate that perceived discrimination and violence are related to poor health through psychological stress as a major mechanism with stronger effects for girls in the study. Differences across the three socio-cultural contexts reveal the complexity and specificity of the relationships between analyzed factors as the association between discrimination and health was attenuated for some groups due to the protective resources of immigrants.

Effects of Targeted Subsidies Policy on Health Behavior in Iranian Households: A Qualitative Study

PubMed Central

DOSHMANGIR, Leila; DOSHMANGIR, Parinaz; ABOLHASSANI, Nazanin; MOSHIRI, Esmaeil; JAFARI, Mehdi

2015-01-01

Background: This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. Methods: In this qualitative study, data were collected between January 2012 and December 2013 through face-to-face interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductive-deductive) and assisted by Atlas-ti software. Results: Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. Conclusion: Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic reform on population health behavior. PMID:26056676

Differences in primary health care delivery to Australia’s Indigenous population: a template for use in economic evaluations

PubMed Central

2012-01-01

Background Health economics is increasingly used to inform resource allocation decision-making, however, there is comparatively little evidence relevant to minority groups. In part, this is due to lack of cost and effectiveness data specific to these groups upon which economic evaluations can be based. Consequently, resource allocation decisions often rely on mainstream evidence which may not be representative, resulting in inequitable funding decisions. This paper describes a method to overcome this deficiency for Australia’s Indigenous population. A template has been developed which can adapt mainstream health intervention data to the Indigenous setting. Methods The ‘Indigenous Health Service Delivery Template’ has been constructed using mixed methods, which include literature review, stakeholder discussions and key informant interviews. The template quantifies the differences in intervention delivery between best practice primary health care for the Indigenous population via Aboriginal Community Controlled Health Services (ACCHSs), and mainstream general practitioner (GP) practices. Differences in costs and outcomes have been identified, measured and valued. This template can then be used to adapt mainstream health intervention data to allow its economic evaluation as if delivered from an ACCHS. Results The template indicates that more resources are required in the delivery of health interventions via ACCHSs, due to their comprehensive nature. As a result, the costs of such interventions are greater, however this is accompanied by greater benefits due to improved health service access. In the example case of the polypill intervention, 58% more costs were involved in delivery via ACCHSs, with 50% more benefits. Cost-effectiveness ratios were also altered accordingly. Conclusions The Indigenous Health Service Delivery Template reveals significant differences in the way health interventions are delivered from ACCHSs compared to mainstream GP practices. It is important that these differences are included in the conduct of economic evaluations to ensure results are relevant to Indigenous Australians. Similar techniques would be generalisable to other disadvantaged minority populations. This will allow resource allocation decision-makers access to economic evidence that more accurately represents the needs and context of disadvantaged groups, which is particularly important if addressing health inequities is a stated goal. PMID:22954136

Germinated wheat: Phytochemical composition and mixing characteristics

USDA-ARS?s Scientific Manuscript database

Germinated grain recently attracts interest due to its beneficial effect on human health. In this research, whole wheat flour samples obtained after three days and five days of germination were analyzed for biochemical components, mixing quality, and effects on human breast cancer cells. Germinati...

Wildfire smoke exposure and cardiopulmonary hospitalizations among those over age 65 in the United States

EPA Science Inventory

Background: The health implications of excess PM2.5 due to wildland fire smoke are not well understood. Very few studies have assessed the effect of wildland fire smoke from multiple fires across the US. Methods: We estimated daily concentrations of PM2.5 due to wildland fire smo...

Pathogenesis, diagnosis and management of osteomalacia.

PubMed

Walker, Jennie

2014-07-01

Osteomalacia is a musculoskeletal condition that results in soft bones due to ineffective mineralisation. Nurses have a unique opportunity to improve awareness of osteomalacia and reduce its incidence through health education. Multidisciplinary management is important to minimise the effect of osteomalacia on activities of daily living and reduce the risk of fracture due to poor mineralisation of the bones.

Perception of risk and communication among conventional and complementary health care providers involving cancer patients' use of complementary therapies: a literature review.

PubMed

Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E; Musial, Frauke; Salamonsen, Anita

2016-09-08

Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with conventional treatment in cancer care. Health care providers who care for cancer patients should be aware of these risks.

Benchmarking Controlled Trial—a novel concept covering all observational effectiveness studies

PubMed Central

Malmivaara, Antti

2015-01-01

Abstract The Benchmarking Controlled Trial (BCT) is a novel concept which covers all observational studies aiming to assess effectiveness. BCTs provide evidence of the comparative effectiveness between health service providers, and of effectiveness due to particular features of the health and social care systems. BCTs complement randomized controlled trials (RCTs) as the sources of evidence on effectiveness. This paper presents a definition of the BCT; compares the position of BCTs in assessing effectiveness with that of RCTs; presents a checklist for assessing methodological validity of a BCT; and pilot-tests the checklist with BCTs published recently in the leading medical journals. PMID:25965700

[Health effects of living habits].

PubMed

Vuori, Ilkka

2015-01-01

Single healthy living habits such as non-smoking and regular physical activity decrease the risk of common non-communicable diseases, unsuccessful aging and premature death to a small to moderate degree. Their cumulative effects are, however, large. Only a small minority of people adhere well to all healthy living habits or even the healthiest ones. Consequently, the population attributable fractions of major public health problems due to unhealthy lifestyles are large. Substantial improvement of public health calls for policies and programs to influence the root causes of the lifestyles in the multiple environments and systems where they are developed, maintained, and changed.

Evaluating the effect of integrated microfinance and health interventions: an updated review of the evidence.

PubMed

Lorenzetti, Lara M J; Leatherman, Sheila; Flax, Valerie L

2017-06-01

Solutions delivered within firm sectoral boundaries are inadequate in achieving income security and better health for poor populations. Integrated microfinance and health interventions leverage networks of women to promote financial inclusion, build livelihoods, and safeguard against high cost illnesses. Our understanding of the effect of integrated interventions has been limited by variability in intervention, outcome, design, and methodological rigour. This systematic review synthesises the literature through 2015 to understand the effect of integrated microfinance and health programs. We searched PubMed, Scopus, Embase, EconLit, and Global Health databases and sourced bibliographies, identifying 964 articles exclusive of duplicates. Title, abstract, and full text review yielded 35 articles. Articles evaluated the effect of intentionally integrated microfinance and health programs on client outcomes. We rated the quality of evidence for each article. Most interventions combined microfinance with health education, which demonstrated positive effects on health knowledge and behaviours, though not health status. Among programs that integrated microfinance with other health components ( i.e. health micro-insurance, linkages to health providers, and access to health products), results were generally positive but mixed due to the smaller number and quality of studies. Interventions combining multiple health components in a given study demonstrated positive effects, though it was unclear which component was driving the effect. Most articles (57%) were moderate in quality. Integrated microfinance and health education programs were effective, though longer intervention periods are necessary to measure more complex pathways to health status. The effect of microfinance combined with other health components was less clear. Stronger randomized research designs with multiple study arms are required to improve evidence and disentangle the effects of multiple component microfinance and health interventions. Few studies attempted to understand changes in economic outcomes, limiting our understanding of the relationship between health and income effects. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

PubMed

McManus, Moira C; Cramer, Robert J; Boshier, Maureen; Akpinar-Elci, Muge; Van Lunen, Bonnie

2018-01-13

Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. 'Other' ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.

[The population's insurance protection as a mechanism responsible for provision of sanitary and epidemiological well-being].

PubMed

Iarushin, S V

2007-01-01

The paper describes a principal scheme of insurance protection organization due to the negative human influences of environmental factors and industrial risks as one of the most effective mechanisms responsible for controlling sanitary-and-epidemiological well-being and human health. It also considers how a voluntary medical collective insurance program and a civil responsibility insurance one are being implemented due to unforeseen damages done to the population's health and how the quality and safety of goods (work, services) are controlled. Organizational, methodic, and normative legal approaches are proposed to developing the population's insurance protection system.

[Probiotics and prebiotics as a bioactive component of functional food].

PubMed

Kapka-Skrzypczak, Lucyna; Niedźwiecka, Joanna; Wojtyła, Andrzej; Kruszewski, Marcin

2012-01-01

The results of food science investigations have confirmed the relationship between the type of eaten food and health. Simultaneously, consumers are paying more and more attention to the kind of food they eat, as their awareness concerning the influence of proper food on health is increasing. On that base the conception of functional food has been created. This kind of food, besides being a source of essential macro- and micronutrients, exerts an additional positive influence on health. Probiotics and prebiotics containing products are a good example of functional food. These products provide not only essential nutrients but also microorganisms and polysaccharides, which are indigestible in the human alimentary tract, but exert a positive effect on human health. It may be a therapeutic or prophylactic effect due to specific affliction or may improve health in general. The paper - based on available literature - shows a positive influence of probiotics and prebiotics on human health, especially in the immunomodulation effect, an advantageous effect on the digestive system, antitumor activity and a possible therapeutic and prophylactic effect on cardiovascular diseases and obesity.

Diagnostic tool for structural health monitoring: effect of material nonlinearity and vibro-impact process

NASA Astrophysics Data System (ADS)

Hiwarkar, V. R.; Babitsky, V. I.; Silberschmidt, V. V.

2013-07-01

Numerous techniques are available for monitoring structural health. Most of these techniques are expensive and time-consuming. In this paper, vibration-based techniques are explored together with their use as diagnostic tools for structural health monitoring. Finite-element simulations are used to study the effect of material nonlinearity on dynamics of a cracked bar. Additionally, several experiments are performed to study the effect of vibro-impact behavior of crack on its dynamics. It was observed that a change in the natural frequency of the cracked bar due to crack-tip plasticity and vibro-impact behavior linked to interaction of crack faces, obtained from experiments, led to generation of higher harmonics; this can be used as a diagnostic tool for structural health monitoring.

Accumulated financial strain and women's health over three decades.

PubMed

Shippee, Tetyana Pylypiv; Wilkinson, Lindsay R; Ferraro, Kenneth F

2012-09-01

Drawing from cumulative inequality theory, this research examines how accumulated financial strain affects women's self-rated health in middle and later life. Using data from the National Longitudinal Survey of Mature Women (1967-2003), we employ random-coefficient growth curve models to examine whether recurring financial strain influences women's health, above and beyond several measures of objective social status. Predicted probabilities of poor health were estimated by the frequency of financial strain. Financial strain is associated with rapid declines in women's health during middle and later life, especially for those women who reported recurrent strain. Changes in household income and household wealth were also associated with women's health but did not eliminate the effects due to accumulated financial strain. Accumulated financial strain has long-term effects on women's health during middle and later life. The findings demonstrate the importance of measuring life course exposure to stressors in studies of health trajectories.

Voluntary private health insurance among the over fifties in Europe◊

PubMed Central

Paccagnella, Omar; Rebba, Vincenzo; Weber, Guglielmo

2012-01-01

Using data from SHARE (Survey of Health, Ageing and Retirement in Europe), we investigate the determinants of voluntary private health insurance (VPHI) among the over fifties in eleven European countries, and their effects on health care spending. Firstly, we find that the main determinants of VPHI are different in each country, reflecting differences in the underlying health care systems, but in most countries education levels and cognitive abilities have a strong positive effect on holding a VPHI policy. We also analyse the effect of holding a voluntary additional health insurance policy on out-of-pocket (OOP) health care spending. We adopt a simultaneous-equations approach to control for self-selection into VPHI policy holding and find that only in the Netherlands VPHI policyholders have lower OOP spending than the rest of the population while in some countries (Italy, Spain, Denmark and Austria) they spend significantly more. This could be due to increased utilisation but also to cost-sharing measures adopted by the insurers in order both to counter the effects of moral hazard and to keep adverse selection under control. PMID:22315160

Polyphenol-Rich Lentils and Their Health Promoting Effects.

PubMed

Ganesan, Kumar; Xu, Baojun

2017-11-10

Polyphenols are a group of plant metabolites with potent antioxidant properties, which protect against various chronic diseases induced by oxidative stress. Evidence showed that dietary polyphenols have emerged as one of the prominent scientific interests due to their role in the prevention of degenerative diseases in humans. Possible health beneficial effects of polyphenols are measured based on the human consumption and their bioavailability. Lentil ( Lens culinaris ; Family: Fabaceae) is a great source of polyphenol compounds with various health-promoting properties. Polyphenol-rich lentils have a potential effect on human health, possessing properties such as antioxidant, antidiabetic, anti-obesity, anti-hyperlipidemic, anti-inflammatory and anticancer. Based on the explorative study, the current comprehensive review aims to give up-to-date information on nutritive compositions, bioactive compounds and the health-promoting effect of polyphenol-rich lentils, which explores their therapeutic values for future clinical studies. All data of in vitro , in vivo and clinical studies of lentils and their impact on human health were collected from a library database and electronic search (Science Direct, PubMed and Google Scholar). Health-promoting information was gathered and orchestrated in the suitable place in the review.

Why we need more than just randomized controlled trials to establish the effectiveness of online social networks for health behavior change.

PubMed

Vandelanotte, Corneel; Maher, Carol A

2015-01-01

Despite their popularity and potential to promote health in large populations, the effectiveness of online social networks (e.g., Facebook) to improve health behaviors has been somewhat disappointing. Most of the research examining the effectiveness of such interventions has used randomized controlled trials (RCTs). It is asserted that the modest outcomes may be due to characteristics specific to both online social networks and RCTs. The highly controlled nature of RCTs stifles the dynamic nature of online social networks. Alternative and ecologically valid research designs that evaluate online social networks in real-life conditions are needed to advance the science in this area.

Local heat stroke prevention plans in Japan: characteristics and elements for public health adaptation to climate change.

PubMed

Martinez, Gerardo Sanchez; Imai, Chisato; Masumo, Kanako

2011-12-01

The adverse health effects from hot weather and heat waves represent significant public health risks in vulnerable areas worldwide. Rising temperatures due to climate change are aggravating these risks in a context of fast urbanization, population growth and societal ageing. However, environmental heat-related health effects are largely preventable through adequate preparedness and responses. Public health adaptation to climate change will often require the implementation of heat wave warning systems and targeted preventive activities at different levels. While several national governments have established such systems at the country level, municipalities do not generally play a major role in the prevention of heat disorders. This paper analyzes selected examples of locally operated heat-health prevention plans in Japan. The analysis of these plans highlights their strengths, but also the need of local institutions for assistance to make the transition towards an effective public health management of high temperatures and heat waves. It can also provide useful elements for municipal governments in vulnerable areas, both in planning their climate change and health adaptation activities or to better protect their communities against current health effects from heat.

Local Heat Stroke Prevention Plans in Japan: Characteristics and Elements for Public Health Adaptation to Climate Change

PubMed Central

Martinez, Gerardo Sanchez; Imai, Chisato; Masumo, Kanako

2011-01-01

The adverse health effects from hot weather and heat waves represent significant public health risks in vulnerable areas worldwide. Rising temperatures due to climate change are aggravating these risks in a context of fast urbanization, population growth and societal ageing. However, environmental heat-related health effects are largely preventable through adequate preparedness and responses. Public health adaptation to climate change will often require the implementation of heat wave warning systems and targeted preventive activities at different levels. While several national governments have established such systems at the country level, municipalities do not generally play a major role in the prevention of heat disorders. This paper analyzes selected examples of locally operated heat-health prevention plans in Japan. The analysis of these plans highlights their strengths, but also the need of local institutions for assistance to make the transition towards an effective public health management of high temperatures and heat waves. It can also provide useful elements for municipal governments in vulnerable areas, both in planning their climate change and health adaptation activities or to better protect their communities against current health effects from heat. PMID:22408589

A review on endocrine disruptors and their possible impacts on human health.

PubMed

Kabir, Eva Rahman; Rahman, Monica Sharfin; Rahman, Imon

2015-07-01

Endocrine disruption is a named field of research which has been very active for over 10 years, although the effects of endocrine disruptors in wildlife have been studied mainly in vast since the 1940s. A large number of chemicals have been identified as endocrine disruptors and humans can be exposed to them either due to their occupations or through dietary and environmental exposure (water, soil and air). Endocrine disrupting chemicals are compounds that alter the normal functioning of the endocrine system of both humans and wildlife. In order to understand the vulnerability and risk factors of people due to endocrine disruptors as well as the remedies for these, methods need to be developed in order to predict effects on populations and communities from the knowledge of effects on individuals. For several years there have been a growing interest on the mechanism and effect of endocrine disruptors and their relation with environment and human health effect. This paper, based on extensive literature survey, briefly studies the progress mainly in human to provide information concerning causative substances, mechanism of action, ubiquity of effects and important issues related to endocrine disruptors. It also reviews the current knowledge of the potential impacts of endocrine disruptors on human health so that the effects can be known and remedies applied for the problem as soon as possible. Copyright © 2015 Elsevier B.V. All rights reserved.

Does the evidence about health risks associated with nitrate ingestion warrant an increase of the nitrate standard for drinking water?

PubMed Central

van Grinsven, Hans JM; Ward, Mary H; Benjamin, Nigel; de Kok, Theo M

2006-01-01

Several authors have suggested that it is safe to raise the health standard for nitrate in drinking water, and save money on measures associated with nitrate pollution of drinking water resources. The major argument has been that the epidemiologic evidence for acute and chronic health effects related to drinking water nitrate at concentrations near the health standard is inconclusive. With respect to the chronic effects, the argument was motivated by the absence of evidence for adverse health effects related to ingestion of nitrate from dietary sources. An interdisciplinary discussion of these arguments led to three important observations. First, there have been only a few well-designed epidemiologic studies that evaluated ingestion of nitrate in drinking water and risk of specific cancers or adverse reproductive outcomes among potentially susceptible subgroups likely to have elevated endogenous nitrosation. Positive associations have been observed for some but not all health outcomes evaluated. Second, the epidemiologic studies of cancer do not support an association between ingestion of dietary nitrate (vegetables) and an increased risk of cancer, because intake of dietary nitrate is associated with intake of antioxidants and other beneficial phytochemicals. Third, 2–3 % of the population in Western Europe and the US could be exposed to nitrate levels in drinking water exceeding the WHO standard of 50 mg/l nitrate, particularly those living in rural areas. The health losses due to this exposure cannot be estimated. Therefore, we conclude that it is not possible to weigh the costs and benefits from changing the nitrate standard for drinking water and groundwater resources by considering the potential consequences for human health and by considering the potential savings due to reduced costs for nitrate removal and prevention of nitrate pollution. PMID:16989661

The 3-year disease management effect: understanding the positive return on investment.

PubMed

Nyman, John A; Jeffery, Molly Moore; Abraham, Jean M; Jutkowitz, Eric; Dowd, Bryan E

2013-11-01

Conventional wisdom suggests that health promotion programs yield a positive return on investment (ROI) in year 3. In the case of the University of Minnesota's program, a positive ROI was achieved in the third year, but it was due entirely to the effectiveness of the disease management (DM) program. The objective of this study is to investigate why. Differences-in-differences regression equations were estimated to determine the effect of DM participation on spending (overall and service specific), hospitalizations, and avoidable hospitalizations. Disease management participation reduced expenditures overall, and especially in the third year for employees, and reduced hospitalizations and avoidable hospitalizations. The positive ROI at Minnesota was due to increased effectiveness of DM in the third year (mostly due to fewer hospitalizations) but also to the simple durability of the average DM effect.

Health-related quality of life two years after injury due to terrorism.

PubMed

Tuchner, Maya; Meiner, Zeev; Parush, Shula; Hartman-Maeir, Adina

2010-01-01

During the past few decades, terrorist acts have been an unfortunate reality worldwide. There is a striking paucity of research investigating the multitude of long-term outcomes after severe physical injury due to terrorist attacks, a unique subgroup of trauma patients. The purpose of this study was to provide a profile of the long-term health-related quality of life (HR-QOL) after injury due to terrorist attacks and to explore the relationships between Post Traumatic Stress Disorder (PTSD), occupational status and injury severity with HR-QOL. We included 35 survivors of terrorist attacks living in the community, two years on average after the injury, mean age at follow-up = 32.1 (±13.8), mean Injury Severity Score (ISS) = 27 (±14.2). The subjects were recruited from consecutive admissions to a rehabilitation department in a tertiary care center between September 2000 - June 2004. Most of the subjects suffered multiple trauma. The main outcome measures were the Short-Form Health Survey (SF-36), Post Traumatic Diagnostic Scale and return to work rates. The mean scores on 6/8 of the SF-36 subscales were significantly lower among the survivors compared to normative population norms. Post Traumatic Stress Disorder (PTSD) was found in 39% of the sample and 43% did not resume their main occupation two years after the injury. Multivariate analysis of variance of PTSD and occupational status (returned vs. did not return to work) on quality of life scores revealed significant main effects for both PTSD (p=. 000) and occupational status (p=. 005) with no interaction effect (p=. 476). No significant correlations were found between injury severity and the SF-36 scores. This study demonstrated the long-term impact of injury due to terrorism. Results showed independent effects of PTSD and occupational status on health related quality of life, two years after injury. These findings suggest that this group may benefit from intervention focusing on their emotional and occupational status in order to improve their quality of life.

Rumors and gossip: a guide for the health care supervisor.

PubMed

Dowd, S B; Davidhizar, R; Dowd, L P

1997-09-01

Rumor and gossip are long-standing means of communication among humans and are prevalent in health care settings in part due to the nature of the organization. Rumor and gossip may be negative or positive, and health care supervisors should monitor the grapevine and consider themselves personally responsible for transmitting accurate information whenever possible to ensure that rumor and gossip do not have a negative effect on the department or institution.

Women Superintendents Who Leave: Stress and Health Factors

ERIC Educational Resources Information Center

Robinson, Kerry K.; Shakeshaft, Charol

2015-01-01

Previous research on stress in the workplace has demonstrated that it can have not only a current, but lasting effect on a worker's health. The superintendency is a stressful job due to all of the competing demands of running a school system, no matter the size. This exploratory study reexamined qualitative interview transcripts from Robinson's…

Effects of Psychological Distress on Academic Achievement in Brunei Student Teachers: Identification Challenges and Counseling Implications

ERIC Educational Resources Information Center

Mundia, Lawrence

2011-01-01

Students with psychological and mental health problems are often accorded a low status and priority compared to peers with other disabilities. Recent research indicated that a female Brunei student teacher prematurely left her training program due to unaddressed mental health problems. The present study used a mixed methods approach. The random…

Climate change and the possible health effects on older Australians.

PubMed

Saniotis, Arthur; Irvine, Rod

2010-01-01

Climate change is an important issue for Australia. Climate change research forecasts that Australia will experience accelerated warming due to anthrogenic activities. Australia's aging society will face special challenges that demand current attention. This paper discusses two issues in relation to climate change and older Australians: first, pharmacology and autoregulation; and second, mental health among older Australians.

Adapting to the health impacts of climate change in a sustainable manner.

PubMed

Hoy, Damian; Roth, Adam; Lepers, Christelle; Durham, Jo; Bell, Johann; Durand, Alexis; Lal, Padma Narsey; Souares, Yvan

2014-12-11

The climate is changing and this poses significant threats to human health. Climate change is one of the greatest challenges facing Pacific Island countries and territories due to their unique geophysical features, and their social, economic and cultural characteristics. The Pacific region also faces challenges with widely dispersed populations, limited resources and fragmented health systems. Over the past few years, there has been a substantial increase in international aid for health activities aimed at adapting to the threats of climate change. This funding needs to be used strategically to ensure an effective approach to reducing the health risk from climate change. Respecting the principles of development effectiveness will result in more effective and sustainable adaptation, in particular, 1) processes should be owned and driven by local communities, 2) investments should be aligned with existing national priorities and policies, and 3) existing systems must not be ignored, but rather expanded upon and reinforced.

The association between perceived unmet medical need and mental health among the Republic of Korea Armed Forces.

PubMed

Kim, Tae Kyung; Lee, S G; Han, K-T; Choi, Y; Lee, S Y; Park, E-C

2017-06-01

We investigated the effect of unmet medical need on the mental health of Republic of Korea (ROK) Armed Forces personnel, as most of the service members work in remote areas and often experience such unmet needs. This study used secondary data from the 2014 Military Health Survey (MHS), conducted by the ROK School of Military Medicine and designed to collect military health determinants. Descriptive statistics showed the general characteristics of the study populations by variable. We specifically compared the population after stratifying participants by suicide ideation. An analysis of variance was also carried out to compare Kessler Psychological Distress Scale 10 Scores. Additionally, dependent spouses and children of both active-duty service members and retirees are included among those entitled to Military Health System healthcare. Among the 4967 military personnel, 681 (13.7%) individuals reported an experience of unmet medical need within the past 12 months and gave reasons of 'no time (5.15%)', 'long office wait (2.6%)', 'no money (0.22%)', 'long distance from base (1.19%)', 'illness but not very serious (1.65%)', 'mistrust in doctors (1.95%)' and 'pressure due to performance appraisal (0.95%)'. Regression analysis revealed that unmet medical need was significantly associated with negative mental health (β=1.753, p<0.0001) and increased suicide ideation (OR=2.649, 95% CI 1.84 to 3.82). Also, soldiers reporting unmet medical need due to 'no money', 'no time' or 'pressure due to performance appraisal' were significantly more likely to experience similar negative mental health effects. Our study indicates that unmet medical need is significantly associated with soldiers' mental health decline and suicide ideation, highlighting the importance of providing military personnel with timely, affordable and sufficient medical care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cost-effectiveness analysis of computerized ECG interpretation system in an ambulatory health care organization.

PubMed

Carel, R S

1982-04-01

The cost-effectiveness of a computerized ECG interpretation system in an ambulatory health care organization has been evaluated in comparison with a conventional (manual) system. The automated system was shown to be more cost-effective at a minimum load of 2,500 patients/month. At larger monthly loads an even greater cost-effectiveness was found, the average cost/ECG being about $2. In the manual system the cost/unit is practically independent of patient load. This is primarily due to the fact that 87% of the cost/ECG is attributable to wages and fees of highly trained personnel. In the automated system, on the other hand, the cost/ECG is heavily dependent on examinee load. This is due to the relatively large impact of equipment depreciation on fixed (and total) cost. Utilization of a computer-assisted system leads to marked reduction in cardiologists' interpretation time, substantially shorter turnaround time (of unconfirmed reports), and potential provision of simultaneous service at several remotely located "heart stations."

Development of key indicators to quantify the health impacts of climate change on Canadians.

PubMed

Cheng, June J; Berry, Peter

2013-10-01

This study aimed at developing a list of key human health indicators for quantifying the health impacts of climate change in Canada. A literature review was conducted in OVID Medline to identify health morbidity and mortality indicators currently used to quantify climate change impacts. Public health frameworks and other studies of climate change indicators were reviewed to identify criteria with which to evaluate the list of proposed key indicators and a rating scale was developed. Total scores for each indicator were calculated based on the rating scale. A total of 77 health indicators were identified from the literature. After evaluation using the chosen criteria, 8 indicators were identified as the best for use. They include excess daily all-cause mortality due to heat, premature deaths due to air pollution (ozone and particulate matter 2.5), preventable deaths from climate change, disability-adjusted life years lost from climate change, daily all-cause mortality, daily non-accidental mortality, West Nile Disease incidence, and Lyme borreliosis incidence. There is need for further data and research related to health effect quantification in the area of climate change.

A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative.

PubMed

Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

Research evidence suggests that access to health care is the key influential factor for improved population health outcomes and health care system sustainability. Although the importance of addressing barriers in access to health care across European countries is well documented, little has been done to improve the situation. This is due to different definitions, approaches and policies, and partly due to persisting disparities in access within and between European countries. To bridge this gap, the Patient Access Partnership (PACT) developed (a) the '5As' definition of access, which details the five critical elements (adequacy, accessibility, affordability, appropriateness, and availability) of access to health care, (b) a multi-stakeholders' approach for mapping access, and (c) a 13-item questionnaire based on the 5As definition in an effort to address these obstacles and to identify best practices. These tools are expected to contribute effectively to addressing access barriers in practice, by suggesting a common framework and facilitating the exchange of knowledge and expertise, in order to improve access to health care between and within European countries. © 2016 S. Karger AG, Basel.

Refugee health and rehabilitation: Challenges and response.

PubMed

Khan, Fary; Amatya, Bhasker

2017-05-16

The current global refugee crisis poses major challenges in providing effective healthcare to refugees, particularly for non-communicable diseases management and disability. This article provides an overview of refugee health and potential challenges from the rehabilitation perspective. A literature search (both academic and grey literature) was conducted using medical and health science electronic databases and internet search engines (2001-2016). Both authors independently selected studies. Due to heterogeneity amongst identified articles, a narrative analysis was performed for best-evidence synthesis to outline the current health and rehabilitation status of refugees and existing gaps in care. Data suggest that infectious diseases requiring treatment in refugees are a minority; whilst non-communicable diseases, musculoskeletal conditions are prevalent. Many refugees arrive with complex health needs. One in 6 refugees have a physical health problem severely affecting their lives and two-thirds experience mental health problems, signifying the important role of rehabilitation. Refugees face continued disadvantage, poverty and dependence due to lack of cohesive support in their new country, which are determinants of both poor physical and mental health. This is compounded by language barriers, impoverishment, and lack of familiarity with the local environment and healthcare system. In Australia, there are concerns about sexual and gender-based violence in off-shore detention camps. Targeted physical and cognitive rehabilitative strategies have much to offer these vulnerable people to allow for improved activity and participation. Strong leadership and effective action from national and international bodies is urgently needed to develop comprehensive rehabilitation-inclusive medical care for refugees.

Estimating comparable English healthcare costs for multiple diseases and unrelated future costs for use in health and public health economic modelling.

PubMed

Briggs, Adam D M; Scarborough, Peter; Wolstenholme, Jane

2018-01-01

Healthcare interventions, and particularly those in public health may affect multiple diseases and significantly prolong life. No consensus currently exists for how to estimate comparable healthcare costs across multiple diseases for use in health and public health cost-effectiveness models. We aim to describe a method for estimating comparable disease specific English healthcare costs as well as future healthcare costs from diseases unrelated to those modelled. We use routine national datasets including programme budgeting data and cost curves from NHS England to estimate annual per person costs for diseases included in the PRIMEtime model as well as age and sex specific costs due to unrelated diseases. The 2013/14 annual cost to NHS England per prevalent case varied between £3,074 for pancreatic cancer and £314 for liver disease. Costs due to unrelated diseases increase with age except for a secondary peak at 30-34 years for women reflecting maternity resource use. The methodology described allows health and public health economic modellers to estimate comparable English healthcare costs for multiple diseases. This facilitates the direct comparison of different health and public health interventions enabling better decision making.

Estimation of health and economic costs of air pollution over the Pearl River Delta region in China.

PubMed

Lu, Xingcheng; Yao, Teng; Fung, Jimmy C H; Lin, Changqing

2016-10-01

The Pearl River Delta region (PRD) is the economic growth engine of China and also one of the most urbanized regions in the world. As a two-sided sword, rapid economic development causes air pollution and poses adverse health effects to the citizens in this area. This work estimated the negative health effects in the PRD caused by the four major ambient pollutants (SO2, NO2, O3 and PM10) from 2010 to 2013 by using a log linear exposure-response function and the WRF-CMAQ modeling system. Economic loss due to mortality and morbidity was evaluated by the value of statistical life (VSL) and cost of illness (COI) methods. The results show that the overall possible short-term all-cause mortality due to NO2, O3 and PM10 reached the highest in 2013 with the values being 13,217-22,800. The highest total economic loss, which ranged from 14,768 to 25,305million USD, occurred in 2013 and was equivalent to 1.4%-2.3% of the local gross domestic product. The monthly profile of cases of negative health effects varied by city and the types of ambient pollutants. The ratio of mortality attributed to air pollutants to total population was higher in urban areas than in rural areas. People living in the countryside should consider the possible adverse health effects of urban areas before they plan a move to the city. The results show that the health burden caused by the ambient pollutants over this region is serious and suggest that tighter control policies should be implemented in the future to reduce the level of air pollution. Copyright © 2016 Elsevier B.V. All rights reserved.

Gender Difference in Health-Care Expenditure: Evidence from India Human Development Survey.

PubMed

Saikia, Nandita; Moradhvaj; Bora, Jayanta Kumar

2016-01-01

While the gender disparity in health and mortality in various stages of life in India is well documented, there is limited evidence on female disadvantage in health-care expenditure (HCE). Examine the gender difference in HCE in short-term and major morbidity in India, and understand the role of factors underlying the difference. Using two rounds of nationally representative panel data-the India Human Development Survey (IHDS) 2004-2005 and 2011-2012 (IHDS I & II)-we calculate morbidity prevalence rate and mean HCE by gender, and examine the adjusted effect of gender on major morbidity-related HCE by using a two-part regression model. Further, we performed Oaxaca-Blinder decomposition of the gender gap in HCE in major morbidity to understand the contribution of demographic and socio-economic factors. Health-care expenditure on females was systematically lower than on males across all demographic and socio-economic groups. Multivariate analysis confirms that female HCE is significantly lower than male HCE even after controlling demographic and socio-economic factors (β = -0.148, p = 0.000, CI:-0.206-0.091). For both short-term and major morbidity, a female disadvantage on HCE increased from IHDS I to IHDS II. For instance, the male-female gap in major morbidity related expenditure increased from INR 1298 to INR 4172. A decomposition analysis of gender gap in HCE demonstrates that about 48% of the gap is attributable to differences in demographic and socio-economic factors (endowment effect), whereas 50% of the gap is due to the differential effect of the determinants (coefficient effect). Indians spend less on female health care than on male health care. Most of the gender gap in HCE is not due to differential distribution of factors affecting HCE.

"Championing GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

NASA Astrophysics Data System (ADS)

Karame, P., Sr.

2016-12-01

"GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health sector indicators) is likely to provide missing links between science, policy, interventions and practical improvement for safe environment, food security and safer health in Rwanda.

"GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

NASA Astrophysics Data System (ADS)

Karame, P., Sr.; Dushimiyimana, V.

2016-12-01

" Championing GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health sector indicators) is likely to provide missing links between science, policy, interventions and practical improvement for safe environment, food security and safer health in Rwanda.

Accommodaton of constitutional due process rights within the new patients' rights legislation in Slovenia.

PubMed

Ivanc, Blaz

2011-09-01

The Constitutional Court of the Republic of Slovenia issued several decisions concerning the protection of patients' rights (e.g. decisions on involuntary commitment, on access to health care, on rights related to obligatory and voluntary health insurance). Consequently, the Parliament renewed Health Legislation by the enactment of the Patients' Rights Act (February 2008) and of the Mental Health Act (July 2008). Both bills enshrine a charter of patients' rights that may be considered as concretization of several human rights that are protected by the Constitution. The discussion is focused on the due process rights (e.g. equal protection of rights, right to judicial protection, right to legal remedies, legal guarantees in proceedings related to deprivation of personal liberty) that were in particular addressed by the Court. The results demonstrate that their effective implementation was one of the most important demands that the Legislature had to accommodate when enacting new bills.

Knowledge needs, available practices, and future challenges in agricultural soils

NASA Astrophysics Data System (ADS)

Key, Georgina; Whitfield, Mike G.; Cooper, Julia; De Vries, Franciska T.; Collison, Martin; Dedousis, Thanasis; Heathcote, Richard; Roth, Brendan; Mohammed, Shamal; Molyneux, Andrew; Van der Putten, Wim H.; Dicks, Lynn V.; Sutherland, William J.; Bardgett, Richard D.

2016-10-01

The goal of this study is to clarify research needs and identify effective practices for enhancing soil health. This was done by a synopsis of soil literature that specifically tests practices designed to maintain or enhance elements of soil health. Using an expert panel of soil scientists and practitioners, we then assessed the evidence in the soil synopsis to highlight practices beneficial to soil health, practices considered detrimental, and practices that need further investigation. A partial Spearman's correlation was used to analyse the panel's responses. We found that increased certainty in scientific evidence led to practices being considered to be more effective due to them being empirically justified. This suggests that for practices to be considered effective and put into practice, a substantial body of research is needed to support the effectiveness of the practice. This is further supported by the high proportion of practices (33 %), such as changing the timing of ploughing or amending the soil with crops grown as green manures, that experts felt had unknown effectiveness, usually due to insufficiently robust evidence. Only 7 of the 27 reviewed practices were considered to be beneficial, or likely to be beneficial in enhancing soil health. These included the use of (1) integrated nutrient management (organic and inorganic amendments); (2) cover crops; (3) crop rotations; (4) intercropping between crop rows or underneath the main crop; (5) formulated chemical compounds (such as nitrification inhibitors); (6) control of traffic and traffic timing; and (7) reducing grazing intensity. Our assessment, which uses the Delphi technique, is increasingly used to improve decision-making in conservation and agricultural policy, identified practices that can be put into practice to benefit soil health. Moreover, it has enabled us to identify practices that need further research and a need for increased communication between researchers, policy-makers, and practitioners, in order to find effective means of enhancing soil health.

Effects of long-range transported air pollution from vegetation fires on daily mortality and hospital admissions in the Helsinki metropolitan area, Finland.

PubMed

Kollanus, Virpi; Tiittanen, Pekka; Niemi, Jarkko V; Lanki, Timo

2016-11-01

Fine particulate matter (PM 2.5 ) emissions from vegetation fires can be transported over long distances and may cause significant air pollution episodes far from the fires. However, epidemiological evidence on health effects of vegetation-fire originated air pollution is limited, particularly for mortality and cardiovascular outcomes. We examined association between short-term exposure to long-range transported PM 2.5 from vegetation fires and daily mortality due to non-accidental, cardiovascular, and respiratory causes and daily hospital admissions due to cardiovascular and respiratory causes in the Helsinki metropolitan area, Finland. Days significantly affected by smoke from vegetation fires between 2001 and 2010 were identified using air quality measurements at an urban background and a regional background monitoring station, and modelled data on surface concentrations of vegetation-fire smoke. Associations between daily PM 2.5 concentration and health outcomes on i) smoke-affected days and ii) all other days (i.e. non-smoke days) were analysed using Poisson time series regression. All statistical models were adjusted for daily temperature and relative humidity, influenza, pollen, and public holidays. On smoke-affected days, 10µg/m 3 increase in PM 2.5 was associated with a borderline statistically significant increase in cardiovascular mortality among total population at a lag of three days (12.4%, 95% CI -0.2% to 26.5%), and among the elderly (≥65 years) following same-day exposure (13.8%, 95% CI -0.6% to 30.4%) and at a lag of three days (11.8%, 95% CI -2.2% to 27.7%). Smoke day PM 2.5 was not associated with non-accidental mortality or hospital admissions due to cardiovascular causes. However, there was an indication of a positive association with hospital admissions due to respiratory causes among the elderly, and admissions due to chronic obstructive pulmonary disease or asthma among the total population. In contrast, on non-smoke days PM 2.5 was generally not associated with the health outcomes, apart from suggestive small positive effects on non-accidental mortality at a lag of one day among the elderly and hospital admissions due to all respiratory causes following same-day exposure among the total population. Our research provides suggestive evidence for an association of exposure to long-range transported PM 2.5 from vegetation fires with increased cardiovascular mortality, and to a lesser extent with increased hospital admissions due to respiratory causes. Hence, vegetation-fire originated air pollution may have adverse effects on public health over a distance of hundreds to thousands of kilometres from the fires. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Marine cosmeceuticals.

PubMed

Kim, Se-Kwon

2014-03-01

Recently, a great deal of interest has been expressed in the cosmetic industry regarding marine-derived cosmetic active ingredients due to their numerous beneficial effects on human skin health. Bioactive substances derived from marine resources have diverse functional roles as natural skin care agents, and these properties can be applied to the development of novel cosmetics as well as nutricosmetics (from edible seaweeds and edible marine animals). This contribution focuses on marine-derived cosmeceutical active ingredients and presents an overview of their health beneficial effects on human skin. © 2014 Wiley Periodicals, Inc.

Towards organizing health knowledge on community-based health services.

PubMed

Akbari, Mohammad; Hu, Xia; Nie, Liqiang; Chua, Tat-Seng

2016-12-01

Online community-based health services accumulate a huge amount of unstructured health question answering (QA) records at a continuously increasing pace. The ability to organize these health QA records has been found to be effective for data access. The existing approaches for organizing information are often not applicable to health domain due to its domain nature as characterized by complex relation among entities, large vocabulary gap, and heterogeneity of users. To tackle these challenges, we propose a top-down organization scheme, which can automatically assign the unstructured health-related records into a hierarchy with prior domain knowledge. Besides automatic hierarchy prototype generation, it also enables each data instance to be associated with multiple leaf nodes and profiles each node with terminologies. Based on this scheme, we design a hierarchy-based health information retrieval system. Experiments on a real-world dataset demonstrate the effectiveness of our scheme in organizing health QA into a topic hierarchy and retrieving health QA records from the topic hierarchy.

Fragranced consumer products: effects on asthmatics.

PubMed

Steinemann, Anne

2018-01-01

Fragranced consumer products, such as cleaning supplies, air fresheners, and personal care products, can emit a range of air pollutants and trigger adverse health effects. This study investigates the prevalence and types of effects of fragranced products on asthmatics in the American population. Using a nationally representative sample ( n  = 1137), data were collected with an on-line survey of adults in the USA, of which 26.8% responded as being medically diagnosed with asthma or an asthma-like condition. Results indicate that 64.3% of asthmatics report one or more types of adverse health effects from fragranced products, including respiratory problems (43.3%), migraine headaches (28.2%), and asthma attacks (27.9%). Overall, asthmatics were more likely to experience adverse health effects from fragranced products than non-asthmatics (prevalence odds ratio [POR] 5.76; 95% confidence interval [CI] 4.34-7.64). In particular, 41.0% of asthmatics report health problems from air fresheners or deodorizers, 28.9% from scented laundry products coming from a dryer vent, 42.3% from being in a room cleaned with scented products, and 46.2% from being near someone wearing a fragranced product. Of these effects, 62.8% would be considered disabling under the definition of the Americans with Disabilities Act. Yet 99.3% of asthmatics are exposed to fragranced products at least once a week. Also, 36.7% cannot use a public restroom if it has an air freshener or deodorizer, and 39.7% would enter a business but then leave as quickly as possible due to air fresheners or some fragranced product. Further, 35.4% of asthmatics have lost workdays or a job, in the past year, due to fragranced product exposure in the workplace. More than twice as many asthmatics would prefer that workplaces, health care facilities and health care professionals, hotels, and airplanes were fragrance-free rather than fragranced. Results from this study point to relatively simple and cost-effective ways to reduce exposure to air pollutants and health risks for asthmatics by reducing their exposure to fragranced products.

Green tea extract for periodontal health

PubMed Central

Venkateswara, Babu; Sirisha, K.; Chava, Vijay K.

2011-01-01

Tea, the commonly consumed beverage, is gaining increased attention in promoting overall health. In specific, green tea is considered a healthful beverage due to the biological activity of its polyphenols namely catechins. Among the polyphenols Epigallo catechin 3 gallate and Epicatechin 3 Gallate are the most predominant catechins. The antioxidant, antimicrobial, anticollagenase, antimutagenic, and c hemopreventive properties of these catechins proved to be helpful in the treatment of chronic diseases like periodontal disease. Studies have demonstrated that the type of processing mainly effects the concentration of catechins. Several epidemiological studies have proved that green tea also has some general health benefitting properties like antihypertensive, reduction of cardiovascular risk, antibacterial, antiviral, and antifungal activity. The present review concentrates on the effects of green tea in periodontal and general health. PMID:21772716

Health effects of home energy efficiency interventions in England: a modelling study

PubMed Central

Milner, James; Chalabi, Zaid; Das, Payel; Jones, Benjamin; Shrubsole, Clive; Davies, Mike; Wilkinson, Paul

2015-01-01

Objective To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets. Design Health impact modelling study. Setting England. Participants English household population. Intervention Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met; (2) as with scenario (1) but with additional ventilation for homes at risk of poor ventilation; (3) as with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance. Main outcome Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including secondhand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures. Results The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2241 (95% credible intervals (CI) 2085 to 2397) QALYs per 10 000 persons over 50 years follow-up due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor-generated particulate matter with a diameter of 2.5 μm or less (PM2.5). Scenario (2) resulted in a negative impact of −728 (95% CI −864 to −592) QALYs per 10 000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in −539 (95% CI −678 to -399) QALYs per 10 000 persons over 50 years follow-up due to an increase in indoor exposures despite the targeting of pollutants. Conclusions If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful understanding of the balance of changes in pollutant exposures, highlighting the importance of ventilation to mitigate the risk of poor indoor air quality. PMID:25916488

BIOLOGICAL EFFECTS OF UTAH VALLEY PARTICLES: A REVIEW

EPA Science Inventory

The Utah Valley provided a unique opportunity to evaluate the health effects of particulate matter (PM) in humans. The area has had intermittently high particle levels with the principal point source being a steel mill. Due to a labor dispute, the mill was shut down. The closu...

Effects of Aftermarket Control Technologies on Gas and Particle Phase Oxidative Potential from Diesel Engine Emissions

EPA Science Inventory

Particulate matter (PM) originating from diesel combustion is a public health concern due to its association with adverse effects on respiratory and cardiovascular diseases and lung cancer. This study investigated emissions from three stationary diesel engines (gensets) with var...

The Silence of the Unblown Whistle: The Nevada Hepatitis C Public Health Crisis

PubMed Central

Leary, Elizabeth; Diers, Donna

2013-01-01

In 2008, one of the worst public health crises occurred in the state of Nevada, where authorities discovered up to 63,000 patients were potentially exposed to hepatitis C infection, largely due to substandard infection control and other negligent practices at two endoscopy clinics in Las Vegas. In the subsequent grand jury proceedings that followed, it was discovered that several clinic employees not only participated in these egregious practices, but doctors, nurses, and other health care professionals witnessed yet failed to report these incidents, largely due to fears of whistleblower retaliation. In response, the Nevada state legislature attempted to strengthen whistleblower protection laws, but it remains unclear if such laws actually protect employees who attempt to report patient safety concerns. As the push for quality patient outcomes becomes more prominent with health care reform, whistleblower concerns must be effectively addressed to ensure that health care professionals can report patient safety concerns without fear of retaliation. PMID:23483090

Father absence due to migration and child illness in rural Mexico.

PubMed

Schmeer, Kammi

2009-10-01

Little research to date has assessed the importance of the presence of fathers in the household for protecting child health, particularly in developing country contexts. Although divorce and non-marital childbearing are low in many developing countries, migration is a potentially important source of father absence that has yet to be studied in relation to child health. This study utilizes prospective, longitudinal data from Mexico to assess whether father absence due to migration is associated with increased child illness in poor, rural communities. Rural Mexico provides a setting where child illness is related to more serious health problems, and where migration is an important source of father absence. Both state- and individual-level fixed effects regression analyses are used to estimate the relationship between father absence due to migration and child illness while controlling for unobserved contextual and individual characteristics. The state-level models illustrate that the odds of children being ill are 39% higher for any illness and 51% higher for diarrhea when fathers are absent compared with when fathers are present in the household. The individual-level fixed effects models support these findings, indicating that, in the context of rural Mexico, fathers may be important sources of support for ensuring the healthy development of young children.

Does More Schooling Improve Health Outcomes and Health Related Behaviors? Evidence from U.K. Twins

PubMed Central

Amin, Vikesh; Behrman, Jere R.; Spector, Tim D.

2013-01-01

Several recent studies using instrumental variables based on changes in compulsory schoolleaving age laws have estimated the causal effect of schooling on health outcomes and health-related behaviors in the U.K. Despite using the same identification strategy and similar datasets, no consensus has been reached. We contribute to the literature by providing results for the U.K. using a different research design and a different dataset. Specifically, we estimate the effect of schooling on health outcomes (obesity and physical health) and health-related behaviors (smoking, alcohol consumption and exercise) for women through within-MZ twins estimates using the TwinsUK database. For physical health, alcohol consumption and exercise, the within-MZ twins estimates are uninformative about whether there is a causal effect. However, we find (1) that the significant association between schooling and smoking status is due to unobserved endowments that are correlated with schooling and smoking (2) there is some indication that more schooling reduces the body mass index for women, even once these unobserved endowments have been controlled for. PMID:24415826

Costs of Illness Due to Cholera, Costs of Immunization and Cost-Effectiveness of an Oral Cholera Mass Vaccination Campaign in Zanzibar

PubMed Central

Schaetti, Christian; Weiss, Mitchell G.; Ali, Said M.; Chaignat, Claire-Lise; Khatib, Ahmed M.; Reyburn, Rita; Duintjer Tebbens, Radboud J.; Hutubessy, Raymond

2012-01-01

Background The World Health Organization (WHO) recommends oral cholera vaccines (OCVs) as a supplementary tool to conventional prevention of cholera. Dukoral, a killed whole-cell two-dose OCV, was used in a mass vaccination campaign in 2009 in Zanzibar. Public and private costs of illness (COI) due to endemic cholera and costs of the mass vaccination campaign were estimated to assess the cost-effectiveness of OCV for this particular campaign from both the health care provider and the societal perspective. Methodology/Principal Findings Public and private COI were obtained from interviews with local experts, with patients from three outbreaks and from reports and record review. Cost data for the vaccination campaign were collected based on actual expenditure and planned budget data. A static cohort of 50,000 individuals was examined, including herd protection. Primary outcome measures were incremental cost-effectiveness ratios (ICER) per death, per case and per disability-adjusted life-year (DALY) averted. One-way sensitivity and threshold analyses were conducted. The ICER was evaluated with regard to WHO criteria for cost-effectiveness. Base-case ICERs were USD 750,000 per death averted, USD 6,000 per case averted and USD 30,000 per DALY averted, without differences between the health care provider and the societal perspective. Threshold analyses using Shanchol and assuming high incidence and case-fatality rate indicated that the purchase price per course would have to be as low as USD 1.2 to render the mass vaccination campaign cost-effective from a health care provider perspective (societal perspective: USD 1.3). Conclusions/Significance Based on empirical and site-specific cost and effectiveness data from Zanzibar, the 2009 mass vaccination campaign was cost-ineffective mainly due to the relatively high OCV purchase price and a relatively low incidence. However, mass vaccination campaigns in Zanzibar to control endemic cholera may meet criteria for cost-effectiveness under certain circumstances, especially in high-incidence areas and at OCV prices below USD 1.3. PMID:23056660

Knowns and unknowns on burden of disease due to chemicals: a systematic review

PubMed Central

2011-01-01

Background Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however little is known about the total disease burden related to chemicals. This is important to know for overall policy actions and priorities. In this article the known burden related to selected chemicals or their mixtures, main data gaps, and the link to public health policy are reviewed. Methods A systematic review of the literature for global burden of disease estimates from chemicals was conducted. Global disease due to chemicals was estimated using standard methodology of the Global Burden of Disease. Results In total, 4.9 million deaths (8.3% of total) and 86 million Disability-Adjusted Life Years (DALYs) (5.7% of total) were attributable to environmental exposure and management of selected chemicals in 2004. The largest contributors include indoor smoke from solid fuel use, outdoor air pollution and second-hand smoke, with 2.0, 1.2 and 0.6 million deaths annually. These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively. Conclusions The known burden due to chemicals is considerable. This information supports decision-making in programmes having a role to play in reducing human exposure to toxic chemicals. These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden. Chemicals with known health effects, such as dioxins, cadmium, mercury or chronic exposure to pesticides could not be included in this article due to incomplete data and information. Effective public health interventions are known to manage chemicals and limit their public health impacts and should be implemented at national and international levels. PMID:21255392

Days out of role due to common physical and mental conditions: results from the Northern Ireland study of health and stress.

PubMed

Ennis, Edel; O'Neill, S; Murphy, S; Bunting, B

2016-11-01

Days out of role due to health problems are a major source of lost human capital. We examined the relative importance of common physical and mental disorders in accounting for days out of role in Northern Ireland using the Northern Ireland Study of Health and Stress (NISHS) WHO World Mental Health (WMH) Survey. Face-to-face interviews were carried out with 4340 respondents (68.4 % response rate). Multiple regression analysis estimated associations of specific chronic physical disorders and mental disorders conditions and comorbidities with days out of role controlling for basic socio-demographics. Overall, 16.8 % of respondents had at least one day totally out of role in the previous year. The strongest population-level effect was associated with arthritis, which accounted for 23.5 % of all days out of role. The strongest individual-level effects (days out of role per year) were associated with any anxiety disorder (32.3) arthritis (26.1) and pain (22.0). The 11 conditions accounted for 93 % of all days out of role, as measured by population attributable risk proportions (PARPs). Common health conditions, including mental disorders, make up a large proportion of the number of days out of role and should be addressed to substantially increase overall productivity.

Sexual Health: Testosterone Therapy

MedlinePlus

... or if it is due to a disease (hypogonadism). Hypogonadism is a disease in which the body is ... Testosterone therapy can help reverse the effects of hypogonadism, but it's unclear whether testosterone therapy would have ...

Functional outcome and cost-effectiveness of pulsed electromagnetic fields in the treatment of acute scaphoid fractures: a cost-utility analysis.

PubMed

Hannemann, Pascal F W; Essers, Brigitte A B; Schots, Judith P M; Dullaert, Koen; Poeze, Martijn; Brink, Peter R G

2015-04-11

Physical forces have been widely used to stimulate bone growth in fracture repair. Addition of bone growth stimulation to the conservative treatment regime is more costly than standard health care. However, it might lead to cost-savings due to a reduction of the total amount of working days lost. This economic evaluation was performed to assess the cost-effectiveness of Pulsed Electromagnetic Fields (PEMF) compared to standard health care in the treatment of acute scaphoid fractures. An economic evaluation was carried out from a societal perspective, alongside a double-blind, randomized, placebo-controlled, multicenter trial involving five centres in The Netherlands. One hundred and two patients with a clinically and radiographically proven fracture of the scaphoid were included in the study and randomly allocated to either active bone growth stimulation or standard health care, using a placebo. All costs (medical costs and costs due to productivity loss) were measured during one year follow up. Functional outcome and general health related quality of life were assessed by the EuroQol-5D and PRWHE (patient rated wrist and hand evaluation) questionnaires. Utility scores were derived from the EuroQol-5D. The average total number of working days lost was lower in the active PEMF group (9.82 days) compared to the placebo group (12.91 days) (p = 0.651). Total medical costs of the intervention group (€1594) were significantly higher compared to the standard health care (€875). The total amount of mean QALY's (quality-adjusted life year) for the active PEMF group was 0.84 and 0.85 for the control group. The cost-effectiveness plane shows that the majority of all cost-effectiveness ratios fall into the quadrant where PEMF is not only less effective in terms of QALY's but also more costly. This study demonstrates that the desired effects in terms of cost-effectiveness are not met. When comparing the effects of PEMF to standard health care in terms of QALY's, PEMF cannot be considered a cost-effective treatment for acute fractures of the scaphoid bone. Netherlands Trial Register (NTR): NTR2064.

The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon.

PubMed

Undurraga, Eduardo A; Behrman, Jere R; Leonard, William R; Godoy, Ricardo A

2016-01-01

Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults' substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon

PubMed Central

Undurraga, Eduardo A.; Behrman, Jere R.; Leonard, William R.; Godoy, Ricardo A.

2015-01-01

Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults’ substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health. PMID:26706403

Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria.

PubMed

Bali, Sulzhan; Stewart, Kearsley A; Pate, Muhammad Ali

2016-01-01

The already significant impact of the Ebola epidemic on Guinea, Liberia and Sierra Leone, was worsened by a fear of contagion that aggravated the health crisis. However, in contrast to other Ebola-affected countries, Nigeria fared significantly better due to its swift containment of the disease. The objective of our study was to describe the impact of Ebola on the Nigerian private sector. This paper introduces and defines the term fearonomic effect as the direct and indirect economic effects of both misinformation as well as fear-induced aversion behaviour, exhibited by individuals, organisations or countries during an outbreak or an epidemic. This study was designed as a cross-sectional mixed-methods study that used semistructured in-depth interviews and a supporting survey to capture the impact of Ebola on the Nigerian private sector after the outbreak. Themes were generated from the interviews on the direct and indirect impact of Ebola on the private sector; the impact of misinformation and fear-based aversion behaviour in the private sector. Our findings reveal that the fearonomic effects of Ebola included health service outages and reduced healthcare usage as a result of misinformation and aversion behaviour by both patients and providers. Although certain sectors (eg, health sector, aviation sector, hospitality sector) in Nigeria were affected more than others, no business was immune to Ebola's fearonomic effects. We describe how sectors expected to prosper during the outbreak (eg, pharmaceuticals), actually suffered due to the changes in consumption patterns and demand shocks. In a high-stressor epidemic-like setting, altered consumption behaviour due to distorted disease perception, misinformation and fear can trigger short-term economic cascades that can disproportionately affect businesses and lead to financial insecurity of the poorest and the most vulnerable in a society.

Cost-effectiveness of ranibizumab in the treatment of visual impairment due to diabetic macular edema.

PubMed

Haig, Jennifer; Barbeau, Martin; Ferreira, Alberto

2016-07-01

Objective Ranibizumab, an anti-vascular endothelial growth factor designed for ocular use, has been deemed cost-effective in multiple indications by several Health Technology Assessment bodies. This study assessed the cost-effectiveness of ranibizumab monotherapy or combination therapy (ranibizumab plus laser photocoagulation) compared with laser monotherapy for the treatment of visual impairment due to diabetic macular edema (DME). Methods A Markov model was developed in which patients moved between health states defined by best-corrected visual acuity (BCVA) intervals and an absorbing 'death' state. The population of interest was patients with DME due to type 1 or type 2 diabetes mellitus. Baseline characteristics were based on those of participants in the RESTORE study. Main outputs were costs (in 2013 CA$) and health outcomes (in quality-adjusted life-years [QALYs]) and the incremental cost-effectiveness ratio (ICER) was calculated. This cost-utility analysis was conducted from healthcare system and societal perspectives in Quebec. Results From a healthcare system perspective, the ICERs for ranibizumab monotherapy and combination therapy vs laser monotherapy were CA$24 494 and CA$36 414 per QALY gained, respectively. The incremental costs per year without legal blindness for ranibizumab monotherapy and combination therapy vs laser monotherapy were CA$15 822 and CA$20 616, respectively. Based on the generally accepted Canadian ICER threshold of CA$50 000 per QALY gained, ranibizumab monotherapy and combination therapy were found to be cost-effective compared with laser monotherapy. From a societal perspective, ranibizumab monotherapy and combination therapy provided greater benefits at lower costs than laser monotherapy (ranibizumab therapy dominated laser therapy). Conclusions Ranibizumab monotherapy and combination therapy resulted in increased quality-adjusted survival and time without legal blindness and lower costs from a societal perspective compared with laser monotherapy.

Polyphenol-Rich Dry Common Beans (Phaseolus vulgaris L.) and Their Health Benefits

PubMed Central

Ganesan, Kumar

2017-01-01

Polyphenols are plant metabolites with potent anti-oxidant properties, which help to reduce the effects of oxidative stress-induced dreaded diseases. The evidence demonstrated that dietary polyphenols are of emerging increasing scientific interest due to their role in the prevention of degenerative diseases in humans. Possible health beneficial effects of polyphenols are based on the human consumption and their bioavailability. Common beans (Phaseolus vulgaris L.) are a greater source of polyphenolic compounds with numerous health promoting properties. Polyphenol-rich dry common beans have potential effects on human health, and possess anti-oxidant, anti-diabetic, anti-obesity, anti-inflammatory and anti-mutagenic and anti-carcinogenic properties. Based on the studies, the current comprehensive review aims to provide up-to-date information on the nutritional compositions and health-promoting effect of polyphenol-rich common beans, which help to explore their therapeutic values for future clinical studies. Investigation of common beans and their impacts on human health were obtained from various library databases and electronic searches (Science Direct PubMed, and Google Scholar). PMID:29113066

An extended cost-effectiveness analysis of schizophrenia treatment in India under universal public finance.

PubMed

Raykar, Neha; Nigam, Aditi; Chisholm, Dan

2016-01-01

Schizophrenia remains a priority condition in mental health policy and service development because of its early onset, severity and consequences for affected individuals and households. This paper reports on an 'extended' cost-effectiveness analysis (ECEA) for schizophrenia treatment in India, which seeks to evaluate through a modeling approach not only the costs and health effects of intervention but also the consequences of a policy of universal public finance (UPF) on health and financial outcomes across income quintiles. Using plausible values for input parameters, we conclude that health gains from UPF are concentrated among the poorest, whereas the non-health gains in the form of out-of-pocket private expenditures averted due to UPF are concentrated among the richest income quintiles. Value of insurance is the highest for the poorest quintile and declines with income. Universal public finance can play a crucial role in ameliorating the adverse economic and social consequences of schizophrenia and its treatment in resource-constrained settings where health insurance coverage is generally poor. This paper shows the potential distributional and financial risk protection effects of treating schizophrenia.

Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: a systematic review.

PubMed

Simou, Effie; Koutsogeorgou, Eleni

2014-04-01

Due to the current economic crisis in Greece, effects on health and healthcare have been reported. The aim of this study was to present a systematic overview of the consequences that the financial crisis has had for health and healthcare in Greece. Systematic literature review was conducted in order to identify articles that were published from January 2009 to March 2013 and explicitly referred to the effects of economic crisis on health or healthcare, in Greece. Data extraction and synthesis was performed with the use of thematic analysis. Thirty-nine studies were considered for further analyses. Various existing and potential relevant effects were identified, including reductions in public health expenditure and changes in healthcare services and the pharmaceutical market, with an increasing number of admissions in public healthcare sector, and efficiency and organizational-related issues being evident, overall. Indications were found for post-crisis deterioration of public health with increasing rates of mental health, suicides, and epidemics, and deterioration of self-rated health. The recent efforts to reform the Greek National Health System have been focusing mainly on short-term effects by reducing expenditure, while the measures imposed seem to have dubious long-term consequences for Greek public health and healthcare. Copyright © 2014 The Authos. Published by Elsevier Ireland Ltd.. All rights reserved.

Measuring the effect of husband's health on wife's labor supply.

PubMed

Siegel, Michele J

2006-06-01

A sizable proportion of women remain married well into late life and an increasing proportion of them participate in the labor force. Since women tend to marry men older than themselves and men tend to experience serious illnesses at younger ages than women, women frequently witness declining health in their husbands. This is likely to affect a wife's labor-leisure trade-off in offsetting ways. Prior studies have not sought to disentangle the effect of a husband's poor health on his wife's reservation wage from the income effect of his ill health. We argue that, if we control for husband's earnings, the coefficient of husband's health in models of his wife's labor force participation (and hours of work) will reflect, in part, her preference over whether to decrease her labor supply to provide health care for her husband or whether to instead increase it to purchase this care in the market. However, husband's earnings are likely to be endogenous in these models due to unobserved characteristics common to husbands and wives. We find that the estimated effect of husband's health depends on whether we instrument for husband's earnings and on the health measure used. This is indicative of the importance of using a variety of health measures and controlling for husband's earnings, and their endogeneity, in future research on the effect of husband's health on wife's labor supply. Copyright 2005 John Wiley & Sons, Ltd.

The role of emotions in the reduction of HIV/AIDS stigma among physicians in training.

PubMed

Varas-Díaz, Nelson; Neilands, Torsten B; Rodríguez-Madera, Sheilla L; Padilla, Mark

2016-01-01

Scientific literature has systematically documented the negative effects of social stigma for people living with HIV/AIDS (PLWHA). HIV/AIDS stigma has the potential to negatively impact self-care strategies for those already affected, and simultaneously hinder prevention efforts to deter the emergence of new infections. When health professionals manifest these negative attitudes access to quality health-care and prevention strategies can be seriously affected. Scientifically tested interventions to reduce HIV/AIDS stigma among health professionals are still scarce. Although the number of tested interventions has increased over the past decade, few of them target Latino health professionals or Spanish-speaking populations. Furthermore, although some of those interventions have been reported as effective for stigma reduction, more work is needed to better understand the underlying variables that account for the reduction of stigma attitudes in those efforts. The SPACES intervention has been documented as an effective HIV/AIDS stigma-reduction intervention focusing on health-care professionals in training. The intervention, which is delivered in Spanish, has been previously tested with medical students in Puerto Rico and shown significant results in addressing negative attitudes toward PLWHA. The main objective of this study was to document the underlying variables that fostered reduction of HIV/AIDS stigma due to participation in the SPACES intervention. Results evidence that health professionals in training who participated in the intervention (n = 507) had less stigmatizing attitudes toward PLWHA due to an increase in their positive emotions toward this population. In light of these results, we discuss the importance of engaging health professionals in HIV/AIDS stigma-reduction interventions that go beyond the provision of information and skills for interacting with PLWHA, and address the emotional component of HIV/AIDS stigma.

Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study.

PubMed

Morita, Tomohiro; Nomura, Shuhei; Tsubokura, Masaharu; Leppold, Claire; Gilmour, Stuart; Ochi, Sae; Ozaki, Akihiko; Shimada, Yuki; Yamamoto, Kana; Inoue, Manami; Kato, Shigeaki; Shibuya, Kenji; Kami, Masahiro

2017-10-01

Evidence on the indirect health impacts of disasters is limited. We assessed the excess mortality risk associated with the indirect health impacts of the 2011 triple disaster (earthquake, tsunami and nuclear disaster) in Fukushima, Japan. The mortality rates in Soma and Minamisoma cities in Fukushima from 2006 to 2015 were calculated using vital statistics and resident registrations. We investigated the excess mortality risk, defined as the increased mortality risk between postdisaster and predisaster after excluding direct deaths attributed to the physical force of the disaster. Multivariate Poisson regression models were used to estimate the relative risk (RR) of mortality after adjusting for city, age and year. There were 6163 and 6125 predisaster and postdisaster deaths, respectively. The postdisaster mortality risk was significantly higher in the first month following the disaster (March 2011) than in the same month during the predisaster period (March 2006-2010). RRs among men and women were 2.64 (95% CI 2.16 to 3.24) and 2.46 (95% CI 1.99 to 3.03), respectively, demonstrating excess mortality risk due to the indirect health effects of the disaster. Age-specific subgroup analyses revealed a significantly higher mortality risk in women aged ≥85 years in the third month of the disaster compared with predisaster baseline, with an RR (95% CI) of 1.73 (1.23 to 2.44). Indirect health impacts are most severe in the first month of the disaster. Early public health support, especially for the elderly, can be an important factor for reducing the indirect health effects of a disaster. © 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.

The role of emotions in the reduction of HIV/AIDS stigma among physicians in training

PubMed Central

Varas-Díaz, Nelson; Neilands, Torsten B.; Rodríguez-Madera, Sheilla L.; Padilla, Mark

2016-01-01

Scientific literature has systematically documented the negative effects of social stigma for people living with HIV/AIDS (PLWHA). HIV/AIDS stigma has the potential to negatively impact self-care strategies for those already affected, and simultaneously hinder prevention efforts to deter the emergence of new infections. When health professionals manifest these negative attitudes access to quality health-care and prevention strategies can be seriously affected. Scientifically tested interventions to reduce HIV/AIDS stigma among health professionals are still scarce. Although the number of tested interventions has increased over the past decade, few of them target Latino health professionals or Spanish-speaking populations. Furthermore, although some of those interventions have been reported as effective for stigma reduction, more work is needed to better understand the underlying variables that account for the reduction of stigma attitudes in those efforts. The SPACES intervention has been documented as an effective HIV/AIDS stigma-reduction intervention focusing on health-care professionals in training. The intervention, which is delivered in Spanish, has been previously tested with medical students in Puerto Rico and shown significant results in addressing negative attitudes toward PLWHA. The main objective of this study was to document the underlying variables that fostered reduction of HIV/AIDS stigma due to participation in the SPACES intervention. Results evidence that health professionals in training who participated in the intervention (n = 507) had less stigmatizing attitudes toward PLWHA due to an increase in their positive emotions toward this population. In light of these results, we discuss the importance of engaging health professionals in HIV/AIDS stigma-reduction interventions that go beyond the provision of information and skills for interacting with PLWHA, and address the emotional component of HIV/AIDS stigma. PMID:26444133

Southern Seven Women's Initiative for Cardiovascular Health: Lessons Learned in Community Health Outreach with Rural Women

ERIC Educational Resources Information Center

Zimmermann, Kristine; Khare, Manorama M.; Huber, Rachel; Moehring, Patricia A.; Koch, Abby; Geller, Stacie E.

2012-01-01

Background: Cardiovascular disease is the leading cause of death in women in the United States. Rural women have an increased risk of cardiovascular disease due to both behavioral and environmental factors. Models of prevention that are tailored to community needs and build on existing resources are essential for effective outreach to rural women.…

The Use of Adventure Therapy in Community-Based Mental Health: Decreases in Problem Severity among Youth Clients

ERIC Educational Resources Information Center

Tucker, Anita R.; Javorski, Steve; Tracy, Julie; Beale, Bobbi

2013-01-01

Background: There is an increasing need to identify effective mental health treatment practices for children and adolescents in community-based settings, due to current mixed findings of existing interventions. This study looked at adventure therapy (AT) as a viable option to meet this need. Objective: Using a sample of 1,135 youth from a…

2013 Advanced Environmental Health/Advanced Food Technology Standing Review Panel Final Report

NASA Technical Reports Server (NTRS)

Steinberg, Susan

2014-01-01

The 2013 Advanced Environmental Health/Advanced Food Technology (AEH/AFT) Standing Review Panel (from here on referred to as the SRP) participated in a WebEx/teleconference with members of the Space Human Factors and Habitability (SHFH) Element, representatives from the Human Research Program (HRP), and NASA Headquarters on November 22, 2013 (list of participants is in Section IX of this report). The SRP reviewed the updated research plans for the Risk of Adverse Health Effects Due to Alterations in Host-Microorganism Interactions (Host Microbe Risk) and the Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System (Food Risk). The SRP also received a status update on the Risk of Adverse Health Effects of Exposure to Dust and Volatiles during Exploration of Celestial Bodies (Dust Risk). Overall, the SRP was impressed with the strong research plans presented by the scientists and staff associated with the SHFH Element. The SRP also thought that the updated research plans were thorough, well organized, and presented in a comprehensive manner. The SRP agrees with the changes made to the Host Microbe Risk and Food Risk portfolios and thinks that the targets for Gap closure are appropriate.

Distraction: an assessment of smartphone usage in health care work settings

PubMed Central

Gill, Preetinder S; Kamath, Ashwini; Gill, Tejkaran S

2012-01-01

Smartphone use in health care work settings presents both opportunities and challenges. The benefits could be severely undermined if abuse and overuse are not kept in check. This practice-focused research paper examines the current panorama of health software applications. Findings from existing research are consolidated to elucidate the level and effects of distraction in health care work settings due to smartphone use. A conceptual framework for crafting guidelines to regulate the use of smartphones in health care work settings is then presented. Finally, specific guidelines are delineated to assist in creating policies for the use of smartphones in a health care workplace. PMID:22969308

Crew health

NASA Technical Reports Server (NTRS)

Billica, Roger D.

1992-01-01

Crew health concerns for Space Station Freedom are numerous due to medical hazards from isolation and confinement, internal and external environments, zero gravity effects, occupational exposures, and possible endogenous medical events. The operational crew health program will evolve from existing programs and from life sciences investigations aboard Space Station Freedom to include medical monitoring and certification, medical intervention, health maintenance and countermeasures, psychosocial support, and environmental health monitoring. The knowledge and experience gained regarding crew health issues and needs aboard Space Station Freedom will be used not only to verify requirements and programs for long duration space flight, but also in planning and preparation for Lunar and Mars exploration and colonization.

[The influence of perceived discrimination on health in migrants].

PubMed

Igel, Ulrike; Brähler, Elmar; Grande, Gesine

2010-05-01

The aim of the study was to investigate the influence of racial discrimination on subjective health in migrants. The sample included 1.844 migrants from the SOEP. Discrimination was assessed by two items. Socioeconomic status, country of origin, and health behavior were included in multivariate regression models to control for effects on health. Differential models with regard to gender and origin were analysed. Migrants who experienced discrimination report a worse health status. Discrimination determines mental and physical health of migrants. There are differences in models due to gender and origin. In addition to socioeconomic factors experienced discrimination should be taken into account as a psycho-social stressor of migrants.

Fiber optic sensors for infrastructure applications

DOT National Transportation Integrated Search

1998-02-01

Fiber optic sensor technology offers the possibility of implementing "nervous systems" for infrastructure elements that allow high performance, cost effective health and damage assessment systems to be achieved. This is possible, largely due to syner...

The Association between Insomnia and Insomnia Treatment Side Effects on Health Status, Work Productivity, and Healthcare Resource Use

PubMed Central

DiBonaventura, Marco; Richard, Lance; Kumar, Maya; Forsythe, Anna; Flores, Natalia M.; Moline, Margaret

2015-01-01

The aims of this study were (1) to compare health outcomes (i.e., health-related quality of life [HRQoL], productivity at work, and healthcare resource use visits) between those with insomnia and non-insomnia controls, (2) to compare health outcomes between those treated for insomnia and non-insomnia controls, and (3) to assess the prevalence of side effects of insomnia medications and their relationship with health outcomes. Data from the 2013 US (N = 75,000) and 5EU (N = 62,000) National Health and Wellness Survey (NHWS) were used. The NHWS is a patient-reported survey administered to a demographically representative sample of adults. Those who met DSM-V criteria for insomnia and, separately, those treated for insomnia were compared with equivalently sized control groups who were identified using a propensity score matching method. Outcomes included HRQoL (Short Form 36v2), productivity at work (Work Productivity and Activity Impairment—General Health questionnaire), and healthcare resource use visits in the past 6 months and were analyzed using one-way ANOVAs. Among those with treated insomnia, those with and without side effects were compared on health outcomes using general linear models controlling for confounding variables. Patients with insomnia (n = 4147) and treated insomnia (n = 2860) in the 5EU reported significantly worse HRQoL than controls (health utilities: 0.60 vs. 0.74; 0.60 vs. 0.74, respectively), greater overall work impairment (38.74% vs. 14.86%; 39.50% vs. 15.66%), and more physician visits in the past 6 months (9.10 vs. 4.08; 9.58 vs. 4.11). Similar findings were observed in the US. Among those treated for insomnia, 13.56% and 24.55% in the US and 5EU, respectively, were non-adherent due to side effects. In the US, non-adherence was associated with significantly worse HRQoL (health utilities: 0.60 vs. 0.64, p <.05) and greater overall work impairment (37.71% vs. 29.08%, p <.05), among other significant differences. These relationships were not significant in the 5EU. A significant burden of insomnia was observed in both the US and 5EU, and the association remained even after treatment. Non-adherence due to side effects was common and, in the case of the US, associated with significantly poorer health outcomes. PMID:26426805

Microbiome and mental health in the modern environment.

PubMed

Deans, Emily

2016-06-27

A revolution in the understanding of the pathophysiology of mental illness combined with new knowledge about host/microbiome interactions and psychoneuroimmunology has opened an entirely new field of study, the "psychobiotics". The modern microbiome is quite changed compared to our ancestral one due to diet, antibiotic exposure, and other environmental factors, and these differences may well impact our brain health. The sheer complexity and scope of how diet, probiotics, prebiotics, and intertwined environmental variables could influence mental health are profound obstacles to an organized and useful study of the microbiome and psychiatric disease. However, the potential for positive anti-inflammatory effects and symptom amelioration with perhaps few side effects makes the goal of clarifying the role of the microbiota in mental health a vital one.

Influencing Adolescent Leisure Motivation: Intervention Effects of HealthWise South Africa

PubMed Central

Caldwell, Linda L.; Patrick, Megan E.; Smith, Edward A.; Palen, Lori-Ann; Wegner, Lisa

2014-01-01

This study investigates changes in self-reported motivation for leisure due to participation in HealthWise, a high school curriculum aimed at decreasing risk behavior and promoting health behavior. Participants were 2,193 mixed race adolescents (M = 14 years old) from 9 schools (4 intervention, 5 control) near Cape Town, South Africa. Students in the HealthWise school with the greatest involvement in teacher training and implementation fidelity reported increased intrinsic and identified motivation and decreased introjected motivation and amotivation compared to students in control schools. These results point to the potential for intervention programming to influence leisure motivation among adolescents in South Africa and represent a first step toward identifying leisure motivation as a mediator of program effects. PMID:25429164

Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health.

PubMed

Gutierrez, Kristie S; LePrevost, Catherine E

2016-02-03

Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015) literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate.

Exploring Spanish health social media for detecting drug effects.

PubMed

Segura-Bedmar, Isabel; Martínez, Paloma; Revert, Ricardo; Moreno-Schneider, Julián

2015-01-01

Adverse Drug reactions (ADR) cause a high number of deaths among hospitalized patients in developed countries. Major drug agencies have devoted a great interest in the early detection of ADRs due to their high incidence and increasing health care costs. Reporting systems are available in order for both healthcare professionals and patients to alert about possible ADRs. However, several studies have shown that these adverse events are underestimated. Our hypothesis is that health social networks could be a significant information source for the early detection of ADRs as well as of new drug indications. In this work we present a system for detecting drug effects (which include both adverse drug reactions as well as drug indications) from user posts extracted from a Spanish health forum. Texts were processed using MeaningCloud, a multilingual text analysis engine, to identify drugs and effects. In addition, we developed the first Spanish database storing drugs as well as their effects automatically built from drug package inserts gathered from online websites. We then applied a distant-supervision method using the database on a collection of 84,000 messages in order to extract the relations between drugs and their effects. To classify the relation instances, we used a kernel method based only on shallow linguistic information of the sentences. Regarding Relation Extraction of drugs and their effects, the distant supervision approach achieved a recall of 0.59 and a precision of 0.48. The task of extracting relations between drugs and their effects from social media is a complex challenge due to the characteristics of social media texts. These texts, typically posts or tweets, usually contain many grammatical errors and spelling mistakes. Moreover, patients use lay terminology to refer to diseases, symptoms and indications that is not usually included in lexical resources in languages other than English.

Health status and air pollution related socioeconomic concerns in urban China.

PubMed

Jiao, Kaishan; Xu, Mengjia; Liu, Meng

2018-02-05

China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investigated with consideration of the socioeconomic factors. Based on nationwide survey data of China in 2014, we applied the multilevel mixed-effects model to evaluate how socioeconomic status (represented by education and income) contributed to the relationship between self-rated air pollution and self-rated health status at community level and individual level. The findings indicated that there was a non-linear relationship between the community socioeconomic status and community air pollution in urban China, with the highest level of air pollution presented in the communities with moderate socioeconomic status. In addition, health effects associated air pollution in different socioeconomic status groups were not equal. Self-rated air pollution had the greatest impact on self-rated health of the lower socioeconomic groups. With the increase of socioeconomic status, the effect of self-rated air pollution on self-rated health decreased. This study verified the different levels of exposure to air pollution and inequality in health effects among different socioeconomic groups in China. It is imperative for the government to urgently formulate public policies to enhance the ability of the lower socioeconomic groups to circumvent air pollution and reduce the health damage caused by air pollution.

[Health risk assessment of traffic-related air pollution near busy roads].

PubMed

Host, S; Chatignoux, E; Leal, C; Grémy, I

2012-08-01

Although ambient urban air pollution has well-established health effects, epidemiology faces many difficulties in estimating the risks due to exposure to traffic pollutants near busy roads. This review aims to summarize how exposure to traffic-related air pollution near busy roads is assessed in epidemiological studies and main findings regarding health effects. After presenting the specificity of emissions due to traffic road, this review identifies the key methods and main results found in epidemiologic studies seeking to measure the influence of exposure to nearby traffic on health published over the past decade. The characterization and measurement of population exposure to traffic pollution faces many difficulties. Thus, epidemiological studies have used two broad categories of surrogates to assess exposure: direct measures of traffic itself such as distance of the residence to the nearest road and traffic volume and modeled concentrations of pollutant surrogates. Studies that implemented these methods showed that people living near heavy traffic road or exposed to near-road air pollution tend to report more health outcomes. Traffic-related air pollution near busy roads is the subject of increasing attention, and tends to be better characterized. However, its health impacts remain difficult to grasp, especially because of the vast diversity of approaches used in epidemiological studies. Greater consistency in the protocols would be desirable to provide better understanding of the health issue of traffic in urban areas and thus to better implement policies to protect those most at risk. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Parental health shocks and schooling: The impact of mutual health insurance in Rwanda.

PubMed

Woode, Maame Esi

2017-01-01

The goal of this study was to look at the educational spill-over effects of health insurance on schooling with a focus on the Rwandan Community Based Health Insurance Programme, the Mutual Health Insurance scheme. Using a two-person general equilibrium overlapping generations model, this paper theoretically analyses the possible effect of health insurance on the relationship between parental health shocks and child schooling. Individuals choose whether or not they want to incur a medical cost by seeking care in order to reduce the effect of health shocks on their labour market availability and productivity. The theoretical results show that, health shocks negatively affect schooling irrespective of insurance status. However, if the health shock is severe (incapacitating) or sudden in nature, there is a discernible mitigating effect of health insurance on the negative impact of parental ill health on child schooling. The results are tested empirically using secondary data from the third Integrated Household Living Conditions Survey (EICV) for Rwanda, collected in 2011. A total of 2401 children between the ages of 13 and 18 are used for the analysis. This age group is selected due to the age of compulsory education in Rwanda. Based on average treatment effect on treated we find a statistically significant difference in attendance between children with MHI affiliated parents and those with uninsured parents of about 0.044. The negative effect of a father being severely ill is significant only for uninsured household. For the case of the mother, this effect is felt by female children with uninsured parents only when the illness is sudden. The observed effects are more pronounced for older children. While the father's ill health (sever or sudden) significantly and negatively affects their working hours, health insurance plays appears to increase their working hours. The effects of health insurance extend beyond health outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Measuring the burden of preventable diabetic hospitalisations in the Mexican Institute of Social Security (IMSS).

PubMed

Lugo-Palacios, David G; Cairns, John; Masetto, Cynthia

2016-08-02

The prevalence of diabetes among adults in Mexico has increased markedly from 6.7 % in 1994 to 14.7 % in 2015. Although the main diabetic complications can be prevented or delayed with timely and effective primary care, a high percentage of diabetic patients have developed them imposing an important preventable burden on Mexican society and on the health system. This paper estimates the financial and health burden caused by potentially preventable hospitalisations due to diabetic complications in hospitals operated by the largest social security institution in Latin America, the Mexican Institute of Social Security (IMSS), in the period 2007-2014. Hospitalisations in IMSS hospitals whose main cause was a diabetic complication were identified. The financial burden was estimated using IMSS diagnostic-related groups. To estimate the health burden, DALYs were computed under the assumption that patients would not have experienced complications if they had received timely and effective primary care. A total of 322,977 hospitalisations due to five diabetic complications were identified during the period studied, of which hospitalisations due to kidney failure and diabetic foot represent 78 %. The financial burden increased by 8.4 % in real terms between 2007 and 2014. However, when measured as cost per IMSS affiliate, it decreased by 11.3 %. The health burden had an overall decrease of 13.6 % and the associated DALYs in 2014 reached 103,688. Resources used for the hospital treatment of diabetic complications are then not available for other health care interventions. In order to prevent these hospitalisations more resources might need to be invested in primary care; the first step could be to consider the financial burden of these hospitalisations as a potential target for switching resources from hospital care to primary care services. However, more evidence of the effectiveness of different primary care interventions is needed to know how much of the burden could be prevented by better primary care.

Implementation of Steps 1-9 to Successful Breastfeeding Reduces the Frequency of Mild and Severe Episodes of Diarrhea and Respiratory Tract Infection Among 0-6 Month Infants in Democratic Republic of Congo.

PubMed

Zivich, Paul; Lapika, Bruno; Behets, Frieda; Yotebieng, Marcel

2018-05-01

Global initiatives to improve breastfeeding practices have focused on the Ten Steps to Successful Breastfeeding. The aim of this study was to assess the effect of implementing Baby-Friendly Hospital Initiative (BFHI) steps 1-9 and BFHI steps 1-10 on incidence of diarrhea and respiratory illnesses in the first 6 months of life. We reanalyzed a cluster randomized trial in which health-care clinics in Kinshasa, Democratic Republic of Congo, were randomly assigned to standard care (control group), BFHI steps 1-9, or BFHI steps 1-10. Outcomes included episodes of diarrhea and respiratory illness. Piecewise Poisson regression with generalized estimation equations to account for clustering by clinic was used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI). Steps 1-9 was associated with a decreased incidence of reported diarrhea (IRR 0.72, 95% CI 0.53, 0.99) and respiratory illness (IRR 0.48, 95% CI 0.37, 0.63), health facility visits due to diarrhea (IRR 0.60, 95% CI 0.42, 0.85) and respiratory illness (IRR 0.47, 95% CI 0.36, 0.63), and hospitalizations due to diarrhea (IRR 0.42, 95% CI 0.17, 1.06) and respiratory illness (IRR 0.33, 95% CI 0.11, 0.98). Addition of Step 10 attenuated this effect: episodes of reported diarrhea (IRR 1.24, 95% CI 0.93, 1.68) and respiratory illness (IRR 0.77, 95% CI 0.60, 0.99), health facility visits due to diarrhea (IRR 0.76, 95% CI 0.54, 1.08) and respiratory illness (IRR 0.75 95% CI 0.57, 0.97), and hospitalizations due to respiratory illness (IRR 0.48 95% CI 0.16, 1.40); but strengthened the effect against hospitalizations due to diarrhea (IRR 0.14, 95% CI 0.03, 0.60). Implementation of steps 1-9 significantly reduced incidence of mild and severe episodes of diarrhea and respiratory infection in the first 6 months of life, addition of step 10 appeared to lessen this effect. NCT01428232.

The development of funding recommendations for health technologies at the state level: A South Australian case study.

PubMed

Lambert, Robyn; Carter, Drew; Burgess, Naomi; Haji Ali Afzali, Hossein

2018-04-20

State governments often face capped budgets that can restrict expenditure on health technologies and their evaluation, yet many technologies are introduced to practice through state-funded institutions such as hospitals, rather than through national evaluation mechanisms. This research aimed to identify the criteria, evidence, and standards used by South Australian committee members to recommend funding for high-cost health technologies. We undertook 8 semi-structured interviews and 2 meeting observations with members of state-wide committees that have a mandate to consider the safety, effectiveness, and cost-effectiveness of high-cost health technologies. Safety and effectiveness were fundamental criteria for decision makers, who were also concerned with increasing consistency in care and equitable access to technologies. Committee members often consider evidence that is limited in quantity and quality; however, they perceive evaluations to be rigorous and sufficient for decision making. Precise standards for safety, effective, and cost-effectiveness could not be identified. Consideration of new technologies at the state level is grounded in the desire to improve health outcomes and equity of access for patients. High quality evidence is often limited. The impact funding decisions have on population health is unclear due to limited use of cost-effectiveness analysis and unclear cost-effectiveness standards. Copyright © 2018 John Wiley & Sons, Ltd.

Impact of regional climate change on human health

NASA Astrophysics Data System (ADS)

Patz, Jonathan A.; Campbell-Lendrum, Diarmid; Holloway, Tracey; Foley, Jonathan A.

2005-11-01

The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance. Here we review the growing evidence that climate-health relationships pose increasing health risks under future projections of climate change and that the warming trend over recent decades has already contributed to increased morbidity and mortality in many regions of the world. Potentially vulnerable regions include the temperate latitudes, which are projected to warm disproportionately, the regions around the Pacific and Indian oceans that are currently subjected to large rainfall variability due to the El Niño/Southern Oscillation sub-Saharan Africa and sprawling cities where the urban heat island effect could intensify extreme climatic events.

Evaluation of nutritive quality of common carp, Cyprinus carpio L.

NASA Astrophysics Data System (ADS)

Ljubojević, D.; Đorđević, V.; Ćirković, M.

2017-09-01

Common carp is the most important commercial fish species in Serbia. This fish is a valuable source of nutritive components and plays a role in healthy human nutrition. This review evaluates the nutritive quality of common carp including proximate and fatty acid compositions as well as their effects on human health. The fat content and fatty acid composition of carp have been shown to vary due to different environmental factors and particularly due to nutrition. Technology of production and composition of planktonic and benthic organisms in fish ponds have been recognised as significant factors affecting carp meat quality and desirable chemical and fatty acid composition. Carp meat quality but also production parameters and fish health are positively influenced by a balanced feed mixture. Due to the low content of saturated fatty acids and cholesterol plus high levels of unsaturated fatty acids, common carp meat consumption could be linked with reduced risk of different heart diseases in humans. Also, fish proteins can have many beneficial roles in the preservation of human health. This paper emphasises the importance of consumption of common carp in order to prevent many diseases and preserve human health.

Impact of regional climate change on human health.

PubMed

Patz, Jonathan A; Campbell-Lendrum, Diarmid; Holloway, Tracey; Foley, Jonathan A

2005-11-17

The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance. Here we review the growing evidence that climate-health relationships pose increasing health risks under future projections of climate change and that the warming trend over recent decades has already contributed to increased morbidity and mortality in many regions of the world. Potentially vulnerable regions include the temperate latitudes, which are projected to warm disproportionately, the regions around the Pacific and Indian oceans that are currently subjected to large rainfall variability due to the El Niño/Southern Oscillation sub-Saharan Africa and sprawling cities where the urban heat island effect could intensify extreme climatic events.

Ecological School Counseling in High-Poverty Elementary Schools: Counselors' Backgrounds and Perceptions Regarding the Effects of Poverty, Importance of Advocacy and School-Based Mental Health Programs

ERIC Educational Resources Information Center

Brown, La Vera C.

2016-01-01

Elementary school counselors working in high-poverty schools experience several challenges due to the multiple barriers associated with serving children from low-SES families. Research shows that children from low-SES families are at risk of adverse consequences to their developmental and psychological progress due to negative environmental…

Economic analysis of use of counterfeit drugs: health impairment risk of counterfeit phosphodiesterase type 5 inhibitor taken as an example.

PubMed

Sugita, Minoru; Miyakawa, Michiko

2010-07-01

The size of the market for counterfeit drugs throughout the world is considerable. Many cases of health impairment due to counterfeits have been reported. The market share of counterfeits in drug markets in developed countries is smaller than that in developing countries. However, the size of the market for counterfeits of phosphodiesterase type 5 inhibitors (PDE5Is) used as anti-erectile-dysfunction drugs is not small. The purpose of the present study was to analyze the health impairment risk of taking the counterfeit PDE5Is and the convenience of obtaining the counterfeits in Japan, using an economic methodology in order to work out countermeasures for reducing the health impairment risk. Information was obtained by interviewing employees of pharmaceutical and chemical corporations in Japan. The size of the market for counterfeit PDE5Is in Japan was recently estimated to be about 2.5 times larger than that of genuine PDE5Is. The price of the counterfeits in their market is reported to be nearly equal to that of the genuine PDE5Is. An outbreak of severe hypoglycemia among users of counterfeit PDE5Is containing an antidiabetic drug in Singapore was reported in 2008, and seven patients remained comatose as a result of prolonged neuroglycopenia. Four of them subsequently died, so the health impairment risk due to counterfeit PDE5Is should not be ignored. In order to obtain a genuine PDE5I in Japan, a patient must be examined and have a prescription written at a medical institution, and buy it at a dispensing pharmacy. Focusing on the health impairment risk due to counterfeit PDE5Is and the convenience of obtaining the counterfeits in Japan, we analyzed the effects on the prices and quantities of PDE5Is in the market from demand and supply curves, using an economic methodology. From the analysis, it was shown that the health impairment risk due to the counterfeits is underestimated in the market in Japan. Physicians should warn their patients not to buy counterfeit PDE5Is, and when they write a prescription for purchasing genuine PDE5Is, should inform their patients of the severe health problems that occurred in Singapore. The present economic analysis indicates that the health impairment risk due to counterfeit PDE5Is is underestimated in the market in Japan. Clarification of the underestimation of the severe health impairment risk due to counterfeits is important.

Religion, health and medicine in African Americans: implications for physicians.

PubMed

Levin, Jeff; Chatters, Linda M; Taylor, Robert Joseph

2005-02-01

Recent years have seen a burgeoning of research and writing on the connections between religion and health. The very best of this work comes from epidemiologic studies of African Americans. This paper summarizes results of these investigations, including findings identifying effects of religious participation on both physical and mental health outcomes. Evidence mostly supports a protective religious effect on morbidity and mortality and on depressive symptoms and overall psychological distress among African Americans. This paper also carefully discusses what the results of these studies mean and do not mean, an important consideration due to frequent misinterpretations of findings on this topic. Because important distinctions between epidemiologic and clinical studies tend to get glossed over, reports of religion-health associations oftentimes draw erroneous conclusions that foster unrealistic expectations about the role of faith and spirituality in health and healing. Finally, implications are discussed for clinical practice, medical education and public health.

Religion, health and medicine in African Americans: implications for physicians.

PubMed Central

Levin, Jeff; Chatters, Linda M.; Taylor, Robert Joseph

2005-01-01

Recent years have seen a burgeoning of research and writing on the connections between religion and health. The very best of this work comes from epidemiologic studies of African Americans. This paper summarizes results of these investigations, including findings identifying effects of religious participation on both physical and mental health outcomes. Evidence mostly supports a protective religious effect on morbidity and mortality and on depressive symptoms and overall psychological distress among African Americans. This paper also carefully discusses what the results of these studies mean and do not mean, an important consideration due to frequent misinterpretations of findings on this topic. Because important distinctions between epidemiologic and clinical studies tend to get glossed over, reports of religion-health associations oftentimes draw erroneous conclusions that foster unrealistic expectations about the role of faith and spirituality in health and healing. Finally, implications are discussed for clinical practice, medical education and public health. PMID:15712787

Assessment of zero gravity effects on space worker health and safety

NASA Technical Reports Server (NTRS)

1980-01-01

One objective of the study is to assess the effects of all currently known deviations from normal of medical, physiological, and biochemical parameters which appear to be due to zero gravity (zero-g) environment and to acceleration and deceleration to be experienced, as outlined in the references Solar Power Satellites (SPS) design, by space worker. Study results include identification of possible health or safety effects on space workers either immediate or delayed due to the zero gravity environment and acceleration and deceleration; estimation of the probability that an individual will be adversely affected; description of the possible consequence to work efficiency in persons adversely affected; and description of the possible/probable consequences to immediate and future health of individuals exposed to this environment. A research plan, which addresses the uncertainties in current knowledge regarding the health and safety hazards to exposed SPS space workers, is presented. Although most adverse affects experienced during space flight soon disappeared upon return to the Earth's environment, there remains a definite concern for the long-term effects to SPS space workers who might spend as much as half their time in space during a possible five year career period. The proposed 90 day up/90 day down cycle, coupled with the fact that most of the effects of weightlessness may persist throughout the flight along with the realization that recovery may occupy much of the terrestrial stay, may keep the SPS workers in a deviant physical condition or state of flux for 60 to 100% of their five year career.

Secondary analysis of a scoping review of health promotion interventions for persons with disabilities: Do health promotion interventions for people with mobility impairments address secondary condition reduction and increased community participation?

PubMed

White, Glen W; Gonda, Chiaki; Peterson, Jana J; Drum, Charles E

2011-04-01

Secondary conditions can have very serious outcomes for people with physical disabilities. Such consequences can range from immobility due to pressure sores to withdrawal and isolation due to depression, decreasing participation in the community. To further investigate these assumptions, we conducted a review of the literature on health promotion interventions that include physical activity for adults with disabilities to determine whether they have a positive effect on the reduction of secondary conditions and increased community participation. We conducted a secondary analysis of the results of a scoping review of health promotion programs containing physical activity for people with mobility impairments (N = 5). This secondary analysis examined the relationship between health promotion containing physical activity and prevention of secondary conditions among people with various physical disabilities. We further examined evidence and effects of independent variables on the outcome of increased community participation for study participants. The outcomes from this investigation are varied, with 2 studies providing evidence of reducing secondary conditions while another shared anecdotal statements referencing a decrease in secondary conditions. Of the remaining 2 studies in this paper, 1 showed no intervention effect on reducing secondary conditions while the remaining study reported an increase in secondary conditions. Regarding increased participation in the community, 2 of 5 studies directly reported on these outcomes, while increased community participation was referenced in another 2 articles, but without any data presented. The final study did not report on any post intervention in the community. This review demonstrates that research on health promotion interventions containing physical activity lack description about whether such interventions help reduce or prevent secondary conditions. Additionally, the review shows that further work is needed in terms of sustaining health programs effects beyond the initial proximal activity gains, with attention given toward more distal outcomes of increased participant participation in the community. Copyright © 2011. Published by Elsevier Inc.

Health effects of Vaccinium myrtillus L.: evaluation of efficacy and technological strategies for preservation of active ingredients.

PubMed

Smeriglio, Antonella; Monteleone, Domenico; Trombetta, Domenico

2014-01-01

Bilberries are a rich dietary source of various phytonutrients, including anthocyanins which contribute greatly to their antioxidant capacity and have demonstrated a broad spectrum of biomedical functions. These include protection against cardiovascular disorders, age-induced oxidative stress, inflammatory responses and several degenerative diseases. Berry anthocyanins also improve neuronal and cognitive brain functions, ocular health as well as protecting genomic DNA integrity. In recent years, sales of many dietary supplements/pharmaceutical products containing anthocyanins in various dosages and formulations have been made by advertising their wide range of beneficial effects. However, there is a heightened risk of distributing deteriorated formulations to consumers due to lax regulations, in particular those applicable to phytochemical characterization and extract standardization, and in terms of quality regarding the stability of anthocyanins. Anthocyanin pigments readily degrade during industrial processing and this can have a dramatic impact on color quality and may also affect nutritional/pharmaceutical properties. This review aims to summarize the main health effects of bilberry extract used in several food supplements/pharmaceutical formulations focusing on some important aspects of anthocyanin degradation during processing and storage. It will also describe the main technological strategies which can give active ingredients greater stability, solubility and dispersibility in order to enhance formulation quality which is of great interest to the consumer and industry due to its direct and indirect impact on consumer health.

Cost-effectiveness of using Polyheal compared with surgery in the management of chronic wounds with exposed bones and/or tendons due to trauma in France, Germany and the UK.

PubMed

Guest, Julian F; Sladkevicius, Erikas; Panca, Monica

2015-02-01

The objective of this study was to assess the cost-effectiveness of Polyheal compared with surgery in treating chronic wounds with exposed bones and/or tendons (EB&T) due to trauma in France, Germany and the UK, from the perspective of the payers. Decision models were constructed depicting the management of chronic wounds with EB&T and spanned the period up to healing or up to 1 year. The models considered the decision by a plastic surgeon to treat these wounds with Polyheal or surgery and was used to estimate the relative cost-effectiveness of Polyheal at 2010/2011 prices. Using Polyheal instead of surgery is expected to increase the probability of healing from 0·93 to 0·98 and lead to a total health-care cost of €7984, €7517 and €8860 per patient in France, Germany and the UK, respectively. Management with surgery is expected to lead to a total health-care cost of €12 300, €18 137 and €11 330 per patient in France, Germany and the UK, respectively. Hence, initial treatment with Polyheal instead of surgery is expected to lead to a 5% improvement in the probability of healing and a substantial decrease in health-care costs of 35%, 59% and 22% in France, Germany and the UK, respectively. Within the models' limitations, Polyheal potentially affords the public health-care system in France, Germany and the UK a cost-effective treatment for chronic wounds with EB&T due to trauma, when compared with surgery. However, this will be dependent on Polyheal's healing rate in clinical practice when it becomes routinely available. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Hydraulic fracturing for natural gas: impact on health and environment.

PubMed

Carpenter, David O

2016-03-01

Shale deposits exist in many parts of the world and contain relatively large amounts of natural gas and oil. Recent technological developments in the process of horizontal hydraulic fracturing (hydrofracturing or fracking) have suddenly made it economically feasible to extract natural gas from shale. While natural gas is a much cleaner burning fuel than coal, there are a number of significant threats to human health from the extraction process as currently practiced. There are immediate threats to health resulting from air pollution from volatile organic compounds, which contain carcinogens such as benzene and ethyl-benzene, and which have adverse neurologic and respiratory effects. Hydrogen sulfide, a component of natural gas, is a potent neuro- and respiratory toxin. In addition, levels of formaldehyde are elevated around fracking sites due to truck traffic and conversion of methane to formaldehyde by sunlight. There are major concerns about water contamination because the chemicals used can get into both ground and surface water. Much of the produced water (up to 40% of what is injected) comes back out of the gas well with significant radioactivity because radium in subsurface rock is relatively water soluble. There are significant long-term threats beyond cancer, including exacerbation of climate change due to the release of methane into the atmosphere, and increased earthquake activity due to disruption of subsurface tectonic plates. While fracking for natural gas has significant economic benefits, and while natural gas is theoretically a better fossil fuel as compared to coal and oil, current fracking practices pose significant adverse health effects to workers and near-by residents. The health of the public should not be compromized simply for the economic benefits to the industry.

Examining the Effectiveness of Mindfulness Meditation for Chronic Pain Management in Combat Veterans with Traumatic Brain Injury

DTIC Science & Technology

2013-01-01

third had commented on issues related to his work schedule before losing contact with the researchers. Finally, one patient was excluded due to a...M., Keller, S., & Ware, J. E. (2001). Sleep problems, health- related quality of life, work functioning and health care utilization among the...et al., 2006). Military deployment to a war zone may significantly alter health status and quality of life, elevating the risk of long -term physical

State of the Science Workshop to Discuss Environmental Health and Protection: Personalized Tools to Support Potential and Actual Health Hazards in the Megacity Operational Environment

DTIC Science & Technology

2015-10-27

term health effects from certain exposures during deployment. Specifically, poor air quality, due to trash incineration, smoke from burning oil ...focusing on rare and unanticipated environmental exposure events. The specific focus of environmental exposure episodes included oil wells and water...technology, and the informatics capability to handle these “big” data, do not currently exist and should be considered as a possible solution towards

CONTAINMENT TECHNOLOGIES

EPA Science Inventory

Hazardous waste containment's primary objective is to isolate wastes deemed as hazardous from man and environmental systems of air, soil, and water. Hazardous wastes differ from other waste classifications due to their increased potential to cause human health effects or environ...

Fiber optic sensors for infrastructure applications : final report.

DOT National Transportation Integrated Search

1998-02-01

Fiber optic sensor technology offers the possibility of implementing "nervous systems" for infrastructure elements that allow high performance, cost effective health and damage assessment systems to be achieved. This is possible, largely due to syner...

Health and cost impact of air pollution from biomass burning over the United States

NASA Astrophysics Data System (ADS)

Eslami, E.; Sadeghi, B.; Choi, Y.

2017-12-01

Effective assessment of health and cost effects of air pollution associated with wildfire events is critical for supporting sustainable management and policy analysis to reduce environmental damages. Since biomass burning events result in higher ozone, PM2.5, and NOx concentration values in urban regions due to long-range transport, preliminary results indicated that wildfire events cause a considerable increase in incident estimates and costs. This study aims to evaluate the health and cost impact of biomass burning events over the continental United States using combined air quality and health impact modeling. To meet this goal, a comprehensive air quality modeling scenarios containing biomass burning emissions were conducted using the Community Multiscale Air Quality (CMAQ) modeling system from 2011 to 2014 with a spatial resolution of 12 km. The modeling period includes fire seasons between April and October over the course of four years. By using modeled pollutants concentrations, the USEPA's GIS-based computer program Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) provides an inclusive figure of health and cost impact caused by changing gaseous and particulate air pollution due to fire events. The basis of BenMAP-CE is the use of a damage-function approach to estimate the health impact of an applied change in air quality by comparing a biomass burning scenario (the one that includes wildfire events) with a baseline scenario (without biomass emissions). This approach considers several factors containing population, exposure to the pollutants, adverse health effects of a particular pollutant, and economic costs. Hence, this study made it capable of showing how biomass burning across U.S. influences people's health in different months, seasons, and regions. Besides, the cost impact of the wildfire events during study periods has also been estimated at both national and regional levels. The results of this study demonstrate the BenMAP-CE can be successfully utilized as a proper tool to obtain health and cost impact of biomass burning events.

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.

Health Information Needs and Health Seeking Behavior During the 2014-2016 Ebola Outbreak: A Twitter Content Analysis.

PubMed

Odlum, Michelle; Yoon, Sunmoo

2018-03-23

For effective public communication during major disease outbreaks like the 2014-2016 Ebola epidemic, health information needs of the population must be adequately assessed. Through content analysis of social media data, like tweets, public health information needs can be effectively assessed and in turn provide appropriate health information to address such needs. The aim of the current study was to assess health information needs about Ebola, at distinct epidemic time points, through longitudinal tracking. Natural language processing was applied to explore public response to Ebola over time from July 2014 to March 2015. A total 155,647 tweets (unique 68,736, retweet 86,911) mentioning Ebola were analyzed and visualized with infographics. Public fear, frustration, and health information seeking regarding Ebola-related global priorities were observed across time. Our longitudinal content analysis revealed that due to ongoing health information deficiencies, resulting in fear and frustration, social media was at times an impediment and not a vehicle to support health information needs. Content analysis of tweets effectively assessed Ebola information needs. Our study also demonstrates the use of Twitter as a method for capturing real-time data to assess ongoing information needs, fear, and frustration over time.

The role of nutrition labels and advertising claims in altering consumers' evaluation and choice.

PubMed

Bialkova, Svetlana; Sasse, Lena; Fenko, Anna

2016-01-01

Despite policy efforts, consumers' well-informed healthful choice is a challenge. Due to increasing number of benefit claims advertising taste or health front of pack (FOP), consumers face the dilemma to trade taste for health. To understand the mechanisms underlying food evaluation, this study investigates the health-pleasure trade-off and its effect on consumers' choice. 240 EU consumers took part in a taste experiment, after being presented with the product FOP. Half of the products carried a nutrition label FOP, respectively, reduced fat for potato chips, reduced sugar for cereal bars. Further, one third of the products carried health benefit claim, one third taste benefit claim, and one third no additional claim FOP. Attention to information and its effect on experienced taste, health perception and the buying intention were measured. The results show that the message displayed FOP altered consumers evaluation and choice. The effectiveness of the FOP message further depended on consumers' health motivation and the healthfulness perception of carrier products. The outcomes are summarized in a framework of health-pleasure trade-off. Current findings call for the establishment of standards to avoid the use of misleading information FOP. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health, Human Capital, and African American Migration Before 1910

PubMed Central

Logan, Trevon D.

2009-01-01

Using both IPUMS and the Colored Troops Sample of the Civil War Union Army Data, I estimate the effects of literacy and health on the migration propensities of African Americans from 1870 to 1910. I find that literacy and health shocks were strong predictors of migration and the stock of health was not. There were differential selection propensities based on slave status—former slaves were less likely to migrate given a specific health shock than free blacks. Counterfactuals suggest that as much as 35 percent of the difference in the mobility patterns of former slaves and free blacks is explained by differences in their human capital, and more than 20 percent of that difference is due to health alone. Overall, the selection effect of literacy on migration is reduced by one-tenth to one-third once health is controlled for. The low levels of human capital accumulation and rates of mobility for African Americans after the Civil War are partly explained by the poor health status of slaves and their immediate descendants. PMID:20161107

Strategic use of communication to market cancer prevention and control to vulnerable populations.

PubMed

Kreps, Gary L

2008-01-01

There are significant challenges to communicating relevant cancer prevention and control information to health care consumers due both to the complexities of the health information to be communicated and the complexities of health communication, especially with vulnerable populations. The need for effective communication about cancer risks, early detection, prevention, care, and survivorship is particularly acute, yet also tremendously complex, for reaching vulnerable populations, those groups of people who are most likely to suffer significantly higher levels of morbidity and mortality from cancers than other segments of the population. These vulnerable populations, typically the poorest, lowest educated, and most disenfranchised members of modern society, are heir to serious cancer-related health disparities. Vulnerable populations often have health literacy difficulties, cultural barriers, and economic challenges to accessing and making sense of relevant health information. This paper examines these challenges to communicating relevant information to vulnerable populations and suggests strategies for effectively using different communication media for marketing cancer prevention and control to reduce health disparities and promote public health.

[International experiences and trends in health care models for the elderly].

PubMed

Veras, Renato Peixoto

2012-01-01

The profound socio-economic transformation occurring in Brazil is also driven by the demographic changes. Health expenditures will increase due to the aging population and increased use of health services. The National Agency for Supplementary Health published a resolution that encourages the participation of beneficiaries in health insurance programs for active aging, with the possibility of discounts in fees. Thus, the elderly now receive cash benefits to adhere to preventive health programs and early detection of diseases. We assessed the programs in the U.S. and UK, analyzing their successes and failings, which may assist in the formulation of health policies that are more appropriate and more cost-effective for the Brazilian elderly. This Opinion article seeks to demonstrate to Brazilian operators that it is time to change and to elicit discussions about the need for new strategies. A creative focus should be directed to the care of the elderly, who are the ones who suffer the effects of their own weakness and demand more health services.

[Selection or Better Service - Why are those with Private Health Insurance Healthier than those Covered by the Public Insurance System?

PubMed

Stauder, J; Kossow, T

2017-03-01

From previous research we know that privately insured people in Germany are healthier than those covered by the compulsory public health insurance system. Whether this difference is due to a selection of healthier people into the private health insurance or a causal effect in the sense that private health insurance better helps their clients to stay in good health than public insurances do is not clear. Using panel regression based on the German Socioeconomic Panel (GSOEP), we show that health status is better for individuals who have bought a private health insurance certificate since 2002 compared to those who remained within the public insurance system. Depending on age at joining the insurance system, the health gap between privately and publicly insured people is widening with time since joining the private insurance system. We argue that these findings point to a causal effect. © Georg Thieme Verlag KG Stuttgart · New York.

Who pays for healthcare in Bangladesh? An analysis of progressivity in health systems financing.

PubMed

Molla, Azaher Ali; Chi, Chunhuei

2017-09-06

The relationship between payments towards healthcare and ability to pay is a measure of financial fairness. Analysis of progressivity is important from an equity perspective as well as for macroeconomic and political analysis of healthcare systems. Bangladesh health systems financing is characterized by high out-of-pocket payments (63.3%), which is increasing. Hence, we aimed to see who pays what part of this high out-of-pocket expenditure. To our knowledge, this was the first progressivity analysis of health systems financing in Bangladesh. We used data from Bangladesh Household Income and Expenditure Survey, 2010. This was a cross sectional and nationally representative sample of 12,240 households consisting of 55,580 individuals. For quantification of progressivity, we adopted the 'ability-to-pay' principle developed by O'Donnell, van Doorslaer, Wagstaff, and Lindelow (2008). We used the Kakwani index to measure the magnitude of progressivity. Health systems financing in Bangladesh is regressive. Inequality increases due to healthcare payments. The differences between the Gini coefficient and the Kakwani index for all sources of finance are negative, which indicates regressivity, and that financing is more concentrated among the poor. Income inequality increases due to high out-of-pocket payments. The increase in income inequality caused by out-of-pocket payments is 89% due to negative vertical effect and 11% due to horizontal inequity. Our findings add substantial evidence of health systems financing impact on inequitable financial burden of healthcare and income. The heavy reliance on out-of-pocket payments may affect household living standards. If the government and people of Bangladesh are concerned about equitable financing burden, our study suggests that Bangladesh needs to reform the health systems financing scheme.

The World Health Organization's Health Promoting Schools framework: a Cochrane systematic review and meta-analysis.

PubMed

Langford, Rebecca; Bonell, Christopher; Jones, Hayley; Pouliou, Theodora; Murphy, Simon; Waters, Elizabeth; Komro, Kelli; Gibbs, Lisa; Magnus, Daniel; Campbell, Rona

2015-02-12

Healthy children achieve better educational outcomes which, in turn, are associated with improved health later in life. The World Health Organization's Health Promoting Schools (HPS) framework is a holistic approach to promoting health and educational attainment in school. The effectiveness of this approach has not yet been rigorously reviewed. We searched 20 health, education and social science databases, and trials registries and relevant websites in 2011 and 2013. We included cluster randomised controlled trials. Participants were children and young people aged four to 18 years attending schools/colleges. HPS interventions had to include the following three elements: input into the curriculum; changes to the school's ethos or environment; and engagement with families and/or local communities. Two reviewers identified relevant trials, extracted data and assessed risk of bias. We grouped studies according to the health topic(s) targeted. Where data permitted, we performed random-effects meta-analyses. We identified 67 eligible trials tackling a range of health issues. Few studies included any academic/attendance outcomes. We found positive average intervention effects for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small. On average across studies, we found little evidence of effectiveness for zBMI (BMI, standardized for age and gender), and no evidence for fat intake, alcohol use, drug use, mental health, violence and bullying others. It was not possible to meta-analyse data on other health outcomes due to lack of data. Methodological limitations were identified including reliance on self-reported data, lack of long-term follow-up, and high attrition rates. This Cochrane review has found the WHO HPS framework is effective at improving some aspects of student health. The effects are small but potentially important at a population level.

Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan

PubMed Central

Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

2015-01-01

Background The Afghan population suffers from a long standing armed conflict. We investigated patients’ experiences of their access to and use of the health services. Methods Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. Results To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Conclusions Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. PMID:25492948

The Effect of Requiring Private Employers to Extend Health Benefit Eligibility to Same-Sex Partners of Employees: Evidence from California

ERIC Educational Resources Information Center

Buchmueller, Thomas C.; Carpenter, Christopher S.

2012-01-01

Health disparities related to sexual orientation are well documented and may be due to unequal access to a partner's employer-sponsored insurance (ESI). We provide the literature's first evaluation of legislation enacted by California in 2005 that required private employers within the state to treat employees in committed same-sex relationships in…

Can donor aid for health be effective in a poor country? Assessment of prerequisites for aid effectiveness in Uganda.

PubMed

Juliet, Nabyonga Orem; Freddie, Ssengooba; Okuonzi, Sam

2009-10-22

Inadequate funding for health is a challenge to attaining health-related Millennium Development Goals. Significant increase in health funding was recommended by the Commission for Macroeconomics and Health. Indeed Official Development Assistance has increased significantly in Uganda. However, the effectiveness of donor aid has come under greater scrutiny. This paper scrutinizes the prerequisites for aid effectiveness. The objective of the study was to assess the prerequisites for effectiveness of donor aid, specifically, its proportion to overall health funding, predictability, comprehensiveness, alignment to country priorities, and channeling mechanisms. Secondary data obtained from various official reports and surveys were analyzed against the variables mentioned under objectives. This was augmented by observations and participation in discussions with all stakeholders to discuss sector performance including health financing. Between 2004-2007, the level of aid increased from US$6 per capita to US$11. Aid was found to be unpredictable with expenditure varying between 174-8722;360 percent from budgets. More than 50% of aid was found to be off budget and unavailable for comprehensive planning. There was disproportionate funding for some items such as drugs. Key health system elements such as human resources and infrastructure have not been given due attention in investment. The government's health funding from domestic sources grew only modestly which did not guarantee fiscal sustainability. Although donor aid is significant there is need to invest in the prerequisites that would guarantee its effective use.

Pros and cons of CLA consumption: an insight from clinical evidences.

PubMed

Benjamin, Sailas; Prakasan, Priji; Sreedharan, Sajith; Wright, Andre-Denis G; Spener, Friedrich

2015-01-01

This comprehensive review critically evaluates whether supposed health benefits propounded upon human consumption of conjugated linoleic acids (CLAs) are clinically proven or not. With a general introduction on the chemistry of CLA, major clinical evidences pertaining to intervention strategies, body composition, cardio-vascular health, immunity, asthma, cancer and diabetes are evaluated. Supposed adverse effects such as oxidative stress, insulin resistance, irritation of intestinal tract and milk fat depression are also examined. It seems that no consistent result was observed even in similar studies conducted at different laboratories, this may be due to variations in age, gender, racial and geographical disparities, coupled with type and dose of CLA supplemented. Thus, supposed promising results reported in mechanistic and pre-clinical studies cannot be extrapolated with humans, mainly due to the lack of inconsistency in analyses, prolonged intervention studies, follow-up studies and international co-ordination of concerted studies. Briefly, clinical evidences accumulated thus far show that CLA is not eliciting significantly promising and consistent health effects so as to uphold it as neither a functional nor a medical food.

Effects of game-based virtual reality on health-related quality of life in chronic stroke patients: A randomized, controlled study.

PubMed

Shin, Joon-Ho; Bog Park, Si; Ho Jang, Seong

2015-08-01

In the present study, we aimed to determine whether game-based virtual reality (VR) rehabilitation, combined with occupational therapy (OT), could improve health-related quality of life, depression, and upper extremity function. We recruited 35 patients with chronic hemiparetic stroke, and these participants were randomized into groups that underwent VR rehabilitation plus conventional OT, or the same amount of conventional OT alone, for 20 sessions over 4 weeks. Compared to baseline, the VR rehabilitation plus OT group exhibited significantly improved role limitation due to emotional problems (p=0.047). Compared to baseline, both groups also exhibited significantly improved depression (p=0.017) and upper extremity function (p=0.001), although the inter-group differences were not significant. However, a significant inter-group difference was observed for role limitation due to physical problems (p=0.031). Our results indicate that game-based VR rehabilitation has specific effects on health-related quality of life, depression, and upper extremity function among patients with chronic hemiparetic stroke. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are German patients burdened by the practice charge for physician visits ('Praxisgebuehr')? A cross sectional analysis of socio-economic and health related factors

PubMed Central

Rückert, Ina-Maria; Böcken, Jan; Mielck, Andreas

2008-01-01

Background In 2004, a practice charge for physician visits ('Praxisgebuehr') was implemented in the German health care system, mainly in order to reduce expenditures of sickness funds by reducing outpatient physician visits. In the statutory sickness funds, all adults now have to pay € 10 at their first physician visit in each 3 month period, except for vaccinations and preventive services. This study looks at the effect of this new patient fee on delaying or avoiding physician visits, with a special emphasis on different income groups. Methods Six representative surveys (conducted between 2004 and 2006) of the Bertelsmann Healthcare Monitor were analysed, comprising 7,769 women and men aged 18 to 79 years. The analyses are based on stratified analyses and logistic regression models, including a focus on the subgroup having a chronic disease. Results Two results can be highlighted. First, avoiding or delaying a physician visit due to this fee is seen most often among younger and healthier adults. Second, those in the lowest income group are much more affected in this way than the better of. The multivariate analysis in the subgroup of respondents having a chronic disease shows, for example, that this reaction is reported 2.45 times more often in the lowest income group than in the highest income group (95% CI: 1.90–3.15). Conclusion The analyses indicate that the effects of the practice charge differ by socio-economic group. It would be important to assess these effects in more detail, especially the effects on health care quality and health outcomes. It can be assumed, however, that avoiding or delaying physician visits jeopardizes both, and that health inequalities are increasing due to the practice charge. PMID:19014476

[Prevention of circulatory system diseases in underground mining workers].

PubMed

Vlasova, E M; Alexeyev, M B; Shliapnikov, D M; Nosov, A E; Barannikov, V G

2015-01-01

The article covers results of preventive measures in workers engaged into underground mining. Those measures are aimed to prevent occupationally mediated health disorders resulting in circulatory diseases. The prophylaxis was proven effective on premorbid condition--that was demonstrated in reliable decrease of cause-effect relationship intensity for health disorders in workers subjected to prophylactic measures. Transitory disablement morbidity due to cicrulatory system diseases decreased. Situational modelling of risk changes for the studied group demonstrated changes of diseases risk under medical prophylactic measures. After the prophylaxis, the risk demonstrated 3.1 times decrease.

Effects of iodine deficiency in pregnancy.

PubMed

Pearce, Elizabeth N

2012-06-01

Dietary iodine requirements are increased in pregnancy due to increased thyroid hormone production, increased renal iodine losses, and fetal iodine requirements. Adverse effects of iodine deficiency in pregnancy include maternal and fetal goiter, cretinism, intellectual impairments, neonatal hypothyroidism, and increased pregnancy loss and infant. Dietary iodine requirements remain increased in lactation due to the concentration of iodine in breast milk. Iodine deficiency remains a significant global public health problem. Excess iodine ingestion in pregnancy, while a relatively uncommon problem, may also have adverse fetal effects. However, the safe upper limit for chronic iodine ingestion in pregnancy and lactation is not currently well defined. Copyright © 2012 Elsevier GmbH. All rights reserved.

Lessons on humanitarian assistance.

PubMed Central

Gracia Antequera, M.; Morales Suárez-Varela, M.

1999-01-01

Conflict almost completely destroyed Rwanda's infrastructure in 1994. Natural disasters, as well as disasters caused by humans, have severely challenged humanitarian aid available within the country. In this study, we have analysed the experiences of nongovernmental organizations since the summer of 1994 to evaluate how these difficulties may be overcome. One of the problems identified has been restrictions on the ability to introduce effective health planning due to the poor quality of available local information. The implementation of effective plans that show due consideration to the environment and society is clearly necessary. Effective monitoring and detailed observation are identified as being essential to the continuity of existing humanitarian assistance. PMID:10444885

Wi-Fi and health: review of current status of research.

PubMed

Foster, Kenneth R; Moulder, John E

2013-12-01

This review summarizes the current state of research on possible health effects of Wi-Fi (a commercial name for IEEE 802.11-compliant wireless networking). In response to public concerns about health effects of Wi-Fi and wireless networks and calls by government agencies for research on possible health and safety issues with the technology, a considerable amount of technology-specific research has been completed. A series of high quality engineering studies have provided a good, but not complete, understanding of the levels of radiofrequency (RF) exposure to individuals from Wi-Fi. The limited number of technology-specific bioeffects studies done to date are very mixed in terms of quality and outcome. Unequivocally, the RF exposures from Wi-Fi and wireless networks are far below U.S. and international exposure limits for RF energy. While several studies report biological effects due to Wi-Fi-type exposures, technical limitations prevent drawing conclusions from them about possible health risks of the technology. The review concludes with suggestions for future research on the topic.

Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions.

PubMed

Farhat, S C L; Paulo, R L P; Shimoda, T M; Conceição, G M S; Lin, C A; Braga, A L F; Warth, M P N; Saldiva, P H N

2005-02-01

In order to assess the effect of air pollution on pediatric respiratory morbidity, we carried out a time series study using daily levels of PM10, SO2, NO2, ozone, and CO and daily numbers of pediatric respiratory emergency room visits and hospital admissions at the Children's Institute of the University of Sao Paulo Medical School, from August 1996 to August 1997. In this period there were 43,635 hospital emergency room visits, 4534 of which were due to lower respiratory tract disease. The total number of hospital admissions was 6785, 1021 of which were due to lower respiratory tract infectious and/or obstructive diseases. The three health end-points under investigation were the daily number of emergency room visits due to lower respiratory tract diseases, hospital admissions due to pneumonia, and hospital admissions due to asthma or bronchiolitis. Generalized additive Poisson regression models were fitted, controlling for smooth functions of time, temperature and humidity, and an indicator of weekdays. NO2 was positively associated with all outcomes. Interquartile range increases (65.04 microg/m3) in NO2 moving averages were associated with an 18.4% increase (95% confidence interval, 95% CI = 12.5-24.3) in emergency room visits due to lower respiratory tract diseases (4-day moving average), a 17.6% increase (95% CI = 3.3-32.7) in hospital admissions due to pneumonia or bronchopneumonia (3-day moving average), and a 31.4% increase (95% CI = 7.2-55.7) in hospital admissions due to asthma or bronchiolitis (2-day moving average). The study showed that air pollution considerably affects children's respiratory morbidity, deserving attention from the health authorities.

Mental health first aid training by e-learning: a randomized controlled trial.

PubMed

Jorm, Anthony F; Kitchener, Betty A; Fischer, Julie-Anne; Cvetkovski, Stefan

2010-12-01

Mental Health First Aid training is a course for the public that teaches how to give initial help to a person developing a mental health problem or in a mental health crisis. The present study evaluated the effects of Mental Health First Aid training delivered by e-learning on knowledge about mental disorders, stigmatizing attitudes and helping behaviour. A randomized controlled trial was carried out with 262 members of the Australian public. Participants were randomly assigned to complete an e-learning CD, read a Mental Health First Aid manual or be in a waiting list control group. The effects of the interventions were evaluated using online questionnaires pre- and post-training and at 6-months follow up. The questionnaires covered mental health knowledge, stigmatizing attitudes, confidence in providing help to others, actions taken to implement mental health first aid and participant mental health. Both e-learning and the printed manual increased aspects of knowledge, reduced stigma and increased confidence compared to waiting list. E-learning also improved first aid actions taken more than waiting list, and was superior to the printed manual in reducing stigma and disability due to mental ill health. Mental Health First Aid information received by either e-learning or printed manual had positive effects, but e-learning was better at reducing stigma.

[Health policy interventions: the pathway to public health].

PubMed

Andersen, Karl; Gudnason, Vilmundur

2013-03-01

Chronic non-communicable diseases (NCDs) are currently the main cause of premature death and disability in the world. Most of these NCDs are due to unhealthy lifestyle choices i.e. tobacco, unhealthy diet, lack of physical exercise and alcohol consumption. Studies have shown that health policy interventions aiming at improving diet and physical activity and reducing tobacco consumption are inexpensive, effective and cost saving. In this paper we address the political health policy interventions that have been shown to improve public health. We discuss some of the theories of behavioral economics which explain the processes involved in our every-day choices regarding lifestyle and diet.

Prescribed fire and timber harvest effects on terrestrial salamander abundance, detectability, and microhabitat use

Treesearch

Katherine M. O' Donnell; Frank R. Thompson; Raymond D. Semlitsch

2015-01-01

Prescribed fire and timber harvest are anthropogenic disturbances that modify resource availability and ecosystem structure, and can affect wildlife both directly and indirectly. Terrestrial salamanders are effective indicators of forest health due to their high abundance and sensitivity to microclimatic conditions. Given their ecological importance, it is critical to...

Direct effect of acaricides on pathogen loads and gene expression levels of honey bee Apis mellifera

USDA-ARS?s Scientific Manuscript database

The effect of using miticides to control varroa mites has long been a concern to the beekeeping industry due to unintended negative impacts on honey bee health. Irregular ontogenesis, immune defense suppression, impairment of normal behavior are some of the described symptoms for the use of pestici...

Making Tobacco Education Relevant to the School Age Child.

ERIC Educational Resources Information Center

Seffrin, John R.

1981-01-01

Due to the trend toward more smoking among the young and to the effect of smoking on human health and life, educators need to devise effective antismoking programs as part of the secondary curriculum. The real problem lies in educating youths prior to the age at which the decision to smoke is made. (JN)

Single particle effects, Biostack, and risk evaluation - Studies on the radiation risk from Galactic cosmic rays

NASA Technical Reports Server (NTRS)

Curtis, Stanley B.

1993-01-01

The possible health risks posed by Galactic cosmic rays, especially the possible heightened cancer risk, are examined. The results of the Biostack studies of the biological effects of high-energy cosmic rays are discussed. The biological mechanisms involved in possible harm due to cosmic rays are considered.

Differential Responses upon Inhalation Exposure to Biodiesel versus Diesel Exhaust on Oxidative Stress, Inflammatory and Immune Outcomes

EPA Science Inventory

Biodiesel (BD) exhaust may have reduced adverse health effects due to lower mass emissions and reduced production of hazardous compounds compared to diesel exhaust. To investigate this possibility, we compared adverse effects in lungs and liver of BALB/cJ mice after inhalation ex...

The relevance of theobromine for the beneficial effects of cocoa consumption.

PubMed

Martínez-Pinilla, Eva; Oñatibia-Astibia, Ainhoa; Franco, Rafael

2015-01-01

Cocoa consumption began in America and in the mid sixteenth Century it quickly spread to Europe. Beyond being considered a pleasant habit due to its rich sweet lingering taste, chocolate was considered a good nutrient and even a medicine. Traditionally, health benefits of cocoa have been related with the high content of antioxidants of Theobroma cocoa beans. However, the direct psychoactive effect due to methylxanthines in cocoa is notable. Theobromine and caffeine, in the proportions found in cocoa, are responsible for the liking of the food/beverage. These compounds influence in a positive way our moods and our state of alertness. Theobromine, which is found in higher amounts than caffeine, seems to be behind several effects attributed to cocoa intake. The main mechanisms of action are inhibition of phosphodiesterases and blockade of adenosine receptors. Further mechanisms are being explored to better understand the health benefits associated to theobromine consumption. Unlike what happens in other mammals -pets- included, theobromine is safe for humans and has fewer unwanted effects than caffeine. Therefore, theobromine deserves attention as one of the most attractive molecules in cocoa.

The relevance of theobromine for the beneficial effects of cocoa consumption

PubMed Central

Martínez-Pinilla, Eva; Oñatibia-Astibia, Ainhoa; Franco, Rafael

2015-01-01

Cocoa consumption began in America and in the mid sixteenth Century it quickly spread to Europe. Beyond being considered a pleasant habit due to its rich sweet lingering taste, chocolate was considered a good nutrient and even a medicine. Traditionally, health benefits of cocoa have been related with the high content of antioxidants of Theobroma cocoa beans. However, the direct psychoactive effect due to methylxanthines in cocoa is notable. Theobromine and caffeine, in the proportions found in cocoa, are responsible for the liking of the food/beverage. These compounds influence in a positive way our moods and our state of alertness. Theobromine, which is found in higher amounts than caffeine, seems to be behind several effects attributed to cocoa intake. The main mechanisms of action are inhibition of phosphodiesterases and blockade of adenosine receptors. Further mechanisms are being explored to better understand the health benefits associated to theobromine consumption. Unlike what happens in other mammals -pets- included, theobromine is safe for humans and has fewer unwanted effects than caffeine. Therefore, theobromine deserves attention as one of the most attractive molecules in cocoa. PMID:25750625

An overview of health-promoting compounds of broccoli (Brassica oleracea var. italica) and the effect of processing.

PubMed

Mahn, Andrea; Reyes, Alejandro

2012-12-01

Broccoli offers many heath-promoting properties owing to its content of antioxidant and anticarcinogenic compounds. The concentration and bioavailability of polyphenols, glucosinolates, sulforaphane and selenium depend on plant biochemistry, cultivation strategy and type of processing. In this article, the main biochemical properties of broccoli are reviewed regarding their health-promoting effects. Additionally, the way these properties are affected by processing is discussed. Steaming and drying result in an apparent increment of sulforaphane content as well as antioxidant activity, most likely due to an increase of the extractability of antioxidants and sulforaphane. Freezing and boiling diminish polyphenols concentration, mainly due to volatilization and leaching into the cooking water. In view of these results, the optimization of broccoli processing in order to maximize the content of bioactive compounds should be possible. The effect of processing on selenium compounds has been poorly studied so far, and therefore this topic should be investigated in the future. Finally, the effect of operating conditions in different drying processes on the content of bioactive compounds in broccoli should be investigated in a greater depth.

OXIDATIVE DNA DAMAGE IN DIESEL BUS MECHANICS

EPA Science Inventory

Rationale:

Diesel exposure has been associated with adverse health effects, including susceptibility to asthma, allergy and cancer. Previous epidemiological studies demonstrated increased cancer incidence among workers exposed to diesel. This is likely due to oxid...

Sorption of Organophosphorus Flame Retardants on Settled Dust

EPA Science Inventory

Organophosphorus flame retardants (OPFRs) are widely used as additives in industrial and consumer products such as electrical and electronic products, furniture, plastics, textiles, and building/construction materials. Due to human exposure and potential health effects, OPFRs inc...

Potential hazards due to food additives in oral hygiene products.

PubMed

Tuncer Budanur, Damla; Yas, Murat Cengizhan; Sepet, Elif

2016-01-01

Food additives used to preserve flavor or to enhance the taste and appearance of foods are also available in oral hygiene products. The aim of this review is to provide information concerning food additives in oral hygiene products and their adverse effects. A great many of food additives in oral hygiene products are potential allergens and they may lead to allergic reactions such as urticaria, contact dermatitis, rhinitis, and angioedema. Dental practitioners, as well as health care providers, must be aware of the possibility of allergic reactions due to food additives in oral hygiene products. Proper dosage levels, delivery vehicles, frequency, potential benefits, and adverse effects of oral health products should be explained completely to the patients. There is a necessity to raise the awareness among dental professionals on this subject and to develop a data gathering system for possible adverse reactions.

The effectiveness of contracting-out primary health care services in developing countries: a review of the evidence.

PubMed

Liu, Xingzhu; Hotchkiss, David R; Bose, Sujata

2008-01-01

The purpose of this study is to review the research literature on the effectiveness of contracting-out of primary health care services and its impact on both programme and health systems performance in low- and middle-income countries. Due to the heightened interest in improving accountability relationships in the health sector and in rapidly scaling up priority interventions, there is an increasing amount of interest in and experimentation with contracting-out. Overall, while the review of the selected studies suggests that contracting-out has in many cases improved access to services, the effects on other performance dimensions such as equity, quality and efficiency are often unknown. Moreover, little is known about the system-wide effects of contracting-out, which could be either positive or negative. Although the study results leave open the question of how contracting-out can be used as a policy tool to improve overall health system performance, the results indicate that the context in which contracting-out is implemented and the design features of the interventions are likely to greatly influence the chances for success.

Health shocks and retirement: the role of welfare state institutions.

PubMed

Datta Gupta, Nabanita; Larsen, Mona

2007-09-01

We investigate the effect of an acute health shock on retirement among elderly male workers in Denmark, 1991-1999, and in particular whether various welfare state programs and institutions impinge on the retirement effect. The results show that an acute health event increases the retirement chances of elderly male workers by 8%, and that this increase in the baseline retirement probability is not affected by eligibility to early exit programs and persists even after accounting for selection due to take-up of disability pension. Neither is it affected by the relatively long duration of sickness benefits in Denmark nor by the promotion of corporate social responsibility initiatives since the mid-1990s. In the late 1990s, however, the retirement rate following a health shock is reduced to 3% with the introduction of the subsidized employment program ( fleksjob ) but this effect is on the margin of being significant. For the most part, the retirement effect following a health shock seems to be immune to the availability of a multitude of government programs for older workers in Denmark.

Mold exposure and health effects following hurricanes Katrina and Rita.

PubMed

Barbeau, Deborah N; Grimsley, L Faye; White, LuAnn E; El-Dahr, Jane M; Lichtveld, Maureen

2010-01-01

The extensive flooding in the aftermath of Hurricanes Katrina and Rita created conditions ideal for indoor mold growth, raising concerns about the possible adverse health effects associated with indoor mold exposure. Studies evaluating the levels of indoor and outdoor molds in the months following the hurricanes found high levels of mold growth. Homes with greater flood damage, especially those with >3 feet of indoor flooding, demonstrated higher levels of mold growth compared with homes with little or no flooding. Water intrusion due to roof damage was also associated with mold growth. However, no increase in the occurrence of adverse health outcomes has been observed in published reports to date. This article considers reasons why studies of mold exposure after the hurricane do not show a greater health impact.

Work overload, burnout, and psychological ill-health symptoms: a three-wave mediation model of the employee health impairment process.

PubMed

de Beer, Leon T; Pienaar, Jaco; Rothmann, Sebastiaan

2016-07-01

The study reported here investigated the causal relationships in the health impairment process of employee well-being, and the mediating role of burnout in the relationship between work overload and psychological ill-health symptoms, over time. The research is deemed important due to the need for longitudinal evidence of the health impairment process of employee well-being over three waves of data. A quantitative survey design was followed. Participants constituted a longitudinal sample of 370 participants, at three time points, after attrition. Descriptive statistics and structural equation modeling methods were implemented. Work overload at time one predicted burnout at time two, and burnout at time two predicted psychological ill-health symptoms at time three. Indirect effects were found between work overload time one and psychological ill-health symptoms time three via burnout time two, and also between burnout time one and psychological ill-health symptoms time three, via burnout time two. The results provided supportive evidence for an "indirect-only" mediation effect, for burnout's causal mediation mechanism in the health impairment process between work overload and psychological ill-health symptoms.

Are health education interventions effective for the control and prevention of urogenital schistosomiasis in sub-Saharan Africa? A systematic review.

PubMed

Price, Amy; Verma, Arpana; Welfare, William

2015-04-01

An estimated 129 million people are infected with urogenital schistosomiasis in sub-Saharan Africa. Current control recommendations endorse mass administration of praziquantel. Health education is an important component of effective schistosomiasis prevention and control, but there has been limited research on its effectiveness. This paper reviews the effectiveness of health education as an intervention in the prevention and control of urogenital schistosomiasis in sub-Saharan Africa. The outcomes of interest were prevalence, incidence or transmission of schistosomiasis, behaviour change associated with infection, or changes in knowledge of the disease. The findings from this review suggest that health education has a beneficial impact on knowledge and understanding of schistosomiasis within the target groups. However, further research is needed due to the poor quality of the included studies. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

New evidence of the effects of education on health in the US: compulsory schooling laws revisited.

PubMed

Fletcher, Jason M

2015-02-01

Estimating the effects of education on health and mortality has been the subject of intense debate and competing findings and summaries. The original Lleras-Muney (2005) methods utilizing state compulsory schooling laws as instrumental variables for completed education and US data to establish effects of education on mortality have been extended to several countries, with mixed and often null findings. However, additional US studies have lagged behind due to small samples and/or lack of mortality information in many available datasets. This paper uses a large, novel survey from the AARP on several hundred thousand respondents to present new evidence of the effects of education on a variety of health outcomes. Results suggest that education may have a role in improving several dimensions of health, such as self reports, cardiovascular outcomes, and weight outcomes. Other results appear underpowered, suggesting that further use of this methodology may require even larger, and potentially unattainable, sample sizes in the US. Copyright © 2014 Elsevier Ltd. All rights reserved.

Enhancing Communication to Improve Patient Safety and to Increase Patient Satisfaction.

PubMed

Burgener, Audrey M

With the continuous rise of sentinel and adverse events due to ineffective communication, it is time for health care organizations to start implementing a focus on enhancing effective communication in which will, in turn, improve patient safety and experience, boosting the bottom line. This article identifies and discusses different communication protocols that can be used to enhance the consistency of more efficient and effective communication within a health care organization to overall improve patient care and patient satisfaction. The rising importance of patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems scores required by the Centers for Medicare and Medicaid Services are causing a shift in how hospitals evaluate and manage their health care organizations today. Following the situation-background-assessment-recommendation and acknowledge-introduce-duration-explain-thank protocols, as well as proper and effective training and educational programs, enhances more effective communication in health care organizations which improves patient safety and increases patient satisfaction.

"It's driving her mad": Gender differences in the effects of commuting on psychological health.

PubMed

Roberts, Jennifer; Hodgson, Robert; Dolan, Paul

2011-09-01

Commuting is an important component of time use for most working people. We explore the effects of commuting time on the psychological health of men and women. We use data from the British Household Panel Survey in a fixed effects framework that includes variables known to determine psychological health, as well as factors which may provide compensation for commuting such as income, job satisfaction and housing quality. Our results show that, even after these variables are considered, commuting has an important detrimental effect on the psychological health of women, but not men, and this result is robust to numerous different specifications. We explore explanations for this gender difference and can find no evidence that it is due to women's shorter working hours or weaker occupational position. Rather women's greater sensitivity to commuting time seems to be a result of their larger responsibility for day-to-day household tasks, including childcare and housework. Copyright © 2011 Elsevier B.V. All rights reserved.

Health Behavior Change for Obesity Management

PubMed Central

Teixeira, Pedro J.; Marques, Marta M.

2018-01-01

Health behavior change is central in obesity management. Due to its complexity, there has been a growing body of research on: i) the factors that predict the adoption and maintenance of health behaviors, ii) the development and testing of theories that conceptualize relationships among these factors and with health behaviors, and iii) how these factors can be implemented in effective behavior change interventions, considering characteristics of the content (techniques) and delivery. This short review provides an overview of advances in behavior change science theories and methods, focusing on obesity management, and includes a discussion of the main challenges imposed by this research field. PMID:29237167

Work status and health of women: a comparative study of northern and southern states of rural India.

PubMed

Basu, Sharmishtha; Sidh, Shiv Narayan

2008-01-01

The paper examines the net effect of work status on women's health and whether the effect persists after controlling for the influence of socio-economic factors. Our hypothesis is that working women face a greater risk of morbidity and mortality, given that most would be expected to shoulder dual responsibilities: market and household. The paper also examines whether the risk varies across regions. In particular, we examine whether the work status-health relationship differs between the southern and northern regions of India, which are known to be distinct in female autonomy. While women in India face many serious health concerns, this analysis focuses on only two issues: nutritional status (as measured by body mass index and prevalence of anemia) and reproductive health (as assessed by the presence of reproductive health problems) of women from villages in the study area. Results show that though both work status and socio-economic factors influence health status, the latter are more important; most of the gross effect of work status is due to socio-economic conditions rather than work participation. This calls for policy intervention in providing better health facilities, female education and supplementary nutrition programs for poor women.

Social contagion of mental health: Evidence from college roommates

PubMed Central

Golberstein, Ezra; Whitlock, Janis L.; Downs, Marilyn F.

2015-01-01

From a policy standpoint the spread of health conditions in social networks is important to quantify, because it implies externalities and possible market failures in the consumption of health interventions. Recent studies conclude that happiness and depression may be highly contagious across social ties. The results may be biased, however, due to selection and common shocks. We provide unbiased estimates by using exogenous variation from college roommate assignments. Our findings are consistent with no significant overall contagion of mental health and no more than small contagion effects for specific mental health measures, with no evidence for happiness contagion and modest evidence for anxiety and depression contagion. The weakness of the contagion effects cannot be explained by avoidance of roommates with poor mental health or by generally low social contact among roommates. We also find that similarity of baseline mental health predicts the closeness of roommate relationships, which highlights the potential for selection biases in studies of peer effects that do not have a clearly exogenous source of variation. Overall our results suggest that mental health contagion is lower, or at least more context-specific, than implied by the recent studies in the medical literature. PMID:23055446

Ethical issues in funding research and development of drugs for neglected tropical diseases.

PubMed

Oprea, L; Braunack-Mayer, A; Gericke, C A

2009-05-01

Neglected and tropical diseases, pervasive in developing countries, are important contributors to global health inequalities. They remain largely untreated due to lack of effective and affordable treatments. Resource-poor countries cannot afford to develop the public health interventions needed to control neglected diseases. In addition, neglected diseases do not represent an attractive market for pharmaceutical industry. Although a number of international commitments, stated in the Millennium Development Goals, have been made to avert the risk of communicable diseases, tropical diseases still remain neglected due to delays in international assistance. This delay can be explained by the form international cooperation has generally taken, which is limited to promoting countries' national interests, rather than social justice at a global level. This restricts the international responsibility for global inequalities in health to a humanitarian assistance. We propose an alternative view, arguing that expanding the scope of international cooperation by promoting shared health and economic value at a global level will create new opportunities for innovative, effective and affordable interventions worldwide. It will also promote neglected diseases as a global research priority. We build our argument on a proposal to replace the patenting system that currently regulates pharmaceutical research with a global fund to reward this research based on actual decreases in morbidity and mortality at a global level. We argue that this approach is beneficent because it will decrease global health inequalities and promote social justice worldwide.

Transdisciplinary assignments in graduate health education as a model for future collaboration.

PubMed

Christie, Catherine; Smith, A Russell; Bednarzyk, Michele

2007-01-01

Transdisciplinary health care continues to be at the forefront of patient treatment in the medical arena, in part due to escalating health care costs, an increasing aging population, and the development of multiple chronic diseases. Gaining the knowledge, experience, and principles associated with transdisciplinary teamwork to successfully prepare for modern-day practice is therefore essential for individuals of various health care professions. This report describes an assignment developed and implemented to facilitate professional interaction between graduate physical therapy, nutrition, and nursing students. The objectives of this assignment were to determine through student evaluation the effects of a transdisciplinary experience on students' understanding of the role of another discipline and students' communication skills across disciplines. When evaluating the assignment, students most often remarked that they developed a greater understanding of the roles of the included disciplines and reported a significant increase in communication skills. However, some students did not concur that this assignment was effective due to the scheduling conflicts and lack of teamwork that can occur during a collaborative project. The students' reports of their experiences in completing the assignment provide valuable insights for implementing and/or updating a preparatory transdisciplinary education component in other settings. Additional research can focus on the challenges faced by the majority of the students venturing into actual health care or "real-world" settings for comparative studies.

Healthcare worker influenza immunization vaccinate or mask policy: strategies for cost effective implementation and subsequent reductions in staff absenteeism due to illness.

PubMed

Van Buynder, P G; Konrad, S; Kersteins, F; Preston, E; Brown, P D; Keen, D; Murray, N J

2015-03-24

A new policy requiring staff in clinical areas to vaccinate or wear a mask was implemented in British Columbia (BC) in the 2012/13 winter. This review assessed the impact of the policy on absenteeism in health care workers. A retrospective cohort study of full-time HCW that worked prior to and during the 2012/13 influenza season in a health authority in BC. The rate of absenteeism due to all cause illness was compared between vaccinated and unvaccinated staff controlling for behaviors outside influenza season. Of the 10079 HCW, 77% were vaccinated. By comparison to absenteeism rates in the pre-influenza season, unvaccinated staff in winter had twice the increase in absenteeism due to all-cause illness than vaccinated staff. After controlling for baseline differences between those vaccinated and unvaccinated, influenza vaccination was associated with reduced absenteeism, saving the Health Authority substantial money. Having regular staff in attendance increases the quality of care. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Contribution of Population Health and Demographic Change to Economic Growth in China and India

PubMed Central

Bloom, David E.; Canning, David; Hu, Linlin; Liu, Yuanli; Mahal, Ajay; Yip, Winnie

2010-01-01

We find that a cross-country model of economic growth successfully tracks the growth takeoffs in China and India. The major drivers of the predicted takeoffs are improved health, increased openness to trade, and a rising labor force-to-population ratio due to fertility decline. We also explore the effect of the reallocation of labor from low-productivity agriculture to the higher-productivity industry and service sectors. Including the money value of longevity improvements in a measure of full income reduces the gap between the magnitude of China's takeoff relative to India's due to the relative stagnation in life expectancy in China since 1980. PMID:20419074

Family Ties and Health Cross-Nationally: The Contextualizing Role of Familistic Culture and Public Pension Spending in Europe

PubMed Central

2013-01-01

Objectives. Although previous research theorizes that cross-national variation in the relationship between family ties and health is due to nation-level differences in culture and policy/economics, no study has examined this theorization empirically. Method. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and the Organization for Economic Co-operation and Development (OECD), this study uses multilevel modeling to analyze individual-, nation-, and cross-level effects for 30,291 older adults in 14 nations. Results. Family ties to spouses/partners and parents are associated with better health, but ties to coresident children are associated with poorer health in certain contexts. Familistic culture and public pension spending have a weak but statistically significant moderating effect on the relationship between intergenerational family ties and health. Discussion. This article underscores the complexity of family and highlights the need for continued theorization and measurement at the nation level to promote older adults’ health in diverse contexts. PMID:24043356

Family ties and health cross-nationally: the contextualizing role of familistic culture and public pension spending in Europe.

PubMed

Mair, Christine A

2013-11-01

Although previous research theorizes that cross-national variation in the relationship between family ties and health is due to nation-level differences in culture and policy/economics, no study has examined this theorization empirically. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and the Organization for Economic Co-operation and Development (OECD), this study uses multilevel modeling to analyze individual-, nation-, and cross-level effects for 30,291 older adults in 14 nations. Family ties to spouses/partners and parents are associated with better health, but ties to coresident children are associated with poorer health in certain contexts. Familistic culture and public pension spending have a weak but statistically significant moderating effect on the relationship between intergenerational family ties and health. This article underscores the complexity of family and highlights the need for continued theorization and measurement at the nation level to promote older adults' health in diverse contexts.

Acculturation and nutritional health of immigrants in Canada: a scoping review.

PubMed

Sanou, Dia; O'Reilly, Erin; Ngnie-Teta, Ismael; Batal, Malek; Mondain, Nathalie; Andrew, Caroline; Newbold, Bruce K; Bourgeault, Ivy L

2014-02-01

Although recent immigrants to Canada are healthier than Canadian born (i.e., the Healthy Immigrant Effect), they experience a deterioration in their health status which is partly due to transitions in dietary habits. Since pathways to these transitions are under-documented, this scoping review aims to identify knowledge gaps and research priorities related to immigrant nutritional health. A total of 49 articles were retrieved and reviewed using electronic databases and a stakeholder consultation was undertaken to consolidate findings. Overall, research tends to confirm the Healthy Immigrant Effect and suggests that significant knowledge gaps in nutritional health persist, thereby creating a barrier to the advancement of health promotion and the achievement of maximum health equity. Five research priorities were identified including (1) risks and benefits associated with traditional/ethnic foods; (2) access and outreach to immigrants; (3) mechanisms and coping strategies for food security; (4) mechanisms of food choice in immigrant families; and (5) health promotion strategies that work for immigrant populations.

Tart Cherries and health: Current knowledge and need for a better understanding of the fate of phytochemicals in the human gastrointestinal tract.

PubMed

Alba C, Mayta-Apaza; Daya, Marasini; Franck, Carbonero

2017-09-28

Tart cherries are increasingly popular due to purported health benefits. This Prunus cesarus species is cultivated worldwide, and its market has increased significantly in the last two decades due to improvements in agricultural practices and food processing technology. Tart cherries are rich in polyphenols, with a very specific profile combining anthocyanins and flavonols (berries-like) and chlorogenic acid (coffee-like). Tart cherries have been suggested to exert several potentially beneficial health effects including: lowering blood pressure, modulating blood glucose, enhancing cognitive function, protecting against oxidative stress and reducing inflammation. Studies focusing on tart cherry consumption have demonstrated particular benefits in recovery from exercise-induced muscle damage and diabetes associated parameters. However, the bioconversion of tart cherry polyphenols by resident colonic microbiota has never been considered, considerably reducing the impact of in vitro studies that have relied on fruit polyphenol extracts. In vitro and in vivo gut microbiota and metabolome studies are necessary to reinforce health claims linked to tart cherries consumption.

[Potential health risks from consumption of water with arsenic in Colima, Mexico].

PubMed

Mendoza-Cano, Oliver; Sánchez-Piña, Ramón Alberto; Barrón-Quintana, Julián; Cuevas-Arellano, Herguin Benjamin; Escalante-Minakata, Pilar; Solano-Barajas, Ramón

2017-01-01

To estimate potential health risks due to chronic ingestion of arsenic from groundwater in Colima, Mexico. Samples were randomly taken in 36 wells from 10 local aquifers. Analysis was performed by ICP-OES following international standards. Geostatistical interpolation was performed with ArcGIS, implementing a model weighting inverse distance to estimate arsenic routes of exposure and consumption on each locality. The Hazard Quotient Ratio (HQ) and carcinogenic risk (R) for As were estimated. The weighted average HQ for arsenic in Colima is 2.41. There are HQ> 1 values indicating adverse non-cancer health effects by continuous and prolonged intake of water with arsenic, which could affect 183 832 individuals in the state. The risk of developing any type of cancer among the population in this study due to high arsenic concentrations in groundwater (R) is 1.089E-3, which could statistically cause 446 cases of cancer. Current levels of arsenic in groundwater increase carcinogenic and non-carcinogenic human health risks in Colima.

Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tobollik, Myriam, E-mail: mtobollik@uni-bielefeld.de; German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin; Keuken, Menno

Background: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Method: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM{sub 2.5}), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020. Results: The intervention aimed at reducing trafficmore » is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11–129) YLDs due to annoyance and 35 (CI: 20–51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13–116) and 41 (CI: 24–60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM{sub 2.5} and EC by around 40% and 60% respectively, from 2010 to 2020. Discussion: The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health. - Highlights: • We estimated co-benefits of greenhouse gas reduction policies from 2010 to 2020. • The city scale health impact assessment base on real transport policy scenarios. • Effects of particulate matter, elemental carbon and noise on health are assessed. • The effects are rather small but still positive for the planned scenarios.« less

Reflecting the real value of health care resources in modelling and cost-effectiveness studies-The example of viral load informed differentiated care.

PubMed

Revill, Paul; Walker, Simon; Cambiano, Valentina; Phillips, Andrew; Sculpher, Mark J

2018-01-01

The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter's value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest gains in population health. The findings have important implications for how economic analyses should be undertaken and reported in HIV and other disease areas. Results provide guidance on conditions under which viral load informed differentiated care will more likely prove to be cost effective when implemented.

Sport activity and health-related quality of life after kidney transplantation.

PubMed

Mazzoni, D; Cicognani, E; Mosconi, G; Totti, V; Roi, G S; Trerotola, M; Nanni Costa, A

2014-09-01

Considering the importance of sport activity for enhancing quality of life, the aim of this study was to investigate the effects of regular sport activity on quality of life of kidney transplant recipients. Health-related quality of life (HRQoL) was assessed with the use of the SF-36 questionnaire on a group of 118 active kidney transplant patients (AKTPs) practicing different sports at low to moderate intensity (5±4 h/wk). Scores were compared with those of 79 sedentary kidney transplant patients (SKTPs) and with 120 active healthy control subjects (AHCs). AKTPs reported higher scores than SKTPs in the SF-36 scales of Physical Functioning (P<.05), Role Limitations due to Physical Problems (P<.05), General Health (P<.01), Vitality (P<.05), Social Functioning (P<.05), Role Limitations due to Emotional Problems (P<.05), and Mental Health (P<.01). AKTPs obtained higher scores than AHCs on the Mental Health (P<.01) and Social Functioning scales (P<.01) and similar scores (P>.05) on all the other scales. The effect of quantity of sport activity was significant on the General Health (P<.01; η2=0.05), and Role Physical scales (P=.04; η2=0.03), with higher sport activity associated with higher HRQoL. The effect of sex was significant for Bodily Pain (P=.05; η2=0.02), Vitality (P=.08; η2=0.06), Social Functioning (P=.08; η2=0.05), and Mental Health (P=.05; η2=0.02), with male participants scoring higher than female participants. This study indicates that regular sport activity significantly improves different dimensions of HRQoL among kidney transplant recipients. The benefits of sport activity go beyond its impact on physical health to involve psychologic and social components of quality of life. Spontaneous and low to moderate sport activity may play an important role after kidney transplantation that has been largely underestimated in the literature. Copyright © 2014 Elsevier Inc. All rights reserved.

The effects of poverty on children's development and oral health.

PubMed

da Fonseca, Marcio A

2012-01-01

According to the US Census Bureau, the poverty rate for children under 18 years of age increased to 22% in 2010. Poverty leads to adverse health outcomes in children and adolescents such as harmful effects on learning, psychosocial development, physical health, productivity and family life. Because the citizens and residents of a country are its most valuable assets, it is unwise to allow housing instability, food insecurity and hunger to continue to exist at its current levels. Reducing poverty is likely to prevent illnesses, decrease hospitalizations, and lead to lower health care costs. There is also a need for intervention strategies to ensure equitable access to healthy foods across the world. Children who are food insecure are more likely to be in poor health and to have poor nutritional outcomes. Poverty may lead to poor dental health due to malnutrition or incorrect diet and it may also have an effect on the child's behavior in the dental office. An understanding of poverty will lessen the anger, frustration and prejudice that pediatric dentists may feel when working with low-income families. This manuscript presents a concise overview of the effects of poverty in children's lives.

Climate change threats to population health and well-being: the imperative of protective solutions that will last

PubMed Central

Kjellstrom, Tord; McMichael, Anthony J.

2013-01-01

Background The observational evidence of the impacts of climate conditions on human health is accumulating. A variety of direct, indirect, and systemically mediated health effects have been identified. Excessive daily heat exposures create direct effects, such as heat stroke (and possibly death), reduce work productivity, and interfere with daily household activities. Extreme weather events, including storms, floods, and droughts, create direct injury risks and follow-on outbreaks of infectious diseases, lack of nutrition, and mental stress. Climate change will increase these direct health effects. Indirect effects include malnutrition and under-nutrition due to failing local agriculture, spread of vector-borne diseases and other infectious diseases, and mental health and other problems caused by forced migration from affected homes and workplaces. Examples of systemically mediated impacts on population health include famine, conflicts, and the consequences of large-scale adverse economic effects due to reduced human and environmental productivity. This article highlights links between climate change and non-communicable health problems, a major concern for global health beyond 2015. Discussion Detailed regional analysis of climate conditions clearly shows increasing temperatures in many parts of the world. Climate modelling indicates that by the year 2100 the global average temperature may have increased by 3-4°C unless fundamental reductions in current global trends for greenhouse gas emissions are achieved. Given other unforeseeable environmental, social, demographic, and geopolitical changes that may occur in a plus-4-degree world, that scenario may comprise a largely uninhabitable world for millions of people and great social and military tensions. Conclusion It is imperative that we identify actions and strategies that are effective in reducing these increasingly likely threats to health and well-being. The fundamental preventive strategy is, of course, climate change mitigation by significantly reducing global greenhouse gas emissions, especially long-acting carbon dioxide (CO2), and by increasing the uptake of CO2 at the earth's surface. This involves urgent shifts in energy production from fossil fuels to renewable energy sources, energy conservation in building design and urban planning, and reduced waste of energy for transport, building heating/cooling, and agriculture. It would also involve shifts in agricultural production and food systems to reduce energy and water use particularly in meat production. There is also potential for prevention via mitigation, adaptation, or resilience building actions, but for the large populations in tropical countries, mitigation of climate change is required to achieve health protection solutions that will last. PMID:23561024

Climate change threats to population health and well-being: the imperative of protective solutions that will last.

PubMed

Kjellstrom, Tord; McMichael, Anthony J

2013-04-03

The observational evidence of the impacts of climate conditions on human health is accumulating. A variety of direct, indirect, and systemically mediated health effects have been identified. Excessive daily heat exposures create direct effects, such as heat stroke (and possibly death), reduce work productivity, and interfere with daily household activities. Extreme weather events, including storms, floods, and droughts, create direct injury risks and follow-on outbreaks of infectious diseases, lack of nutrition, and mental stress. Climate change will increase these direct health effects. Indirect effects include malnutrition and under-nutrition due to failing local agriculture, spread of vector-borne diseases and other infectious diseases, and mental health and other problems caused by forced migration from affected homes and workplaces. Examples of systemically mediated impacts on population health include famine, conflicts, and the consequences of large-scale adverse economic effects due to reduced human and environmental productivity. This article highlights links between climate change and non-communicable health problems, a major concern for global health beyond 2015. Detailed regional analysis of climate conditions clearly shows increasing temperatures in many parts of the world. Climate modelling indicates that by the year 2100 the global average temperature may have increased by 34°C unless fundamental reductions in current global trends for greenhouse gas emissions are achieved. Given other unforeseeable environmental, social, demographic, and geopolitical changes that may occur in a plus-4-degree world, that scenario may comprise a largely uninhabitable world for millions of people and great social and military tensions. It is imperative that we identify actions and strategies that are effective in reducing these increasingly likely threats to health and well-being. The fundamental preventive strategy is, of course, climate change mitigation by significantly reducing global greenhouse gas emissions, especially long-acting carbon dioxide (CO(2)), and by increasing the uptake of CO(2) at the earth's surface. This involves urgent shifts in energy production from fossil fuels to renewable energy sources, energy conservation in building design and urban planning, and reduced waste of energy for transport, building heating/cooling, and agriculture. It would also involve shifts in agricultural production and food systems to reduce energy and water use particularly in meat production. There is also potential for prevention via mitigation, adaptation, or resilience building actions, but for the large populations in tropical countries, mitigation of climate change is required to achieve health protection solutions that will last.

Health protection and promotion at work.

PubMed Central

Schilling, R S

1989-01-01

Official United Kingdom figures record annually 1400 deaths and 145,000 sufferers from chronic effects of occupational injury and disease. Evidence indicates that occupational disease directly due to work is underestimated. With more understanding of the multiple causes of disease, the concept of work related disorders has broadened to include four categories: work as a direct cause, a contributory cause, or an aggravating factor, and work offering easy access to potential dangers (alcohol). As an example, work factors that increase the risk of coronary heart disease are discussed. Evidence for work stress as a causal factor and the role of leadership are considered. Prevention depends on identifying risks, preferably before anyone is exposed, but more commonly through recognition of adverse effects on workers. The need for occupational health services to have health promotion programmes that include screening for disease and its precursors, counselling and education, is considered. The positive effects of work itself as a protector and promoter of health are discussed. Responsibility for improving health has to be shared by government, management, trade unions, health professionals, and the individual worker. PMID:2818956

Current evidence on physiological activity and expected health effects of kombucha fermented beverage.

PubMed

Vīna, Ilmāra; Semjonovs, Pāvels; Linde, Raimonds; Deniņa, Ilze

2014-02-01

Consumption of kombucha fermented tea (KT) has always been associated with different health benefits. Many personal experiences and testimonials of KT drinkers are available throughout the world on the ability of KT to protect against a vast number of metabolic and infectious diseases, but very little scientific evidence is available that validates the beneficial effects of KT. The aim of this review is to give an overview of the recent studies in search of experimental confirmation of the numerous KT health-promoting aspects cited previously. Analysis of the literature data is carried out in correspondence to the recent concepts of health protection's requirements. Attention is given to the active compounds in KT, responsible for the particular effect, and to the mechanisms of their actions. It is shown that KT can efficiently act in health prophylaxis and recovery due to four main properties: detoxification, antioxidation, energizing potencies, and promotion of depressed immunity. The recent experimental studies on the consumption of KT suggest that it is suitable for prevention against broad-spectrum metabolic and infective disorders. This makes KT attractive as a fermented functional beverage for health prophylaxis.

Can decision biases improve insurance outcomes? An experiment on status quo bias in health insurance choice.

PubMed

Krieger, Miriam; Felder, Stefan

2013-06-19

Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure.

Sex on premises venue (SOPV) health promotion project in response to sustained increases in HIV notifications.

PubMed

Mullens, Amy B; Staunton, Shaun; Debattista, Joseph; Hamernik, Elisabeth; Gill, Darren

2009-03-01

Due to increases in HIV notifications in Queensland, a health promotion outreach project was developed with sex on premises venues (SOPV) in Brisbane. A health promotion officer (HPO) promoted safer sex behaviours among SOPV patrons over 14 months, including providing information, counselling and skills to enhance safer sexual behaviours and providing referrals. Surveys were introduced to facilitate discussions regarding HIV/sexually transmissible infections, testing and safer sex practices. The project demonstrated feasibility within this highly sexualised environment, and was enhanced by careful monitoring and revising the procedure to improve patron/staff responses to the project. The introduction of a survey instrument was a significant contributor to the project's effectiveness, providing opportunities for patrons to discuss a variety of key sexual health issues. This initiative reflected effective partnering between the Health Department, a community HIV/lesbian, gay, bisexual and transgender organisation and private industry. Despite initial difficulties, the presence of a health worker within an SOPV was acceptable to patrons and allowed for brief interventions to be conducted. This project was deemed effective for a limited time period and within certain constraints.

Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005.

PubMed

Hoffmann, Rasmus; Plug, Iris; McKee, Martin; Khoshaba, Bernadette; Westerling, Ragnar; Looman, Caspar; Rey, Gregoire; Jougla, Eric; Lang, Katrin; Pärna, Kersti; Mackenbach, Johan P

2014-04-01

Although the contribution of health care to survival from cancer has been studied extensively, much less is known about its contribution to population health. We examine how medical innovations have influenced trends in cause-specific mortality at the national level. Based on literature reviews, we selected six innovations with proven effectiveness against cervical cancer, Hodgkin's disease, breast cancer, testicular cancer, and leukaemia. With data on the timing of innovations and cause-specific mortality (1970-2005) from seven European countries we identified associations between innovations and favourable changes in mortality. For none of the five specific cancers, sufficient evidence for an association between introduction of innovations and a positive change in mortality could be found. The highest association was found between the introduction of Tamoxifen and breast cancer mortality. The lack of evidence of health care effectiveness may be due to gradual improvements in treatment, to effects limited to certain age groups or cancer subtypes, and to contemporaneous changes in cancer incidence. Research on the impact of health care innovations on population health is limited by unreliable data on their introduction.

Cost per case or total cost? The potential of prevention of hand injuries in young children – Retrospective and prospective studies

PubMed Central

Ljungberg, Elinor M; Carlsson, Katarina Steen; Dahlin, Lars B

2008-01-01

Background Health-care costs for hand and forearm injuries in young children are poorly documented. We examined costs in 533 children injured years 1996–2003. Methods Health-care costs and costs for lost productivity were retrospectively calculated in children from three catchment areas in Sweden. Seven case categories corresponding to alternative prevention strategies were constructed. Results Over time, diminishing number of ward days reduced the health-care cost per case. Among children, the cost of lost productivity due to parental leave was 14 percent of total cost. Fingertip injuries had low median costs but high total costs due to their frequency. Complex injuries by machine or rifle had high costs per case, and despite a low number of cases, total cost was high. Type of injury, surgery and physiotherapy sessions were associated with variations in health-care cost. Low age and ethnic background had a significant effect on number of ward days. Conclusion The costs per hand injury for children were lower compared to adults due to both lower health-care costs and to the fact that parents had comparatively short periods of absence from work. Frequent simple fingertip injuries and rare complex injuries induce high costs for society. Such costs should be related to costs for prevention of these injuries. PMID:18606018

[Quality of life of hemodialysis patients in a Brazilian Public Hospital in Belém - Pará].

PubMed

Silveira, Cíntia Botelho; Pantoja, Ivaneida Kzarina Olaia Ribeiro; Silva, Allan Roberto Marques; Azevedo, Rômulo Nina de; Sá, Nayara Bandeira de; Turiel, Marck Gregório Pereira; Nunes, Mário Barbosa Guedes

2010-03-01

End-stage chronic kidney disease (CKD) requiring dialysis affects the quality of life sometimes more severely than other chronic diseases, such as rheumatoid arthritis, heart failure, coronary artery disease, and chronic obstructive pulmonary disease, exerting a negative effect on the energy and vitality levels, limiting social interactions, and hindering psychic health. To evaluate the quality of life of patients with CKD on hemodialysis in a public Brazilian Amazonian hospital. Data were collected through interview based on the Brazilian version of the SF-36 questionnaire. The study was conducted on 50 patients (mean age, 48 ± 16 years; mean hemodialysis time, 3 ± 2.9 years). The most affected domain was role limitations due to physical health, with a mean score of 36 ± 36, and 58% of the patients in the lowest quartile, while mental health and social functioning were relatively preserved, with most patients in the highest quartile. Men obtained poorer scores than women did for role limitations due to physical health and vitality. Age correlated negatively with physical functioning. Patients on hemodialysis for more than one year had better scores in the social functioning domain, with a positive correlation between dialysis time and physical functioning. The domains assessed were globally impaired in the population studied, especially regarding role limitations due to physical health, suggesting that chronic disease with prolonged treatment has a negative influence on those domains.

Linking the oceans to public health: current efforts and future directions

PubMed Central

Kite-Powell, Hauke L; Fleming, Lora E; Backer, Lorraine C; Faustman, Elaine M; Hoagland, Porter; Tsuchiya, Ami; Younglove, Lisa R; Wilcox, Bruce A; Gast, Rebecca J

2008-01-01

We review the major linkages between the oceans and public health, focusing on exposures and potential health effects due to anthropogenic and natural factors including: harmful algal blooms, microbes, and chemical pollutants in the oceans; consumption of seafood; and flooding events. We summarize briefly the current state of knowledge about public health effects and their economic consequences; and we discuss priorities for future research. We find that: • There are numerous connections between the oceans, human activities, and human health that result in both positive and negative exposures and health effects (risks and benefits); and the study of these connections comprises a new interdisciplinary area, "oceans and human health." • The state of present knowledge about the linkages between oceans and public health varies. Some risks, such as the acute health effects caused by toxins associated with shellfish poisoning and red tide, are relatively well understood. Other risks, such as those posed by chronic exposure to many anthropogenic chemicals, pathogens, and naturally occurring toxins in coastal waters, are less well quantified. Even where there is a good understanding of the mechanism for health effects, good epidemiological data are often lacking. Solid data on economic and social consequences of these linkages are also lacking in most cases. • The design of management measures to address these risks must take into account the complexities of human response to warnings and other guidance, and the economic tradeoffs among different risks and benefits. Future research in oceans and human health to address public health risks associated with marine pathogens and toxins, and with marine dimensions of global change, should include epidemiological, behavioral, and economic components to ensure that resulting management measures incorporate effective economic and risk/benefit tradeoffs. PMID:19025677

Linking the oceans to public health: current efforts and future directions.

PubMed

Kite-Powell, Hauke L; Fleming, Lora E; Backer, Lorraine C; Faustman, Elaine M; Hoagland, Porter; Tsuchiya, Ami; Younglove, Lisa R; Wilcox, Bruce A; Gast, Rebecca J

2008-11-07

We review the major linkages between the oceans and public health, focusing on exposures and potential health effects due to anthropogenic and natural factors including: harmful algal blooms, microbes, and chemical pollutants in the oceans; consumption of seafood; and flooding events. We summarize briefly the current state of knowledge about public health effects and their economic consequences; and we discuss priorities for future research.We find that:* There are numerous connections between the oceans, human activities, and human health that result in both positive and negative exposures and health effects (risks and benefits); and the study of these connections comprises a new interdisciplinary area, "oceans and human health."* The state of present knowledge about the linkages between oceans and public health varies. Some risks, such as the acute health effects caused by toxins associated with shellfish poisoning and red tide, are relatively well understood. Other risks, such as those posed by chronic exposure to many anthropogenic chemicals, pathogens, and naturally occurring toxins in coastal waters, are less well quantified. Even where there is a good understanding of the mechanism for health effects, good epidemiological data are often lacking. Solid data on economic and social consequences of these linkages are also lacking in most cases.* The design of management measures to address these risks must take into account the complexities of human response to warnings and other guidance, and the economic tradeoffs among different risks and benefits. Future research in oceans and human health to address public health risks associated with marine pathogens and toxins, and with marine dimensions of global change, should include epidemiological, behavioral, and economic components to ensure that resulting management measures incorporate effective economic and risk/benefit tradeoffs.

Non-Renal Effects and the Risk Assessment of Environmental Cadmium Exposure

PubMed Central

Barregard, Lars; Bergdahl, Ingvar A.; Nordberg, Gunnar F.; Nordberg, Monica; Skerfving, Staffan

2014-01-01

Background: Exposure to cadmium (Cd) has long been recognized as a health hazard, both in industry and in general populations with high exposure. Under the currently prevailing health risk assessment, the relationship between urinary Cd (U-Cd) concentrations and tubular proteinuria is used. However, doubts have recently been raised regarding the justification of basing the risk assessment on this relationship at very low exposure. Objectives: Our objective was to review available information on health effects of Cd exposure with respect to human health risk assessment. Discussion: The associations between U-Cd and urinary proteins at very low exposure may not be due to Cd toxicity, and the clinical significance of slight proteinuria may also be limited. More importantly, other effects have been reported at very low Cd exposure. There is reason to challenge the basis of the existing health risk assessment for Cd. Our review of the literature found that exposure to low concentrations of Cd is associated with effects on bone, including increased risk of osteoporosis and fractures, and that this observation has implications for the health risk assessment of Cd. Other effects associated with Cd should also be considered, in particular cancer, although the information is still too limited for appropriate use in quantitative risk assessment. Conclusion: Non-renal effects should be considered critical effects in the health risk assessment of Cd. Citation: Åkesson A, Barregard L, Bergdahl IA, Nordberg GF, Nordberg M, Skerfving S. 2014. Non-renal effects and the risk assessment of environmental cadmium exposure. Environ Health Perspect 122:431–438; http://dx.doi.org/10.1289/ehp.1307110 PMID:24569905

Effect of medical institution change on gestational duration after the Great East Japan Earthquake: The Fukushima Health Management Survey.

PubMed

Suzuki, Kohta; Goto, Aya; Fujimori, Keiya

2016-12-01

The aim of this study was to examine the association between medical institution change for perinatal care and gestational duration after the Great East Japan Earthquake using data from the Fukushima Health Management Survey. The data of pregnant women who experienced the earthquake in Fukushima prefecture and participated in the Pregnancy and Birth Survey as part of the Fukushima Health Management Survey were analyzed. The primary and secondary outcomes of this study were gestational duration and preterm birth, respectively. The main study factor was prenatal checkup institution (only one institution, changed institution due to self-referral, changed institution due to medical indication, and went to parents' home for childbirth). Self-referral was considered as indicative of relocation after the disaster. Multiple linear and logistic regression analyses were conducted to examine the effect of earthquake on each outcome. A total of 5593 (60.2%) participants experienced the earthquake between the 4th and 37th weeks of their gestational period. After controlling for variables, pregnant women who changed their perinatal checkup institution due to medical indication were significantly associated with shorter gestational duration (β = -10.6, P < 0.001) and preterm birth (adjusted odds ratio, 8.5; 95% confidence interval, 5.8-12.5) compared with women who visited only one institution. Self-referral, however, was not significantly associated with the outcomes. According to prenatal checkup status, our results suggest that the effect on gestational duration of the Great East Japan Earthquake and the subsequent Fukushima Daiichi nuclear disaster was not significant. © 2016 Japan Society of Obstetrics and Gynecology.

Determinants of maternal immunization in developing countries.

PubMed

Pathirana, Jayani; Nkambule, Jerome; Black, Steven

2015-06-12

Maternal immunization is an effective intervention to protect newborns and young infants from infections when their immune response is immature. Tetanus toxoid vaccination of pregnant women is the most widely implemented maternal vaccine in developing countries where neonatal mortality is the highest. We identified barriers to maternal tetanus vaccination in developing African and Asian countries to identify means of improving maternal immunization platforms in these countries. We categorized barriers into health system, health care provider and patient barriers to maternal tetanus immunization and conducted a literature review on each category. Due to limited literature from Africa, we conducted a pilot survey of health care providers in Malawi on barriers they experience in immunizing pregnant women. The major barriers of the health system are due to inadequate financial and human resources which translate to inadequate vaccination services delivery and logistics management. Health care providers are limited by poor attendance of Antenatal Care and inadequate knowledge on vaccinating pregnant women. Patient barriers are due to lack of education and knowledge on pregnancy immunization and socioeconomic factors such as low income and high parity. There are several factors that affect maternal tetanus immunization. Increasing knowledge in health care providers and patients, increasing antenatal care attendance and outreach activities will aid the uptake of maternal immunization. Health system barriers are more difficult to address requiring an improvement of overall immunization services. Further analyses of maternal immunization specific barriers and the means of addressing them are required to strengthen the existing program and provide a more efficient delivery system for additional maternal vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health Effects of PCBs in Residences and Schools (HESPERUS): PCB – health Cohort Profile

PubMed Central

Bräuner, Elvira Vaclavik; Andersen, Zorana Jovanovic; Frederiksen, Marie; Specht, Ina Olmer; Hougaard, Karin Sørig; Ebbehøj, Niels; Bailey, Janice; Giwercman, Aleksander; Steenland, Kyle; Longnecker, Matthew Paul; Bonde, Jens Peter

2016-01-01

Polychlorinated-biphenyls (PCBs) were introduced in the late 1920s and used until the 1970s when they were banned in most countries due to evidence of environmental build-up and possible adverse health effects. However they still persist in the environment, indoors and in humans. Indoor air in contaminated buildings may confer airborne exposure markedly above background regional PCB levels. To date, no epidemiological studies have assessed the health effects from exposure to semi-volatile PCBs in the indoor environment. Indoor air PCBs are generally less chlorinated than PCBs that are absorbed via the diet, or via past occupational exposure; therefore their health effects require separate risk assessment. Two separate cohorts of individuals who have either attended schools (n = 66,769; 26% exposed) or lived in apartment buildings (n = 37,185; 19% exposed), where indoor air PCB concentrations have been measured were created. An individual estimate of long-term airborne PCB exposure was assigned based on measurements. The cohorts will be linked to eight different national data sources on mortality, school records, residential history, socioeconomic status, and chronic disease and reproductive outcomes. The linking of indoor air exposures with health outcomes provides a dataset unprecedented worldwide. We describe a project, called HESPERUS (Health Effects of PCBs in Residences and Schools), which will be the first study of the long term health effects of the lower-chlorinated, semi-volatile PCBs in the indoor environment. PMID:27090775

Health Effects of PCBs in Residences and Schools (HESPERUS): PCB - health Cohort Profile.

PubMed

Bräuner, Elvira Vaclavik; Andersen, Zorana Jovanovic; Frederiksen, Marie; Specht, Ina Olmer; Hougaard, Karin Sørig; Ebbehøj, Niels; Bailey, Janice; Giwercman, Aleksander; Steenland, Kyle; Longnecker, Matthew Paul; Bonde, Jens Peter

2016-04-19

Polychlorinated-biphenyls (PCBs) were introduced in the late 1920s and used until the 1970s when they were banned in most countries due to evidence of environmental build-up and possible adverse health effects. However they still persist in the environment, indoors and in humans. Indoor air in contaminated buildings may confer airborne exposure markedly above background regional PCB levels. To date, no epidemiological studies have assessed the health effects from exposure to semi-volatile PCBs in the indoor environment. Indoor air PCBs are generally less chlorinated than PCBs that are absorbed via the diet, or via past occupational exposure; therefore their health effects require separate risk assessment. Two separate cohorts of individuals who have either attended schools (n = 66,769; 26% exposed) or lived in apartment buildings (n = 37,185; 19% exposed), where indoor air PCB concentrations have been measured were created. An individual estimate of long-term airborne PCB exposure was assigned based on measurements. The cohorts will be linked to eight different national data sources on mortality, school records, residential history, socioeconomic status, and chronic disease and reproductive outcomes. The linking of indoor air exposures with health outcomes provides a dataset unprecedented worldwide. We describe a project, called HESPERUS (Health Effects of PCBs in Residences and Schools), which will be the first study of the long term health effects of the lower-chlorinated, semi-volatile PCBs in the indoor environment.

Competition between health maintenance organizations and nonintegrated health insurance companies in health insurance markets.

PubMed

Baranes, Edmond; Bardey, David

2015-12-01

This article examines a model of competition between two types of health insurer: Health Maintenance Organizations (HMOs) and nonintegrated insurers. HMOs vertically integrate health care providers and pay them at a competitive price, while nonintegrated health insurers work as indemnity plans and pay the health care providers freely chosen by policyholders at a wholesale price. Such difference is referred to as an input price effect which, at first glance, favors HMOs. Moreover, we assume that policyholders place a positive value on the provider diversity supplied by their health insurance plan and that this value increases with the probability of disease. Due to the restricted choice of health care providers in HMOs a risk segmentation occurs: policyholders who choose nonintegrated health insurers are characterized by higher risk, which also tends to favor HMOs. Our equilibrium analysis reveals that the equilibrium allocation only depends on the number of HMOs in the case of exclusivity contracts between HMOs and providers. Surprisingly, our model shows that the interplay between risk segmentation and input price effects may generate ambiguous results. More precisely, we reveal that vertical integration in health insurance markets may decrease health insurers' premiums.

The effects of outdoor air pollution on the respiratory health of Canadian children: A systematic review of epidemiological studies.

PubMed

Rodriguez-Villamizar, Laura Andrea; Magico, Adam; Osornio-Vargas, Alvaro; Rowe, Brian H

2015-01-01

Outdoor air pollution is a global problem with serious effects on human health, and children are considered to be highly susceptible to the effects of air pollution. To conduct a comprehensive and updated systematic review of the literature reporting the effects of outdoor air pollution on the respiratory health of children in Canada. Searches of four electronic databases between January 2004 and November 2014 were conducted to identify epidemiological studies evaluating the effect of exposure to outdoor air pollutants on respiratory symptoms, lung function measurements and the use of health services due to respiratory conditions in Canadian children. The selection process and quality assessment, using the Newcastle-Ottawa Scale, were conducted independently by two reviewers. Twenty-seven studies that were heterogeneous with regard to study design, population, respiratory outcome and air pollution exposure were identified. Overall, the included studies reported adverse effects of outdoor air pollution at concentrations that were below Canadian and United States standards. Heterogeneous effects of air pollutants were reported according to city, sex, socioeconomic status and seasonality. The present review also describes trends in research related to the effect of air pollution on Canadian children over the past 25 years. The present study reconfirms the adverse effects of outdoor air pollution on the respiratory health of children in Canada. It will help researchers, clinicians and environmental health authorities identify the available evidence of the adverse effect of outdoor air pollution, research gaps and the limitations for further research.

Racial and ethnic health disparities: evidence of discrimination's effects across the SEP spectrum.

PubMed

D'Anna, Laura Hoyt; Ponce, Ninez A; Siegel, Judith M

2010-04-01

Perceived discrimination is a psychosocial stressor that plays a role in explaining racial/ethnic disparities in self-reported physical and mental health. The purpose of this paper is: (1) to investigate the association between perceived discrimination in receiving healthcare and racial/ethnic disparities in self-rated health status, physical, and emotional functional limitations among a diverse sample of California adults; (2) to assess whether discrimination effects vary by racial/ethnic group and gender; and (3) to evaluate how the effects of discrimination on health are manifest across the socioeconomic position (SEP) spectrum. Data were drawn from the 2001 California Health Interview Survey adult file (n=55,428). The analytic approach employed multivariate linear and logistic regressions. Discrimination is qualitatively identified into two types: (1) discrimination due to race/ethnicity, language, or accent, and (2) other discrimination. Findings show that both types of discrimination negatively influenced self-rated health, and were associated with a two to three-fold odds of limitations in physical and emotional health. Further, these effects varied by racial/ethnic group and gender, and the effects were mixed. Most notably, for emotional health, racial/ethnic discrimination penalized Latinas more than non-Latina Whites, but for physical health, other discrimination was less detrimental to Latinas than it was to non-Latina Whites. At higher levels of SEP, the effects of racial/ethnic discrimination on self-rated health and other discriminations' effects on physical health were attenuated. Higher SEP may serve as an important mitigator, particularly when comparing the medium to the low SEP categories. It is also possible that SEP effects cannot be extracted from the relationships of interest in that SEP is an expression of social discrimination. In fact, negative health effects associated with discrimination are evident across the SEP spectrum. This study highlights the complexity of the relationships between discrimination and racial/ethnic identity, gender, and SEP.

Exposures to Endocrine Disrupting Chemicals in Consumer Products-A Guide for Pediatricians.

PubMed

Wong, Katelyn H; Durrani, Timur S

2017-05-01

Endocrine disrupting chemicals, a group of exogenous chemicals that can interfere with hormone action in the body, have been implicated in disrupting endocrine function, which negatively affects human health and development. Endocrine disrupting chemicals are ubiquitously detected in consumer products, foods, beverages, personal care products, and household cleaning products. Due to concerns about their negative effects on human health, several professional health provider societies have recommended the reduction of common endocrine disrupting chemical exposures. The purpose of this review is to provide a brief overview of common endocrine disrupting chemicals (bisphenol A, phthalates, triclosan, polybrominated ethers, and parabens) and potential effects on child development and health. In addition, we aim to provide guidance and resources for pediatricians and other health care providers with counseling strategies to help patients to minimize exposures to common endocrine disrupting chemicals. Copyright © 2017 Mosby, Inc. All rights reserved.

Stakeholders' perception of the nutrition and health claim regulation.

PubMed

de Boer, Alie; Bast, Aalt

2015-05-01

In 2007, the Nutrition and Health Claim Regulation (NHCR) entered into force, which required scientific substantiation of health claims. In the field of antioxidants, most proposed claims were negatively assessed by the European Food Safety Authority (EFSA). This study reviews the perception of the NHCR of 14 Dutch stakeholders to unravel the grounds for disproving the putative health claims. Most claims are shown to be refused based on the quality of scientific substantiation, due to usage of scientific methods on which no consensus has been reached and the differences in expectations and requirements. Three themes exemplify the need for improvement in applying the NHCR: (i) enforcement; (ii) methodology; and (iii) perceived impact of the NHCR. With highly diverging perceptions of stakeholders, the current effectiveness of the NHCR can be questioned. The views of different stakeholders on these themes help to focus the discussion on the NCHR in capturing health effects.

Challenges facing effective implementation of co-trimoxazole prophylaxis in children born to HIV-infected mothers in the public health facilities.

PubMed

Kamuhabwa, Appolinary Ar; Manyanga, Vicky

2015-01-01

If children born to HIV-infected mothers are not identified early, approximately 30% of them will die within the first year of life due to opportunistic infections. In order to prevent morbidity and mortality due to opportunistic infections in children, the World Health Organization recommends the use of prophylaxis using co-trimoxazole. However, the challenges affecting effective implementation of this policy in Tanzania have not been documented. In this study, we assessed the challenges facing the provision of co-trimoxazole prophylaxis among children born to HIV-infected mothers in the public hospitals of Dar es Salaam, Tanzania. Four hundred and ninety-eight infants' PMTCT (Prevention of Mother-to-Child Transmission of HIV) register books for the past 2 years were reviewed to obtain information regarding the provision of co-trimoxazole prophylaxis. One hundred and twenty-six health care workers were interviewed to identify success stories and challenges in the provision of co-trimoxazole prophylaxis in children. In addition, 321 parents and guardians of children born to HIV-infected mothers were interviewed in the health facilities. Approximately 80% of children were initiated with co-trimoxazole prophylaxis within 2 months after birth. Two hundred and ninety-one (58.4%) children started using co-trimoxazole within 4 weeks after birth. Majority (n=458, 91.8%) of the children were prescribed 120 mg of co-trimoxazole per day, whereas 39 (7.8%) received 240 mg per day. Only a small proportion (n=1, 0.2%) of children received 480 mg/day. Dose determination was based on the child's age rather than body weight. Parents and guardians reported that 42 (13.1%) children had missed one or more doses of co-trimoxazole during the course of prophylaxis. The majority of health care workers (89.7%) reported that co-trimoxazole is very effective for the prevention of opportunistic infections among children, but frequent shortage of co-trimoxazole in the health facilities was the main challenge. Most children who were initiated with co-trimoxazole prophylaxis did not experience significant opportunistic infections, and the drug was well tolerated. The major barrier for co-trimoxazole prophylaxis was due to frequent out-of-stocks of pediatric co-trimoxazole formulations in the health facilities. Dose determination was based on the age rather than the weight of children, thus creating potential for under- or over-dosing of children.

Studies of Health Effects from Nuclear Testing near the Semipalatinsk Nuclear Test Site, Kazakhstan.

PubMed

Grosche, Bernd; Zhunussova, Tamara; Apsalikov, Kazbek; Kesminiene, Ausrele

2015-01-01

The nuclear bomb testing conducted at the Semipalatinsk nuclear test site in Kazakhstan is of great importance for today's radiation protection research, particularly in the area of low dose exposures. This type of radiation is of particular interest due to the lack of research in this field and how it impacts population health. In order to understand the possible health effects of nuclear bomb testing, it is important to determine what studies have been conducted on the effects of low dose exposure and dosimetry, and evaluate new epidemiologic data and biological material collected from populations living in proximity to the test site. With time, new epidemiological data has been made available, and it is possible that these data may be linked to biological samples. Next to linking existing and newly available data to examine health effects, the existing dosimetry system needs to be expanded and further developed to include residential areas, which have not yet been taken into account. The aim of this paper is to provide an overview of previous studies evaluating the health effects of nuclear testing, including some information on dosimetry efforts, and pointing out directions for future epidemiologic studies.

Studies of Health Effects from Nuclear Testing near the Semipalatinsk Nuclear Test Site, Kazakhstan

PubMed Central

Grosche, Bernd; Zhunussova, Tamara; Apsalikov, Kazbek; Kesminiene, Ausrele

2015-01-01

The nuclear bomb testing conducted at the Semipalatinsk nuclear test site in Kazakhstan is of great importance for today’s radiation protection research, particularly in the area of low dose exposures. This type of radiation is of particular interest due to the lack of research in this field and how it impacts population health. In order to understand the possible health effects of nuclear bomb testing, it is important to determine what studies have been conducted on the effects of low dose exposure and dosimetry, and evaluate new epidemiologic data and biological material collected from populations living in proximity to the test site. With time, new epidemiological data has been made available, and it is possible that these data may be linked to biological samples. Next to linking existing and newly available data to examine health effects, the existing dosimetry system needs to be expanded and further developed to include residential areas, which have not yet been taken into account. The aim of this paper is to provide an overview of previous studies evaluating the health effects of nuclear testing, including some information on dosimetry efforts, and pointing out directions for future epidemiologic studies. PMID:29138710

Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health

PubMed Central

Gutierrez, Kristie S.; LePrevost, Catherine E.

2016-01-01

Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015) literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate. PMID:26848673

Sorption of Organophosphorus Flame Retardants (OPFRs) on Settled Dust

EPA Science Inventory

Organophosphorus flame retardants (OPFRs) are widely used as additives in industrial and consumer products such as electrical and electronic products, furniture, plastics, textiles, and building/construction materials. Due to human exposure and potential health effects, OPFRs inc...

IDENTIFICATION OF NEW DISINFECTION BY-PRODUCTS IN DRINKING WATER

EPA Science Inventory

Due to concern over the potential adverse health effects of trihalomethanes (THMs) and other chlorinated by-products in chlorinated drinking water, alternative disinfectants are being explored. Ozone, chlorine dioxide, and chloramine are popular alternatives, as they produce low...

Cost-effectiveness of an Evidence-Based Childhood Asthma Intervention in Real-World Primary Care Settings.

PubMed

Dor, Avi; Luo, Qian; Gerstein, Maya Tuchman; Malveaux, Floyd; Mitchell, Herman; Markus, Anne Rossier

We present an incremental cost-effectiveness analysis of an evidence-based childhood asthma intervention (Community Healthcare for Asthma Management and Prevention of Symptoms [CHAMPS]) to usual management of childhood asthma in community health centers. Data used in the analysis include household surveys, Medicaid insurance claims, and community health center expenditure reports. We combined our incremental cost-effectiveness analysis with a difference-in-differences multivariate regression framework. We found that CHAMPS reduced symptom days by 29.75 days per child-year and was cost-effective (incremental cost-effectiveness ratio: $28.76 per symptom-free days). Most of the benefits were due to reductions in direct medical costs. Indirect benefits from increased household productivity were relatively small.

Social accounting matrix and the effects of economic reform on health price index and household expenditures: Evidence from Iran.

PubMed

Keshavarz, Khosro; Najafi, Behzad; Andayesh, Yaghob; Rezapour, Aziz; Abolhallaj, Masoud; Sarabi Asiabar, Ali; Hashemi Meshkini, Amir; Sanati, Ehsan; Mirian, Iman; Nikfar, Shekoofeh; Lotfi, Farhad

2017-01-01

Background: Socioeconomic indicators are the main factors that affect health outcome. Health price index (HPI) and households living costs (HLC) are affected by economic reform. This study aimed at examining the effect of subsidy targeting plan (STP) on HPI and HLC. Methods: The social accounting matrix was used to study the direct and indirect effects of STP. We chose 11 health related goods and services including insurance, compulsory social security services, hospital services, medical and dental services, other human health services, veterinary services, social services, environmental health services, laundry& cleaning and dyeing services, cosmetic and physical health services, and pharmaceutical products in the social accounting matrix to examine the health price index. Data were analyzed by the I-O&SAM software. Results: Due to the subsidy release on energy, water, and bread prices, we found that (i) health related goods and services groups' price index rose between 33.43% and 77.3%, (ii) the living cost index of urban households increased between 48.75% and 58.21%, and (iii) the living cost index of rural households grew between 53.51% and 68.23%. The results demonstrated that the elimination of subsidy would have negative effects on health subdivision and households' costs such that subsidy elimination increased the health prices index and the household living costs, especially among low-income families. The STP had considerable effects on health subdivision price index. Conclusion: The elimination or reduction of energy carriers and basic commodities subsidies have changed health price and households living cost index. Therefore, the policymakers should consider controlling the price of health sectors, price fluctuations and shocks.

Portfolio theory and cost-effectiveness analysis: a further discussion.

PubMed

Sendi, Pedram; Al, Maiwenn J; Rutten, Frans F H

2004-01-01

Portfolio theory has been suggested as a means to improve the risk-return characteristics of investments in health-care programs through diversification when costs and effects are uncertain. This approach is based on the assumption that the investment proportions are not subject to uncertainty and that the budget can be invested in toto in health-care programs. In the present paper we develop an algorithm that accounts for the fact that investment proportions in health-care programs may be uncertain (due to the uncertainty associated with costs) and limited (due to the size of the programs). The initial budget allocation across programs may therefore be revised at the end of the investment period to cover the extra costs of some programs with the leftover budget of other programs in the portfolio. Once the total budget is equivalent to or exceeds the expected costs of the programs in the portfolio, the initial budget allocation policy does not impact the risk-return characteristics of the combined portfolio, i.e., there is no benefit from diversification anymore. The applicability of portfolio methods to improve the risk-return characteristics of investments in health care is limited to situations where the available budget is much smaller than the expected costs of the programs to be funded.

Drinking water incidents due to chemical contamination in England and Wales, 2006-2008.

PubMed

Paranthaman, Karthikeyan; Harrison, Henrietta

2010-12-01

Contamination of drinking water by microbiological and chemical agents can lead to adverse health effects. In England and Wales, the Chemicals Hazards and Poisons Division (CHaPD) of the Health Protection Agency provides expert advice on the consequences to public health of chemical contamination incidents affecting drinking water. In this study, we extracted data from the National Database on the type and nature of drinking water contamination events reported to the CHaPD between 2006 and 2008. Eighty-two incidents with confirmed chemical contamination were identified. Among the 70 incidents where data was available, 40% (28/70) of incidents related to contamination of drinking water provided by private suppliers, 31% (22/70) were due to contamination occurring close to the point of consumption (i.e. near consumer) and 29% (20/70) related to incidents where public water supplies were identified as the contaminated source. For the majority of incidents, little or no information was available on the critical exposure variables such as duration of contamination and actual or estimates of the population affected. Reassuringly, the levels of exposure in most incidents were considered unlikely to cause serious immediate or long term ill health effects. Recording of exposure data for reported contamination incidents needs to be improved.

Challenges in researching migration status, health and health service use: an intersectional analysis of a South London community

PubMed Central

Gazard, Billy; Frissa, Souci; Nellums, Laura; Hotopf, Matthew; Hatch, Stephani L.

2015-01-01

Objectives. This study aimed to investigate the associations between migration status and health-related outcomes and to examine whether and how the effect of migration status changes when it is disaggregated by length of residence, first language, reason for migration and combined with ethnicity. Design. A total of 1698 adults were interviewed from 1076 randomly selected households in two South London boroughs. We described the socio-demographic and socio-economic differences between migrants and non-migrants and compared the prevalence of health-related outcomes by migration status, length of residence, first language, reason for migration and migration status within ethnic groups. Unadjusted models and models adjusted for socio-demographic and socio-economic indicators are presented. Results. Migrants were disadvantaged in terms of socio-economic status but few differences were found between migrant and non-migrants regarding health or health service use indicators; migration status was associated with decreased hazardous alcohol use, functional limitations due to poor mental health and not being registered with a general practitioner. Important differences emerged when migration status was disaggregated by length of residence in the UK, first language, reason for migration and intersected with ethnicity. The association between migration status and functional limitations due to poor mental health was only seen in White migrants, migrants whose first language was not English and migrants who had moved to the UK for work or a better life or for asylum or political reasons. There was no association between migration status and self-rated health overall, but Black African migrants had decreased odds for reporting poor health compared to their non-migrant counterparts [odds ratio = 0.15 (0.05–0.48), p < 0.01]. Conclusions. Disaggregating migration status by length of residence, first language and reason for migration as well as intersecting it with ethnicity leads to better understanding of the effect migration status has on health and health service use. PMID:25271468

[Contribution of natural spaces to human health and wellbeing].

PubMed

Claßen, Thomas; Bunz, Maxie

2018-05-16

Natural spaces and especially urban green and blue spaces have been recognised for a long time as spaces with great potential for protecting and promoting human health and well-being. They may affect human physical, mental and social health and well-being in various ways. On one hand, this comes to pass through reduction and moderation of potential environmental health risks (e. g. noise, particulate matter, heat), psycho-physiological effects of nature experience, as well as physical effects of exposure to natural compounds and elements. On the other hand, natural spaces can affect health and well-being indirectly e. g. through motivation of health promoting behaviour (e. g. more physical activity) and through use as outdoor meeting spaces, by decreasing aggression, and through the resulting positive effects on social well-being. Yet, some potential adverse health effects of nature and landscapes have been reported, too (e. g. insecurity or fear in confusing or unmaintained natural spaces, potential rivalry in usage, allergies or skin irritations due to natural elements, risk of communicable diseases from vectors). Against the background of positive effects of natural spaces, creating, restoring and enhancing urban green and blue spaces are often claimed in terms of sustainable and integrated urban development. But which associations and impacts exist between natural spaces and health? What are the resulting demands when integrating natural spaces for a health-promoting implementation practice? This overview article provides some answers to these questions.

Environmental Noise Pollution in the United States: Developing an Effective Public Health Response

PubMed Central

Hammer, Monica S.; Swinburn, Tracy K.

2013-01-01

Background: Tens of millions of Americans suffer from a range of adverse health outcomes due to noise exposure, including heart disease and hearing loss. Reducing environmental noise pollution is achievable and consistent with national prevention goals, yet there is no national plan to reduce environmental noise pollution. Objectives: We aimed to describe some of the most serious health effects associated with noise, summarize exposures from several highly prevalent noise sources based on published estimates as well as extrapolations made using these estimates, and lay out proven mechanisms and strategies to reduce noise by incorporating scientific insight and technological innovations into existing public health infrastructure. Discussion: We estimated that 104 million individuals had annual LEQ(24) levels > 70 dBA (equivalent to a continuous average exposure level of >70 dBA over 24 hr) in 2013 and were at risk of noise-induced hearing loss. Tens of millions more may be at risk of heart disease, and other noise-related health effects. Direct regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions. Conclusion: Significant public health benefit can be achieved by integrating interventions that reduce environmental noise levels and exposures into the federal public health agenda. Citation: Hammer MS, Swinburn TK, Neitzel RL. 2014. Environmental noise pollution in the United States: developing an effective public health response. Environ Health Perspect 122:115–119; http://dx.doi.org/10.1289/ehp.1307272 PMID:24311120

[Health care access of Sub-Saharan African migrants living with chronic hepatitis B].

PubMed

Vignier, Nicolas; Spira, Rosemary Dray; Lert, France; Pannetier, Julie; Ravalihasy, Andrainolo; Gosselin, Anne; Lydié, Nathalie; Bouchaud, Olivier; Desgrées du Loû, Annabel

2017-07-10

Objective: The objective of this study was to analyse health care access of Sub-Saharan African migrants living with chronic hepatitis B (CHB) in France. Methods: The ANRS-Parcours survey was a life-event survey conducted in 2012-2013 among Sub-Saharan African migrants recruited by health care facilities managing CHB in the Paris region. Data were collected by face-to-face interview using a biographical grid and a standardized questionnaire. Results: 96.4% of the 619 participants basic health insurance coverage with CMU universal health insurance coverage in 18.6% of cases and AME state medical assistance in 23.4% of cases. One-third of basic health insurance beneficiaries did not have any complementary health insurance and 75.7% had long-term disease status. The median time to acquisition of health insurance cover after arrival in France was one year. 22.0% of participants reported delaying health care for financial reasons since their arrival in France and 9.7% reported being refused health care usually due to refusal of CMU or AME. Health care access was effective within one year of the diagnosis. Delayed health care access was more common among people without health insurance coverage in the year of diagnosis. Patients lost to follow-up for more than 12 months were rare. Conclusion: Sub-Saharan African migrants living with chronic hepatitis B rapidly access health insurance coverage and health care. However, barriers to health care access persist for some people, essentially due to absent or incomplete health insurance cover and refusal of care for AME or CMU beneficiaries.

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

PubMed

Fang, Hai; Jin, Yinzi; Zhao, Miaomiao; Zhang, Huyang; A Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

2017-10-20

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants' probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management.

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

PubMed Central

Fang, Hai; Jin, Yinzi; Zhang, Huyang; A. Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

2017-01-01

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants’ probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management. PMID:29053607

Consequences of violence across the lifespan: Mental health and sleep quality in pregnant women.

PubMed

Miller-Graff, Laura E; Cheng, Philip

2017-09-01

Research has demonstrated that exposure to violence and adversity has negative effects on both mental health and biobehavioral outcomes, such as sleep health. Research examining the relationship between past and recent violence exposure and mental health suggests that the effects of childhood adversity are especially pernicious, but to date, no studies have attempted to disentangle the direct, indirect and relative effects of past year versus childhood exposure to violence and adversity on sleep. The objective of the current study was to examine the direct effects of adverse childhood experiences (ACEs) and past year intimate partner violence (IPV) on different aspects of sleep health in pregnant women. A sample of high-risk pregnant women (n = 101) were interviewed. Mediation analysis with bias-corrected, bootstrapped confidence intervals was used to evaluate direct and indirect effects. Findings indicated that while ACEs had significant direct effects on mental health, past year IPV had stronger effects on sleep quality, latency, and efficiency. ACEs did, however, indirectly affect subjective sleep quality via past year psychological IPV. These findings suggest that sleep disturbance may be a regulatory stress response that is most clearly linked to past year violence and trauma. That is, though long-term sleep disturbance may be evident following childhood adversity, it is likely that this relationship is better explained by the role of childhood adversity in predicting adulthood revictimization or due to long-term mental health difficulties associated with early trauma. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The emerging phenomenon of electronic cigarettes.

PubMed

Caponnetto, Pasquale; Campagna, Davide; Papale, Gabriella; Russo, Cristina; Polosa, Riccardo

2012-02-01

The need for novel and more effective approaches to tobacco control is unquestionable. The electronic cigarette is a battery-powered electronic nicotine delivery system that looks very similar to a conventional cigarette and is capable of emulating smoking, but without the combustion products accountable for smoking's damaging effects. Smokers who decide to switch to electronic cigarettes instead of continuing to smoke would achieve large health gains. The electronic cigarette is an emerging phenomenon that is becoming increasingly popular with smokers worldwide. Users report buying them to help quit smoking, to reduce cigarette consumption, to relieve tobacco withdrawal symptoms due to workplace smoking restrictions and to continue to have a 'smoking' experience but with reduced health risks. The focus of the present article is the health effects of using electronic cigarettes, with consideration given to the acceptability, safety and effectiveness of this product to serve as a long-term substitute for smoking or as a tool for smoking cessation.

Impacts of Extreme Events on Human Health. Chapter 4

NASA Technical Reports Server (NTRS)

Bell, Jesse E.; Herring, Stephanie C.; Jantarasami, Lesley; Adrianopoli, Carl; Benedict, Kaitlin; Conlon, Kathryn; Escobar, Vanessa; Hess, Jeremy; Luvall, Jeffrey; Garcia-Pando, Carlos Perez;

Health facilities safety in natural disasters: experiences and challenges from South East Europe.

PubMed

Radovic, Vesela; Vitale, Ksenija; Tchounwou, Paul B

2012-05-01

The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.

An overview: modern techniques for railway vehicle on-board health monitoring systems

NASA Astrophysics Data System (ADS)

Li, Chunsheng; Luo, Shihui; Cole, Colin; Spiryagin, Maksym

2017-07-01

Health monitoring systems with low-cost sensor networks and smart algorithms are always needed in both passenger trains and heavy haul trains due to the increasing need for reliability and safety in the railway industry. This paper focuses on an overview of existing approaches applied for railway vehicle on-board health monitoring systems. The approaches applied in the data measurement systems and the data analysis systems in railway on-board health monitoring systems are presented in this paper, including methodologies, theories and applications. The pros and cons of the various approaches are analysed to determine appropriate benchmarks for an effective and efficient railway vehicle on-board health monitoring system. According to this review, inertial sensors are the most popular due to their advantages of low cost, robustness and low power consumption. Linearisation methods are required for the model-based methods which would inevitably introduce error to the estimation results, and it is time-consuming to include all possible conditions in the pre-built database required for signal-based methods. Based on this review, future development trends in the design of new low-cost health monitoring systems for railway vehicles are discussed.

Gender Difference in Health-Care Expenditure: Evidence from India Human Development Survey

PubMed Central

Saikia, Nandita; Moradhvaj; Bora, Jayanta Kumar

2016-01-01

Background While the gender disparity in health and mortality in various stages of life in India is well documented, there is limited evidence on female disadvantage in health-care expenditure (HCE). Aims Examine the gender difference in HCE in short-term and major morbidity in India, and understand the role of factors underlying the difference. Data and Methods Using two rounds of nationally representative panel data—the India Human Development Survey (IHDS) 2004–2005 and 2011–2012 (IHDS I & II)—we calculate morbidity prevalence rate and mean HCE by gender, and examine the adjusted effect of gender on major morbidity-related HCE by using a two-part regression model. Further, we performed Oaxaca-Blinder decomposition of the gender gap in HCE in major morbidity to understand the contribution of demographic and socio-economic factors. Results Health-care expenditure on females was systematically lower than on males across all demographic and socio-economic groups. Multivariate analysis confirms that female HCE is significantly lower than male HCE even after controlling demographic and socio-economic factors (β = -0.148, p = 0.000, CI:-0.206–0.091). For both short-term and major morbidity, a female disadvantage on HCE increased from IHDS I to IHDS II. For instance, the male–female gap in major morbidity related expenditure increased from INR 1298 to INR 4172. A decomposition analysis of gender gap in HCE demonstrates that about 48% of the gap is attributable to differences in demographic and socio-economic factors (endowment effect), whereas 50% of the gap is due to the differential effect of the determinants (coefficient effect). Interpretation Indians spend less on female health care than on male health care. Most of the gender gap in HCE is not due to differential distribution of factors affecting HCE. PMID:27391322

Pregnancy prevention among American Indian men ages 18 to 24: the role of mental health and intention to use birth control.

PubMed

Rink, Elizabeth; FourStar, Kris; Medicine Elk, Jarrett; Dick, Rebecca; Jewett, Lacey; Gesink, Dionne

2012-01-01

The Fort Peck Sexual Health Project: A Contextual Analysis of Native American Men is a community-based participatory research (CBPR) project that explores the extent to which knowledge, attitudes, and beliefs about sex, intimate relationships, and mental health influence sexual and reproductive health. For the purpose of this study, the influence of age, fatherhood, and mental health factors related to historical trauma and loss on young American Indian (AI) men's intention to use birth control was examined. In-depth interviews were conducted with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21 years. Thirty-eight percent of the young men reported having children. The young men reported experiences of historical trauma during their lifetime as well as emotional responses due to historical losses. Ninety-five percent reported that it was very important that they use some form of birth control to prevent their partner from getting pregnant within the next year. Logistic regression analysis indicated that, as age increased, young men were less likely to use birth control to prevent pregnancy. The young men who reported feelings of loss due to experiences related to historical trauma and loss were more likely to use birth control. Findings from this study suggest that public health efforts to educate AI men about planned pregnancies and the use of birth control may be most effective in adolescence. Public health programs that address mental health concerns such as the emotional responses due to historical losses may assist young AI men in their decision to use birth control.

Environmental noise pollution in the United States: developing an effective public health response.

PubMed

Hammer, Monica S; Swinburn, Tracy K; Neitzel, Richard L

2014-02-01

Tens of millions of Americans suffer from a range of adverse health outcomes due to noise exposure, including heart disease and hearing loss. Reducing environmental noise pollution is achievable and consistent with national prevention goals, yet there is no national plan to reduce environmental noise pollution. We aimed to describe some of the most serious health effects associated with noise, summarize exposures from several highly prevalent noise sources based on published estimates as well as extrapolations made using these estimates, and lay out proven mechanisms and strategies to reduce noise by incorporating scientific insight and technological innovations into existing public health infrastructure. We estimated that 104 million individuals had annual LEQ(24) levels > 70 dBA (equivalent to a continuous average exposure level of >70 dBA over 24 hr) in 2013 and were at risk of noise-induced hearing loss. Tens of millions more may be at risk of heart disease, and other noise-related health effects. Direct regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions. Significant public health benefit can be achieved by integrating interventions that reduce environmental noise levels and exposures into the federal public health agenda.

Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications

PubMed Central

Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

2016-01-01

Introduction: 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. Methods: 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. Results: 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. Conclusion: 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. PMID:27493592

The Effectiveness of International Non-Governmental Organizations' Response Operations during Public Health Emergency: Lessons Learned from the 2014 Ebola Outbreak in Sierra Leone.

PubMed

Shin, Yoon Ah; Yeo, Jungwon; Jung, Kyujin

2018-04-01

International Nongovernmental Organizations (INGOs) have played critical roles in improving the quality of primary health care in ordinary time and, indeed, responding to epidemic crises in developing countries. Due to a lack of empirical research for effectiveness of their responding activities, the legitimacy and accountability of nonprofits' engagement in the health crisis as a critical responder is doubted. This paper aims to examine the effectiveness of INGOs in a context of managing a fatal epidemic outbreak of Ebola in Sierra Leone during May-November, 2014; building healthcare infrastructures, providing medical supplies, educating local residents, and training response staffs. The analysis results show that development of healthcare infrastructures and provision of medical supplies have been significantly effective in terms of decreasing the severity of the crisis in chiefdoms. The findings imply that policy tools, which allow INGOs to enter to the field in a timely manner, can improve the effectiveness of INGOs' responses in current and future epidemic outbreaks in developing countries where people suffer from a lack of health infrastructures.

The Effectiveness of International Non-Governmental Organizations’ Response Operations during Public Health Emergency: Lessons Learned from the 2014 Ebola Outbreak in Sierra Leone

PubMed Central

Shin, Yoon Ah; Yeo, Jungwon

2018-01-01

International Nongovernmental Organizations (INGOs) have played critical roles in improving the quality of primary health care in ordinary time and, indeed, responding to epidemic crises in developing countries. Due to a lack of empirical research for effectiveness of their responding activities, the legitimacy and accountability of nonprofits’ engagement in the health crisis as a critical responder is doubted. This paper aims to examine the effectiveness of INGOs in a context of managing a fatal epidemic outbreak of Ebola in Sierra Leone during May–November, 2014; building healthcare infrastructures, providing medical supplies, educating local residents, and training response staffs. The analysis results show that development of healthcare infrastructures and provision of medical supplies have been significantly effective in terms of decreasing the severity of the crisis in chiefdoms. The findings imply that policy tools, which allow INGOs to enter to the field in a timely manner, can improve the effectiveness of INGOs’ responses in current and future epidemic outbreaks in developing countries where people suffer from a lack of health infrastructures. PMID:29614756

The effectiveness of removing precursors of chlorinated organic substances in pilot water treatment plant

NASA Astrophysics Data System (ADS)

Wolska, Małgorzata; Szerzyna, Sławomir; Machi, Justyna; Mołczan, Marek; Adamski, Wojciech; Wiśniewski, Jacek

2017-11-01

The presence of organic substances in the water intaken for consumption could be hazardous to human health due to the potential formation of disinfection by-products (TOX). The study were carried out in the pilot surface water treatment system consisting of coagulation, sedimentation, filtration, ozonation, adsorption and disinfection. Due to continuous operation of the system and interference with the parameters of the processes it was possible not only assess the effectiveness of individual water treatment processes in removing TOX, but also on factors participating on the course of unit processes.

Health inequalities by socioeconomic characteristics in Spain: the economic crisis effect.

PubMed

Barroso, Clara; Abásolo, Ignacio; Cáceres, José J

2016-04-11

An economic crisis can widen health inequalities between individuals. The aim of this paper is to explore differences in the effect of socioeconomic characteristics on Spaniards' self-assessed health status, depending on the Spanish economic situation. Data from the 2006-2007 and 2011-2012 National Health Surveys were used and binary logit and probit models were estimated to approximate the effects of socioeconomic characteristics on the likelihood to report good health. The difference between high and low education levels leads to differences in the likelihood to report good health of 16.00-16.25 and 18.15-18.22 percentage points in 2006-07 and 2011-12, respectively. In these two periods, the difference between employees and unemployed is 5.24-5.40 and 4.60-4.90 percentage points, respectively. Additionally, the difference between people who live in households with better socioeconomic conditions and those who are in worse situation reaches 5.37-5.46 and 3.63-3.74 percentage points for the same periods, respectively. The magnitude of the contribution of socioeconomic characteristics to health inequalities changes with the economic cycle; but this effect is different depending on the socioeconomic characteristics indicator that is being measured. In recessive periods, health inequalities due to education level increase, but those linked to individual professional status and household living conditions are attenuated. When the joint effects of individuals' characteristics are considered, the economic crisis brings about a slight increase in the inequalities in the probability of reporting good health between the two extreme profiles of individuals. The design of public policies aimed at preventing any worsening of health inequalities during recession periods should take into account these differential effects of socioeconomic characteristics indicators on health inequalities.

Landfill leachate sludge use as soil additive prior and after electrocoagulation treatment: A cytological assessment using CHO-k1 cells.

PubMed

Morozesk, M; Bonomo, M M; Rocha, L D; Duarte, I D; Zanezi, E R L; Jesus, H C; Fernandes, M N; Matsumoto, S T

2016-09-01

Electrocoagulation has recently attracted attention as a potential technique for treating toxic effluents due to its versatility and environmental compatibility, generating a residue chemically suitable to be used as a soil additive. In the present study, landfill leachate sludge hazardous effects were investigated prior and after electrocoagulation process using in vitro assays with the mammalian cells CHO-k1. An integrated strategy for risk assessment was used to correctly estimate the possible adverse landfill leachate sludge effects on human health and ecosystem. Electrocoagulation process proved to be an effective treatment due to possibility to improve effluent adverse characteristics and produce sludge with potential to be used as soil additive. Despite low cytoxicity, the residue presented genotoxic and mutagenic effects, indicating a capacity to induce genetic damages, probably due to induction of polyploidization process in cells. The observed effects demand an improvement of waste management methods for reduce negative risks of landfill leachate sludge application. Copyright © 2016 Elsevier Ltd. All rights reserved.

Risk Assessment and Control through Countermeasure System Iplementation for Long-term Crew Exposure to Microgravity

NASA Technical Reports Server (NTRS)

Gernand, Jeremy M.

2004-01-01

Experience with the International Space Station (ISS) program demonstrates the degree to which engineering design and operational solutions must protect crewmembers from health risks due to long-term exposure to the microgravity environment. Risks to safety and health due to degradation in the microgravity environment include crew inability to complete emergency or nominal activities, increased risk of injury, and inability to complete safe return to the ground due to reduced strength or embrittled bones. These risks without controls slowly increase in probability for the length of the mission and become more significant for increasing mission durations. Countermeasures to microgravity include hardware systems that place a crewmember s body under elevated stress to produce an effect similar to daily exposure to gravity. The ISS countermeasure system is predominately composed of customized exercise machines. Historical treatment of microgravity countermeasure systems as medical research experiments unintentionally reduced the foreseen importance and therefore the capability of the systems to function in a long-term operational role. Long-term hazardous effects and steadily increasing operational risks due to non-functional countermeasure equipment require a more rigorous design approach and incorporation of redundancy into seemingly non- mission-critical hardware systems. Variations in the rate of health degradation and responsiveness to countermeasures among the crew population drastically increase the challenge for design requirements development and verification of the appropriate risk control strategy. The long-term nature of the hazards and severe limits on logistical re-supply mass, volume and frequency complicates assessment of hardware availability and verification of an adequate maintenance and sparing plan. Design achievement of medically defined performance requirements by microgravity countermeasure systems and incorporation of adequate failure tolerance significantly reduces these risks. Future implementation of on-site monitoring hardware for critical health parameters such as bone mineral density would allow greater responsiveness, efficiency, and optimized design of the countermeasures system.

The effect of streptomycin, oxytetracycline, tilmicosin and phenylbutazone on spermatogenesis in bulls.

PubMed Central

Barth, A D; Wood, M R

1998-01-01

To determine whether declining semen quality associated with health problems may be due to certain antibiotic or anti-inflammatory treatments, semen was collected 3 times per week for up to 42 d from 6 normal bulls after treatment with oxytetracycline, tilmicosin, dihydrostreptomycin, or phenylbutazone. No adverse effects on semen quality were observed. PMID:10051958

Health Effects and Environmental Justice Concerns of Exposure to Uranium in Drinking Water.

PubMed

Corlin, Laura; Rock, Tommy; Cordova, Jamie; Woodin, Mark; Durant, John L; Gute, David M; Ingram, Jani; Brugge, Doug

2016-12-01

We discuss the recent epidemiologic literature regarding health effects of uranium exposure in drinking water focusing on the chemical characteristics of uranium. While there is strong toxicologic evidence for renal and reproductive effects as well as DNA damage, the epidemiologic evidence for these effects in people exposed to uranium in drinking water is limited. Further, epidemiologic evidence is lacking for cardiovascular and oncogenic effects. One challenge in characterizing health effects of uranium in drinking water is the paucity of long-term cohort studies with individual level exposure assessment. Nevertheless, there are environmental justice concerns due to the substantial exposures for certain populations. For example, we present original data suggesting that individuals living in the Navajo Nation are exposed to high levels of uranium in unregulated well water used for drinking. In 10 out of 185 samples (5.4 %), concentrations of uranium exceeded standards under the Safe Drinking Water Act. Therefore, efforts to mitigate exposure to toxic elements in drinking water are warranted and should be prioritized.

Health Information Needs and Health Seeking Behavior During the 2014-2016 Ebola Outbreak: A Twitter Content Analysis

PubMed Central

Odlum, Michelle; Yoon, Sunmoo

2018-01-01

Introduction: For effective public communication during major disease outbreaks like the 2014-2016 Ebola epidemic, health information needs of the population must be adequately assessed. Through content analysis of social media data, like tweets, public health information needs can be effectively assessed and in turn provide appropriate health information to address such needs. The aim of the current study was to assess health information needs about Ebola, at distinct epidemic time points, through longitudinal tracking. Methods: Natural language processing was applied to explore public response to Ebola over time from July 2014 to March 2015. A total 155,647 tweets (unique 68,736, retweet 86,911) mentioning Ebola were analyzed and visualized with infographics. Results: Public fear, frustration, and health information seeking regarding Ebola-related global priorities were observed across time. Our longitudinal content analysis revealed that due to ongoing health information deficiencies, resulting in fear and frustration, social media was at times an impediment and not a vehicle to support health information needs.  Discussion: Content analysis of tweets effectively assessed Ebola information needs. Our study also demonstrates the use of Twitter as a method for capturing real-time data to assess ongoing information needs, fear, and frustration over time.  PMID:29707416

Increased Mortality in Schizophrenia Due to Cardiovascular Disease – A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions

PubMed Central

Ringen, Petter Andreas; Engh, John A.; Birkenaes, Astrid B.; Dieset, Ingrid; Andreassen, Ole A.

2014-01-01

Background: Schizophrenia is among the major causes of disability worldwide and the mortality from cardiovascular disease (CVD) is significantly elevated. There is a growing concern that this health challenge is not fully understood and efficiently addressed. Methods: Non-systematic review using searches in PubMed on relevant topics as well as selection of references based on the authors’ experience from clinical work and research in the field. Results: In most countries, the standardized mortality rate in schizophrenia is about 2.5, leading to a reduction in life expectancy between 15 and 20 years. A major contributor of the increased mortality is due to CVD, with CVD mortality ranging from 40 to 50% in most studies. Important causal factors are related to lifestyle, including poor diet, lack of physical activity, smoking, and substance abuse. Recent findings suggest that there are overlapping pathophysiology and genetics between schizophrenia and CVD-risk factors, further increasing the liability to CVD in schizophrenia. Many pharmacological agents used for treating psychotic disorders have side effects augmenting CVD risk. Although several CVD-risk factors can be effectively prevented and treated, the provision of somatic health services to people with schizophrenia seems inadequate. Further, there is a sparseness of studies investigating the effects of lifestyle interventions in schizophrenia, and there is little knowledge about effective programs targeting physical health in this population. Discussion: The risk for CVD and CVD-related deaths in people with schizophrenia is increased, but the underlying mechanisms are not fully known. Coordinated interventions in different health care settings could probably reduce the risk. There is an urgent need to develop and implement effective programs to increase life expectancy in schizophrenia, and we argue that mental health workers should be more involved in this important task. PMID:25309466

[A Survey about the Radiation Effects and A Health Survey of Fukushima Inhabitants after the Fukushima Daiichi Nuclear Power Plant Accident].

PubMed

Okazaki, Ryuji; Ohga, Kazuhiro; Yoko-O, Makoto; Kohzaki, Masaoki

According to questionnaire surveys in 2011 and 2013 about the health effects of radiation after the Fukushima Daiichi Nuclear Power Plant Accident, the guardians of child patients were more anxious than doctors and medical students. Also, according to the thyroid examinations in a Fukushima health survey, 190 cases of thyroid cancer were reported, and anxiety about radiation effects remained. This study is based on a survey about the guardians of child patients anxiety about radiation effects six years after the nuclear power plant accident, and includes a questionnaire survey about radiation effects and thyroid examinations in a Fukushima health survey. Anonymous question sheets with 20 questions were sent to pediatric medical facilities in Fukushima, and the parents of children who consulted the pediatric and medical staff answered the questionnaire. Thirty percent of the guardians of child patients had never been educated about radiation and 67% had never been educated about the effects of radiation on humans. The guardians of child patients were more anxious than the medical staff about thyroid cancer, health effects on children and genetic effects. Our results indicate that the guardians of child patients think that the increase in the incidence of thyroid cancer is due to radiation effects after the nuclear power plant accident and they desire continued thyroid examinations.

Milk kefir: nutritional, microbiological and health benefits.

PubMed

Rosa, Damiana D; Dias, Manoela M S; Grześkowiak, Łukasz M; Reis, Sandra A; Conceição, Lisiane L; Peluzio, Maria do Carmo G

2017-06-01

Kefir is fermented milk produced from grains that comprise a specific and complex mixture of bacteria and yeasts that live in a symbiotic association. The nutritional composition of kefir varies according to the milk composition, the microbiological composition of the grains used, the time/temperature of fermentation and storage conditions. Kefir originates from the Caucasus and Tibet. Recently, kefir has raised interest in the scientific community due to its numerous beneficial effects on health. Currently, several scientific studies have supported the health benefits of kefir, as reported historically as a probiotic drink with great potential in health promotion, as well as being a safe and inexpensive food, easily produced at home. Regular consumption of kefir has been associated with improved digestion and tolerance to lactose, antibacterial effect, hypocholesterolaemic effect, control of plasma glucose, anti-hypertensive effect, anti-inflammatory effect, antioxidant activity, anti-carcinogenic activity, anti-allergenic activity and healing effects. A large proportion of the studies that support these findings were conducted in vitro or in animal models. However, there is a need for systematic clinical trials to better understand the effects of regular use of kefir as part of a diet, and for their effect on preventing diseases. Thus, the present review focuses on the nutritional and microbiological composition of kefir and presents relevant findings associated with the beneficial effects of kefir on human and animal health.

Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea

PubMed Central

2017-01-01

Purpose This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002–2013. Methods A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions. PMID:29093985

TREATMENT OF PAHS AND PCBS USING SULFATE RADICAL-BASED OXIDATION PROCESSES

EPA Science Inventory

Polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) in aquatic systems pose serious threat to public health due to their toxicity and potential carcinogenicity [1]. Sulfate radical-based oxidation processes can be effectively used for degradation of these...

AIR POLLUTION AND EXERCISE-INDUCED BRONCHOCONSTRICTION

EPA Science Inventory

If ambient PM is toxic, a statistical relationship might be expected between personal exposure to ambient PM and health effects due to ambient PM. However, some exposure analysts seem to believe that there cannot be a meaningful relationship between ambient concentrations of PM ...

5 CFR 842.106 - Elections of retirement coverage under the District of Columbia Financial Responsibility and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... employee has elected to participate in a retirement, health or life insurance program offered by the... timely election and the employee thereafter acted with due diligence in making the election. (d) Effect...

5 CFR 831.204 - Elections of retirement coverage under the District of Columbia Financial Responsibility and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... retirement, health or life insurance program offered by the District of Columbia. (2) Exception. A former... timely election and the employee thereafter acted with due diligence in making the election. (e) Effect...

IDENTIFICATION OF CHLORINE DIOXIDE AND CHLORAMINE DRINKING WATER DISINFECTION BY-PRODUCTS

EPA Science Inventory

Due to concern over the potential adverse health effects of trihalomethanes (THMs) and other chlorinated by-products in chlorinated drinking water, alternative disinfection methods are being explored. Chlorine dioxide and chloramine are two popular alternative disinfectants, with...

Oral Health in Electroconvulsive Therapy: A Neglected Topic.

PubMed

Muzyka, Brian C; Glass, Magdalena; Glass, Oliver M

2017-03-01

Psychiatric medications may have serious and untoward adverse effects such as blurred vision, restlessness, agranulocytosis, muscle rigidity, and tremors. When compared to medications, electroconvulsive therapy (ECT) is becoming a more acceptable treatment due to its efficacy, tolerability, and minimal adverse effect profile. Oral trauma can be an ECT-related adverse effect. We reviewed the published literature on oral health and dental protection in patients undergoing ECT, and found that there are deficits in all guidelines on dental protection during ECT. Dental assessment and treatment before and after ECT is warranted. Given the increased risk of poor oral health in psychiatric patients, and the continued evolution of ECT as a mainstay treatment, it is important that studies be conducted to determine the optimal method of oral protection. If adequate care can be ensured, the risks of ECT-induced oral trauma will be minimized.

Physical changes of the environment and health effects with special reference to water pollution and sanitation in Malaysia.

PubMed

Sekarajasekaran, I A

1979-12-01

Development of a human community are not without changes in its environment. Such changes result in either beneficial or adverse effects on human health. In Malaysia, in the wake of the New Economic Policy aimed at the redressing of the poor population and income distribution, development of the nation has brought about various changes in the environment. Some of these changes have elevated basic public health problems, while others, particularly new agricultural practices and industrialisation programmes with urbanisation trends, have brought a new set of problems due to water pollution and sanitation. Various measures are being taken to protect and to improve the environment so that progress can be realised with minimum adverse effects. This also calls for assistance from international sources, in terms of expertise, training and funds.

Improving the Effectiveness of Electronic Health Record-Based Referral Processes

PubMed Central

2012-01-01

Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. However, despite support by technology, referral communication between primary care providers and specialists is often unsatisfactory and is unable to eliminate care delays. This may be in part due to lack of attention to how information and communication technology fits within the social environment of health care. Making electronic referral communication effective requires a multifaceted “socio-technical” approach. Using an 8-dimensional socio-technical model for health information technology as a framework, we describe ten recommendations that represent good clinical practices to design, develop, implement, improve, and monitor electronic referral communication in the outpatient setting. These recommendations were developed on the basis of our previous work, current literature, sound clinical practice, and a systems-based approach to understanding and implementing health information technology solutions. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication. PMID:22973874

Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan.

PubMed

Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

2015-05-01

The Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services. Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Poverty dynamics in Germany: Evidence on the relationship between persistent poverty and health behavior.

PubMed

Aue, Katja; Roosen, Jutta; Jensen, Helen H

2016-03-01

Previous studies have found poverty to be related to lower levels of health due to poor health behavior such as unhealthy eating, smoking or less physical activity. Longer periods of poverty seem to be especially harmful for individual health behavior. Studies have shown that poverty has a dynamic character. Moreover, poverty is increasingly regarded as being a multidimensional construct and one that considers more aspects than income alone. Against this background this paper analyzes the relationship between health behavior and persistent spells of income poverty as well as a combined poverty indicator using data of the German Socio-Economic Panel (2000-2010). Next to cross-sectional logistic regression models we estimate fixed-effects models to analyze the effect of persistent poverty on dietary behavior, tobacco consumption, and physical activity. Cross-sectional results suggest that persistent poverty is related to poor health behavior, particularly regarding tobacco consumption and physical activity. Results also show that multidimensional and dynamic aspects of poverty matter. Complementary panel analyses reveal negative effects for the combined poverty indicator only for dietary behavior in the total sample. However, by analyzing the sample by gender we identify further effects of persistent poverty on health behavior. The analyses show that not only do individuals in poverty but also those in precarious situations show health-damaging behavior more often. Copyright © 2016 Elsevier Ltd. All rights reserved.

Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria

PubMed Central

Bali, Sulzhan; Stewart, Kearsley A

2016-01-01

Background The already significant impact of the Ebola epidemic on Guinea, Liberia and Sierra Leone, was worsened by a fear of contagion that aggravated the health crisis. However, in contrast to other Ebola-affected countries, Nigeria fared significantly better due to its swift containment of the disease. The objective of our study was to describe the impact of Ebola on the Nigerian private sector. This paper introduces and defines the term fearonomic effect as the direct and indirect economic effects of both misinformation as well as fear-induced aversion behaviour, exhibited by individuals, organisations or countries during an outbreak or an epidemic. Methods This study was designed as a cross-sectional mixed-methods study that used semistructured in-depth interviews and a supporting survey to capture the impact of Ebola on the Nigerian private sector after the outbreak. Themes were generated from the interviews on the direct and indirect impact of Ebola on the private sector; the impact of misinformation and fear-based aversion behaviour in the private sector. Results Our findings reveal that the fearonomic effects of Ebola included health service outages and reduced healthcare usage as a result of misinformation and aversion behaviour by both patients and providers. Although certain sectors (eg, health sector, aviation sector, hospitality sector) in Nigeria were affected more than others, no business was immune to Ebola's fearonomic effects. We describe how sectors expected to prosper during the outbreak (eg, pharmaceuticals), actually suffered due to the changes in consumption patterns and demand shocks. Conclusion In a high-stressor epidemic-like setting, altered consumption behaviour due to distorted disease perception, misinformation and fear can trigger short-term economic cascades that can disproportionately affect businesses and lead to financial insecurity of the poorest and the most vulnerable in a society. PMID:28588965

The Reciprocal Interactions between Polyphenols and Gut Microbiota and Effects on Bioaccessibility

PubMed Central

Ozdal, Tugba; Sela, David A.; Xiao, Jianbo; Boyacioglu, Dilek; Chen, Fang; Capanoglu, Esra

2016-01-01

As of late, polyphenols have increasingly interested the scientific community due to their proposed health benefits. Much of this attention has focused on their bioavailability. Polyphenol–gut microbiota interactions should be considered to understand their biological functions. The dichotomy between the biotransformation of polyphenols into their metabolites by gut microbiota and the modulation of gut microbiota composition by polyphenols contributes to positive health outcomes. Although there are many studies on the in vivo bioavailability of polyphenols, the mutual relationship between polyphenols and gut microbiota is not fully understood. This review focuses on the biotransformation of polyphenols by gut microbiota, modulation of gut microbiota by polyphenols, and the effects of these two-way mutual interactions on polyphenol bioavailability, and ultimately, human health. PMID:26861391

[The importance of soy in Mexico, its nutritional value and effect on health].

PubMed

Torres y Torres, Nimbe; Tovar-Palacio, Armando R

2009-01-01

Soy protein has been used in several Latin-American countries including Mexico in various food programs with the purpose to improve the nutritional status of the population due to the high nutritional value and its relatively low cost that was maintained for some time. In the present work, the use and research on soy in Mexico since 1970 is described. In addition, this review shows the effects of the different components of soy, in particular its protein and the isoflavones on health, the mechanism of action of soy protein to reduce cholesterol and triglycerides, and insulin secretion, as well as its glycemic response, and finally, the recommendations of soy protein consumption to obtain a health benefit.

Promoting universal financial protection: health insurance for the poor in Georgia--a case study.

PubMed

Zoidze, Akaki; Rukhazde, Natia; Chkhatarashvili, Ketevan; Gotsadze, George

2013-11-15

The present study focuses on the program "Medical Insurance for the Poor (MIP)" in Georgia. Under this program, the government purchased coverage from private insurance companies for vulnerable households identified through a means testing system, targeting up to 23% of the total population. The benefit package included outpatient and inpatient services with no co-payments, but had only limited outpatient drug benefits. This paper presents the results of the study on the impact of MIP on access to health services and financial protection of the MIP-targeted and general population. With a holistic case study design, the study employed a range of quantitative and qualitative methods. The methods included document review and secondary analysis of the data obtained through the nationwide household health expenditure and utilisation surveys 2007-2010 using the difference-in-differences method. The study findings showed that MIP had a positive impact in terms of reduced expenditure for inpatient services and total household health care costs, and there was a higher probability of receiving free outpatient benefits among the MIP-insured. However, MIP insurance had almost no effect on health services utilisation and the households' expenditure on outpatient drugs, including for those with MIP insurance, due to limited drug benefits in the package and a low claims ratio. In summary, the extended MIP coverage and increased financial access provided by the program, most likely due to the exclusion of outpatient drug coverage from the benefit package and possibly due to improper utilisation management by private insurance companies, were not able to reverse adverse effects of economic slow-down and escalating health expenditure. MIP has only cushioned the negative impact for the poorest by decreasing the poor/rich gradient in the rates of catastrophic health expenditure. The recent governmental decision on major expansion of MIP coverage and inclusion of additional drug benefit will most likely significantly enhance the overall MIP impact and its potential as a viable policy instrument for achieving universal coverage. The Georgian experience presented in this paper may be useful for other low- and middle-income countries that are contemplating ways to ensure universal coverage for their populations.

HIV treatment and reproductive health in the health system in Burkina Faso: resource allocation and the need for integration.

PubMed

Windisch, Ricarda; de Savigny, Don; Onadja, Geneviève; Somda, Antoine; Wyss, Kaspar; Sié, Ali; Kouyaté, Bocar

2011-11-01

Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Climate change: overview of data sources, observed and predicted temperature changes, and impacts on public and environmental health

Treesearch

David H. Levinson; Christopher J. Fettig

2014-01-01

This chapter addresses the societal and the environmental impacts of climate change related to increasing surface temperatures on air quality and forest health. Increasing temperatures at and near the earth’s surface, due to both a warming climate and urban heat island effects, have been shown to increase ground-level ozone concentrations in cities across the U.S. In...

Joint Force Quarterly. Issue 48, 1st Quarter 2008

DTIC Science & Technology

2008-01-01

Closure and joint basing initiatives. n Engage in the development of a broad- based, flexible, effective , and affordable joint military health care system...in a London hospital in November 2006 due to ingested alpha particles from Polonium 210 . Just the trace trail of Polonium 210 across the city and...can we adequately defend the Nation. Therefore, we will: n Determine the true health of our ground forces in terms of people, training, equipment

Practice points in utilizing local volunteers in community health projects.

PubMed

Muula, Adamson S; Theu, Joe; Hofman, Jan J

2004-07-01

Community volunteers are recruited for many health intervention projects. There are various motivations for the use of the volunteers and these include: the desire to reduce financial costs of projects/programmes; to encourage community ownership; ensure long-term sustainability of the health intervention; and to empower local communities through training offered the project. Health intervention measures working with community volunteers should not be implemented without due consideration of issues regarding mobilization and engagement, skills and motivation of the volunteers and their effectiveness and efficiency towards the attainment of the project goals. This paper discusses some tips that should be considered when community volunteers are used in resource-limited situations.

Community Response to Impaired Drinking Water Quality: Evidence from Bottled Water Sales

NASA Astrophysics Data System (ADS)

Allaire, M.; Zheng, S.; Lall, U.

2017-12-01

Drinking water contaminants pose a harm to public health. When confronted with elevated contaminate levels, individuals can take averting actions to reduce exposure, such as bottled water purchases. This study addresses a problem of national interest given that 9 to 45 million people have been affected by drinking water quality violations in each of the past 34 years. Moreover, few studies address averting behavior and avoidance costs due to water quality violations. This study assesses how responses might differ across baseline risk of impaired water quality and demographics of service area. We match a panel of weekly supermarket sales data with geocoded violations data for 67 counties in the Southeast from 2006-2015. We estimate the change in bottled water sales due to drinking water violations using a fixed effects model. Observing market behavior also allows us to calculate the cost of these averting actions. Critical findings from this study contribute to understanding how communities respond to water quality violations. We find that violations have considerable effects on bottled water consumption. Sales increase 8.1 percent due to violations related to microorganisms and 31.2 percent due to Tier 1 violations, which pose an immediate health risk. In addition, we calculate a national cost of averting actions of $26 million for microorganism violations from 2006-2015, which represents a lower-bound estimate. Averting costs vary considerably across the U.S. and some counties bear a particularly large burden, such as in California and Texas. Overall, this study provides insight into how averting behavior differs across contaminant type, water utility characteristics, and community demographics. Such knowledge can aid public health agencies, water systems, and environmental regulators to direct assistance to communities most in need.

Oral health behaviour of urban and semi-urban schoolchildren in the Lao PDR.

PubMed

Jürgensen, N; Petersen, P E

2011-12-01

To describe the oral health related knowledge, behaviour, and attitude towards health of 12-year old Lao schoolchildren; analyse how health risk factors relate to socio-demographic background; and determine the relative effect of living conditions on health and risk behaviour. Cross sectional study of 12-year old schoolchildren chosen by multistage sampling to fit the objective of the study. The final sample comprised 621 children of 2nd grade of secondary schools in Vientiane, Lao Peoples Democratic Republic. Data were collected by structured questionnaire covering behaviour, attitudes and knowledge related to oral and general health and perception of own health. 69% of the children reported toothache during the previous 12 months and 38% reported school absenteeism due to toothache. Nevertheless, 77% stated frequent brushing and 91% the use of fluoridated toothpaste. Only 29% reported dental visits for this period while 42% had never seen a dentist. Fear of pain, cost and distance were stated as barriers for dental visits. Knowledge on caries prevention was high, aetiology of oral disease less known, and intake of hidden sugar surprisingly frequent. Socio-economic position and attitude towards health were important predictors for oral health behaviour and risk behaviour. Despite regular tooth brushing practice and widespread use of fluoridated toothpaste school absenteeism due to toothache is high. Significant socio-demographic gradient exists in risk factors for oral health. To reduce oral health inequality systematic oral health promotion should be implemented through the existing school health platform strengthening healthy behaviour and focussing on risk factors for oral as well as general health.

The influence of the rural health security schemes on health utilization and household impoverishment in rural China: data from a household survey of western and central China

PubMed Central

2010-01-01

Background The New Rural Cooperative Medical Scheme (NRCMS, voluntary health insurance) and the Medical Financial Assistance (MFA, financial relief program) were established in 2003 for rural China. The aim of this study was to document their coverage, assess their effectiveness on access to in-patient care and protection against financial catastrophe and household impoverishment due to health spending, and identify the factors predicting impoverishment with and without these schemes. Methods A cross-sectional household survey was conducted in 2008 in Hebei and Shaanxi provinces and the Inner Mongolia Autonomous Region using a multi-stage sampling technique. Information on personal demographic characteristics, chronic illness status, health care use, household expenditure, and household health spending were collected by interview. Results NRCMS covered 90.8% of the studied individuals and among the designated poor, 7.6% had their premiums paid by MFA. Of those referred for hospitalization in the year prior to the interview, 34.3% failed to comply, mostly (80.2%) owing to financial constraints. There was no significant difference in the unmet need for admission between the insured with NRCMS and the uninsured. Before reimbursement, the incidence of catastrophic health payment (household health spending more than 40% of household's capacity to pay) and medical impoverishment (household per capita income falling below the poverty line due to medical expense) was 14.3% and 8.2%, respectively. NRCMS prevented 9.9% of the households from financial catastrophe and 7.7% from impoverishment, whereas MFA kept just one household from impoverishment and had no effect on financial catastrophe. Household per capita expenditure and household chronic disease proportion (proportion of members of a household with chronic illness) were the most important determinants of the unmet need for admission, risk of being impoverished and the chance of not being saved from impoverishment. Conclusion The coverage of NRCMS among the rural population was high but not adequate to improve access to in-patient care and protect against financial catastrophe and household impoverishment due to health payment, especially for the poor and the chronically ill. Furthermore, MFA played almost no such role; therefore, the current schemes need to be improved. PMID:20178565

Measurement of inequity in health care with heterogeneous response of use to need.

PubMed

Van de Poel, Ellen; Van Doorslaer, Eddy; O'Donnell, Owen

2012-07-01

We propose a method of measuring and decomposing inequity in health care utilisation that allows for heterogeneity in the use-need relationship. This makes explicit inequity that derives from unequal treatment response to variation in need, as well as that due to differential effects of non-need determinants. Under plausible conditions concerning heterogeneity in the use-need relationship and the distribution of need, existing methods that impose homogeneity will underestimate pro-rich inequity. This prediction is confirmed for four middle-income Asian countries. In those countries, around one half of the observed socioeconomic inequality is due to utilisation being more responsive to need among the higher wealth and urban dwelling individuals. Copyright © 2012 Elsevier B.V. All rights reserved.

Public concerns and behaviours towards solid waste management in Italy.

PubMed

Sessa, Alessandra; Di Giuseppe, Gabriella; Marinelli, Paolo; Angelillo, Italo F

2010-12-01

A self-administered questionnaire investigated knowledge, perceptions of the risks to health associated with solid waste management, and practices about waste management in a random sample of 1181 adults in Italy. Perceived risk of developing cancer due to solid waste burning was significantly higher in females, younger, with an educational level lower than university and who believed that improper waste management is linked to cancer. Respondents who had visited a physician at least once in the last year for fear of contracting a disease due to the non-correct waste management had an educational level lower than university, have modified dietary habits for fear of contracting disease due to improper waste management, believe that improper waste management is linked to allergies, perceive a higher risk of contracting infectious disease due to improper waste management and have participated in education/information activities on waste management. Those who more frequently perform with regularity differentiate household waste collection had a university educational level, perceived a higher risk of developing cancer due to solid waste burning, had received information about waste collection and did not need information about waste management. Educational programmes are needed to modify public concern about adverse health effects of domestic waste.

Exploring Spanish health social media for detecting drug effects

PubMed Central

2015-01-01

Background Adverse Drug reactions (ADR) cause a high number of deaths among hospitalized patients in developed countries. Major drug agencies have devoted a great interest in the early detection of ADRs due to their high incidence and increasing health care costs. Reporting systems are available in order for both healthcare professionals and patients to alert about possible ADRs. However, several studies have shown that these adverse events are underestimated. Our hypothesis is that health social networks could be a significant information source for the early detection of ADRs as well as of new drug indications. Methods In this work we present a system for detecting drug effects (which include both adverse drug reactions as well as drug indications) from user posts extracted from a Spanish health forum. Texts were processed using MeaningCloud, a multilingual text analysis engine, to identify drugs and effects. In addition, we developed the first Spanish database storing drugs as well as their effects automatically built from drug package inserts gathered from online websites. We then applied a distant-supervision method using the database on a collection of 84,000 messages in order to extract the relations between drugs and their effects. To classify the relation instances, we used a kernel method based only on shallow linguistic information of the sentences. Results Regarding Relation Extraction of drugs and their effects, the distant supervision approach achieved a recall of 0.59 and a precision of 0.48. Conclusions The task of extracting relations between drugs and their effects from social media is a complex challenge due to the characteristics of social media texts. These texts, typically posts or tweets, usually contain many grammatical errors and spelling mistakes. Moreover, patients use lay terminology to refer to diseases, symptoms and indications that is not usually included in lexical resources in languages other than English. PMID:26100267

Smoking and early retirement due to chronic disability.

PubMed

Bengtsson, Tommy; Nilsson, Anton

2018-05-01

This paper considers the long-term effects of smoking on disability retirement in Sweden. Smoking is known to have damaging effects on health, but there is limited evidence on how the effects of smoking translate into worse labour market outcomes, such as the inability to work. In contrast to the few previous studies on smoking and disability retirement, we use a large population sample with registry information on smoking, which is recorded for all women who give birth in Sweden. Thanks to these comprehensive data, we are able to account for a much broader range of potential confounders. In particular, by the use of sibling and twin fixed effects, we account for unobserved heterogeneity in childhood environment and family characteristics. Given that smoking is often initiated in adolescence, one would suspect such factors to play important roles. Among individuals aged 50-64 in 2011, a simple model suggested smokers to have a 5 percentage point higher probability of receiving (full) disability pension, making them more than twice as likely as non-smokers to receive this. However, in a model with sibling fixed effects, the size of the effect was reduced by more than a third. The results point to the importance of confounders, such as childhood circumstances or behaviours, which were not accounted for by previous studies. We also consider effects on disability due to different health conditions. In relative terms, effects are the largest for circulatory conditions and tumours. Results are largely driven by health problems severe enough to merit hospitalization, and there is no evidence of a role played by financial incentives. Copyright © 2018 Elsevier B.V. All rights reserved.

Determining Types of Health Effects To Persian Gulf Veterans Due To Exposure To Occupational Hazards

DTIC Science & Technology

1995-12-01

complications . No other systemic effects were observed in animal tests [59:271. No studies have been found pertaining to immunological, developmental...lethargy, coma, and semicoma, and complications of the central nervous system [59:281. Other effects noted were convulsions, unconsciousness...more often in women than in men [11:20491. Many investigators feel that CFS is closely related to Epstein-Barr syndrome, mononucleosis , postviral

The effect of assisted reproduction treatment on mental health in fertile women.

PubMed

Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza

2016-01-01

The process of assisted reproductive treatment is a stressful situation in the treatment of infertile couples and it would harm the mental health of women. Fertile women who started infertility treatment due to male factor infertility have reported to experience less stress and depression than other women before the assisted reproductive process but considering the cultural and social factors and also the etiology of the assisted reproductive process, it could affect the metal health of these women. Therefore, this study was conducted to evaluate the mental health of fertile women who undergo assisted reproductive treatment due to male factor infertility. This study was a prospective study on 70 fertile women who underwent assisted reproductive treatment due to male factor infertility. The exclusion criterion was to stop super ovulation induction. To assess mental health, anxiety and depression dimensions of the general health questionnaire were used. Before starting ovulation induction and after oocyte harvesting, the general health questionnaire was filled by women who were under treatment. Data were analyzed using multi-variable linear regression, paired t-test, and Chi-square. The results showed that the mean score of depression and anxiety before ovulation induction and after oocyte harvesting were not significantly different; but the rate of mental health disorder in the depression dimension was significantly decreased after oocytes harvesting (31.7% vs. 39.7%). Also, there was a significant relation between the level of anxiety and depression before ovulation induction and after oocyte harvesting (P < 0.05). The anxiety level after oocyte harvesting had a positive and significant correlation with the economic situation (P < 0.05). This study revealed that the process of assisted reproductive treatment does not affect the mental health in fertile women independently, but these women start assisted reproductive process with high levels of depression and anxiety. Therefore, prior to the assisted reproductive treatment mental health consultation is needed.

Odor investigation of a Portland cement plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pleus, R.C.

1998-12-31

The main concern expressed by Smithville residents is whether the odors they were smelling during odor events were due to chemicals that could cause adverse health effects. Odors were allegedly emanating from the town`s Portland cement plant. The purpose of the study was to measure the ambient air for 20 reduced sulfur, 50 volatile organic compounds, and air samples for olfactometric analysis. Carbonyl sulfide was found to be at a concentration that could create a sense of odor and irritation. This sense of irritation may be due to a physiological response by the central nervous system, and is not associatedmore » with any known adverse effects. This physiological response could account for some or all of the irritation experienced by residents during odor events. Comparing chemical concentrations that were detected in air samples to standard and recognized guidelines for acceptable exposure, all measured concentrations were found to be well below the acceptable criteria. From these data the authors conclude that no acute or chronic adverse health effects are expected at the concentrations of the chemicals detected downwind of the cement plant, either routinely or during odor events.« less

Elucidative analysis and sequencing of two respiratory health monitoring methods to study the impact of varying atmospheric composition on human health

NASA Astrophysics Data System (ADS)

Awasthi, Amit; Hothi, Navjot; Kaur, Prabhjot; Singh, Nirankar; Chakraborty, Monojit; Bansal, Sangeeta

2017-12-01

Atmospheric composition of ambient air consists of different gases in definite proportion that affect the earth's climate and its ecological system. Due to varied anthropogenic reasons, this composition is changed, which ultimately have an impact on the health of living beings. For survival, the human respiratory system is one of the sensitive systems, which is easily and closely affected by the change in atmospheric composition of an external environment. Many studies have been conducted to quantify the effects of atmospheric pollution on human health by using different approaches. This article presents different scenario of studies conducted to evaluate the effects on different human groups. Differences between the studies conducted using spirometry and survey methods are presented in this article to extract a better sequence between these two methodologies. Many studies have been conducted to measure the respiratory status by evaluating the respiratory symptoms and hospital admissions. Limited numbers of studies are found with repeated spirometry on the same subjects for long duration to nullify the error arising due to decrease in efforts by the same subjects during manoeuvre of pulmonary function tests. Present study reveals the importance of methodological sequencing in order to obtain more authentic and reliable results. This study suggests that impacts of deteriorating atmospheric composition on human health can be more significantly studied if spirometry is done after survey analysis. The article also proposes that efficiency and authenticity of surveys involving health impacts will increase, if medical data information of patients is saved in hospitals in a proper format.

African Programme for Onchocerciasis Control 1995–2015: Model-Estimated Health Impact and Cost

PubMed Central

Coffeng, Luc E.; Stolk, Wilma A.; Zouré, Honorat G. M.; Veerman, J. Lennert; Agblewonu, Koffi B.; Murdoch, Michele E.; Noma, Mounkaila; Fobi, Grace; Richardus, Jan Hendrik; Bundy, Donald A. P.; Habbema, Dik; de Vlas, Sake J.; Amazigo, Uche V.

2013-01-01

Background Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. Methods and Findings With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Conclusions Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future. PMID:23383355

African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.

PubMed

Coffeng, Luc E; Stolk, Wilma A; Zouré, Honorat G M; Veerman, J Lennert; Agblewonu, Koffi B; Murdoch, Michele E; Noma, Mounkaila; Fobi, Grace; Richardus, Jan Hendrik; Bundy, Donald A P; Habbema, Dik; de Vlas, Sake J; Amazigo, Uche V

2013-01-01

Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.

Selenium and Human Health: Witnessing a Copernican Revolution?

PubMed

Jablonska, Ewa; Vinceti, Marco

2015-01-01

In humans, selenium was hypothesized to lower the risk of several chronic diseases, mainly due to the antioxidant activity of selenium-containing proteins. Recent epidemiologic and laboratory studies, however, are changing our perception of the biological effects of this nutritionally essential trace element. We reviewed the most recent epidemiologic and biochemical literature on selenium, synthesizing the findings from these studies into a unifying view. Randomized trials have shown that selenium did not protect against cancer and other chronic diseases, but even increased the risk of specific neoplasms such as advanced prostate cancer and skin cancer, in addition to type 2 diabetes. Biochemical studies indicate that selenium may exert a broad pattern of toxic effects at unexpectedly low concentrations. Furthermore, its upregulation of antioxidant proteins (selenium-dependent and selenium-independent) may be a manifestation of self-induced oxidative stress. In conclusion, toxic effects of selenium species occur at lower concentrations than previously believed. Those effects may include a large range of proteomic changes and adverse health effects in humans. Since the effects of environmental exposure to this element on human health still remain partially unknown, but are potentially serious, the toxicity of selenium exposure should be further investigated and considered as a public health priority.

The Potential Health Effects of Melicoccus bijugatus Jacq. Fruits: Phytochemical, Chemotaxonomic and Ethnobotanical Investigations

PubMed Central

Bystrom, Laura M.

2011-01-01

Most natural product research is market-driven and thus many plant species are overlooked for their health value due to lack of financial incentives. This may explain the limited information available about the health effects of the edible fruit species Melicoccus bijugatus, a member of the Sapindaceae family that grows mostly in the Caribbean and in parts of South America. However, recent phytochemical studies of these fruits have shed some light on their biological effects. In this review the health effects of M. bijugatus fruit pulp and seeds are assessed in relation to phytochemical and ethnobotanical studies, as well as chemotaxonomic information and medicinal uses of other Sapindaceae species. The chemistry of M. bijugatus fruits was found to be different than the other Sapindaceae fruits, although some of the medicinal uses were similar. Specific phenolics or sugars in M. bijugatus fruits may contribute to their therapeutic uses, especially for gastrointestinal problems, and to some extent toxicological effects. This review focuses our understanding about the specific biological effects of M. bijugatus fruits, which may be useful for predicting other medicinal uses, potential drug or food interactions and may benefit people where the fruits are prevalent and healthcare resources are scarce. PMID:22155593

Evaluating the Effectiveness of Passive Sampling as a Surrogate for Organism Bioaccumulation.

EPA Science Inventory

Measurement of hydrophobic organic contaminants (HOCs) and the subsequent evaluation of their ecological and human health risks are common endpoints in aquatic environmental monitoring. Due to their hydrophobicity, many anthropogenic HOCs will partition from the water into organi...

Evaluating the Effectiveness of Passive Sampling as a Surrogate for Organism Bioaccumulation

EPA Science Inventory

Measurement of hydrophobic organic contaminants (HOCs) and the subsequent evaluation of their ecological and human health risks are common endpoints in aquatic environmental monitoring. Due to their hydrophobicity, many anthropogenic HOCs will partition from the water into organi...

TOXCAST: A TOOL FOR THE PRIORITIZATION OF CHEMICALS FOR TOXICOLOGICAL EVALUATION

EPA Science Inventory

Due to various legislatiave mandates, the US EPA is faced with evaluating the potential of tens of thousands of chemicals (e.g., high production volume chemicals, pestididal inerts, and drinking water contaminants) to cause adverse human health & environmental effects.

OPTIMIZING THE PAKS METHOD FOR MEASURING AIRBORNE ACROLEIN

EPA Science Inventory

Airborne acrolein is produced from the combustion of fuel and tobacco and is of concern due to its potential for respiratory tract irritation and other adverse health effects. Active sampling with DNPH-coated solid sorbents has been widely used for sampling airborne carbonyls; ...

OPTIMIZING THE PAKS METHOD FOR MEASURING AIRBORNE ACROLEIN

EPA Science Inventory

Airborne acrolein is produced from the combustion of fuel and tobacco and is of concern due to its potential for respiratory tract irritation and other adverse health effects. DNPH active-sampling is a method widely used for sampling airborne aldehydes and ketones (carbonyls); ...

The role of probiotics on each component of the metabolic syndrome and other cardiovascular risks.

PubMed

Miglioranza Scavuzzi, Bruna; Miglioranza, Lucia Helena da Silva; Henrique, Fernanda Carla; Pitelli Paroschi, Thanise; Lozovoy, Marcell Alysson Batisti; Simão, Andréa Name Colado; Dichi, Isaias

2015-01-01

Probiotics are defined as live microorganisms that when administered in adequate amounts confer health benefits to the host. The consumption of probiotics has gained increasing recognition from the scientific community due to the promising effects on metabolic health through gut microbiota modulation. This article presents a review of scientific studies investigating probiotic species and their effects on different risk factors of the metabolic syndrome (MetS). This article also presents a summary of the major mechanisms involved with gut microbiota and the components of the MetS and raises the key issues to be considered by scientists in search of probiotics species for treatment of patients suffering from this metabolic disorder. Probiotics may confer numerous health benefits to the host through positive gut microbiota modulation. The strain selection is the most important factor for determining health effects. Further studies may consider gut microbiota as a novel target for prevention and management of MetS components and other cardiovascular risks.

The effect of premiums on the decision to participate in health insurance and other fringe benefits offered by the employer: evidence from a real-world experiment.

PubMed

Royalty, Anne Beeson; Hagens, John

2005-01-01

In this paper, we investigate the effect of the out-of-pocket premium on the decision to enroll in employer health insurance and other benefits plans including dental insurance, vision care, long-term care insurance, and wellness benefits. Previous estimates of the effects of premium on takeup of health insurance could be biased toward zero due to a correlation between premium and unobservable demand or plan quality. We solve this problem using data representing hypothetical choices by employees under three different price regimes, providing price variation uncorrelated with either individual-specific or plan-specific unobservables. We find that workers are insensitive to price in health insurance takeup. Workers show much greater price sensitivity to decisions about dental insurance, vision plans, long-term care insurance, and wellness benefits. We conclude that premium subsidies are unlikely to have a substantial impact on increasing insurance rates of workers already offered employer insurance.

Wars and Child Health: Evidence from the Eritrean-Ethiopian Conflict *

PubMed Central

Akresh, Richard; Lucchetti, Leonardo; Thirumurthy, Harsha

2012-01-01

Conflict between and within countries can have lasting health and economic consequences, but identifying such effects can be empirically challenging. This paper uses household survey data from Eritrea to estimate the effect of exposure to the 1998–2000 Eritrea-Ethiopia war on children’s health. The identification strategy exploits exogenous variation in the conflict’s geographic extent and timing and the exposure of different birth cohorts to the fighting. The unique survey data include details on each household’s migration history, which allows us to measure a child’s geographic location during the war and without which war exposure would be incorrectly classified. War-exposed children have lower height-for-age Z-scores, with similar effects for children born before or during the war. Both boys and girls who are born during the war experience negative impacts due to conflict. Effects are robust to including region-specific time trends, alternative conflict exposure measures, and mother fixed effects. PMID:22962514

Estimated Dietary Intake of Radionuclides and Health Risks for the Citizens of Fukushima City, Tokyo, and Osaka after the 2011 Nuclear Accident

PubMed Central

Murakami, Michio; Oki, Taikan

2014-01-01

The radionuclides released from the Fukushima Daiichi nuclear power plant in 2011 pose a health risk. In this study, we estimated the 1st-year average doses resulting from the intake of iodine 131 (131I) and cesium 134 and 137 (134Cs and 137Cs) in drinking water and food ingested by citizens of Fukushima City (∼50 km from the nuclear power plant; outside the evacuation zone), Tokyo (∼230 km), and Osaka (∼580 km) after the accident. For citizens in Fukushima City, we considered two scenarios: Case 1, citizens consumed vegetables bought from markets; Case 2, citizens consumed vegetables grown locally (conservative scenario). The estimated effective doses of 134Cs and 137Cs agreed well with those estimated through market basket and food-duplicate surveys. The average thyroid equivalent doses due to ingestion of 131I for adults were 840 µSv (Case 1) and 2700 µSv (Case 2) in Fukushima City, 370 µSv in Tokyo, and 16 µSv in Osaka. The average effective doses due to 134Cs and 137Cs were 19, 120, 6.1, and 1.9 µSv, respectively. The doses estimated in this study were much lower than values reported by the World Health Organization and the United Nations Scientific Committee on the Effects of Atomic Radiation, whose assessments lacked validation and full consideration of regional trade in foods, highlighting the importance of including regional trade. The 95th percentile effective doses were 2–3 times the average values. Lifetime attributable risks (LARs) of thyroid cancers due to ingestion were 2.3–39×10−6 (Case 1) and 10–98×10−6 (Case 2) in Fukushima City, 0.95–14×10−6 in Tokyo, and 0.11–1.3×10−6 in Osaka. The contributions of LARs of thyroid cancers due to ingestion were 7.5%–12% of all exposure (Case 1) and 12%–30% (Case 2) in Fukushima City. PMID:25390339

Radon-222 from different sources of water and the assessment of health hazard.

PubMed

Ademola, Janet A; Ojeniran, Oluwaferanmi R

2017-02-01

Water samples collected from different sources were analysed for radon concentrations in order to evaluate the health effect associated with radon in water. The radon concentrations were in the range of 3.56-98.57, 0.88-25.49, 0.73-1.35 and 0.24-1.03 Bq.L -1 for borehole, well, packaged and utility water, respectively. Samples from boreholes had the highest radon concentrations with about 67% being higher than the threshold value of 11.1 Bq.L -1 recommended by the USEPA. The mean annual effective dose (AED) due to ingestion for adult, child and infant ranged from 8.71 × 10 -3 to 0.831 mSv.y -1 for the different sources. The mean AED calculated for consuming water from boreholes and wells for the three age groups were higher than the recommended reference dose level of 0.1 mSv.y -1 . The mean AED due to inhalation of radon in drinking water was negligible, ranging from 0.13 to 6.20 μSv.y -1 . The health burden associated with radon in water in the study is through ingestion of water directly from boreholes.

"The fairer the better?" Use of potentially toxic skin bleaching products.

PubMed

Darj, Elisabeth; Infanti, Jennifer J; Ahlberg, Beth Maina; Okumu, Jecinta

2015-12-01

Skin bleaching is a widespread phenomenon in spite of their potentially toxic health effects. This study aimed to determine if such products are used in Sweden in particular by pregnant women, furthermore to explore immigrant women's view skin bleaching. 455 pregnant women completed a questionnaire, which were statistically analysed. Focus groups and individual interviews were conducted with immigrant women, content analysis was used to assess the data. Skin bleaching products were used by 2.6% of pregnant women, significantlly more by women born in non-European countries. Motivating factors were associated with the concept of beauty together with social and economic advantages. The women had low awareness of the potential health risks of the products. Regulations on the trade of skin bleaching products have not effectively reduced the availability of the products in Sweden nor the popularity of skin bleaching. There is need for further research especially among pregnant women and possible effects on newborns. Products should be tested for toxicity. Public health information should be developed and health care providers educated and aware of this practice, due to their potential negative health implications.

Investigation of Health Effects According to the Exposure of Low Concentration Arsenic Contaminated Ground Water

PubMed Central

Hong, Young-seoub; Ye, Byeong-jin; Kim, Yu-mi; Kim, Byoung-gwon; Kang, Gyeong-hui; Kim, Jeong-jin; Song, Ki-hoon; Kim, Young-hun

2017-01-01

Recent epidemiological studies have reported adverse health effects, including skin cancer, due to low concentrations of arsenic via drinking water. We conducted a study to assess whether low arsenic contaminated ground water affected health of the residents who consumed it. For precise biomonitoring results, the inorganic (trivalent arsenite (As III) and pentavalent arsenate (As V)) and organic forms (monomethylarsonate (MMA) and dimethylarsinate (DMA)) of arsenic were separately quantified by combining high-performance liquid chromatography and inductively coupled plasma mass spectroscopy from urine samples. In conclusion, urinary As III, As V, MMA, and hair arsenic concentrations were significantly higher in residents who consumed arsenic contaminated ground water than control participants who consumed tap water. But, most health screening results did not show a statistically significant difference between exposed and control subjects. We presume that the elevated arsenic concentrations may not be sufficient to cause detectable health effects. Consumption of arsenic contaminated ground water could result in elevated urinary organic and inorganic arsenic concentrations. We recommend immediate discontinuation of ground water supply in this area for the safety of the residents. PMID:29186890

Soy and Gut Microbiota: Interaction and Implication for Human Health.

PubMed

Huang, Haiqiu; Krishnan, Hari B; Pham, Quynhchi; Yu, Liangli Lucy; Wang, Thomas T Y

2016-11-23

Soy (Glycine max) is a major commodity in the United States, and soy foods are gaining popularity due to their reported health-promoting effects. In the past two decades, soy and soy bioactive components have been studied for their health-promoting/disease-preventing activities and potential mechanisms of action. Recent studies have identified gut microbiota as an important component in the human body ecosystem and possibly a critical modulator of human health. Soy foods' interaction with the gut microbiota may critically influence many aspects of human development, physiology, immunity, and nutrition at different stages of life. This review summarizes current knowledge on the effects of soy foods and soy components on gut microbiota population and composition. It was found, although results vary in different studies, in general, both animal and human studies have shown that consumption of soy foods can increase the levels of bifidobacteria and lactobacilli and alter the ratio between Firmicutes and Bacteroidetes. These changes in microbiota are consistent with reported reductions in pathogenic bacteria populations in the gut, thereby lowering the risk of diseases and leading to beneficial effects on human health.

Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.

PubMed

Ewig, Christina; Bello, Amparo Hernández

2009-03-01

In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.

Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use.

PubMed

Tobollik, Myriam; Keuken, Menno; Sabel, Clive; Cowie, Hilary; Tuomisto, Jouni; Sarigiannis, Denis; Künzli, Nino; Perez, Laura; Mudu, Pierpaolo

2016-04-01

Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM2.5), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020. The intervention aimed at reducing traffic is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11-129) YLDs due to annoyance and 35 (CI: 20-51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13-116) and 41 (CI: 24-60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM2.5 and EC by around 40% and 60% respectively, from 2010 to 2020. The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health. Copyright © 2016 Elsevier Inc. All rights reserved.

Does consideration of larger study areas yield more accurate estimates of air pollution health effects? An illustration of the bias-variance trade-off in air pollution epidemiology.

PubMed

Pedersen, Marie; Siroux, Valérie; Pin, Isabelle; Charles, Marie Aline; Forhan, Anne; Hulin, Agnés; Galineau, Julien; Lepeule, Johanna; Giorgis-Allemand, Lise; Sunyer, Jordi; Annesi-Maesano, Isabella; Slama, Rémy

2013-10-01

Spatially-resolved air pollution models can be developed in large areas. The resulting increased exposure contrasts and population size offer opportunities to better characterize the effect of atmospheric pollutants on respiratory health. However the heterogeneity of these areas may also enhance the potential for confounding. We aimed to discuss some analytical approaches to handle this trade-off. We modeled NO2 and PM10 concentrations at the home addresses of 1082 pregnant mothers from EDEN cohort living in and around urban areas, using ADMS dispersion model. Simulations were performed to identify the best strategy to limit confounding by unmeasured factors varying with area type. We examined the relation between modeled concentrations and respiratory health in infants using regression models with and without adjustment or interaction terms with area type. Simulations indicated that adjustment for area limited the bias due to unmeasured confounders varying with area at the costs of a slight decrease in statistical power. In our cohort, rural and urban areas differed for air pollution levels and for many factors associated with respiratory health and exposure. Area tended to modify effect measures of air pollution on respiratory health. Increasing the size of the study area also increases the potential for residual confounding. Our simulations suggest that adjusting for type of area is a good option to limit residual confounding due to area-associated factors without restricting the area size. Other statistical approaches developed in the field of spatial epidemiology are an alternative to control for poorly-measured spatially-varying confounders. © 2013 Elsevier Ltd. All rights reserved.

The Effects of Exercise on Cardiovascular Biomarkers: New Insights, Recent Data, and Applications.

PubMed

Che, Lin; Li, Dong

2017-01-01

The benefit of regular exercise or physical activity with appropriate intensity on improving cardiopulmonary function and endurance has long been accepted with less controversy. The challenge remains, however, quantitatively evaluate the effect of exercise on cardiovascular health due in part to the amount and intensity of exercise varies widely plus lack of effective, robust and efficient biomarker evaluation systems. Better evaluating the overall function of biomarker and validate biomarkers utility in cardiovascular health should improve the evidence regarding the benefit or the effect of exercise or physical activity on cardiovascular health, in turn increasing the efficiency of the biomarker on individuals with mild to moderate cardiovascular risk. In this review, beyond traditional cytokines, chemokines and inflammatory factors, we systemic reviewed the latest novel biomarkers in metabolomics, genomics, proteomics, and molecular imaging mainly focus on heart health, as well as cardiovascular diseases such as atherosclerosis and ischemic heart disease. Furthermore, we highlight the state-of-the-art biomarker developing techniques and its application in the field of heart health. Finally, we discuss the clinical relevance of physical activity and exercise on key biomarkers in molecular basis and practical considerations.

Influences of low-frequency and other noises produced by wind turbines: An epidemiological literature review.

PubMed

Kubo, Tatsuhiko; Hasunuma, Hideki; Morimatsu, Yoshitaka; Fujino, Yoshihisa; Hara, Kunio; Ishitake, Tatsuya

2017-01-01

Objectives　Due to its' environment-friendly and clean energy characteristics, wind power has been increasingly used globally, particularly in advanced countries. However, concerns about health hazards, especially due to low-frequency and other noises generated from wind turbines, have been reported repeatedly. In order to manage adverse health effects appropriately, regulatory standards or guidelines that consider the health of residents need to be developed. To provide a scientific basis for the development of such regulatory standards and guidelines, this paper conducted a literature review to analyze epidemiological studies involving residents living in the vicinity of wind farms.Methods　Using the PubMED database, epidemiological papers that examined the health effects of noises produced by wind turbines were searched and collected. Additional papers were collected from the abstracts presented at relevant international academic conferences such as the Inter-Noise 2013 and Wind Turbine Noise 2015. An evidence table comprising the study design, subjects, exposure assessment, outcomes, confounders, and research results of each selected study was created.Results　A total of 11 papers were collected (2 of which were abstracts from the international academic conferences). These studies reported outcomes such as perception of noises, annoyance caused by the noises, and the association of the noises with stress and sleeplessness. Significant associations between the noises or annoyance produced by wind turbines and subjective adverse health effects were reported repeatedly. Two studies reported an odds ratio of 1.1 for an increase of 1 dB in the A-weighted sound pressure level as a factor representing the influence level. For other factors, it was not possible to compare the magnitude of the impact among the collected studies. Individual attitudes toward wind power and landscapes, economic benefits of wind farms, visibility of wind turbines, sensitivity to sounds, and concerns over health hazards were reported as confounders.Conclusion　Significant associations between the noises or annoyance produced by wind turbines and subjective adverse health effects were reported repeatedly. However, there was insufficient evidence to conclude whether the annoyance was caused by the psychological response to the construction of wind farms or by the actual exposure to noises generated by wind farms.

Central Asian Post-Soviet health systems in transition: has different aid engagement produced different outcomes?

PubMed Central

Ulikpan, Anar; Mirzoev, Tolib; Jimenez, Eliana; Malik, Asmat; Hill, Peter S.

2014-01-01

Background The collapse of the Soviet Union in 1991 resulted in a transition from centrally planned socialist systems to largely free-market systems for post-Soviet states. The health systems of Central Asian Post-Soviet (CAPS) countries (Kyrgyzstan, Mongolia, Tajikistan, Turkmenistan, and Uzbekistan) have undergone a profound revolution. External development partners have been crucial to this reorientation through financial and technical support, though both relationships and outcomes have varied. This research provides a comparative review of the development assistance provided in the health systems of CAPS countries and proposes future policy options to improve the effectiveness of development. Design Extensive documentary review was conducted using Pubmed, Medline/Ovid, Scopus, and Google scholar search engines, local websites, donor reports, and grey literature. The review was supplemented by key informant interviews and participant observation. Findings The collapse of the Soviet dominance of the region brought many health system challenges. Donors have played an essential role in the reform of health systems. However, as new aid beneficiaries, neither CAPS countries’ governments nor the donors had the experience of development collaboration in this context. The scale of development assistance for health in CAPS countries has been limited compared to other countries with similar income, partly due to their limited history with the donor community, lack of experience in managing donors, and a limited history of transparency in international dealings. Despite commonalities at the start, two distinctive trajectories formed in CAPS countries, due to their differing politics and governance context. Conclusions The influence of donors, both financially and technically, remains crucial to health sector reform, despite their relatively small contribution to overall health budgets. Kyrgyzstan, Mongolia, and Tajikistan have demonstrated more effective development cooperation and improved health outcomes; arguably, Uzbekistan and Turkmenistan have made slower progress in their health and socio-economic indices because of their resistance to open and accountable development relationships. PMID:25231098

Linking the Gut Microbial Ecosystem with the Environment: Does Gut Health Depend on Where We Live?

PubMed Central

Tasnim, Nishat; Abulizi, Nijiati; Pither, Jason; Hart, Miranda M.; Gibson, Deanna L.

2017-01-01

Global comparisons reveal a decrease in gut microbiota diversity attributed to Western diets, lifestyle practices such as caesarian section, antibiotic use and formula-feeding of infants, and sanitation of the living environment. While gut microbial diversity is decreasing, the prevalence of chronic inflammatory diseases such as inflammatory bowel disease, diabetes, obesity, allergies and asthma is on the rise in Westernized societies. Since the immune system development is influenced by microbial components, early microbial colonization may be a key factor in determining disease susceptibility patterns later in life. Evidence indicates that the gut microbiota is vertically transmitted from the mother and this affects offspring immunity. However, the role of the external environment in gut microbiome and immune development is poorly understood. Studies show that growing up in microbe-rich environments, such as traditional farms, can have protective health effects on children. These health-effects may be ablated due to changes in the human lifestyle, diet, living environment and environmental biodiversity as a result of urbanization. Importantly, if early-life exposure to environmental microbes increases gut microbiota diversity by influencing patterns of gut microbial assembly, then soil biodiversity loss due to land-use changes such as urbanization could be a public health threat. Here, we summarize key questions in environmental health research and discuss some of the challenges that have hindered progress toward a better understanding of the role of the environment on gut microbiome development. PMID:29056933

[Air pollution and cardiovascular toxicity: known risks].

PubMed

Kostrzewa, A; Filleul, L; Eilstein, D; Harrabi, I; Tessier, J F

2004-03-01

Review of studies about epidemiological and physiopathological knowledge of ambient air particles short-term cardio-vascular effects. CURRENTS AND STRONG POINTS: Many studies, in contrasted countries for pollution's sources, meteorological conditions or socio-demographical characteristics, have shown health effects due to ambient air particles. After having studied mainly the respiratory effects of particulate air pollution, epidemiologists are now interested in the cardio-vascular effects of ambient air particles. In fact, serious effects seem to exist in fragile people which can get to emergency department visits, hospitalisation and even death. In addition, studies have shown less serious effects, but likely to be frequent (cardiac symptoms, and stoppages for cardio-vascular causes, notably). The exact mechanism by which particles have cardio-vascular adverse health effects is unknown, but experimental and epidemiological studies have led to several hypotheses: local pulmonary effects seem to be followed by systemic effects, which would be responsible for effects on the electrical activity of the heart through cardiac autonomic dysfunction and effects on the blood supply to the heart. The objective of this work is to summarise epidemiological and physiopathological knowledge about the cardio-vascular effects of ambient air particles. To evaluate the real importance of cardio-vascular effects due to particulate air pollution and to identify their exact mechanism, a more precise knowledge of detailed causes of deaths and hospitalisations and a better knowledge of less serious effects, but likely to be frequent, is necessary. Equally, a detailed identification of fragile people is essential for developing preventive actions.

[The globalization of health].

PubMed

Franco, A

2003-01-01

In this article diverse aspects of the relationship between health and globalization are explored. Different dimensions of globalization (economic, technological, cultural and political) are considered. Aspects of its effects on health (epidemiological, ethical and environmental), as well as its relationship with public health, power distribution and equity are discussed. Data that demonstrate the globalization of risks and of diseases, due to the current model of international relations and geographical mobility, are analyzed. The article defends the globalization of health and integrates renewed concepts and scientific advances in public health with politics, social strategies and new organizational forms of the practice of public health. Finally, we discuss the opportunities that have been provided by globalization since the middle of the last century for redefining world government and for developing local movements, based on solidarity and a new concept of politics, which could favor the universalization of health.

Comparative risk analysis of dioxins in fish and fine particles from heavy-duty vehicles.

PubMed

Leino, Olli; Tainio, Marko; Tuomisto, Jouni T

2008-02-01

Dioxins and airborne fine particles are both environmental health problems that have been the subject of active public debate. Knowledge on fine particles has increased substantially during the last 10 years, and even the current, lowered levels in the Europe and in the United States appear to be a major public health problem. On the other hand, dioxins are ubiquitous persistent contaminants, some being carcinogens at high doses, and therefore of great concern. Our aim was to (a) quantitatively analyze the two pollutant health risks and (b) study the changes in risk in view of the current and forthcoming EU legislations on pollutants. We performed a comparative risk assessment for both pollutants in the Helsinki metropolitan area (Finland) and estimated the health effects with several scenarios. For primary fine particles: a comparison between the present emission situation for heavy-duty vehicles and the new fine particle emission standards set by the EU. For dioxins: an EU directive that regulates commercial fishing of Baltic salmon and herring that exceed the dioxin concentration limit set for fish meat, and a derogation (= exemption) from the directive for these two species. Both of these two decisions are very topical issues and this study estimates the expected changes in health effects due to these regulations. It was found that the estimated fine particle risk clearly outweighed the estimated dioxin risk. A substantial improvement to public health could be achieved by initiating reductions in emission standards; about 30 avoided premature deaths annually in the study area. In addition, the benefits of fish consumption due to omega-3 exposure were notably higher than the potential dioxin cancer risk. Both regulations were instigated as ways of promoting public health.

Activity limitations in the lower extremities in patients with osteoarthritis: the modifying effects of illness perceptions and mental health.

PubMed

Botha-Scheepers, S; Riyazi, N; Kroon, H M; Scharloo, M; Houwing-Duistermaat, J J; Slagboom, E; Rosendaal, F R; Breedveld, F C; Kloppenburg, M

2006-11-01

Using the International Classification of Functioning, Disability and Health as framework, we evaluated modifying effects of illness perceptions and mental health on the association between impairments in body structures and functions due to osteoarthritis (OA) and limitation in activities in the lower extremities. Self-reported limitation in activities was assessed by the Western Ontario and McMaster Universities OA index (WOMAC) function subscale in 316 patients with knee or hip pain or evidence of OA on knee or hip radiographs. Body structures and functions were evaluated during clinical and radiological assessments. Illness perceptions and mental health were assessed with the revised Illness Perception Questionnaire (IPQ-R) and the mental component summary score of the RAND 36-item Health Survey, respectively. For each patient an expected WOMAC function score was calculated, using an equation based on a multivariate model of the association of body structures and functions with limitation in activities. The median (interquartile) self-reported WOMAC function score was 22.2 (9.6-43.5). Ninety-one patients reported more and 120 patients reported less limitation in activities than expected. Patients with lumbar spine degeneration, physical or exercise therapy and high IPQ-R identity, consequences and chronic timeline scores had an increased risk to report more limitation in activities than the expected range. Low IPQ-R identity, consequences and emotional representation scores and better mental health were associated with reporting less limitation in activities than the expected range. Illness perceptions and mental health modify the association between self-reported limitation in activities and calculated limitation in activities based on impairments in body structures and functions due to OA.

No Smoke Without Fire: the hidden costs of early life exposure to landscape fire emissions in Indonesia

NASA Astrophysics Data System (ADS)

Jina, A.; Marlier, M. E.

2012-12-01

Air pollution from landscape fire emissions can have devastating effects upon public health. The consequent health costs place a burden upon the economies of many nations, particularly in developing countries. Recent research has assessed contemporaneous mortality due to respiratory infections or cardiovascular disease, but little has looked at the potential long-term consequences and hidden costs of exposure to fire pollution at a population scale. The difficulty of quantifying these costs is partly due to incomplete or inaccurate health data in many developing countries, and is further compounded by sparse air pollution monitoring data. While satellite data partially compensates for this, there can still be significant gaps in data availability and difficulty in retrieving surface concentrations. In this study, we demonstrate the dramatic long-term health and human development consequences of fine particulate matter (PM2.5) exposure by using modeled PM2.5 to quantify repeated exposure to landscape fire emissions in Indonesia, which is prone to large, catastrophic fires during El Niño conditions. Surface PM2.5 concentrations at 2x2.5° resolution are obtained from GISS-E2-Puccini (the new version of the NASA GISS ModelE general circulation model), run with monthly fire emissions from the Global Fire Emissions Database version 3 (GFED3). 24-hour ambient PM2.5 concentrations across Indonesia are matched to geographically and socioeconomically representative longitudinal surveys conducted by the Indonesian government. We find important medium- to long-term morbidity associated with early life exposure to ambient air pollution from fire emissions. Our analysis indicates that children exposed to high levels of PM2.5 in utero are more likely to suffer from impaired physical and cognitive development. A one standard deviation increase in ambient air pollution, derived from the GISS-E2-Puccini model, leads to effects that are directly comparable to those from indoor air pollution. In addition, income shocks due to pollution-caused family illness can lead to an antenatal amplification of these in utero effects. The impacts of exposure in early life can be difficult to reverse, leading to a persistent effects upon a society which may contribute a significant cost to the more readily demonstrated losses associated with immediate health impacts.

Overall human mortality and morbidity due to exposure to air pollution.

PubMed

Samek, Lucyna

2016-01-01

Concentrations of particulate matter that contains particles with diameter ≤ 10 mm (PM10) and diameter ≤ 2.5 mm (PM2.5) as well as nitrogen dioxide (NO2) have considerable impact on human mortality, especially in the cases when cardiovascular or respiratory causes are attributed. Additionally, they affect morbidity. An estimation of human mortality and morbidity due to the increased concentrations of PM10, PM2.5 and NO2 between the years 2005-2013 was performed for the city of Kraków, Poland. For this purpose the Air Quality Health Impact Assessment Tool (AirQ) software was successfully applied. The Air Quality Health Impact Assessment Tool was used for the calculation of the total, cardiovascular and respiratory mortality as well as hospital admissions related to cardiovascular and respiratory diseases. Data on concentrations of PM10, PM2.5 and NO2, which was obtained from the website of the Voivodeship Inspectorate for Environmental Protection (WIOS) in Kraków, was used in this study. Total mortality due to exposure to PM10 in 2005 was found to be 41 deaths per 100 000 and dropped to 30 deaths per 100 000 in 2013. Cardiovascular mortality was 2 times lower than the total mortality. However, hospital admissions due to respiratory diseases were more than an order of magnitude higher than the respiratory mortality. The calculated total mortality due to PM2.5 was higher than that due to PM10. Air pollution was determined to have a significant effect on human health. The values obtained by the use of the AirQ software for the city of Kraków imply that exposure to polluted air can result in serious health problems. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

[Preventive measures against health damage due to chemicals in household products].

PubMed

Kaniwa, Masa-aki

2010-01-01

Chemicals in household products have been paid much attention as the main cause of health damage in consumers, such as allergic contact dermatitis. Preventive measures against health damage due to chemicals in fabrics, plastics and rubber products for household use, are reviewed, focusing on 1) the incidence of health damage due to household products, 2) causative product-chemical investigation, and 3) case studies on skin damage.

Home Environment Quality Mediates the Effects of an Early Intervention on Children's Social-Emotional Development in Rural Pakistan

ERIC Educational Resources Information Center

Finch, Jenna E.; Obradovic, Jelena; Yousafzai, Aisha

2016-01-01

Over 200 million children under the age of 5 are not fulfilling their developmental potential due to poverty, poor health, and lack of cognitive stimulation. Experiences in early childhood have long term-effects on brain development and thus the cognitive and social-emotional skills that promote children's school success. Further, early childhood…

The effect of emerald ash borer-caused tree mortality on the invasive shrub Amur honeysuckle and their combined effects on tree and shrub seedlings

Treesearch

Brian M. Hoven; David L. Gorchov; Kathleen S. Knight; Valerie E. Peters

2017-01-01

Invasive insects and plants are major threats to the health and viability of North American forests. Emerald ash borer (Agrilus planipennis) (EAB) may cause extensive changes to forest composition due to rapid ash (Fraxinus spp.) mortality. Invasive shrubs like Amur honeysuckle (Lonicera maackii) may...

Life Expectancy and Human Capital Investments: Evidence from Maternal Mortality Declines. NBER Working Paper No. 13947

ERIC Educational Resources Information Center

Jayachandran, Seema; Lleras-Muney, Adriana

2008-01-01

Longer life expectancy should encourage human capital accumulation, since a longer time horizon increases the value of investments that pay out over time. Previous work has been unable to determine the empirical importance of this life-expectancy effect due to the difficulty of isolating it from other effects of health on education. We examine a…

The effect of perch access during pullet rearing and egg laying on physiological measurements of stress in 71-week-old White Leghorns

USDA-ARS?s Scientific Manuscript database

Egg laying strains of chickens have a strong motivation to perch. Providing caged chickens with perches allows them to perform their natural perching instinct and also improves their musculoskeletal health due to exercise. Little is known about the effect of perch access by hens on physiological mea...

Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi.

PubMed

Kabaghe, Alinune N; Phiri, Mphatso D; Phiri, Kamija S; van Vugt, Michèle

2017-10-18

Prompt and effective malaria treatment are key in reducing transmission, disease severity and mortality. With the current scale-up of artemisinin-based combination therapy (ACT) coverage, there is need to focus on challenges affecting implementation of the intervention. Routine indicators focus on utilization and coverage, neglecting implementation quality. A health system in rural Malawi was assessed for uncomplicated malaria treatment implementation in children. A cross-sectional health facility survey was conducted in six health centres around the Majete Wildlife Reserve in Chikwawa district using a health system effectiveness approach to assess uncomplicated malaria treatment implementation. Interviews with health facility personnel and exit interviews with guardians of 120 children under 5 years were conducted. Health workers appropriately prescribed an ACT and did not prescribe an ACT to 73% (95% CI 63-84%) of malaria rapid diagnostic test (RDT) positive and 98% (95% CI 96-100%) RDT negative children, respectively. However, 24% (95% CI 13-37%) of children receiving artemisinin-lumefantrine had an inappropriate dose by weight. Health facility findings included inadequate number of personnel (average: 2.1 health workers per 10,000 population), anti-malarial drug stock-outs or not supplied, and inconsistent health information records. Guardians of 59% (95% CI 51-69%) of children presented within 24 h of onset of child's symptoms. The survey presents an approach for assessing treatment effectiveness, highlighting bottlenecks which coverage indicators are incapable of detecting, and which may reduce quality and effectiveness of malaria treatment. Health service provider practices in prescribing and dosing anti-malarial drugs, due to drug stock-outs or high patient load, risk development of drug resistance, treatment failure and exposure to adverse effects.

Chronic non-communicable disease as a new epidemic in Africa: focus on The Gambia

PubMed Central

Omoleke, Semeeh A

2013-01-01

Introduction Recent epidemiological data suggest increasing burden of NCDs in many African countries but these diseases have not been given adequate attention due to the overwhelming burden of infectious diseases. There are no recent reports or studies on NCDs or related issues in The Gambia, consequently, this report intends to stimulate further epidemiological studies and also policy initiatives to forestall an epidemic. Methods Routine data on morbidity (in and out-patients), hospitalisation and mortality due to NCDs from health facilities in The Gambia between 2008 and 2011 were used. Other relevant data from multiple sources were also used. Results There is an increasing trend in the morbidity, hospitalisation and mortality due to NCDs in the Gambia between 2008 and 2011; 19.8%, 9.9% and 23.4% increments respectively. There is evidence of gender differences in these variables; more males suffer higher mortality from NCDs than females (p < 0.001). Furthermore, there is dearth of highly skilled health workforce as well as poor health infrastructures in The Gambia. Conclusion NCDs are becoming a public health challenge and the capacity to respond to NCDs in most African countries, particularly, The Gambia is very weak. There is need for a population-based study to accurately quantify the burden and their risk factors as a first step towards policy formulation and effective implementation. Furthermore, there is dire need for increased investments on health workforce as well as medical products and technologies towards addressing the consequences of this emerging epidemic. PMID:23646223

The possible influence of noise frequency components on the health of exposed industrial workers--a review.

PubMed

Mahendra Prashanth, K V; Venugopalachar, Sridhar

2011-01-01

Noise is a common occupational health hazard in most industrial settings. An assessment of noise and its adverse health effects based on noise intensity is inadequate. For an efficient evaluation of noise effects, frequency spectrum analysis should also be included. This paper aims to substantiate the importance of studying the contribution of noise frequencies in evaluating health effects and their association with physiological behavior within human body. Additionally, a review of studies published between 1988 and 2009 that investigate the impact of industrial/occupational noise on auditory and non-auditory effects and the probable association and contribution of noise frequency components to these effects is presented. The relevant studies in English were identified in Medknow, Medline, Wiley, Elsevier, and Springer publications. Data were extracted from the studies that fulfilled the following criteria: title and/or abstract of the given study that involved industrial/occupational noise exposure in relation to auditory and non-auditory effects or health effects. Significant data on the study characteristics, including noise frequency characteristics, for assessment were considered in the study. It is demonstrated that only a few studies have considered the frequency contributions in their investigations to study auditory effects and not non-auditory effects. The data suggest that significant adverse health effects due to industrial noise include auditory and heart-related problems. The study provides a strong evidence for the claims that noise with a major frequency characteristic of around 4 kHz has auditory effects and being deficient in data fails to show any influence of noise frequency components on non-auditory effects. Furthermore, specific noise levels and frequencies predicting the corresponding health impacts have not yet been validated. There is a need for advance research to clarify the importance of the dominant noise frequency contribution in evaluating health effects.

Damage of composite structures: Detection technique, dynamic response and residual strength

NASA Astrophysics Data System (ADS)

Lestari, Wahyu

2001-10-01

Reliable and accurate health monitoring techniques can prevent catastrophic failures of structures. Conventional damage detection methods are based on visual or localized experimental methods and very often require prior information concerning the vicinity of the damage or defect. The structure must also be readily accessible for inspections. The techniques are also labor intensive. In comparison to these methods, health-monitoring techniques that are based on the structural dynamic response offers unique information on failure of structures. However, systematic relations between the experimental data and the defect are not available and frequently, the number of vibration modes needed for an accurate identification of defects is much higher than the number of modes that can be readily identified in the experiment. These motivated us to develop an experimental data based detection method with systematic relationships between the experimentally identified information and the analytical or mathematical model representing the defective structures. The developed technique use changes in vibrational curvature modes and natural frequencies. To avoid misinterpretation of the identified information, we also need to understand the effects of defects on the structural dynamic response prior to developing health-monitoring techniques. In this thesis work we focus on two type of defects in composite structures, namely delamination and edge notch like defect. Effects of nonlinearity due to the presence of defect and due to the axial stretching are studied for beams with delamination. Once defects are detected in a structure, next concern is determining the effects of the defects on the strength of the structure and its residual stiffness under dynamic loading. In this thesis, energy release rate due to dynamic loading in a delaminated structure is studied, which will be a foundation toward determining the residual strength of the structure.

What have health care reforms achieved in Turkey? An appraisal of the "Health Transformation Programme".

PubMed

Ökem, Zeynep Güldem; Çakar, Mehmet

2015-09-01

Poor health status indicators, low quality care, inequity in the access to health services and inefficiency due to fragmented health financing and provision have long been problems in Turkey's health system. To address these problems a radical reform process known as the Health Transformation Programme (HTP) was initiated in 2003. The health sector reforms in Turkey are considered to have been among the most successful of middle-income countries undergoing reform. Numerous articles have been published that review these reforms in terms of, variously, financial sustainability, efficiency, equity and quality. Evidence suggests that Turkey has indeed made significant progress, yet these achievements are uneven among its regions, and their long-term financial sustainability is unresolved due to structural problems in employment. As yet, there is no comprehensive evidence-based analysis of how far the stated reform objectives have been achieved. This article reviews the empirical evidence regarding the outcomes of the HTP during 10 years of its implementation. Strengthening the strategic purchasing function of the Social Security Institution (SSI) should be a priority. Overall performance can be improved by linking resource allocation to provider performance. More emphasis on prevention rather than treatment, with an effective referral chain, can also bring better outcomes, greater efficiency gains and contribute to sustainability. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effects of Genetically Modified Milk Containing Human Beta-Defensin-3 on Gastrointestinal Health of Mice

PubMed Central

Yang, Yange; Shi, Zhaopeng; Gao, Ming-Qing; Zhang, Yong

2016-01-01

This study was performed to investigate the effects of genetically modified (GM) milk containing human beta-defensin-3 (HBD3) on mice by a 90-day feeding study. The examined parameters included the digestibility of GM milk, general physical examination, gastric emptying function, intestinal permeability, intestinal microflora composition of mice, and the possibility of horizontal gene transfer (HGT). The emphasis was placed on the effects on gastrointestinal (GI) tract due to the fact that GI tract was the first site contacting with food and played crucial roles in metabolic reactions, nutrition absorption and immunity regulation in the host. However, the traditional methods for analyzing the potential toxicological risk of GM product pay little attention on GI health. In this study, the results showed GM milk was easy to be digested in simulated gastric fluid, and it did not have adverse effects on general and GI health compared to conventional milk. And there is little possibility of HGT. This study may enrich the safety assessment of GM product on GI health. PMID:27438026

Climate change, extreme weather events, air pollution and respiratory health in Europe.

PubMed

De Sario, M; Katsouyanni, K; Michelozzi, P

2013-09-01

Due to climate change and other factors, air pollution patterns are changing in several urbanised areas of the world, with a significant effect on respiratory health both independently and synergistically with weather conditions; climate scenarios show Europe as one of the most vulnerable regions. European studies on heatwave episodes have consistently shown a synergistic effect of air pollution and high temperatures, while the potential weather-air pollution interaction during wildfires and dust storms is unknown. Allergen patterns are also changing in response to climate change, and air pollution can modify the allergenic potential of pollens, especially in the presence of specific weather conditions. The underlying mechanisms of all these interactions are not well known; the health consequences vary from decreases in lung function to allergic diseases, new onset of diseases, exacerbation of chronic respiratory diseases, and premature death. These multidimensional climate-pollution-allergen effects need to be taken into account in estimating both climate and air pollution-related respiratory effects, in order to set up adequate policy and public health actions to face both the current and future climate and pollution challenges.

Innovative Medical Technology, Health Technology Assessment, and Health Policy: The Case of Remote Patient Monitoring of Cardiac Implantable Electronic Devices in South Korea.

PubMed

Lee, Sang-Soo; Salole, Eugene

2017-01-01

In many developed countries with universal coverage healthcare systems, payers require new medical technologies to be assessed as safe, effective, and cost-effective through health technology assessment (HTA) before approval for reimbursement coverage and market access. However, in some cases, HTA is not the sole criterion for decision-making and other factors override the evidence. Remote patient monitoring (RPM) for cardiac implantable electronic devices, a novel technology recognized as safe, effective, and cost-effective, and the standard of care in many countries, is prohibited in South Korea. This peculiar situation is apparently due to deficiencies in healthcare policy and the delivery system and also to poor engagement between stakeholders. We propose that a higher level of engagement and trust between stakeholders needs to be developed, and healthcare providers should be involved in the early development of health policy, so that unnecessary barriers to access to useful medical technology are corrected, thereby allowing Koreans to enjoy the benefits available in other developed countries.

Significance of wine and resveratrol in cardiovascular disease: French paradox revisited.

PubMed

Vidavalur, Ramesh; Otani, Hajime; Singal, Pawan K; Maulik, Nilanjana

2006-01-01

Many recent studies have reported promising health benefits from red wine consumption. The present article reviews some of the key studies, and the known mechanisms for these beneficial effects. Evidence from different experimental studies, including from the authors' laboratories, have suggested that these beneficial effects are due to polyphenols found in red wine, especially resveratrol in grape skins. These benefits include a reduction in cardiovascular morbidity and mortality, lung cancer and prostate cancer by approximately 30% to 50%, 57% and 50%, respectively. Polyphenols possess antioxidant, superoxide-scavenging, ischemic-preconditioning and angiogenic properties. Some of these properties of polyphenols may explain their protective effects on the cardiovascular system, as well as other body organs. In fact, results from several epidemiological, case-control and prospective studies have prompted the United States Department of Health and Human Services to recommend moderate alcohol consumption in its national health promotion and disease prevention initiative, Healthy People 2010. Further studies are warranted to describe the precise molecular mechanisms for these potential beneficial effects of red wine on the general health of the population, particularly on cardiovascular morbidity and mortality.

Systematic screening for unsafe driving due to medical conditions: Still debatable

PubMed Central

Leproust, Sandy; Lagarde, Emmanuel; Salmi, L Rachid

2008-01-01

Background Assessing people's ability to drive has become a public health concern in most industrialized countries. Although age itself is not a predictive factor of an increased risk for dangerous driving, the prevalence of medical conditions that may impair driving increases with age. Because the implementation of a screening for unsafe driving due to medical conditions is a public health issue, its usefulness should be judged using standardised criteria already proposed for screening for chronic disease. The aim of this paper is to propose standardised criteria suitable to assess the scientific validity of screening for unsafe driving due to medical conditions, and identify potential issues to be clarified before screening can be implemented and effective. Discussion Using criteria developed for screening for chronic diseases and published studies on driving with medical conditions, we specify six criteria to judge the opportunity of screening for unsafe driving due to medical conditions. This adaptation was needed because of the complexity of the natural history of medical conditions and their potential consequences on driving and road safety. We then illustrate that published studies pleading for or against screening for unsafe driving due to medical conditions fail to provide the needed documentation. Individual criteria were mentioned in 3 to 72% of 36 papers pleading for or against screening. Quantitative estimates of relevant indicators were provided in at most 42% of papers, and some data, such as the definition of an appropriate unsafe driving period were never provided. Summary The standardised framework described in this paper provides a template for assessing the effectiveness (or lack of effectiveness) of proposed measures for screening for unsafe driving due to medical conditions. Even if most criteria were mentioned in the published literature pleading for or against such a screening, the failure to find quantitative and evidence-based estimates of relevant indicators provides useful insight for further research. PMID:18215269

A rapid evidence review on the effectiveness of institutional health partnerships.

PubMed

Kelly, Ema; Doyle, Vicki; Weakliam, David; Schönemann, Yvonne

2015-12-14

Institutional Health Partnerships are long-term, institution to institution partnerships between high income and low and middle income countries which seek to build capacity and strengthen health institutions in order to improve health service delivery and outcomes. Funding for Institutional Health Partnerships has increased in recent years. This paper outlines a rapid evidence review on the effectiveness of this modality. A rapid evidence review of published and grey literature was conducted. Content relating to the effectiveness of working in partnership and methods and frameworks used were extracted and analysed. The results of this analysis were used to structure a discussion regarding the next steps to strengthen the evidence base for the effectiveness of institutional health partnerships. The evidence review, including citation mapping, returned 27 published papers and 17 grey literature documents that met all of the inclusion criteria. Most of the literature did not meet the high standards of formal academic rigour and there was no original research amongst this literature that specifically addressed the effectiveness of institutional health partnerships. This was not surprising given institutional health partnerships do not lend themselves easily to case control studies and randomised control trials due to their high level of diversity and operation in complex social systems. There was, however, a body of practice based knowledge and experience. Evidence for the effectiveness of Institutional Health Partnerships is thin both in terms of quantity and academic rigour. There is a need to better define and differentiate Institutional Health Partnerships in order to measure and compare effectiveness across such a diverse group. Effectiveness needs to be measured at the level of individual partnerships, the bodies that facilitate partnership programmes and the level of health service delivery. There is a need to develop indicators and frameworks that specifically address the benefits and values of partnership working and how these relate to effectiveness. These indicators need to be content neutral of specific interventions which are already measured through routine project monitoring and evaluation. This will allow the development of methodological pathways to assess the effectiveness of institutional health partnerships. Until more primary research is conducted or published there is little benefit in further systematic reviews.

Health equity in an unequal country: the use of medical services in Chile.

PubMed

Paraje, Guillermo; Vásquez, Felipe

2012-12-18

A recent health reform was implemented in Chile (the AUGE reform) with the objective of reducing the socioeconomic gaps to access healthcare. This reform did not seek to eliminate the private insurance system, which coexists with the public one, but to ensure minimum conditions of access to the entire population, at a reasonable cost and with a quality guarantee, to cover an important group of health conditions. This paper's main objective is to enquire what has happened with the use of several healthcare services after the reform was fully implemented. Concentration and Horizontal Inequity indices were estimated for the use of general practitioners, specialists, emergency room visits, laboratory and x-ray exams and hospitalization days. The change in such indices (pre and post-reform) was decomposed, following Zhong (2010). A "mean effect" (how these indices would change if the differential use in healthcare services were evenly distributed) and a "distribution effect" (how these indices would change with no change in average use) were obtained. Changes in concentration indices were mainly due to mean effects for all cases, except for specialists (where "distribution effect" prevailed) and hospitalization days (where none of these effects prevailed over others). This implies that by providing more services across socioeconomic groups, less inequality in the use of services was achieved. On the other hand, changes in horizontal inequity indices were due to distribution effects in the case of GP, ER visits and hospitalization days; and due to mean effect in the case of x-rays. In the first three cases indices reduced their pro-poorness implying that after the reform relatively higher socioeconomic groups used these services more (in relation to their needs). In the case of x-rays, increased use was responsible for improving its horizontal inequity index. The increase in the average use of healthcare services after the AUGE reform has not always led to improved equity in the use of such services in most services. This indicates that there are still barriers to the equitable use of healthcare services (e.g. insufficient medical human resources, financial barriers, capacity constraints, etc.) that have remained after the reform.

Strengthening of Oral Health Systems: Oral Health through Primary Health Care

PubMed Central

Petersen, Poul Erik

2014-01-01

Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work with the newly established WHO Collaborating Centre, Kuwait University, to strengthen the development of appropriate models for primary oral health care. PMID:24525450

Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice

PubMed Central

Krieger, Miriam; Felder, Stefan

2013-01-01

Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure. PMID:23783222

Health care professional development: Working as a team to improve patient care

PubMed Central

El Husseini, Maha; Al Nemri, Abdurrahman; Al Frayh, Abdurrahman; Al Juryyan, Nasir; Faki, Mohamed O; Assiri, Asaad; Al Saadi, Muslim; Shaikh, Farheen; Al Zamil, Fahad

2014-01-01

In delivering health care, an effective teamwork can immediately and positively affect patient safety and outcome. The need for effective teams is increasing due to increasing co-morbidities and increasing complexity of specialization of care. Time has gone when a doctor or a dentist or any other health practitioner in whatsoever health organization would be able to solely deliver a quality care that satisfies his or her patients. The evolution in health care and a global demand for quality patient care necessitate a parallel health care professional development with a great focus on patient centred teamwork approach. This can only be achieved by placing the patient in the centre of care and through sharing a wide based culture of values and principles. This will help forming and developing an effective team able to deliver exceptional care to the patients. Aiming towards this goal, motivation of team members should be backed by strategies and practical skills in order to achieve goals and overcome challenges. This article highlights values and principles of working as a team and principles and provides team players with a practical approach to deliver quality patient care. PMID:27493399

Health care professional development: Working as a team to improve patient care.

PubMed

Babiker, Amir; El Husseini, Maha; Al Nemri, Abdurrahman; Al Frayh, Abdurrahman; Al Juryyan, Nasir; Faki, Mohamed O; Assiri, Asaad; Al Saadi, Muslim; Shaikh, Farheen; Al Zamil, Fahad

2014-01-01

In delivering health care, an effective teamwork can immediately and positively affect patient safety and outcome. The need for effective teams is increasing due to increasing co-morbidities and increasing complexity of specialization of care. Time has gone when a doctor or a dentist or any other health practitioner in whatsoever health organization would be able to solely deliver a quality care that satisfies his or her patients. The evolution in health care and a global demand for quality patient care necessitate a parallel health care professional development with a great focus on patient centred teamwork approach. This can only be achieved by placing the patient in the centre of care and through sharing a wide based culture of values and principles. This will help forming and developing an effective team able to deliver exceptional care to the patients. Aiming towards this goal, motivation of team members should be backed by strategies and practical skills in order to achieve goals and overcome challenges. This article highlights values and principles of working as a team and principles and provides team players with a practical approach to deliver quality patient care.

The impact of organizational changes on work stress, sleep, recovery and health.

PubMed

Greubel, Jana; Kecklund, Göran

2011-01-01

The study objective was to investigate the impact of different kinds of organizational changes, as well as anticipation of such changes, on work-related stress, sleep, recovery and health. It was hypothesized that impaired sleep and recovery increase the adverse health consequences of organizational changes. The data consisted of cross sectional questionnaire data from a random sample of 1,523 employees in the Swedish police force. It could be shown that extensive organizational changes including downsizing or a change in job tasks were associated with a small increase in work stress, disturbed sleep, incomplete recovery and health complaints. However, less extensive organizational changes like relocation did not affect these outcome variables. Anticipation of extensive organizational changes had almost the same effect as actual changes. Furthermore a moderating effect of sleep and work stress on gastrointestinal complaints and depressive symptoms was found. Thus, like former studies already suggested, extensive organizational changes resulted in increased stress levels, poorer health and impaired sleep and recovery. Furthermore, organizational instability due to anticipation of changes was as negative as actual changes. There was also some evidence that disturbed sleep increased these adverse health effects, in particular with respect to anticipation of organizational changes.

The possible effects of health professional mobility on access to care for patients.

PubMed

Glinos, Irene A

2014-01-01

The chapter explains how health professional mobility impacts on the resources and capacity available within a health system, and how this affects service delivery and access. The contrasting experiences of destination countries, which receive foreign inflows of health professionals, and of source countries, which loose workforce due to outflows, are illustrated with country examples. The evidence opens the debate on how EU countries compete for health workforce, what this means for resource-strained, crisis-hit Member States, and whether there is any room for intra-European solidarity. The nexus between patient mobility and health professional mobility is moreover highlighted. This take on free mobility in the EU has received little attention, and while evidence is scarce, it calls for careful analysis when considering the possible effects of free movement on access to care in national health systems. The chapter reformulates the question on 'who wins' and 'who looses' from freedom of movement in the EU to turn our attention away from those who go abroad for care and instead focus on those who stay at home.

Acute changes in community violence and increases in hospital visits and deaths from stress-responsive diseases.

PubMed

Ahern, Jennifer; Matthay, Ellicott C; Goin, Dana E; Farkas, Kriszta; Rudolph, Kara E

2018-06-06

Community violence may affect a broad range of health outcomes through physiologic stress responses and changes in health behaviors among residents. However, existing research on the health impacts of community violence suffers from problems with bias. We examined the relations of acute changes in community violence with hospital visits and deaths due to stress-responsive diseases (mental, respiratory, and cardiac conditions) in statewide data from California 2005-2013. The community violence exposure was measured as both binary spikes and continuous acute changes. We applied a combined fixed-effects and time-series design that separates the effects of violence from those of community- and individual-level confounders more effectively than past research. Temporal patterning was removed from community violence rates and disease rates in each place using a Kalman smoother, resulting in residual rates. We used linear regression with place fixed-effects to examine within-place associations of acute changes in community violence with residual rates of each outcome, controlling for local time-varying covariates. We found acute increases in hospital visits and deaths due to anxiety disorders (0.31 per 100,000; 95% Confidence Interval (CI) 0.02,0.59), substance use (0.47 per 100,000; 95%CI 0.14,0.80), asthma (0.56 per 100,000; 95%CI 0.16,0.95), and fatal acute myocardial infarction (0.09 per 100,000; 95%CI 0.00,0.18) co-occurring with violence spikes. The pattern of findings was similar for the exposure of continuous acute violence changes. Although the associations were small, the identified increases in stress-responsive conditions suggest the possibility of health impacts of acute changes in community violence.

Ageing and mental health: changes in self-reported health due to physical illness and mental health status with consecutive cross-sectional analyses.

PubMed

Lorem, Geir Fagerjord; Schirmer, Henrik; Wang, Catharina E A; Emaus, Nina

2017-01-18

It is known that self-reported health (SRH) declines with increasing age and that comorbidity increases with age. We wished to examine how age transfers its effect to SRH through comorbid disease and mental illness and whether these processes remained stable from 1994 until 2008. The hypothesis is that ageing and/or the increased age-related burden of pathology explains the declining SRH. The Tromsø Study (TS) is a cohort study using a survey approach with repeated physical examinations. It was conducted in the municipality of Tromsø, Norway, from 1974 to 2008. A total of 21 199 women and 19 229 men participated. SRH is the outcome of interest. We calculated and compared the effect sizes of age, comorbidity and mental health symptoms using multimediator analysis based on OLS regression. Ageing had a negative impact on SRH, but the total effect of age decreased from 1994 to 2007. We assessed the direct effect of age and then the proportion of indirect age-related effects through physical illness and mental health symptoms on the total effect. The direct effect of age represented 79.3% of the total effect in 1994 and decreased to 58.8% in 2007. Physical illness emerged as an increasingly important factor and increased its influence from 15.7% to 41.2% of the total effect. Age alone had a protective effect on mental health symptoms and this increased (2.5% to 17.3%), but we found a stronger association between mental health symptoms and physical disease in the later waves of the study (increasing from 3.7% to 14.8%). The results suggest that the effect on SRH of mental health symptoms caused by physical illness is an increasing public health problem. Treatment and care for specific medical conditions must therefore focus more strongly on how these conditions affect the patient's mental health and address these concerns accordingly. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Association between particulate matter from biomass burning and respiratory diseases in the southern region of the Brazilian Amazon].

PubMed

do Carmo, Cleber Nascimento; Hacon, Sandra; Longo, Karla Maria; Freitas, Saulo; Ignotti, Eliane; Ponce de Leon, Antonio; Artaxo, Paulo

2010-01-01

To investigate the short-term effects of exposure to particulate matter from biomass burning in the Amazon on the daily demand for outpatient care due to respiratory diseases in children and the elderly. Epidemiologic study with ecologic time series design. Daily consultation records were obtained from the 14 primary health care clinics in the municipality of Alta Floresta, state of Mato Grosso, in the southern region of the Brazilian Amazon, between January 2004 and December 2005. Information on the daily levels of fine particulate matter was made available by the Brazilian National Institute for Spatial Research. To control for confounding factors (situations in which a non-causal association between exposure and disease is observed due to a third variable), variables related to time trends, seasonality, temperature, relative humidity, rainfall, and calendar effects (such as occurrence of holidays and weekends) were included in the model. Poisson regression with generalized additive models was used. A 10 microg/m3 increase in the level of exposure to particulate matter was associated with increases of 2.9% and 2.6% in outpatient consultations due to respiratory diseases in children on the 6th and 7th days following exposure. Significant associations were not observed for elderly individuals. The results suggest that the levels of particulate matter from biomass burning in the Amazon are associated with adverse effects on the respiratory health of children.

Future premature mortality due to O3, secondary inorganic aerosols and primary PM in Europe--sensitivity to changes in climate, anthropogenic emissions, population and building stock.

PubMed

Geels, Camilla; Andersson, Camilla; Hänninen, Otto; Lansø, Anne Sofie; Schwarze, Per E; Skjøth, Carsten Ambelas; Brandt, Jørgen

2015-03-04

Air pollution is an important environmental factor associated with health impacts in Europe and considerable resources are used to reduce exposure to air pollution through emission reductions. These reductions will have non-linear effects on exposure due, e.g., to interactions between climate and atmospheric chemistry. By using an integrated assessment model, we quantify the effect of changes in climate, emissions and population demography on exposure and health impacts in Europe. The sensitivity to the changes is assessed by investigating the differences between the decades 2000-2009, 2050-2059 and 2080-2089. We focus on the number of premature deaths related to atmospheric ozone, Secondary Inorganic Aerosols and primary PM. For the Nordic region we furthermore include a projection on how population exposure might develop due to changes in building stock with increased energy efficiency. Reductions in emissions cause a large significant decrease in mortality, while climate effects on chemistry and emissions only affects premature mortality by a few percent. Changes in population demography lead to a larger relative increase in chronic mortality than the relative increase in population. Finally, the projected changes in building stock and infiltration rates in the Nordic indicate that this factor may be very important for assessments of population exposure in the future.

Future Premature Mortality Due to O3, Secondary Inorganic Aerosols and Primary PM in Europe — Sensitivity to Changes in Climate, Anthropogenic Emissions, Population and Building Stock

PubMed Central

Geels, Camilla; Andersson, Camilla; Hänninen, Otto; Lansø, Anne Sofie; Schwarze, Per E.; Ambelas Skjøth, Carsten; Brandt, Jørgen

2015-01-01

Air pollution is an important environmental factor associated with health impacts in Europe and considerable resources are used to reduce exposure to air pollution through emission reductions. These reductions will have non-linear effects on exposure due, e.g., to interactions between climate and atmospheric chemistry. By using an integrated assessment model, we quantify the effect of changes in climate, emissions and population demography on exposure and health impacts in Europe. The sensitivity to the changes is assessed by investigating the differences between the decades 2000–2009, 2050–2059 and 2080–2089. We focus on the number of premature deaths related to atmospheric ozone, Secondary Inorganic Aerosols and primary PM. For the Nordic region we furthermore include a projection on how population exposure might develop due to changes in building stock with increased energy efficiency. Reductions in emissions cause a large significant decrease in mortality, while climate effects on chemistry and emissions only affects premature mortality by a few percent. Changes in population demography lead to a larger relative increase in chronic mortality than the relative increase in population. Finally, the projected changes in building stock and infiltration rates in the Nordic indicate that this factor may be very important for assessments of population exposure in the future. PMID:25749320

Measuring the Health of an Invisible Population: Lessons from the Colorado Transgender Health Survey.

PubMed

Christian, Robin; Mellies, Amy Anderson; Bui, Alison Grace; Lee, Rita; Kattari, Leo; Gray, Courtney

2018-05-15

Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited. The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado. The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations. Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data. Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without. The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into national efforts to eliminate health disparities.

Insurance disruption due to spousal Medicare transitions: implications for access to care and health care utilization for women approaching age 65.

PubMed

Schumacher, Jessica R; Smith, Maureen A; Liou, Jinn-Ing; Pandhi, Nancy

2009-06-01

To assess whether a husband's Medicare transition leads to insurance disruptions for his wife that impact her perceived access to care, health care utilization, or health status. Respondents were married women under age 65 from the 2003-2005 round of the Wisconsin Longitudinal Study (N=655). Instrumental variable (IV) linear and IV-probit analyses provided unbiased estimates of the effect of an insurance disruption on study outcomes. The instrument was the husband's age: (1) women with husbands who transitioned to Medicare within the previous year (age 65-66); (2) women with husbands who did not transition (60

Growing cell-phone population and noncoverage bias in traditional random digit dial telephone health surveys.

PubMed

Lee, Sunghee; Brick, J Michael; Brown, E Richard; Grant, David

2010-08-01

Examine the effect of including cell-phone numbers in a traditional landline random digit dial (RDD) telephone survey. The 2007 California Health Interview Survey (CHIS). CHIS 2007 is an RDD telephone survey supplementing a landline sample in California with a sample of cell-only (CO) adults. We examined the degree of bias due to exclusion of CO populations and compared a series of demographic and health-related characteristics by telephone usage. When adjusted for noncoverage in the landline sample through weighting, the potential noncoverage bias due to excluding CO adults in landline telephone surveys is diminished. Both CO adults and adults who have both landline and cell phones but mostly use cell phones appear different from other telephone usage groups. Controlling for demographic differences did not attenuate the significant distinctiveness of cell-mostly adults. While careful weighting can mitigate noncoverage bias in landline telephone surveys, the rapid growth of cell-phone population and their distinctive characteristics suggest it is important to include a cell-phone sample. Moreover, the threat of noncoverage bias in telephone health survey estimates could mislead policy makers with possibly serious consequences for their ability to address important health policy issues.

Occupational health hazards resulting from elevated work rate situations.

PubMed

Ohara, H; Nakagiri, S; Itani, T; Wake, K; Aoyama, H

1976-12-01

Some occupational health hazards resulting from an elevated rate of work due to recent mechanization and automatization are discussed on the basis of results of health examinations. A rapid increase of a cervicobrachial disorder among young cash register and packing machine operators has been observed. Switching to the use of electronic cash registers has been shown to have only limited efficacy due to increased operation speed, and high-speed complex finger and hand movements of packer operators have also proven to be as hazardous as key-board operations. The high incidence of low-back pain, in particular gradually developing pain, among workers in electric power supply work has been suggested to be the result of quick and intensified work to meet increasing supply demand. Likewise, the workload of electric locomotive and bullet train drivers has increased in accordance with increased train speeds, and has been shown to have had significant effects on their health particularly in regards to neural strain, intra-cab environment such as air pressure change, vibration, and noise, and rotation on irregular shifts. New steps seem required therefore to meet the new health problems arising from a combination of modern technological changes and elevated working speeds.

[Cellular phones and public health].

PubMed

Leventhal, Alex; Karsenty, Eric; Sadetzki, Siegal

2004-08-01

The increased use of mobile cellular phone by the public is associated with a wave of contradictory reports about the possible health effects, due to the exposure of the users to electromagnetic non-ionizing radiation. This article reviews the state of the art of the present knowledge concerning the biological and medical effects of exposure to cellular phones, with an emphasis on its possible carcinogenic effect. Health conditions, which have been ascribed to the use of mobile phones mainly include some types of cancer and changes of brain activity. However, the balance of evidence from available studies has not yet supported these claims. Following the recommendation of special international expert committees, the IARC (International Association for Research on Cancer) is conducting a multi-center study to determine the possible effect of cellular phone use on brain and salivary gland tumors. Israel is one of the participants of this study. The only established health effect associated with the use of such technology is an increased risk for road accidents, unrelated to the amount of radiation emitted by phone. The challenge posed by this new technology to health authorities all over the world has lead to the definition of a new principle, the so-called "prudent avoidance", used as guidelines for the definition of an adequate public health policy. The public policy in Israel has used the prudent avoidance principles, while awaiting the results of the multi-national epidemiological studies.

The effectiveness of health systems in influencing avoidable mortality: a study in Valencia, Spain, 1975-90.

PubMed Central

Albert, X; Bayo, A; Alfonso, J L; Cortina, P; Corella, D

1996-01-01

OBJECTIVES: To measure variations in the Holland and Charlton classifications of avoidable death causes and to estimate the effect of the Spanish national health system on avoidable mortality. DESIGN: Mortality in the Valencian Community was assessed between 1975 and 1990. The classifications of Holland and Charlton, used to assess avoidable causes of death, were compared. Holland's classification was then used to divide avoidable mortality into two groups--medical care indicators (MCI), which show the effectiveness of health care, and national health policy indicators (NHPI), which show the status of primary prevention. Comparisons were made with rates, group rates, and population rates. Trends and indices were also studied. SETTING: Valencia, Spain, 1975-90. RESULTS: During the study period, avoidable morality (only assessed by MCI) fell 63%, whereas the remainder of the mortality (non-MCI causes, that is all the non-avoidable causes together with the NHPI group) fell by 17%. If it is assumed that the mortality due to non-MCI causes indicates the overall effect of the environmental, social, nutritional, and genetic influences, then the difference between this and the MCI group would take us nearer the actual effect of the intervention of the health system. CONCLUSIONS: It is concluded that in this community, the health system has been responsible for approximately 47% of the total reduction in mortality from avoidable causes in the period studied. PMID:8935465

Self-reported health among Cambodians in Lowell, Massachusetts.

PubMed

Koch-Weser, Susan; Liang, Sidney L; Grigg-Saito, Dorcas C

2006-05-01

National health data reported for Asians in the aggregate present a picture of good health, but significant health disparities exist between Southeast Asian refugees, and Cambodians in particular, and the overall population of the U.S. To effectively address health disparities, ethnically specific data is needed. Data from a community survey of 381 Cambodian adults 25 years of age and older are presented. Overall, 44% of respondents reported fair or poor health. Using multivariate logistic regression, we examined the relationships between self-rated health and demographics, timing of immigration, language use and literacy, and access to health care. In our final model those most likely to report fair or poor health were female, older, unable to work due to disability, to have spent a smaller proportion of their life in the U.S., and to have wanted to see a doctor in the past year, but not been able to.

Long-term health outcomes of youth sports injuries.

PubMed

Maffulli, N; Longo, U G; Gougoulias, N; Loppini, M; Denaro, V

2010-01-01

Injuries can counter the beneficial effects of sports participation at a young age if a child or adolescent is unable to continue to participate because of residual effects of injury. This paper reviews current knowledge in the field of long-term health outcomes of youth sports injuries to evaluate the evidence regarding children dropping out of sport due to injury, physeal injuries and growth disturbance, studies of injuries affecting the spine and knee of young and former athletes and surgical outcome of anterior cruciate ligament (ACL) reconstruction in children. Studies of dropping out of sport due to injury are limited primarily to gymnasts and implicate such injuries as ACL rupture and osteochondritis dissecans of the elbow joint in the early retirement of young athletes. Although most physeal injuries resolve with treatment and rest, there is evidence of disturbed physeal growth as a result of injury. Radiological findings implicate the effects of intense physical loading and injury in the development of spinal pathology and back pain during the growth of youth athletes; however, long-term effects are unclear. Follow-up studies of young athletes and adults indicate a high risk of osteoarthritis after meniscus or ACL injury. Prospective cohort studies with a follow-up into adulthood are needed to clarify the long-term health outcomes of youth sports injuries. Important to this research is meticulous documentation of injuries on injury report forms that include age-appropriate designations of the type of injury and accurate determination of exposure-based injury rates.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

One objective of the study is to assess the effects of all currently known deviations from normal of medical, physiological, and biochemical parameters which appear to be due to zero gravity (zero-g) environment and to acceleration and deceleration to be experienced, as outlined in the reference Solar Power Satellite (SPS) design, by space worker. Study results include identification of possible health or safety effects on space workers - either immediate or delayed - due to the zero gravity environment and acceleration and deceleration; estimation of the probability that an individual will be adversely affected; description of the possible consequence tomore » work efficiently in persons adversely affected; and description of the possible/probable consequences to immediate and future health of individuals exposed to this environment. A research plan, which addresses the uncertainties in current knowledge regarding the health and safety hazards to exposed SPS space workers, is presented. Although most adverse affects experienced during space flight soon disappeared upon return to the Earth's environment, there remains a definite concern for the long-term effects to SPS space workers who might spend as much as half their time in space during a possible five-year career period. The proposed 90-day up/90 day down cycle, coupled with the fact that most of the effects of weightlessness may persist throughout the flight along with the realization that recovery may occupy much of the terrestrial stay, may keep the SPS workers in a deviant physical condition or state of flux for 60 to 100% of their five-year career. (JGB)« less

METABOLIC FATE OF HALOGENATED DISINFECTION BY-PRODUCTS IN VIVO, AND RELATION TO BIOLOGICAL ACTIVITY

EPA Science Inventory

Objectives/Hypotheses: Halogenated by-products of drinking water disinfection are of concern because of uncertainty over their health effects, particularly an increased risk of kidney and bladder cancer and widespread consumption. Due to their abundance relative to other h...

Bicyclists' Uptake of Traffic-Related Air Pollution: Effects of the Urban Transportation System

DOT National Transportation Integrated Search

2014-10-27

While bicyclists and other active travelers obtain health benefits from increased physical activity, they also risk uptake of traffic-related air pollution. But pollution uptake by urban bicyclists is not well understood due to a lack of direct measu...

A Reference Method for Measuring Emissions of SVOCs in Small Chambers

EPA Science Inventory

Semivolatile organic compounds (SVOCs) are indoor air pollutants that may may have significant adverse effects on human health, and emission of SVOCs from building materials and consumer products is of growing concern. Few chamber studies have been conducted due to the challenge...

Pulmonary and Hematological Effects in Rats Following a Single Inhalation Exposure to Ce02 Nanoparticles

EPA Science Inventory

Engineered nanomaterials have unknown environmental and health implications due to their novel properties and/or by-products associated with their applications. Combustion studies have shown nanoCe-enabled fuel additives alter the physicochemical properties of diesel emissions (D...

CHARACTERIZATION OF AUTOMOTIVE EMISSIONS BY BACTERIAL MUTAGENESIS BIOASSAY: A REVIEW

EPA Science Inventory

Due to the growing numbers of diesel passenger automobiles in the United States, there has been an expanded effort to understand the health effects of airborne pollutants arising from increased automotive emissions. Bacterial mutagenicity testing has played an important role in t...

IDENTIFICATION OF NEW DRINKING WATER DISINFECTION BY-PRODUCTS FROM OZONE, CHLORINE DIOXIDE, CHLORAMINE, AND CHLORINE

EPA Science Inventory

Due to concern over the potential adverse health effects of trihalomethanes (THMs) and other chlorinated by-products in chlorinated drinking water, alternative disinfection methods are being explored. Ozone, chlorine dioxide, and chloramine are currently popular alternatives to ...

IDENTIFICATION OF CHLORINE DIOXIDE DRINKING WATER DISINFECTION BY-PRODUCTS FORMED AT HIGH BROMIDE LEVELS

EPA Science Inventory

Due to concern over the potential adverse health effects of trihalomethanes (THMs), haloacetic acids, and other chlorinated by-products in chlorinated drinking water, alternative disinfection methods are being explored. Chlorine dioxide is a popular alternative, with over 500 dri...

Finalizing the Libby Action Plan Research Program | Science ...

EPA Pesticide Factsheets

Libby, Montana is the location of a former vermiculite mine that operated from 1923 to 1990. The vermiculite ore from the mine co-existed with amphibole asbestos, referred to as Libby Amphibole Asbestos (LAA). Combined with the cessation of the asbestos mining and processing operations, there has been significant progress in reducing the exposure to LAA in Libby, Montana. In 2009, the U.S Environmental Protection Agency (EPA) jointly with the Department of Health and Human Services (DHHS) declared a public health emergency in Libby due to observed asbestos-related health effects in the region. As part of this effort, the EPA led a cross-agency research program that conducted analytical, toxicological, and epidemiological research on the health effects of asbestos at the Libby Asbestos Superfund Site (Libby Site) in Libby, Montana. The Libby Action Plan (LAP) was initiated in 2007 to support the site-specific risk assessment for the Libby Site. The goal of the LAP research program was to explore the health effects of LAA, and determine toxicity information specific to LAA in order to accurately inform a human health risk assessment at the Libby Site. LAP research informed data gaps related to the health effects of exposure to LAA, particularly related to specific mechanisms of fiber dosimetry and toxicity (e.g., inflammatory responses), as well as investigated disease progression in exposed populations and advanced asbestos analytical techniques. This work incl

Quantitative health impact assessment of transport policies: two simulations related to speed limit reduction and traffic re-allocation in the Netherlands.

PubMed

Schram-Bijkerk, D; van Kempen, E; Knol, A B; Kruize, H; Staatsen, B; van Kamp, I

2009-10-01

Few quantitative health impact assessments (HIAs) of transport policies have been published so far and there is a lack of a common methodology for such assessments. To evaluate the usability of existing HIA methodology to quantify health effects of transport policies at the local level. Health impact of two simulated but realistic transport interventions - speed limit reduction and traffic re-allocation - was quantified by selecting traffic-related exposures and health endpoints, modelling of population exposure, selecting exposure-effect relations and estimating the number of local traffic-related cases and disease burden, expressed in disability-adjusted life-years (DALYs), before and after the intervention. Exposure information was difficult to retrieve because of the local scale of the interventions, and exposure-effect relations for subgroups and combined effects were missing. Given uncertainty in the outcomes originating from this kind of missing information, simulated changes in population health by two local traffic interventions were estimated to be small (<5%), except for the estimated reduction in DALYs by less traffic accidents (60%) due to speed limit reduction. Quantitative HIA of transport policies at a local scale is possible, provided that data on exposures, the exposed population and their baseline health status are available. The interpretation of the HIA information should be carried out in the context of the quality of input data and assumptions and uncertainties of the analysis.

The influence of global warming on natural disasters and their public health outcomes.

PubMed

Diaz, James H

2007-01-01

With a documented increase in average global surface temperatures of 0.6 degrees C since 1975, Earth now appears to be warming due to a variety of climatic effects, most notably the cascading effects of greenhouse gas emissions resulting from human activities. There remains, however, no universal agreement on how rapidly, regionally, or asymmetrically the planet will warm or on the true impact of global warming on natural disasters and public health outcomes. Most reports to date of the public health impact of global warming have been anecdotal and retrospective in design and have focused on the increase in heat-stroke deaths following heat waves and on outbreaks of airborne and arthropod-borne diseases following tropical rains and flooding that resulted from fluctuations in ocean temperatures. The effects of global warming on rainfall and drought, tropical cyclone and tsunami activity, and tectonic and volcanic activity will have far-reaching public health effects not only on environmentally associated disease outbreaks but also on global food supplies and population movements. As a result of these and other recognized associations between climate change and public health consequences, many of which have been confounded by deficiencies in public health infrastructure and scientific debates over whether climate changes are spawned by atmospheric cycles or anthropogenic influences, the active responses to progressive climate change must include combinations of economic, environmental, legal, regulatory, and, most importantly, public health measures.

Absenteeism due to mental health problems and systems for return to work: an internet-based unmatched case-control study.

PubMed

Doki, Shotaro; Sasahara, Shinichiro; Hirai, Yasuhito; Oi, Yuichi; Matsuzaki, Ichiyo

2016-11-01

The aim of this study was to investigate the risk factors for absenteeism due to mental health problems with regard to company characteristics and systems for return to work in Japan. This was an Internet-based unmatched case-control study. Two hundred and fifty-eight workers who experienced over 28 days of sick leave due to mental health problems (cases) and 258 workers who have not taken sick leave (controls) were recruited. Company characteristics and the awareness and presence of systems for return to work were analysed as indicators of absenteeism. A total of 501 workers were included in the analysis. Females were less likely to experience absenteeism when adjustments were made for both the awareness and presence of systems [odds ratio (OR) = 0.51 and 0.41, respectively]. Large companies showed an increased risk of having absentee workers than small companies. The awareness of a gradual resumption system and the presence of a sick pay system were related to absenteeism (OR = 2.75 and 2.40, respectively). The awareness and presence of systems for return to work are related to the long-term absenteeism. The predictors of sex and company size are also related to the experience of the long-term absenteeism. To understand the effect of systems for return to work on absenteeism due to mental problems, further studies are needed.

Medical aspects of atmosphere pollution in Tbilisi, Georgia.

PubMed

Lagidze, Lamzira; Matchavariani, Lia; Tsivtsivadze, Nodar; Khidasheli, Nargiz; Paichadze, Nino; Motsonelidze, Nargiz; Vakhtangishvili, Maia

2015-01-01

Climate change and its impact on ecosystems is one of the main problem of 21st century. Increase in green house gas in the atmosphere was regarded as an important cause. Atmospheric composition had significantly changed due to intensive technogenic pollution. Increase in aerosol (solid, liquid and gas) concentration had serious impact on human health and raised the level of risk factors for longevity of life. Despite, global character of climatic change and its intensity in numerous ways was influenced by local specificity of regions, their geographical location and meteorological factors. A study on the atmospheric quality (quantitative and percentage estimation of aerosols) of Georgia was carried out. Also the assessment of impact of meteorological and ecological conditions on human health was made for Tbilisi city. A relation between contaminants and meteorological factors was evaluated, particularly gas pollutants were strongly correlated with each other due to their photochemical activity; positive correlation (0.65; 0.69) between air temperature and pollutants. All the contaminants showed negative correlation with relative humidity, due to hydrolyzing ability. On the basis of multi-factorial statistical analysis, correlation between ambulance call, weather type, atmosphere pollution index, change in ground ozone quantity and earth magnetic field were determined. Atmospheric pollution due to dust, carbon, sulfur and nitrogen oxides, ground ozone quantity in Tbilisi significantly exceeded maximum permissible level, that effected human health.

Potential health consequences of ground-water contamination by nitrates in Nebraska.

PubMed

Weisenburger, D D

1993-01-01

Ground water serves as the primary source of drinking water for nearly all of rural Nebraska. However, ground-water contamination by nitrates, largely due to the use of fertilizers, is an increasing problem. In an ecologic study, the author found that counties characterized by high fertilizer usage and significant ground-water contamination by nitrates also had a high incidence of non-Hodgkin's lymphoma. Other potential health effects of nitrates in drinking water are also discussed.

Breast cancer screening services: trade-offs in quality, capacity, outreach, and centralization.

PubMed

Güneş, Evrim D; Chick, Stephen E; Akşin, O Zeynep

2004-11-01

This work combines and extends previous work on breast cancer screening models by explicitly incorporating, for the first time, aspects of the dynamics of health care states, program outreach, and the screening volume-quality relationship in a service system model to examine the effect of public health policy and service capacity decisions on public health outcomes. We consider the impact of increasing standards for minimum reading volume to improve quality, expanding outreach with or without decentralization of service facilities, and the potential of queueing due to stochastic effects and limited capacity. The results indicate a strong relation between screening quality and the cost of screening and treatment, and emphasize the importance of accounting for service dynamics when assessing the performance of health care interventions. For breast cancer screening, increasing outreach without improving quality and maintaining capacity results in less benefit than predicted by standard models.

Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture.

PubMed

Nicolopoulou-Stamati, Polyxeni; Maipas, Sotirios; Kotampasi, Chrysanthi; Stamatis, Panagiotis; Hens, Luc

2016-01-01

The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken.

Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture

PubMed Central

Nicolopoulou-Stamati, Polyxeni; Maipas, Sotirios; Kotampasi, Chrysanthi; Stamatis, Panagiotis; Hens, Luc

2016-01-01

The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken. PMID:27486573

Linking Air Quality and Human Health Effects Models: An Application to the Los Angeles Air Basin

PubMed Central

Stewart, Devoun R; Saunders, Emily; Perea, Roberto A; Fitzgerald, Rosa; Campbell, David E; Stockwell, William R

2017-01-01

Proposed emission control strategies for reducing ozone and particulate matter are evaluated better when air quality and health effects models are used together. The Community Multiscale Air Quality (CMAQ) model is the US Environmental Protection Agency’s model for determining public policy and forecasting air quality. CMAQ was used to forecast air quality changes due to several emission control strategies that could be implemented between 2008 and 2030 for the South Coast Air Basin that includes Los Angeles. The Environmental Benefits Mapping and Analysis Program—Community Edition (BenMAP-CE) was used to estimate health and economic impacts of the different emission control strategies based on CMAQ simulations. BenMAP-CE is a computer program based on epidemiologic studies that link human health and air quality. This modeling approach is better for determining optimum public policy than approaches that only examine concentration changes. PMID:29162976

The Combined Effect of Long Working Hours and Low Job Control on Self-Rated Health: An Interaction Analysis.

PubMed

Cho, Seong-Sik; Ju, Young-Su; Paek, Domyung; Kim, Hyunjoo; Jung-Choi, Kyunghee

2018-05-01

The aim of this study was to investigate the combined effects of long working hours and low job control on self-rated health. We analyzed employees' data obtained from the third Korean Working Conditions Survey (KWCS). Multiple survey logistic analysis and postestimation commands were employed to estimate the relative excess risk due to interaction (RERI). The odds ratio (OR) for poor self-rated health was 1.24 [95% confidence interval (95% CI): 1.13 to 1.35] for long working hours, 1.04 (95% CI: 0.97 to 1.13) for low job control, and 1.47 (95% CI: 1.33 to 1.62) for both long working hours and low job control. The RERI was 0.18 (95% CI: 0.02 to 0.34). These results imply that low job control may increase the negative influence of long working hours on self-rated health.

The Combined Effect of Long Working Hours and Low Job Control on Self-Rated Health

PubMed Central

Cho, Seong-Sik; Ju, Young-Su; Paek, Domyung; Kim, Hyunjoo; Jung-Choi, Kyunghee

2018-01-01

Objectives: The aim of this study was to investigate the combined effects of long working hours and low job control on self-rated health. Methods: We analyzed employees’ data obtained from the third Korean Working Conditions Survey (KWCS). Multiple survey logistic analysis and postestimation commands were employed to estimate the relative excess risk due to interaction (RERI). Results: The odds ratio (OR) for poor self-rated health was 1.24 [95% confidence interval (95% CI): 1.13 to 1.35] for long working hours, 1.04 (95% CI: 0.97 to 1.13) for low job control, and 1.47 (95% CI: 1.33 to 1.62) for both long working hours and low job control. The RERI was 0.18 (95% CI: 0.02 to 0.34). Conclusion: These results imply that low job control may increase the negative influence of long working hours on self-rated health. PMID:29200187

Linking Air Quality and Human Health Effects Models: An Application to the Los Angeles Air Basin.

PubMed

Stewart, Devoun R; Saunders, Emily; Perea, Roberto A; Fitzgerald, Rosa; Campbell, David E; Stockwell, William R

2017-01-01

Proposed emission control strategies for reducing ozone and particulate matter are evaluated better when air quality and health effects models are used together. The Community Multiscale Air Quality (CMAQ) model is the US Environmental Protection Agency's model for determining public policy and forecasting air quality. CMAQ was used to forecast air quality changes due to several emission control strategies that could be implemented between 2008 and 2030 for the South Coast Air Basin that includes Los Angeles. The Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) was used to estimate health and economic impacts of the different emission control strategies based on CMAQ simulations. BenMAP-CE is a computer program based on epidemiologic studies that link human health and air quality. This modeling approach is better for determining optimum public policy than approaches that only examine concentration changes.

Impacts of Climate Change on Inequities in Child Health.

PubMed

Bennett, Charmian M; Friel, Sharon

2014-12-03

This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world's poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

Worksite health promotion programs in college settings

PubMed Central

Hill-Mey, Patricia E.; Kumpfer, Karol L.; Merrill, Ray M.; Reel, Justine; Hyatt-Neville, Beverly; Richardson, Glenn E.

2015-01-01

The purpose of this paper is to describe the multifaceted nature and benefits of worksite health promotion programs (WHPPs), with emphasis on the college setting. An assessment of the peer-reviewed literature was conducted of articles published since 2000. Several search engines were accessed and selected key words were used. Most studies examining WHPPs have focused on return on investment and productivity. Research that targets the softer side-benefits of health promotion programs in the workplace is less available. Although the college setting offers some advantages for implementing health promotion programs. They may also have unique challenges due to their large and diverse employee population. There is little research to show the effectiveness and unique challenges of college-based health promotion programs. PMID:25861657