WorldWideScience

Sample records for body burden

  1. FRAMES User Defined Body Burden Concentration File Module Documentation

    International Nuclear Information System (INIS)

    Pelton, Mitchell A.; Rutz, Frederick C.; Eslinger, Melany A.; Gelston, Gariann M.

    2001-01-01

    The Framework for Risk Analysis in Multimedia Environmental Systems (FRAMES) Body Burden Concentration File (BBF) contains time-varying, instantaneous, constituent concentrations for body burden by contaminant. This report contains the requirements for this file and will be used by software engineers and testers to ensure that the file inputs properly.

  2. Interaction of ethanol and mercury body burden in the mouse

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, J.D.

    1978-01-01

    The interaction of ethanol with mercury in the body resulting in increased exhalation of the metal was studied in the mouse. A persistent elimination of the metal in the breath was demonstrated after single, sublethal (<1 mgHg/Kg body weight) exposures to mercury vapor (Hg/sup 0/) or mercury II chloride (HgCl/sub 2/). The amount of mercury exhaled per unit time was enhanced by oral or parenteral administration of ethanol solutions. These modifications were investigated in dose-response studies in which the drug was administered in doses ranging from 0.2g to 5.5g/Kg to mice pretreated with mercury. The EC/sub 50/ for blood ethanol with respect to mercury exhalation was determined to be approximately 200 mg/dl corresponding to an output rate of approximately 0.1% of the simultaneous body burden in 30 min several days after mercury. A hypothesis that mercury expired by these animals was proportional to the body burden after mercury administration was addressed in experiments whereby mice given one of several doses of mercuric chloride (0.16 to 500 ..mu..g/Kg) were monitored for pulmonary mercury elimination for a fifteen day period. The high correlation obtained between the amount of mercury exhaled in a standard time period and the body burden by group indicated that breath sampling could be applied as an indicator of the mercury body burden which may not be limited to the mouse.

  3. Estimation of 137Cs body burden in Japanese, 2

    International Nuclear Information System (INIS)

    Uchiyama, Masashi

    1978-01-01

    The biological half-life of 137 Cs in the total body of human subjects was determined in 23 individuals of Japanese male adult in their normal works by measuring amount of 137 Cs in both their total body and daily urine in the same period. For the group, the value was determined by averaging the half-lives for individuals, by comparing the mean body burden and the mean daily urinary excretion, or by applying a curve fitting method to the body burden estimate. The biological half-life averaged 86 days, ranging from 50 to 161 days. The averages of the biological half-lives for the group were 83, 87 and 82 days in the different periods of observation. By the curve fitting method, 85 days was found for the group. The biological half-life for the individuals depended on both body weight and age, to a lesser extent, of the subjects. (author)

  4. Monitoring body iron burden using X-ray fluorescence (XRF)

    International Nuclear Information System (INIS)

    Farquharson, M.J.; Bagshaw, A.P.

    2001-01-01

    X-ray fluorescence, using Cu K alpha and K beta radiation, has been used to measure the Fe content of skin of two groups of rats, one Fe overloaded and one control group. These skin Fe levels were compared to the liver and heart Fe levels measured using colorimetry. Correlation coefficients of 0.86 and 0.88 respectively were found indicating that skin Fe levels may be a potential marker for body iron burden.

  5. History of PUQFUA: plutonium body burden (Q) from urine assays

    International Nuclear Information System (INIS)

    Lawrence, J.N.P.

    1978-10-01

    PUQFUA is a FORTRAN computer program that calculates plutonium body burdens (Q) from urine assay data. This report describes the historical development of the program at the Los Alamos Scientific Laboratory (LASL) since 1959. After a review of the basic techniques used in the original PUQFUA, its deficiencies are listed. The procedures used to improve the program and correct the deficiencies are described. Appendixes provide a detailed discussion of the evaluation made of the analytical errors in the plutonium urine assay program at LASL from 1944 to 1978

  6. Cesium-137 body burden in Japanese from 1967 to 1975

    Energy Technology Data Exchange (ETDEWEB)

    Anzai, I; Ueda, K; Togo, M [Tokyo Univ. (Japan). Faculty of Medicine

    1976-11-01

    Cesium-137 concentrations in Japanese male adults were measured monthly during 1967 to 1975 by whole body counting. The /sup 137/Cs content decreased rapidly until 1968, then the reduction rate was considerably decelerated, being probably affected by the French and Chinese nuclear testing. A small rise was observed at the end of 1970, and its causes have been multilaterally studied from the radioecological viewpoints, which has not resulted in a clearcut conclusion. Daily intake estimated from body burden varies in a wide range but, on the average, agrees well with the reported values based on the radiochemical analyses of foods. The integrated absorbed dose from January 1967 to April 1975 is calculated to be 2.5 mrads. The authors re-emphasize the importance of the periodic measurement of human population.

  7. Evaluation of modelling body burden of Cs-137

    Energy Technology Data Exchange (ETDEWEB)

    Bergstroem, U; Nordlinder, S

    1996-05-01

    Within the IAEA/CEC VAMP-program one working group studied the precision in dose assessment models when calculating body burden of {sup 137}Cs as a result of exposure through multiple exposure pathways. One scenario used data from southern Finland regarding contamination of various media due to the fallout from the Chernobyl accident. In this study, a time dependent multiple exposure pathway model was constructed based on compartment theory. Uncertainties in model responses due to uncertainties in input parameter values were studied. The initial predictions for body burden were good, within a factor of 2 of the observed, while the time dynamics of levels in milk and meat did not agree satisfactorily. Some results, nevertheless, showed good agreement with observations due to compensatory effects. After disclosure of additional observational data, major reasons for mispredictions were identified as lack of consideration of time dependence of fixation of {sup 137}Cs in soils, and the selection of parameter values. When correction of this was made, a close agreement between predictions and observations was obtained. This study shows that the dose contribution due to {sup 137}Cs in food products from the seminatural environment is important for long-term exposure to man. The evaluation provided a basis for improvements of crucial parts in the model. 14 refs, 18 figs, 8 tabs.

  8. Evaluation of modelling body burden of Cs-137

    International Nuclear Information System (INIS)

    Bergstroem, U.; Nordlinder, S.

    1996-05-01

    Within the IAEA/CEC VAMP-program one working group studied the precision in dose assessment models when calculating body burden of 137 Cs as a result of exposure through multiple exposure pathways. One scenario used data from southern Finland regarding contamination of various media due to the fallout from the Chernobyl accident. In this study, a time dependent multiple exposure pathway model was constructed based on compartment theory. Uncertainties in model responses due to uncertainties in input parameter values were studied. The initial predictions for body burden were good, within a factor of 2 of the observed, while the time dynamics of levels in milk and meat did not agree satisfactorily. Some results, nevertheless, showed good agreement with observations due to compensatory effects. After disclosure of additional observational data, major reasons for mispredictions were identified as lack of consideration of time dependence of fixation of 137 Cs in soils, and the selection of parameter values. When correction of this was made, a close agreement between predictions and observations was obtained. This study shows that the dose contribution due to 137 Cs in food products from the seminatural environment is important for long-term exposure to man. The evaluation provided a basis for improvements of crucial parts in the model. 14 refs, 18 figs, 8 tabs

  9. Assessment of the body burden of chelatable lead: a model and its application to lead workers

    Energy Technology Data Exchange (ETDEWEB)

    Araki, S.; Ushio, K.

    1982-05-01

    A hypothetical model was introduced to estimate the body burden of chelatable lead from the mobilisation yield of lead by calcium disodium ethylenediamine tetra-acetate. It was estimated that, on average, 14 and 19% of the body burden was mobilized into the urine during the 24 hours after an injection of 53.4 mumol and 107 mumol CaEDTA per kg bodyweight, respectively. The body burden of chelatable lead ranged from 4 mumol to 120 mumol in lead workers with blood lead concentrations of 0.3-2.9 mumol/kg. There were linear relationships between blood lead concentrations and body burden of chelatable lead on a log scale.

  10. Sampling and Analysis for Assessment of Body Burdens

    International Nuclear Information System (INIS)

    Harley, J.H.

    1964-01-01

    A review of sampling criteria and techniques and of sample processing methods for indirect assessment of body burdens is presented. The text is limited to the more recent developments in the field of bioassay and to the nuclides which cannot be readily determined in the body directly. A selected bibliography is included. The planning of a bioassay programme should emphasize the detection of high or unusual exposures and the concentrated study of these cases when detected. This procedure gives the maximum amount of data for the dosimetry of individuals at risk and also adds to our scientific background for an understanding of internal emitters. Only a minimum of effort should be spent on sampling individuals having had negligible exposure. The chemical separation procedures required for bioassay also fall into two categories. The first is the rapid method, possibly of low accuracy, used for detection. The second is the more accurate method required for study of the individual after detection of the exposure. Excretion, whether exponential or a power function, drops off rapidly. It is necessary to locate the exposure in time before any evaluation can be made, even before deciding if the exposure is significant. One approach is frequent sampling and analysis by a quick screening technique. More commonly, samples are collected at longer intervals and an arbitrary level of re-sampling is set to assist in the detection of real exposures. It is probable that too much bioassay effort has gone into measurements on individuals at low risk and not enough on those at higher risk. The development of bioassay procedures for overcoming this problem has begun, and this paper emphasizes this facet of sampling and sample processing. (author) [fr

  11. Body burdens of heavy metals in Lake Michigan wetland turtles.

    Science.gov (United States)

    Smith, Dayna L; Cooper, Matthew J; Kosiara, Jessica M; Lamberti, Gary A

    2016-02-01

    Tissue heavy metal concentrations in painted (Chrysemys picta) and snapping (Chelydra serpentina) turtles from Lake Michigan coastal wetlands were analyzed to determine (1) whether turtles accumulated heavy metals, (2) if tissue metal concentrations were related to environmental metal concentrations, and (3) the potential for non-lethal sampling techniques to be used for monitoring heavy metal body burdens in freshwater turtles. Muscle, liver, shell, and claw samples were collected from painted and snapping turtles and analyzed for cadmium, chromium, copper, iron, lead, magnesium, manganese, and zinc. Turtle tissues had measurable quantities of all eight metals analyzed. Statistically significant correlations between tissue metal concentrations and sediment metal concentrations were found for a subset of metals. Metals were generally found in higher concentrations in the larger snapping turtles than in painted turtles. In addition, non-lethal samples of shell and claw were found to be possible alternatives to lethal liver and muscle samples for some metals. Human consumption of snapping turtles presents potential health risks if turtles are harvested from contaminated areas. Overall, our results suggest that turtles could be a valuable component of contaminant monitoring programs for wetland ecosystems.

  12. Maternal body burden of cadmium and offspring size at birth

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Megan E., E-mail: megan_romano@brown.edu [Department of Epidemiology, Brown University School of Public Health, Providence, RI (United States); Enquobahrie, Daniel A. [Department of Epidemiology, University of Washington, Seattle, WA (United States); Center for Perinatal Studies, Swedish Medical Center, Seattle, WA (United States); Simpson, Christopher [Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA (United States); Checkoway, Harvey [Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA (United States); Williams, Michelle A. [Center for Perinatal Studies, Swedish Medical Center, Seattle, WA (United States); Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA (United States)

    2016-05-15

    Increasing evidence suggests an inverse association between cadmium (Cd) and size at birth, potentially greatest among female neonates. We evaluated whether greater maternal body burden of Cd is associated with reduced neonatal anthropometry (birthweight, birth length, head circumference, and ponderal index) and assessed whether these associations differ by infant sex. The analytic sample for the present study (n=396) was derived from a subcohort of 750 women randomly drawn from among all participants (N=4344) in the Omega Study, a prospective pregnancy cohort. Creatinine-corrected Cd in maternal clean-catch spot urine samples (U-Cd) was quantified by inductively coupled plasma mass spectrometry. Continuous log{sub 2}-transformed Cd (log{sub 2}-Cd) and U-Cd tertiles (low<0.29 μg/g creatinine, middle 0.29–0.42 μg/g creatinine, high≥0.43 μg/g creatinine) were used in multivariable linear regression models. Females had reduced birth length with greater U-Cd tertile, whereas males birth length marginally increased [β(95% CI) females: low=reference, middle=−0.59 cm (−1.37, 0.19), high=−0.83 cm (−1.69, 0.02), p-trend=0.08; males: low=reference, middle=0.18 cm (−0.59, 0.95), high=0.78 cm (–0.04, 1.60), p-trend=0.07; p for interaction=0.03]. The log{sub 2}-Cd by infant sex interaction was statistically significant for ponderal index [p=0.003; β(95% CI): female=0.25 kg/m{sup 3} (−0.20, 0.70); male=−0.63 kg/m{sup 3} (−1.01, −0.24)] and birth length [p<0.001; β(95% CI): female=−0.47 cm (−0.74, −0.20), male=0.32 cm (0.00, 0.65)]. Our findings suggest potential sex-specific reversal of Cd’s associations on birth length and contribute to the evidence suggesting Cd impairs fetal growth. - Highlights: • Cadmium levels in the general population potentially adversely affect size at birth. • Maternal urinary cadmium was inversely related to birth length among female infants. • For male infants, maternal cadmium was positively associated

  13. Maternal body burden of cadmium and offspring size at birth

    International Nuclear Information System (INIS)

    Romano, Megan E.; Enquobahrie, Daniel A.; Simpson, Christopher; Checkoway, Harvey; Williams, Michelle A.

    2016-01-01

    Increasing evidence suggests an inverse association between cadmium (Cd) and size at birth, potentially greatest among female neonates. We evaluated whether greater maternal body burden of Cd is associated with reduced neonatal anthropometry (birthweight, birth length, head circumference, and ponderal index) and assessed whether these associations differ by infant sex. The analytic sample for the present study (n=396) was derived from a subcohort of 750 women randomly drawn from among all participants (N=4344) in the Omega Study, a prospective pregnancy cohort. Creatinine-corrected Cd in maternal clean-catch spot urine samples (U-Cd) was quantified by inductively coupled plasma mass spectrometry. Continuous log 2 -transformed Cd (log 2 -Cd) and U-Cd tertiles (low<0.29 μg/g creatinine, middle 0.29–0.42 μg/g creatinine, high≥0.43 μg/g creatinine) were used in multivariable linear regression models. Females had reduced birth length with greater U-Cd tertile, whereas males birth length marginally increased [β(95% CI) females: low=reference, middle=−0.59 cm (−1.37, 0.19), high=−0.83 cm (−1.69, 0.02), p-trend=0.08; males: low=reference, middle=0.18 cm (−0.59, 0.95), high=0.78 cm (–0.04, 1.60), p-trend=0.07; p for interaction=0.03]. The log 2 -Cd by infant sex interaction was statistically significant for ponderal index [p=0.003; β(95% CI): female=0.25 kg/m 3 (−0.20, 0.70); male=−0.63 kg/m 3 (−1.01, −0.24)] and birth length [p<0.001; β(95% CI): female=−0.47 cm (−0.74, −0.20), male=0.32 cm (0.00, 0.65)]. Our findings suggest potential sex-specific reversal of Cd’s associations on birth length and contribute to the evidence suggesting Cd impairs fetal growth. - Highlights: • Cadmium levels in the general population potentially adversely affect size at birth. • Maternal urinary cadmium was inversely related to birth length among female infants. • For male infants, maternal cadmium was positively associated with birth length.

  14. Assessment of the body burden of chelatable lead: a model and its application to lead workers.

    OpenAIRE

    Araki, S; Ushio, K

    1982-01-01

    A hypothetical model was introduced to estimate the body burden of chelatable lead from the mobilisation yield of lead by calcium disodium ethylenediamine tetra-acetate (CaEDTA). It was estimated that, on average, 14 and 19% of the body burden was mobilised into the urine during the 24 hours after an injection of 53.4 mumol (20 mg) and 107 mumol (40 mg) CaEDTA per kg bodyweight, respectively. The body burden of chelatable lead ranged from 4 mumol (0.8 mg) to 120 mumol (24.9 mg) (mean 37 mumol...

  15. National Status and Trends: Contaminant body burdens and histopathology of fish and shellfish from Alaska

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In response to the growing concerns among Chugach communities, contaminant body burden and histopathological condition of chum and sockeye salmon (Oncorhynchus keta...

  16. Assessment of the body burden of chelatable lead: a model and its application to lead workers.

    Science.gov (United States)

    Araki, S; Ushio, K

    1982-01-01

    A hypothetical model was introduced to estimate the body burden of chelatable lead from the mobilisation yield of lead by calcium disodium ethylenediamine tetra-acetate (CaEDTA). It was estimated that, on average, 14 and 19% of the body burden was mobilised into the urine during the 24 hours after an injection of 53.4 mumol (20 mg) and 107 mumol (40 mg) CaEDTA per kg bodyweight, respectively. The body burden of chelatable lead ranged from 4 mumol (0.8 mg) to 120 mumol (24.9 mg) (mean 37 mumol (7.7 mg) in lead workers with blood lead concentrations of 0.3-2.9 mumol/kg (6-60 microgram/100 g) (mean 1.4 mumol/kg (29 microgram/100 g)). There were linear relationships between blood lead concentrations and body burden of chelatable lead on a log scale. PMID:6802167

  17. Estimating the burden of disease attributable to excess body weight ...

    African Journals Online (AJOL)

    Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. ... Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ... lasting change in the determinants and impact of excess body weight.

  18. Body Burden of Dichlorodiphenyl Dichloroethene (DDE and Childhood Pulmonary Function

    Directory of Open Access Journals (Sweden)

    Pallavi P. Balte

    2017-11-01

    Full Text Available Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was to understand the relationships between DDE exposure and pulmonary function in children, and, particularly, whether associations are mediated by the height of the children. We used data from an environmental epidemiologic study conducted in central Germany in children aged 8-10 years. The pulmonary function (forced vital capacity, FVC, and forced expiratory volume in one second, FEV1 were measured in three consecutive years. Blood DDE levels were measured at 8 and 10 years. We used linear mixed models for repeated measurements and path analyses to assess the association between blood levels of DDE and pulmonary function measurements. All models were adjusted for confounders. Linear mixed approaches and modelling concurrent effects showed no significant associations. The path analytical models demonstrated that DDE measured at eight years had significant, inverse, indirect, and total effects on FVC at ten years (n = 328; −0.18 L per μg/L of DDE and FEV1 (n = 328; −0.17 L per μg/L of DDE, mediated through effects of DDE on height and weight. The DDE burden reduces pulmonary function through its diminishing effects on height and weight in children. Further studies are required to test these associations in other samples, preferably from a region with ongoing, high DDT application.

  19. Distribution of radium-226 body burden among workers in an underground uranium mine in India

    International Nuclear Information System (INIS)

    Patnaik, R.L.; Srivastava, V.S.; Kumar, Rajesh; Shukla, A.K.; Tripathi, R.M.; Puranik, V.D.

    2007-01-01

    Workers are exposed to ore dust containing uranium and its daughter products during mining and processing of uranium ore. These radio nuclides may be an inhalation hazard to the workers during the course of their occupation. The most significant among these radio nuclides is 226 Ra. Measurement of radium body burden of uranium mine and mill workers are important to control the exposure of workers within the prescribed limit. Radon-in-breath measurement technique is used for measurement of radium body burden. Workers associated with different category of underground mining operations were monitored. The measurement results indicate that workers associated with different category of underground mining operations are having 226 Ra body burden ranging from 0.15 - 2.85 kBq. It was also observed that workers involved in timbering operation are having maximum average 226 Ra body burden of 0.97 ± 0.54 kBq. Overall average radium body burden observed for 683 workers is 0.80 kBq. (author)

  20. Cesium-137 body burdens in Norwegian Lapps, 1965-1983

    International Nuclear Information System (INIS)

    Westerlund, E.A.; Berthelsen, T.; Berteig, L.

    1987-01-01

    Results of measurements of the whole-body contents of 137 Cs during the period 1965-1983 in Lapps from the Kautokeino area in Norway are reported with measurements of 137 Cs in reindeer meat during the period 1966-1983. By using available data on 137 Cs in precipitation for the period 1950-1980, transfer coefficients from 137 Cs in precipitation to reindeer meat have been assessed. A correlation between the 137 Cs content in reindeer meat and the 137 Cs content in Lapp reindeer breeders has been established. The average whole-body committed dose equivalent, H50, to the reindeer breeders from internally deposited 137 Cs from intakes up to year 2000 was assessed to 13 mSv with a peak value of 30 mSv. In comparison, the corresponding committed dose equivalent to the Norwegian population from internally deposited 137 Cs has been estimated to be about 1 mSv. The higher intake of 137 Cs by reindeer breeders is due to the lichen-reindeer-man exposure pathway

  1. Classifying the body in Marlene Dumas' The Image as Burden.

    Science.gov (United States)

    Gordon, Anthea

    2018-03-01

    Medical photography, and in particular dermatological imagery, is often assumed to provide an objective, and functional, representation of disease and that it can act as a diagnostic aid. By contrast, artistic conceptions of the images of the body tend to focus on interpretative heterogeneity and ambiguity, aiming to create or explore meaning rather than enact a particular function. In her 2015 retrospective exhibition at the Tate Modern, South African artist Marlene Dumas questions these disciplinary divides by using medical imagery (among other photographic sources) as the basis for her portraits. Her portrait 'The White Disease' draws on an unidentified photograph taken from a medical journal, but obscures the original image to such a degree that any representation of a particular disease is highly questionable. The title creates a new classification, which reflects on disease and on the racial politics of South Africa during apartheid. Though, on the one hand, these techniques are seemingly disparate from the methods of medical understanding, features such as reliance on classification, and attempts at dispelling ambiguity, bring Dumas' work closer to the history of dermatological portraits than would usually be perceived to be the case. In considering the continuities and disparities between conceptualisations of skin in dermatology and Dumas' art, this paper questions assumptions of photographic objectivity to suggest that there is greater complexity and interpretative scope in medical dermatological images than might initially be assumed. 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/.

  2. Programs and subroutines for calculating cadmium body burdens based on a one-compartment model

    International Nuclear Information System (INIS)

    Robinson, C.V.; Novak, K.M.

    1980-08-01

    A pair of FORTRAN programs for calculating the body burden of cadmium as a function of age is presented, together with a discussion of the assumptions which serve to specify the underlying, one-compartment model. Account is taken of the contributions to the body burden from food, from ambient air, from smoking, and from occupational inhalation. The output is a set of values for ages from birth to 90 years which is either longitudinal (for a given year of birth) or cross-sectional (for a given calendar year), depending on the choice of input parameters

  3. Distribution of {sup 226}Ra body burden of workers in an underground uranium mine in India

    Energy Technology Data Exchange (ETDEWEB)

    Patnaik, R.L.; Jha, V.N.; Kumar, R.; Srivastava, V.S.; Ravi, P.M.; Tripathi, R.M. [Bhabha Atomic Research Centre, Health Physics Unit, Jaduguda, Jharkhand (India)

    2014-11-15

    Uranium mine workers are exposed to ore dust containing uranium and its daughter products during different mining operations. These radionuclides may pose inhalation hazards to workers during the course of their occupation. The most significant among these radionuclides is {sup 226}Ra. The measurement of radium body burden of uranium mine workers is important to assess their internal exposure. For this purpose, the radon-in-breath measurement technique has been used in the present paper. Workers at the Jaduguda mine, India, associated with different categories of mining operations were monitored between 2001 and 2007. The measurement results indicate that workers - depending on mining operation category - show {sup 226}Ra body burdens ranging from 0.15 to 2.85 kBq. The maximum body burden was found for workers associated with timbering operations, with an average {sup 226}Ra body burden of 0.85 ± 0.54 kBq. Overall, the average value observed for 800 workers was 0.76 ± 0.51 kBq, which gives rise to an average effective dose of 1.67 mSv per year for inhalation and 0.21 mSv per year for ingestion. (orig.)

  4. Distribution of 226Ra body burden of workers in an underground uranium mine in India.

    Science.gov (United States)

    Patnaik, R L; Jha, V N; Kumar, R; Srivastava, V S; Ravi, P M; Tripathi, R M

    2014-11-01

    Uranium mine workers are exposed to ore dust containing uranium and its daughter products during different mining operations. These radionuclides may pose inhalation hazards to workers during the course of their occupation. The most significant among these radionuclides is (226)Ra. The measurement of radium body burden of uranium mine workers is important to assess their internal exposure. For this purpose, the radon-in-breath measurement technique has been used in the present paper. Workers at the Jaduguda mine, India, associated with different categories of mining operations were monitored between 2001 and 2007. The measurement results indicate that workers--depending on mining operation category--show (226)Ra body burdens ranging from 0.15 to 2.85 kBq. The maximum body burden was found for workers associated with timbering operations, with an average (226)Ra body burden of 0.85 ± 0.54 kBq. Overall, the average value observed for 800 workers was 0.76 ± 0.51 kBq, which gives rise to an average effective dose of 1.67 mSv per year for inhalation and 0.21 mSv per year for ingestion.

  5. An investigation into the potassium body burden in humans with the help of a whole-body counter

    International Nuclear Information System (INIS)

    Selzer, A.

    1981-01-01

    The purpose of this study was to examine the available information concerning the potassium body burden of a large number of adults and to find a correlation with other easily measurable body parameters such as mass, height and age so that a normal expected body potassium may be predicted for patients with potassium abnormalities who are also referred to the whole-body counter. The calibration of the whole-body counter to make provision for the differences in geometry and absorption in various body sizes was carried out by injecting a number of people with a small dose of potassium-42 and calculating a correction factor for the potassium standard which is in use daily. All measurements of body potassium were corrected with the calculated correction factor. Fatty tissue in the body contains very little potassium in comparison with muscle tissue and a better correction should therefore be obtained between body potassium and lean body mass. Although it is not possible to predict the smaller potassium abnormalities even when lean body mass is used, the derived regression equation in which lean body mass and age are used, may be viewed as a good first approach in the advance estimation of body potassium

  6. Chromosome breakage in lymphocytes from humans with body burdens of 226Ra

    International Nuclear Information System (INIS)

    Hoegerman, S.F.; Cummins, H.T.; Bronec, J.F.

    1976-01-01

    Peripheral lymphocytes from 10 controls and 40 patients with body burdens of 226 Ra ranging from below the limit of detection to 8.6 μCi were scored for unstable chromosome aberrations. The patient population was divided into four groups: a group with body burdens below the limit of detection (less than 0.003 μCi, 12 patients); a low-burden group (0.003 to 0.099 μCi, 13 patients); a moderate-burden group (0.1 to 0.99 μCi, 11 patients); and a high-burden group (greater than 1.0 μCi, 4 patients). In none of these groups was the frequency of cells with unstable aberrations significantly elevated above that in the controls. The rate of occurrence of dicentric and ring chromosomes was above the control frequency in only the two patients with the highest burdens (3.55 and 8.6 μCi). Our results are consistent with the expectation derived from a recent calculation of alpha dose delivered to blood by bone-deposited radium and its decay products. Marshall and Hoegerman have estimated that the blood dose for an individual with a radium burden of 1.0 μCi is 0.09 +- 0.03 rad/year. The value is compared with the dose estimate used by Boyd et al. in their study of British radium-dial painters, and the relevance of the blood dose to the lymphocyte dose is discussed

  7. Personal factors affecting thoron exhalation from occupationally acquired thorium body burdens

    International Nuclear Information System (INIS)

    Stebbings, J.H.

    1985-01-01

    Thorium workers with thorium body burdens (primarily thoracic) above 0.7 nCi 224 Ra equivalent are shown to exhale about 15% of thoron produced in vivo, compared to 5% exhaled by subjects with body burdens in the range of 0.4 to 0.7 nCi 224 Ra. There was a false negative correlation between average adult daily cigarettes smoked and thoron exhalation. White blood cell counts that were about 85% of expected were observed in seven subjects exhaling greater than or equal to 100 pCi of thoron above predicted; no other variable examined showed a clear pattern of association. These differences in fractional thoron exhalation, and their consequences, are discussed. 3 references, 4 figures, 8 tables

  8. Radium-226 body burden in U miners by measurement of Rn in exhaled breath.

    Science.gov (United States)

    Srivastava, G K; Raghavayya, M; Kotrappa, P; Somasundaram, S

    1986-02-01

    Uranium miners were made to inhale Rn-free medical O2 and exhale through a 5.2-1 A1 chamber before reporting to work. The chamber was sealed and isolated from the sampling circuit. An electrostatic plate collected the freshly formed Rn-decay products. The subsequent programmed alpha counting of the plate yielded a Rn concentration in the exhaled breath. Assuming that the exhaled breath represents a certain fraction of the Rn produced inside the body, the body burden of 226Ra was calculated. Standardisation of this procedure and the data collected on 310 miners are discussed. The procedure is simple and applicable for routine measurements. The miner needs to be in the laboratory for only 10 min. The system is also portable for field application. For routine use, the minimum detectable concentration is 3.87 Bq X m-3 which corresponds to a body burden of 0.26 kBq in a typical miner, if one assumes the Rn release fraction from the body as 84%. The system offers a more convenient and sensitive alternative to whole-body counting of workers for 226Ra.

  9. A systematic review of the human body burden of e-waste exposure in China.

    Science.gov (United States)

    Song, Qingbin; Li, Jinhui

    2014-07-01

    As China is one of the countries facing the most serious pollution and human exposure effects of e-waste in the world, much of the population there is exposed to potentially hazardous substances due to informal e-waste recycling processes. This report reviews recent studies on human exposure to e-waste in China, with particular focus on exposure routes (e.g. dietary intake, inhalation, and soil/dust ingestion) and human body burden markers (e.g. placenta, umbilical cord blood, breast milk, blood, hair, and urine) and assesses the evidence for the association between such e-waste exposure and the human body burden in China. The results suggest that residents in the e-waste exposure areas, located mainly in the three traditional e-waste recycling sites (Taizhou, Guiyu, and Qingyuan), are faced with a potential higher daily intake of these pollutants than residents in the control areas, especially via food ingestion. Moreover, pollutants (PBBs, PBDEs, PCBs, PCDD/Fs, and heavy metals) from the e-waste recycling processes were all detectable in the tissue samples at high levels, showing that they had entered residents' bodies through the environment and dietary exposure. Children and neonates are the groups most sensitive to the human body effects of e-waste exposure. We also recorded plausible outcomes associated with exposure to e-waste, including 7 types of human body burden. Although the data suggest that exposure to e-waste is harmful to health, better designed epidemiological investigations in vulnerable populations, especially neonates and children, are needed to confirm these associations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. In-vivo assessment of whole-body radioisotope burdens at the Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Vasilik, D.G.; Aikin, I.C.

    1983-08-01

    The Los Alamos National Laboratory program for in-vivo measurements includes the capability for the whole-body assessment of body burdens for x-ray or gamma-ray emitting radioisotopes. This capability is an important part of the health and safety program at Los Alamos where a wide variety of radioisotopes are utilized. This report addresses the whole body portion of our in-vivo measurement capabilities. Whole-body measurements at Los Alamos make use of a hyperpure germanium (HpGe) detector and a lithium-drifted germanium [Ge(Li)] detector for identification and quantification of radioisotopes. Analysis results are interpreted in terms of two basic statistical measures of detection limits. One measure is called the minimum significant measured activity (MSMA), which is interpreted as meaning that there is some activity in the body. The second measure is called the minimum detectable true activity (MDTA), which is defined as the smallest amount of activity required to be in the body in order that a measurement of an individual can be expected to imply correctly the presence of activity with a predetermined degree of confidence. 7 references, 8 figures

  11. Body Burden of Hg in Different Bio-Samples of Mothers in Shenyang City, China

    Science.gov (United States)

    Xu, Jian; Du, Juan; Yan, Chong-huai

    2014-01-01

    Hg is an accumulative and neuro-toxic heavy metal which has a wide range of adverse effects in human health. However, few studies are available on body burden of Hg level in different bio-samples of pregnant women in Chinese population. Therefore, this study evaluated Hg levels in different maternal bio-samples in Shenyang city, China and investigated the correlation of Hg levels in different bio-samples. From October to December 2008, 200 pregnant women about to deliver their babies at ShengJing Hospital (Shenyang city, northeast of China) participated in this study. The geometric mean (GM) of Hg levels in cord blood, maternal venous blood, breast milk, and maternal urine were 2.18 µg/L, 1.17 µg/L, 1.14 µg/L, and 0.73 µg/L, respectively, and the GM of maternal hair Hg level was 404.45 µg/kg. There was a strong correlation between cord blood and maternal blood total Hg level (r = 0.713, PHg exposure (unadjusted OR 3.5, adjusted OR 2.94, PHg burden of mothers and the risk factors of prenatal Hg exposure in Shenyang city, China. PMID:24858815

  12. Body burden of Hg in different bio-samples of mothers in Shenyang city, China.

    Directory of Open Access Journals (Sweden)

    Min-Ming Li

    Full Text Available Hg is an accumulative and neuro-toxic heavy metal which has a wide range of adverse effects in human health. However, few studies are available on body burden of Hg level in different bio-samples of pregnant women in Chinese population. Therefore, this study evaluated Hg levels in different maternal bio-samples in Shenyang city, China and investigated the correlation of Hg levels in different bio-samples. From October to December 2008, 200 pregnant women about to deliver their babies at ShengJing Hospital (Shenyang city, northeast of China participated in this study. The geometric mean (GM of Hg levels in cord blood, maternal venous blood, breast milk, and maternal urine were 2.18 µg/L, 1.17 µg/L, 1.14 µg/L, and 0.73 µg/L, respectively, and the GM of maternal hair Hg level was 404.45 µg/kg. There was a strong correlation between cord blood and maternal blood total Hg level (r = 0.713, P<0.001. Frequency of fish consumption more than or equal to 3 times per week during pregnancy was suggested as a significant risk factor of prenatal Hg exposure (unadjusted OR 3.5, adjusted OR 2.94, P<0.05. This study provides evidence about Hg burden of mothers and the risk factors of prenatal Hg exposure in Shenyang city, China.

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

    International Nuclear Information System (INIS)

    Agree, M.D.

    1991-01-01

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

  14. The Severity of Autism Is Associated with Toxic Metal Body Burden and Red Blood Cell Glutathione Levels

    Energy Technology Data Exchange (ETDEWEB)

    Adams, J B; Mitchell, I J [Division of Basic Medical Sciences, Southwest College of Naturopathic Medicine, Tempe, AZ 85282 (United States); Baral, M; Bradstreet, J [Department of Pediatric Medicine, Southwest College of Naturopathic Medicine, Tempe, AZ 85282 (United States); Geis, E; Ingram, J; Hensley, A; Zappia, I; Gehn, E; Mitchell, K [Autism Research Institute, San Diego, CA 92116-2599 (United States); Newmark, S [Center for Integrative Pediatric Medicine, Tucson, AZ 85711 (United States); Rubin, R A [Department of Mathematics, Whittier College, Whittier, CA 90601-4413 (United States); Bradstreet, J [International Child Development Resource Center, Phoenix, AZ (United States); El-Dahrn, J M [Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA 70112 (United States)

    2009-07-01

    This study investigated the relationship of children's autism symptoms with their toxic metal body burden and red blood cell (RBC) glutathione levels. In children ages 38 years, the severity of autism was assessed using four tools: ADOS, PDD-BI, ATEC, and SAS. Toxic metal body burden was assessed by measuring urinary excretion of toxic metals, both before and after oral dimercaptosuccinic acid (DMSA). Multiple positive correlations were found between the severity of autism and the urinary excretion of toxic metals. Variations in the severity of autism measurements could be explained, in part, by regression analyses of urinary excretion of toxic metals before and after DMSA and the level of RBC glutathione (adjusted R2 of 0.220.45, P<.005 in all cases). This study demonstrates a significant positive association between the severity of autism and the relative body burden of toxic metals.

  15. The Severity of Autism Is Associated with Toxic Metal Body Burden and Red Blood Cell Glutathione Levels

    International Nuclear Information System (INIS)

    Adams, J.B.; Mitchell, I.J.; Baral, M.; Bradstreet, J.; Geis, E.; Ingram, J.; Hensley, A.; Zappia, I.; Gehn, E.; Mitchell, K.; Newmark, S.; Rubin, R.A.; Bradstreet, J.; El-Dahrn, J.M.

    2009-01-01

    This study investigated the relationship of children's autism symptoms with their toxic metal body burden and red blood cell (RBC) glutathione levels. In children ages 38 years, the severity of autism was assessed using four tools: ADOS, PDD-BI, ATEC, and SAS. Toxic metal body burden was assessed by measuring urinary excretion of toxic metals, both before and after oral dimercaptosuccinic acid (DMSA). Multiple positive correlations were found between the severity of autism and the urinary excretion of toxic metals. Variations in the severity of autism measurements could be explained, in part, by regression analyses of urinary excretion of toxic metals before and after DMSA and the level of RBC glutathione (adjusted R2 of 0.220.45, P<.005 in all cases). This study demonstrates a significant positive association between the severity of autism and the relative body burden of toxic metals.

  16. An approach to calculating childhood body burdens of dibenzodioxins and dibenzofurans which accounts for age-dependent biological half lives

    Energy Technology Data Exchange (ETDEWEB)

    Paustenbach, D. [ChemRisk, San Francisco, CA (United States); Leung, H.W. [Leung, H.W. Private Consultant, Danbury, CT (United States); Scott, P. [ChemRisk, Pittsburgh, PA (United States); Kerger, B. [HSRI, Tallahassee, FL (United States)

    2004-09-15

    The purpose of this study is to apply an age-dependent half life model to examine the range of child (ages 0-7) body burdens that correspond to selected exposure scenarios involving background dietary and environmental doses of dioxins. The scenarios examined include breast-fed and nonbreast- fed infants feeding for 6 months, other dioxin uptake from foods through age 7, and exposures to urban residential soils at 1 ppb TCDD toxic equivalents (TEQ). These body burden estimates in children are then compared to the adult body burden estimates corresponding to the range of tolerable daily intakes (1 to 4 pg TEQ/kg-day) proposed by some U.S. and international regulatory/advisory groups.

  17. Intercomparison of Finnish and Russian whole-body counters used for the determination of 137Cs body burden in reindeer-herding populations

    International Nuclear Information System (INIS)

    Rahola, T.; Tillander, M.

    1995-01-01

    Intercalibration is a very important quality control in whole-body counting, as the human body is a very difficult ''sample'' to calibrate for. In 1994 the Finnish Centre for Radiation and Nuclear Safety (STUK), the Laboratory of Radiochemistry of the University of Helsinki and the Institute of Radiation Hygiene (IRH) of St. Petersburg agreed to undertake the first Finnish-Russian intercalibration project for whole-body counters. The monitoring of body burdens of indigenous inhabitants in the far north of Russia, from the Kola Peninsula to Chuhodka, has been the responsibility of the ISH since 1960; the above-.mentioned Finnish institutes have monitored reindeer breeders in Finnish Lapland since 1961. The intercalibration was done in the field by measuring the same persons with both systems in Finnish Lapland and in the Kola Peninsula. Mean body burdens in the reindeer-herding population in the areas of current interest are presented in the present paper. 7 refs., 3 figs., 1 tab

  18. Body burden of cadmium and its related factors: A large-scale survey in China

    Energy Technology Data Exchange (ETDEWEB)

    Ke, Shen; Cheng, Xi-Yu; Li, Hao; Jia, Wen-Jing; Zhang, Jie-Ying; Luo, Hui-Fang; Wang, Zi-Ling; Chen, Zhi-Nan, E-mail: chen_zhinan56@163.com

    2015-04-01

    A survey of more than 6000 participants from four distinct non-polluted and polluted regions in China was conducted to evaluate the body burden of cadmium (Cd) on the Chinese populations using urinary Cd (UCd) as a biomarker. The findings revealed that the UCd level was 1.24 μg/g creatinine (μg/g cr) for the sample population from non-polluted Shanghai, and the UCd levels exceeded 5 μg/g cr, which is the health-based exposure limit set by the World Health Organization (WHO), in 1.1% of people. The mean UCd levels in moderately polluted (Hubei and Liaoning) and highly polluted areas (Guizhou) were 4.69 μg/g cr, 3.62 μg/g cr and 6.08 μg/g cr, respectively, and these levels were 2.9 to 4.9 times the levels observed in Shanghai. Notably, the UCd levels exceeded the recently updated human biomonitoring II values (i.e., intervention or “action level”) in 44.8%–87.9% of people from these areas compared to only 5.1%–21.4% of people in Shanghai. The corresponding prevalence of elevated UCd levels (> WHO threshold, 5 μg/g cr) was also significantly higher (30.7% to 63.8% vs. 1.1%), which indicates that elevated Cd-induced health risks to residents in these areas. Age and region were significant determinants for UCd levels in a population, whereas gender did not significantly influence UCd. - Highlights: • We performed a Cd exposure survey that involved more than 6000 Chinese subjects. • The body burden of Cd in most of subjects of non-polluted Shanghai is relatively safe. • The UCd levels were much higher in the subjects from polluted areas than from Shanghai. • The UCd levels in the population from Guizhou substantially exceeded the safety limit. • Age and region were significant determinants of UCd.

  19. Survival, reproduction, and arsenic body burdens in Chironomus riparius exposed to arsenate and phosphate

    Energy Technology Data Exchange (ETDEWEB)

    Mogren, Christina L., E-mail: christina.mogren@email.ucr.edu [Department of Entomology, University of California, Riverside, 900 University Ave, Riverside, CA 92521 (United States); Kiparski, Guntram R. von; Parker, David R. [Department of Environmental Science, University of California, Riverside, 900 University Ave, Riverside, CA 92521 (United States); Trumble, John T. [Department of Entomology, University of California, Riverside, 900 University Ave, Riverside, CA 92521 (United States)

    2012-05-15

    Despite the increasing awareness of arsenic (As) contamination in surface waters worldwide, little is known about how As alone and in the presence of other chemicals affects aquatic insects. Larvae of Chironomus riparius were exposed in a laboratory investigation to factorial combinations of 0, 0.13, 2.0, 5.3, and 13 {mu}mol As l{sup -1} and 0, 0.15, and 15 {mu}mol PO{sub 4} l{sup -1} throughout development from first instar to pupal emergence. The time between male and female emergence increased from 1.8 {+-} 0.17 days to 2.9 {+-} 0.34 days with exposure at higher As levels. The highest As exposure also decreased the number of eggs per egg mass, which may affect population maintenance. For these parameters, there was no effect from PO{sub 4}, and no interaction between As and PO{sub 4}. Total As determination of larval and adult tissues was conducted using Hydride Generated Atomic Absorption Spectroscopy (HGAAS) and revealed concentrations ranging from 2.48 {+-} 0.363 to 30.5 {+-} 0.473 {mu}g/g and 1.03 {+-} 0.286 to 8.97 {+-} 0.662 {mu}g/g, respectively, indicating elimination of approximately 72% of total As body burdens between the fourth instar and adult stages. There was no effect of PO{sub 4}, indicating PO{sub 4} does not alter uptake of As in C. riparius. The potential for movement of As to terrestrial systems exists, though trophic transfer may be more likely during the aquatic larval stage. - Highlights: Black-Right-Pointing-Pointer We evaluate how sublethal concentrations of As and P affect C. riparius. Black-Right-Pointing-Pointer High As exposure significantly increased the time between male and female emergence. Black-Right-Pointing-Pointer High As exposure significantly decreased the number of eggs per egg mass. Black-Right-Pointing-Pointer Fourth instar larvae eliminate 72% of As body burdens before the adult stage.

  20. Distribution of "2"2"6Ra body burden of workers in an underground uranium mine in India

    International Nuclear Information System (INIS)

    Patnaik, R.L.; Jha, V.N.; Kumar, R.; Srivastava, V.S.; Ravi, P.M.; Tripathi, R.M.

    2014-01-01

    Uranium mine workers are exposed to ore dust containing uranium and its daughter products during different mining operations. These radionuclides may pose inhalation hazards to workers during the course of their occupation. The most significant among these radionuclides is "2"2"6Ra. The measurement of radium body burden of uranium mine workers is important to assess their internal exposure. For this purpose, the radon-in-breath measurement technique has been used in the present paper. Workers at the Jaduguda mine, India, associated with different categories of mining operations were monitored between 2001 and 2007. The measurement results indicate that workers - depending on mining operation category - show "2"2"6Ra body burdens ranging from 0.15 to 2.85 kBq. The maximum body burden was found for workers associated with timbering operations, with an average "2"2"6Ra body burden of 0.85 ± 0.54 kBq. Overall, the average value observed for 800 workers was 0.76 ± 0.51 kBq, which gives rise to an average effective dose of 1.67 mSv per year for inhalation and 0.21 mSv per year for ingestion. (orig.)

  1. The use of comparative 137Cs body burden estimates from environmental data/models and whole body counting to evaluate diet models for the ingestion pathway

    International Nuclear Information System (INIS)

    Robison, W.L.; Sun, C.

    1997-01-01

    Rongelap and Utirik Atolls were contaminated on 1 March 1954, by a U.S. nuclear test at Bikini Atoll code named BRAVO. The people at both atolls were removed from their atolls in the first few days after the detonation and were returned to their atolls at different times. Detailed studies have been carried out over the years by Lawrence Livermore National Laboratory (LLNL) to determine the radiological conditions at the atolls and estimate the doses to the populations. The contribution of each exposure pathway and radionuclide have been evaluated. All dose assessments show that the major potential contribution to the estimated dose is 137 Cs uptake via the terrestrial food chain. Brookhaven National Laboratory (BNL) has carried out an extensive whole body counting program at both atolls over several years to directly measure the 137 Cs body burden. Here we compare the estimates of the body burdens from the LLNL environmental method with body burdens measured by the BNL whole body counting method. The combination of the results from both methods is used to evaluate proposed diet models to establish more realistic dose assessments. Very good agreement is achieved between the two methods with a diet model that includes both local and imported foods. Other diet models greatly overestimate the body burdens (i.e., dose) observed by whole body counting. The upper 95% confidence limit of interindividual variability around the population mean value based on the environmental method is similar to that calculated from direct measurement by whole body counting. Moreover, the uncertainty in the population mean value based on the environmental method is in very good agreement with the whole body counting data. This provides additional confidence in extrapolating the estimated doses calculated by the environmental method to other islands and atolls. 46 refs., 8 figs., 5 tabs

  2. Role of Airborne Lead in Increased Body Burden of Lead in Hartford Children*

    Science.gov (United States)

    Lepow, Martha L.; Bruckman, Leonard; Rubino, Robert A.; Markowitz, Steven; Gillette, Marybeth; Kapish, Janet

    1974-01-01

    The ingestion of airborne lead fallout is the mechanism responsible for increased lead body burdens found in 10 urban Connecticut children. The mean indoor lead levels found in housedust was 11,000 μg/g; highest concentrations occurred on windowsills and in floor dust. The mean lead content of Hartford street dirt was 1,200 μg/g; levels were highest near the street and next to the buildings. The mean lead concentration of hand samples taken from the subject children was 2,400 μg/g; the mean weight of hand samples was 11 mg. The concentration of lead in dirt and househould dust was high enough to theoretically result in excessive lead accumulation in young children who are putting their dusty, dirty hands in their mouths during play. While we believe that lead emitted from automobiles contributes significantly to air, dirt and dust lead levels the environmental impact of reducing or eliminating lead from gasoline is not yet completely understood. PMID:4133903

  3. The double burden of undernutrition and excess body weight in Ecuador.

    Science.gov (United States)

    Freire, Wilma B; Silva-Jaramillo, Katherine M; Ramírez-Luzuriaga, María J; Belmont, Philippe; Waters, William F

    2014-12-01

    Ecuador's current nutrition policies have not taken adequate notice of the double burden of malnutrition and continue to focus on stunting and to a lesser extent on overweight, without addressing the simultaneous presence of undernutrition, micronutrient deficiencies, and overweight or obesity (OW/OB). The aim of this article was to describe the prevalence and distribution of undernutrition (stunting, anemia, and zinc deficiency), overweight, and obesity in Ecuador to explore the evolving double burden of malnutrition at the national, household, and individual levels and to discuss whether current public health policies are addressing the double burden. Data from the 2012 Ecuadorian National Health and Nutrition Survey (ENSANUT-ECU) was used to estimate the dual burden of malnutrition at the national, household, and individual levels in children Ecuador. Although integrated approaches to address the emerging double burden are required, public health policies to date have not responded adequately. © 2014 American Society for Nutrition.

  4. Tumor segmentation of whole-body magnetic resonance imaging in neurofibromatosis type 1 patients: tumor burden correlates

    Energy Technology Data Exchange (ETDEWEB)

    Heffler, Michael A.; Xi, Yin; Chhabra, Avneesh [University of Texas Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Le, Lu Q. [University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, TX (United States)

    2017-01-15

    Segmentation of whole-body MRI (WBMRI) to assess the feasibility, quantitate the total tumor volume (tumor burden) in patients with neurofibromatosis type 1 (NF1) and examine associations with demographic, disease-related and anthropomorphic features. A consecutive series of patients with NF1 underwent WBMRI and were reviewed for tumors. Tumors were segmented using a semiautomated software-based tool. Tumors were classified as superficial or deep and discrete or plexiform. Segmentation times were recorded. Segmentation yielded the quantity and tumor burden of superficial, internal and plexiform tumors. Correlations between segmentation data and demographic, disease-related and anthropomorphic features were examined. Fifteen patients were evaluated (42.3 ± 13.6 years, 10 female, 5 male). Segmentation times were a median of 30 min and yielded 2,328 tumors (1,582 superficial, 746 internal and 23 plexiform). One tumor was malignant. Tumor counts ranged from 14 to 397. Tumor burden ranged from 6.95 cm3 to 571 cm3. Individual tumor volume ranged from 0.0120 cm3 to 298 cm3. Significant correlation was found between the total volume of superficial tumors and height (ρ = 0.5966, p < 0.02). Male patients had higher overall tumor burdens (p < 0.05) and higher superficial tumor burden (p < 0.03). Patients with negative family history had more tumors (p < 0.05). Segmentation of WBMRI in patients with NF1 is feasible and elucidates meaningful relationships among disease phenotype, anthropomorphic and demographic features. (orig.)

  5. Tumor segmentation of whole-body magnetic resonance imaging in neurofibromatosis type 1 patients: tumor burden correlates

    International Nuclear Information System (INIS)

    Heffler, Michael A.; Xi, Yin; Chhabra, Avneesh; Le, Lu Q.

    2017-01-01

    Segmentation of whole-body MRI (WBMRI) to assess the feasibility, quantitate the total tumor volume (tumor burden) in patients with neurofibromatosis type 1 (NF1) and examine associations with demographic, disease-related and anthropomorphic features. A consecutive series of patients with NF1 underwent WBMRI and were reviewed for tumors. Tumors were segmented using a semiautomated software-based tool. Tumors were classified as superficial or deep and discrete or plexiform. Segmentation times were recorded. Segmentation yielded the quantity and tumor burden of superficial, internal and plexiform tumors. Correlations between segmentation data and demographic, disease-related and anthropomorphic features were examined. Fifteen patients were evaluated (42.3 ± 13.6 years, 10 female, 5 male). Segmentation times were a median of 30 min and yielded 2,328 tumors (1,582 superficial, 746 internal and 23 plexiform). One tumor was malignant. Tumor counts ranged from 14 to 397. Tumor burden ranged from 6.95 cm3 to 571 cm3. Individual tumor volume ranged from 0.0120 cm3 to 298 cm3. Significant correlation was found between the total volume of superficial tumors and height (ρ = 0.5966, p < 0.02). Male patients had higher overall tumor burdens (p < 0.05) and higher superficial tumor burden (p < 0.03). Patients with negative family history had more tumors (p < 0.05). Segmentation of WBMRI in patients with NF1 is feasible and elucidates meaningful relationships among disease phenotype, anthropomorphic and demographic features. (orig.)

  6. Identification of threshold body burdens of metals for the protection of the aquatic ecological status using two benthic invertebrates

    International Nuclear Information System (INIS)

    Bervoets, Lieven; De Jonge, Maarten; Blust, Ronny

    2016-01-01

    In this study accumulated concentrations of As, Cd, Cr, Cu, Ni, Pb and Zn in two benthic invertebrate taxa, Chironomus sp. and Tubificidae are related to ecological responses expressed as changes in macro invertebrate communities. In addition critical body burdens were estimated above which ecological quality was always lower than a certain threshold. Data from existing studies on bioaccumulation of the metals in both taxa were combined with different biological water quality indices. For all metal-endpoint combinations threshold values could be calculated above which ecological quality was always low. Safe threshold body burdens could be estimated for both species for all metals although the data set was more extended for Chrionomus sp. with estimated threshold values being 65, 3.2, 10, 57, 6.5, 73 and 490 μg/g dw for As, Cd, Cr, Cu, Ni, Pb and Zn. This study demonstrated that metal accumulation in resistant species such as chironomids and tubificid worms have the potential to be used as predictors of ecological effects in aquatic ecosystems. However, the estimated threshold values have to be validated and supported by more lines of evidence before they can be used by regulators. - Highlights: • Chironomid larvae and Tubificid worms can be used to relate accumulated metals to ecological endpoints. • Ecological water quality, calculated with biotic indices, is always low at high accumulated metal concentrations. • Critical body burdens in chironomids and tubificds could be estimated for As, Cd, Cr, Cu, Ni, Pb and Zn. - Maximal body burdens of metals in two invertebrate species could be estimated above which ecological quality was always low.

  7. Body burden of aluminum in relation to central nervous system function among metal inert-gas welders.

    Science.gov (United States)

    Riihimäki, V; Hänninen, H; Akila, R; Kovala, T; Kuosma, E; Paakkulainen, H; Valkonen, S; Engström, B

    2000-04-01

    The relationship between elevated internal aluminum loads and central nervous system function was studied among aluminum welders, and the threshold level for adverse effect was defined. For 65 aluminum welders and 25 current mild steel welders body burden was estimated, and the aluminum concentrations in serum (S-Al) and urine (U-Al) were analyzed with graphite furnace atomic absorption spectrometry with Zeeman background correction. Referents and low-exposure and high-exposure groups were defined according to an aggregated measure of aluminum body burden, the group median S-Al levels being 0.08, 0.14, and 0.46 micromol/l, respectively, and the corresponding values for U-Al being 0.4, 1.8, and 7.1 micromol/l. Central nervous system functions were assessed with a neuropsychological test battery, symptom and mood questionnaires, a visual and quantitative analysis of electroencephalography (EEG), and P3 event-related potentials with pitch and duration paradigms. Subjective symptoms showed exposure-related increases in fatigue, mild depression, and memory and concentration problems. Neuropsychological testing revealed a circumscribed effect of aluminum, mainly in tasks demanding complex attention and the processing of information in the working memory system and in the analysis and recall of abstract visual patterns. The visual EEG analysis revealed pathological findings only for aluminum welders. Mild, diffuse abnormalities were found in 17% of the low-exposure group and 27% of the high-exposure group, and mild to moderate epileptiform abnormalities at a frequency of 7% and 17%, respectively. Both objective neurophysiological and neuropsychological measures and subjective symptomatology indicated mild but unequivocal findings dose-dependently associated with increased aluminum body burden. The study indicates that the body burden threshold for adverse effect approximates an U-Al value of 4-6 micromol/l and an S-Al value of 0.25-0.35 micromol/l among aluminum welders.

  8. Understanding differences in the body burden-age relationships of bioaccumulating contaminants based on population cross sections versus individuals.

    Science.gov (United States)

    Quinn, Cristina L; Wania, Frank

    2012-04-01

    Body burdens of persistent bioaccumulative contaminants estimated from the cross-sectional biomonitoring of human populations are often plotted against age. Such relationships have previously been assumed to reflect the role of age in bioaccumulation. We used a mechanistic modeling approach to reproduce concentration-versus-age relationships and investigate factors that influence them. CoZMoMAN is an environmental fate and human food chain bioaccumulation model that estimates time trends in human body burdens in response to time-variant environmental emissions. Trends of polychlorinated biphenyl (PCB) congener 153 concentrations versus age for population cross sections were estimated using simulated longitudinal data for individual women born at different times. The model was also used to probe the influence of partitioning and degradation properties, length of emissions, and model assumptions regarding lipid content and liver metabolism on concentration-age trends of bioaccumulative and persistent contaminants. Body burden-age relationships for population cross sections and individuals over time are not equivalent. The time lapse between the peak in emissions and sample collection for biomonitoring is the most influential factor controlling the shape of concentration-age trends for chemicals with human metabolic half-lives longer than 1 year. Differences in observed concentration-age trends for PCBs and polybrominated diphenyl ethers are consistent with differences in emission time trends and human metabolic half-lives. Bioaccumulation does not monotonically increase with age. Our model suggests that the main predictors of cross-sectional body burden trends with age are the amount of time elapsed after peak emissions and the human metabolic and environmental degradation rates.

  9. Screening for 137Cs body burden due to the Chernobyl accident in Korosten city, Zhitomir, Ukraine. 1996-2008

    International Nuclear Information System (INIS)

    Hayashida, Naomi; Sekitani, Yui; Yamashita, Shunichi; Takamura, Noboru; Kozlovsky, A.; Rafalsky, R.; Gutevich, A; Daniliuk, V.

    2011-01-01

    During the Chernobyl Nuclear Power Plant (CNPP) accident on 26 April 1986, large amounts of radionuclides were released and spread to vast areas. Inhabitants residing around CNPP have been exposed to external and internal irradiation due to the long half-life of 137 Cs (30 years). In this study, we screened for internal whole-body 137 Cs concentration using a whole-body counter in the Zhitomir state of Ukraine. The total number of participants was 144,972 (96,149 females and 48,823 males). The median body burden of 137 Cs per body weight decreased from 1996 to 2008. In particular, after 2003, more than half of subjects had internal exposure doses below the detectable level. A weak seasonal effect was found in measurement data from 1997 to 1999, but no such effects were observed in later years. We also calculated annual dose for each year and confirmed that doses have been decreasing gradually. In particular, after 2003, the annual effective dose decreased to 0.1 mSv y -1 for 95% of the participants. Only two persons were found to have received more than 5 mSv y -1 since 2007. Although the health effects of 137 Cs body burden due to the Chernobyl accident remain uncertain, further screening is needed to monitor the health status and to allay the anxiety of inhabitants in the contaminated areas around CNPP. (author)

  10. Chromosome aberrations in the peripheral lymphocytes of thorium workers with low body burdens of 212Bi

    International Nuclear Information System (INIS)

    Hoegerman, S.F.

    1976-01-01

    Cytogenetic analysis of 8 thorium workers and 3 controls has not shown a significant elevation in the level of chromosome breakage in the workers' peripheral lymphocytes. This finding is consistent with an estimate of the amount of damage to be expected in these cases, based on the level of chromosome breakage observed in Thorotrast cases with measured 212 Bi burdens

  11. School governing bodies - the principal's burden or the light of his ...

    African Journals Online (AJOL)

    In this article I focus on the relationship between principals and school governing bodies in South Africa. Although the school governing body represents many role players, this article will focus mainly on the role and function of parent representatives in the school governing body. Parents constitute the majority in the ...

  12. Cadmium body burden and increased blood pressure in middle-aged American Indians: the Strong Heart Study.

    Science.gov (United States)

    Franceschini, N; Fry, R C; Balakrishnan, P; Navas-Acien, A; Oliver-Williams, C; Howard, A G; Cole, S A; Haack, K; Lange, E M; Howard, B V; Best, L G; Francesconi, K A; Goessler, W; Umans, J G; Tellez-Plaza, M

    2017-03-01

    Cadmium (Cd) is an environmental pollutant that has been associated with cardiovascular disease in populations, but the relationship of Cd with hypertension has been inconsistent. We studied the association between urinary Cd concentrations, a measure of total body burden, and blood pressure in American Indians, a US population with above national average Cd burden. Urinary Cd was measured using inductively coupled plasma mass spectrometry, and adjusted for urinary creatinine concentration. Among 3714 middle-aged American Indian participants of the Strong Heart Study (mean age 56 years, 41% male, 67% ever-smokers, 23% taking antihypertensive medications), urinary Cd ranged from 0.01 to 78.48 μg g -1 creatinine (geometric mean=0.94 μg g -1 ) and it was correlated with smoking pack-year among ever-smokers (r 2 =0.16, Pyears), and urinary Cd was similarly elevated in light- and never-smokers (geometric means of 0.88 μg g -1 creatinine for both categories). Log-transformed urinary Cd was significantly associated with higher systolic blood pressure in models adjusted for age, sex, geographic area, body mass index, smoking (ever vs never, and cumulative pack-years) and kidney function (mean blood pressure difference by lnCd concentration (β)=1.64, P=0.002). These associations were present among light- and never-smokers (β=2.03, P=0.002, n=2627), although not significant among never-smokers (β=1.22, P=0.18, n=1260). Cd was also associated with diastolic blood pressure among light- and never-smokers (β=0.94, P=0.004). These findings suggest that there is a relationship between Cd body burden and increased blood pressure in American Indians, a population with increased cardiovascular disease risk.

  13. The double burden of undernutrition and excess body weight in Mexico.

    Science.gov (United States)

    Kroker-Lobos, Maria F; Pedroza-Tobías, Andrea; Pedraza, Lilia S; Rivera, Juan A

    2014-12-01

    In Mexico, stunting and anemia have declined but are still high in some regions and subpopulations, whereas overweight and obesity have increased at alarming rates in all age and socioeconomic groups. The objective was to describe the coexistence of stunting, anemia, and overweight and obesity at the national, household, and individual levels. We estimated national prevalences of and trends for stunting, anemia, and overweight and obesity in children aged obesity in women aged 20-49 y by using the National Health and Nutrition Surveys conducted in 1988, 1999, 2006, and 2012. With the use of the most recent data (2012), the double burden of malnutrition at the household level was estimated and defined as the coexistence of stunting in children aged obesity in the mother. At the individual level, double burden was defined as concurrent stunting and overweight and obesity in children aged 5-11 y and concurrent anemia and overweight or obesity in children aged 5-11 y and in women. We also tested if the coexistence of the conditions corresponded to expected values, under the assumption of independent distributions of each condition. At the household level, the prevalence of concurrent stunting in children aged obesity in mothers was 8.4%; at the individual level, prevalences were 1% for stunting and overweight or obesity and 2.9% for anemia and overweight or obesity in children aged 5-11 y and 7.6% for anemia and overweight or obesity in women. At the household and individual levels in children aged 5-11 y, prevalences of double burden were significantly lower than expected, whereas anemia and the prevalence of overweight or obesity in women were not different from that expected. Although some prevalences of double burden were lower than expected, assuming independent distributions of the 2 conditions, the coexistence of stunting, overweight or obesity, and anemia at the national, household, and intraindividual levels in Mexico calls for policies and programs to prevent

  14. Assessment of Radioactivity in Man. Vol. II. Proceedings of the Symposium on the Assessment of Radioactive Body Burdens

    International Nuclear Information System (INIS)

    1964-01-01

    This Symposium on the Assessment of Radioactive Body Burdens in Man was organized jointly by the International Atomic Energy Agency, the International Labour Organisation and the World Health Organization and was held in Heidelberg from 11-15 May 1964. It was attended by 181 participants from 28 countries and 6 international organizations. It was the objective of the Symposium to bring together experts from the various scientific disciplines of physics, chemistry, biology, medicine and mathematics, and to survey their experience in the assessment of radioactive body burdens in man and the resultant radiation doses. In most investigations of internal contamination the errors in the physical measurements are smaller than the errors associated with the interpretation of measurements. For this reason special emphasis was laid in this meeting on the interpretation of measured data. The 67 papers and the discussions which they stimulated are published in these Proceedings produced in two volumes. Volume I includes all papers which deal with problems generally common to many isotopes: in- vivo counting, bioassay techniques, sample counting and analysis of data. Volume II includes those papers concerned with radioisotopes of specific elements: caesium, radium, radon, strontium, tritium, thorium, uranium, plutonium and rare earth elements. These Proceedings should prove invaluable to all radiation protection services entrusted with the physical surveillance of internal radiation exposure of man. They should complement the studies of the International Commission on Radiological Protection (ICRP) and assist the work of the Organizations that jointly organized the meeting

  15. Studies on the current 137Cs body burden of children in Belarus - Can the dose be further reduced?

    International Nuclear Information System (INIS)

    Hill, P.; Schlaeger, M.; Vogel, V.; Hille, R.; Nesterenko, A. V.; Nesterenko, V. B.

    2007-01-01

    After the Chernobyl reactor accident wide areas of Belarus were contaminated with radioactive fallout. The verification and documentation of the long-term development of radiation doses is still going on. A population group of special concern are the children living in contaminated regions. The annual dose limit of 1 mSv is still exceeded in some cases, essentially due to high body burdens of 137 Cs as indicated by screening measurements with portable incorporation monitors. In this situation the evaluation of possible dose reduction measures in addition to the control of food contamination is being investigated. Special attention is given to the therapeutic application of a pectin preparation (Vitapect), for which a dose-lowering effect is presumed by Belarusian scientists. In a placebo-controlled double-blind study, several groups of contaminated children received a pectin compound named Vitapect for a two-week period during their stay in a sanatorium. For comparison the same number of control groups were given a placebo preparation. The 137 Cs body burden of the children was measured at the beginning and the end. The mean relative reduction of the specific activity within the Vitapect groups was found to be ∼33%, whereas the specific activity of the children who received a placebo decreased only by ∼14%, due to clean food supply. It is known that pectins chemically bind cations like caesium in the gastrointestinal tract and thereby increase faecal excretion. Theoretical calculations based on this assumption and considering metabolism processes are qualitatively consistent with the experimentally found retention of radiocaesium in the human body after pectin treatment. (authors)

  16. Studies on the current Cs-137 body burden of children in Belarus - can the dose be further reduced?

    International Nuclear Information System (INIS)

    Hill, P.; Schlaeger, M.; Vogel, V.; Hille, R.; Nesterenko, A.V.; Nesterenko, V.B.

    2005-01-01

    Full text: After the Chernobyl reactor accident wide areas of Belarus have been contaminated with radioactive fallout. The verification and documentation of the long-term development of radiation doses is still going on. A population group of special concern are the children living in contaminated regions. The annual dose limit of 1 mSv/a is still exceeded in some cases, essentially due to high body burdens of Cs-137 as indicated by screening measurements with portable incorporation monitors. In this situation the evaluation of possible dose reduction measures in addition to the control of food contamination is being investigated. Special attention is given to the cure-like application of a pectin-preparation (Vitapekt), for which a dose-lowering effect is presumed by Belarusian scientists. In a placebo-controlled double-blind study, several groups of contaminated children were treated with Vitapekt for a two-week period during their stay in a sanatorium. For comparison the same number of control groups were given a placebo preparation. The Cs-137 body burden of the children was measured at the beginning and the end. First results indicate a mean relative reduction of the specific activity within the Vitapekt groups of about 35 %, whereas the specific activity of the children who received a placebo decreased only by about 15 %. It is proposed that pectins chemically bind cesium in the gastrointestinal tract and thereby increase fecal excretion. Theoretical calculations based on this assumption are qualitatively consistent with the experimentally found retention of radiocesium in the human body after a pectin treatment. (author)

  17. Stress and Burden among Caregivers of Patients with Lewy Body Dementia

    Science.gov (United States)

    Leggett, Amanda N.; Zarit, Steven; Taylor, Angela; Galvin, James E.

    2011-01-01

    Purpose: Patients with Lewy body dementia (LBD) may present a unique set of symptoms and challenges to family caregivers compared with other types of dementia. Prominent difficulties include motor impairment, activities of daily living (ADLs) disability, recurrent behavioral and emotional problems (BEPs), and diagnostic difficulties. These…

  18. The cesium -137 body burden of a control group in Stockholm, 1976

    International Nuclear Information System (INIS)

    Falk, R.; Eklund, G.

    1977-01-01

    Measurements of the 136 Cs content in a control group consisting of 20 - 30 persons have been carried out since 1959. Until 1966 the measurements were made in an 'open-both' type whole-body counter and after that in a three-crystal counter. Individual weighting factors for each member of the group is used to compensate for changes in the control group during the years. The calculation of the weighted mean of the cesium-137 level includes a correction for RaC contamination. During 1976 measurements were made on 24 members of the group, 14 men and 10 women. Measured content of potassium was 1.9+-0.3 g/kg body weight for the men and 1.6+-0.2 g/kg body weight for the women of the group. Tables show these results together with earlier results from the 'open-both' counter. The weighted mean and the highest and the lowest values within the group are indicated. The total error of the weighted mean and the highest value 1976 are about 15 percent and 12 percent respectively. For the last few years the cesium content has been below the detection limit, 10-15 pCi/gK, for some members of the group. (author)

  19. Bioassay of hair for estimation of body burden by tritium exposure

    International Nuclear Information System (INIS)

    Takeda, Hiroshi; Iwakura, Tetsuo

    1989-01-01

    For accurate estimation of radiation dose to human body from tritium exposure, it is needed to assess the concentration of tritium organically bound to the tissue constituents(OBT) as well as body water tritium. Since hair is an easily accessible tissue, it seems to be interesting to study the possibility of using hair for this purpose. In the present study, the pattern of tritium incorporation into hair and the quantitative relationship between OBT content in hair and in other internal tissues were investigated in rats exposed singly or continously to tritiated water, tritiated leucine and tritiated glycine. The rate of tritium incorporation into hair was slower than that into other tissues and the maximum concentrations were found on the 15-30th day after a single ingestion. The alterations in the concentration of OBT in internal tissues due to the difference of chemical form of ingested tritium were reflected on the OBT concentration in hair. Especially, the OBT content in hair under the condition of continuous exposure was almost the same as that in other tissues. These findings indicate the validity of hair analysis as a means for assessing OBT deposition in the body or tissues. (author)

  20. The cesium-137 body burden of a control group in Stockholm, 1975

    International Nuclear Information System (INIS)

    Hagberg, N.; Eklund, G.

    1976-03-01

    Measurements of the 137 Cs content in a control group consisting of 20-30 persons have been carried out since 1959 (1,4,6,7,9,10). Unitl 1966 the measurements were made in an open-booth type whole-body counter (Fig. 1) (2). From observation series 30 the measurements were made in the three-crystal counter (Fig. 1) in the new low-activity laboratory described in refs. (3) and (5). The use of individual weighting factors for each member of the group makes it possible to calculate a weighted mean of the 137 Cs level (1,5), to compensate for the changes in the control group during the years. The calculation includes a correction for RaC contamination. During 1975 measurements were made on 25 members of the group, 14 men and 11 women. The mean age and weight were 44 years and 71 kg respectively for men and 51 years and 61 kg respectively for women. For all the measured persons the mean age was 47 years and the mean weight was 67 kg. Measured content of potassium was 1,95+-0,20 g/kg body weight (1 sigma) for the men and 1,60+-0,15 g/kg body weight for the women of the group. Table 1 shows the results of the 137 Cs measurements obtained with the three-crystal counter. Fig. 2 shows these results together with earlier results from the open-booth counter. The weighted mean and the highest and the lowest values within the group are indicated. The total error of the weighted mean and the highest value 1975 are about 10 percent and 16 percent respectively. For the last few years the cesium content has been below the detection limit, 10-15 pCi/gK, for some members of the group. (author)

  1. Dietary treatment for decreasing 141Ce body burden in immature rats

    International Nuclear Information System (INIS)

    Kargacin, B.; Kostial, K.; Landeka, M.

    1987-01-01

    The purpose of this work was to evaluate the effect of prolonged (immediate or delayed) administration of dietary additives to suckling rats on the absorption and retention of radioactive cerium in the body. The experiment was performed on 6-day-old suckling rats. According to dietary treatment the animals were divided into three groups. Each group was artificially fed over 8 h for 6 or 12 days on one of the diets: the first group of animals was fed milk, the second group was given ingredients of rat diet and the third received milk during the first 2 days of the experiment and the ingredients of rat diet afterwards. At the end of the artificial feeding period the pups returned to their mothers and suckled overnight. On the 1st day of the experiment the food was labelled with 141 Ce. Whole body radioactivity was determined in a double crystal scintillation counter every 48 h over a 12-day period. Half of the animals from each group were killed 6 days after 141 Ce administration and the other half after 12 days. At these intervals retention was determined in the gut, liver, kidneys and femur. The early and delayed administration of rat diet ingredients - fish meal, sunflower meal, alfalfa, cane molasses and premix - greatly reduced whole body retention. The early treatment was more efficacious than the delayed one. The reduction was mostly due to decreased gut retention but organ retentions were also lower. The results obtained indicate that by prolonged (immediate or delayed) administration of some dietary means the retention of radioactive cerium in sucklings can be significantly decreased. (orig.)

  2. Dietary treatment for decreasing /sup 141/Ce body burden in immature rats

    Energy Technology Data Exchange (ETDEWEB)

    Kargacin, B; Kostial, K; Landeka, M

    1987-02-01

    The purpose of this work was to evaluate the effect of prolonged (immediate or delayed) administration of dietary additives to suckling rats on the absorption and retention of radioactive cerium in the body. The experiment was performed on 6-day-old suckling rats. According to dietary treatment the animals were divided into three groups. Each group was artificially fed over 8 h for 6 or 12 days on one of the diets: the first group of animals was fed milk, the second group was given ingredients of rat diet and the third received milk during the first 2 days of the experiment and the ingredients of rat diet afterwards. At the end of the artificial feeding period the pups returned to their mothers and suckled overnight. On the 1st day of the experiment the food was labelled with /sup 141/Ce. Whole body radioactivity was determined in a double crystal scintillation counter every 48 h over a 12-day period. Half of the animals from each group were killed 6 days after /sup 141/Ce administration and the other half after 12 days. At these intervals retention was determined in the gut, liver, kidneys and femur. The early and delayed administration of rat diet ingredients - fish meal, sunflower meal, alfalfa, cane molasses and premix - greatly reduced whole body retention. The early treatment was more efficacious than the delayed one. The reduction was mostly due to decreased gut retention but organ retentions were also lower. The results obtained indicate that by prolonged (immediate or delayed) administration of some dietary means the retention of radioactive cerium in sucklings can be significantly decreased.

  3. Mobilized plasma lead as an index of lead body burden and its relation to the heme-related indices.

    Science.gov (United States)

    Sakai, T; Ushio, K; Ikeya, Y

    1998-07-01

    Plasma lead (Pb-P) from workers were distributed in two main fractions: a protein bound fraction and low molecular weight fractions. Lead mobilized into plasma by CaEDTA was mainly observed in the low molecular weight fraction corresponding to lead disodium ethylenediamine tetraacetic acid (PbEDTA). The peak levels of Pb-P was attained around 1.5 and 2.5 hours after the start of CaEDTA injection. Pb-P and blood lead levels (Pb-B) at 2 h after the injection were 4.26 (+/- 2.84) and 0.96 (+/- 0.27) fold of the initial levels just before the injection. Pb-P concentrations at 2 hours after the start of CaEDTA injection (MPb-P) were well correlated (r = 0.740) with amounts of lead excreted in urine for 24 h thereafter (MPb-U). log MPb-P as well as log MPb-U were correlated with Pb-B (r = 0.765 and 0.817, respectively). Correlation coefficients of lead body burden (MPb-P or MPb-U) vs the logarithms of the effect indices (delta-aminolevulinic acid (ALA) dehydratase, ALA in urine, coproporphyrin in urine, and erythrocyte zinc protoporphyrin) were higher than the correlation coefficients of exposure indices (Pb-B or Pb-U) vs the logarithms of the effect indices. Thus the biological effect monitoring is significant and reliable for evaluating the functional components of lead body burden (MPb-P or MPb-U).

  4. Hair as an indicator of the body burden of metals in relation to age

    International Nuclear Information System (INIS)

    Kostial, K.

    1993-01-01

    Many factors influencing metal deposition in hair are still unknown. Animal experiments were performed to obtain data on the mechanism of transfer of elements into hair and to estimate whether hair retention is influenced by age, sex and chelating agent treatment. Experiments were performed on albino rats (Wistar strain) of different age and sex. Whole body hair (skin included) and organ retention of various elements was determined at different periods of time after intraperitoneal administration of the radioactive isotopes 115m Cd, 203 Hg, 54 Mn, 59 Fe, 65 Zn, 141 Ce, 137 Cs, 203 Pb and 85 Sr. In some experiments DTPA was used for reducing body retention of 155m Cd and 141 Ce and DMPS for reducing 203 Hg retention. Results show that hair and organ retention of elements in rats varies with age, sex and chelation treatment and such changes are specific for each element and can not be generalized. Age as a factor influencing hair retention of metals is likely to be more important for some elements than for others. In kinetic studies we found that due to differences in element distribution and kinetics, the relationship between hair and organ retention at various time intervals varies both with age and the element concerned. Sex influences not only hair but also metal retention and distribution in other organs. (author). 4 refs

  5. Examination of some chelating agents to decorporate fixed body-burdens of cadmium

    International Nuclear Information System (INIS)

    Jones, C.W.; Lloyd, R.D.; Mays, C.W.

    1979-01-01

    Male and female C57BL/Do mice, five to six months old, were injected intraperitoneally with 2.0 mg/kg cadmium citrate labeled with about 2.0 μCi 109 Cd per mouse. Three days after cadmium injection, male mice were injected subcutaneously with 2,3 dimercaptopropanesulfonate (DMPS), and female mice were injected subcutaneously with calcium disodium ethylenediaminetetra-acetate (CaEDTA), salicylic acid (SA), or 2,3 dimercaptopropanesulfonate, alone, or in combination. A total of four treatment injections were administered to each group of mice. Cadmium total-body retention was measured by in vivo counting using NaI(T1) spectrometry. Male mice given DMPS, and groups of females given EDTA, SA, EDTA + DMPS, EDTA + SA, or EDTA + DMPS + SA had total-body retentions of cadmium no different from saline controls (P > 0.05). Measurement of cadmium content in kidneys, livers, gonads, and femora excised from test animals also showed no difference from corresponding organs in control animals

  6. Body burdens of metals in spiders from the Lidice coal dump near Ostrava (Czech Republic)

    Energy Technology Data Exchange (ETDEWEB)

    Wilczek, G.; Babczynska, A.; Majkus, Z. [Silesian University, Katowice (Poland)

    2005-09-01

    Spiders' feeding behaviour and external digestion expose them to man-made pollutants, especially those easily transferred along the food chain. The problem for this study was whether the levels of heavy metals in selected species of spiders from the Lidice coal dump reflect adaptation to environmental pollutants. We used flameless and flame AAS to measure the whole-body concentrations of Cd, Pb, Cu, Zn, Fe, Ni and Mg in male and female spiders differing in their hunting strategies, type of web construction, prey, and taxonomic position (Araneidae, Agelenidae, Linyphiidae, Theridiidae, Tetragnathidae, Lycosidae, Salticidae, Pisauridae, Clubionidae, Philodromidae). The levels of metals found in the spiders were species-dependent, indicating differences related to the hunting strategy and type of prey. Accumulation of Pb, Cu and Zn was always higher in ground spiders than in web-constructing species. Sheet-web spiders Linyphia triangularis and wandering spiders Clubiona lutescens had the lowest Cd, Mg and Cu content of all the studied species. Web-building spiders of the Tetragnathidae family showed the highest Cd, Cu and Pb content, even in species with feeding behaviour similar to spiders of other families. There were no interspecific differences in accumulation only for Fe and Mg. The concentrations of Cd, Ni and Pb were lower in females than in males, irrespective of their taxonomic position and the intensity of their hunting activity. This may suggest that females have better metal-excretion ability than males.

  7. The significance of hair mineral analysis as a means for assessing internal body burdens of environmental pollutants

    International Nuclear Information System (INIS)

    1993-01-01

    In recent years there has been a considerable growth of interest in problems of environmental pollution from industrial and agricultural substances and the harmful impact of such pollution on human health. There has been an increasing interest in using hair mineral analysis for biological monitoring of human population exposure to environmental mineral pollutants. This is because hair has some ideal attributes for such purposes. It can be collected by simple, non-invasive methods, and is easily sampled and stored. Concentrations of most of the toxic trace elements, i.e. mercury and lead, in scalp hair are at least an order of magnitude higher than those in body fluids or other easily accessible tissues. In addition, mineral elements in hair can easily be determined with good precision and sensitivity by nuclear as well as conventional methods of chemical analysis. Despite these apparent advantages of using hair as a biomonitor, serious uncertainty existed, and to some extent still exist, as to the meaningful interpretation of human hair mineral data in environmental health studies. The Co-ordinated Research Programme (CRP), which is the subject of this report, has attempted to tackle this problem by promoting a variety of studies (as distinct from routine monitoring) to investigate the quantitative relationships between internal body burdens of a number of elements of environmental health significance and their respective concentrations in hair. Refs, figs and tabs

  8. An effective and better strategy for reducing body burden of radiostrontium

    International Nuclear Information System (INIS)

    Jagtap, V S; Sonawane, V R; Pahuja, D N; Rajan, M G R; Rajashekharrao, B; Samuel, A M

    2003-01-01

    In this study we have examined the effect of different calcium salts, Ca gluconate (CaG), Ca lactate (CaL), Ca carbonate (CaC) and Ca phosphate (CaP), on the clearance of radiostrontium (*Sr) administered either intraperitoneally (ip) (*Sr-ip group) or orally (*Sr-oral group) in rats. The influence of these Ca salts was examined in a group of animals administered *Sr ip, while the effect of three Ca salts (CaG, CaL and CaP) was studied in another group of rats given *Sr orally and compared with that of Ca alginate (CaA), normally advised for *Sr decorporation. Rats from both groups were subdivided into control and four experimental subgroups and were housed individually. The experimental subgroups were given the respective Ca salts (elemental Ca = 9 mg/rat/day) 2 h post 85 Sr, and thereafter once daily. In the *Sr-ip group, CaG was administered ip while the other Ca salts were given orally. In the *Sr-oral group all Ca salts were administered orally. In addition, the diet of all the experimental subgroups was supplemented with the respective Ca salts to 2% elemental Ca. The whole-body retention (WBR) of *Sr in animals treated with Ca salts was found to be significantly reduced from 50-60% at 24 h to 20-30% at the end of 15 days compared with 70-80% at 24 h to 50-60% at the end of 15 days in the untreated control animals. The results strongly suggest that CaA could be replaced by any of the commonly used Ca salts for curtailing the WBR of *Sr. CaG which was administered ip, in the *Sr-ip group, was found to be more effective in reducing the WBR of *Sr

  9. Body burden of pesticides and wastewater-derived pollutants on freshwater invertebrates: Method development and application in the Danube River

    International Nuclear Information System (INIS)

    Inostroza, Pedro A.; Wicht, Anna-Jorina; Huber, Thomas; Nagy, Claudia; Brack, Werner; Krauss, Martin

    2016-01-01

    While environmental risk assessment is typically based on toxicant concentrations in water and/or sediment, awareness is increasing that internal concentrations or body burdens are the key to understand adverse effects in organisms. In order to link environmental micropollutants as causes of observed effects, there is an increasing demand for methods to analyse these chemicals in organisms. Here, a multi-target screening method based on pulverised liquid extraction (PuLE) and a modified QuEChERS approach with an additional hexane phase was developed. It is capable to extract and quantify organic micropollutants of diverse chemical classes in freshwater invertebrates. The method was tested on gammarids from the Danube River (within the Joint Danube Survey 3) and target compounds were analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Furthermore, a non-target screening using high resolution-tandem mass spectrometry (LC-HRMS/MS) was conducted. A total of 17 pollutants were detected and/or quantified in gammarids at low concentrations. Pesticide concentrations ranged from 0.1 to 6.52 ng g −1 (wet weight), those of wastewater-derived pollutants from 0.1 to 2.83 ng g −1 (wet weight). The presence of wastewater-derived pollutants was prominent at all spots sampled. Using non-target screening, we could successfully identify several chlorinated compounds. These results demonstrate for the first time the presence of pesticides and wastewater-derived pollutants in invertebrates of the Danube River. - Highlights: • A method based on pulverised liquid extraction/QuEChERS for organic micropollutants in invertebrates was developed. • The method is applicable in assessing target environmental pollutants in invertebrates by LC-MS/MS. • The method allows for a nontarget screening of extracts by LC-HRMS. • First body burden analysis of pesticides and wastewater-derived pollutants in invertebrates in the Danube River is reported. - Capsule: A multi

  10. Comparison of organochlorine chemical body burdens of female breast cancer cases with cancer free women in Rio Grande do Sul, Brazil--Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Erdmann, C.A.; Petreas, M.X.; Caleffi, M.; Barbosa, F.S.; Goth-Goldstein, R.

    1999-12-01

    This pilot study collected preliminary data to examine known and suspected breast cancer risk factors among women living in rural and urban areas in the state of Rio Grande do Sul, Brazil by questionnaire. In addition, the body burden levels of a panel of organochlorines was measured in a small clinic-based prospective sample.

  11. Whole body cardiovascular magnetic resonance imaging to stratify symptomatic and asymptomatic atherosclerotic burden in patients with isolated cardiovascular disease

    International Nuclear Information System (INIS)

    Weir-McCall, Jonathan R.; Duce, Suzanne L.; Gandy, Stephen J.; Matthew, Shona Z.; Martin, Patricia; Cassidy, Deirdre B.; McCormick, Lynne; Belch, Jill J. F.; Struthers, Allan D.; Colhoun, Helen M.; Houston, J. Graeme

    2016-01-01

    The aim of this study was to use whole body cardiovascular magnetic resonance imaging (WB CVMR) to assess the heart and arterial network in a single examination, so as to describe the burden of atherosclerosis and subclinical disease in participants with symptomatic single site vascular disease. 64 patients with a history of symptomatic single site vascular disease (38 coronary artery disease (CAD), 9 cerebrovascular disease, 17 peripheral arterial disease (PAD)) underwent whole body angiogram and cardiac MR in a 3 T scanner. The arterial tree was subdivided into 31 segments and each scored according to the degree of stenosis. From this a standardised atheroma score (SAS) was calculated. Cine and late gadolinium enhancement images of the left ventricle were obtained. Asymptomatic atherosclerotic disease with greater than 50 % stenosis in arteries other than that responsible for their presenting complain was detected in 37 % of CAD, 33 % of cerebrovascular and 47 % of PAD patients. Unrecognised myocardial infarcts were observed in 29 % of PAD patients. SAS was significantly higher in PAD patients 24 (17.5-30.5) compared to CAD 4 (2–11.25) or cerebrovascular disease patients 6 (2-10) (ANCOVA p < 0.001). Standardised atheroma score positively correlated with age (β 0.36 p = 0.002), smoking status (β 0.34 p = 0.002), and LV mass (β -0.61 p = 0.001) on multiple linear regression. WB CVMR is an effective method for the stratification of cardiovascular disease. The high prevalence of asymptomatic arterial disease, and silent myocardial infarctions, particularly in the peripheral arterial disease group, demonstrates the importance of a systematic approach to the assessment of cardiovascular disease

  12. Imposex and butyltin body burden in Nassarius nitidus (Jeffreys, 1867), in coastal waters within the Basque Country (northern Spain)

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, J. German, E-mail: grodriguez@pas.azti.es [AZTI-Tecnalia, Herrera Kaia Portualdea z/g, 20110-Pasaia (Spain); Borja, Angel; Franco, Javier [AZTI-Tecnalia, Herrera Kaia Portualdea z/g, 20110-Pasaia (Spain); Garcia Alonso, J. Ignacio [Department of Physical and Analytical Chemistry, Faculty of Chemistry, University of Oviedo, Julian Claveria 8, 33006 Oviedo (Spain); Garmendia, Joxe Mikel; Muxika, Inigo [AZTI-Tecnalia, Herrera Kaia Portualdea z/g, 20110-Pasaia (Spain); Sariego, Cristina [Servicio de Espectrometria de Masas, SCT' s, University of Oviedo, Julian Claveria s/n, 33006, Oviedo (Spain); Valencia, Victoriano [AZTI-Tecnalia, Herrera Kaia Portualdea z/g, 20110-Pasaia (Spain)

    2009-07-01

    Levels of imposex (superimposition of male characters, upon females) and the presence of sterile females are assessed in the gastropod Nassarius nitidus (Jeffreys, 1867), at 22 locations in the Basque Country (northern Spain). At 18 of these localities, butyltin bioaccumulation (tributyltin (TBT); dibutyltin; monobutyltin) was analysed using isotope dilution and GC-ICP-MS. Higher imposex levels and TBT body burden were found in confined harbours, with a large vessel traffic or the presence of a fishing fleet or a shipyard. For the first time, four apparently sequential types of aborted capsules are described in this species. Another novelty is the interspecific comparison between imposex intensities in sympatrically living populations of N. nitidus and N. reticulatus. This showed that sensitivity to TBT pollution of both species is relatively similar (in terms of Relative Penis Length Index). Since N. nitidus has a restricted habitat distribution due to its low presence in wave-exposed habitats, its complementary use with other species is recommended for its use in TBT monitoring programmes.

  13. Imposex and butyltin body burden in Nassarius nitidus (Jeffreys, 1867), in coastal waters within the Basque Country (northern Spain)

    International Nuclear Information System (INIS)

    Rodriguez, J. German; Borja, Angel; Franco, Javier; Garcia Alonso, J. Ignacio; Garmendia, Joxe Mikel; Muxika, Inigo; Sariego, Cristina; Valencia, Victoriano

    2009-01-01

    Levels of imposex (superimposition of male characters, upon females) and the presence of sterile females are assessed in the gastropod Nassarius nitidus (Jeffreys, 1867), at 22 locations in the Basque Country (northern Spain). At 18 of these localities, butyltin bioaccumulation (tributyltin (TBT); dibutyltin; monobutyltin) was analysed using isotope dilution and GC-ICP-MS. Higher imposex levels and TBT body burden were found in confined harbours, with a large vessel traffic or the presence of a fishing fleet or a shipyard. For the first time, four apparently sequential types of aborted capsules are described in this species. Another novelty is the interspecific comparison between imposex intensities in sympatrically living populations of N. nitidus and N. reticulatus. This showed that sensitivity to TBT pollution of both species is relatively similar (in terms of Relative Penis Length Index). Since N. nitidus has a restricted habitat distribution due to its low presence in wave-exposed habitats, its complementary use with other species is recommended for its use in TBT monitoring programmes.

  14. The significance of mineral pollutants in hair for the assessment of the body burden and the concentration in the critical organs in laboratory animals

    International Nuclear Information System (INIS)

    Kollmer, W.E.

    1993-01-01

    If the content of an element in hair of an individual is used for the assessment of health risk of that person it is of special importance to know if the hair analytical data reflect the body burden or the content of the organ or tissues at risk. Ideally the content in hair should rise and fall in parallel to an increase or decrease of the body burden or the content in the critical organs. It was the aim of this project to study the transfer of Hg, methyl-mercury and Zn to hair and to compare it with the levels simultaneously observed in the total body and the relevant organs under controlled experimental conditions in an animal model. In addition, a similar study on As and the analyses of two experiments of a long term study on Cd exposure were also included. 11 refs, 3 figs, 4 tabs

  15. Adjustment of a direct method for the determination of man body burden in Pu-239 on by X-ray detection of U-235

    International Nuclear Information System (INIS)

    Boulay, P.

    1968-04-01

    The use of Pu-239 on a larger scale sets a problem about the contamination measurement by aerosol at lung level. A method of direct measurement of Pu-239 lung burden is possible, thanks to the use of a large area window proportional counter. A counter of such pattern, has been especially carried out for this purpose. The adjustment of the apparatus allows an adequate sensibility to detect a contamination at the maximum permissible body burden level. Besides, a method for individual 'internal calibration', with a plutonium mock: the protactinium-233, is reported. (author) [fr

  16. Body burden of pesticides and wastewater-derived pollutants on freshwater invertebrates: Method development and application in the Danube River.

    Science.gov (United States)

    Inostroza, Pedro A; Wicht, Anna-Jorina; Huber, Thomas; Nagy, Claudia; Brack, Werner; Krauss, Martin

    2016-07-01

    While environmental risk assessment is typically based on toxicant concentrations in water and/or sediment, awareness is increasing that internal concentrations or body burdens are the key to understand adverse effects in organisms. In order to link environmental micropollutants as causes of observed effects, there is an increasing demand for methods to analyse these chemicals in organisms. Here, a multi-target screening method based on pulverised liquid extraction (PuLE) and a modified QuEChERS approach with an additional hexane phase was developed. It is capable to extract and quantify organic micropollutants of diverse chemical classes in freshwater invertebrates. The method was tested on gammarids from the Danube River (within the Joint Danube Survey 3) and target compounds were analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Furthermore, a non-target screening using high resolution-tandem mass spectrometry (LC-HRMS/MS) was conducted. A total of 17 pollutants were detected and/or quantified in gammarids at low concentrations. Pesticide concentrations ranged from 0.1 to 6.52 ng g(-1) (wet weight), those of wastewater-derived pollutants from 0.1 to 2.83 ng g(-1) (wet weight). The presence of wastewater-derived pollutants was prominent at all spots sampled. Using non-target screening, we could successfully identify several chlorinated compounds. These results demonstrate for the first time the presence of pesticides and wastewater-derived pollutants in invertebrates of the Danube River. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Body burdens of brominated flame retardants and other persistent organo-halogenated compounds and their descriptors in US girls

    Energy Technology Data Exchange (ETDEWEB)

    Windham, Gayle C., E-mail: gayle.windham@cdph.ca.gov [CA Department of Public Health, DEODC, 850 Marina Bay Pkwy, Bldg. P, Richmond, CA 94804 (United States); Pinney, Susan M. [University of Cincinnati College of Medicine, Cincinnati, OH 45267 (United States); Sjodin, Andreas [Centers for Disease Control and Prevention, Atlanta, GA 30341 (United States); Lum, Raymond [Impact Assessment Inc., San Diego, CA (United States); Jones, Richard S.; Needham, Larry L. [Centers for Disease Control and Prevention, Atlanta, GA 30341 (United States); Biro, Frank M. [University of Cincinnati College of Medicine, Cincinnati, OH 45267 (United States); Hiatt, Robert A. [University of California Medical School, San Francisco, CA (United States); Kushi, Lawrence H. [Kaiser Permanente Northern California, Oakland, CA 94612 (United States)

    2010-04-15

    Background: Levels of brominated flame retardants are increasing in US populations, yet little data are available on body burdens of these and other persistent hormonally active agents (HAAs) in school-aged children. Exposures to such chemicals may affect a number of health outcomes related to development and reproductive function. Objective: Determine the distribution of biomarkers of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), and organo-chlorinated pesticides (OCPs), such as DDT/DDE, in children, and their variation by key descriptor variables. Methods: Ethnically diverse cohorts of girls 6-8 y old at baseline are being followed for growth and pubertal development in a multi-site, longitudinal study. Nearly 600 serum samples from the California and Ohio sites were analyzed for lipids, 35 PCB congeners, 11 PBDE congeners, and 9 OCPs. The biomarker distributions were examined and geometric means compared for selected analytes across categories of age, race, site, body mass index (BMI), parental education, maternal age at delivery, and breast feeding in adjusted models. Results: Six PBDE congeners were detected among greater than 70% of samples, with BDE-47 having the highest concentration (median 42.2, range 4.9-855 ng/g lipid). Girls in California had adjusted geometric mean (GM) PBDE levels significantly higher than girls in Ohio. Furthermore, Blacks had significantly higher adjusted GMs of all six PBDE congeners than Whites, and Hispanics had intermediate values. GMs tended to be lower among more obese girls, while other variables were not strongly associated. In contrast, GMs of the six PCB congeners most frequently detected were significantly lower among Blacks and Hispanics than Whites. PCBs and the three pesticides most frequently detected were also consistently lower among girls with high BMI, who were not breast-fed, whose mothers were younger, or whose care-givers (usually parents) were less educated. Girls in California had

  18. Body burdens of brominated flame retardants and other persistent organo-halogenated compounds and their descriptors in US girls

    International Nuclear Information System (INIS)

    Windham, Gayle C.; Pinney, Susan M.; Sjodin, Andreas; Lum, Raymond; Jones, Richard S.; Needham, Larry L.; Biro, Frank M.; Hiatt, Robert A.; Kushi, Lawrence H.

    2010-01-01

    Background: Levels of brominated flame retardants are increasing in US populations, yet little data are available on body burdens of these and other persistent hormonally active agents (HAAs) in school-aged children. Exposures to such chemicals may affect a number of health outcomes related to development and reproductive function. Objective: Determine the distribution of biomarkers of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), and organo-chlorinated pesticides (OCPs), such as DDT/DDE, in children, and their variation by key descriptor variables. Methods: Ethnically diverse cohorts of girls 6-8 y old at baseline are being followed for growth and pubertal development in a multi-site, longitudinal study. Nearly 600 serum samples from the California and Ohio sites were analyzed for lipids, 35 PCB congeners, 11 PBDE congeners, and 9 OCPs. The biomarker distributions were examined and geometric means compared for selected analytes across categories of age, race, site, body mass index (BMI), parental education, maternal age at delivery, and breast feeding in adjusted models. Results: Six PBDE congeners were detected among greater than 70% of samples, with BDE-47 having the highest concentration (median 42.2, range 4.9-855 ng/g lipid). Girls in California had adjusted geometric mean (GM) PBDE levels significantly higher than girls in Ohio. Furthermore, Blacks had significantly higher adjusted GMs of all six PBDE congeners than Whites, and Hispanics had intermediate values. GMs tended to be lower among more obese girls, while other variables were not strongly associated. In contrast, GMs of the six PCB congeners most frequently detected were significantly lower among Blacks and Hispanics than Whites. PCBs and the three pesticides most frequently detected were also consistently lower among girls with high BMI, who were not breast-fed, whose mothers were younger, or whose care-givers (usually parents) were less educated. Girls in California had

  19. [Secondhand smoke in hospitality venues. Exposure, body burden, economic and health aspects in conjunction with smoking bans].

    Science.gov (United States)

    Fromme, H; Kuhn, J; Bolte, G

    2009-04-01

    Secondhand smoke was classified by national and international organisations as a known cause of cancer in humans and has many adverse health effects, especially cardiovascular diseases and lung tumours. Global studies have clearly shown that hospitality venues have the highest levels of indoor air pollution containing different substances that are clearly carcinogenic--such as tobacco-related chemicals--compared with other, smoke-free indoor spaces. Data from the human biomonitoring of non-smoking employees in the food service industry confirm this high exposure level. Non-smokers exposed to secondhand smoke in these environments are at increased risk for adverse health effects. The consistent protection of non-smokers in public places such as restaurants and bars through a smoking ban results in a significant reduction of the pollutants in the air (mostly > 90%) and clearly reduces the internal body burden for users and employees. Furthermore, health complaints by non-smoking employees are reduced and the higher risk for lung tumours of employees in the food service industry compared with the general population can be effectively reduced as well. According to current standards of knowledge, other measures such as spatial separation of smoking areas or the use of mechanical venting systems do not achieve a comparably high and effective pollutant reduction under field conditions. Studies concerning the economic effects of prohibiting smoking in public places conducted in various countries have shown that beverage-focused gastronomic enterprises experience a short-term down trend but that food-focused gastronomic enterprises do not experience any negative or even positive effects. The positive effects of a ban on smoking in public places on the general population are a decline in cigarette consumption and the reduction of secondhand smoke exposure by non-smokers. Smoking bans in hospitality venues are not necessarily linked with a shift of the tobacco consumption to

  20. Effects of variations in cadmium and lead levels in river sediments on local foods and body burden of local residents in non-polluted areas in Japan.

    Science.gov (United States)

    Ikeda, Masayuki; Watanabe, Takao; Ohashi, Fumiko; Shimbo, Shinichiro

    2010-03-01

    This study was initiated to examine if variations in the concentrations of cadmium (Cd) and lead (Pb) in water environment may affect metal levels in local foods and body burden of local residents in non-polluted areas in Japan. Two nationwide databases have been made available on concentrations of Cd in locally harvested brown rice and of Cd and Pb in sediments in local river beds. These data were combined with published data on metal concentrations in polished rice, food duplicates, and blood and urine from the residents. Cd in river sediments correlated significantly with those in brown rice, food duplicates, blood, and urine. Cd in food duplicates correlated with Cd in rice. In contrast, Pb concentrations in the river sediments either did not correlate or correlated only weakly with Pb in biological materials or food duplicates. Possible implication of the different behavior between Cd and Pb regarding the intensity of correlation was discussed with reference to the different routes of exposure to the elements. In conclusions, the Cd body burden on local residents in Japan is significantly influenced by Cd levels in water in the general environment, whereas water-borne Pb did not show clear correlation with the Pb body burden.

  1. A review of environmental fate, body burdens, and human health risk assessment of PCDD/Fs at two typical electronic waste recycling sites in China

    International Nuclear Information System (INIS)

    Chan, Janet Kit Yan; Wong, Ming H.

    2013-01-01

    This paper reviews the levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in different environmental media, human body burdens and health risk assessment results at e-waste recycling sites in China. To provide an indication of the seriousness of the pollution levels in the e-waste recycling sites in China, the data are compared with guidelines and available existing data for other areas. The comparison clearly shows that PCDD/Fs derived from the recycling processes lead to serious pollution in different environmental compartments (such as air, soil, sediment, dust and biota) and heavy body burdens. Of all kinds of e-waste recycling operations, open burning of e-waste and acid leaching activities are identified as the major sources of PCDD/Fs. Deriving from the published data, the estimated total exposure doses via dietary intake, inhalation, soil/dust ingestion and dermal contact are calculated for adults, children and breast-fed infants living in two major e-waste processing locations in China. The values ranged from 5.59 to 105.16 pg WHO-TEQ/kg bw/day, exceeding the tolerable daily intakes recommended by the WHO (1–4 pg WHO-TEQ/kg bw/day). Dietary intake is the most important exposure route for infants, children and adults living in these sites, contributing 60–99% of the total intakes. Inhalation is the second major exposure route, accounted for 12–30% of the total exposure doses of children and adults. In order to protect the environment and human health, there is an urgent need to control and monitor the informal e-waste recycling operations. Knowledge gaps, such as comprehensive dietary exposure data, epidemiological and clinical studies, body burdens of infants and children, and kinetics about PCDD/Fs partitions among different human tissues should be addressed. - Highlights: ► PCDD/F levels at e-waste recycling sites in China were reviewed. ► Data on environment and body burden and health risk assessment results were reviewed

  2. A review of environmental fate, body burdens, and human health risk assessment of PCDD/Fs at two typical electronic waste recycling sites in China

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Janet Kit Yan, E-mail: chanjky@hku.hk [School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong (China); Wong, Ming H., E-mail: mhwong@hkbu.edu.hk [Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Hong Kong (China)

    2013-10-01

    This paper reviews the levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in different environmental media, human body burdens and health risk assessment results at e-waste recycling sites in China. To provide an indication of the seriousness of the pollution levels in the e-waste recycling sites in China, the data are compared with guidelines and available existing data for other areas. The comparison clearly shows that PCDD/Fs derived from the recycling processes lead to serious pollution in different environmental compartments (such as air, soil, sediment, dust and biota) and heavy body burdens. Of all kinds of e-waste recycling operations, open burning of e-waste and acid leaching activities are identified as the major sources of PCDD/Fs. Deriving from the published data, the estimated total exposure doses via dietary intake, inhalation, soil/dust ingestion and dermal contact are calculated for adults, children and breast-fed infants living in two major e-waste processing locations in China. The values ranged from 5.59 to 105.16 pg WHO-TEQ/kg bw/day, exceeding the tolerable daily intakes recommended by the WHO (1–4 pg WHO-TEQ/kg bw/day). Dietary intake is the most important exposure route for infants, children and adults living in these sites, contributing 60–99% of the total intakes. Inhalation is the second major exposure route, accounted for 12–30% of the total exposure doses of children and adults. In order to protect the environment and human health, there is an urgent need to control and monitor the informal e-waste recycling operations. Knowledge gaps, such as comprehensive dietary exposure data, epidemiological and clinical studies, body burdens of infants and children, and kinetics about PCDD/Fs partitions among different human tissues should be addressed. - Highlights: ► PCDD/F levels at e-waste recycling sites in China were reviewed. ► Data on environment and body burden and health risk assessment results were reviewed

  3. Modeling response of species to microcontaminants: comparative ecotoxicology by (sub)lethal body burdens as a function of species size and partition ratio of chemicals.

    Science.gov (United States)

    Hendriks, A J

    1995-11-01

    A model was designed and calibrated with accumulation data to calculate the internal concentrations of microcontaminants in organisms as a function of a few constants and variables. The main factors are the exposure time, the external exposure concentration, the partition ratio of the compound, and the size of the taxon concerned. The model was applied to calculate the lethal and sublethal body burdens of several priority compounds and some major taxa. Estimations were generally confirmed at the order of magnitude level by measured residues and applied doses if available. According to the estimations, most priority compounds chosen were critical for most taxa above internal concentrations of 0.1 mmol.kg-1 wet wt. Trichloromethane, 1,2,4-trichlorobenzene, and hexachlorobenzene were lethal above this level only, whereas other organic microcontaminants affected at least some taxa at lower body burdens. The log(Kow) of the organic compounds ranged from 2.0 to 7.0. Keeping in mind that bioconcentration and -magnification ratios for metals may be quite variable, the lowest critical residues estimated were just below the value of 0.1 mmol.kg-1 wet wt. Here, external concentrations encountered in natural habitats seem to be a promising tool for predictive comparative ecotoxicology. The critical body burdens for plants and invertebrates may have been overestimated due to uncertainty about the parameters. Among the different taxa, however, the fish families chosen (Salmonidae and Cyprinidae) seem to be most sensitive to most compounds. Internal response concentrations of the herbicide atrazine were the lowest in micro- and macrophytes, whereas parathion affected invertebrates at low levels. The database that provided the external response concentrations was also consulted to estimate so-called extrapolation or safety factors. On average, long-term no effect concentrations in water are estimated to be about 10-30 times below short-term median lethal levels. In general, short

  4. Association of PCB, PBDE and PCDD/F body burdens with hormone levels for children in an e-waste dismantling area of Zhejiang Province, China

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Peiwei, E-mail: pwxu@cdc.zj.cn; Lou, Xiaoming; Ding, Gangqiang; Shen, Haitao; Wu, Lizhi; Chen, Zhijian; Han, Jianlong; Han, Guangen; Wang, Xiaofeng, E-mail: zjcdcwxf@gmail.com

    2014-11-15

    Increased electronic waste (e-waste) has raised public concerns regarding exposure to numerous toxic contaminants, particularly polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). In China, the body burdens of PCBs, PBDEs and PCDD/Fs are associated with thyroid hormones in populations from e-waste dismantling sites; however, it is unclear whether this association occurs in children. In this study, we determined the serum levels of PCBs, PBDEs and PCDD/Fs and the endocrine hormones including free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), cortisol and growth hormone (GH) in 21 children from an e-waste dismantling area and 24 children from a control area. The results showed that the mean levels of ∑ PCBs and ∑ PBDEs in the exposure group were significantly higher than in the control group (40.56 and 32.09 ng g{sup −1} lipid vs. 20.69 and 8.43 ng g{sup −1} lipid, respectively, p < 0.01 for each), and the mean level of ∑ PCDD/Fs in the exposure group was higher than in the control group, but the difference was not significant (206.17 vs. 160.27 pg g{sup −1} lipid, p > 0.05). For the endocrine hormones, we did not find significant differences between the exposed and control groups, although the mean levels of FT3, TT3, TT4, ACTH, cortisol and GH were higher, whereas the mean levels of FT4 and TSH were lower in the exposed group. The mean level of ∑ PBDEs was positively correlated with the mean levels of ∑ PCBs (r = 0.60, p < 0.05) and ∑ PCDD/Fs (r = 0.61, p < 0.05). Furthermore, the mean level of ∑ PBDEs was positively correlated with ACTH (r = 0.61, p < 0.05). In conclusion, our data suggested that exposure to e-waste dismantling environment increased the body burdens of PCBs and PBDEs in local children and that these contaminants

  5. Association of PCB, PBDE and PCDD/F body burdens with hormone levels for children in an e-waste dismantling area of Zhejiang Province, China

    International Nuclear Information System (INIS)

    Xu, Peiwei; Lou, Xiaoming; Ding, Gangqiang; Shen, Haitao; Wu, Lizhi; Chen, Zhijian; Han, Jianlong; Han, Guangen; Wang, Xiaofeng

    2014-01-01

    Increased electronic waste (e-waste) has raised public concerns regarding exposure to numerous toxic contaminants, particularly polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). In China, the body burdens of PCBs, PBDEs and PCDD/Fs are associated with thyroid hormones in populations from e-waste dismantling sites; however, it is unclear whether this association occurs in children. In this study, we determined the serum levels of PCBs, PBDEs and PCDD/Fs and the endocrine hormones including free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), cortisol and growth hormone (GH) in 21 children from an e-waste dismantling area and 24 children from a control area. The results showed that the mean levels of ∑ PCBs and ∑ PBDEs in the exposure group were significantly higher than in the control group (40.56 and 32.09 ng g −1 lipid vs. 20.69 and 8.43 ng g −1 lipid, respectively, p < 0.01 for each), and the mean level of ∑ PCDD/Fs in the exposure group was higher than in the control group, but the difference was not significant (206.17 vs. 160.27 pg g −1 lipid, p > 0.05). For the endocrine hormones, we did not find significant differences between the exposed and control groups, although the mean levels of FT3, TT3, TT4, ACTH, cortisol and GH were higher, whereas the mean levels of FT4 and TSH were lower in the exposed group. The mean level of ∑ PBDEs was positively correlated with the mean levels of ∑ PCBs (r = 0.60, p < 0.05) and ∑ PCDD/Fs (r = 0.61, p < 0.05). Furthermore, the mean level of ∑ PBDEs was positively correlated with ACTH (r = 0.61, p < 0.05). In conclusion, our data suggested that exposure to e-waste dismantling environment increased the body burdens of PCBs and PBDEs in local children and that these contaminants released from the e

  6. A genetic variant of NLRP1 gene is associated with asbestos body burden in patients with malignant pleural mesothelioma.

    Science.gov (United States)

    Crovella, S; Moura, R R; Cappellani, S; Celsi, F; Trevisan, E; Schneider, M; Brollo, A; Nicastro, E M; Vita, F; Finotto, L; Zabucchi, G; Borelli, V

    2018-01-01

    The presence of asbestos bodies (ABs) in lung parenchyma is considered a histopathologic hallmark of past exposure to asbestos fibers, of which there was a population of longer fibers. The mechanisms underlying AB formation are complex, involving inflammatory responses and iron (Fe) metabolism. Thus, the responsiveness to AB formation is variable, with some individuals appearing to be poor AB formers. The aim of this study was to disclose the possible role of genetic variants of genes encoding inflammasome and iron metabolism proteins in the ability to form ABs in a population of 81 individuals from North East Italy, who died after having developed malignant pleural mesothelioma (MPM). This study included 86 genetic variants distributed in 10 genes involved in Fe metabolism and 7 genetic variants in two genes encoding for inflammasome molecules. Genotypes/haplotypes were compared according to the number of lung ABs. Data showed that the NLRP1 rs12150220 missense variant (H155L) was significantly correlated with numbers of ABs in MPM patients. Specifically, a low number of ABs was detected in individuals carrying the NLRP1 rs12150220 A/T genotype. Our findings suggest that the NLRP1 inflammasome might contribute in the development of lung ABs. It is postulated that the NLRP1 missense variant may be considered as one of the possible host genetic factors contributing to individual variability in coating efficiency, which needs to be taken when assessing occupational exposure to asbestos.

  7. Increased body mass index in ankylosing spondylitis is associated with greater burden of symptoms and poor perceptions of the benefits of exercise.

    Science.gov (United States)

    Durcan, Laura; Wilson, Fiona; Conway, Richard; Cunnane, Gaye; O'Shea, Finbar D

    2012-12-01

    Increased body mass index (BMI) in patients with ankylosing spondylitis (AS) is associated with a greater burden of symptoms and poor perceptions of the benefits of exercise. In AS, the effect of obesity on disease characteristics and exercise perceptions is unknown. We evaluated the prevalence of obesity in AS, to assess the attitudes of patients toward exercise and to evaluate the effect of obesity on symptoms and disease activity. Demographic data and disease characteristics were collected from 46 patients with AS. Disease activity, symptomatology, and functional disability were examined using standard AS questionnaires. BMI was calculated. Comorbidity was analyzed using the Charlson Comorbidity Index. Patients' attitudes toward exercise were assessed using the Exercise Benefits and Barriers Scale (EBBS). We compared the disease characteristics, perceptions regarding exercise, and functional limitations in those who were overweight to those who had a normal BMI. The mean BMI in the group was 27.4; 67.5% of subjects were overweight or obese. There was a statistically significant difference between those who were overweight and those with a normal BMI regarding their perceptions of exercise (EBBS 124.7 vs 136.6, respectively), functional limitation (Bath AS Functional Index 4.7 vs 2.5, Health Assessment Questionnaire 0.88 vs 0.26), and disease activity (Bath AS Disease Activity Index 4.8 vs 2.9). There was no difference between the groups in terms of their comorbid conditions or other demographic variables. The majority of patients in this AS cohort were overweight. They had a greater burden of symptoms, worse perceptions regarding the benefits of exercise, and enhanced awareness of their barriers to exercising. This is of particular concern in a disease where exercise plays a crucial role.

  8. 68Ga-PSMA-11 PET/CT-derived metabolic parameters for determination of whole-body tumor burden and treatment response in prostate cancer.

    Science.gov (United States)

    Schmidkonz, Christian; Cordes, Michael; Schmidt, Daniela; Bäuerle, Tobias; Goetz, Theresa Ida; Beck, Michael; Prante, Olaf; Cavallaro, Alexander; Uder, Michael; Wullich, Bernd; Goebell, Peter; Kuwert, Torsten; Ritt, Philipp

    2018-05-03

    We aimed at evaluating the role of 68 Ga-PSMA-11 PET/CT-derived metabolic parameters for assessment of whole-body tumor burden and its capability to determine therapeutic response in patients with prostate cancer. A total of 142 patients with biochemical recurrence of prostate cancer underwent PET/CT with [ 68 Ga]Ga-PSMA-HBED-CC ( 68 Ga-PSMA-11). Quantitative assessment of all 641 68 Ga-PSMA-11-positive lesions in the field of view was performed to calculate PSMA-derived parameters, including whole-body PSMA tumor volume (PSMA-TV) and whole-body total lesion PSMA (TL-PSMA), as well as the established SUVmax and SUVmean values. All PET-derived parameters were tested for correlation with serum PSA levels and for association with Gleason scores. In 23 patients who underwent 68 Ga-PSMA-11 PET/CT before and after therapy with either external beam radiation, androgen deprivation, or docetaxel chemotherapy, SUVmax and TL-PSMA were compared to radiographic response assessment of CT images based on RECIST 1.1 criteria and to biochemical response determined by changes of serum PSA levels. PSMA-TV and TL-PSMA demonstrated a significant correlation with serum PSA levels (P PET and biochemical response was 87% (95% confidence interval, 0.66-0.97; Cohen's κ = 0.78; P PET and CT were most likely due to limitations of CT and RECIST in rating small lymph nodes as metastases, as well as bone involvement, which was sometimes not detectable in CT. 68 Ga-PSMA-11 PET/CT-derived metabolic tumor parameters showed promising results for evaluation of treatment response. Especially, TL-PSMA demonstrated higher agreement rates with biochemical response compared to SUVmax. Larger, ideally prospective trials are needed to help to reveal the full potential of metabolic parameters derived from PET imaging with 68 Ga-PSMA-11.

  9. Evaluation of 137Cs body burden in inhabitants of Bryansk Oblast, Russian Federation, where a high incidence of thyroid cancer was observed after the accident at the Chernobyl nuclear power plant

    International Nuclear Information System (INIS)

    Sekitani, Y.; Hayashida, N.; Karevskaya, I. V.; Vasilitsova, O. A.; Kozlovsky, A.; Omiya, M.; Yamashita, S.; Takamura, N.

    2010-01-01

    To determine the current risk of internal radiation exposure after the Chernobyl accident, the 137 Cs body burden of the inhabitants of Bryansk Oblast (Russian Federation) was evaluated, from 1998 to 2008. The study population is composed of 84 666 people who visited Bryansk No. 2 Hospital. A whole-body counter was used for measurement of 137 Cs body burden. 137 Cs concentration was significantly higher in the late period during the study and showed seasonal variation, suggesting that inhabitants may have consumed contaminated forest products. However, people with high annual exposure doses were quite rare during all years of the study. In conclusion, although internal radiation exposure from 137 Cs continues to this day in Bryansk Oblast, the annual exposure dose is low in almost all inhabitants. Because of the long half-life of 137 Cs, the long term follow-up is necessary to monitor the health status and relieve the anxiety of the inhabitants around Chernobyl. (authors)

  10. Relationship between trace element content in human organs and hair - significance of hair mineral analysis as a means for assessing internal body burdens of environmental mineral pollutants. Final report for the period October 1984 - September 1988

    Energy Technology Data Exchange (ETDEWEB)

    Kinova, L [Bulgarian Academy of Sciences, Sofia (Bulgaria). Inst. of Nuclear Research and Nuclear Energy

    1988-12-31

    The purpose of the project was to establish a possibility to use hair as a monitor for internal body burden with toxic metals. For this purpose samples of human organs (heart, spleen, liver, kidney) and hair were analysed by neutron activation analysis and radiochemical techniques for the determination of As, Cd, Hg, Cu, Zn, Se, Ca, K, Mg, Mn, Na, S. 6 refs, 4 tabs.

  11. A comparison of mercury burdens between St. Marks National Wildlife Refuge and St. Andrew Bay, Florida: Evaluation of fish body burdens and physiological responses in largemouth bass, spotted seatrout, striped mullet, and sunfish

    Science.gov (United States)

    Huge, D.H.; Rauschenberger, R.H.; Wieser, F.M.; Hemming, J.M.

    2011-01-01

    Musculature from the dorsal region of 130 largemouth bass (Micropterus salmoides), 140 sunfish (Lepomis sp.), 41 spotted seatrout (Cynoscion nebulosus) and 67 striped mullet (Mugil cephalus) were collected from five estuarine and five freshwater sites within the St. Marks National Wildlife Refuge and two estuarine and two freshwater sites from St. Andrew Bay, Florida, United States of America. Musculature was analyzed for total mercury content, sagittal otoliths were removed for age determination and physiological responses were measured. Largemouth bass and sunfish from the refuge had higher mercury concentrations in musculature than those from the bay. Male spotted seatrout, male striped mullet, male and female sunfish and female largemouth bass had mercury burdens positively correlated with length. The majority of all four species of fish from both study areas contained mercury levels below 1.5 part per million, the limit for safe consumption recommended the Florida Department of Health. In comparison, a significant percentage of largemouth bass and sunfish from several sampled sites, most notably Otter Lake and Lake Renfroe within St. Marks National Wildlife Refuge, had mercury levels consistent with the health department's guidelines of 'limited consumption' or 'no consumption guidelines.'

  12. Relationship between selenium body burdens and tissue concentrations in fish exposed to coal ash at the Tennessee Valley Authority Kingston spill site

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, Teresa J [ORNL; Fortner, Allison M [ORNL; Jett, Robert T [ORNL; Peterson, Mark J [ORNL; Carriker, Neil [Tennessee Valley Authority (TVA); Morris, Jesse G [ORNL; Gable, Jennifer [Environmental Standards, Inc.

    2014-01-01

    In December 2008, 4.1 million m3 of coal ash were released into the Emory and Clinch Rivers by the Tennessee Valley Authority (TVA) Kingston Fossil Plant. Coal ash contains several contaminants, including the bioaccumulative metalloid selenium (Se). Because Se is predominantly accumulated in aquatic organisms through dietary, rather than aqueous exposure, tissue-based toxicity thresholds for Se are currently being considered. The proposed threshold concentrations range between 4-9 g/g Se (dry wt.) in whole body fish, with a proposed fillet threshold of 11.8 g/g. In the present study we examined the spatial and temporal trends in Se bioaccumulation and examined the relationship between the Se content in fillets and in whole bodies of fish collected around the Kingston spill site to determine whether Se bioaccumulation was a significant concern at the ash spill site. While Se concentrations in fish (whole bodies and fillets) were elevated at sampling locations affected by the Kingston ash spill relative to reference locations, concentrations do not appear to be above risk thresholds and have not been increasing over the five year period since the spill. Our results are not only relevant to guiding the human health and ecological risk assessments at the Kingston ash spill site, but because of current national discussions on appropriate guidelines for Se in fish as well for the disposal of coal combustion wastes, our results are also relevant to the general understanding of Se bioaccumulation in contaminated water bodies.

  13. Excess of Radiation Burden for Young Testicular Cancer Patients using Automatic Exposure Control and Contrast Agent on Whole-body Computed Tomography Imaging.

    Science.gov (United States)

    Niiniviita, Hannele; Kulmala, Jarmo; Pölönen, Tuukka; Määttänen, Heli; Järvinen, Hannu; Salminen, Eeva

    2017-06-01

    The aim of the study was to assess patient dose from whole-body computed tomography (CT) in association with patient size, automatic exposure control (AEC) and intravenous (IV) contrast agent. Sixty-five testicular cancer patients (mean age 28 years) underwent altogether 279 whole-body CT scans from April 2000 to April 2011. The mean number of repeated examinations was 4.3. The GE LightSpeed 16 equipped with AEC and the Siemens Plus 4 CT scanners were used for imaging. Whole-body scans were performed with (216) and without (63) IV contrast. The ImPACT software was used to determine the effective and organ doses. Patient doses were independent (p < 0.41) of patient size when the Plus 4 device (mean 7.4 mSv, SD 1.7 mSv) was used, but with the LightSpeed 16 AEC device, the dose (mean 14 mSv, SD 4.6 mSv) increased significantly (p < 0.001) with waist cirfumference. Imaging with the IV contrast agent caused significantly higher (13% Plus 4, 35% LightSpeed 16) exposure than non-contrast imaging (p < 0.001). Great caution on the use of IV contrast agent and careful set-up of the AEC modulation parameters is recommended to avoid excessive radiation exposure on the whole-body CT imaging of young patients.

  14. Diet, Lifestyle and Chronic disease burden

    NARCIS (Netherlands)

    Struijk, E.A.

    2014-01-01

    Background Diet, Body Mass Index (BMI), physical activity and smoking are among the most important lifestyle factors that influence global disease burden. In this thesis we investigate the relations of these factors with total disease burden in a large Dutch population, the EPIC-NL cohort. In this

  15. Human bones obtained from routine joint replacement surgery as a tool for studies of plutonium, americium and {sup 90}Sr body-burden in general public

    Energy Technology Data Exchange (ETDEWEB)

    Mietelski, Jerzy W., E-mail: jerzy.mietelski@ifj.edu.pl [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Edward B. [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Department of Physical Therapy Basics, Faculty of Physical Therapy, Administration College, Bielsko-Biala (Poland); Tomankiewicz, Ewa [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Joanna [Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Nowak, Sebastian [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Szczygiel, Elzbieta [Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Brudecki, Kamil [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland)

    2011-06-15

    The paper presents a new sampling method for studying in-body radioactive contamination by bone-seeking radionuclides such as {sup 90}Sr, {sup 239+240}Pu, {sup 238}Pu, {sup 241}Am and selected gamma-emitters, in human bones. The presented results were obtained for samples retrieved from routine surgeries, namely knee or hip joints replacements with implants, performed on individuals from Southern Poland. This allowed to collect representative sets of general public samples. The applied analytical radiochemical procedure for bone matrix is described in details. Due to low concentrations of {sup 238}Pu the ratio of Pu isotopes which might be used for Pu source identification is obtained only as upper limits other then global fallout (for example Chernobyl) origin of Pu. Calculated concentrations of radioisotopes are comparable to the existing data from post-mortem studies on human bones retrieved from autopsy or exhumations. Human bones removed during knee or hip joint surgery provide a simple and ethical way for obtaining samples for plutonium, americium and {sup 90}Sr in-body contamination studies in general public. - Highlights: > Surgery for joint replacement as novel sampling method for studying in-body radioactive contamination. > Proposed way of sampling is not causing ethic doubts. > It is a convenient way of collecting human bone samples from global population. > The applied analytical radiochemical procedure for bone matrix is described in details. > The opposite patient age correlations trends were found for 90Sr (negative) and Pu, Am (positive).

  16. Nerve Sheath Tumors in Neurofibromatosis Type 1: Assessment of Whole-Body Metabolic Tumor Burden Using F-18-FDG PET/CT.

    Directory of Open Access Journals (Sweden)

    Johannes Salamon

    Full Text Available To determine the metabolically active whole-body tumor volume (WB-MTV on F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT in individuals with neurofibromatosis type 1 (NF1 using a three-dimensional (3D segmentation and computerized volumetry technique, and to compare PET WB-MTV between patients with benign and malignant peripheral nerve sheath tumors (PNSTs.Thirty-six NF1 patients (18 patients with malignant PNSTs and 18 age- and sex-matched controls with benign PNSTs were examined by F-18-FDG PET/CT. WB-MTV, whole-body total lesion glycolysis (WB-TLG and a set of semi-quantitative imaging-based parameters were analyzed both on a per-patient and a per-lesion basis.On a per-lesion basis, malignant PNSTs demonstrated both a significantly higher MTV and TLG than benign PNSTs (p < 0.0001. On a per-patient basis, WB-MTV and WB-TLG were significantly higher in patients with malignant PNSTs compared to patients with benign PNSTs (p < 0.001. ROC analysis showed that MTV and TLG could be used to differentiate between benign and malignant tumors.WB-MTV and WB-TLG may identify malignant change and may have the potential to provide a basis for investigating molecular biomarkers that correlate with metabolically active disease manifestations. Further evaluation will determine the potential clinical impact of these PET-based parameters in NF1.

  17. Burden of Sexual Dysfunction.

    Science.gov (United States)

    Balon, Richard

    2017-01-02

    Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

  18. Dioxin body burden of persons living near incinerators and sintering plants: results from Belgium; Evaluation de la charge corporelle en dioxines des riverains d'incinerateurs et de la siderurgie: resultats d'une etude realisee en Belgique

    Energy Technology Data Exchange (ETDEWEB)

    Fierens, S.; Bernard, A. [Universite Catholique de Louvain (UCL), Unite de Toxicologie Industrielle et de Medecine du Travail, Faculte de Medecine, Louvain-la-Neuve (Belgium); Focant, J.F.; Eppe, G.; Pauw, E. de [Liege Univ., Lab. de Spectrometrie de Masse (CART) (Belgium)

    2005-01-15

    The aim of this study was to evaluate the impact on local residents' exposure to dioxines and coplanar PCBs (polychlorinated biphenyls) of two municipal solid waste incinerators (MSWI), one in an industrial area and the other in a rural zone, and two sintering plants, all located in Wallonia (Belgium). In all, 142 volunteers subjects living around these facilities and 63 volunteer referents from an unpolluted rural area were recruited and compared. They completed a self-administered questionnaire that furnished information about dietary habits, smoking habits, anthropometric characteristics, residential history and health status. They also provided blood samples under fasting conditions so that the body burden of dioxines (17 PCDD/Fs congeners) and coplanar PCBs could be assessed. After adjustment for co-variates determined by multiple linear regression analysis, serum concentrations of dioxines and coplanar PCBs in subjects living in the vicinity of the MSWI in the industrial area and of the sintering plants were similar to those of referents. In contrast, subjects living in the vicinity of the rural MSWI had significantly higher serum levels of dioxines (geometric mean, 38 vs 24 pg TEQ/g fat, p{<=}0.0001) and coplanar PCBs (geometric mean, 10.8 vs 7.0 pg TEQ/g fat, p{<=}0.05). Age-adjusted dioxin levels in referents did not vary with local animal fat consumption, but dioxin concentrations in subjects living around the MSWIs correlated positively with their intake of local animal fat, with levels almost doubled in subjects with the highest intake. These results show that the dioxines and coplanar PCBs emitted by MSWIs can indeed accumulate in the body of residents who consume animal products of local origin. (authors)

  19. Analytical quality assessment and interpretation of the trace element data obtained in the frame of the IAEA Co-ordinated Research Programme on the significance of hair mineral analysis as a means for assessing internal body burdens of environmental pollutants

    International Nuclear Information System (INIS)

    Goeij, J.J.M. de; Blaauw, M.; Zegers, C.

    1993-01-01

    At the request of the IAEA, the authors have performed an assessment of the analytical quality and the interpretation of the trace element data obtained within the framework of the IAEA Co-ordinated Research Programme (CRP) on The Significance of Hair Mineral Analysis as a Means of Assessing Internal Body Burdens of Environmental Pollutants. In this CRP research groups from various countries participated, using different analytical procedures, based on NAA, XRF and AAS. Data have been collected for Zn, CU, Pb, Cd, As, Hg, and Se in male human hair, liver, kidney, lung, brain, and bone. The samples analyzed originated from China, Hungary, Bulgaria, Japan, the former GDR, Sweden and Norway. The analytical quality of the data has been assessed on basis of the calculated limits of quantitation per trace element determined, per tissue analyzed and per participant, as well as from the trace element values found for reference materials and ''blind'' materials. The analytical quality of the data differs widely, from generally good to reasonable (Zn, Cu, and Se) to generally inadequate to strongly inadequate (Pb, Cd, As, and Hg). 15 refs, 29 tabs

  20. The Global Cancer Burden

    Centers for Disease Control (CDC) Podcasts

    2012-02-02

    This podcast describes the global burden of cancer and efforts by CDC and others to reduce that burden.  Created: 2/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/2/2012.

  1. Burden of Rabies

    Science.gov (United States)

    ... this? Submit Button Past Emails The Burden of Rabies Recommend on Facebook Tweet Share Compartir Learn how ... bitten by an animal that has the disease. Rabies in the U.S. Rabies continues to be a ...

  2. Examination of body burden and taint for Iceland scallop (Chlamys islandica) and American plaice (Hippoglossoides platessoides) near the Terra Nova offshore oil development over ten years of drilling on the Grand Banks of Newfoundland, Canada

    Science.gov (United States)

    DeBlois, Elisabeth M.; Kiceniuk, Joe W.; Paine, Michael D.; Kilgour, Bruce W.; Tracy, Ellen; Crowley, Roger D.; Williams, Urban P.; Gregory Janes, G.

    2014-12-01

    This paper presents results of analyses of body burdens of metals and hydrocarbons, and taste tests for taint, in Iceland scallop and American plaice performed as part of the Environmental Effects Monitoring (EEM) program for the Terra Nova offshore oil development (Grand Banks of Newfoundland, Canada). Scallop and plaice were collected in a Study Area located within approximately 1 km of drill centres at Terra Nova and in a Reference Area located approximately 20 km from the development. Samples were collected in 1997 to establish a baseline, and from 2000 to 2010, during drilling periods. Scallop adductor muscle tissue was contaminated with >C10-C21 aliphatic hydrocarbons resembling the drilling fluid in the synthetic drilling mud (SBM) used at Terra Nova in 2000, 2002 and 2004, but contamination of adductor muscle was not noted in 2006, 2008 and 2010. The maximum concentration in muscle was 28 mg/kg wet weight, noted in 2002. Scallop viscera was contaminated with hydrocarbons resembling drilling fluid in SBMs near drill centres in all EEM years except 2010. Viscera contamination with >C10-C21 hydrocarbons gradually decreased from a maximum of 150 mg/kg in 2000, to a maximum of 27 mg/kg in 2008; all values were below the laboratory reporting detection limit of 15 mg/kg in 2010. Therefore, evidence from both muscle and viscera indicates a decrease in tissue hydrocarbon contamination in recent years. Barium, another major constituent in drilling muds, has not been noted in scallop adductor muscles at concentrations above the reporting detection limit, but barium was detected in viscera in baseline and EEM years. The maximum concentration of barium in viscera during baseline sampling was 8 mg/kg. The maximum concentration in EEM years (29 mg/kg) was noted in 2000. The maximum concentration in 2010 was 25 mg/kg. The concentration of metals other than barium in scallop tissues was similar between the Terra Nova Study Area and the Reference Area. Hydrocarbons

  3. Burden control by artificial intelligence

    Energy Technology Data Exchange (ETDEWEB)

    Saxen, H.; Nikus, M. [Aabo Akademi, Turku (Finland). Heat Engineering Lab.

    1998-07-01

    The burden distribution plays an important role for the fuel economy of the blast furnace. By an appropriate burden distribution, the operation of the furnace is smooth and the gas is utilized well, the burden descends steadily and the wear of the lining is minimal. Since it is very difficult to obtain reliable information about the burden distribution in operating blast furnaces, this research project developed methods for interpretation of burden and gas distribution in the shaft mainly based on temperature measurements from above-burden probes.

  4. EAMJ Jan. Burden.indd

    African Journals Online (AJOL)

    2009-01-01

    Jan 1, 2009 ... developed world where the burden of disease is accurately determined. ... Projections indicate an expected yearly incidence of 15 to 20 million new .... of global mortality and burden of diseases from 2002 to 2030. Plos. Med.

  5. The psychosocial burden of psoriatic arthritis.

    Science.gov (United States)

    Husni, M Elaine; Merola, Joseph F; Davin, Sara

    2017-12-01

    To assess the psychosocial impact of psoriatic arthritis (PsA), describe how health-related quality of life (QoL) is affected in patients with PsA, discuss measures used to evaluate the psychosocial impact of PsA, and review studies examining the effect of therapy on QoL. A targeted review on the impact of PsA on QoL and the role of tailored psychosocial management in reducing the psychosocial burden of the disease was performed. PubMed literature searches were conducted using the terms PsA, psychosocial burden, QoL, and mood/behavioral changes. Articles were deemed relevant if they presented information regarding the psychosocial impact of PsA, methods used to evaluate these impacts, or ways to manage/improve management of PsA and its resulting comorbidities. The findings of this literature search are descriptively reviewed and the authors׳ expert opinion on their interpretation is provided. The psychosocial burden of PsA negatively affects QoL. Patients suffer from sleep disorders, fatigue, low-level stress, depression and mood/behavioral changes, poor body image, and reduced work productivity. Additionally, each patient responds to pain differently, depending on a variety of psychological factors including personality structure, cognition, and attention to pain. Strategies for evaluating the burdens associated with PsA and the results of properly managing patients with PsA are described. PsA is associated with a considerable psychosocial burden and new assessment tools, specific to PsA, have been developed to help quantify this burden in patients. Future management algorithms of PsA should incorporate appropriate assessment and management of psychological and physical concerns of patients. Furthermore, patients with PsA should be managed by a multidisciplinary team that works in coordination with the patient and their family or caregivers. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Effective dose and time-integrated effective dose to humans from internal contamination of 134Cs and 137Cs: Results from a compilation of a Swedish national database of internal body burden of radiocaesium in various populations between 1964 and 2002

    International Nuclear Information System (INIS)

    Raeaef, L.C.; Zakaria, M.; Hubbard, L.; Falk, R.; Aagren, G.; Vesanen, R.

    2003-01-01

    A compilation of data on the whole-body burden of 134 Cs, 137 Cs and 40 K in various Swedish populations between 1964 and 2002 has been made. The compilation was carried out in co-operation with the Department of Radiation Physics in Malmoe, the Swedish Radiation Protection Authority (SSI), the Swedish Defence Research Agency Department (FOI) and the Department of Radiation Physics, Goeteborg University. Individual body burden values have been inserted into a calculation spread sheet, with data on body weight, gender, age, occupation (if available) and place of residence. The database enables a study of the time-pattern and geographical dependence of radiocaesium transfer from ground deposition to man, and the associated absorbed dose. The Swedish government has assigned SSI the responsibility for obtaining and assuring one of Sweden's national environmental quality objectives, A Safe Radiation Environment. A natural consequence of this responsibility is that a means for quantifying progress towards the objective is necessary. The data compilation discussed here is one important component in the national environmental monitoring programme that is currently (2002) being developed at SSI. The new program for monitoring environmental radiation has the goal of following geographical and ecological differences in the radiological effects to both mankind and the environment, and assessing relevant doses and risks. During the period between 1964 and 2002, fallout of radiocaesium from nuclear weapons tests (only 137 Cs) and from the Chernobyl accident in 1986 (both 134 Cs and 137 Cs) have occurred in Sweden. The ground deposition of the radiocaesium has gradually been transferred through different ecological pathways to man. From the database it can be deduced that large regional variations in the body burden of radiocaesium in man have occurred through this period. Three populations exhibit considerably higher body content levels than others; (i) reindeer herders in

  7. Salmonella burden in Lebanon.

    Science.gov (United States)

    Malaeb, M; Bizri, A R; Ghosn, N; Berry, A; Musharrafieh, U

    2016-06-01

    Salmonellosis is a disease that represents a major public health concern in both developing and developed countries. The aim of this article is to evaluate the public health burden of Salmonella illness in Lebanon. The current scope of the Salmonella infection problem was assessed in relation to disease incidence and distribution with respect to age, gender and district. Factors that provide a better understanding of the magnitude of the problem were explored and highlighted. Data reported to the Epidemiologic Surveillance Department at the Lebanese Ministry of Public Health between 2001 and 2013 was reviewed. Information obtained was compared to information reported regionally and globally. The estimated true incidence was derived using multipliers from the CDC and Jordan. A literature review of all published data from Lebanon about Salmonella susceptibility/resistance patterns and its serious clinical complications was conducted. The estimated incidence was 13·34 cases/100 000 individuals, most cases occurred in the 20-39 years age group with no significant gender variation. Poor and less developed districts of Lebanon had the highest number of cases and the peak incidence was in summer. Reflecting on the projected incidence derived from the use of multipliers indicates a major discrepancy between what is reported and what is estimated. We conclude that data about Salmonella infection in Lebanon and many Middle Eastern and developing countries lack crucial information and are not necessarily representative of the true incidence, prevalence and burden of illness.

  8. Adjustment of a direct method for the determination of man body burden in Pu-239 on by X-ray detection of U-235; Mise au point d'une methode directe de determination de la charge corporelle en plutonium 239 chez l'homme par detection X de l'uranium 235

    Energy Technology Data Exchange (ETDEWEB)

    Boulay, P [Commissariat a l' Energie Atomique, Bruyeres-le-Chatel (France). Centre d' Etudes

    1968-04-01

    The use of Pu-239 on a larger scale sets a problem about the contamination measurement by aerosol at lung level. A method of direct measurement of Pu-239 lung burden is possible, thanks to the use of a large area window proportional counter. A counter of such pattern, has been especially carried out for this purpose. The adjustment of the apparatus allows an adequate sensibility to detect a contamination at the maximum permissible body burden level. Besides, a method for individual 'internal calibration', with a plutonium mock: the protactinium-233, is reported. (author) [French] L'utilisation a une echelle de plus en plus large du plutonium-239 pose un probleme de la mesure de la contamination par aerosol au niveau du poumon. Une methode de mesure directe de la charge pulmonaire en plutonium-239 est possible grace a l'utilisation d'un compteur proportionnel a fenetre de grande surface. Un compteur de ce type a specialement ete realise dans ce but. La mise au point de l'appareillage permet une sensibilite suffisante pour deceler une contamination au niveau de la Q.M.A (quantite maximale admissible). D'autre part, une methode 'd'etalonnage interne' de l'individu a l'aide d'un simulateur de plutonium, le protactinium-233, est decrite. (auteur)

  9. HIV / AIDS: An Unequal Burden

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 ... high-risk category, emphasizes Dr. Cargill. Photo: iStock HIV and Pregnancy Are there ways to help HIV- ...

  10. Socioeconomic burden of hereditary angioedema

    DEFF Research Database (Denmark)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen

    2014-01-01

    who were working or in school (n = 120), 72 provided work/school absenteeism data, resulting in an estimated 20 days missing from work/school on average per year; 51% (n = 84) indicated that HAE has hindered their career/educational advancement. CONCLUSION: HAE poses a considerable burden on patients...... and their families in terms of direct medical costs and indirect costs related to lost productivity. This burden is substantial at the time of attacks and in between attacks....

  11. Subclinical Disease Burden as Assessed by Whole-Body MRI in Subjects With Prediabetes, Subjects With Diabetes, and Normal Control Subjects From the General Population: The KORA-MRI Study.

    Science.gov (United States)

    Bamberg, Fabian; Hetterich, Holger; Rospleszcz, Susanne; Lorbeer, Roberto; Auweter, Sigrid D; Schlett, Christopher L; Schafnitzel, Anina; Bayerl, Christian; Schindler, Andreas; Saam, Tobias; Müller-Peltzer, Katharina; Sommer, Wieland; Zitzelsberger, Tanja; Machann, Jürgen; Ingrisch, Michael; Selder, Sonja; Rathmann, Wolfgang; Heier, Margit; Linkohr, Birgit; Meisinger, Christa; Weber, Christian; Ertl-Wagner, Birgit; Massberg, Steffen; Reiser, Maximilian F; Peters, Annette

    2017-01-01

    Detailed pathophysiological manifestations of early disease in the context of prediabetes are poorly understood. This study aimed to evaluate the extent of early signs of metabolic and cardio-cerebrovascular complications affecting multiple organs in individuals with prediabetes. Subjects without a history of stroke, coronary artery disease, or peripheral artery disease were enrolled in a case-control study nested within the Cooperative Health Research in the Region of Augsburg (KORA) FF4 cohort and underwent comprehensive MRI assessment to characterize cerebral parameters (white matter lesions, microbleeds), cardiovascular parameters (carotid plaque, left ventricular function, and myocardial late gadolinium enhancement [LGE]), and metabolic parameters (hepatic proton-density fat fraction [PDFF] and subcutaneous and visceral abdominal fat). Among 400 subjects who underwent MRI, 103 subjects had prediabetes and 54 had established diabetes. Subjects with prediabetes had an increased risk for carotid plaque and adverse functional cardiac parameters, including reduced early diastolic filling rates as well as a higher prevalence of LGE compared with healthy control subjects. In addition, people with prediabetes had significantly elevated levels of PDFF and total and visceral fat. Thus, subjects with prediabetes show early signs of subclinical disease that include vascular, cardiac, and metabolic changes, as measured by whole-body MRI after adjusting for cardiometabolic risk factors. © 2017 by the American Diabetes Association.

  12. Burden of Proof in Bioethics.

    Science.gov (United States)

    Koplin, Julian J; Selgelid, Michael J

    2015-11-01

    A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons. © 2015 John Wiley & Sons Ltd.

  13. Case report: heavy metal burden presenting as Bartter syndrome.

    Science.gov (United States)

    Crinnion, Walter J; Tran, Jessica Q

    2010-12-01

    Maternal transfer of heavy metals during fetal development or lactation possibly contributed to the clinical manifestations of Bartter syndrome and developmental delay in the offspring. An 11-month-old child diagnosed with Bartter syndrome and failure to thrive was treated concurrently for elevated metal burden while he was undergoing standard medical interventions. Treatment with body-weight doses of meso-2,3-dimercaptosuccinic acid (DMSA) reduced the body burden of lead, beryllium, copper, mercury, and cadmium at the three- and sixth-month follow-up tests. During the course of the six-month treatment, the patient gained 2.4 kg (5.2 lb) and grew approximately 9.5 cm (3.75 in). His weight shifted from significantly below the 5th percentile in weight to within the 5th percentile, and from below the 5th to within the 10th percentile for length. The child's acquisition of lead, beryllium, and copper correspond to his mother's history of stained glass assembly and occurred during fetal development or lactation, since there were no other identifiable sources that could have contributed to the heavy metal burden. Tests for known genetic mutations leading to Bartter syndrome were all negative. This case report highlights the potential benefit of DMSA for treatment of heavy metal body burden in infants who present with Bartter syndrome.

  14. School Trouble: A Mother's Burden.

    Science.gov (United States)

    Dudley-Marling, Curt

    2001-01-01

    Used interviews with a diverse group of parents of children who struggled academically in school to examine the effects of school troubles on mothers. Overall, the material and emotional burden for children's schoolwork fell to the mothers, many of whom felt overwhelmed and believed that the demands of schooling had diminished their quality of…

  15. Indigenous identity: burden or liberation?

    DEFF Research Database (Denmark)

    Steur, Luisa Johanna

    2010-01-01

    With the rise of ‘adivasi’ (‘indigenous’ or ‘tribal’) movements in different parts of South Asia in the past two decades, the question of how to understand ‘adivasi identity’ has become hotly debated: is it a burden, inviting distorted stereotypical depictions of subaltern people...

  16. The Physical Burdens of Secrecy

    Science.gov (United States)

    Slepian, Michael L.; Masicampo, E. J.; Toosi, Negin R.; Ambady, Nalini

    2012-01-01

    The present work examined whether secrets are experienced as physical burdens, thereby influencing perception and action. Four studies examined the behavior of people who harbored important secrets, such as secrets concerning infidelity and sexual orientation. People who recalled, were preoccupied with, or suppressed an important secret estimated…

  17. Body burdens of polybrominated diphenyl ethers among urban anglers.

    Science.gov (United States)

    Morland, Kimberly B; Landrigan, Philip J; Sjödin, Andreas; Gobeille, Alayne K; Jones, Richard S; McGahee, Ernest E; Needham, Larry L; Patterson, Donald G

    2005-12-01

    Polybrominated diphenyl ethers (PBDEs) have been widely used in the United States and worldwide as flame retardants. Recent PBDE production figures show that worldwide use has increased. To determine whether fish consumption is a source of PBDE exposure for humans, a cross-sectional epidemiologic study of New York and New Jersey urban anglers was conducted during the summers of 2001-2003. Frequency of local fish consumption was assessed by questionnaire, and blood samples for PBDE analysis were collected from 94 anglers fishing from piers on the lower Hudson River and Newark Bay. We analyzed PBDEs by gas chromatography-isotope dilution-high-resolution mass spectrometry. The congeners found in anglers' serum at the highest concentrations were, by International Union of Pure and Applied Chemistry numbers, BDE-47, BDE-153, and BDE-99. Anglers reporting consumption of local fish had higher, but nonstatistically significantly different, concentrations of PBDEs than did anglers who did not eat local fish. For some congeners (BDE-100 and BDE-153), we observed moderate dose-response relationships between serum PBDE levels and frequency of reported fish intake. These findings suggest that consumption of locally caught fish is not a major route of human exposure for this study population.

  18. Phenobarbital treatments lower DDT body burden in rhesus monkeys

    Energy Technology Data Exchange (ETDEWEB)

    Ferguson, P.W.; Clark, C.R.; Gee, S.J.; Krieger, R.I.

    1981-01-01

    Decreased DDT, DDD, DDE in blood and DDA in urine followed phenobarbital treatments (10 mg/kg/day, 11 days, intramuscular (im)) in three male rhesus monkeys (Macaca mulatta). Animals were fed DDT diets containing up to 500 ppm DDT during a 3-year period. Induction of liver monooxygenases was confirmed by reduced in vivo antipyrine plasma half-life and increased in vitro oxidation rates of dihydroisodrin, p-nitroanisole and benz(alpha)pyrene by homogenates of liver obtained from closed needle biopsy. Chlorohydrocarbon blood levels significantly decreased during the induction period (days 1-11). Concentrations on day 28 were at or below pre-DDT exposure levels. Urine DDA gradually decreased in all monkeys from days 16 to 28.

  19. Do fish growth rates correlate with PCB body burdens?

    Science.gov (United States)

    Andrew L. Rypel; David R.. Bayne

    2010-01-01

    We evaluated whether growth rates of six fish species correlated with PCB concentrations in a moderately-to-heavily polluted freshwater ecosystem. Using a large dataset (n ¼ 984 individuals), and after accounting for growth effects related to fish age, habitat, sex, and lipids, growth correlated significantly, but positively with lipid-corrected PCB concentrations for...

  20. The burden of cesium 137 in forest clerks

    International Nuclear Information System (INIS)

    Piechotowski, I.; Jaroni, J.; Link, B.; Groezinger, O.

    2000-01-01

    In 47 forest clerks from the regions Ortenau and Oberschwaben in south-west Germany the incorporation of cesium 137 and potassium 40 was measured in autumn 1994. Soil burden as well as burden of nutrition with cesium 137 are different in these regions for geological reasons and as a result of the nuclear accident of Chernobyl. Caused by low content of clay in Oberschwaben, the transfer of cesium to plants is assisted. Heavy rainfall after the nuclear accident led to an additional increase of burden. The median of the concentration of cesium 137 was 1.4 Bq/kg body weight. The median for potassium 40 was 58 Bq/kg body weight. For cesium 137 regional differences were observed. For persons from Oberschwaben the median for cesium 137 was with 2.8 Bq/kg body weight clearly higher than for persons from Ortenau with 0,6 Bq/kg body weight. Concerning nutrition habits, the clearest difference was found comparing persons who had ate a minimum of four portions of deer from the surroundings within the last four weeks with persons who had ate less than four portions of deer from the surroundings within the last four weeks. The difference was greater in Oberschwaben than in Ortenau. The effective dose of cesium 137 calculated on the basis of the incorporation is very low compared to natural radiation. This is also valid for persons from Oberschwaben. (orig.) [de

  1. The Relationship between Sleep Quality and Brain Amyloid Burden.

    Science.gov (United States)

    Brown, Belinda M; Rainey-Smith, Stephanie R; Villemagne, Victor L; Weinborn, Michael; Bucks, Romola S; Sohrabi, Hamid R; Laws, Simon M; Taddei, Kevin; Macaulay, S Lance; Ames, David; Fowler, Christopher; Maruff, Paul; Masters, Colin L; Rowe, Christopher C; Martins, Ralph N

    2016-05-01

    To evaluate the association between self-reported sleep quality and levels of brain β-amyloid (Aβ) burden, and to determine the effect of the apolipoprotein E (APOE) ε4 allele on any associations found. This study is a cross-sectional analysis of 184 cognitively healthy men and women aged over 60 y. We measured sleep quality factors: specifically, sleep duration, latency (time taken to fall asleep), disturbances, efficiency, daytime dysfunction, and overall sleep quality, using the Pittsburgh Sleep Quality Index. All participants underwent Aβ positron emission tomography imaging for the quantification of brain Aβ burden and were APOE genotyped. Linear regression analyses were used to evaluate the relationship between sleep quality factors and brain Aβ burden, adjusting for age, body mass index, cardiovascular disease, and symptoms of depression, with APOE ε4 carriage entered as a moderator. Of the sleep factors, longer sleep latency was associated with higher levels of brain Aβ (B = 0.003 [standard error = 0.001], P = 0.02). APOE ε4 allele (carrier/noncarrier) did not moderate the relationship between sleep latency and brain Aβ burden. Our findings suggest a relationship between brain Aβ burden and sleep latency, independent of APOE ε4 genotype. © 2016 Associated Professional Sleep Societies, LLC.

  2. The increasing burden of depression

    Directory of Open Access Journals (Sweden)

    Lépine J-P

    2011-05-01

    Full Text Available Jean-Pierre Lépine1, Mike Briley21Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris Unité INSERM 705 CNRS UMR 8206, Université Paris Diderot, Paris, France; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Recent epidemiological surveys conducted in general populations have found that the lifetime prevalence of depression is in the range of 10% to 15%. Mood disorders, as defined by the World Mental Health and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, have a 12-month prevalence which varies from 3% in Japan to over 9% in the US. A recent American survey found the prevalence of current depression to be 9% and the rate of current major depression to be 3.4%. All studies of depressive disorders have stressed the importance of the mortality and morbidity associated with depression. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Recent studies have also shown the importance of depression as a risk factor for cardiovascular death. The risk of cardiac mortality after an initial myocardial infarction is greater in patients with depression and related to the severity of the depressive episode. Greater severity of depressive symptoms has been found to be associated with significantly higher risk of all-cause mortality including cardiovascular death and stroke. In addition to mortality, functional impairment and disability associated with depression have been consistently reported. Depression increases the risk of decreased workplace productivity and absenteeism resulting in lowered income or unemployment. Absenteeism and presenteeism (being physically present at work but functioning suboptimally have been estimated to result in a loss of $36.6 billion per year in the US. Worldwide projections by the World Health Organization for the year 2030 identify unipolar major depression as the leading cause of disease burden

  3. Schizophrenia: management and family burden.

    Science.gov (United States)

    Sebit, M B

    2007-01-01

    To explore schizophrenia with respect to its management, causes, risk factors as well as the impact it has in families regarding the burden and social networks support. Desk literature reviews. The findings are that patients with schizophrenia typically have great difficulty following a medication regimen, but they also have the greatest potential for benefiting from adherence. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services, enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. Finally, this paper is not exhaustive, but a pointer for further readings.

  4. Burden of pediatric hepatitis C

    OpenAIRE

    El-Shabrawi, Mortada Hassan; Kamal, Naglaa Mohamed

    2013-01-01

    Hepatitis C virus (HCV) is a major health burden infecting 170-210 million people worldwide. Additional 3-4 millions are newly-infected annually. Prevalence of pediatric infection varies from 0.05%-0.36% in the United States and Europe; up to 1.8%-5.8% in some developing countries. The highest prevalence occurs in Egypt, sub-Saharan Africa, Amazon basin and Mongolia. HCV has been present in some populations for several centuries, notably genotypes 1 and 2 in West Africa. Parenteral anti-schis...

  5. Burden of pediatric hepatitis C.

    Science.gov (United States)

    El-Shabrawi, Mortada Hassan; Kamal, Naglaa Mohamed

    2013-11-28

    Hepatitis C virus (HCV) is a major health burden infecting 170-210 million people worldwide. Additional 3-4 millions are newly-infected annually. Prevalence of pediatric infection varies from 0.05%-0.36% in the United States and Europe; up to 1.8%-5.8% in some developing countries. The highest prevalence occurs in Egypt, sub-Saharan Africa, Amazon basin and Mongolia. HCV has been present in some populations for several centuries, notably genotypes 1 and 2 in West Africa. Parenteral anti-schistosomal therapy practiced in the 1960s until the early 1980s had spread HCV infection throughout Egypt. Parenteral acquisition of HCV remains a major route for infection among Egyptian children. Insufficient screening of transfusions, unsterilized injection equipment and re-used needles and syringes continue to be major routes of HCV transmission in developing countries, whereas vertical transmission and adolescent high-risk behaviors (e.g., injection drug abuse) are the major routes in developed countries. The risk of vertical transmission from an infected mother to her unborn/newborn infant is approximately 5%. Early stages of HCV infection in children do not lead to marked impairment in the quality of life nor to cognitive, behavioral or emotional dysfunction; however, caregiver stress and family system strain may occur. HCV slowly progresses to serious complications as cirrhosis (1%-2%) and hepatocellular carcinoma (HCC) especially in the presence of risk factors as hemolytic anemias, obesity, treated malignancy, and concomitant human immune deficiency and/or hepatitis B virus co-infection. HCV vaccine remains elusive to date. Understanding the immune mechanisms in patients who successfully cleared the infection is essential for vaccine development. The pediatric standard of care treatment consists of pegylated interferon-α 2a or b plus ribavirin for 24-48 wk. The new oral direct acting antivirals, approved for adults, need further evaluation in children. Sustained

  6. 45 CFR 672.17 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Burden of presentation; burden of persuasion. 672.17 Section 672.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.17 Burden of presentation; burden of persuasion. The...

  7. 40 CFR 305.33 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 305.33 Section 305.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Hearing Procedure § 305.33 Burden of presentation; burden of persuasion. The Requestor has the burden of... justified. Accordingly, the Requestor bears the burdens of presentation and persuasion. Following the...

  8. Caregiving burden and its determinants in Polish caregivers of stroke survivors.

    Science.gov (United States)

    Jaracz, Krystyna; Grabowska-Fudala, Barbara; Górna, Krystyna; Kozubski, Wojciech

    2014-10-27

    Despite the growing body of literature on the consequences of providing non-professional care to stroke survivors, the determinants of caregiving burden are still not fully recognized. Identification of significant determinants can facilitate caregiver intervention programs. The aim of this study was to evaluate the level of burden borne by caregivers of stroke patients and to identify the most important determinants of burden at 6 months after hospitalization. Data were collected from 150 pairs of stroke patients/caregivers. Caregiver burden was assessed on the Caregiver Burden scale (CB). Several characteristics were measured as potential predictors of the burden. Special attention was paid to the caregiver's sense of coherence (SOC) and anxiety. Regression analysis was employed to test the hypothesized relationships between these variables and the burden. Forty-seven percentage of the caregivers reported a substantial burden (severe or moderate). Caregiver SOC (p emotional state and the level of patients' dependency, as these are the vital and modifiable factors affecting caregiver burden following stroke.

  9. The burden of allergic rhinitis.

    Science.gov (United States)

    Nathan, Robert A

    2007-01-01

    Although formerly regarded as a nuisance disease, allergic rhinitis (AR) has a considerable effect on quality of life and can have significant consequences if left untreated. The total burden of this disease lies not only in impaired physical and social functioning but also in a financial burden made greater when considering evidence that AR is a possible causal factor in comorbid diseases such as asthma or sinusitis. Compared with matched controls, patients with AR have an approximate twofold increase in medication costs and 1.8-fold the number of visits to health practitioners. Hidden direct costs include the treatment of comorbid asthma, chronic sinusitis, otitis media, upper respiratory infection, and nasal polyposis. Nasal congestion, the most prominent symptom in AR, is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse. Furthermore, sleep-disordered breathing in childhood and adolescence is associated with increased disorders of learning performance, behavior, and attention. In the United States, AR results in 3.5 million lost workdays and 2 million lost schooldays annually. Patients struggle to alleviate their misery, frequently self-adjusting their treatment regimen of over-the-counter and prescription medications because of lack of efficacy, deterioration of efficacy, lack of 24-hour relief, and bothersome side effects. Ironically, health care providers overestimate patient satisfaction with therapy. Therefore, improvement in patient-practitioner communication may enhance patient adherence with prescribed regimens.

  10. The global burden of cholera

    Science.gov (United States)

    Lopez, Anna Lena; You, Young Ae; Kim, Young Eun; Sah, Binod; Maskery, Brian; Clemens, John

    2012-01-01

    Abstract Objective To estimate the global burden of cholera using population-based incidence data and reports. Methods Countries with a recent history of cholera were classified as endemic or non-endemic, depending on whether they had reported cholera cases in at least three of the five most recent years. The percentages of the population in each country that lacked access to improved sanitation were used to compute the populations at risk for cholera, and incidence rates from published studies were applied to groups of countries to estimate the annual number of cholera cases in endemic countries. The estimates of cholera cases in non-endemic countries were based on the average numbers of cases reported from 2000 to 2008. Literature-based estimates of cholera case-fatality rates (CFRs) were used to compute the variance-weighted average cholera CFRs for estimating the number of cholera deaths. Findings About 1.4 billion people are at risk for cholera in endemic countries. An estimated 2.8 million cholera cases occur annually in such countries (uncertainty range: 1.4–4.3) and an estimated 87 000 cholera cases occur in non-endemic countries. The incidence is estimated to be greatest in children less than 5 years of age. Every year about 91 000 people (uncertainty range: 28 000 to 142 000) die of cholera in endemic countries and 2500 people die of the disease in non-endemic countries. Conclusion The global burden of cholera, as determined through a systematic review with clearly stated assumptions, is high. The findings of this study provide a contemporary basis for planning public health interventions to control cholera. PMID:22461716

  11. Burden of Stroke in Qatar.

    Science.gov (United States)

    Ibrahim, Faisal; Deleu, Dirk; Akhtar, Naveed; Al-Yazeedi, Wafa; Mesraoua, Boulenouar; Kamran, Sadaat; Shuaib, Ashfaq

    2015-12-01

    Qatar is located on the northeastern coast of the Arabian Peninsula. The total population is over 2.1 million with around 15% being Qatari citizens. Hamad General Hospital (HGH) is the only tertiary referral governmental hospital in Qatar which admits acute (thrombolysis-eligible) stroke patients. To provide an overview of the burden of stroke in Qatar. Data from literature databases, online sources and our stroke registry were collated to identify information on the burden of stroke in Qatar. Overall, over 80% of all stroke patients in Qatar are admitted in HGH. In 2010, the age-standardized incidence for first-ever ischemic stroke was 51.88/100,000 person-years. To date our stroke registry reveals that 79% of all stroke patients are male and almost 50% of stroke patients are 50 years or less. Hypertension, diabetes and dyslipidemia are the main predisposing factors for stroke, with ischemic stroke being more common (87%) than hemorrhagic stroke (13%). Despite the lack of a stroke unit, 9% of ischemic stroke patients are being thrombolyzed. However the presence of a stroke ward allows swift turnover of patients with a length of stay of less than 5 days before discharge or, if required, transfer to the fully-equipped hospital-based rehabilitation service. Several community awareness programs are ongoing, in addition to several research programs funded by the Qatar National Research Fund and Hamad Medical Corporation. In a country where over 15% of the population suffers from diabetes there is continuous need for national community-based awareness campaigns, prevention and educational programs particularly targeting patients and health care workers. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Possible use of wild-living rats (Rattus norvegicus) as bioindicators for heavy metal pollution. Part 2. Body burden calculations for identification of depot compartments; Untersuchungen zur Eignung wildlebender Wanderratten (Rattus norvegicus) als Indikatoren der Schwermetallbelastung. Teil 2. Die Berechnung der Koerperlast zur Identifikation von Depotkompartimenten

    Energy Technology Data Exchange (ETDEWEB)

    Wuenschmann, S. [Internationales Hochschulinstitut Zittau, Lehrstuhl Umweltverfahrenstechnik, Zittau (Germany); Hochschule Zittau/Goerlitz, Fachbereich Mathematik/Naturwissenschaften, Zittau (Germany); Oehlmann, J. [J.W. Goethe-Univ. Frankfurt, Zoologisches Inst., Frankfurt/M. (Germany); Delakowitz, B. [Hochschule Zittau/Goerlitz, Fachbereich Mathematik/Naturwissenschaften, Zittau (Germany); Markert, B. [Internationales Hochschulinstitut Zittau, Lehrstuhl Umweltverfahrenstechnik, Zittau (Germany)

    2002-07-01

    Background concentrations of eleven elements in tissues and organs of wild-living rats (Rattus norvegicus) obtained from a region (Euroregion Neisse, around the trilateral border region of Germany, Poland and the Czech Republic) distinguished by low to intermediate levels of environmental contaminations are given in part I of this work. In order to identify the most important depot compartments for certain elements, a body burden method was applied. Differences of affinity due to sex and age of analyzed rats are discussed, as are the suitability of specific organs and tissues with regard to bioaccumulation measurements concerning metals. The principal depot compartments for the heavy metals Cu, Mn, Cd, (in adult rats) and Tl are the liver and kidneys, whereas the elements Ni, Sr, Pb (for adult animals) and Ti are more affinitively to bones. Co and Zn displayed a more pronounced affinity towards tissues of the bones and liver. The analysis revealed large differences in Cd and Pb distributions both among young and adult rats, and with respect to sexes. It can be concluded that the distribution of the elements investigated in this study in free-living rats agrees with that in man, except for that of Ni. The above agreement gives proof of the possibility to use depot organs of rats for bioindication which was already mentioned in part I of this work. (Sex and age-related quantification of Al, As, Cd, Co, Cu, Mn, Ni, Pb, Sr, Ti, Tl and Zn in liver, heart, lung, kidney, muscle, brain and bones and establishment of distribution patterns'). (orig.) [German] Die in Teil I quantifizierten Hintergrundkonzentrationen von 11 Elementen in Geweben und Organen wildlebender Ratten (Rattus norvegicus) aus einem gering bis maessig belasteten Untersuchungsgebiet (Euroregion Neisse) werden im 2. Teil fuer die Berechnung ihres relativen Beitrags zur Gesamtkoerperbelastung (Koerperlast oder Bodyburden) verwendet, um bevorzugte Depotkompartimente fuer die untersuchten Elemente

  13. The Humanistic and Economic Burden of Narcolepsy.

    Science.gov (United States)

    Flores, Natalia M; Villa, Kathleen F; Black, Jed; Chervin, Ronald D; Witt, Edward A

    2016-03-01

    To evaluate the burden of narcolepsy--with respect to psychiatric comorbidities, Health-Related Quality of Life (HRQoL), direct costs for healthcare resource utilization, and indirect costs for reported work loss-through comparison of patients to matched controls. This analysis was conducted on data from the 2011, 2012, and 2013 US National Health and Wellness Survey (NHWS; 2011 NHWS n = 75,000, 2012 NHWS n = 71,157, and 2013 NHWS n = 75,000). Patients who reported a narcolepsy diagnosis (n = 437) were matched 1:2 with controls (n = 874) on age, sex, race/ethnicity, marital status, education, household income, body mass index, smoking status, alcohol use, exercise, and physical comorbidity. Chi-square tests and one-way analyses of variance were used to assess whether the narcolepsy and control groups differed on psychiatric comorbidities, HRQoL, labor force participation, work productivity, and healthcare resource utilization. Patients with narcolepsy, in comparison to matched controls, reported substantially (two to four times) greater psychiatric comorbidity, HRQoL impairment, prevalence of long-term disability, absenteeism, and presenteeism, and greater resource use in the past 6 mo as indicated by higher mean number of hospitalizations, emergency department visits, traditional healthcare professional visits, neurologist visits, and psychiatrist visits (each p productivity through effective assessment and treatment of narcolepsy. © 2016 American Academy of Sleep Medicine.

  14. The Burden of Schizophrenia on Caregivers

    OpenAIRE

    Filiz Adana; Hulya Arslantas

    2011-01-01

    Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family suc...

  15. Caregiver Burden in Alcohol Dependence Syndrome

    Directory of Open Access Journals (Sweden)

    Ramanujam Vaishnavi

    2017-01-01

    Full Text Available Background. Alcoholism is a major threat to the individual as well as the society and the maximum burden of the illness is borne by the family. Aim. The study is aimed at assessing the pattern of burden on the caregivers of alcohol dependent patients and at assessing the relationship between the severity of dependence and the burden on caregivers. Settings and Design. Cross-sectional descriptive study conducted in the Department of Psychiatry, Sri Ramachandra Medical College and Research Institute. Materials and Methods. A cross-sectional assessment was done in 200 patients with alcohol dependence and their caregivers. The severity of dependence and the pattern of burden on caregivers were assessed. Statistical Analysis. The data thus collected was analyzed using SPSS version 20. Results. The study demonstrates that caregivers of alcohol dependent patients reported significant objective burden and subjective burden. Furthermore, the severity of alcohol dependence and the domains of burden such as financial burden, disruption of family interaction, and disruption of family routine activities were positively correlated with high level of significance. Conclusion. The current study has illustrated that all the caregivers experienced significant amount of burden which has to be addressed for better treatment outcome of the patients.

  16. The burden of illness in patients with hereditary angioedema.

    Science.gov (United States)

    Banerji, Aleena

    2013-11-01

    Hereditary angioedema (HAE) is a rare genetic disease characterized by long-term recurrent attacks of subcutaneous or submucosal edema in different parts of the body. A comprehensive review of the literature on burden of illness for patients with HAE is presented. A Boolean search was performed using MEDLINE and EMBASE databases and the Internet. Articles discussing aspects of the burden of illness in HAE were selected. Topics focused on the course of the disease, nature of attacks, treatment, quality of life, and costs. Hereditary angioedema is associated with a significant and multifaceted disease burden. Diagnosis is often delayed for years, with patients receiving ineffective treatment and unnecessary medical procedures before diagnosis. HAE attacks are painful, unpredictable, and debilitating and often require emergency medical attention. Attacks can affect a patient's daily activities, including work or schooling. Depression and anxiety are prevalent in patients with HAE. Recent advances in treatment provide patients with effective and well-tolerated prophylactic and on-demand therapeutic options. However, end points specific to HAE that better measure the impact of treatment on disease burden are lacking. Furthermore, there is a notable paucity of literature directed toward physicians who are instrumental in diagnosing and treating patients with HAE (eg, emergency department). More publications are broadening the understanding of HAE. However, important gaps remain. Effective management of HAE requires a more comprehensive understanding of the disease burden so that disease management can be individualized to meet specific patient needs. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. The Body Burden of Caesium-137 in People of Southern Finland 1961-1963; Charge Corporelle de Cesium 137 chez les Habitants de la Finlande Meridionale en 1961-1963; 0421 041e 0414 ; Carga Corporal de Cesio-137 en Ciertos Grupos Demograficos del Sur de Finlandia en 1961-1963

    Energy Technology Data Exchange (ETDEWEB)

    Haesaenen, E.; Miettinen, J. K. [Department of Radiochemistry, University of Helsinki (Finland)

    1964-11-15

    In connection with the investigations of the caesium-137, body burden of Finnish Lapps several measurements of smaller groups of people living in Southern Finland were carried out. In November 1961 eleven Helsinki inhabitants, five men and six women, 15 to 54 yr. old, were counted for caesium-137 and potassium in Stockholm. None of these persons were laboratory workers, two were schoolboys. They were apparently healthy. Their diet was studied by the interview method. Ten of these people were counted again in the mobile whole-body counter of the Radiochemical Department of the University of Helsinki one year later. The average body burden of caesium-137 in men (5, average age 29) had increased from 8.4 nc in November 1961 to 18.4 nc in November 1962, in women (5, average age 34) from 2.9 nc to 8.7 nc. Potassium contents were the same within 2% (men 140 g, women, 100 g) For more detailed studies larger control groups were selected at the beginning of 1963 and counted four times, in February, May, August and October. For the group of men 25 privates of an infantry battalion (age 19, average weight 65 kg), for women 24 girl students of a household school (age 22, average weight 60 kg), were selected. In both cases the diet could be checked in detail and could be considered to be an average Finnish diet. In addition, the individual food consumption of each subject was studied by interview with the aid of weighed samples. Caesium-137 contents of both diets were determined for the time periods between the measurements. In both groups the caesium-137 content remained about constant (men, 17,5 nc; women, 11 nc) until the end of June, when the caesium-137 content of milk and meat was approximately doubled within about one week. At the end of August the body burden of caesium-137 had increased in, both groups to about 40% above the spring level in the middle of October the men's values had increased by 22%, the women's values by 14% of the August level. The determination of

  18. Incidental Findings in Imaging Research: Evaluating Incidence, Benefit and Burden

    Science.gov (United States)

    Orme, Nicholas M.; Fletcher, Joel G.; Siddiki, Hassan A.; Harmsen, W. Scott; O’Byrne, Megan M.; Port, John D.; Tremaine, William J.; Pitot, Henry C.; McFarland, Beth; Robinson, Marguerite E.; Koenig, Barabara A.; King, Bernard F.; Wolf, Susan M.

    2013-01-01

    Context Little information exists concerning the frequency of clinically significant incidental findings (IFs) identified in the course of imaging research across a broad spectrum of imaging modalities and body regions. Objective To estimate the frequency with which research imaging IFs generate further clinical action, and the medical benefit/burden of identifying these IFs. Design, Setting, and Participants Retrospective review of subjects undergoing a research imaging exam that was interpreted by a radiologist for IFs in the first quarter of 2004, with 3-year clinical follow-up. An expert panel reviewed IFs generating clinical action to determine medical benefit/burden based on predefined criteria. Main Outcome Measures Frequency of (1) IFs that generated further clinical action by modality, body part, age, gender, and (2) IFs resulting in clear medical benefit or burden. Results 1376 patients underwent 1426 research imaging studies. 40% (567/1426) of exams had at least one IF (1055 total). Risk of an IF increased significantly by age (OR=1.5; [1.4–1.7=95% C.I.] per decade increase). Abdominopelvic CT generated more IFs than other exams (OR=18.9 compared with ultrasound; 9.2% with subsequent clinical action), with CT Thorax and MR brain next (OR=11.9 and 5.9; 2.8% and 2.2% with action, respectively). Overall 6.2% of exams (35/567) with an IF generated clinical action, resulting in clear medical benefit in 1.1% (6/567) and clear medical burden in 0.5% (3/567). In most instances, medical benefit/burden was unclear (4.6%; 26/567). Conclusions The frequency of IFs in imaging research exams varies significantly by imaging modality, body region and age. Research imaging studies at high risk for generating IFs can be identified. Routine evaluation of research images by radiologists may result in identification of IFs in a substantial number of cases and subsequent clinical action to address them in much smaller number. Such clinical action can result in medical

  19. BODY COMPOSITION OF A MILITARY POPULATION FT. CARSON 1963. I. BODY DENSITY, FAT, AND POTASSIUM 40.

    Science.gov (United States)

    Body volumes were measured on 97 soldiers between the ages of 17 - 52 years by water displacement volumetry and corrected for respiratory gas by a...Effective ranking of body fat burden of populations was demonstrated by body volumetry and age differences were noted from potassium 40 counting. A

  20. Formalising arguments about the burden of persuasion.

    NARCIS (Netherlands)

    Prakken, H.; Sartor, G.

    2007-01-01

    This paper presents an argument-based logic for reasoning about allocations of the burden of persuasion. The logic extends the system of Prakken (2001), which in turn modified the system of Prakken & Sartor (1996) with the possibility to distribute the burden of proof over both sides in an argument

  1. 40 CFR 22.24 - Burden of presentation; burden of persuasion; preponderance of the evidence standard.

    Science.gov (United States)

    2010-07-01

    ... persuasion; preponderance of the evidence standard. 22.24 Section 22.24 Protection of Environment... Burden of presentation; burden of persuasion; preponderance of the evidence standard. (a) The complainant has the burdens of presentation and persuasion that the violation occurred as set forth in the...

  2. 40 CFR 179.91 - Burden of going forward; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 179.91 Section 179.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...; burden of persuasion. (a) The party whose request for an evidentiary hearing was granted has the burden... FFDCA has the burden of persuasion in the hearing on that issue, whether the proceeding concerns the...

  3. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    J.D. Stanaway (Jeffrey D.); D.S. Shepard (Donald); E.A. Undurraga (Eduardo); Halasa, Y.A. (Yara A); L.E. Coffeng (Luc); Brady, O.J. (Oliver J); Hay, S.I. (Simon I); Bedi, N. (Neeraj); I.M. Bensenor (Isabela M.); C.A. Castañeda-Orjuela (Carlos A); T.-W. Chuang (Ting-Wu); K.B. Gibney (Katherine B); Z.A. Memish (Ziad); A. Rafay (Anwar); K.N. Ukwaja (Kingsley N); N. Yonemoto (Naohiro); C.J.L. Murray (Christopher)

    2016-01-01

    textabstractBackground Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and

  4. Body Hair

    Science.gov (United States)

    ... girlshealth.gov/ Home Body Puberty Body hair Body hair Even before you get your first period , you ... removing pubic hair Ways to get rid of hair top Removing body hair can cause skin irritation, ...

  5. The humanistic burden of hereditary angioedema: results from the Burden of Illness Study in Europe.

    Science.gov (United States)

    Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen; Hautamaki, Emily; Sisic, Zlatko; Wait, Suzanne; Boysen, Henrik B

    2014-01-01

    Hereditary angioedema (HAE) is a rare but potentially life-threatening disease marked by spontaneous, recurrent attacks of swelling. The broad range of consequences of HAE on patients' lives is not well understood. The study objective was to comprehensively characterize the burden of illness and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical and emotional impacts. One hundred eighty-six patients participated; 59% reported having an attack at least once a month, 67% reported moderate-to-severe pain during their last attack, and 74% reported moderate-to-severe swelling. The most common sites of the last attack were the abdomen and extremities; 24% experienced an attack in more than one site. The impact of HAE on daily activities was high during attacks and did not vary significantly by body site affected; patients also reported that HAE impacted their daily activities between attacks. Patients reported substantial anxiety about future attacks, traveling, and passing HAE to their children. Based on Hospital Anxiety and Depression Scale scores, 38 and 14% had clinically meaningful anxiety and depression, respectively. Despite standard of care, HAE patients still have frequent and painful attacks. Patients experience substantial impairment physically and emotionally both during and between attacks. A better understanding of these effects may help in the clinical management of HAE patients.

  6. 137Cs radiation burden on children from a highly contaminated area of Belarus

    International Nuclear Information System (INIS)

    Kortmann, B.; Wendhausen, H.; Wassermann, O.; Fischer, R.; Nielsen, P.; Shaverda, V.F.

    1996-01-01

    The radiation burden from 137 Cs sources on 22 children from a small Byelorussian village was studied from 1992 to 1994. Foodstuff, whole body burden and urinary excretion of 137 Cs were measured, intake rates, biological half-lives and doses were calculated. The median value for the 137 Cs whole body incorporation level was found to be 124 Bq, the biological half life was calculated as 68 d for girls and 50 d for boys. The internal dose caused by 137 Cs was found to be negligible in comparison to that from external sources. No deviation from normal values could be shown in simultaneously studied clinico-chemical parameters

  7. Distribution of major health risks: findings from the Global Burden of Disease study.

    Directory of Open Access Journals (Sweden)

    Anthony Rodgers

    2004-10-01

    Full Text Available Most analyses of risks to health focus on the total burden of their aggregate effects. The distribution of risk-factor-attributable disease burden, for example by age or exposure level, can inform the selection and targeting of specific interventions and programs, and increase cost-effectiveness.For 26 selected risk factors, expert working groups conducted comprehensive reviews of data on risk-factor exposure and hazard for 14 epidemiological subregions of the world, by age and sex. Age-sex-subregion-population attributable fractions were estimated and applied to the mortality and burden of disease estimates from the World Health Organization Global Burden of Disease database. Where possible, exposure levels were assessed as continuous measures, or as multiple categories. The proportion of risk-factor-attributable burden in different population subgroups, defined by age, sex, and exposure level, was estimated. For major cardiovascular risk factors (blood pressure, cholesterol, tobacco use, fruit and vegetable intake, body mass index, and physical inactivity 43%-61% of attributable disease burden occurred between the ages of 15 and 59 y, and 87% of alcohol-attributable burden occurred in this age group. Most of the disease burden for continuous risks occurred in those with only moderately raised levels, not among those with levels above commonly used cut-points, such as those with hypertension or obesity. Of all disease burden attributable to being underweight during childhood, 55% occurred among children 1-3 standard deviations below the reference population median, and the remainder occurred among severely malnourished children, who were three or more standard deviations below median.Many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to produce substantial reductions in disease burden.

  8. The Burden of Schizophrenia on Caregivers

    Directory of Open Access Journals (Sweden)

    Filiz Adana

    2011-06-01

    Full Text Available Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family such as the patients disturbing behaviors, economic difficulties, and loss of income, restricted social activities, distressed household atmosphere, and undesirable influences on physical and mental health of the family members. The subjective burden refers to the extent of emotional distress caused by the objective burden. The data in the pertinent literature suggest an association between caregivers’ burden and sex, ethnicity, culture, caregivers’ health and quality of life, social support, and the symptomatology as presented by the patient. In order to promote mental health of schizophrenia patients along with their caregivers, the mental health workers should strive to find the means of supporting, informing, and cooperating with the family members. Psychosocial interventions designed for families and psychosocial rehabilitations programs designed for schizophrenia patients are effective means of easing caregivers’ burden.

  9. Organ burdens and excretion rates of inhaled uranium - computations using ICRP model

    International Nuclear Information System (INIS)

    Abani, M.C.; Murthy, K.B.S.; Sunta, C.M.

    1988-01-01

    Uranium being a highly toxic material, proper estimation of the body burden is very important. During manufacture of uranium fuel, it is likely to enter the body by inhalation. By the body burden and excretion measurements, one should be able to assess whether the intake is within the safe limits or not. This is possible if one performs theoretical calculations and estimates the amount of uranium which builds up in the body as a function of time. Similarly theoretical estimates in case of excretion have to be made. For this purpose, a computer programme has been developed to find out organ burdens and excretion rates resulting from exposure to a radioactive nuclide. ICRP-30 lung model has been used and cases of single instantaneous inhalation of 1 ALI as well as inhalation at a steady rate of ALI/365 per day have been considered. Using this programme, results for uranium aerosols of classes D, W and Y and sizes 0.2, 1 and 5 microns are generated by ND computers in tabular as well as graphical forms. These will be useful in conjunction with body burden measurements by direct counting or excretion analysis. (author). 7 tabs., 56 figs

  10. Health and economic burden of obesity in Brazil.

    Directory of Open Access Journals (Sweden)

    Ketevan Rtveladze

    Full Text Available INTRODUCTION: Higher and lower-middle income countries are increasingly affected by obesity. Obesity-related diseases are placing a substantial health and economic burden on Brazil. Our aim is to measure the future consequences of these trends on the associated disease burden and health care costs. METHOD: A previously developed micro-simulation model is used to project the extent of obesity, obesity-related diseases and associated healthcare costs to 2050. In total, thirteen diseases were considered: coronary heart disease, stroke, hypertension, diabetes, osteoarthritis, and eight cancers. We simulated three hypothetical intervention scenarios: no intervention, 1% and 5% reduction in body mass index (BMI. RESULTS: In 2010, nearly 57% of the Brazilian male population was overweight or obese (BMI ≥25 kg/m(2, but the model projects rates as high as 95% by 2050. A slightly less pessimistic picture is predicted for females, increasing from 43% in 2010 to 52% in 2050. Coronary heart disease, stroke, hypertension, cancers, osteoarthritis and diabetes prevalence cases are projected to at least double by 2050, reaching nearly 34,000 cases of hypertension by 2050 (per 100,000. 1% and 5% reduction in mean BMI will save over 800 prevalence cases and nearly 3,000 cases of hypertension by 2050 respectively (per 100,000. The health care costs will double from 2010 ($5.8 billion in 2050 alone ($10.1 billion. Over 40 years costs will reach $330 billion. However, with effective interventions the costs can be reduced to $302 billion by 1% and to $273 billion by 5% reduction in mean BMI across the population. CONCLUSION: Obesity rates are rapidly increasing creating a high burden of disease and associated costs. However, an effective intervention to decrease obesity by just 1% will substantially reduce obesity burden and will have a significant effect on health care expenditure.

  11. Economic Study of Global Tobacco Burden

    Science.gov (United States)

    In an interview on Cancer Currents, Dr. Mark Parascandola discusses findings from an economics study showing that, globally, tobacco use burdens economies with more than US $1 trillion annually in health care costs and lost productivity.

  12. Economic and psychological burden of scheduled surgery ...

    African Journals Online (AJOL)

    Background: Cancellation of scheduled surgery creates a financial burden for hospitals, caregivers and ..... costs and disregard some of the aspects mentioned in the ..... cancellation of elective surgical procedures in a Spanish general.

  13. The Global Burden of Cancer 2013

    OpenAIRE

    2015-01-01

    Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. Evidence Review The general methodology of the Global Burden of Disease (GBD) 2013 study was us...

  14. Dementia Caregiver Burden: a Research Update and Critical Analysis.

    Science.gov (United States)

    Cheng, Sheung-Tak

    2017-08-10

    This article provides an updated review of the determinants of caregiver burden and depression, with a focus on care demands and especially the differential effects of various neuropsychiatric symptoms or symptom clusters. Moreover, studies on caregivers for frontotemporal and Lewy body dementias were referred to in order to identify differences and similarities with the mainstream literature based largely on Alzheimer caregivers. As a group, neuropsychiatric symptoms are most predictive of caregiver burden and depression regardless of dementia diagnosis, but the effects appear to be driven primarily by disruptive behaviors (e.g., agitation, aggression, disinhibition), followed by delusions and mood disturbance. Disruptive behaviors are more disturbing partly because of the adverse impact on the emotional connection between the caregiver and the care-recipient and partly because they exacerbate difficulties in other domains (e.g., caring for activities of daily living). In behavioral variant frontotemporal dementia, not only are these disruptive behaviors more prominent but they are also more disturbing due to the care-recipient's insensitivity to others' feelings. In Lewy body dementia, visual hallucinations also appear to be distressing. The disturbing nature of disruptive behaviors cuts across dementia conditions, but the roles played by symptoms that are unique or particularly serious in a certain condition need to be explored further.

  15. Burdens of Proof, Presumptions and Standards of Proof in Criminal ...

    African Journals Online (AJOL)

    Worku_Y

    evidential and persuasive burdens of proof as between the state and the ..... scholars have observed that the evidential burden is a function of the burden of ..... required to convince judges by creating such an intensity of belief in their minds.

  16. Gastroesophageal reflux disease burden in Iran.

    Science.gov (United States)

    Delavari, Alireza; Moradi, Ghobad; Elahi, Elham; Moradi-Lakeh, Maziar

    2015-02-01

    Gastroesophageal reflux disease is one of the most common disorders of the gastrointestinal tract. The prevalence of this disease ranges from 5% to 20% in Asia, Europe, and North America. The aim of this study was to estimate the burden of gastroesophageal reflux disease in Iran. Burden of gastroesophageal reflux disease in Iran was estimated for one year from 21 March 2006 to 20 March 2007. The definition was adjusted with ICD-code of K21. Incident-based disability-adjusted life year (DALY) was used as the unit of analysis to quantify disease burden. A simplified disease model and DisMod II software were used for modeling. The annual incidence for total population of males and females in Iran was estimated 17.72 and 28.06 per 1000, respectively. The average duration of gastroesophageal reflux disease as a chronic condition was estimated around 10 years in both sexes. Total DALYs for an average of 59 symptomatic days per year was estimated 153,554.3 (60,330.8 for males and 93,223.5 for females).   The results of this study showed that reflux imposes high burden and high financial costs on the Iranian population. The burden of this disease in Iran is more similar to that of European countries rather than Asian countries. It is recommended to consider the disease as a public health problem and make decisions and public health plans to reduce the burden and financial costs of the disease in Iran.

  17. Foreign Body

    Science.gov (United States)

    ... SearchingPediatrics.com Pediatrics Common Questions, Quick Answers Foreign Body Donna D'Alessandro, M.D. Lindsay Huth, B. ... I call the doctor? What is a foreign body? A foreign body is when an object is ...

  18. The economic burden of schizophrenia in Malaysia.

    Science.gov (United States)

    Teoh, Siew Li; Chong, Huey Yi; Abdul Aziz, Salina; Chemi, Norliza; Othman, Abdul Razak; Md Zaki, Nurzuriana; Vanichkulpitak, Possatorn; Chaiyakunapruk, Nathorn

    2017-01-01

    Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia. A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted. The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M. This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

  19. Assessment of the Total Body Burden of Caesium-137 in Humans by the Analysis of Blood; Determination de la Charge Corporelle de Cesium 137 chez l'Homme, par Analyse Du Sang; 041e 041f 0420 0415 0414 ; Evaluacion de la Carga Corporal Total de Cesio-137 en el Hombre por Analisis de Sangre

    Energy Technology Data Exchange (ETDEWEB)

    Yamagata, N. [Institute of Public Health, Tokyo (Japan)

    1964-11-15

    Analysis of post-mortem samples for caesium-137 has been carried on in Japan because whole-body counters are limited in number and not mobile, making the assessment of the population mean levels inconvenient. However, the collection of muscles from autopsies throughout the country is complicated and inconvenient in that a sample should be taken immediately after death. Considering that only such data as are useful for the assessment of the mean levels of caesium-137 in people are required and it is unnecessary to know individual values, the composite samples of as many individuals as possible would be enough for the analysis. For this purpose, whole blood samples were considered as the best substitute for muscles, as the blood collection system covers the whole country, including 47 licensed blood banks and about 100 hospitals. Sampling inspection is made continuously of citrated whole blood at the National Institute of Health, Tokyo, where about 500 ampoules are checked, representing more than three million donors throughout the country per year. Less than half the blood in an ampoule was consumed for inspection and the remaining half was stocked to make a composite for the determination of caesium-137 level. Blood ashes were analysed for the stable caesium content by a neutron activation method. The results afforded the relation between the concentration in the whole blood and the total body amount (1.4 mg for 70 kg man) and this relation would be identical to that for caesium-137 in an equilibrium condition. The results of blood analysis for caesium-137 obtained since June 1963 were compared with those of muscle analyses made during the same period. Good agreement was observed and the blood analysis was found to be the best means for assessing the total body burden of caesium-137 in a population. (author) [French] Au Japon, on a dose le cesium 137 d'echantillons de tissus musculaires preleves au cours d'autopsies, car il n'y a qu'un petit nombre d

  20. The economic burden of tuberculosis in Indonesia.

    Science.gov (United States)

    Collins, D; Hafidz, F; Mustikawati, D

    2017-09-01

    Indonesia has a high prevalence of tuberculosis (TB) and is one of the 22 countries with the highest TB burdens in the world. To understand the economic burden of TB in Indonesia. TB data for 2015 were combined with cost data using a simple type of cost-benefit analysis in a decision tree model to show the economic burden under different scenarios. In Indonesia, there were an estimated 1 017 378 new active TB cases in 2015, including multidrug-resistant TB. It is estimated that 417 976 of these cases would be treated and cured, 160 830 would be unsuccessfully treated and would die, 131 571 would be untreated and would achieve cure spontaneously, and 307 000 would be untreated and would die. The total economic burden related to treated and untreated cases would be approximately US$6.9 billion. Loss of productivity due to premature death would be by far the largest element, comprising US$6.0 billion (discounted), which represents 86.6% of the total cost. Loss of productivity due to illness would be US$700 million (10.1%), provider medical costs US$156 million (2.2%), and direct non-medical costs incurred by patients and their households US$74 million (1.1%). The economic burden of TB in Indonesia is extremely high. Detecting and treating more cases would result not only in major reductions in suffering but also in economic savings to society.

  1. Uncertainties in Organ Burdens Estimated from PAS

    International Nuclear Information System (INIS)

    La Bone, T.R.

    2004-01-01

    To calculate committed effective dose equivalent, one needs to know the quantity of the radionuclide in all significantly irradiated organs (the organ burden) as a function of time following the intake. There are two major sources of uncertainty in an organ burden estimated from personal air sampling (PAS) data: (1) The uncertainty in going from the exposure measured with the PAS to the quantity of aerosol inhaled by the individual, and (2) The uncertainty in going from the intake to the organ burdens at any given time, taking into consideration the biological variability of the biokinetic models from person to person (interperson variability) and in one person over time (intra-person variability). We have been using biokinetic modeling methods developed by researchers at the University of Florida to explore the impact of inter-person variability on the uncertainty of organ burdens estimated from PAS data. These initial studies suggest that the uncertainties are so large that PAS might be considered to be a qualitative (rather than quantitative) technique. These results indicate that more studies should be performed to properly classify the reliability and usefulness of using PAS monitoring data to estimate organ burdens, organ dose, and ultimately CEDE

  2. Subjective burden on spouses of schizophrenia patients

    Directory of Open Access Journals (Sweden)

    Surekha Kumari

    2009-01-01

    Full Text Available Background : There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. Materials and Methods: The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981. The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients. Results: The findings suggest that both the groups, viz., male and female spouses of schizophrenia patients, showed moderate level of subjective burden, i.e., 13 (52% and 15 (60% male and female spouses, respectively, which was statistically found to be insignificant. Conclusion : No significant difference was found between male and female spouses of schizophrenia patients with regard to the level of subjective burden.

  3. Burden of childhood-onset arthritis

    Directory of Open Access Journals (Sweden)

    Hassett Afton L

    2010-07-01

    Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

  4. Whole body monitoring - Goiania

    International Nuclear Information System (INIS)

    Oliveira, C.A.N. de; Lourenco, M.C.; Bertelli Neto, L.; Lucena, E.A. de; Becker, P.H.B.

    1988-01-01

    Due to the radiological Cs accident in Goiania, Goias in September 1987, it became necessary to evaluate internal contamination levels of: - Individual from the general public that for any reason had direct or indirect involvement with the radioactive source (group 1). - Occupationally involved persons (group 2). For each of these groups, procedures of whole body monitoring were developped. In order to attend group 1 individuals, the IRD/CNEN installed a whole body unit in the INAMPS General Hospital of Goiania in 11.08.87, which was later transferred to 121,57 street, Central Sector in Goiania in 2.06.88. In this unit 547 people were monitored, 356 from group 1 and 241 from group 2, until 04.13.88. In the IRD whole body counter installation, 194 individuals were counted, 185 from group 2 and 9 from group 1. The frequency of monitoring of each individual was established according to the Cs activity present in the body or to the job to be assigned. In this paper we will present some burden activity curves for Cs 137 as a function of the time elapsed from the first measurement. There people from group 1 were measured in both counters, the IRD and the Goiania ones. The values obtained in both installations are compatible with the body activity x time curve. (author) [pt

  5. Allostatic load but not medical burden predicts memory performance in late-life bipolar disorder.

    Science.gov (United States)

    Vaccarino, Sophie R; Rajji, Tarek K; Gildengers, Ariel G; Waters, Sarah E S; Butters, Meryl A; Menon, Mahesh; Blumberger, Daniel M; Voineskos, Aristotle N; Miranda, Dielle; Mulsant, Benoit H

    2018-03-01

    Older patients with bipolar disorder (BD) present with variable degrees of cognitive impairment. Over time, stress, mood episodes, and comorbidities increase the body's allostatic load. We assessed the extent to which allostatic load vs more traditional measures of medical burden account for the heterogeneity in cognition in this population. Thirty-five older euthymic patients with BD and 30 age-equated, gender-equated, and education-equated comparison participants were administered a comprehensive assessment including a neuropsychological battery, and 9 physiological measures to determine allostatic load. The relationship among allostatic load, medical burden, and cognition was assessed. Compared with the mentally healthy comparators, patients were impaired globally, and in 4 cognitive domains-information-processing speed / executive functioning, delayed memory, language, and visuomotor ability, and presented with greater medical burden but not a different allostatic load. Allostatic load, but not medical burden, was associated with delayed memory performance both in a correlational analysis and in a multivariate regression analysis. Euthymic older patients with BD are impaired on several cognitive domains and have high medical burden. Their memory performance is more strongly associated with allostatic load than with traditional measures of medical burden. These findings need to be replicated and extended longitudinally. Copyright © 2017 John Wiley & Sons, Ltd.

  6. The unrecognized burden of typhoid fever.

    Science.gov (United States)

    Obaro, Stephen K; Iroh Tam, Pui-Ying; Mintz, Eric Daniel

    2017-03-01

    Typhoid fever (TF), caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, responsible for an estimated 129,000 deaths and more than 11 million cases annually. Although several reviews have provided global and regional TF disease burden estimates, major gaps in our understanding of TF epidemiology remain. Areas covered: We provide an overview of the gaps in current estimates of TF disease burden and offer suggestions for addressing them, so that affected communities can receive the full potential of disease prevention offered by vaccination and water, sanitation, and hygiene interventions. Expert commentary: Current disease burden estimates for TF do not capture cases from certain host populations, nor those with atypical presentations of TF, which may lead to substantial underestimation of TF cases and deaths. These knowledge gaps pose major obstacles to the informed use of current and new generation typhoid vaccines.

  7. The global burden of periodontal disease

    DEFF Research Database (Denmark)

    Petersen, Poul E; Ogawa, Hiroshi

    2012-01-01

    Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease...... is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases......). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper...

  8. The Global Burden of Occupational Disease.

    Science.gov (United States)

    Rushton, Lesley

    2017-09-01

    Burden of occupational disease estimation contributes to understanding of both magnitude and relative importance of different occupational hazards and provides essential information for targeting risk reduction. This review summarises recent key findings and discusses their impact on occupational regulation and practice. New methods have been developed to estimate burden of occupational disease that take account of the latency of many chronic diseases and allow for exposure trends and workforce turnover. Results from these studies have shown in several countries and globally that, in spite of improvements in workplace technology, practices and exposures over the last decades, occupational hazards remain an important cause of ill health and mortality worldwide. Major data gaps have been identified particularly regarding exposure information. Reliable data on employment and disease are also lacking especially in developing countries. Burden of occupational disease estimates form an important part of decision-making processes.

  9. Burden attributable to child maltreatment in Australia.

    Science.gov (United States)

    Moore, Sophie E; Scott, James G; Ferrari, Alize J; Mills, Ryan; Dunne, Michael P; Erskine, Holly E; Devries, Karen M; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A; McCarthy, Molly; Norman, Rosana E

    2015-10-01

    Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. The economic burden of schizophrenia in Malaysia

    Directory of Open Access Journals (Sweden)

    Teoh SL

    2017-07-01

    Full Text Available Siew Li Teoh,1 Huey Yi Chong,1 Salina Abdul Aziz,2 Norliza Chemi,2 Abdul Razak Othman,2 Nurzuriana Md Zaki,2 Possatorn Vanichkulpitak,3 Nathorn Chaiyakunapruk1,4–6 1School of Pharmacy, Monash University Malaysia, Selangor, 2Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 3Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 4Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 5School of Pharmacy, University of Wisconsin, Madison, WI, USA; 6Health and Well-being Cluster, Global Asia in the 21st Century (GA21 Platform, Monash University Malaysia, Selangor, MalaysiaIntroduction: Schizophrenia (SCZ is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia.Methods: A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL. The medical charts were identified electronically by matching the unique patient’s identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted.Results: The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million

  11. Metallic Burden of Deciduous Teeth and Childhood Behavioral Deficits

    Directory of Open Access Journals (Sweden)

    Tony J.H. Chan

    2015-06-01

    Full Text Available Attention Deficit/Hyperactivity Disorder (ADHD affects 5%–8% of children in the U.S. (10% of males and 4% of females. The contributions of multiple metal exposures to the childhood behavioral deficits are unclear, although particular metals have been implicated through their neurotoxicity. The objective of this study was to test the hypothesis that the body burden of Mn is positively correlated with ADHD symptoms. We also investigated the putative roles of Ca, Fe, Pb, and Hg. We collected shed molars from 266 children (138 boys and 128 girls who lost a tooth between 11 and 13 years of age. The molars were analyzed for metals using ICP-OES. The third grade teacher of each child completed the Teacher’s Disruptive Behavior Disorders Rating Scale (DBD to produce a score for “Total Disruptive Behavior” and subscale scores for “Attention Deficit Hyperactivity Disorder”, Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant. The mean Mn, Fe, Pb and Ca concentrations found in teeth was 6.1 ± 5.7 µg/g, 22.7 ± 24.1 µg/g, 0.9 ± 1.4 µg/g, and 6.0 × 105 ± 1.6 × 105 µg/g, respectively. Hg was not detected. No significant association was found between Mn and behavioral deficits. Ca was significantly negatively associated, and Pb showed a significant positive association with Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant Disorders. These findings call into question the putative independent association of manganese exposure and behavioral deficits in children, when the balance of other metallic burden, particularly Ca and Pb burdens play significant roles.

  12. EDITORIAL Neglected Diseases: Burden and attention

    African Journals Online (AJOL)

    Preferred Customer

    Neglected diseases are largely infectious diseases that have burdened humanity for centuries, but currently receiving little attention. Infectious diseases in their long histories have resulted in considerable morbidities, disabilities and deformities, often subjecting to stigma. The magnitude of their impact on health and labor.

  13. Schizophrenia: management and family burden | Sebit | Central ...

    African Journals Online (AJOL)

    Schizophrenia: management and family burden. MB Sebit. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/cajm.v53i9-12.62618 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  14. Tackling the high burden of blindness

    African Journals Online (AJOL)

    ... care delivery, and tackling the five major eye conditions that contribute to most blindness could reduce the current burden of blindness. This would open the window for addressing glaucoma, diabetic retinopathy, and macula degeneration which are the new emerging global consequences of non-communicable diseases.

  15. The Global Burden of Cancer 2013

    NARCIS (Netherlands)

    Fitzmaurice, C.; Geleijnse, J.M.; Naghavi, M.R.; et al.,

    2015-01-01

    Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs),

  16. The dual burden of malnutrition in Colombia.

    Science.gov (United States)

    Sarmiento, Olga L; Parra, Diana C; González, Silvia A; González-Casanova, Inés; Forero, Ana Y; Garcia, Johnattan

    2014-12-01

    Almost all nutrition policies in Colombia currently focus on either undernutrition or obesity, with the predominant emphasis on undernutrition. It is crucial to assess the prevalence of the dual burden of malnutrition in Colombia to better target programs and policies. The aim was to estimate the national prevalence of the dual burden of malnutrition in Colombia at the individual and household levels in children aged malnutrition was defined as the coexistence of overweight and stunting or anemia in the same person or household. In Colombia, low to high prevalences of overweight and obesity (3.4-51.2%) coexist with moderate to high prevalences of anemia (8.1-27.5%) and stunting (13.2%). The observed prevalence of the dual burden was lower than expected. Approximately 5% of households had at least one stunted child aged malnutrition in Colombia are lower than expected. Despite the independence of the occurrence of these conditions, the fact that the dual burden coexists at the national, household, and intraindividual levels suggests that public policies should address both conditions through multiple strategies. It is imperative to evaluate the current nutrition policies to inform malnutrition prevention efforts in Colombia and to share lessons with other countries at a similar stage of nutritional transition. © 2014 American Society for Nutrition.

  17. THE MALARIA BURDEN AND AGRICULTURAL OUTPUT IN ...

    African Journals Online (AJOL)

    iya beji

    on the physical, mental and social well being of the people as well as on the ... direct health burden of malaria by which its victims suffer physical and ..... Audibert, M. (1986), “Agricultural Non-wage Production and Health-Status – A Case.

  18. The Burden of Psychological Symptoms in Gynaecological ...

    African Journals Online (AJOL)

    The Burden of Psychological Symptoms in Gynaecological Conditions among Women in Uyo, Akwa Ibom State, Nigeria. ... Nigerian Journal of Psychiatry ... Background: There is an increasing evidence of significant psychological symptoms (anxiety and depression) among a large percentage of women with gynaecological ...

  19. Economic impacts assessment of pleuropneumonia burden and ...

    African Journals Online (AJOL)

    Contagious bovine pleuropneumonia (CBPP) is a trans-boundary infectious and contagious respiratory disease of cattle caused by Mycoplasma mycoides subsp. mycoides. It is a disease of high economic importance because of its ability to compromise food security. Information on its economic burden in pastoral cattle ...

  20. Body Lice

    Science.gov (United States)

    What are body lice? Body lice (also called clothes lice) are tiny insects which live and lay nits (lice eggs) on clothing. They are parasites, ... usually only move to the skin to feed. Body lice are one of the three types of ...

  1. Body integrity identity disorder.

    Science.gov (United States)

    Blom, Rianne M; Hennekam, Raoul C; Denys, Damiaan

    2012-01-01

    Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation) were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

  2. Body integrity identity disorder.

    Directory of Open Access Journals (Sweden)

    Rianne M Blom

    Full Text Available INTRODUCTION: Body Integrity Identity Disorder (BIID is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. METHODS: Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. RESULTS: Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. CONCLUSIONS: The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

  3. Methodological Challenges in Estimating Trends and Burden of Cardiovascular Disease in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Jacob K. Kariuki

    2015-01-01

    Full Text Available Background. Although 80% of the burden of cardiovascular disease (CVD is in developing countries, the 2010 global burden of disease (GBD estimates have been cited to support a premise that sub-Saharan Africa (SSA is exempt from the CVD epidemic sweeping across developing countries. The widely publicized perspective influences research priorities and resource allocation at a time when secular trends indicate a rapid increase in prevalence of CVD in SSA by 2030. Purpose. To explore methodological challenges in estimating trends and burden of CVD in SSA via appraisal of the current CVD statistics and literature. Methods. This review was guided by the Critical review methodology described by Grant and Booth. The review traces the origins and evolution of GBD metrics and then explores the methodological limitations inherent in the current GBD statistics. Articles were included based on their conceptual contribution to the existing body of knowledge on the burden of CVD in SSA. Results/Conclusion. Cognizant of the methodological challenges discussed, we caution against extrapolation of the global burden of CVD statistics in a way that underrates the actual but uncertain impact of CVD in SSA. We conclude by making a case for optimal but cost-effective surveillance and prevention of CVD in SSA.

  4. Physical Activity and Sedentary Behaviors of Urban Chinese Children: Grade Level Prevalence and Academic Burden Associations

    Directory of Open Access Journals (Sweden)

    Xihe Zhu

    2017-01-01

    Full Text Available The objectives of this study were (a to report grade level prevalence in physical activity and sedentary behaviors and (b to examine academic burden associations with these behaviors. School-aged children (n = 48,118 reported their physical activity, perception of physical activity sufficiency, factors for activity insufficiency, homework hours, and screen time in a typical week. Data were analyzed using general linear models and logistic regression models of Complex Samples. Prevalence results showed that children had lower physical activity and lower screen viewing time, but higher homework time during transition grades (6th, 9th, and 12th and high school years. Academic burden was cited as the primary reason for not having sufficient physical activity (76.6%. Compared to those citing academic burden, students who did not report academic burden were significantly more likely to meet physical activity guidelines (Odds Ratio (OR = 5.38, 95% CI = 4.74–6.11, but less likely to meet screen time guidelines (OR = 0.78, 95% CI = 0.72–0.84, controlling for body mass index, gender, and grade level. Additionally, children who reported academic burdens had significantly longer average daily homework time than those who did not (p<0.01. Policy makers should promote physical activity and help children find a balance between homework and physical activity time particularly among the educational transition grades.

  5. Global Epidemiology and Burden of Schizophrenia

    DEFF Research Database (Denmark)

    Charlson, Fiona J; Ferrari, Alize J; Santomauro, Damian F

    2018-01-01

    countries. Method: We conducted a systematic review to identify studies reporting the prevalence, incidence, remission, and/or excess mortality associated with schizophrenia. Reported estimates which met our inclusion criteria were entered into a Bayesian meta-regression tool used in GBD 2016 to derive...... prevalence for 20 age groups, 7 super-regions, 21 regions, and 195 countries and territories. Burden of disease estimates were derived for acute and residual states of schizophrenia by multiplying the age-, sex-, year-, and location-specific prevalence by 2 disability weights representative of the disability......-standardized point prevalence rates did not vary widely across countries or regions. Globally, prevalent cases rose from 13.1 (95% UI: 11.6-14.8) million in 1990 to 20.9 (95% UI: 18.5-23.4) million cases in 2016. Schizophrenia contributes 13.4 (95% UI: 9.9-16.7) million years of life lived with disability to burden...

  6. The global burden of alveolar echinococcosis.

    Directory of Open Access Journals (Sweden)

    Paul R Torgerson

    Full Text Available BACKGROUND: Human alveolar echinococcosis (AE is known to be common in certain rural communities in China whilst it is generally rare and sporadic elsewhere. The objective of this study was to provide a first estimate of the global incidence of this disease by country. The second objective was to estimate the global disease burden using age and gender stratified incidences and estimated life expectancy with the disease from previous results of survival analysis. Disability weights were suggested from previous burden studies on echinococcosis. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a detailed review of published literature and data from other sources. We were unable to make a standardised systematic review as the quality of the data was highly variable from different countries and hence if we had used uniform inclusion criteria many endemic areas lacking data would not have been included. Therefore we used evidence based stochastic techniques to model uncertainty and other modelling and estimating techniques, particularly in regions where data quality was poor. We were able to make an estimate of the annual global incidence of disease and annual disease burden using standard techniques for calculation of DALYs. Our studies suggest that there are approximately 18,235 (CIs 11,900-28,200 new cases of AE per annum globally with 16,629 (91% occurring in China and 1,606 outside China. Most of these cases are in regions where there is little treatment available and therefore will be fatal cases. Based on using disability weights for hepatic carcinoma and estimated age and gender specific incidence we were able to calculate that AE results in a median of 666,434 DALYs per annum (CIs 331,000-1.3 million. CONCLUSIONS/SIGNIFICANCE: The global burden of AE is comparable to several diseases in the neglected tropical disease cluster and is likely to be one of the most important diseases in certain communities in rural China on the Tibetan plateau.

  7. Economic Burden of Diabetes in Urban Indians

    OpenAIRE

    Chandra, Pablo; Gogate, Bageshri; Gogate, Parikshit; Thite, Nilesh; Mutha, Abhay; Walimbe, Amit

    2014-01-01

    Purpose : To find out the average economic burden of medical care on a patient with diabetes in Pune, India Methods : A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as d...

  8. Burden of arrhythmia in recreational marijuana users.

    Science.gov (United States)

    Desai, Rupak; Patel, Upenkumar; Deshmukh, Abhishek; Sachdeva, Rajesh; Kumar, Gautam

    2018-03-27

    Marijuana or Cannabis is extensively used as a recreational substance globally. Case reports have reported cardiac arrhythmias immediately following recreational marijuana use. However, the burden of arrhythmias in hospitalized marijuana users have not been evaluated through prospective or cross-sectional studies. Therefore, we planned to measure temporal trends of the frequency of arrhythmias in hospitalized marijuana users using National Inpatient Sample (NIS) database in the United States. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Curbing the burden of lung cancer.

    Science.gov (United States)

    Urman, Alexandra; Hosgood, H Dean

    2016-06-01

    Lung cancer contributes substantially to the global burden of disease and healthcare costs. New screening modalities using low-dose computerized tomography are promising tools for early detection leading to curative surgery. However, the screening and follow-up diagnostic procedures of these techniques may be costly. Focusing on prevention is an important factor to reduce the burden of screening, treatment, and lung cancer deaths. The International Agency for Research on Cancer has identified several lung carcinogens, which we believe can be considered actionable when developing prevention strategies. To curb the societal burden of lung cancer, healthcare resources need to be focused on early detection and screening and on mitigating exposure(s) of a person to known lung carcinogens, such as active tobacco smoking, household air pollution (HAP), and outdoor air pollution. Evidence has also suggested that these known lung carcinogens may be associated with genetic predispositions, supporting the hypothesis that lung cancers attributed to differing exposures may have developed from unique underlying genetic mechanisms attributed to the exposure of interest. For instance, smokingattributed lung cancer involves novel genetic markers of risk compared with HAP-attributed lung cancer. Therefore, genetic risk markers may be used in risk stratification to identify subpopulations that are at a higher risk for developing lung cancer attributed to a given exposure. Such targeted prevention strategies suggest that precision prevention strategies may be possible in the future; however, much work is needed to determine whether these strategies will be viable.

  10. More accurate picture of human body organs

    International Nuclear Information System (INIS)

    Kolar, J.

    1985-01-01

    Computerized tomography and nucler magnetic resonance tomography (NMRT) are revolutionary contributions to radiodiagnosis because they allow to obtain a more accurate image of human body organs. The principles are described of both methods. Attention is mainly devoted to NMRT which has clinically only been used for three years. It does not burden the organism with ionizing radiation. (Ha)

  11. The Tax Burden on Tobacco Volume 51, 1970-2016

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1970-2016. Orzechowski and Walker. Tax Burden on Tobacco. Tax burden data was obtained from the annual compendium on tobacco revenue and industry statistics, The Tax...

  12. Prevalence and burden of Sickle Cell Disease among ...

    African Journals Online (AJOL)

    femi oloka

    the variables pain severity, monthly income, the psychological and ... 44% had significant psychological burden while 37.3% have socio-cultural burden. The ..... 6. Otis-Green S. Psychosocial Pain. Assessment Form. In Dow (Ed.), Nursing.

  13. Estimating the burden of disease attributable to indoor air pollution ...

    African Journals Online (AJOL)

    Estimating the burden of disease attributable to indoor air pollution from household ... To estimate the burden of respiratory ill health in South African children and adults in ... Mortality and disability-adjusted life years (DALYs) from acute lower ...

  14. Body contact and body language

    DEFF Research Database (Denmark)

    Winther, Helle

    2008-01-01

    and the boundaries between self and world. In western societies, the modern premises for contact are in some ways developing from close contact to virtual communication. With this breadth of perspective in mind, the ques­tion is whether conscious and experimental work with body contact and body language in move......­ment psychology and education provide potential for intense personal develop­ment as well as for social and cultural learning processes. This performative research project originates from the research project entitled, Movement Psy­chol­ogy: The Language of the Body and the Psy­chol­ogy of Movement based......Body contact and body language are unique and existential and, although culturally dependent and socially embodied, they are also universal communication forms. For small children all over the world, warm, close and nourishing body contact is fundamental to their embodied experi­ence of themselves...

  15. Body punk

    DEFF Research Database (Denmark)

    Mogensen, Kevin

    BODYPUNK - A Treatise on male body builders and the meaning of the body in the shadow of an Anti Doping Campaign Based on a qualitative study, the thesis investigates the visual representation of the male bodybuilder found in the national anti doping campaign: ‗ "The hunt has begun" along...

  16. Estimation of thorium lung burden in mineral separation plant workers by thoron-in-breath measurements

    International Nuclear Information System (INIS)

    Radhakrishnan, Sujata; Sreekumar, K.; Tripathi, R.M.; Puranik, V.D.; Selvan, Esai

    2010-01-01

    The Minerals Separation Plant (MSP) of M/s Indian Rare Earths Ltd. (IREL) at Manavalakurichi in Tamil Nadu is engaged in the processing of beach sands to separate ilmenite, monazite, rutile, sillimanite, garnet, and zircon. The present study has been carried out on nearly 200 workers of the mineral separation plant who are chronically exposed to the radiation hazards. Measurement of thoron in the exhaled breath of the worker is an indirect method of estimating the body burden with regard to Th

  17. 12 CFR 508.10 - Burden of persuasion.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Burden of persuasion. 508.10 Section 508.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.10 Burden of persuasion. The petitioner has the burden of...

  18. Double burden of disease in the slums of Kenya

    NARCIS (Netherlands)

    Oti, S.O.

    2015-01-01

    The goal of this thesis was to provide evidence of a double burden of disease in the slums of Nairobi and to make a case for an integrated health systems approach to tackling this situation. A double burden of disease refers to the coexistence of a high burden of communicable and non-communicable

  19. The burden experienced by family caregivers of patients with ...

    African Journals Online (AJOL)

    BACKGROUND: Caring for patients with chronic medical and psychiatric disorders is associated with significant burden. However little is known about the burden experience by caregivers of patients with epilepsy in Nigeria. The objective of this study, therefore, was to assess the level and correlates of burden among ...

  20. Immunologic burden links periodontitis to acute coronary syndrome.

    Science.gov (United States)

    Liljestrand, John M; Paju, Susanna; Pietiäinen, Milla; Buhlin, Kåre; Persson, G Rutger; Nieminen, Markku S; Sinisalo, Juha; Mäntylä, Päivi; Pussinen, Pirkko J

    2018-01-01

    Periodontitis, a common polymicrobial inflammatory disease in the tooth supporting tissues, is a risk factor for coronary artery disease. One of the proposed underlying mechanisms is the systemic immune response to periodontal infection. We studied how serum antibodies against seven periodontal pathogens and their subgingival levels associate with each other, periodontitis, and coronary artery disease. The Parogene cohort included 505 Finnish patients (mean age 63 y) who underwent coronary angiography, and clinical and radiographic oral examinations. Coronary diagnosis was defined as no significant coronary artery disease (disease (≥50% stenosis, n = 184) and acute coronary syndrome (n = 169). Levels of subgingival Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, Tannerella forsythia, Campylobacter rectus, and Fusobacterium nucleatum were determined by checkerboard DNA-DNA hybridization. Serum antibody (IgA/IgG) levels were analyzed with enzyme-linked immunosorbent assay (ELISA). Aggregate IgA/IgG burdens were calculated by summing and standardizing the serum antibody levels. Patients with active periodontitis were characterized by higher levels of subgingival bacteria and corresponding IgA/IgG response. Quartiles 2-4 of serum IgA/IgG burden indicated higher risk for acute coronary syndrome (OR 1.84, 95%CI 1.01-3.35 for IgA; OR 1.87, 95%CI 1.01-3.46 for IgG) independently of established cardiovascular risk factors, body mass index, number of teeth, subgingival bacterial levels and periodontal diagnosis. Our findings support the hypothesis that the association between periodontitis and cardiovascular diseases is partly mediated by the immunologic response for periodontal pathogens. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Burden of serious fungal infections in Guatemala.

    Science.gov (United States)

    Medina, N; Samayoa, B; Lau-Bonilla, D; Denning, D W; Herrera, R; Mercado, D; Guzmán, B; Pérez, J C; Arathoon, E

    2017-06-01

    Guatemala is a developing country in Central America with a high burden of HIV and endemic fungal infections; we attempted to estimate the burden of serious fungal infections for the country. A full literature search was done to identify epidemiology papers reporting fungal infections from Guatemala. We used specific populations at risk and fungal infection frequencies in the population to estimate national rates. The population of Guatemala in 2013 was 15.4 million; 40% were younger than 15 and 6.2% older than 60. There are an estimated 53,000 adults with HIV infection, in 2015, most presenting late. The estimated cases of opportunistic fungal infections were: 705 cases of disseminated histoplasmosis, 408 cases of cryptococcal meningitis, 816 cases of Pneumocystis pneumonia, 16,695 cases of oral candidiasis, and 4,505 cases of esophageal candidiasis. In the general population, an estimated 5,568 adult asthmatics have allergic bronchopulmonary aspergillosis (ABPA) based on a 2.42% prevalence of asthma and a 2.5% ABPA proportion. Amongst 2,452 pulmonary tuberculosis patients, we estimated a prevalence of 495 for chronic pulmonary aspergillosis in this group, and 1,484 for all conditions. An estimated 232,357 cases of recurrent vulvovaginal candidiasis is likely. Overall, 1.7% of the population are affected by these conditions. The true fungal infection burden in Guatemala is unknown. Tools and training for improved diagnosis are needed. Additional research on prevalence is needed to employ public health measures towards treatment and improving the reported data of fungal diseases.

  2. The economic burden of prematurity in Canada.

    Science.gov (United States)

    Johnston, Karissa M; Gooch, Katherine; Korol, Ellen; Vo, Pamela; Eyawo, Oghenowede; Bradt, Pamela; Levy, Adrian

    2014-04-05

    Preterm birth is a major risk factor for morbidity and mortality among infants worldwide, and imposes considerable burden on health, education and social services, as well as on families and caregivers. Morbidity and mortality resulting from preterm birth is highest among early (prematurity due to the larger number of late preterm infants relative to early and moderate preterm infants. The aim in this study was to characterize the burden of premature birth in Canada for early, moderate, and late premature infants, including resource utilization, direct medical costs, parental out-of-pocket costs, education costs, and mortality, using a validated and published decision model from the UK, and adapting it to a Canadian setting based on analysis of administrative, population-based data from Québec. Two-year survival was estimated at 56.0% for early preterm infants, 92.8% for moderate preterm infants, and 98.4% for late preterm infants. Per infant resource utilization consistently decreased with age. For moderately preterm infants, hospital days ranged from 1.6 at age two to 0.09 at age ten. Cost per infant over the first ten years of life was estimated to be $67,467 for early preterm infants, $52,796 for moderate preterm infants, and $10,010 for late preterm infants. Based on population sizes this corresponds to total national costs of $123.3 million for early preterm infants, $255.6 million for moderate preterm infants, $208.2 million for late preterm infants, and $587.1 million for all infants. Premature birth results in significant infant morbidity, mortality, healthcare utilization and costs in Canada. A comprehensive decision-model based on analysis of a Canadian population-based administrative data source suggested that the greatest national-level burden is associated with moderate preterm infants due to both a large cost per infant and population size while the highest individual-level burden is in early preterm infants and the largest total population size is

  3. The humanistic burden of hereditary angioedema

    DEFF Research Database (Denmark)

    Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette

    2014-01-01

    and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical......, traveling, and passing HAE to their children. Based on Hospital Anxiety and Depression Scale scores, 38 and 14% had clinically meaningful anxiety and depression, respectively. Despite standard of care, HAE patients still have frequent and painful attacks. Patients experience substantial impairment...

  4. Signifying Bodies

    DEFF Research Database (Denmark)

    of biosemiosis connect signifying bodies with their natural surroundings, cultural activities and subjective experiences. Health stretches all the way from the ecosocial surroundings, through the skin and into the self-organizing processes of every living cell. Signifying Bodies lays out a new approach to health...... and health care. Eschewing all forms of dualism, the authors emphasise the interdependency of how we act, think, feel and function. They advocate a relational turn in health care, in which bodies live and learn from suffering and care. In this view, health is inseparable from both living beings...

  5. Bog bodies

    DEFF Research Database (Denmark)

    Lynnerup, Niels

    2015-01-01

    In northern Europe during the Iron Age, many corpses were deposited in bogs. The cold, wet and anaerobic environment leads in many cases to the preservation of soft tissues, so that the bodies, when found and excavated several thousand years later, are remarkably intact. Since the 19th century...... the bog bodies have been studied using medical and natural scientific methods, and recently many bog bodies have been re-examined using especially modern, medical imaging techniques. Because of the preservation of soft tissue, especially the skin, it has been possible to determine lesions and trauma....... Conversely, the preservation of bones is less good, as the mineral component has been leached out by the acidic bog. Together with water-logging of collagenous tissue, this means that if the bog body is simply left to dry out when found, as was the case pre-19th century, the bones may literally warp...

  6. BODY CONDITION

    African Journals Online (AJOL)

    Andrew Taylor

    African antelope have both advantages and disadvantages in terms of meat production when compared with domestic .... Because juveniles can be differentiated from adults using BW, age differences in body ..... Meat and carcass by-products.

  7. The economic burden of Clostridium difficile

    Science.gov (United States)

    McGlone, S. M.; Bailey, R. R.; Zimmer, S. M.; Popovich, M. J.; Tian, Y.; Ufberg, P.; Muder, R. R.; Lee, B. Y.

    2013-01-01

    Although Clostridium difficile (C. difficile) is the leading cause of infectious diarrhoea in hospitalized patients, the economic burden of this major nosocomial pathogen for hospitals, third-party payers and society remains unclear. We developed an economic computer simulation model to determine the costs attributable to healthcare-acquired C. difficile infection (CDI) from the hospital, third-party payer and societal perspectives. Sensitivity analyses explored the effects of varying the cost of hospitalization, C. difficile-attributable length of stay, and the probability of initial and secondary recurrences. The median cost of a case ranged from $9179 to $11 456 from the hospital perspective, $8932 to $11 679 from the third-party payor perspective, and $13 310 to $16 464 from the societal perspective. Most of the costs incurred were accrued during a patient’s primary CDI episode. Hospitals with an incidence of 4.1 CDI cases per 100 000 discharges would incur costs ≥$3.2 million (hospital perspective); an incidence of 10.5 would lead to costs ≥$30.6 million. Our model suggests that the annual US economic burden of CDI would be ≥$496 million (hospital perspective), ≥$547 million (third-party payer perspective) and ≥$796 million (societal perspective). Our results show that C. difficile infection is indeed costly, not only to third-party payers and the hospital, but to society as well. These results are consistent with current literature citing C. difficile as a costly disease. PMID:21668576

  8. In vivo monitoring of skeletal aluminium burden in patients with renal failure

    International Nuclear Information System (INIS)

    Ellis, K.J.; Kelleher, S.; Raciti, A.; Savory, J.; Wills, M.

    1988-01-01

    In vivo neutron activation analysis was used to examine the total body and partial body (hand) aluminium levels in patients with end-stage renal failure. Patients maintained on chronic hemodialysis had higher mean body burdens of aluminium than did those clinically managed without dialysis. Approximately 70% of the patients examined indicated elevated levels of body or skeletal aluminium. A significant correlation was observed between the in vivo aluminium/calcium ratio obtained for the hand measurement and the increase in serum aluminium levels following a disferroxamine infusion test. The direct in vivo monitoring of hand Al/Ca values in patients may provide an alternate choice to bone biopsy for the detection of aluminium intoxication. (author) 15 refs.; 5 figs.; 2 tabs

  9. Disability and functional burden of disease because of mental in comparison to somatic disorders in general practice patients.

    Science.gov (United States)

    Linden, M; Linden, U; Schwantes, U

    2015-09-01

    Severity of illness is not only depending on the symptom load, but also on the burden in life. Mental disorders are among those illnesses, which in particular cause suffering to the individual and society. To study burden of disease for mental in comparison to somatic disorders, 2099 patients from 40 general practitioners filled in (a) the Burvill scale which measures acute and chronic illnesses in ten different body systems and (b) the IMET scale which measures impairment in ten different areas of life. Patients were suffering on average from acute and/or chronic illness in 3.5 (SD: 2.0) body systems and 56.6% of patients complained about acute and/or chronic mental disorders. The most significant negative impact on the IMET total score have acute and chronic mental disorders, followed by chronic neurological and musculoskeletal and acute respiratory and gastrointestinal disorders, while cardiovascular, metabolic, urogenital, haematological and ear/eye disorders have no greater impact. Acute as well as chronic mental disorders cause impairment across all areas of life and most burden of disease (functional burden of disease 1.69), followed by musculoskeletal disorders (1.62). Mental disorders are among the most frequent health problems with high negative impact across all areas of life. When combining frequency and impairment mental disorders cause most burden of disease in comparison to other illnesses. This should be reflected in the organization of medical care including family medicine. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. Neglected Tropical Diseases: Epidemiology and Global Burden

    Directory of Open Access Journals (Sweden)

    Amal K. Mitra

    2017-08-01

    Full Text Available More than a billion people—one-sixth of the world’s population, mostly in developing countries—are infected with one or more of the neglected tropical diseases (NTDs. Several national and international programs (e.g., the World Health Organization’s Global NTD Programs, the Centers for Disease Control and Prevention’s Global NTD Program, the United States Global Health Initiative, the United States Agency for International Development’s NTD Program, and others are focusing on NTDs, and fighting to control or eliminate them. This review identifies the risk factors of major NTDs, and describes the global burden of the diseases in terms of disability-adjusted life years (DALYs.

  11. The global burden of paediatric heart disease

    DEFF Research Database (Denmark)

    Musa, Ndidiamaka L; Hjortdal, Vibeke; Zheleva, Bistra

    2017-01-01

    An estimated 15 million children die or are crippled annually by treatable or preventable heart disease in low- and middle-income countries. Global efforts to reduce under-5 mortality have focused on reducing death from communicable diseases in low- and middle-income countries with little...... to no attention focusing on paediatric CHD and acquired heart disease. Lack of awareness of CHD and acquired heart disease, access to care, poor healthcare infrastructure, competing health priorities, and a critical shortage of specialists are important reasons why paediatric heart disease has not been addressed...... in low resourced settings. Non-governmental organisations have taken the lead to address these challenges. This review describes the global burden of paediatric heart disease and strategies to improve the quality of care for paediatric heart disease. These strategies would improve outcomes for children...

  12. Sacralising Bodies

    DEFF Research Database (Denmark)

    Kaur, Ravinder

    2010-01-01

    of sacralisation is realised through co-production within a social setting when the object of sacralisation is recognised as such by others. In contemporary Iran, however, the moment of sacralising bodies by the state is also the moment of its own subversion as the political-theological field of martyrdom......-sacrifice became central to the mass mobilisation against the monarchy. Once the revolutionary government came into existence, this sacred tradition was regulated to create ‘martyrs’ as a fixed category, in order to consolidate the legacy of the revolution. In this political theatre, the dead body is a site...

  13. Burden of serious fungal infections in Ukraine.

    Science.gov (United States)

    Osmanov, Ali; Denning, David W

    2015-10-01

    Ukraine has high rates of TB, AIDS and cancer. We estimated the burden of fungal disease from epidemiology papers and specific populations at risk and fungal infection frequencies. HIV/AIDS cases and deaths (2012) and tuberculosis statistics were obtained from the State Service of Ukraine, while chronic obstructive pulmonary disease (COPD) cases were from M. Miravitlles et al., Thorax 64, 863-868 (2009). Annual estimates are 893,579 Ukrainian women get recurrent vaginal thrush (≥4× per year), 50,847 cases of oral candidiasis and 13,727 cases of oesophageal candidiasis in HIV, and 101 (1%) of 10,085 new AIDS cases develop cryptococcal meningitis, 6152 cases of Pneumocystis pneumonia (13.5 cases per 100,000). Of the 29,265 cases of active respiratory TB in 2012, it is estimated that 2881 new cases of chronic pulmonary aspergillosis (CPA) occurred and that the 5-year period prevalence is 7724 cases with a total CPA burden of 10,054 cases. Assuming adult asthma prevalence is ~2.9%, 28,447 patients with allergic bronchopulmonary aspergillosis (ABPA) are likely and 37,491 with severe asthma with fungal sensitisation. We estimate 2278 cases and 376 postsurgical intra-abdominal Candida infections. Invasive aspergillosis in immunocompromised patients is estimated at 303 patients annually; 930 cases in COPD patients. Ninety cases of mucormycosis (2 per 1,000,000) are estimated. In total, ~1,000,000 (2.2%) people in Ukraine develop serious fungal infections annually. © 2015 Blackwell Verlag GmbH.

  14. The Burden of Cholera in Uganda

    Science.gov (United States)

    Bwire, Godfrey; Malimbo, Mugagga; Maskery, Brian; Kim, Young Eun; Mogasale, Vittal; Levin, Ann

    2013-01-01

    Introduction In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination. Methods The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured. Results Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61–182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4–44 weeks. Discussion There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations

  15. Economic burden associated with hospital postadmission dehydration.

    Science.gov (United States)

    Pash, Elizabeth; Parikh, Niraj; Hashemi, Lobat

    2014-11-01

    Development of dehydration after hospital admission can be a measure of quality care, but evidence describing the incidence, economic burden, and outcomes of dehydration in hospitalized patients is lacking. The objective of this study was to compare costs and resource utilization of U.S. patients experiencing postadmission dehydration (PAD) with those who do not in a hospital setting. All adult inpatient discharges, excluding those with suspected dehydration present on admission (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes for dehydration: 276.0, 276.1, 276.5), were identified from the Premier database using ICD-9-CM codes. PAD and no-PAD (NPAD) groups were matched on propensity score adjusting for demographics (age, sex, race, medical, elective patients), patient severity (All Patient Refined Diagnosis-Related Groups severity scores), and hospital characteristics (geographic location, bed size, teaching and urban hospital). Costs, length of stay (LOS), and incidence of mortality and catheter-associated urinary tract infection (CAUTI) were compared between groups using the t test for continuous variables and the χ(2) test for categorical variables. In total, 86,398 (2.1%) of all the selected patients experienced PAD. Postmatching mean total costs were significantly higher for the PAD group compared with the NPAD group ($33,945 vs $22,380; P < .0001). Departmental costs were also significantly higher for the PAD group (all P < .0001). Compared with the NPAD group, the PAD group had a higher mean LOS (12.9 vs 8.2 days), a higher incidence of CAUTI (0.6% vs 0.5%), and higher in-hospital mortality (8.6% vs 7.8%) (all P < .05). The results for subgroup analysis also showed significantly higher total cost and longer LOS days for patients with PAD (all P < .05). The economic burden associated with hospital PAD in medical and surgical patients was substantial. © 2014 American Society for Parenteral and Enteral

  16. Psoriasis causes significant economic burden to patients.

    Science.gov (United States)

    Mustonen, A; Mattila, K; Leino, M; Koulu, L; Tuominen, R

    2014-06-01

    Psoriasis results in expenses to patients from many cost sources. Psoriasis treatments may result in considerable time and traveling costs, yet many studies fail to account for these costs. The objective of this study was to evaluate the multidimensional economic burden of psoriasis to patients. The study was based on 232 Finnish patients with psoriasis or psoriatic arthritis visiting a tertiary level dermatological clinic during a 1-year study period between October 1, 2009 and September 30, 2010. The data were based on a patient questionnaire, clinical data from the medical records and reimbursement data from the Finnish Social Insurance Institution. Item costs were based on true costs charged from the patients and all time cost estimates were based on the Human Capital Approach method. 199 patients with psoriasis and 33 with psoriatic arthritis were included in the study. Total costs were higher for patients receiving traditional systemic medications or phototherapy than those not receiving such treatment. Travel costs and travel time costs accounted for more than 60% of the costs of phototherapy. Skin care at home was time consuming and thus caused significant burden to patients. The majority of the visit costs arose from hospital visits and only a small proportion were attributed to visiting primary health care providers. Visit charges and other patient co-payments were estimated to play a minor role in the total cost of psoriasis incurred by patients, while travel costs and lost time comprised the majority of the costs, which should not be omitted in future studies regarding costs of treatments.

  17. Economic burden of cervical cancer in Malaysia

    Directory of Open Access Journals (Sweden)

    Sharifa E.W. Puteh

    2008-12-01

    Full Text Available Cervical cancers form the second highest number of female cancers in Malaysia, imposing a substantial amount of cost burden on its management. However, an estimation of cost burden of abnormal smears, cervical pre-invasive and invasive diseases needs to be done to show how much spending has been allocated to the problem. An expert panel committee came up with the clinical pathway and management algorithm of  cervical pre invasive and invasive diseases from July-December 2006 Malaysia. An activity based costing for each clinical pathway was done. Results were converted to USD. The cost of managing pre-invasive cervical cancers stage is USD 420,150 (Range: USD 197,158-879,679. Management of invasive cancer (new cases costs USD 51,533,233.44 (Range: USD 32,405,399.69 - USD 129,014,768.40. The cost of managing existing cases is USD 17,005,966.87 (Range: USD 10,693,781.90 - USD  28,901,587.12. The total cost of managing cervical cancers by health care providers in a public setting is around USD 75,888,329.45 (Range: USD 48,083,804.60 - USD 48,083,804.60. The outcome of this study has shown that preventive modalities such as screening have only contributed to 10.3 % of the total management cost of cervical cancer. The major cost contribution (67% came from treatment of invasive cancer especially at more advanced stages of cancer, followed by treatment of existing cases (22% and lastly on pre-invasive disease (0.6%. This study revealed that proportion of preventive modality in this country was still low, and the major cost came from actual treatment cost of cervical cancer. Therefore, heightened public cervical cancer screening in the country is needed. (Med J Indones 2008; 17: 272-80Keywords: cervical cancers, pre invasive disease, HPV vaccination

  18. Burden Sharing with Climate Change Impacts

    Science.gov (United States)

    Tavoni, M.; van Vuuren, D.; De Cian, E.; Marangoni, G.; Hof, A.

    2014-12-01

    Efficiency and equity have been at the center of the climate change policy making since the very first international environmental agreements on climate change, though over time how to implement these principles has taken different forms. Studies based on Integrated Assessment Models have also shown that the economic effort of achieving a 2 degree target in a cost-effective way would differ widely across regions (Tavoni et al. 2013) because of diverse economic and energy structure, baseline emissions, energy and carbon intensity. Policy instruments, such as a fully-fledged, global emission trading schemes can be used to pursuing efficiency and equity at the same time but the literature has analyzed the compensations required to redistribute only mitigation costs. However, most of these studies have neglected the potential impacts of climate change. In this paper we use two integrated assessment models -FAIR and WITCH- to explore the 2°C policy space when accounting for climate change impacts. Impacts are represented via two different reduced forms equations, which despite their simplicity allows us exploring the key sensitivities- Our results show that in a 2 degree stabilization scenarios residual damages remain significant (see Figure 1) and that if you would like to compensate those as part of an equal effort scheme - this would lead to a different allocation than focusing on a mitigation based perspective only. The residual damages and adaptation costs are not equally distributed - and while we do not cover the full uncertainty space - with 2 different models and 2 sets of damage curves we are still able to show quite similar results in terms of vulnerable regions and the relative position of the different scenarios. Therefore, accounting for the residual damages and the associated adaptation costs on top of the mitigation burden increases and redistributes the full burden of total climate change.

  19. Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake.

    Science.gov (United States)

    Sekiyama, Makiko; Jiang, Hong Wei; Gunawan, Budhi; Dewanti, Linda; Honda, Ryo; Shimizu-Furusawa, Hana; Abdoellah, Oekan S; Watanabe, Chiho

    2015-10-02

    Indonesia is facing household-level double burden malnutrition. This study aimed at examining (1) household-level double burden for the mother-child and father-child pairs; (2) risk of adiposity of double burden households; and (3) associated dietary factors. Subjects were 5th and 6th grade elementary school children (n = 242), their mothers (n = 242), and their fathers (n = 225) in five communities (1 = urban, 4 = rural) in the Bandung District. Questionnaires on socioeconomic factors, blood hemoglobin measurements, and anthropometric measurements were administered. For adults, body fat percentage (BF%) was estimated by bioelectrical impedance (BF%-BI) and by converting skinfold thickness (ST) data using Durnin and Womersley's (1974) formula (BF%-ST). Food frequency questionnaires were also completed. Double burden was defined as coexistence of maternal or paternal overweight (Body mass index (BMI) ≥ 23) and child stunting (height-for-age z-score child double burden occurred in 30.6% of total households, whereas paternal-child double burden was only in 8.4%. Mothers from double burden households showed high adiposity; 87.3% with BF%-BI and 66.2% with BF%-ST had BF% >35%, and 60.6% had waists >80 cm. The major dietary patterns identified were "Modern" and "High-animal products". After controlling for confounding factors, children in the highest quartile of the "High-animal products" dietary pattern had a lower risk of maternal-child double burden (Adjusted OR: 0.46, 95% CI: 0.21-1.04) than those in the lowest quartile. Given that the "High-animal products" dietary pattern was associated with the decreased risk of maternal-child double burden through a strong negative correlation with child stunting, improving child stunting through adequate intake of animal products is critical to solve the problem of maternal-child double burden in Indonesia.

  20. Ventilator associated pneumonia: perspectives on the burden of illness.

    Science.gov (United States)

    Cook, D

    2000-01-01

    The objective of this narrative review is to summarize selected current concepts and clinical evidence regarding the burden of illness of VAP, including its epidemiology, diagnosis, attributable mortality and risk factors. Studies were identified through MEDLINE, EMBASE, bibliographies of primary and review articles and personal files. While cross sectional studies inform us about VAP prevalence, longitudinal studies inform us of the cumulative risk and conditional risk of developing VAP. Reported VAP rates are modulated by factors related to case mix, causative microorganisms, interventions that influence risk over time, and VAP definitions employed. Population-specific and organism-specific VAP rates are needed to avoid misleading benchmarking between different ICUs, and to minimize inappropriate between-study comparisons. Observational studies have shown that invasive sampling techniques versus non-invasive approaches to diagnose VAP facilitates more targeted antibiotic treatment; however, the influence of the diagnostic method on endpoints such as mortality is less clear. VAP is associated with approximately a 4 day increase in length of ICU stay and an attributable mortality of approximately 20-30%. Fixed VAP risk factors include underlying cardiorespiratory disease, neurologic injury and trauma. Modifiable VAP risk factors include supine body position, witnessed aspiration, paralytic agents and antibiotic exposure. If modifiable risk factors tested in randomized trials lower VAP rates, such as semirecumbency versus supine positioning, these represent effective VAP prevention strategies. Ventilator-associated pneumonia is a major morbid outcome among critically ill patients. Studies evaluating more effective prevention and treatment strategies are needed.

  1. Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review.

    Science.gov (United States)

    Tzioumis, Emma; Adair, Linda S

    2014-06-01

    In low- and middle-income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively. To critically review literature on the prevalence, trends, and predictors of the dual burden, with a focus on children from birth to 18 years of age. We reviewed literature since January 1, 1990, published in English, using the PubMed search terms nutrition transition, double burden, dual burden, nutrition status, obesity, overweight, underweight, stunting, body composition, and micronutrient deficiencies. The findings were classified and described according to dual burden level (community, household, or individual). Global trends indicate decreases in diseases of undernutrition, while overnutrition is increasing. On the community level, economic status may influence the extent of the dual burden, with obesity increasingly affecting the already undernourished poor. In a household, shared determinants of poor nutritional status among members can result in disparate nutritional status across generations. Within an individual, obesity may co-occur with stunting or anemia due to shared underlying determinants or physiologic links. The dual burden of malnutrition poses a threat to children's health in low- and middle-income countries. We must remain committed to reducing undernutrition while simultaneously preventing over-nutrition through integrated child health programs that incorporate prevention of infection, diet quality, and physical activity.

  2. Body Basics

    Science.gov (United States)

    ... learn more about how the body works, what basic human anatomy is, and what happens when parts of ... consult your doctor. © 1995- The Nemours Foundation. All rights reserved. Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.

  3. Body / Antibody

    Directory of Open Access Journals (Sweden)

    Lawrence R. Schehr

    1996-06-01

    Full Text Available Unique object in the exchange-system, the gay body occupies a locus where a phantom identity and an imagined reciprocity define the poles of the subject-object relation. Made of the right stuff, it is an object circulating in a system that tends to reproduce the concept of identity in its search for mirror images of itself. Often rejected by the world, it has recently become a cynosure equated with sickness, pestilence, and death in the age of AIDS. The representations of that object change: no longer perceived as a part of libidinal economy, it has become a mass of symptoms, having changed from being an index of sexuality into being the visible dissipation of the flesh. The gay body in the age of AIDS is the mark of a pariah with the abject nature of the outcast. The body with AIDS takes the form of a text made of many signs and with many ways of reading the checkerboard pattern of the flesh. And the AIDS-narrative turns the body into the limit of the representable.

  4. Body Language.

    Science.gov (United States)

    Pollard, David E.

    1993-01-01

    Discusses how the use of body language in Chinese fiction strikes most Westerners as unusual, if not strange. Considers that, although this may be the result of differences in gestures or different conventions in fiction, it is a problem for translators, who handle the differences by various strategies, e.g., omission or expansion. (NKA)

  5. Beyond Attributable Burden: Estimating the Avoidable Burden of Disease Associated with Household Air Pollution.

    Directory of Open Access Journals (Sweden)

    Randall Kuhn

    Full Text Available The Global Burden of Disease (GBD studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia.We estimate the avoidable burden associated with HAP using International Futures (IFs, an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI and four noncommunicable diseases (NCDs. We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs

  6. Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

    Science.gov (United States)

    Sorrell, Jeanne M

    2014-03-01

    Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient. Copyright 2014, SLACK Incorporated.

  7. Burden of illness in functional gastrointestinal disorder--the consequences for the individual and society.

    Science.gov (United States)

    Glise, H; Wiklund, I; Hallerbäck, B

    1998-01-01

    To review the consequences of functional gastrointestinal disorders (FGD), i.e. heartburn without esophagitis, dyspepsia and IBS for the individual and society. Current publications indicate that functional gastrointestinal disorders are more prevalent than organic gastrointestinal disorders in the population. Symptoms, not the organic finding per se, are most important to the individual. Functional disorders are furthermore linked to somatic symptoms, from other parts of the body, as well as to mental health. Together they constitute a large medical burden on society in terms of consultations, drug consumption and surgery. Social costs are further increased by problems at work and a considerable increase in absenteeism. Functional gastrointestinal disorders should be taken more seriously by the medical community and society, since the burden of illness seems much larger than earlier anticipated.

  8. Implementation of Department of Defense Survey Burden Action Plan - Reducing Survey Burden, Cost and Duplication

    Science.gov (United States)

    2017-08-23

    vulnerable populations (e.g., minors); or 3) sensitive topics (e.g., gender relations, discrimination , UCMJ violations) to improve tracking of survey...e.g., gender relations, discrimination , UCMJ violations) to improve tracking of survey burden. The applicable ISSCC-member Survey Office will...their families per year; or 2) vulnerable populations (e.g., minors); or 3) sensitive topics (e.g., gender relations, discrimination , UCMJ violations

  9. Measuring the burden of neglected tropical diseases: the global burden of disease framework.

    Directory of Open Access Journals (Sweden)

    Colin D Mathers

    2007-11-01

    Full Text Available Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY.This paper describes key features of the Global Burden of Disease analytic approach, which provides a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and a systematic approach to the evaluation of data. The paper describes the evolution of the GBD, starting from the first study for the year 1990, summarizes the methodological improvements incorporated into GBD revisions for the years 2000-2004 carried out by the World Health Organization, and examines priorities and issues for the next major GBD study, funded by the Bill & Melinda Gates Foundation, and commencing in 2007.The paper presents an overview of summary results from the Global Burden of Disease study 2002, with a particular focus on the neglected tropical diseases, and also an overview of the comparative risk assessment for 26 global risk factors. Taken together, trypanosomiasis, Chagas disease, schistosomiasis, leishmaniasis, lymphatic filariasis, onchocerciasis, intestinal nematode infections, Japanese encephalitis, dengue, and leprosy accounted for an estimated 177,000 deaths worldwide in 2002, mostly in sub-Saharan Africa, and about 20 million DALYs, or 1.3% of the global burden of disease and injuries. Further research is currently underway to revise and update these estimates.

  10. The Global Burden of Cancer 2013

    Science.gov (United States)

    2015-01-01

    IMPORTANCE Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. EVIDENCE REVIEW The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. The MI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated using MI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs. FINDINGS In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16

  11. Burden of Serious Fungal Infections in Jordan

    Directory of Open Access Journals (Sweden)

    Jamal Wadi

    2018-01-01

    Full Text Available Objective: To estimate the burden of fungal infections in Jordan for the first time. Material and Methods: Population data was from UN 2011 statistics and TB cases from WHO in 2012. Fewer than 100 patients with HIV were recorded in Jordan in 2013. Approximately 100 renal transplants and eight liver transplants are performed annually. There were 12,233 major surgical procedures in Jordan in 2013, of which 5.3% were major abdominal surgeries; candidemia was estimated in 5% of the population based on other countries, with 33% occurring in the ICU. Candida peritonitis/intra-abdominal candidiasis was estimated to affect 50% of the number of ICU candidemia cases. No adult asthma rates have been recorded for Jordan, so the rate from the Holy Land (8.54% clinical asthma from To et al. has been used. There are an estimated 49,607 chronic obstructive pulmonary disease (COPD patients in Jordan, with 64% symptomatic, 25% Gold stage 3% or 4%, and 7% (3472 are assumed to be admitted to hospital each year. No cystic fibrosis cases have been recorded. Literature searches on fungal infections revealed few data and no prevalence data on fungal keratitis or tinea capitis, even though tinea capitis comprised 34% of patients with dermatophytoses in Jordan. Results: Jordan has 6.3 million inhabitants (65% adults, 6% are >60 years old. The current burden of serious fungal infections in Jordan was estimated to affect ~119,000 patients (1.9%, not including any cutaneous fungal infections. Candidemia was estimated at 316 cases and invasive aspergillosis in leukemia, transplant, and COPD patients at 84 cases. Chronic pulmonary aspergillosis prevalence was estimated to affect 36 post-TB patients, and 175 in total. Allergic bronchopulmonary aspergillosis (ABPA and severe asthma with fungal sensitization (SAFS prevalence in adults with asthma were estimated at 8900 and 11,748 patients. Recurrent vulvovaginal candidiasis was estimated to affect 97,804 patients, using a 6

  12. The burden on informal caregivers of people with bipolar disorder.

    Science.gov (United States)

    Ogilvie, Alan D; Morant, Nicola; Goodwin, Guy M

    2005-01-01

    Caregivers of people with bipolar disorder may experience a different quality of burden than is seen with other illnesses. A better understanding of their concerns is necessary to improve the training of professionals working with this population. Conceptualizing caregiver burden in a conventional medical framework may not focus enough on issues important to caregivers, or on cultural and social issues. Perceptions of caregivers about bipolar disorder have important effects on levels of burden experienced. It is important to distinguish between caregivers' experience of this subjective burden and objective burden as externally appraised. Caregivers' previous experiences of health services may influence their beliefs about the illness. Caregiver burden is associated with depression, which affects patient recovery by adding stress to the living environment. The objective burden on caregivers of patients with bipolar disorder is significantly higher than for those with unipolar depression. Caregivers of bipolar patients have high levels of expressed emotion, including critical, hostile, or over-involved attitudes. Several measures have been developed to assess the care burden of patients with depressive disorders, but may be inappropriate for patients with bipolar disorder because of its cyclical nature and the stresses arising from manic and hypomanic episodes. Inter-episode symptoms pose another potential of burden in patients with bipolar disorder. Subsyndromal depressive symptoms are common in this phase of the illness, resulting in severe and widespread impairment of function. Despite the importance of assessing caregiver burden in bipolar disorder, relevant literature is scarce. The specific effects of mania and inter-episode symptoms have not been adequately addressed, and there is a lack of existing measures to assess burden adequately, causing uncertainty regarding how best to structure family interventions to optimally alleviate burden. The relatively few

  13. CAREGIVER BURDEN AMONG PEOPLE CARING FOR PATIENTS WITH SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Shivani Bansal

    2017-04-01

    Full Text Available BACKGROUND Caregivers of patients suffering from mental illness report burden in different areas including effects on family functioning, psychological problems, financial problems and health. The aim of the study is to determine the sociodemographic profile and caregiver burden among caregivers of persons with schizophrenia and to study the effect of patients’ psychopathology on caregiver burden scale. MATERIALS AND METHODS The present study was conducted in the Psychiatry Department, Government Medical College, Amritsar. A sample size of 34 was taken who were primary caregivers (preferably parents or spouse of schizophrenia patients diagnosed using ICD10. Measures included caregiver’s demographic variables and caregiver’s burden using the Zarit burden interview and PANSS scale in patients. Statistical Analysis- Data was analysed using SPSS software version 21. RESULTS The mean age of the caregiver was 42 SD (12.16 years. The majority of the caregivers were parents, married and employed. The mean average score of the responses to Zarit burden interview was (SD=59.52 ± 20.92. Majority of the caregivers experienced severe burden (52.9%, 9 (26.4% caregivers had reported moderate burden and 6 (17.6% had reported mild burden. The mean duration of illness was 6.89 (SD=5.03 years. The level of burden experienced was significantly associated with total PANSS score, negative symptoms, positive symptoms, general psychopathology score and duration of schizophrenia illness (p=0.00. CONCLUSION There is need for psychological assistance and social support for the vulnerable caregivers to help them reduce the burden levels and employ positive coping strategies.

  14. Caregivers' burden in patients with COPD.

    Science.gov (United States)

    Miravitlles, Marc; Peña-Longobardo, Luz María; Oliva-Moreno, Juan; Hidalgo-Vega, Álvaro

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a very prevalent and invalidating disease. The aim of this study was to analyze the burden borne by informal caregivers of patients with COPD. We used the Survey on Disabilities, Personal Autonomy, and Dependency Situations (Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia [EDAD]-2008) to obtain information on the characteristics of disabled individuals with COPD and their caregivers in Spain. Additionally, statistical multivariate analyses were performed to analyze the impact that an increase in dependence would have on the problems for which caregivers provide support, in terms of health, professional, and leisure/social dimensions. A total of 461,884 individuals with one or more disabilities and with COPD were identified, and 220,892 informal caregivers were estimated. Results showed that 35% of informal caregivers had health-related problems due to the caregiving provided; 83% had leisure/social-related problems; and among caregivers of working age, 38% recognized having profession-related problems. The probability of a problem arising was significantly associated with the degree of dependence of the patient receiving care. Caregivers of patients with great dependence showed a 39% higher probability of presenting health-related problems, 27% more professional problems, and 23% more leisure problems compared with those with nondependent patients. The results show the large impact on society in terms of the welfare of informal caregivers of patients with COPD. A higher level of dependence was associated with more severe problems in caregivers, in all dimensions.

  15. Burden of serious fungal infections in Mexico.

    Science.gov (United States)

    Corzo-León, D E; Armstrong-James, D; Denning, D W

    2015-10-01

    Serious fungal infections (SFIs) could be more frequent than are recognised. Estimates of the incidence and prevalence of SFIs are essential in order to identify public health problems. We estimated the rates of SFIs in Mexico, following a methodology similar to that used in prior studies. We obtained information about the general population and populations at risk. A systematic literature search was undertaken to identify epidemiological reports of SFIs in Mexico. When Mexican reports were unavailable, we based our estimates on international literature. The most prevalent SFIs in Mexico are recurrent vulvovaginal candidiasis (5999 per 100,000) followed by allergic bronchopulmonary aspergillosis (60 per 100,000), chronic pulmonary aspergillosis (15.9 per 100,000), fungal keratitis (10.4 per 100,000), invasive candidiasis (8.6 per 100,000) and SFIs in HIV (8.2 per 100,000); coccidioidomycosis (7.6 per 100,000), IA (4.56 per 100,000). These correspond to 2,749,159 people affected in any year (2.45% of the population), probably >10,000 deaths and 7000 blind eyes. SFIs affect immunocompromised and healthy populations. Most are associated with high morbidity and mortality rates. Validation of these estimates with epidemiological studies is required. The burdens indicate that an urgent need to improve medical skills, surveillance, diagnosis, and management of SFIs exists. © 2015 Blackwell Verlag GmbH.

  16. Caregiver burden among relatives of patients with schizophrenia in ...

    African Journals Online (AJOL)

    both patients and their caregivers.1,2 Caregiver burden in mental illness can either be ... with chronic mental illness.9 Consequently, there is a need to study the burden of ..... References. 1. Kung W. The illness, stigma, culture or immigration?

  17. Burdens and Standards of Proof in Possession of Unexplained ...

    African Journals Online (AJOL)

    Cases such as Workineh Kenbato & Amelework Dalie demonstrate the confusion regarding who bears what burden, for which facts the burden would apply and the required standard of proof thereof. Despite efforts to use the prosecution of illicit enrichment as a weapon in the combat against corruption, there are concerns ...

  18. 34 CFR 34.14 - Burden of proof.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Burden of proof. 34.14 Section 34.14 Education Office of the Secretary, Department of Education ADMINISTRATIVE WAGE GARNISHMENT § 34.14 Burden of proof. (a... those in § 34.24. (d)(1) If you object on the ground that applicable law bars us from collecting the...

  19. 6 CFR 27.325 - Burden of proof.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Burden of proof. 27.325 Section 27.325 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM... burden of proving the facts necessary to support the challenged administrative action at every proceeding...

  20. The burden of disease attributable to sexually transmitted infections ...

    African Journals Online (AJOL)

    Years of life lost (YLL) and years lived with disability (YLD) were estimated using different approaches for HIV I AIDS, other STis and cervical cancer. Burden in respect of HIV I AIDS was estimated using the ASSA2002 model, and for the other diseases the revised national burden of disease estimates for 2000 based on ...

  1. Tuberculous Pericarditis is Multibacillary and Bacterial Burden Drives High Mortality

    Directory of Open Access Journals (Sweden)

    Jotam G. Pasipanodya

    2015-11-01

    Interpretation: Patients with culture confirmed tuberculous pericarditis have a high bacillary burden, and this bacterial burden drives mortality. Thus proven tuberculosis pericarditis is not a paucibacillary disease. Moreover, the severe immunosuppression suggests limited inflammation. There is a need for the design of a highly bactericidal regimen for this condition.

  2. Thailand's Student Loans Fund: Interest Rate Subsidies and Repayment Burdens

    Science.gov (United States)

    Chapman, Bruce; Lounkaew, Kiatanantha; Polsiri, Piruna; Sarachitti, Rangsit; Sitthipongpanich, Thitima

    2010-01-01

    Government student loan schemes typically have implicit interest rate subsidies which, while these are a cost to taxpayers, they have the benefit of diminishing repayment burdens for graduates. Our goal is to illustrate the extent of both interest rate subsidies and repayment burdens with respect to Thailand's Student Loans Fund (SLF), using…

  3. Caregiver burden among relatives of patients with schizophrenia in ...

    African Journals Online (AJOL)

    Background. Caring for patients with schizophrenia places an enormous burden on the caregivers. The magnitude of this problem remains largely unknown in sub-Saharan Africa. Objective. The objective of this study was to determine the nature of the burden reported by caregiving relatives of patients with schizophrenia.

  4. Estimating the burden of disease attributable to unsafe water and ...

    African Journals Online (AJOL)

    Objectives. To estimate the burden of disease attributable to unsafe water, sanitation and hygiene (WSH) by age group for South Africa in 2000. Design. World Health Organization comparative risk assessment methodology was used to estimate the disease burden attributable to an exposure by comparing the observed risk ...

  5. Caregiver burden and correlates among caregivers of children and ...

    African Journals Online (AJOL)

    Journal of Child and Adolescent Mental Health ... Data on socio-demographic factors, psychiatric morbidity among caregivers, and level of caregiver burden was collected using a researcher-designed socio-demographic questionnaire, Mini International Neuropsychiatric Interview, and Zarit burden interview, respectively.

  6. Household burden of chronic diseases in Ghana | Togoe | Ghana ...

    African Journals Online (AJOL)

    Conclusion: The relatively high direct cost of illness among households with person(s) living with NCDs and the associated high indirect burden of illness places undue stress on households. Research requires better measurement of the indirect burden with focus on the household. These findings suggest the necessity of ...

  7. The disease burden of congenital toxoplasmosis in Denmark, 2014

    DEFF Research Database (Denmark)

    Nissen, Ioanna; Jokelainen, Pikka; Stensvold, Christen Rune

    2017-01-01

    Congenital toxoplasmosis (CT) causes a substantial disease burden worldwide. The aim of this study was to estimate the disease burden of CT in Denmark, a developed country with free public healthcare and nationwide data available. Using data primarily from two public health surveillance programmes...

  8. Estimating the burden of disease attributable to unsafe water and ...

    African Journals Online (AJOL)

    Estimating the burden of disease attributable to unsafe water and lack of sanitation and hygiene in South Africa in 2000. ... Disease burden from diarrhoeal diseases, intestinal parasites and schistosomiasis, measured by deaths and disability-adjusted life years (DALYs). Results. 13 434 deaths were attributable to unsafe ...

  9. Caregiver burden in amyotrophic lateral sclerosis : A systematic review

    NARCIS (Netherlands)

    de Wit, Jessica; Bakker, Leonhard A; van Groenestijn, Annerieke C; van den Berg, Leonard H; Schröder, Carin D; Visser-Meily, Johanna Ma; Beelen, Anita

    BACKGROUND: Informal caregivers of patients with amyotrophic lateral sclerosis experience increased levels of caregiver burden as the disease progresses. Insight in the factors related to caregiver burden is needed in order to develop supportive interventions. AIM: To evaluate the evidence on

  10. Burden, genotype and phenotype profiles of adult patients with ...

    African Journals Online (AJOL)

    burden of SCD disease, with in excess of 300 000 new affected births annually ... child births globally.[3] In spite of the high burden of disease in SSA, SCD is often ..... supportive medication such as folic acid and patient clinic attendance.

  11. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    Science.gov (United States)

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  12. Private prayer among Alzheimer's caregivers: mediating burden and resiliency.

    Science.gov (United States)

    Wilks, Scott E; Vonk, M Elizabeth

    2008-01-01

    This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

  13. [Burden, empathy, and resilience in dependent people caregivers].

    Science.gov (United States)

    Navarro-Abal, Yolanda; López-López, María José; Climent-Rodríguez, José Antonio; Gómez-Salgado, Juan

    2018-02-10

    To analyse the differences in perceived burden between family caregivers who are users of patient associations and those who are not; to assess the relationship between burden, resilience, and empathy levels. Retrospective ex post facto study of two groups, one of them quasi control. The sample was composed of 155 informal caregivers (28 men and 155 women); 109 of them were users of patient relatives' associations and 46 were not. Both descriptive and bivariate comparative analyses were carried out. Caregivers who were members of patient associations showed lower burden and empathy levels than those who were not. This highlighted that the higher their level of perceived burden, the lower their level of resilience. Belonging to carers' associations results in a lower level of perceived burden and a lower risk of developing compassion fatigue syndrome. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Impossible body.

    Science.gov (United States)

    Lusero, L

    1999-01-01

    SUMMARY This play tells the story of one woman coming to terms with her "poly" identity through a journey into the multiple layers of love, race, sex, appearance and Otherness. The one-woman show Impossible Body was first performed for a reading series sponsored by "Onstage" at the University of Colorado, Boulder, in February 1997. A revised version was developed and staged at the University of Puget Sound in Tacoma, Washington in April 1997. The current script, from which these excerpts are taken, was first presented at the Queer Studies Conference in Boulder, Colorado.

  15. Body counter

    International Nuclear Information System (INIS)

    Koeppe, P.

    1975-01-01

    The paper gives a survey on some applications of the whole body counter in clinical practice and a critical study of its application as a routine testing method. Remarks on the necessary precautions are followed by a more detailed discussion of the determination of the natural potassium content, the iron metabolism, the vitamin B12 test, investigations of the metabolism of the bone using 47 Ca and 85 Sr, investigations with iodine and iodine-labelled substances, clearance investigations (in particular the 51 Cr EDTA clearance test), as well as the possibilities of neutron activation in vivo. (ORU/AK) [de

  16. The burden of insomnia in Japan

    Directory of Open Access Journals (Sweden)

    Mishima K

    2015-01-01

    Full Text Available Kazuo Mishima,1 Marco daCosta DiBonaventura,2 Hillary Gross2 1Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; 2Kantar Health, New York, NY, USA Objectives: Several studies have suggested that patients who experience insomnia report a number of significant impairments. However, despite this literature, fewer studies have focused on the burden of insomnia among patients in Japan. The objective of the current study is to extend this work in Japan to further understand the effect of insomnia on health-related quality of life (hrQOL. Further, another objective is to understand general predictors of hrQOL among patients with insomnia. Methods: Data from the 2012 Japan National Health and Wellness Survey, an annual, cross-sectional study of adults aged 18 years or older, were used (N=30,000. All National Health and Wellness Survey respondents were categorized based on the incidence of self-reported insomnia diagnosis and prescription medication usage (clinical insomniacs under treatment versus [vs] good sleepers without insomnia or insomnia symptoms. Comparisons among different groups were made using multiple regression models controlling for demographics and health history. Results: Clinical insomniacs (n=1,018; 3.4% reported significantly worse hrQOL compared with good sleepers (n=20,542 (mental component summary: 34.2 vs 48.0; physical component summary: 48.0 vs 52.8; health utilities: 0.61 vs 0.76; all P<0.05. Health behaviors (smoking, exercise, alcohol use and comorbidities were the strongest predictors of health utilities for clinical insomniacs. For all three clinical insomniac subgroups of interest, those with a physical comorbidity but not a psychiatric one, those with a psychiatric comorbidity but not a physical one, and those without either a physical or psychiatric comorbidity, large decrements in health utilities were observed for respondents who did

  17. Sacroiliac joint pain: burden of disease

    Science.gov (United States)

    Cher, Daniel; Polly, David; Berven, Sigurd

    2014-01-01

    Objectives The sacroiliac joint (SIJ) is an important and significant cause of low back pain. We sought to quantify the burden of disease attributable to the SIJ. Methods The authors compared EuroQol 5D (EQ-5D) and Short Form (SF)-36-based health state utility values derived from the preoperative evaluation of patients with chronic SIJ pain participating in two prospective clinical trials of minimally invasive SIJ fusion versus patients participating in a nationally representative USA cross-sectional survey (National Health Measurement Study [NHMS]). Comparative analyses controlled for age, sex, and oversampling in NHMS. A utility percentile for each SIJ subject was calculated using NHMS as a reference cohort. Finally, SIJ health state utilities were compared with utilities for common medical conditions that were published in a national utility registry. Results SIJ patients (number [n]=198) had mean SF-6D and EQ-5D utility scores of 0.51 and 0.44, respectively. Values were significantly depressed (0.28 points for the SF-6D utility score and 0.43 points for EQ-5D; both P<0.0001) compared to NHMS controls. SIJ patients were in the lowest deciles for utility compared to the NHMS controls. The SIJ utility values were worse than those of many common, major medical conditions, and similar to those of other common preoperative orthopedic conditions. Conclusion Patients with SIJ pain presenting for minimally invasive surgical care have marked impairment in quality of life that is worse than in many chronic health conditions, and this is similar to other orthopedic conditions that are commonly treated surgically. SIJ utility values are in the lowest two deciles when compared to control populations. PMID:24748825

  18. Burden of serious fungal infections in Bangladesh.

    Science.gov (United States)

    Gugnani, H C; Denning, D W; Rahim, R; Sadat, A; Belal, M; Mahbub, M S

    2017-06-01

    In Bangladesh there are several published papers on superficial mycoses. Deep mycoses are also recognized as an important emerging problem. Here, we estimate the annual incidence and prevalence of serious fungal infections in Bangladesh. Demographic data were obtained from world population reports and the data on TB and HIV extracted from the online publications on tuberculosis in Bangladesh and Asia Pacific research statistical data information resources AIDS Data HUB. All the published papers on fungal infections in Bangladesh were identified through extensive search of literature. We estimated the number of affected people from populations at risk and local epidemiological data. Bangladesh has a population of ∼162.6 million, 31% children and only 6% over the age of 60 years. The pulmonary TB caseload reported in 2014 was 119,520, and we estimate a prevalence of 30,178 people with chronic pulmonary aspergillosis, 80% attributable to TB. An anticipated 90,262 and 119,146 patients have allergic bronchopulmonary aspergillosis or severe asthma with fungal sensitization. Only 8,000 people are estimated to be HIV-infected, of whom 2900 are not on ART with a CD4 count Bangladesh. Candida bloodstream infection was estimated based on a 5 per 100,000 rate (8100 cases) and invasive aspergillosis based primarily on leukemia and COPD rates, at 5166 cases. Histoplasmosis was documented in 16 cases mostly with disseminated disease and presumed in 21 with HIV infection. This study constitutes the first attempt to estimate the burden of several types of serious fungal infections in Bangladesh.

  19. Arsenic burden survey among refuse incinerator workers

    Directory of Open Access Journals (Sweden)

    Chao Chung-Liang

    2005-01-01

    Full Text Available Background: Incinerator workers are not considered to have arsenic overexposure although they have the risk of overexposure to other heavy metals. Aim: To examine the relationship between arsenic burden and risk of occupational exposure in employees working at a municipal refuse incinerator by determining the concentrations of arsenic in the blood and urine. Settings and Design: The workers were divided into three groups based on their probability of contact with combustion-generated residues, namely Group 1: indirect contact, Group 2: direct contact and Group 3: no contact. Healthy age- and sex-matched residents living in the vicinity were enrolled as the control group. Materials and Methods: Heavy metal concentrations were measured by atomic absorption spectrophotometer. Downstream rivers and drinking water of the residents were examined for environmental arsenic pollution. A questionnaire survey concerning the contact history of arsenic was simultaneously conducted. Statistical analysis: Non-parametric tests, cross-tabulation and multinomial logistic regression. Results: This study recruited 122 incinerator workers. The urine and blood arsenic concentrations as well as incidences of overexposure were significantly higher in the workers than in control subjects. The workers who had indirect or no contact with combustion-generated residues had significantly higher blood arsenic level. Arsenic contact history could not explain the difference. Airborne and waterborne arsenic pollution were not detected. Conclusion: Incinerator workers run the risk of being exposed to arsenic pollution, especially those who have incomplete protection in the workplace even though they only have indirect or no contact with combustion-generated pollutants.

  20. Economic burden of diabetes in urban indians.

    Science.gov (United States)

    Chandra, Pablo; Gogate, Bageshri; Gogate, Parikshit; Thite, Nilesh; Mutha, Abhay; Walimbe, Amit

    2014-01-01

    To find out the average economic burden of medical care on a patient with diabetes in Pune, India. A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as direct cost (cost of medicines, doctor's fees, investigations, lasers and surgery) and indirect cost (travel, diet control, health classes and loss of wages). Data was collected regarding the socioeconomic status according to Kuppaswamy classification. 219 patients participated of whom 129 were males (58.9%). Average annual direct cost of diabetes treatment was Rs 8,822 of which 52.1% was spend on medicines, 3.2% was spend on lasers, 12.6% was spend on surgical procedures, 11.6% spent on investigations and 10.4% was spend on clinician fees. Average annual indirect cost was Rs. 3949 of which 3.4% was spend on travelling purpose, 0.4% was spent on health classes, 4.9% was spent on diet control and 91.3% was loss of wages. Average expenditure done by lower middle class was 23.7% of their income. Average percentage of income for direct and indirect cost was 3.6% and 1.4% respectively. The cost of the treatment formed1.3% of the annual income for those in Socio-economic class I, 1.7% in class II, 3.7% in class III and 23.7% in class IV. The cost of managing diabetes was a significant proportion of the patients' income, especially for those on lower socio-economic scale (class IV).

  1. Musculoskeletal disease burden of hereditary hemochromatosis.

    Science.gov (United States)

    Sahinbegovic, Enijad; Dallos, Tomáš; Aigner, Elmar; Axmann, Roland; Manger, Bernhard; Englbrecht, Matthias; Schöniger-Hekele, Maximilian; Karonitsch, Thomas; Stamm, Tanja; Farkas, Martin; Karger, Thomas; Stölzel, Ulrich; Keysser, Gernot; Datz, Christian; Schett, Georg; Zwerina, Jochen

    2010-12-01

    To determine the prevalence, clinical picture, and disease burden of arthritis in patients with hereditary hemochromatosis. In this cross-sectional observational study of 199 patients with hemochromatosis and iron overload, demographic and disease-specific variables, genotype, and organ involvement were recorded. The prevalence, intensity, and localization of joint pain were assessed, and a complete rheumatologic investigation was performed. Radiographs of the hands, knees, and ankles were scored for joint space narrowing, erosions, osteophytes, and chondrocalcinosis. In addition, the number and type of joint replacement surgeries were recorded. Joint pain was reported by 72.4% of the patients. Their mean ± SD age at the time of the initial joint symptoms was 45.8 ± 13.2 years. If joint pain was present, it preceded the diagnosis of hemochromatosis by a mean ± SD of 9.0 ± 10.7 years. Bony enlargement was observed in 65.8% of the patients, whereas synovitis was less common (13.6%). Joint space narrowing and osteophytes as well as chondrocalcinosis of the wrist and knee joints were frequent radiographic features of hemochromatosis. Joint replacement surgery was common, with 32 patients (16.1%) undergoing total joint replacement surgery due to severe OA. The mean ± SD age of these patients was 58.3 ± 10.4 years at time of joint replacement surgery. Female sex, metacarpophalangeal joint involvement, and the presence of chondrocalcinosis were associated with a higher risk of early joint failure (i.e., the need for joint replacement surgery). Arthritis is a frequent, early, and severe symptom of hemochromatosis. Disease is not confined to involvement of the metacarpophalangeal joints and often leads to severe damage requiring the replacement of joints. Copyright © 2010 by the American College of Rheumatology.

  2. Burden of Serious Fungal Infections in Argentina

    Directory of Open Access Journals (Sweden)

    Fernando O. Riera

    2018-04-01

    Full Text Available The number of fungal infections at any given time in Argentina is not known. Here we estimate the burden of serious fungal infections in Argentina for the first time. Specific population statistics were searched from multiple sources, local literature was identified, and estimates made. Some additional data were sourced from the Ministry of Health, the Global Initiative for Asthma (GINA program, and national haematology and transplant societies. Argentina has a population of 43.8 million, with 25% of this total being children under 15 years. The predicted candidemia annual incidence is 2193 cases, with 50% occurring in the ICU. At a 6% prevalence rate, an estimated 593,695 women suffer from recurrent vulvovaginal candidiasis. Invasive aspergillosis is relatively common because of high smoking and chronic obstructive pulmonary disease (COPD rates, with 268 cases in immunocompromised patients and another 1938 in the 168,000 COPD patients admitted to hospital. Asthma is also common, affecting 14% of adults, and so allergic bronchopulmonary aspergillosis (ABPA and severe asthma with fungal sensitization (SAFS are major problems. An estimated 432 cases of cryptococcal meningitis (CM—90% of them in AIDS patients—and 1177 cases of Pneumocystis pneumonia (PCP occur each year. The estimated annual case number of disseminated histoplasmosis is 404 in AIDS patients, almost as frequent as CM. Paracoccidioidomycosis annual incidence is estimated at 219, and coccidioidomycosis at 16 cases. At least 881,023 people (>2.01% in Argentina are affected by a serious fungal disease annually, with considerable morbidity and mortality.

  3. Caregivers’ burden in patients with COPD

    Science.gov (United States)

    Miravitlles, Marc; Peña-Longobardo, Luz María; Oliva-Moreno, Juan; Hidalgo-Vega, Álvaro

    2015-01-01

    Objective Chronic obstructive pulmonary disease (COPD) is a very prevalent and invalidating disease. The aim of this study was to analyze the burden borne by informal caregivers of patients with COPD. Methods We used the Survey on Disabilities, Personal Autonomy, and Dependency Situations (Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia [EDAD]-2008) to obtain information on the characteristics of disabled individuals with COPD and their caregivers in Spain. Additionally, statistical multivariate analyses were performed to analyze the impact that an increase in dependence would have on the problems for which caregivers provide support, in terms of health, professional, and leisure/social dimensions. Results A total of 461,884 individuals with one or more disabilities and with COPD were identified, and 220,892 informal caregivers were estimated. Results showed that 35% of informal caregivers had health-related problems due to the caregiving provided; 83% had leisure/social-related problems; and among caregivers of working age, 38% recognized having profession-related problems. The probability of a problem arising was significantly associated with the degree of dependence of the patient receiving care. Caregivers of patients with great dependence showed a 39% higher probability of presenting health-related problems, 27% more professional problems, and 23% more leisure problems compared with those with nondependent patients. Conclusion The results show the large impact on society in terms of the welfare of informal caregivers of patients with COPD. A higher level of dependence was associated with more severe problems in caregivers, in all dimensions. PMID:25709429

  4. [The burden of disability in Cameroon].

    Science.gov (United States)

    Foti, Calogero; Albensi, Caterina; Giordani, Laura; Azeufack Ngueko, Yannick; Sanou Sobze, Martin; Colizzi, Vittorio

    2017-01-01

    Rehabilitation services for disabled persons are lacking in countries with limited economic resources. Reliable and objective data are needed to plan for their implementation and to determine the burden of disability in these countries. A descriptive cross-sectional study conducted in June 2013 among people living in Dschang Health District, in the West region of Cameroon, to collect information about socio-demographic aspects of physically disabled subjects and health determinants of disabilities. Data was collected using a standard questionnaire in French. In total, 159 physically disabled subjects were enrolled in the study. Mean age was 36 years [± SD 17.26], 55.9% of subjects were female, and 33.8% had a low educational-level. The most frequently reported disabilities were orthopaedic problems (mainly fractures) [45.8%], infectious diseases [29.1%]), and neurological disabilities (mainly hemiplegia [33.3%], hemiparesis [23.8%], and monoplegia [23.8%]). The main causes of disability were trauma due to traffic accidents (17.8%) and inappropriate medical interventions (14.5%). Disability was related to age and 50% of participants experienced social discrimination. Disabled subjects with low-incomes (from 50.000 to 200.000 XAF) were required to pay for rehabilitative care (XAF 10.000 to 100.000), and up to 83% had appealed for improved quality of Rehabilitation Medicine. Although Law n. 83/013 for the protection of persons with disabilities in Cameroon dates back to 1983, the results of this study show that disabled people, and children in particular, are still marginalized, vulnerable and have little chance of recovery. Therefore, there is a clear need to improve the quality and availability of rehabilitative care services , with programmatic interventions that ensure implementation of existing laws, improve access to rehabilitative services, provide disabled persons with the necessary specialty medical products, and eliminate barriers to their social

  5. The personal, societal, and economic burden of schizophrenia in the People's Republic of China: implications for antipsychotic therapy.

    Science.gov (United States)

    Montgomery, William; Liu, Li; Stensland, Michael D; Xue, Hai Bo; Treuer, Tamas; Ascher-Svanum, Haya

    2013-01-01

    This article describes the personal, societal, and economic burden attributable to schizophrenia in the People's Republic of China and highlights the potential for effective outpatient treatment to reduce this burden given recent changes in the Chinese health care system. The importance of effective antipsychotic therapy in reducing the burden of schizophrenia is also examined. Published research on the burden, disability, management, and economic costs of schizophrenia in the People's Republic of China was examined in the context of the larger body of global research. Research written in English or Chinese and published before June 2012 was identified using PubMed, CNKI, and Wanfang Med database searches. The contribution of effective antipsychotic therapy in reducing the risk for relapse and hospitalization and improving patients' functioning is described. Schizophrenia imposes a substantial burden on Chinese society, with indirect costs accounting for the majority of the total cost. Functional impairment is high, leading to lost wages and work impairment. In the People's Republic of China, schizophrenia is the most common diagnosis among hospitalized psychiatric patients. Ongoing changes in the Chinese health care system may reduce some barriers to effective relapse prevention in schizophrenia and potentially reduce hospitalizations. The use of antipsychotics for acute episodes and maintenance treatment has been shown to decrease symptom severity and reduce the risk for relapse and hospitalization. However, discontinuing antipsychotic medication appears common and is a strong predictor of relapse. Cost-effectiveness research in the People's Republic of China is needed to examine the potential gains from improved outpatient antipsychotic treatment. Schizophrenia is a very costly mental illness in terms of personal, economic, and societal burden, both in the People's Republic of China and globally. When treated effectively, patients tend to persist longer with

  6. Childhood dual burden of under- and over-nutrition in low- and middle-income countries: a critical review

    Science.gov (United States)

    Tzioumis, Emma; Adair, Linda S.

    2015-01-01

    Background In low- and middle income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively. Objective To critically review literature on the prevalence, trends, and predictors of the dual burden, with a focus on children from birth to 18 years. Methods We reviewed literature since January 1, 1990, published in English, using the PubMed search terms: nutrition transition, double burden, dual burden, nutrition status, obesity, overweight, underweight, stunting, body composition, and micronutrient deficiencies. Findings were classified and described according to dual burden level (community, household, individual). Results Global trends indicate decreases in diseases of undernutrition, while overnutrition is increasing. On the community level, economic status may influence the dual burden’s extent, with obesity increasingly affecting the already undernourished poor. In a household, shared determinants of poor nutritional status among members can result in disparate nutritional status across generations. Within an individual, obesity may co-occur with stunting or anemia, due to shared underlying determinants or physiologic links. Conclusions The dual burden of malnutrition poses a threat to children’s health in low- and middle-income countries. We must remain committed to reducing undernutrition while simultaneously preventing overnutrition, through integrated child health programs that incorporate prevention of infection, diet quality, and physical activity. PMID:25076771

  7. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Foreign Body Retrieval Foreign body retrieval is the removal of ... foreign body detection and removal? What is Foreign Body Retrieval? Foreign body retrieval involves the removal of ...

  8. Dioxin body burden among blood donors before and after the Belgian dioxin/PCB incident

    Energy Technology Data Exchange (ETDEWEB)

    Debacker, N.; Sasse, A.; Wouwe, N. Van; Windal, I.; Carbonnelle, S.; Overmeire, I. Van; Sartor, F.; Goeyens, L.; Oyen, H. Van [Scientific Inst. of Public Health, Brussels (Belgium); Eppe, G.; Xhrouet, C.; Pauw, E. De [Centre of Analysis of Residues in Traces, Luik (Belgium)

    2004-09-15

    In spring 1999, Belgium faced a severe food contamination when about 50 kg of PCBs containing 1 g of dioxins were introduced in the food chain. The possible public health impact of this food chain contamination was subject of a debate between different scientists. According to Vrijens et al. and Bernard et al. there was no significant public health impact, whereas van Larebeke et al. presumed the opposite claiming a significant increase of cancer incidence. These risk assessments were based on measurements of dioxins/PCBs in contaminated foods and nutritional habits observed in a selected group of adolescents (14-18 years old) using simulation techniques or on the estimation of the incremental cancer risk associated with the incremental levels of exposure to dioxins/PCBs during the incident. In the meantime, an epidemiological survey has been carried out in order to measure the dioxin levels in plasma samples collected before and after the incident. The aim of this paper is to report the preliminary results of this epidemiological survey.

  9. America's Children and the Environment: Measures of Contaminants, Body Burdens, and Illnesses. Second Edition.

    Science.gov (United States)

    Woodruff, Tracey J.; Axelrad, Daniel A.; Kyle, Amy D.; Nweke, Onyemaechi; Miller, Gregory G.

    Noting that children may be affected by environmental contaminants in ways quite different from the way adults are affected, this report is the second on trends in measures reflecting environmental factors that may affect the U.S. children's health and well-being. A list of measures and key findings begins the report, followed by five main…

  10. Using in vitro derived enzymatic reaction rates of metabolism to inform pesticide body burdens in amphibians

    Science.gov (United States)

    Understanding how pesticide exposure to non-target species influences toxicity is necessary to accurately assess the ecological risks these compounds pose. To assess the potential metabolic activation of broad use pesticides in amphibians, in vitro and in vivo metabolic rate cons...

  11. Influence of heavy metals body burden on biochemical peculiarities of small mammals

    Directory of Open Access Journals (Sweden)

    O. A. Zemlianyj

    2007-01-01

    Full Text Available The influence of technogenic pollution on the protein and lipid content in small mammals from different ecosystems is observed in the paper. It was defined that its content increased in organs, which take an active part in the metabolic processes.

  12. Incidence of liver tumors in beagles with body burdens of 239Pu or 241Am

    International Nuclear Information System (INIS)

    Taylor, G.N.; Mays, C.W.; Wrenn, M.E.; Shabestari, L.; Lloyd, R.D.

    1986-01-01

    Tetravalent 239 Pu or trivalent 241 Am in a citrate buffer, given via a single intravenous injection to beagles, induced very pronounced liver changes, usually at relatively long postinjection times. The lesions consisted of cell injury or cell necrosis which was followed by nodular hyperplasia and a significant incidence of primary liver tumors. The most frequent neoplasm was the bile duct adenoma, followed by the bile duct carcinoma. A lesser number of sarcomas were also induced, especially fibrosarcomas. The number of hepatic cell tumors was low. An abnormally high incidence of both hyperplastic nodules and primary liver tumors occurred at long postinjection times and at average doses extending down to ∼10 rads. The various nodular lesions and liver tumors frequently occurred as incidental findings in dogs dying from other causes, especially bone cancer. In comparison to bone neoplasia, the liver was a much less important target organ in the high-dose level groups, but in some of the low-dose groups, especially in the 241 Am groups, the risk of radiation-induced liver cancer was approximately equal to or exceeded the risk of skeletal tumors. However, in any projection of the risks observed in this animal model to man, one should be mindful that the beagle skeleton is approximately 25 times more sensitive to radiation-induced bone neoplasia than is the human skeleton (Mays et al., 1976) and that the radiosensitivity difference for the beagle and human liver is unknown. 41 refs., 8 figs., 5 tabs

  13. Organohalogen body burdens in a breast cancer case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Petreas, M.; She, J.; Visita, P.; Winkler, J. [Hazardous Materials Lab., California Dept. of Toxic Substances Control, Berkeley, CA (United States); Hurley, S.; Smith, D.; Reynolds, P. [Environmental Health Investigations Branch, California Dept. of Health Services, Oakland, CA (United States); Jeffrey, S.; Mahoney, E. [Dept. of Surgery, Stanford Univ. School of Medicine, Stanford, CA (United States)

    2004-09-15

    Due to their lipophilic properties, dioxins (PCDD/PCDFs) and other organohalogen compounds bioaccumulate in the food chain, with diet accounting for over 90% of non-occupational exposures. To date, few epidemiologic studies have examined the relationship between dioxins and breast cancer in human populations. Most have examined risks in occupational cohorts or in populations exposed to dioxins from the Seveso accident6-8. Results from these studies have been conflicting and have largely been limited by a lack of individual-level measures of exposure, small numbers of cases, and inability to account for established breast cancer risk factors. Very little is known about the potential health effects of low-level environmental dioxin contamination. We present data on PCDD/PCDFs, organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs) in adipose tissues of women participating in a breast cancer case-control study centered in the San Francisco Bay Area. In addition, we examine distributions of these chemicals in breast and abdominal adipose of women undergoing mastectomies with concurrent breast reconstruction. If concentrations were equivalent, use of abdominal adipose would greatly enhance the pool for controls for future epidemiological studies.

  14. Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases.

    Directory of Open Access Journals (Sweden)

    Charles H King

    2008-03-01

    Full Text Available The disability-adjusted life year (DALY initially appeared attractive as a health metric in the Global Burden of Disease (GBD program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs, in world health. The conceptual design of the DALY comes out of a perspective largely focused on the individual risk rather than the ecology of disease, thus failing to acknowledge the implications of context on the burden of disease for the poor. It is nonrepresentative of the impact of poverty on disability, which results in the significant underestimation of disability weights for chronic diseases such as the NTDs. Finally, the application of the DALY in policy estimates does not account for the nonlinear effects of poverty in the cost-utility analysis of disease control, effectively discounting the utility of comprehensively treating NTDs. The present DALY framework needs to be substantially revised if the GBD is to become a valid and useful system for determining health priorities.

  15. Socioeconomic burden of hereditary angioedema: results from the hereditary angioedema burden of illness study in Europe.

    Science.gov (United States)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen; Hautamaki, Emily; Sisic, Zlatko; Wait, Suzanne; Boysen, Henrik B; Caballero, Teresa

    2014-07-04

    Hereditary angioedema (HAE) due to C1 inhibitor deficiency is a rare but serious and potentially life-threatening disease marked by spontaneous, recurrent attacks of swelling. The study objective was to characterize direct and indirect resource utilization associated with HAE from the patient perspective in Europe. The study was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE via a cross-sectional survey of HAE patients, including direct and indirect resource utilization during and between attacks for patients and their caregivers over the past 6 months. A regression model examined predictors of medical resource utilization. Overall, 164 patients had an attack in the past 6 months and were included in the analysis. The most significant predictor of medical resource utilization was the severity of the last attack (OR 2.6; p career/educational advancement. HAE poses a considerable burden on patients and their families in terms of direct medical costs and indirect costs related to lost productivity. This burden is substantial at the time of attacks and in between attacks.

  16. ANALYSIS OF TAX BURDEN PARAMETERS OF UKRAINE'S ECONOMY

    Directory of Open Access Journals (Sweden)

    I. Moyseyenko

    2017-11-01

    Full Text Available The need to solve the problems of macro-economic stabilization of the country's economy on the basis of determining the tax system efficiency led to the actuality and importance of developing methodological issues of macro-economic tax regulation. In terms of macro-financial stability for the purpose of strategic analysis, the macroeconomic category of tax burden and its fiscal efficiency in terms of direct and indirect taxation is considered. Tax burden indicators at a macro-level quantitatively measure the total level of tax payment and pumping up the budget. Based on the analysis of tax burden it is found that in Ukraine the major fiscal function is performed by consumption taxes (indirect taxes. The methodological principles of the diagnostics of tax burden influence on macro-indices of economic stabilization are as follows: selecting parameters of monitoring tax burden state and fiscal burden efficiency; the assessment of an impact on fiscal efficiency on macro-indices. To prognosticate the efficiency of fiscal burden performance in terms of indirect taxes linear and exponential trend equations are calculated. In terms of the analysis of macro-financial stability the usage of tax rates of indirect taxes as indicators of fiscal efficiency provides sufficient reasons for the conclusions regarding long-term trends of pumping the budget.

  17. Sacroiliac joint pain: burden of disease

    Directory of Open Access Journals (Sweden)

    Cher D

    2014-04-01

    Full Text Available Daniel Cher,1 David Polly,2 Sigurd Berven31SI-BONE, Inc., San Jose, CA, USA; 2Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA; 3Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USAObjectives: The sacroiliac joint (SIJ is an important and significant cause of low back pain. We sought to quantify the burden of disease attributable to the SIJ.Methods: The authors compared EuroQol 5D (EQ-5D and Short Form (SF-36-based health state utility values derived from the preoperative evaluation of patients with chronic SIJ pain participating in two prospective clinical trials of minimally invasive SIJ fusion versus patients participating in a nationally representative USA cross-sectional survey (National Health Measurement Study [NHMS]. Comparative analyses controlled for age, sex, and oversampling in NHMS. A utility percentile for each SIJ subject was calculated using NHMS as a reference cohort. Finally, SIJ health state utilities were compared with utilities for common medical conditions that were published in a national utility registry.Results: SIJ patients (number [n]=198 had mean SF-6D and EQ-5D utility scores of 0.51 and 0.44, respectively. Values were significantly depressed (0.28 points for the SF-6D utility score and 0.43 points for EQ-5D; both P<0.0001 compared to NHMS controls. SIJ patients were in the lowest deciles for utility compared to the NHMS controls. The SIJ utility values were worse than those of many common, major medical conditions, and similar to those of other common preoperative orthopedic conditions.Conclusion: Patients with SIJ pain presenting for minimally invasive surgical care have marked impairment in quality of life that is worse than in many chronic health conditions, and this is similar to other orthopedic conditions that are commonly treated surgically. SIJ utility values are in the lowest two deciles when compared to control populations

  18. Financial Burden Borne by Laparoscopic Living Kidney Donors.

    Science.gov (United States)

    Wiseman, Jennifer F; Jacobs, Cheryl L; Larson, Dawn B; Berglund, Danielle M; Garvey, Catherine A; Ibrahim, Hassan N; Matas, Arthur J

    2017-09-01

    Living kidney donors have donation-related out-of-pocket costs (direct costs) and/or ongoing daily expenses while losing income (indirect costs). Yet there is little information about how much of a subjective burden these constitute for the donors. From December 2003 through December 2014, we surveyed donors 6 months postdonation to determine their financial burden related to donation (on a scale of 1 to 10) and what resources were used to cover expenses. Of 1136 surveyed, 796 (70%) responded. Among respondents, mean age at donation was 43.6 ± 10.6 years, 64% were women, 96% were white, and 53% were related by blood to their recipient. Overall, 26% scored their financial burden as 5 or higher; 8% scored it as 8 or higher. Increased expenses were associated with a higher reported burden; however, significant burden was reported by some with no out-of-pocket expenses (presumably due to lost wages and continuing expenses). The burden was scored as 5 or higher by 27% of those employed outside the home (n = 660), 15% homemakers, 13% retirees, 40% students; 28% unemployed; and 26% whose occupation was unknown. Over half (51%) of those receiving a local or (means-tested) national grant still reported moderate to severe burden. Besides grants, donors used a variety of sources to help offset expenses: dipped into savings, borrowed from friends or family, took out a loan, and/or had a fundraiser. Those with the highest burden reported using the most additional sources. Donors should not have to incur costs or a financial burden to donate; the transplant community should strive to make donation financially neutral.

  19. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010.

    Directory of Open Access Journals (Sweden)

    Alize J Ferrari

    2013-11-01

    Full Text Available Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease.Burden was calculated for major depressive disorder (MDD and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs and disability adjusted life years (DALYs. Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8% of global YLDs and dysthymia for 1.4% (0.9%-2.0%. Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2% of global DALYs and dysthymia for 0.5% (0.3%-0.6%. There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8% to 3.8% (3.0%-4.7% of global DALYs.GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing

  20. WHO Initiative to Estimate the Global Burden of Foodborne Diseases

    DEFF Research Database (Denmark)

    Havelaar, Arie H.; Cawthorne, Amy; Angulo, Fred

    2013-01-01

    BackgroundThe public health impact of foodborne diseases globally is unknown. The WHO Initiative to Estimate the Global Burden of Foodborne Diseases was launched out of the need to fill this data gap. It is anticipated that this effort will enable policy makers and other stakeholders to set...... appropriate, evidence-informed priorities in the area of food safety. MethodsThe Initiative aims to provide estimates on the global burden of foodborne diseases by age, sex, and region; strengthen country capacity for conducting burden of foodborne disease assessments in parallel with food safety policy...

  1. Global burden of disease--a race against time

    DEFF Research Database (Denmark)

    Meyrowitsch, Dan W; Bygbjerg, Ib Christian

    2007-01-01

    Low-income communities will within the next decades undergo rapid changes. The burden of non-communicable diseases (NCDs), such as diabetes, cardio-vascular disease and cancer, will comprise an increasing proportion of the total disease burden. The results of projections indicate that the already...... constrained health systems will face a double burden of disease, in which HIV/AIDS and other common infectious diseases will co-exist with the new NCDs. In order for preventive measures directed towards NCD to be cost-effective, these have to be implemented within the next 10-20 years....

  2. Double burden of malnutrition: A silent driver of double burden of disease in low– and middle–income countries

    Directory of Open Access Journals (Sweden)

    Ivana Kolcˇic´

    2012-09-01

    Full Text Available Double burden of malnutrition, characterised by undernutrition among poor children and obesity among deprived adults, is a serious global problem and an important promoter of ‘double burden of disease’ which is currently affecting low– and middle–income countries. Possible ways to reduce this burden is through education on the importance of equilibrium between energy intake and expenditure; ensuring conditions for optimal fetal and early child development; and reducing poverty as one of the main drivers of both undernutrition and obesity, through empowering local communities.

  3. Identification of environmentally derived cesium-137 burdens in a worker population

    International Nuclear Information System (INIS)

    MacLellan, J.A.; Lynch, T.P.; Rieksts, G.A.; Brodzinski, R.L.

    1993-01-01

    During 1990, whole body measurements of a number of workers with little probability of onsite occupational exposure showed positive evidence of 137 Cs. Further investigation revealed that many of these workers supplemented their diet with a significant portion of wild game, mainly deer and elk. To validate the assumption of an environmental source, donated samples of venison and other game were analyzed by gamma spectroscopy. Results ranged from less than 0.1 to almost 100 Bq kg -l (0.003 to 2.7 nCi kg -1 ) and showed a correlation with the habitat from which the game was taken. Venison samples obtained from the two workers with the highest body burdens showed the highest activity. A questionnaire is now used to identify workers with an elevated potential for environmental-intakes

  4. Living green saves money. Personal environmental burden test

    International Nuclear Information System (INIS)

    2003-01-01

    Based on a number of questions one can calculate the environmental burden of a lifestyle and determine which measures can unburden the environment and how much money can be saved by changing a lifestyle [nl

  5. Renewable energy burden sharing. REBUS. Manual for the REBUS model

    International Nuclear Information System (INIS)

    Voogt, M.H.

    2001-03-01

    The REBUS model quantifies the effects of implementing renewable electricity targets, and the impact of introducing burden sharing systems within the EU, such as a Tradable Green Certificate (TGC) system. Results are obtained for a range of so-called burden sharing options that reflect differences in economic, social and geographical possibilities to increase the share of renewables in individual geographical regions. The REBUS model furthermore analyses the impact of other supporting mechanisms for renewable electricity on the effects of a burden sharing mechanism. With this, the REBUS model is a framework that can be used for quantifying the most equitable distribution of costs (burden sharing) and compare consequences of different equity criteria. Therewith it aims to support key policy makers, industrial stakeholders and consumers in making decisions on the possibilities to achieve their joint RES-E targets

  6. Socioeconomic differences in the burden of disease in Sweden

    DEFF Research Database (Denmark)

    Ljung, Rickard; Peterson, Stefan; Hallqvist, Johan

    2005-01-01

    OBJECTIVE: We sought to analyse how much of the total burden of disease in Sweden, measured in disability-adjusted life years (DALYs), is a result of inequalities in health between socioeconomic groups. We also sought to determine how this unequal burden is distributed across different disease...... of disease that take both mortality and morbidity into account can help policy-makers understand the magnitude of inequalities in health for different disease groups....... groups and socioeconomic groups. METHODS: Our analysis used data from the Swedish Burden of Disease Study. We studied all Swedish men and women in three age groups (15-44, 45-64, 65-84) and five major socioeconomic groups. The 18 disease and injury groups that contributed to 65% of the total burden...

  7. Musculoskeletal disorders – disease burden and challenges in the ...

    African Journals Online (AJOL)

    burden in the developed and developing world, respectively.[6]. Osteoarthritis and ... USA, Western Europe and Canada, where 5- and 10-year survival rates surpass ... from MSK disorders increases and quality of life deteriorates. To improve ...

  8. A study on caregiver burden: stressors, challenges, and possible solutions.

    Science.gov (United States)

    Bialon, Laura Nelson; Coke, Sallie

    2012-05-01

    The purpose of this qualitative study was to explore factors impacting caregiver burden and to explore possible solutions for family caregivers of terminally ill patients. The majority of caregivers reported experiencing role conflict and inadequate stress management. Caregivers who worked outside the home, those who cared for two parents concurrently, those with the least amount of outside assistance, and caregivers who spent a longer period of time caregiving reported the highest levels of health problems and overall burden. Caregivers stated a need for more support from Hospice agencies, more education on caregiver training, and more public education about Hospice services. Faith played a positive role in alleviating caregiver burden. Early identification, intervention, education and coordination of services may help to alleviate caregiver burden, which will improve quality of life for both patient and caregiver.

  9. THE SOCIOECONOMIC BURDEN OF BURULI ULCER DISEASE IN ...

    African Journals Online (AJOL)

    Apusigah

    Ghana Journal of Development Studies, 9(1): May 2012. Page 5 ... We highlight the social and economic burden of 86 BU patients studied in a Ghanaian district in .... Some of the emotion-focused strategies they noted included rationalization.

  10. Strategy to improve the burden of gestational diabetes in African ...

    African Journals Online (AJOL)

    Strategy to improve the burden of gestational diabetes in African women: Rwandan perspective. Herbert T. Mapira, David K. Tumusiime, Kevin Yarasheski, Nadine Rujeni, Todd W. Cade, Eugene Mutimura ...

  11. Burden of mortality in Greenland--today and tomorrow

    DEFF Research Database (Denmark)

    Nielsen, Lasse Christian; Hansen, Kristian Schultz; Nielsen, Ulla Ringgren

    2004-01-01

    : Concerted multi-sectoral approaches and broad holistic health strategies related to health promotion and prevention today will strategically improve the capability of the Greenlandic society to manage the future disease burden from ageing via its health care sector and the institutional sector for care......OBJECTIVES: Investigation of the relative impact of three factors expected to influence the future mortality burden in Greenland: demographic change, epidemiological transition and behavioural patterns. STUDY DESIGN: To identify general trends in public health status, evaluating the effect...... of public health campaigns and providing the basis for making predictions of future trends in the mortality burden data from the Greenlandic Death Causes Register to estimate Years of Life Lost (YLL) in the period 1976-1998 has been used. METHODS: YLL were estimated according to the Burden of Disease Method...

  12. Dementia caregiver burden: reliability of the Brazilian version of the Zarit caregiver burden interview

    Directory of Open Access Journals (Sweden)

    Taub Anita

    2004-01-01

    Full Text Available The object of this article is to examine the reliability of the Brazilian version of the Zarit Caregiver Burden Interview (ZBI. The instrument is a 22-item scale assessing the extent to which caregivers view their responsibilities as having an adverse impact on their social life, health, emotional well-being, and finances. We assessed 50 primary informal caregivers of demented patients coming from 3 different health care centers, using the test-retest method. Analysis of the results showed an intraclass reliability coefficient of 0.88, while Cronbach's coefficient alpha was 0.77 for the test and 0.80 for the retest items. The Brazilian version of ZBI shows sufficient reliability, comparable to the original version.

  13. Outdoor air dominates burden of disease from indoor exposures

    DEFF Research Database (Denmark)

    Hänninen, O.; Asikainen, A.; Carrer, P.

    2014-01-01

    Both indoor and outdoor sources of air pollution have significant public health impacts in Europe. Based on quantitative modelling of the burden of disease the outdoor sources dominate the impacts by a clear margin.......Both indoor and outdoor sources of air pollution have significant public health impacts in Europe. Based on quantitative modelling of the burden of disease the outdoor sources dominate the impacts by a clear margin....

  14. Estimating Global Burden of Disease due to congenital anomaly

    DEFF Research Database (Denmark)

    Boyle, Breidge; Addor, Marie-Claude; Arriola, Larraitz

    2018-01-01

    OBJECTIVE: To validate the estimates of Global Burden of Disease (GBD) due to congenital anomaly for Europe by comparing infant mortality data collected by EUROCAT registries with the WHO Mortality Database, and by assessing the significance of stillbirths and terminations of pregnancy for fetal...... the burden of disease due to congenital anomaly, and thus declining YLL over time may obscure lack of progress in primary, secondary and tertiary prevention....

  15. The burden of non-filarial elephantiasis in Ethiopia.

    Science.gov (United States)

    Animut, Abebe

    2007-12-01

    Although known for many years, non-filarial elephantiasis remains a public health problem in tropical Africa, including the farming community of Ethiopia. The problem may be exacerbated in women who shoulder most of the burden of agricultural labour in the countryside. The intention of this brief review is to emphasise the burden of the disease and to alert researchers and organisations concerned with health care and prevention.

  16. The personal financial burden of chronic rhinosinusitis: A Canadian perspective.

    Science.gov (United States)

    Yip, Jonathan; Vescan, Allan D; Witterick, Ian J; Monteiro, Eric

    2017-07-01

    Previous studies describe the financial burden of chronic rhinosinusitis (CRS) from the perspective of third-party payers, but, to our knowledge, none analyze the costs borne by patients (i.e., out-of-pocket expenses [OOPE]). Furthermore, this burden has not been previously investigated in the context of a publicly funded health care system. The purpose of this study was to characterize the financial impact of CRS on patients, specifically by evaluating its associated OOPEs and the perceived financial burden. The secondary aim was to determine the factors predictive of OOPEs and perceived burden. Patients with CRS at a tertiary care sinus center completed a self-administered questionnaire that assessed their socioeconomic characteristics, disease-specific quality of life (22-item Sino-Nasal Outcome Test [SNOT-22]), workdays missed due to CRS, perceived financial burden, and direct medical and nonmedical OOPEs over a 12-month period. Total OOPEs were calculated from the sum of direct medical and nonmedical OOPEs. Regression analyses determined factors predictive of OOPEs and the perceived burden. A total of 84 patients completed the questionnaires. After accounting for health insurance coverage and the median direct medical, direct nonmedical, and total OOPEs per patient over a 12-month period were Canadian dollars (CAD) $336.00 (2011) [U.S. $339.85], CAD $129.87 [U.S. $131.86], and CAD $607.10 [U.S. $614.06], respectively. CRS resulted in an average of 20.6 workdays missed over a 12-month period. Factors predictive of a higher financial burden included younger age, a greater number of previous sinus surgeries, financial burden and consider counseling them on strategies to offset expenses, including obtaining travel grants, using telemedicine for follow-up assessments, providing drug samples, and streamlining diagnostic testing with medical visits.

  17. Burden of motorcycle-related injury in Malaysia

    OpenAIRE

    Rahman, Nik Hisamuddin NA; Baharuddin, Kamarul A; Mohamad, Syarifah Mastura S

    2015-01-01

    Background Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country. Methods The cross-sectiona...

  18. Influence of home care services on caregivers' burden and satisfaction.

    Science.gov (United States)

    Kim, Eun-Young; Yeom, Hyun-E

    2016-06-01

    To examine the factors affecting the burden and satisfaction of family caregivers, focusing on the beneficial impacts of home care service use. Long-term care for older patients is a multifaceted process that brings both burden and satisfaction to family caregivers. It is expected that home care services offered by the Korean long-term care insurance may contribute to decreasing the burden of family caregivers and enhancing their satisfaction by assisting with practical caregiving tasks. A cross-sectional study. A convenience sample of 157 family caregivers was recruited from five home care service agencies in South Korea. Information about the caregivers, caregiving history, older care recipients and use of home care services was assessed. The effects of home care service use on caregiving burden and satisfaction were tested using hierarchical multiple regression analyses after adjusting for the characteristics of the caregivers, caregiving history and older care recipients. There was no significant influence of home care service use on reducing caregiving burden or on increasing caregivers' satisfaction. Although several factors were associated with caregiving burden and satisfaction, family functioning was the most unique factor to significantly affect both caregiving burden and satisfaction. Home care services might not automatically have a positive impact on caregivers' burden and satisfaction, but maintaining healthy family functioning is an important issue for family caregivers. The findings highlight the important need to reconsider ways to provide home care services and to develop nursing interventions to reinforce supportive family functioning. Practical strategies for providing home care services should be developed through a concrete assessment of the family dynamics and the needs of family caregivers. Health professionals should play a pivotal role in performing the assessment and in developing interventions to strengthen supportive family functioning

  19. Reversal burden of proof on corruption in Indonesia

    OpenAIRE

    Nugroho, Hibnu

    2018-01-01

    Corruption becomes the greatest enemy most countries face including Indonesia. Commitment to eradicate corruption significantly increases yet it would be meaningless if it is not supported by adequate legislation to implement the law effectively. Reversal burden of proof essentially aims to facilitate law enforcers to seek and disclose assets a suspect owns allegedly as corruption crime. The principle of reversal burden of proof was originated from Anglo-Saxon countries and this still applies...

  20. Managing the changing burden of cancer in Asia

    OpenAIRE

    Sankaranarayanan, Rengaswamy; Ramadas, Kunnambath; Qiao, You-lin

    2014-01-01

    Asia accounts for 60% of the world population and half the global burden of cancer. The incidence of cancer cases is estimated to increase from 6.1 million in 2008 to 10.6 million in 2030, due to ageing and growing populations, lifestyle and socioeconomic changes. Striking variations in ethnicity, sociocultural practices, human development index, habits and dietary patterns are reflected in the burden and pattern of cancer in different regions. The existing and emerging cancer patterns and bu...

  1. 20 CFR 498.215 - The hearing and burden of proof.

    Science.gov (United States)

    2010-04-01

    ... burden of going forward and the burden of persuasion with respect to affirmative defenses and any... persuasion with respect to all other issues. (c) The burden of persuasion will be judged by a preponderance...

  2. The economic burden of kidney disorders in Korea.

    Science.gov (United States)

    Kim, Ju Hee; Ho, Seung Hee; Kim, Hyun-Jin; Lee, Sol

    2018-03-01

    To estimate the economic burden of kidney disorders in Korea. The economic burden of kidney disorders was estimated using a prevalence-based approach. Related kidney diseases in patients with kidney disorders (RPWKD) were defined using codes from the tenth International Classification of Disease (E70-E90, F30-F48, F60-F69, F90-F99, K65-K67, N00-N08, N17-N19, and N30-N39). All diseases in patients with kidney disorders (APWKD) were defined as kidney disorders that involved all disease codes. Economic costs were divided into direct costs (medical costs and non-medical costs) and indirect costs (productivity loss because of morbidity and premature mortality). The prevalence of kidney disorders increased from 0.08% (2008) to 0.11% (2011). The total economic burden of RPWKD also substantially increased from $898.9 million (2008) to $1.43 billion (2011). This ∼59.4% increase in the economic burden was equal to 0.12% of the Korean gross domestic product. The economic burden of APWKD also increased during the study period: $1.06 billion (2008), $1.23 billion (2009), $1.44 billion (2010), and $1.46 billion (2011). The present study provides the first data regarding the economic burden of kidney disorders in Korea. The findings support the need for early intervention services and prevention programs to prevent, identify, and manage kidney disorders.

  3. A Kinetic Model Describing Injury-Burden in Team Sports.

    Science.gov (United States)

    Fuller, Colin W

    2017-12-01

    Injuries in team sports are normally characterised by the incidence, severity, and location and type of injuries sustained: these measures, however, do not provide an insight into the variable injury-burden experienced during a season. Injury burden varies according to the team's match and training loads, the rate at which injuries are sustained and the time taken for these injuries to resolve. At the present time, this time-based variation of injury burden has not been modelled. To develop a kinetic model describing the time-based injury burden experienced by teams in elite team sports and to demonstrate the model's utility. Rates of injury were quantified using a large eight-season database of rugby injuries (5253) and exposure (60,085 player-match-hours) in English professional rugby. Rates of recovery from injury were quantified using time-to-recovery analysis of the injuries. The kinetic model proposed for predicting a team's time-based injury burden is based on a composite rate equation developed from the incidence of injury, a first-order rate of recovery from injury and the team's playing load. The utility of the model was demonstrated by examining common scenarios encountered in elite rugby. The kinetic model developed describes and predicts the variable injury-burden arising from match play during a season of rugby union based on the incidence of match injuries, the rate of recovery from injury and the playing load. The model is equally applicable to other team sports and other scenarios.

  4. Disease burden of methylmercury in the German birth cohort 2014.

    Directory of Open Access Journals (Sweden)

    Julia Lackner

    Full Text Available This study aimed to estimate the disease burden of methylmercury for children born in Germany in the year 2014. Humans are mainly exposed to methylmercury when they eat fish or seafood. Prenatal methylmercury exposure is associated with IQ loss. To quantify this disease burden, we used Monte Carlo simulation to estimate the incidence of mild and severe mental retardation in children born to mothers who consume fish based on empirical data. Subsequently, we calculated the disease burden with the disability-adjusted life years (DALY-method. DALYs combine mortality and morbidity in one measure and quantify the gap between an ideal situation, where the entire population experiences the standard life expectancy without disease and disability, and the actual situation. Thus, one DALY corresponds to the loss of one year of life in good health. The methylmercury-induced burden of disease for the German birth cohort 2014 was an average of 14,186 DALY (95% CI 12,915-15,440 DALY. A large majority of the DALYs was attributed to morbidity as compared to mortality. Of the total disease burden, 98% were attributed to mild mental retardation, which only leads to morbidity. The remaining disease burden was a result of severe mental retardation with equal proportions of premature death and morbidity.

  5. Economic burden of disease-associated malnutrition in China.

    Science.gov (United States)

    Linthicum, Mark T; Thornton Snider, Julia; Vaithianathan, Rhema; Wu, Yanyu; LaVallee, Chris; Lakdawalla, Darius N; Benner, Jennifer E; Philipson, Tomas J

    2015-05-01

    Disease-associated malnutrition (DAM) is a well-recognized problem in many countries, but the extent of its burden on the Chinese population is unclear. This article reports the results of a burden-of-illness study on DAM in 15 diseases in China. Using data from the World Health Organization (WHO), the China Health and Nutrition Survey, and the published literature, mortality and disability-adjusted life years (DALYs) lost because of DAM were calculated; a financial value of this burden was calculated following WHO guidelines. DALYs lost annually to DAM in China varied across diseases, from a low of 2248 in malaria to a high of 1 315 276 in chronic obstructive pulmonary disease. The total burden was 6.1 million DALYs, for an economic burden of US$66 billion (Chinese ¥ 447 billion) annually. This burden is sufficiently large to warrant immediate attention from public health officials and medical providers, especially given that low-cost and effective interventions are available. © 2014 APJPH.

  6. Estimating the true global burden of mental illness.

    Science.gov (United States)

    Vigo, Daniel; Thornicroft, Graham; Atun, Rifat

    2016-02-01

    We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Some remarks on the natural radiation burden of population

    International Nuclear Information System (INIS)

    Feher, I.; Gemesi, J.; Toth, A.

    1975-04-01

    A large scale of the population's radiation burden is due to the natural radioactivity of building materials. An appropriate model has been developed for the calculation of the burden of population from the concentration of radioisotopes in building materials. The external and internal radiation burden of Hungary's population were determined (weighted means were 33 mrem/year and the bronhial dose 730 mrad/year, respectively) and the effect of new building technologies and materials on the radiation burden was studied. In dwellings built of precast concrete slabs containing low-activity ballast available in Hungary the radiation burden was found to be significantly lower than the present average. The increase in the contamination hazard expected from the peaceful uses of atomic energy could be compensated by reducing the average external radiation burden together with the average bronchial dose. This reduction can be 1.6 mrem/year and 58 mrad/year, respectively (according to our estimations based on simple assumptions), requiring acceptable excess cost. (K.A.)

  8. State plans to force companies to eliminate environmental burdens

    International Nuclear Information System (INIS)

    Marcan, P.

    2004-01-01

    The Ministry of Environment is preparing legislation aimed at forcing the state and especially private enterprises to map and eliminate tips, refuse from company premises and farmyards, and manure heaps. It is expected that the main burden will fall on private enterprises. The department is still working on the wording of this new Act on environmental burdens and so it is not yet clear whether it will be of assistance in the elimination of environmental burdens. The Ministry is aware that economic aspects must also be taken into account when exercising pressure on the companies. Closing down a company that cannot meet environmental criteria would result in redundancies and so the time schedule for the elimination of environmental burdens will be adjusted to fit the financial situation of the company involved. The ministry plans to first find companies responsible for environmental debts and then set a deadline for the preparation of a project to eliminate the environmental burden. The project would have to contain a description of elimination methods, in addition to a time schedule and cost assessment. If a private company does not report an environmental burden, the competent public authority will have the power to request access to the premises to undertake an inspection. (author)

  9. [Burden of proof in medical cases--presumption of fact and prima facie evidence. 1. Burden of proof].

    Science.gov (United States)

    Sliwka, Marcin

    2004-01-01

    The aim of this paper was to present the main rules concerning the burden of proof in polish civil trials, including medical cases. This paper also describes the subject of evidence were presented and explained. The court influence on evidence procedure was also analysed. The effect of the institution of informed consent on burden of proof in polish civil law is also described. This paper includes numerous High Court sentences on evidential and medical issues.

  10. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... percent of foreign body ingestions occur among children. Most foreign bodies pass through the gastrointestinal tract without ... fainting and shock. Foreign bodies in the airway: Most foreign bodies in the airway are usually expelled ...

  11. Estimating the burden of antimicrobial resistance: a systematic literature review.

    Science.gov (United States)

    Naylor, Nichola R; Atun, Rifat; Zhu, Nina; Kulasabanathan, Kavian; Silva, Sachin; Chatterjee, Anuja; Knight, Gwenan M; Robotham, Julie V

    2018-01-01

    Accurate estimates of the burden of antimicrobial resistance (AMR) are needed to establish the magnitude of this global threat in terms of both health and cost, and to paramaterise cost-effectiveness evaluations of interventions aiming to tackle the problem. This review aimed to establish the alternative methodologies used in estimating AMR burden in order to appraise the current evidence base. MEDLINE, EMBASE, Scopus, EconLit, PubMed and grey literature were searched. English language studies evaluating the impact of AMR (from any microbe) on patient, payer/provider and economic burden published between January 2013 and December 2015 were included. Independent screening of title/abstracts followed by full texts was performed using pre-specified criteria. A study quality score (from zero to one) was derived using Newcastle-Ottawa and Philips checklists. Extracted study data were used to compare study method and resulting burden estimate, according to perspective. Monetary costs were converted into 2013 USD. Out of 5187 unique retrievals, 214 studies were included. One hundred eighty-seven studies estimated patient health, 75 studies estimated payer/provider and 11 studies estimated economic burden. 64% of included studies were single centre. The majority of studies estimating patient or provider/payer burden used regression techniques. 48% of studies estimating mortality burden found a significant impact from resistance, excess healthcare system costs ranged from non-significance to $1 billion per year, whilst economic burden ranged from $21,832 per case to over $3 trillion in GDP loss. Median quality scores (interquartile range) for patient, payer/provider and economic burden studies were 0.67 (0.56-0.67), 0.56 (0.46-0.67) and 0.53 (0.44-0.60) respectively. This study highlights what methodological assumptions and biases can occur dependent on chosen outcome and perspective. Currently, there is considerable variability in burden estimates, which can lead in

  12. Estimating the burden of paratyphoid a in Asia and Africa.

    Directory of Open Access Journals (Sweden)

    Michael B Arndt

    2014-06-01

    Full Text Available Despite the increasing availability of typhoid vaccine in many regions, global estimates of mortality attributable to enteric fever appear stable. While both Salmonella enterica serovar Typhi (S. Typhi and serovar Paratyphi (S. Paratyphi cause enteric fever, limited data exist estimating the burden of S. Paratyphi, particularly in Asia and Africa. We performed a systematic review of both English and Chinese-language databases to estimate the regional burden of paratyphoid within Africa and Asia. Distinct from previous reviews of the topic, we have presented two separate measures of burden; both incidence and proportion of enteric fever attributable to paratyphoid. Included articles reported laboratory-confirmed Salmonella serovar classification, provided clear methods on sampling strategy, defined the age range of participants, and specified the time period of the study. A total of 64 full-text articles satisfied inclusion criteria and were included in the qualitative synthesis. Paratyphoid A was commonly identified as a cause of enteric fever throughout Asia. The highest incidence estimates in Asia came from China; four studies estimated incidence rates of over 150 cases/100,000 person-years. Paratyphoid A burden estimates from Africa were extremely limited and with the exception of Nigeria, few population or hospital-based studies from Africa reported significant Paratyphoid A burden. While significant gaps exist in the existing population-level estimates of paratyphoid burden in Asia and Africa, available data suggest that paratyphoid A is a significant cause of enteric fever in Asia. The high variability in documented incidence and proportion estimates of paratyphoid suggest considerable geospatial variability in the burden of paratyphoid fever. Additional efforts to monitor enteric fever at the population level will be necessary in order to accurately quantify the public health threat posed by S. Paratyphi A, and to improve the prevention

  13. Economic Burden for Lung Cancer Survivors in Urban China.

    Science.gov (United States)

    Zhang, Xin; Liu, Shuai; Liu, Yang; Du, Jian; Fu, Wenqi; Zhao, Xiaowen; Huang, Weidong; Zhao, Xianming; Liu, Guoxiang; Mao, Zhengzhong; Hu, Teh-Wei

    2017-03-15

    With the rapid increase in the incidence and mortality of lung cancer, a growing number of lung cancer patients and their families are faced with a tremendous economic burden because of the high cost of treatment in China. This study was conducted to estimate the economic burden and patient responsibility of lung cancer patients and the impact of this burden on family income. This study uses data from a retrospective questionnaire survey conducted in 10 communities in urban China and includes 195 surviving lung cancer patients diagnosed over the previous five years. The calculation of direct economic burden included both direct medical and direct nonmedical costs. Indirect costs were calculated using the human capital approach, which measures the productivity lost for both patients and family caregivers. The price index was applied for the cost calculation. The average economic burden from lung cancer was $43,336 per patient, of which the direct cost per capita was $42,540 (98.16%) and the indirect cost per capita was $795 (1.84%). Of the total direct medical costs, 35.66% was paid by the insurer and 9.84% was not covered by insurance. The economic burden for diagnosed lung cancer patients in the first year following diagnosis was $30,277 per capita, which accounted for 171% of the household annual income, a percentage that fell to 107% after subtracting the compensation from medical insurance. The economic burden for lung cancer patients is substantial in the urban areas of China, and an effective control strategy to lower the cost is urgently needed.

  14. Estimating the Global Burden of Endemic Canine Rabies

    Science.gov (United States)

    Hampson, Katie; Coudeville, Laurent; Lembo, Tiziana; Sambo, Maganga; Kieffer, Alexia; Attlan, Michaël; Barrat, Jacques; Blanton, Jesse D.; Briggs, Deborah J.; Cleaveland, Sarah; Costa, Peter; Freuling, Conrad M.; Hiby, Elly; Knopf, Lea; Leanes, Fernando; Meslin, François-Xavier; Metlin, Artem; Miranda, Mary Elizabeth; Müller, Thomas; Nel, Louis H.; Recuenco, Sergio; Rupprecht, Charles E.; Schumacher, Carolin; Taylor, Louise; Vigilato, Marco Antonio Natal; Zinsstag, Jakob; Dushoff, Jonathan

    2015-01-01

    Background Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. Methodology/Principal Findings We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). Conclusions/Significance This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to

  15. Economic Burden of Human Papillomavirus-Related Diseases in Italy

    Science.gov (United States)

    Baio, Gianluca; Capone, Alessandro; Marcellusi, Andrea; Mennini, Francesco Saverio; Favato, Giampiero

    2012-01-01

    Introduction Human papilloma virus (HPV) genotypes 6, 11, 16, and 18 impose a substantial burden of direct costs on the Italian National Health Service that has never been quantified fully. The main objective of the present study was to address this gap: (1) by estimating the total direct medical costs associated with nine major HPV-related diseases, namely invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, and head and neck, anogenital warts, and recurrent respiratory papillomatosis, and (2) by providing an aggregate measure of the total economic burden attributable to HPV 6, 11, 16, and 18 infection. Methods For each of the nine conditions, we used available Italian secondary data to estimate the lifetime cost per case, the number of incident cases of each disease, the total economic burden, and the relative prevalence of HPV types 6, 11, 16, and 18, in order to estimate the aggregate fraction of the total economic burden attributable to HPV infection. Results The total direct costs (expressed in 2011 Euro) associated with the annual incident cases of the nine HPV-related conditions included in the analysis were estimated to be €528.6 million, with a plausible range of €480.1–686.2 million. The fraction attributable to HPV 6, 11, 16, and 18 was €291.0 (range €274.5–315.7 million), accounting for approximately 55% of the total annual burden of HPV-related disease in Italy. Conclusions The results provided a plausible estimate of the significant economic burden imposed by the most prevalent HPV-related diseases on the Italian welfare system. The fraction of the total direct lifetime costs attributable to HPV 6, 11, 16, and 18 infections, and the economic burden of noncervical HPV-related diseases carried by men, were found to be cost drivers relevant to the making of informed decisions about future investments in programmes of HPV prevention. PMID:23185412

  16. Estimating the global burden of endemic canine rabies.

    Directory of Open Access Journals (Sweden)

    Katie Hampson

    2015-04-01

    Full Text Available Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries.We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000 human deaths, over 3.7 million (95% CIs: 1.6-10.4 million disability-adjusted life years (DALYs and 8.6 billion USD (95% CIs: 2.9-21.5 billion economic losses annually. The largest component of the economic burden is due to premature death (55%, followed by direct costs of post-exposure prophylaxis (PEP, 20% and lost income whilst seeking PEP (15.5%, with only limited costs to the veterinary sector due to dog vaccination (1.5%, and additional costs to communities from livestock losses (6%.This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts.

  17. The mercury burden of the Czech population: An integrated approach.

    Science.gov (United States)

    Puklová, Vladimíra; Krsková, Andrea; Cerná, Milena; Cejchanová, Mája; Rehůrková, Irena; Ruprich, Jirí; Kratzer, Karel; Kubínová, Růzena; Zimová, Magdaléna

    2010-07-01

    In this paper an integrated approach in assessment of the population exposure from various sources of total mercury (THg) oral intake in the Czech Republic is presented. The information on total mercury levels in diet, drinking water, surface urban soil and body fluids and tissues stem from the Czech national Environmental Health Monitoring System (EHMS) operated since 1994. The THg concentration was determined by the special atomic absorption spectrophotometer AMA 254. The data on THg content in food from the sales network were collected in 12 cities. The estimated average dietary intake representing more than 95% of weight of usual diet composition ranged 1-2% of the JECFA/FAO WHO provisional tolerable weekly intake (PTWI) value for total mercury (5 microg/kg b.w./week). Data on drinking water quality stem from the nationwide monitoring database. The content of THg in drinking water is generally low; only 0.2% of the Czech population supplied with drinking water from the distribution networks (total of 92% of the population) has a mercury intake from drinking water higher than 1% PTWI and not exceeding 5% PTWI. The estimation of potential mercury intake by unintentional consumption of soil in small children was based on THg content in surface soil of a total of 324 nursery schools in 24 cities and towns. Median value was 0.16 mg/kg. Human biomonitoring was performed in 9 Czech cities. In 2007, the mercury median values in blood of adults (N=412) were 0.85 and 0.89 microg/l in males and in females, respectively; urine median value in adults was 1.10 microg/g creatinine. In 2008, the blood median value in children (N=324) amounted to 0.35 microg/l; urine median value is 0.16 microg/g creatinine. In children's hair the median THg value was 0.18 microg/g. The correlation between fish consumption and blood THg levels was observed in both adults and children. Also the biomonitoring outputs did not reveal a substantial burden of the population. Copyright 2010 Elsevier

  18. Response Burden in Official Business Surveys: Measurement and Reduction Practices of National Statistical Institutes

    Directory of Open Access Journals (Sweden)

    Bavdaž Mojca

    2015-12-01

    Full Text Available Response burden in business surveys has long been a concern for National Statistical Institutes (NSIs for three types of reasons: political reasons, because response burden is part of the total administrative burden governments impose on businesses; methodological reasons, because an excessive response burden may reduce data quality and increase data-collection costs; and strategic reasons, because it affects relations between the NSIs and the business community. This article investigates NSI practices concerning business response burden measurement and reduction actions based on a survey of 41 NSIs from 39 countries. Most NSIs monitor at least some burden aspects and have implemented some actions to reduce burden, but large differences exist between NSIs’ methodologies for burden measurement and actions taken to reduce burden. Future research should find ways to deal with methodological differences in burden conceptualization, operationalization, and measurement, and provide insights into the effectiveness and efficiency of burden-reduction actions.

  19. Global economic burden of schizophrenia: a systematic review

    Directory of Open Access Journals (Sweden)

    Chong HY

    2016-02-01

    Full Text Available Huey Yi Chong,1 Siew Li Teoh,1 David Bin-Chia Wu,1 Surachai Kotirum,1 Chiun-Fang Chiou,2 Nathorn Chaiyakunapruk1,3–5 1School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; 2Janssen Pharmaceutical Companies Asia Pacific, Singapore; 3Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 4School of Pharmacy, University of Wisconsin, Madison, WI, USA; 5School of Population Health, University of Queensland, Brisbane, Australia Background: Schizophrenia is one of the top 25 leading causes of disability worldwide in 2013. Despite its low prevalence, its health, social, and economic burden has been tremendous, not only for patients but also for families, caregivers, and the wider society. The magnitude of disease burden investigated in an economic burden study is an important source to policymakers in decision making. This study aims to systematically identify studies focusing on the economic burden of schizophrenia, describe the methods and data sources used, and summarize the findings of economic burden of schizophrenia. Methods: A systematic review was performed for economic burden studies in schizophrenia using four electronic databases (Medline, EMBASE, PsycINFO, and EconLit from inception to August 31, 2014. Results: A total of 56 articles were included in this review. More than 80% of the studies were conducted in high-income countries. Most studies had undertaken a retrospective- and prevalence-based study design. The bottom-up approach was commonly employed to determine cost, while human capital method was used for indirect cost estimation. Database and literature were the most commonly used data sources in cost estimation in high-income countries, while chart review and interview were the main data sources in low and middle-income countries. Annual costs for the schizophrenia population in the country ranged from US$94

  20. The burden of non communicable diseases in developing countries

    Directory of Open Access Journals (Sweden)

    Boutayeb Abdesslam

    2005-01-01

    Full Text Available Abstract Background By the dawn of the third millennium, non communicable diseases are sweeping the entire globe, with an increasing trend in developing countries where, the transition imposes more constraints to deal with the double burden of infective and non-infective diseases in a poor environment characterised by ill-health systems. By 2020, it is predicted that these diseases will be causing seven out of every 10 deaths in developing countries. Many of the non communicable diseases can be prevented by tackling associated risk factors. Methods Data from national registries and international organisms are collected, compared and analyzed. The focus is made on the growing burden of non communicable diseases in developing countries. Results Among non communicable diseases, special attention is devoted to cardiovascular diseases, diabetes, cancer and chronic pulmonary diseases. Their burden is affecting countries worldwide but with a growing trend in developing countries. Preventive strategies must take into account the growing trend of risk factors correlated to these diseases. Conclusion Non communicable diseases are more and more prevalent in developing countries where they double the burden of infective diseases. If the present trend is maintained, the health systems in low-and middle-income countries will be unable to support the burden of disease. Prominent causes for heart disease, diabetes, cancer and pulmonary diseases can be prevented but urgent (preventive actions are needed and efficient strategies should deal seriously with risk factors like smoking, alcohol, physical inactivity and western diet.

  1. Burden of tuberculosis in indigenous peoples globally: a systematic review.

    Science.gov (United States)

    Tollefson, D; Bloss, E; Fanning, A; Redd, J T; Barker, K; McCray, E

    2013-09-01

    The burden of tuberculosis (TB) in the estimated 370 million indigenous peoples worldwide is unknown. To conduct a literature review to summarize the TB burden in indigenous peoples, identify gaps in current knowledge, and provide the foundation for a research agenda prioritizing indigenous health within TB control. A systematic literature review identified articles published between January 1990 and November 2011 quantifying TB disease burden in indigenous populations worldwide. Among the 91 articles from 19 countries included in the review, only 56 were from outside Australia, Canada, New Zealand and the United States. The majority of the studies showed higher TB rates among indigenous groups than non-indigenous groups. Studies from the Amazon generally reported the highest TB prevalence and incidence, but select populations from South-East Asia and Africa were found to have similarly high rates of TB. In North America, the Inuit had the highest reported TB incidence (156/100000), whereas the Metis of Canada and American Indians/Alaska Natives experienced rates of indigenous groups. Where data exist, indigenous peoples were generally found to have higher rates of TB disease than non-indigenous peoples; however, this burden varied greatly. The paucity of published information on TB burden among indigenous peoples highlights the need to implement and improve TB surveillance to better measure and understand global disparities in TB rates.

  2. Primary caregivers of schizophrenia outpatients: burden and predictor variables.

    Science.gov (United States)

    Grandón, Pamela; Jenaro, Cristina; Lemos, Serafín

    2008-04-15

    This article explores family burden in relation to relatives' coping strategies and social networks, as well as in relation to the patients' severity of positive and negative symptoms. Data on the severity of symptoms (Positive and Negative Syndrome Scale for Schizophrenia [PANSS]), social functioning (Social Functioning Scale [SFS]), caregivers burden (Interview on Objective and Subjective Family Burden or Entrevista de Carga Familiar Objetiva y Subjetiva [ECFOS]), coping skills (Family Coping Questionnaire [FCQ]), and social support (Social Network Questionnaire [SNQ]) were gathered from a randomized sample of 101 Chilean outpatients and their primary caregivers, mostly mothers. Low levels of burden were typically found, with the exception of moderate levels on general concerns for the ill relative. A hierarchical regression analysis with four blocks showed that clinical characteristics, such as higher frequency of relapses, more positive symptoms and lower independence-performance, together with lower self-control attributed to the patient, decrease in social interests, and less affective support, predict burden. The results support the relevance of psychoeducational interventions where families' needs are addressed.

  3. Assessing burden in families of critical care patients.

    Science.gov (United States)

    Kentish-Barnes, Nancy; Lemiale, Virginie; Chaize, Marine; Pochard, Frédéric; Azoulay, Elie

    2009-10-01

    To provide critical care clinicians with information on validated instruments for assessing burden in families of critical care patients. PubMed (1979-2009). We included all quantitative studies that used a validated instrument to evaluate the prevalence of, and risk factors for, burden on families. We extracted the descriptions of the instruments used and the main results. Family burden after critical illness can be detected reliably and requires preventive strategies and specific treatments. Using simple face-to-face interviews, intensivists can learn to detect poor comprehension and its determinants. Instruments for detecting symptoms of anxiety, depression, or stress can be used reliably even by physicians with no psychiatric training. For some symptoms, the evaluation should take place at a distance from intensive care unit discharge or death. Experience with families of patients who died in the intensive care unit and data from the literature have prompted studies of bereaved family members and the development of interventions aimed at decreasing guilt and preventing complicated grief. We believe that burden on families should be assessed routinely. In clinical studies, using markers for burden measured by validated tools may provide further evidence that effective communication and efforts to detect and to prevent symptoms of stress, anxiety, or depression provide valuable benefits to families.

  4. Atrial therapies reduce atrial arrhythmia burden in defibrillator patients.

    Science.gov (United States)

    Friedman, P A; Dijkman, B; Warman, E N; Xia, H A; Mehra, R; Stanton, M S; Hammill, S C

    2001-08-28

    Approximately 25% of patients who receive an implantable cardioverter-defibrillator (ICD) to treat ventricular tachyarrhythmias have documented atrial tachyarrhythmias before implantation. This study assessed the ability of device-based prevention and termination therapies to reduce the burden of spontaneous atrial tachyarrhythmias. Patients with a standard indication for the implantation of an ICD and 2 episodes of atrial tachyarrhythmias in the preceding year received a dual-chamber ICD (Medtronic 7250 Jewel AF) that uses pacing and shock therapies for prevention and/or termination of atrial tachyarrhythmias. In a multicenter trial, patients were randomized to 3-month periods with atrial therapies "on" or "off" and subsequently crossed over. Analysis was performed on the 52 of 269 patients who had episodes of atrial tachyarrhythmia and had >/=30 days of follow-up with atrial therapies on and off. The atrial therapies resulted in a reduction of atrial tachyarrhythmia burden from a mean of 58.5 to 7.8 h/mo. A paired analysis (Wilcoxon signed-rank test) showed that the median difference in burden (1.1 h/mo) was highly significant (P=0.007). When the subgroup of 41 patients treated only with atrial pacing therapies was analyzed, the reduction in burden persisted (P=0.01). In this study, patients with a standard ICD indication and atrial tachyarrhythmias had a significant reduction in atrial tachyarrhythmia burden with use of atrial pacing and shock therapies.

  5. Reversal burden of proof on corruption in Indonesia

    Directory of Open Access Journals (Sweden)

    Hibnu Nugroho

    2018-03-01

    Full Text Available Corruption becomes the greatest enemy most countries face including Indonesia. Commitment to eradicate corruption significantly increases yet it would be meaningless if it is not supported by adequate legislation to implement the law effectively. Reversal burden of proof essentially aims to facilitate law enforcers to seek and disclose assets a suspect owns allegedly as corruption crime. The principle of reversal burden of proof was originated from Anglo-Saxon countries and this still applies to certain cases such as bribery-related gratifications as Malaysia and Singapore implement. In Indonesia, provisions on the principle of reversal burden of proof have been long recognized even since 1960 on the first law on corruption crimes. Nevertheless, for more than a half of century, the provision on reversal burden of proof has never been implemented. It occurs since articles which govern the issues barely provide clear regulation. It only mentions the principle yet never issues an implemented regulation to support the principle. In regards to this, the research is aimed at investigating, seeking and analyzing the weaknesses in implementing the principle of reversal burden of proof in corruption crimes recently as well as discussing obstacles in law enforcement.

  6. [The current perspectives regarding the burden on mental health caregivers].

    Science.gov (United States)

    Cardoso, Lucilene; Vieira, Mariana Verderoce; Ricci, Maira Aparecida Malagutti; Mazza, Rafael Severio

    2012-04-01

    A systematic literature review was performed regarding the burden on mental health caregivers. The studies were selected from the Virtual Health Library - Biblioteca Virtual de Saúde (BVS), using the keyword caregiver burden. The main criteria for this study were: full-text articles published between 2000 and 2010, in Portuguese, English or Spanish; indexed on the BVS databases; which investigated the burden of mental health caregivers, and had caregivers as the main subject. The analysis was performed considering the following: title, year of publication, objectives, methodological approach, instruments and main results. The analysis of 114 full-text articles showed the predominant objectives were the burden on informal caregivers and the validation of psychometric scales, particularly the Zarit Scale. Some studies showed an association between high levels of burden, feelings of guilt and depressive symptoms. On the other hand, psycho-educational interventions were indicated as having a positive impact. This theme has a growing scientific interest and there is a need for deeper studies addressing formal caregivers.

  7. Burden of Diarrhea in the Eastern Mediterranean Region, 1990–2013: Findings from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Khalil, Ibrahim; Colombara, Danny V.; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Rao, Puja C.; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; El Razek, Mohammed Magdy Abd; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Al-Raddadi, Rajaa Mohammad Salem; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T.; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M.; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Bin Abdulhak, Aref A.; Butt, Zahid A.; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad D. A.; Farid, Talha; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Fitchett, Joseph Robert Anderson; Gibney, Katherine B.; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L.; Hedayati, Mohammad T.; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Jibat, Tariku; Jonas, Jost B.; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Latif, Asma Abdul Abdul; Lunevicius, Raimundas; El Razek, Hassan Magdy Abd; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Misganaw, Awoke; Mohamed, Layla Abdalla Ibrahim; Nachega, Jean B.; Le Nguyen, Quyen; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Rana, Saleem M.; Ranabhat, Chhabi L.; Rao, Sowmya R.; Refaat, Amany H.; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sawhney, Monika; Sepanlou, Sadaf G.; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T.; Sykes, Bryan L.; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S.; Ukwaja, Kingsley; Uthman, Olalekan A.; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A.; Yonemoto, Naohiro; Younis, Mustafa Z.; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Al Rabeeah, Abdullah A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.; Mokdad, Ali H.

    2016-01-01

    Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0–1) in Bahrain and Oman to 471 (95% UI = 245–763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520–989) in Syria to 40,869 (95% UI = 21,540–65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden. PMID:27928080

  8. "I Have to Listen to This Old Body": Femininity and the Aging Body.

    Science.gov (United States)

    Rutagumirwa, Sylivia Karen; Bailey, Ajay

    2017-10-13

    This study explores how older women with low socioeconomic status living in rural Tanzania give meaning to their (aging) body in relation to the ideals of femininity. Ten qualitative in-depth interviews and 10 focus group discussions (N = 60) were conducted among women aged 60 and older. The findings reveal that older women perceive their aging body as "a burden." This characterization of the body is linked to the inability of the aging body to live up to the women's gendered lives. The conflict between their physical limitations and the desire to perform gendered tasks (internalized feminine habitus) affect the women's process of self-identification. This led to emotional distress and subsequently threatened their survival and well-being. The results suggest that older women need to be supported through interventions that are tailored to their cultural and socioeconomic context. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

  9. Burden of typhoid fever in Sulaimania, Iraqi Kurdistan.

    Science.gov (United States)

    Dworkin, Jonathan; Saeed, Rebeen; Mykhan, Hawar; Kanan, Shwan; Farhad, Dlawer; Ali, Kocher Omer; Abdulwahab, Runak Hama Kareem; Palardy, John; Neill, Marguerite A

    2014-10-01

    Typhoid fever imposes a high disease burden worldwide, but resource limitations mean that the burden of typhoid fever in many countries is poorly understood. The authors conducted a prospective surveillance study at the adult and pediatric teaching hospitals in Sulaimania, Iraqi Kurdistan. All patients presenting with an undifferentiated febrile illness consistent with typhoid were eligible for enrollment. Enrolled patients had blood cultures and Brucella serologies performed. Incidence was calculated with reference to census data. Both typhoid fever and brucellosis were common, and the incidence of typhoid fever was 21 cases/100 000 patient-years. Classic disease symptoms were uncommonly observed. Cost-effective surveillance projects to calculate disease burden of typhoid fever are practical and replicable. Typhoid has successfully adapted to the healthcare environment in Sulaimania. Additional work in the region should focus on antibiotic resistance and other enteric pathogens such as Brucella spp. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Everyday burden of musculoskeletal conditions among villagers in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Hartvigsen, Jan; Myburgh, Corrie

    2016-01-01

    with an interpreter. Audio recordings were transcribed verbatim, with Setswana contextually translated into English. The theoretical lens included Bury's biographical disruption, in which he distinguishes between "meaning as consequence" and "meaning as significance". RESULTS: Interviews revealed co-existing accounts...... for the consequences and significance of musculoskeletal burden related to 3 themes: (i) hard work for traditional lives; (ii) bearing the load of a rugged landscape; and, (iii) caring for others with disrupted lives. Physical labour with musculoskeletal symptoms had economic and subsistence consequences. The loss...... of independence and social identity to fulfil traditional roles held meaning as significance. Outmigration for wage labour and other shifts in family structure compounded everyday musculoskeletal burden. CONCLUSION: Uncovering burden is an important first step to address musculoskeletal care needs in developing...

  11. [Burden of mothers and fathers of persons with schizophrenia].

    Science.gov (United States)

    Friedrich, Fabian; Gross, Rainer; Wrobel, Margit; Klug, Günter; Unger, Annemarie; Fellinger, Matthäus; Süßenbacher, Stefanie; Freidl, Marion; Saumer, Gertraud; Wancata, Johannes

    2015-05-01

    Most studies about the burden of schizophrenia carers included only one care-giving relative, usually the patients' mothers. The present study intended to analyse differences of the level of burden between mothers and fathers of the same patients. 101 mothers and 101 fathers of the same patients suffering from schizophrenia were included into this study. They were assessed by means of the "Involvement Evaluation Questionnaire" and the "Carers' Needs Assessment for Schizophrenia". Mothers showed significantly higher scores than fathers regarding the subscores "Tensions" and "Urging". Multiple linear regression analyses showed positive associations between the frequency of mothers' as well as fathers' unmet needs and dimensions of caregiver involvement. Unmet needs among mothers and fathers have negative effects on their burden. The differences between mothers and fathers indicate the importance of considering the carer's gender in clinical work. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Standardization of calibration method of whole-body counter. 1. Calibration by using anthropometric phantoms

    International Nuclear Information System (INIS)

    Ishikawa, Tetsuo; Matsumoto, Masaki; Uchiyama, Masafumi; Kobayashi, Sadayoshi; Mizushita, Seiichi.

    1995-01-01

    To standardize the calibration methods of whole-body counters, three anthropometric phantoms were manufactured based on dozens of Japanese average value of body size data. Using these phantoms, the calibrations of some whole-body counters were carried out and the comparison of counting efficiency between anthropometric phantoms and block phantoms, which used to be used for the calibration of whole-body counters generally, was implemented. Five whole-body counters, one scanning system, two stationary systems and two chair systems, were used for this study. The following results were derived: As an example, in NIRS scanning system, the counting efficiency of anthropometric phantom of 162cm height was 12.7% greater than that of block phantom of the same height. This means 137 Cs body burdens in adult men used to be estimated with the excess of about 10%. Body burdens tended to be estimated excessively in adult because the difference of counting efficiency between anthropometric phantom and block phantom increases with increase of height. To standardize body burden data measured with various whole-body counters, the calibration of each whole-body counter should be conducted using anthropometric phantoms and phantoms which used to be used for the calibration of that whole-body counter. (author)

  13. Quantifying the burden of vampire bat rabies in Peruvian livestock.

    Directory of Open Access Journals (Sweden)

    Julio A Benavides

    2017-12-01

    Full Text Available Knowledge of infectious disease burden is necessary to appropriately allocate resources for prevention and control. In Latin America, rabies is among the most important zoonoses for human health and agriculture, but the burden of disease attributed to its main reservoir, the common vampire bat (Desmodus rotundus, remains uncertain.We used questionnaires to quantify under-reporting of livestock deaths across 40 agricultural communities with differing access to health resources and epidemiological histories of vampire bat rabies (VBR in the regions of Apurimac, Ayacucho and Cusco in southern Peru. Farmers who believed VBR was absent from their communities were one third as likely to report livestock deaths from disease as those who believed VBR was present, and under-reporting increased with distance from reporting offices. Using generalized mixed-effect models that captured spatial autocorrelation in reporting, we project 4.6 (95% CI: 4.4-8.2 rabies cases per reported case and identify geographic areas with potentially greater VBR burden than indicated by official reports. Spatially-corrected models estimate 505-724 cattle deaths from VBR in our study area during 2014 (421-444 deaths/100,000 cattle, costing US$121,797-171,992. Cost benefit analysis favoured vaccinating all cattle over the current practice of partial vaccination or halting vaccination all together.Our study represents the first estimate of the burden of VBR in Latin America to incorporate data on reporting rates. We confirm the long-suspected cost of VBR to small-scale farmers and show that vaccinating livestock is a cost-effective solution to mitigate the burden of VBR. More generally, results highlight that ignoring geographic variation in access to health resources can bias estimates of disease burden and risk.

  14. Burden of paediatric influenza in Western Europe: a systematic review

    Directory of Open Access Journals (Sweden)

    Antonova Evgeniya N

    2012-11-01

    Full Text Available Abstract Background Influenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden in children in Western Europe via a systematic literature review. Methods We conducted a systematic literature search of PubMed, EMBASE, and the Cochrane Library (1970-April 2011 and extracted data on influenza burden in children (defined as aged ≤ 18 years from 50 publications (13 reporting laboratory-confirmed influenza; 37 reporting influenza-like illness. Results Children with laboratory-confirmed influenza experienced hospitalisations (0.3%-20%, medical visits (1.7-2.8 visits per case, antibiotic prescriptions (7%-55%, and antipyretic or other medications for symptomatic relief (76%-99%; young children and those with severe illness had the highest rates of health care use. Influenza in children also led to absenteeism from day care, school, or work for the children, their siblings, and their parents. Average (mean or median length of absence from school or day care associated with confirmed influenza ranged from 2.8 to 12.0 days for the children, from 1.3 to 6.0 days for their siblings, and from 1.3 to 6.3 days for their parents. Influenza negatively affected health-related quality of life in children with asthma, including symptoms and activities; this negative effect was smaller in vaccinated children than in non-vaccinated children. Conclusions Influenza burden in children is substantial and has a significant direct impact on the ill children and an indirect impact on their siblings and parents. The identified evidence regarding the burden of influenza may help inform both influenza antiviral use in children and paediatric immunisation policies in

  15. Disease burden of chronic hepatitis C among immigrants in Canada.

    Science.gov (United States)

    Chen, W; Krahn, M

    2015-12-01

    Immigrants with chronic hepatitis C (CHC) in Canada have doubled risk of hepatocellular carcinoma. To measure the burden of CHC among immigrants in Canada. A decision analytic model was developed to compare immigrants with CHC and age-matched immigrants without CHC for survival years, quality-adjusted life-years (QALYs) and medical costs per life year. Hepatitis C epidemiology among immigrants was based on hepatitis C prevalence in their home countries. A cohort of immigrant patients was retrospectively followed up to estimate fibrosis stage distribution, treatment patterns and prognosis of compensated cirrhosis. Other model variables were based on published sources. Base case analysis, one-way sensitivity analysis and probabilistic sensitivity analysis were performed to measure the burden of CHC and assess the impact of uncertainty associated with model variables on the burden of CHC. CHC could reduce survival by 9.6 years [95% credible interval (CI): 8.0-10.9 years], reduce QALYs by 9.5 years (95% CI: 6.0-13.8 years) and increase medical costs per life year by $1950 (95% CI: $1518 to $2486, 2006 Canadian dollars). Because nearly half of immigrants with CHC were not diagnosed until the development of cirrhosis, the burden of CHC was highly sensitive to the risks of liver-related complications and mortality but insensitive to pegylated interferon plus ribavirin. The burden of CHC among immigrants in Canada is substantial mainly due to liver-related complications and mortality. The delay in diagnosis was another important contributor to the burden of CHC among immigrants. © 2015 John Wiley & Sons Ltd.

  16. The economic burden of angina on households in South Asia

    Science.gov (United States)

    2014-01-01

    Background Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. Methods We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Results Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p angina-affected households relative to matched controls in India (9.60%, p Angina-affected households significantly relied on borrowing or selling assets to finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased. Conclusions Households that had the respondent reporting angina in South Asia face an economic burden of OOP health expenses (primarily on drugs and other outpatient expenses), and tend to rely on borrowing or selling assets. Our analysis underscores the need to protect South Asian households from the financial burden of CVD. PMID:24548585

  17. The economic burden of angina on households in South Asia.

    Science.gov (United States)

    Alam, Khurshid; Mahal, Ajay

    2014-02-19

    Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p < 0.01) and Sri Lanka (7.80%, p = 0.01). However, impoverishment, non-medical consumption expenditure and employment status of the angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased. Households that had the respondent reporting angina in South Asia face an economic burden of OOP health expenses (primarily on drugs and other outpatient expenses), and tend to rely on borrowing or selling assets. Our analysis underscores the need to protect South Asian households from the financial burden of CVD.

  18. [Occupational burdens in special educators working with intellectually disabled students].

    Science.gov (United States)

    Plichta, Piotr

    2014-01-01

    The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy) with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. The results were obtained using Plichta and Pyzalski's Questionnaire of Occupational Burdens in Teaching (QOBT). The presented results are based on a research sample (N = 100) of special educators (female) teaching intellectually disabled students attending special schools in the city of Lódz. The obtained results were compared with the results coming from a large random sample of public school teachers working with non-intellectually disabled children from the Lodi voivodeship (N = 429) and referred to the norms of QOBT. The results show significant percentage of respondents obtaining high level of occupational burdens (conflict situations - 45%, organizational burdens - 31%, lack of work sense - 40%, global score - 40%). Seniority is not related to the level of burdens. Some significant differences concerning the level of occupational burdens between both groups of teachers were found. The study showed e.g. the strong need for supporting special educators in the workplace context and the need of implementing preventive and remedial measures at both individual and organizational levels (especially in terms of improving personal relationships in a workplace). Generally, the results show similarity of the stressors' ranking in special educators and school teachers working with non-intellectually disabled children.

  19. Occupational burdens in special educators working with intellectually disabled students

    Directory of Open Access Journals (Sweden)

    Piotr Plichta

    2014-04-01

    Full Text Available Background: The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. Material and Methods: The results were obtained using Plichta and Pyżalski's Questionnaire of Occupational Burdens in Teaching (QOBT. The presented results are based on a research sample (N = 100 of special educators (female teaching intellectually disabled students attending special schools in the city of Łódź. The obtained results were compared with the results coming from a large random sample of public school teachers working with non-intellectually disabled children from the Łodź voivodeship (N = 429 and referred to the norms of QOBT. Results: The results show significant percentage of respondents obtaining high level of occupational burdens (conflict situations - 45%, organizational burdens - 31%, lack of work sense - 40%, global score - 40%. Seniority is not related to the level of burdens. Some significant differences concerning the level of occupational burdens between both groups of teachers were found. Conclusions: The study showed e.g. the strong need for supporting special educators in the workplace context and the need of implementing preventive and remedial measures at both individual and organizational levels (especially in terms of improving personal relationships in a workplace. Generally, the results show similarity of the stressors' ranking in special educators and school teachers working with non-intellectually disabled children. Med Pr 2014;65(2:239–250

  20. The burden of leishmaniasis in Iran, acquired from the global burden of disease during 1990–2010

    Directory of Open Access Journals (Sweden)

    Alireza Badirzadeh

    2017-09-01

    Full Text Available Objective: To report and measure the burden of leishmaniasis in Iran using the global burden of disease (GBD results, conducted by the Institute for Health Metrics and Evaluation for the years 1990 to 2010, and provide some recommendations for reaching better conclusions about the burden of disease. Methods: GBD burden and fatality rates of leishmaniasis were compared with the findings registered by the Ministry of Health and Medical Education (MOHME. Data obtained from the GBD for the years 1990 to 2010 were used to estimate the disability-adjusted life-years and fatality rates of leishmaniasis in Iran. Results: The GBD estimated 229 714 disability-adjusted life-years due to leishmaniasis in Iranian people of all ages and both sexes. The number of deaths caused by visceral leishmaniasis (VL had decreased significantly in recent years. MOHME registered data on fewer than 30 deaths in Iran from 1990 to 2010. Conclusions: The underreporting of VL deaths is always more pronounced. Findings indicate that the GBD estimation of mortality rates was surprisingly higher than MOHME’s data. The burden of leishmaniasis decreased significantly between the years 1990 and 2010 in both data sources. The possible explanation for this decrease has been discovered through the establishment of a VL surveillance system in various parts of Iran, particularly in endemic areas.

  1. Economic and Disease Burden of Dengue in Mexico

    Science.gov (United States)

    Undurraga, Eduardo A.; Betancourt-Cravioto, Miguel; Ramos-Castañeda, José; Martínez-Vega, Ruth; Méndez-Galván, Jorge; Gubler, Duane J.; Guzmán, María G.; Halstead, Scott B.; Harris, Eva; Kuri-Morales, Pablo; Tapia-Conyer, Roberto; Shepard, Donald S.

    2015-01-01

    Background Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies. Methods and Findings We estimated the annual economic and disease burden of dengue in Mexico for the years 2010–2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL) for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000–253,000) symptomatic and 119 (95%CL: 75–171) fatal dengue episodes annually on average (2010–2011), compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151–292) million, or $1.56 (95%CL: 1.38–2.68) per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87–209) million or $0.80 per capita (95%CL: 0.62–1.12) corresponds to illness. Annual disease burden averaged 65 (95%CL: 36–99) disability-adjusted life years (DALYs) per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden. Conclusion With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive) empirical estimates of dengue burden. Burden varies annually; during an outbreak

  2. On the burden of proof in civil procedure

    Directory of Open Access Journals (Sweden)

    Keča Ranko

    2013-01-01

    Full Text Available The appliance of burden of proof rules is conceived of assumption that evidences are taken and that court didn't reach the required degree of conviction of a particular fact, what implies limitation of application of these rules on proceedings in which the judgment is rendered after the plenary proceedings. The Code of Civil Procedure (CCP has no suitable answers for the problems arising from new conception of the principle of party control of facts and means of proof in Serbian litigation legislature, by which the court has no more power to take the evidence ex offo. There is no answer to the question how should court conduct when evidence is not taken because of a lack of parties' indication of the means of proof. In this case courts practice somehow wider conception of burden of proof rules, which however has no explicit legal ground. They are applying them even though evidences are not taken. In any case it would be useful to reformulate basic rule of burden of proof in manner which would correspondent to the new conception of the principle of party presentation. The rule of burden of proof applies when the high degree of conviction of facts is demanded from the court, in order to render the judgment. Consequently this rule loses its' sense when mere probability of factual findings is demanded. The broader conception of parties' representation principle however does not liberate court from his responsibility to clarify facts that should be base for adjudication. Circumstance that CCP does mention the principle of material truth anymore should not be seen as argument for liberation of mentioned responsibility. It is still expected from the court to be active. Only when joint effort of the court and parties is left without of goal, in sense that court doesn't reach the high degree conviction, there would be ground for burden of proof rule's application. In this situation court also must justify why he couldn't reach required degree of

  3. Economic and disease burden of dengue in Mexico.

    Directory of Open Access Journals (Sweden)

    Eduardo A Undurraga

    2015-03-01

    Full Text Available Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies.We estimated the annual economic and disease burden of dengue in Mexico for the years 2010-2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000-253,000 symptomatic and 119 (95%CL: 75-171 fatal dengue episodes annually on average (2010-2011, compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151-292 million, or $1.56 (95%CL: 1.38-2.68 per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87-209 million or $0.80 per capita (95%CL: 0.62-1.12 corresponds to illness. Annual disease burden averaged 65 (95%CL: 36-99 disability-adjusted life years (DALYs per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden.With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive empirical estimates of dengue burden. Burden varies annually; during an outbreak, dengue burden may be significantly higher than that of

  4. Economic and disease burden of dengue in Mexico.

    Science.gov (United States)

    Undurraga, Eduardo A; Betancourt-Cravioto, Miguel; Ramos-Castañeda, José; Martínez-Vega, Ruth; Méndez-Galván, Jorge; Gubler, Duane J; Guzmán, María G; Halstead, Scott B; Harris, Eva; Kuri-Morales, Pablo; Tapia-Conyer, Roberto; Shepard, Donald S

    2015-03-01

    Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies. We estimated the annual economic and disease burden of dengue in Mexico for the years 2010-2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL) for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000-253,000) symptomatic and 119 (95%CL: 75-171) fatal dengue episodes annually on average (2010-2011), compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151-292) million, or $1.56 (95%CL: 1.38-2.68) per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87-209) million or $0.80 per capita (95%CL: 0.62-1.12) corresponds to illness. Annual disease burden averaged 65 (95%CL: 36-99) disability-adjusted life years (DALYs) per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden. With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive) empirical estimates of dengue burden. Burden varies annually; during an outbreak, dengue burden may be significantly higher than that of the pre

  5. Dementia and family burden of care in Lebanon

    DEFF Research Database (Denmark)

    Chaaya, Monique; Phung, Kieu; Atweh, Samir

    2017-01-01

    The burden on and mental well-being of family carers for the elderly, especially those with dementia, has been well studied in high-income countries and to a lesser extent in the Arab region. Our study of Lebanese carers highlights the importance of considering the psychological well......-being of the family carer, and the role of dementia and depression in increasing the burden of care. Psychosocial interventions have produced equivocal results and therefore customised and contextualised interventions need to be researched. Greater understanding of the coping mechanisms used by carers is required...

  6. Burden of informal caregiving for stroke patients: Identification of caregivers at risk of adverse health effects

    NARCIS (Netherlands)

    Exel, N.J.A. van; Koopmanschap, M.A.; Berg, B. van den; Brouwer, W.B.F.; Bos, G.A.M. van den

    2005-01-01

    Background: We assessed the objective and subjective burden of caregiving for stroke patients and investigated which characteristics of the patient, the informal caregiver and the objective burden contribute most to subjective burden and to the condition of feeling substantially burdened. Methods:

  7. Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake

    Directory of Open Access Journals (Sweden)

    Makiko Sekiyama

    2015-10-01

    Full Text Available Indonesia is facing household-level double burden malnutrition. This study aimed at examining (1 household-level double burden for the mother-child and father-child pairs; (2 risk of adiposity of double burden households; and (3 associated dietary factors. Subjects were 5th and 6th grade elementary school children (n = 242, their mothers (n = 242, and their fathers (n = 225 in five communities (1 = urban, 4 = rural in the Bandung District. Questionnaires on socioeconomic factors, blood hemoglobin measurements, and anthropometric measurements were administered. For adults, body fat percentage (BF% was estimated by bioelectrical impedance (BF%-BI and by converting skinfold thickness (ST data using Durnin and Womersley’s (1974 formula (BF%-ST. Food frequency questionnaires were also completed. Double burden was defined as coexistence of maternal or paternal overweight (Body mass index (BMI ≥ 23 and child stunting (height-for-age z-score <−2 within households. Maternal-child double burden occurred in 30.6% of total households, whereas paternal-child double burden was only in 8.4%. Mothers from double burden households showed high adiposity; 87.3% with BF%-BI and 66.2% with BF%-ST had BF% >35%, and 60.6% had waists >80 cm. The major dietary patterns identified were “Modern” and “High-animal products”. After controlling for confounding factors, children in the highest quartile of the “High-animal products” dietary pattern had a lower risk of maternal-child double burden (Adjusted OR: 0.46, 95% CI: 0.21–1.04 than those in the lowest quartile. Given that the “High-animal products” dietary pattern was associated with the decreased risk of maternal-child double burden through a strong negative correlation with child stunting, improving child stunting through adequate intake of animal products is critical to solve the problem of maternal-child double burden in Indonesia.

  8. Burden differentiation: criteria for evaluation and development of burden sharing rules. The Joint CICERO-ECN project on sharing the burden of greenhouse gas reduction among countries

    International Nuclear Information System (INIS)

    Torvanger, Asbjoern; Ringius, Lasse

    2000-02-01

    This article discusses nine criteria for evaluation of potential Burden Sharing Rules (BSRs) in climate policy agreements. Three of the criteria reflect fairness principles while six of them are operational requirements. These criteria are useful for identifying potential BSRs that could be promising in future climate policy negotiations. The two sector approaches, Multi-sector Convergence Approach and Triptych, received the highest score according to the criteria presented in this article. The Multi-sector Convergence Approach was developed in the joint ECN (Netherlands Energy Research Foundation) and CICERO (Center for International Climate and Environmental Research - Oslo) project on burden sharing in climate policy agreements. This is a sector-oriented approach that comprises convergence of per capita emissions to the same level for all countries, and has a global coverage. The Triptych approach has been employed by the European Union for their internal differentiation of national abatement targets. Sector approaches have some specific advantages in linking burden sharing to the economic structure of countries. This indicates that the Multi-sector Convergence Approach could play a useful role in climate policy negotiations among a larger group of countries, and could encourage developing countries to take on greenhouse gas abatement targets. (author)

  9. Contribution of cardiac and extra-cardiac disease burden to risk of cardiovascular outcomes varies by ejection fraction in heart failure

    DEFF Research Database (Denmark)

    Wolsk, Emil; Claggett, Brian; Køber, Lars

    2018-01-01

    AIMS: Patients with heart failure (HF) often have multiple co-morbidities that contribute to the risk of adverse cardiovascular (CV) and non-CV outcomes. We assessed the relative contribution of cardiac and extra-cardiac disease burden and demographic factors to CV outcomes in HF patients...... Association class, systolic blood pressure, time since HF diagnosis, HF medication use), extra-cardiac (body mass index, creatinine, diabetes mellitus, chronic obstructive pulmonary disease, smoker), and demographic (age, gender) categories, and calculated subscores for each patient representing the burden......EF patients (PAR: 76% cardiac disease vs. 58% extra-cardiac disease, P vs. 49% extra-cardiac disease, P

  10. Whole-body monitoring: Goiania case, Brazil

    International Nuclear Information System (INIS)

    Oliveira, C.A.N. de; Lourenco, M.C.; Dantas, B.M.; Lucena, E.A. de; Becker, P.H.B.

    1988-01-01

    Due to the radiological Cs accident in Goiania, Goias in September 1987, it became necessary to evaluate internal contamination levels of: individuals from the general public that for any reason had direct or indirect involvement with the radioactive source (group 1); occupationally involved persons (group 2). For each of these groups, procedures of whole body monitoring were developped. In order to attend group 1 individuals, the IRD/CNEN installed a whole body unit in the INAMPS General Hospital of Goiania in 11.08.87, which was later transferred to 121, 57 street, Central Sector in Goiania in 2.06.88. In this unit 547 people were monitored, 356 from group 1 and 241 from group 2, until 04.13.88. In the IRD whole body counter installation, 194 individuals were counted, 185 from group 2 and 9 from group 1. The frequency of monitoring of each individual was stablished according to the Cs activity present in the body or to the job that will be done. Some body burden activity curves for Cs 137 as a function of the time elapsed from the first measurement, are presented. There people from group 1 were measured in both counters, the IRD and the Goiania ones. The values obtained in both installations are compatible with the body activity X time curve. (author) [pt

  11. The impact of dietary risk factors on the burden of non-communicable diseases in Ethiopia : findings from the Global Burden of Disease study 2013

    NARCIS (Netherlands)

    Melaku, Yohannes Adama; Temesgen, Awoke Misganaw; Deribew, Amare; Tessema, Gizachew Assefa; Deribe, Kebede; Sahle, Berhe W.; Abera, Semaw Ferede; Bekele, Tolesa; Lemma, Ferew; Amare, Azmeraw T.; Seid, Oumer; Endris, Kedir; Hiruye, Abiy; Worku, Amare; Adams, Robert; Taylor, Anne W.; Gill, Tiffany K.; Shi, Zumin; Afshin, Ashkan; Forouzanfar, Mohammad H.

    2016-01-01

    Background: The burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia. The contribution of dietary behaviours to the NCD burden in Ethiopia has not been evaluated. This study, therefore, aimed to assess diet-related burden of disease in Ethiopia

  12. [Perspectives on body: embodiment and body image].

    Science.gov (United States)

    Chang, Shiow-Ru; Chao, Yu-Mei Yu

    2007-06-01

    "Body" is a basic concept of both the natural and human sciences. This extensive review of the literature explores the various philosophical approaches to the body, including empiricism, idealism, existentialism and phenomenology, as well as the relationship between body and mind. Embodiment and body image are the two main concepts of body addressed in this article. Merleau-Ponty's perspective on embodiment, an important new area of theory development, emphasizes that embodiment research must focus on life experiences, such as the study of body image. Using Schilder's framework of psychosocialology, this article provides a comprehensive understanding of the concept of body image and women's perspectives on the "body" in both Western culture and Eastern cultures. Body size and shape significantly influence the self-image of women. Body image is something that develops and changes throughout one's life span and is continually being constructed, destructed, and reconstructed. Personal body image has important psychological effects on the individual, especially women. This integrative review can make a significant contribution to knowledge in this area and, consequently, to related practice and research.

  13. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... top of page What are the benefits vs. risks? Benefits Removal of a foreign body will reduce ... good tool for guiding foreign body removal procedures. Risks While foreign body removal procedures are safe and ...

  14. Lewy Body Dementia

    Science.gov (United States)

    Lewy body dementia Overview Lewy body dementia, also known as dementia with Lewy bodies, is the second most common type of progressive dementia after Alzheimer's disease dementia. Protein deposits, ...

  15. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... 80 percent of foreign body ingestions occur among children. Most foreign bodies pass through the gastrointestinal tract ... blockages that may require surgical removal of magnets. Children account for about 80 percent of foreign body ...

  16. Whole Body Counters (rev.)

    Energy Technology Data Exchange (ETDEWEB)

    Woodburn, John H. [Walter Johnson High School, Rockville, MD; Lengemann, Frederick W. [Cornell University

    1967-01-01

    Whole body counters are radiation detecting and measuring instruments that provide information about the human body. This booklet describes different whole body counters, scientific principles that are applied to their design, and ways they are used.

  17. Variability of the strontium-90 and caesium-137 burden of native plants and animals

    Energy Technology Data Exchange (ETDEWEB)

    Eberhardt, L L

    1946-10-17

    Cesium-137 and /sup 90/Sr body burdens were determined in plants and animals at selected sites in Alaska, Idaho, Nevada, Utah, California, and Maryland, and coefficients of variations were derived. Coefficients of variation for burdens of /sup 90/Sr and /sup 137/Cs were suprisingly consistent over a wide range of plants and animals. Values for /sup 90/Sr ranged from about 0.30 to 0.45 while those for /sup 137/Cs appeared somewhat lower, ranging roughly from 0.25 to 0.35. Various factors possibly affecting individual sets of data were indicated. With one exception (Maryland white-tailed deer), the bone-strontium-90 values were calculated in terms of picocuries (10/sup -12/c) per g calcium (strontium units). Analysis of the Alaskan caribou data in terms of picocuries per g standard dry weight yields virtually the same coefficient of variation. The plant data were calculated on the standard dry weight basis, while soil-levels were on a unit area basis. All /sup 137/Cs values were expressed in units per g dry weight. Results reported here should not be interpreted as meaning that the coefficient of variation for levels of these two radionuclides is everywhere roughly constant.

  18. Comparing Cerebral White Matter Lesion Burdens between Parkinson’s Disease with and without Dementia

    Directory of Open Access Journals (Sweden)

    Sun-Ah Choi

    2010-05-01

    Full Text Available Cerebral white matter lesions (CWMLs have been suggested to be associated with an increased risk of dementia, disability, and death. CWMLs are more common in individuals with Alzheimer’s disease (AD than in normal elderly individuals of comparable age. Only a few studies have been done to determine whether CWMLs may influence cognitive decline in Parkinson’s disease (PD. Fully developed PD with concurrent AD was reported to likely cause impaired cognition in spite of accumulating evidence suggesting that PD with dementia (PDD is more closely associated with Lewy body (LB pathology. Currently, contradictory data on the neuropathology of dementia in PD require further prospective clinicopathological studies in larger cohorts to elucidate the impact of AD and α-synuclein (SCNA pathologies on the cognitive status in these disorders. Previous reports did not suggest CWMLs to be associated with an increased risk of PDD. After adjusting for age at death, age at onset of PD, and duration of PD, our recent study investigating CWMLs in PDD via autopsy has shown a positive correlation between the burden of CWMLs and PDD. The frequent co-existence of both LB and AD lesions suggests that both pathologies independently or synergistically contribute to both movement disorders and cognitive impairment. The individual and cumulative burden of CWMLs, LB lesions, and AD lesions may synergistically contribute to cognitive decline in LB disorders such as PDD.

  19. Sex-gender differences in drug abuse: a shift in the burden of proof?

    Science.gov (United States)

    Wetherington, Cora Lee

    2007-10-01

    In the early years of NIDA-supported drug abuse research, much of the research on women was treatment related and conducted out of concern for their pregnancy status. Since then, drug abuse research on women has expanded to include females of all ages, including infants, children, and adolescents, both human and animal. This expansion has also extended to the study of male-female differences. In the early years of the expansion, National Institutes of Health study sections demanded a heavy burden of proof from drug abuse researchers who proposed to study male-female differences. The need for such research appeared not to have face validity. The tide has now changed with the growing body of literature attesting to its scientific and clinical validity. This change is often reflected in concerns expressed in study sections reviewing drug abuse grant applications that an applicant does not propose to analyze the data for sex-gender differences when in fact the literature suggests that such differences would be observed. Although the change has been slow, it suggests that the burden of proof is shifting from having to defend why sex-gender differences should be studied to having to defend why they should not. (c) 2007 APA

  20. Instruments measuring family or caregiver burden in severe mental illness

    NARCIS (Netherlands)

    Schene, A. H.; Tessler, R. C.; Gamache, G. M.

    1994-01-01

    The consequences of psychiatric disorders for family members, usually called family or caregiver burden, have been studied during the last 4 decades. During this period a variety of instruments have been developed to measure the impact of mental illness on family members, but not all instruments

  1. The economic burden of personality disorders in mental health care

    NARCIS (Netherlands)

    Soeteman, D.I.; Hakkaart-van Roijen, L.; Verheul, R.; Busschbach, J.J.V.

    2008-01-01

    Objective: Some evidence suggests that personality disorders are associated with a high economic burden due to, for example, a high demand on psychiatric, health, and social care services. However, state-of-the-art cost studies for the broad range of personality disorder diagnoses are lacking. The

  2. Economic burden of motorcycle accidents in Northern Ghana ...

    African Journals Online (AJOL)

    Background: Motorcycles are the most popular means of transportation in northern Ghana, and their accidents are major causes of out-patient attendance and admis-sions in the Bolgatanga Municipality. Objective: This paper estimates the economic burden of motorcycle accidents in the Bolgatanga Municipality in Northern ...

  3. Prevalence and burden of Sickle Cell Disease among ...

    African Journals Online (AJOL)

    Background: Sickle cell disease (SCD) is the most common form of haemoglobin opathy in Nigeria but there is paucity of data for its effects on undergraduate students in universities despite the fact that this population of people suffer more burdens of the disease due to relative lack of parental care and their recently ...

  4. Marital History and the Burden of Cardiovascular Disease in Midlife

    Science.gov (United States)

    Zhang, Zhenmei

    2006-01-01

    This study examines the effects of marital history on the burden of cardiovascular disease in midlife. With use of data from the 1992 Health and Retirement Study, a series of nested logistic regression models was used to estimate the association between marital history and the likelihood of cardiovascular disease. Results suggest that, in midlife,…

  5. 20 CFR 726.312 - Burdens of proof.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Burdens of proof. 726.312 Section 726.312 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Civil...

  6. Disease burden of foodborne pathogens in the Netherlands, 2009

    NARCIS (Netherlands)

    Havelaar, A.H.|info:eu-repo/dai/nl/072306122; Haagsma, J.A.; Mangen, M.J.J.; Kemmeren, J.M.; Verhoef, L.; Vijgen, S.M.; Wilson, M; Friesema, I.H.; Kortbeek, L.M.; van Duynhoven, Y.T.; van Pelt, W.

    2012-01-01

    To inform risk management decisions on control, prevention and surveillance of foodborne disease, the disease burden of foodborne pathogens is estimated using Disability Adjusted Life Years as a summary metric of public health. Fourteen pathogens that can be transmitted by food are included in the

  7. The consequences of Nigeria's debt burden on a new international ...

    African Journals Online (AJOL)

    The consequences of Nigeria's debt burden on a new international economic order. Goke Lalude. Abstract. No Abstract. The Nigerian Journal of Economic History Vol. 3 2000: 74-83. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online.

  8. Disease burden of infectious diseases in Europe: a pilot study

    NARCIS (Netherlands)

    Lier EA van; Havelaar AH; LZO

    2007-01-01

    Consequences of different infectious diseases cannot be adequately compared with each other on the basis of the number of patients or mortality data only. It is better to combine all health effects and express the total impact as disease burden, which also takes duration and severity of diseases

  9. Socioeconomic Risk Factors for Celiac Disease Burden and Symptoms.

    Science.gov (United States)

    Oza, Sveta S; Akbari, Mona; Kelly, Ciarán P; Hansen, Joshua; Theethira, Thimmaiah; Tariq, Sohaib; Dennis, Melinda; Leffler, Daniel A

    2016-04-01

    Celiac disease (CD) affects approximately 1% of the population and negatively affects aspects of life including physical and social function. The relationship between socioeconomic (SE) factors, symptom severity, and perceived burden of living with CD is not well understood. The objective of this study was to assess the relationships between income, symptoms, and perceived burden of CD. In this survey study conducted at a tertiary care center, 773 patients 18 years of age or more with biopsy confirmed CD were eligible to participate. Patients completed a survey with information on SE data, the validated Celiac Symptom Index (CSI), and visual analog scales (VAS) assessing overall health, CD-related health, difficulty in following a gluten-free diet (GFD), and importance of following a GFD. Three hundred forty one patients completed the survey. Higher income predicted better overall health, better CD related health, and fewer symptoms. In the logistic regression model, low income was associated with greater CD symptoms (odds ratio=6.04, P=0.002). Other factors associated with greater symptoms were younger age, poor overall health state, and more physician visits. Factors associated with increased burden of CD included hospitalizations, more symptoms, poor overall health state, and burden of following a GFD. Patients with lower incomes have worse CD-related health and greater symptoms. Those with low income had 6 times the odds of greater symptoms compared with those with high income. Our data suggest that income is associated with perceived overall health, CD-related health, and CD symptoms.

  10. Burden of four vaccine preventable diseases in older adults

    NARCIS (Netherlands)

    Kristensen, Maartje; van Lier, Alies; Eilers, Renske; McDonald, Scott A.; Opstelten, Wim; van der Maas, Nicoline; van der Hoek, Wim; Kretzschmar, Mirjam E.; Nielen, Mark M.; de Melker, Hester E.

    2016-01-01

    Background: Implementation of additional targeted vaccinations to prevent infectious diseases in the older adults is under discussion in different countries. When considering the added value of such preventive measures, insight into the current disease burden will assist in prioritization. The aim

  11. The Hierarchical Clustering of Tax Burden in the EU27

    Directory of Open Access Journals (Sweden)

    Simkova Nikola

    2015-09-01

    Full Text Available The issue of taxation has become more important due to a significant share of the government revenue. There are several ways of expressing the tax burden of countries. This paper describes the traditional approach as a share of tax revenue to GDP which is applied to the total taxation and the capital taxation as a part of tax systems affecting investment decisions. The implicit tax rate on capital created by Eurostat also offers a possible explanation of the tax burden on capital, so its components are analysed in detail. This study uses one of the econometric methods called the hierarchical clustering. The data on which the clustering is based comprises countries in the EU27 for the period of 1995 – 2012. The aim of this paper is to reveal clusters of countries in the EU27 with similar tax burden or tax changes. The findings suggest that mainly newly acceding countries (2004 and 2007 are in a group of countries with a low tax burden which tried to encourage investors by favourable tax rates. On the other hand, there are mostly countries from the original EU15. Some clusters may be explained by similar historical development, geographic and demographic characteristics.

  12. Melanoma Surveillance in the US: The Economic Burden of Melanoma

    Centers for Disease Control (CDC) Podcasts

    This podcast accompanies the publication of a series of articles on melanoma surveillance in the United States, available in the November supplement edition of the Journal of the American Academy of Dermatology. Dr. Gery Guy, from the CDC’s Division of Cancer Prevention and Control, discusses the economic burden of melanoma.

  13. [The perceived burden of care and its correlates in schizophrenia].

    Science.gov (United States)

    Gülseren, Leyla; Cam, Birmay; Karakoç, Berna; Yiğit, Tamer; Danacı, Ayşen Esen; Cubukçuoğlu, Zeynep; Taş, Cumhur; Gülseren, Seref; Mete, Levent

    2010-01-01

    The present study aimed to investigate the perceived level of burden of care and its correlates in family members of schizophrenia patients. The study included 239 schizophrenic patients that were followed-up at the psychiatric outpatient clinics of Izmir Ataturk Education and Research Hospital, and Celal Bayar University Medical School, and 239 of their primary caregivers. Patients were assessed using the Positive and Negative Syndrome Scale (PANNS), Global Assessment of Functioning Scale (GAF), Social Functioning Scale (SFS), Brief Cognitive State Examination (BCE), and UKU Side Effect Rating Scale. Their primary caregivers were assessed using the Perceived Family Burden Scale (PFBS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Caregiver PFBS scores ere correlated with male patients, female caregivers, inadequate social support, economic difficulty, the presence of chronic physical disorder in the caregivers, patient violence toward the caregivers, total duration of illness, the number of patient hospitalizations, PANNS total and subscale scores, and SFS, BDI, and BAI scores. Perceived burden of care was predicted by the severity of the patients' positive symptoms, SFS independence/competence and interpersonal functioning subscale scores, and caregivers' anxiety and depression levels. In order to decrease the burden of care in schizophrenia we recommend effective management of patient symptoms, enhancement of patient social functioning, interventions that target caregivers with high levels anxiety and depression, and social support provided by healthcare professionals.

  14. Dementia and family burden of care in Lebanon

    DEFF Research Database (Denmark)

    Chaaya, Monique; Phung, Kieu; Atweh, Samir

    2017-01-01

    The burden on and mental well-being of family carers for the elderly, especially those with dementia, has been well studied in high-income countries and to a lesser extent in the Arab region. Our study of Lebanese carers highlights the importance of considering the psychological well-being of the...

  15. Neurological Disease Burden in two Semi-urban Communities in ...

    African Journals Online (AJOL)

    BACKGROUND: Neurological disorders are a significant cause of morbidity and mortality worldwide. Urban hospital -based studies give some perspectives on the burden of neurological disease but there are no community- based studies from South East Nigeria. AIM: This study sought to screen for the scope and pattern of ...

  16. Global and regional burden of stroke during 1990-2010

    DEFF Research Database (Denmark)

    Feigin, Valery L; Forouzanfar, Mohammad H; Krishnamurthi, Rita

    2014-01-01

    BACKGROUND: Although stroke is the second leading cause of death worldwide, no comprehensive and comparable assessment of incidence, prevalence, mortality, disability, and epidemiological trends has been estimated for most regions. We used data from the Global Burden of Diseases, Injuries, and Ri...

  17. Burden of disease in Nariño, Colombia, 2010

    Science.gov (United States)

    Trujillo-Montalvo, Elizabeth; Hidalgo-Patiño, Carlos; Hidalgo-Eraso, Angela

    2014-01-01

    Objective: This study sought to measure burden of disease and identifies health priorities from the Disability Adjusted Life Years (DALYs) indicator. Methods: This is the first study on burden of disease for a department in Colombia by using a standardized methodology. By using the DALYs indicator, burden of disease was identified in the department of Nariño according to the guidelines established by the World Health Organization. Results: The DALYs in the Department of Nariño highlight the emergence of communicable, maternal, perinatal, and nutritional diseases during the first years of life; of accidents and lesions among youth, and non-communicable diseases in older individuals. Also, accidents and lesions are highlighted in men and non-communicable diseases in women. Conclusions: This study is part of the knowledge management process in the Departmental Health Plan for Nariño - Colombia 2012-2015 and contributes to the system of indicators of the 2012 ten-year public health plan. This research evidences that communicable diseases generate the biggest part of the burden of disease in the Department of Nariño, that DALYs due to non-communicable diseases are on the rise, and that accidents and lesions, especially due to violence are an important cause of DALYs in this region, which is higher than that of the country. PMID:25386034

  18. Burden of emerging/re emerging diseases in India

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Burden of emerging/re emerging diseases in India. 1-2 million deaths for 1994 epidemic of plague. 20,565 deaths in 2004 due to rabies. 400 million chronic carriers of hepatitis B virus. More than 18 million carriers of hepatitis C virus. 'Mutant' measles virus infection in ...

  19. The Global Burden of Disease assessments--WHO is responsible?

    Directory of Open Access Journals (Sweden)

    Claudia Stein

    2007-12-01

    Full Text Available The Global Burden of Disease (GBD concept has been used by the World Health Organization (WHO for its reporting on health information for nearly 10 years. The GBD approach results in a single summary measure of morbidity, disability, and mortality, the so-called disability-adjusted life year (DALY. To ensure transparency and objectivity in the derivation of health information, WHO has been urged to use reference groups of external experts to estimate burden of disease. Under the leadership and coordination of WHO, expert groups have been appraising and abstracting burden of disease information. Examples include the Child Health Epidemiology Reference Group (CHERG, the Malaria Monitoring and Evaluation Reference Group (MERG, and the recently established Foodborne Disease Burden Epidemiology Reference Group (FERG. The structure and functioning of and lessons learnt by these groups are described in this paper. External WHO expert groups have provided independent scientific health information while operating under considerable differences in structure and functioning. Although it is not appropriate to devise a single "best practice" model, the common thread described by all groups is the necessity of WHO's leadership and coordination to ensure the provision and dissemination of health information that is to be globally accepted and valued.

  20. Addressing the double burden of work for rural women | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2017-03-27

    Mar 27, 2017 ... These are the millions of women engaged in agricultural work in small ... theater to change norms and practices around fishing and domestic work. ... where the best opportunities are to reduce the burden of care work. In 2013, USAID's Feed the Future program developed the Women's Empowerment in ...

  1. Societal perspective on the burden of migraine in The Netherlands

    NARCIS (Netherlands)

    van Roijen, L.; Essink-Bot, M. L.; Koopmanschap, M. A.; Michel, B. C.; Rutten, F. F.

    1995-01-01

    This study presents a comprehensive overview of the societal burden of migraine in The Netherlands. We assessed the direct and indirect costs of this disease, and the health status of patients with migraine. We developed the 'illness and labour' (I&L) questionnaire to collect data on the effect of

  2. Estimating the burden of disease attributable to high blood pressure ...

    African Journals Online (AJOL)

    Objectives. To estimate the burden of disease attributable to high blood pressure (BP) in adults aged 30 years and older in South Africa in 2000. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. Mean systolic BP (SBP) estimates by age and sex were obtained from the 1998 ...

  3. Estimating the burden of disease attributable to iron deficiency ...

    African Journals Online (AJOL)

    Objectives. To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000. Design. The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was ...

  4. Estimating the burden of disease attributable to high cholesterol in ...

    African Journals Online (AJOL)

    Objectives. To estimate the burden of disease attributable to high cholesterol in adults aged 30 years and older in South Africa in 2000. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. Small community studies were used to derive the prevalence by population group.

  5. Estimating the burden of disease attributable to lead exposure in ...

    African Journals Online (AJOL)

    Objectives. To estimate the burden of disease attributable to lead exposure in South Africa in 2000. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. Recent community studies were used to derive mean blood lead concentrations in adults and children in urban and rural ...

  6. Burden and pattern of micro vascular complications in type 2 ...

    African Journals Online (AJOL)

    Introduction: Diabetes mellitus (DM) afflicts at least 5 million people in Nigeria, with more than 80% having type 2 diabetes mellitus (T2DM). Microvascular complications increase both morbidity and mortality inpatients with T2DM. The aims of this study were to report the burden of various microvascular complications in ...

  7. The transmission of Mycobacterium tuberculosis in high burden settings

    NARCIS (Netherlands)

    Yates, Tom A.; Khan, Palwasha Y.; Knight, Gwenan M.; Taylor, Jonathon G.; McHugh, Timothy D.; Lipman, Marc; White, Richard G.; Cohen, Ted; Cobelens, Frank G.; Wood, Robin; Moore, David A. J.; Abubakar, Ibrahim

    2016-01-01

    Unacceptable levels of Mycobacterium tuberculosis transmission are noted in high burden settings and a renewed focus on reducing person-to-person transmission in these communities is needed. We review recent developments in the understanding of airborne transmission. We outline approaches to measure

  8. The effects of debt burden on the Nigerian economy | Ogege ...

    African Journals Online (AJOL)

    It employs the ordinary least squares (OLS) to test the relationship between debt burden and the growth in the Nigerian economy. The finding shows that there is a negative relationship between debt stock (internal and external debt) and gross domestic product, meaning that an increase in debt stock will lead to reduction ...

  9. National Economic Burden Associated with Management of Periodontitis in Malaysia.

    Science.gov (United States)

    Mohd Dom, Tuti Ningseh; Ayob, Rasidah; Abd Muttalib, Khairiyah; Aljunid, Syed Mohamed

    2016-01-01

    Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

  10. Caregiver burden in Alzheimer's disease patients in Spain.

    Science.gov (United States)

    Peña-Longobardo, Luz María; Oliva-Moreno, Juan

    2015-01-01

    Alzheimer's disease constitutes one of the leading causes of burden of disease, and it is the third leading disease in terms of economic and social costs. To analyze the burden and problems borne by informal caregivers of patients who suffer from Alzheimer's disease in Spain. We used the Survey on Disabilities, Autonomy and Dependency to obtain information on the characteristics of disabled people with Alzheimer's disease and the individuals who provide them with personal care. Additionally, statistical multivariate analyses using probit models were performed to analyze the burden placed on caregivers in terms of health, professional, and leisure/social aspects. 46% of informal caregivers suffered from health-related problems as a result of providing care, 90% had leisure-related problems, and 75% of caregivers under 65 years old admitted to suffering from problems related to their professional lives. The probability of a problem arising for an informal caregiver was positively associated with the degree of dependency of the person cared for. In the case of caring for a greatly dependent person, the probability of suffering from health-related problems was 22% higher, the probability of professional problems was 18% higher, and there was a 10% greater probability of suffering from leisure-related problems compared to non-dependents. The results show a part of the large hidden cost for society in terms of problems related to the burden lessened by the caregivers. This information should be a useful tool for designing policies focused toward supporting caregivers and improving their welfare.

  11. Humanistic and economic burden of fibromyalgia in Japan [Corrigendum

    Directory of Open Access Journals (Sweden)

    Lee LK

    2016-12-01

    Full Text Available Lee LK, Ebata N, Hlavacek P, DiBonaventura M, Cappelleri JC, Sadosky A. Humanistic and economic burden of fibromyalgia in Japan. Journal of Pain Research. 2016;9:967–978.Figures 3, 4, 5, and 6 contain errors in the key. Fibromyalgia should be dark gray and matched controls should be light gray.Read the original article.

  12. Air Pollution, Disease Burden, and Health Economic Loss in China.

    Science.gov (United States)

    Niu, Yue; Chen, Renjie; Kan, Haidong

    2017-01-01

    As the largest developing country in the world, China is now facing one of the severest air pollution problems. The objective of this section is to evaluate the disease burden and corresponding economic loss attributable to ambient air pollution in China. We reviewed a series of studies by Chinese or foreign investigators focusing on the disease burden and economic loss in China. These studies showed both the general air pollution and haze episodes have resulted in substantial disease burden in terms of excess number of premature deaths, disability-adjusted life-year loss, and years of life lost. The corresponding economic loss has accounted for an appreciable proportion of China's national economy. Overall, the disease burden and health economic loss due to ambient air pollution in China is greater than in the remaining parts of the world, for one of the highest levels of air pollution and the largest size of exposed population. Consideration of both health and economic impacts of air pollution can facilitate the Chinese government to develop environmental policies to reduce the emissions of various air pollutants and protect the public health.

  13. Disability weights for the Global Burden of Disease 2013 study

    NARCIS (Netherlands)

    Salomon, Joshua A.; Haagsma, Juanita A.; Davis, Adrian; de Noordhout, Charline Maertens; Polinder, Suzanne; Havelaar, Arie H.|info:eu-repo/dai/nl/072306122; Cassini, Alessandro; Devleesschauwer, Brecht; Kretzschmar, Mirjam; Speybroeck, Niko; Murray, Christopher J L; Vos, Theo

    2015-01-01

    Background: The Global Burden of Disease (GBD) study assesses health losses from diseases, injuries, and risk factors using disability-adjusted life-years, which need a set of disability weights to quantify health levels associated with non-fatal outcomes. The objective of this study was to estimate

  14. Disability weights for the Global Burden of Disease 2013 study

    NARCIS (Netherlands)

    Salomon, Joshua A; Haagsma, Juanita A; Davis, Adrian; de Noordhout, Charline Maertens; Polinder, Suzanne; Havelaar, Arie H; Cassini, Alessandro; Devleesschauwer, Brecht; Kretzschmar, MEE; Speybroeck, Niko; Murray, Christopher J L; Vos, Theo

    2015-01-01

    BACKGROUND: The Global Burden of Disease (GBD) study assesses health losses from diseases, injuries, and risk factors using disability-adjusted life-years, which need a set of disability weights to quantify health levels associated with non-fatal outcomes. The objective of this study was to estimate

  15. Alcohol-attributed disease burden in four Nordic countries

    DEFF Research Database (Denmark)

    Agardh, Emilie E; Danielsson, Anna-Karin; Ramstedt, Mats

    2016-01-01

    , changes in consumption generally corresponded to changes in disease burden, but not to the same extent in Sweden and Norway. All countries had a similar disease pattern and the majority of DALYs were due to YLLs (62-76%), mainly from alcohol use disorder, cirrhosis, transport injuries, self-harm...

  16. Original Research Characterising cancer burden and quality of care ...

    African Journals Online (AJOL)

    Cancer burden at two palliative care clinics in Malawi 130 ... Cancer is a leading cause of mortality and morbidity worldwide. ... Health Organization (WHO) defines palliative care as an .... period, patients aged 15 years ..... GLOBOCAN 2012 ... Young People: A Case Series of 109 Cases and Review of the Literature.

  17. Burden of diseases in poor resource countries: meeting the ...

    African Journals Online (AJOL)

    In Tanzania morbidity due to HIV/AIDS, tuberculosis and malaria leads to ... Key words: HIV/AIDS, malaria, tuberculosis, burden, poverty, research. Introduction ... children and women in particular, die without ever accessing ... 1990s in Tanzania show a mixed picture despite .... percent of the country is highly endemic for the.

  18. Family Stigma and Caregiver Burden in Alzheimer's Disease

    Science.gov (United States)

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  19. National Economic Burden Associated with Management of Periodontitis in Malaysia

    Directory of Open Access Journals (Sweden)

    Tuti Ningseh Mohd Dom

    2016-01-01

    Full Text Available Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010 data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

  20. Effects of external debt burden on LDC's investments: empirical ...

    African Journals Online (AJOL)

    Effects of external debt burden on LDC's investments: empirical evidence from Nigeria. Michael I Moughalu, Chinedu B Ezirim. Abstract. No Abstract. African Journal of Finance and Management Vol. 14(2) 2006: 3-18. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  1. burden of intestinal parasites amongst hiv/aids patients attending

    African Journals Online (AJOL)

    boaz

    ABSTRACT. Background: Intestinal parasitic infections cause severe diarrhea especially in debilitated subjects with clinical ... Regional Hospital, Entamoeba histolytica and other intestinal parasites represented a common burden. .... Attempt was made to go through all the fields of ..... Control of Intestinal parasite Infections.

  2. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... a personal story about radiology? Share your patient story here Images ... Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body General Ultrasound Contrast ...

  3. Systematic Review of the Economic Burden of Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Gu, Shuyan; Hu, Huimei; Dong, Hengjin

    2016-06-01

    Pulmonary arterial hypertension (PAH), as a life-threatening disease with no efficient cure, may impose a tremendous economic burden on patients and healthcare systems. However, most existing studies have mainly emphasised epidemiology and medications, while large observational studies reporting on the economic burden are currently lacking. To review and evaluate evidence on the costs of PAH and the cost effectiveness of PAH treatments, and to summarise the corresponding cost drivers. Systematic literature searches were conducted in English-language databases (PubMed, Web of Science, ScienceDirect) and Chinese-language databases (China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP) to identify studies (published from 2000 to 2014) assessing the costs of PAH or the cost effectiveness of PAH treatments. The search results were independently reviewed and extracted by two reviewers. Costs were converted into 2014 US dollars. Of 1959 citations identified in the initial search, 19 papers were finally included in this analysis: eight on the economic burden of PAH and 11 on economic evaluation of PAH treatments. The economic burden on patients with PAH was rather large, with direct healthcare costs per patient per month varying from $2476 to $11,875, but none of the studies reported indirect costs. Sildenafil was universally reported to be a cost-effective treatment, with lower costs and better efficacy than other medications. Medical costs were reported to be the key cost drivers. The economic burden of patients with PAH is substantial, while the paucity of comprehensive country-specific evidence in this area and the lack of reports on indirect costs of PAH warrant researchers' concern, especially in China.

  4. Financial burden in recipients of allogeneic hematopoietic cell transplantation.

    Science.gov (United States)

    Khera, Nandita; Chang, Yu-hui; Hashmi, Shahrukh; Slack, James; Beebe, Timothy; Roy, Vivek; Noel, Pierre; Fauble, Veena; Sproat, Lisa; Tilburt, Jon; Leis, Jose F; Mikhael, Joseph

    2014-09-01

    Although allogeneic hematopoietic cell transplantation (HCT) is an expensive treatment for hematological disorders, little is known about the financial consequences for the patients who undergo this procedure. We analyzed factors associated with its financial burden and its impact on health behaviors of allogeneic HCT recipients. A questionnaire was retrospectively mailed to 482 patients who underwent allogeneic HCT from January 2006 to June 2012 at the Mayo Clinic, to collect information regarding current financial concerns, household income, employment, insurance, out-of-pocket expenses, and health and functional status. A multivariable logistic regression analysis identified factors associated with financial burden and treatment nonadherence. Of the 268 respondents (56% response rate), 73% reported that their sickness had hurt them financially. All patients for whom the insurance information was available (missing, n = 13) were insured. Forty-seven percent of respondents experienced financial burden, such as household income decreased by >50%, selling/mortgaging home, or withdrawing money from retirement accounts. Three percent declared bankruptcy. Younger age and poor current mental and physical functioning increased the likelihood of financial burden. Thirty-five percent of patients reported deleterious health behaviors because of financial constraints. These patients were likely to be younger, have lower education, and with a longer time since HCT. Being employed decreased the likelihood of experiencing financial burden and treatment nonadherence due to concern about costs. A significant proportion of allogeneic HCT survivors experience financial hardship despite insurance coverage. Future research should investigate potential interventions to help at-risk patients and prevent adverse financial outcomes after this life-saving procedure. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  5. Financial burden of medical care: a family perspective.

    Science.gov (United States)

    Cohen, Robin A; Kirzinger, Whitney K

    2014-01-01

    Data from the National Health Interview Survey, 2012. In 2012, more than one in four families experienced financial burdens of medical care. Families with incomes at or below 250% of the federal poverty level (FPL) were more likely to experience financial burdens of medical care than families with incomes above 250% of the FPL. Families with children aged 0-17 years were more likely than families without children to experience financial burdens of medical care. The presence of a family member who was uninsured increased the likelihood that a family would experience a financial burden of medical care. Recently published data from the National Health Interview Survey (NHIS) found that 1 in 5 persons was in a family having problems paying medical bills, and 1 in 10 persons was in a family with medical bills that they were unable to pay at all (1-3). NHIS defines "family" as an individual or a group of two or more related persons living together in the same housing unit. The family perspective is important to consider when examining financial risk because significant expenses for one family member may adversely affect the whole family. Health insurance coverage is one way for a family to mitigate financial risk associated with health care costs, although health insurance status may differ among family members. This report explores selected family demographic characteristics and their association with financial burdens of medical care (problems paying medical bills, paying medical bills over time, and having medical bills that cannot be paid) based on data from the 2012 NHIS. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  6. The burden of parasitic zoonoses in Nepal: a systematic review.

    Directory of Open Access Journals (Sweden)

    Brecht Devleesschauwer

    Full Text Available Parasitic zoonoses (PZs pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY. However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding.We examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs.Between 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI: 5450-27,694] and 9255 DALYs [95% CrI: 6135-13,292], respectively, followed by cystic echinococcosis (251 DALYs [95% CrI: 105-458]. Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur.In settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this study would enable additional burden estimates, and a more

  7. The economic burden of skin disease in the United States.

    Science.gov (United States)

    Dehkharghani, Seena; Bible, Jason; Chen, John G; Feldman, Steven R; Fleischer, Alan B

    2003-04-01

    Skin diseases and their complications are a significant burden on the nation, both in terms of acute and chronic morbidities and their related expenditures for care. Because accurately calculating the cost of skin disease has proven difficult in the past, we present here multiple comparative techniques allowing a more expanded approach to estimating the overall economic burden. Our aims were to (1) determine the economic burden of primary diseases falling within the realm of skin disease, as defined by modern clinical disease classification schemes and (2) identify the specific contribution of each component of costs to the overall expense. Costs were taken as the sum of several factors, divided into direct and indirect health care costs. The direct costs included inpatient hospital costs, ambulatory visit costs (further divided into physician's office visits, outpatient department visits, and emergency department visits), prescription drug costs, and self-care/over-the-counter drug costs. Indirect costs were calculated as the outlay of days of work lost because of skin diseases. The economic burden of skin disease in the United States is large, estimated at approximately $35.9 billion for 1997, including $19.8 billion (54%) in ambulatory care costs; $7.2 billion (20.2%) in hospital inpatient charges; $3.0 billion (8.2%) in prescription drug costs; $4.3 billion (11.7%) in over-the-counter preparations; and $1.6 billion (6.0%) in indirect costs attributable to lost workdays. Our determination of the economic burden of skin care in the United States surpasses past estimates several-fold, and the model presented for calculating cost of illness allows for tracking changes in national expenses for skin care in future studies. The amount of estimated resources devoted to skin disease management is far more than required to treat conditions such as urinary incontinence ($16 billion) and hypertension ($23 billion), but far less than required to treat musculoskeletal

  8. The burden of illness of osteoporosis in Canada.

    Science.gov (United States)

    Tarride, J-E; Hopkins, R B; Leslie, W D; Morin, S; Adachi, J D; Papaioannou, A; Bessette, L; Brown, J P; Goeree, R

    2012-11-01

    To update the 1993 burden of illness of osteoporosis in Canada, administrative and community data were used to calculate the 2010 costs of osteoporosis at $2.3 billion in Canada or 1.3% of Canada's healthcare expenditures. Prevention of fractures in high-risk individuals is key to decrease the financial burden of osteoporosis. Since the 1996 publication of the burden of osteoporosis in 1993 in Canada, the population has aged and the management of osteoporosis has changed. The study purpose was to estimate the current burden of illness due to osteoporosis in Canadians aged 50 and over. Analyses were conducted using five national administrative databases from the Canadian Institute for Health Information for the fiscal-year ending March 31 2008 (FY 2007/2008). Gaps in national data were supplemented by provincial and community data extrapolated to national levels. Osteoporosis-related fractures were identified using a combination of most responsible diagnosis at discharge and intervention codes. Fractures associated with severe trauma codes were excluded. Costs, expressed in 2010 dollars, were calculated for osteoporosis-related hospitalizations, emergency care, same day surgeries, rehabilitation, continuing care, homecare, long-term care, prescription drugs, physician visits, and productivity losses. Sensitivity analyses were conducted to measure the impact on the results of key assumptions. Osteoporosis-related fractures were responsible for 57,413 acute care admissions and 832,594 hospitalized days in FY 2007/2008. Acute care costs were estimated at $1.2 billion. When outpatient care, prescription drugs, and indirect costs were added, the overall yearly cost of osteoporosis was over $2.3 billion for the base case analysis and as much as $3.9 billion if a proportion of Canadians were assumed to be living in long-term care facilities due to osteoporosis. Osteoporosis is a chronic disease that affects a large segment of the adult population and results in a

  9. Periodontal disease burden and pathological changes in organs of dogs.

    Science.gov (United States)

    Pavlica, Zlatko; Petelin, Milan; Juntes, Polona; Erzen, Damjan; Crossley, David A; Skaleric, Uros

    2008-06-01

    Bacterial plaque associated periodontal disease is the most common chronic infection in man and dogs. In man, there is an association between periodontal disease and myocardial infarction and stroke, while in dogs it has also been associated with changes in internal organs. Inflamed periodontal tissues present a 'periodontal disease burden' to the host and the extent of this inflammatory disease burden is likely to affect the degree of associated pathological change in distant organs. This hypothesis was investigated in dogs with naturally occurring periodontal disease. Post-mortem investigations including periodontal assessment, standard necropsy, and organ histology were performed on 44 mature toy and miniature Poodles (related, periodontitis predisposed breeds) that died naturally or were euthanized based on clinical disease. Animals with gross primary organ pathology were excluded. The periodontal disease burden was estimated from the total surface area of periodontal pocket epithelium using six measurements of probing depth for each tooth and the tooth circumferences. Ordinal logistic regression (OR) analysis established that for each square centimeter of periodontal disease burden there was a 1.4-times higher likelihood of greater changes being present in the left atrio-ventricular valves (OR = 1.43), plus 1.2 and 1.4 times higher likelihoodfor greater liver and kidney pathology (OR = 1.21; OR = 1.42), respectively The results show that there is a link between the estimated 'periodontal disease burden' resulting from plaque-bacteria associated periodontal disease and the level of internal pathology in this population, implying that periodontitis might contribute to the development of systemic pathology in dogs.

  10. Disease burden of COPD in China: a systematic review

    Science.gov (United States)

    Zhu, Bifan; Wang, Yanfang; Ming, Jian; Chen, Wen; Zhang, Luying

    2018-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. The aim of this systematic review was to quantify the disease burden of COPD in China and to determine the risk factors of the disease. The number of studies included in the review was 47 with an average quality assessment score of 7.70 out of 10. Reported COPD prevalence varied between 1.20% and 8.87% in different provinces/cities across China. The prevalence rate of COPD was higher among men (7.76%) than women (4.07%). The disease was more prevalent in rural areas (7.62%) than in urban areas (6.09%). The diagnostic rate of COPD patients in China varied from 23.61% to 30.00%. The percentage of COPD patients receiving outpatient treatment was around 50%, while the admission rate ranged between 8.78% and 35.60%. Tobacco exposure and biomass fuel/solid fuel usage were documented as two important risk factors of COPD. COPD ranked among the top three leading causes of death in China. The direct medical cost of COPD ranged from 72 to 3,565 USD per capita per year, accounting for 33.33% to 118.09% of local average annual income. The most commonly used scales for the assessment of quality of life (QoL) included Saint George Respiratory Questionnaire, Airways Questionnaire 20, SF-36, and their revised versions. The status of QoL was worse among COPD patients than in non-COPD patients, and COPD patients were at higher risks of depression. The COPD burden in China was high in terms of economic burden and QoL. In view of the high smoking rate and considerable concerns related to air pollution and smog in China, countermeasures need to be taken to improve disease prevention and management to reduce disease burdens raised by COPD. PMID:29731623

  11. The disproportionate economic burden associated with severe and complicated obesity: a systematic review.

    Science.gov (United States)

    Grieve, E; Fenwick, E; Yang, H-C; Lean, M

    2013-11-01

    Burden of disease studies typically classify individuals with a body mass index (BMI) ≥ 30 kg m(-2) as a single group ('obese') and make comparisons to those with lower BMIs. Here, we review the literature on the additional economic burden associated with severe obesity or classes 3 and 4 obesity (BMI ≥ 40 kg m(-2) ), the fastest growing category of obesity, with the aim of exploring and disaggregating differences in resource use as BMI increases beyond 40 kg m(-2) . We recognize the importance of comparing classes 3 and 4 obesity to less severe obesity (classes 1 and 2) as well as quantifying the single sub-class impacts (classes 3 and 4). Although the latter analysis is the aim of this review, we include results, where found in the literature, for movement between the recognized subclasses and within classes 3 and 4 obesity. Articles presenting data on the economic burden associated with severe obesity were identified from a search of Ovid MEDLINE, EMBASE, EBSCO CINAHL and Cochrane Library databases. Data were extracted on the direct costs, productivity costs and resource use associated with severe obesity along with estimates of the multiplier effects associated with increasing BMI. Fifteen studies were identified, of which four disaggregated resource use for BMI ≥ 40 kg m(-2) . The multiplier effects derived for a variety of different types of costs incurred by the severely obese compared with those of normal weight (18.5 kg m(-2)  productivity costs. There are few published data on the economic burden of obesity disaggregated by BMI ≥ 40 kg m(-2) . By grouping people homogenously above a threshold of BMI 40 kg m(-2) , the multiplier effects for those at the highest end of the spectrum are likely to be underestimated. This will, in turn, impact on the estimates of cost-effectiveness for interventions and policies aimed at the severely obese. © 2013 The Authors. obesity reviews © 2013 International

  12. Mercury (Hg) burden in children: The impact of dental amalgam

    Energy Technology Data Exchange (ETDEWEB)

    Al-Saleh, Iman, E-mail: iman@kfshrc.edu.sa [Biological and Medical Research Department, King Faisal Specialist Hospital and Research Centre, PO Box: 3354, Riyadh 11211 (Saudi Arabia); Al-Sedairi, Al anoud [Department of Zoology, College of Science, King Saud University, PO Box: 24452, Riyadh 11495 (Saudi Arabia)

    2011-07-15

    The risks and benefits of using mercury (Hg) in dental amalgam have long been debated. This study was designed to estimate Hg body burden and its association with dental amalgam fillings in 182 children (ages: 5-15 years) living in Taif City. Hg was measured in urine (UHg), hair (HHg) and toenails (NHg) by the Atomic Absorption Spectrophotometer with Vapor Generator Accessory system. Urinary Hg levels were calculated as both micrograms per gram creatinine ({mu}g/g creatinine) and micrograms per liter ({mu}g/L). We found that children with amalgam fillings (N = 106) had significantly higher UHg-C levels than children without (N = 76), with means of 3.763 {mu}g/g creatinine versus 3.457 {mu}g/g creatinine, respectively (P = 0.019). The results were similar for UHg (P = 0.01). A similar pattern was also seen for HHg, with means of 0.614 {mu}g/g (N = 97) for children with amalgam versus 0.242 {mu}g/g (N = 74) for those without amalgam fillings (P = 0). Although the mean NHg was higher in children without amalgam (0.222 {mu}g/g, N = 61) versus those with (0.163 {mu}g/g, N = 101), the relationship was not significant (P = 0.069). After adjusting for many confounders, the multiple logistic regression model revealed that the levels of UHg-C and HHg were 2.047 and 5.396 times higher, respectively, in children with dental amalgam compared to those without (P < 0.01). In contrast, a significant inverse relationship was seen between NHg levels and dental amalgam fillings (P = 0.003). Despite the controversy surrounding the health impact of dental amalgam, this study showed some evidence that amalgam-associated Hg exposure might be related with symptoms of oral health, such as aphthous ulcer, white patches, and a burning-mouth sensation. Further studies are needed to reproduce these findings. The present study showed that significant numbers of children with or without amalgam had Hg levels exceeding the acceptable reference limits. The detrimental neurobehavioral and

  13. Mercury (Hg) burden in children: The impact of dental amalgam

    International Nuclear Information System (INIS)

    Al-Saleh, Iman; Al-Sedairi, Al anoud

    2011-01-01

    The risks and benefits of using mercury (Hg) in dental amalgam have long been debated. This study was designed to estimate Hg body burden and its association with dental amalgam fillings in 182 children (ages: 5-15 years) living in Taif City. Hg was measured in urine (UHg), hair (HHg) and toenails (NHg) by the Atomic Absorption Spectrophotometer with Vapor Generator Accessory system. Urinary Hg levels were calculated as both micrograms per gram creatinine (μg/g creatinine) and micrograms per liter (μg/L). We found that children with amalgam fillings (N = 106) had significantly higher UHg-C levels than children without (N = 76), with means of 3.763 μg/g creatinine versus 3.457 μg/g creatinine, respectively (P = 0.019). The results were similar for UHg (P = 0.01). A similar pattern was also seen for HHg, with means of 0.614 μg/g (N = 97) for children with amalgam versus 0.242 μg/g (N = 74) for those without amalgam fillings (P = 0). Although the mean NHg was higher in children without amalgam (0.222 μg/g, N = 61) versus those with (0.163 μg/g, N = 101), the relationship was not significant (P = 0.069). After adjusting for many confounders, the multiple logistic regression model revealed that the levels of UHg-C and HHg were 2.047 and 5.396 times higher, respectively, in children with dental amalgam compared to those without (P < 0.01). In contrast, a significant inverse relationship was seen between NHg levels and dental amalgam fillings (P = 0.003). Despite the controversy surrounding the health impact of dental amalgam, this study showed some evidence that amalgam-associated Hg exposure might be related with symptoms of oral health, such as aphthous ulcer, white patches, and a burning-mouth sensation. Further studies are needed to reproduce these findings. The present study showed that significant numbers of children with or without amalgam had Hg levels exceeding the acceptable reference limits. The detrimental neurobehavioral and/or nephrotoxic effects of

  14. The Burden and Determinants of Neck Pain in Whiplash-Associated Disorders After Traffic Collisions

    Science.gov (United States)

    Carroll, Linda J.; Cassidy, J. David; Hogg-Johnson, Sheilah; Côté, Pierre; Guzman, Jamie; Peloso, Paul; Nordin, Margareta; Hurwitz, Eric; van der Velde, Gabrielle; Carragee, Eugene; Haldeman, Scott

    2008-01-01

    Study Design Best evidence synthesis. Objective To undertake a best evidence synthesis on the burden and determinants of whiplash-associated disorders (WAD) after traffic collisions. Study Design Summary of Background Data. Previous best evidence synthesis on WAD has noted a lack of evidence regarding incidence of and risk factors for WAD. Therefore there was a warrant of a reanalyze of this body of research. Methods A systematic search of Medline was conducted. The reviewers looked for studies on neck pain and its associated disorders published 1980 –2006. Each relevant study was independently and critically reviewed by rotating pairs of reviewers. Data from studies judged to have acceptable internal validity (scientifically admissible) were abstracted into evidence tables, and provide the body of the best evidence synthesis. Results The authors found 32 scientifically admissible studies related to the burden and determinants of WAD. In the Western world, visits to emergency rooms due to WAD have increased over the past 30 years. The annual cumulative incidence of WAD differed substantially between countries. They found that occupant seat position and collision impact direction were associated with WAD in one study. Eliminating insurance payments for pain and suffering were associated with a lower incidence of WAD injury claims in one study. Younger ages and being a female were both associated with filing claims or seeking care for WAD, although the evidence is not consistent. Preliminary evidence suggested that headrests/car seats, aimed to limiting head extension during rear-end collisions had a preventive effect on reporting WAD, especially in females. Conclusion WAD after traffic collisions affects many people. Despite many years of research, the evidence regarding risk factors for WAD is sparse but seems to include personal, societal, and environmental factors. More research including, well-defined studies with accurate denominators for calculating risk

  15. Housing as a Social Determinant of Health: Exploring the Relationship between Rent Burden and Risk Behaviors for Single Room Occupancy Building Residents.

    Science.gov (United States)

    Bowen, Elizabeth A; Mitchell, Christopher G

    2016-01-01

    A growing body of health determinants research recognizes that housing and health are intimately linked. This study explores the relationship between rent burden (the ratio of rent to income) and health risk behaviors among a sample of single room occupancy (SRO) building residents. Cross-sectional data were gathered from a sample of 162 residents living in privately owned, for-profit SROs in Chicago. Findings indicated that participants who had full rental subsidies and thus were designated in a no-rent-burden category were more likely to engage in risk behaviors including illicit drug use, having multiple sexual partners, and having sex without a condom, in comparison to participants with moderate or high-rent burdens. These findings suggest that interventions to increase housing stability and affordability and bolster reliable income sources (in addition to rental subsidies) may be key in reducing risk behaviors and improving health for vulnerably housed populations such as SRO residents.

  16. Psychological Resilience, Affective Mechanisms, and Symptom Burden in a Tertiary Care Sample of Patients with Fibromyalgia

    Science.gov (United States)

    McAllister, Samantha J; Vincent, Ann; Hassett, Afton L; Whipple, Mary O; Oh, Terry H; Benzo, Roberto P; Toussaint, Loren L

    2014-01-01

    Research demonstrates that patients with fibromyalgia who have higher positive and lower negative affect have lower symptom burden. Affect has been shown to be associated with resilience. This study examined the relationship between affect, resilience, and fibromyalgia symptom burden in a clinical sample of patients with fibromyalgia. We hypothesized that (a) positive and negative affect would be associated with fibromyalgia symptom burden; (b) resilience would be associated with positive and negative affect; (c) resilience would be associated with fibromyalgia symptom burden; and (d) the connection between resilience and fibromyalgia symptom burden would be mediated by both positive and negative affect. A sample of 858 patients with fibromyalgia completed questionnaires. Mediation modeling revealed statistically significant direct effects of resilience on fibromyalgia symptom burden (β =−.10, P fibromyalgia symptom burden through affect (β =−.36, P fibromyalgia symptom burden. Our results suggest that improving affect through resiliency training could be studied as a modality for improving fibromyalgia symptom burden. PMID:24376184

  17. Subjective caregiver burden: validity of the 10-item short version of the Burden Scale for Family Caregivers BSFC-s.

    Science.gov (United States)

    Graessel, Elmar; Berth, Hendrik; Lichte, Thomas; Grau, Hannes

    2014-02-20

    Subjective burden is a central variable describing the situation encountered by family caregivers. The 10-item short version of the Burden Scale for Family Caregivers (BSFC-short/BSFC-s) was developed to provide an economical measure of this variable. The present study examined the reliability and validity of the BSFC-s. Comprehensive data from "the IDA project" were the basis of the calculations, which included 351 dyads and examined medical data on people with dementia, interview data from their family caregivers, and health insurance data. A factor analysis was performed to explore the structure of the BSFC-s; Cronbach's alpha was used to evaluate the internal consistency of the scale. The items were analyzed to determine the item difficulty and the discriminatory power. Construct validity was tested with five hypotheses. To establish the predictive validity of the BSFC-s, predictors of institutionalization at a follow-up time of 2.5 years were analyzed (binary logistic regression). The BSFC-s score adhered to a one-factor structure. Cronbach's alpha for the complete scale was .92. A significant increase in the BSFC-s score was observed when dementia progressed, disturbing behavior occurred more frequently, care requirements increased, and when caregivers were diagnosed with depression. Caregiver burden was the second strongest predictor of institutionalization out of a total of four significant predictors. All hypotheses that referred to the construct validity were supported. The BSFC-short with its ten items is a very economical instrument for assessing the caregiver's total subjective burden in a short time frame. The BSFC-s score has predictive validity for the institutionalization of people with dementia. Therefore it is an appropriate outcome measure to evaluate caregiver interventions. The scale is available for free in 20 languages (http://www.caregiver-burden.eu). This availability facilitates the comparison of international research findings.

  18. Burden of gout in the Nordic region, 1990-2015: findings from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    Kiadaliri, A A; Uhlig, T; Englund, M

    2018-01-29

    To explore the burden of gout in the Nordic region, with a population around 27 million in 2015 distributed across six countries. We used the findings of the 2015 Global Burden of Diseases study to report prevalence and disability associated with gout in the Nordic region. From 1990 to 2015, the number of prevalent gout cases rose by 30% to 252 967 [95% uncertainty interval (UI) 223 478‒287 288] in the Nordic region. In 2015, gout contributed to 7982 (95% UI 5431‒10 800) years lived with disability (YLDs) in the region, an increase of 29% (95% UI 24‒35%) from 1990. While the crude YLD rate of gout increased by 12.9% (95% UI 7.8‒18.1%) between 1990 and 2015, the age-standardized YLD rate remained stable. Gout was ranked as the 63rd leading cause of total YLDs in the region in 2015, with the highest rank in men aged 55-59 years (38th leading cause of YLDs). The corresponding rank at the global level was 94. Of 195 countries studied, four Nordic countries [Greenland (2nd), Iceland (12th), Finland (14th), and Sweden (15th)] were among the top 15 countries with the highest age-standardized YLD rate of gout. The burden of gout is rising in the Nordic region. Gout's contribution to the total burden of diseases in the region is more significant than the global average. Expected increases in gout burden owing to population growth and ageing call for stronger preventive and therapeutic strategies for gout management in Nordic countries.

  19. The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    Ciobanu, Liliana G; Ferrari, Alize J; Erskine, Holly E; Santomauro, Damian F; Charlson, Fiona J; Leung, Janni; Amare, Azmeraw T; Olagunju, Andrew T; Whiteford, Harvey A; Baune, Bernhard T

    2018-05-01

    Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.

  20. Projections of global mortality and burden of disease from 2002 to 2030.

    Science.gov (United States)

    Mathers, Colin D; Loncar, Dejan

    2006-11-01

    Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results. Relatively simple models were used to project future health trends under three scenarios-baseline, optimistic, and pessimistic-based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012. Under the optimistic scenario, which

  1. Projections of global mortality and burden of disease from 2002 to 2030.

    Directory of Open Access Journals (Sweden)

    Colin D Mathers

    2006-11-01

    Full Text Available BACKGROUND: Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results. METHODS AND FINDINGS: Relatively simple models were used to project future health trends under three scenarios-baseline, optimistic, and pessimistic-based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs

  2. Projections of Global Mortality and Burden of Disease from 2002 to 2030

    Science.gov (United States)

    Mathers, Colin D; Loncar, Dejan

    2006-01-01

    Background Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results. Methods and Findings Relatively simple models were used to project future health trends under three scenarios—baseline, optimistic, and pessimistic—based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012

  3. Adolescence and Body Image.

    Science.gov (United States)

    Weinshenker, Naomi

    2002-01-01

    Discusses body image among adolescents, explaining that today's adolescents are more prone to body image distortions and dissatisfaction than ever and examining the historical context; how self-image develops; normative discontent; body image distortions; body dysmorphic disorder (BDD); vulnerability of boys (muscle dysmorphia); who is at risk;…

  4. Reinforced Airfoil Shaped Body

    DEFF Research Database (Denmark)

    2011-01-01

    The present invention relates to an airfoil shaped body with a leading edge and a trailing edge extending along the longitudinal extension of the body and defining a profile chord, the airfoil shaped body comprising an airfoil shaped facing that forms the outer surface of the airfoil shaped body...

  5. Disease burden of COPD in China: a systematic review

    Directory of Open Access Journals (Sweden)

    Zhu B

    2018-04-01

    Full Text Available Bifan Zhu,1 Yanfang Wang,2 Jian Ming,3 Wen Chen,4 Luying Zhang4 1Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China; 2The First Affiliated Hospital of Wannan Medical College, Wuhu, China; 3IQVIA, Shanghai, China; 4School of Public Health, Fudan University, Shanghai, China Abstract: Chronic obstructive pulmonary disease (COPD is one of the main contributors to the global burden of disease. The aim of this systematic review was to quantify the disease burden of COPD in China and to determine the risk factors of the disease. The number of studies included in the review was 47 with an average quality assessment score of 7.70 out of 10. Reported COPD prevalence varied between 1.20% and 8.87% in different provinces/cities across China. The prevalence rate of COPD was higher among men (7.76% than women (4.07%. The disease was more prevalent in rural areas (7.62% than in urban areas (6.09%. The diagnostic rate of COPD patients in China varied from 23.61% to 30.00%. The percentage of COPD patients receiving outpatient treatment was around 50%, while the admission rate ranged between 8.78% and 35.60%. Tobacco exposure and biomass fuel/solid fuel usage were documented as two important risk factors of COPD. COPD ranked among the top three leading causes of death in China. The direct medical cost of COPD ranged from 72 to 3,565 USD per capita per year, accounting for 33.33% to 118.09% of local average annual income. The most commonly used scales for the assessment of quality of life (QoL included Saint George Respiratory Questionnaire, Airways Questionnaire 20, SF-36, and their revised versions. The status of QoL was worse among COPD patients than in non-COPD patients, and COPD patients were at higher risks of depression. The COPD burden in China was high in terms of economic burden and QoL. In view of the high smoking rate and considerable concerns related to air pollution and smog in China, countermeasures

  6. Morphological Computation: Synergy of Body and Brain

    Directory of Open Access Journals (Sweden)

    Keyan Ghazi-Zahedi

    2017-08-01

    Full Text Available There are numerous examples that show how the exploitation of the body’s physical properties can lift the burden of the brain. Examples include grasping, swimming, locomotion, and motion detection. The term Morphological Computation was originally coined to describe processes in the body that would otherwise have to be conducted by the brain. In this paper, we argue for a synergistic perspective, and by that we mean that Morphological Computation is a process which requires a close interaction of body and brain. Based on a model of the sensorimotor loop, we study a new measure of synergistic information and show that it is more reliable in cases in which there is no synergistic information, compared to previous results. Furthermore, we discuss an algorithm that allows the calculation of the measure in non-trivial (non-binary systems.

  7. Fungal burden exposure assessment in podiatry clinics from Ireland.

    Science.gov (United States)

    Viegas, Carla; Coggins, Ann Marie; Faria, Tiago; Caetano, Liliana Aranha; Gomes, Anita Quintal; Sabino, Raquel; Verissimo, Cristina; Roberts, Nigel; Watterson, David; MacGilchrist, Claire; Fleming, Gerard T A

    2018-03-26

    Fungi are amongst the bioaerosols of most importance, as indicated by the growing interest in this field of research. The aim was to characterize the exposure to fungal burden in podiatry clinics using culture-based and molecular methods. Airborne fungi were collected using an impaction air sampler and surface samples were also performed. Fourteen air samples were collected for direct detection of fungal DNA from filamentous fungi and dermatophytes. Overall, 63.6 % of the evening samples and 46 % of the morning samples surpassed the threshold values (150 CFU/m 3 ). Molecular detection, by real time PCR, of the target fungal species/strains (Aspergillus and Stachybotrys species) was negative for all samples collected. Trichophyton rubrum was detected by PCR analysis in one DNA sample collected on day six. Results suggest the use of both culture-based and molecular methodologies are desirable for a complete evaluation of fungal burden in this particular health care setting.

  8. The alteration of the BPM, burden neutrality and autonomous greening

    International Nuclear Information System (INIS)

    2009-01-01

    The foundation of the purchase tax on passenger cars (BPM) in the Netherlands is gradually altered from catalogue value to CO2 emission per kilometer of the new car. The tariffs have been established in such a way that they meet the precondition of burden neutrality of the BPM alteration. There is some discussion about this and the first part of this publication will address this issue. The issue of burden neutrality is part of a study by DHV Investment Services (DHV). The first main conclusion of the DHV study is that the alteration is not budget neutral. The study entails an applied welfare analysis of the alteration of the BPM foundation. Some comments on the welfare analysis are provided in the second part of this memo. Another issue that is addressed involves the question if and how the autonomous decrease in CO2 emission of newly sold cars can be established in practice. [nl

  9. The burden of rotavirus disease in Denmark 2009-2010

    DEFF Research Database (Denmark)

    Fischer, Thea Kølsen; Rungø, Christine; Jensen, Claus Sixtus

    2011-01-01

    BACKGROUND: This study sought to determine the incidence and the burden of severe diarrheal disease in Denmark with emphasis on rotavirus (RV) disease. METHODS: This study was designed as a national prospective disease surveillance of children gastroenteritis...... in Denmark during March 2009 to April 2010, using rapid RV and adenovirus antigen detection. RESULTS: A total of 3100 hospitalizations annually among Danish children gastroenteritis and 1210 (39%) of these to RV disease. The majority of RV...... demonstrated RV-associated hospitalizations throughout the year. Genotyping of a subset of RV-samples demonstrated high frequency of G1 (39%) and G4 (32%). Adenovirus was detected in 350 acute gastroenteritis-associated hospitalizations (11.2%). CONCLUSION: In conclusion, we present national disease burden...

  10. The burden of asthma in children: a Latin American perspective.

    Science.gov (United States)

    Fischer, Gilberto Bueno; Camargos, Paulo Augusto Moreira; Mocelin, Helena Teresinha

    2005-03-01

    Worldwide, studies on asthma prevalence have shown major rises over the last 30 years. The impact on the burden of asthma is being increasingly recognised. In some countries in Latin America, the prevalence of asthma is among the highest in the world. Asthma admissions are very common in children, leading to high costs for the health systems of those countries. Unfortunately, Latin America has limited resources to pay for appropriate treatment. The main goals of the international guidelines for asthma treatment are not being met. However, asthma programmes operating in some countries are showing promising results in reducing asthma admissions and consequently decreasing the burden of asthma. Local adaptation of international guidelines must be implemented in order to decrease costs and optimise outcomes.

  11. Analysis of the debt burden in Russian economy sectors

    Directory of Open Access Journals (Sweden)

    Svetlana Popova

    2017-12-01

    Full Text Available This paper provides an analysis of the debt burden of Russian companies and raises the issue of debt-level heterogeneity across economic sectors. To identify the causes of this heterogeneity, it estimates a regression model that includes both fundamental explanatory variables of companies and industry fixed effects. The results of the analysis demonstrate that standard variables, such as profitability, company size, asset turnover, and fixed-asset turnover ratio have a strong statistical significance. However, these do not fully explain the variation in the debt levels of companies in different sectors. According to model estimation, there are other industry specific factors that produce an imbalance between fundamental factors and companies’ debt levels. An understanding of the formation process and structure of debt burden in individual industries is extremely important for the financial stability of companies and for an effective monetary policy.

  12. Organ burdens and elimination rates of inhaled thorium and plutonium

    International Nuclear Information System (INIS)

    Unnikrishnan, K.; Murthy, K.B.S.; Sunta, C.M.

    1986-01-01

    For the purpose of interpreting observations from internal monitoring programmes, organ burdens and excretion rates resulting from inhalation of long-lived isotopes of plutonium and thorium have been calculated, on the basis of the ICRP model. Two types of inhalation, instantaneous (acute) and at a steady rate (chronic) are considered. The expected buildups of the burden in lungs, lymph nodes, bone, liver and other tissues, as well as the excretion rates, have been calculated for aerosol classes W and Y, and particle sizes of AMAD 1 μm and 6 μm. Further, in view of their use in selecting the periodicity of routine monitoring, theoretical results are also presented for the case of a total inhalation of 1 ALI in one year, instantaneously or at a constant rate. (author)

  13. Atlas of the Global Burden of Stroke (1990-2013)

    DEFF Research Database (Denmark)

    Feigin, Valery L; Mensah, George A; Norrving, Bo

    2015-01-01

    for ischemic stroke and hemorrhagic stroke in the world for 1990-2013. METHODOLOGY: Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated following the general approach of the Global Burden of Disease (GBD) 2010 with several important improvements in methods. Data were updated for mortality......BACKGROUND: World mapping is an important tool to visualize stroke burden and its trends in various regions and countries. OBJECTIVES: To show geographic patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends...... estimates of global population. All estimates have been computed with 95% uncertainty intervals. RESULTS: Age-standardized incidence, mortality, prevalence and DALYs/YLDs declined over the period from 1990 to 2013. However, the absolute number of people affected by stroke has substantially increased across...

  14. Patients' self-perceived burden, caregivers' burden and quality of life for amyotrophic lateral sclerosis patients: a cross-sectional study.

    Science.gov (United States)

    Geng, Dan; Ou, RuWei; Miao, XiaoHui; Zhao, LiHong; Wei, QianQian; Chen, XuePing; Liang, Yan; Shang, HuiFang; Yang, Rong

    2017-10-01

    This study surveys the quality of life of amyotrophic lateral sclerosis patients and the factors associated with amyotrophic lateral sclerosis patients' self-perceived burden and their caregivers' burden. Burdens of patients with amyotrophic lateral sclerosis and their caregivers in Chinese population are largely unknown. A cross-sectional study was conducted among 81 pairs of amyotrophic lateral sclerosis patients and their caregivers. Amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden were assessed by the Self-Perceived Burden Scale and Zarit-Burden Interview, respectively. Quality of life of amyotrophic lateral sclerosis patients was measured using the World Health Organization Quality of Life-Bref. The amyotrophic lateral sclerosis Functional Rating Scale-Revised questionnaire was used to estimate patients' physical function. Both patients and caregivers reported a mild to moderate burden. The World Health Organization quality of life-Bref scores were decreased in respondents with lower amyotrophic lateral sclerosis Functional Rating Scale-Revised, higher Self-Perceived Burden Scale and higher Zarit-Burden Interview scores. Self-Perceived Burden Scale scores were associated with patients' knowledge of amyotrophic lateral sclerosis, respiratory function and female sex. Zarit-Burden Interview scores were associated with caregivers' age, patients' motor function and out-of-pocket payment. With increase in amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden, quality of life of amyotrophic lateral sclerosis patients decreased. Female patients, who had known more about the disease, and those with severe respiratory dysfunction were subject to higher self-perceived burden. Older caregivers and caregivers of patients with severe motor dysfunction and more out-of-pocket payment experienced more care burdens. Our study suggests that paying more attention to female amyotrophic lateral sclerosis patients

  15. Innocent Body-Shadow Mimics Physical Body

    Directory of Open Access Journals (Sweden)

    Kenri Kodaka

    2017-04-01

    Full Text Available The paradigm of the rubber hand illusion was applied to a shadow to determine whether the body-shadow is a good candidate for the alternative belonging to our body. Three kinds of shadows, a physical hand, a hand-shaped cloth, and a rectangle cloth, were tested for this purpose. The questionnaire results showed that both anatomical similarity and visuo-proprioception correlation were effective in enhancing illusory ownership of the shadow. According to the proprioceptive drift measurement, whether the shadow purely originated from the physical body was a critical factor in yielding the significantly positive drift. Thus, results demonstrated that the shadow can distort illusory ownership with the rubber hand illusion paradigm, but the proprioception was clearly distorted only when the body-shadow was purely applied. This implies the presence of special cognitive processing to discriminate the self-body shadow from the others.

  16. 'Tablet burden' in patients with metastatic breast cancer.

    Science.gov (United States)

    Milic, Marina; Foster, Anna; Rihawi, Karim; Anthoney, Alan; Twelves, Chris

    2016-03-01

    The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored. We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment. One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets. The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience. Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Melanoma Surveillance in the US: The Economic Burden of Melanoma

    Centers for Disease Control (CDC) Podcasts

    2011-10-19

    This podcast accompanies the publication of a series of articles on melanoma surveillance in the United States, available in the November supplement edition of the Journal of the American Academy of Dermatology. Dr. Gery Guy, from the CDC’s Division of Cancer Prevention and Control, discusses the economic burden of melanoma.  Created: 10/19/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/19/2011.

  18. Updated Global Burden of Cholera in Endemic Countries

    Science.gov (United States)

    Ali, Mohammad; Nelson, Allyson R.; Lopez, Anna Lena; Sack, David A.

    2015-01-01

    Background The global burden of cholera is largely unknown because the majority of cases are not reported. The low reporting can be attributed to limited capacity of epidemiological surveillance and laboratories, as well as social, political, and economic disincentives for reporting. We previously estimated 2.8 million cases and 91,000 deaths annually due to cholera in 51 endemic countries. A major limitation in our previous estimate was that the endemic and non-endemic countries were defined based on the countries’ reported cholera cases. We overcame the limitation with the use of a spatial modelling technique in defining endemic countries, and accordingly updated the estimates of the global burden of cholera. Methods/Principal Findings Countries were classified as cholera endemic, cholera non-endemic, or cholera-free based on whether a spatial regression model predicted an incidence rate over a certain threshold in at least three of five years (2008-2012). The at-risk populations were calculated for each country based on the percent of the country without sustainable access to improved sanitation facilities. Incidence rates from population-based published studies were used to calculate the estimated annual number of cases in endemic countries. The number of annual cholera deaths was calculated using inverse variance-weighted average case-fatality rate (CFRs) from literature-based CFR estimates. We found that approximately 1.3 billion people are at risk for cholera in endemic countries. An estimated 2.86 million cholera cases (uncertainty range: 1.3m-4.0m) occur annually in endemic countries. Among these cases, there are an estimated 95,000 deaths (uncertainty range: 21,000-143,000). Conclusion/Significance The global burden of cholera remains high. Sub-Saharan Africa accounts for the majority of this burden. Our findings can inform programmatic decision-making for cholera control. PMID:26043000

  19. The social and economic burden of frontotemporal degeneration.

    Science.gov (United States)

    Galvin, James E; Howard, David H; Denny, Sharon S; Dickinson, Susan; Tatton, Nadine

    2017-11-14

    To quantify the socioeconomic burden of frontotemporal degeneration (FTD) compared to previously published data for Alzheimer disease (AD). A 250-item internet survey was administered to primary caregivers of patients with behavioral-variant FTD (bvFTD), primary progressive aphasia, FTD with motor neuron disease, corticobasal syndrome, or progressive supranuclear palsy. The survey included validated scales for disease staging, behavior, activities of daily living, caregiver burden, and health economics, as well as investigator-designed questions to capture patient and caregiver experience with FTD. The entire survey was completed by 674 of 956 respondents (70.5%). Direct costs (2016 US dollars) equaled $47,916 and indirect costs $71,737, for a total annual per-patient cost of $119,654, nearly 2 times higher than reported costs for AD. Patients ≥65 years of age, with later stages of disease, and with bvFTD correlated with higher direct costs, while patients <65 years of age and men were associated with higher indirect costs. An FTD diagnosis produced a mean decrease in household income from $75,000 to $99,000 12 months before diagnosis to $50,000 to $59,999 12 months after diagnosis, resulting from lost days of work and early departure from the workforce. The economic burden of FTD is substantial. Counting productivity-related costs, per-patient costs for FTD appear to be greater than per-patient costs reported for AD. There is a need for biomarkers for accurate and timely diagnosis, effective treatments, and services to reduce this socioeconomic burden. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  20. A Review of the Soldier’s Equipment Burden

    Science.gov (United States)

    2011-12-01

    allow heavy items to be packed close to the soldier’s natural centre of mass . The Infantryman, with such a large equipment burden, is in effect...COM Centre of Mass COTS Commercial Off-the-Shelf CPL Corporal DARPA Defense Advanced Research Project Agency DMO Defence Materiel...Eighteen soldiers had customised their packs, either the issued packs or their own. The most common customisation was the addition of an external

  1. A neurodegenerative vascular burden index and the impact on cognition

    Directory of Open Access Journals (Sweden)

    Sebastian eHeinzel

    2014-07-01

    Full Text Available A wide range of vascular burden factors have been identified to impact vascular function and structure as indicated by carotid intima-media thickness (IMT. On the basis of their impact on IMT, vascular factors may be selected and clustered in a vascular burden index (VBI. Since many vascular factors increase the risk of Alzheimer's disease (AD, a multifactorial neurodegenerative VBI may be related to early pathological processes in AD and cognitive decline in its preclinical stages.We investigated an elderly cohort at risk for neurodegeneration (TREND study, n = 1102 for the multifactorial influence of vascular burden factors on IMT measured by ultrasound. To create a VBI for this cohort, vascular factors and their definitions (considering medical history, medication and/or blood marker data were selected based on their statistical effects on IMT in multiple regressions including age and sex. The impact of the VBI on cognitive performance was assessed using the Trail-Making Test (TMT and the CERAD neuropsychological battery.IMT was significantly predicted by age (standardized β = .26, sex (.09; males > females and the factors included in the VBI: obesity (.18, hypertension (.14, smoking (.08, diabetes (.07, and atherosclerosis (.05, whereas other cardiovascular diseases or hypercholesterolemia were not significant. Individuals with 2 or more VBI factors compared to individuals without had an odds ratio of 3.17 regarding overly increased IMT (≥1.0 mm. The VBI showed an impact on executive control (log(TMT B-A, p = .047 and a trend towards decreased global cognitive function (CERAD total score, p = .057 independent of age, sex and education.A VBI established on the basis of IMT may help to identify individuals with overly increased vascular burden linked to decreased cognitive function indicating neurodegenerative processes. The longitudinal study of this risk cohort will reveal the value of the VBI as prodromal marker for cognitive decline and

  2. The East West binary and the burden of representation.

    OpenAIRE

    Burt, Ramsay, 1953-

    2012-01-01

    paper presented at Gdansk Dance Conference, "Asia and Europe – cross-cultural dialogues in theatre and dance” June 18th 2012 In a 1990 article, ‘Black art and the burden of representation’, Kobena Mercer discusses general expectations about the work of artists of colour. Critics and spectators in Europe and North America, he argues, invariably assume that the work of black artists always ‘represents’ Black identities or addresses the concerns of the Black community. This paper examines the...

  3. HOW TO MOTIVATE ENGLISH LEARNERS FACED WITH PSYCHOLOGICAL BURDEN

    Directory of Open Access Journals (Sweden)

    Himpun Panggabean

    2007-01-01

    Full Text Available The misleading assumptions of Indonesian-speaking learners of English on the nature of English results in psychological burden inhibiting the process of teaching and learning. The assumptions should be eliminated at the beginning of English class. Besides, the instructor should extensively motivate and encourage the learners to maximize their potentials in learning process. Such approach will gradually lead the learners to self-confidence and self-discovery.

  4. Economic burden of stroke in a large county in Sweden

    Directory of Open Access Journals (Sweden)

    Persson Josefine

    2012-09-01

    Full Text Available Abstract Background Stroke remains to be a major burden of disease, often causing death or physical impairment or disability. This paper estimates the economic burden of stroke in a large county of 1.5 million inhabitants in western Sweden. Methods The economic burden of stroke was estimated from a societal perspective with an incidence approach. Data were collected from clinical registries and 3,074 patients were included. In the cost calculations, both direct and indirect costs were estimated and were based on costs for 12 months after a first-ever stroke. Results The total excess costs in the first 12 months after the first-ever stroke for a population of 1.5 million was 629 million SEK (€69 million. Men consumed more acute care in hospitals, whereas women consumed more rehabilitation and long-term care provided by the municipalities. Younger patients brought a significantly higher burden on society compared with older patients due to the loss of productivity and the increased use of resources in health care. Conclusions The results of this cost-of-illness study were based on an improved calculation process in a number of fields and are consistent with previous studies. In essence, 50% of costs for stroke care fall on acute care hospital, 40% on rehabilitation and long-time care and informal care and productivity loss explains 10% of total cost for the stroke disease. The result of this study can be used for further development of the methods for economic analyses as well as for analysis of improvements and investments in health care.

  5. Occupational burdens in special educators working with intellectually disabled students

    OpenAIRE

    Piotr Plichta

    2014-01-01

    Background: The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy) with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. Material and Methods: The resu...

  6. The Relationship of Obesity to Increasing Health-Care Burden in the Setting of Orthopaedic Polytrauma.

    Science.gov (United States)

    Licht, Heather; Murray, Mark; Vassaur, John; Jupiter, Daniel C; Regner, Justin L; Chaput, Christopher D

    2015-11-18

    With the rise of obesity in the American population, there has been a proportionate increase of obesity in the trauma population. The purpose of this study was to use a computed tomography-based measurement of adiposity to determine if obesity is associated with an increased burden to the health-care system in patients with orthopaedic polytrauma. A prospective comprehensive trauma database at a level-I trauma center was utilized to identify 301 patients with polytrauma who had orthopaedic injuries and intensive care unit admission from 2006 to 2011. Routine thoracoabdominal computed tomographic scans allowed for measurement of the truncal adiposity volume. The truncal three-dimensional reconstruction body mass index was calculated from the computed tomography-based volumes based on a previously validated algorithm. A truncal three-dimensional reconstruction body mass index of obese patients and ≥ 30 kg/m(2) denoted obese patients. The need for orthopaedic surgical procedure, in-hospital mortality, length of stay, hospital charges, and discharge disposition were compared between the two groups. Of the 301 patients, 21.6% were classified as obese (truncal three-dimensional reconstruction body mass index of ≥ 30 kg/m(2)). Higher truncal three-dimensional reconstruction body mass index was associated with longer hospital length of stay (p = 0.02), more days spent in the intensive care unit (p = 0.03), more frequent discharge to a long-term care facility (p obesity on patients with polytrauma. Obese patients were found to have higher total hospital charges, longer hospital stays, discharge to a continuing-care facility, and a higher rate of orthopaedic surgical intervention. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  7. One world health: socioeconomic burden and parasitic disease control priorities.

    Science.gov (United States)

    Torgerson, Paul R

    2013-08-01

    Parasitic diseases present a considerable socio-economic impact to society. Zoonotic parasites can result in a considerable burden of disease in people and substantive economic losses to livestock populations. Ameliorating the effects of these diseases may consist of attempts at eradicating specific diseases at a global level, eliminating them at a national or local level or controlling them to minimise incidence. Alternatively with some parasitic zoonoses it may only be possible to treat human and animal cases as they arise. The choice of approach will be determined by the potential effectiveness of a disease control programme, its cost and the cost effectiveness or cost benefit of undertaking the intervention. Furthermore human disease burden is being increasingly measured by egalitarian non-financial measures which are difficult to apply to livestock. This adds additional challenges to the assessment of socio-economic burdens of zoonotic diseases. Using examples from the group of neglected zoonotic diseases, information regarding the socio-economic effects is reviewed together with how this information is used in decision making with regard to disease control and treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Burden of Respiratory Syncytial Virus Hospitalizations in Canada

    Directory of Open Access Journals (Sweden)

    Ian Mitchell

    2017-01-01

    Full Text Available Objective. To examine the socioeconomic burden of respiratory syncytial virus (RSV disease for Canadian infants hospitalized for the condition. Data and Methods. The descriptive study used data collected in Alberta, Canada, during 2 consecutive RSV seasons. Infants (<1 year of age were included if they had not received palivizumab and were hospitalized with a confirmed diagnosis of RSV. Hospitalization resource use and parental time burden, out-of-pocket costs, lost work productivity, and stress and anxiety were assessed. Results. 13.4% of all infants (n = 67 had intensive care unit (ICU admission, and average ICU stay for these infants was 6.5 days. Families had average out-of-pocket expenses of 736.69 Canadian dollars (CAD $, and the average time both parents spent in hospital was nearly 7 days (164.0 hours. For working parents (n = 43, average absenteeism was 49% and overall work impairment was 77.8%. Parents also exhibited significant parental stress (3.6 on the Parental Stressor Scale: 43.9 state anxiety and 36.9 trait anxiety scores. Conclusions. Results indicate a high burden associated with the hospitalization of an infant due to RSV disease in terms of resource use, time, productivity, costs, and stress, even among a population of infants not considered to be at risk for the condition.

  9. Benefits and Burdens of Participation in a Longitudinal Clinical Trial

    Science.gov (United States)

    Lazovski, Jaime; Losso, Marcelo; Krohmal, Benjamin; Emanuel, Ezekiel J.; Grady, Christine; Wendler, David

    2010-01-01

    systematic data on the impact that longitudinal clinical trials have on patient participants are needed to ensure that all the risks and potential benefits of participating in clinical research are properly evaluated and disclosed. Recognizing the lack of systematic data on this topic, we surveyed 582 individuals from Argentina, Brazil, and Thailand who were participating in the ESPRIT study, a Phase III randomized trial of interleukin-2 in HIV disease. Respondents were asked about the benefits and burdens of participating in ESPRIT using a self-administered survey. We found that 91% of respondents in the IL-2 treatment arm and 79% in the no IL-2 control arm reported medical benefits from their participation. In addition, 68% in the IL-2 treatment arm and 60% of the no IL-2 controls reported non-medical benefits. Thirteen percent of the IL-2 respondents and 5% of the non-IL2 respondents reported problems with their jobs due to study participation. Given that respondents, including those in the control arm, reported medical and non-medical benefits and burdens from their research participation, investigators and review committees should be aware of and respond to the potential for research participants to experience benefits and burdens that are unrelated to the intervention being tested. PMID:19754238

  10. [Predictive value of Hodgkin's lymphoma tumor burden in present].

    Science.gov (United States)

    Kulyova, S A; Karitsky, A P

    2014-01-01

    Today approximately 70% of patients with Hodgkin lymphoma can be cured with the combined-modality therapy. Tumor burden, the importance of which was demonstrated 15 years ago for the first time, is a powerful prognostic factor. Data of literature of representations on predictive value of Hodgkin's lymphoma tumor burden are shown in the article. The difficult immunological relations between tumor cells and reactive ones lead to development of the main symptoms. Nevertheless, the collective sign of tumor burden shows the greatest influence on survival and on probability of resistance, which relative risk can be predicted on this variable and treatment program. Patients with bulky disease need escalated therapy with high-dose chemotherapy. Integration into predictive models of the variable will change an expected contribution of clinical and laboratory parameters in the regression analyses constructed on patients with Hodgkin's lymphoma. Today the role of diagnostic functional methods, in particular a positron emission tomography, for metabolic active measurement is conducted which allows excluding a reactive component.

  11. Somatostatin Negatively Regulates Parasite Burden and Granulomatous Responses in Cysticercosis

    Directory of Open Access Journals (Sweden)

    Mitra Khumbatta

    2014-01-01

    Full Text Available Cysticercosis is an infection of tissues with the larval cysts of the cestode, Taenia  solium. While live parasites elicit little or no inflammation, dying parasites initiate a granulomatous reaction presenting as painful muscle nodules or seizures when cysts are located in the brain. We previously showed in the T. crassiceps murine model of cysticercosis that substance P (SP, a neuropeptide, was detected in early granulomas and was responsible for promoting granuloma formation, while somatostatin (SOM, another neuropeptide and immunomodulatory hormone, was detected in late granulomas; SOM’s contribution to granuloma formation was not examined. In the current studies, we used somatostatin knockout (SOM−/− mice to examine the hypothesis that SOM downmodulates granulomatous inflammation in cysticercosis, thereby promoting parasite growth. Our results demonstrated that parasite burden was reduced 5.9-fold in SOM−/− mice compared to WT mice (P<0.05. This reduction in parasite burden in SOM−/− mice was accompanied by a 95% increase in size of their granulomas (P<0.05, which contained a 1.5-fold increase in levels of IFN-γ and a 26-fold decrease in levels of IL-1β (P<0.05 for both compared to granulomas from WT mice. Thus, SOM regulates both parasite burden and granulomatous inflammation perhaps through modulating granuloma production of IFN-γ and IL-1β.

  12. Cost and disease burden of Dengue in Cambodia

    Directory of Open Access Journals (Sweden)

    Beauté Julien

    2010-08-01

    Full Text Available Abstract Background Dengue is endemic in Cambodia (pop. estimates 14.4 million, a country with poor health and economic indicators. Disease burden estimates help decision makers in setting priorities. Using recent estimates of dengue incidence in Cambodia, we estimated the cost of dengue and its burden using disability adjusted life years (DALYs. Methods Recent population-based cohort data were used to calculate direct and productive costs, and DALYs. Health seeking behaviors were taken into account in cost estimates. Specific age group incidence estimates were used in DALYs calculation. Results The mean cost per dengue case varied from US$36 - $75 over 2006-2008 respectively, resulting in an overall annual cost from US$3,327,284 in 2008 to US$14,429,513 during a large epidemic in 2007. Patients sustain the highest share of costs by paying an average of 78% of total costs and 63% of direct medical costs. DALY rates per 100,000 individuals ranged from 24.3 to 100.6 in 2007-2008 with 80% on average due to premature mortality. Conclusion Our analysis confirmed the high societal and individual family burden of dengue. Total costs represented between 0.03 and 0.17% of Gross Domestic Product. Health seeking behavior has a major impact on costs. The more accurate estimate used in this study will better allow decision makers to account for dengue costs particularly among the poor when balancing the benefits of introducing a potentially effective dengue vaccine.

  13. Globalization, Tax Competition and Tax Burden İn Turkey

    Directory of Open Access Journals (Sweden)

    Veli KARGI

    2016-07-01

    Full Text Available 1990’s world was quite different from the world of 1950’s. Especially in the last twenty years, the increasing involvement of Japan in the world economy since the 1990s, in addition to the dominance of globalization and market economy throughout the world, the rapid spread of information resulting from the developments in IT-technology and the international competition emerging in the field of technology have all led to some significant developments in the world economy. Reduction of high mobility income and corporate tax rates due to tax competition may cause an unjust distribution of the tax burden. The fact that indirect taxation constitutes about 70% of the tax revenues obtained in Turkey can be taken as an indication of the unfairness in the distribution of tax burden in Turkey. In this study, following a definition of globalization and tax competition, classification of tax competition, reasons for increasing tax competition, benefits and losses of tax competition are explained, and changes introduced by various countries in their tax systems due to tax competition, the distribution of tax burden resulting from tax competition in Turkey and the effectiveness of the new income tax law in Turkey in terms of tax competition are analyzed.

  14. Clinical and Economic Burden of Revision Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohit Bhandari

    2012-01-01

    Full Text Available Surgery is indicated for symptomatic knee osteoarthritis (OA when conservative measures are unsuccessful. High tibial osteotomy (HTO, unicompartmental knee arthroplasty (UKA, and total knee arthroplasty (TKA are surgical options intended to relieve knee OA pain and dysfunction. The choice of surgical intervention is dependent on several factors such as disease location, patient age, comorbidities, and activity levels. Regardless of surgical treatment, complications such as infection, loosening or lysis, periprosthetic fracture, and postoperative pain are known risks and are indications for revision surgery. The clinical and economic implications for revision surgery are underappreciated. Over 55,000 revision surgeries were performed in 2010 in the US, with 48% of these revisions in patients under 65 years. Total costs associated with each revision TKA surgery have been estimated to be in excess of $49,000. The current annual economic burden of revision knee OA surgery is $2.7 billion for hospital charges alone. By 2030, assuming a 5-fold increase in the number of revision procedures, this economic burden will exceed $13 billion annually. It is appealing to envision a therapy that could delay or obviate the need for arthroplasty. From an actuarial standpoint, this would have the theoretical downstream effect of substantially reducing the number of revision procedures. Although no known therapies currently meet these criteria, such a breakthrough would have a tremendous impact in lessening the clinical and economic burden of knee OA revision surgery.

  15. [Clostridium difficile infection: epidemiology, disease burden and therapy].

    Science.gov (United States)

    Gulácsi, László; Kertész, Adrienne; Kopcsóné Németh, Irén; Banai, János; Ludwig, Endre; Prinz, Gyula; Reményi, Péter; Strbák, Bálint; Zsoldiné Urbán, Edit; Baji, Petra; Péntek, Márta; Brodszky, Valentin

    2013-07-28

    C. difficile causes 25 percent of the antibiotic associated infectious nosocomial diarrhoeas. C. difficile infection is a high-priority problem of public health in each country. The available literature of C. difficile infection's epidemiology and disease burden is limited. Review of the epidemiology, including seasonality and the risk of recurrences, of the disease burden and of the therapy of C. difficile infection. Review of the international and Hungarian literature in MEDLINE database using PubMed up to and including 20th of March, 2012. The incidence of nosocomial C. difficile associated diarrhoea is 4.1/10 000 patient day. The seasonality of C. difficile infection is unproved. 20 percent of the patients have recurrence after metronidazole or vancomycin treatment, and each recurrence increases the chance of a further one. The cost of C. difficile infection is between 130 and 500 thousand HUF (430 € and 1665 €) in Hungary. The importance of C. difficile infection in public health and the associated disease burden are significant. The available data in Hungary are limited, further studies in epidemiology and health economics are required.

  16. Dealing with uncertainties in environmental burden of disease assessment

    Directory of Open Access Journals (Sweden)

    van der Sluijs Jeroen P

    2009-04-01

    Full Text Available Abstract Disability Adjusted Life Years (DALYs combine the number of people affected by disease or mortality in a population and the duration and severity of their condition into one number. The environmental burden of disease is the number of DALYs that can be attributed to environmental factors. Environmental burden of disease estimates enable policy makers to evaluate, compare and prioritize dissimilar environmental health problems or interventions. These estimates often have various uncertainties and assumptions which are not always made explicit. Besides statistical uncertainty in input data and parameters – which is commonly addressed – a variety of other types of uncertainties may substantially influence the results of the assessment. We have reviewed how different types of uncertainties affect environmental burden of disease assessments, and we give suggestions as to how researchers could address these uncertainties. We propose the use of an uncertainty typology to identify and characterize uncertainties. Finally, we argue that uncertainties need to be identified, assessed, reported and interpreted in order for assessment results to adequately support decision making.

  17. The global burden of disease due to outdoor air pollution.

    Science.gov (United States)

    Cohen, Aaron J; Ross Anderson, H; Ostro, Bart; Pandey, Kiran Dev; Krzyzanowski, Michal; Künzli, Nino; Gutschmidt, Kersten; Pope, Arden; Romieu, Isabelle; Samet, Jonathan M; Smith, Kirk

    As part of the World Health Organization (WHO) Global Burden of Disease Comparative Risk Assessment, the burden of disease attributable to urban ambient air pollution was estimated in terms of deaths and disability-adjusted life years (DALYs). Air pollution is associated with a broad spectrum of acute and chronic health effects, the nature of which may vary with the pollutant constituents. Particulate air pollution is consistently and independently related to the most serious effects, including lung cancer and other cardiopulmonary mortality. The analyses on which this report is based estimate that ambient air pollution, in terms of fine particulate air pollution (PM(2.5)), causes about 3% of mortality from cardiopulmonary disease, about 5% of mortality from cancer of the trachea, bronchus, and lung, and about 1% of mortality from acute respiratory infections in children under 5 yr, worldwide. This amounts to about 0.8 million (1.2%) premature deaths and 6.4 million (0.5%) years of life lost (YLL). This burden occurs predominantly in developing countries; 65% in Asia alone. These estimates consider only the impact of air pollution on mortality (i.e., years of life lost) and not morbidity (i.e., years lived with disability), due to limitations in the epidemiologic database. If air pollution multiplies both incidence and mortality to the same extent (i.e., the same relative risk), then the DALYs for cardiopulmonary disease increase by 20% worldwide.

  18. Blood pressure and the global burden of cardiovascular disease.

    Science.gov (United States)

    Rodgers, A; MacMahon, S

    1999-01-01

    Cardiovascular disease is responsible for a large and increasing proportion of death and disability worldwide. Half of this burden occurs in Asia. This study assessed the possible effects of population-wide (2% lower DBP for all) and targeted (7% lower DBP for those with usual DBP > or = 95 mmHg) BP interventions in Asia, using data from surveys of blood pressure levels, the Global Burden of Disease Project, Eastern Asian cohort studies and randomised trials of blood pressure lowering. Overall each of the two interventions would be expected to avert about one million deaths per year throughout Asia in 2020. These benefits would be approximately additive. About half a million deaths might be averted annually by each intervention in China alone, with about four-fifths of this benefit due to averted stroke. The relative benefits of these two strategies are similar to estimates made for US and UK populations. However, the absolute benefits are many times greater due to the size of the predicted CVD burden in Asia.

  19. The heterogeneity in financial and time burden of caregiving to children with chronic conditions.

    Science.gov (United States)

    Zan, Hua; Scharff, Robert L

    2015-03-01

    We examine the financial and time burdens associated with caring for children with chronic conditions, focusing on disparities across types of conditions. Using linked data from the 2003 to 2006 National Health Interview Survey and 2004-2008 Medical Expenditure Panel Survey, we created measures of financial burden (out-of-pocket healthcare costs, the ratio of out-of-pocket healthcare costs to family income, healthcare costs paid by insurance, and total healthcare costs) and time burden (missed school time due to illness or injury and the number of doctor visits) associated with 14 groups of children's chronic conditions. We used the two-part model to assess the effect of condition on financial burden and finite mixture/latent class model to analyze the time burden of caregiving. Controlling for the influences of other socio-demographic characteristics on caregiving burden, children with chronic conditions have higher financial and time burdens relative to caregiving burdens for healthy children. Levels of financial burden and burden sharing between families and insurance system also vary by type of condition. For example, children with pervasive developmental disorder or heart disease have a relatively low financial burden for families, while imposing a high cost on the insurance system. In contrast, vision difficulties are associated with a high financial burden for families relative to the costs borne by others. With respect to time burden, conditions such as cerebral palsy and heart disease impose a low time burden, while conditions such as pervasive developmental disorder are associated with a high time burden. This study demonstrates that differences exist in caregiving burden for children by type of chronic condition. Each condition has a unique profile of time and financial cost burden for families and the insurance system. These results have implications for policymakers and for families' savings and employment decisions.

  20. Written on the Body

    DEFF Research Database (Denmark)

    Christiansen, Steen Ledet

    Our bodies define a border between ourselves and the world around us. However we might feel about our body, it is what we present to the world. Victoria L. Blum in her book Flesh Wounds discusses how bodies are a form of inkblots, where discontent is projected onto. As bodies can be modified, we...... may choose to alter how we are perceived and to at least some extent control the discontent we may project onto our own body. Through body modification, we can alter the impression of our personality and express a cultural solidarity, as Chris Rojek points out. Tattoos, piercings and other body...... modifications become ways to express a difference from or identification with, a particular cultural segment. Body modification marks a personal subjectivity, just as it marks a border around those who participate. A distinctive bodily border is formed through the use of body modifications, and it can be viewed...

  1. Burden and correlates of non-communicable-diseases among rural residents: a cross-sectional study in Hebei, China.

    Science.gov (United States)

    Yang, Junjun; Yu, Wenya; Zhou, Qiang; Mahapatra, Tanmay; Li, Yiqiu; Zhang, Xiaoyan; Chen, Lei; Mahapatra, Sanchita; Yan, Yuying; Tang, Weiming

    2015-06-20

    Burden of non-communicable diseases (NCDs) is increasing rapidly in most of the developing countries including China, even in rural areas. Dearth of representative data called for an investigation to estimate the burden and identify the correlates of NCDs in rural China. A cross-sectional study was conducted involving a representative sample of 6003 consenting randomly selected rural residents aged 15 years or more, from 36 villages of Shijiazhuang in Hebei province of China between July 2010 and June 2011. Information on demographics and behavior were collected, body mass index (BMI) and blood pressure were measured and blood samples were tested to diagnose diabetes and hyperlipidemia. Majority participants were aged problems (12.1%) and gastrointestinal NCDs (7.8%) were identified among the participants, while proportion of subjects with one, two and three or more NCDs were 43%, 14.4% and 5.5% respectively. Higher odds of having more NCDs were associated with higher BMI (Kg/M(2)), family history of NCDs, daily and past history of smoking and drinking, passive smoking, lack of exercise, skipping breakfast and psychological disturbances. Despite limitations associated with cross-sectional design and self-reporting, observation in this large sample of rural residents could develop important insights regarding high burden of NCDs in this population. Based on the identified correlates, targeted intervention strategies seem to be required urgently to control NCDs in rural China.

  2. Global economic burden of schizophrenia: response to authors’ reply

    Directory of Open Access Journals (Sweden)

    Neil AL

    2017-02-01

    Full Text Available Amanda L Neil,1 Vaughan J Carr2,3 1Menzies Institute for Medical Research, The University of Tasmania, Hobart, TAS, 2Research Unit for Schizophrenia Epidemiology, University of New South Wales, Sydney, NSW, 3Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, AustraliaFor clarification, we undertook bottom-up costing using individual participant data from the Low Prevalence Disorders Study in our costing study.1 We did not use the data reported in the study by Carr et al2 as asserted by Chong et al.3 Chong et al have thus misunderstood and thus misrepresented our methodology in both their systematic review4 and their response to our letter.5 Authors' reply  Huey Yi Chong,1 Nathorn Chaiyakunapruk1–41School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; 2Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 3School of Pharmacy, University of Wisconsin, Madison, USA; 4School of Population Health, University of Queensland, Brisbane, Australia We thank Dr Neil and Professor Carr for their clarification on the data source used in their study.1 In this regard, we would like to highlight one of the most common challenges when conducting any systematic review, for example economic burden of schizophrenia in this case – the marked diversity in reporting among the included studies, which increases the likelihood of any potential misinterpretation. In convergence with a number of published systematic reviews of economic burden studies,2–5 there has been a consistent call for a more explicit reporting in various aspects of an economic burden study, thus readability and transparency can be enhanced. However, a standardized guide/checklist for conducting and reporting economic burden is yet to be available. On the final note, we strongly urge for the development of such a guidance document

  3. The Global Burden of Potential Productivity Loss from Uncorrected Presbyopia.

    Science.gov (United States)

    Frick, Kevin D; Joy, Susan M; Wilson, David A; Naidoo, Kovin S; Holden, Brien A

    2015-08-01

    The onset of presbyopia in middle adulthood results in potential losses in productivity among otherwise healthy adults if uncorrected or undercorrected. The economic burden could be significant in lower-income countries, where up to 94% of cases may be uncorrected or undercorrected. This study estimates the global burden of potential productivity lost because of uncorrected functional presbyopia. Population data from the US Census Bureau were combined with the estimated presbyopia prevalence, age of onset, employment rate, gross domestic product (GDP) per capita in current US dollars, and near vision impairment disability weights from the Global Burden of Disease 2010 study to estimate the global loss of productivity from uncorrected and undercorrected presbyopia in each country in 2011. To allow comparison with earlier work, we also calculated the loss with the conservative assumption that the contribution to productivity extends only up to 50 years of age. The economic modeling did not require the use of subjects. We estimated the number of cases of uncorrected or undercorrected presbyopia in each country among the working-age population. The number of working-age cases was multiplied by the labor force participation rate, the employment rate, a disability weight, and the GDP per capita to estimate the potential loss of GDP due to presbyopia. The outcome being measured is the lost productivity in 2011 US dollars resulting from uncorrected or undercorrected presbyopia. There were an estimated 1.272 billion cases of presbyopia worldwide in 2011. A total of 244 million cases, uncorrected or undercorrected among people aged productivity loss of US $11.023 billion (0.016% of global GDP). If all those people aged productive, the potential productivity loss would be US $25.367 billion or 0.037% of global GDP. Correcting presbyopia to the level achieved in Europe would reduce the burden to US $1.390 billion (0.002% of global GDP). Even with conservative assumptions

  4. Aging, body image, and body shape.

    Science.gov (United States)

    Ferraro, F Richard; Muehlenkamp, Jennifer J; Paintner, Ashley; Wasson, Kayla; Hager, Tracy; Hoverson, Fallon

    2008-10-01

    Participants were 25 older men (M age = 72 years, SD = 10 years) and 27 older women (M age = 71 years, SD = 8 years) who examined multiple line-drawing figures of babies, children, young adults, middle-aged adults, and older adults. Participants picked a number on a Likert-type scale ranging from 1 (very thin) to 9 (very obese) in response to questions including "Which is the most attractive?" and "Which figure would you most like to look like?" They also completed questionnaires about their body image and body shape. In response to the age-specific line drawings (e.g., those depicting older men and older women), older women endorsed thinner figures (e.g., picked smaller numbers) than did men. Likewise, older women reported thinking more about their body shape and appearance than did men and perceived their body image as "a little too big" in comparison with the older men who perceived their body image as "just the right size." However, a breakdown of normal and overweight women in this sample revealed that for some overweight elderly women, obesity could become a satisfactory way of life. Much as with college-aged women, the endorsement of a thinner body image by many of the older adult female participants appeared to persist into late adulthood and suggests that research into body image issues with older adults is relevant and necessary.

  5. Warming up human body by nanoporous metallized polyethylene textile

    OpenAIRE

    Cai, Lili; Song, Alex Y.; Wu, Peilin; Hsu, Po-Chun; Peng, Yucan; Chen, Jun; Liu, Chong; Catrysse, Peter B.; Liu, Yayuan; Yang, Ankun; Zhou, Chenxing; Zhou, Chenyu; Fan, Shanhui; Cui, Yi

    2017-01-01

    Space heating accounts for the largest energy end-use of buildings that imposes significant burden on the society. The energy wasted for heating the empty space of the entire building can be saved by passively heating the immediate environment around the human body. Here, we demonstrate a nanophotonic structure textile with tailored infrared (IR) property for passive personal heating using nanoporous metallized polyethylene. By constructing an IR-reflective layer on an IR-transparent layer wi...

  6. STUDY ON SOFTENING AND DROPPING PROPERTIES OF METALIZED BURDEN INSIDE BLAST FURNACE

    Directory of Open Access Journals (Sweden)

    Bi-yang Tuo

    2014-12-01

    Full Text Available The inferences of burden metallization rate on softening-melting dropping properties were investigated through softening-melting dropping test of three kinds of metalized burden pressure drop. The results indicated that the softeningmelting temperature interval of pre-reduction mixed burden is bigger than primeval mixed burden, the melting interval narrow with the rise of metallization rate of ferric burden as well as dropping temperature interval. The average pressure drop, maximum pressure drop and softening-melting dropping properties eigenvalue decrease with the rise of metallization rate of ferric burden. Besides, the dropping temperature of burden reduces with the rise of carbon content of molten iron. The combination high metalized burden and higher carbon content of molten iron is benefit to decreasing thickness of cohesive zone and improve permeability of cohesive zone.

  7. The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010

    Science.gov (United States)

    Whiteford, Harvey A.; Ferrari, Alize J.; Degenhardt, Louisa; Feigin, Valery; Vos, Theo

    2015-01-01

    Background The Global Burden of Disease Study 2010 (GBD 2010), estimated that a substantial proportion of the world’s disease burden came from mental, neurological and substance use disorders. In this paper, we used GBD 2010 data to investigate time, year, region and age specific trends in burden due to mental, neurological and substance use disorders. Method For each disorder, prevalence data were assembled from systematic literature reviews. DisMod-MR, a Bayesian meta-regression tool, was used to model prevalence by country, region, age, sex and year. Prevalence data were combined with disability weights derived from survey data to estimate years lived with disability (YLDs). Years lost to premature mortality (YLLs) were estimated by multiplying deaths occurring as a result of a given disorder by the reference standard life expectancy at the age death occurred. Disability-adjusted life years (DALYs) were computed as the sum of YLDs and YLLs. Results In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%), followed by neurological disorders (28.6%) and substance use disorders (14.7%). DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson’s disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific. Conclusion Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the

  8. The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010.

    Science.gov (United States)

    Whiteford, Harvey A; Ferrari, Alize J; Degenhardt, Louisa; Feigin, Valery; Vos, Theo

    2015-01-01

    The Global Burden of Disease Study 2010 (GBD 2010), estimated that a substantial proportion of the world's disease burden came from mental, neurological and substance use disorders. In this paper, we used GBD 2010 data to investigate time, year, region and age specific trends in burden due to mental, neurological and substance use disorders. For each disorder, prevalence data were assembled from systematic literature reviews. DisMod-MR, a Bayesian meta-regression tool, was used to model prevalence by country, region, age, sex and year. Prevalence data were combined with disability weights derived from survey data to estimate years lived with disability (YLDs). Years lost to premature mortality (YLLs) were estimated by multiplying deaths occurring as a result of a given disorder by the reference standard life expectancy at the age death occurred. Disability-adjusted life years (DALYs) were computed as the sum of YLDs and YLLs. In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%), followed by neurological disorders (28.6%) and substance use disorders (14.7%). DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson's disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific. Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the research necessary to develop better

  9. Developing a nursing personnel policy to address body art using an evidence-based model.

    Science.gov (United States)

    Dorwart, Shawna D; Kuntz, Sandra W; Armstrong, Myrna L

    2010-12-01

    An increase in the prevalence of body art as a form of self-expression has motivated health care organizations to develop policies addressing nursing personnel's body art. A systematic review of literature on body art was completed and a telephone survey of 15 hospitals was conducted to query existing policy statements addressing nursing personnel's body art. The literature established no prevalence of body art among nurses or effect of nurses' body art. Of the 13 hospitals (86%) that shared their policy on body art, none provided a rationale or references to support their existing policies. A lack of published evidence identifying the effect of body art among nurses shifts the burden of determining care outcomes to the leadership of individual hospitals. Further research on patients' perception of nursing personnel with visible body art, using an evidence-based model, is recommended. Copyright 2010, SLACK Incorporated.

  10. The burden of allergies--and the capacity of medications to reduce this burden-in a heavy manufacturing environment.

    Science.gov (United States)

    Bunn, William B; Pikelny, Dan B; Paralkar, Sadhna; Slavin, Thomas; Borden, Spencer; Allen, Harris M

    2003-09-01

    This article addresses the observational findings of the first systematic study undertaken by a manufacturer to address the impact of allergies and use of allergy medications on health, safety, and productivity. It provides background for 3 other papers from the same project, including an evaluation of an intervention to promote appropriate medication use among affected employees, which appear in this issue. The observational data are developed on 10,714 employees from: 1) 2 employee surveys; 2) administrative databases monitoring employee absenteeism, workers compensation, short-term disability, and group health. The results show that health, productivity, absenteeism, workplace injury, and workers compensation measures register consistent declines as allergy severity levels increase. This pattern is present but less pronounced for the short-term disability and group health measures. In addition, among the 16 measures registering a significant allergy burden, 6 posted significant advantages for the use of nonsedating antihistamines relative to other medication regimens that included sedative antihistamines. These results document the burden of allergies and the capacity of medications to reduce this burden. Effective intervention programs that target this condition can achieve improved health, productivity, and related outcomes.

  11. Renewable energy burden sharing. REBUS. Effects of burden sharing and certificate trade on the renewable electricity market in Europe

    International Nuclear Information System (INIS)

    Voogt, M.H.; Uyterlinde, M.A.; De Noord, M.; Skytte, K.; Nielsen, L.H.; Leonardi, M.; Whiteley, M.H.; Chapman, M.

    2001-05-01

    Creation of an internal market for renewable electricity will involve a political negotiation process, similar to previous European Union (EU) greenhouse gas negotiations. The Energy Ministers in the EU have agreed upon an overall target of 22% of electricity supply from Renewable Energy Sources (RES-E) and a distribution of targets over the individual Member States. The REBUS project provides insights in the effects of implementing targets for renewable electricity generation at EU Member State level and the impact of introducing burden sharing systems within the EU, such as a Tradable Green Certificate (TGC) system. Member States can participate in such burden sharing systems to reduce the costs of achieving RES-E targets. The project concentrated on the development of the REBUS model, which quantifies the impact of trade (in green certificates, quotas or targets), the specification of cost potential curves for renewable electricity options in each of the 15 EU Member States and the implementation of different rules to setting targets at individual Member State level. In addition, utilities and consumer organisations were interviewed on their requirements and expectations for an international burden sharing scheme. 49 refs

  12. Comparing contemporary revision burden among hip and knee joint replacement registries

    Directory of Open Access Journals (Sweden)

    Brian J. McGrory, MD, MS

    2016-06-01

    Conclusions: Revision burden has gradually decreased for hip replacements and has remained relatively constant for knee replacements both for the last 4 years and compared to historic controls. Knee revision burden was lower than hip revision burden for each period examined. Revision burden is one measure that may be helpful in following the effect of changes in surgical technique and implant design over time in registry populations and may be a helpful way to compare overall results between registries.

  13. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... the body. When your physician suspects that a blunt foreign body is stuck in the esophagus, you ... tract. Other drugs taken by mouth can help blunt foreign objects pass through the digestive tract by ...

  14. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... body is an outside object like a splinter, rock or piece of metal or glass that gets ... examined, an x-ray machine produces a small burst of radiation that passes through the body, recording ...

  15. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... extended over the patient while an x-ray film holder or image recording plate is placed beneath ... through the body, recording an image on photographic film or a special detector. Many foreign bodies, like ...

  16. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... bear denotes child-specific content. Related Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body General Ultrasound Contrast Materials Anesthesia Safety X-ray, Interventional Radiology and ...

  17. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... batteries, small toys or pieces of toys and fish bones. Swallowing of magnets can cause significant problems ... bodies like toothpicks. Small esophageal foreign bodies like fish bones also may be difficult to visualize. Additional ...

  18. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... may include magnetic resonance imaging (MRI) or computed tomography (CT). top of page How is the procedure ... child-specific content. Related Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body General ...

  19. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... may include magnetic resonance imaging (MRI) or computed tomography (CT). top of page How is the procedure performed? ... child-specific content. Related Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body General Ultrasound ...

  20. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... can leak into the bowel and cause mercury poisoning. Magnetic toys can obstruct the bowel when they ... soft tissue foreign body, contact your physician immediately. Treatment will depend on the type of foreign body ...

  1. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... tissues. top of page What are some common uses of the procedure? Foreign body retrieval is used ... bones also may be difficult to visualize. Additional evaluation is required when the suspected foreign body is ...

  2. Inside Your Body

    Science.gov (United States)

    ... brain control certain body parts. In general, the right side of the brain controls the left side of the body, and the left side of the brain controls the right side. Digestive system The digestive (say: di-JES- ...

  3. Lewy Body Dementia Diagnosis

    Science.gov (United States)

    ... provide an experienced diagnostic team skilled in Lewy body dementia. A thorough dementia diagnostic evaluation includes physical ... a good way to benefit others with Lewy body dementia. Medications Medications are one of the most ...

  4. Body temperature norms

    Science.gov (United States)

    Normal body temperature; Temperature - normal ... Morrison SF. Regulation of body temperature. In: Boron WF, Boulpaep EL, eds. Medical Physiology . 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 59. Sajadi MM, Mackowiak ...

  5. About Body Water

    Science.gov (United States)

    ... Video) Thyroid Disease Additional Content Medical News About Body Water By James L. Lewis, III, MD, Attending ... here for the Professional Version Water Balance About Body Water Dehydration Overhydration Water accounts for about one ...

  6. Lewy Body Dementia Association

    Science.gov (United States)

    ... Now events There are no upcoming events. Lewy Body Digest September 2017 Lewy Digest Caregiving as a ... and research, we support those affected by Lewy body dementias, their families and caregivers. We are dedicated ...

  7. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... waves), as well as the type of body structure and composition of body tissue through which the ... such as when it is located near vital structures like nerves and blood vessels, so your physician ...

  8. Body Dysmorphic Disorder

    Science.gov (United States)

    ... compulsive disorder. Environment. Your environment, life experiences and culture may contribute to body dysmorphic disorder, especially if they involve negative social evaluations about your body or self-image, or even childhood neglect or abuse. Risk factors ...

  9. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... by probing the wound. Additional tests may include magnetic resonance imaging (MRI) or computed tomography (CT). top of ... Related Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body General Ultrasound Contrast Materials Anesthesia ...

  10. Abstract: Body Work

    DEFF Research Database (Denmark)

    Otto, Lene

    2012-01-01

    This panel will explore the usefulness of the term ‘body work’ in cultural history. Body work is understood as work focusing on the bodies of others as component in a range of occupations in health and social care, as well as in unpaid work in the family. How can the notion of body work inform...... cultural history of health and illness whether through a micro-social focus on the intercorporeal aspects of work in health and social care, or through clarifying our understanding of the times and spaces of work, or through highlighting the relationship between mundane body work and global processes....... The British sociologist Julia Twigg has introduced and explored the term `bodywork', most recently in Body Work in Health and Social Care - Critical Themes, New Agendas (2011). She extends the term body work from applying to the work that individuals undertake on their own bodies, often as part of regimens...

  11. 40 CFR 154.5 - Burden of persuasion in determinations under this part.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Burden of persuasion in determinations... (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES General Provisions § 154.5 Burden of persuasion in... principle that the burden of persuasion that a pesticide product is entitled to registration or continued...

  12. Whole-body retention of 65Zn during pregnancy and lactation, and its secretion into milk in mice

    International Nuclear Information System (INIS)

    Matsusaka, N.

    1978-01-01

    The relationship between the maternal whole-body retention of 65 Zn during pregnancy and lactation was studied in mice. Mice administered 65 Zn late in gestation had extremely high retention before parturition which was followed by an abrupt decrease after parturition. The magnitude of the abrupt decrease of maternal body burden becomes smaller with an increase in the interval between administration of isotope and parturition, i.e., the greater the interval between administration and parturition, the smaller the fetal uptake of 65 Zn during intrauterine life. The amount of 65 Zn secreted into milk was estimated from the pup's body burden during the nursing period. When 65 Zn was administered 5 days after parturition to dams nursing eight pups each, the maximum body burden of the litter reached 64% of the initial dose 10 days after injection. In mouse dams, the secretion of 65 Zn in milk is an important elimination pathway in addition to excretion in feces

  13. TITLE: OTIC FOREIGN BODIES

    African Journals Online (AJOL)

    Dr. A.O.A. Ogunleye

    A large variety of foreign bodies may be encountered in the external auditory meatus 1 . The objects may be organic or inorganic. Organic foreign bodies include paper, cotton wool, rubber, seeds, etc while inorganic objects include beads, ball bearings, stones, and crayons 1- 4. Foreign bodies are inserted into the ear.

  14. [Foreign Body in Esophagus].

    Science.gov (United States)

    Domeki, Yasushi; Kato, Hiroyuki

    2015-07-01

    An esophageal foreign body is the term for a foreign body in the esophagus. The 2 age groups most prone to this condition are children age 9 and under (and especially toddlers age 4 and under) and elderly individuals age 70 and over. A foreign body often lodges where the esophagus is most constricted. In toddlers, the foreign body is often currency or coins or a toy. In adults, the body is often a piece of fish, dentures, a piece of meat, a pin or needle, or a drug in its blister pack packaging. In children, an esophageal foreign body is treated by fluoroscopically guided removal of the body with a balloon catheter or magnetic catheter or removal of the body via endoscopy or direct esophagoscopy under general anesthesia. In adults, the best choice for treating an esophageal foreign body is removing the body with an endoscope but there are instances where surgery is performed because the body is hard to remove endoscopically, a puncture has occurred, or empyema or mediastinitis has developed. This paper reviews the diagnosis and treatment of an esophageal foreign body.

  15. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... sound waves), as well as the type of body structure and composition of body tissue through which the sound travels. A small ... complications. There is always a slight chance of cancer from excessive exposure ... limitations of foreign body detection and removal? The primary limitation of an ...

  16. Editorial: Body Movements

    Directory of Open Access Journals (Sweden)

    Carina Assuncao

    2018-01-01

    Full Text Available Today, the juxtaposition between physical bodies and the gameworld is ever more fluid. Virtual Reality headsets are available at game stores with more AAA games being created for the format. The release of the Nintendo Switch and its dynamic JoyCon controllers reintroduce haptic movement based controls.  Pokémon GO’s augmented reality took gamers outdoors and has encouraged the Harry Potter franchise to follow in its mobile footsteps. Each development encourages a step further into the digital world. At the same time, the movement of bodies always has political dimensions. We live in a world where walls seem like solutions to the movement of bodies, while the mere meeting of bodies elsewhere – for sex, marriage and other reasons – is still forbidden by many states’ rules. Games and game-like interfaces have shown the ability to bend those rules, and to sometimes project other worlds and rule systems over our world in order to make bodies move and meet. For this special issue on ‘Body Movements’, Press Start invited authors to focus on embodiment, body movements, political bodies, community bodies, virtual bodies, physical bodies, feminine, masculine, trans- bodies, agency or its lack, and anything else in between. The response to this invitation was variegated, and provocative, as outlined here.

  17. Literacies in the Body

    Science.gov (United States)

    Jones, Stephanie

    2013-01-01

    In this commentary, the author invites readers to consider the body and its central place in literacy pedagogy, practice and research. She emphasizes two interrelated paths for teachers and researchers interested in literacies to tend to the body: (1) the ways literacies are engaged and cultivated for making sense of bodies, and (2) the literacies…

  18. Lewy body dementias

    DEFF Research Database (Denmark)

    Løkkegaard, Annemette; Korbo, Lise

    2017-01-01

    Dementia with Lewy bodies and Parkinson disease dementia share the same pathophysiology. Together they are called Lewy body dementias and are the second most common type of dementia. Lewy body dementias receive little attention, and patients are often misdiagnosed, leading to less than ideal...

  19. Body Integrity Identity Disorder

    NARCIS (Netherlands)

    Blom, Rianne M.; Hennekam, Raoul C.; Denys, Damiaan

    2012-01-01

    Introduction: Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal

  20. Male Body Practices.

    Science.gov (United States)

    Lefkowich, Maya; Oliffe, John L; Hurd Clarke, Laura; Hannan-Leith, Madeline

    2017-03-01

    The pressure on boys and men to engage in extensive body practices (e.g., closely monitored eating and exercise habits) and achieve ideal male bodies has grown significantly over the past 20 years. Central to the depiction of ideal male bodies and body practices are both the pursuit and achievement of lean and well-defined muscles. The labels "pitches," "purchases," and "performativities" were inductively derived from the literature, and used to describe the multifaceted connections between masculinities, muscularity, and idealized male body practices. "Pitches" distil how popular culture posture norms of masculinity, and manly bodies and behaviors attainable and necessary. "Purchases" refer to men's diverse buy-in to dominant discourses about acceptable male bodies and practices. "Performativities" chronicle how men embody and navigate gender norms as they evaluate their own bodies, behaviors, and eating habits and those of their peers. Based on findings from the current scoping review, future research could benefit from fully linking masculinities with the drive for muscularity to address health and social risks associated with the pursuit of the idealized male body. In highlighting the plurality of masculinities and the complexity of men's diverse identities, health care providers can better reach and support men. Focusing on, and celebrating, a wider range of male bodies could help recenter dominant discourses about how and whose bodies and experiences are idealized. The current scoping review article offers an overview of how masculinities and muscularity have been linked to male body practices, and recommendations to advance this emergent field.