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Sample records for body burden

  1. FRAMES User Defined Body Burden Concentration File Module Documentation

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-06-01

    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. 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.

  3. 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.

  4. LEWY BODY DEMENTIA: CAREGIVER BURDEN AND UNMET NEEDS

    OpenAIRE

    Galvin, James E.; Duda, John E.; Kaufer, Daniel I.; Lippa, Carol F.; Taylor, Angela; Zarit, Steven H.

    2010-01-01

    Lewy body dementia (LBD) is a common cause of dementia but to date, little is known about caregiver burden. The Lewy Body Dementia Association (www.LBDA.org) conducted a web-based survey of 962 caregivers (mean age 56y; 88% women). The most common initial symptoms were cognitive (48%), motor (39%), or both (13%). Caregivers expressed concerns about fear of future (77%), feeling stressed (54%), loss of social life (52%) and uncertainty about what to do next (50%). Caregivers reported moderate ...

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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...

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

    African Journals Online (AJOL)

    Overall, 87% of type 2 diabetes, 68% of hypertensive disease, 61 % of endometrial cancer, 45% of ischaemic stroke, 38% of ischaemic heart disease, 31 % of kidney cancer, 24% of osteoarthritis, 17% of colon cancer, and 13% of postmenopausal breast cancer were attributable to a BMI ≥ 21 kg/m2. Excess body weight is ...

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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 <5 y old, school-aged children, and women of reproductive age. In 13.1% of households, mothers with excess body weight coexist with a stunted child <5 y old. Moreover, among households with overweight or obese mothers, 12.6% have an anemic child and 14% have a zinc-deficient child. At the individual levels, the coexistence of OW/OB and stunting, anemia, or zinc deficiency was found in 2.8%, 0.7%, and 8.4% of school-aged children, respectively. In addition, 8.9% and 32.6% of women aged 12-49 y have excess body weight and anemia or zinc deficiency, respectively. This article shows the coexistence of high rates of undernutrition and OW/OB at the individual, household, and national levels in 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.

  16. 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.

  17. Quantitative assessment of whole-body tumor burden in adult patients with neurofibromatosis.

    Science.gov (United States)

    Plotkin, Scott R; Bredella, Miriam A; Cai, Wenli; Kassarjian, Ara; Harris, Gordon J; Esparza, Sonia; Merker, Vanessa L; Munn, Lance L; Muzikansky, Alona; Askenazi, Manor; Nguyen, Rosa; Wenzel, Ralph; Mautner, Victor F

    2012-01-01

    Patients with neurofibromatosis 1 (NF1), NF2, and schwannomatosis are at risk for multiple nerve sheath tumors and premature mortality. Traditional magnetic resonance imaging (MRI) has limited ability to assess disease burden accurately. The aim of this study was to establish an international cohort of patients with quantified whole-body internal tumor burden and to correlate tumor burden with clinical features of disease. We determined the number, volume, and distribution of internal nerve sheath tumors in patients using whole-body MRI (WBMRI) and three-dimensional computerized volumetry. We quantified the distribution of tumor volume across body regions and used unsupervised cluster analysis to group patients based on tumor distribution. We correlated the presence and volume of internal tumors with disease-related and demographic factors. WBMRI identified 1286 tumors in 145/247 patients (59%). Schwannomatosis patients had the highest prevalence of tumors (P = 0.03), but NF1 patients had the highest median tumor volume (P = 0.02). Tumor volume was unevenly distributed across body regions with overrepresentation of the head/neck and pelvis. Risk factors for internal nerve sheath tumors included decreasing numbers of café-au-lait macules in NF1 patients (P = 0.003) and history of skeletal abnormalities in NF2 patients (P = 0.09). Risk factors for higher tumor volume included female gender (P = 0.05) and increasing subcutaneous neurofibromas (P = 0.03) in NF1 patients, absence of cutaneous schwannomas in NF2 patients (P = 0.06), and increasing age in schwannomatosis patients (p = 0.10). WBMRI provides a comprehensive phenotype of neurofibromatosis patients, identifies distinct anatomic subgroups, and provides the basis for investigating molecular biomarkers that correlate with unique disease manifestations.

  18. Influence of parasitism in controlling the health, reproduction and PAH body burden of petroleum seep mussels

    Science.gov (United States)

    Powell, Eric N.; Barber, Robert D.; Kennicutt, Mahlon C., II; Ford, Susan E.

    1999-12-01

    Petroleum seep mussels are often exposed to high hydrocarbon concentrations in their natural habitat and, thus, offer the opportunity to examine the relationship between parasitism, disease and contaminant exposure under natural conditions. This is the first report on the histopathology of cold-seep mussels. Seep mussels were collected by submersible from four primary sites in the Gulf of Mexico, lease blocks Green Canyon (GC) 184, GC-234, GC-233, and Garden Banks 425 in 550-650 m water depth. Five types of parasites were identified in section: (1) gill "rosettes" of unknown affinity associated with the gill bacteriocytes, (2) gill "inclusions" similar to chlamydia/rickettsia inclusions, (3) extracellular gill ciliates, (4) body "inclusions" that also resemble chlamydial/rickettsial inclusions, and (5) Bucephalus-like trematodes. Comparison to shallow-water mytilids demonstrates that: (1) both have similar parasite faunas; (2) seep mytilids are relatively heavily parasitized; and (3) infection intensities are extremely high in comparison to shallow-water mytilids for Bucephalus and chlamydia/rickettsia. In this study, the lowest prevalence for chlamydia/rickettsia was 67%. Prevalences of 100% were recorded from three populations. Bucephalus prevalence was ⩾70% in three of 10 populations. The parasite fauna was highly variable between populations. Some important parasites were not observed in some primary sites. Even within primary sites, some important parasites were not observed in some populations. Bucephalus may exert a significant influence on seep mussel population dynamics. Forty percent of the populations in this study are severely reproductively compromised by Bucephalus infection. Only a fraction of petroleum seep mussel populations are maintaining the entire beta-level population structure of this species. Variation in two parasites, gill ciliates and Bucephalus, explained most of the variation in PAH body burden between mussel populations. PAHs are

  19. Relationships between host body condition and immunocompetence, not host sex, best predict parasite burden in a bat-helminth system.

    Science.gov (United States)

    Warburton, Elizabeth M; Pearl, Christopher A; Vonhof, Maarten J

    2016-06-01

    Sex-biased parasitism highlights potentially divergent approaches to parasite resistance resulting in differing energetic trade-offs for males and females; however, trade-offs between immunity and self-maintenance could also depend on host body condition. We investigated these relationships in the big brown bat, Eptesicus fuscus, to determine if host sex or body condition better predicted parasite resistance, if testosterone levels predicted male parasite burdens, and if immune parameters could predict male testosterone levels. We found that male and female hosts had similar parasite burdens and female bats scored higher than males in only one immunological measure. Top models of helminth burden revealed interactions between body condition index and agglutination score as well as between agglutination score and host sex. Additionally, the strength of the relationships between sex, agglutination, and helminth burden is affected by body condition. Models of male parasite burden provided no support for testosterone predicting helminthiasis. Models that best predicted testosterone levels did not include parasite burden but instead consistently included month of capture and agglutination score. Thus, in our system, body condition was a more important predictor of immunity and worm burden than host sex.

  20. Time course of cesium radionuclides body burden in residents of regions with elevated background radiation

    International Nuclear Information System (INIS)

    Vasil'ev, V.N.; Luchkov, A.B.; Trushin, V.I.; Khazins, E.D.

    1990-01-01

    The authors represent summarized data on the time course of 134 Cs and 137 Cs body burden in the population of the Krasnogorsky District of the Bryansk Region (Byelorussian SSR) over the period of June 1986-Jule 1989. A RISh-5M was used as a whole-body counter, its performance and calibration methods were described. A retrospective analysis has shown that the main accumulation of radionuclides occurred before May 15 1986. The highest half-life noted from August 1986 till Februal 1987. The ratio of accumulated Cs in children and adults was 0.3, in men and women - 1.4. The effectiveness of measures aimed at reducing collective doses of internal irradiation was analyzed

  1. Dioxin body burden in women with long term residency near and away from major chemical industries in Teesside, UK

    Energy Technology Data Exchange (ETDEWEB)

    Pless-Mulloli, T.; Howel, D. [Univ. of Newcastle upon Tyne (United Kingdom); Edwards, R. [Univ. of Manchester (United Kingdom); Paepke, O. [ergo Forschungs Gesellschaft, Hamburg (Germany); Hermann, T.

    2004-09-15

    Retrospective exposure assessment poses a major challenge for environmental epidemiology studies. Body burden measures may act as markers for long-term exposure if biomarkers can be found with sufficiently long half lives in the human body. Some studies of human exposures have reported data from exposures over several years and before and after sources started production, however none have investigated the usefulness of such approach when exposure is estimated over more than a decade. Whilst for the general population food intake forms the major source of long term dioxin exposures other occupational and environmental sources can contribute to elevated body burdens. The UK has rich data sets for dioxin levels in food, but no body burden data are yet available for a general population sample. We tested the hypothesis that women with long term residence close to an industrial complex have a higher body burden and a distinct pattern of dioxins, furans (PCDD/F) and polychlorinated biphenyls (PCBs). We estimated exposure by recording residential history and food intakes and compared this information with body burden measurements as proxy for all forms of exposure.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. Toxicokinetics of halogenated benzenes in fish: Lethal body burden as a toxicological end point

    Energy Technology Data Exchange (ETDEWEB)

    Sijm, D.T.H.M.; Schipper, M.; Opperhuizen, A. (University of Utrecht, (Netherlands). Research Inst. of Toxicology)

    1993-06-01

    The lethal body burden (LBB), the whole-body concentration in millimoles per kilogram at time of death or immobilization, and the LC50 of dihalogenated (F,Cl,Br) benzenes were measured. Except for 1,4-difluorobenzene in guppy, LBBs varied between 2 and 8 mmol kg[sub [minus]8]. The LBBs of the chemicals in guppies were not significantly different from those in fat head minnows. LC50 values varied between 0.54 and 41 [mu]mol L[sub [minus]1] and were inversely related to the octanol/water partition coefficient, K[sub ow]. To estimate the risk of a compound to fish, the LBB requires the exposure concentration in combination with a first-order one-compartment bioaccumulation model. Therefore, the time of death or the time of immobility, and bioconcentration parameters such as the uptake rate constant (k[sub 1]) and the elimination rate constant (k[sub 2]), were determined. For both species, k[sub 1] values of the chlorinated benzenes were smaller than those of the brominated compounds and k[sub 2] values decreased with increasing hydrophobicity. The lipid-normalized bioaccumulation factors (k[sub l]'s) were linearly related to K[sub ow].

  8. 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

  9. 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.

  10. Radiocesium body burdens in immigrants to Israel from areas of the Ukraine, Belarus and Russia near Chernobyl.

    Science.gov (United States)

    Quastel, M R; Kramer, G H; Goldsmith, J R; Polyak, S; Kordysh, E; Noel, L; Cohen, R; Gorodisher, R

    1995-07-01

    Of the 500,000 immigrants from the former Soviet Union who came to Israel during 1990-1993, about 100,000 are estimated to have come from radiocontaminated areas near Chernobyl. These people were subject to chronic uptake of environmental radiocesium over protracted periods. During October-November 1991, a joint Israeli-Canadian investigation measured radiocesium body burdens in immigrants to Israel from the Ukraine, Belarus, and the southern Russian republic in order to provide factual information on radiocesium levels to concerned immigrants and to relate the body burdens to the geographic area of residence before coming to Israel. Assessments were made of 137Cs body burdens in 1,228 volunteer men, women, and children. These measurements were accompanied by medical assessments based on clinical histories and examinations. Radiocesium levels were strongly dependent on the duration of residence in Israel, with the highest levels being found in the most recent immigrants. The maximum level, extrapolated back to the time of leaving the former Soviet Union, was estimated to be about 0.83 kBq (10.3 Bq kg-1). Of the most recent immigrants from the Kiev region ( 50 Bq, whereas 53% of those coming from Gomel and other towns in the contaminated zones (> 3.7 x 10(10) Bq km-2 of radiocesium) had detectable levels > 50 Bq. People coming from the latter region had significantly higher body burdens as compared to those from the former, in accordance with the higher degree of ground radiocesium contamination reported for the latter region. Women and children showed considerably lower total radiocesium content in comparison to men. All radiocesium body burdens at the time of measurement were too low to be of health concern.

  11. Caregiver burden in family carers of people with dementia with Lewy bodies and Alzheimer's disease.

    Science.gov (United States)

    Svendsboe, Ellen; Terum, Toril; Testad, Ingelin; Aarsland, Dag; Ulstein, Ingun; Corbett, Anne; Rongve, Arvid

    2016-09-01

    To characterise the differences in caregiver distress between carers of people diagnosed with dementia with Lewy bodies (DLB) and people with Alzheimer's disease (AD), with a view to differentiating and improving support for caregivers. This study is a part of two larger Norwegian studies, DemVest (n = 265) and The Norwegian Dementia Register (n = 2220), with data from caregivers and people diagnosed with AD (n = 100) and DLB (n = 86) between 2005 and 2013. The average age was 74.9 years (SD = 7.8). Caregiver distress was rated by the Relative Stress Scale. Diagnosis of the person receiving care was based on a comprehensive standardised assessment program (International Classification of Diseases, Revision 10 or Diagnostic and Statistical Manual for Mental Disorders, fourth edition). Additional data collected from people receiving care were neuropsychiatric symptoms, comorbidity and activities of daily living (ADL) score. Linear regression analyses were applied, first unadjusted and then in stepwise-adjusts in addition to descriptive analyses. Caregivers to people with AD (20.2%) and 40% of caregivers for people with DLB experienced moderate or high caregiver burden with an increased risk of psychiatric disorders in the early stage of dementia. High Relative Stress Scale (RSS) total scores in caregivers was significantly associated with neuropsychiatric symptoms (Neuropsychiatric Inventory, p = 0.004) and also with impaired ADL functioning (Rapid Disability Rating Scale-2, p Caregiver distress differed (RSS total, p = 0.005) between people caring for someone with AD (15.0) and those caring for someone with DLB (19.9). These findings have direct implications for the needs and resources that could be available for these individuals and indicate the need for further research into caregiver burden in carers to people with DLB. Copyright © 2016 John Wiley & Sons, Ltd. Cohorts were ethically approved by the Regional Ethics Committee for

  12. 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.)

  13. 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.)

  14. 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.

  15. 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 ...

  16. Relationship between whole-body tumor burden, clinical phenotype, and quality of life in patients with neurofibromatosis.

    Science.gov (United States)

    Merker, Vanessa L; Bredella, Miriam A; Cai, Wenli; Kassarjian, Ara; Harris, Gordon J; Muzikansky, Alona; Nguyen, Rosa; Mautner, Victor F; Plotkin, Scott R

    2014-06-01

    Patients with neurofibromatosis 1 (NF1), NF2, and schwannomatosis share a predisposition to develop multiple nerve sheath tumors. Previous studies have demonstrated that patients with NF1 and NF2 have reduced quality of life (QOL), but no studies have examined the relationship between whole-body tumor burden and QOL in these patients. We administered a QOL questionnaire (the SF-36) and a visual analog pain scale (VAS) to a previously described cohort of adult neurofibromatosis patients undergoing whole-body MRI. One-sample t-tests were used to compare norm-based SF-36 scores to weighted population means. Spearman correlation coefficients and multiple linear regression analyses controlling for demographic and disease-specific clinical variable were used to relate whole-body tumor volume to QOL scales. Two hundred forty-five patients (142 NF1, 53 NF2, 50 schwannomatosis) completed the study. Subjects showed deficits in selected subscales of the SF-36 compared to adjusted general population means. In bivariate analysis, increased tumor volume was significantly associated with pain in schwannomatosis patients, as measured by the SF-36 bodily pain subscale (rho = -0.287, P = 0.04) and VAS (rho = 0.34, P = 0.02). Regression models for NF2 patients showed a positive relationship between tumor burden and increased pain, as measured by the SF-36 (P = 0.008). Patients with NF1, NF2, and schwannomatosis suffer from reduced QOL, although only pain shows a clear relationship to patient's overall tumor burden. These findings suggest that internal tumor volume is not a primary contributor to QOL and emphasize the need for comprehensive treatment approaches that go beyond tumor-focused therapies such as surgery by including psychosocial interventions. © 2014 Wiley Periodicals, Inc.

  17. 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

  18. Caregiver burden, sleep quality, depression, and anxiety in dementia caregivers: a comparison of frontotemporal lobar degeneration, dementia with Lewy bodies, and Alzheimer's disease.

    Science.gov (United States)

    Liu, Shuai; Liu, Jing; Wang, Xiao-Dan; Shi, Zhihong; Zhou, Yuying; Li, Jing; Yu, Tao; Ji, Yong

    2017-12-10

    Very few recent studies are available that compare caregiver burden, sleep quality, and stress in caregivers of different types of dementia. We aimed to investigate caregiver burden, sleep quality, and stress in caregivers of patients with frontotemporal lobar degeneration and dementia with Lewy bodies, as compared with caregivers of patients with Alzheimer's disease. This study was carried out from March 2011 to January 2014. In total, 492 dyads of patient and caregiver (frontotemporal lobar degeneration, n = 131; dementia with Lewy bodies, n = 36; Alzheimer's disease, n = 325) participated in this study. We compared patients with respect to the Neuropsychiatric Inventory and caregivers with respect to the Zarit Caregiver Burden Interview, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder scale. Frontotemporal lobar degeneration and dementia with Lewy bodies patients presented significantly more neuropsychiatric symptoms compared to Alzheimer's disease patients. Caregivers of frontotemporal lobar degeneration and dementia with Lewy bodies patients experienced significantly more burden compared to Alzheimer's disease caregivers. Furthermore, among caregivers of both frontotemporal lobar degeneration and dementia with Lewy bodies patients burden was predicted by the neuropsychiatric symptoms, PHQ-9 scores, and GAD-7 scores. The frequency and severity of behavioral disturbances in patient and caregiver stress accounted for the increased caregiver burden, which suggests that frontotemporal lobar degeneration and dementia with Lewy bodies caregivers should receive more support than is currently available.

  19. Assessment of Radioactivity in Man. Vol. I. Proceedings of the Symposium on the Assessment of Radioactive Body Burdens in Man

    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

  20. 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

  1. 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)

  2. 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)

  3. 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…

  4. Tooth manganese as a biomarker of exposure and body burden in rats.

    Science.gov (United States)

    Austin, Christine; Richardson, Cardius; Smith, Donald; Arora, Manish

    2017-05-01

    Neonates and children are particularly vulnerable to the toxic effects of excess manganese (Mn), but studies of Mn exposure during these developmental periods are hampered by a lack of validated biomarkers. Deciduous teeth may be used to assess Mn exposure during these developmental periods but require further validation to determine the relationship between tooth Mn, Mn in target tissues, and exposure. To determine the relationship of tooth Mn concentrations with: (i) exposure dose, (ii) the timing/duration of exposure, and (iii) with Mn concentrations in blood, brain and bone. Rats in different treatment groups were orally exposed to 0, 25 or 50µg/g/day Mn either from postnatal day (PND) 1 - 21 and culled at PND 24, from PND 1 - 21 and culled as adults (>PND 290), or from PND 1 - throughout life and culled at >290 PND. Mn was measured in second molars, femurs, brain and blood by ICP-MS. Tooth Mn increased significantly with dose in rats exposed for 21 PND and culled at 24 PND (p290 PND, tooth Mn increased with exposure duration (pbone (rho 0.69, pbone were also significantly positively associated in animals exposed only early in life (rho 0.76, p<0.001). Teeth are a sensitive biomarker of active and past Mn exposure and Mn burden in tissues. Unlike blood, teeth retain information on exposure history over the short and long-term. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Lake levels and water quality in comparison to fish mercury body burdens, Voyageurs National Park, Minnesota, 2013–15

    Science.gov (United States)

    Christensen, Victoria G.; Larson, James H.; Maki, Ryan P.; Sandheinrich, Mark B.; Brigham, Mark E.; Kissane, Claire; LeDuc, Jamie F.

    2017-01-18

    Within Voyageurs National Park in Minnesota, lake levels are controlled by a series of dams to support a variety of uses. Previous research indicates a link between these artificially maintained water levels, referred to as rule curves, and mercury concentrations in fish owing to the drying and rewetting of wetlands and other nearshore areas, which may release methylmercury into the water when inundated. The U.S. Geological Survey, National Park Service, and University of Wisconsin-La Crosse cooperated in a study to assess the importance of lake-level fluctuation and other factors affecting mercury concentrations in Perca flavescens (yellow perch) in the lakes of Voyageurs National Park. For this study, mercury body burdens were determined for young-of-the-year yellow perch collected from the large lakes within Voyageurs National Park during 2013–15. These mercury body burdens were compared to lake levels and water-quality constituents from the same period.Field properties and profiles of lake water quality indicated that Sand Point, Little Vermilion, and Crane Lakes were anoxic at times near the lake bottom sediments, where sulfate-reducing bacteria may convert mercury to methylmercury. The median dissolved sulfate concentration was highest in Crane Lake, the median total organic carbon concentration was highest in Sand Point Lake, and the median total phosphorus concentration was highest in Kabetogama Lake, all of which is consistent with previous research. All lakes had median chlorophyll a concentrations of 3.6 micrograms per liter or less with the exception of Kabetogama Lake, where the median concentrations were 4.3 micrograms per liter for the midlake sites and 7.1 micrograms per liter and 9.0 micrograms per liter for the nearshore sites.Mercury concentrations in sampled fish varied widely between years and among lakes, from 14.7 nanograms per gram in fish samples from Kabetogama Lake in 2015 to 178 nanograms per gram in fish samples from Crane Lake in

  6. 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)

  7. 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.)

  8. 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

  9. PCB body burdens in US women of childbearing age 2001-2002: An evaluation of alternate summary metrics of NHANES data.

    Science.gov (United States)

    Axelrad, Daniel A; Goodman, Stephanie; Woodruff, Tracey J

    2009-05-01

    An extensive body of epidemiologic data associates prenatal exposure to polychlorinated biphenyls (PCBs) with neurodevelopmental deficits and other childhood health effects. Neurological effects and other adverse health effects may also result from exposure during infancy, childhood, and adulthood. Although manufacture and use of PCBs were banned in the US in 1977, exposure to PCBs is a continuing concern due to the widespread distribution of these compounds in the environment and their persistence. The National Health and Nutrition Examination Survey provides PCB body burden measurements representative of the US population for the years 1999-2002. Interpretation of these data is challenging due to the large number of PCB congeners reported. We examined 6 PCB body burden metrics to identify an approach for summarizing the NHANES data and for characterizing changes over time in potential risks to children's health. We focused on women of childbearing age, defined here as 16-39 years, because in utero exposures have been associated with neurodevelopmental effects, and used only the 2001-2002 data because of higher detection rates. The 6 metrics, each consisting of different combinations of the 9 most frequently detected congeners, were as follows: total PCBs (all 9 congeners); highly chlorinated PCBs (2 congeners); dioxin-like PCBs (3 congeners, weighted by toxic equivalency factors); non-dioxin-like PCBs (6 congeners); a 4-congener metric (PCBs 118, 138, 153, and 180); and PCB-153 alone. The PCB metrics were generally highly correlated with each other. There was a strong association of PCB body burdens with age for all metrics. Median body burdens of Mexican American women were lower than those of non-Hispanic White and non-Hispanic Black women for 5 of the 6 metrics, and there were no significant differences in body burdens between the latter two groups. Body burdens of women with incomes above poverty level were greater than those for lower-income women at the

  10. Does long term residency near industry have an impact on the body burden of polychlorinated dibenzo-p-dioxins, furans, and polychlorinated biphenyls in older women?

    Science.gov (United States)

    Pless-Mulloli, T; Edwards, R; Howel, D; Wood, R; Paepke, O; Herrmann, T

    2005-12-01

    For the retrospective study of environment and health linkages biomarkers of exposure are required. Polychlorinated dibenzo-dioxins and furans (PCDD/F) and polychlorinated biphenyls (PCBs) have been useful markers in some settings. This is the first study of PCDD/F body burden in a population based sample from the UK. The authors aimed to investigate whether long term residents close to a heavy chemical industrial complex (Teesside, UK) had a higher body burden and distinct pattern of PCDD/F and PCBs. We measured current levels of PCDD/F and PCBs in a population based sample of older women (mean 64 years, range 42-79 years). Forty women were recruited, 20 living near (zone A: 0.1-2.7 km) and 20 distant (zone C: 5-40 km) from industry during 2000-03. The authors ascertained occupational exposure to lung carcinogens, residential history, consumption of local produce, breast feeding, diet, and height and weight. The mean body burden measured on lipid basis in ng/kg for the whole sample was: WHO-TEQ (PCDD/Fs): 29.9, 2378TCDD: 4.0, PCB 118:16200, PCB156: 13100. Body burdens were similar to others reported from industrialised countries, except that mean 2378TCDD was slightly higher. Mean ages, body mass index, and lifelong dietary patterns were similar in both zones. The authors found no significant difference in mean body burden levels between zones A and C before or after adjustment for covariates. All congener patterns were consistent with an urban background pattern, and there was no significant difference between congener compositions in the two zones. The TCDD body burden increased with age with accelerated increments above age 70. Long term residency near heavy and chemical industry did not have an effect on women's body burden of PCDD/Fs and PCBs on Teesside, UK. The body burden of PCDD/F and PCBs was not a suitable biomarker for chronic, non-occupational exposure to industrial air pollution.

  11. 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

  12. 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

  13. 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/.

  14. Evaluation of the effect of test medium on total Cu body burden of nano CuO-exposed Daphnia magna: A TXRF spectroscopy study.

    Science.gov (United States)

    Muna, Marge; Heinlaan, Margit; Blinova, Irina; Vija, Heiki; Kahru, Anne

    2017-12-01

    Toxicity of Cu and Cu-based nanoparticles (NPs) to aquatic biota is usually mitigated in natural freshwater compared to organics-free artificial freshwater. The main aim of this study was to evaluate whether mitigated toxicity is accompanied by lower total copper body burden in the freshwater crustacean Daphnia magna and whether CuO NPs are more hazardous in this aspect than soluble Cu salts. Total copper body burden in different media (OECD202 artificial freshwater and two natural freshwaters) was measured by a relatively novel technique - total reflection X-ray fluorescence (TXRF) spectroscopy - which proved suitable for the analysis of individual juvenile daphnids. Mean copper body burden was 2.8-42 times higher in daphnids exposed to CuO NPs (0.05 mg Cu/L and 1 mg Cu/L) than in daphnids exposed to equal or equitoxic concentrations (0.025 mg Cu/L and 0.05 mg Cu/L) of CuSO 4 . Using natural freshwater instead of artificial one resulted in increased copper burden after exposure to CuO NPs but not after exposure to Cu salt. After 24 h post-exposure depuration in the presence of algae Raphidocelis subcapitata, total copper body burden in daphnids exposed to CuO NPs sharply decreased while in daphnids exposed to Cu salt it did not. Despite the CuO NP toxicity mitigating effect of natural freshwater, total copper body burden of aquatic crustaceans in natural waterbodies may be greater than could be predicted based on the results obtained using artificial freshwater as the test medium. Copyright © 2017. Published by Elsevier Ltd.

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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

  20. The effects of behavioral and psychological symptoms on caregiver burden in frontotemporal dementia, Lewy body dementia, and Alzheimer's disease: clinical experience in China.

    Science.gov (United States)

    Liu, Shuling; Jin, Yi; Shi, Zhihong; Huo, Ya Ruth; Guan, Yalin; Liu, Mengyuan; Liu, Shuai; Ji, Yong

    2017-06-01

    Caregivers of individuals with neurodegenerative diseases, including frontotemporal dementia (FTD), Lewy body dementia (DLB), and Alzheimer's disease (AD), experience high levels of psychological and physical stress, likely due to behavioral and psychological symptoms of dementia (BPSD). This study is the first to simultaneously evaluate the effects of BPSD on caregiver burden in these three types of dementia. A total of 214 dementia patients, including probable FTD (n = 82), DLB (n = 22), and AD (n = 110), as well as their primary caregivers, were assessed using psychological inventories and cognitive evaluation. The FTD group was further divided into the three established clinical variants: behavioral variant frontotemporal dementia (bvFTD, n = 51), non-fluent variant primary progressive aphasia (nfvPPA, n = 15), and semantic variant primary progressive aphasia (svPPA, n = 16). Cognitive impairment and neuropsychiatric symptoms were assessed using the Mini Mental State Examination, Montreal Cognitive Assessment, Clock Drawing Test, and Neuropsychiatric Inventory (NPI), respectively. Caregiver burden was assessed using the Zarit Burden Inventory (ZBI). FTD patients had higher NPI and ZBI scores than DLB and AD patients, whose scores were similar. Logistic regression analysis revealed that the factors influencing caregiver burden for each group were: FTD: total NPI scores, agitation, and aberrant motor behavior; bvFTD: total NPI scores; DLB: total NPI scores; and AD: total NPI scores, onset age, apathy, and ADL. Caregivers of bvFTD patients had the highest levels of burden, which were significantly greater than for caregivers of nfvPPA, svPPA, DLB, and AD patients. BPSD was highly correlated with emotional burden in caregivers of FTD, DLB, and AD patients. The highest burden was observed in bvFTD caregivers.

  1. The body composition and excretory burden of lean, obese, and severely obese individuals has implications for the assessment of chronic kidney disease.

    Science.gov (United States)

    Fotheringham, James; Weatherley, Nicholas; Kawar, Bisher; Fogarty, Damian G; Ellam, Timothy

    2014-12-01

    Obesity could affect associations between creatinine generation, estimated body surface area, and excretory burden, with effects on chronic kidney disease assessment. We therefore examined the impact of obesity on the performances of estimated glomerular filtration rate (eGFR), the urine albumin:creatinine ratio (ACR), and excretory burden in 3611 participants of the Chronic Renal Insufficiency Cohort. Urine creatinine excretion significantly increased with body mass index (BMI) (34 and 31% greater at 40 kg/m(2) or more versus the normal of 18.5-25 kg/m(2)) in men and women, respectively, such that patients with a normal BMI and an ACR of 30 mg/g had the same 24-h albuminuria as severely obese patients with ACR 23 mg/g. The bias of eGFR (referenced to body surface area-indexed iothalamate (i-)GFR) had a U-shaped relationship to obesity in men but progressively increased in women. Nevertheless, obesity-associated body surface area increases were accompanied by a greater absolute (non-indexed) iGFR for a given eGFR, particularly in men. Two men with eGFRs of 45 ml/min per 1.73 m(2), height 1.76 m, and BMI 22 or 45 kg/m(2) had absolute iGFRs of 46 and 62 ml/min, respectively. The excretory burden, assessed as urine urea nitrogen and estimated dietary phosphorus, sodium, and potassium intakes, also increased in obesity. However, obese men had lower odds of anemia, hyperkalemia, and hyperphosphatemia. Thus, for a given ACR and eGFR, obese individuals have greater albuminuria, absolute GFR, and excretory burden. This has implications for chronic kidney disease management, screening, and research.

  2. Projection of body burdens to assess the relative risk from exposure to trace elements from coal combustion emissions, drinking water, and diet

    Energy Technology Data Exchange (ETDEWEB)

    Gasper, J.R.; Dauzvardis, P.A.; Surles T.G.

    1979-12-01

    This study compares the relative health risk of exposure to seven trace elements from four sources - coal-fired electricity generation with a cold-side electrostatic precipitator, coal-fired electricity generation with a hot-side electrostatic precipitator, drinking water, and diet. The measure used for comparing health risks is body burden, which is the amount of an element accumulating within an exposed subject. Body burdens were used as a measure of risk because the lack of dose-response data restricts the projection of absolute risks of exposure, such as death or illness. Thus, projection of body burdens provides a measure of relative risk that can be used for comparison of impact potential from different sources of exposure. The assessment trace elements - arsenic, cadmium, chromium, nickel, lead, selenium, and zinc - were chosen to represent a range of physiological, environmental, and physical characteristics that affect the amount of accumulation. These factors include: toxicity, absorption, excretion, biological half life, bioaccumulation, biotransformation, volatility, and solubility.

  3. 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.

  4. [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

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

    Science.gov (United States)

    Chan, Janet Kit Yan; Wong, Ming H

    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. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. 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

  7. 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

  8. 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

  9. 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

  10. Exposure to sublethal concentrations of Co3O4 and Mn2O3 nanoparticles induced elevated metal body burden in Daphnia magna.

    Science.gov (United States)

    Heinlaan, Margit; Muna, Marge; Juganson, Katre; Oriekhova, Olena; Stoll, Serge; Kahru, Anne; Slaveykova, Vera I

    2017-08-01

    Despite the significant progress made in ecotoxicological research on nanoparticles (NPs), there is still very limited information available regarding the biological effects of certain types of NPs such as Co 3 O 4 and Mn 2 O 3 . Only a couple of studies provide data on their impact on aquatic organisms whereas, alarmingly, these NPs have been proposed to have high toxicity potential. In addition, more data are needed to determine whether the adverse effects the metal NPs induce on aquatic organisms are rather due to their chemical or particulate nature. To address these open questions, the (sub)lethal effects of Co and Mn NPs in parallel with the respective soluble metal salts on Daphnia magna were studied. The aims of the current study were to i) assess the acute toxicity of Co 3 O 4 and Mn 2 O 3 NPs (primary size 10-30nm) to D. magna, ii) evaluate whether the acute NP exposure at sublethal concentrations influences D. magna post-exposure feeding behaviour and iii) quantify D. magna metal body burden after exposure and after the post-exposure feeding to estimate the potential of trophic transfer of metals. Flow cytometry and total reflection X-ray fluorescence spectroscopy were applied for feeding and metal body burden evaluations, respectively. CuO NPs (primary size 22-25nm) that are very toxic to D. magna were included in the study as a positive control. Since the release of metal ions is an important possibility for toxicity of metal NPs, soluble Co-, Mn- and Cu-salts were analysed in parallel. The solubilisation of Co 3 O 4 NPs in the OECD202 assay conditions was 0.1% and Mn 2 O 3 NPs 35%. Mn 2 O 3 NPs also produced reactive oxygen species in abiotic conditions. However Co 3 O 4 and Mn 2 O 3 NPs were not acutely toxic to D. magna (48h EC 50 >100mg metal/L) at OECD202 assay conditions. The 48h EC 50 values of soluble Co- and Mn-salts were 3.2mgCo/L and 41mgMn/L, respectively. Post-exposure feeding behaviour after 48h exposure to sublethal concentrations (≤10

  11. Non-fatal disease burden associated with excess body mass index and waist circumference in New Zealand adults.

    Science.gov (United States)

    Turley, Maria; Tobias, Martin; Paul, Sue

    2006-06-01

    To describe the relationship between two measures of body fat and selected non-fatal health conditions in the New Zealand adult population in 2003. Data were obtained from the 2002/03 New Zealand Health Survey. A total of 10,026 adults aged 25 years and over were classified according to measured body mass index (BMI) and waist circumference (WC). BMI classes were 18.5-24.9, 25.0-29.9, 30.0-34.9, > or = 35.0 kg/m2. WC classes were 102 centimetres (cm) for males and 88 cm for females. Prevalence rate ratio estimates for selected self-reported health conditions were calculated for males and females separately, adjusting for age, ethnicity, deprivation and smoking using logistic regression. Increasing BMI or WC class was associated with increasing prevalence of cardiovascular disease, diabetes, high blood pressure, high blood cholesterol, osteoarthritis, asthma and sleep disorders in both males and females. The association with depression was not statistically significant in either gender. Associations were strongest for diabetes and blood pressure, with adults in the highest BMI or WC class at least 3.5 times more likely to have diabetes and 2-3 times more likely to have high blood pressure compared with those in the lowest classes. Increasing body fatness, defined by either BMI or WC, was associated with increased prevalence of many important health conditions. If the obesity epidemic is not halted or reversed, the impact on both the New Zealand population and health system will be considerable.

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

    Science.gov (United States)

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

    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(-1) lipid vs. 20.69 and 8.43 ng g(-1) lipid, respectively, p0.05). 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, pe-waste dismantling environment increased the body burdens of PCBs and PBDEs in local children and that these contaminants released from the e-waste might contribute to abnormal changes in hormone levels. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. [The human body burden of polychlorinated dibenzo-p-dioxins and dibenzofurans and dioxin-like polychlorinated biphenyls in residents' human breast milk from Beijing in 2007].

    Science.gov (United States)

    Zhang, Lei; Liu, Yin-ping; Li, Jing-guang; Zhao, Yun-feng; Wu, Yong-ning

    2013-06-01

    To investigate contamination levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (dl-PCBs) in human breast milk from Beijing residents, and evaluate the human body burden of PCDD/Fs and dl-PCBs of general population. A total of 110 human milk samples were collected from 11 regions in Beijing in 2007. After 11 pooled samples were made, concentrations of PCDD/Fs and dl-PCBs in breast milk pooled samples were measured by a high resolution gas chromatography - high resolution mass spectrometry (HRCG-HRMS) with isotope dilution. For congeners of PCDD/Fs and dl-PCBs in human breast milk from Beijing, the highest content of congeners was octachlorodibenzo-p-dioxin (OCDD), polychlorinated biphenyl (PCB)-118, and PCB-105 with the median of 20.6 pg/g fat, 4.07 ng/g fat and 1.63 ng/g fat, respectively. The concentration median of total dioxins in 11 pooled human milk samples from Beijing was 7.4 pg TEQ/g fat. The highest was 13.5 pg TEQ/g fat from Tongzhou, and the lowest was 4.3 pg TEQ/g fat from Pinggu. The contamination level of PCDD/Fs and dl-PCBs in human milk from Beijing is relatively low. However, with the rapid industrialization in China, the human body burden of PCDD/Fs and dl-PCBs will be likely to rise. Thus, further studies should be conducted to continuously monitor the trend of contamination level.

  14. Quantifying annual internal effective137Cesium dose utilizing direct body-burden measurement and ecological dose modeling.

    Science.gov (United States)

    Jelin, Benjamin A; Sun, Wenjie; Kravets, Alexandra; Naboka, Maryna; Stepanova, Eugenia I; Vdovenko, Vitaliy Y; Karmaus, Wilfried J; Lichosherstov, Alex; Svendsen, Erik R

    2016-11-01

    The Chernobyl Nuclear Power Plant (CNPP) accident represents one of the most significant civilian releases of 137 Cesium ( 137 Cs, radiocesium) in human history. In the Chernobyl-affected region, radiocesium is considered to be the greatest on-going environmental hazard to human health by radiobiologists and public health scientists. The goal of this study was to characterize dosimetric patterns and predictive factors for whole-body count (WBC)-derived radiocesium internal dose estimations in a CNPP-affected children's cohort, and cross-validate these estimations with a soil-based ecological dose estimation model. WBC data were used to estimate the internal effective dose using the International Commission on Radiological Protection (ICRP) 67 dose conversion coefficient for 137 Cs and MONDAL Version 3.01 software. Geometric mean dose estimates from each model were compared utilizing paired t-tests and intra-class correlation coefficients. Additionally, we developed predictive models for WBC-derived dose estimation in order to determine the appropriateness of EMARC to estimate dose for this population. The two WBC-derived dose predictive models identified 137 Cs soil concentration (Pmodel. The geometric mean internal effective dose estimate of the EMARC model (0.183 mSv/y) was the highest followed by the ICRP 67 dose estimates (0.165 mSv/y) and the MONDAL model estimates (0.149 mSv/y). All three models yielded significantly different geometric mean dose (Pecological model dose estimations, in conjunction with findings from animal toxicological studies, should help elucidate possible deterministic radiogenic health effects associated with chronic low-dose internal exposure to 137 Cs.

  15. 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.

  16. Body burdens of polybrominated diphenyl ethers in childbearing-aged women at an intensive electronic-waste recycling site in China.

    Science.gov (United States)

    Leung, Anna O W; Chan, Janet K Y; Xing, Guan Hua; Xu, Ying; Wu, Sheng Chun; Wong, Chris K C; Leung, Clement K M; Wong, Ming H

    2010-08-01

    This study is the first to investigate PBDE body burden with regard to the concurrent analyses of multiple human matrices, namely milk, placenta, and hair, collected from a group of childbearing-aged women at an electronic waste (e-waste) recycling site to determine the partitioning of PBDEs in these different human matrices and the possible health risks imposed to infants at the e-waste recycling site. Five sets of milk, placenta, and hair samples were collected from an e-waste site (Taizhou, Zhejiang Province) and a reference site (Lin'an city, Zhejiang Province; 245 km away from Taizhou) in China. The concentrations of total PBDEs in different human tissues were analyzed according to US EPA standard methods. PBDE body burdens of women from the e-waste site (milk 117 +/- 191, 8.89-457 ng/g fat, placenta 19.5 +/- 29.9, 1.28-72.1 ng/g fat, hair 110 +/- 210, 8.47-486 ng/g dry wt.) showed significantly higher levels than those from the reference site (milk 2.06 +/- 0.94, 1.0-3.56 ng/g fat, placenta 1.02 +/- 0.36, 0.59-1.42 ng/g fat, hair 3.57 +/- 2.03, 1.56-5.61 ng/g dry wt.) and were higher than those reported in other studies, due to e-waste recycling operations, especially open burning. On a dry-weight basis, the following trend was found for PBDE among the samples from Taizhou: hair>milk>placenta. Among the donors, the body burden of an e-waste worker ranked second. Higher brominated BDEs (hepta-BDEs) contributed a significantly greater proportion to total PBDEs in hair of the Taizhou women (20%) than that in milk (2.9%) and in placenta (2.6%). The estimated intake of PBDEs of 6-month-old breastfed infants living at the e-waste site was 572 +/- 839 ng/kg body wt/day, which was 57 times higher than that of infants from the reference site (10.1 +/- 4.60 ng/kg body wt/day). Moreover, the maximum calculated value (2,240 ng/kg body wt/day) exceeded the chronic oral reference dose for penta-BDE (2,000 ng/kg/day) of US EPA. BDE-47 was the dominant congener accounting

  17. 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)

  18. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden: a cross sectional study using whole body magnetic resonance angiography.

    Science.gov (United States)

    Weir-McCall, Jonathan R; Khan, Faisel; Lambert, Matthew A; Adamson, Carly L; Gardner, Michael; Gandy, Stephen J; Ramkumar, Prasad Guntur; Belch, Jill J F; Struthers, Allan D; Rauchhaus, Petra; Morris, Andrew D; Houston, J Graeme

    2014-01-01

    Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). 50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated. The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005). ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is primarily due to

  19. Body

    OpenAIRE

    Riggs, Christina

    2010-01-01

    The human body is both the physical form inhabited by an individual “self” and the medium through which an individual engages with society. Hence the body both shapes and is shaped by an individual’s social roles. In contrast to the cognate fields of archaeology, anthropology, and classics, there has been little explicit discussion or theorization of the body in Egyptology. Some recent works, discussed here, constitute an exception to this trend, but there is much more scope for exploring anc...

  20. 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 agent caused significantly higher (13% Plus 4, 35% LightSpeed 16) exposure than non-contrast imaging (p 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.

  1. 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).

  2. 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.

  3. 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.

  4. 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

  5. Power Functions Relating Excretion to Body Burden

    CERN Document Server

    Sanders, S M J

    2003-01-01

    Formulae necessary to relate the quantity of radionuclides excreted to that assimilated in exposures that are acute and those that are multiple or continuous are derived from power function relationships. Particular attention is given to providing equations having variables for which the bioassayer can easily derive numerical values. This paper presents this data.

  6. 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.

  7. 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 ...

  8. Components of Burden: Interventive Implications.

    Science.gov (United States)

    Kosberg, Jordan I.; And Others

    1990-01-01

    Studied 127 informal caregivers of Alzheimer's disease patients to determine correlates of 5 components of burden as measured by Cost of Care Index. Significant relationships between predictor variables and burden components suggest that global scores and measures of burden do not identify specific problem areas relative to various components of…

  9. Worldwide burden of diabetes

    Directory of Open Access Journals (Sweden)

    Jaikrit Bhutani

    2014-01-01

    Full Text Available Diabetes is a pandemic of major public health importance cannot be disputed. While the IDF data does emphasis the importance of diabetes as a global public health problem, it does not place in perspective the ranking of diabetes as compared to other diseases and illnesses. The GBD data highlight this fact in multiple ways. The disease and its complications or comorbid conditions rank high in the list of risk factors, and causes of death. This communication describes the global burden of diabetes especially south-east Asia and the statistical sequelae of the disease.

  10. 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

  11. Acute Gastroenteritis and Recreational Water: Highest Burden ...

    Science.gov (United States)

    OBJECT I VES : To provide summary estimates of gastroenteritis risks and illness burden associated with recreational water exposure and determine whether children have higher risks and burden.METHODS: We combined individual participant data from 13 prospective cohorts at marine and freshwater beaches throughout the United States (n = 84 411). We measured incident outcomes within 10 days of exposure: diarrhea, gastrointestinal illness, missed daily activity (work, school, vacation), and medical visits. We estimated the relationship between outcomes and 2 exposures: body immersion swimming and Enterococcus spp. fecal indicator bacteria levels in the water. We also estimated the population-attributable risk associated with these exposures.RESULTS: Water exposure accounted for 21% of diarrhea episodes and 9% of missed daily activities but was unassociated with gastroenteritis leading to medical consultation. Children aged 0 to 4 and 5 to 10 years had the most water exposure, exhibited stronger associations between levels of water quality and illness, and accounted for the largest attributable illness burden.CONCLUSIONS: The higher gastroenteritis risk and associated burden in young children presents important new information to inform future recreational water quality guidelines designed to protect public health. Meta-analysis of 13 beach sites and nearly 90,000 subjects found that swimming at the beach increased diarrhea incidence and individuals who swam in water

  12. Burden of obesity in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 Study

    OpenAIRE

    Global Burden of Disease 2015 Eastern Mediterranean Region Obesity Collaborators,; Bennet, DA; Hay, SI

    2017-01-01

    Objectives\\ud \\ud We used the Global Burden of Disease (GBD) 2015 study results to explore the burden of high body mass index (BMI) in the Eastern Mediterranean Region (EMR).\\ud \\ud Methods\\ud \\ud We estimated the prevalence of overweight and obesity among children (2–19 years) and adults (≥20 years) in 1980 and 2015. The burden of disease related to high BMI was calculated using the GBD comparative risk assessment approach.\\ud \\ud Results\\ud \\ud The prevalence of obesity increased for adults...

  13. Tick burden on European roe deer (Capreolus capreolus).

    Science.gov (United States)

    Vor, Torsten; Kiffner, Christian; Hagedorn, Peter; Niedrig, Matthias; Rühe, Ferdinand

    2010-08-01

    In our study we assessed the tick burden on roe deer (Capreolus capreolus L.) in relation to age, physical condition, sex, deer density and season. The main objective was to find predictive parameters for tick burden. In September 2007, May, July, and September 2008, and in May and July 2009 we collected ticks on 142 culled roe deer from nine forest departments in Southern Hesse, Germany. To correlate tick burden and deer density we estimated deer density using line transect sampling that accounts for different detectability in March 2008 and 2009, respectively. We collected more than 8,600 ticks from roe deer heads and necks, 92.6% of which were Ixodes spp., 7.4% Dermacentor spp. Among Ixodes, 3.3% were larvae, 50.5% nymphs, 34.8% females and 11.4% males, with significant seasonal deviation. Total tick infestation was high, with considerable individual variation (from 0 to 270 ticks/deer). Adult tick burden was positively correlated with roe deer body indices (body mass, age, hind foot length). Significantly more nymphs were found on deer from forest departments with high roe deer density indices, indicating a positive correlation with deer abundance. Overall, tick burden was highly variable. Seasonality and large scale spatial characteristics appeared to be the most important factors affecting tick burden on roe deer.

  14. Caregiver Burden in Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Murat Ilhan Atagun

    2011-09-01

    Full Text Available Duration of human life has been substantially increased in the last fifty years. Survivals of diseases have been prolonged through the advances in medicine. Together with these gratifying consequences, there appeared novel difficulties to cope with. Furthermore developments including globalization, industrialization and transition from rural to urban life occurred during the last century; so family units became smaller and numbers of members on employment in family units increased. As a result numbers of family members to undertake the responsibility of care decreased. As a concept, caregiver burden expresses physical, psychosocial and financial reactions during the course of care providing. Distinct factors including structures of social, cultural and family units and health care systems may affect conditions of care. Caregiver’s age, gender, ethnicity, education, relationship with the patient, attitude towards providing care, financial situation, coping abilities, her own health, beliefs, social support and cultural pattern are the personal factors that are related to perception of caregiver burden. Burden of care giving is geared to differential aspects of care needs. For instance care needs of physically disabled and medical care requiring patients with spinal cord injuries may differ from care needs of chronic psychiatric disorders, demented patients in advanced age of their lives or cancer patients in terminal periods. Strain due to care giving may differ as a result of properties of care demands. It is aimed to review the burden of caregivers in different medical and psychiatric care requiring conditions and to introduce differential aspects of caregiver burden in these different conditions.

  15. 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.

  16. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...... audits to be a net burden. Furthermore, based on DeAngelo's (1981) initial audit pricing model and legislators' claim that joint audits are an unnecessary economic burden to the companies we predict and find discounts (of around 25%) in audit fees in companies that change to single audits. The primary...

  17. Longitudinal measurements of the cadmium burden of 'jig solderers' using IVNAA.

    Science.gov (United States)

    Perrin, B; Green, S; Morgan, W D

    1998-01-01

    The liver and kidney cadmium burdens of a population of 10 'jig solderers' were measured in 1983 and 1995 using similar IVNAA measuring systems. Cadmium exposure ceased in 1985. No significant variation in kidney content was observed. The mean body burden had fallen by 18%, due to a decrease of mean liver content of 35%.

  18. 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, or is it a prom......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...

  19. 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…

  20. Burden of allergic respiratory disease

    DEFF Research Database (Denmark)

    Linneberg, Allan René; Dam Petersen, K; Hahn-Pedersen, J

    2016-01-01

    -specific and generic HRQL instruments, and was reflected by an impact on both physical and mental health. A systematic review of cost data on AR and AA in selected European countries demonstrated that the majority of the economic burden was indirectly caused by high levels of absenteeism and presenteeism...

  1. Obesity: definition, comorbidities, causes, and burden.

    Science.gov (United States)

    Apovian, Caroline M

    2016-06-01

    Body mass index of 30 kg/m2 or higher is used to identify individuals with obesity. In the last 3 decades, the worldwide prevalence of obesity has increased 27.5% for adults and 47.1% for children. Obesity is the result of complex relationships between genetic, socioeconomic, and cultural influences. Consumption patterns, urban development, and lifestyle habits influence the prevalence of obesity. The condition may be the result of disease or pharmacologic treatment. It may also be a risk factor for the development of comorbid conditions. Persons who are obese have less school attendance, reduced earning potential, and higher healthcare costs that may result in an economic burden on society. A review of the prevalence and economic consequences of obesity is provided. Potential causes and comorbidities associated with obesity are also discussed.

  2. 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. Setting. South Africa. Subjects. Adults ≥ 30 years of age. Outcome measures. Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ischaemic stroke, hypertensive disease, osteoarthritis, type 2 diabetes mellitus, ...

  3. 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...

  4. Moving knowledge of global burden into preventive action.

    Science.gov (United States)

    Eijkemans, Gerry J M; Takala, Jukka

    2005-12-01

    Estimation of the global burden of disease and injury due to selected occupational factors is a topic of interest to policy makers, governments, and international bodies. The World Health Organization (WHO) has implemented a Comparative Risk Assessment (CRA) to estimate risk to exposed populations. Estimates of the risk factor-burden relationships by age, sex, and WHO subregion were generated. Risk measurements (relative risks and mortality rates) for the health outcomes were determined primarily from studies published in peer review journals. The resulting burden was described as the attributable fraction of disease or injury, using both mortality and disability-adjusted life years (DALYs). The papers in this issue include discussions of worldwide mortality and morbidity from lung cancer, leukemia, and malignant mesothelioma arising from occupational exposures; mortality and morbidity from asthma, COPD, and pneumoconiosis; the global burden of low back pain; exposure to contaminated sharps injuries among health care workers; noise-induced hearing loss; and occupational injuries. Three papers focus on economic issues: estimation of net-costs for prevention of occupational low back pain; cost effectiveness of occupational health interventions; and the cost effectiveness of interventions in the prevention of silicosis. The magnitude of the occupational health burden in the world is overwhelming, and the causes and mechanisms are multiple and complex. Commitment from all stakeholders is imperative to translate economic progress into sustainable human development and well-being. 2005 Wiley-Liss, Inc.

  5. 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.

  6. Socioeconomic burden of hereditary angioedema

    DEFF Research Database (Denmark)

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

    2014-01-01

    .001). Among patients who sought medical care during the last attack (23%), more than half utilized the emergency department. The last attack prevented patients from their normal activities an average of 4-12 hours. Patient and caregiver absenteeism increased with attack severity and frequency. Among patients...... 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....

  7. Burden of COPD in Nepal

    DEFF Research Database (Denmark)

    Adhikari, Tara Ballav; Neupane, Dinesh; Kallestrup, Per

    2018-01-01

    Background: COPD is a globally significant public health problem and is the second leading cause of mortality. This study presents the health burden of COPD in Nepal using the Global Burden of Disease (GBD) study 2016 dataset. Methods: This study used the data from the GBD repository presenting...... morbidity and mortality attributed to COPD, by sex and age. In GBD 2016, due to a lack of the primary source of data in Nepal, estimations on morbidity and mortality of COPD were based on its predictive covariates. Years of life lost (YLLs) were calculated based on the cause of death estimations, applying...... age-standardized mortality rate due to COPD was decreasing for both genders, but the decline was much higher among males. Unlike the high rate of incidence among males, the age-standardized DALYs were found to be high among females (2,274.9 [95% UI: 1,702.0-2,881.5] per 100,000). YLLs contributed...

  8. Overlooking Informal Dementia Caregivers' Burden.

    Science.gov (United States)

    Riedel, Oliver; Klotsche, Jens; Wittchen, Hans-Ulrich

    2016-07-01

    Patients with Alzheimer's disease (AD) need early caregiver support. Caregivers often have poor health, but usually do not have time to seek medical advice for their own conditions. Patients' physicians, who are frequently the sole medical practitioner caregivers contact regularly, have an important function in recognizing family caregivers' burdens. The current study investigated to what extent medical practitioners recognized family caregivers' problems. In a two-staged survey in neurology outpatient care, caregivers of patients with mild or moderate AD were enrolled and assessed by physicians regarding their physical and mental burden, as well as need for help and advice about AD. Subsequently, caregivers' mental health was evaluated in a comprehensive diagnostic interview by blinded psychologists. Overall, 73.7% of caregivers had at least one somatic condition and 43.7% had clinically relevant depressive symptoms (of these, 37.5% met criteria for major depression). The findings suggest that the burden of a substantial proportion of affected family caregivers is overlooked. [Res Gerontol Nurs. 2016; 9(4):167-174.]. Copyright 2016, SLACK Incorporated.

  9. Burden of epilepsy in Colombia.

    Science.gov (United States)

    Méndez-Ayala, Alejandro; Nariño, Daniel; Rosselli, Diego

    2015-01-01

    Epilepsy lays an important burden on healthcare systems and society in general. Disability adjusted life years (DALYs) have been developed to compare the burden of this disease both between conditions and between geographical boundaries. With improving data on disease incidence and prevalence in Colombia, we can refine our DALYs-based estimates. Using different strategies, including the official healthcare provision database and death certificates, as well as extrapolation from published neuroepidemiologic studies, we estimated the incidence and prevalence by age groups, disease duration and attributable mortality. With this information we calculated DALYs for the year 2012. Overall, it was found that epilepsy was responsible for 0.88% of all deaths in Colombia. A total of 5.25 DALYs per 1,000 person-years are lost due to epilepsy in Colombia, 75% of which (3.91 DALYs) are due to premature mortality, with a higher burden in men (6.12 DALYs) than in women (4.41 DALYs). We reported new estimations on epilepsy incidence and prevalence by age groups in Colombia and conclude that DALYs lost due to epilepsy in Colombia are almost double the previous figure, mostly because of the underestimation of attributable mortality. With this figure, epilepsy ranks 12th instead of 19th in the list of the most important causes of DALYs lost. © 2015 S. Karger AG, Basel.

  10. 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......, or is it a promising means toward their liberation? As Luisa Steur’s fieldwork on the Adivasi Gothra Maha Sabha (AGMS), the main adivasi movement in Kerala, demonstrates, answers to this question can be of immediate political consequence....

  11. 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...

  12. 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

  13. 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...

  14. 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...

  15. [Levels of burden of Alzheimer disease caregivers].

    Science.gov (United States)

    Passoni, Serena; Mazzà, Manuela; Zanardi, Gabriele; Bottini, Gabriella

    2010-01-01

    Our aim was to investigate the caregiver burden by means of scales to quantify the perceived burden, and the anxiety and depression levels. Seventy-seven caregivers of patients with Alzheimer disease or other kinds of dementia (19 males and 58 females) admitted to the Alzheimer Evaluation Unit of Milan Niguarda Ca'Granda Hospital, were enrolled and filled in Caregiver Burden Inventory (CBI) and the short form of the Anxiety and Depression scale (AD-R). The statistical analysis demonstrates that caregiver with relatives affected by more severe cognitive impairment (patients) show significant levels of burden and anxiety. The most relevant burden dimensions are: Time-Dependence Burden, Developmental Burden and Physical Burden. Time-Dependence Burden and Social Burden significantly correlate with cognitive (p = 0.01, p = 0.05) and functional rates of patients (p = 0.01, p = 0.05), whereas Developmental Burden only correlates with cognitive rates (p = 0.01). The more prolonged patients' disease the higher the caregivers'anxiety level (p caregivers' sample, and the cognitive and functional state of patients. Alzheimer disease caregivers need an increase of their personal time anda specific intervention aimed to reduce the perceived feeling of social isolation, the physical distress and the anxious and depressive symptoms.

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. Neuropsychiatric Burden in Huntington's Disease.

    Science.gov (United States)

    Paoli, Ricardo Augusto; Botturi, Andrea; Ciammola, Andrea; Silani, Vincenzo; Prunas, Cecilia; Lucchiari, Claudio; Zugno, Elisa; Caletti, Elisabetta

    2017-06-16

    Huntington's disease is a disorder that results in motor, cognitive, and psychiatric problems. The symptoms often take different forms and the presence of disturbances of the psychic sphere reduces patients' autonomy and quality of life, also impacting patients' social life. It is estimated that a prevalence between 33% and 76% of the main psychiatric syndromes may arise in different phases of the disease, often in atypical form, even 20 years before the onset of chorea and dementia. We present a narrative review of the literature describing the main psychopathological patterns that may be found in Huntington's disease, searching for a related article in the main database sources (Medline, ISI Web of Knowledge, Scopus, and Medscape). Psychiatric conditions were classified into two main categories: affective and nonaffective disorders/symptoms; and anxiety and neuropsychiatric features such as apathy and irritability. Though the literature is extensive, it is not always convergent, probably due to the high heterogeneity of methods used. We summarize main papers for pathology and sample size, in order to present a synoptic vision of the argument. Since the association between Huntington's disease and psychiatric symptoms was demonstrated, we argue that the prevalent and more invalidating psychiatric components should be recognized as early as possible during the disease course in order to best address psychopharmacological therapy, improve quality of life, and also reduce burden on caregivers.

  1. 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

  2. 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

  3. 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...

  4. 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...

  5. [Family caregivers' burden and marital satisfaction].

    Science.gov (United States)

    Hiyoshi, Kazuko; Becker, Carl; Siwaku, Kuninori; Kinoshita, Ayae

    2009-12-01

    The purpose of this study is to determine the correlation between home-based elder care and marital satisfaction. Care managers distributed a questionnaire to home caregivers in order to assess the items such as annual income, marital satisfaction, Zarit caregiver burden, sleeping hours and how often they have to get up in the night to take care of the elder. A total of 149 caregivers completed the questionnaire. Their marital satisfaction was inversely correlated to caregiver burden, but positively correlated with annual income. Subjective psychological perception of caregiver burden was the most important factor influencing a marital satisfaction. It appears that a marital satisfaction depend far more on subjective perception of caregiver burden than on more objective measurements of caregiver burden.

  6. 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.

  7. 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, ...

  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. Plasma S100β is not a useful biomarker for tumor burden in neurofibromatosis.

    Science.gov (United States)

    Smith, Miriam J; Esparza, Sonia; Merker, Vanessa L; Muzikansky, Alona; Bredella, Miriam A; Harris, Gordon J; Kassarjian, Ara; Cai, Wenli; Walker, James A; Mautner, Victor F; Plotkin, Scott R

    2013-05-01

    Neurofibromatosis 1 (NF1), NF2, and schwannomatosis are characterized by a predisposition to develop multiple neurofibromas and schwannomas. Currently, there is no blood test to estimate tumor burden in patients with these disorders. We explored whether S100β would act as a biomarker of tumor burden in NF since S100β is a classic immunohistochemical marker of astrocytes, oligodendrocytes and Schwann cells and a small study showed S100β concentrations correlate with the volume of vestibular schwannomas. We calculated whole-body tumor burden in subjects with NF1, NF2, and schwannomatosis using whole-body MRI (WBMRI) and measured the concentration of S100β in plasma using ELISA. We used chi-square tests and Spearman rank correlations to test the relationship between S100β levels and whole-body tumor burden. 127 consecutive patients were enrolled in the study (69 NF1 patients, 28 NF2 patients, and 30 schwannomatosis patients). The median age was 40years, 43% were male, and median whole-body tumor volume was 26.9mL. There was no relationship between the presence of internal tumors and the presence of detectable S100β in blood for the overall group or for individual diagnoses (p>0.05 by chi-square for all comparisons). Similarly, there was no correlation between whole-body tumor volume and S100β concentration for the overall group or for individual diagnoses (p>0.05 by Spearman for all comparisons). Plasma S100β is not a useful biomarker for tumor burden in the neurofibromatoses. Further work is needed to identify a reliable biomarker of tumor burden in NF patients. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  11. 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.

  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 patients. Cancellation ... management. High cancellation rates may indicate that rare health resources are being used ineffectively, thereby increasing costs. There are many reasons for surgery cancellation including.

  13. 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.

  14. International Peacekeeping Operations: Burden Sharing and Effectiveness.

    Science.gov (United States)

    Sandler, Todd

    2017-10-01

    This article takes stock of some of the important contributions to the study of peacekeeping (PK). Two key topics stand out: peacekeeping burden sharing and mission effectiveness. For burden sharing, the theoretical foundation is the private provision of public goods and joint products. Implications for burden sharing differ whether financial or troop contributions are being shared, with the latter driven by jointly produced country-specific benefits. Financial burden sharing can also differ between United Nations (UN)-led and non-UN-led peacekeeping operations, wherein country-specific benefits are especially important for the latter. Many articles gauge peacekeeping effectiveness by the mission's ability to maintain the peace or to protect lives for a set time period. More recently, multiple criteria are raised for evaluating peacekeeping in today's world of multifaceted peacebuilding operations.

  15. 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...

  16. Solar geoengineering reduces atmospheric carbon burden

    Science.gov (United States)

    Keith, David W.; Wagner, Gernot; Zabel, Claire L.

    2017-09-01

    Solar geoengineering is no substitute for cutting emissions, but could nevertheless help reduce the atmospheric carbon burden. In the extreme, if solar geoengineering were used to hold radiative forcing constant under RCP8.5, the carbon burden may be reduced by ~100 GTC, equivalent to 12-26% of twenty-first-century emissions at a cost of under US$0.5 per tCO2.

  17. 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.

  18. 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 ...

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. Epidemiology and burden of alopecia areata: a systematic review

    Directory of Open Access Journals (Sweden)

    Villasante Fricke AC

    2015-07-01

    Full Text Available Alexandra C Villasante Fricke, Mariya MitevaDepartment of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USABackground: Alopecia areata (AA is an autoimmune disorder characterized by patches of non-scarring alopecia affecting scalp and body hair that can be psychologically devastating. AA is clinically heterogenous, and its natural history is unpredictable. There is no preventative therapy or cure.Objective: The objective of this study is to provide an evidence-based systematic review on the epidemiology and the burden of AA.Methods and selection criteria: A search was conducted of the published, peer-reviewed literature via PubMed, Embase, and Web of Science. Studies published in English within the last 51 years that measured AA’s incidence, prevalence, distribution, disability-adjusted life years (DALYs, quality of life, and associated psychiatric and medical comorbidities were included. Two authors assessed studies and extracted the data.Results: The lifetime incidence of AA is approximately 2% worldwide. Both formal population studies found no sex predominance. First onset is most common in the third and fourth decades of life but may occur at any age. An earlier age of first onset corresponds with an increased lifetime risk of extensive disease. Global DALYs for AA were calculated at 1,332,800 in 2010. AA patients are at risk for depression and anxiety, atopy, vitiligo, thyroid disease, and other autoimmune conditions.Conclusion: AA is the most prevalent autoimmune disorder and the second most prevalent hair loss disorder after androgenetic alopecia, and the lifetime risk in the global population is approximately 2%. AA is associated with psychiatric and medical comorbidities including depression, anxiety, and several autoimmune disorders, and an increased global burden of disease.Keywords: hair loss, hair, prevalence, incidence, burden of disease

  5. 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.

  6. Skinfold Parameter as Predictor of Body Density for Undergraduate ...

    African Journals Online (AJOL)

    DATONYE ALASIA

    order to reduce this burden and to prevent other non-communicable obesity - related disorders. In order to ... for reducing body fat and improving health and fitness, the evaluation of body composition has become an ..... popular exercise and weight loss program on weight loss, body composition, energy expenditure and ...

  7. 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),

  8. Economic burden of Parkinson's disease in Singapore.

    Science.gov (United States)

    Zhao, Y J; Tan, L C S; Li, S C; Au, W L; Seah, S H; Lau, P N; Luo, N; Wee, H L

    2011-03-01

    This study was carried out to evaluate the economic burden of Parkinson's disease (PD) and factors independently associated with individual components of total cost in Singapore. A consecutive sample of 195 patients with PD (mean age: 68.2, men: 51.8%) attending a tertiary neuroscience clinic were identified and interviewed using standardized questionnaires including a financial burden questionnaire, two Health Related Quality of Life (HRQoL) questionnaires and the Beck Depression Inventory questionnaire. Annual total cost of PD from a societal perspective was SGD11345 (USD10129) per patient, with direct cost accounted for 38.5% and indirect cost 61.5%. The main cost components for direct medical cost, direct non-medical cost, and indirect cost was pharmacotherapy (50.4%), home care (76.1%), and productivity loss (97.9%), respectively. In multiple linear regression analysis, higher education, younger age and longer duration of PD were associated with higher total cost. Parkinson's disease exerts a considerable burden on patients, health care system and society in Singapore. As productivity loss accounts for a large share of the economic burden imposed by PD, treatments and health care programmes with potential for returning patients to higher productivity are urgently needed. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  9. 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 ...

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

    African Journals Online (AJOL)

    iya beji

    This together with evidence from other related studies suggest that the agricultural sector bears about 75 per cent of the direct economic burden of malaria in. Nigeria. This translates to about 3 per cent of the real GDP that is lost annually in agricultural outputs to the malaria disease. This being the case, the government is.

  11. Burden of Illness in Hereditary Angioedema

    DEFF Research Database (Denmark)

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

    2015-01-01

    The objective of the Hereditary Angioedema Burden of Illness Study in Europe was to assess the real-world experience of HAE from the patient perspective. Based on open-ended qualitative interviews with 30 patients from Spain, Germany and Denmark, 5 key themes emerged characterizing the impact...

  12. 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.

  13. 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 ...

  14. 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.

  15. BURDEN OF DISEASE CALCULATION, COST OF ILLNESS ...

    African Journals Online (AJOL)

    CIU

    adjustment life. Introduction. Since the works of Murray and co-workers about two decades ago, calculating the. Burden of Disease (BoD), and Oostenbrink, Bouwtmans, ... involved in BoD and CoI calculations, particularly the outcome tree, perspective of evaluation .... The cost of assembling of materials and gathering data.

  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 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 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. Body Image

    Science.gov (United States)

    ... affect body image Pre-baby body Pregnancy and eating disorders Looking for information on mental health conditions? Visit ... Mental health section. Fact sheets Anorexia nervosa Binge eating disorder Bulimia nervosa Cosmetics and your health Depression during ...

  18. 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.

  19. 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.

  20. 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.

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

    Science.gov (United States)

    Zhu, Xihe; Haegele, Justin A; Tang, Yan; Wu, Xueping

    2017-01-01

    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 homework and physical activity time particularly among the educational transition grades.

  2. 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.

  3. The global distribution and burden of dengue.

    Science.gov (United States)

    Bhatt, Samir; Gething, Peter W; Brady, Oliver J; Messina, Jane P; Farlow, Andrew W; Moyes, Catherine L; Drake, John M; Brownstein, John S; Hoen, Anne G; Sankoh, Osman; Myers, Monica F; George, Dylan B; Jaenisch, Thomas; Wint, G R William; Simmons, Cameron P; Scott, Thomas W; Farrar, Jeremy J; Hay, Simon I

    2013-04-25

    Dengue is a systemic viral infection transmitted between humans by Aedes mosquitoes. For some patients, dengue is a life-threatening illness. There are currently no licensed vaccines or specific therapeutics, and substantial vector control efforts have not stopped its rapid emergence and global spread. The contemporary worldwide distribution of the risk of dengue virus infection and its public health burden are poorly known. Here we undertake an exhaustive assembly of known records of dengue occurrence worldwide, and use a formal modelling framework to map the global distribution of dengue risk. We then pair the resulting risk map with detailed longitudinal information from dengue cohort studies and population surfaces to infer the public health burden of dengue in 2010. We predict dengue to be ubiquitous throughout the tropics, with local spatial variations in risk influenced strongly by rainfall, temperature and the degree of urbanization. Using cartographic approaches, we estimate there to be 390 million (95% credible interval 284-528) dengue infections per year, of which 96 million (67-136) manifest apparently (any level of disease severity). This infection total is more than three times the dengue burden estimate of the World Health Organization. Stratification of our estimates by country allows comparison with national dengue reporting, after taking into account the probability of an apparent infection being formally reported. The most notable differences are discussed. These new risk maps and infection estimates provide novel insights into the global, regional and national public health burden imposed by dengue. We anticipate that they will provide a starting point for a wider discussion about the global impact of this disease and will help to guide improvements in disease control strategies using vaccine, drug and vector control methods, and in their economic evaluation.

  4. Burden of Fungal Infections in Algeria

    OpenAIRE

    Chekiri-Talbi, Mey; Denning, David

    2017-01-01

    We report for the first time in Algeria and provide burden estimates.We searched for existing data and estimated the incidence and prevalence of fungal diseases based on the population at risk and available epidemiological data. Demographic data were derived from the Service (Office) of the Statistics (ONES), World Health Organization (WHO), The Joint Nations Programme on HIV/AIDS (UNAIDS) and national published reports. When no data existed, risk populations were used to estimate frequencies...

  5. 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.

  6. 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.

  7. Caregiver Burden in Epilepsy: Determinants and Impact

    Directory of Open Access Journals (Sweden)

    Ioannis Karakis

    2014-01-01

    Full Text Available Aim. Caregiver burden (CB in epilepsy constitutes an understudied area. Here we attempt to identify the magnitude of this burden, the factors associated with it, and its impact to caregiver quality of life (QOL. Methods. 48 persons with epilepsy (PWE underwent video-EEG monitoring and their caregivers completed questionnaires providing demographic, disease-related, psychiatric, cognitive, sleep, QOL, and burden information. Results. On regression analysis, higher number of antiepileptic drugs, poorer patient neuropsychological performance, lower patient QOL score, and lower caregiver education level were associated with higher CB. Time allocated to patient care approximated but did not attain statistical significance. A moderate inverse correlation between CB and caregiver QOL physical component summary score and a stronger inverse correlation between CB and caregiver QOL mental component summary score were seen. Conclusion. In a selected cohort of PWE undergoing video-EEG monitoring, we identified modest degree of CB, comparable to that reported in the literature for other chronic neurological conditions. It is associated with specific patient and caregiver characteristics and has a negative effect on caregiver QOL.

  8. Causes and consequences of higher Leishmania infantum burden in patients with kala-azar: a study of 625 patients.

    Science.gov (United States)

    Zacarias, Danielle A; Rolão, Nuno; de Pinho, Flaviane A; Sene, Ingridi; Silva, Jailthon C; Pereira, Teresinha C; Costa, Dorcas L; Costa, Carlos H N

    2017-06-01

    An infected host's Leishmania infantum load in blood is considered to be an estimate of his or her total parasite burden. Therefore, the measurement of blood parasite burden is important in the identification of factors involved in parasite control. Quantitative polymerase chain reaction was performed on blood samples from 625 patients with kala-azar consecutively admitted to a reference hospital in Teresina, Brazil. Primers were used to amplify a segment of kDNA using the TaqMan system. Non-parametric statistical tests were applied. The median blood parasite burden was 499.2 amastigote equivalents (AE)/ml. Children <1 year old (yo) had a high parasite burden, which dropped sharply after the first year of life (192.8, AE/ml at 1 < 2 yo) and remained lower until adolescence. Following adolescence, the parasite burden increased with age, peaking among elderly individuals. Men had a higher parasite burden than women. HIV-infected patients had a much higher parasite burden than non-infected patients. The parasite burden of children under 5 years with acute moderate to severe malnourishment (weight-for-age and body mass index z-scores <-2) was almost three times greater than that of better-nourished children. The parasite burden identified in deceased patients was more than twice that of surviving patients; those with a higher risk of death, sepsis, pneumonia and jaundice also had increased parasite burdens. All of these differences were statistically significant at P-values <0.05. These data indicate that the parasite burden in patients with kala-azar was associated with age- and gender-associated factors and with HIV infection status. Acute malnutrition could be either a cause or a consequence of a higher parasite burden. An individual's parasite burden influences his or her clinical profile, disease severity and mortality risk. The best explanation for the presence of a higher parasite burden in individuals with these immunoregulatory conditions and severe disease is

  9. Estimation of Vietnam national burden of disease 2008.

    Science.gov (United States)

    Nhung, Nguyen Thi Trang; Long, Tran Khanh; Linh, Bui Ngoc; Vos, Theo; Huong, Nguyen Thanh; Anh, Ngo Duc

    2014-09-01

    Burden of disease has been used to assess population health status. This article presents the first estimations of burden of disease in Vietnam in 2008 using disability-adjusted life years (DALYs). DALYs were calculated using the Global Burden of Disease (GBD) methods. Incidence, prevalence of diseases, and causes of death was extracted from Vietnam data. Disability weights were borrowed from GBD and Dutch research. In 2008, the total burden of disease in Vietnam was 12.3 million DALYs. Noncommunicable diseases dominated the total burden of diseases in Vietnam, accounting for 71% of the total burden, and cardiovascular disease was the leading cause group of premature death. While pneumonia was an important cause of burden in Vietnamese children, stroke and depression were the main causes of disease burden among adults. The study provides a snapshot of Vietnamese health status and offers guidance for health policymaking in Vietnam. © 2013 APJPH.

  10. 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...

  11. burden of soil transmitted helminthiases in primary school children

    African Journals Online (AJOL)

    impaired memory and cognition. These adverse health consequences impair educational performance, and reduce school attendance. Determination of the burden is central to designing and implementing appropriate interventions. Objective: To determine the burden of soil-transmitted helminthiases among primary.

  12. Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants

    OpenAIRE

    Goldhaber-Fiebert, Jeremy D; Jeon, Christie Y; Cohen, Ted; Murray, Megan B

    2011-01-01

    Background A growing body of evidence supports the role of type 2 diabetes as an individual-level risk factor for tuberculosis (TB), though evidence from developing countries with the highest TB burdens is lacking. In developing countries, TB is most common among the poor, in whom diabetes may be less common. We assessed the relationship between individual-level risk, social determinants and population health in these settings.

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

    African Journals Online (AJOL)

    The burden of disease attributable to sexually transmitted infections in South Africa in 2000. Leigh Johnson, Debbie Bradshaw, Rob Dorrington. Abstract. Objectives. To estimate the burden of disease attributable to sexually transmitted infections (STis) in South Africa, to identify the factors contributing to this burden, and to ...

  14. 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

  15. 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 ...

  16. 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...

  17. 42 CFR 426.330 - Burden of proof.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Burden of proof. 426.330 Section 426.330 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... aggrieved party bears the burden of proof and the burden of persuasion for the issue(s) raised in a...

  18. 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...... with an analysis of the embodied meaning of men‘s bodybuilding....

  19. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

    Science.gov (United States)

    Feigin, Valery L; Roth, Gregory A; Naghavi, Mohsen; Parmar, Priya; Krishnamurthi, Rita; Chugh, Sumeet; Mensah, George A; Norrving, Bo; Shiue, Ivy; Ng, Marie; Estep, Kara; Cercy, Kelly; Murray, Christopher J L; Forouzanfar, Mohammad H

    2016-08-01

    The contribution of modifiable risk factors to the increasing global and regional burden of stroke is unclear, but knowledge about this contribution is crucial for informing stroke prevention strategies. We used data from the Global Burden of Disease Study 2013 (GBD 2013) to estimate the population-attributable fraction (PAF) of stroke-related disability-adjusted life-years (DALYs) associated with potentially modifiable environmental, occupational, behavioural, physiological, and metabolic risk factors in different age and sex groups worldwide and in high-income countries and low-income and middle-income countries, from 1990 to 2013. We used data on stroke-related DALYs, risk factors, and PAF from the GBD 2013 Study to estimate the burden of stroke by age and sex (with corresponding 95% uncertainty intervals [UI]) in 188 countries, as measured with stroke-related DALYs in 1990 and 2013. We evaluated attributable DALYs for 17 risk factors (air pollution and environmental, dietary, physical activity, tobacco smoke, and physiological) and six clusters of risk factors by use of three inputs: risk factor exposure, relative risks, and the theoretical minimum risk exposure level. For most risk factors, we synthesised data for exposure with a Bayesian meta-regression method (DisMod-MR) or spatial-temporal Gaussian process regression. We based relative risks on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks, such as high body-mass index (BMI), through other risks, such as high systolic blood pressure (SBP) and high total cholesterol. Globally, 90·5% (95% UI 88·5-92·2) of the stroke burden (as measured in DALYs) was attributable to the modifiable risk factors analysed, including 74·2% (95% UI 70·7-76·7) due to behavioural factors (smoking, poor diet, and low physical activity). Clusters of metabolic factors (high SBP, high BMI, high

  20. Childhood pneumococcal disease burden in Argentina.

    Science.gov (United States)

    Augustovski, Federico Ariel; García Martí, Sebastián; Pichon-Riviere, Andrés; Debbag, Roberto

    2009-05-01

    To understand the disease burden of pneumococcal disease (PD), a major cause of childhood morbidity and mortality in Argentina, and to draw a baseline against which the need for and effectiveness of vaccination with pneumococcal conjugate vaccines might be measured. A Markov model was constructed to estimate incidence and mortality rates of PD-meningitis (MEN), bacteremia/septicemia (BACT), pneumonia (PNEU), acute otitis media (AOM)-among a hypothetical, birth cohort of 750,000 Argentine infants born in 2006-2015. A systematic review of the literature was performed to select and incorporate input parameters. Life years and costs in 2006 US$ were expressed as both undiscounted and discounted. The number of PD episodes estimated to occur over a 10-year period in the hypothetical birth cohort were: MEN, 225; BACT, 2841; PNEU, 2628; and AOM, 2,066,719. Chronic sequelae of MEN could be expected to cause neurological damage in 43 children and severe hearing issues in 28. Results indicate that there would be 78 PD-related deaths in the cohort (29% due to MEN; 54%, BACT; and 17%, PNEU). The undiscounted life-expectancy for individuals in the birth cohort was estimated to be 72.4 years (29.0 years discounted). Mean, undiscounted, lifetime costs attributed to PD for each child of the cohort totaled US$167 (US$151 discounted), imposing a total, cohort cost-burden of more than US$126 million (US$113 million discounted). The study shows that PD imposes a significant health and economic burden on the Argentine population. This information is essential for assessing the potential health and economic impact of introducing pneumococcal conjugate vaccine into the national immunization schedule.

  1. Global burden of molar incisor hypomineralization.

    Science.gov (United States)

    Schwendicke, Falk; Elhennawy, Karim; Reda, Seif; Bekes, Katrin; Manton, David J; Krois, Joachim

    2018-01-01

    We aimed to systematically review and meta-analyze the global, super-regional, regional and national prevalence of molar-incisor-hypomineralization (MIH) and to determine the numbers of prevalent and incident cases on different spatial scales. The review was registered (PROSPERO CRD42017063842). Five electronic databases (Medline, EMBASE, LILACS, Web of Science, Google Scholar) were searched systematically. Observational studies on the prevalence of MIH were included and the prevalence on different spatial scales (global, super-regional, regional, national) synthesized using random-effects meta-analyses. The prevalence was then regressed on a large set of methodological, socioeconomic and environmental variables to estimate the global burden (incident and prevalent cases) of MIH. Of 2239 identified studies, 99 studies on 113,144 participants from 43 countries were included. The meta-analysis yielded a mean (95% CI) prevalence of 13.1% (11.8-14.5%), with significant differences between super-regions, regions and countries. The number of prevalent cases in 2015 was estimated at 878 (791-971) million people, while the number of incident cases in 2016 was 17.5 (15.8-19.4) million. Of these, 27.4% (23.5-31.7%) (in mean, 240 million prevalent and 4.8 million incident cases, respectively) were or will be in need of therapy due to pain, hypersensitivity or posteruptive breakdown. Heavily populated countries contribute significantly to the burden of prevalent cases, while growing countries like India, but also Pakistan or Indonesia rank first with respect to the number of incident cases. MIH is highly prevalent across the globe. Certain (mainly low- and middle income) countries shoulder the majority of this burden. Clinical significance The consistently high prevalence and the large proportion of cases in need of care should be considered by both clinicians in their daily practice and healthcare planners and policy makers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. The humanistic burden of hereditary angioedema

    DEFF Research Database (Denmark)

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

    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......, 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...

  3. Global Economic Burden of Norovirus Gastroenteritis.

    Directory of Open Access Journals (Sweden)

    Sarah M Bartsch

    Full Text Available Despite accounting for approximately one fifth of all acute gastroenteritis illnesses, norovirus has received comparatively less attention than other infectious pathogens. With several candidate vaccines under development, characterizing the global economic burden of norovirus could help funders, policy makers, public health officials, and product developers determine how much attention and resources to allocate to advancing these technologies to prevent and control norovirus.We developed a computational simulation model to estimate the economic burden of norovirus in every country/area (233 total stratified by WHO region and globally, from the health system and societal perspectives. We considered direct costs of illness (e.g., clinic visits and hospitalization and productivity losses.Globally, norovirus resulted in a total of $4.2 billion (95% UI: $3.2-5.7 billion in direct health system costs and $60.3 billion (95% UI: $44.4-83.4 billion in societal costs per year. Disease amongst children <5 years cost society $39.8 billion, compared to $20.4 billion for all other age groups combined. Costs per norovirus illness varied by both region and age and was highest among adults ≥55 years. Productivity losses represented 84-99% of total costs varying by region. While low and middle income countries and high income countries had similar disease incidence (10,148 vs. 9,935 illness per 100,000 persons, high income countries generated 62% of global health system costs. In sensitivity analysis, the probability of hospitalization had the largest impact on health system cost estimates ($2.8 billion globally, assuming no hospitalization costs, while the probability of missing productive days had the largest impact on societal cost estimates ($35.9 billion globally, with a 25% probability of missing productive days.The total economic burden is greatest in young children but the highest cost per illness is among older age groups in some regions. These large

  4. The Psychological Burden of Skin Diseases

    DEFF Research Database (Denmark)

    Dalgard, Florence J; Gieler, Uwe; Tomas-Aragones, Lucia

    2015-01-01

    The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational...... with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants--3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1...

  5. Caregiver burden, health status, and learned resourcefulness of older caregivers.

    Science.gov (United States)

    Chen, Meng-Chun; Chen, Kuei-Min; Chu, Tsui-Ping

    2015-06-01

    As caregivers undertake caregiving responsibilities over a long period of time, the burdens placed on them could lead to undue stress and affect their health. This correlation study examined the current situations and relationships among caregiver burden, health status, and learned resourcefulness (LR) of older caregivers who care for disabled older adults, and predicted the important factors that affect their caregiver burden. In all, 108 older caregivers were recruited from home care services of two hospitals. Structured questionnaire interviews were applied to collect data: the Caregiver Burden Scale, the SF-36 Health Survey (SF-36), and the Rosenbaum's Self-Control Schedule. Results indicated that the caregiver burden was negatively correlated with physical health, mental health, and LR. Physical and mental health were positively correlated with LR. The predictors of caregiver burden included LR, health status, economic status, and activities of daily living, which accounted for 58.60% of the total caregiver burden variance. © The Author(s) 2014.

  6. 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...

  7. Lifetime economic burden of prostate cancer

    Directory of Open Access Journals (Sweden)

    Stokes Michael E

    2011-12-01

    Full Text Available Abstract Background Prostate cancer (PCa is the most common cancer affecting men in the United States. The initial treatment and subsequent monitoring of PCa patients places a large burden on U.S. health care systems. The objectives of this study were to estimate the total and disease-related per-patient lifetime costs using a phase-based model of cancer care for PCa patients enrolled in Medicare. Methods A model was developed to estimate life-time costs for patients diagnosed with PCa. Patients ≥ 65 years old and diagnosed with PCa between calendar years 1991-2002 were selected from the SEER database. Using SEER, we estimated survival times for PCa patients from diagnosis until death. The period of time patients contributed to treatment phases was determined using an algorithm designed to model the natural history of PCa. Costs were obtained from the US SEER-Medicare database and estimated during specific phases of care. Cost estimates were then combined with survival data to yield total and PCa-related life-time costs. Results Overall, the model estimated life-time costs of $110,520 (95% CI 110,324-110,739 per patient. PCa-related costs made up approximately 31% of total costs ($34,432. Conclusions Prostate cancer places a significant burden on U.S. health-care systems with average life-time PCa-related costs in excess of $30,000.

  8. Worldwide burden of colorectal cancer: a review.

    Science.gov (United States)

    Favoriti, Pasqualino; Carbone, Gabriele; Greco, Marco; Pirozzi, Felice; Pirozzi, Raffaele Emmanuele Maria; Corcione, Francesco

    2016-03-01

    Colorectal cancer is a major public health problem, being the third most commonly diagnosed cancer and the fourth cause of cancer death worldwide. There is wide variation over time among the different geographic areas due to variable exposure to risk factors, introduction and uptake of screening as well as access to appropriate treatment services. Indeed, a large proportion of the disparities may be attributed to socioeconomic status. Although colorectal cancer continues to be a disease of the developed world, incidence rates have been rising in developing countries. Moreover, the global burden is expected to further increase due to the growth and aging of the population and because of the adoption of westernized behaviors and lifestyle. Colorectal cancer screening has been proven to greatly reduce mortality rates that have declined in many longstanding as well as newly economically developed countries. Statistics on colorectal cancer occurrence are essential to develop targeted strategies that could alleviate the burden of the disease. The aim of this paper is to provide a review of incidence, mortality and survival rates for colorectal cancer as well as their geographic variations and temporal trends.

  9. Body Piercing

    Science.gov (United States)

    ... Health Medical Conditions Nutrition & Fitness Emotional Health Body Piercing Posted under Health Guides . Updated 1 August 2017. + ... medical reasons why I should not get a piercing? Yes. There are medical conditions (see the list ...

  10. The global burden of periodontal disease

    DEFF Research Database (Denmark)

    Petersen, Poul E; Ogawa, Hiroshi

    2012-01-01

    middle-income countries, whereas the tooth-loss rates, at the time of writing, are modest for low-income countries. In high-income countries somewhat lower rates for edentulism are found when compared with upper middle-income countries. Around the world, social inequality in tooth loss is profound within......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...

  11. Carbonated soft drinks and carbonyl stress burden.

    Science.gov (United States)

    Nakayama, Keisuke; Nakayama, Masaaki; Terawaki, Hiroyuki; Murata, Yaeko; Sato, Toshinobu; Kohno, Masahiro; Ito, Sadayoshi

    2009-12-01

    Carbonated soft drinks reportedly contain methylglyoxal (MG), which is strongly associated with human carbonyl stress. We sought to evaluate the effects of carbonated drink intake on human carbonyl stress. We measured MG levels in 4 commercial beverage brands, and evaluated the changes in plasma MG in healthy subjects following the intake of carbonated drinks. By 30 min after intake of samples containing high glucose and high MG, the levels of plasma MG, glucose, insulin and uric acid had increased significantly, and then returned to basal levels by 120 min. After intake of the low-calorie carbonated samples containing little MG, there were no increases in plasma MG. Our results suggest that glucose-containing carbonated soft drinks are associated with increases in not only glucose but also carbonyl burden.

  12. 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...

  13. Body Disposal.

    Science.gov (United States)

    Sea, Jonghan; Beauregard, Eric

    2017-02-01

    This study explores the body disposal patterns in a sample of 54 Korean homicides that occurred between 2006 and 2012. Based on information collected by the police during their investigation, factors that could influence body disposal patterns were examined, such as homicide classification, intention, whether an accomplice was present, and offender mental disorder. Bivariate analyses showed that the majority of the victims who were disposed of were acquaintances of the offenders. Moreover, several offenders were more likely to dispose of the dead body "within hours" of killing the victim. Dead bodies were usually recovered in agricultural areas, forest/wooded areas, as well as residential areas. It was also noteworthy that, in 47 cases, the offender had knowledge of the geographic area where the body was dumped. In cases of "expressive" homicide, victims were more likely to be disposed of somewhere far away (e.g., over 40 km) from the crime scene, whereas "instrumental" homicide victims appeared to be disposed of somewhere closer (e.g., within 30 km) to the crime scene. Results are discussed in light of their practical implications for homicide investigations.

  14. 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.

  15. The burden of cholera in Uganda.

    Directory of Open Access Journals (Sweden)

    Godfrey Bwire

    Full Text Available 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.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.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.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 prior to introducing the

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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

  1. Body Imaging

    Science.gov (United States)

    2001-01-01

    The high-tech art of digital signal processing (DSP) was pioneered at NASA's Jet Propulsion Laboratory (JPL) in the mid-1960s for use in the Apollo Lunar Landing Program. Designed to computer enhance pictures of the Moon, this technology became the basis for the Landsat Earth resources satellites and subsequently has been incorporated into a broad range of Earthbound medical and diagnostic tools. DSP is employed in advanced body imaging techniques including Computer-Aided Tomography, also known as CT and CATScan, and Magnetic Resonance Imaging (MRI). CT images are collected by irradiating a thin slice of the body with a fan-shaped x-ray beam from a number of directions around the body's perimeter. A tomographic (slice-like) picture is reconstructed from these multiple views by a computer. MRI employs a magnetic field and radio waves, rather than x-rays, to create images.

  2. Overview of the burden of diseases in North Korea.

    Science.gov (United States)

    Lee, Yo Han; Yoon, Seok-Jun; Kim, Young Ae; Yeom, Ji Won; Oh, In-Hwan

    2013-05-01

    This article evaluates the overall current disease burden of North Korea through the recent databases of international organizations. It is notable that North Korea as a nation is exhibiting a relatively low burden from deaths and that there is greater burden from deaths caused by non-communicable diseases than from those caused by communicable diseases and malnutrition. However, the absolute magnitude of problems from communicable diseases like TB and from child malnutrition, which will increase the disease burden in the future, remains great. North Korea, which needs to handle both communicable and nutritional conditions, and non-communicable diseases, whose burden is ever more increasing in the nation, can now be understood as a country with the 'double-burden' of disease.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...... analyses; increase awareness and commitment among Member States for the implementation of food safety policy and standards; and encourage countries to use burden of foodborne disease estimates for cost-effectiveness analyses of prevention, intervention, and control measures. To estimate the global burden...... (expressed in disability-adjusted life-years), the Foodborne Disease Burden Epidemiology Reference Group (FERG) focused on the contamination of food with enteric and parasitic pathogens, chemicals, and toxins. FindingsStudy findings will provide the technical background and challenges of assessing the burden...

  4. Body parts

    Science.gov (United States)

    Ayiter, Elif

    2010-01-01

    In this project, the artist wishes to examine corporeality in the virtual realm, through the usage of the (non)-physical body of the avatar. An art installation created in the virtual world of Second Life, which is meant to be accessed with site specific avatars, will provide the creative platform whereby this investigation is undertaken. Thus, "body parts" seeks to challenge the residents of virtual environments into connecting with the virtual manifestations, i.e., avatars of others in an emotionally expressive/intimate manner.

  5. Tick burden on European roe deer (Capreolus capreolus)

    OpenAIRE

    Vor, Torsten; Kiffner, Christian; Hagedorn, Peter; Niedrig, Matthias; R?he, Ferdinand

    2010-01-01

    In our study we assessed the tick burden on roe deer (Capreolus capreolus L.) in relation to age, physical condition, sex, deer density and season. The main objective was to find predictive parameters for tick burden. In September 2007, May, July, and September 2008, and in May and July 2009 we collected ticks on 142 culled roe deer from nine forest departments in Southern Hesse, Germany. To correlate tick burden and deer density we estimated deer density using line transect sampling that acc...

  6. Atlas of the Global Burden of Stroke (1990-2013)

    DEFF Research Database (Denmark)

    Feigin, Valery L; Mensah, George A; Norrving, Bo

    2015-01-01

    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....... CONCLUSIONS: Global burden of stroke has continued to increase in spite of dramatic declines in age-standardized incidence, prevalence, mortality rates and disability. Population growth and aging have played an important role in the observed increase in stroke burden....

  7. Three-year trajectories of caregiver burden in Alzheimer's disease.

    Science.gov (United States)

    Conde-Sala, Josep L; Turró-Garriga, Oriol; Calvó-Perxas, Laia; Vilalta-Franch, Joan; Lopez-Pousa, Secundino; Garre-Olmo, Josep

    2014-01-01

    Although numerous studies have examined caregiver burden in the context of Alzheimer's disease, discrepancies remain regarding the influence of certain factors. This study aimed to identify trajectories of caregiver burden in the context of Alzheimer's disease, as well as the factors associated with them. A cohort of patients and caregivers (n = 330) was followed up over three years. Growth mixture models were fitted to identify trajectories of caregiver burden according to scores on the Zarit Burden Interview (ZBI). A multilevel multinomial regression analysis was then conducted with the resulting groups and the patient and caregiver factors. In the sample as a whole, burden increased during follow-up (F = 4.4, p = 0.004). Three groups were identified: G1 (initially high but decreasing burden), G2 (moderate but increasing burden), and G3 (low burden that increased slightly). Patients in G1 and G2 presented more neuropsychiatric symptoms and poorer functional status than did those in G3. Caregivers in G1 and G2 had poorer mental health. Spouses and, especially, adult children who lived with their parent (the patient) were more likely to belong to G2 (odds ratio [OR] 6.24; 95% CI 2.89-13.47), as were sole caregivers (OR 3.51; 95% CI 1.98-6.21). The patient factors associated with increased burden are neuropsychiatric symptoms and functional status, while among caregivers, being the sole carer, poor mental health, and living with the patient are of relevance.

  8. Spousal Caregiver Burden and Its Relation with Disability in Schizophrenia.

    Science.gov (United States)

    Arun, R; Inbakamal, S; Tharyan, Anna; Premkumar, Prasanna S

    2018-01-01

    Schizophrenia, a chronic psychiatric disorder, can affect one's productivity and psychosocial functioning. In Indian context, the responsibility of caring persons with schizophrenia is increasingly on their spouses. Spousal caregiver experience and its relation with disability in schizophrenia need to be studied. We conducted a cross-sectional study among 52 outpatients with schizophrenia and their spouses attending a tertiary psychiatric center. The objectives were: (a) to explore spousal caregiver burden in schizophrenia and (b) to assess the relation between disability and spousal caregiver burden. The study adopted recommended ethical principles. Scales such as Burden Assessment Schedule, Indian Disability Evaluation and Assessment Scale (IDEAS), and Positive and Negative Syndrome Scale were used to collect appropriate data. Descriptive analysis, bivariate analysis, and multivariate analysis were done in SPSS software version 16.0. The mean spousal caregiver burden score was 73.5 (standard deviation: 14.0). In bivariate analysis, disability, duration of schizophrenia, severity of schizophrenia, place of residence, and socioeconomic status had statistically significant relation with spousal caregiver burden. Adjusted for spouses' age, gender, and other significant factors in bivariate analysis, the IDEAS global disability score (2.6, [confidence interval 0.5-3.8, P = 0.013]) retained statistically significant association with spousal caregiver burden. Spouses of persons with schizophrenia experience significant caregiver burden. Disability was found to be the most powerful determinant of spousal caregiver burden in the sample. Focus on disability alleviation in the management of schizophrenia may help reduce spousal caregiver burden.

  9. 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

  10. 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 th...

  11. BODY CONDITION

    African Journals Online (AJOL)

    Andrew Taylor

    Table 1 Seasonal variation in body and kidney weight of adult mountain reedbuck culled at Sterkfontein. Values are ..... This leads to a decrease in nutritional quality of grazing for mountain reedbuck and a loss of condition. .... This would decrease the chances of starvation of those animals left, and allow them to build up ...

  12. Sacralising Bodies

    DEFF Research Database (Denmark)

    Kaur, Ravinder

    2010-01-01

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

    Science.gov (United States)

    2017-08-23

    of the same populations are being administered to obtain feedback on the same topics (e.g., sexual assault, well-being, retention). This...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

  14. 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.

  15. Comorbidities and personal burden of urgency urinary incontinence: a systematic review.

    Science.gov (United States)

    Coyne, K S; Wein, A; Nicholson, S; Kvasz, M; Chen, C-I; Milsom, I

    2013-10-01

    Studies on the burden and comorbidities associated with urgency urinary incontinence (UUI) are difficult to compare, partly because of the evolution of definitions for lower urinary tract symptoms and the various instruments used to assess health-related quality of life (HRQL). This article summarises published evidence on comorbidities and the personal burden associated specifically with UUI to provide clinicians with a clear perspective on the impact of UUI on patients. A PubMed search was conducted using the terms: (urgency urinary incontinence OR urge incontinence OR mixed incontinence OR overactive bladder) AND (burden OR quality of life OR well-being OR depression OR mental health OR sexual health OR comorbid), with limits for English-language articles published between 1991 and 2011. Of 1364 identified articles, data from 70 retained articles indicate that UUI is a bothersome condition that has a marked negative impact on HRQL, with the severity of UUI a predictor of HRQL. UUI is significantly associated with falls in elderly individuals, depression, urinary tract infections, increased body mass index, diabetes and deaths. The burden of UUI appears to be greater than that of stress urinary incontinence or overactive bladder symptoms without UUI. UUI adversely impacts physical and mental health, sexual function and work productivity. UUI is associated with numerous comorbid conditions and inflicts a substantial personal burden on many aspects of patients' lives. Healthcare providers should discuss UUI with patients and be aware of the impact of UUI and its associated comorbidities on patients' lives. © 2013 John Wiley & Sons Ltd.

  16. 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

  17. Taking entry heating credit to address planetary protection bio-burden limits

    Science.gov (United States)

    Witte, J.; Clark, B.; Linch, S.; Johnson, M.; Bomba, K.; Oakman, K.; Tice, N.; Kast, W.; Willcockson, W.

    In 2005 NASA will launch a large orbiting science observatory, the Mars Reconnaissance Orbiter (MRO), for what should be a 5.4-year mission. High resolution imaging of the surface is a principle goal of the mission. One consequence of this goal however is the need for a low science orbit. Unfortunately this orbit fails the required 20-year orbit life requirements set in NASA Policy Guideline. So rather than sacrifice the science goals of the mission by raising the science orbit, the MRO Project chose to be the first orbiter to pursue the bio-burden reduction approach. Because the orbiter is so large, cleaning only is insufficient to achieve the bio-burden threshold requirement in NASA Policy. This presentation outlines one of the processes developed to reduce bio-burden by taking credit for hardware that will either never reach the surface or achieves high temperature during entry due to ablation and aero-heating. Lockheed Martin engineers developed a process to perform what is called breakup and burn-up analysis. This process considers the assumptions that go into modeling and into decision methods that result on structural degradation branching points. Structural degradation rate is driven by thermal properties of the hardware. These branching points produce multiple trajectory bodies of their own. Assumptions of body shape, mass and velocity drive the rate aero-heating in the entry trajectory. As entry velocity decays so does the available entry heating. In the end, an inventory of all the SC hardware is done in terms of Exempt (burned-up or sufficiently heated) and Non-exempt (survived to surface) components. © Lockheed Martin Corporation A companion paper by the Jet Propulsion Laboratory discusses how this data is integrated into the overall bio-burden assessment activity and the derivation of the Implementation Plan.

  18. 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

  19. Tumor burden talks in cancer treatment with PEGylated liposomal drugs.

    Directory of Open Access Journals (Sweden)

    Yi-Yu Lin

    Full Text Available PURPOSE: PEGylated liposomes are important drug carriers that can passively target tumor by enhanced permeability and retention (EPR effect in neoplasm lesions. This study demonstrated that tumor burden determines the tumor uptake, and also the tumor response, in cancer treatment with PEGylated liposomal drugs in a C26/tk-luc colon carcinoma-bearing mouse model. METHODS: Empty PEGylated liposomes (NanoX and those encapsulated with VNB (NanoVNB were labeled with In-111 to obtain InNanoX and InVNBL in high labeling yield and radiochemical purity (all >90%. BALB/c mice bearing either small (58.4±8.0 mm(3 or large (102.4±22.0 mm(3 C26/tk-luc tumors in the right dorsal flank were intravenously administered with NanoVNB, InNanoX, InVNBL, or NanoX as a control, every 7 days for 3 times. The therapeutic efficacy was evaluated by body weight loss, tumor growth inhibition (using calipers and bioluminescence imaging and survival fraction. The scintigraphic imaging of tumor mouse was performed during and after treatment. RESULTS: The biodistribution study of InVNBL revealed a clear inverse correlation (r (2 = 0.9336 between the tumor uptake and the tumor mass ranged from 27.6 to 623.9 mg. All three liposomal drugs showed better therapeutic efficacy in small-tumor mice than in large-tumor mice. Tumor-bearing mice treated with InVNBL (a combination drug showed the highest tumor growth inhibition rate and survival fraction compared to those treated with NanoVNB (chemodrug only and InNanoX (radionuclide only. Specific tumor targeting and significantly increased tumor uptake after periodical treatment with InVNBL were evidenced by scintigraphic imaging, especially in mice bearing small tumors. CONCLUSION: The significant differences in the outcomes of cancer treatment and molecular imaging between animals bearing small and large tumors revealed that tumor burden is a critical and discriminative factor in cancer therapy using PEGylated liposomal drugs.

  20. Development of a measure of caregiver burden in paediatric chronic kidney disease: The Paediatric Renal Caregiver Burden Scale.

    Science.gov (United States)

    Parham, Rhian; Jacyna, Nicola; Hothi, Daljit; Marks, Stephen D; Holttum, Sue; Camic, Paul

    2016-02-01

    To inform the development of a measure of caregiver burden for carers of children with chronic kidney disease, interviews were conducted with 16 caregivers and 10 renal healthcare professionals. A pool of 97 items generated from interviews was reduced to 60 items following review. A piloting exercise provided evidence for the usability, readability and relevance of items and informed further adaptations resulting in the 51-item Paediatric Renal Caregiver Burden Scale. Further to assessment of its psychometric properties, it is hoped that that the Paediatric Renal Caregiver Burden Scale will serve as a useful measure of caregiver burden in paediatric chronic kidney disease. © The Author(s) 2014.

  1. 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.

  2. Characterizing the epidemiological transition in Mexico: national and subnational burden of diseases, injuries, and risk factors.

    Directory of Open Access Journals (Sweden)

    Gretchen Stevens

    2008-06-01

    Full Text Available BACKGROUND: Rates of diseases and injuries and the effects of their risk factors can have substantial subnational heterogeneity, especially in middle-income countries like Mexico. Subnational analysis of the burden of diseases, injuries, and risk factors can improve characterization of the epidemiological transition and identify policy priorities. METHODS AND FINDINGS: We estimated deaths and loss of healthy life years (measured in disability-adjusted life years [DALYs] in 2004 from a comprehensive list of diseases and injuries, and 16 major risk factors, by sex and age for Mexico and its states. Data sources included the vital statistics, national censuses, health examination surveys, and published epidemiological studies. Mortality statistics were adjusted for underreporting, misreporting of age at death, and for misclassification and incomparability of cause-of-death assignment. Nationally, noncommunicable diseases caused 75% of total deaths and 68% of total DALYs, with another 14% of deaths and 18% of DALYs caused by undernutrition and communicable, maternal, and perinatal diseases. The leading causes of death were ischemic heart disease, diabetes mellitus, cerebrovascular disease, liver cirrhosis, and road traffic injuries. High body mass index, high blood glucose, and alcohol use were the leading risk factors for disease burden, causing 5.1%, 5.0%, and 7.3% of total burden of disease, respectively. Mexico City had the lowest mortality rates (4.2 per 1,000 and the Southern region the highest (5.0 per 1,000; under-five mortality in the Southern region was nearly twice that of Mexico City. In the Southern region undernutrition and communicable, maternal, and perinatal diseases caused 23% of DALYs; in Chiapas, they caused 29% of DALYs. At the same time, the absolute rates of noncommunicable disease and injury burdens were highest in the Southern region (105 DALYs per 1,000 population versus 97 nationally for noncommunicable diseases; 22 versus

  3. Burden of Aquagenic Pruritus in Polycythaemia Vera

    Directory of Open Access Journals (Sweden)

    Edyta Lelonek

    2017-10-01

    Full Text Available Aquagenic pruritus (AP has a significant influence on quality of life (QoL in patients with polycythaemia vera. This study analysed the impact of AP on patient well-being in 102 patients with polycythaemia vera. Intensity of pruritus was evaluated using a visual analogue scale (VAS, verbal rating scale (VRS and a 4-item Itch Questionnaire. Psychosocial aspects of AP were assessed with the Hospital Anxiety and Depression Scale (HADS, EQ-5D and itch-specific QoL questionnaire (ItchyQoL. AP of mean duration 6.6 ± 8.6 years and intensity 4.8 ± 1.9 points (VAS was present in 42/102 individuals. The prevalence of depression and anxiety among patients with AP was 23.8% and 9.5%, respectively. Depression was more frequent in the AP group (vs. non-AP. Moreover, patients with AP had higher HADS-anxiety scoring than those without pruritus (p = 0.005. A negative correlation was found between duration of AP and EQ-5D-VAS. The ItchyQol score of 37.3 ± 12.3 points was influenced by the extent (p =0.01 and duration of episodes of AP (p = 0.02. In conclusion, AP places an additional burden on patients with polycy­thaemia vera, negatively influencing their QoL.

  4. 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.

  5. 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.

  6. [Burden of psychiatric diseases in Chile].

    Science.gov (United States)

    Vicente P, Benjamín; Kohn, Robert; Saldivia B, Sandra; Rioseco S, Pedro

    2007-12-01

    Chile has one of the highest disease burdens caused by neuropsychiatric illnesses in the world, according to WHO, reaching to 31%. Major depression and alcohol use disorders are ranked first and second in attributed disability among adults. Nearly one-third of the population has had a psychiatric disorder in their lifetime, and 22.2% in the past year. Anxiety disorders are the most prevalent conditions, followed by major depression and alcohol abuse. Currently, mental health accounts for 2.3%) of the health care budget, which is less than some neighboring countries. The availability of 1.3 psychiatric beds per 10,000 inhabitants, is less than the mean of lower-income countries. Moreover, 81% are for chronic rather than acute care. Chile has 4.0 psychiatrist per 100,000 inhabitants, which is lower than other countries in Latin America. Only 38.5% of those patients with a psychiatric diagnosis receive any kind of mental health care, whether from a specialist or primary care. There is a perception among lay persons, that psychiatric treatments lack efficacy, despite evidence demonstrating the contrary. Not addressing the treatment gap in mental health has serious public health implications.

  7. Body Weight and Body Image

    Directory of Open Access Journals (Sweden)

    McFarlane Traci

    2004-08-01

    Full Text Available Abstract Health Issue Body weight is of physical and psychological importance to Canadian women; it is associated with health status, physical activity, body image, and self-esteem. Although the problems associated with overweight and obesity are indeed serious, there are also problems connected to being underweight. Weight prejudice and the dieting industry intensify body image concerns for Canadian women and can have a major negative impact on self-esteem. Key Findings Women have lower BMIs than men, a lower incidence of being overweight and a higher incidence of being underweight. However, women across all weight categories are more dissatisfied with their bodies. Sixty percent of women are inactive, and women with a BMI of 27 or higher are more likely to be inactive than women with lower BMIs. The data show that women are aware of the health benefits of exercise, but there is a gap between knowledge and practice. When asked about barriers to health improvement, 39.7% of women cited lack of time and 39.2% lack of willpower. Data Gaps and Recommendations Weight prejudice must be made unacceptable and positive body image should be encouraged and diversity valued. Health policies should encourage healthy eating and healthy activity. Health curricula for young students should include information about healthy eating, active lifestyle, and self-esteem. Physical activities that mothers can participate in with their families should be encouraged. Research should be funded to elucidate the most effective methods of getting women to become and remain physically active without focusing on appearance.

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

    African Journals Online (AJOL)

    Worku_Y

    6 Id, at 377; CRM Dlamini (2003), 'The Burden of Proof: Its Role and Meaning', 14 .... The prosecutor loses on the case if it fails to preliminarily discharge its ..... Failure to successfully discharge one's form of burden of proof at the right time with the required intensity of proof entails irreversible consequences. As most of the.

  9. 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.

  10. 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…

  11. Family burden in injecting versus noninjecting opioid users

    Directory of Open Access Journals (Sweden)

    Naresh Nebhinani

    2013-01-01

    Full Text Available Background: A substance-dependent person in the family affects almost all aspects of family life that also impact the lives of the significant others and causes enormous burden. Objectives: This study was aimed to assess the pattern of burden borne by the family caregivers of patients with opioid-dependence-injecting drug users (IDU and noninjecting drug users (NIDU. Materials and Methods: A cross-sectional study was conducted with ICD-10 diagnosed-opioid-dependent subjects (IDU and NIDU, N = 40 in each group and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in North India. Family Burden interview schedule was used to assess the pattern of burden borne by the family caregivers. Results: The IDU group was characterized by older age, longer duration of substance dependence, greater subjective and objective family burden in all the areas compared to NIDU group, and single status and unemployment were associated with severe objective burden. The family burden was associated neither with age, education, or duration of dependence of the patients, nor with family size, type of caregiver or caregiver′s education in either group. Conclusion: All caregivers reported a moderate or severe burden, which indicates the significance and need for further work in this area.

  12. 34 CFR 34.14 - Burden of proof.

    Science.gov (United States)

    2010-07-01

    ... would cause financial hardship, you bear the burden of proving by a preponderance of the credible... basic living expenses of you and your dependents. (2) The standards for proving financial hardship are... debt by garnishment at this time, you bear the burden of proving the facts that would establish that...

  13. 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.

  14. 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 ...

  15. 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...... in trends in stroke burden between countries of different income levels. FUNDING: Bill & Melinda Gates Foundation....

  16. 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 ...

  17. 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 ...

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

    African Journals Online (AJOL)

    burden attributed to high cholesterol for the four population groups. Monte Carlo ... stroke. Results. Overall, about 59% of IHD and 29% of ischaemic stroke burden in adult males and females (30+ years) were attributable to high cholesterol (~ 3.8 mmol/l), with marked variation by population ..... Attributable DAL Vs= 89 726.

  19. 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

    2018-01-01

    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

  20. THE ASSESSMENT OF CAREGIVER BURDEN IN CAREGIVERS OF HEMODIALYSIS PATIENTS.

    Science.gov (United States)

    Mashayekhi, Fatemeh; Pilevarzadeh, Motahareh; Rafati, Foozieh

    2015-10-01

    Chronic renal failure is among the chronic disease which due to persistence of the disease and long treatment process has various effects on the physiological, psychological, functional ability, lifestyle changes, and independence status of the patient and his family. This may result in the burden feeling in caregivers. According to the importance of the subject, this study is to assess the level of caregiver burden in caregivers of hemodialysis patients. This is a cross-sectional analytical descriptive study that was conducted in 2014 on the caregivers of hemodialysis patients. Research instruments were consisted of two parts: demographic data check list and caregiver burden questionnaire. Data were analyzed by SPSS statistical software and Pearson correlation coefficient tests. A p value of less than 0.05 was considered statistically significant. In this study, 72.5% of caregivers reported moderate to severe levels of caregiver burden. A significant relationship was observed between gender of the patient with caregiver burden score of (p=0.031) and type of the income with caregiver burden score of (p=0.000). Caregivers of male patients and patients with inadequate income had a higher caregiver burden score. Our results showed that more than half of the caregivers of hemodialysis patients had moderate to severe levels of caregiver burden, therefore it is worthy that health officials and nurses pay special attention to this issue by communicating with these patients and their caregivers.

  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...

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

    African Journals Online (AJOL)

    Disease 2010 study.[6]. This is against the background of MSK disorders contributing only 3.4% and 1.7% of the total disease burden in the developed and developing world, respectively.[6]. Osteoarthritis and low back pain remain the largest contributors to the global disability burden.[6] The Bone and Joint Decade 2000 -.

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

    African Journals Online (AJOL)

    Apusigah

    b) This paper benefited from grants from the International Development Research Center. (IDRC), Canada ... disease in Ghana (Asiedu & Etuaful, 1998), there is very little on the social burden, including the burden of .... Due to these superstitious perceptions, BU afflicted persons are often stigmatised in society and largely.

  4. 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...

  5. Inter-state Variation in the Burden of Fragility Fractures

    Science.gov (United States)

    Demographic differences may produce inter-state variation in the burden of osteoporosis. The objective of this study was to estimate the burden of fragility fractures by race/ethnicity, age, sex, and service site across 5 diverse and populous states. State inpatient databases for 2000 were used to ...

  6. 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 objective or subjective. Objective burdens are defined as readily verifiable behavioural phenomena, e.g. negative patient symptoms; caregivers' lives disrupted in terms of domestic routine, social activities and leisure; social isolation;.

  7. 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 ...

  8. 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…

  9. Socioeconomic differences in the burden of disease in Sweden

    DEFF Research Database (Denmark)

    Ljung, Rickard; Peterson, Stefan; Hallqvist, Johan

    2005-01-01

    of this unequally distributed burden falls on unskilled manual workers. The largest contributors to inequalities in health for women are ischaemic heart disease, depression and neurosis, and stroke. For men, the largest contributors are ischaemic heart disease, alcohol addiction and self-inflicted injuries......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...... 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...

  10. [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.

  11. 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...... analyses; increase awareness and commitment among Member States for the implementation of food safety policy and standards; and encourage countries to use burden of foodborne disease estimates for cost-effectiveness analyses of prevention, intervention, and control measures. To estimate the global burden...

  12. 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

  13. 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

  14. The "silent" global burden of congenital cytomegalovirus.

    Science.gov (United States)

    Manicklal, Sheetal; Emery, Vincent C; Lazzarotto, Tiziana; Boppana, Suresh B; Gupta, Ravindra K

    2013-01-01

    Human cytomegalovirus (CMV) is a leading cause of congenital infections worldwide. In the developed world, following the virtual elimination of circulating rubella, it is the commonest nongenetic cause of childhood hearing loss and an important cause of neurodevelopmental delay. The seroprevalence of CMV in adults and the incidence of congenital CMV infection are highest in developing countries (1 to 5% of births) and are most likely driven by nonprimary maternal infections. However, reliable estimates of prevalence and outcome from developing countries are not available. This is largely due to the dogma that maternal preexisting seroimmunity virtually eliminates the risk for sequelae. However, recent data demonstrating similar rates of sequelae, especially hearing loss, following primary and nonprimary maternal infection have underscored the importance of congenital CMV infection in resource-poor settings. Although a significant proportion of congenital CMV infections are attributable to maternal primary infection in well-resourced settings, the absence of specific interventions for seronegative mothers and uncertainty about fetal prognosis have discouraged routine maternal antibody screening. Despite these challenges, encouraging results from prototype vaccines have been reported, and the first randomized phase III trials of prenatal interventions and prolonged postnatal antiviral therapy are under way. Successful implementation of strategies to prevent or reduce the burden of congenital CMV infection will require heightened global awareness among clinicians and the general population. In this review, we highlight the global epidemiology of congenital CMV and the implications of growing knowledge in areas of prevention, diagnosis, prognosis, and management for both low (50 to 70%)- and high (>70%)-seroprevalence settings.

  15. 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

  16. 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.

  17. The burden of illness of rheumatoid arthritis.

    Science.gov (United States)

    Boonen, Annelies; Severens, Johan L

    2011-03-01

    It is necessary to understand the full burden of illness of a disease before the value of interventions can be assessed. Rheumatoid arthritis (RA) has an impact on a variety of stakeholders, including patients, healthcare systems, and society as a whole. This overview discusses the societal and patient perspectives, distinguishing several domains of impact. Epidemiology is important from a societal perspective, as it affects the total impact on health and costs related to RA and influences healthcare organization priorities. Co-morbidities, such as cardiovascular disease, are important factors contributing to the impact of RA. The impact on health is, naturally, relevant to both patients and society as a whole, and is summarized by health-related quality-of-life measures from the point of view of the patient and by utilities from the societal perspective. Similarly, work participation is important for both patients and society. Withdrawal from the labor force and short- and long-term sick leave are extensively studied in RA and lead to substantial productivity costs at the societal level and to income loss for patients. In addition, the recent concept of presenteeism, which reflects the problems that patients experience while at work, is considered. Finally, the costs of illness of RA are summarized. Societal costs are mainly driven by the costs of drug treatment and inpatient care, including surgery. Patient and family costs are mainly driven by the need for formal and informal care. Overall, RA has a significant impact on the health of and costs to patients and society, suggesting that effective interventions to reduce the impact are of value.

  18. 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.

  19. The objective burden in partners of heart failure patients; development and initial validation of the Dutch Objective Burden Inventory

    NARCIS (Netherlands)

    Luttik, Marie Louise; Jaarsma, Tiny; Tijssen, Jan G. P.; van Veldhuisen, Dirk J.; Sanderman, Robbert

    2008-01-01

    BACKGROUND: Measures on objective caregiver burden in partners of Heart Failure patients are hardly available and never include HF specific aspects. AIM: The main objective of our study was to develop an inventory that assesses the objective caregiver burden of partners of HF patients, including the

  20. The objective burden in partners of heart failure patients; development and initial validation of the Dutch objective burden inventory

    NARCIS (Netherlands)

    Luttik, Marie Louise; Jaarsma, Tiny; Tijssen, Jan G. P.; van Veldhuisen, Dirk J.; Sanderman, Robbert

    Background: Measures on objective caregiver burden in partners of Heart Failure patients are hardly available and never include HF specific aspects. Aim: The main objective of our study was to develop an inventory that assesses the objective caregiver burden of partners of HF patients, including the

  1. 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.

  2. 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

  3. The Comparative Burden of Chronic Widespread Pain and Fibromyalgia in the United States.

    Science.gov (United States)

    Schaefer, Caroline; Mann, Rachael; Masters, Elizabeth T; Cappelleri, Joseph C; Daniel, Shoshana R; Zlateva, Gergana; McElroy, Heather J; Chandran, Arthi B; Adams, Edgar H; Assaf, Annlouise R; McNett, Michael; Mease, Philip; Silverman, Stuart; Staud, Roland

    2016-06-01

    Little information exists on the comparative patient and economic burden of chronic widespread pain (CWP) and fibromyalgia (FM) in the United States. This multistage, observational study included an online screening survey of a large geographically diverse US sample to assess CWP status, a physician/site visit to determine FM diagnosis, and an online subject questionnaire to capture clinical characteristics, pain, health status, functioning, sleep, healthcare resource use (HRU), productivity, and costs. Based on the screener and physician evaluation, mutually exclusive groups of subjects without CWP (CWP-), with CWP but without FM (CWP+), and with confirmed FM were identified. Disease burden was examined in 472 subjects (125 CWP-, 176 CWP+, 171 FM). Age, race, and ethnicity were similar across groups. Mean body mass index and number of comorbidities increased from CWP- to CWP+ to FM (P = 0.0044, P Pain severity, interference with function (BPI-SF), and overall work impairment (WPAI:SHP) increased from CWP- to CWP+ to FM (all P pain-related prescription medications relative to CWP- subjects (32.8%; P Fibromyalgia subjects were characterized by the greatest disease burden with more comorbidities and pain-related medications, poorer health status, function, sleep, lower productivity, and higher costs. © 2015 World Institute of Pain.

  4. The socioeconomic burden of parasitic zoonoses: global trends.

    Science.gov (United States)

    Torgerson, Paul R; Macpherson, Calum N L

    2011-11-24

    Diseases resulting from zoonotic transmission of parasites are common. Humans become infected through food, water, soil and close contact with animals. Most parasitic zoonoses are neglected diseases despite causing a considerable global burden of ill health in humans and having a substantial financial burden on livestock industries. This review aims to bring together the current data available on global burden estimates of parasitic zoonoses and indicate any changes in the trends of these diseases. There is a clear need of such information as interventions to control zoonoses are often in their animal hosts. The costs of such interventions together with animal health issues will drive the cost effectiveness of intervention strategies. What is apparent is that collectively, parasitic zoonoses probably have a similar human disease burden to any one of the big three human infectious diseases: malaria, tuberculosis or HIV in addition to animal health burden. Although the global burden for most parasitic zoonoses is not yet known, the major contributors to the global burden of parasitic zoonoses are toxoplasmosis, food borne trematode infections, cysticercosis, echinococcosis, leishmaniosis and zoonotic schistosomosis. In addition, diarrhoea resulting from zoonotic protozoa may have a significant impact. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. 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.

  6. 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.

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

    Science.gov (United States)

    King, Charles H; Bertino, Anne-Marie

    2008-03-26

    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.

  8. Utilizing In Vitro Derived Metabolic Rate Constants to Inform Pesticide Body Burdens in Amphibians

    Science.gov (United States)

    Over 2.4 billion kilograms of pesticides have been used worldwide in preventing diseases, dealing with nuisance animals and aiding in crop management Although pesticides are used to control insects and diseases, exposure to non-target species frequently occurs.Amphibians are impo...

  9. 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.

  10. 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.

  11. 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…

  12. 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...

  13. Migrating bards: Writers' burdens and a writers' body in Nigeria at ...

    African Journals Online (AJOL)

    Wole Soyinka's 1986 Nobel Prize for literature was received as a well deserved international recognition not only of the distinction of Soyinka's sustained output but also as a tribute to Nigerian and African literature in general. However, given decades of irresponsible leadership in the country, a sober appraisal of the ...

  14. The Body Burden of Organic Vapors in Artificial Air Trial Measurements Aboard a Moored Submarine

    Science.gov (United States)

    1984-12-19

    1202 140 CloH20 Cyclodecane isomer 7 1203 152 C1 0H16 0 Camphor 3 1208 Alkane isomer 76 1210 140 CloH 20 Butylcyclohexane 51 1220 120 C9H1 2 Alkyl...syndrome: when work makes you sick. Occupational Health and Safety (January): 51-56. 4. Johnson, J. E., A. J. Chiantella, W. D. Smith, and M. L. Umstcad

  15. 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

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

    Science.gov (United States)

    Glinski, Donna A; Henderson, W Matthew; Van Meter, Robin J; Purucker, S Thomas

    2018-02-13

    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 constants were derived from toad (Anaxyrus terrestris) livers in experiments measuring the depletion of atrazine (ATZ), triadimefon (TDN), and fipronil (FIP) as well as formation of their metabolites. To determine the predictability of these in vitro derived rate constants, Fowler's toads (Anaxyrus fowleri) were exposed to soil contaminated with each of the pesticides at maximum application rate. Desethyl atrazine (DEA) and deisopropyl atrazine (DIA), both metabolites of ATZ, exhibited similar velocities (V max ) while the K M constant for DIA was two times higher than DEA. TDN was metabolized into two diastereomers of triadimenol (TDL A and TDL B), where TDL B had a V max around two times higher than TDL A. The metabolite fipronil sulfone's V max and K M were 150 pmol min -1  mg -1 and 29 μM, respectively. While intrinsic clearance rates for the pesticides ranged from 0.54 to 38.31 mL min -1  kg -1 . Thus, gaining knowledge on differences in metabolism of pesticides within amphibians is important in estimating risk to these non-target species since the inherent toxicity of metabolites can differ from the parent compound. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. 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.

  18. 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 ...

  19. Prevalence and determinants of the dual burden of malnutrition at the household level in Puna and Quebrada of Humahuaca, Jujuy, Argentina.

    Science.gov (United States)

    Bassete, M N; Romaguera, D; Giménez, M A; Lobo, M O; Samman, N C

    2014-02-01

    The objective of the present study was to identify households in which overweight and underweight coexisted (dual burden of malnutrition) and explore the factors that could be contributing to the dual burden of malnutrition at the household level in this population. Cross-sectional nutritional survey. After applying the exclusion criteria, 136 households were included. Mothers were classified as normal weight or overweight/obese based on body mass index (BMI) cut-off points and children and adolescents were classified as stunted or not based on height-for-age z-score. Households with an obese mother and a stunted children or adolescent were categorized as dual burden households. The prevalence of dual burden household was 12%. Compared with other households, dual burden households tended to have more people living in the house, and the educational level of the head of household was lower. Individuals living in dual burden households showed overall lower energy intakes and were more likely to have inadequate intakes of calcium and iron. The nutrition transition in this community might be one of the leading causes of the observed dual burden of malnutrition. The results presented here indicate the need to consider whether programs that focus on only one type of nutritional problem come might actually exacerbate the other. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Benefits of psychodynamic group therapy on depression, burden and quality of life of family caregivers to Alzheimer’s disease patients

    Directory of Open Access Journals (Sweden)

    Dorli Kamkhagi

    2015-12-01

    Full Text Available Abstract Background Family members providing continuous care to demented patients suffer from severe burden that impairs quality of life and often evolves to depression. Objective This study aims to evaluate the effect of psychodynamic group psychotherapy (PGT compared to body awareness therapy (BAT on caregiver burden, depressive symptoms, and quality of life among family caregivers to Alzheimer disease (AD patients. Methods Thirty-seven healthy family caregivers were randomly allocated to receive PGT (n = 20 or BAT (n = 17. Interventions were administered in the format of 14 weekly group sessions. Outcome measures were: modification of scores on Zarit Burden Scale, Beck Depression Inventory and WHO-QoL Scale. Results Participants in the PGT group displayed significant reduction on burden (p = 0.01 and depression scores (p = 0.005, and improved quality of life (p = 0.002, whereas those in the BAT group showed improvements in burden of care (p = 0.001 and quality of life (p = 0.01, but not on depressive symptoms (p = 0.13. Discussion Psychodynamic psychotherapy was associated with amelioration of depressive symptoms, but overall benefits on burden of care and quality of life were similar irrespective of the type of intervention, i.e., psychologically-oriented or not. We hypothesize that these interventions can be complementary to improve depression and burden of care among family caregivers of AD patients.

  1. Potential Impact of Time Trend of Life-Style Factors on Cardiovascular Disease Burden in China.

    Science.gov (United States)

    Li, Yanping; Wang, Dong D; Ley, Sylvia H; Howard, Annie Green; He, Yuna; Lu, Yuan; Danaei, Goodarz; Hu, Frank B

    2016-08-23

    Cardiovascular disease (CVD) is a leading cause of death in China. Evaluation of risk factors and their impacts on disease burden is important for future public health initiatives and policy making. The study used data from a cohort of the China Health and Nutrition Survey to estimate time trends in cardiovascular risk factors from 1991 to 2011. We applied the comparative risk assessment method to estimate the number of CVD events attributable to all nonoptimal levels (e.g., theoretical-minimum-risk exposure distribution [TMRED]) of each risk factor. In 2011, high blood pressure, high low-density lipoprotein cholesterol, and high blood glucose were associated with 3.1, 1.4, and 0.9 million CVD events in China, respectively. Increase in body mass index was associated with an increase in attributable CVD events, from 0.5 to 1.1 million between 1991 and 2011, whereas decreased physical activity was associated with a 0.7-million increase in attributable CVD events. In 2011, 53.4% of men used tobacco, estimated to be responsible for 30.1% of CVD burden in men. Dietary quality improved, but remained suboptimal; mean intakes were 5.4 (TMRED: 2.0) g/day for sodium, 67.7 (TMRED: 300.0) g/day for fruits, 6.2 (TMRED: 114.0) g/day for nuts, and 25.0 (TMRED: 250.0) mg/day for marine omega-3 fatty acids in 2011. High blood pressure remains the most important individual risk factor related to CVD burden in China. Increased body mass index and decreased physical activity were also associated with the increase in CVD burden from 1991 to 2011. High rates of tobacco use in men and unhealthy dietary factors continue to contribute to the burden of CVD in China. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Inpatient Financial Burden of Atopic Dermatitis in the United States

    DEFF Research Database (Denmark)

    Narla, Shanthi; Hsu, Derek Y; Thyssen, Jacob P

    2017-01-01

    Little is known about the inpatient burden of atopic dermatitis (AD). We sought to determine the risk factors and financial burden of hospitalizations for AD in the United States. Data were analyzed from the 2002-2012 National Inpatient Sample, including a 20% representative sample of all...... hospitalizations in the United States. Hospitalization rates for AD or eczema were highest in the northeast during the winter and south during the summer. Geometric mean cost of care (95% confidence interval) was lower for a primary diagnosis of AD or eczema versus no AD or eczema in adults ($3,502 [$3......, there is a substantial inpatient financial burden of AD in the United States....

  3. [Excessive alcohol consumption: what is the burden on natural caregivers?].

    Science.gov (United States)

    Hoertel, N; Crochard, A; Limosin, F; Rouillon, F

    2014-04-01

    Data on the natural caregivers burdened by the excessive consumption of alcohol by members of the family circle or friends in the general population are lacking. Therefore, our aim was twofold: (i) to assess the burden of individuals with excessive alcohol consumption on natural caregivers and (ii) to examine the factors explaining the association between alcohol consumption and the level of burden. Data were derived from a national representative survey of the French adult population, conducted in 2013, that involved 1018 participants who had in their close environment a person consuming excessive amounts of alcohol. The level of burden was assessed using the Zarit Burden Scale (ZBI). The average score of the ZBI was 28.5 (SE=16.0). The average volume of alcohol consumed per day, heavy drinking days, as well as the consumers' profiles defined by the AUDIT-C were significantly associated with the level of burden. Following adjustments for the participants' characteristics and for the closeness between participants and individuals with excessive consumption, these associations remained significant. Following adjustments for these variables as well as demographic, social, behavioral and medical characteristics of individuals with excessive consumption, the associations between the level of burden and respectively consumers' profiles and heavy drinking days remained significant. At last, following adjustments for social, behavioral and medical characteristics of individuals with excessive consumption and for the closeness between them and participants, only the association between heavy drinking days and the level of burden remained significant. One out of five participants having in their close environment a person consuming excessive amount of alcohol reported an important burden. The association between the individuals' alcohol intake and the level of burden for natural caregivers was mainly influenced by social, behavioral and medical consequences of alcohol

  4. 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.

  5. Initial burden of disease estimates for South Africa, 2000 | Bradshaw ...

    African Journals Online (AJOL)

    Initial burden of disease estimates for South Africa, 2000. D Bradshaw, P Groenewald, R Laubscher, N Nannan, B Nojilana, R Norman, D Pieterse, M Schneider, D.E. Bourne, I.M. Timaeus,, R Dorrington, L Johnson ...

  6. Estimating the burden of disease attributable to interpersonal ...

    African Journals Online (AJOL)

    Estimating the burden of disease attributable to interpersonal violence in South Africa in 2000. R Norman, D Bradshaw, M Schneider, R Jewkes, S Mathews, N Abrahams, R Matzopoulos, T Vos, South African Comparitive Risk Assessment Collaboration Grou ...

  7. Estimating the burden of disease attributable to vitamin A deficiency ...

    African Journals Online (AJOL)

    Estimating the burden of disease attributable to vitamin A deficiency in South Africa in 2000. B Nojilana, R Norman, D Bradshaw, M E van Stuijvenberg, M A Dhansay, D Labadarios, South African Comparitive Risk Assessment Collaboration Grou ...

  8. 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

  9. Optimizing the protection against the physiological burden of CBRN clothing

    NARCIS (Netherlands)

    Brasser, P.

    2010-01-01

    Soldiers can wear chemical, biological, radiological and nuclear (CBRN) protective clothing to be protected agaist warfare agents. The disadvantage of that clothing is that higher protection introduces higher physiological burden. Therefore an optimum between comfort and protection must be found.

  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. 47 CFR 64.2333 - Burden of proof.

    Science.gov (United States)

    2010-10-01

    ... RULES RELATING TO COMMON CARRIERS Subscriber List Information § 64.2333 Burden of proof. (a) In any... listing for base file subscriber list information or $0.06 per listing for updated subscriber list...

  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. Estimating the true global burden of mental illness

    OpenAIRE

    Vigo, Daniel; Thornicroft, Graham; Atun, Rifat

    2016-01-01

    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 as...

  14. 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.

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

    OpenAIRE

    Benavides, Julio A.; Rojas Paniagua, Elizabeth; Hampson, Katie; Valderrama, William; Streicker, Daniel G.

    2017-01-01

    Background 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. Methodology/Principal findings We used questionnaires to quantify under-reporting of livestock deaths across 40 agricultural communities with differing...

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

    Science.gov (United States)

    2014-01-01

    Background 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. Methods 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. Results 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 < 0.001). Among patients who sought medical care during the last attack (23%), more than half utilized the emergency department. The last attack prevented patients from their normal activities an average of 4–12 hours. Patient and caregiver absenteeism increased with attack severity and frequency. Among patients 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. PMID:24996814

  17. 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...

  18. [Multifaceted body. I. The bodies of medicine].

    Science.gov (United States)

    Saraga, M; Bourquin, C; Wykretowicz, H; Stiefel, F

    2015-02-11

    The human body is the object upon which medicine is acting, but also lived reality, image, symbol, representation and the object of elaboration and theory. All these elements which constitute the body influence the way medicine is treating it. In this series of three articles, we address the human body from various perspectives: medical (1), phenomenological (2), psychosomatic and socio-anthropological (3). This first article discusses four distinct types of representation of the body within medicine, each related to a specific epistemology and shaping a distinct kind of clinical legitimacy: the body-object of anatomy, the body-machine of physiology, the cybernetic body of biology, the statistical body of epidemiology.

  19. 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.

  20. Multidimensional determinants of family caregiver burden in Alzheimer's disease.

    Science.gov (United States)

    Park, Myonghwa; Sung, Mira; Kim, Sun Kyung; Kim, Sungjin; Lee, Dong Young

    2015-08-01

    Caregiver burden is a complex and multidimensional construct. Although previous studies have explored numerous factors associated with caregiver burden, these factors have not been identified with a large population-based sample in a theory-based multidimensional way. This study explores multidimensional determinants associated with family caregiver burden to determine the main contributors of caregiver burden in Alzheimer's disease (AD) using a large community dataset. A retrospective secondary data analysis was conducted on 1,133 patients with AD and 1,133 primary caregivers who were registered in a metropolitan city dementia center in South Korea. The patient data included socio-demographic and disease profiles. The caregiver data consisted of socio-demographic and caregiving profiles. The study results identified that dementia-related factors were the most significant factors, representing 25.6% of caregiver burden and were followed by caregiving-related factors explaining caregiver burden significantly. Behavioral problems and instrumental activities of daily living (IADL) dependency of the patient, spousal relationship, hours of caregiving, and the number of diseases associated with the caregiver were found to be significant individual variables. It is vital to develop a service and support program with a greater emphasis on the behavioral problems and IADL deficiency of patients with AD as well as on improving the competence ability of caregivers to deal with such difficulties.

  1. 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.

  2. Estimating the burden of foodborne diseases in Japan

    Science.gov (United States)

    Kumagai, Yuko; Gilmour, Stuart; Ota, Erika; Momose, Yoshika; Onishi, Toshiro; Bilano, Ver Luanni Feliciano; Kasuga, Fumiko; Sekizaki, Tsutomu

    2015-01-01

    Abstract Objective To assess the burden posed by foodborne diseases in Japan using methods developed by the World Health Organization’s Foodborne Disease Burden Epidemiology Reference Group (FERG). Methods Expert consultation and statistics on food poisoning during 2011 were used to identify three common causes of foodborne disease in Japan: Campylobacter and Salmonella species and enterohaemorrhagic Escherichia coli (EHEC). We conducted systematic reviews of English and Japanese literature on the complications caused by these pathogens, by searching Embase, the Japan medical society abstract database and Medline. We estimated the annual incidence of acute gastroenteritis from reported surveillance data, based on estimated probabilities that an affected person would visit a physician and have gastroenteritis confirmed. We then calculated disability-adjusted life-years (DALYs) lost in 2011, using the incidence estimates along with disability weights derived from published studies. Findings In 2011, foodborne disease caused by Campylobacter species, Salmonella species and EHEC led to an estimated loss of 6099, 3145 and 463 DALYs in Japan, respectively. These estimated burdens are based on the pyramid reconstruction method; are largely due to morbidity rather than mortality; and are much higher than those indicated by routine surveillance data. Conclusion Routine surveillance data may indicate foodborne disease burdens that are much lower than the true values. Most of the burden posed by foodborne disease in Japan comes from secondary complications. The tools developed by FERG appear useful in estimating disease burdens and setting priorities in the field of food safety. PMID:26478611

  3. 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.

  4. Choosing and using disposable body-worn continence pads.

    Science.gov (United States)

    Gilbert, Rachel

    Disposable, body-worn pads are the product most commonly chosen to contain and absorb urine and faeces (Pomfret, 2000). The cost to the NHS of supplying continence pads has been estimated at 80 million pounds per annum (Euromonitor, 1999) and is a huge financial burden on local services.

  5. Spatial and temporal variation in cadmium body loads of four ...

    African Journals Online (AJOL)

    Two-way analysis of variance indicated that spatial (location) rather than temporal (seasonal) factors affected Cd concentrations in the invertebrates. Cd concentrations in False Bay sometimes exceeded the norms or water quality standards. Key words: Cd, invertebrate body burdens, marine pollution, seasonal variations.

  6. Development of a measure of caregiver burden in paediatric chronic kidney disease: the Paediatric Renal Caregiver Burden Scale

    OpenAIRE

    Parham, Rhian; Jacyna, N.; Horthi, D.; Marks, S.D.; Holttum, S.; Camic, Paul M.

    2014-01-01

    To inform the development of a measure of caregiver burden for carers of children with chronic kidney disease, interviews were conducted with 16 caregivers and 10 renal healthcare professionals. A pool of 97 items generated from interviews was reduced to 60 items following review. A piloting exercise provided evidence for the usability, readability and relevance of items and informed further adaptations resulting in the 51-item Paediatric Renal Caregiver Burden Scale. Further to assessment of...

  7. Addressing the burden of stroke caregivers: a literature review.

    Science.gov (United States)

    Camak, Deborah Jacks

    2015-09-01

    To examine the empirical literature regarding the risk of burden experienced by the older adult caregiver of the stroke survivor. The scope of this review was limited to older adult family members caring for older adult stroke survivors as evidenced in the literature written between the years of 2009-2014. This article will explore published research within the past five years (2009-2014) that addresses the issue of burden among older adult caregivers of stroke survivors in addition to the implication for the changes needed within the nursing profession to mitigating the burden experienced by the caregiver. Many stroke survivors are in their 6th decade of life or older, with caregivers approximately the same age. This literature review specifically focuses on the role of nursing and the issue of caregiver burden. Literature Review. A review of the literature published between 2009-2014 related to the lived experience of caregivers of stroke survivors and the role of nursing related to mitigating caregiver burden. Numerous factors impact the lived experience of caregivers providing care for the stroke survivor. Assuming the role of caregiver has an inherent risk which can result in health compromises for the caregiver. It is the responsibility of the nurse to assess, design interventions and provide education to prepare the caregiver for the demands of the role. The literature review has shown that research regarding the risk of caregiver burden and the resulting health compromise is scarce. In addition, there is a lack of evidence-based nursing interventions aimed at assuaging the risk of caregiver burden. Caregiver stress culminating in burden is commonly a reason for the eventual institutionalisation of the stroke survivor. Critically assessing and providing for the physical, psychosocial and educational support needs of stroke caregivers will assist in mitigating the daily burden experienced by the caregiver. Caregiver burden often results in psychological and

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

    Science.gov (United States)

    Jokelainen, Pikka; Stensvold, Christen Rune; Trevisan, Chiara; Fuchs, Josefine; Burgdorf, Kristoffer Sølvsten; Nielsen, Henrik Vedel; Pires, Sara M.

    2017-01-01

    Background 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. Methods Using data primarily from two public health surveillance programmes conducted between 1992 and 2007, we estimated the incidence, occurrence of sequelae, mortality and the burden of disease in terms of disability-adjusted life years (DALYs) of CT in Denmark in 2014. Findings We estimated that 14 children were born with CT in 2014, of which six will have developed sequelae by the age of 12. CT resulted in a total disease burden of 123 DALYs (95% uncertainty interval [UI], 100–148), of which 78 (95% UI, 64–94) were due to foetal loss and 2 (95% UI, 1–3) were due to neonatal death; the remaining burden was due to moderate to severe life-long sequelae. A comparison of the estimated incidence of CT with the number of reported CT cases in 2008–2014 indicated that for each reported CT case, at least five other CT cases could be expected to have occurred and gone unreported. Interpretation Early onset, severity, and life-long duration of sequelae have a major effect on the disease burden of CT. Our data suggest that CT is under-diagnosed or under-reported in Denmark. The estimated disease burden and public health impact in Denmark is lower than in other European countries, highlighting the need for country-specific studies. PMID:28558051

  9. 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.

  10. Economic burden of human papillomavirus-related diseases in Italy.

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    Gianluca Baio

    Full Text Available 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.

  11. Estimating the global burden of endemic canine rabies.

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    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.

  12. 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

  13. 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 ...

  14. Mercury (Hg) burden in children: the impact of dental amalgam.

    Science.gov (United States)

    Al-Saleh, Iman; Al-Sedairi, Al Anoud

    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 (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 (Phealth 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 such an increased Hg on children should be a cause of concern, and further investigation is warranted. Our results are alarming and indicate an urgent need for biomonitoring and

  15. A review of the economic burden of ADHD

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    Paramore Clark

    2005-06-01

    Full Text Available Abstract Attention-deficit hyperactivity disorder (ADHD is a common disorder that is associated with broad functional impairment among both children and adults. The purpose of this paper is to review and summarize available literature on the economic costs of ADHD, as well as potential economic benefits of treating this condition. A literature search was performed using MEDLINE to identify all published articles on the economic implications of ADHD, and authors were contacted to locate conference abstracts and articles in press that were not yet indexed. In total, 22 relevant items were located including published original studies, economic review articles, conference presentations, and reports available on the Internet. All costs were updated and presented in terms of year 2004 US dollars. A growing body of literature, primarily published in the United States, has demonstrated that ADHD places a substantial economic burden on patients, families, and third-party payers. Results of the medical cost studies consistently indicated that children with ADHD had higher annual medical costs than either matched controls (difference ranged from $503 to $1,343 or non-matched controls (difference ranged from $207 to $1,560 without ADHD. Two studies of adult samples found similar results, with significantly higher annual medical costs among adults with ADHD (ranging from $4,929 to $5,651 than among matched controls (ranging from $1,473 to $2,771. A limited number of studies have examined other economic implications of ADHD including costs to families; costs of criminality among individuals with ADHD; costs related to common psychiatric and medical comorbidities of ADHD; indirect costs associated with work loss among adults with ADHD; and costs of accidents among individuals with ADHD. Treatment cost-effectiveness studies have primarily focused on methylphenidate, which is a cost-effective treatment option with cost-effectiveness ratios ranging from $15

  16. 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

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

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    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.

  18. Influence of personality on depression, burden, and health-related quality of life in family caregivers of persons with dementia.

    Science.gov (United States)

    Kim, Sun Kyung; Park, Myonghwa; Lee, Yunhwan; Choi, Seong Hye; Moon, So Young; Seo, Sang Won; Park, Kyung Won; Ku, Bon D; Han, Hyun Jeong; Park, Kee Hyung; Han, Seol-Heui; Kim, Eun-Joo; Lee, Jae-Hong; Park, Sun A; Shim, Yong S; Kim, Jong Hun; Hong, Chang Hyung; Na, Duk L; Ye, Byoung Seok; Kim, Hee Jin; Moon, Yeonsil

    2017-02-01

    Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression. Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers' personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined. Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL. Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.

  19. Global economic burden of schizophrenia: a systematic review

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    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. An updated review on burden on caregivers of schizophrenia patients.

    Science.gov (United States)

    Caqueo-Urízar, Alejandra; Miranda-Castillo, Claudia; Lemos Giráldez, Serafín; Lee Maturana, Sau-Lyn; Ramírez Pérez, Mauricio; Mascayano Tapia, Franco

    2014-05-01

    Schizophrenia is a debilitating mental illness that has a significant impact not only in the patient but also in the entire family as well. Caregivers assume almost the totality of the patient care. This responsibility exposes caregivers to an intense burden with negative consequences for them and the rest of the family system. This is an updated review of existing literature about burden on families with schizophrenia patients. An electronic search of articles from MEDLINE, EMBASE, APA, EBSCO, and Cochrane databases was conducted for articles published between 2008 and 2013. A systematization of information and frequency analysis revealed the existence of eight factors related to burden that were present in almost all the reviewed literature: Programs of family treatment, Ethnic group, Expressed Emotion, Stress and Burden, Preoccupations of the caregiver, Kind of caregiver, Social networks, Social support, Finances and Coping Strategies. This study supports the statements of different theories reflecting the complexity of schizophrenia caregivers' burden and these, in turn, may be related to the above factors.

  1. Perceived embarrassment and caregiver burden in essential tremor caregivers.

    Science.gov (United States)

    Kellner, Sarah; Morgan, Sarah; Gutierrez, Jesus; Collins, Kathleen; Rohl, Brittany; Migliore, Fanny; Cosentino, Stephanie; Huey, Edward D; Louis, Elan D; Monin, Joan K

    2017-12-15

    Essential tremor (ET) is a progressive neurological disease associated with functional disability, diminished quality of life and, in some individuals, poorer balance, cognitive impairment, depression and sleep dysregulation. Individuals with ET may rely on family members and friends to act as informal caregivers to assist with daily activities and provide emotional support. There is a high prevalence of embarrassment among individuals with ET, which may be a result of the outwardly visible nature of tremor. Studies in populations with outwardly visible disability have shown that perception by caregivers of a care-recipient's social distress can contribute to caregiver burden. We hypothesize that in ET, perception by caregivers of ET participant embarrassment is a predictor for caregiver burden. Data were collected from 57 ET participants and their caregivers. We measured ET participant embarrassment using the Essential Tremor Embarrassment Assessment (ETEA), and measured perception by caregivers of ET participant embarrassment using a modified version of the ETEA. The Zarit Burden Interview was used to measure caregiver burden. Perceived embarrassment was associated with ET participant embarrassment. In linear regression models, perceived embarrassment was a stronger predictor for caregiver burden than measures of ET participant cognitive and physical impairment. The results indicate that perception of ET participant embarrassment can be burdensome for caregivers. Clinicians may wish to address patient embarrassment and perceived embarrassment to better support caregivers and ET patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Caregiver burden and coping in early-stage Alzheimer disease.

    Science.gov (United States)

    Zucchella, Chiara; Bartolo, Michelangelo; Pasotti, Chiara; Chiapella, Laura; Sinforiani, Elena

    2012-01-01

    This study was set out to describe caregiver-perceived burden and coping in early-stage Alzheimer disease (AD). A total of 163 consecutive pairs of patients with AD and their principal caregivers were initially recruited. The caregivers completed the Caregiver Burden Inventory (CBI) and the Coping Orientations to Problems Experienced scale, and also provided sociodemographic information; the patients with AD were assessed by means of the Mini Mental State Examination and the Neuropsychiatric Inventory. Data from 126 patient-caregiver pairs were analyzed. The caregivers (mean age 56.11±12.37 y) were mainly women (76%); 64% were the patient's offspring; 39% lived with the patient. From the CBI data, it emerged that caregivers perceived loss of personal time (objective burden, 33%) and the feeling of missing out on opportunities (developmental burden, 25%) as their main stressors. Total CBI score was negatively correlated with Mini Mental State Examination (P=0.005). As regards coping strategies, the caregivers predominantly used problem-oriented strategies associated with a positive attitude. The use of dysfunctional strategies was predictive of caregiver burden. It is important to be aware that avoidance and dysfunctional coping strategies predispose caregivers of patients with AD to higher level of distress, whereas successful caregiving seems to be based on the use of problem-oriented strategies early in the disease when solutions are still available. (C) 2012 Lippincott Williams & Wilkins, Inc.

  3. [Characteristics and factors associated with dementia caregivers burden].

    Science.gov (United States)

    Delgado Parada, Eduardo; Suárez Alvarez, Óscar; de Dios del Valle, Ricardo; Valdespino Páez, Ineyvis; Sousa Ávila, Yolanda; Braña Fernández, Gerardo

    2014-03-01

    To describe the characteristics and determining factors of carer stress in a group of elderly home care patients with dementia evaluated in a Geriatric Assessment Unit. An observational descriptive cross-sectional study was conducted using an assessment of baseline characteristics of patients and carers. Estimation of caregiver burden was registered by validated scales: Goldberg Anxiety Scale (GAS), Goldberg Depression Scales (GDS), and Zarit Burden Scale (ZS). A total of 130 patients were included. No item related to dementia patients was associated with caregiver burden. A poor perception of health and quality of life by the caregivers were associated with anxiety risk, depression and burden. Attendance rates for primary care and lack of paid work outside the home were associated with both, depression (GDS>2) and anxiety (GAS>4). Carer age and a lower education were related to depression. Anti-inflammatory, anxiolytics and antidepressants consumption was associated with anxiety, and anti-inflammatory consumption with caregiver burden (ZS >47). The profile of carers in our sample is comparable to that described in other national studies, but care time is longer. The target population is difficult to identify and in need of help. Although there is not a formal demand for help, we should be encouraged to develop new healthcare methods. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  4. "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.

  5. 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.

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

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    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

  7. 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.

  8. 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

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

    Science.gov (United States)

    Benavides, Julio A; Rojas Paniagua, Elizabeth; Hampson, Katie; Valderrama, William; Streicker, Daniel G

    2017-12-01

    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.

  10. 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.

  11. 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:

  12. 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.

  13. 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...

  14. 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

  15. 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

  16. 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

  17. The economic burden of tuberculosis in Denmark 1998-2010

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Wejse, Christian

    2015-01-01

    OBJECTIVE: To evaluate the economic burden of tuberculosis (TB) in Denmark, METHODS: 8,433 Danish TB-patients (1998-2010) were matched with 33,707 controls by age, gender, civil status and geography. Health-related costs (health system contacts and -procedures, medications) and socio-economic par......OBJECTIVE: To evaluate the economic burden of tuberculosis (TB) in Denmark, METHODS: 8,433 Danish TB-patients (1998-2010) were matched with 33,707 controls by age, gender, civil status and geography. Health-related costs (health system contacts and -procedures, medications) and socio...

  18. 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)

  19. Posttraumatic stress and depression: potential pathways to disease burden among heart failure patients.

    Science.gov (United States)

    Taylor-Clift, April; Hobfoll, Stevan E; Gerhart, James I; Richardson, DeJuran; Calvin, James E; Powell, Lynda H

    2016-01-01

    Posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) are associated with high disease burden. Pathways by which PTSD and MDD contribute to disease burden are not understood. Path analysis was used to examine pathways between PTSD symptoms, MDD symptoms, and disease burden among 251 low-income heart failure patients. In Model 1, we explored the independent relationship between PTSD and MDD symptoms on disease burden. In Model 2, we examined the association of PTSD symptoms and disease burden on MDD symptoms. We also examined indirect associations of PTSD symptoms on MDD symptoms, mediated by disease burden, and of PTSD symptoms on disease burden mediated by MDD symptoms. Disease burden correlated with PTSD symptoms (r = .41; p disease burden. Disease burden did mediate the relationship between PTSD symptoms and MDD symptoms. Results support the importance of detection of PTSD in individuals with disease. Results also provide preliminary models for testing longitudinal data in future studies.

  20. Body Image and Body Contouring Procedures.

    Science.gov (United States)

    Sarwer, David B; Polonsky, Heather M

    2016-10-01

    Dissatisfaction with physical appearance and body image is a common psychological phenomena in Western society. Body image dissatisfaction is frequently reported by those who have excess body weight, but also is seen in those of normal body weight. For both groups of individuals, this dissatisfaction impacts self-esteem and quality of life. Furthermore, it is believed to be the motivational catalyst to a range of appearance-enhancing behaviors, including weight loss efforts and physical activity. Body image dissatisfaction is also believed to play a role in the decision to seek the wide range of body contouring procedures offered by aesthetic physicians. Individuals who seek these procedures typically report increased body image dissatisfaction, focus on the feature they wish to alter with treatment, and often experience improvement in body image following treatment. At the same time, extreme body image dissatisfaction is a symptom of a number of recognized psychiatric disorders. These include anorexia nervosa, bulimia nervosa, and body dysmorphic disorder (BDD), all of which can contraindicate aesthetic treatment. This special topic review paper provides an overview of the relationship between body image dissatisfaction and aesthetic procedures designed to improve body contouring. The review specifically focuses on the relationship of body image and body weight, as well as the presentation of body image psychopathology that would contraindicate aesthetic surgery. The overall goal of the paper is to highlight the clinical implications of the existing research and provide suggestions for future research on the psychological aspects of body contouring procedures. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  1. 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

  2. The Vitiligo Impact Patient Scale (VIPs): Development and Validation of a Vitiligo Burden Assessment Tool.

    Science.gov (United States)

    Salzes, Camille; Abadie, Sophie; Seneschal, Julien; Whitton, Maxine; Meurant, Jean-Marie; Jouary, Thomas; Ballanger, Fabienne; Boralevi, Franck; Taieb, Alain; Taieb, Charles; Ezzedine, Khaled

    2016-01-01

    Vitiligo has a major impact on health-related quality of life. Although a few vitiligo-specific quality of life instruments exist, there is no specific vitiligo burden tool. We developed and validated a specific vitiligo burden tool according to skin phototype. In total, 301 patients completed 35 items of the Vitiligo Impact Patient scale, of whom 235 were of skin phototype I to III and 66 of phototype IV to VI. The dimensionality of the items was evaluated using factor analyses, with results suggesting three factors in fair- and dark-skinned patients ("Psychological effects on daily life," "Relationships and Sexuality," and "Economic Constraints, Care & Management of Disease"). Unidimensionality was confirmed by higher order factor analysis. Cronbach's α were high-and intradimensional coherences all demonstrated good reliability (α > 0.8). The final instrument consists of 29 items (19 items common to all patients, 3 specific to fair skin, and 7 to dark skin). The test-retest reliability demonstrated very good reproducibility. The intraclass correlation of each dimension was greater than 0.90 for each population. External validity was confirmed by the correlation coefficients and Bland and Altman plots of the Vitiligo Impact Patient scale-Fair Skin and Vitiligo Impact Patient scale-Dark Skin versus the Short-Form-12, PVC Metra, Body Image States Scale, and Daily Life Quality Index assessment tools. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. Estimating the global burden of low back pain attributable to combined occupational exposures.

    Science.gov (United States)

    Punnett, Laura; Prüss-Utün, Annette; Nelson, Deborah Imel; Fingerhut, Marilyn A; Leigh, James; Tak, SangWoo; Phillips, Sharonne

    2005-12-01

    There is little information about the global burden of non-traumatic low back pain (LBP) attributable to the effects of physical and psychosocial occupational stressors. Based on a review of the epidemiological evidence, occupation-specific relative risks were used to compute attributable proportions by age, gender, and geographical sub-region for the economically active population aged 15 and older. The reference group was professional/administrative workers; other risk categories were Low, clerical and sales; Moderate, operators (production workers) and service; and High, farmers. Worldwide, 37% of LBP was attributed to occupation, with twofold variation across regions. The attributable proportion was higher for men than women, because of higher participation in the labor force and in occupations with heavy lifting or whole-body vibration. Work-related LBP was estimated to cause 818,000 disability-adjusted life years lost annually. Occupational exposures to ergonomic stressors represent a substantial source of preventable back pain. Specific research on children is needed to quantify the global burden of disease due to child labor. 2005 Wiley-Liss, Inc.

  5. 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

  6. Symptom burden in the last week of life

    NARCIS (Netherlands)

    Klinkenberg, Marianne; Willems, Dick L.; van der Wal, Gerrit; Deeg, Dorly J. H.

    2004-01-01

    In order to investigate symptom burden in the last week of life, we conducted after-death interviews with close relatives of deceased older persons from a population-based sample of older people in The Netherlands (n=270). Results show that fatigue, pain, and shortness of breath were common (83%,

  7. Who Bears the Tax Burden? Studies of Government Finance Series.

    Science.gov (United States)

    Pechman, Joseph A.; Okner, Benjamin A.

    The purpose of this book is to estimate the effect of all U.S. taxes on the distribution of income by size of income and by other taxpayer characteristics. The book is concerned solely with the distribution of tax burdens, without any reference to the distribution of the governmental benefits that are supported by taxes. Based on an analysis of…

  8. 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

  9. Violence and injury observatories: Reducing the burden of injury in ...

    African Journals Online (AJOL)

    Violence has been recognised officially as a global health issue, with the World Health Organization (WHO) reporting that 1.6 million people die annually from violence. South Africa's injury burden is very high, particularly for homicide, which is six times the global average. The idea of an 'observatory' has expanded recently ...

  10. Burden and psychological effects : caregiver experiences in a ...

    African Journals Online (AJOL)

    60% of patients had a diagnosis of schizophrenia (ICD 10 diagnostic criteria) while 25% had a diagnosis of bipolar affective disorder, 6.3% had depression and 6.3% had complex partial seizure disorders. The commonest diagnosis among the patients of those relatives with more than average burden was schizophrenia.

  11. 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 diabe- tes mellitus ... Conclusion: There is a high burden of microvascular complications in patients with type 2 diabetes. Age, male gender, ..... of its prevalence and its risk factors in Port Harcourt,. Nigeria.

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

    DEFF Research Database (Denmark)

    Hondras, Maria; Hartvigsen, Jan; Myburgh, Corrie

    2016-01-01

    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...

  13. The Double Burden of Malnutrition : A Review of Global Evidence

    OpenAIRE

    Rokx, Claudia; Shrimpton, Roger

    2012-01-01

    The Double Burden of Malnutrition (DBM) is the coexistence of both under nutrition and over nutrition in the same population across the life course. 'Across the life course' refers to the phenomenon that under nutrition early in life contributes to an increased propensity for over nutrition in adulthood. The DBM affects all countries, rich and poor, and is a particular concern in countries...

  14. The burden of gunshot injuries on orthopaedic healthcare resources ...

    African Journals Online (AJOL)

    Background. Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 ...

  15. 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 ...

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

    African Journals Online (AJOL)

    Worku_Y

    Fight against Public Corruption: Identifying the Elements of the Offence under the. Criminal Code of Ethiopia' in ..... of evidential presumption has the effect of transferring or “shifting” evidential burden in respect of the fifth ... under the direct or indirect possession of the accused public servant is a result of some illegal or illicit ...

  17. Burden in informal carers of mentally infirm elderly in Lancashire ...

    African Journals Online (AJOL)

    ... carer socio-demography, carer-dependant interpersonal relationship in relation to care giving and care-recipient dependency needs using a modified version of the CADI; and, the 28-item GHQ. ... Out of 51 carers receiving respite admission services, six (12%) considered such admissions as additional burden.

  18. 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.

  19. 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.

  20. 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,…

  1. Estimating the burden of disease attributable to deficiency anaemia ...

    African Journals Online (AJOL)

    Estimating the burden of disease attributable to deficiency anaemia in South Africa in 2000. ... Direct sequelae of IDA, maternal andperinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1 % of children and 9 - 12% of pregnant women had IDA and ...

  2. 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

  3. 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, 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

  4. 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

  5. Thrombosis: A major contributor to global disease burden

    NARCIS (Netherlands)

    Raskob, G. E.; Angchaisuksiri, P.; Blanco, A. N.; Buller, H.; Gallus, A.; Hunt, B. J.; Hylek, E. M.; Kakkar, A.; Konstantinides, S. V.; McCumber, M.; Ozaki, Y.; Wendelboe, A.; Weitz, J. I.

    2014-01-01

    Thrombosis is a common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischemic heart disease and stroke collectively caused one in four deaths worldwide. GBD 2010 did not report data

  6. Thrombosis: A major contributor to global disease burden

    NARCIS (Netherlands)

    Raskob, G. E.; Angchaisuksiri, P.; Blanco, A. N.; Buller, H.; Gallus, A.; Hunt, B. J.; Hylek, E. M.; Kakkar, A.; Konstantinides, S. V.; McCumber, M.; Ozaki, Y.; Wendelboe, A.; Weitz, J. I.

    2014-01-01

    Thrombosis is a common pathology underlying ischaemic heart disease, ischaemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischaemic heart disease and stroke collectively caused one in four deaths worldwide. GBD 2010 did not report

  7. Thrombosis: a major contributor to global disease burden

    NARCIS (Netherlands)

    Raskob, G. E.; Angchaisuksiri, P.; Blanco, A. N.; Buller, H.; Gallus, A.; Hunt, B. J.; Hylek, E. M.; Kakkar, A.; Konstantinides, S. V.; McCumber, M.; Ozaki, Y.; Wendelboe, A.; Weitz, J. I.

    2014-01-01

    Thrombosis is the common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischemic heart disease and stroke collectively caused 1 in 4 deaths worldwide. GBD 2010 did not report data for

  8. Thrombosis: a major contributor to the global disease burden

    NARCIS (Netherlands)

    Raskob, G. E.; Angchaisuksiri, P.; Blanco, A. N.; Buller, H.; Gallus, A.; Hunt, B. J.; Hylek, E. M.; Kakkar, A.; Konstantinides, S. V.; McCumber, M.; Ozaki, Y.; Wendelboe, A.; Weitz, J. I.

    2014-01-01

    Thrombosis is a common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2010 documented that ischemic heart disease and stroke collectively caused one in four deaths worldwide. GBD

  9. Thrombosis: a major contributor to global disease burden

    NARCIS (Netherlands)

    Raskob, Gary E.; Angchaisuksiri, Pantep; Blanco, Alicia N.; Büller, Harry; Gallus, Alexander; Hunt, Beverley J.; Hylek, Elaine M.; Kakkar, The Lord; Konstantinides, Stavros V.; McCumber, Micah; Ozaki, Yukio; Wendelboe, Aaron; Weitz, Jeffrey I.

    2014-01-01

    Thrombosis is a common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischemic heart disease and stroke collectively caused one in four deaths worldwide. GBD 2010 did not report data

  10. Estimating the burden of disease attributable to vitamin A deficiency ...

    African Journals Online (AJOL)

    Objectives. To estimate the burden of disease attributable to vitamin A deficiency in children aged 0 - 4 years and pregnant women aged 15 - 49 years in South Africa in 2000. Design. The framework adopted for the most recent World Health Organization comparative risk assessment (CRA) methodology was followed.

  11. 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.

  12. Ghana's burden of chronic non-communicable diseases: Future ...

    African Journals Online (AJOL)

    The prevalence of major chronic non-communicable diseases and their risk factors has increased over time and contributes significantly to the Ghana's disease burden. Conditions like hypertension, stroke and diabetes affect young and old, urban and rural, and wealthy and poor communities. The high cost of care

  13. 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.

  14. 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.

  15. Burden and psychological effects : caregiver experiences in a ...

    African Journals Online (AJOL)

    Objective: Worldwide, research into experiences of care givers are gradually increasing and their central role in community care is being acknowledged. Caregivers experience a multidimensional range of problems, often associated with their caregiving role. It becomes important to identify these areas of burden and ...

  16. Burden of mental illness on family members, caregivers and the ...

    African Journals Online (AJOL)

    Objective: To determine the burden of mental illness in the family/caregiver and the community. Design: A cross-sectional descriptive study. Setting: Rehabilitation centres, community day centres, resettlement villages and in the community in three provinces (Harare, Bulawayo and Masvingo), Zimbabwe. Subjects: A sample ...

  17. 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.

  18. Intestinal obstruction in a child with an exceptional ascaris burden ...

    African Journals Online (AJOL)

    Intestinal obstruction in a child with an exceptional ascaris burden - a case report. E A Agbakwuru, O Akinola, O Adejuyigbe, E O Komolafe. Abstract. No Abstract. NQJHM Vol. 8 (4) 1998: pp. 270-271. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  19. Volume of alcohol consumption, patterns of drinking and burden of ...

    African Journals Online (AJOL)

    The aim of this study was to provide an overview of the volume of alcohol consumption, type of beverage, patterns of drinking and alcohol-attributable burden of disease among adults in sub- Saharan Africa (SSA) for the year 2002. Exposure data were taken from surveys, the World Health Organization (WHO) Global Status ...

  20. 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.

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

    African Journals Online (AJOL)

    Objective: To determine levels and correlates of caregiver burden among caregivers of children and adolescents with psychiatric morbidity. Method: Over a period of four months, a total of 252 caregivers of children and adolescents with psychiatric morbidity were recruited. Data on socio-demographic factors, psychiatric ...

  2. Role burdens and physical health of women and men.

    Science.gov (United States)

    Verbrugge, L M

    1986-01-01

    This article looks at role burdens experienced by women and men, asking if heavy burdens are linked with poor physical health status and frequent health care. The role burden variables refer to job schedule, feelings about roles and life, time constraints and pressures, family dependency, and levels of role involvement and responsibility. The data source is the Health In Detroit Study, which has health items from a retrospective interview and prospective health diaries. Results show that dissatisfaction with roles/life and feelings of very great or very little time pressure are associated with poor health. To a lesser extent, very low or very high objective time constraints, irregular and short job schedules, no or high family dependency, and very low or very high income responsibility are linked with poor health. By contrast, having numerous roles is associated with good health. Some of these results point toward social causation (how the quantity and quality of roles influence health) and others to social selection (how health influences role involvements). The relationships are similar for women and men. But women are more at risk of poor health because, more often than men, they tend to have few roles (especially nonemployment), more dissatisfaction with their main role and life, low time constraints, low income responsibility, and irregular job schedules. In conclusion, role burdens may lie more in subjective feelings about one's activities than in their objective characteristics. Having low quality roles may jeopardize health, whereas having numerous ones can help maintain or enhance it.

  3. 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 <5 years of age hospitalized for acute gastroenteriti...

  4. 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.

  5. Burden of typhoid fever in Sulaimania, Iraqi Kurdistan

    Directory of Open Access Journals (Sweden)

    Jonathan Dworkin

    2014-10-01

    Discussion: 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.

  6. 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 ...

  7. The burden of disease in commercial motorcycle injuries at Ibadan ...

    African Journals Online (AJOL)

    Background: Commuting by the motorcycle ('Okada') has become a menace in Nigeria due to injuries from preventable crashes. This study elucidates the pattern of injuries and the burden of disease from motorcycle crashes presenting in our facility. Patients and methods: Patients presenting to our tertiary hospital following ...

  8. 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 ...

  9. Burden, etiology and predictors of visual impairment among children ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... hood visual impairment among the children attending the eye clinic in Mulago National Referral Hospital. ... Cite as: Kinengyere P, Kizito S, Kiggundu JB, Ampaire A, Wabulembo G. Burden, etiology and predictors of visual impairment among children ..... College of Health Sciences for all the support.

  10. Estimating the burden of disease attributable to vitamin A deficiency ...

    African Journals Online (AJOL)

    other infections, and mortality and DALYs associated with malaria in .... the burden of disease in South Africa attributable to vitamin A .... of deaths from diarrhoeal diseases,. 23% of those from measles and 21% of those from malaria in children. D. The prevalence of vitamin A deficiency in South African children aged 0 - 4.

  11. 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

  12. Socioeconomic differences in the burden of disease in Sweden

    DEFF Research Database (Denmark)

    Ljung, Rickard; Peterson, Stefan; Hallqvist, Johan

    2005-01-01

    of this unequally distributed burden falls on unskilled manual workers. The largest contributors to inequalities in health for women are ischaemic heart disease, depression and neurosis, and stroke. For men, the largest contributors are ischaemic heart disease, alcohol addiction and self-inflicted injuries...

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

    African Journals Online (AJOL)

    Population-attributable fractions were calculated and applied to revised burden of disease estimates for the relevant disease categories for South Africa in the year 2000. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. Setting. South Africa. Subjects. Children under 5 and adults 30 years ...

  14. 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.

  15. Burden and outcome of acute otitis media in rural Bangladesh

    African Journals Online (AJOL)

    Acute otitis media (AOM) is a common childhood condition that contributes significantly to the medical, social and economic burden of disease in children worldwide.1-3 In developed countries, AOM is the most frequent reason for doctor visits for illness.4-6 Survey data show that approximately 10% of children in the USA ...

  16. Characterising cancer burden and quality of care at two palliative ...

    African Journals Online (AJOL)

    Background: This paper describes cancer burden and compares characteristics of cancer patients enrolled at 2 palliative care facilities of contrasting resources ... Methods: Data on all cancer patients registered between October 2010 and October 2015 at Tiyanjane Clinic (at Queen Elizabeth Central Hospital, Blantyre) and ...

  17. National Policy Agenda to Reduce the Burden of Student Debt

    Science.gov (United States)

    Institute for College Access & Success, 2014

    2014-01-01

    Since 2005, "The Institute for College Access & Success" (TICAS) and its Project on Student Debt have worked to reduce the risks and burdens of student debt. TICAS helped create and improve income-based repayment plans to keep federal loan payments manageable; strengthen Pell Grants, which reduce the need to borrow; and simplify the…

  18. 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

  19. Assessment of the burden of human African trypanosomiasis by ...

    African Journals Online (AJOL)

    Background: The public health and socio-economic burden of Human African Trypanosomiasis (HAT) in East Africa is not well documented. Understanding the epidemiology and impact of HAT in such settings is difficult due to a lack of robust surveillance and reporting systems, restricting evidence-based policy ...

  20. The dual burden household and the nutrition transition paradox

    NARCIS (Netherlands)

    Doak, C.M.; Adair, L.S.; Bentley, M.; Monteiro, C.; Popkin, B.M.

    2005-01-01

    OBJECTIVE: The purpose of this study is to document the prevalence of households with underweight and overweight persons (henceforth referred to as dual burden households) and their association with income and urban residence. The explorations by urban residence and income will test whether dual

  1. Disease burden of selected gastrointestinal pathogens in Australia, 2010

    Directory of Open Access Journals (Sweden)

    Katherine B. Gibney

    2014-11-01

    Conclusions: The pathogen causing the greatest disease burden varied according to the metric used, however DALYs are considered most useful given the incorporation of morbidity, mortality, and sequelae. These results can be used to prioritize public health interventions toward Salmonella and Campylobacter infections and to measure the impact of these interventions.

  2. 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…

  3. 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 ...

  4. Disease burden of chronic hepatitis C in Brazil

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Abrão Ferreira

    2015-07-01

    Conclusions: While the incidence and prevalence of hepatitis C virus in Brazil are decreasing; cases of advanced liver disease continue to rise. Besides higher sustained virological response rates; new strategies focused on increasing the proportion of diagnosed patients and eligibility to treatment should be adopted in order to reduce the burden of hepatitis C virus infection in Brazil.

  5. Burden of diseases in poor resource countries: meeting the ...

    African Journals Online (AJOL)

    HIV/AIDS, malaria and tuberculosis are by far the commonest causes of ill-health and death in the poorest countries of the world which happen to be in the tropics and temperate countries in Africa, ... Key words: HIV/AIDS, malaria, tuberculosis, burden, poverty, research ..... investigations for HIV and tuberculosis for adults.

  6. The increasing burden of tuberculosis in rural South Africa - impact ...

    African Journals Online (AJOL)

    esman &. e cost of. Afr le. In: nd. ARTICLES. The increasing burden of tuberculosis in rural South. Africa - impact of the HIV epidemic. Cavid Wilkinson, G R Cavies. Objective. To determine the impact of the HIV epidemic on tuberculosis caseload in rural South Africa. Setting. Hlabisa health district, Kwazulu-Natal. Methods.

  7. 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 ...

  8. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

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

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

    2017-03-27

    Mar 27, 2017 ... But if we dig a bit deeper to learn how rural women farmers are spending their time, it's clear that they face the double burden of work more than anyone. Data from UN Women shows that rural women are spending more time than urban women and men in reproductive and household work, including time ...

  10. 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 ...

  11. [Evaluation indices of social burden caused by advanced schistosomiasis].

    Science.gov (United States)

    Deng, Yao; Zhou, Xiao-Nong; Jia, Tie-Wu; Wang, Xian-Hong; Yang, Kun; Wu, Xiao-Hua; Li, Shi-Zhu

    2008-06-30

    To study the evaluation indices and their weights of social burden caused by advanced schistosomiasis so as to provide scientific basis for control of the disease. Primary indices of social burden evaluation for advanced schistosomiasis were summarized based on literature review. Secondary indices were put forward by a brainstorming process of experts. After the first round Delphi method, the secondary indices that needed were chosen, and the importance of primary indices was prioritized. Through the second and third round Delphi method, the weight of each secondary index was obtained. Four primary indices and 16 secondary indices consisted the index system of social burden induced by the disease. According to the significance, the 4 primary indices were arranged as social economy, government image, public psychology and social security. The weight of "funding for schistosomiasis control from central and local governments" in "social economic" stood the largest (14.063), while that of "equity to patients" in "government image", the smallest (3.125). The study covers all major aspects and their significance in social burden of advanced schistosomiasis, and an evaluation index system has been established for field validation.

  12. 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

  13. Original Research Characterising cancer burden and quality of care ...

    African Journals Online (AJOL)

    This paper describes cancer burden and compares characteristics of cancer patients enrolled at 2 palliative care facilities of contrasting resources ... Data on all cancer patients registered between October 2010 and October 2015 at Tiyanjane Clinic (at Queen Elizabeth Central Hospital, ..... rectum, and colon) was observed.

  14. 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.

  15. The burden, antibiogram and pathogenicity of bacteria found in ...

    African Journals Online (AJOL)

    Municipal wastes may harbour microbial pathogens but the quantum and diseasecausing capacities of such organisms are rarely investigated. This study sought to establish the burden, antibiogram and pathogenicity of bacteria in 4 selected waste dumpsites and those found on hands and clothings of the respective waste ...

  16. The problem: high burden on the health system?

    NARCIS (Netherlands)

    Jong, J. de; Schäfer, W.

    2013-01-01

    Background: Often, ageing of the population is seen as an important cause for rising costs and an increasing burden on European health care systems in terms of workforce and rising expenditures (e.g. due to higher costs in long term care). In this presentation we discuss what is known today about

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

    African Journals Online (AJOL)

    Objectives. To estimate the burden of respiratory ill health in South African children and adults in 2000 from exposure to indoor air pollution associated with household use of solid fuels. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. The South African Census 2001 was ...

  18. [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.

  19. The socio-economic burden of snakebite in Sri Lanka.

    Science.gov (United States)

    Kasturiratne, Anuradhani; Pathmeswaran, Arunasalam; Wickremasinghe, A Rajitha; Jayamanne, Shaluka F; Dawson, Andrew; Isbister, Geoff K; de Silva, Hithanadura Janaka; Lalloo, David G

    2017-07-01

    Snakebite is a major problem affecting the rural poor in many of the poorest countries in the tropics. However, the scale of the socio-economic burden has rarely been studied. We undertook a comprehensive assessment of the burden in Sri Lanka. Data from a representative nation-wide community based household survey were used to estimate the number of bites and deaths nationally, and household and out of pocket costs were derived from household questionnaires. Health system costs were obtained from hospital cost accounting systems and estimates of antivenom usage. DALYs lost to snakebite were estimated using standard approaches using disability weights for poisoning. 79% of victims suffered economic loss following a snakebite with a median out of pocket expenditure of $11.82 (IQR 2-28.57) and a median estimated loss of income of $28.57 and $33.21 for those in employment or self-employment, respectively. Family members also lost income to help care for patients. Estimated health system costs for Sri Lanka were $ 10,260,652 annually. The annual estimated total number of DALYS was 11,101 to 15,076 per year for envenoming following snakebite. Snakebite places a considerable economic burden on the households of victims in Sri Lanka, despite a health system which is accessible and free at the point of care. The disability burden is also considerable, similar to that of meningitis or dengue, although the relatively low case fatality rate and limited physical sequelae following bites by Sri Lankan snakes means that this burden may be less than in countries on the African continent.

  20. 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

  1. 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.

  2. The socio-economic burden of snakebite in Sri Lanka.

    Directory of Open Access Journals (Sweden)

    Anuradhani Kasturiratne

    2017-07-01

    Full Text Available Snakebite is a major problem affecting the rural poor in many of the poorest countries in the tropics. However, the scale of the socio-economic burden has rarely been studied. We undertook a comprehensive assessment of the burden in Sri Lanka.Data from a representative nation-wide community based household survey were used to estimate the number of bites and deaths nationally, and household and out of pocket costs were derived from household questionnaires. Health system costs were obtained from hospital cost accounting systems and estimates of antivenom usage. DALYs lost to snakebite were estimated using standard approaches using disability weights for poisoning.79% of victims suffered economic loss following a snakebite with a median out of pocket expenditure of $11.82 (IQR 2-28.57 and a median estimated loss of income of $28.57 and $33.21 for those in employment or self-employment, respectively. Family members also lost income to help care for patients. Estimated health system costs for Sri Lanka were $ 10,260,652 annually. The annual estimated total number of DALYS was 11,101 to 15,076 per year for envenoming following snakebite.Snakebite places a considerable economic burden on the households of victims in Sri Lanka, despite a health system which is accessible and free at the point of care. The disability burden is also considerable, similar to that of meningitis or dengue, although the relatively low case fatality rate and limited physical sequelae following bites by Sri Lankan snakes means that this burden may be less than in countries on the African continent.

  3. Economic burden of neonatal sepsis in sub-Saharan Africa.

    Science.gov (United States)

    Ranjeva, Sylvia L; Warf, Benjamin C; Schiff, Steven J

    2018-01-01

    The third Sustainable Development Goal for child health, which aims to end preventable deaths of newborns and children less than 5 years of age by 2030, cannot be met without substantial reduction of infection-specific neonatal mortality in the developing world. Neonatal infections are estimated to account for 26% of annual neonatal deaths, with mortality rates highest in sub-Saharan Africa (SSA). Reliable and comprehensive estimates of the incidence and aetiology surrounding neonatal sepsis in SSA remain incompletely available. We estimate the economic burden of neonatal sepsis in SSA. Data available through global health agencies and in the medical literature were used to determine population demographics in SSA, as well as to determine the incidence, disease burden, mortality and resulting disabilities associated with neonatal sepsis. The disability-adjusted life years (DALY) associated with successful treatment or prevention of neonatal sepsis in SSA for 1 year were calculated. The value of a statistical life (VSL) methodology was estimated to evaluate the economic burden of untreated neonatal sepsis in SSA. We conservatively estimate that 5.29-8.73 million DALYs are lost annually in SSA due to neonatal sepsis. Corresponding VSL estimates predict an annual economic burden ranging from $10 billion to $469 billion. Our results highlight and quantify the scope of the public health and economic burden posed by neonatal sepsis in SSA. We quantify the substantial potential impact of more successful treatment and prevention strategies, and we highlight the need for greater investment in strategies to characterise, diagnose, prevent and manage neonatal sepsis and its long-term sequelae in SSA.

  4. The Burden of Parasitic Zoonoses in Nepal: A Systematic Review

    Science.gov (United States)

    Devleesschauwer, Brecht; Ale, Anita; Torgerson, Paul; Praet, Nicolas; Maertens de Noordhout, Charline; Pandey, Basu Dev; Pun, Sher Bahadur; Lake, Rob; Vercruysse, Jozef; Joshi, Durga Datt; Havelaar, Arie H.; Duchateau, Luc; Dorny, Pierre; Speybroeck, Niko

    2014-01-01

    Background 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. Methodology 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. Principal Findings 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. Conclusions/Significance 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

  5. The Burden of Zoonoses in Kyrgyzstan: A Systematic Review.

    Science.gov (United States)

    Counotte, Michel J; Minbaeva, Gulnara; Usubalieva, Jumagul; Abdykerimov, Kubanychbek; Torgerson, Paul R

    2016-07-01

    Zoonotic disease (ZD) pose a serious threat to human health in low-income countries. In these countries the human burden of disease is often underestimated due to insufficient monitoring because of insufficient funding. Quantification of the impact of zoonoses helps in prioritizing healthcare needs. Kyrgyzstan is a poor, mountainous country with 48% of the population employed in agriculture and one third of the population living below the poverty line. We have assessed the burden of zoonoses in Kyrgyzstan by conducting a systematic review. We have used the collected data to estimate the burden of ZDs and addressed the underestimation in officially reported disease incidence. The estimated incidences of the ZDs were used to calculate incidence-based Disability Adjusted Life Years (DALYs). This standardized health gap measure enhances comparability between injuries and diseases. The combined burden for alveolar echinococcosis, cystic echinococcosis, brucellosis, campylobacteriosis, congenital toxoplasmosis, non-typhoidal salmonellosis and rabies in Kyrgyzstan in 2013 was 35,209 DALYs [95% Uncertainty interval (UI):13,413-83,777]; 576 deaths [95% UI: 279-1,168] were attributed to these infections. We estimate a combined median incidence of ZDs of 141,583 cases [95% UI: 33,912-250,924] in 2013. The highest burden was caused by non-typhoidal Salmonella and Echinococcus multilocularis, respectively 14,792 DALYs [95% UI: 3,966-41,532] and 11,915 DALYs [95% UI: 4,705-27,114] per year. The health impact of zoonoses in Kyrgyzstan is substantial, comparable to that of HIV. Community-based surveillance studies and hospital-based registration of all occurrences of zoonoses would increase the accuracy of the estimates.

  6. The Burden of Zoonoses in Kyrgyzstan: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Michel J Counotte

    2016-07-01

    Full Text Available Zoonotic disease (ZD pose a serious threat to human health in low-income countries. In these countries the human burden of disease is often underestimated due to insufficient monitoring because of insufficient funding. Quantification of the impact of zoonoses helps in prioritizing healthcare needs. Kyrgyzstan is a poor, mountainous country with 48% of the population employed in agriculture and one third of the population living below the poverty line.We have assessed the burden of zoonoses in Kyrgyzstan by conducting a systematic review. We have used the collected data to estimate the burden of ZDs and addressed the underestimation in officially reported disease incidence. The estimated incidences of the ZDs were used to calculate incidence-based Disability Adjusted Life Years (DALYs. This standardized health gap measure enhances comparability between injuries and diseases. The combined burden for alveolar echinococcosis, cystic echinococcosis, brucellosis, campylobacteriosis, congenital toxoplasmosis, non-typhoidal salmonellosis and rabies in Kyrgyzstan in 2013 was 35,209 DALYs [95% Uncertainty interval (UI:13,413-83,777]; 576 deaths [95% UI: 279-1,168] were attributed to these infections. We estimate a combined median incidence of ZDs of 141,583 cases [95% UI: 33,912-250,924] in 2013. The highest burden was caused by non-typhoidal Salmonella and Echinococcus multilocularis, respectively 14,792 DALYs [95% UI: 3,966-41,532] and 11,915 DALYs [95% UI: 4,705-27,114] per year.The health impact of zoonoses in Kyrgyzstan is substantial, comparable to that of HIV. Community-based surveillance studies and hospital-based registration of all occurrences of zoonoses would increase the accuracy of the estimates.

  7. Economic burden of neonatal sepsis in sub-Saharan Africa

    Science.gov (United States)

    Ranjeva, Sylvia L; Warf, Benjamin C

    2018-01-01

    Background and significance The third Sustainable Development Goal for child health, which aims to end preventable deaths of newborns and children less than 5 years of age by 2030, cannot be met without substantial reduction of infection-specific neonatal mortality in the developing world. Neonatal infections are estimated to account for 26% of annual neonatal deaths, with mortality rates highest in sub-Saharan Africa (SSA). Reliable and comprehensive estimates of the incidence and aetiology surrounding neonatal sepsis in SSA remain incompletely available. We estimate the economic burden of neonatal sepsis in SSA. Methods Data available through global health agencies and in the medical literature were used to determine population demographics in SSA, as well as to determine the incidence, disease burden, mortality and resulting disabilities associated with neonatal sepsis. The disability-adjusted life years (DALY) associated with successful treatment or prevention of neonatal sepsis in SSA for 1 year were calculated. The value of a statistical life (VSL) methodology was estimated to evaluate the economic burden of untreated neonatal sepsis in SSA. Results We conservatively estimate that 5.29–8.73 million DALYs are lost annually in SSA due to neonatal sepsis. Corresponding VSL estimates predict an annual economic burden ranging from $10 billion to $469 billion. Conclusions Our results highlight and quantify the scope of the public health and economic burden posed by neonatal sepsis in SSA. We quantify the substantial potential impact of more successful treatment and prevention strategies, and we highlight the need for greater investment in strategies to characterise, diagnose, prevent and manage neonatal sepsis and its long-term sequelae in SSA. PMID:29564153

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Montgomery W

    2013-08-01

    Full Text Available William Montgomery,1 Li Liu,2 Michael D Stensland,5 Hai Bo Xue,2 Tamas Treuer,4 Haya Ascher-Svanum31Eli Lilly and Company, Sydney, NSW, Australia; 2Lilly Suzhou Pharmaceutical Company, Ltd, Shanghai, People's Republic of China; 3Eli Lilly and Company, Global Health Outcomes, Indianapolis, IN, USA; 4Eli Lilly and Company, Budapest, Hungary; 5Agile Outcomes Research, Inc, Rochester, MN, USABackground: 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.Methods: 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.Results: 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

  10. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... Articles and Media Computed Tomography (CT) - Body Magnetic Resonance Imaging (MRI) - Body General Ultrasound Contrast Materials Anesthesia Safety X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Videos related to Foreign Body Retrieval ...

  11. 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 ...

  12. Foreign Body Retrieval

    Medline Plus

    Full Text Available ... the limitations of foreign body detection and removal? What is Foreign Body Retrieval? Foreign body retrieval involves ... and damage to surrounding tissues. top of page What are some common uses of the procedure? Foreign ...

  13. Lewy Body Disease

    Science.gov (United States)

    Lewy body disease is one of the most common causes of dementia in the elderly. Dementia is the loss of mental ... to affect normal activities and relationships. Lewy body disease happens when abnormal structures, called Lewy bodies, build ...

  14. 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.

  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. Intra-individual double burden of overweight and micronutrient deficiencies among Vietnamese women.

    Science.gov (United States)

    Laillou, Arnaud; Yakes, Elizabeth; Le, Thi Hop; Wieringa, Frank Tammo; Le, Bach Mai; Moench-Pfanner, Regina; Berger, Jacques

    2014-01-01

    Vietnamese Living Standard Surveys showed that the rate of overweight and obese in Vietnamese adults doubled between 1992 and 2002, from 2% to 5.5%, respectively with no significant difference in the proportions of overweight/obesity between men and women. Considering the increasing public health concern over the double burden of malnutrition in Vietnam, we investigated micronutrient deficiencies among women of reproductive age according to their Body Mass Index. A transversal study was conducted in 2010 among 1530 women of reproductive age from 19 provinces. Participating women were asked to give a non-fasting blood sample for plasma iron, vitamin A, folate, vitamin B12 and zinc assessment. Although % body fat was associated with haemoglobin, ferritin, retinol and zinc concentrations, BMI category was only associated with marginal vitamin A status (19% among underweight vs 7% among overweight/obese; poverweight/obese women; prevalence of zinc deficiency and marginal/deficient folate status was much higher, affecting respectively 61.1% and 25.8%. Intra-individual double burden of malnutrition (overweight/obesity (OW) and micronutrient deficiency) was observed among 2.0% for OW-anemia, 2.3% OW-iron deficient, 3.0% for OW-Vitamin B12 deficiency, 12.2% for OW-Zinc deficiency and 5.2% for OW-marginal/deficient folate status. This large, cross-sectional survey demonstrated that micronutrient deficiencies are an issue across the weight spectrum among women in Vietnam, with only vitamin A status being better among overweight than underweight women. It is therefore essential for Vietnam to actively prevent women of reproductive age from overweight/obesity and at same time to control micronutrient deficiencies in this population to limit their economic and health consequences.

  17. Foreign body orbital cyst

    DEFF Research Database (Denmark)

    Yazdanfard, Younes; Heegard, Steffen; Fledelius, Hans C.

    2001-01-01

    Ophthalmology, penetrating orbital injury, orbital foreign body, ultrasound, computed tomography (CT), histology......Ophthalmology, penetrating orbital injury, orbital foreign body, ultrasound, computed tomography (CT), histology...

  18. 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 ...

  19. 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

  20. Caregiver burden and coping: a prospective study of relationship between burden and coping in caregivers of patients with schizophrenia and bipolar affective disorder.

    Science.gov (United States)

    Chadda, Rakesh K; Singh, Tej B; Ganguly, Kalyan K

    2007-11-01

    Caregivers of patients of schizophrenia and bipolar affective disorder (BAD) experience considerable burden while caring their patients. They develop different coping strategies to deal with this burden. Longitudinal studies are required to assess the relationship between caregiver burden and coping. The present study was conducted to assess relationship between burden and coping in caregivers of clinically stable patients with schizophrenia and BAD. One hundred patients each of schizophrenia and BAD attending a psychiatric outpatient setting and their caregivers were followed up for a period of 6 months. Burden and coping strategies were assessed in the caregivers at baseline, and after 3 and 6 months using the Burden Assessment Schedule (BAS) and Ways of Coping Checklist - Hindi Adaptation (WCC - HA). Burden remained stable over 6 months and was comparable in the two groups of caregivers. Caregivers from both the groups were found to use problem focused coping strategies more often than seek social support and avoidance strategies. Scores on avoidance type of coping showed a positive correlation with the total burden scores and a number of burden factors. Caregivers of patients of schizophrenia and BAD face similar levels of burden and use similar types of coping methods to deal with it. Relationship between caregiver burden and coping is quite complex.

  1. The global burden of scabies: a cross-sectional analysis from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    Karimkhani, Chante; Colombara, Danny V; Drucker, Aaron M; Norton, Scott A; Hay, Roderick; Engelman, Daniel; Steer, Andrew; Whitfeld, Margot; Naghavi, Mohsen; Dellavalle, Robert P

    2017-12-01

    Numerous population-based studies have documented high prevalence of scabies in overcrowded settings, particularly among children and in tropical regions. We provide an estimate of the global burden of scabies using data from the Global Burden of Disease (GBD) Study 2015. We identified scabies epidemiological data sources from an extensive literature search and hospital insurance data and analysed data sources with a Bayesian meta-regression modelling tool, DisMod-MR 2·1, to yield prevalence estimates. We combined prevalence estimates with a disability weight, measuring disfigurement, itch, and pain caused by scabies, to produce years lived with disability (YLDs). With an assumed zero mortality from scabies, YLDs were equivalent to disability-adjusted life-years (DALYs). We estimated DALYs for 195 countries divided into 21 world regions, in both sexes and 20 age groups, between 1990 and 2015. Scabies was responsible for 0·21% of DALYs from all conditions studied by GBD 2015 worldwide. The world regions of east Asia (age-standardised DALYs 136·32), southeast Asia (134·57), Oceania (120·34), tropical Latin America (99·94), and south Asia (69·41) had the greatest burden of DALYs from scabies. Mean percent change of DALY rate from 1990 to 2015 was less than 8% in all world regions, except North America, which had a 23·9% increase. The five individual countries with greatest scabies burden were Indonesia (age-standardised DALYs 153·86), China (138·25), Timor-Leste (136·67), Vanuatu (131·59), and Fiji (130·91). The largest standard deviations of age-standardised DALYs between the 20 age groups were observed in southeast Asia (60·1), Oceania (58·3), and east Asia (56·5), with the greatest DALY burdens in children, adolescents, and the elderly. The burden of scabies is greater in tropical regions, especially in children, adolescents, and elderly people. As a worldwide epidemiological assessment, GBD 2015 provides broad and frequently updated measures of

  2. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010

    Science.gov (United States)

    Feigin, Valery L; Forouzanfar, Mohammad H; Krishnamurthi, Rita; Mensah, George A; Connor, Myles; Bennett, Derrick A; Moran, Andrew E; Sacco, Ralph L; Anderson, Laurie; Truelsen, Thomas; O’Donnell, Martin; Venketasubramanian, Narayanaswamy; Barker-Collo, Suzanne; Lawes, Carlene M M; Wang, Wenzhi; Shinohara, Yukito; Witt, Emma; Ezzati, Majid; Naghavi, Mohsen; Murray, Christopher

    2014-01-01

    Summary 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 Risk Factors Study 2010 (GBD 2010) to estimate the global and regional burden of stroke during 1990–2010. Methods We searched Medline, Embase, LILACS, Scopus, PubMed, Science Direct, Global Health Database, the WHO library, and WHO regional databases from 1990 to 2012 to identify relevant studies published between 1990 and 2010. We applied the GBD 2010 analytical technique (DisMod-MR), based on disease-specific, pre-specified associations between incidence, prevalence, and mortality, to calculate regional and country-specific estimates of stroke incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) lost by age group (stroke significantly decreased by 12% (95% CI 6–17) in high-income countries, and increased by 12% (–3 to 22) in low-income and middle-income countries, albeit non-significantly. Mortality rates decreased significantly in both high income (37%, 31–41) and low-income and middle-income countries (20%, 15–30). In 2010, the absolute numbers of people with first stroke (16·9 million), stroke survivors (33 million), stroke-related deaths (5·9 million), and DALYs lost (102 million) were high and had significantly increased since 1990 (68%, 84%, 26%, and 12% increase, respectively), with most of the burden (68·6% incident strokes, 52·2% prevalent strokes, 70·9% stroke deaths, and 77·7% DALYs lost) in low-income and middle-income countries. In 2010, 5·2 million (31%) strokes were in children (aged stroke burden between GBD regions and countries. More than 62% of new strokes, 69·8% of prevalent strokes, 45·5% of deaths from stroke, and 71·7% of DALYs lost because of stroke were in people younger than 75 years

  3. 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

  4. Caregiver burden, patients' self-perceived burden, and preference for palliative care among cancer patients and caregivers.

    Science.gov (United States)

    Lee, Ji Eun; Shin, Dong Wook; Cho, Juhee; Yang, Hyung Kook; Kim, So Young; Yoo, Hyo Sang; Jho, Hyun Jung; Shin, Joo Yeon; Cho, Belong; Park, Keeho; Park, Jong-Hyock

    2015-11-01

    Recently, caregiver burden (CB) has emerged as an important issue in the area of palliative medicine. However, patients' feelings related to being a burden to their families (i.e., self-perceived burden [SPB]) is also a significant issue. We evaluated the relation of CB and SPB as preference for palliative care. A national, multicenter, cross-sectional survey of 326 patient-caregiver dyads was performed. A set of paired questionnaires evaluating CB and SPB (five domain items assessed on a four-point Likert scale) were independently administered to patients and their caregivers. Among the respondents, only the patients with distant stage cancer and their caregivers were included. Multivariate analyses were conducted to identify the associations between CB and SPB and preference for palliative care. Caregivers and patients who preferred palliative care to life sustaining treatment reported higher CB and SPB scores, respectively. Caregivers who felt more of a burden were more likely to prefer palliative care over life sustaining treatment for their patients (adjusted odds ratio [aOR] = 1.67, 95% CI: 1.21-2.31). In addition, patients who perceived their caregivers' burden as large tended to prefer palliative care (aOR = 1.61, 95% CI: 1.16-2.22). Both CB and SPB increased preference for palliative care. This could be interpreted that high CB can lead to preference for palliative care in both patients and their caregivers, potentially threatening patient autonomy. Efforts to relieve CB and SPB are needed. Copyright © 2015 John Wiley & Sons, Ltd.

  5. 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

  6. High levels of caregiver burden in Prader-Willi syndrome

    Science.gov (United States)

    Farrar, Evan; Comtois, Katherine Anne; Strong, Theresa V.

    2018-01-01

    Objectives Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder that is characterized by hyperphagia, developmental delay, incomplete sexual development, mild-to-moderate intellectual disability, and a variety of challenging behavioral and psychiatric symptoms. The characteristics of PWS can be difficult for caregivers to cope with and are likely to cause significant and long- term caregiver burden. The current study examined burden in 142 caregivers of children and adults with PWS living in the US using the Zarit Burden Interview (ZBI). The study aimed to measure the level of burden in caregivers of individuals with PWS, to explore the impact of PWS on caregiver quality of life, and to assess ZBI as an indicator of that impact. Results Caregivers participating in this study were predominantly mothers, 30–59 years old, non-Hispanic Whites, married or in a relationship, with an annual household income slightly distributed towards higher income. Nearly 90% of the caregiver`s children with PWS lived at home. Caregivers experienced high caregiver burden with an average ZBI score of 44.4 ± 15.4. ZBI scores were highest for caregivers of teenage and young adult individuals with PWS (49.2 ± 14.6 and 49.2 ± 14.1, respectively), while those caring for older adults (>30) and the youngest age group had lower scores (38.6 ±10.5 and 34.8 ±12.5, respectively). Caregivers reported that caring for a person with PWS negatively impacted their romantic relationship, ability to work, sleep, and mood. Whereas we did not find strong correlations between family income or level of help the caregiver receives and ZBI scores, the results showed significant correlations and a linear relationship between ZBI scores and caregiver depressed mood, feelings of anxiety, negative romantic relationship impact, as well as sleep and work disruption. Conclusions Our study reveals that PWS incurs high caregiver burden and impacts many aspects of the lives of caregiver. We

  7. Books as Bodies, Bodies as Books

    OpenAIRE

    Couch, Amanda

    2016-01-01

    Books as Bodies, Bodies as Books was a performance-lecture at the Wellcome Library, and part of the Wellcome Library Insights, a series of events which offer the opportunity to explore a theme or topic, whilst showcasing the Wellcome Library’s collection. The performance-lecture explored birthing girdles, reading as rumination, livers as tablets, flap anatomy, folds as metaphors of digestion, and palimpsests and skin. Karin Littau writes in her book, Theories of Reading: Books, Bodie...

  8. Relation between the global burden of disease and randomized clinical trials conducted in Latin America published in the five leading medical journals.

    Science.gov (United States)

    Perel, Pablo; Miranda, J Jaime; Ortiz, Zulma; Casas, Juan Pablo

    2008-02-27

    Since 1990 non communicable diseases and injuries account for the majority of death and disability-adjusted life years in Latin America. We analyzed the relationship between the global burden of disease and Randomized Clinical Trials (RCTs) conducted in Latin America that were published in the five leading medical journals. We included all RCTS in humans, exclusively conducted in Latin American countries, and published in any of the following journals: Annals of Internal Medicine, British Medical Journal, Journal of the American Medical Association, Lancet, and New England Journal of Medicine. We described the trials and reported the number of RCTs according to the main categories of the global burden of disease. Sixty-six RCTs were identified. Communicable diseases accounted for 38 (57%) reports. Maternal, perinatal, and nutritional conditions accounted for 19 (29%) trials. Non-communicable diseases represent 48% of the global burden of disease but only 14% of reported trials. No trial addressed injuries despite its 18% contribution to the burden of disease in 2000. A poor correlation between the burden of disease and RCTs publications was found. Non communicable diseases and injuries account for up to two thirds of the burden of disease in Latin America but these topics are seldom addressed in published RCTs in the selected sample of journals. Funding bodies of health research and editors should be aware of the increasing burden of non communicable diseases and injuries occurring in Latin America to ensure that this growing epidemic is not neglected in the research agenda and not affected by publication bias.

  9. 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.

  10. 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;…

  11. Burden of Oral Diseases in Iran, 1990-2010: Findings from the Global Burden of Disease Study 2010.

    Science.gov (United States)

    Shoaee, Shervan; Ghasemian, Anoosheh; Mehrabani, Kamran; Naderimagham, Shohreh; Delavari, Farnaz; Sheidaei, Ali; Hajizadeh, Nastaran; Varmaghani, Mehdi; Hessari, Hossein

    2015-08-01

    Oral diseases, as a group of chronic diseases, are among the major public health problems that lead to disability throughout the world. The major part of burden of oral diseases is caused by dental caries, periodontal diseases, edentulism, mouth cancer, cleft lip, and cleft palate. The aim of the present paper is to report the global results for the burden of oral disease in Iran from 1990 to 2010, derived from GBD study 2010 by sex and age. The Global Burden of Disease Study 2010 (GBD 2010) was a systematic effort with a common framework to estimate disability adjusted life years (DALYs) for diseases in different parts of the world. Years of life lost due to premature mortality (YLLs) were assessed based on cause-of-death estimates and by means of a cause of death ensemble model (CODEm). Years of life lost due to disability (YLDs) were computed by multiplying the prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was conducted to estimate disease distribution using a Bayesian meta-regression method (DisMod-MR). Disability weights were measured by collecting data from population-based surveys. In this paper, we describe the results of GBD 2010 regarding oral diseases in Iran, critique the results, and provide some recommendations. Between 1990 and 2010 in Iran, an increase occurred in DALYs at all ages, attributed to dental caries (from 37,230 to 56,521) as well as periodontal diseases (from 21,482 to 43,308), and a decrease was found for edentulism (from 53,134 to 47,960). DALYs at all ages attributed to mouth cancer increased (from 5,597 to 7,771), while a decline was noted for cleft lip and cleft palate (from 6,157 to 5,034). The age-standardized DALY rates per 100,000 population did not considerably change for dental caries and periodontal diseases, while edentulism showed a reduction. The corresponding DALY rate due to mouth cancer decreased, while it remained almost unchanged for

  12. 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.

  13. 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

  14. Challenges in reducing dengue burden; diagnostics, control measures and vaccines.

    Science.gov (United States)

    Lam, Sai Kit

    2013-09-01

    Dengue is a major public health concern worldwide, with the number of infections increasing globally. The illness imposes the greatest economic and human burden on developing countries that have limited resources to deal with the scale of the problem. No cure for dengue exists; treatment is limited to rehydration therapy, and with vector control strategies proving to be relatively ineffective, a vaccine is an urgent priority. Despite the numerous challenges encountered in the development of a dengue vaccine, several vaccine candidates have shown promise in clinical development and it is believed that a vaccination program would be at least as cost-effective as current vector control programs. The lead candidate vaccine is a tetravalent, live attenuated, recombinant vaccine, which is currently in Phase III clinical trials. Vaccine introduction is a complex process that requires consideration and is discussed here. This review discusses the epidemiology, burden and pathogenesis of dengue, as well as the vaccine candidates currently in clinical development.

  15. 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

  16. 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

  17. Burden of disease due to cancer in Spain

    Directory of Open Access Journals (Sweden)

    Pérez-Gómez Beatriz

    2009-01-01

    Full Text Available Abstract Background Burden of disease is a joint measure of mortality and morbidity which makes it easier to compare health problems in which these two components enjoy different degrees of relative importance. The objective of this study is ascertaining the burden of disease due to cancer in Spain via the calculation of disability-adjusted life years (DALYs. Methods DALYs are the sum of years of life lost due to premature mortality and years lost due to disability. World Health Organization methodology and the following sources of data were used: the Mortality Register and Princeton Model Life Table for Years of life lost due to premature mortality and population, incidence estimates (Spanish tumour registries and fitting of generalized linear mixed models, duration (from data of survival in Spain from the EUROCARE-3 study and fitting of Weibull distribution function and disability (weights published in the literature for Years lost due to disability. Results There were 828,997 DALYs due to cancer (20.5 DALYs/1,000 population, 61% in men. Of the total, 51% corresponded to lung, colorectal, breast, stomach and prostate cancers. Mortality (84% of DALYs predominated over disability. Subjects aged under 20 years accounted for 1.6% and those aged over 70 years accounted for 30.1% of DALYs. Conclusion Lung, colorectal and breast cancers are responsible for the highest number of DALYs in Spain. Even if the burden of disease due to cancer is predominantly caused by mortality, some cancers have a significant weight of disability. Information on 2000 burden of disease due to cancer can be useful to assess how it has evolved over time and the impact of medical advances on it in terms of mortality and disability.

  18. Economic Burden of Cancer in Korea during 2000-2010.

    Science.gov (United States)

    Lee, Kwang-Sig; Chang, Hoo-Sun; Lee, Sun-Mi; Park, Eun-Cheol

    2015-07-01

    This study estimated the economic burden of cancer in Korea during 2000-2010 by cancer site, gender, age group, and cost component. Data came from national health insurance claims data and information from Statistics Korea. Based on the cost of illness method, this study calculated direct, morbidity and mortality cost of cancer in the nation during 2000-2010 by cancer site, gender, and age group. With an average annual growth rate of 8.9%, the economic burden of cancer in Korea increased from 11,424 to 20,858 million US$ (current US dollars) during 2000-2010. Colorectal, thyroid, and breast cancers became more significant during the period, i.e., the 5th/837, the 11th/257, and the 7th/529 in 2000 to the 3rd/2,210, the 5th/1,724, and the 6th/1,659 in 2010, respectively (rank/amount in million US$ for the total population). In addition, liver and stomach cancers were prominent during the period in terms of the same measures, i.e., the 1st/2,065 and the 2nd/2,036 in 2000 to the 1st/3,114 and the 2nd/3,046 in 2010, respectively. Finally, the share of mortality cost in the total burden dropped from 71% to 51% in Korea during 2000-2010, led by colorectal, thyroid, breast, and prostate cancers during the period. These results show that the economic burden of cancer in Korea is characterized by an increasing importance of chronic components. Incorporation of distinctive epidemiological, sociocultural contexts into Korea's cancer control program, with greater emphasis on primary prevention such as sodium-controlled diet and hepatitis B vaccination, may be needed.

  19. Urbanization, malaria transmission and disease burden in Africa

    OpenAIRE

    Hay, Simon I.; Guerra, Carlos A.; Tatem, Andrew J.; Atkinson, Peter M.; Snow, Robert W.

    2005-01-01

    Many attempts have been made to quantify Africa’s malaria burden but none has addressed how urbanization will affect disease transmission and outcome, and therefore mortality and morbidity estimates. In 2003, 39% of Africa’s 850 million people lived in urban settings; by 2030, 54% of Africans are expected to do so. We present the results of a series of entomological, parasitological and behavioural meta-analyses of studies that have investigated the effect of urbanization on malaria in Africa...

  20. Epidemiology, costs, and the economic burden of fibromyalgia

    OpenAIRE

    Spaeth, Michael

    2009-01-01

    The assumption that fibromyalgia is associated with a major impact on the utilization of both healthcare and nonhealthcare resources has not been thoroughly supported by evidence-based data. Despite the differences between healthcare and sociopolitical systems in various countries, more recent results from epidemiological research now clearly demonstrate the socioeconomic burden of fibromyalgia and its comorbidities. The costs of the disease, calculated in single studies and countries, allow ...

  1. 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

  2. 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.

  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. '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.

  5. 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.

  6. Body Image and Transsexualism

    OpenAIRE

    Kraemer, B; Delsignore, A; Schnyder, U; Hepp, U

    2008-01-01

    BACKGROUND: To achieve a detailed view of the body image of transsexual patients, an assessment of perception, attitudes and experiences about one's own body is necessary. To date, research on the body image of transsexual patients has mostly covered body dissatisfaction with respect to body perception. SAMPLING AND METHODS: We investigated 23 preoperative (16 male-to-female and 7 female-to-male transsexual patients) and 22 postoperative (14 male-to-female and 8 female-to-male) transsexual pa...

  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 paediatric pyoderma and scabies in North West Queensland.

    Science.gov (United States)

    Whitehall, John; Kuzulugil, Deniz; Sheldrick, Kyle; Wood, Angela

    2013-02-01

    The study aims to assess the health burden of children admitted with 'scabies' to Mt Isa Hospital, the referral centre for North West Queensland, from 2006 to 2010. This is a retrospective chart audit of admissions of children with 'scabies' including age, sex, date, residence, Indigenous status, result of skin swabs and length of stay, and the number of admissions with acute rheumatic fever (ARF) and acute post-streptococcal glomerulo-nephritis (APSGN) in that period. Financial burden was estimated from daily bed costs and transportation. There were 113 admissions with mean age of 23/12: 11% were Scabies' accounted for 10.1% of medical admissions resistant. There were 29 admissions for ARF and 23 with APSGN. All children with 'scabies' and ARF and all but three with APSGN were Indigenous. Pyoderma and scabies are major health burdens in North West Queensland, requiring organised community-based prevention. The number of repeat admissions emphasises the futility of individual treatment. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  9. Cost and disease burden of Dengue in Cambodia

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    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.

  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. The burden of diverticular disease on patients and healthcare systems.

    Science.gov (United States)

    Reddy, Vikram B; Longo, Walter E

    2013-01-01

    Diverticulitis is a debilitating complication of diverticular disease that affects approximately 2.5 million individuals in the United States. Compared to many other gastrointestinal conditions, diverticular disease is poorly understood in terms of its burden on patients and healthcare systems. This review examines the existing literature and discusses the current knowledge of the burden of diverticular disease. Literature confirmed that bothersome symptoms (such as abdominal pain and bloating) and potentially serious, disease-related complications (such as diverticulitis and diverticular bleeding) place a significant burden on patients. Broad-spectrum antibiotic therapy and surgery are the generally accepted mainstays of treatment for acute complications of diverticular disease. Despite these options, patients frequently experience substantially reduced quality of life (particularly in terms of social and emotional functioning) and increased mortality (predominantly due to disease-related complications) compared to healthy controls. Furthermore, diverticular disease accounted for 254,179 inpatient discharges and 1,493,865 outpatient clinic visits in the United States in 2002, at an estimated cost per hospitalization of $9,742-$11,729. Enhancing the quality of life of patients with diverticular disease and reducing disease exacerbations and complications will substantially benefit patients and healthcare systems. However, long-established treatment algorithms fall short of these therapeutic goals. Research into new treatment options for patients with diverticular disease should therefore be pursued.

  12. Under diagnosis of adult ADHD: cultural influences and societal burden.

    Science.gov (United States)

    Asherson, Philip; Akehurst, Ron; Kooij, J J Sandra; Huss, Michael; Beusterien, Kathleen; Sasané, Rahul; Gholizadeh, Shadi; Hodgkins, Paul

    2012-07-01

    To explore the literature focusing on cultural influences in the diagnosis of adult ADHD and respective societal burden. A review of the literature over the past 10 years was performed using OVID. Although numerous articles focused on diagnosis and burden of adult ADHD, few focused on cultural factors influencing diagnosis. Like other mental health disorders, cultural and social perspectives contribute to our understanding of adult ADHD and may play a significant role in the diagnosis and varying acceptance of the condition. Moreover, adults with ADHD may underestimate the impact of ADHD symptoms, and in many cases have learned to compensate for ADHD related impairments by choosing lifestyles that help compensate for symptoms. Some adults with ADHD may appear to function well, however they may expend excessive amounts of energy to overcome impairments; and they may be distressed by ongoing symptoms such as restlessness, mood instability and low self-esteem. Research shows that ADHD can be detrimental to many areas of life including work, daily activities, social and family relationships and psychological and physical well-being. Patient-reported impairments in productivity due to poor time management, procrastination, and distractibility can translate into significant indirect costs and decreased quality of life. ADHD in adults is also associated with increased accidents, medical resource utilization, antisocial behaviour and drug alcohol abuse. The substantial societal burden of adult ADHD highlights the importance of providing a better understanding of the factors that contribute to accurate diagnosis and of improving the low recognition of the disorder in many world regions.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. Patterns, factors associated and morbidity burden of asthma in India.

    Directory of Open Access Journals (Sweden)

    Prakash Kumar

    Full Text Available Asthma is a non-curable but preventable disease, responsible for higher morbidity worldwide. According to recent WHO report, nearly 235 million people are suffering from asthma leading to 383000 deaths in 2015. The burden of asthma morbidity is higher in developed countries and is increasing in developing countries.The present study was aimed at studying the change in prevalence rate of asthma, associated risk factors and estimation of morbidity burden and avoidable cases of asthma in India.The second round of Indian Human Development Survey (IHDS-II, 2011-12, was used for the study. For the present study, asthma was defines as ever diagnosed with asthma or having cough with short breath. Multiple-logistic regression was used to identify the possible risk factors associated with prevalence of reporting asthma. Population attributable fractions (PAFs were computed to estimate the overall and risk factors specific burden of morbidity due to asthma using the extrapolated population of year 2015 using 2011 census.Overall prevalence rate of asthma increased from 41.9 (per 1000 population in 2004-05 to 54.9 (per 1000 population in 2011-12. The prevalence rate of reporting asthma was higher in poorer states compared to richer states, and also varied by sub-geographies, with higher prevalence rate in northern states of the country and lower rates in north-eastern states of the country. The odds of reporting asthma was higher for younger and older ages, individual with fewer years of schooling (OR: 1.41; 95% CI: 1.21-1.64 for individual with zero years of schooling compared to those with 11 or more years of schooling, individual from lower economic status, individual living in household using unclean fuels (OR:1.21; 95% CI: 1.08-1.34 and smokers (OR: 1.34; 95% CI: 1.17-1.55 compared to their counterparts. In the year 2015, the overall morbidity burden of asthma was estimated at nearly 65 million and more than 82 thousand deaths were attributed due to

  1. Patterns, factors associated and morbidity burden of asthma in India.

    Science.gov (United States)

    Kumar, Prakash; Ram, Usha

    2017-01-01

    Asthma is a non-curable but preventable disease, responsible for higher morbidity worldwide. According to recent WHO report, nearly 235 million people are suffering from asthma leading to 383000 deaths in 2015. The burden of asthma morbidity is higher in developed countries and is increasing in developing countries. The present study was aimed at studying the change in prevalence rate of asthma, associated risk factors and estimation of morbidity burden and avoidable cases of asthma in India. The second round of Indian Human Development Survey (IHDS-II), 2011-12, was used for the study. For the present study, asthma was defines as ever diagnosed with asthma or having cough with short breath. Multiple-logistic regression was used to identify the possible risk factors associated with prevalence of reporting asthma. Population attributable fractions (PAFs) were computed to estimate the overall and risk factors specific burden of morbidity due to asthma using the extrapolated population of year 2015 using 2011 census. Overall prevalence rate of asthma increased from 41.9 (per 1000 population) in 2004-05 to 54.9 (per 1000 population) in 2011-12. The prevalence rate of reporting asthma was higher in poorer states compared to richer states, and also varied by sub-geographies, with higher prevalence rate in northern states of the country and lower rates in north-eastern states of the country. The odds of reporting asthma was higher for younger and older ages, individual with fewer years of schooling (OR: 1.41; 95% CI: 1.21-1.64) for individual with zero years of schooling compared to those with 11 or more years of schooling, individual from lower economic status, individual living in household using unclean fuels (OR:1.21; 95% CI: 1.08-1.34) and smokers (OR: 1.34; 95% CI: 1.17-1.55) compared to their counterparts. In the year 2015, the overall morbidity burden of asthma was estimated at nearly 65 million and more than 82 thousand deaths were attributed due to asthma. The

  2. STUDY ON SOFTENING AND DROPPING PROPERTIES OF METALIZED BURDEN INSIDE BLAST FURNACE

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    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.

  3. Methodological Framework for World Health Organization Estimates of the Global Burden of Foodborne Disease

    DEFF Research Database (Denmark)

    Devleesschauwer, Brecht; Haagsma, Juanita A; Angulo, Frederick J

    2015-01-01

    The Foodborne Disease Burden Epidemiology Reference Group (FERG) was established in 2007 by the World Health Organization to estimate the global burden of foodborne diseases (FBDs). This paper describes the methodological framework developed by FERG's Computational Task Force to transform...

  4. Rotavirus infection in hospitalized children and estimates of disease burden in Kyrgyzstan, 2005-2007.

    Science.gov (United States)

    Flem, Elmira T; Kasymbekova, Kaliya T; Vainio, Kirsti; Gentsch, Jon; Abdikarimov, Sabirjan T; Glass, Roger I; Bresee, Joseph S

    2009-11-20

    To estimate the rotavirus-associated burden in Kyrgyzstan, we conducted hospital surveillance among children Kyrgyzstan may be attributable to rotavirus. Rotavirus vaccination could be an important health intervention to reduce the burden of rotavirus gastroenteritis.

  5. 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

  6. Abstract: Body Work

    DEFF Research Database (Denmark)

    Otto, Lene

    2012-01-01

    social and age groups are regarded? In what ways has different practices limited or extended its involvement in the body? Has work been organized hierarchically in relation to the degree of direct body work? What happened when body work became mediated by machines and technology? Has body work as forms......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...

  7. The Non-Communicable Disease Burden in Korea: Findings from the 2012 Korean Burden of Disease Study.

    Science.gov (United States)

    Yoon, Jihyun; Seo, Hyeyoung; Oh, In Hwan; Yoon, Seok Jun

    2016-11-01

    In recognition of Korea's rising burden of non-communicable diseases (NCDs), we investigated the nation's NCD status and extracted detailed information from the 2012 Korean Burden of Disease study. Consistent with that study, we used disability-adjusted life year (DALY) as a metric. Using national data sources and disability weights specific to the Korean population, we analyzed 116 disaggregated NCDs from the study's four-level disease and injury hierarchy for both sexes and nine age groups. Per 100,000 population, 21,019 DALYs were lost to 116 NCDs. Of those, 13.97% were due to premature death (death prior to the standard life expectancy for a subject's age) and 86.03% to non-fatal health outcomes. Based on traditional statistics, the main causes of health loss were mortality of neoplasms; cardiovascular and circulatory diseases; diabetes, urogenital, blood, and endocrine diseases; and chronic respiratory diseases. When combined with analyses of premature death and non-fatal outcomes, however, a substantially different view emerged: the main causes of health loss were diabetes mellitus, low back pain, chronic obstructive pulmonary disease, ischemic heart disease, ischemic stroke, cirrhosis of the liver, osteoarthritis, asthma, gastritis and duodenitis, and periodontal disease (in that order), collectively causing 49.20% of DALYs. Thus, burden of disease data using DALYs rather than traditional statistics brings a new perspective to characterization of the population's health that provides practical information useful for developing and targeting national NCD control programs to better meet national needs.

  8. 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

  9. 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.

  10. Ischaemic heart disease in the former Soviet Union 1990-2015 according to the Global Burden of Disease 2015 Study.

    Science.gov (United States)

    Murphy, Adrianna; Johnson, Catherine O; Roth, Gregory A; Forouzanfar, Mohammad H; Naghavi, Mohsen; Ng, Marie; Pogosova, Nana; Vos, Theo; Murray, Christopher J L; Moran, Andrew E

    2018-01-01

    The objective of this study was to compare ischaemic heart disease (IHD) mortality and risk factor burden across former Soviet Union (fSU) and satellite countries and regions in 1990 and 2015. The fSU and satellite countries were grouped into Central Asian, Central European and Eastern European regions. IHD mortality data for men and women of any age were gathered from national vital registration, and age, sex, country, year-specific IHD mortality rates were estimated in an ensemble model. IHD morbidity and mortality burden attributable to risk factors was estimated by comparative risk assessment using population attributable fractions. In 2015, age-standardised IHD death rates in Eastern European and Central Asian fSU countries were almost two times that of satellite states of Central Europe. Between 1990 and 2015, rates decreased substantially in Central Europe (men -43.5% (95% uncertainty interval -45.0%, -42.0%); women -42.9% (-44.0%, -41.0%)) but less in Eastern Europe (men -5.6% (-9.0, -3.0); women -12.2% (-15.5%, -9.0%)). Age-standardised IHD death rates also varied within regions: within Eastern Europe, rates decreased -51.7% in Estonian men (-54.0, -47.0) but increased +19.4% in Belarusian men (+12.0, +27.0). High blood pressure and cholesterol were leading risk factors for IHD burden, with smoking, body mass index, dietary factors and ambient air pollution also ranking high. Some fSU countries continue to experience a high IHD burden, while others have achieved remarkable reductions in IHD mortality. Control of blood pressure, cholesterol and smoking are IHD prevention priorities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Ischaemic heart disease in the former Soviet Union 1990–2015 according to the Global Burden of Disease 2015 Study

    Science.gov (United States)

    Murphy, Adrianna; Johnson, Catherine O; Roth, Gregory A; Forouzanfar, Mohammad H; Naghavi, Mohsen; Ng, Marie; Pogosova, Nana; Vos, Theo; Murray, Christopher J L; Moran, Andrew E

    2018-01-01

    Objective The objective of this study was to compare ischaemic heart disease (IHD) mortality and risk factor burden across former Soviet Union (fSU) and satellite countries and regions in 1990 and 2015. Methods The fSU and satellite countries were grouped into Central Asian, Central European and Eastern European regions. IHD mortality data for men and women of any age were gathered from national vital registration, and age, sex, country, year-specific IHD mortality rates were estimated in an ensemble model. IHD morbidity and mortality burden attributable to risk factors was estimated by comparative risk assessment using population attributable fractions. Results In 2015, age-standardised IHD death rates in Eastern European and Central Asian fSU countries were almost two times that of satellite states of Central Europe. Between 1990 and 2015, rates decreased substantially in Central Europe (men −43.5% (95% uncertainty interval −45.0%, −42.0%); women −42.9% (−44.0%, −41.0%)) but less in Eastern Europe (men −5.6% (−9.0, –3.0); women −12.2% (−15.5%, −9.0%)). Age-standardised IHD death rates also varied within regions: within Eastern Europe, rates decreased −51.7% in Estonian men (−54.0, −47.0) but increased +19.4% in Belarusian men (+12.0, +27.0). High blood pressure and cholesterol were leading risk factors for IHD burden, with smoking, body mass index, dietary factors and ambient air pollution also ranking high. Conclusions Some fSU countries continue to experience a high IHD burden, while others have achieved remarkable reductions in IHD mortality. Control of blood pressure, cholesterol and smoking are IHD prevention priorities. PMID:28883037

  12. THE PARADIGM OF TAX BURDEN, ITS COMPETITIVENESS IN THE RUSSIAN ECONOMY TAXATION POLICY

    Directory of Open Access Journals (Sweden)

    Daria O. Shatkhan

    2015-01-01

    Full Text Available The theoretic issues of tax burden have been studied, as well as its competitiveness; the structure specifics of Russian tax burden in the system of the Russian Federation political state have been analyzed. There is no legislative definition of tax burden conception at present, which does not interfere with its formulization based on the generally accepted standards of the current legislation.

  13. Research Administrative Burden: A Qualitative Study of Local Variations and Relational Effects

    Science.gov (United States)

    Spencer, Thomas; Scott, James

    2017-01-01

    As research administrators look to define their roles as professionals, the need to address perceived administrative burden becomes a valuable next step in improving research administration. A qualitative investigation into the causes of the perceived burden identifies local variability of research administration as regulatory burden for those…

  14. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

    DEFF Research Database (Denmark)

    Roth, Gregory A; Johnson, Catherine; Abajobir, Amanuel

    2017-01-01

    BACKGROUND: The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. OBJECTIVES: The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. M...

  15. The impact of dementia severity on caregiver burden in frontotemporal dementia and Alzheimer disease.

    Science.gov (United States)

    Mioshi, Eneida; Foxe, David; Leslie, Felicity; Savage, Sharon; Hsieh, Sharpley; Miller, Laurie; Hodges, John R; Piguet, Olivier

    2013-01-01

    Caregiver burden is greater in frontotemporal dementia (FTD) than in Alzheimer disease (AD). However, little is known of the impact of the 3 main clinical variants of FTD- behavioral-variant frontotemporal dementia (bvFTD), semantic dementia (SemDem), and progressive nonfluent aphasia (PNFA)-or the role of disease severity in caregiver burden. The Zarit Burden Inventory was used to measure caregiver burden of bvFTD (n=17), SemDem (n=20), PNFA (n=20), and AD (n=19) patients. Symptom duration, caregiver age, and relationship type were matched across groups. Moreover, a number of caregiver (mood, social network) and patient variables (functional disability, behavioral changes, relationship with caregiver, and dementia stage) were addressed to investigate their impact on caregiver burden. Caregivers of bvFTD patients reported the highest burden, whereas SemDem and PNFA caregivers reported burden similar to AD. A regression analysis revealed that caregiver burden in FTD, regardless of subtype, was explained by a model combining disease staging, relationship changes, and caregiver depression. Burden increased with disease severity in FTD. This study is the first to show that caregivers of SemDem, PNFA, and AD patients show similar burden, while confirming that bvFTD caregivers show higher burden than AD caregivers. More importantly, this study demonstrates that burden worsens with disease progression in FTD.

  16. Multivariate models of subjective caregiver burden in dementia: A systematic review

    NARCIS (Netherlands)

    van der Lee, J.H.; Bakker, T.J.E.M.; Duivenvoorden, H.J.; Dröes, R.M.

    2014-01-01

    Background: Burden in dementia caregivers is a complex and multidimensional construct. Several models of burden and other representations of burden like depression or mental health are described in literature. To clarify the state of science, we systematically reviewed complex models that include

  17. 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...

  18. 42 CFR 1005.15 - The hearing and burden of proof.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false The hearing and burden of proof. 1005.15 Section 1005.15 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... respondent or petitioner, as applicable, bears the burden of going forward and the burden of persuasion with...

  19. 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

  20. Association of Hidradenitis Suppurativa With Body Image.

    Science.gov (United States)

    Schneider-Burrus, Sylke; Jost, Agata; Peters, Eva Milena Johanna; Witte-Haendel, Ellen; Sterry, Wolfram; Sabat, Robert

    2018-02-21

    subscale score that was not different between patients with HS and controls. Patients with HS have major body image impairment, which might lead to depression and anxiety, disorders that have been largely acknowledged in HS. This study identified another element of the psychosocial burden of patients with HS and reveals that body image could potentially be used as an outcome measure in future studies of HS.