Sample records for human health vulnerability
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Shen, Jing; Lu, Hongwei; Zhang, Yang; Song, Xinshuang; He, Li
2016-05-01
As ecosystem management is a hotspot and urgent topic with increasing population growth and resource depletion. This paper develops an urban ecosystem vulnerability assessment method representing a new vulnerability paradigm for decision makers and environmental managers, as it's an early warning system to identify and prioritize the undesirable environmental changes in terms of natural, human, economic and social elements. The whole idea is to decompose a complex problem into sub-problem, and analyze each sub-problem, and then aggregate all sub-problems to solve this problem. This method integrates spatial context of Geographic Information System (GIS) tool, multi-criteria decision analysis (MCDA) method, ordered weighted averaging (OWA) operators, and socio-economic elements. Decision makers can find out relevant urban ecosystem vulnerability assessment results with different vulnerable attitude. To test the potential of the vulnerability methodology, it has been applied to a case study area in Beijing, China, where it proved to be reliable and consistent with the Beijing City Master Plan. The results of urban ecosystem vulnerability assessment can support decision makers in evaluating the necessary of taking specific measures to preserve the quality of human health and environmental stressors for a city or multiple cities, with identifying the implications and consequences of their decisions.
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Temporal trends in human vulnerability to excessive heat
Sheridan, Scott C.; Allen, Michael J.
2018-04-01
Over recent decades, studies have examined various morbidity and mortality outcomes associated with heat exposure. This review explores the collective knowledge of the temporal trends of heat on human health, with regard to the hypothesis that humans are less vulnerable to heat events presently than in the past. Using Web of Science and Scopus, the authors identified all peer-reviewed articles that contained keywords on human impact (e.g. mortality, morbidity) and meteorological component (e.g. heat, heatwave). After sorting, a total of 71 articles, both case studies and epidemiological studies, contained explicit assessments of temporal trends in human vulnerability, and thus were used in this review. Most of the studies utilized mortality data, focused on the developed world, and showed a general decrease in heat sensitivity. Factors such as the implementation of a heat warning system, increased awareness, and improved quality of life were cited as contributing factors that led to the decreased impact of heat. Despite the overall recent decreases in heat vulnerability, spatial variability was shown, and differences with respect to health outcomes were also discussed. Several papers noted increases in heat’s impact on human health, particularly when unprecedented conditions occurred. Further, many populations, from outdoor workers to rural residents, in addition to the populations in much of the developing world, have been significantly underrepresented in research to date, and temporal changes in their vulnerability should be assessed in future studies. Moreover, continued monitoring and improvement of heat intervention is needed; with projected changes in the frequency, duration, and intensity of heat events combined with shifts in demographics, heat will remain a major public health issue moving forward.
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Projecting Drivers of Human Vulnerability under the Shared Socioeconomic Pathways.
Rohat, Guillaume
2018-03-19
The Shared Socioeconomic Pathways (SSPs) are the new set of alternative futures of societal development that inform global and regional climate change research. They have the potential to foster the integration of socioeconomic scenarios within assessments of future climate-related health impacts. To date, such assessments have primarily superimposed climate scenarios on current socioeconomic conditions only. Until now, the few assessments of future health risks that employed the SSPs have focused on future human exposure-i.e., mainly future population patterns-, neglecting future human vulnerability. This paper first explores the research gaps-mainly linked to the paucity of available projections-that explain such a lack of consideration of human vulnerability under the SSPs. It then highlights the need for projections of socioeconomic variables covering the wide range of determinants of human vulnerability, available at relevant spatial and temporal scales, and accounting for local specificities through sectoral and regional extended versions of the global SSPs. Finally, this paper presents two innovative methods of obtaining and computing such socioeconomic projections under the SSPs-namely the scenario matching approach and an approach based on experts' elicitation and correlation analyses-and applies them to the case of Europe. They offer a variety of possibilities for practical application, producing projections at sub-national level of various drivers of human vulnerability such as demographic and social characteristics, urbanization, state of the environment, infrastructure, health status, and living arrangements. Both the innovative approaches presented in this paper and existing methods-such as the spatial disaggregation of existing projections and the use of sectoral models-show great potential to enhance the availability of relevant projections of determinants of human vulnerability. Assessments of future climate-related health impacts should thus rely
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Mapping vulnerability to climate change and its repercussions on human health in Pakistan.
Malik, Sadia Mariam; Awan, Haroon; Khan, Niazullah
2012-09-03
Pakistan is highly vulnerable to climate change due to its geographic location, high dependence on agriculture and water resources, low adaptive capacity of its people, and weak system of emergency preparedness. This paper is the first ever attempt to rank the agro-ecological zones in Pakistan according to their vulnerability to climate change and to identify the potential health repercussions of each manifestation of climate change in the context of Pakistan. A climate change vulnerability index is constructed as an un-weighted average of three sub-indices measuring (a) the ecological exposure of each region to climate change, (b) sensitivity of the population to climate change and (c) the adaptive capacity of the population inhabiting a particular region. The regions are ranked according to the value of this index and its components. Since health is one of the most important dimensions of human wellbeing, this paper also identifies the potential health repercussions of each manifestations of climate change and links it with the key manifestations of climate change in the context of Pakistan. The results indicate that Balochistan is the most vulnerable region with high sensitivity and low adaptive capacity followed by low-intensity Punjab (mostly consisting of South Punjab) and Cotton/Wheat Sindh. The health risks that each of these regions face depend upon the type of threat that they face from climate change. Greater incidence of flooding, which may occur due to climate variability, poses the risk of diarrhoea and gastroenteritis; skin and eye Infections; acute respiratory infections; and malaria. Exposure to drought poses the potential health risks in the form of food insecurity and malnutrition; anaemia; night blindness; and scurvy. Increases in temperature pose health risks of heat stroke; malaria; dengue; respiratory diseases; and cardiovascular diseases. The study concludes that geographical zones that are more exposed to climate change in ecological and
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Vulnerability, Health Agency and Capability to Health.
Straehle, Christine
2016-01-01
One of the defining features of the capability approach (CA) to health, as developed in Venkatapuram's book Health Justice, is its aim to enable individual health agency. Furthermore, the CA to health hopes to provide a strong guideline for assessing the health-enabling content of social and political conditions. In this article, I employ the recent literature on the liberal concept of vulnerability to assess the CA. I distinguish two kinds of vulnerability. Considering circumstantial vulnerability, I argue that liberal accounts of vulnerability concerned with individual autonomy, align with the CA to health. Individuals should, as far as possible, be able to make health-enabling decisions about their lives, and their capability to do so should certainly not be hindered by public policy. The CA to health and a vulnerability-based analysis then work alongside to define moral responsibilities and designate those who hold them. Both approaches demand social policy to address circumstances that hinder individuals from taking health-enabling decisions. A background condition of vulnerability, on the other hand, even though it hampers the capability for health, does not warrant the strong moral claim proposed by the CA to health to define health as a meta-capability that should guide social policy. Nothing in our designing social policy could change the challenge to health agency when we deal with background conditions of vulnerability. © 2016 John Wiley & Sons Ltd.
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Syndemic vulnerability and the right to health.
Willen, Sarah S; Knipper, Michael; Abadía-Barrero, César E; Davidovitch, Nadav
2017-03-04
Investigators working both in syndemics, a field of applied health research with roots in medical anthropology, and in the field of health and human rights recognise that upstream social, political, and structural determinants contribute more to health inequities than do biological factors or personal choices. Syndemics investigates synergistic, often deleterious interactions among comorbid health conditions, especially under circumstances of structural and political adversity. Health and human rights research draws on international law to argue that all people deserve access not only to health care, but also to the underlying determinants of good health. Taking the urgent matter of migrant health as an empirical focus, we juxtapose the fields of syndemics and health and human rights, identify their complementarities, and advocate for a combined approach. By melding insights from these fields, the combined syndemics/health and human rights approach advanced here can provide clinicians and other key stakeholders with concrete insights, tools, and strategies to tackle the health inequities that affect migrants and other vulnerable groups by: (1) mapping the effect of social, political, and structural determinants on health; (2) identifying opportunities for upstream intervention; and (3) working collaboratively to tackle the structures, institutions, and processes that cause and exacerbate health inequities. Undergirding this approach is an egalitarian interpretation of the right to health that differs from narrow legalistic and individual interpretations by insisting that all people are equal in worth and, as a result, equally deserving of protection from syndemic vulnerability. Copyright © 2017 Elsevier Ltd. All rights reserved.
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The right to health care and vulnerability
Directory of Open Access Journals (Sweden)
João Carlos Loureiro
2017-10-01
Full Text Available The article seeks to clarify the concept of vulnerability, by taking structural and epochal frailty into account. To understand the right to health care, the author reflects about the fundamental goods, and he then examines how that same right is present in the Portuguese and the Spanish constitutions. The association between vulnerability and the law is also tackled, with a special reference –in dialogue with Herbert Hart– to its fundamental level and to other links between both terms in the field of health. The article closes with a few remarks on posthumanist attempts at saying goodbye to human frailty.
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Climate Vulnerability and Human Migration in Global Perspective
Grecequet, Martina; DeWaard, Jack; Hellmann, Jessica J.; Abel, Guy J.
2018-01-01
The relationship between climate change and human migration is not homogenous and depends critically on the differential vulnerability of population and places. If places and populations are not vulnerable, or susceptible, to climate change, then the climate–migration relationship may not materialize. The key to understanding and, from a policy perspective, planning for whether and how climate change will impact future migration patterns is therefore knowledge of the link between climate vulnerability and migration. However, beyond specific case studies, little is known about this association in global perspective. We therefore provide a descriptive, country-level portrait of this relationship. We show that the negative association between climate vulnerability and international migration holds only for countries least vulnerable to climate change, which suggests the potential for trapped populations in more vulnerable countries. However, when analyzed separately by life supporting sector (food, water, health, ecosystem services, human habitat, and infrastructure) and vulnerability dimension (exposure, sensitivity, and adaptive capacity), we detect evidence of a relationship among more, but not the most, vulnerable countries. The bilateral (i.e., country-to-country) migration show that, on average, people move from countries of higher vulnerability to lower vulnerability, reducing global risk by 15%. This finding is consistent with the idea that migration is a climate adaptation strategy. Still, ~6% of bilateral migration is maladaptive with respect to climate change, with some movement toward countries with greater climate change vulnerability. PMID:29707262
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Climate Vulnerability and Human Migration in Global Perspective.
Grecequet, Martina; DeWaard, Jack; Hellmann, Jessica J; Abel, Guy J
2017-05-01
The relationship between climate change and human migration is not homogenous and depends critically on the differential vulnerability of population and places. If places and populations are not vulnerable, or susceptible, to climate change, then the climate-migration relationship may not materialize. The key to understanding and, from a policy perspective, planning for whether and how climate change will impact future migration patterns is therefore knowledge of the link between climate vulnerability and migration. However, beyond specific case studies, little is known about this association in global perspective. We therefore provide a descriptive, country-level portrait of this relationship. We show that the negative association between climate vulnerability and international migration holds only for countries least vulnerable to climate change, which suggests the potential for trapped populations in more vulnerable countries. However, when analyzed separately by life supporting sector (food, water, health, ecosystem services, human habitat, and infrastructure) and vulnerability dimension (exposure, sensitivity, and adaptive capacity), we detect evidence of a relationship among more, but not the most, vulnerable countries. The bilateral (i.e., country-to-country) migration show that, on average, people move from countries of higher vulnerability to lower vulnerability, reducing global risk by 15%. This finding is consistent with the idea that migration is a climate adaptation strategy. Still, ~6% of bilateral migration is maladaptive with respect to climate change, with some movement toward countries with greater climate change vulnerability.
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Reliability, Resilience, and Vulnerability criteria for the evaluation of Human Health Risks
Rodak, C. M.; Silliman, S. E.; Bolster, D.
2011-12-01
Understanding the impact of water quality on the health of a general population is challenging due high degrees of uncertainty and variability in hydrological, toxicological and human aspects of the system. Assessment of the impact of changes in water quality of a public water supply is critical to management of that water supply. We propose the use of three different system evaluation criteria: Reliability, Resilience and Vulnerability (RRV) as a tool for assessing the impact of uncertainty in the arrival of contaminant mass through time with respect to human health risks on a variable population. These criteria were first introduced to the water resources community by Hashimoto et al (1982). Most simply one can understand these criteria as the following: Reliability is the likelihood of the system being in a state of success; Resilience is the probability that the system will return to a state of success at t+1 if it is in failure at time step t, and Vulnerability is the severity of failure, which here is defined as the maximum health risk. These concepts are applied to a theoretical example where the water quality at a water supply well varies over time: health impact is considered based on sliding, 30-year windows of exposure to water derived from the well. We apply the methodology, in terms of uncertainty in water quality deviations, to eight simulated breakthrough curves of a contaminant at the well: each curve represents equal mass of contaminant arriving at the well over a 70-year lifetime of the well, but different mass distributions over time. These curves are used to investigate the impact of uncertainty in the distribution through time of the contaminant mass at the well, as well as the initial arrival of the contaminant over the 70-year lifetime of the well. In addition to extending the health risk through time with uncertainty in mass distribution, we incorporate variability in the human population to examine the evolution of the three criteria within
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Vulnerability assessment of atmospheric environment driven by human impacts.
Zhang, Yang; Shen, Jing; Ding, Feng; Li, Yu; He, Li
2016-11-15
Atmospheric environment quality worsening is a substantial threat to public health worldwide, and in many places, air pollution due to the intensification of the human activity is increasing dramatically. However, no studies have been investigated the integration of vulnerability assessment and atmospheric environment driven by human impacts. The objective of this study was to identify and prioritize the undesirable environmental changes as an early warning system for environment managers and decision makers in term of human, atmospheric environment, and social economic elements. We conduct a vulnerability assessment method of atmospheric environment associated with human impact, this method integrates spatial context of Geographic Information System (GIS) tool, multi-criteria decision analysis (MCDA) method, ordered weighted averaging (OWA) operators under the Exposure-Sensitivity- Adaptive Capacity (ESA) framework. Decision makers can find out relevant vulnerability assessment results with different vulnerable attitudes. In the Beijing-Tianjin-Hebei (BTH) region, China, we further applied this developed method and proved it to be reliable and consistent with the China Environmental Status Bulletin. Results indicate that the vulnerability of atmospheric environment in the BTH region is not optimistic, and environment managers should do more about air pollution. Thus, the most appropriate strategic decision and development program of city or state can be picked out assisting by the vulnerable results. Copyright © 2016 Elsevier B.V. All rights reserved.
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Keim, Mark E
2011-06-01
Global warming could increase the number and severity of extreme weather events. These events are often known to result in public health disasters, but we can lessen the effects of these disasters. By addressing the factors that cause changes in climate, we can mitigate the effects of climate change. By addressing the factors that make society vulnerable to the effects of climate, we can adapt to climate change. To adapt to climate change, a comprehensive approach to disaster risk reduction has been proposed. By reducing human vulnerability to disasters, we can lessen--and at times even prevent--their impact. Human vulnerability is a complex phenomenon that comprises social, economic, health, and cultural factors. Because public health is uniquely placed at the community level, it has the opportunity to lessen human vulnerability to climate-related disasters. At the national and international level, a supportive policy environment can enable local adaptation to disaster events. The purpose of this article is to introduce the basic concept of disaster risk reduction so that it can be applied to preventing and mitigating the negative effects of climate change and to examine the role of community-focused public health as a means for lessening human vulnerability and, as a result, the overall risk of climate-related disasters.
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Vulnerable Populations Perceive Their Health as at Risk from Climate Change.
Akerlof, Karen L; Delamater, Paul L; Boules, Caroline R; Upperman, Crystal R; Mitchell, Clifford S
2015-12-04
Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change's health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change-due to social vulnerability, health susceptibility, and exposure to hazards-already feel they are at risk. In a 2013 survey we measured Maryland residents' climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages.
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Vulnerable Populations Perceive Their Health as at Risk from Climate Change
Directory of Open Access Journals (Sweden)
Karen L. Akerlof
2015-12-01
Full Text Available Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change’s health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change—due to social vulnerability, health susceptibility, and exposure to hazards—already feel they are at risk. In a 2013 survey we measured Maryland residents’ climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126. We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages.
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Vulnerable Populations Perceive Their Health as at Risk from Climate Change
Akerlof, Karen L.; Delamater, Paul L.; Boules, Caroline R.; Upperman, Crystal R.; Mitchell, Clifford S.
2015-01-01
Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change’s health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change—due to social vulnerability, health susceptibility, and exposure to hazards—already feel they are at risk. In a 2013 survey we measured Maryland residents’ climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages. PMID:26690184
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Brown, Tim
2011-02-01
The question of global health has, at least since 9/11, (re)emerged as one of the world's key geopolitical issues and, as many scholars have noted, this increased attention to the state of world health is especially focused on questions of national security and vulnerability. Despite its prominence in political, health policy and scholarly circles, health geographers have tended to overlook this particular aspect of global health discourse. This paper seeks to redress this lacuna. It does so for three reasons. The first lies in the idea that this discourse is inherently geographical; after all, it is in essence concerned with the flows of human and non-human agents within and, more importantly here, across, national borders. It is also of interest because a focus on vulnerability allows for an analysis that goes beyond the current fixation with emerging and re-emerging infectious diseases. Although it is certainly true that the concern with such diseases dominates, and the recent focus upon H1N1 swine flu is testament to that, there is also a suggestion that the processes associated with the enhanced threat posed by these diseases are similar to those that have caused non-communicable diseases to become a global health problem too. A third reason for focussing on this aspect of the global health discourse is that the subsequent search for 'security' is highly problematic; especially if we consider the question of "who is to be protected, and from what". The aim of the paper is, then, to offer a critical review of the international discourse on global health and to highlight its relevance to scholars that self-identify as health and medical geographers. Copyright © 2010 Elsevier Ltd. All rights reserved.
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CDC's Social Vulnerability Index (SVI)
U.S. Department of Health & Human Services — Social vulnerability refers to the resilience of communities when confronted by external stresses on human health, stresses such as natural or human-caused...
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Padowski, Julie C.; Gorelick, Steven M.; Thompson, Barton H.; Rozelle, Scott; Fendorf, Scott
2015-10-01
Global freshwater vulnerability is a product of environmental and human dimensions, however, it is rarely assessed as such. Our approach identifies freshwater vulnerability using four broad categories: endowment, demand, infrastructure, and institutions, to capture impacts on natural and managed water systems within the coupled human-hydrologic environment. These categories are represented by 19 different endogenous and exogenous characteristics affecting water supply vulnerability. By evaluating 119 lower per capita income countries (Yemen and Djibouti nearly as vulnerable. Surprising similarities in vulnerability were also found among geographically disparate nations such as Vietnam, Sri Lanka, and Guatemala. Determining shared patterns of freshwater vulnerability provides insights into why water supply vulnerabilities are manifested in human-water systems at the national scale.
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Identification of vulnerability within a child and family health service.
Kimla, Katarina; Nathanson, Dania; Woolfenden, Susan; Zwi, Karen
2017-11-21
Objective The aims of the present study were to describe the prevalence of vulnerability in a cohort of newborns, identify the factors that increase the risk of vulnerability and examine whether those who are most vulnerable are receiving home visits. Methods A prospective cross-sectional study was performed using data collected from questionnaires completed by child and family health nurses and obstetric discharge summaries for each mother-baby dyad. Descriptive frequencies and percentages are used to describe the proportions of children who were vulnerable, offered services and had risk factors for vulnerability. Categorical data were compared using Pearson's Chi-squared analysis. Results In all, 1517 newborns were included in the present study. Of these, 40.5% were identified as vulnerable and 13.9% had two or more risk factors for vulnerability (95% confidence interval (CI) 12-16%). The most common risk factors were biological. Across all newborns, 33.7% were visited at home, and 74.6% of vulnerable newborns were offered a home visit. Children identified as vulnerable were more likely to have a home visit than those who were not (z for 95% CI=1.96; Pvulnerability allowed the offer of home visiting to be directed towards those most likely to benefit. What is known about the topic? Of the Australian child population, 10-20% are vulnerable to adverse health, developmental and wellbeing outcomes. Vulnerable infants are at a greater risk of becoming vulnerable children, adolescents and adults over the life course. Biological and psychosocial risk factors for vulnerability are well described. Families with the greatest need are often the least likely to access or receive support, and have lower utilisation of preventative health services despite evidence that support in the first few years of life can significantly improve long-term outcomes. What does this paper add? This paper provides a detailed description of vulnerabilities in a cohort of newborns and
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Human Rights and Vulnerability. Examples of Sexism and Ageism
Directory of Open Access Journals (Sweden)
Mª DEL CARMEN BARRANCO AVILÉS
2015-12-01
Full Text Available A human rights based approach applied to the idea of ‘vulnerable group’ connects vulnerability and structural discrimination. The Convention on the Rights of Persons with Disability provides some elements that allow to state that we are facing a new paradigm in the International Human Rights Law. One of the keys for the understanding of this new framework is the assumption of the disadvantage related to vulnerability as, at least in a part, socially built and ideologically justified. Sexism and ageism are examples of how ideologies reinforce vulnerability of women, children and aged persons transforming them in groups which members are in risk of discrimination.
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Vulnerable participants in health research
DEFF Research Database (Denmark)
Nordentoft, Helle Merete; Nanna, Kappel
2011-01-01
Ethical guidelines for conducting research are embedded in the Helsinki declaration of 1964. We contend that these abstract and intentionally universal guidelines need to be appropriated for social and health care research in which purpose and methods often deviate from medical research. The guid......Ethical guidelines for conducting research are embedded in the Helsinki declaration of 1964. We contend that these abstract and intentionally universal guidelines need to be appropriated for social and health care research in which purpose and methods often deviate from medical research...... and problems of vulnerable patients and - at the same time - respect their integrity without exposing them unnecessarily? The article illuminates the interactional construction of roles and relationships and how they affect the contextual construction of vulnerability. In this respect we demonstrate...
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Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.
2012-04-01
This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to
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Community vulnerability to health impacts of wildland fire ...
Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on factors known to increase the risks of health effects from air pollution and wildfire smoke exposures. These factors included county prevalence rates for asthma in children and adults, chronic obstructive pulmonary disease, hypertension, diabetes, obesity, percent of population 65 years of age and older, and indicators of socioeconomic status including poverty, education, income and unemployment. Using air quality simulated for the period between 2008 and 2012 over the continental U.S. we also characterized the population size at risk with respect to the level and duration of exposure to fire-originated fine particulate matter (fire-PM2.5) and CHVI. We estimate that 10% of the population (30.5 million) lived in the areas where the contribution of fire-PM2.5 to annual average ambient PM2.5 was high (>1.5 µg m3) and that 10.3 million individuals experienced unhealthy air quality levels for more than 10 days due to smoke. Using CHVI we identified the most vulnerable counties and determined that these communities experience more smoke exposures in comparison to less vulnerable communities. We describe the development of an index of community vulnerability for the health effects of smoke based o
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Ekmekci, Perihan Elif
2017-09-01
Vulnerability is a broad concept widely addressed in recent scholarly literature. Lesbian, gay, bisexual, and transgender (LGBT) people are among the vulnerable populations with significant disadvantages related to health and the social determinants of health. Medical ethics discourse tackles vulnerability from philosophical and political perspectives. LGBT people experience several disadvantages from both perspectives. This article aims to justify the right to health for LGBT people and their particular claims regarding healthcare because they belong to a vulnerable group. Rawls' theory of justice and Norman Daniels' normal functioning approach will be discussed in this context. Despite the fact that the right to health can be justified by Daniels' normal functioning approach, there is still a theoretical gap in justifying the right to health for particular vulnerable populations such as LGBT peopleand discussing society's duty to compensate for these disadvantages. In search of solid theoretical grounds for the justification of the right to health for LGBT people, the present author takes the opportunity to utilize Daniels' flexible definition of normal functioning to show that normal functioning not only varies by age but also by different states of human existence, including sexual orientation and gender identity, and to propose replacing the life span approach with normal states of human existence.
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Community vulnerability to health impacts of wildland fire smoke exposure
Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on fact...
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Health implications of human trafficking.
Richards, Tiffany A
2014-01-01
Freedom is arguably the most cherished right in the United States. But each year, approximately 14,500 to 17,500 women, men and children are trafficked into the United States for the purposes of forced labor or sexual exploitation. Human trafficking has significant effects on both physical and mental health. This article describes the features of human trafficking, its physical and mental health effects and the vital role nurses can play in providing care to this vulnerable population. © 2014 AWHONN.
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Respect for Human Vulnerability: The Emergence of a New Principle in Bioethics.
ten Have, Henk
2015-09-01
Vulnerability has become a popular though controversial topic in bioethics, notably since 2000. As a result, a common body of knowledge has emerged (1) distinguishing between different types of vulnerability, (2) criticizing the categorization of populations as vulnerable, and (3) questioning the practical implications. It is argued that two perspectives on vulnerability, i.e., the philosophical and political, pose challenges to contemporary bioethics discourse: they re-examine the significance of human agency, the primacy of the individual person, and the negativity of vulnerability. As a phenomenon of globalization, vulnerability can only be properly addressed in a global bioethics that takes the social dimension of human existence seriously.
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Human rights approach to health.
Haigh, Fiona
2002-04-01
Adopting human rights approach to health carries many benefits, because it emphasizes the equality of all persons and their inherent right to health as the foundation of the health care system. It also argues that promotion and protection of health are fundamentally important social goals, focuses particularly on the needs of the most disadvantaged and vulnerable communities, balances individual needs with the common good, and so forth. However, it also raises some practical issues, such as organization of interdisciplinary education and work, and different use of the language, which often goes unacknowledged. The relationship between human rights and health is a reciprocal one, and can be beneficial or harmful. For the relationship to be beneficial and successful, the differences between human rights and public health approach to health, centered around the perspective taking, attitudes, and abilities of health professionals, need to be acknowledged and reconciled, and the need for interdisciplinarity adequately fulfilled.
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Spatial Analysis of Human Exposure and Vulnerability to Coastal ...
African Journals Online (AJOL)
Disasters in coastal cities have shown an ever-increasing frequency of occurrence. Population growth and urbanisation have increased the vulnerability of properties and societies in coastal flood-prone areas. Analysis of human exposure and vulnerability is one of the main strategies used to determine the necessary ...
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The Power of Being Vulnerable in Christian Soul Care: Common Humanity and Humility.
Kim, Kyubo
2017-02-01
Soul caregivers often hesitate to be vulnerable in their pastoral practices. Jesus, however, embraced his vulnerabilities as a human to redeem humanity even though he was the Son of God. This paper first explores the dynamics of shame and power that make soul caregivers reluctant to accept their vulnerabilities and then describes the contributions of sharing caregiver's vulnerabilities in a soul care practice. This article argues that being vulnerable allows a soul caregiver to imitate Jesus by sharing in the client's common humanity, initiating an authentic relationship between the client and the soul caregiver; it is also a practice of humility, inviting God's cure in soul care. This study proposes the necessity of embracing vulnerability in soul care ministry, instead of hiding it.
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Family vulnerability index to disability and dependence (FVI-DD), by social and health conditions.
Amendola, Fernanda; Alvarenga, Márcia Regina Martins; Latorre, Maria do Rosário Dias de Oliveira; Oliveira, Maria Amélia de Campos
2017-06-01
The Family Vulnerability Index to Disability and Dependence (FVI-DD) aims to summarize the dimensions of vulnerability to disability and dependence using family data monitored by Family Health Strategy (ESF) teams. This study aims to analyze the FVI-DD according to the social and health vulnerability, to validate and extract a cutoff point for each dimension. The FVI-DD was built with a sample of 248 families living in a region of São Paulo. The dimension related to health conditions was validated with good internal consistency, with respect to the Katz Index and the Lawton Scale, whereas the dimension related to social conditions was only validated in relation to Lawton Scale. Thus, a vulnerable family was defined as one with 15 or more points in the Total FVI-DD, and a vulnerable family in health conditions that with a score of 6 or more points in that dimension. Therefore, it is possible to classify families as not vulnerable, vulnerable in the social aspects, vulnerable in the health aspects and the more vulnerable family (social and health) using social indicators of empowerment and wear and health indicators related not only to the biological sphere, but also in the access to health services, health self-assessment and existing vulnerable groups.
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[Health vulnerability mapping in the Community of Madrid (Spain)].
Ramasco-Gutiérrez, Milagros; Heras-Mosteiro, Julio; Garabato-González, Sonsoles; Aránguez-Ruiz, Emiliano; Aguirre Martín-Gil, Ramón
The Public Health General Directorate of Madrid has developed a health vulnerability mapping methodology to assist regional social health teams in health planning, prioritisation and intervention based on a model of social determinants of health and an equity approach. This process began with the selection of areas with the worst social indicators in health vulnerability. Then, key stakeholders of the region jointly identified priority areas of intervention and developed a consensual plan of action. We present the outcomes of this experience and its connection with theoretical models of asset-based community development, health-integrated georeferencing systems and community health interventions. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
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Directory of Open Access Journals (Sweden)
Ana Flávia Quintão
2017-01-01
Full Text Available Vulnerability to climate change is a complex and dynamic phenomenon involving both social and physical/environmental aspects. It is presented as a method for the quantification of the vulnerability of all municipalities of Minas Gerais, a state in southeastern Brazil. It is based on the aggregation of different kinds of environmental, climatic, social, institutional, and epidemiological variables, to form a composite index. This was named “Index of Human Vulnerability” and was calculated using a software (SisVuClima® specifically developed for this purpose. Social, environmental, and health data were combined with the climatic scenarios RCP 4.5 and 8.5, downscaled from ETA-HadGEM2-ES for each municipality. The Index of Human Vulnerability associated with the RCP 8.5 has shown a higher vulnerability for municipalities in the southern and eastern parts of the state of Minas Gerais.
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Bradfield, Sarah
2018-01-01
Introduction: Lifestyle choices, social and environmental factors impact 60% of health outcomes, while health system impacts 10%. Why then, do we continue to focus on health as the place for early intervention with young people?Young people become vulnerable through a combination of their circumstances, stages of development and barriers to participation. Vulnerabilities can be a combination of health (physical, mental health, substance use), educational (disengagement from school) and social...
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Land Use Transition and Human Health in the context of Climate ...
International Development Research Centre (IDRC) Digital Library (Canada)
Land Use Transition and Human Health in the context of Climate Change in the Eastern Himalayas. Land use change is ... it at the communal level. The overall goal is to reduce the vulnerability of mountain people to health issues caused by land use change using ecosystem approaches to human health (Ecohealth).
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Human Security and Mutual Vulnerability: The Global Political ...
International Development Research Centre (IDRC) Digital Library (Canada)
Human Security and Mutual Vulnerability: The Global Political Economy of Development and ... that will help us understand this turbulent and chaotic period in human history. ... The Rapid Research Fund (RRF) for Ebola Virus Disease Outbreaks will fund ... Copyright · Open access policy · Privacy policy · Research ethics ...
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Impact, adaptation and vulnerability of natural and human systems in Europe
International Nuclear Information System (INIS)
Martin, Eric; Salas y Melia, David; Delire, Christine; Lemonsu, Aude; Masson, Valery; Badeau, Vincent; Gattuso, Jean-Pierre; Pigeon, Gregoire; Regimbeau, Mathieu; Viguie, Vincent
2015-01-01
This article analyses the observed and projected impacts of climate change on human and natural systems, their vulnerability and adaptation options. It provides insight into the main results related to hydrology, agriculture, natural ecosystems, transport, energy, tourism, infrastructures, health and social aspects. This article presents the main results concerning Europe that were compiled in the contribution of Working Group II to the IPCC fifth assessment report published in 2014. Several studies focused on mainland France are also presented, without claiming to be exhaustive. (authors)
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Haque, Md Aminul; Budi, Aji; Azam Malik, Ahmad; Suzanne Yamamoto, Shelby; Louis, Val?rie R; Sauerborn, Rainer
2013-01-01
Background Among the many challenges faced by the people of Bangladesh, the effects of climate change are discernibly threatening, impacting on human settlement, agricultural production, economic development, and human health. Bangladesh is a low-income country with limited resources; its vulnerability to climate change has influenced individuals to seek out health coping strategies. The objectives of the study were to explore the different strategies/measures people employ to cope with clima...
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Crea, Thomas M; Lombe, Margaret; Robertson, Laura A; Dumba, Lovemore; Mushati, Phyllis; Makoni, J C; Mavise, Gideon; Eaton, Jeffrey W; Munatsi, Brighton; Nyamukapa, Constance A; Gregson, Simon
2013-01-01
The high prevalence of human immunodeficiency virus/acquired immune deficiency syndrome in sub-Saharan Africa has resulted in a dramatic increase in orphans and vulnerable children (OVC) over the past decade. These children typically rely on extended family networks for support, but the magnitude of the crisis has resulted in traditional familial networks becoming overwhelmed and more economically and socially vulnerable. Previous research consistently demonstrates the positive influence of household asset ownership on children's well-being. Using data from impoverished households caring for OVC in rural Manicaland Province, Zimbabwe, this study explores the influence of household asset ownership on OVC health vulnerability (HV) and social vulnerability (SV). Findings indicate that asset ownership is associated with significantly lower SV, in terms of school attendance and birth registration. Yet, assets do not emerge as a direct influence of OVC HV as measured by disease and chronic illness, although having a chronically ill adult in the household increases HV. These findings suggest that asset ownership, specifically a combination of fixed and movable assets, may offset the influence of other risk factors for children's SV.
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Health Services Vulnerability During the Ebola Outbreak: A Qualitative Report
Directory of Open Access Journals (Sweden)
Nasir Amanat
2017-07-01
Full Text Available Ebola is an infectious disease, which is caused by a virus belonging to the Filoviridae group. The outbreak of the disease in the African countries in 2015 caused massive death and contamination of the healthcare personnel those who were engaged in treating the infected patients and caused irreparable damage to the healthcare system. In this study, the vulnerability of the team of health service providers during the Ebola outbreak in Liberia, Guinea and Sierra Leone is studied. The article also proposes solutions that can be learned as a lesson, help in increasing their resilience in similar biological hazards and planning management strategies for similar events in the future. Long before the outbreak took place, West African countries were already facing acute problems in terms of access to health services and health infrastructure. The most important shortcomings for the same were identified as insufficient number of health personnel and capacity shortage that prevented the people from being ready to deal with such uncalled events viz. accidents and epidemic disease outbreak. The Ebola epidemic exacerbated the persisting problems caused due to a shortage of personnel in these countries and caused the death of a large number of common people as well as healthcare personnel. Generally, the vulnerability of the health team working during the Ebola outbreak could be divided into five general dimensions: 1. Management weakness; 2. Lack of engineering and environmental control; 3. Obstacles in the use of personal protective equipment; 4. Not having enough skills and practice exercises; and 5. Ignoring the social factors and satisfaction of the healthcare personnel. The main theme of the study was failure to understand the risk of personnel in accidents and disasters. Findings revealed building capacity and reducing vulnerability of the healthcare personnel against disasters and epidemics depends upon the perceived risk, which is a decisive factor
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Ivanova, Olena; Dræbel, Tania; Tellier, Siri
2015-08-12
Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine). It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policy-makers. Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group's involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include representatives of vulnerable communities which could
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Directory of Open Access Journals (Sweden)
Olena Ivanova
2015-10-01
Full Text Available Background Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine. It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policymakers. Methods Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. Results The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group’s involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Conclusion Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include
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Human trafficking in hotels: an 'invisible' threat for a vulnerable industry
Paraskevas, Alexandros; Brookes, Maureen
2018-01-01
Purpose: To identify and analyse the hotel sector's vulnerabilities that human traffickers exploit in order to use hotels as conduits for trafficking in human beings (THB).\\ud Design/methodology/approach: Using the MAVUS framework of sector vulnerability analysis, the study adopted a qualitative approach employing environmental scanning and semi-structured key stakeholder interviews in three European countries: UK, Finland and Romania.\\ud Findings: The study identifies the types of THB occurr...
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Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica
2011-01-01
Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473
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CSIR Research Space (South Africa)
Garland, Rebecca M
2017-10-01
Full Text Available Southern Africa has multiple risks that contribute to the overall burden of disease (i.e. the quadruple burden of disease), which may make people more vulnerable to the health impacts from climate change. In addition, the sector is vulnerable...
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Human Security and Mutual Vulnerability: The Global Political ...
International Development Research Centre (IDRC) Digital Library (Canada)
-Cold War era: the search for an analytical framework that will help us understand this turbulent and chaotic period in human history. His lucid and visionary analysis rests on the concept of mutual vulnerability: that in an increasingly ...
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Tandlich, Roman; Chirenda, Tatenda G; Srinivas, Chandra S S
2013-01-01
South Africa has reached a medium level of human development and has a heterogeneous situation with respect to disaster risk management. In this article, a preliminary assessment of the gender aspects of disaster vulnerability and fatalities is presented. The United Nations, the Health Systems Trust and Statistics South Africa were used as data sources for the following gender-segregated values: the life expectancy at birth, unemployment rates, the human development index values, the maternal...
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Carbon pollution increases health inequities: lessons in resilience from the most vulnerable
Directory of Open Access Journals (Sweden)
Kristie L. Ebi
Full Text Available ABSTRACT Climate change is a social justice as well as an environmental issue. The magnitude and pattern of changes in weather and climate variables are creating differential exposures, vulnerabilities, and health risks that increase stress on health systems while exacerbating existing and creating new health inequities. Examples from national and local health adaptation projects highlight that developing partnerships across sectors and levels are critical for building climate-resilient health systems and communities. Strengthening current and implementing new health interventions, such as using environmental information to develop early warning systems, can be effective in protecting the most vulnerable. However, not all projected risks of climate change can be avoided by climate policies and programs, so health system strengthening is also critical. Applying a health inequity lens can reduce current vulnerabilities while building resilience to longer-term climate change. Taking inequities into account is critical if societies are to effectively prepare for and manage the challenges ahead.
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Gadamus, Lily
2013-01-01
Indigenous residents of Alaska's Bering Strait Region depend, both culturally and nutritionally, on ice seal and walrus harvests. Currently, climate change and resultant increases in marine industrial development threaten these species and the cultures that depend on them. To document: (a) local descriptions of the importance of marine mammal hunting; (b) traditional methods for determining if harvested marine mammals are safe to consume; and (c) marine mammal outcomes that would have adverse effects on community health, the perceived causes of these outcomes, strategies for preventing these outcomes and community adaptations to outcomes that cannot be mitigated. Semi-structured interviews and focus groups were conducted with 82 indigenous hunters and elders from the Bering Strait region. Standard qualitative analysis was conducted on interview transcripts, which were coded for both inductive and deductive codes. Responses describing marine mammal food safety and importance are presented using inductively generated categories. Responses describing negative marine mammal outcomes are presented in a vulnerability framework, which links human health outcomes to marine conditions. Project participants perceived that shipping noise and pollution, as well as marine mammal food source depletion by industrial fishing, posed the greatest threats to marine mammal hunting traditions. Proposed adaptations primarily fell into 2 categories: (a) greater tribal influence over marine policy; and (b) documentation of traditional knowledge for local use. This paper presents 1 example of documenting traditional knowledge as an adaptation strategy: traditional methods for determining if marine mammal food is safe to eat. Participant recommendations indicate that 1 strategy to promote rural Alaskan adaptation to climate change is to better incorporate local knowledge and values into decision-making processes. Participant interest in documenting traditional knowledge for local use also
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Juárez-Ramírez, Clara; Márquez-Serrano, Margarita; Salgado de Snyder, Nelly; Pelcastre-Villafuerte, Blanca Estela; Ruelas-González, María Guadalupe; Reyes-Morales, Hortensia
2014-04-01
Health vulnerability refers to a lack of protection for specific population groups with specific health problems, as well as the disadvantages they face in solving them in comparison with other population groups. This major public health problem has multiple and diverse causes, including a shortage of trained health care personnel and the lack of family, social, economic, and institutional support in obtaining care and minimizing health risks. Health vulnerability is a dynamic condition arising from the confluence of multiple social determinants. This article attempts to describe the health situation of three vulnerable groups in Mexico-older adults, indigenous people, and migrants-and, after defining the needs of each, explore measures that could contribute to the design and implementation of public health policies better tailored to their respective needs.
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2018-01-01
The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California. PMID:29659481
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Directory of Open Access Journals (Sweden)
Raoul S. Liévanos
2018-04-01
Full Text Available The California Community Environmental Health Screening Tool (CalEnviroScreen advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.
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Liévanos, Raoul S
2018-04-16
The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.
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Strand, Linn B; Tong, Shilu; Aird, Rosemary; McRae, David
2010-07-28
There is overwhelming scientific evidence that human activities have changed and will continue to change the climate of the Earth. Eco-environmental health, which refers to the interdependencies between ecological systems and population health and well-being, is likely to be significantly influenced by climate change. The aim of this study was to examine perceptions from government stakeholders and other relevant specialists about the threat of climate change, their capacity to deal with it, and how to develop and implement a framework for assessing vulnerability of eco-environmental health to climate change. Two focus groups were conducted in Brisbane, Australia with representatives from relevant government agencies, non-governmental organisations, and the industry sector (n = 15) involved in the discussions. The participants were specialists on climate change and public health from governmental agencies, industry, and non-governmental organisations in South-East Queensland. The specialists perceived climate change to be a threat to eco-environmental health and had substantial knowledge about possible implications and impacts. A range of different methods for assessing vulnerability were suggested by the participants and the complexity of assessment when dealing with multiple hazards was acknowledged. Identified factors influencing vulnerability were perceived to be of a social, physical and/or economic nature. They included population growth, the ageing population with associated declines in general health and changes in the vulnerability of particular geographical areas due to for example, increased coastal development, and financial stress. Education, inter-sectoral collaboration, emergency management (e.g. development of early warning systems), and social networks were all emphasised as a basis for adapting to climate change. To develop a framework, different approaches were discussed for assessing eco-environmental health vulnerability, including literature
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Directory of Open Access Journals (Sweden)
McRae David
2010-07-01
Full Text Available Abstract Background There is overwhelming scientific evidence that human activities have changed and will continue to change the climate of the Earth. Eco-environmental health, which refers to the interdependencies between ecological systems and population health and well-being, is likely to be significantly influenced by climate change. The aim of this study was to examine perceptions from government stakeholders and other relevant specialists about the threat of climate change, their capacity to deal with it, and how to develop and implement a framework for assessing vulnerability of eco-environmental health to climate change. Methods Two focus groups were conducted in Brisbane, Australia with representatives from relevant government agencies, non-governmental organisations, and the industry sector (n = 15 involved in the discussions. The participants were specialists on climate change and public health from governmental agencies, industry, and non-governmental organisations in South-East Queensland. Results The specialists perceived climate change to be a threat to eco-environmental health and had substantial knowledge about possible implications and impacts. A range of different methods for assessing vulnerability were suggested by the participants and the complexity of assessment when dealing with multiple hazards was acknowledged. Identified factors influencing vulnerability were perceived to be of a social, physical and/or economic nature. They included population growth, the ageing population with associated declines in general health and changes in the vulnerability of particular geographical areas due to for example, increased coastal development, and financial stress. Education, inter-sectoral collaboration, emergency management (e.g. development of early warning systems, and social networks were all emphasised as a basis for adapting to climate change. To develop a framework, different approaches were discussed for assessing eco
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Directory of Open Access Journals (Sweden)
Roman Tandlich
2013-03-01
Full Text Available South Africa has reached a medium level of human development and has a heterogeneous situation with respect to disaster risk management. In this article, a preliminary assessment of the gender aspects of disaster vulnerability and fatalities is presented. The United Nations, the Health Systems Trust and Statistics South Africa were used as data sources for the following gender-segregated values: the life expectancy at birth, unemployment rates, the human development index values, the maternal mortality rates and the number of deaths from unnatural and non-natural causes. The relevant inequality indices were then calculated and used to draw conclusions regarding the gender aspects of disaster risk management in South Africa. Results of the calculations indicate that between 1980 and 2011 men were 10% more vulnerable with respect to their health status. However, the gender differences have been decreasing in recent years. Access of women to healthcare is decreasing with time, potentially decreasing the recovery potential of whole families. Women are more economically vulnerable than men in South Africa, as they are 16.3% – 33% more likely to be unemployed than men. Educational status of both genders in South Africa is comparable based on literacy and enrolment rates at primary and secondary level. On the other hand, men are five times more likely to suffer fatal injuries during disasters.
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Factors Contributing to Human Trafficking, Contexts of Vulnerability ...
African Journals Online (AJOL)
Human trafficking has recently emerged as an exceedingly intricate international crime. Sub-Saharan Africa is the most vulnerable region from which a substantial amount of victims has been recruited for both continental and intercontinental transaction. This also holds true for Ethiopian men, women and children who have ...
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Noise and health in vulnerable groups: A review
Directory of Open Access Journals (Sweden)
Irene van Kamp
2013-01-01
Full Text Available Vulnerable or susceptible groups are mentioned in most reviews and documents regarding noise and health. But only a few studies address this issue in a concrete and focused way. Groups at risk most often mentioned in the literature are children, the elderly, the chronically ill and people with a hearing impairment. The other categories encountered are those of sensitive persons, shiftworkers, people with mental illness (e.g., schizophrenia or autism, people suffering from tinnitus, and fetuses and neonates. The mechanism for this vulnerability has not been clearly described and relevant research has seldom focused on the health effects of noise in these groups in an integrated manner. This paper summarizes the outcomes and major conclusions of a systematic, qualitative review of studies over the past 5 years. This review was prepared for the 10 th Conference on Noise as a Public Health Problem (ICBEN, 2011. Evidence is reviewed describing effects, groups assumed to be at risk, and mechanisms pertaining to noise sensitivity and learned helplessness.
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Seidel, Bastian M; Bell, Erica
2014-11-28
Many countries are developing or reviewing national adaptation policy for climate change but the extent to which these meet the health needs of vulnerable groups has not been assessed. This study examines the adequacy of such policies for nine known climate-vulnerable groups: people with mental health conditions, Aboriginal people, culturally and linguistically diverse groups, aged people, people with disabilities, rural communities, children, women, and socioeconomically disadvantaged people. The study analyses an exhaustive sample of national adaptation policy documents from Annex 1 ('developed') countries of the United Nations Framework Convention on Climate Change: 20 documents from 12 countries. A 'critical computational linguistics' method was used involving novel software-driven quantitative mapping and traditional critical discourse analysis. The study finds that references to vulnerable groups are relatively little present or non-existent, as well as poorly connected to language about practical strategies and socio-economic contexts, both also little present. The conclusions offer strategies for developing policy that is better informed by a 'social determinants of health' definition of climate vulnerability, consistent with best practice in the literature and global policy prescriptions.
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The changing climate and human vulnerability in north-central Namibia
Directory of Open Access Journals (Sweden)
Margaret N. Angula
2016-01-01
Full Text Available North-central Namibia is more vulnerable to effects of climate change and variability. Combined effects of environmental degradation, social vulnerability to poverty and a changing climate will compromise subsistence farming in north-central Namibia (NCN. This will make subsistence and small-scale farmers in the region more vulnerable to projected changes in the climate system. Thus, the aim of this article was to examine factors contributing to subsistence farmers’ vulnerability to impacts of climate change. The article further discusses different aspects of human vulnerability and existing adaptation strategies in response to impacts of climate related disasters experienced over the past three to four decades in NCN. Qualitative and quantitative research approaches and methodology were employed to obtain information from subsistence farmers in north-central Namibia. The sociodemographic characteristics of Ohangwena, Oshana and Omusati Region reveals high levels of unemployment, high adult and elderly population and high dependency on agricultural livelihood system. These indicators help understand levels of household vulnerability. The study concludes that households interviewed revealed low levels of adaptive capacity due to exposure to climate risks and combined effects of social, political and cultural factors. This article provided an understanding that is required to inform the adaptation pathways relevant for NCN.
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Directory of Open Access Journals (Sweden)
Nicole Molinari
2017-04-01
Full Text Available Despite an enormous amount of attention paid to the factors that shape vulnerability to human trafficking, such as poverty and a lack of economic opportunity, the debate of evidence for what enables these factors to exist in the first place is relatively less explored. Presently, discussions of the relationship between climate change and human insecurity have been marginal to broader debates about vulnerability to trafficking. This paper argues that this signifies a gap in our understanding of the underlying drivers that push individuals and communities into situations where vulnerability to trafficking amplifies, but also that increase the pull of risky migration pathways and exploitative work situations. This paper proceeds by examining and problematising dominant conceptualisations of vulnerability in human trafficking and climate change discourses. Next, it presents a case study of the Sundarbans region of India to highlight how climate change impacts compound and exacerbate the same factors that shape vulnerability to human trafficking—including environmental degradation, loss of livelihood, destitution, and forced migration. Lastly, it argues for enhanced attention to climate change-related insecurity as evidence of vulnerability to trafficking and outlines what such insights can bring to anti-trafficking efforts.
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Public Health Planning for Vulnerable Populations and Pandemic Influenza
National Research Council Canada - National Science Library
Cameron, Wendy K
2008-01-01
This thesis addresses planning for vulnerable populations, those segments of each community that are normally independent but that may require special assistance during a health emergency such as an influenza pandemic...
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CDC's Social Vulnerability Index (SVI) Mapping Dashboard
U.S. Department of Health & Human Services — The interactive maps are visual representations of the Social Vulnerability Index (SVI). Data were extracted from the US Census and the American Community Survey.
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Examining occupational health and safety vulnerability among Canadian workers with disabilities.
Breslin, F Curtis; Lay, A Morgan; Jetha, Arif; Smith, Peter
2017-05-26
To compare workers with and without disabilities on their reported workplace hazard exposure and the presence of occupational health and safety vulnerability factors. Working-aged adults in Ontario or British Columbia were recruited to participate in a cross-sectional survey (n = 1988). Self-reported measures included demographic factors, work-related variables, perceived level of activity limitation at work, and presence of work safety vulnerability factors utilizing a novel framework. Reporting a disability at work was significantly associated with greater hazard exposure than those without a disability. In addition, those reporting a disability at work were more likely to be employed in conditions where hazard exposure was combined with inadequate policies and procedures, or hazard exposures were combined with inadequate empowerment. Work safety vulnerability is one way that health inequalities can be perpetuated even among those with disabilities who have found work. Our results suggest that employers and policy makers need to focus on assessing and addressing hazard exposures and targeting occupational health and safety resources in the workplace in a way that includes workers with disabilities. Implications for Rehabilitation Workers with disabilities experience greater hazard exposure than those without a disability. Those with moderate and severe disabilities reported occupational health and safety vulnerability, suggesting that workplace accommodations should be available to a broader range of disability levels. It appears that, above and beyond standard safety procedures, providing workplace accommodations for people with disabilities may further reduce their hazard exposure and improve their safety.
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Expanding Health Coverage for Vulnerable Groups in India
Nagpal, Somil
2013-01-01
India's health sector continues to be challenged by overall low levels of public financing, entrenched accountability issues in the public delivery system, and the persistent dominance of out-of-pocket spending. In this context, this case study describes three recent initiatives introduced by the central and state governments in India, aimed at addressing some of these challenges and improving the availability of and access to health services, particularly for the poor and vulnerable groups i...
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Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj
2017-04-10
Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards.
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How economic empowerment reduces women's reproductive health vulnerability in Tanzania
Westeneng, J.; D'Exelle, B.S.H.
2015-01-01
This article uses data from Northern Tanzania to analyse how economic empowerment helps women reduce their reproductive health (RH) vulnerability. It analyses the effect of women's employment and economic contribution to their household on health care use at three phases in the reproductive cycle:
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A review of the consequences of global climate change on human health.
Kim, Ki-Hyun; Kabir, Ehsanul; Ara Jahan, Shamin
2014-01-01
The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.
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Gutierrez, Kristie S; LePrevost, Catherine E
2016-02-03
Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015) literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate.
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Health and Human Rights: New challenges for social responsiveness
Directory of Open Access Journals (Sweden)
Leslie London
2009-11-01
Full Text Available South Africa’s struggle against apartheid discrimination, including struggles in the health sector, laid the basis for a vibrant engagement of staff and students in human rights research, teaching and outreach in the Health Sciences Faculty at the University of Cape Town (UCT. This article provides a brief overview of this background context, then shows how this engagement has continued with new challenges emerging in the post-apartheid democratic period. Teaching at undergraduate and postgraduate levels has been complemented by a programme of ‘Training the Trainers’ in health and human rights. The programme targets teachers of health professionals at institutions in South and Southern Africa, resulting in national adoption of human rights competencies as an essential component of health professionals’ skills base. Research has also extended lessons learnt from the apartheid period into work with vulnerable groups, such as rural farm workers and the deaf, and seeks to build the capacity of marginal populations to change the conditions of their vulnerability in order to realize their rights. Partnerships with civil society organisations have been a strong thread, creating new knowledge and new ways of joint work towards realizing the right to health, including advocacy engagement in civil society movements and regional networks. Further, a focus on health professionals’ practice, in terms of dealing with potential dual loyalty conflicts and their role as gatekeepers in the health services on matters of patients’ rights, has shaped the research agenda. This article illustrates how knowledge production for the public good extends beyond notions of enhancing economic productivity for national development and provides a base for transdisciplinary and transinstitutional engagement. Additionally, non-traditional forms of knowledge networking and transfer have also been explored, including engagement with policy-makers and health managers
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Directory of Open Access Journals (Sweden)
Xiang He
2015-09-01
Full Text Available Guizhou Plateau is a region in China that typically shows the contradictory human-earth system. A vulnerability assessment indicator system was constructed to explore the coupled human-natural system characteristic of the karst landform based on the grey correlation analysis mathematic model. The quantitative assessment results show that Qiandongnan and Tongren Districts belong to the slight degree of the sensitivity evaluation index. Bijie district belongs to the middle degree and the other districts of Guizhou Plateau belong to the light degree. In terms of the exposure and resilience evaluation index, only Guiyang City belongs to the slight degree and other districts are in the middle degree. Thus, Guizhou Plateau could be divided into three level zones based on the comprehensive vulnerability degree of the coupled human-natural system. The strong degree vulnerability zone includes Liupanshui City, Bijie City, Anshun City, and Qiannan District. The middle degree vulnerability zone includes the districts of Qiandongnan, Qianxinan, and Tongren and the city of Zunyi. The slight degree vulnerability zone only includes Guiyang City. The research results suggest that the coupled human-natural system in Guizhou Plateau has a high vulnerability.
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Vulnerability, diversity and scarcity: on universal rights.
Turner, Bryan Stanley; Dumas, Alex
2013-11-01
This article makes a contribution to the on-going debates about universalism and cultural relativism from the perspective of sociology. We argue that bioethics has a universal range because it relates to three shared human characteristics,--human vulnerability, institutional precariousness and scarcity of resources. These three components of our argument provide support for a related notion of 'weak foundationalism' that emphasizes the universality and interrelatedness of human experience, rather than their cultural differences. After presenting a theoretical position on vulnerability and human rights, we draw on recent criticism of this approach in order to paint a more nuanced picture. We conclude that the dichotomy between universalism and cultural relativism has some conceptual merit, but it also has obvious limitations when we consider the political economy of health and its impact on social inequality.
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Zhang, Linda; Norena, Monica; Gadermann, Anne; Hubley, Anita; Russell, Lara; Aubry, Tim; To, Matthew J; Farrell, Susan; Hwang, Stephen; Palepu, Anita
2018-03-01
Individuals who are homeless or vulnerably housed have a higher prevalence of concurrent disorders, defined as having a mental health diagnosis and problematic substance use, compared to the general housed population. The study objective was to investigate the effect of having concurrent disorders on health care utilization among homeless or vulnerably housed individuals, using longitudinal data from the Health and Housing in Transition Study. In 2009, 1190 homeless or vulnerably housed adults were recruited in Ottawa, Toronto, and Vancouver, Canada. Participants completed baseline interviews and four annual follow-up interviews, providing data on sociodemographics, housing history, mental health diagnoses, problematic drug use with the Drug Abuse Screening Test (DAST-10), problematic alcohol use with the Alcohol Use Disorders Identification Test (AUDIT), chronic health conditions, and utilization of the following health care services: emergency department (ED), hospitalization, and primary care. Concurrent disorders were defined as the participant having ever received a mental health diagnosis at baseline and having problematic substance use (i.e., DAST-10 ≥ 6 and/or AUDIT ≥ 20) at any time during the study period. Three generalized mixed effects logistic regression models were used to examine the independent association of having concurrent disorders and reporting ED use, hospitalization, or primary care visits in the past 12 months. Among our sample of adults who were homeless or vulnerably housed, 22.6% (n = 261) reported having concurrent disorders at baseline. Individuals with concurrent disorders had significantly higher odds of ED use (adjusted odds ratio [AOR] = 1.71; 95% confidence interval [CI], 1.4-2.11), hospitalization (AOR = 1.45; 95% CI, 1.16-1.81), and primary care visits (AOR = 1.34; 95% CI, 1.05-1.71) in the past 12 months over the four-year follow-up period, after adjusting for potential confounders. Concurrent disorders were associated with
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Andrews, Gail; Skinner, Donald; Zuma, Khangelani
2006-04-01
The HIV/AIDS epidemic in sub-Saharan Africa has already orphaned a generation of children, and it is projected that by 2010, 18 million African children under the age of 18 are likely to be orphans from this single cause (UNICEF, 2005, The state of the Worlds Children: Childhood under threat. New York: UNICEF). Results from a Kellogg funded OVC project (Skinner et al., 2004, Definition of orphaned and vulnerable children. Cape Town: HSRC) supported the construct that the loss of either or both parents would indicate a situation of likely vulnerability of children. A key problem in the literature on the impact of orphanhood on the well-being of children, families and communities, is that the focus of assertions and predictions is often on the negative impact on 'AIDS orphans', or households. There are hardly any studies that compare the experiences of orphans with non-orphans. This paper thus attempts to fill that gap. It uses epidemiological data to explore the epidemiology of health and vulnerability of children within the context of AIDS in sub-Saharan Africa. Because of data limitations, only the following aspects are examined: (i) orphan status; (ii) household structure (in particular, grandparent headedness and female-headedness); (iii) illness of parents; (iv) poverty; and (v) access to services, especially schooling, health, social services. While recognizing the limitations of the analysis, data presented in this paper indicates that orphans in sub-Saharan Africa are more vulnerable than non-orphans. The authors conclude with some suggestions for policy makers and programme implementers, highlighting the importance of focusing on interventions that will have maximum impact on the health and well-being of children.
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Strategies for expanding health insurance coverage in vulnerable populations.
Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue
2014-11-26
Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. We searched Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. www.thecochranelibrary.com (searched 2 November 2012), PubMed (searched 1 November 2012), EMBASE (searched 6 July 2012), Global Health (searched 6 July 2012), IBSS (searched 6 July 2012), WHO Library Database (WHOLIS) (searched 1 November 2012), IDEAS (searched 1 November 2012), ISI-Proceedings (searched 1 November 2012),OpenGrey (changed from OpenSIGLE) (searched 1 November 2012), African Index Medicus (searched 1 November 2012), BLDS (searched 1 November 2012), Econlit (searched 1 November 2012), ELDIS (searched 1 November 2012), ERIC (searched 1 November 2012), HERDIN NeON Database (searched 1 November 2012), IndMED (searched 1 November 2012), JSTOR (searched 1 November 2012), LILACS(searched 1 November 2012), NTIS (searched 1 November 2012), PAIS (searched 6 July 2012), Popline (searched 1 November 2012), ProQuest Dissertation &Theses Database (searched 1 November 2012), PsycINFO (searched 6 July 2012), SSRN (searched 1 November 2012), Thai Index Medicus (searched 1 November 2012), World Bank (searched 2 November 2012), WanFang (searched 3 November 2012), China National Knowledge Infrastructure (CHKD-CNKI) (searched 2 November 2012).In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via Web of Science to find other potentially relevant studies. Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) studies and Interrupted time series (ITS) studies that
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Kabir, Md Iqbal; Rahman, Md Bayzidur; Smith, Wayne; Lusha, Mirza Afreen Fatima; Azim, Syed; Milton, Abul Hasnat
2016-03-15
Bangladesh is one of the countries most vulnerable to climate change (CC). A basic understanding of public perception on vulnerability, attitude and the risk in relation to CC and health will provide strategic directions for government policy, adaptation strategies and development of community-based guidelines. The objective of this study was to collect community-based data on peoples' knowledge and perception about CC and its impact on health. In 2012, a cross-sectional survey was undertaken among 6720 households of 224 enumeration areas of rural villages geographically distributed in seven vulnerable districts of Bangladesh, with total population of 19,228,598. Thirty households were selected randomly from each enumeration area using the household listing provided by the Bangladesh Bureau of Statistics (BBS). Information was collected from all the 6720 research participants using a structured questionnaire. An observation checklist was used by the interviewers to collect household- and community-related information. In addition, we selected the head of each household as the eligible participant for an interview. Evidence of association between sociodemographic variables and knowledge of CC was explored by cross-tabulation and measured using chi-square tests. Logistic regression models were used to further explore the predictors of knowledge. The study revealed that the residents of the rural communities selected for this study largely come from a low socioeconomic background: only 9.6% had postsecondary education or higher, the majority worked as day labourer or farmer (60%), and only 10% earned a monthly income above BDT 12000 (equivalent to US $150 approx.). The majority of the participants (54.2%) had some knowledge about CC but 45.8% did not (p change of climate (83.2%). Among all the respondents (n = 6720), 94.5% perceived change in climate and extreme weather events. Most of them (91.9%) observed change in rainfall patterns in the last 10 years, and 97
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Strategies for expanding health insurance coverage in vulnerable populations
Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue
2014-01-01
Background Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. Objectives To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. www.thecochranelibrary.com (searched 2 November 2012), PubMed (searched 1 November 2012), EMBASE (searched 6 July 2012), Global Health (searched 6 July 2012), IBSS (searched 6 July 2012), WHO Library Database (WHOLIS) (searched 1 November 2012), IDEAS (searched 1 November 2012), ISI-Proceedings (searched 1 November 2012),OpenGrey (changed from OpenSIGLE) (searched 1 November 2012), African Index Medicus (searched 1 November 2012), BLDS (searched 1 November 2012), Econlit (searched 1 November 2012), ELDIS (searched 1 November 2012), ERIC (searched 1 November 2012), HERDIN NeON Database (searched 1 November 2012), IndMED (searched 1 November 2012), JSTOR (searched 1 November 2012), LILACS(searched 1 November 2012), NTIS (searched 1 November 2012), PAIS (searched 6 July 2012), Popline (searched 1 November 2012), ProQuest Dissertation &Theses Database (searched 1 November 2012), PsycINFO (searched 6 July 2012), SSRN (searched 1 November 2012), Thai Index Medicus (searched 1 November 2012), World Bank (searched 2 November 2012), WanFang (searched 3 November 2012), China National Knowledge Infrastructure (CHKD-CNKI) (searched 2 November 2012). In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via Web of Science to find other potentially relevant studies. Selection criteria Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA
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Human health and well-being are and will be affected by climate change, both directly through changes in extreme weather events and indirectly through weather-induced changes in human and natural systems. Populations are vulnerable to these changes in varying degrees, depending ...
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Climate change and Public health: vulnerability, impacts, and adaptation
Guzzone, F.; Setegn, S.
2013-12-01
Climate Change plays a significant role in public health. Changes in climate affect weather conditions that we are accustomed to. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases. According to studies by EPA, the impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's public health and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change. Transmissions of infectious disease have been associated with social, economic, ecological, health care access, and climatic factors. Some vector-borne diseases typically exhibit seasonal patterns in which the role of temperature and rainfall is well documented. Some of the infectious diseases that have been documented by previous studies, include the correlation between rainfall and drought in the occurrence of malaria, the influence of the dry season on epidemic meningococcal disease in the sub-Saharan African, and the importance of warm ocean waters in driving cholera occurrence in the Ganges River delta in Asia The rise of climate change has been a major concern in the public health sector. Climate change mainly affects vulnerable populations especially in developing countries; therefore, it's important that public health advocates are involve in the decision-making process in order to provide resources and preventative measures for the challenges that are associated with climate change. The main objective of this study is to assess the vulnerability and impact of climate change
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Shrestha, Rehana; Flacke, Johannes; Martinez, Javier; van Maarseveen, Martin
2016-01-01
Differential exposure to multiple environmental burdens and benefits and their distribution across a population with varying vulnerability can contribute heavily to health inequalities. Particularly relevant are areas with high cumulative burdens and high social vulnerability termed as “hotspots”. This paper develops an index-based approach to assess these multiple burdens and benefits in combination with vulnerability factors at detailed intra-urban level. The method is applied to the city of Dortmund, Germany. Using non-spatial and spatial methods we assessed inequalities and identified “hotspot” areas in the city. We found modest inequalities burdening higher vulnerable groups in Dortmund (CI = −0.020 at p vulnerability, is essential to inform environmental justice debates and to mobilize local stakeholders. Locating “hotspot” areas at this detailed spatial level can serve as a basis to develop interventions that target vulnerable groups to ensure a health conducive equal environment. PMID:27409625
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After The Tsunami: Human Rights of Vulnerable Populations
Fletcher, Laurel; Stover, Eric; Weinstein, Harvey
2005-01-01
The tsunami of December 26, 2004 devastated thousands of communities along the coastline of the Indian Ocean. More than 240,000 people were killed, with tens of thousands missing and presumed dead, and more than a million people displaced. Immediately following the tsunami, international aid agencies feared that human traffickers might seize the opportunity to compel those most vulnerable (women, children, and migrant workers) into situations of forced labor. Fortunately, few incidents of tra...
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Vulnerability and the bioethics through the experiences of illness
Directory of Open Access Journals (Sweden)
Rolim-Neto Leite Modesto
2012-03-01
Full Text Available Background: Vulnerable people are relatively or absolutely incapable of protecting their own interests. Vulnerability is an anthropological attribute of human beings due to the simple fact of being alive. Brazilian society has long been established as a matter through the eyes of social scientists. In the name of it, the vulnerability in the doctor-patient context is now being a much-discussed issue. Purpose: This study aims to analyze the current studies regarding the insertion of vulnerability in the health issue, reflexively dealing with the ethical matters involved, as well as with the narratives’ insertion in this process. Methods: This article is based on data extracted from Scientific Electronic Library Online (Scielo and on secondary data from textbooks about vulnerability, ethics, physician-patient relationship and narratives. Results and discussion: Doctors are faced with dilemmas in clinical practice: moral, ethical, legal, social, religious and economic. On these occasions, question their own values. By listening carefully to the stories of patients, health professionals broaden their perspectives, organize and integrate complex situations, which assists in conducting these difficult situations. Conclusion: Reflect the concept of vulnerability raises (re think health practices, particularly in bringing to light the social experience of illness and hospitalization of the patient.
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Vulnerability and the bioethics through the experiences of illness
Directory of Open Access Journals (Sweden)
Rolim-Neto Leite Modesto
2012-01-01
Full Text Available Background: Vulnerable people are relatively or absolutely incapable of protecting their own interests. Vulnerability is an anthropological attribute of human beings due to the simple fact of being alive. Brazilian society has long been established as a matter through the eyes of social scientists. In the name of it, the vulnerability in the doctor-patient context is now being a much-discussed issue. Purpose: This study aims to analyze the current studies regarding the insertion of vulnerability in the health issue, reflexively dealing with the ethical matters involved, as well as with the narratives’ insertion in this process. Methods: This article is based on data extracted from Scientific Electronic Library Online (Scielo and on secondary data from textbooks about vulnerability, ethics, physician-patient relationship and narratives. Results and discussion: Doctors are faced with dilemmas in clinical practice: moral, ethical, legal, social, religious and economic. On these occasions, question their own values. By listening carefully to the stories of patients, health professionals broaden their perspectives, organize and integrate complex situations, which assists in conducting these difficult situations. Conclusion: Reflect the concept of vulnerability raises (re think health practices, particularly in bringing to light the social experience of illness and hospitalization of the patient.
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Riosmena, Fernando; Jochem, Warren C
2012-01-01
In this paper, we offer a general outlook of the health of Latin Americans (with a special emphasis on Mexicans) during the different stages of the migration process to the U.S. given the usefulness of the social vulnerability concept and given that said vulnerability varies conspicuously across the different stages of the migration process. Severe migrant vulnerability during the transit and crossing has serious negative health consequences. Yet, upon their arrival to the U.S., migrant health is favorable in outcomes such as mortality by many causes of death and in several chronic conditions and risk factors, though these apparent advantages seem to disappear during the process of adaptation to the host society. We discuss potential explanations for the initial health advantage and the sources of vulnerability that explain its erosion, with special emphasis in systematic timely access to health care. Given that migration can affect social vulnerability processes in sending areas, we discuss the potential health consequences for these places and conclude by considering the immigration and health policy implications of these issues for the United States and sending countries, with emphasis on Mexico.
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Health complaints and regulatory reform: Implications for vulnerable populations?
Carney, Terry; Beaupert, Fleur; Chiarella, Mary; Bennett, Belinda; Walton, Merrilyn; Kelly, Patrick J; Satchell, Claudette S
2016-03-01
Complaints and disciplinary processes play a significant role in health professional regulation. Many countries are transitioning from models of self-regulation to greater external oversight through systems including meta-regulation, responsive (risk-based) regulation, and "networked governance". Such systems harness, in differing ways, public, private, professional and non-governmental bodies to exert influence over the conduct of health professionals and services. Interesting literature is emerging regarding complainants' motivations and experiences, the impact of complaints processes on health professionals, and identification of features such as complainant and health professional profiles, types of complaints and outcomes. This article concentrates on studies identifying vulnerable groups and their participation in health care regulatory systems.
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Vulnerability of health to market forces.
Brezis, Mayer; Wiist, William H
2011-03-01
This article reviews adverse influences of for-profit enterprises on health care and public health, and examines significance for public policy. Narrative review. For-profit health-care industries may increase costs and reduce quality, leading to market failure and contributing to the USA's unflattering position in international comparisons of health-care efficiency. Drug and device corporations use strategies such as making biased inferences, influencing scientists and physicians, marketing rather than informing the public, and lobbying to control their own industry regulations to create market advantage. Successful marketing leads to the increased use of costly profit-making drugs and procedures over cheaper, nonpatented therapies. Because resources are limited, the overuse of costly modalities contributes to expensive health care, which presents a challenge to universal coverage. The free market also fosters the proliferation of industries, such as tobacco, food, and chemicals, which externalize costs to maximize profits, seek to unduly influence research by paying experts and universities, and attempt to control the media and regulatory agencies. Most vulnerable to the cumulative harm of these tactics are children, the poor, the sick, and the least educated. The free market can harm health and health care. The corporate obligation to increase profits and ensure a return to shareholders affects public health. Such excesses of capitalism pose formidable challenges to social justice and public health. The recognition of the health risks entailed by corporation-controlled markets has important implications for public policy. Reforms are required to limit the power of corporations.
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Vulnerability and mental health in Afghanistan: looking beyond war exposure.
Trani, Jean-François; Bakhshi, Parul
2013-02-01
This study examined the prevalence of mental distress among groups in Afghanistan considered to be at risk. Data were drawn from a representative cross-sectional disability survey carried out in Afghanistan including 5,130 households in 171 clusters throughout the 34 provinces of the country. The sample included 838 nondisabled control participants aged above 14, and 675 disabled participants. Results showed that various vulnerable groups (disabled people, the unemployed, the elderly, minority ethnic groups, as well as widowed, divorced or separated women) were at higher risk of experiencing mild to severe mental health problems. The adjusted odds ratio for war-related disability compared to nondisabled was 4.09 (95% confidence interval 2.09 to 7.99) for mild mental distress disorders, and 7.10 (3.45-14.5) and 14.14 (3.38-59.00) for moderate or severe mental distress disorders, respectively. Women with disabilities (whatever the cause of impairment) when compared with nondisabled men, as well as poorer segments of society compared to the richest, had a higher prevalence of mental health problems. Women with non-war-related disabilities compared with nondisabled men were respectively 3.35 (1.27-8.81) and 8.57 (3.03-24.1) times more likely to experience mild or moderate mental distress disorders. People who experience multiple vulnerabilities are more at risk of deteriorating mental health in conflict zones. The study shows that mental health, in times of war, is influenced by a combination of demographic and socioeconomic characteristics linked to social exclusion mechanisms that were in place before the conflict began and that are redefined in relation to the changing social, cultural, and economic contexts. Mental health policies and programmes must prioritise the most vulnerable segments of Afghan society.
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Ahadnezhad Reveshty, Mohsen; Kamelifar, Mohammad Javad; Ranjbarnia, Behzad; Pashaiifar, Alireza
2014-01-01
Estimation of urban vulnerability to earthquakes can be consid-ered as an Ill-structured problem in urban in both unplanned and planned areas. Multi-criteria evaluation (MCE) provides a way to integrate different spatial data layers in a geographic information system to create composite maps representing risk. We utilized MCE in a raster Geographic Information System (GIS) to evaluate risk in vulnerable tissues of Tabriz, Iran zone. In this MCE physical risk factors and sub-factors were included and were weighted by experts. Afterward data entered to GIS and then the layers of the criteria were exported. The obtained results were entered to IDRISI and fuzzified. Ultimately the final map of physical vulnerability was outputted by overlaying order. Vulnerable tissues are highly consistent to non-official areas. However, the planned area which is called Valiasr is in low risky condition and this condition is desirable in crisis times. Here, we observe the preference of physical pre-planning operations. The links between urban planning and health are many and varied. Environmental, social and economic conditions in cities can have both positive and negative influences on human health and centre. Urban planning and related professions play an important role in shaping those conditions.
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Directory of Open Access Journals (Sweden)
Mohsen Ahadnezhad Reveshty
2014-07-01
Full Text Available Background: Estimation of urban vulnerability to earthquakes can be considered as an Ill-structured problem in urban in both unplanned and planned ar-eas. Multi-criteria evaluation (MCE provides a way to integrate different spatial data layers in a geographic information system to create composite maps representing risk. We utilized MCE in a raster Geographic Information System (GIS to evaluate risk in vulnerable tissues of Tabriz, Iran zone. Methods: In this MCE physical risk factors and sub-factors were included and were weighted by experts. Afterward data entered to GIS and then the layers of the criteria were exported. The obtained results were entered to IDRISI and fuzzified. Ultimately the final map of physical vulnerability was outputted by overlaying order. Results: Vulnerable tissues are highly consistent to non-official areas. How-ever, the planned area which is called Valiasr is in low risky condition and this condition is desirable in crisis times. Here, we observe the preference of physical pre-planning operations. Conclusion: The links between urban planning and health are many and varied. Environmental, social and economic conditions in cities can have both positive and negative influences on human health and centre. Urban planning and related professions play an important role in shaping those conditions.
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Human rights in patient care and public health-a common ground.
Peled-Raz, Maya
2017-01-01
Medical law and public health law have both served extensively as instruments of health protection and promotion-yet both are limited in their effect and scope and do not sufficiently cover nor supply a remedy to systematic, rather than anecdotal, mistreatments in the health care system. A possible solution to this deficiency may be found in the human rights in patient care legal approach. The concept of human rights in patient care is a reframing of international human rights law, as well as constitutional thought and tools, into a coherent approach aimed at the protection and furthering of both personal and communal health. It applies human rights discourse and human rights law onto the patient care setting while moving away from the narrow consumeristic view of health care delivery. By applying human rights in patient care approach, both national and international courts may and should serve as policy influencing instruments, protecting the rights of the most vulnerable and prejudiced against groups, which are want of a remedy through traditional patients' rights legal schemes.
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Muzyamba, Choolwe; Broaddus, Elena; Campbell, Catherine
2015-10-05
Human rights approaches now dominate the HIV prevention landscape across sub-Saharan Africa, yet little is known about how they are viewed by the populations they are designed to serve. Health interventions are most effective when they resonate with the worldviews and interests of target groups. This study examined local Zambian understandings of human rights approaches to HIV-prevention among three highly HIV-vulnerable groups: women, youth, and men-who-have-sex-with-men (MSM). Focus groups included 23 women, youth, and MSM who had participated in activities organized by local non-governmental organizations (NGOs) using rights-based approaches, and interviews included 10 Zambian employees of these NGOs. Topics included participants' experiences and views of the utility of these activities. Thematic analysis mapped out diverse ways participants viewed the concept of human rights in relation to HIV-prevention. Whilst NGO workers noted the need for human rights programs to address the complex drivers of the HIV epidemic, they struggled to tailor them to the Zambian context due to donor stipulations. Women program beneficiaries noted that the concept of human rights helped challenge harmful sexual practices and domestic abuse, and youth described rights-based approaches as more participatory than previous HIV-prevention efforts. However, they criticized the approach for conflicting with traditional values such as respect for elders and 'harmonious' marital relationships. They also critiqued it for threatening the social structures and relationships that they relied on for material survival, and for failing to address issues like poverty and unemployment. In contrast, MSM embraced the rights approach, despite being critical of its overly confrontational implementation. A rights-based approach seeks to tackle the symbolic drivers of HIV-its undeniable roots in cultural and religious systems of discrimination. Yet, it fails to resonate with youth and women's own
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Vulnerability to the transmission of human visceral leishmaniasis in a Brazilian urban area.
Toledo, Celina Roma Sánchez de; Almeida, Andréa Sobral de; Chaves, Sergio Augusto de Miranda; Sabroza, Paulo Chagastelles; Toledo, Luciano Medeiros; Caldas, Jefferson Pereira
2017-05-15
To analyze the determinants for the occurrence of human visceral leishmaniasis linked to the conditions of vulnerability. This is an ecological study, whose spatial analysis unit was the Territorial Analysis Unit in Araguaína, State of Tocantins, Brazil, from 2007 to 2012. We have carried out an analysis of the sociodemographic and urban infrastructure situation of the municipality. Normalized primary indicators were calculated and used to construct the indicators of vulnerability of the social structure, household structure, and urban infrastructure. From them, we have composed a vulnerability index. Kernel density estimation was used to evaluate the density of cases of human visceral leishmaniasis, based on the coordinates of the cases. Bivariate global Moran's I was used to verify the existence of spatial autocorrelation between the incidence of human visceral leishmaniasis and the indicators and index of vulnerability. Bivariate local Moran's I was used to identify spatial clusters. We have observed a pattern of centrifugal spread of human visceral leishmaniasis in the municipality, where outbreaks of the disease have progressively reached central and peri-urban areas. There has been no correlation between higher incidences of human visceral leishmaniasis and worse living conditions. Statistically significant clusters have been observed between the incidences of human visceral leishmaniasis in both periods analyzed (2007 to 2009 and 2010 to 2012) and the indicators and index of vulnerability. The environment in circumscribed areas helps as protection factor or increases the local vulnerability to the occurrence of human visceral leishmaniasis. The use of methodology that analyzes the conditions of life of the population and the spatial distribution of human visceral leishmaniasis is essential to identify the most vulnerable areas to the spread/maintenance of the disease. Analisar determinantes para a ocorrência da leishmaniose visceral humana vinculados
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Shi, Weifang; Zeng, Weihua
2013-06-20
Reducing human vulnerability to chemical hazards in the industrialized city is a matter of great urgency. Vulnerability mapping is an alternative approach for providing vulnerability-reducing interventions in a region. This study presents a method for mapping human vulnerability to chemical hazards by using clustering analysis for effective vulnerability reduction. Taking the city of Shanghai as the study area, we measure human exposure to chemical hazards by using the proximity model with additionally considering the toxicity of hazardous substances, and capture the sensitivity and coping capacity with corresponding indicators. We perform an improved k-means clustering approach on the basis of genetic algorithm by using a 500 m × 500 m geographical grid as basic spatial unit. The sum of squared errors and silhouette coefficient are combined to measure the quality of clustering and to determine the optimal clustering number. Clustering result reveals a set of six typical human vulnerability patterns that show distinct vulnerability dimension combinations. The vulnerability mapping of the study area reflects cluster-specific vulnerability characteristics and their spatial distribution. Finally, we suggest specific points that can provide new insights in rationally allocating the limited funds for the vulnerability reduction of each cluster.
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Directory of Open Access Journals (Sweden)
Weihua Zeng
2013-06-01
Full Text Available Reducing human vulnerability to chemical hazards in the industrialized city is a matter of great urgency. Vulnerability mapping is an alternative approach for providing vulnerability-reducing interventions in a region. This study presents a method for mapping human vulnerability to chemical hazards by using clustering analysis for effective vulnerability reduction. Taking the city of Shanghai as the study area, we measure human exposure to chemical hazards by using the proximity model with additionally considering the toxicity of hazardous substances, and capture the sensitivity and coping capacity with corresponding indicators. We perform an improved k-means clustering approach on the basis of genetic algorithm by using a 500 m × 500 m geographical grid as basic spatial unit. The sum of squared errors and silhouette coefficient are combined to measure the quality of clustering and to determine the optimal clustering number. Clustering result reveals a set of six typical human vulnerability patterns that show distinct vulnerability dimension combinations. The vulnerability mapping of the study area reflects cluster-specific vulnerability characteristics and their spatial distribution. Finally, we suggest specific points that can provide new insights in rationally allocating the limited funds for the vulnerability reduction of each cluster.
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Impact of climate change on human health and health systems in Tanzania: a review.
Mboera, Leonard E G; Mayala, Benjamin K; Kweka, Eliningaya J; Mazigo, Humphrey D
2011-12-01
Climate change (CC) has a number of immediate and long-term impacts on the fundamental determinants of human health. A number of potential human health effects have been associated either directly or indirectly with global climate change. Vulnerability to the risks associated with CC may exacerbate ongoing socio-economic challenges. The objective of this review was to analyse the potential risk and vulnerability in the context of climate-sensitive human diseases and health system in Tanzania. Climate sensitive vector- and waterborne diseases and other health related problems and the policies on climate adaptation in Tanzania during the past 50 years are reviewed. The review has shown that a number of climate-associated infectious disease epidemics have been reported in various areas of the country; mostly being associated with increase in precipitation and temperature. Although, there is no single policy document that specifically addresses issues of CC in the country, the National Environmental Management Act of 1997 recognizes the importance of CC and calls for the government to put up measures to address the phenomenon. A number of strategies and action plans related to CC are also in place. These include the National Biodiversity Strategy and Action Plan, the National Action Programme, and the National Bio-safety Framework. The government has put in place a National Climate Change Steering Committee and the National Climate Change Technical Committee to oversee and guide the implementation of CC activities in the country. Recognizing the adverse impacts of natural disasters and calamities, the government established a Disaster Management Division under the Prime Minister's Office. Epidemic Preparedness and Response Unit of the Ministry of Health and Social Welfare is responsible for emergency preparedness, mostly disease outbreaks. However, specific climate changes associated with human health issues are poorly addressed in the MoHSW strategies and the national
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Environmental safety and health vulnerabilities of plutonium at the Los Alamos National Laboratory
International Nuclear Information System (INIS)
Pillay, K.K.S.
1995-01-01
A national effort to assess the environmental safety and health issues of plutonium at nuclear facilities included an assessment of such vulnerabilities at the Los Alamos National Laboratory (LANL). LANL was well below the most serious problem sites, however, the problems are serious enough to require immediate attention and resources are being sought to address the most serious vulnerabilities
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Natuzzi, Eileen S.; Joshua, Cynthia; Shortus, Matthew; Reubin, Reginald; Dalipanda, Tenneth; Ferran, Karen; Aumua, Audrey; Brodine, Stephanie
2016-01-01
Extreme weather events are common and increasing in intensity in the southwestern Pacific region. Health impacts from cyclones and tropical storms cause acute injuries and infectious disease outbreaks. Defining population vulnerability to extreme weather events by examining a recent flood in Honiara, Solomon Islands, can help stakeholders and policymakers adapt development to reduce future threats. The acute and subacute health impacts following the April 2014 floods were defined using data obtained from hospitals and clinics, the Ministry of Health and in-country World Health Organization office in Honiara. Geographical information system (GIS) was used to assess morbidity and mortality, and vulnerability of the health system infrastructure and households in Honiara. The April flash floods were responsible for 21 acute deaths, 33 injuries, and a diarrhea outbreak that affected 8,584 people with 10 pediatric deaths. A GIS vulnerability assessment of the location of the health system infrastructure and households relative to rivers and the coastline identified 75% of the health infrastructure and over 29% of Honiara's population as vulnerable to future hydrological events. Honiara, Solomon Islands, is a rapidly growing, highly vulnerable urban Pacific Island environment. Evaluation of the mortality and morbidity from the April 2014 floods as well as the infectious disease outbreaks that followed allows public health specialists and policy makers to understand the health system and populations vulnerability to future shocks. Understanding the negative impacts natural disaster have on people living in urban Pacific environments will help the government as well as development partners in crafting resilient adaptation development. PMID:27091867
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Rickles, Michael; Rebeiro, Peter F; Sizemore, Lindsey; Juarez, Paul; Mutter, Mitchell; Wester, Carolyn; McPheeters, Melissa
2018-05-17
Knowing which factors contribute to county-level vulnerability to a human immunodeficiency virus (HIV)/hepatitis C virus (HCV) outbreak, and which counties are most vulnerable, guides public health and clinical interventions. We therefore examined the impact of locally available indicators related to the opioid epidemic on prior national models of HIV/HCV outbreak vulnerability. Tennessee's 95 counties were the study sample. Predictors from 2012 and 2013 were used, mirroring prior methodology from the US Centers for Disease Control and Prevention (CDC). Acute HCV incidence was the proxy measure of county-level vulnerability. Seventy-eight predictors were identified as potentially predictive for HIV/HCV vulnerability. We used multiple dimension reduction techniques to determine predictors for inclusion and Poisson regression to generate a composite index score ranking county-level vulnerability for HIV/HCV. There was overlap of high-risk counties with the national analysis (25 of 41 counties). The distribution of vulnerability reinforces earlier research indicating that eastern Tennessee is at particularly high risk but also demonstrates that the entire state has high vulnerability. Prior research placed Tennessee among the top states for opioid prescribing, acute HCV infection, and greatest risk for an HIV/HCV outbreak. Given this confluence of risk, the Tennessee Department of Health expanded upon prior work to include more granular, local data, including on opioid prescribing. We also explored nonfatal and fatal overdoses. The more complete statewide view of risk generated, not only in eastern counties but also in the western corridor, will enable local officials to monitor vulnerability and better target resources.
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Directory of Open Access Journals (Sweden)
Md Iqbal Kabir
2016-03-01
Full Text Available Abstract Background Bangladesh is one of the countries most vulnerable to climate change (CC. A basic understanding of public perception on vulnerability, attitude and the risk in relation to CC and health will provide strategic directions for government policy, adaptation strategies and development of community-based guidelines. The objective of this study was to collect community-based data on peoples’ knowledge and perception about CC and its impact on health. Methods In 2012, a cross-sectional survey was undertaken among 6720 households of 224 enumeration areas of rural villages geographically distributed in seven vulnerable districts of Bangladesh, with total population of 19,228,598. Thirty households were selected randomly from each enumeration area using the household listing provided by the Bangladesh Bureau of Statistics (BBS. Information was collected from all the 6720 research participants using a structured questionnaire. An observation checklist was used by the interviewers to collect household- and community-related information. In addition, we selected the head of each household as the eligible participant for an interview. Evidence of association between sociodemographic variables and knowledge of CC was explored by cross-tabulation and measured using chi-square tests. Logistic regression models were used to further explore the predictors of knowledge. Results The study revealed that the residents of the rural communities selected for this study largely come from a low socioeconomic background: only 9.6 % had postsecondary education or higher, the majority worked as day labourer or farmer (60 %, and only 10 % earned a monthly income above BDT 12000 (equivalent to US $150 approx.. The majority of the participants (54.2 % had some knowledge about CC but 45.8 % did not (p < 0.001. The majority of knowledgeable participants (n = 3645 felt excessive temperature as the change of climate (83.2 %. Among all the
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The regional impacts of climate change: an assessment of vulnerability
National Research Council Canada - National Science Library
Zinyowera, Marufu C; Moss, Richard H; Watson, R. T
1998-01-01
.... The Regional Impacts of Climate Change: An Assessment of Vulnerability reviews state-of-the-art information on potential impacts of climate change for ecological systems, water supply, food production, coastal infrastructure, human health...
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Koleva, Yordanka Nikolova
Chronic diseases are increasingly recognized as major contributors to the global burden of disease. Individuals with chronic disease are particularly vulnerable during mass emergencies as they may suffer an interruption in their therapeutic programs, leading to life-threatening conditions and complications. Based on the individual and community risk factors framework, three categories are defined as the most vulnerable to extreme natural events: physically, psychologically, and socially vulnerable. Complex emergencies that occurred in the recent decade have provided evidence that these groups suffer more pronounced effects than others. Individuals seeking community support during emergencies have been predominantly medically dependent, elderly, children, people with chronic health conditions, and lower socioeconomic status. The purpose of this study was to investigate the effect of health-related vulnerability on shelter operations, and to estimate the burden of chronic disease on community resources following catastrophic events. A comprehensive survey data collection conducted by the United States Public Health Service in 2005 was used to evaluate clinical services for populations with health conditions accommodated by Louisiana temporary disaster shelters. Correlation and multiple regression analyses determined the relationship between shelter characteristics and the factors predicting shelters' needs for short-term assistance. Significant predictors were identified in all three explored domains: structural shelter characteristics (sponsor, interpreter needed); clinical characteristics (access to health providers, clinic on site, staff had no days off); population characteristics (census, compromised mental health alone, or in combination with chronic conditions and diseases with epidemic potential). Shelters sponsored by faith-based organizations were less likely to be in risk of rapid resource depletion. Shelters with large census demonstrated association with
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Impacts of Extreme Events on Human Health. Chapter 4
Bell, Jesse E.; Herring, Stephanie C.; Jantarasami, Lesley; Adrianopoli, Carl; Benedict, Kaitlin; Conlon, Kathryn; Escobar, Vanessa; Hess, Jeremy; Luvall, Jeffrey; Garcia-Pando, Carlos Perez;
2016-01-01
Increased Exposure to Extreme Events Key Finding 1: Health impacts associated with climate-related changes in exposure to extreme events include death, injury, or illness; exacerbation of underlying medical conditions; and adverse effects on mental health[High Confidence]. Climate change will increase exposure risk in some regions of the United States due to projected increases in the frequency and/or intensity of drought, wildfires, and flooding related to extreme precipitation and hurricanes [Medium Confidence].Disruption of Essential Infrastructure Key Finding 2: Many types of extreme events related to climate change cause disruption of infrastructure, including power, water, transportation, and communication systems, that are essential to maintaining access to health care and emergency response services and safeguarding human health [High Confidence].Vulnerability to Coastal Flooding Key Finding 3: Coastal populations with greater vulnerability to health impacts from coastal flooding include persons with disabilities or other access and functional needs, certain populations of color, older adults, pregnant women and children, low-income populations, and some occupational groups [High Confidence].Climate change will increase exposure risk to coastal flooding due to increases in extreme precipitation and in hurricane intensity and rainfall rates, as well as sea level rise and the resulting increases in storm surge.
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Will Global Climate Change Alter Fundamental Human Immune Reactivity: Implications for Child Health?
Swaminathan, Ashwin; Lucas, Robyn M; Harley, David; McMichael, Anthony J
2014-11-11
The human immune system is an interface across which many climate change sensitive exposures can affect health outcomes. Gaining an understanding of the range of potential effects that climate change could have on immune function will be of considerable importance, particularly for child health, but has, as yet, received minimal research attention. We postulate several mechanisms whereby climate change sensitive exposures and conditions will subtly impair aspects of the human immune response, thereby altering the distribution of vulnerability within populations-particularly for children-to infection and disease. Key climate change-sensitive pathways include under-nutrition, psychological stress and exposure to ambient ultraviolet radiation, with effects on susceptibility to infection, allergy and autoimmune diseases. Other climate change sensitive exposures may also be important and interact, either additively or synergistically, to alter health risks. Conducting directed research in this area is imperative as the potential public health implications of climate change-induced weakening of the immune system at both individual and population levels are profound. This is particularly relevant for the already vulnerable children of the developing world, who will bear a disproportionate burden of future adverse environmental and geopolitical consequences of climate change.
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Will Global Climate Change Alter Fundamental Human Immune Reactivity: Implications for Child Health?
Directory of Open Access Journals (Sweden)
Ashwin Swaminathan
2014-11-01
Full Text Available The human immune system is an interface across which many climate change sensitive exposures can affect health outcomes. Gaining an understanding of the range of potential effects that climate change could have on immune function will be of considerable importance, particularly for child health, but has, as yet, received minimal research attention. We postulate several mechanisms whereby climate change sensitive exposures and conditions will subtly impair aspects of the human immune response, thereby altering the distribution of vulnerability within populations—particularly for children—to infection and disease. Key climate change-sensitive pathways include under-nutrition, psychological stress and exposure to ambient ultraviolet radiation, with effects on susceptibility to infection, allergy and autoimmune diseases. Other climate change sensitive exposures may also be important and interact, either additively or synergistically, to alter health risks. Conducting directed research in this area is imperative as the potential public health implications of climate change-induced weakening of the immune system at both individual and population levels are profound. This is particularly relevant for the already vulnerable children of the developing world, who will bear a disproportionate burden of future adverse environmental and geopolitical consequences of climate change.
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McIver, Lachlan; Kim, Rokho; Woodward, Alistair; Hales, Simon; Spickett, Jeffery; Katscherian, Dianne; Hashizume, Masahiro; Honda, Yasushi; Kim, Ho; Iddings, Steven; Naicker, Jyotishma; Bambrick, Hilary; McMichael, Anthony J; Ebi, Kristie L
2016-11-01
Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries-Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a "likelihood versus impact" matrix, and adaptation strategies were prioritized and planned accordingly. The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity
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A Peer-to-Peer Health Education Program for Vulnerable Children in Uganda
Falk, Diane S.; Pettet, Kristen; Mpagi, Charles
2016-01-01
In this paper, children attending a U.S.-sponsored private primary school serving orphaned and vulnerable children in Uganda were interviewed in focus groups about their participation in a peer-to-peer health education program in which they used music, dance, poetry, art, and drama to convey health information. The children reported enhanced…
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Li, Lianfa; Wang, Jinfeng; Leung, Hareton; Zhao, Sisi
2012-06-01
Vulnerability of human beings exposed to a catastrophic disaster is affected by multiple factors that include hazard intensity, environment, and individual characteristics. The traditional approach to vulnerability assessment, based on the aggregate-area method and unsupervised learning, cannot incorporate spatial information; thus, vulnerability can be only roughly assessed. In this article, we propose Bayesian network (BN) and spatial analysis techniques to mine spatial data sets to evaluate the vulnerability of human beings. In our approach, spatial analysis is leveraged to preprocess the data; for example, kernel density analysis (KDA) and accumulative road cost surface modeling (ARCSM) are employed to quantify the influence of geofeatures on vulnerability and relate such influence to spatial distance. The knowledge- and data-based BN provides a consistent platform to integrate a variety of factors, including those extracted by KDA and ARCSM to model vulnerability uncertainty. We also consider the model's uncertainty and use the Bayesian model average and Occam's Window to average the multiple models obtained by our approach to robust prediction of the risk and vulnerability. We compare our approach with other probabilistic models in the case study of seismic risk and conclude that our approach is a good means to mining spatial data sets for evaluating vulnerability. © 2012 Society for Risk Analysis.
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Vulnerable populations in terms of health care and their right to decent work
Directory of Open Access Journals (Sweden)
Stojković-Zlatanović Sanja
2016-01-01
Full Text Available Vulnerability may arise from individual characteristics of individuals or social groups, employment conditions or as a result of difficulties in exercising fundamental social human rights. Principle of equity in terms of labor and employment as well as equity in health are closely linked and represented in a concept of decent work for all, promoted by the International Labor Organization. The concept of decent work aims to improve work conditions for the marginalized and vulnerable workers, where the notions “vulnerable” and “marginalized” represent people on the periphery of formal, standard employment, people working in an environment where the risk of being denied employment rights is high and also those who do not have the capacity to protect themselves from the abuse. The labor status of social groups whose personal characteristics, i.e. health characteristics, make them vulnerable in terms of work conditions and labor rights has been analyzed. In international, comparative and Serbian law, workers with disabilities are already protected by the special law provisions of professional rehabilitation and employment of people with disabilities. On the contrary, the status of workers who are not considered as people with disabilities but who are faced with some health problems are not recognized in the labor legislation and protected by the law. People with health problems may be those who are chronically ill i.e. people in a remission of a disease. Considering the current demographic process of population aging, an increase of elderly in economically active population/labor force could be expected, which also means the increase of chronically ill workers. This fact, argue in favor of regulation the labor status of people with health problems. Furthermore, according to the World Health Organization, health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, where the third
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Vulnerability of complex networks
Mishkovski, Igor; Biey, Mario; Kocarev, Ljupco
2011-01-01
We consider normalized average edge betweenness of a network as a metric of network vulnerability. We suggest that normalized average edge betweenness together with is relative difference when certain number of nodes and/or edges are removed from the network is a measure of network vulnerability, called vulnerability index. Vulnerability index is calculated for four synthetic networks: Erdős-Rényi (ER) random networks, Barabási-Albert (BA) model of scale-free networks, Watts-Strogatz (WS) model of small-world networks, and geometric random networks. Real-world networks for which vulnerability index is calculated include: two human brain networks, three urban networks, one collaboration network, and two power grid networks. We find that WS model of small-world networks and biological networks (human brain networks) are the most robust networks among all networks studied in the paper.
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Marzari, Carla Kowalski; Backes, Dirce Stein; Backes, Marli Stein; Marchiori, Mara Teixeira; Souza, Martha Teixeira de; Carpes, Adriana Dornelles
2013-01-01
The scope of this paper is to ascertain the perception of community leadership, health professionals and users regarding citizenship status and the enhancement of the healthcare conditions of families belonging to a vulnerable community. This is an exploratory study of a qualitative nature, guided by theory based on data. Data were collected between July and December 2009, by means of interviews with four community health leaders, a team of eight family health team professionals and twelve health users. The codification of the data resulted in the following categories: Understanding the social conditions, the political conditions, the environmental conditions and the health conditions of families in a vulnerable community. The conclusions reached were, that if on the one hand the social security and health policies made it possible to reduce poverty and local inequalities, on the other hand they do not ensure the requisite enhancement of citizenship or even the improvement of health conditions.
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Quantifying human vulnerability in rural areas: case study of Tutova Hills (Eastern Romania)
Stângă, I. C.; Grozavu, A.
2012-06-01
This paper aims to assess the vulnerability at regional level, the model and the proposed indicators being explicitly intended for an essentially rural region, in this case-Tutova Hills (Eastern Romania). Five categories of variables were taken into account to define the vulnerability components: rural habitat, demographic features, agriculture, environmental quality and emergency situations. For each one, five variables were analyzed and ranked based on the level of determination or subordination. In order to ensure the flexibility of the model and to avoid the criteria duplication in assessing vulnerability, only a single indicator of each category was retained and included in analysis: total number of inhabitants, dependency ratio, weight of arable land on slope categories, weight of land under forestry and road accessibility of villages. The selected indicators were mathematically processed in order to maximize their relevance and to unitary express the results in the spread 0-1. Also, values of each indicator were grouped into four classes, corresponding to the level of vulnerability: low, medium, high and very high. A general index was obtained through the integration of vulnerability factors in an equation based on the geometric mean. Spatial analysis was based on features of the MicroImages TNTmips 7.3. software, which allow the vulnerability mapping. This approach argues and states that vulnerability assessment through indicator-based methods can be made only according to the level and scale of analysis and related to natural or human conditions of a region.
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Structural Vulnerability and Health: Latino Migrant Laborers in the United States
Quesada, James; Hart, Laurie K.; Bourgois, Philippe
2011-01-01
Latino immigrants in the United States constitute a paradigmatic case of a population group subject to structural violence. Their subordinated location in the global economy and their culturally depreciated status in the United States are exacerbated by legal persecution. Medical Anthropology Volume 30, issues 4 and 5, include a series of ethnographic analyses of the processes that render undocumented Latino immigrants structurally vulnerable to ill-health. We hope to extend the social science concept of ‘structural vulnerability’ to make it a useful tool for health care. Defined as a positionality that imposes physical/emotional suffering on specific population groups and individuals in patterned ways, structural vulnerability is a product of two complementary forces: (1) class-based economic exploitation and cultural, gender/sexual, and racialized discrimination; and (2) processes of symbolic violence and subjectivity formation that have increasingly legitimized punitive neoliberal discourses of individual unworthiness. PMID:21777121
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Hullmann, Stephanie E; Wolfe-Christensen, Cortney; Meyer, William H; McNall-Knapp, Rene Y; Mullins, Larry L
2010-11-01
The current study sought to examine the relation of parental overprotection and perceived child vulnerability to parent-reported health-related quality of life in parents of children with cancer. Parents (N = 89) of children who had been diagnosed with cancer completed measures of parental overprotection, perceived child vulnerability, and parent-proxy report of health-related quality of life. After controlling for theoretically relevant covariates, parental overprotection and perceived child vulnerability were both found to be significantly related to child health-related quality of life. Additional analyses revealed that perceived child vulnerability mediated the relationship between overprotective parenting behaviors and the child's health-related quality of life. The findings highlight the need to assess for these discrete parenting variables in parents of children with cancer and to develop interventions to target parental perceptions of vulnerability.
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MacLachlan, Malcolm; Amin, Mutamad; Mannan, Hasheem; El Tayeb, Shahla; Bedri, Nafisa; Swartz, Leslie; Munthali, Alister; Van Rooy, Gert; McVeigh, Joanne
2012-01-01
While many health services strive to be equitable, accessible and inclusive, peoples’ right to health often goes unrealized, particularly among vulnerable groups. The extent to which health policies explicitly seek to achieve such goals sets the policy context in which services are delivered and evaluated. An analytical framework was developed – EquiFrame – to evaluate 1) the extent to which 21 Core Concepts of human rights were addressed in policy documents, and 2) coverage of 12 Vulnerable Groups who might benefit from such policies. Using this framework, analysis of 51 policies across Malawi, Namibia, South Africa and Sudan, confirmed the relevance of all Core Concepts and Vulnerable Groups. Further, our analysis highlighted some very strong policies, serious shortcomings in others as well as country-specific patterns. If social inclusion and human rights do not underpin policy formation, it is unlikely they will be inculcated in service delivery. EquiFrame facilitates policy analysis and benchmarking, and provides a means for evaluating policy revision and development. PMID:22649488
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Directory of Open Access Journals (Sweden)
Malcolm MacLachlan
Full Text Available While many health services strive to be equitable, accessible and inclusive, peoples' right to health often goes unrealized, particularly among vulnerable groups. The extent to which health policies explicitly seek to achieve such goals sets the policy context in which services are delivered and evaluated. An analytical framework was developed--EquiFrame--to evaluate 1 the extent to which 21 Core Concepts of human rights were addressed in policy documents, and 2 coverage of 12 Vulnerable Groups who might benefit from such policies. Using this framework, analysis of 51 policies across Malawi, Namibia, South Africa and Sudan, confirmed the relevance of all Core Concepts and Vulnerable Groups. Further, our analysis highlighted some very strong policies, serious shortcomings in others as well as country-specific patterns. If social inclusion and human rights do not underpin policy formation, it is unlikely they will be inculcated in service delivery. EquiFrame facilitates policy analysis and benchmarking, and provides a means for evaluating policy revision and development.
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McCauley, Linda A
2005-07-01
Immigrant workers are a rapidly growing segment of the U.S. work force, and these increasing numbers have resulted in a different ethnic mix in the work force than in previous decades. Immigrant workers are not a homogenous group, but are over-represented in low-paying occupations. Their diversity and vulnerability present distinct challenges for occupational health nurses. High-risk occupations in which a large proportion of immigrant workers are hired include agriculture, sweatshops, day laborers, and construction. Initiatives needed to improve the working conditions of this vulnerable population include improved surveillance and research, culturally competent care providers, improved health care access, advocacy, and changes in immigration and health policy.
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Directory of Open Access Journals (Sweden)
Allison A. Vanderbilt
2013-03-01
Full Text Available Healthcare in the United States (US is burdened with enormous healthcare disparities associated with a variety of factors including insurance status, income, and race. Highly vulnerable populations, classified as those with complex medical problems and/or social needs, are one of the fastest growing segments within the US. Over a decade ago, the US Surgeon General publically challenged the nation to realize the importance of oral health and its relationship to general health and well-being, yet oral health disparities continue to plague the US healthcare system. Interprofessional education and teamwork has been demonstrated to improve patient outcomes and provide benefits to participating health professionals. We propose the implementation of interprofessional education and teamwork as a solution to meet the increasing oral and systemic healthcare demands of highly vulnerable US populations.
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Directory of Open Access Journals (Sweden)
Kathryn Elizabeth Khumalo
2015-01-01
Full Text Available Community-based natural resource management (CBNRM programmes are designed to ensure that rural residents benefit from conservation initiatives. But where human-wildlife conflict threatens life and livelihood, wildlife impacts can undermine the goals of CBNRM. Based on research on women′s experiences in Namibia′s Kwandu Conservancy, we examine both the visible and hidden impacts of human-wildlife conflict. In Kwandu Conservancy, the effects of human-wildlife conflict are ongoing, reaching beyond direct material losses to include hidden impacts such as persistent worries about food insecurity, fears for physical safety, and lost investments. Existing vulnerabilities related to poverty and marital statuses make some women more susceptible to wildlife impacts, and less able to recover from losses or to access compensation. This process may actually deepen the vulnerability of women whose economic status is already marginal. Because the benefits of wildlife conservation accrue at multiple scales, we recommend that the cost of human-wildlife conflict be better distributed, with additional resources for prevention and compensation made available for conservancy residents.
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Bozzaro, Claudia; Boldt, Joachim; Schweda, Mark
2018-05-01
The elderly are often considered a vulnerable group in public and academic bioethical debates and regulations. In this paper, we examine and challenge this assumption and its ethical implications. We begin by systematically delineating the different concepts of vulnerability commonly used in bioethics, before then examining whether these concepts can be applied to old age. We argue that old age should not, in and of itself, be used as a marker of vulnerability, since ageing is a process that can develop in a variety of different ways and is not always associated with particular experiences of vulnerability. We, therefore, turn to more fundamental phenomenological considerations in order to reconstruct from a first person perspective the intricate interconnections between the experiences of ageing and vulnerability. According to this account, ageing and old age are phenomena in which the basic anthropological vulnerability of human beings can manifest itself in an increased likelihood of harm and exploitation. Thus, we plead for a combined model of vulnerability that helps to avoid problems related to the current concepts of vulnerability. We conclude first that old age as such is not a sufficient criterion for being categorized as vulnerable in applied ethics, and second that reflections on ageing can help to develop a better understanding of the central role of vulnerability in human existence and in applied ethics. © 2018 John Wiley & Sons Ltd.
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Assessment of bullet effectiveness based on a human vulnerability model.
Liu, Susu; Xu, C; Wen, Y; Li, G; Zhou, J
2017-12-25
Penetrating wounds from explosively propelled fragments and bullets are the most common causes of combat injury. There is a requirement to assess the potential effectiveness of bullets penetrating human tissues in order to optimise preventive measures and wound trauma management. An advanced voxel model based on the Chinese Visible Human data was built. A digital human vulnerability model was established in combination with wound reconstruction and vulnerability assessment rules, in which wound penetration profiles were obtained by recreating the penetration of projectiles into ballistic gelatin. An effectiveness evaluation method of bullet penetration using the Abbreviated Injury Scale (AIS) was developed and solved using the Monte Carlo sampling method. The effectiveness of rifle bullets was demonstrated to increase with increasing velocity in the range of 300-700 m/s. When imparting the same energy, the effectiveness of the 5.56 mm bullet was higher than the 7.62 mm bullet in this model. The superimposition of simulant penetration profiles produced from ballistic gelatin simulant has been used to predict wound tracts in damaged tissues. The authors recognise that determining clinical effectiveness based on the AIS scores alone without verification of outcome by review of clinical hospital records means that this technique should be seen more as a manner of comparing the effectiveness of bullets than an injury prediction model. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Cheng, Fangman; Lin, Ping; Wang, Yini; Liu, Guojie; Li, Ling; Yu, Huai; Yu, Bo; Zhao, Zhenjuan; Gao, Xueqin
2018-05-01
The association between type D personality and coronary plaque vulnerability has been suggested. The objective of the study was to evaluate the potential mediating effects of health behavior on the association between type D personality and plaque vulnerability in coronary artery disease (CAD) patients. A total of 319 CAD patients were assessed for type D personality and health behavior via self-administered questionnaires. The plaque vulnerability, evaluated according to characteristics, accompaniment, and outcomes of plaque, was assessed by optical coherence tomography. Regression analysis showed that type D personality was independently associated with lipid plaque (odds ratio [OR] = 2.387, p = 0.001), thin cap fibroatheroma (TCFA) (OR = 2.366, p = 0.001), rupture (OR = 2.153, p = 0.002), and lipid arc (β = -0.291, p vulnerability. Psychological stress mediated the relationship between type D and lipid plaque (p = 0.030), TCFA (p = 0.034), and rupture (p = 0.013). Living habits significantly mediated the relationship between type D and lipid plaque (p = 0.028), TCFA (p = 0.036), but not rupture (p = 0.066). Participating in activities was not a significant mediator of the relationship between type D personality and lipid plaque (p = 0.115), TCFA (p = 0.115), or rupture (p = 0.077). Health behaviors (psychological stress and living habits) may be mediators of the association between type D personality and plaque vulnerability. Copyright © 2018 Elsevier Inc. All rights reserved.
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Directory of Open Access Journals (Sweden)
Rosanna Cabré
2016-12-01
Full Text Available Brain neurons offer diverse responses to stresses and detrimental factors during development and aging, and as a result of both neurodegenerative and neuropsychiatric disorders. This multiplicity of responses can be ascribed to the great diversity among neuronal populations. Here we have determined the metabolomic profile of three healthy adult human brain regions—entorhinal cortex, hippocampus, and frontal cortex—using mass spectrometry-based technologies. Our results show the existence of a lessened energy demand, mitochondrial stress, and lower one-carbon metabolism (particularly restricted to the methionine cycle specifically in frontal cortex. These findings, along with the better antioxidant capacity and lower mTOR signaling also seen in frontal cortex, suggest that this brain region is especially resistant to stress compared to the entorhinal cortex and hippocampus, which are more vulnerable regions. Globally, our results show the presence of specific metabolomics adaptations in three mature, healthy human brain regions, confirming the existence of cross-regional differences in cell vulnerability in the human cerebral cortex.
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Atilola, Olayinka
2014-01-01
Efforts at improving child-health and development initiatives in sub-Saharan Africa had focused on the physical health of children due to the neglect of child and adolescent mental health (CAMH) policy initiatives. A thorough and broad-based understanding of the prevalent child mental-health risk and vulnerability factors is needed to successfully articulate CAMH policies. In this discourse, we present a narrative on the child mental-health risk and vulnerability factors in sub-Saharan Africa...
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Hardships of the Great Recession and health: Understanding varieties of vulnerability
Directory of Open Access Journals (Sweden)
Julie A Kirsch
2016-05-01
Full Text Available The Great Recession of 2007–2009 is regarded as the most severe economic downturn since World War II. This study examined relationships between reported recession hardships and physical health in a national survey of American adults ( N = 1275. Furthermore, education and psychological resources (perceived control, purpose in life, and conscientiousness were tested as moderators of the health impacts of the recession. A greater number of hardships predicted poorer health, especially among the less educated. Psychological resources interacted with education and hardships to predict health outcomes. Although typically viewed as protective factors, such resources became vulnerabilities among educationally disadvantaged adults experiencing greater recession hardships.
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Hardships of the Great Recession and health: Understanding varieties of vulnerability.
Kirsch, Julie A; Ryff, Carol D
2016-01-01
The Great Recession of 2007-2009 is regarded as the most severe economic downturn since World War II. This study examined relationships between reported recession hardships and physical health in a national survey of American adults ( N = 1275). Furthermore, education and psychological resources (perceived control, purpose in life, and conscientiousness) were tested as moderators of the health impacts of the recession. A greater number of hardships predicted poorer health, especially among the less educated. Psychological resources interacted with education and hardships to predict health outcomes. Although typically viewed as protective factors, such resources became vulnerabilities among educationally disadvantaged adults experiencing greater recession hardships.
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Using indicators to determine the contribution of human rights to public health efforts
Ferguson, Laura
2009-01-01
Abstract There is general agreement on the need to integrate human rights into health policies and programmes, although there is still reluctance to go beyond rhetorical acknowledgement of their assumed significance. To determine the actual value of human rights for the effectiveness of public health efforts requires clarity about what their incorporation looks like in practice and how to assess their contribution. Despite the pervasive use of indicators in the public health field, indicators that specifically capture human rights concerns are not well developed and those that exist are inconsistently used. Even though “health and human rights indicators” are increasingly being constructed, it is often the case that health indicators are used to draw conclusions about some interaction between human rights and health; or that law and policy or other indicators, traditionally the domain of the human rights community, are used to make conclusions about health outcomes. To capture the added value that human rights bring to health, the differences in the contributions offered by these indicators need to be understood. To determine the value of different measures for advancing programme effectiveness, improving health outcomes and promoting human rights, requires questioning the intended purpose behind the construction of an indicator, who uses it, the kind of indicator it is, the extent to which it provides information about vulnerable populations, as well as how the data are collected and used. PMID:19784452
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English, Abigail
2011-08-01
Sexual exploitation and trafficking of the young and vulnerable has devastating consequences for their physical and emotional development, health, and well-being. The horrific treatment they suffer bears the hallmarks of evil made manifest. Governments have enacted laws pursuant to international treaties, conventions, and protocols. Nonprofit and nongovernmental organizations (NGOs) are working to prevent young people from being exploited and trafficked, to identify victims, and to provide services to survivors. Progress in addressing the problem is haltingly slow in relation to its magnitude. The prevalence and persistence of this phenomenon is an ethical, legal, and human rights disgrace.
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Directory of Open Access Journals (Sweden)
Olayinka Atilola
2014-01-01
Full Text Available Efforts at improving child-health and development initiatives in sub-Saharan Africa had focused on the physical health of children due to the neglect of child and adolescent mental health (CAMH policy initiatives. A thorough and broad-based understanding of the prevalent child mental-health risk and vulnerability factors is needed to successfully articulate CAMH policies. In this discourse, we present a narrative on the child mental-health risk and vulnerability factors in sub-Saharan Africa. Through an ecological point of view, we identified widespread family poverty, poor availability and uptake of childcare resources, inadequate community and institutional childcare systems, and inadequate framework for social protection for vulnerable children as among the risk and vulnerability factors for CAMH in the region. Others are poor workplace policy/practice that does not support work-family life balance, poor legislative framework for child protection, and some harmful traditional practices. We conclude that an ecological approach shows that child mental-health risks are diverse and cut across different layers of the care environment. The approach also provides a broad and holistic template from which appropriate CAMH policy direction in sub-Saharan Africa can be understood.
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Atilola, Olayinka
2014-01-01
Efforts at improving child-health and development initiatives in sub-Saharan Africa had focused on the physical health of children due to the neglect of child and adolescent mental health (CAMH) policy initiatives. A thorough and broad-based understanding of the prevalent child mental-health risk and vulnerability factors is needed to successfully articulate CAMH policies. In this discourse, we present a narrative on the child mental-health risk and vulnerability factors in sub-Saharan Africa. Through an ecological point of view, we identified widespread family poverty, poor availability and uptake of childcare resources, inadequate community and institutional childcare systems, and inadequate framework for social protection for vulnerable children as among the risk and vulnerability factors for CAMH in the region. Others are poor workplace policy/practice that does not support work-family life balance, poor legislative framework for child protection, and some harmful traditional practices. We conclude that an ecological approach shows that child mental-health risks are diverse and cut across different layers of the care environment. The approach also provides a broad and holistic template from which appropriate CAMH policy direction in sub-Saharan Africa can be understood.
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Atilola, Olayinka
2014-01-01
Efforts at improving child-health and development initiatives in sub-Saharan Africa had focused on the physical health of children due to the neglect of child and adolescent mental health (CAMH) policy initiatives. A thorough and broad-based understanding of the prevalent child mental-health risk and vulnerability factors is needed to successfully articulate CAMH policies. In this discourse, we present a narrative on the child mental-health risk and vulnerability factors in sub-Saharan Africa. Through an ecological point of view, we identified widespread family poverty, poor availability and uptake of childcare resources, inadequate community and institutional childcare systems, and inadequate framework for social protection for vulnerable children as among the risk and vulnerability factors for CAMH in the region. Others are poor workplace policy/practice that does not support work-family life balance, poor legislative framework for child protection, and some harmful traditional practices. We conclude that an ecological approach shows that child mental-health risks are diverse and cut across different layers of the care environment. The approach also provides a broad and holistic template from which appropriate CAMH policy direction in sub-Saharan Africa can be understood. PMID:24834431
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Mullany, Luke C; Lee, Catherine I; Yone, Lin; Paw, Palae; Oo, Eh Kalu Shwe; Maung, Cynthia; Lee, Thomas J; Beyrer, Chris
2008-12-23
Health indicators are poor and human rights violations are widespread in eastern Burma. Reproductive and maternal health indicators have not been measured in this setting but are necessary as part of an evaluation of a multi-ethnic pilot project exploring strategies to increase access to essential maternal health interventions. The goal of this study is to estimate coverage of maternal health services prior to this project and associations between exposure to human rights violations and access to such services. Selected communities in the Shan, Mon, Karen, and Karenni regions of eastern Burma that were accessible to community-based organizations operating from Thailand were surveyed to estimate coverage of reproductive, maternal, and family planning services, and to assess exposure to household-level human rights violations within the pilot-project target population. Two-stage cluster sampling surveys among ever-married women of reproductive age (15-45 y) documented access to essential antenatal care interventions, skilled attendance at birth, postnatal care, and family planning services. Mid-upper arm circumference, hemoglobin by color scale, and Plasmodium falciparum parasitemia by rapid diagnostic dipstick were measured. Exposure to human rights violations in the prior 12 mo was recorded. Between September 2006 and January 2007, 2,914 surveys were conducted. Eighty-eight percent of women reported a home delivery for their last pregnancy (within previous 5 y). Skilled attendance at birth (5.1%), any (39.3%) or > or = 4 (16.7%) antenatal visits, use of an insecticide-treated bed net (21.6%), and receipt of iron supplements (11.8%) were low. At the time of the survey, more than 60% of women had hemoglobin level estimates rights were widely reported: 32.1% of Karenni households reported forced labor and 10% of Karen households had been forced to move. Among Karen households, odds of anemia were 1.51 (95% confidence interval [CI] 0.95-2.40) times higher among women
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A synthesized biophysical and social vulnerability assessment for Taiwan
Lee, Yung-Jaan
2017-11-01
Taiwan, located in the Western Pacific, is a country that is one of the most vulnerable to disasters that are associated with the changing climate; it is located within the Ring of Fire, which is the most geologically active region in the world. The environmental and geological conditions in Taiwan are sensitive and vulnerable to such disasters. Owing to increasing urbanization in Taiwan, floods and climate-related disasters have taken an increasing toll on human lives. As global warming accelerates the rising of sea levels and increasing of the frequency of extreme weather events, disasters will continue to affect socioeconomic development and human conditions. Under such circumstances, researchers and policymakers alike must recognize the importance of providing useful knowledge concerning vulnerability, disaster recovery and resilience. Strategies for reducing vulnerability and climate-related disaster risks and for increasing resilience involve preparedness, mitigation and adaptation. In the last two decades, extreme climate events have caused severe flash floods, debris flows, landslides, and other disasters and have had negative effects of many sectors, including agriculture, infrastructure and health. Since climate change is expected to have a continued impact on socio-economic development, this work develops a vulnerability assessment framework that integrates both biophysical and social vulnerability and supports synthesized vulnerability analyses to identify vulnerable areas in Taiwan. Owing to its geographical, geological and climatic features, Taiwan is susceptible to earthquakes, typhoons, droughts and various induced disasters. Therefore, Taiwan has the urgent task of establishing a framework for assessing vulnerability as a planning and policy tool that can be used to identify not only the regions that require special attention but also hotspots in which efforts should be made to reduce vulnerability and the risk of climate-related disaster. To
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Global health and local poverty: rich countries' responses to vulnerable populations.
Simms, Chris D; Persaud, D David
2009-01-01
Poverty is an important determinant of ill health, mortality and suffering across the globe. This commentary asks what we can learn about poverty by looking at the way rich countries respond to the needs of vulnerable populations both within their own societies and those of low-income countries. Taking advantage of recent efforts to redefine child poverty in a way that is consistent with the World Health Organization's Commission on Social Determinants of Health, three sets of data are reviewed: levels of child well-being within 23 Organization of Economic Community Development countries; the amount of official development assistance these countries disburse to poor countries; and, government social transfers targeted at families as a percentage of GDP. Analysis shows that countries in Northern Europe tend to have lower levels of child poverty, and are the most generous with social transfers and providing development assistance to poor countries; in contrast, the non-European countries like Australia, Canada, Japan, and the United States, and generally, the G7 countries, are the least generous towards the vulnerable at home and abroad and tend to have the highest levels of child poverty. The findings suggest that nations' responses tend to be ideologically based rather than evidence or needs based and that poverty is neither inevitable nor intractable.
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Automated Software Vulnerability Analysis
Sezer, Emre C.; Kil, Chongkyung; Ning, Peng
Despite decades of research, software continues to have vulnerabilities. Successful exploitations of these vulnerabilities by attackers cost millions of dollars to businesses and individuals. Unfortunately, most effective defensive measures, such as patching and intrusion prevention systems, require an intimate knowledge of the vulnerabilities. Many systems for detecting attacks have been proposed. However, the analysis of the exploited vulnerabilities is left to security experts and programmers. Both the human effortinvolved and the slow analysis process are unfavorable for timely defensive measure to be deployed. The problem is exacerbated by zero-day attacks.
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Thomasgard, M; Metz, W P
1996-06-01
While a parental perception of child vulnerability to illness/injury is often used interchangeably with parental overprotection, research suggests that they are independent constructs. We hypothesized more frequent pediatric nonwell-child visits for perceived child vulnerability, but not for parental overprotection. The parents of 300 children, ages 2-5 years, enrolled in a health maintenance organization, were sampled. For children without medical conditions, there were no differences in nonwell-child care visits between the high perceived vulnerability and high parental protection groups (Wilcoxon Rank Sum Test, WRST, P = .31). As expected, high parental protection was not significantly associated with increased nonwell-child care visits compared with the low parental protection group (WRST, P = .14). These findings suggest that markers other than health care utilization are required to identify these forms of parent-child relationship disorders.
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Proposing a Universal Framework for Resilience: Optimizing Risk and Combating Human Vulnerabilities
Sarkar, Arunima
2017-04-01
In the recent years we have seen a massive impact of loss created to urban settlements and critical infrastructure as a result of disasters. The disaster risk associates itself vulnerabilities and many complexities which can disrupt the functioning of human society. The uncertain loss created by disasters can present unforeseeable risk which remain unaccounted to human understanding. It is imperative to note that human urbanization and development is correlated with human vulnerabilities and challenges posed by disasters. Disaster risks are aggravated by improper planning of cities, weak framework for urban governance and regulatory regimes and lack of equalities amongst the citizens. The international agenda on disaster risk reduction talks about increasing losses due to disasters associated with development and urbanization. The United Nations announced that the year 1990 was the International Decade for Natural Disaster Reduction. In relation to this, the "Yokohama Strategy and Plan of Action" was adopted at the first United Nations World Conference on Disaster Reduction. The United Nations Educational, Scientific and Cultural Organization's (UNESCO) Intergovernmental Oceanic Commission coordinated the World Conference on Disaster Reduction in 2005 where the Hyogo Framework for Action was adopted. The Hyogo Framework for Action: Building the resilience of communities to disaster was adopted by 168 nations after the massive loss caused by Indian ocean tsunami in 2005. The Hyogo Framework proposes to focus on implementation of risk and reliability system to shield disasters, proposes global scientific and community platform for disaster prevention and mitigation etc. The early warning system and its importance as an effective tool for reduction of human vulnerabilities for disaster management was majorly emphasized. It is imperative to highlight that resilience framework is important in order to minimize cost of disruption caused to critical infrastructure and to
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Structural drivers of vulnerability to zoonotic disease in Africa.
Dzingirai, Vupenyu; Bukachi, Salome; Leach, Melissa; Mangwanya, Lindiwe; Scoones, Ian; Wilkinson, Annie
2017-07-19
This paper argues that addressing the underlying structural drivers of disease vulnerability is essential for a 'One Health' approach to tackling zoonotic diseases in Africa. Through three case studies-trypanosomiasis in Zimbabwe, Ebola and Lassa fever in Sierra Leone and Rift Valley fever in Kenya-we show how political interests, commercial investments and conflict and securitization all generate patterns of vulnerability, reshaping the political ecology of disease landscapes, influencing traditional coping mechanisms and affecting health service provision and outbreak responses. A historical, political economy approach reveals patterns of 'structural violence' that reinforce inequalities and marginalization of certain groups, increasing disease risks. Addressing the politics of One Health requires analysing trade-offs and conflicts between interests and visions of the future. For all zoonotic diseases economic and political dimensions are ultimately critical and One Health approaches must engage with these factors, and not just end with an 'anti-political' focus on institutional and disciplinary collaboration.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.
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A heat vulnerability index to improve urban public health management in San Juan, Puerto Rico.
Méndez-Lázaro, Pablo; Muller-Karger, Frank E; Otis, Daniel; McCarthy, Matthew J; Rodríguez, Ernesto
2018-05-01
Increased frequency and length of high heat episodes are leading to more cardiovascular issues and asthmatic responses among the population of San Juan, the capital of the island of Puerto Rico, USA. An urban heat island effect, which leads to foci of higher temperatures in some urban areas, can raise heat-related mortality. The objective of this research is to map the risk of high temperature in particular locations by creating heat maps of the city of San Juan. The heat vulnerability index (HVI) maps were developed using images collected by satellite-based remote sensing combined with census data. Land surface temperature was assessed using images from the Thermal Infrared Sensor flown on Landsat 8. Social determinants (e.g., age, unemployment, education and social isolation, and health insurance coverage) were analyzed by census tract. The data were examined in the context of land cover maps generated using products from the Puerto Rico Terrestrial Gap Analysis Project (USDA Forest Service). All variables were set in order to transform the indicators expressed in different units into indices between 0 and 1, and the HVI was calculated as sum of score. The tract with highest index was considered to be the most vulnerable and the lowest to be the least vulnerable. Five vulnerability classes were mapped (very high, high, moderate, low, and very low). The hottest and the most vulnerable tracts corresponded to highly built areas, including the Luis Munoz International Airport, seaports, parking lots, and high-density residential areas. Several variables contributed to increased vulnerability, including higher rates of the population living alone, disabilities, advanced age, and lack of health insurance coverage. Coolest areas corresponded to vegetated landscapes and urban water bodies. The urban HVI map will be useful to health officers, emergency preparedness personnel, the National Weather Service, and San Juan residents, as it helps to prepare for and to mitigate
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A heat vulnerability index to improve urban public health management in San Juan, Puerto Rico
Méndez-Lázaro, Pablo; Muller-Karger, Frank E.; Otis, Daniel; McCarthy, Matthew J.; Rodríguez, Ernesto
2018-05-01
Increased frequency and length of high heat episodes are leading to more cardiovascular issues and asthmatic responses among the population of San Juan, the capital of the island of Puerto Rico, USA. An urban heat island effect, which leads to foci of higher temperatures in some urban areas, can raise heat-related mortality. The objective of this research is to map the risk of high temperature in particular locations by creating heat maps of the city of San Juan. The heat vulnerability index (HVI) maps were developed using images collected by satellite-based remote sensing combined with census data. Land surface temperature was assessed using images from the Thermal Infrared Sensor flown on Landsat 8. Social determinants (e.g., age, unemployment, education and social isolation, and health insurance coverage) were analyzed by census tract. The data were examined in the context of land cover maps generated using products from the Puerto Rico Terrestrial Gap Analysis Project (USDA Forest Service). All variables were set in order to transform the indicators expressed in different units into indices between 0 and 1, and the HVI was calculated as sum of score. The tract with highest index was considered to be the most vulnerable and the lowest to be the least vulnerable. Five vulnerability classes were mapped (very high, high, moderate, low, and very low). The hottest and the most vulnerable tracts corresponded to highly built areas, including the Luis Munoz International Airport, seaports, parking lots, and high-density residential areas. Several variables contributed to increased vulnerability, including higher rates of the population living alone, disabilities, advanced age, and lack of health insurance coverage. Coolest areas corresponded to vegetated landscapes and urban water bodies. The urban HVI map will be useful to health officers, emergency preparedness personnel, the National Weather Service, and San Juan residents, as it helps to prepare for and to mitigate
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Gutierrez, Kristie S.; LePrevost, Catherine E.
2016-01-01
Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are ...
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Directory of Open Access Journals (Sweden)
Richard J. Servatius
2017-09-01
Full Text Available U.S. Coast Guard (CG personnel face occupational stressors (e.g., search and rescue which compound daily life stressors encountered by civilians. However, the degree CG personnel express stress-related mental health symptoms of posttraumatic stress disorder (PTSD and major depressive disorder (MDD is understudied as a military branch, and little is known concerning the interplay of vulnerabilities and neurocognitive outcomes in CG personnel. The current study addressed this knowledge gap, recruiting 241 active duty CG personnel (22% female to assess mental health, personality, and neurocognitive function. Participants completed a battery of scales: PTSD Checklist with military and non-military prompts to screen for PTSD, Psychological Health Questionnaire 8 for MDD, and scales for behaviorally inhibited (BI temperament, and distressed (Type D personality. Neurocognitive performance was assessed with the Defense Automated Neurobehavioral Assessment (DANA battery. Cluster scoring yielded an overall rate of PTSD of 15% (95% CI: 11–20% and 8% (95% CI: 3–9% for MDD. Non-military trauma was endorsed twice that of military trauma in those meeting criteria for PTSD. Individual vulnerabilities were predictive of stress-related mental health symptoms in active duty military personnel; specifically, BI temperament predicted PTSD whereas gender and Type D personality predicted MDD. Stress-related mental health symptoms were also associated with poorer reaction time and response inhibition. These results suggest rates of PTSD and MDD are comparable among CG personnel serving Boat Stations to those of larger military services after combat deployment. Further, vulnerabilities distinguished between PTSD and MDD, which have a high degree of co-occurrence in military samples. To what degree stress-related mental healthy symptoms and attendant neurocognitive deficits affect operational effectiveness remains unknown and warrant future study.
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Menezes, Júlia Alves; Confalonieri, Ulisses; Madureira, Ana Paula; Duval, Isabela de Brito; Santos, Rhavena Barbosa Dos; Margonari, Carina
2018-01-01
Vulnerability, understood as the propensity to be adversely affected, has attained importance in the context of climate change by helping to understand what makes populations and territories predisposed to its impacts. Conditions of vulnerability may vary depending on the characteristics of each territory studied-social, environmental, infrastructural, public policies, among others. Thus, the present study aimed to evaluate what makes the municipalities of the state of Amazonas, Brazil, vulnerable to climate change in the context of the largest tropical forest in the world, and which regions of the State are the most susceptible. A Municipal Vulnerability Index was developed, which was used to associate current socio-environmental characteristics of municipalities with climate change scenarios in order to identify those that may be most affected by climate change. The results showed that poor adaptive capacity and poverty had the most influence on current vulnerability of the municipalities of Amazonas with the most vulnerable areas being the southern, northern, and eastern regions of the state. When current vulnerability was related to future climate change projections, the most vulnerable areas were the northern, northeastern, extreme southern, and southwestern regions. From a socio-environmental and climatic point of view, these regions should be a priority for public policy efforts to reduce their vulnerability and prepare them to cope with the adverse aspects of climate change.
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Directory of Open Access Journals (Sweden)
Júlia Alves Menezes
Full Text Available Vulnerability, understood as the propensity to be adversely affected, has attained importance in the context of climate change by helping to understand what makes populations and territories predisposed to its impacts. Conditions of vulnerability may vary depending on the characteristics of each territory studied-social, environmental, infrastructural, public policies, among others. Thus, the present study aimed to evaluate what makes the municipalities of the state of Amazonas, Brazil, vulnerable to climate change in the context of the largest tropical forest in the world, and which regions of the State are the most susceptible. A Municipal Vulnerability Index was developed, which was used to associate current socio-environmental characteristics of municipalities with climate change scenarios in order to identify those that may be most affected by climate change. The results showed that poor adaptive capacity and poverty had the most influence on current vulnerability of the municipalities of Amazonas with the most vulnerable areas being the southern, northern, and eastern regions of the state. When current vulnerability was related to future climate change projections, the most vulnerable areas were the northern, northeastern, extreme southern, and southwestern regions. From a socio-environmental and climatic point of view, these regions should be a priority for public policy efforts to reduce their vulnerability and prepare them to cope with the adverse aspects of climate change.
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Vulnerability and resilience: a critical nexus.
Lotz, Mianna
2016-02-01
Not all forms of human fragility or vulnerability are unavoidable. Sometimes we knowingly and intentionally impose conditions of vulnerability on others; and sometimes we knowingly and intentionally enter into and assume conditions of vulnerability for ourselves (for example, when we decide to trust or forgive, enter into intimate relationships with others, become a parent, become a subject of medical or psychotherapeutic treatment, and the like). In this article, I propose a presently overlooked basis on which one might evaluate whether the imposition or assumption of vulnerability is acceptable, and on which one might ground a significant class of vulnerability-related obligations. Distinct from existing accounts of the importance of promoting autonomy in conditions of vulnerability, this article offers a preliminary exploration of the nature, role, and importance of resilience promotion, its relationship to autonomy promotion, and its prospects for improving human wellbeing in autonomy inhibiting conditions.
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Medina-Carmona, Encarnación; Fuchs, Julian E; Gavira, Jose A; Mesa-Torres, Noel; Neira, Jose L; Salido, Eduardo; Palomino-Morales, Rogelio; Burgos, Miguel; Timson, David J; Pey, Angel L
2017-09-15
Human proteins are vulnerable towards disease-associated single amino acid replacements affecting protein stability and function. Interestingly, a few studies have shown that consensus amino acids from mammals or vertebrates can enhance protein stability when incorporated into human proteins. Here, we investigate yet unexplored relationships between the high vulnerability of human proteins towards disease-associated inactivation and recent evolutionary site-specific divergence of stabilizing amino acids. Using phylogenetic, structural and experimental analyses, we show that divergence from the consensus amino acids at several sites during mammalian evolution has caused local protein destabilization in two human proteins linked to disease: cancer-associated NQO1 and alanine:glyoxylate aminotransferase, mutated in primary hyperoxaluria type I. We demonstrate that a single consensus mutation (H80R) acts as a disease suppressor on the most common cancer-associated polymorphism in NQO1 (P187S). The H80R mutation reactivates P187S by enhancing FAD binding affinity through local and dynamic stabilization of its binding site. Furthermore, we show how a second suppressor mutation (E247Q) cooperates with H80R in protecting the P187S polymorphism towards inactivation through long-range allosteric communication within the structural ensemble of the protein. Our results support that recent divergence of consensus amino acids may have occurred with neutral effects on many functional and regulatory traits of wild-type human proteins. However, divergence at certain sites may have increased the propensity of some human proteins towards inactivation due to disease-associated mutations and polymorphisms. Consensus mutations also emerge as a potential strategy to identify structural hot-spots in proteins as targets for pharmacological rescue in loss-of-function genetic diseases. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please
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Directory of Open Access Journals (Sweden)
Luke C Mullany
2008-12-01
Full Text Available BACKGROUND: Health indicators are poor and human rights violations are widespread in eastern Burma. Reproductive and maternal health indicators have not been measured in this setting but are necessary as part of an evaluation of a multi-ethnic pilot project exploring strategies to increase access to essential maternal health interventions. The goal of this study is to estimate coverage of maternal health services prior to this project and associations between exposure to human rights violations and access to such services. METHODS AND FINDINGS: Selected communities in the Shan, Mon, Karen, and Karenni regions of eastern Burma that were accessible to community-based organizations operating from Thailand were surveyed to estimate coverage of reproductive, maternal, and family planning services, and to assess exposure to household-level human rights violations within the pilot-project target population. Two-stage cluster sampling surveys among ever-married women of reproductive age (15-45 y documented access to essential antenatal care interventions, skilled attendance at birth, postnatal care, and family planning services. Mid-upper arm circumference, hemoglobin by color scale, and Plasmodium falciparum parasitemia by rapid diagnostic dipstick were measured. Exposure to human rights violations in the prior 12 mo was recorded. Between September 2006 and January 2007, 2,914 surveys were conducted. Eighty-eight percent of women reported a home delivery for their last pregnancy (within previous 5 y. Skilled attendance at birth (5.1%, any (39.3% or > or = 4 (16.7% antenatal visits, use of an insecticide-treated bed net (21.6%, and receipt of iron supplements (11.8% were low. At the time of the survey, more than 60% of women had hemoglobin level estimates < or = 11.0 g/dl and 7.2% were Pf positive. Unmet need for contraceptives exceeded 60%. Violations of rights were widely reported: 32.1% of Karenni households reported forced labor and 10% of Karen
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Human vulnerability in volcanic environments: the case of Furnas, São Miguel, Azores
Dibben, Christopher; Chester, David K.
1999-09-01
The need to examine the vulnerability of people to natural hazards, in addition to the long-established requirement to study extreme events of nature, is being increasingly recognised within disaster research. Following a discussion of the nature of human vulnerability, we propose a framework for its analysis within the context of volcanic activity and we exemplify our approach by a detailed study of Furnas, a village located at the centre of a volcano with the same name on the island of São Miguel in the Azores. The methods used included in-depth interviews with permanent residents ( n=50), analysis of census records and an examination of the socio-economic history of the town. The vulnerability of an individual to volcanic hazards involves a complex interaction of elements which, in addition to the usual factors taken into account in programmes of hazard reduction (e.g., the nature of the physical threat, location and economic situation), also comprises his or her social context and a number of physiological and psychological considerations. It is argued, further, that both generally and in the case of Furnas, the root causes of vulnerability lie in the history and development of society. Individual decision making is fundamental but takes place within and cannot be separated from this social context. Vulnerability analysis allows the identification of points where intervention may be successful in reducing the likelihood of suffering in a society. It avoids the problem of people's unexpected reactions to invention leading to a changing or even increasing level of vulnerability, by studying society rather than just one aspect of volcanic hazard in isolation.
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Heidenreich, Kaja; Bremer, Anders; Materstvedt, Lars Johan; Tidefelt, Ulf; Svantesson, Mia
2017-12-14
In Moral Case Deliberation (MCD), healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals' moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient's nebulous interests, and coping with the conflict between using coercion to achieve good while protecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient's autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients' influence and at the same time take responsibility for their needs as vulnerable humans.
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Directory of Open Access Journals (Sweden)
Jennifer M. Kreslake
2016-09-01
Full Text Available Abstract Background Individuals with chronic health conditions or low socioeconomic status (SES are more vulnerable to the health impacts of climate change. Health communication can provide information on the management of these impacts. This study tested, among vulnerable audiences, whether viewing targeted materials increases knowledge about the health impacts of climate change and strength of climate change beliefs, and whether each are associated with stronger intentions to practice recommended behaviors. Methods Low-SES respondents with chronic conditions were recruited for an online survey in six cities. Respondents were shown targeted materials illustrating the relationship between climate change and chronic conditions. Changes in knowledge and climate change beliefs (pre- and post-test and behavioral intentions (post-test only were tested using McNemar tests of marginal frequencies of two binary outcomes or paired t-tests, and multivariable linear regression. Qualitative interviews were conducted among target audiences to triangulate survey findings and make recommendations on the design of messages. Results Respondents (N = 122 reflected the target population regarding income, educational level and prevalence of household health conditions. (1 Knowledge. Significant increases in knowledge were found regarding: groups that are most vulnerable to heat (children [p < 0.001], individuals with heart disease [p < 0.001], or lung disease [p = 0.019]; and environmental conditions that increase allergy-producing pollen (increased heat [p = 0.003], increased carbon dioxide [p < 0.001]. (2 Strength of certainty that climate change is happening increased significantly between pre- and post-test (p < 0.001, as did belief that climate change affected respondents’ health (p < 0.001. (3 Behavioral intention. At post-test, higher knowledge of heat vulnerabilities and environmental conditions that trigger pollen
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Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio
2017-07-01
Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation's most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.
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VT - Vermont Social Vulnerability Index
Vermont Center for Geographic Information — Social vulnerability refers to the resilience of communities when responding to or recovering from threats to public health. The Vermont Social Vulnerability Index...
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Sung, Ki Wol; Kang, Hye Seung; Nam, Ji Ran; Park, Mi Kyung; Park, Ji Hyeon
2018-04-01
This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population. © 2018 Korean Society of Nursing Science.
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Animal models to study plaque vulnerability
Schapira, K.; Heeneman, S.; Daemen, M. J. A. P.
2007-01-01
The need to identify and characterize vulnerable atherosclerotic lesions in humans has lead to the development of various animal models of plaque vulnerability. In this review, current concepts of the vulnerable plaque as it leads to an acute coronary event are described, such as plaque rupture,
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Nobis, Regina; Sandén, Inger
2008-06-01
Masculinity, in its hegemonic form, can have the effect that men avoid talking about health problems and do not consult health care, even when help is needed. This study had two aims: firstly to describe how young men relate to health, ill health, masculinity and their bodies, and secondly to investigate their abilities of self-care. Interviews with eleven men were conducted using a semi-structured approach. Qualitative content analysis was used to analyse the transcribed interviews. The findings revealed five main themes; 'body awareness', 'the creation of self-reliance', 'feelings of freedom', 'the process of self-care awareness' and, finally, 'feelings of vulnerability'. Hegemonic masculinity impacted greatly on the men in this study and could be traced in expressions of dependency, vulnerability, loss of freedom and an altered body image. These were viewed as health disadvantages due to the threat to hegemonic masculinity.
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Digital divide, biometeorological data infrastructures and human vulnerability definition
Fdez-Arroyabe, Pablo; Lecha Estela, Luis; Schimt, Falko
2018-05-01
The design and implementation of any climate-related health service, nowadays, imply avoiding the digital divide as it means having access and being able to use complex technological devices, massive meteorological data, user's geographic location and biophysical information. This article presents the co-creation, in detail, of a biometeorological data infrastructure, which is a complex platform formed by multiple components: a mainframe, a biometeorological model called Pronbiomet, a relational database management system, data procedures, communication protocols, different software packages, users, datasets and a mobile application. The system produces four daily world maps of the partial density of the atmospheric oxygen and collects user feedback on their health condition. The infrastructure is shown to be a useful tool to delineate individual vulnerability to meteorological changes as one key factor in the definition of any biometeorological risk. This technological approach to study weather-related health impacts is the initial seed for the definition of biometeorological profiles of persons, and for the future development of customized climate services for users in the near future.
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Digital divide, biometeorological data infrastructures and human vulnerability definition
Fdez-Arroyabe, Pablo; Lecha Estela, Luis; Schimt, Falko
2017-06-01
The design and implementation of any climate-related health service, nowadays, imply avoiding the digital divide as it means having access and being able to use complex technological devices, massive meteorological data, user's geographic location and biophysical information. This article presents the co-creation, in detail, of a biometeorological data infrastructure, which is a complex platform formed by multiple components: a mainframe, a biometeorological model called Pronbiomet, a relational database management system, data procedures, communication protocols, different software packages, users, datasets and a mobile application. The system produces four daily world maps of the partial density of the atmospheric oxygen and collects user feedback on their health condition. The infrastructure is shown to be a useful tool to delineate individual vulnerability to meteorological changes as one key factor in the definition of any biometeorological risk. This technological approach to study weather-related health impacts is the initial seed for the definition of biometeorological profiles of persons, and for the future development of customized climate services for users in the near future.
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Digital divide, biometeorological data infrastructures and human vulnerability definition.
Fdez-Arroyabe, Pablo; Lecha Estela, Luis; Schimt, Falko
2018-05-01
The design and implementation of any climate-related health service, nowadays, imply avoiding the digital divide as it means having access and being able to use complex technological devices, massive meteorological data, user's geographic location and biophysical information. This article presents the co-creation, in detail, of a biometeorological data infrastructure, which is a complex platform formed by multiple components: a mainframe, a biometeorological model called Pronbiomet, a relational database management system, data procedures, communication protocols, different software packages, users, datasets and a mobile application. The system produces four daily world maps of the partial density of the atmospheric oxygen and collects user feedback on their health condition. The infrastructure is shown to be a useful tool to delineate individual vulnerability to meteorological changes as one key factor in the definition of any biometeorological risk. This technological approach to study weather-related health impacts is the initial seed for the definition of biometeorological profiles of persons, and for the future development of customized climate services for users in the near future.
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Health Effects of Coastal Storms and Flooding in Urban Areas: A Review and Vulnerability Assessment
Directory of Open Access Journals (Sweden)
Kathryn Lane
2013-01-01
Full Text Available Coastal storms can take a devastating toll on the public's health. Urban areas like New York City (NYC may be particularly at risk, given their dense population, reliance on transportation, energy infrastructure that is vulnerable to flood damage, and high-rise residential housing, which may be hard-hit by power and utility outages. Climate change will exacerbate these risks in the coming decades. Sea levels are rising due to global warming, which will intensify storm surge. These projections make preparing for the health impacts of storms even more important. We conducted a broad review of the health impacts of US coastal storms to inform climate adaptation planning efforts, with a focus on outcomes relevant to NYC and urban coastal areas, and incorporated some lessons learned from recent experience with Superstorm Sandy. Based on the literature, indicators of health vulnerability were selected and mapped within NYC neighborhoods. Preparing for the broad range of anticipated effects of coastal storms and floods may help reduce the public health burden from these events.
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Health effects of coastal storms and flooding in urban areas: a review and vulnerability assessment.
Lane, Kathryn; Charles-Guzman, Kizzy; Wheeler, Katherine; Abid, Zaynah; Graber, Nathan; Matte, Thomas
2013-01-01
Coastal storms can take a devastating toll on the public's health. Urban areas like New York City (NYC) may be particularly at risk, given their dense population, reliance on transportation, energy infrastructure that is vulnerable to flood damage, and high-rise residential housing, which may be hard-hit by power and utility outages. Climate change will exacerbate these risks in the coming decades. Sea levels are rising due to global warming, which will intensify storm surge. These projections make preparing for the health impacts of storms even more important. We conducted a broad review of the health impacts of US coastal storms to inform climate adaptation planning efforts, with a focus on outcomes relevant to NYC and urban coastal areas, and incorporated some lessons learned from recent experience with Superstorm Sandy. Based on the literature, indicators of health vulnerability were selected and mapped within NYC neighborhoods. Preparing for the broad range of anticipated effects of coastal storms and floods may help reduce the public health burden from these events.
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A Review of Frameworks for Developing Environmental Health Indicators for Climate Change and Health
Hambling, Tammy; Weinstein, Philip; Slaney, David
2011-01-01
The role climate change may play in altering human health, particularly in the emergence and spread of diseases, is an evolving area of research. It is important to understand this relationship because it will compound the already significant burden of diseases on national economies and public health. Authorities need to be able to assess, anticipate, and monitor human health vulnerability to climate change, in order to plan for, or implement action to avoid these eventualities. Environmental health indicators (EHIs) provide a tool to assess, monitor, and quantify human health vulnerability, to aid in the design and targeting of interventions, and measure the effectiveness of climate change adaptation and mitigation activities. Our aim was to identify the most suitable framework for developing EHIs to measure and monitor the impacts of climate change on human health and inform the development of interventions. Using published literature we reviewed the attributes of 11 frameworks. We identified the Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework as the most suitable one for developing EHIs for climate change and health. We propose the use of EHIs as a valuable tool to assess, quantify, and monitor human health vulnerability, design and target interventions, and measure the effectiveness of climate change adaptation and mitigation activities. In this paper, we lay the groundwork for the future development of EHIs as a multidisciplinary approach to link existing environmental and epidemiological data and networks. Analysis of such data will contribute to an enhanced understanding of the relationship between climate change and human health. PMID:21845162
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EDCs Mixtures: A Stealthy Hazard for Human Health?
Directory of Open Access Journals (Sweden)
Edna Ribeiro
2017-02-01
Full Text Available Endocrine disrupting chemicals (EDCs are exogenous chemicals that may occur naturally (e.g., phytoestrogens, while others are industrial substances and plasticizers commonly utilized worldwide to which human exposure, particularly at low-doses, is omnipresent, persistent and occurs in complex mixtures. EDCs can interfere with/or mimic estrogenic hormones and, consequently, can simultaneously trigger diverse signaling pathways which result in diverse and divergent biological responses. Additionally, EDCs can also bioaccumulate in lipid compartments of the organism forming a mixed “body burden” of contaminants. Although the independent action of chemicals has been considered the main principle in EDCs mixture toxicity, recent studies have demonstrated that numerous effects cannot be predicted when analyzing single compounds independently. Co-exposure to these agents, particularly in critical windows of exposure, may induce hazardous health effects potentially associated with a complex “body burden” of different origins. Here, we performed an exhaustive review of the available literature regarding EDCs mixtures exposure, toxicity mechanisms and effects, particularly at the most vulnerable human life stages. Although the assessment of potential risks to human health due to exposure to EDCs mixtures is a major topic for consumer safety, information regarding effective mixtures effects is still scarce.
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Ramirez, Bernadette
2017-12-12
Diseases transmitted to humans by vectors account for 17% of all infectious diseases and remain significant public health problems. Through the years, great strides have been taken towards combatting vector-borne diseases (VBDs), most notably through large scale and coordinated control programmes, which have contributed to the decline of the global mortality attributed to VBDs. However, with environmental changes, including climate change, the impact on VBDs is anticipated to be significant, in terms of VBD-related hazards, vulnerabilities and exposure. While there is growing awareness on the vulnerability of the African continent to VBDs in the context of climate change, there is still a paucity of research being undertaken in this area, and impeding the formulation of evidence-based health policy change. One way in which the gap in knowledge and evidence can be filled is for donor institutions to support research in this area. The collaboration between the WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the International Centre for Research and Development (IDRC) builds on more than 10 years of partnership in research capacity-building in the field of tropical diseases. From this partnership was born yet another research initiative on VBDs and the impact of climate change in the Sahel and sub-Saharan Africa. This paper lists the projects supported under this research initiative and provides a brief on some of the policy and good practice recommendations emerging from the ongoing implementation of the research projects. Data generated from the research initiative are expected to be uptaken by stakeholders (including communities, policy makers, public health practitioners and other relevant partners) to contribute to a better understanding of the impacts of social, environmental and climate change on VBDs(i.e. the nature of the hazard, vulnerabilities, exposure), and improve the ability of African countries to adapt to and reduce the
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Institute of Scientific and Technical Information of China (English)
Bernadette Ramirez
2017-01-01
Background:Diseases transmitted to humans by vectors account for 17％ of all infectious diseases and remain significant public health problems.Through the years,great strides have been taken towards combatting vectorborne diseases (VBDs),most notably through large scale and coordinated control programmes,which have contributed to the decline of the global mortality attributed to VBDs.However,with environmental changes,including climate change,the impact on VBDs is anticipated to be significant,in terms of VBD-related hazards,vulnerabilities and exposure.While there is growing awareness on the vulnerability of the African continent to VBDs in the context of climate change,there is still a paucity of research being undertaken in this area,and impeding the formulation of evidence-based health policy change.Main body:One way in which the gap in knowledge and evidence can be filled is for donor institutions to support research in this area.The collaboration between the WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the International Centre for Research and Development (IDRC) builds on more than 10 years of partnership in research capacity-building in the field of tropical diseases.From this partnership was born yet another research initiative on VBDs and the impact of climate change in the Sahel and sub-Saharan Africa.This paper lists the projects supported under this research initiative and provides a brief on some of the policy and good practice recommendations emerging from the ongoing implementation of the research projects.Conclusion:Data generated from the research initiative are expected to be uptaken by stakeholders (including communities,policy makers,public health practitioners and other relevant partners) to contribute to a better understanding of the impacts of social,environmental and climate change on VBDs(i.e.the nature of the hazard,vulnerabilities,exposure),and improve the ability of African countries to adapt to and
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A socioeconomic profile of vulnerable land to desertification in Italy.
Salvati, Luca
2014-01-01
Climate changes, soil vulnerability, loss in biodiversity, and growing human pressure are threatening Mediterranean-type ecosystems which are increasingly considered as a desertification hotspot. In this region, land vulnerability to desertification strongly depends on the interplay between natural and anthropogenic factors. The present study proposes a multivariate exploratory analysis of the relationship between the spatial distribution of land vulnerability to desertification and the socioeconomic contexts found in three geographical divisions of Italy (north, center and south) based on statistical indicators. A total of 111 indicators describing different themes (demography, human settlements, labor market and human capital, rural development, income and wealth) were used to discriminate vulnerable from non-vulnerable areas. The resulting socioeconomic profile of vulnerable areas in northern and southern Italy diverged significantly, the importance of demographic and economic indicators being higher in southern Italy than in northern Italy. On the contrary, human settlement indicators were found more important to discriminate vulnerable and non-vulnerable areas in northern Italy, suggesting a role for peri-urbanization in shaping the future vulnerable areas. An in-depth knowledge of the socioeconomic characteristics of vulnerable land may contribute to scenarios' modeling and the development of more effective policies to combat desertification. © 2013 Elsevier B.V. All rights reserved.
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Kreslake, Jennifer M; Price, Katherine M; Sarfaty, Mona
2016-09-07
Individuals with chronic health conditions or low socioeconomic status (SES) are more vulnerable to the health impacts of climate change. Health communication can provide information on the management of these impacts. This study tested, among vulnerable audiences, whether viewing targeted materials increases knowledge about the health impacts of climate change and strength of climate change beliefs, and whether each are associated with stronger intentions to practice recommended behaviors. Low-SES respondents with chronic conditions were recruited for an online survey in six cities. Respondents were shown targeted materials illustrating the relationship between climate change and chronic conditions. Changes in knowledge and climate change beliefs (pre- and post-test) and behavioral intentions (post-test only) were tested using McNemar tests of marginal frequencies of two binary outcomes or paired t-tests, and multivariable linear regression. Qualitative interviews were conducted among target audiences to triangulate survey findings and make recommendations on the design of messages. Respondents (N = 122) reflected the target population regarding income, educational level and prevalence of household health conditions. (1) Knowledge. Significant increases in knowledge were found regarding: groups that are most vulnerable to heat (children [p concise language, how climate change affects health conditions and how to engage in protective adaptation behaviors.
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Directory of Open Access Journals (Sweden)
J. Richardson B.Sc., Ph.D., RN., DipDN., CPsychol., PGCE.
2008-01-01
Full Text Available Background A number of policy documents suggest that health services should be taking climate change and sustainability seriously and recommendations have been made to mitigate and adapt to the challenges health care providers will face. Actions include, for example, moving towards locally sourced food supplies, reducing waste, energy consumption and travel, and including sustainability in policies and strategies. A Strategic Health Authority (SHA is part of the National Health Service (NHS in England. They are responsible for developing strategies for the local health services and ensuring high-quality performance. They manage the NHS locally and are a key link between the U.K. Department of Health and the NHS. They also ensure that national priorities are integrated into local plans. Thus they are in a key position to influence policies and practices to mitigate and adapt to the impact of climate change and promote sustainability. Aim The aim of this study was to review publicly available documents produced by Strategic Health Authorities (SHA to assess the extent to which current activity and planning locally takes into consideration climate change and energy vulnerability. Methods A retrospective thematic content analysis of publicly available materials was undertaken by two researchers over a six month period in 2008. These materials were obtained from the websites of the 10 SHAs in England. Materials included annual reports, plans, policies and strategy documents. Results Of the 10 SHAs searched, 4 were found to have an absence of content related to climate change and sustainability. Of the remaining 6 SHAs that did include content related to climate change and energy vulnerability on their websites consistent themes were seen to emerge. These included commitment to a regional sustainability framework in collaboration with other agencies in the pursuit and promotion of sustainable development. Results indicate that many SHAs in England
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Orphans and at-risk children in Haiti: vulnerabilities and human rights issues postearthquake.
Nicholas, Patrice K; George, Erin K; Raymond, Nadia; Lewis-OʼConnor, Annie; Victoria, Stephanie; Lucien, Sergeline; Peters-Lewis, Angelleen; Hickey, Nancy; Corless, Inge B; Tyer-Viola, Lynda; Davis, Sheila M; Barry, Donna; Marcelin, Naomie; Valcourt, Roodeline
2012-01-01
The vulnerability of children in Haiti has increased dramatically since the earthquake in January 2010. Prior to the earthquake, the prevalence of orphans and at-risk children was high but since the earthquake, more than 1 million people-with more than 380,000 children remaining displaced and living in over 1200 displacement sites. These existing conditions leave orphans and at-risk children vulnerable to exploitation, abuse, and increased risk of HIV/AIDS. This article will focus on the complex issues affecting orphans and at-risk children and the intersection with HIV/AIDS and human rights. Specific recommendations by United Nations Children's Fund are discussed. Nursing in Haiti must address the policy-related and population-specific approaches for the care of children living with or affected by HIV/AIDS.
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Vulnerabilities in snakebites in Sao Paulo, Brazil
Directory of Open Access Journals (Sweden)
Maria Rita Bertolozzi
2015-01-01
Full Text Available ABSTRACTOBJECTIVE To describe elements of vulnerability of victims of snakebite.METHODS This qualitative, descriptive, cross-sectional study had, as theoretical framework, the concept of vulnerability in individual, social, and programmatic dimensions. We interviewed 21 patients admitted into a hospital specialized in the care of accidents caused by venomous animals. The interviews were analyzed according to a discourse analysis technique.RESULTS Patients were mainly young men, living in remote countryside areas, where health services frequently have limited resources. We found social and individual conditions of vulnerability, such as precarious schooling, low professional qualification, housing without access to piped water, no sewage treated, and no regular garbage collection, and lack of knowledge on this health problem. Regarding the programmatic dimension, we found limited accessibility to the health services that could affect the prognosis and the frequency of sequelae and deaths.CONCLUSIONS Considering such vulnerabilities evoke the need to improve the program for control the Accidents by Venomous Animals and the training of health workers, we highlight the potential use of the concept of vulnerability, which may amplify the understanding and the recommendations for the practice and education related to snakebites.
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dos Reis, Dener Carlos; de Almeida, Thiara Amanda Corrêa; Miranda, Mariane Mendes; Alves, Rodrigo Henrique; Madeira, Anézia Moreira Faria
2013-01-01
to analyze the health vulnerabilities in adolescence associated with socioeconomic conditions, social networks, drugs and violence from the perspective of students. cross-sectional study with 678 students between 14-15 years old in Contagem, Brazil. A self-administered questionnaire divided into modules by subject was used. Quantitative, descriptive and stratified analyses were performed by sex. high percentage of adolescents (40.4%) were beneficiaries of Government financial support called "Bolsa Família" and 14.6% had a job, 57.1% and 23.6% had tried alcohol and tobacco, respectively. We identified 15% of aggression and 26.7% of bullying. The majority informed they never/rarely talk to parents about the daily difficulties (64.5%) and 22% reported insomnia and/or feelings of loneliness. the results indicated that there is a need to intensify educational activities that seek to develop cognitive, affective and social skills aimed at improving the way adolescents face the vulnerabilities, in these activities, nursing has a fundamental role.
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Frati, Elena R; Fasoli, Ester; Martinelli, Marianna; Colzani, Daniela; Bianchi, Silvia; Carnelli, Luciana; Amendola, Antonella; Olivani, Pierfranco; Tanzi, Elisabetta
2017-06-20
Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs) in undocumented migrant women in Milan, Italy. Women (ages 18-65) were enrolled at the NAGA Centre (2012-2013) and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV), Chlamydia trachomatis ( Ct ), Trichomonas vaginalis ( Tv ), Neisseria gonorrhoeae ( Ng )-DNA. Socio-demographic and sexual behavior information were collected. All HPV/ Ct + women were offered Pap tests and/or were prescribed antibiotic treatment. 537/757 women participated in the study (acceptability rate: 70.9%). Most of the women were from Latin America (45.6%) and Eastern Europe (30.7%); >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct , Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women's health are required.
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Using Remotely Sensed Data to Map Urban Vulnerability to Heat
Stefanov, William L.
2010-01-01
This slide presentation defines remote sensing, and presents examples of remote sensing and astronaut photography, which has been a part of many space missions. The presentation then reviews the project aimed at analyzing urban vulnerability to climate change, which is to test the hypotheses that Exposure to excessively warm weather threatens human health in all types of climate regimes; Heat kills and sickens multitudes of people around the globe every year -- directly and indirectly, and Climate change, coupled with urban development, will impact human health. Using Multiple Endmember Spectral Mixing Analysis (MESMA), and the Phoenix urban area as the example, the Normalized Difference Vegetation Index (NDVI) is calculated, a change detection analysis is shown, and surface temperature is shown.
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Skouloudis, Andreas N; Kassomenos, Pavlos
2014-08-01
The use of emerging technologies for environmental monitoring with satellite and in-situ sensors have become essential instruments for assessing the impact of environmental pollution on human health, especially in areas that require high spatial and temporal resolution. This was until recently a rather difficult problem. Regrettably, with classical approaches the spatial resolution is frequently inadequate in reporting environmental causes and health effects in the same time scale. This work examines with new tools different levels of air-quality with sensor monitoring with the aim to associate those with severe health effects. The process established here facilitates the precise representation of human exposure with the population attributed in a fine spatial grid and taking into account environmental stressors of human exposure. These stressors can be monitored with innovative sensor units with a temporal resolution that accurately describes chronic and acute environmental burdens. The current understanding of the situation in densely populated areas can be properly analyzed, before commitments are made for reductions in total emissions as well as for assessing the effects of reduced trans-boundary fluxes. In addition, the data processed here with in-situ sensors can assist in establishing more effective regulatory policies for the protection of vulnerable population groups and the satellite monitoring instruments permit abatement strategies that are close to real-time over large geographical areas. Copyright © 2014 Elsevier B.V. All rights reserved.
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Ecclestone, Kathryn; Goodley, Daniel
2016-01-01
Contemporary discourses of social justice in education, disability, mental health, social policy and feminist studies are refracted increasingly through concerns about psychological and structural vulnerabilities created by the crises of late capitalism. Focusing on developments in British social policy generally and educational research…
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Floods and human health: a systematic review.
Alderman, Katarzyna; Turner, Lyle R; Tong, Shilu
2012-10-15
Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004-2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Pete Driezen
2016-08-01
Full Text Available This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012 of the International Tobacco Control (ITC Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a cigarette smoking and (b smokeless tobacco use and (c whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control.
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Driezen, Pete; Abdullah, Abu S.; Nargis, Nigar; Hussain, A. K. M. Ghulam; Fong, Geoffrey T.; Thompson, Mary E.; Quah, Anne C. K.; Xu, Steve
2016-01-01
This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control. PMID:27571090
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Jankowska, Marta M.; Lopez-Carr, David; Funk, Chris; Husak, Gregory J.; Chafe, Z.A.
2012-01-01
This study develops a novel approach for projecting climate trends in the Sahel in relation to shifting livelihood zones and health outcomes. Focusing on Mali, we explore baseline relationships between temperature, precipitation, livelihood, and malnutrition in 407 Demographic and Health Survey (DHS) clusters with a total of 14,238 children, resulting in a thorough spatial analysis of coupled climate-health dynamics. Results suggest links between livelihoods and each measure of malnutrition, as well as a link between climate and stunting. A ‘front-line’ of vulnerability, related to the transition between agricultural and pastoral livelihoods, is identified as an area where mitigation efforts might be usefully targeted. Additionally, climate is projected to 2025 for the Sahel, and demographic trends are introduced to explore how the intersection of climate and demographics may shift the vulnerability ‘front-line’, potentially exposing an additional 6 million people in Mali, up to a million of them children, to heightened risk of malnutrition from climate and livelihood changes. Results indicate that, holding constant morbidity levels, approximately one quarter of a million children will suffer stunting, nearly two hundred thousand will be malnourished, and over one hundred thousand will become anemic in this expanding arid zone by 2025. Climate and health research conducted at finer spatial scales and within shorter projected time lines can identify vulnerability hot spots that are of the highest priority for adaptation interventions; such an analysis can also identify areas with similar characteristics that may be at heightened risk. Such meso-scale coupled human-environment research may facilitate appropriate policy interventions strategically located beyond today’s vulnerability front-line.
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2014-01-01
Background Bangladesh has the highest natural disaster mortality rate in the world, with over half a million people lost to disaster events since 1970. Most of these people have died during floods or cyclones, both of which are likely to become more frequent due to global climate change. To date, the government’s post-disaster response strategy has focused, increasingly effectively, on the physical needs of survivors, through the provision of shelter, food and medical care. However, the serious and widespread mental health consequences of natural disasters in Bangladesh have not yet received the attention that they deserve. This Debate article proposes a practical model that will facilitate the provision of comprehensive and effective post-disaster mental health services for vulnerable Bangladeshis on a sustainable basis. Discussion A series of socially determined factors render the women and the poor of Bangladesh particularly vulnerable to dying in natural disasters; and, for those who survive, to suffering from some sort of disaster-related mental health illness. For women, this is largely due to the enforced gender separation, or purdah, that they endure; while for the poor, it is the fact that they are, by definition, only able to afford to live in the most climatically dangerous, and under-served parts of the country. Although the disasters themselves are brought by nature, therefore, social determinants increase the vulnerability of particular groups to mental illness as a result of them. While deeply entrenched, these determinants are at least partially amenable to change through policy and action. Summary In response to the 2004 Indian Ocean tsunami, the World Health Organisation developed a framework for providing mental health and psychosocial support after major disasters, which, we argue, could be adapted to Bangladeshi post-cyclone and post-flood contexts. The framework is community-based, it includes both medical and non-clinical components, and it
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Oyanedel, Juan Carlos; Vargas, Salvador; Mella, Camila; Páez, Darío
2015-09-01
Personal well-being calculates quality of life in terms of the necessary conditions required to live well. To validate the Personal Wellbeing Index (PWI) in a representative sample of vulnerable users of the public health system in Santiago, Chile. A probabilistic and multistage sample consisting of 400 individuals aged 44 ± 18 years (61% females) belonging to the lower income group of the National Health Fund (FONASA), residents of Gran Santiago was surveyed. Internal consistency and correlation between items and scale were examined. Structure was analyzed through confirmatory factor analysis. The seven-item PWI is a good indicator of subjective well-being in the population under study, considering internal consistency, factor loadings, relation with overall life satisfaction and goodness of fit. The indicators mostly associated with personal well-being are the socioeconomic level followed by relationships with the community, health conditions and achievements. The 7-item version of the PWI is suitable for application in vulnerable health service users.
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Wilson, Ander; Chiu, Yueh-Hsiu Mathilda; Hsu, Hsiao-Hsien Leon; Wright, Robert O; Wright, Rosalind J; Coull, Brent A
2017-07-01
Epidemiological research supports an association between maternal exposure to air pollution during pregnancy and adverse children's health outcomes. Advances in exposure assessment and statistics allow for estimation of both critical windows of vulnerability and exposure effect heterogeneity. Simultaneous estimation of windows of vulnerability and effect heterogeneity can be accomplished by fitting a distributed lag model (DLM) stratified by subgroup. However, this can provide an incomplete picture of how effects vary across subgroups because it does not allow for subgroups to have the same window but different within-window effects or to have different windows but the same within-window effect. Because the timing of some developmental processes are common across subpopulations of infants while for others the timing differs across subgroups, both scenarios are important to consider when evaluating health risks of prenatal exposures. We propose a new approach that partitions the DLM into a constrained functional predictor that estimates windows of vulnerability and a scalar effect representing the within-window effect directly. The proposed method allows for heterogeneity in only the window, only the within-window effect, or both. In a simulation study we show that a model assuming a shared component across groups results in lower bias and mean squared error for the estimated windows and effects when that component is in fact constant across groups. We apply the proposed method to estimate windows of vulnerability in the association between prenatal exposures to fine particulate matter and each of birth weight and asthma incidence, and estimate how these associations vary by sex and maternal obesity status in a Boston-area prospective pre-birth cohort study. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Neighborhood Environments: Links to Health Behaviors and Obesity Status in Vulnerable Children.
Choo, Jina; Kim, Hye-Jin; Park, Sooyeon
2017-08-01
This study aimed to identify the actual and perceived features of neighborhood environments linked to health behaviors and obesity status in vulnerable children by using geographic information systems, walking surveys, and focus group interviews. The participants were 126 children registered at community child centers and 10 mothers of study participants. Increased availability of fast food outlets and convenience stores was significantly and positively associated with fast food and sugar-sweetened beverage consumption and inversely with physical activity. Reduced availability of physical activity outlets was significantly and positively associated with sedentary behaviors. Mothers' perceptions of their neighborhoods fell into three content categories: (a) changed to be unfriendly for children, (b) adapted to fast food and convenience eating, and (c) confined to physically inactive living. Based on these findings, community-level environmental strategies for reducing unhealthy behaviors linked to neighborhood environments should be prioritized to prevent childhood obesity in vulnerable populations.
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Gómez, José M; Verdú, Miguel
2017-03-06
Epidemics can spread across large regions becoming pandemics by flowing along transportation and social networks. Two network attributes, transitivity (when a node is connected to two other nodes that are also directly connected between them) and centrality (the number and intensity of connections with the other nodes in the network), are widely associated with the dynamics of transmission of pathogens. Here we investigate how network centrality and transitivity influence vulnerability to diseases of human populations by examining one of the most devastating pandemic in human history, the fourteenth century plague pandemic called Black Death. We found that, after controlling for the city spatial location and the disease arrival time, cities with higher values of both centrality and transitivity were more severely affected by the plague. A simulation study indicates that this association was due to central cities with high transitivity undergo more exogenous re-infections. Our study provides an easy method to identify hotspots in epidemic networks. Focusing our effort in those vulnerable nodes may save time and resources by improving our ability of controlling deadly epidemics.
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Saldaña-Zorrilla, Sergio O; Sandberg, Krister
2009-10-01
Mexico's vast human and environmental diversity offers an initial framework for comprehending some of the prevailing great disparities between rich and poor. Its socio-economic constructed vulnerability to climatic events serves to expand this understanding. Based on a spatial econometric model, this paper tests the contribution of natural disasters to stimulating the emigration process in vulnerable regions of Mexico. Besides coping and adaptive capacity, it assesses the effects of economic losses due to disasters as well as the adverse production and trade conditions of the 1990s on emigration rates in 2000 at the municipality level. Weather-related disasters were responsible for approximately 80 per cent of economic losses in Mexico between 1980 and 2005, mostly in the agricultural sector, which continues to dominate many parts of the country. It is dramatic that this sector generates around only four per cent of gross domestic product but provides a livelihood to about one-quarter of the national population. It is no wonder, therefore, that most emigration from this country arises in vulnerable rural areas.
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Jaworsky, Denise; Gadermann, Anne; Duhoux, Arnaud; Naismith, Trudy E; Norena, Monica; To, Matthew J; Hwang, Stephen W; Palepu, Anita
2016-08-01
This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.
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Pleistocene megafaunal interaction networks became more vulnerable after human arrival.
Pires, Mathias M; Koch, Paul L; Fariña, Richard A; de Aguiar, Marcus A M; dos Reis, Sérgio F; Guimarães, Paulo R
2015-09-07
The end of the Pleistocene was marked by the extinction of almost all large land mammals worldwide except in Africa. Although the debate on Pleistocene extinctions has focused on the roles of climate change and humans, the impact of perturbations depends on properties of ecological communities, such as species composition and the organization of ecological interactions. Here, we combined palaeoecological and ecological data, food-web models and community stability analysis to investigate if differences between Pleistocene and modern mammalian assemblages help us understand why the megafauna died out in the Americas while persisting in Africa. We show Pleistocene and modern assemblages share similar network topology, but differences in richness and body size distributions made Pleistocene communities significantly more vulnerable to the effects of human arrival. The structural changes promoted by humans in Pleistocene networks would have increased the likelihood of unstable dynamics, which may favour extinction cascades in communities facing extrinsic perturbations. Our findings suggest that the basic aspects of the organization of ecological communities may have played an important role in major extinction events in the past. Knowledge of community-level properties and their consequences to dynamics may be critical to understand past and future extinctions. © 2015 The Author(s).
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Tsevat, Rebecca K; Sinha, Anoushka A; Gutierrez, Kevin J; DasGupta, Sayantani
2015-11-01
As health humanities programs grow and thrive across the country, encouraging medical students to read, write, and become more reflective about their professional roles, educators must bring a sense of self-reflexivity to the discipline itself. In the health humanities, novels, patient histories, and pieces of reflective writing are often treated as architectural spaces or "homes" that one can enter and examine. Yet, narrative-based learning in health care settings does not always allow its participants to feel "at home"; when not taught with a critical attention to power and pedagogy, the health humanities can be unsettling and even dangerous. Educators can mitigate these risks by considering not only what they teach but also how they teach it.In this essay, the authors present three pedagogical pillars that educators can use to invite learners to engage more fully, develop critical awareness of medical narratives, and feel "at home" in the health humanities. These pedagogical pillars are narrative humility (an awareness of one's prejudices, expectations, and frames of listening), structural competency (attention to sources of power and privilege), and engaged pedagogy (the protection of students' security and well-being). Incorporating these concepts into pedagogical practices can create safe and productive classroom spaces for all, including those most vulnerable and at risk of being "unhomed" by conventional hierarchies and oppressive social structures. This model then can be translated through a parallel process from classroom to clinic, such that empowered, engaged, and cared-for learners become empowering, engaging, and caring clinicians.
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Kinser, Patricia A; Lyon, Debra E
2014-09-01
Depression is a chronic mental health condition that affects millions of individuals worldwide. It is well-established that psychological stress plays an integral role in depression and that depression has numerous negative health outcomes. However, a closer look at components of stress vulnerabilities and depression is required to allow for the development and testing of appropriate interventions. This article describes a conceptual framework about the complex and bidirectional relationship between stress vulnerability, depression, and health outcomes in women. The authors elucidate how the framework can be applied in clinical research about cellular aging and on the mechanisms of complementary and alternative medicine (CAM) for depression, using yoga as an example of a CAM modality. The proposed conceptual framework may be helpful for adding depth to the body of knowledge about the use of mind-body therapies for individuals at high risk of stress vulnerability and/or depression.
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Baghapour, Mohammad Ali; Fadaei Nobandegani, Amir; Talebbeydokhti, Nasser; Bagherzadeh, Somayeh; Nadiri, Ata Allah; Gharekhani, Maryam; Chitsazan, Nima
2016-01-01
Extensive human activities and unplanned land uses have put groundwater resources of Shiraz plain at a high risk of nitrate pollution, causing several environmental and human health issues. To address these issues, water resources managers utilize groundwater vulnerability assessment and determination of protection. This study aimed to prepare the vulnerability maps of Shiraz aquifer by using Composite DRASTIC index, Nitrate Vulnerability index, and artificial neural network and also to compare their efficiency. The parameters of the indexes that were employed in this study are: depth to water table, net recharge, aquifer media, soil media, topography, impact of the vadose zone, hydraulic conductivity, and land use. These parameters were rated, weighted, and integrated using GIS, and then, used to develop the risk maps of Shiraz aquifer. The results indicated that the southeastern part of the aquifer was at the highest potential risk. Given the distribution of groundwater nitrate concentrations from the wells in the underlying aquifer, the artificial neural network model offered greater accuracy compared to the other two indexes. The study concluded that the artificial neural network model is an effective model to improve the DRASTIC index and provides a confident estimate of the pollution risk. As intensive agricultural activities are the dominant land use and water table is shallow in the vulnerable zones, optimized irrigation techniques and a lower rate of fertilizers are suggested. The findings of our study could be used as a scientific basis in future for sustainable groundwater management in Shiraz plain.
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2014-01-01
Background Numerous social factors, generally studied in isolation, have been associated with older adults’ health. Even so, older people’s social circumstances are complex and an approach which embraces this complexity is desirable. Here we investigate many social factors in relation to one another and to survival among older adults using a social ecology perspective to measure social vulnerability among older adults. Methods 2740 adults aged 65 and older were followed for ten years in the Canadian National Population Health Survey (NPHS). Twenty-three individual-level social variables were drawn from the 1994 NPHS and five Enumeration Area (EA)-level variables were abstracted from the 1996 Canadian Census using postal code linkage. Principal Component Analysis (PCA) was used to identify dimensions of social vulnerability. All social variables were summed to create a social vulnerability index which was studied in relation to ten-year mortality. Results The PCA was limited by low variance (47%) explained by emergent factors. Seven dimensions of social vulnerability emerged in the most robust, yet limited, model: social support, engagement, living situation, self-esteem, sense of control, relations with others and contextual socio-economic status. These dimensions showed complex inter-relationships and were situated within a social ecology framework, considering spheres of influence from the individual through to group, neighbourhood and broader societal levels. Adjusting for age, sex, and frailty, increasing social vulnerability measured using the cumulative social vulnerability index was associated with increased risk of mortality over ten years in a Cox regression model (HR 1.04, 95% CI:1.01-1.07, p = 0.01). Conclusions Social vulnerability has important independent influence on older adults’ health though relationships between contributing variables are complex and do not lend themselves well to fragmentation into a small number of discrete factors. A
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Narushima, Miya; Liu, Jian; Diestelkamp, Naomi
2018-04-01
The Active Ageing Framework has been adapted as a global strategy in ageing policies, practices and research over the last decade. Lifelong learning, however, has not been fully integrated into this discourse. Using survey data provided by 416 adults (aged 60 years and above) enrolled in non-formal general-interest courses in a public continuing education programme in Canada, this study examined the association between older adults' duration of participation in the courses and their level of psychological wellbeing, while taking their age, gender, self-rated health and vulnerability level into consideration. An analytical framework was developed based on the literature of old-age vulnerabilities and the benefits of lifelong learning. Two logistic regression and trend analyses were conducted. The results indicate that older adults' participation is independently and positively associated with their psychological wellbeing, even among those typically classified as 'vulnerable'. This result provides additional evidence that suggests the continuous participation in non-formal lifelong learning may help sustain older adults' psychological wellbeing. It provides older learners, even those who are most vulnerable, with a compensatory strategy to strengthen their reserve capacities, allowing them to be autonomous and fulfilled in their everyday life. The result of this study highlights the value of the strategic and unequivocal promotion of community-based non-formal lifelong learning opportunities for developing inclusive, equitable and caring active ageing societies.
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Semple, Bridgette D.; Blomgren, Klas; Gimlin, Kayleen; Ferriero, Donna M.; Noble-Haeusslein, Linda J.
2013-01-01
Hypoxic-ischemic and traumatic brain injuries are leading causes of long-term mortality and disability in infants and children. Although several preclinical models using rodents of different ages have been developed, species differences in the timing of key brain maturation events can render comparisons of vulnerability and regenerative capacities difficult to interpret. Traditional models of developmental brain injury have utilized rodents at postnatal day 7–10 as being roughly equivalent to a term human infant, based historically on the measurement of post-mortem brain weights during the 1970s. Here we will examine fundamental brain development processes that occur in both rodents and humans, to delineate a comparable time course of postnatal brain development across species. We consider the timing of neurogenesis, synaptogenesis, gliogenesis, oligodendrocyte maturation and age-dependent behaviors that coincide with developmentally regulated molecular and biochemical changes. In general, while the time scale is considerably different, the sequence of key events in brain maturation is largely consistent between humans and rodents. Further, there are distinct parallels in regional vulnerability as well as functional consequences in response to brain injuries. With a focus on developmental hypoxicischemic encephalopathy and traumatic brain injury, this review offers guidelines for researchers when considering the most appropriate rodent age for the developmental stage or process of interest to approximate human brain development. PMID:23583307
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Gruebner, Oliver; Lowe, Sarah R; Sampson, Laura; Galea, Sandro
2015-06-10
Only very few studies have investigated the geographic distribution of psychological resilience and associated mental health outcomes after natural or man made disasters. Such information is crucial for location-based interventions that aim to promote recovery in the aftermath of disasters. The purpose of this study therefore was to investigate geographic variability of (1) posttraumatic stress (PTS) and depression in a Hurricane Sandy affected population in NYC and (2) psychological vulnerability and resilience factors among affected areas in NYC boroughs. Cross-sectional telephone survey data were collected 13 to 16 months post-disaster from household residents (N = 418 adults) in NYC communities that were most heavily affected by the hurricane. The Posttraumatic Stress Checklist for DSM-5 (PCL-5) was applied for measuring posttraumatic stress and the nine-item Patient Health Questionnaire (PHQ-9) was used for measuring depression. We applied spatial autocorrelation and spatial regimes regression analyses, to test for spatial clusters of mental health outcomes and to explore whether associations between vulnerability and resilience factors and mental health differed among New York City's five boroughs. Mental health problems clustered predominantly in neighborhoods that are geographically more exposed towards the ocean indicating a spatial variation of risk within and across the boroughs. We further found significant variation in associations between vulnerability and resilience factors and mental health. Race/ethnicity (being Asian or non-Hispanic black) and disaster-related stressors were vulnerability factors for mental health symptoms in Queens, and being employed and married were resilience factors for these symptoms in Manhattan and Staten Island. In addition, parental status was a vulnerability factor in Brooklyn and a resilience factor in the Bronx. We conclude that explanatory characteristics may manifest as psychological vulnerability and resilience
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Vulnerable to HIV / AIDS. Migration.
Fernandez, I
1998-01-01
This special report discusses the impact of globalization, patterns of migration in Southeast Asia, gender issues in migration, the links between migration and HIV/AIDS, and spatial mobility and social networks. Migrants are particularly marginalized in countries that blame migrants for transmission of infectious and communicable diseases and other social ills. Effective control of HIV/AIDS among migrant and native populations requires a multisectoral approach. Programs should critically review the privatization of health care services and challenge economic models that polarize the rich and the poor, men and women, North and South, and migrant and native. Programs should recognize the equality between locals and migrants in receipt of health services. Countermeasures should have input from migrants in order to reduce the conditions that increase vulnerability to HIV/AIDS. Gender-oriented research is needed to understand women's role in migration. Rapid assessment has obscured the human dimension of migrants' vulnerability to HIV. Condom promotion is not enough. Migration is a major consequence of globalization, which holds the promise, real or imagined, of prosperity for all. Mass migration can be fueled by explosive regional developments. In Southeast Asia, migration has been part of the process of economic development. The potential to emigrate increases with greater per capita income. "Tiger" economies have been labor importers. Safe sex is not practiced in many Asian countries because risk is not taken seriously. Migrants tend to be used as economic tools, without consideration of social adjustment and sex behavior among singles.
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Downs, Timothy J; Ross, Laurie; Goble, Robert; Subedi, Rajendra; Greenberg, Sara; Taylor, Octavia
2011-04-01
Millions of low-income people of diverse ethnicities inhabit stressful old urban industrial neighborhoods. Yet we know little about the health impacts of built-environment stressors and risk perceptions in such settings; we lack even basic health profiles. Difficult access is one reason (it took us 30 months to survey 80 households); the lack of multifaceted survey tools is another. We designed and implemented a pilot vulnerability assessment tool in Worcester, Massachusetts. We answer: (1) How can we assess vulnerability to multiple stressors? (2) What is the nature of complex vulnerability-including risk perceptions and health profiles? (3) How can findings be used by our wider community, and what lessons did we learn? (4) What implications arise for science and policy? We sought a holistic picture of neighborhood life. A reasonably representative sample of 80 respondents captured data for 254 people about: demographics, community concerns and resources, time-activity patterns, health information, risk/stress perceptions, and resources/capacities for coping. Our key findings derive partly from the survey data and partly from our experience in obtaining those data. Data strongly suggest complex vulnerability dominated by psychosocial stress. Unexpected significant gender and ethnic disease disparities emerged: notably, females have twice the disease burden of males, and white females twice the burden of females of color (p Risk Analysis.
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Directory of Open Access Journals (Sweden)
Bonita Bernice Visagie
2017-12-01
Full Text Available Introduction: The escalation of HIV/AIDS infections in the last decade has increased the need for palliative care community organizations to care for orphans and vulnerable children, who are in dire need of support. Many of these organizations depend on the services of lay community health workers to provide constant care to those in need of it in their local communities. The focus of this study is to explore the role of lay health workers in a community organization located in rural Bronkhorstspruit, Gauteng Province of South Africa. That provides palliative care for orphans and vulnerable children diagnosed with HIV/AIDS. Their roles were analysed critically through a job-demands and job-resources theoretical framework. Methods: A descriptive phenomenological case study design was employed to collect data through twenty five individual interviews, two separate focus groups consisting of ten participants in one group and eleven participants in the other group, observations and document analysis. Data were processed through a rigorous thematic analysis. Results: The findings pointed out specific knowledge and skills these lay community health workers needed in order to be satisfied with, and successful in, their administration of palliative care to orphans and vulnerable children. Participants identified the following organizational challenges that were deemed to be impacting negatively on their work experiences: the lack of career pathing processes; sufficient career guidance; and inadequate employment processes, such as staff retention, succession planning, and promotion. Conclusion: Through the findings, a framework for enhancing the work experiences of the lay community health workers was developed. The uniqueness of this framework is that the focus is on improving the work lives of the lay community health workers, who have serious skills-resourcing needs. There were specific concrete strategies that the organization could adopt to support
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van Spijk, Piet
2015-05-01
If it is true that health is a priority objective of medicine, then medical practice can only be successful if the meaning of the term "health" is known. Various attempts have been made over the years to define health. This paper proposes a new definition. In addition to current health concepts, it also takes into account the distinction between specifically human (great) health and health as the absence of disease and illness-i.e. small health. The feeling of leading a life that makes sense plays a key role in determining specifically human great health.
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Brewer, T D; Cinner, J E; Green, A; Pressey, R L
2013-06-01
Coral reef fisheries are crucial to the livelihoods of tens of millions of people; yet, widespread habitat degradation and unsustainable fishing are causing severe depletion of stocks of reef fish. Understanding how social and economic factors, such as human population density, access to external markets, and modernization interact with fishing and habitat degradation to affect fish stocks is vital to sustainable management of coral reef fisheries. We used fish survey data, national social and economic data, and path analyses to assess whether these factors explain variation in biomass of coral reef fishes among 25 sites in Solomon Islands. We categorized fishes into 3 groups on the basis of life-history characteristics associated with vulnerability to extinction by fishing (high, medium, and low vulnerability). The biomass of fish with low vulnerability was positively related to habitat condition. The biomass of fishes with high vulnerability was negatively related to fishing conducted with efficient gear. Use of efficient gear, in turn, was strongly and positively related to both population density and market proximity. This result suggests local population pressure and external markets have additive negative effects on vulnerable reef fish. Biomass of the fish of medium vulnerability was not explained by fishing intensity or habitat condition, which suggests these species may be relatively resilient to both habitat degradation and fishing. © 2012 Society for Conservation Biology.
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The Vulnerability of Earth Systems to Human-Induced Global Change and Strategies for Mitigation
Watson, R. T.
2002-12-01
Since the IGY, there has been growing evidence that climate is changing in response to human activities. The overwhelming majority of scientific experts, whilst recognizing that scientific uncertainties exist, nonetheless believe that human-induced climate change is inevitable. Indeed, during the last few years, many parts of the world have suffered major heat waves, floods, droughts, fires and extreme weather events leading to significant economic losses and loss of life. While individual events cannot be directly linked to human-induced climate change, the frequency and magnitude of these types of events are predicted to increase in a warmer world. The question is not whether climate will change, but rather how much (magnitude), how fast (the rate of change) and where (regional patterns). It is also clear that climate change and other human-induced modifications to the environment will, in many parts of the world, adversely affect socio-economic sectors, including water resources, agriculture, forestry, fisheries and human settlements, ecological systems (particularly forests and coral reefs), and human health (particularly diseases spread by insects), with developing countries being the most vulnerable. Environmental degradation of all types (i.e., climate change, loss of biodiversity, land degradation, air and water quality) all undermine the challenge of poverty alleviation and sustainable economic growth. One of the major challenges facing humankind is to provide an equitable standard of living for this and future generations: adequate food, water and energy, safe shelter and a healthy environment (e.g., clean air and water). Unfortunately, human-induced climate change, as well as other global environmental issues such as land degradation, loss of biological diversity and stratospheric ozone depletion, threatens our ability to meet these basic human needs. The good news is, however, that the majority of experts believe that significant reductions in net
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Camelo, Lidyane do Valle; Giatti, Luana; Barreto, Sandhi Maria
2016-01-01
To investigate whether social relations, sociodemographic characteristics, lifestyle, and health conditions are associated with health-related quality of life (HRQOL) among elderly persons living in regions classified as high vulnerable in terms of health. A cross-sectional study conducted with a population-based random sample of 366 elderly (≥ 60 years of age) persons registered at a primary health-care unit in Belo Horizonte, Minas Gerais, Brazil. HRQOL was measured using the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and the scores obtained in the physical component score (PCS) and mental component score (MCS) were our response variables. Social relations, sociodemographic characteristics, lifestyle, and health conditions were considered our groups of explanatory variables. Multiple linear regression models were used for the analysis. In the final multivariate models, we found that elevated number of diagnosis of chronic diseases, and being bedridden for the last 15 days were variables associated with worse PCS and MCS. However, lack of education, dissatisfaction with personal relationships, lack of support and help when bedridden or to go to the doctor, and to prepare meals were associated with worse HRQOL only in MCS. Participants who reported black race/color, absence of work activity, lack of physical activity, no alcohol consumption, and hospitalization in the last 12 months had worse HRQOL only in PCS. In addition to the aspects related to social adversity, lifestyle, and health conditions, some functional aspects of social relations were important for understanding the HRQOL in elderly persons living in social vulnerability.
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Diversity loss with persistent human disturbance increases vulnerability to ecosystem collapse.
MacDougall, A S; McCann, K S; Gellner, G; Turkington, R
2013-02-07
Long-term and persistent human disturbances have simultaneously altered the stability and diversity of ecological systems, with disturbances directly reducing functional attributes such as invasion resistance, while eliminating the buffering effects of high species diversity. Theory predicts that this combination of environmental change and diversity loss increases the risk of abrupt and potentially irreversible ecosystem collapse, but long-term empirical evidence from natural systems is lacking. Here we demonstrate this relationship in a degraded but species-rich pyrogenic grassland in which the combined effects of fire suppression, invasion and trophic collapse have created a species-poor grassland that is highly productive, resilient to yearly climatic fluctuations, and resistant to invasion, but vulnerable to rapid collapse after the re-introduction of fire. We initially show how human disturbance has created a negative relationship between diversity and function, contrary to theoretical predictions. Fire prevention since the mid-nineteenth century is associated with the loss of plant species but it has stabilized high-yield annual production and invasion resistance, comparable to a managed high-yield low-diversity agricultural system. In managing for fire suppression, however, a hidden vulnerability to sudden environmental change emerges that is explained by the elimination of the buffering effects of high species diversity. With the re-introduction of fire, grasslands only persist in areas with remnant concentrations of native species, in which a range of rare and mostly functionally redundant plants proliferate after burning and prevent extensive invasion including a rapid conversion towards woodland. This research shows how biodiversity can be crucial for ecosystem stability despite appearing functionally insignificant beforehand, a relationship probably applicable to many ecosystems given the globally prevalent combination of intensive long-term land
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English, Paul B; Sinclair, Amber H; Ross, Zev; Anderson, Henry; Boothe, Vicki; Davis, Christine; Ebi, Kristie; Kagey, Betsy; Malecki, Kristen; Shultz, Rebecca; Simms, Erin
2009-11-01
To develop public health adaptation strategies and to project the impacts of climate change on human health, indicators of vulnerability and preparedness along with accurate surveillance data on climate-sensitive health outcomes are needed. We researched and developed environmental health indicators for inputs into human health vulnerability assessments for climate change and to propose public health preventative actions. We conducted a review of the scientific literature to identify outcomes and actions that were related to climate change. Data sources included governmental and nongovernmental agencies and the published literature. Sources were identified and assessed for completeness, usability, and accuracy. Priority was then given to identifying longitudinal data sets that were applicable at the state and community level. We present a list of surveillance indicators for practitioners and policy makers that include climate-sensitive health outcomes and environmental and vulnerability indicators, as well as mitigation, adaptation, and policy indicators of climate change. A review of environmental health indicators for climate change shows that data exist for many of these measures, but more evaluation of their sensitivity and usefulness is needed. Further attention is necessary to increase data quality and availability and to develop new surveillance databases, especially for climate-sensitive morbidity.
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Directory of Open Access Journals (Sweden)
Gosselin Pierre
2009-04-01
Full Text Available Abstract Background Climate change has a significant impact on population health. Population vulnerabilities depend on several determinants of different types, including biological, psychological, environmental, social and economic ones. Surveillance of climate-related health vulnerabilities must take into account these different factors, their interdependence, as well as their inherent spatial and temporal aspects on several scales, for informed analyses. Currently used technology includes commercial off-the-shelf Geographic Information Systems (GIS and Database Management Systems with spatial extensions. It has been widely recognized that such OLTP (On-Line Transaction Processing systems were not designed to support complex, multi-temporal and multi-scale analysis as required above. On-Line Analytical Processing (OLAP is central to the field known as BI (Business Intelligence, a key field for such decision-support systems. In the last few years, we have seen a few projects that combine OLAP and GIS to improve spatio-temporal analysis and geographic knowledge discovery. This has given rise to SOLAP (Spatial OLAP and a new research area. This paper presents how SOLAP and climate-related health vulnerability data were investigated and combined to facilitate surveillance. Results Based on recent spatial decision-support technologies, this paper presents a spatio-temporal web-based application that goes beyond GIS applications with regard to speed, ease of use, and interactive analysis capabilities. It supports the multi-scale exploration and analysis of integrated socio-economic, health and environmental geospatial data over several periods. This project was meant to validate the potential of recent technologies to contribute to a better understanding of the interactions between public health and climate change, and to facilitate future decision-making by public health agencies and municipalities in Canada and elsewhere. The project also aimed at
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Bernier, Eveline; Gosselin, Pierre; Badard, Thierry; Bédard, Yvan
2009-04-03
Climate change has a significant impact on population health. Population vulnerabilities depend on several determinants of different types, including biological, psychological, environmental, social and economic ones. Surveillance of climate-related health vulnerabilities must take into account these different factors, their interdependence, as well as their inherent spatial and temporal aspects on several scales, for informed analyses. Currently used technology includes commercial off-the-shelf Geographic Information Systems (GIS) and Database Management Systems with spatial extensions. It has been widely recognized that such OLTP (On-Line Transaction Processing) systems were not designed to support complex, multi-temporal and multi-scale analysis as required above. On-Line Analytical Processing (OLAP) is central to the field known as BI (Business Intelligence), a key field for such decision-support systems. In the last few years, we have seen a few projects that combine OLAP and GIS to improve spatio-temporal analysis and geographic knowledge discovery. This has given rise to SOLAP (Spatial OLAP) and a new research area. This paper presents how SOLAP and climate-related health vulnerability data were investigated and combined to facilitate surveillance. Based on recent spatial decision-support technologies, this paper presents a spatio-temporal web-based application that goes beyond GIS applications with regard to speed, ease of use, and interactive analysis capabilities. It supports the multi-scale exploration and analysis of integrated socio-economic, health and environmental geospatial data over several periods. This project was meant to validate the potential of recent technologies to contribute to a better understanding of the interactions between public health and climate change, and to facilitate future decision-making by public health agencies and municipalities in Canada and elsewhere. The project also aimed at integrating an initial collection of geo
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Eric Coker; Samuel Kizito
2018-01-01
An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the re...
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Frati, Elena R.; Fasoli, Ester; Martinelli, Marianna; Colzani, Daniela; Bianchi, Silvia; Carnelli, Luciana; Amendola, Antonella; Olivani, Pierfranco; Tanzi, Elisabetta
2017-01-01
Background: Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs) in undocumented migrant women in Milan, Italy. Methods: Women (ages 18–65) were enrolled at the NAGA Centre (2012–2013) and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV), Chlamydia trachomatis (Ct), Trichomonas vaginalis (Tv), Neisseria gonorrhoeae (Ng)-DNA. Socio-demographic and sexual behavior information were collected. All HPV/Ct+ women were offered Pap tests and/or were prescribed antibiotic treatment. Results: 537/757 women participated in the study (acceptability rate: 70.9%). Most of the women were from Latin America (45.6%) and Eastern Europe (30.7%); >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct, Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. Conclusions: This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women’s health are required. PMID:28632191
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Directory of Open Access Journals (Sweden)
Elena R. Frati
2017-06-01
Full Text Available Background: Migrant women are one of the most vulnerable population to health problems and well-being. This study aimed at implementing a counseling and preventive strategy for sexually transmitted infections (STIs in undocumented migrant women in Milan, Italy. Methods: Women (ages 18–65 were enrolled at the NAGA Centre (2012–2013 and asked for a urine sample in order to carry out molecular detection of Human papillomavirus (HPV, Chlamydia trachomatis (Ct, Trichomonas vaginalis (Tv, Neisseria gonorrhoeae (Ng-DNA. Socio-demographic and sexual behavior information were collected. All HPV/Ct+ women were offered Pap tests and/or were prescribed antibiotic treatment. Results: 537/757 women participated in the study (acceptability rate: 70.9%. Most of the women were from Latin America (45.6% and Eastern Europe (30.7%; >60% of them had stable partners, did not use contraception and had had at least one pregnancy. The prevalence rates of HPV, Ct, Tv and Ng infections were 24.2%, 7.8%, 4.8% and 0%, respectively. In all, 43.2% of the positive women agreed to undergo a gynecological examination and accepted suitable treatment. Conclusions: This study shows an overall high prevalence of STIs in undocumented migrant women in Milan. The screening strategy based on counseling and urine testing contributed to the successfully high acceptability rate. More appropriate health services that adequately address all aspects of women’s health are required.
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Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen
engaging vulnerable populations and addressing social and economic barriers to health and wellness during the long-term disaster recovery phase. Health coaches and community health workers may be instrumental in helping to address the health and wellness needs of vulnerable residents living in disaster-affected areas.
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Population Health Vulnerabilities to Vector-borne Diseases ...
International Development Research Centre (IDRC) Digital Library (Canada)
Damming, irrigation and other forms of water management are also creating new habitats ... adaptation, particularly to improve the resilience of vulnerable populations. ... Linking research to urban planning at the ICLEI World Congress 2018.
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Vulnerable Genders, Vulnerable Loves
DEFF Research Database (Denmark)
Schleicher, Marianne
2015-01-01
This chapter analyses religious reflections on vulnerable genders and vulnerable loves from the Hebrew Bible to early Rabbinic literature. It is based on theories by inter alia Donna Haraway on complex identities, Turner and Maryanski on love as a prerequisite for survival, Michel Foucault...... on gathering knowledge and its often unpremeditated effect of recognition and inclusion, and Judith Butler on cultural intelligibility and subversion from within. With these theories as a departing point for the analysis, the chapter links the vulnerability of complex identities with the vulnerability...... of cultures which leads to the overall understanding that culture can accommodate complex identities associated with individual and cultural vulnerability as long as the overall survival of the culture is not threatened. This understanding questions the feasibility of the ethical position of thinkers...
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Wood, Jennifer D; Beierschmitt, Laura
2014-01-01
Law enforcement officers continue to serve on the front lines as mental health interventionists, and as such have been subject to a wave of "first generation" reform designed to enhance their crisis response capabilities. Yet, this focus on crisis intervention has not answered recent calls to move "upstream" and bolster early intervention in the name of long-term recovery. This paper reports on findings from an action research project in Philadelphia aimed at exploring opportunities for enhanced upstream engagement. Study methods include spatial analyses of police mental health transportations from an eight year period (2004-2011) and qualitative data from twenty-three "framing conversations" with partners and other stakeholders, seven focus groups with police and outreach workers, five key informant interviews as well as document reviews of the service delivery system in Philadelphia. Recommendations include the need to move beyond a focus on what police can do to a wider conception of city agencies and business stakeholders who can influence vulnerable people and vulnerable spaces of the city. We argue for the need to develop shared principles and rules of engagement that clarify roles and stipulate how best to enlist city resources in a range of circumstances. Since issues of mental health, substance use and disorder are so tightly coupled, we stress the importance of establishing a data-driven approach to crime and disorder reduction in areas of the city we term "hotspots of vulnerability". In line with a recovery philosophy, such an approach should reduce opportunities for anti-social behavior among the "dually labeled" in ways consistent with "procedural justice". Furthermore, crime and disorder data flowing from police and security to behavioral health analysts could contribute to a more focused case management of "repeat utilizers" across the two systems. Our central argument is that a twin emphasis on "case management" and "place management" may provide
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Economic development and declining vulnerability to climate-related disasters in China
Wu, Jidong; Han, Guoyi; Zhou, Hongjian; Li, Ning
2018-03-01
Exposure and vulnerability are the main contributing factors of growing impact from climate-related disasters globally. Understanding the spatiotemporal dynamic patterns of vulnerability is important for designing effective disaster risk mitigation and adaptation measures. At national scale, most cross-country studies have suggested that economic vulnerability to disasters decreases as income increases, especially for developing countries. Research covering sub-national climate-related natural disasters is indispensable to obtaining a comprehensive understanding of the effect of regional economic growth on vulnerability reduction. Taking China as a case, this subnational scale study shows that economic development is correlated with the significant reduction in human fatalities but increase in direct economic losses (DELs) from climate-related disasters since 1949. The long-term trend in climate-related disaster vulnerability, reflected by mortality (1978-2015) and DELs (1990-2015) as a share of the total population and Gross Domestic Product, has seen significant decline among all economic regions in China. While notable differences remain among its West, Central and East economic regions, the temporal vulnerability change has been converging. The study further demonstrated that economic development level is correlated with human and economic vulnerability to climate-related disasters, and this vulnerability decreased with the increase of per-capita income. This study suggested that economic development can have nuanced effects on overall human and economic vulnerability to climate-related disasters. We argue that climate change science needs to acknowledge and examine the different pathways of vulnerability effects related to economic development.
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Stans, Steffy E A; Dalemans, Ruth J P; de Witte, Luc P; Smeets, Hester W H; Beurskens, Anna J
2017-12-01
The role of the physical environment in communication between health-care professionals and persons with communication problems is a neglected area. This study provides an overview of factors in the physical environment that play a role in communication during conversations between people who are communication vulnerable and health-care professionals. A scoping review was conducted using the methodological framework of Arksey and O'Malley. The PubMed, PsycINFO, CINAHL and Cochrane Library databases were screened, and a descriptive and thematic analysis was completed. Sixteen publications were included. Six factors in the physical environment play a role in conversations between people who are communication vulnerable and health-care professionals: (1) lighting, (2) acoustic environment, (3) humidity and temperature, (4) setting and furniture placement, (5) written information, and (6) availability of augmentative and alternative communication (AAC) tools. These factors indicated barriers and strategies related to the quality of these conversations. Relatively small and simple strategies to adjust the physical environment (such as adequate lighting, quiet environment, providing pen and paper) can support people who are communication vulnerable to be more involved in conversations. It is recommended that health-care professionals have an overall awareness of the potential influence of environmental elements on conversations. Implications for rehabilitation The physical environment is an important feature in the success or disturbance of communication. Small adjustments to the physical environment in rehabilitation can contribute to a communication-friendly environment for conversations with people who are communication vulnerable. Professionals should consider adjustments with regard to the following factors in the physical environment during conversations with people who are communication vulnerable: lighting, acoustic environment, humidity and temperature, setting
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Strategic use of communication to market cancer prevention and control to vulnerable populations.
Kreps, Gary L
2008-01-01
There are significant challenges to communicating relevant cancer prevention and control information to health care consumers due both to the complexities of the health information to be communicated and the complexities of health communication, especially with vulnerable populations. The need for effective communication about cancer risks, early detection, prevention, care, and survivorship is particularly acute, yet also tremendously complex, for reaching vulnerable populations, those groups of people who are most likely to suffer significantly higher levels of morbidity and mortality from cancers than other segments of the population. These vulnerable populations, typically the poorest, lowest educated, and most disenfranchised members of modern society, are heir to serious cancer-related health disparities. Vulnerable populations often have health literacy difficulties, cultural barriers, and economic challenges to accessing and making sense of relevant health information. This paper examines these challenges to communicating relevant information to vulnerable populations and suggests strategies for effectively using different communication media for marketing cancer prevention and control to reduce health disparities and promote public health.
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Categorisation of typical vulnerability patterns in global drylands
Sietz, D.; Lûdeke, M.K.B.; Walther, C.
2011-01-01
Drylands display specific vulnerability-creating mechanisms which threaten ecosystems and human well-being. The upscaling of successful interventions to reduce vulnerability arises as an important, but challenging aim, since drylands are not homogenous. To support this aim, we present the first
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Cowburn, B; Samoilys, M A; Obura, D
2018-05-31
Coral bleaching and various human stressors have degraded the coral reefs of the Comoros Archipelago in the past 40 years and rising atmospheric CO 2 levels are predicted to further impact marine habitats. The condition of reefs in the Comoros is poorly known; using SCUBA based methods we surveyed reef condition and resilience to bleaching at sites in Grande Comore and Mohéli in 2010 and 2016. The condition of reefs was highly variable, with a range in live coral cover between 6% and 60% and target fishery species biomass between 20 and 500 kg per ha. The vulnerability assessment of reefs to future coral bleaching and their exposure to fishing, soil erosion and river pollution in Mohéli Marine Park found that offshore sites around the islets south of the island were least likely to be impacted by these negative pressures. The high variability in both reef condition and vulnerability across reefs in the Park lends itself to spatially explicit conservation actions. However, it is noteworthy that climate impacts to date appear moderate and that local human pressures are not having a major impact on components of reef health and recovery, suggesting these reefs are relatively resilient to the current anthropogenic stresses that they are experiencing. Copyright © 2018 Elsevier Ltd. All rights reserved.
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An oral health survey of vulnerable older people in Belgium.
De Visschere, Luc; Janssens, Barbara; De Reu, Griet; Duyck, Joke; Vanobbergen, Jacques
2016-11-01
The aim of this study was to gain insight in the oral health of persons aged 65 years or more. Data were obtained from 652 vulnerable older persons (≥65) by means of a clinical oral examination. Additional demographic data were gathered including age, gender, residence, and care dependency. The mean age of the total study sample was 83 (7.7) years and 71 % was female. Nearly 33 % of the sample was living at home with support, and 67 % was residing in nursing homes. The number of occluding pairs was low and the proportion of edentulous people was highest among persons with the highest care dependency. The mean Decay-missing-filled teeth index (DMFT) was 20.3 (9.0). A prosthetic treatment need and inadequate oral hygiene levels were observed in 40 % and more than 60 % of the subjects, respectively. The highest treatment need was observed in the oldest age group and the highest mean dental plaque in older persons with the highest care dependency. The oral health in frail older people in Belgium is poor. The restorative and prosthetic treatment need is high and oral hygiene levels are problematic. Age, residence, and care dependency seemed to have some influence on oral health parameters. In the long term, the most important future challenge of oral health care policies is to identify older adults before they begin to manifest such oral health deterioration. Regular dental visits should be strongly promoted by all (oral) health care workers during the lifespan of all persons including older adults.
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Human rights and political crisis in Brazil: Public health impacts and challenges.
Malta, Monica
2018-01-25
In 31 August 2016, Brazilian president Dilma Rousseff was impeached and replaced by her vice president Michel Temer. Herein, we examine how the conservative agenda of Mr Temer and his supporters is influencing key decisions in the human rights and public health arena in Brazil. The government's austerity agenda includes severe cuts in critical areas such as health, education and science, jeopardising well-known strategies such as the Brazilian Public Health System (SUS) and nationwide cash transfer program, 'Bolsa Familia' - both benefited millions and were the largest of their kind in the world. Mr Temer's decisions show not only severe cuts in critical areas but also a political agenda that clearly demonstrates a broad shift away from the progressivism and social agenda presented and supported by its predecessors. Most vulnerable groups such as the LGBTQ community, women, people who use drugs and disenfranchised communities have been severely affected. Mr Temer's administration is putting Brazil far from its once nationwide goal to foster free and universal health care access and social equity for all its citizens. The near future for Brazil is unknown, but both national and international communities anticipate severe problems within the national human rights arena, if nothing changes. CCT: Conditional Cash Transfer; LGBTQ: Lesbian, Gay, Bisexual, Transgender and Queer (and/or Questioning); SUS: Brazilian Public Health System.
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Storytelling: A Qualitative Tool to Promote Health Among Vulnerable Populations.
Palacios, Janelle F; Salem, Benissa; Hodge, Felicia Schanche; Albarrán, Cyndi R; Anaebere, Ann; Hayes-Bautista, Teodocia Maria
2015-09-01
Storytelling is a basic cultural phenomenon that has recently been recognized as a valuable method for collecting research data and developing multidisciplinary interventions. The purpose of this article is to present a collection of nursing scholarship wherein the concept of storytelling, underpinned by cultural phenomena, is explored for data collection and intervention. A conceptual analysis of storytelling reveals key variables. Following a brief review of current research focused on storytelling used within health care, three case studies among three vulnerable populations (American Indian teen mothers, American Indian cancer survivors, and African American women at risk for HIV/AIDS) demonstrate the uses of storytelling for data collection and intervention. Implications for transcultural nursing regarding storytelling are discussed. © The Author(s) 2014.
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Canadian governance of health research involving human subjects: is anybody minding the store?
McDonald, M
2001-01-01
From an ethical perspective, good governance involves the translation of collective moral intentions into effective and accountable institutional actions. With respect to the use of human subjects in Canadian health research, I contend that there have been many good intentions but very little in the way of appropriate governance arrangements. Hence, the question, "who minds the store?" is especially acute with respect to the protection of vulnerable individuals and groups that are typically recruited as subjects for health research in Canada. Beyond diagnosing failures in governance and their causes, I offer suggestions for significant reforms, including evidence-based ethics assessment, independent oversight, and greater participation of research subjects in governance. I will close with some more general reflections on ethics, law, and governance.
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Defining Resilience and Vulnerability Based on Ontology Engineering Approach
Kumazawa, T.; Matsui, T.; Endo, A.
2014-12-01
It is necessary to reflect the concepts of resilience and vulnerability into the assessment framework of "Human-Environmental Security", but it is also in difficulty to identify the linkage between both concepts because of the difference of the academic community which has discussed each concept. The authors have been developing the ontology which deals with the sustainability of the social-ecological systems (SESs). Resilience and vulnerability are also the concepts in the target world which this ontology covers. Based on this point, this paper aims at explicating the semantic relationship between the concepts of resilience and vulnerability based on ontology engineering approach. For this purpose, we first examine the definitions of resilience and vulnerability which the existing literatures proposed. Second, we incorporate the definitions in the ontology dealing with sustainability of SESs. Finally, we focus on the "Water-Energy-Food Nexus Index" to assess Human-Environmental Security, and clarify how the concepts of resilience and vulnerability are linked semantically through the concepts included in these index items.
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Fujiu, Makoto; Morisaki, Yuma; Takayama, Junichi; Yanagihara, Kiyoko; Nishino, Tatsuya; Sagae, Masahiko; Hirako, Kohei
2018-01-01
The 2013 Partial Amendment of the Disaster Countermeasures Basic Law mandated that a roster of vulnerable persons during disasters be created, and further development of evacuation support is expected. In this study, the number of vulnerable people living in target analytical areas are identified in terms of neighborhood units by using the National Health Insurance Database to create a realistic and efficient evacuation support plan. Later, after considering the “vulnerability” of an area to earthquake disaster damage, a quantitative evaluation of the state of the disaster is performed using a principle component analysis that further divided the analytical target areas into neighborhood units to make a detailed determination of the number of disaster-vulnerable persons, the severity of the disaster, etc. The results of the disaster evaluation performed after considering the vulnerability of an area are that 628 disaster-vulnerable persons live in areas with a relatively higher disaster evaluation value. PMID:29534021
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Assessment of groundwater vulnerability and sensitivity to pollution ...
African Journals Online (AJOL)
Groundwater pollution caused by human activity is a serious environmental problem in cities. Pollution vulnerability assessment of groundwater resources provides information on how to protect areas vulnerable to pollution. The present study is a detailed investigation of the potential for groundwater contamination through ...
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Vulnerability of southern plains agriculture to climate change
Climate is a key driver for all ecological and economic systems; therefore, climate change introduces additional uncertainty and vulnerability into these systems. Agriculture represents a major land use that is critical to the survival of human societies and it is highly vulnerable to climate. Clima...
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Susceptibility to mountain hazards in Austria - paradigms of vulnerability revisited
Fuchs, Sven
2010-05-01
The concept of vulnerability is pillared by multiple disciplinary theories underpinning either a technical or a social origin of the concept and resulting in a range of paradigms for either a qualitative or quantitative assessment of vulnerability. However, efforts to reduce susceptibility to hazards and to create disaster-resilient communities require intersections among these theories, since human activity cannot be seen independently from the environmental setting. Acknowledging different roots of disciplinary paradigms, issues determining structural, economic, institutional and social vulnerability are discussed with respect to mountain hazards in Austria. The underlying idea of taking such an integrative viewpoint was the cognition that human action in mountain environments affects the state of vulnerability, and the state of vulnerability in turn shapes the possibilities of human action. It is argued that structural vulnerability as originator results in considerable economic vulnerability, generated by the institutional settings of dealing with natural hazards and shaped by the overall societal framework. Hence, the vulnerability of a specific location and within a considered point of time is triggered by the hazardous event and the related physical susceptibility of structures, such as buildings located on a torrent fan. Depending on the specific institutional settings, economic vulnerability of individuals or of the society results, above all with respect to imperfect loss compensation mechanisms in the areas under investigation. While this potential for harm can be addressed as social vulnerability, the concept of institutional vulnerability has been developed with respect to the overall political settings of governmental risk management. As a result, the concept of vulnerability, as being used in natural sciences, can be extended by integration of possible reasons why such physical susceptibility of structures exists, and by integration of compensation
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In Search for Anchors The Fundamental Motivational Force in Compensating for Human Vulnerability
Directory of Open Access Journals (Sweden)
Bagus Riyono
2012-09-01
Full Text Available The purpose of this study is to develop a new integrative theory of motivation drawn from the existing theories and data. The method used is a combination of meta-ethnography and grounded theory. The second phase of the study employed a thought experiment to test the newly developed theoretical propositions of motivational force. The first phase of the study revealed a central phenomenon for the occurrence of motivational force, i.e. “In Search for Anchors,” which is a result of the paradox between freedom to choose and human vulnerability. “Freedom to choose” is the central factor of a motivational model that includes “urge,” “challenge,” “incentive,” and “meaning.” These five factors are motivational sources, which have holistic-dynamic-integrative interaction. Human vulnerability is the other side of the motivational model that comprises risk, uncertainty, and hope that ignite motivational force. The dynamic interaction of risk, uncertainty, and hope is represented in a mathematical formula that produces the strength of the force, (R – H2 x U, which can be potrayed in a “twin-peak” curve. The thought experiment was conducted to test the hypothetical formula. The result shows that the “twin-peak” hypothesis is supported but the shape of the curve is found to be not symmetrical. The data show that hope is the strongest motivational force, therefore the formula is modified into = (R – U2 x H. The implication of the study and the utility of the new theory are discussed.
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Moiseenko, T I; Voinov, A A; Megorsky, V V; Gashkina, N A; Kudriavtseva, L P; Vandish, O I; Sharov, A N; Sharova, Yu; Koroleva, I N
2006-10-01
There are rich deposits of mineral and fossil natural resources in the Arctic, which make this region very attractive for extracting industries. Their operations have immediate and vast consequences for ecological systems, which are particularly vulnerable in this region. We are developing a management strategy for Arctic watersheds impacted by industrial production. The case study is Lake Imandra watershed (Murmansk oblast, Russia) that has exceptionally high levels of economic development and large numbers of people living there. We track the impacts of toxic pollution on ecosystem health and then--human health. Three periods are identified: (a) natural, pre-industrial state; (b) disturbed, under rapid economic development; and (c) partial recovery, during recent economic meltdown. The ecosystem is shown to transform into a qualitatively new state, which is still different from the original natural state, even after toxic loadings have substantially decreased. Fish disease where analyzed to produce and integral evaluation of ecosystem health. Accumulation of heavy metals in fish is correlated with etiology of many diseases. Dose-effect relationships are between integral water quality indices and ecosystem health indicators clearly demonstrates that existing water quality standards adopted in Russia are inadequate for Arctic regions. Health was also poor for people drinking water from the Lake. Transport of heavy metals from drinking water, into human organs, and their effect on liver and kidney diseases shows the close connection between ecosystem and human health. A management system is outlined that is based on feedback from indices of ecosystem and human health and control over economic production and/or the amount of toxic loading produced. We argue that prospects for implementation of such a system are quite bleak at this time, and that more likely we will see a continued depopulation of these Northern regions.
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Close social ties and health in later life: Strengths and vulnerabilities.
Rook, Karen S; Charles, Susan T
2017-09-01
The world is aging at an unprecedented rate, with older adults representing the fastest-growing segment of the population in most economically developed and developing countries. This demographic shift leaves much uncharted territory for researchers who study social relationships and health. Social relationships exert powerful influences on physical health in later adulthood, a critical consideration given age-related increases in the prevalence of chronic health conditions and physical disability. A large body of research indicates that older adults report greater satisfaction with their social networks than do younger adults, and that they often take measures to minimize their exposure to negative social encounters. These emotionally satisfying and generally positive social ties afford some health protection against a backdrop of mounting physical limitations and play an important role when juxtaposed with the potentially health-damaging frictions that sometimes emerge in older adults' social relationships. Although most older adults report that they are satisfied with their social ties, some older adults experience frequent conflicts or ambivalent exchanges with members of their social networks, and these experiences detract from their health. In addition, many older adults will experience the loss of one or more close relationships during the course of their lives, with ramifications for their health and, often, for the reorganization of their social lives over time. Understanding how both the strengths and vulnerabilities of close social relationships affect health and well-being in later life is an important goal, particularly in view of the accelerating rate of population aging worldwide. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Directory of Open Access Journals (Sweden)
Carla Kowalski Marzari
2013-01-01
Full Text Available OBJETIVO: Conhecer a percepção de lideranças, profissionais de saúde e usuários acerca da cidadania e melhoria das condições de saúde de famílias pertencentes a uma comunidade vulnerável. MÉTODO: Estudo exploratório, de caráter qualitativo, orientado pela teoria fundamentada nos dados. Os dados foram coletados entre julho e dezembro de 2009, mediante entrevistas com quatro lideranças comunitárias de saúde, oito profissionais de uma equipe de saúde da família e doze usuários da saúde. RESULTADOS: A codificação dos dados resultou nas categorias: Compreendendo as Condições sociais, as Condições políticas, as Condições ambientais e as Condições de saúde de famílias de uma comunidade vulnerável. CONCLUSÕES: Se por um lado as políticas de seguridade social e de saúde possibilitaram a redução da pobreza e das desigualdades locais, por outro lado, não garantem a necessária expansão da cidadania e nem mesmo a melhoria das condições de saúde.The scope of this paper is to ascertain the perception of community leadership, health professionals and users regarding citizenship status and the enhancement of the healthcare conditions of families belonging to a vulnerable community. This is an exploratory study of a qualitative nature, guided by theory based on data. Data were collected between July and December 2009, by means of interviews with four community health leaders, a team of eight family health team professionals and twelve health users. The codification of the data resulted in the following categories: Understanding the social conditions, the political conditions, the environmental conditions and the health conditions of families in a vulnerable community. The conclusions reached were, that if on the one hand the social security and health policies made it possible to reduce poverty and local inequalities, on the other hand they do not ensure the requisite enhancement of citizenship or even the improvement
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Chersich, Matthew F; Rees, Helen V
2008-12-01
To review biomedical determinants of women's vulnerability to infection with HIV and interventions to counter this, within the southern African context. Apart from number of exposures, if any, several factors influence the efficiency of HIV transmission during sex. Acute HIV infection, with extraordinarily high semen viral load, in conjunction with concurrent partnerships maximizes this efficiency. Delaying sexual debut and avoiding HIV exposure among biologically and socially vulnerable youth is critical. Reducing unintended pregnancies keeps girls in school and prevents vertical (also possibly horizontal) transmission. Female condoms, especially newer versions, are an under-exploited prevention technology. Control of sexually transmitted infections (STI), which facilitate HIV acquisition and transmission, remains important, especially among the most at-risk populations. Pathogens, such as herpes simplex virus type 2, which contribute most to HIV transmission in southern Africa must be targeted, although the importance of bacterial vaginosis and Trichomonas vaginalis is under-recognized. Also, heavy episodic alcohol use affects sexual decision-making and condom skills. Moreover, prevailing social contexts, partly a consequence of poor leadership, constrain the behavioural 'choices' available for girls and women. Priority health sector interventions for preventing HIV are: male and female condom programming; prevention and control of STI; outreach to most vulnerable populations; HIV testing in all patient-provider encounters; male circumcision; and the integration of HIV prevention within sexual and reproductive health services. Future interventions during acute HIV infection and microbicides will reduce women's biological vulnerability. Far-reaching measures, such as sexual equity and alcohol control, create conditions necessary for achieving sustained prevention results. These are, however, contingent on stronger, more informed cultural and political leadership.
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The principle of vulnerability and its potential applications in bioethics
Directory of Open Access Journals (Sweden)
Demény Enikő
2016-12-01
Full Text Available The principle of vulnerability is a specific principle within European Bioethics. On the one hand, vulnerability expresses human limits and frailty on the other hand it represents moral and ethical action principles. In this paper a discussion on the relationship between the concepts of autonomy, vulnerability and responsibility is proposed and presentation of some possible applications of the principle of vulnerability within bioethics. In conclusion, some potential benefits of applying the principle of vulnerability as well as possible difficulties in its application are highlighted.
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Okpala, Charles Odilichukwu R; Sardo, Giacomo; Vitale, Sergio; Bono, Gioacchino; Arukwe, Augustine
2017-04-10
The mercury (Hg) poisoning of Minamata Bay of Japan widely activated a global attention to Hg toxicity and its potential consequences to the aquatic ecosystem and human health. This has resulted to an increased need for a dynamic assembly, contextualization, and quantification of both the current state-of-the-art and approaches for understanding the cause-and-effect relationships of Hg exposure. Thus, the objective of this present review is to provide both hazardous toxic properties and toxicological update of Hg, focusing on how it ultimately affects the aquatic biota to potentially produce human health effects. Primarily, we discussed processes that relate to Hg exposure, including immunological aspects and risk assessment, vulnerability, toxicokinetics, and toxicodynamics, using edible fish, swordfish (Xiphias gladius), as a model. In addition, we summarized available information about Hg concentration limits set by different governmental agencies, as recognized by national and international standardization authorities.
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International Nuclear Information System (INIS)
Raupach, Michael; Canadell, Josep G.; Ciais, Philippe; Friedlingstein, Pierre; Rayner, Peter J.; Trudinger, Catherine M.
2011-01-01
Interactions between the carbon cycle, climate and human societies are subject to several major vulnerabilities, broadly defined as factors contributing to the risk of harm from human-induced climate change. We assess five vulnerabilities: (1) effects of increasing CO 2 on the partition of anthropogenic carbon between atmospheric, land and ocean reservoirs; (2) effects of climate change (quantified by temperature) on CO 2 fluxes; (3) uncertainty in climate sensitivity; (4) non-CO 2 radiative forcing and (5) anthropogenic CO 2 emissions. Our analysis uses a physically based expression for Tp(Qp), the peak warming Tp associated with a cumulative anthropogenic CO 2 emission Qp to the time of peak warming. The approximations in this expression are evaluated using a non-linear box model of the carbon-climate system, forced with capped emissions trajectories described by an analytic form satisfying integral and smoothness constraints. The first four vulnerabilities appear as parameters that influence Tp(Qp), whereas the last appears through the independent variable. In terms of likely implications for Tp(Qp), the decreasing order of the first four vulnerabilities is: uncertainties in climate sensitivity, effects of non-CO 2 radiative forcing, effects of climate change on CO 2 fluxes and effects of increasing CO 2 on the partition of anthropogenic carbon. (authors)
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Lupien, Sonia J; Juster, Robert-Paul; Raymond, Catherine; Marin, Marie-France
2018-04-01
For the last five decades, science has managed to delineate the mechanisms by which stress hormones can impact on the human brain. Receptors for glucocorticoids are found in the hippocampus, amygdala and frontal cortex, three brain regions involved in memory processing and emotional regulation. Studies have shown that chronic exposure to stress is associated with reduced volume of the hippocampus and that chronic stress can modulate volumes of both the amygdala and frontal cortex, suggesting neurotoxic effects of stress hormones on the brain. Yet, other studies report that exposure to early adversity and/or familial/social stressors can increase vulnerability to stress in adulthood. Models have been recently developed to describe the roles that neurotoxic and vulnerability effects can have on the developing brain. These models suggest that developing early stress interventions could potentially counteract the effects of chronic stress on the brain and results going along with this hypothesis are summarized. Copyright © 2018 Elsevier Inc. All rights reserved.
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Livelihoods, vulnerability and adaptation to climate change in Morogoro, Tanzania
International Nuclear Information System (INIS)
Paavola, Jouni
2008-01-01
This article examines farmers' livelihood responses and vulnerability to climate variability and other stressors in Morogoro, Tanzania, to understand their implications for adaptation to climate change by agricultural households in developing world more generally. In Morogoro, agricultural households have extended cultivation, intensified agriculture, diversified livelihoods and migrated to gain access to land, markets and employment as a response to climatic and other stressors. Some of these responses have depleted and degraded natural resources such as forest, soil and water resources, which will complicate their living with climate change in the future. This will be particularly problematic to vulnerable groups such as women, children and pastoralists who have limited access to employment, markets and public services. In this light, fair adaptation to climate change by agricultural households in Morogoro and elsewhere in developing countries requires several complementary responses. Adaptation efforts should involve effective governance of natural resources because they function as safety nets to vulnerable groups. In addition, strengthening of national markets by infrastructure investments and institutional reforms is needed to give incentives to intensification and diversification in agriculture. Market participation also demands enhancement of human capital by public programs on health, education and wellbeing
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Digital Threat and Vulnerability Management: The SVIDT Method
Directory of Open Access Journals (Sweden)
Roland W. Scholz
2017-04-01
Full Text Available The Digital Revolution is inducing major threats to many types of human systems. We present the SVIDT method (a Strengths, Vulnerability, and Intervention Assessment related to Digital Threats for managing the vulnerabilities of human systems with respect to digital threats and changes. The method first performs a multilevel system–actor analysis for assessing vulnerabilities and strengths with respect to digital threats. Then, the method identifies threat scenarios that may become real. By constructing, evaluating, and launching interventions against all identified digital threats and their critical negative outcomes, the resilience of a specific human system can be improved. The evaluation of interventions is done when strengthening the adaptive capacity, i.e., a system’s capability to cope with negative outcomes that may take place in the future. The SVIDT method is embedded in the framework of coupled human–environment systems, the theory of risk and vulnerability assessment, types of adaptation (assimilation vs. accommodation, and a comprehensive sustainability evaluation. The SVIDT method is exemplarily applied to an enterprise (i.e., a Swiss casino for which online gaming has become an essential digital-business field. The discussion reflects on the specifics of digital threats and discusses both the potential benefits and limitations of the SVIDT method.
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Not the usual suspects: addressing layers of vulnerability.
Luna, Florencia; Vanderpoel, Sheryl
2013-07-01
This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. © 2013 John Wiley & Sons Ltd.
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Sari, Mega M; Inoue, Takanobu; Matsumoto, Yoshitaka; Yokota, Kuriko
2016-01-01
This research is comparative study of gold mining and non-gold mining areas, using four community vulnerability indicators. Vulnerability indicators are exposure degree, contamination rate, chronic, and acute toxicity. Each indicator used different samples, such as wastewater from gold mining process, river water from Tajum river, human hair samples, and health questionnaire. This research used cold vapor atomic absorption spectrometry to determine total mercury concentration. The result showed that concentration of total mercury was 2,420 times than the maximum content of mercury permitted in wastewater based on the Indonesian regulation. Moreover, the mercury concentration in river water reached 685 ng/l, exceeding the quality threshold standards of the World Health Organization (WHO). The mercury concentration in hair samples obtained from the people living in the research location was considered to identify the health quality level of the people or as a chronic toxicity indicator. The highest mercury concentration--i.e. 17 ng/mg, was found in the gold mining respondents. Therefore, based on the total mercury concentration in the four indicators, the community in the gold mining area were more vulnerable to mercury than communities in non-gold mining areas. It was concluded that the community in gold mining area was more vulnerable to mercury contamination than the community in non-gold mining area.
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Jones, D. K.
2016-12-01
Human and biotic communities are becoming increasingly vulnerable to sea-level rise and severe storms due to climate change. These events enhance the dispersion and concentration of natural and anthropogenic chemicals and pathogenic microorganisms, which could adversely impact the health and resilience of coastal communities and ecosystems in coming years. The U.S. Geological Survey (USGS) has developed spatial screening methods to identify and map contaminant sources and potential exposure pathways for human and ecological receptors. These methods have been applied within the northeastern U.S. to document contaminants of emerging concern, highlight vulnerable communities, and prioritize locations for future sampling campaigns. Integration of this information provides a means to better assess the baseline status of a complex system and the significance of changes in contaminant hazards due to storm-induced (episodic) and sea-level rise (incremental) disturbances. This presentation will provide an overview of a decision support tool developed by the USGS to document contaminants in the environment relative to key receptor populations and historic storm vulnerabilities. The support tool is designed to accommodate a broad array of geologic, land-use, and climatic variables and utilizes public, nationally available data sources to define contaminant sources and storm vulnerabilities. By employing a flexible and adaptable strategy built upon publicly available data, the method can readily be applied to other site selection or landscape evaluation efforts. Examples will be presented including the Sediment-bound Contaminant Resiliency and Response pilot study (see http://toxics.usgs.gov/scorr/), and investigations of endocrine disruption in the Chesapeake Bay. Key limitations and future applications will be discussed in addition to ongoing method developments to accommodate non-coastal disaster scenarios and more refined contaminant definitions.
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Social Vulnerability and Ebola Virus Disease in Rural Liberia.
Stanturf, John A; Goodrick, Scott L; Warren, Melvin L; Charnley, Susan; Stegall, Christie M
2015-01-01
The Ebola virus disease (EVD) epidemic that has stricken thousands of people in the three West African countries of Liberia, Sierra Leone, and Guinea highlights the lack of adaptive capacity in post-conflict countries. The scarcity of health services in particular renders these populations vulnerable to multiple interacting stressors including food insecurity, climate change, and the cascading effects of disease epidemics such as EVD. However, the spatial distribution of vulnerable rural populations and the individual stressors contributing to their vulnerability are unknown. We developed a Social Vulnerability Classification using census indicators and mapped it at the district scale for Liberia. According to the Classification, we estimate that districts having the highest social vulnerability lie in the north and west of Liberia in Lofa, Bong, Grand Cape Mount, and Bomi Counties. Three of these counties together with the capital Monrovia and surrounding Montserrado and Margibi counties experienced the highest levels of EVD infections in Liberia. Vulnerability has multiple dimensions and a classification developed from multiple variables provides a more holistic view of vulnerability than single indicators such as food insecurity or scarcity of health care facilities. Few rural Liberians are food secure and many cannot reach a medical clinic in Liberia may be warranted. We demonstrate how social vulnerability index approaches can be applied in the context of disease outbreaks, and our methods are relevant elsewhere.
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Access to justice: evaluating law, health and human rights programmes in Kenya.
Gruskin, Sofia; Safreed-Harmon, Kelly; Ezer, Tamar; Gathumbi, Anne; Cohen, Jonathan; Kameri-Mbote, Patricia
2013-11-13
In Kenya, human rights violations have a marked impact on the health of people living with HIV. Integrating legal literacy and legal services into healthcare appears to be an effective strategy to empower vulnerable groups and address underlying determinants of health. We carried out an evaluation to collect evidence about the impact of legal empowerment programmes on health and human rights. The evaluation focused on Open Society Foundation-supported legal integration activities at four sites: the Academic Model of Providing Access to Healthcare (AMPATH) facility, where the Legal Aid Centre of Eldoret (LACE) operates, in Eldoret; Kenyatta National Hospital's Gender-based Violence Recovery Centre, which hosts the COVAW legal integration program; and Christian Health Association of Kenya (CHAK) facilities in Mombasa and Naivasha. In consultation with the organizations implementing the programs, we designed a conceptual logic model grounded in human rights principles, identified relevant indicators and then coded structure, process and outcome indicators for the rights-related principles they reflect. The evaluation included a resource assessment questionnaire, a review of program records and routine data, and semi-structured interviews and focus group discussions with clients and service providers. Data were collected in May-August 2010 and April-June 2011. Clients showed a notable increase in practical knowledge and awareness about how to access legal aid and claim their rights, as well as an enhanced ability to communicate with healthcare providers and to improve their access to healthcare and justice. In turn, providers became more adept at identifying human rights violations and other legal difficulties, which enabled them to give clients basic information about their rights, refer them to legal aid and assist them in accessing needed support. Methodological challenges in evaluating such activities point to the need to strengthen rights-oriented evaluation
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Global Climate Change and Children's Health.
Ahdoot, Samantha; Pacheco, Susan E
2015-11-01
Rising global temperature is causing major physical, chemical, and ecological changes across the planet. There is wide consensus among scientific organizations and climatologists that these broad effects, known as climate change, are the result of contemporary human activity. Climate change poses threats to human health, safety, and security. Children are uniquely vulnerable to these threats. The effects of climate change on child health include physical and psychological sequelae of weather disasters, increased heat stress, decreased air quality, altered disease patterns of some climate-sensitive infections, and food, water, and nutrient insecurity in vulnerable regions. Prompt implementation of mitigation and adaptation strategies will protect children against worsening of the problem and its associated health effects. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health. Copyright © 2015 by the American Academy of Pediatrics.
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Older women's health and financial vulnerability: implications of the Medicare benefit structure.
Sofaer, S; Abel, E
1990-01-01
Elderly women and men have different patterns of disease and utilize health services differently. This essay examines the extent to which Medicare covers the specific conditions and services associated with women and men. Elderly women experience higher rates of poverty than elderly men; consequently, elderly women are especially likely to be unable to pay high out-of-pocket costs for health care. Using a new method for simulating out-of-pocket costs, the Illness Episode Approach, the essay shows that Medicare provides better coverage for illnesses which predominate among men than for those which predominate among women. In addition, women on Medicare who supplement their basic coverage by purchasing a typical private insurance "Medigap" policy do not receive as much of an advantage from their purchases as do men. The calculations also show that the Medicare Catastrophic Coverage Act would have had little impact on the gender gap in financial vulnerability.
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Wesson, Donald E; Kitzman, Heather E
2018-01-16
Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve. Health systems will need the help of community entities and individuals who have the trust of the population being served to act on behalf of the health system if they are to achieve this effective working partnership. The need for these trusted agents is particularly pertinent for vulnerable and historically underserved segments of the population. In this Invited Commentary, the authors discuss ways by which health systems might identify, engage, and leverage trusted agents to improve the health of the population through value-based care.
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Maintaining dignity in vulnerability
DEFF Research Database (Denmark)
Høy, Bente
2016-01-01
to understand the meaning of the narrated text. Results. The meaning of maintaining dignity was constituted in a sense of vulnerability to the self, and elucidated in three major interrelated themes: Being involved as a human being, being involved as the person one is and strives to become, and being involved...
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Mapping social-ecological vulnerability to inform local decision making.
Thiault, Lauric; Marshall, Paul; Gelcich, Stefan; Collin, Antoine; Chlous, Frédérique; Claudet, Joachim
2018-04-01
An overarching challenge of natural resource management and biodiversity conservation is that relationships between people and nature are difficult to integrate into tools that can effectively guide decision making. Social-ecological vulnerability offers a valuable framework for identifying and understanding important social-ecological linkages, and the implications of dependencies and other feedback loops in the system. Unfortunately, its implementation at local scales has hitherto been limited due at least in part to the lack of operational tools for spatial representation of social-ecological vulnerability. We developed a method to map social-ecological vulnerability based on information on human-nature dependencies and ecosystem services at local scales. We applied our method to the small-scale fishery of Moorea, French Polynesia, by combining spatially explicit indicators of exposure, sensitivity, and adaptive capacity of both the resource (i.e., vulnerability of reef fish assemblages to fishing) and resource users (i.e., vulnerability of fishing households to the loss of fishing opportunity). Our results revealed that both social and ecological vulnerabilities varied considerably through space and highlighted areas where sources of vulnerability were high for both social and ecological subsystems (i.e., social-ecological vulnerability hotspots) and thus of high priority for management intervention. Our approach can be used to inform decisions about where biodiversity conservation strategies are likely to be more effective and how social impacts from policy decisions can be minimized. It provides a new perspective on human-nature linkages that can help guide sustainability management at local scales; delivers insights distinct from those provided by emphasis on a single vulnerability component (e.g., exposure); and demonstrates the feasibility and value of operationalizing the social-ecological vulnerability framework for policy, planning, and participatory
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Climate Change, Vulnerability, and Health in Colombia and Bolivia ...
International Development Research Centre (IDRC) Digital Library (Canada)
They will apply a watershed approach to study social and ecological systems and their interactions. ... multistakeholder action research studies, researchers will propose and test adaptation strategies to improve ecosystems and human health.
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Directory of Open Access Journals (Sweden)
Raquel de Deus Mendonça
2015-06-01
Full Text Available OBJECTIVES: To analyze the dietary profile of participants who used two health promotion services located in socially vulnerable areas in a Brazilian metropolis. METHODS: A cross-sectional comparative study was conducted with participants (n = 370 aged ≥ 20 years who joined two services of the Academias da Cidade program in Belo Horizonte, Minas Gerais, Brazil. The study participants engaged in physical activity and nutritional education actions directed by the services from 2009 to 2010. The sociodemographic and economic conditions and health and nutrition profiles of each individual were assessed. RESULTS: Participants from a high social-risk who used the service did not demonstrate adequate intake of vegetables (54.6 versus 43.6%; p = 0.038, sweets (33.5 versus 23.2%; p = 0.030, soft drinks (28.5 versus 11.9%; p < 0.001, artificial juice (34.7 versus 22.6%; p = 0.011, and processed meat (48.8 versus 32.7; p = 0.002. However, in the other service, lower social vulnerability, a higher prevalence of abdominal adiposity (60.7 versus 43.0%; p = 0.004 and consumption of high-fat meat products (53.0 versus 36.5%; p = 0.002 was observed. CONCLUSION: Participants who used both services demonstrated inadequate food intake compatible with the development of chronic disease profiles. However, the participants in each service were distinct from each other. This suggests that promotion of healthy eating should to contemplate the territory and its interface with people health.
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Urban health in daily practice: livelihood, vulnerability and resilience in Dar es Salaam, Tanzania.
Obrist, Brigit
2003-12-01
Health is the core value and ultimate goal of health development, yet we know very little about health conceptions in everyday life. Inspired by investigations into lay health concepts in Europe, our study explores experiences and meanings of health in a strikingly different context, namely, in a low-income neighbourhood of an African city. Grounded in ethnographic research in Dar es Salaam, we introduce the concept of 'health practice' and examine health definitions, explanations, and activities of urban Swahili women. Our findings show that representations of health form a set of experiences, meanings and embodied practice centring on the links between body, mind, and living conditions. We suggest that 'livelihood', 'vulnerability' and 'resilience' best capture women's main concerns of health practice in such a setting. All women face an emotional burden of being exposed to urban afflictions and an intellectual and practical burden of overcoming them, but some meet this challenge more successfully than others do. This approach tips the balance towards a positive view of health that has been neglected in medical anthropology. It also opens new lines of inquiry in urban health research by consequently following a resource orientation that acknowledges women's struggle to stay healthy and directs attention to their agency.
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Taback, I.
1979-01-01
The discussion of vulnerability begins with a description of some of the electrical characteristics of fibers before definiting how vulnerability calculations are done. The vulnerability results secured to date are presented. The discussion touches on post exposure vulnerability. After a description of some shock hazard work now underway, the discussion leads into a description of the planned effort and some preliminary conclusions are presented.
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The ROE is divided into 5 themes: Air, Water, Land, Human Exposure and Health and Ecological Condition. From these themes, the report indicators address fundamental questions that the ROE attempts to answer. For human health there are 3 questions.
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Rafighi, Elham; Poduval, Shoba; Legido-Quigley, Helena; Howard, Natasha
2016-05-08
Recent British National Health Service (NHS) reforms, in response to austerity and alleged 'health tourism,' could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. A qualitative study design was selected. Data were collected through document review and 22 in-depth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. The experiences of those 'vulnerable migrants' (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access) able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over 'health tourism,' and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP) responsibilities and migrant entitlements. Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs) in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers). Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health. © 2016 by Kerman University of Medical Sciences
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M. Van Der Hulst (Marije); M.W. de Groot (Marjolein); J.P. de Graaf (Hanneke); R. Kok (Rianne); P.J. Prinzie (Peter); A. Burdorf (Alex); L.C.M. Bertens (Loes C.M.); E.A.P. Steegers (Eric)
2018-01-01
markdownabstractIntroduction: Social vulnerability is known to be related to ill health. When a pregnant woman is socially vulnerable, the ill health does not only affect herself, but also the health and development of her (unborn) child. To optimise care for highly vulnerable pregnant women, in
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Hames, Elizabeth; Stoler, Justin; Emrich, Christopher T; Tewary, Sweta; Pandya, Naushira
2017-11-10
We define, map, and analyze geodemographic patterns of socially and medically vulnerable older adults within the tri-county region of South Florida. We apply principal components analysis (PCA) to a set of previously identified indicators of social and medical vulnerability at the census tract level. We create and map age-stratified vulnerability scores using a geographic information system (GIS), and use spatial analysis techniques to identify patterns and interactions between social and medical vulnerability. Key factors contributing to social vulnerability in areas with higher numbers of older adults include age, large household size, and Hispanic ethnicity. Medical vulnerability in these same areas is driven by disease burden, access to emergency cardiac services, availability of nursing home and hospice beds, access to home health care, and available mental health services. Age-dependent areas of social vulnerability emerge in Broward County, whereas age-dependent areas of medical vulnerability emerge in Palm Beach County. Older-adult social and medical vulnerability interact differently throughout the study area. Spatial analysis of older adult social and medical vulnerability using PCA and GIS can help identify age-dependent pockets of vulnerability that are not easily identifiable in a populationwide analysis; improve our understanding of the dynamic spatial organization of health care, health care needs, access to care, and outcomes; and ultimately serve as a tool for health care planning. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Social Vulnerability and Ebola Virus Disease in Rural Liberia.
Directory of Open Access Journals (Sweden)
John A Stanturf
Full Text Available The Ebola virus disease (EVD epidemic that has stricken thousands of people in the three West African countries of Liberia, Sierra Leone, and Guinea highlights the lack of adaptive capacity in post-conflict countries. The scarcity of health services in particular renders these populations vulnerable to multiple interacting stressors including food insecurity, climate change, and the cascading effects of disease epidemics such as EVD. However, the spatial distribution of vulnerable rural populations and the individual stressors contributing to their vulnerability are unknown. We developed a Social Vulnerability Classification using census indicators and mapped it at the district scale for Liberia. According to the Classification, we estimate that districts having the highest social vulnerability lie in the north and west of Liberia in Lofa, Bong, Grand Cape Mount, and Bomi Counties. Three of these counties together with the capital Monrovia and surrounding Montserrado and Margibi counties experienced the highest levels of EVD infections in Liberia. Vulnerability has multiple dimensions and a classification developed from multiple variables provides a more holistic view of vulnerability than single indicators such as food insecurity or scarcity of health care facilities. Few rural Liberians are food secure and many cannot reach a medical clinic in <80 minutes. Our results illustrate how census and household survey data, when displayed spatially at a sub-county level, may help highlight the location of the most vulnerable households and populations. Our results can be used to identify vulnerability hotspots where development strategies and allocation of resources to address the underlying causes of vulnerability in Liberia may be warranted. We demonstrate how social vulnerability index approaches can be applied in the context of disease outbreaks, and our methods are relevant elsewhere.
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A pragmatic analysis of vulnerability in clinical research.
Wendler, David
2017-09-01
Identifying which subjects are vulnerable, and implementing safeguards to protect them, is widely regarded as essential to clinical research. Commentators have endorsed a number of responses to these challenges and have thereby made significant progress in understanding vulnerability in clinical research. At the same time, this literature points to a central contradiction which calls into question its potential to protect vulnerable subjects in practice. Specifically, analysis suggests that all human subjects are vulnerable and vulnerability in clinical research is comparative and context dependent, in the sense that individuals are vulnerable relative to others and in some contexts only. Yet, if everyone is vulnerable, there seems to be no point in citing the vulnerability of some individuals. Moreover, the conclusion that everyone is vulnerable seems inconsistent with the claims that vulnerability is comparative and context dependent, raising concern over whether it will be possible to develop a comprehensive account of vulnerability that is internally consistent. The solution to this dilemma lies in recognition of the fact that the practical significance of claims regarding vulnerability depends on the context in which they are used. The claims that appear to lead to the central contradiction are in fact accurate conclusions that follow from different uses of the term 'vulnerability'. The present manuscript describes this 'pragmatic' approach to vulnerability in clinical research and considers its implications for ensuring that subjects receive appropriate protection. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Chapman, Audrey R
2016-12-15
The UN's Sustainable Development Goals (SDGs), adopted in September 2015, include a comprehensive health goal, "to ensure healthy lives and promote well-being at all ages." The health goal (SDG 3) has nine substantive targets and four additional targets which are identified as a means of implementation. One of these commitments, to achieve universal health coverage (UHC), has been acknowledged as central to the achievement of all of the other health targets. As defined in the SDGs, UHC includes financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. This article evaluates the extent to which the UHC target in the SDGs conforms with the requirements of the right to health enumerated in the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, and other international human rights instruments and interpreted by international human rights bodies. It does so as a means to identify strengths and weaknesses in the framing of the UHC target that are likely to affect its implementation. While UHC as defined in the SDGs overlaps with human rights standards, there are important human rights omissions that will likely weaken the implementation and reduce the potential benefits of the UHC target. The most important of these is the failure to confer priority to providing access to health services to poor and disadvantaged communities in the process of expanding health coverage and in determining which health services to provide. Unless the furthest behind are given priority and strategies adopted to secure their participation in the development of national health plans, the SDGs, like the MDGs, are likely to leave the most disadvantaged and vulnerable communities behind.
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The Mental Vulnerability Questionnaire: a psychometric evaluation
DEFF Research Database (Denmark)
Eplov, Lene Falgaard; Petersen, Janne; Jørgensen, Torben
2010-01-01
The Mental Vulnerability Questionnaire was originally a 22 item scale, later reduced to a 12 item scale. In population studies the 12 item scale has been a significant predictor of health and illness. The scale has not been psychometrically evaluated for more than 30 years, and the aim of the pre......The Mental Vulnerability Questionnaire was originally a 22 item scale, later reduced to a 12 item scale. In population studies the 12 item scale has been a significant predictor of health and illness. The scale has not been psychometrically evaluated for more than 30 years, and the aim...... 0.30 for the 12 and the 22 item scales. All five Mental Vulnerability scales had positively skewed score distributions which were associated significantly with both SCL-90-R symptom scores and NEO-PI-R personality scales (primarily Neuroticism and Extraversion). Coefficient alpha was highest...
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CSIR Research Space (South Africa)
Van Niekerk, Cornelia W
2017-09-01
Full Text Available risk of deaths and injuries by drowning in floods and migration- related health effects. • Increased migration, which can result in human suffering, human rights violations, conflicts and political instability. • Loss of property and livelihoods.... The vulnerability of settlements in southern Africa is impacted by various and complex socio-economic processes related to the cultural, political and institutional contexts and demographic pressure, as well as specific high-risk zones susceptible to flash floods...
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Vulnerability to air pollution: To intervene or not to intervene
CSIR Research Space (South Africa)
John, J
2008-11-01
Full Text Available The Environmental Health Research Group has, amongst other interests, a specific focus on understanding and addressing vulnerability of communities to environmental pollution. No appropriate tools to determine vulnerability to environmental...
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Importance of biometrics to addressing vulnerabilities of the U.S. infrastructure
Arndt, Craig M.; Hall, Nathaniel A.
2004-08-01
Human identification technologies are important threat countermeasures in minimizing select infrastructure vulnerabilities. Properly targeted countermeasures should be selected and integrated into an overall security solution based on disciplined analysis and modeling. Available data on infrastructure value, threat intelligence, and system vulnerabilities are carefully organized, analyzed and modeled. Prior to design and deployment of an effective countermeasure; the proper role and appropriateness of technology in addressing the overall set of vulnerabilities is established. Deployment of biometrics systems, as with other countermeasures, introduces potentially heightened vulnerabilities into the system. Heightened vulnerabilities may arise from both the newly introduced system complexities and an unfocused understanding of the set of vulnerabilities impacted by the new countermeasure. The countermeasure's own inherent vulnerabilities and those introduced by the system's integration with the existing system are analyzed and modeled to determine the overall vulnerability impact. The United States infrastructure is composed of government and private assets. The infrastructure is valued by their potential impact on several components: human physical safety, physical/information replacement/repair cost, potential contribution to future loss (criticality in weapons production), direct productivity output, national macro-economic output/productivity, and information integrity. These components must be considered in determining the overall impact of an infrastructure security breach. Cost/benefit analysis is then incorporated in the security technology deployment decision process. Overall security risks based on system vulnerabilities and threat intelligence determines areas of potential benefit. Biometric countermeasures are often considered when additional security at intended points of entry would minimize vulnerabilities.
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Tripartite Governance: Enabling Successful Implementations with Vulnerable Populations.
Kennedy, Margaret Ann
2016-01-01
Vulnerable populations are often at a distinct disadvantage when it comes to the implementation of health information systems in an equitable, appropriate, and timely manner. The disadvantages experienced by vulnerable populations are innumerable and include lack of representation, lack of appropriate levels of funding, lack of resources and capacity, and lack of representation. Increasingly, models of representation for complex implementations involve a tripartite project governance model. This tripartite partnership distributes accountability across all partners, and ensures that vulnerable populations have an equitable contribution to the direction of implementation according to their needs. This article shares lessons learned and best practices from complex tripartite partnerships supporting implementations with vulnerable populations in Canada.
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Identification and ranking of environmental threats with ecosystem vulnerability distributions.
Zijp, Michiel C; Huijbregts, Mark A J; Schipper, Aafke M; Mulder, Christian; Posthuma, Leo
2017-01-01
Responses of ecosystems to human-induced stress vary in space and time, because both stressors and ecosystem vulnerabilities vary in space and time. Presently, ecosystem impact assessments mainly take into account variation in stressors, without considering variation in ecosystem vulnerability. We
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Mathiesen, Anne Sophie; Thomsen, Thordis; Jensen, Tonny; Schiøtz, Charlotte; Langberg, Henning; Egerod, Ingrid
2017-09-01
Digital interventions for improving diabetes management in Type 2 diabetes mellitus (T2DM) are used universally. Digital interventions are defined as any intervention accessed and taking input from people with T2DM in the form of a web-based or mobile phone-based app to improve diabetes self-management. However, the current confidence in digital interventions threatens to augment social inequalities in health, also known as the "digital divide". To counteract dissemination of the digital divide, we aimed to assess the potential of a tailored digital intervention for improving diabetes management in vulnerable people with T2DM. A qualitative design using semi-structured in-depth interviews to explore the perspectives of 12 vulnerable people with T2DM. Interviews were analyzed using inductive content analysis. Vulnerability was defined by the presence of one or more comorbidities, one or more lifestyle risk factors, poor diabetes management, low educational level and low health literacy. The main themes identified were: "Dealing with diabetes distress" characterized by psychological avoidance mechanisms; "Suffering informational confusion" dealing with inconsistent information; "Experiencing digital alienation" dealing with loss of freedom when technology invades the private sphere; and "Missing the human touch" preferring human interaction over digital contact. Vulnerable people with T2DM are unprepared for digital interventions for disease management. Experiencing diabetes distress may be an intermediate mechanism leading to nonadherence to digital interventions and the preference for human interaction in vulnerable people with T2DM. Future interventions could include a designated caregiver and an allocated buddy to provide support and assist uptake of digital interventions for diabetes management.
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Global analysis of urban surface water supply vulnerability
International Nuclear Information System (INIS)
Padowski, Julie C; Gorelick, Steven M
2014-01-01
This study presents a global analysis of urban water supply vulnerability in 71 surface-water supplied cities, with populations exceeding 750 000 and lacking source water diversity. Vulnerability represents the failure of an urban supply-basin to simultaneously meet demands from human, environmental and agricultural users. We assess a baseline (2010) condition and a future scenario (2040) that considers increased demand from urban population growth and projected agricultural demand. We do not account for climate change, which can potentially exacerbate or reduce urban supply vulnerability. In 2010, 35% of large cities are vulnerable as they compete with agricultural users. By 2040, without additional measures 45% of cities are vulnerable due to increased agricultural and urban demands. Of the vulnerable cities in 2040, the majority are river-supplied with mean flows so low (1200 liters per person per day, l/p/d) that the cities experience ‘chronic water scarcity’ (1370 l/p/d). Reservoirs supply the majority of cities facing individual future threats, revealing that constructed storage potentially provides tenuous water security. In 2040, of the 32 vulnerable cities, 14 would reduce their vulnerability via reallocating water by reducing environmental flows, and 16 would similarly benefit by transferring water from irrigated agriculture. Approximately half remain vulnerable under either potential remedy. (letter)
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[The Helsinki Declaration: relativism and vulnerability].
Diniz, D; Corrêa, M
2001-01-01
The Helsinki Declaration is a crucial ethical landmark for clinical research involving human beings. Since the Declaration was issued, a series of revisions and modifications have been introduced into the original text, but they have not altered its humanist approach or its international force for regulating clinical research. A proposal for an extensive revision of the Declaration's underlying ethical principles has been debated for the past four years. If the proposal is approved, international clinical research involving human beings will be modified, further increasing the vulnerability of certain social groups. This article discusses the historical process involved in passing the Helsinki Declaration and the most recent debate on the new draft. The article analyzes the new text's social implications for underdeveloped countries, arguing for a political approach to the vulnerability concept.
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Does Aquaculture Support the Needs of Nutritionally Vulnerable Nations?
Directory of Open Access Journals (Sweden)
Christopher D. Golden
2017-05-01
Full Text Available Aquaculture now supplies half of the fish consumed directly by humans. We evaluate whether aquaculture, given current patterns of production and distribution, supports the needs of poor and food-insecure populations throughout the world. We begin by identifying 41 seafood-reliant nutritionally vulnerable nations (NVNs, and ask whether aquaculture meets human nutritional demand directly via domestic production or trade, or indirectly via purchase of nutritionally rich dietary substitutes. We find that a limited number of NVNs have domestically farmed seafood, and of those, only specific aquaculture approaches (e.g., freshwater in some locations have the potential to benefit nutritionally vulnerable populations. While assessment of aquaculture's direct contribution via trade is constrained by data limitations, we find that it is unlikely to contribute substantially to human nutrition in vulnerable groups, as most exported aquaculture consists of high-value species for international markets. We also determine that subpopulations who benefit from aquaculture profits are likely not the same subpopulations who are nutritionally vulnerable, and more research is needed to understand the impacts of aquaculture income gains. Finally, we discuss the relationship of aquaculture to existing trends in capture fisheries in NVNs, and suggest strategies to create lasting solutions to nutritional security, without exacerbating existing challenges in access to food and land resources.
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The detrimental effects of lead on human and animal health
Directory of Open Access Journals (Sweden)
Mohammed Abdulrazzaq Assi
2016-06-01
Full Text Available Lead, a chemical element in the carbon group with symbol Pb (from Latin: Plumbum, meaning “the liquid silver” and has an atomic number 82 in the periodic table. It was the first element that was characterized by its kind of toxicity. In animal systems, lead (Pb has been incriminated in a wide spectrum of toxic effects and it is considered one of the persistent ubiquitous heavy metals. Being exposed to this metal could lead to the change of testicular functions in human beings as well as in the wildlife. The lead poising is a real threat to the public health, especially in the developing countries. Accordingly, great efforts on the part of the occupational and public health have been taken to curb the dangers of this metal. Hematopoietic, renal, reproductive, and central nervous system are among the parts of the human body and systems that are vulnerable toward the dangers following exposure to high level of Pb. In this review, we discussed the massive harmful impact that leads acetate toxicity has on the animals and the worrying fact that this harmful toxicant can be found quite easily in the environment and abundance. Highlighting its (Pb effects on various organs in the biological systems, its economic, as well as scientific importance, with the view to educate the public/professionals who work in this area. In this study, we focus on the current studies and research related to lead toxicity in animals and also to a certain extent toward human as well.
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How Health Humanities Will Save the Life of the Humanities.
Klugman, Craig M
2017-12-01
In the last decade, the humanities have been shrinking in number of students, percent of faculty, and in number of degrees awarded. Humanities students also earn lower salaries than their STEM-prepared peers. At the same time, the health humanities have been in ascendance over the last fifteen years. The number of majors, minors and certificates has increased 266% in that time frame, attracting large numbers of students and preparing future patients, lay caregivers, and health care providers to interact with a complicated and dehumanized medical system. In 1982, British philosopher and educator Stephen Toulmin declared that medicine saved philosophy from irrelevance and possibly extinction. I propose that the health humanities can serve a similar function to stave off the decline of the broader humanities. The health humanities can (1) model an applied approach for the broader humanities to attract student interest; (2) develop students' capacity for critical reading, writing and reflection about health and medicine in society, practice, and their own lives and (3) inoculate all students against the influence of medicine, whether through preparing pre-health students to navigate the hidden medical curriculum or preparing future patients to navigate the health care system.
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(Public) Health and Human Rights in Practice.
Annas, George J; Mariner, Wendy K
2016-02-01
Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing. Copyright © 2016 by Duke University Press.
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Directory of Open Access Journals (Sweden)
Elham Rafighi
2016-10-01
Full Text Available Background: Recent British National Health Service (NHS reforms, in response to austerity and alleged ‘health tourism,’ could impose additional barriers to healthcare access for non-European Economic Area (EEA migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. Methods: A qualitative study design was selected. Data were collected through document review and 22 indepth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. Results: The experiences of those ‘vulnerable migrants’ (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over ‘health tourism,’ and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP responsibilities and migrant entitlements. Conclusion: Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers. Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health.
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Muniyandi, M; Rao, V G; Bhat, J; Yadav, R; Sharma, R K; Bhondeley, M K
2015-05-01
Health literacy on tuberculosis (TB) is an understanding about TB to perform activities with regard to prevention, diagnosis and treatment. We undertook a study to assess the health literacy on TB among one of the vulnerable tribal groups (Saharia) in central India. In this cross-sectional study, 2721 individuals aged >15 yr from two districts of Madhya Pradesh State of India were interviewed at their residence during December 2012-July 2013. By using a short-form questionnaire, health literacy on cause, symptoms, mode of transmission, diagnosis, treatment and prevention of TB was assessed. Of the 2721 (Gwalior 1381; Shivpuri 1340) individuals interviewed; 76 per cent were aged literacy rate was 19 per cent, and 22 per cent had >7 members in a house. Of the 2721 respondents participated, 52 per cent had never heard of TB; among them 8 per cent mentioned cough as a symptom, 64 per cent mentioned coughing up blood, and 91 per cent knew that TB diagnosis, and treatment facilities were available in both government and private hospitals. Health literacy score among participants who had heard of TB was 60 per cent among 8 per cent of respondents. The finding that nearly half of the respondents had not heard of TB indicated an important gap in education regarding TB in this vulnerable population. There is an urgent need to implement targeted interventions to educate this group for better TB control.
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Coastal Vulnerability to Erosion Processes: Study Cases from Different Countries
Anfuso, Giorgio; Martinez Del Pozo, Jose Angel; Rangel-Buitrago, Nelson
2010-05-01
When natural processes affect or threaten human activities or infrastructures they become a natural hazard. In order to prevent the natural hazards impact and the associated economic and human losses, coastal managers need to know the intrinsic vulnerability of the littoral, using information on the physical and ecological coastal features, human occupation and present and future shoreline trends. The prediction of future coastline positions can be based on the study of coastal changes which have occurred over recent decades. Vertical aerial photographs, satellite imagery and maps are very useful data sources for the reconstruction of coast line changes at long (>60 years) and medium (between 60 and 10 years) temporal and spatial scales. Vulnerability maps have been obtained for several coastal sectors around the world through the use of Geographical Information Systems (GIS), computer-assisted multivariate analysis and numerical models. In the USA, "Flood Insurance Rate Maps" have been created by the government and "Coastal Zone Hazard Maps" have been prepared for coastal stretches affected by hurricane Hugo. In Spain, the vulnerability of the Ebro and an Andalusia coastal sector were investigated over different time scales. McLaughlin et al., (2002) developed a GIS based coastal vulnerability index for the Northern Ireland littoral that took into account socio-economic activities and coastal resistance to erosion and energetic characteristics. Lizárraga et al., (2001) combined beach reduction at Rosario (Mexico) with the probability of damage to landward structures, obtaining a vulnerability matrix. In this work several coastal vulnerability maps have also been created by comparing data on coastal erosion/accretion and land use along different coastal sectors in Italy, Morocco and Colombia. Keywords: Hazard, Vulnerability, Coastal Erosion, Italy, Morocco, Colombia.
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Lucan, Sean C; Maroko, Andrew R; Sanon, Omar C; Schechter, Clyde B
2017-04-01
Unhealthful food-and-beverage advertising often targets vulnerable groups. The extent of such advertising in subway stations has not been reported and it is not clear how ad placement may relate to subway ridership or community demographics, or what the implications might be for diets and diet-related health in surrounding communities. Riding all subway lines (n = 7) in the Bronx, NY, USA, investigators systematically assessed all print ads (n = 1586) in all stations (n = 68) in 2012. Data about subway ridership came from the Metropolitan Transportation Authority. Demographic data on surrounding residential areas came from the U.S. Census Bureau. Data on dietary intake and diet-related conditions came from a city health-department survey. There were no ads promoting "more-healthful" food-or-beverage items (i.e., fruits, vegetables, whole grains, nuts, water or milk). There were many ads for "less-healthful" items (e.g., candies, chips, sugary cereals, frozen pizzas, "energy" drinks, coffee confections, hard alcohol, and beer). Ad placement did not relate to the number of riders entering at stations. Instead, exposure to food-or-beverage ads generally, and to "less-healthful" ads particularly (specifically ads in Spanish, directed at youth, and/or featuring minorities), was directly correlated with poverty, lower high-school graduation rates, higher percentages of Hispanics, and/or higher percentages of children in surrounding residential areas. Correlations were robust to sensitivity analyses. Additional analyses suggested correlations between ad exposures and sugary-drink consumption, fruit-and-vegetable intake, and diabetes, hypertension, and high-cholesterol rates. Subway-station ads for "less-healthful" items were located disproportionately in areas home to vulnerable populations facing diet and diet-related-health challenges. The fact that uneven ad placement did not relate to total rider counts suggests ads were not directed at the largest
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Associations Between Social Vulnerabilities and Psychosocial Problems in European Children
DEFF Research Database (Denmark)
Iguacel, Isabel; Michels, Nathalie; Fernández-Alvira, Juan M.
2017-01-01
The effect of socioeconomic inequalities on children’s mental health remains unclear. This study aims to explore the cross-sectional and longitudinal associations between social vulnerabilities and psychosocial problems, and the association between accumulation of vulnerabilities and psychosocial...
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Climate change and marine fisheries: Least developed countries top global index of vulnerability.
Blasiak, Robert; Spijkers, Jessica; Tokunaga, Kanae; Pittman, Jeremy; Yagi, Nobuyuki; Österblom, Henrik
2017-01-01
Future impacts of climate change on marine fisheries have the potential to negatively influence a wide range of socio-economic factors, including food security, livelihoods and public health, and even to reshape development trajectories and spark transboundary conflict. Yet there is considerable variability in the vulnerability of countries around the world to these effects. We calculate a vulnerability index of 147 countries by drawing on the most recent data related to the impacts of climate change on marine fisheries. Building on the Intergovernmental Panel on Climate Change framework for vulnerability, we first construct aggregate indices for exposure, sensitivity and adaptive capacity using 12 primary variables. Seven out of the ten most vulnerable countries on the resulting index are Small Island Developing States, and the top quartile of the index includes countries located in Africa (17), Asia (7), North America and the Caribbean (4) and Oceania (8). More than 87% of least developed countries are found within the top half of the vulnerability index, while the bottom half includes all but one of the Organization for Economic Co-operation and Development member states. This is primarily due to the tremendous variation in countries' adaptive capacity, as no such trends are evident from the exposure or sensitivity indices. A negative correlation exists between vulnerability and per capita carbon emissions, and the clustering of states at different levels of development across the vulnerability index suggests growing barriers to meeting global commitments to reducing inequality, promoting human well-being and ensuring sustainable cities and communities. The index provides a useful tool for prioritizing the allocation of climate finance, as well as activities aimed at capacity building and the transfer of marine technology.
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Hippocampal developmental vulnerability to methylmercury extends into prepubescence
Directory of Open Access Journals (Sweden)
Maryann eObiorah
2015-05-01
Full Text Available The developing brain is sensitive to environmental toxicants such as methylmercury (MeHg, to which humans are exposed via contaminated seafood. Prenatal exposure in children is associated with learning, memory and IQ deficits, which can result from hippocampal dysfunction. To explore underlying mechanisms, we have used the postnatal day (P7 rat to model the third trimester of human gestation. We previously showed that a single low exposure (0.6 µg/gbw that approaches human exposure reduced hippocampal neurogenesis in the dentate gyrus (DG 24 hours later, including later proliferation and memory in adolescence. Yet, the vulnerable stem cell population and period of developmental vulnerability remain undefined. In this study, we find that P7 exposure of stem cells has long-term consequences for adolescent neurogenesis. It reduced the number of mitotic S-phase cells (BrdU, especially those in the highly proliferative Tbr2+ population, and immature neurons (Doublecortin in adolescence, suggesting partial depletion of the later stem cell pool. To define developmental vulnerability to MeHg in prepubescent (P14 and adolescent (P21 rats, we examined acute 24 h effects of MeHg exposure on mitosis and apoptosis. We found that low exposure did not adversely impact neurogenesis at either age, but that a higher exposure (5 µg/gbw at P14 reduced the total number of neural stem cells (Sox2+ by 23% and BrdU+ cells by 26% in the DG hilus, suggesting that vulnerability diminishes with age. To see if these effects may reflect changes in MeHg transfer across the blood brain barrier, we assessed Hg content in the hippocampus after peripheral injection and found that similar levels (~800 ng/gm were obtained at 24 h at both P14 and P21, declining in parallel, suggesting that changes in vulnerability depend more on local tissue and cellular mechanisms. Together, we show that MeHg vulnerability depends on age, and that early exposure impairs later neurogenesis in
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Ross, Claire; Dimitrova, Stoyanka; Howard, Louise M; Dewey, Michael; Zimmerman, Cathy; Oram, Siân
2015-01-01
Objectives (1) To estimate the proportion of National Health Service (NHS) professionals who have come into contact with trafficked people and (2) to measure NHS professionals’ knowledge and confidence to respond to human trafficking. Design A cross-sectional survey. Setting Face-to-face mandatory child protection and/or vulnerable adults training sessions at 10 secondary healthcare provider organisations in England, and meetings of the UK College of Emergency Medicine. Participants 782/892 (84.4%) NHS professionals participated, including from emergency medicine, maternity, mental health, paediatrics and other clinical disciplines. Measures Self-completed questionnaire developed by an expert panel. Questionnaire asks about prior training and contact with potential victims of trafficking, perceived and actual human trafficking knowledge, confidence in responding to human trafficking, and interest in future human trafficking training. Results 13% participants reported previous contact with a patient they knew or suspected of having been trafficked; among maternity services professionals this was 20.4%. However, 86.8% (n=679) reported lacking knowledge of what questions to ask to identify potential victims and 78.3% (n=613) reported that they had insufficient training to assist trafficked people. 71% (n=556), 67.5% (n=528) and 53.4% (n=418) lacked confidence in making appropriate referrals for men, women and children, respectively, who had been trafficked. 95.3% (n=746) of respondents were unaware of the scale of human trafficking in the UK, and 76.5% (n=598) were unaware that calling the police could put patients in more danger. Psychometric analysis showed that subscales measuring perceived knowledge, actual knowledge and confidence to respond to human trafficking demonstrated good internal consistency (Cronbach's αs 0.93, 0.63 and 0.64, respectively) and internal correlations. Conclusions NHS professionals working in secondary care are in contact with potential
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Vulnerability of Coastal Communities from Storm Surge and Flood Disasters
Bathi, Jejal Reddy; Das, Himangshu S.
2016-01-01
Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters. PMID:26907313
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Losing ground, losing sleep: Local economic conditions, economic vulnerability, and sleep.
Perales, Francisco; Plage, Stefanie
2017-02-01
Medical research shows that healthy sleep has benefits for human wellbeing. We contribute to the emerging social-epidemiological literature on the social determinants of sleep by considering how living in an area with poor economic circumstances can result in sleep loss through financial worry, uncertainty and stress. We use multilevel regression models and nationally-representative data from the Household, Income and Labour Dynamics in Australia Survey (n = 9181) and find that individuals who live in areas with high unemployment rates or experience individual-level economic vulnerability sleep less than comparable individuals in areas with low unemployment rates, or who do not experience financial hardships. The negative association between local economic conditions and sleep duration is substantially stronger amongst economically vulnerable individuals. This highlights the importance of considering multiple levels in the analysis of health inequalities, as status and location can intersect to produce and reproduce disadvantage systems. Copyright © 2016 Elsevier Inc. All rights reserved.
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Chuah, Joon Hao; Lok, Benjamin; Black, Erik
2013-04-01
Health sciences students often practice and are evaluated on interview and exam skills by working with standardized patients (people that role play having a disease or condition). However, standardized patients do not exist for certain vulnerable populations such as children and the intellectually disabled. As a result, students receive little to no exposure to vulnerable populations before becoming working professionals. To address this problem and thereby increase exposure to vulnerable populations, we propose using virtual humans to simulate members of vulnerable populations. We created a mixed reality pediatric patient that allowed students to practice pediatric developmental exams. Practicing several exams is necessary for students to understand how to properly interact with and correctly assess a variety of children. Practice also increases a student's confidence in performing the exam. Effective practice requires students to treat the virtual child realistically. Treating the child realistically might be affected by how the student and virtual child physically interact, so we created two object interaction interfaces - a natural interface and a mouse-based interface. We tested the complete mixed reality exam and also compared the two object interaction interfaces in a within-subjects user study with 22 participants. Our results showed that the participants accepted the virtual child as a child and treated it realistically. Participants also preferred the natural interface, but the interface did not affect how realistically participants treated the virtual child.
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Nutrition, health and human rights.
Brundtland, G H
1999-07-01
This paper presents the speech delivered by Gro Harlem Brundtland, Director-General of WHO, on issues related to nutrition from a health and a human rights perspective. According to Brundtland, nutrition is a universal factor that both affects and defines the health of all people. It affects not only growth and physical development of a child, but also his cognitive and social development. However, inequity, poverty, underdevelopment, as well as inadequate access to food, health and care still exist which have resulted to the deaths of millions of children and left many more suffering from diseases. Poverty has also been identified as the main obstacle to the attainment of health. The existence of structural poverty and ill health eventually leads to poor development, which includes poor nutrition, poor health, and poor human rights. The impact of poverty on health is further worsened by discrimination on the basis of race, color, sex, language, or religion. To address this issue, the WHO will renew their focus on the political and legal links between health and human rights. A human rights perspective provides the international community with an opportunity to support the development of public health policies and practices that promote healthy nutrition as a center of all social and economic development.
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Vulnerability-attention analysis for space-related activities
Ford, Donnie; Hays, Dan; Lee, Sung Yong; Wolfsberger, John
1988-01-01
Techniques for representing and analyzing trouble spots in structures and processes are discussed. Identification of vulnerable areas usually depends more on particular and often detailed knowledge than on algorithmic or mathematical procedures. In some cases, machine inference can facilitate the identification. The analysis scheme proposed first establishes the geometry of the process, then marks areas that are conditionally vulnerable. This provides a basis for advice on the kinds of human attention or machine sensing and control that can make the risks tolerable.
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Realization of the international human right to health in an economically integrated North America.
Kinney, Eleanor D
2009-01-01
With the North American Free Trade Agreement (NAFTA), the health care sectors of the United States, Canada, and Mexico are becoming more economically integrated. NAFTA poses major challenges to the realization of the international human right. These include: (1) Cross Border Trade in Medical Products, (2) Cross Border Trade in Medical Services, and the attendant investment protections, (3) Portability and Comparability of Health Insurance Coverage, and (4) Protection of Public Health Insurance Programs. The United States, Mexico, and Canada all provide public health insurance programs either to the entire population as in Canada or to vulnerable groups as in the United States. In none of these countries have private, for-profit providers and insurers been able to provide universal and affordable health coverage and care in a truly free market. Private insurers and for-profit providers should not profit from the care of the healthy and wealthy in ways that compromise the public programs that serve the poor and seriously ill. Nor should they be allowed to use NAFTA processes to compromise public programs. Policy makers must consider implications of NAFTA and move toward assuring access to affordable health care for all people on the North American continent.
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Trust, Endangerment and Divine Vulnerability
DEFF Research Database (Denmark)
Christoffersen, Mikkel Gabriel
2017-01-01
Faith is trusting God in the midst of endangerment. Yet, human experience of excessive suffering has challenged any spontaneous trust in God. In this article, I reconsider the idea of faith as trust in God, adding an emphasis on the divine vulnerability in the incarnation, and I develop a more...
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Directory of Open Access Journals (Sweden)
Amy B. Martin
2012-09-01
Full Text Available Disasters serve as shocks and precipitate unanticipated disturbances to the health care system. Public health surveillance is generally focused on monitoring latent health and environmental exposure effects, rather than health system performance in response to these local shocks. The following intervention study sought to determine the long-term effects of the 2005 chlorine spill in Graniteville, South Carolina on primary care access for vulnerable populations. We used an interrupted time-series approach to model monthly visits for Ambulatory Care Sensitive Conditions, an indicator of unmet primary care need, to quantify the impact of the disaster on unmet primary care need in Medicaid beneficiaries. The results showed Medicaid beneficiaries in the directly impacted service area experienced improved access to primary care in the 24 months post-disaster. We provide evidence that a health system serving the medically underserved can prove resilient and display improved adaptive capacity under adverse circumstances (i.e., technological disasters to ensure access to primary care for vulnerable sub-groups. The results suggests a new application for ambulatory care sensitive conditions as a population-based metric to advance anecdotal evidence of secondary surge and evaluate pre- and post-health system surge capacity following a disaster.
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The vulnerabilities in childhood and adolescence and the Brazilian public policy intervention.
Fonseca, Franciele Fagundes; Sena, Ramony Kris R; dos Santos, Rocky Lane A; Dias, Orlene Veloso; Costa, Simone de Melo
2013-06-01
To review and discuss childhood and adolescence vulnerabilities, as well as Brazilian public policies of intervention. A narrative review was performed, considering studies published between 1990 and 2012, found in the Virtual Health Library databases (Biblioteca Virtual em Saúde - BVS). A combination of the following descriptors was used in the search strategy: "Adolescent Health", "Child Health", "Health Public Politics" and "Vulnerability". In addition, Brazilian official documents, the Statute of the Child and the Adolescent, Guardianship Council, Bolsa Família and Saúde na Escola Programs were evaluated. The results were divided into five categories of analysis: Vulnerability of Children and Adolescents in Brazil, Public Politics of Intervention to Risk Factors in Childhood and Adolescence, the Statute of the Child and the Adolescent and Guardianship Council, Bolsa Família Program and Saúde na Escola Program. The studies show that children and adolescents are vulnerable to environmental and social situations. Vulnerabilities are exhibited in daily violence within families and schools, which results in the premature entrance of children and adolescents in the work environment and/or in the drug traffic. To deal with these problems, the Brazilian Government established the Statute of the Child and the Adolescent as well as social programs. Literature exposes the risks experienced by children and adolescents in Brazil. In the other hand, a Government endeavor was identified to eliminate or minimize the suffering of those in vulnerable situations through public policies targeted to this population group.
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Exploring the Sports Experiences of Socially Vulnerable Youth
Directory of Open Access Journals (Sweden)
Sabina Super
2017-06-01
Full Text Available Sports participation is considered beneficial for the development of socially vulnerable youth, not only in terms of physical health but also in terms of cognitive, social and emotional health. Despite the strong belief that sports clubs offer a setting for positive youth development, there is limited knowledge about how socially vulnerable youths experience their participation in these clubs. Interviews were conducted with 22 socially vulnerable youths that play a sport at a local sports club. An inductive content analysis was conducted and three themes were discovered that are included in the positive and negative sports experiences: the extent to which the youths experienced visibility of their skills, the extent to which the youths felt confident while playing their sport, and the extent to which the youths felt that sport was a challenge they liked to take on. More importantly, there was a fragile balance within each of the themes and the sports coaches played an important role in installing and maintaining a supportive environment in which the youths could have meaningful, consistent and balanced sports experiences. It is not self-evident that for socially vulnerable youth sports experiences are positive and supporting.
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One health: The interface between veterinary and human health
Directory of Open Access Journals (Sweden)
Kshitiz Shrestha
2018-01-01
Full Text Available One Health is an emerging global key concept integrating human and animal health through international research and policy. The complex relationships between the human and animal have resulted in a human-animal-environment interface since prehistorical times. The people, animals, plants, and the environment are so intrinsically linked that prevention of risks and the mitigation of effects of crises that originate at the interface between humans, animals, and their environments can only improve health and wellbeing. The “One Health” approach has been successfully implemented in numerous projects around the world. The containment of pandemic threats such as avian influenza and severe acute respiratory syndrome within months of outbreak are few examples of successful applications of the One Health paradigm. The paper begins with a brief overview of the human-animal interface and continues with the socio-economic and public health impact caused by various zoonotic diseases such as Middle East respiratory syndrome, Influenza, and Ebola virus. This is followed by the role of “One Health” to deal the global problem by the global solution. It emphasizes the interdisciplinary collaboration, training for health professionals and institutional support to minimize global health threats due to infectious diseases. The broad definition of the concept is supposed to lead multiple interpretations that impede the effective implementation of One Health approach within veterinary profession, within the medical profession, by wildlife specialists and by environmentalists, while on the other side, it gives a value of interdisciplinary collaboration for reducing threats in human-animal-environment interface.
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Health Care Access for Migrant Domestic Workers (Philippines ...
International Development Research Centre (IDRC) Digital Library (Canada)
This translates into an absence of protection and recognition of human rights, including access to health services. Migrant workers are exposed to conditions of vulnerability throughout the migration cycle and often endure abuse, exploitation, violence, discrimination, work-related accidents and injuries, mental health ...
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Influence resistance on human health
Abdul Harits, M.; Bahtiar, Yusuf; Achdan, M. Syahdani; Sunarno, .
2010-05-01
Health is an important part of human life. Every person in this world want healthy body, in other words free of any disease. When seeing the pattern of human life today is high activity, always eat instant foods and lack of exercise makes a very bad human health from year to year. Therefore, there is need for the health revolution that can keep human health in order to remain in the condition is always healthy. Eat healthy foods four plus five perfect diligent exercise is the real solution to maintain health. In addition also advisable to always check each month to the doctor so that our health can be controlled. Most people underestimate it, especially the routine checks once a month to the doctor, therefore I created a simple research that aims to get people to mengonytrol health at any time without having to check into the doctor. By utilizing the resistance in the human body's health so we can be controlled. By using a simple tool to measure human resistance by using the concept of the bridge. Bridge circuit used to convert impedance variations into voltage variations. One advantage of this circuit is the voltage produced can vary around 0. This means strengthening can be used to raise the voltage level so as sensitivity to variations in impedance also increases. Another application is the impedance measurement accuracy. The bridge is the simplest and most widely used is the Wheatstone bridge circuit. This circuit is used for signal conditioning applications where a sensor can change the resistance value when the process variable is changed.
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NASA Human Health and Performance Strategy
Davis, Jeffrey R.
2012-01-01
In May 2007, what was then the Space Life Sciences Directorate, issued the 2007 Space Life Sciences Strategy for Human Space Exploration. In January 2012, leadership and key directorate personnel were once again brought together to assess the current and expected future environment against its 2007 Strategy and the Agency and Johnson Space Center goals and strategies. The result was a refined vision and mission, and revised goals, objectives, and strategies. One of the first changes implemented was to rename the directorate from Space Life Sciences to Human Health and Performance to better reflect our vision and mission. The most significant change in the directorate from 2007 to the present is the integration of the Human Research Program and Crew Health and Safety activities. Subsequently, the Human Health and Performance Directorate underwent a reorganization to achieve enhanced integration of research and development with operations to better support human spaceflight and International Space Station utilization. These changes also enable a more effective and efficient approach to human system risk mitigation. Since 2007, we have also made significant advances in external collaboration and implementation of new business models within the directorate and the Agency, and through two newly established virtual centers, the NASA Human Health and Performance Center and the Center of Excellence for Collaborative Innovation. Our 2012 Strategy builds upon these successes to address the Agency's increased emphasis on societal relevance and being a leader in research and development and innovative business and communications practices. The 2012 Human Health and Performance Vision is to lead the world in human health and performance innovations for life in space and on Earth. Our mission is to enable optimization of human health and performance throughout all phases of spaceflight. All HH&P functions are ultimately aimed at achieving this mission. Our activities enable
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... and Research Centers Beaches Contact Us Share LEARN: Human Health at the Beach Swimming at beaches with pollution ... water pollution, there are other potential threats to human health at the beach to be aware of. The ...
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Climate Change Vulnerability and Resilience: Current Status and Trends for Mexico
Energy Technology Data Exchange (ETDEWEB)
Ibarraran , Maria E.; Malone, Elizabeth L.; Brenkert, Antoinette L.
2008-12-30
Climate change alters different localities on the planet in different ways. The impact on each region depends mainly on the degree of vulnerability that natural ecosystems and human-made infrastructure have to changes in climate and extreme meteorological events, as well as on the coping and adaptation capacity towards new environmental conditions. This study assesses the current resilience of Mexico and Mexican states to such changes, as well as how this resilience will look in the future. In recent studies (Moss et al. 2000, Brenkert and Malone 2005, Malone and Brenket 2008, Ibarrarán et al. 2007), the Vulnerability-Resilience Indicators Model (VRIM) is used to integrate a set of proxy variables that determine the resilience of a region to climate change. Resilience, or the ability of a region to respond to climate variations and natural events that result from climate change, is given by its adaptation and coping capacity and its sensitivity. On the one hand, the sensitivity of a region to climate change is assessed, emphasizing its infrastructure, food security, water resources, and the health of the population and regional ecosystems. On the other hand, coping and adaptation capacity is based on the availability of human resources, economic capacity and environmental capacity.
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Naudí, Alba; Cabré, Rosanna; Dominguez-Gonzalez, Mayelin; Ayala, Victoria; Jové, Mariona; Mota-Martorell, Natalia; Piñol-Ripoll, Gerard; Gil-Villar, Maria Pilar; Rué, Montserrat; Portero-Otín, Manuel; Ferrer, Isidre; Pamplona, Reinald
2017-05-01
Lipids played a determinant role in the evolution of the brain. It is postulated that the morphological and functional diversity among neural cells of the human central nervous system (CNS) is projected and achieved through the expression of particular lipid profiles. The present study was designed to evaluate the differential vulnerability to oxidative stress mediated by lipids through a cross-regional comparative approach. To this end, we compared 12 different regions of CNS of healthy adult subjects, and the fatty acid profile and vulnerability to lipid peroxidation, were determined by gas chromatography (GC) and gas chromatography/mass spectrometry (GC/MS), respectively. In addition, different components involved in PUFA biosynthesis, as well as adaptive defense mechanisms against lipid peroxidation, were also measured by western blot and immunohistochemistry, respectively. We found that: i) four fatty acids (18.1n-9, 22:6n-3, 20:1n-9, and 18:0) are significant discriminators among CNS regions; ii) these differential fatty acid profiles generate a differential selective neural vulnerability (expressed by the peroxidizability index); iii) the cross-regional differences for the fatty acid profiles follow a caudal-cranial gradient which is directly related to changes in the biosynthesis pathways which can be ascribed to neuronal cells; and iv) the higher the peroxidizability index for a given human brain region, the lower concentration of the protein damage markers, likely supported by the presence of adaptive antioxidant mechanisms. In conclusion, our results suggest that there is a region-specific vulnerability to lipid peroxidation and offer evidence of neuronal mechanisms for polyunsaturated fatty acid biosynthesis in the human central nervous system. Copyright © 2017 Elsevier B.V. All rights reserved.
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Directory of Open Access Journals (Sweden)
Diego Montenegro
Full Text Available BACKGROUND Chagas disease (CD, caused by the protozoan Trypanosoma cruzi, is a neglected human disease. It is endemic to the Americas and is estimated to have an economic impact, including lost productivity and disability, of 7 billion dollars per year on average. OBJECTIVES To assess vulnerability to vector-borne transmission of T. cruzi in domiciliary environments within an area undergoing domiciliary vector interruption of T. cruzi in Colombia. METHODS Multi-criteria decision analysis [preference ranking method for enrichment evaluation (PROMETHEE and geometrical analysis for interactive assistance (GAIA methods] and spatial statistics were performed on data from a socio-environmental questionnaire and an entomological survey. In the construction of multi-criteria descriptors, decision-making processes and indicators of five determinants of the CD vector pathway were summarily defined, including: (1 house indicator (HI; (2 triatominae indicator (TI; (3 host/reservoir indicator (Ho/RoI; (4 ecotope indicator (EI; and (5 socio-cultural indicator (S-CI. FINDINGS Determination of vulnerability to CD is mostly influenced by TI, with 44.96% of the total weight in the model, while the lowest contribution was from S-CI, with 7.15%. The five indicators comprise 17 indices, and include 78 of the original 104 priority criteria and variables. The PROMETHEE and GAIA methods proved very efficient for prioritisation and quantitative categorisation of socio-environmental determinants and for better determining which criteria should be considered for interrupting the man-T. cruzi-vector relationship in endemic areas of the Americas. Through the analysis of spatial autocorrelation it is clear that there is a spatial dependence in establishing categories of vulnerability, therefore, the effect of neighbors’ setting (border areas on local values should be incorporated into disease management for establishing programs of surveillance and control of CD via vector
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Montenegro, Diego; Cunha, Ana Paula da; Ladeia-Andrade, Simone; Vera, Mauricio; Pedroso, Marcel; Junqueira, Angela
2017-10-01
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is a neglected human disease. It is endemic to the Americas and is estimated to have an economic impact, including lost productivity and disability, of 7 billion dollars per year on average. To assess vulnerability to vector-borne transmission of T. cruzi in domiciliary environments within an area undergoing domiciliary vector interruption of T. cruzi in Colombia. Multi-criteria decision analysis [preference ranking method for enrichment evaluation (PROMETHEE) and geometrical analysis for interactive assistance (GAIA) methods] and spatial statistics were performed on data from a socio-environmental questionnaire and an entomological survey. In the construction of multi-criteria descriptors, decision-making processes and indicators of five determinants of the CD vector pathway were summarily defined, including: (1) house indicator (HI); (2) triatominae indicator (TI); (3) host/reservoir indicator (Ho/RoI); (4) ecotope indicator (EI); and (5) socio-cultural indicator (S-CI). Determination of vulnerability to CD is mostly influenced by TI, with 44.96% of the total weight in the model, while the lowest contribution was from S-CI, with 7.15%. The five indicators comprise 17 indices, and include 78 of the original 104 priority criteria and variables. The PROMETHEE and GAIA methods proved very efficient for prioritisation and quantitative categorisation of socio-environmental determinants and for better determining which criteria should be considered for interrupting the man-T. cruzi-vector relationship in endemic areas of the Americas. Through the analysis of spatial autocorrelation it is clear that there is a spatial dependence in establishing categories of vulnerability, therefore, the effect of neighbors' setting (border areas) on local values should be incorporated into disease management for establishing programs of surveillance and control of CD via vector. The study model proposed here is flexible and
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[Clinical trials: vulnerability and ethical relativism].
Lima, Cristina
2005-01-01
Research in human beings is an important chapter of medical ethics. In recent years, investigation has been taken over by profit driven corporations that must guarantee the medical and commercial application of results. This new model of investigation has generated conflicts of interest in doctor-patient, researcher-subject relationship. The inevitable debate and media reaction has led. These trials of controversial design to regions of the globe where the vulnerability of the populations continues to allow their undertaking. This article includes a historical perspective on experimentation in human beings and the conditions that led to its regulation: the Nuremberg CODE, followed by the Helsinky Declaration in its different versions, and the Belmont Report, that defend the subject according to the ethic of principles used in western medicine. There is then a review of the attempts to change international regulation to reintroduce clinical trials with placebo--which since 1996 is only permitted where there are no therapeutic or diagnostic methods--on populations that would otherwise have no access to treatment. This then leads on to the issue of double standards in medical investigation defended by many investigators and some official entities. The article concludes that it may be prudent to allow local ethical commissions to approve deviation from the established norm if such is necessary to resolve urgent questions of health in the country, but it is unacceptable that any such emergency is used as a reason to reduce the ethical prerequisites, in clinical trials. It also concludes that true urgency is in making available to all who need it the effective products already in existence. Furthermore, that the acceptance of ethical relativism can result in the exploitation of vulnerable third world populations for research programmes that cannot be undertaken in their sponsoring countries due to the ethical restrictions in place.
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Directory of Open Access Journals (Sweden)
S M Thumbi
Full Text Available For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status.We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households.Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively. Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%. In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40% and diarrhea illnesses (5%. While controlling for household
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Thumbi, S M; Njenga, M Kariuki; Marsh, Thomas L; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M; Bigogo, Godfrey; Breiman, Robert F; Palmer, Guy H; McElwain, Terry F
2015-01-01
For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling for household size, the
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Ecological determinants of health: food and environment on human health.
Li, Alice M L
2017-04-01
Human health and diseases are determined by many complex factors. Health threats from the human-animal-ecosystems interface (HAEI) and zoonotic diseases (zoonoses) impose an increasing risk continuously to public health, from those emerging pathogens transmitted through contact with animals, food, water and contaminated environments. Immense challenges forced on the ecological perspectives on food and the eco-environments, including aquaculture, agriculture and the entire food systems. Impacts of food and eco-environments on human health will be examined amongst the importance of human interventions for intended purposes in lowering the adverse effects on the biodiversity. The complexity of relevant conditions defined as factors contributing to the ecological determinants of health will be illuminated from different perspectives based on concepts, citations, examples and models, in conjunction with harmful consequential effects of human-induced disturbances to our environments and food systems, together with the burdens from ecosystem disruption, environmental hazards and loss of ecosystem functions. The eco-health literacy should be further promoting under the "One Health" vision, with "One World" concept under Ecological Public Health Model for sustaining our environments and the planet earth for all beings, which is coincidentally echoing Confucian's theory for the environmental ethics of ecological harmony.
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Climate change and human health: a One Health approach.
Patz, Jonathan A; Hahn, Micah B
2013-01-01
Climate change adds complexity and uncertainty to human health issues such as emerging infectious diseases, food security, and national sustainability planning that intensify the importance of interdisciplinary and collaborative research. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate clearer understanding of climate change impacts on environmental, animal, and human health. Here we present a brief introduction to climate science and projections for the next century and a review of current knowledge on the impacts of climate-driven environmental change on human health. We then turn to the links between ecological and evolutionary responses to climate change and health. The literature on climate impacts on biological systems is rich in both content and historical data, but the connections between these changes and human health is less understood. We discuss five mechanisms by which climate changes impacts on biological systems will be felt by the human population: Modifications in Vector, Reservoir, and Pathogen Lifecycles; Diseases of Domestic and Wild Animals and Plants; Disruption of Synchrony Between Interacting Species; Trophic Cascades; and Alteration or Destruction of Habitat. Each species responds to environmental changes differently, and in order to predict the movement of disease through ecosystems, we have to rely on expertise from the fields of veterinary, medical, and public health, and these health professionals must take into account the dynamic nature of ecosystems in a changing climate.
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Urban settlements' vulnerability to flood risks in African cities: A conceptual framework
Directory of Open Access Journals (Sweden)
Rafiu O. Salami
2017-02-01
Full Text Available In the recent past, the frequency and gravity of large-scale flood disasters have increased globally, resulting in casualties, destruction of property and huge economic loss. The destructive flood disaster devastating Louisiana, USA, is a recent example. Despite the availability of advanced technological capabilities for dealing with floods in developed nations, flood disasters continue to become more rampant and disastrous. Developing countries in Africa such as Benin, Ghana, Nigeria, Senegal and Sudan have recently experienced severe flooding, leaving a considerable number of human casualties and thousands displaced. In African cities, most vulnerable urban residents usually have lesser capacity and fewer resources to recover from the shocks of disaster as a result of the failure of governments to build human security for poor African residents. Many scholars have acknowledged the lack of appropriate vulnerability assessment frameworks and policies, questioning the efficiency and effectiveness of the tested models in Africa. The ability to accurately identify, measure and evaluate the various vulnerabilities of affected people and communities is a right step towards reducing disaster risk. This article aimed at developing a framework for assessing urban settlements’ vulnerability to flood risks in Africa. The framework is currently being tested to assess various dimensions of vulnerability drivers in three urban communities in Ibadan metropolis, the third largest city in Nigeria, focusing more on flood risk perceptions and behaviour of the risk bearers. It uses participatory and mixed method approaches to socially construct vulnerability of populations at risk. This model emanates from the evaluation of considerable relevant literature and an array of vulnerability assessment frameworks. It integrates some approaches that are applicable to African cities in a bid to create a versatile tool to assess, identify and mitigate the effects of
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van Oers, Hedy A.; Tacke, Carline E.; Haverman, Lotte; Kuipers, Irene M.; Maurice-Stam, Heleen; Kuijpers, Taco W.; Grootenhuis, Martha A.
2014-01-01
Kawasaki disease (KD) is an acute paediatric vasculitis. The psychosocial consequences of this sudden illness for parents are unknown. This study aimed to evaluate health related quality of life (HRQOL) and parental perceptions of child vulnerability (PPCV) in parents of children with KD, and to
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Assessing global exposure and vulnerability towards natural hazards: the Disaster Risk Index
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P. Peduzzi
2009-07-01
Full Text Available This paper presents a model of factors influencing levels of human losses from natural hazards at the global scale, for the period 1980–2000. This model was designed for the United Nations Development Programme as a building stone of the Disaster Risk Index (DRI, which aims at monitoring the evolution of risk. Assessing what countries are most at risk requires considering various types of hazards, such as droughts, floods, cyclones and earthquakes. Before assessing risk, these four hazards were modelled using GIS and overlaid with a model of population distribution in order to extract human exposure. Human vulnerability was measured by crossing exposure with selected socio-economic parameters. The model evaluates to what extent observed past losses are related to population exposure and vulnerability. Results reveal that human vulnerability is mostly linked with country development level and environmental quality. A classification of countries is provided, as well as recommendations on data improvement for future use of the model.
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Sandifer, P. A.; Trtanj, J.; Collier, T. K.
2012-12-01
Scientists and policy-makers are increasingly recognizing that sustainable coastal communities depend on healthy and resilient economies, ecosystems, and people, and that the condition or "health" of the coastal ocean and humans are intimately and inextricably connected. A wealth of ecosystem services provided by ocean and coastal environments are crucial for human survival and well being. Nonetheless, the health of coastal communities, their economies, connected ecosystems and ecosystem services, and people are under increasing threats from health risks associated with environmental degradation, climate change, and unwise land use practices, all of which contribute to growing burdens of naturally-occurring and introduced pathogens, noxious algae, and chemical contaminants. The occurrence, frequency, intensity, geographic range, and number and kinds of ocean health threats are increasing, with concomitant health and economic effects and eroding public confidence in the safety and wholesomeness of coastal environments and resources. Concerns in the research and public health communities, many summarized in the seminal 1999 NRC Report, From Monsoons to Microbes and the 2004 final report of the US Commission on Ocean Policy, resulted in establishment of a new "meta-discipline" known as Oceans and Human Health (OHH). OHH brings together practitioners in oceanography, marine biology, ecology, biomedical science, medicine, economics and other social sciences, epidemiology, environmental management, and public health to focus on water- and food-borne causes of human and animal illnesses associated with ocean and coastal systems and on health benefits of seafood and other marine products. It integrates information across multiple disciplines to increase knowledge of ocean health risks and benefits and communicate such information to enhance public safety. Recognizing the need for a comprehensive approach to ocean health threats and benefits, Congress passed the Oceans and
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Toward a legal framework that promotes and protects sex workers' health and human rights.
Overs, Cheryl; Loff, Bebe
2013-06-14
Complex combinations of law, policy, and enforcement practices determine sex workers vulnerability to HIV and rights abuses. We identify "lack of recognition as a person before the law" as an important but undocumented barrier to accessing services and conclude that multi-faceted, setting-specific reform is needed-rather than a singular focus on decriminalization-if the health and human rights of sex workers are to be realized. Copyright © 2013 Overs and Loff. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Human resources for health policies: a critical component in health policies
Directory of Open Access Journals (Sweden)
Dussault Gilles
2003-04-01
Full Text Available Abstract In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM; a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: • the central role of the workforce in the health sector; • the various challenges thrown up by health system reforms; • the need to anticipate the effect on the health workforce (and consequently on service provision arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs. Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH: • to move beyond the traditional approach of personnel administration to a more global concept of HRM; • to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy; • to foster a more proactive attitude among human resources (HR policy-makers and managers; • to promote the full commitment of all professionals and sectors in all phases of the process. The development of explicit human resources
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A Culture Of Health And Human Rights.
Mariner, Wendy K; Annas, George J
2016-11-01
A culture of health can be seen as a social norm that values health as the nation's priority or as an appeal to improve the social determinants of health. Better population health will require changing social and economic policies. Effective changes are unlikely unless health advocates can leverage a framework broader than health to mobilize political action in collaboration with non-health sector advocates. We suggest that human rights-the dominant international source of norms for government responsibilities-provides this broader framework. Human rights, as expressed in the Universal Declaration of Human Rights and enforceable treaties, require governments to assure their populations nondiscriminatory access to food, water, education, work, social security, and a standard of living adequate for health and well-being. The policies needed to realize human rights also improve population health, well-being, and equity. Aspirations for human rights are strong enough to endure beyond inevitable setbacks to specific causes. Project HOPE—The People-to-People Health Foundation, Inc.
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Assessing flash flood vulnerability using a multi-vulnerability approach
Directory of Open Access Journals (Sweden)
Karagiorgos Konstantinos
2016-01-01
Full Text Available In the framework of flood risk assessment, while the understanding of hazard and exposure has significantly improved over the last years, knowledge on vulnerability remains one of the challenges. Current approaches in vulnerability research are characterised by a division between social scientists and natural scientists. In order to close this gap, we present an approach that combines information on physical and social vulnerability in order to merge information on the susceptibility of elements at risk and society. With respect to physical vulnerability, the study is based on local-scale vulnerability models using nonlinear regression approaches. Modified Weibull distributions were fit to the data in order to represent the relationship between process magnitude and degree of loss. With respect to social vulnerability we conducted a door-to-door survey which resulted in particular insights on flood risk awareness and resilience strategies of exposed communities. In general, both physical and social vulnerability were low in comparison with other European studies, which may result from (a specific building regulations in the four Mediterranean test sites as well as general design principles leading to low structural susceptibility of elements at risk, and (b relatively low social vulnerability of citizens exposed. As a result it is shown that a combination of different perspectives of vulnerability will lead to a better understanding of exposure and capacities in flood risk management.
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Mapping the vulnerability hotspots over Hindu-Kush Himalaya region to flooding disasters
Directory of Open Access Journals (Sweden)
Shada Elalem
2015-06-01
Full Text Available A disproportionate share of the global economic and human losses caused by environmental shocks is borne by people in the developing nations. The mountain region of Hindu-Kush Himalaya (HKH in South Asia is threatened by numerous flooding events annually. An efficient disaster risk reduction often needs to rest upon location-based synoptic view of vulnerability. Resolving this deficit improves the ability to take risk reduction measures in a cost-effective way, and in doing so, strengthens the resilience of societies to flooding disasters. The central aim of this research is to identify the vulnerable locations across HKH boundary from the perspective of reported history of economic and human impacts due to occurrence of flooding disasters. A detailed analysis indicates a very high spatial heterogeneity in flooding disaster occurrence in the past 6 decades. The most recent decade reported highest number of disasters and greater spatial coverage as compared to the earlier decades. The data indicates that, in general, economic impacts of flooding disasters were notably higher in Pakistan, Afghanistan and Nepal. On the other hand, vulnerability scenarios with respect to human impacts were diverse for different countries. In terms of morbidity and mortality, Bangladesh, Pakistan, Bhutan and India were detected to be most susceptible to human impacts. Although Bhutan had seen lesser number of flooding disasters, higher population living within disaster prone region make them vulnerable. In summary, complex interactions between natural and socio-economic conditions play a dominant role to define and characterize the type and magnitude of vulnerability of HKH countries to disaster occurrence and their economic and human impacts.
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Energy Technology Data Exchange (ETDEWEB)
Brauch, Hans Guenter [Freie Univ. Berlin (Germany). Dept. of Political and Social Sciences; UNU-EHS, Bonn (DE). College of Associated Scientists and Advisors (CASA); Oswald Spring, Ursula [National Univ. of Mexico, Cuernavaca (MX). Regional Multidisciplinary Research Centre (CRIM); Mesjasz, Czeslaw [Cracow Univ. of Exonomics (Poland). Faculty of Management; Grin, John [Amsterdam Univ. (Netherlands). Dept. of Political Science; Dutch Knowledge network for Systems Innovations and Transitions (KSI), Amsterdam (Netherlands); Kameri-Mbote, Patricia [Strathmore Univ., Nairobi (Kenya). Dept. of Law; International Environmental Law Research Centre, Nairobi (Kenya); Chourou, Bechir [Univ. of Tunis-Carthage, Hammam-Chatt (Tunisia); Dunay, Pal [Geneva Centre for Security Policy (Switzerland). International Training Course in Security Policy; Birkmann, Joern (eds.) [United Nations Univ. (UNU), Bonn (DE). Inst. for Environment and Human Security (EHS)
2011-07-01
This policy-focused Global Environmental and Human Security Handbook for the Anthropo-cene (GEHSHA) addresses new security threats, challenges, vulnerabilities and risks posed by global environmental change and disasters. In 6 forewords, 5 preface essays 95 peer reviewed chapcountries analyse in 10 parts concepts of military and political hard security and economic, social, environmental soft security with a regional focus on the Near East, North and Sub-Sahara Africa and Asia and on hazards in urban centres. The major focus is on coping with global environmental change: climate change, desertification, water, food and health and with hazards and strategies on social vulnerability and resilience building and scientific, international, regional and national political strategies, policies and measures including early warning of conflicts and hazards. The book proposes a political geo-ecology and discusses a 'Fourth Green Revolution' for the Anthropocene era of earth history. (orig.)
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Brown, Emma S; Allsopp, Philip J; Magee, Pamela J; Gill, Chris I R; Nitecki, Sonja; Strain, Conall R; McSorley, Emeir M
2014-03-01
Seaweeds may have an important role in modulating chronic disease. Rich in unique bioactive compounds not present in terrestrial food sources, including different proteins (lectins, phycobiliproteins, peptides, and amino acids), polyphenols, and polysaccharides, seaweeds are a novel source of compounds with potential to be exploited in human health applications. Purported benefits include antiviral, anticancer, and anticoagulant properties as well as the ability to modulate gut health and risk factors for obesity and diabetes. Though the majority of studies have been performed in cell and animal models, there is evidence of the beneficial effect of seaweed and seaweed components on markers of human health and disease status. This review is the first to critically evaluate these human studies, aiming to draw attention to gaps in current knowledge, which will aid the planning and implementation of future studies.
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National legal system in relation to vulnerable population groups
Directory of Open Access Journals (Sweden)
Sjeničić Marta
2015-01-01
Full Text Available Vulnerable social groups can be recognized in everyday life, and local legal regulations identify them as well. Strategies and laws clearly identify the increased needs of vulnerable groups. Local legislation, for example, observes comparative law trends and attempts to prevent discrimination of persons with disabilities, emphasizes their human rights and creates the legal framework for taking these persons out of the institutional form of protection and including them into the community. In Serbia however, strategies and laws, as well as by-laws, are written in sectors, and not in cross-sectors manner. Proper caring for persons with disabilities, including persons with mental disabilities, requires an integral approach, namely a mutual approach of the social, health, educational and other sectors. True enough, local regulations stress the need for an intersectional approach, but such an approach is scantily applied in practice, so the comprehensive care that would satisfy the multiple needs of persons with mental disabilities often turns out to be less than expected in the community. Pursuant to national laws and basic ethic principals, all citizens of the Republic of Serbia have the right to health protection without discrimination. Therefore, methods for using health protection, easier than the existing ones, should be found for certain vulnerable groups, depending on their characteristics, and so for the Roma as well, and bearing in mind that systemic health regulations in Serbia open the door to special treatment of these groups. The inaccessible approach to health care of the Roma population persists primarily due to insufficient basic health documentation and basic personal documentation. Personal documents are linked with the registered place of residence, which the Roma, largely do not have. The problem is thus on a wider scale and is not only focused on the health sector. As such, it requires a wider, intersectional approach and a
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Goldman-Mellor, Sidra; Caspi, Avshalom; Arseneault, Louise; Ajala, Nifemi; Ambler, Antony; Danese, Andrea; Fisher, Helen; Hucker, Abigail; Odgers, Candice; Williams, Teresa; Wong, Chloe; Moffitt, Terrie E.
2016-01-01
Background Labour market disengagement among youths has lasting negative economic and social consequences, yet is poorly understood. We compared four types of work-related self-perceptions, as well as vulnerability to mental health and substance abuse problems, among youths not in education, employment, or training (NEET) and among their peers. Methods Participants were from the Environmental Risk (E-Risk) longitudinal study, a nationally representative U.K. cohort of 2,232 twins born in 1994–95. We measured commitment to work, job-search effort, professional/technical skills, “soft” skills (e.g., teamwork, decision-making, communication), optimism about getting ahead, and mental health and substance-use disorders at age 18. We also examined childhood mental health. Results At age 18, 11.6% of participants were NEET. NEET participants reported themselves as committed to work and searching for jobs with greater diligence than their non-NEET peers. However, they reported fewer “soft” skills (B = −0.98, p life (B = −2.41, p < .001). NEET youths also had higher rates of concurrent mental health and substance-abuse problems, but these did not explain the relationship with work-related self-perceptions. Nearly 60% of NEET (vs. 35% of non-NEET) youths had already experienced ≥1 mental health problem in childhood/adolescence. Associations of NEET status with concurrent mental health problems were independent of pre-existing mental health vulnerability. Conclusions Our findings indicate that while NEET is clearly an economic and mental health issue, it does not appear to be a motivation issue. Alongside skills, work-related self-perceptions and mental-health problems may be targets for intervention and service provision among this high-risk population. PMID:26791344
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Shaw, David; Elger, Bernice
2015-05-01
It is widely recognised that prisoners constitute a vulnerable population that is subject to numerous health inequalities and merits special protection. Improving prisoners' access to healthcare by ensuring adherence to the principle of equivalence has been the main focus of efforts to ensure that their health is not jeopardised. However, another means of respecting prisoners' autonomy and improving their health is to involve them (and prison staff) in social science research within prisons. Such research not only produces valuable data which can be used to assess whether the principle of equivalence is being respected; it also enfranchises prisoners by allowing them to air concerns about perceived ill-treatment and influence their environment. If prison authorities enable such research and adjust policy accordingly, both they and prisoners will benefit from the increased level of respect for prisoners' autonomy, and the improvements in individual and public health that flow from this. Conducting social science research in prisons enables the creation of a virtuous cycle of respect that makes prisons safer and healthier places. Copyright © 2015 Elsevier Inc. All rights reserved.
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Energy Technology Data Exchange (ETDEWEB)
Dan Gheorghiu, Ioan; Visa, Ion; Carabulea, Anatol; Morar, Adrian; Popper, Laurentiu; Popper, Gabriel; Bucur, Camelia
2010-09-15
We present the causes generating vulnerabilities and propose the models for diminishing the risks and catastrophes based on the education of the human resources incorporated in the evolution of the local power system and not only. We specify the fuzzy structure of the model for increasing the quality of the human factor and of the models for rating the human resources in power plants and the networks of the power systems exemplified on the evolving structure of the Romanian installations subject to dynamic reconfiguring over the forecast interval (2020 - 2035).
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Directory of Open Access Journals (Sweden)
Woi-Hyun S. Hong
2009-09-01
Conclusion: This research adds to the understanding of the importance of nurses' interventions toward health promotion with the vulnerable population. This preliminary analysis suggests that the ACHIS provide a clinical information system for collecting, storing, processing, retrieving, and managing clinical data in a data repository. [Asian Nursing Research 2009;3(3:130–138
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Haugen, Hans Morten
2010-08-01
The article analyses the three terms autonomy, dignity and vulnerability. The relevance and practical application of the terms is tested in two spheres. First, as guiding principles in the area of ethics of medicines and science. Second, as human rights principles, serving to guide the conduct of public policies for an effective realization of human rights. The article argues that all human beings have the same dignity, but that the autonomy--and therefore vulnerability--differs considerably. Simply said, with reduced autonomy comes increased vulnerability, implying extra attention to the protective dimensions. The article finds that the three terms approach the protection of human beings in different ways and that all are relevant and applicable in both spheres, but that an isolated notion of autonomy and a 'group-based' notion of vulnerability are not adequate.
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[Assessment of eco-environmental vulnerability of Hainan Island, China].
Huang, Bao-rong; Ouyang, Zhi-yun; Zhang, Hui-zhi; Zhang, Li-hua; Zheng, Hua
2009-03-01
Based on the assessment method of environmental vulnerability constructed by SOPAC and UNEP, this paper constructed an indicator system from three sub-themes including hazard, resistance, and damage to assess the eco-environmental vulnerability of Hainan Island. The results showed that Hainan Island was suffering a middling level eco-environmental hazard, and the main hazards came from some intensive human activities such as intensive agriculture, mass tourism, mining, and a mass of solid wastes thrown by islanders and tourists. Some geographical characters such as larger land area, larger altitude range, integrated geographical form, and abundant habitat types endowed Hainan Island higher resistance to environmental hazards. However, disturbed by historical accumulative artificial and natural hazards, the Island ecosystem had showed serious ecological damage, such as soil degradation and biodiversity loss. Comprehensively considered hazard, resistance, damage, and degradation, the comprehensive environmental vulnerability of the Island was at a middling level. Some indicators showed lower vulnerability, but some showed higher vulnerability.
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Directory of Open Access Journals (Sweden)
Mohammed Saif Al-Kalbani
2014-10-01
Full Text Available Climate change and its consequences present one of the most important threats to water resources systems which are vulnerable to such changes due to their limited adaptive capacity. Water resources in arid mountain regions, such as Al Jabal Al Akhdar; northern Sultanate of Oman, are vulnerable to the potential adverse impacts of environmental and climate change. Besides climatic change, current demographic trends, economic development and related land use changes are exerting pressures and have direct impacts on increasing demands for water resources and their vulnerability. In this study, vulnerability assessment was carried out using guidelines prepared by United Nations Environment Programme (UNEP and Peking University to evaluate four components of the water resource system: water resources stress, water development pressure, ecological health, and management capacity. The calculated vulnerability index (VI was high, indicating that the water resources are experiencing levels of stress. Ecosystem deterioration was the dominant parameter and management capacity was the dominant category driving the vulnerability on water resources. The vulnerability assessment will support policy and decision makers in evaluating options to modify existing policies. It will also help in developing long-term strategic plans for climate change mitigation and adaptation measures and implement effective policies for sustainable water resources management, and therefore the sustenance of human wellbeing in the region.
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How Should We Treat the Vulnerable?: Qualitative Study of Authoritative Ethics Documents.
Zagorac, Ivana
2016-01-01
The aim of this study is to explore what actual guidance is provided by authoritative ethics documents regarding the recognition and protection of the vulnerable. The documents included in this analysis are the Belmont Report, the Declaration of Helsinki, The Council for International Organizations of Medical Sciences (CIOMS) Guidelines, and the UNESCO Universal Declaration on Bioethics and Human Rights, including its supplementary report on vulnerability. A qualitative analysis of these documents was conducted in light of three questions: what is vulnerability, who are the vulnerable, and how should the vulnerable be protected? The results show significant differences among the documents regarding the first two questions. None of the documents provides any guidance on the third question (how to protect the vulnerable). These results suggest a great discrepancy between the acknowledged importance of the concept of vulnerability and a general understanding of the scope, content, and practical implications of vulnerability.
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Planetary health: protecting human health on a rapidly changing planet.
Myers, Samuel S
2018-12-23
The impact of human activities on our planet's natural systems has been intensifying rapidly in the past several decades, leading to disruption and transformation of most natural systems. These disruptions in the atmosphere, oceans, and across the terrestrial land surface are not only driving species to extinction, they pose serious threats to human health and wellbeing. Characterising and addressing these threats requires a paradigm shift. In a lecture delivered to the Academy of Medical Sciences on Nov 13, 2017, I describe the scale of human impacts on natural systems and the extensive associated health effects across nearly every dimension of human health. I highlight several overarching themes that emerge from planetary health and suggest advances in the way we train, reward, promote, and fund the generation of health scientists who will be tasked with breaking out of their disciplinary silos to address this urgent constellation of health threats. I propose that protecting the health of future generations requires taking better care of Earth's natural systems. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Vulnerability to Climate Change in Rural Nicaragua
Byrne, T. R.; Townshend, I.; Byrne, J. M.; McDaniel, S. A.
2013-12-01
While there is a growing recognition of the impact that climate change may have on human development, there has been a shift in focus from an impacts-led assessment approach towards a vulnerability-led assessment approach. This research operationalizes the IPCC's definition of vulnerability in a sub-national assessment to understand how different factors that shape vulnerability to climate change vary spatially across rural Nicaragua. The research utilizes the Food and Agriculture Organization of the United Nations' (FAO UN) CropWat model to evaluate how the annual yield of two of Nicaragua's staple crops may change under projected changes in temperature and precipitation. This analysis of agricultural sensitivity under exposure to climate change is then overlain with an indicator-based assessment of adaptive capacity in rural Nicaraguan farming households. Adaptive capacity was evaluated using household survey data from the 2001 National Household Survey on Living Standards Measurement, which was provided to us by the FAO UN. The result is a map representing current vulnerability to future climate change, and can serve as a basis for targeting policy interventions in rural Nicaragua.
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On the Science-Policy Bridge: Do Spatial Heat Vulnerability Assessment Studies Influence Policy?
Directory of Open Access Journals (Sweden)
Tanja Wolf
2015-10-01
Full Text Available Human vulnerability to heat varies at a range of spatial scales, especially within cities where there can be noticeable intra-urban differences in heat risk factors. Mapping and visualizing intra-urban heat vulnerability offers opportunities for presenting information to support decision-making. For example the visualization of the spatial variation of heat vulnerability has the potential to enable local governments to identify hot spots of vulnerability and allocate resources and increase assistance to people in areas of greatest need. Recently there has been a proliferation of heat vulnerability mapping studies, all of which, to varying degrees, justify the process of vulnerability mapping in a policy context. However, to date, there has not been a systematic review of the extent to which the results of vulnerability mapping studies have been applied in decision-making. Accordingly we undertook a comprehensive review of 37 recently published papers that use geospatial techniques for assessing human vulnerability to heat. In addition, we conducted an anonymous survey of the lead authors of the 37 papers in order to establish the level of interaction between the researchers as science information producers and local authorities as information users. Both paper review and author survey results show that heat vulnerability mapping has been used in an attempt to communicate policy recommendations, raise awareness and induce institutional networking and learning, but has not as yet had a substantive influence on policymaking or preventive action.
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On the Science-Policy Bridge: Do Spatial Heat Vulnerability Assessment Studies Influence Policy?
Wolf, Tanja; Chuang, Wen-Ching; McGregor, Glenn
2015-10-23
Human vulnerability to heat varies at a range of spatial scales, especially within cities where there can be noticeable intra-urban differences in heat risk factors. Mapping and visualizing intra-urban heat vulnerability offers opportunities for presenting information to support decision-making. For example the visualization of the spatial variation of heat vulnerability has the potential to enable local governments to identify hot spots of vulnerability and allocate resources and increase assistance to people in areas of greatest need. Recently there has been a proliferation of heat vulnerability mapping studies, all of which, to varying degrees, justify the process of vulnerability mapping in a policy context. However, to date, there has not been a systematic review of the extent to which the results of vulnerability mapping studies have been applied in decision-making. Accordingly we undertook a comprehensive review of 37 recently published papers that use geospatial techniques for assessing human vulnerability to heat. In addition, we conducted an anonymous survey of the lead authors of the 37 papers in order to establish the level of interaction between the researchers as science information producers and local authorities as information users. Both paper review and author survey results show that heat vulnerability mapping has been used in an attempt to communicate policy recommendations, raise awareness and induce institutional networking and learning, but has not as yet had a substantive influence on policymaking or preventive action.
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Goldman-Mellor, Sidra; Caspi, Avshalom; Arseneault, Louise; Ajala, Nifemi; Ambler, Antony; Danese, Andrea; Fisher, Helen; Hucker, Abigail; Odgers, Candice; Williams, Teresa; Wong, Chloe; Moffitt, Terrie E
2016-02-01
Labour market disengagement among youths has lasting negative economic and social consequences, yet is poorly understood. We compared four types of work-related self-perceptions, as well as vulnerability to mental health and substance abuse problems, among youths not in education, employment or training (NEET) and among their peers. Participants were from the Environmental Risk (E-Risk) longitudinal study, a nationally representative UK cohort of 2,232 twins born in 1994-1995. We measured commitment to work, job-search effort, professional/technical skills, 'soft' skills (e.g. teamwork, decision-making, communication), optimism about getting ahead, and mental health and substance use disorders at age 18. We also examined childhood mental health. At age 18, 11.6% of participants were NEET. NEET participants reported themselves as committed to work and searching for jobs with greater diligence than their non-NEET peers. However, they reported fewer 'soft' skills (B = -0.98, p life (B = -2.41, p < .001). NEET youths also had higher rates of concurrent mental health and substance abuse problems, but these did not explain the relationship with work-related self-perceptions. Nearly 60% of NEET (vs. 35% of non-NEET) youths had already experienced ≥1 mental health problem in childhood/adolescence. Associations of NEET status with concurrent mental health problems were independent of pre-existing mental health vulnerability. Our findings indicate that while NEET is clearly an economic and mental health issue, it does not appear to be a motivation issue. Alongside skills, work-related self-perceptions and mental health problems may be targets for intervention and service provision among this high-risk population. © 2015 Association for Child and Adolescent Mental Health.
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Ross, Claire; Dimitrova, Stoyanka; Howard, Louise M; Dewey, Michael; Zimmerman, Cathy; Oram, Siân
2015-08-20
(1) To estimate the proportion of National Health Service (NHS) professionals who have come into contact with trafficked people and (2) to measure NHS professionals' knowledge and confidence to respond to human trafficking. A cross-sectional survey. Face-to-face mandatory child protection and/or vulnerable adults training sessions at 10 secondary healthcare provider organisations in England, and meetings of the UK College of Emergency Medicine. 782/892 (84.4%) NHS professionals participated, including from emergency medicine, maternity, mental health, paediatrics and other clinical disciplines. Self-completed questionnaire developed by an expert panel. Questionnaire asks about prior training and contact with potential victims of trafficking, perceived and actual human trafficking knowledge, confidence in responding to human trafficking, and interest in future human trafficking training. 13% participants reported previous contact with a patient they knew or suspected of having been trafficked; among maternity services professionals this was 20.4%. However, 86.8% (n=679) reported lacking knowledge of what questions to ask to identify potential victims and 78.3% (n=613) reported that they had insufficient training to assist trafficked people. 71% (n=556), 67.5% (n=528) and 53.4% (n=418) lacked confidence in making appropriate referrals for men, women and children, respectively, who had been trafficked. 95.3% (n=746) of respondents were unaware of the scale of human trafficking in the UK, and 76.5% (n=598) were unaware that calling the police could put patients in more danger. Psychometric analysis showed that subscales measuring perceived knowledge, actual knowledge and confidence to respond to human trafficking demonstrated good internal consistency (Cronbach's αs 0.93, 0.63 and 0.64, respectively) and internal correlations. NHS professionals working in secondary care are in contact with potential victims of human trafficking, but lack knowledge and confidence in
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International Nuclear Information System (INIS)
1994-09-01
The Plutonium Environmental, Safety, and Health (ES and H) Vulnerability Assessment is being conducted by the DOE Office of Environment, Safety, and Health (DOE-EH) to evaluate the ES and H vulnerabilities arising from the Department's storage and handling of its holdings of plutonium and other transuranic isotopes. This report on Savannah River Site (SRS) facilities and materials provides the results of a self-assessment for the purpose of identifying issues as potential vulnerabilities. The report provides data and analyses for the DOE-EH and independent Working Group Assessment Team, which will make the final determination as to ES and H vulnerabilities at SRS. The term ES and H vulnerabilities is defined for the purpose of this assessment to mean conditions that could lead to unnecessary or increased radiation exposure of workers, release of radioactive materials to the environment, or radiation exposure of the public. The self-assessment identifies and prioritizes candidate or potential vulnerabilities and issues for consideration by the Working Group Assessment Team, and will serve as an information base for identifying interim corrective actions and options for the safe management of fissile materials. It will also establish a foundation for decision making regarding the safe management and disposition of DOE plutonium
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Ceré, Raphaël; Kaiser, Christian
2015-04-01
Currently, three quarters of the Swiss population is living in urban areas. The total population is still increasing, and urbanized space is increasing event faster. Consequently, the intensity of use has decreased but the exposure of the urban space to natural events has grown along with the cost related to the impact of hazards. In line with this fact, during the 20th century there has been a noticeable increase of natural disasters accompanied by the rapid increase of the world population, leading to higher costs. Additionally to the fact that more people are exposed to natural hazards, the value of goods globally has increased more than proportionally. Consequently, the vulnerability of urban space is, more than ever before, a major issue for socio-economic development. Here, vulnerability is defined as the potential human loss or loss of infrastructure caused by a hazardous event. It encompasses factors of urban infrastructure, population and the environment, which increase the susceptibility of a location to the impact of hazards. This paper describes a novel method for improving the interactive use of exploratory data analysis in the context of minimizing vulnerability and disaster risk by prevention or mitigation. This method is used to assess the similarity between different locations with respect to several characteristics relevant to vulnerability at different scales, allowing for automatic display of multiple locations similar to the one under investigation by an expert. Visualizing vulnerability simultaneously for several locations allows for analyzing and comparing of metric characteristics between multiple places and at different scales. The interactivity aspect is also useful for understanding vulnerability patterns and it facilitates disaster risk management and decisions on global preventive measures in urban spaces. Metrics for vulnerability assessment can be extracted from extensive geospatial datasets such as high-resolution digital elevation
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Greenberg, Henry; Shiau, Stephanie
2014-09-01
The Trans Pacific Partnership Agreement (TPPA) is a regional trade agreement currently being negotiated by 11 Pacific Rim countries, excluding China. While the negotiations are being conducted under a veil of secrecy, substantive leaks over the past 4 years have revealed a broad view of the proposed contents. As it stands the TPPA poses serious risks to global public health, particularly chronic, non-communicable diseases. At greatest risk are national tobacco regulations, regulations governing the emergence of generic drugs and controls over food imports by transnational corporations. Aside from a small group of public health professionals from Australia, the academic public health community has missed these threats to the global community, although many other health-related entities, international lawyers and health-conscious politicians have voiced serious concerns. As of mid-2014 there has been no comment in the leading public health journals. This large lacuna in interest or recognition reflects the larger problem that the public health education community has all but ignored global non-communicable diseases. Without such a focus, the risks are unseen and the threats not perceived. This cautionary tale of the TPPA reflects the vulnerability of being ill informed of contemporary realities. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Balbus, J. M.; Kirsch, T.; Mitrani-Reiser, J.
2017-12-01
Over recent decades, natural disasters and mass-casualty events in United States have repeatedly revealed the serious consequences of health care facility vulnerability and the subsequent ability to deliver care for the affected people. Advances in predictive modeling and vulnerability assessment for health care facility failure, integrated infrastructure, and extreme weather events have now enabled a more rigorous scientific approach to evaluating health care system vulnerability and assessing impacts of natural and human disasters as well as the value of specific interventions. Concurrent advances in computing capacity also allow, for the first time, full integration of these multiple individual models, along with the modeling of population behaviors and mass casualty responses during a disaster. A team of federal and academic investigators led by the National Center for Disaster Medicine and Public Health (NCDMPH) is develoing a platform for integrating extreme event forecasts, health risk/impact assessment and population simulations, critical infrastructure (electrical, water, transportation, communication) impact and response models, health care facility-specific vulnerability and failure assessments, and health system/patient flow responses. The integration of these models is intended to develop much greater understanding of critical tipping points in the vulnerability of health systems during natural and human disasters and build an evidence base for specific interventions. Development of such a modeling platform will greatly facilitate the assessment of potential concurrent or sequential catastrophic events, such as a terrorism act following a severe heat wave or hurricane. This presentation will highlight the development of this modeling platform as well as applications not just for the US health system, but also for international science-based disaster risk reduction efforts, such as the Sendai Framework and the WHO SMART hospital project.
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An Overview of Soils and Human Health
Brevik, Eric C.
2013-04-01
Few people recognize the connection between soils and human health, even though soils are actually very important to health. Soils influence health through the nutrients taken up by plants and the animals that eat those plants, nutrients that are needed for adequate nutrition for growth and development. Soils can also act to harm human health in three major ways: i) toxic levels of substances or disease-causing organisms may enter the human food chain from the soil ii) humans can encounter pathogenic organisms through direct contact with the soil or inhaling dust from the soil, and iii) degraded soils produce nutrient-deficient foods leading to malnutrition. Soils have also been a major source of medicines. Therefore, soils form an integral link in the holistic view of human health. In this presentation, soils and their influence on human health are discussed from a broad perspective, including both direct influences of soils on health and indirect influences through things such as climate change, occupational exposure to soil amendments, and the role of soils in providing food security.
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Directory of Open Access Journals (Sweden)
Ming Ji
2014-01-01
Full Text Available The vulnerability assessment model, composed by 11 vulnerability factors, is established with the introduction of the concept of “vulnerability” into the assessment of tunnel support system. Analytic hierarchy process is utilized to divide these 11 factors into human attributes and natural attributes, and define the weight of these factors for the model. The “vulnerability” applied io the assessment of the tunnel support system model is reached. The vulnerability assessment model was used for evaluating and modifying the haulage tunnel #3207 of Bo-fang mine panel #2. The results decreased the vulnerability of the tunnel support system and demonstrated acceptable effects. Furthermore, the results show that the impact of human attributes on tunnel support systems is dramatic under the condition that natural attributes are permanent, and the “vulnerability” is exactly a notable factor to manifest the transformation during this process. The results also indicate that optimizing human attributes can attenuate vulnerability in tunnel support systems. As a result, enhancement of stability of tunnel support systems can be achieved.
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Mapping vulnerability to multiple stressors: climate change and globalization in India
Energy Technology Data Exchange (ETDEWEB)
O' Brien, Karen; Aandahl, Guro; Tompkins, Heather [CICERO, Oslo (NO)] (and others)
2004-12-01
There is growing recognition in the human dimensions research community that climate change impact studies must take into account the effects of other ongoing global changes. Yet there has been no systematic methodology to study climate change vulnerability in the context of multiple stressors. Using the example of Indian agriculture, this paper presents a methodology for investigating regional vulnerability to climate change in combination with other global stressors. This method, which relies on both vulnerability mapping and local- level case studies, may be used to assess differential vulnerability for any particular sector within a nation or region, and it can serve as a basis for targeting policy interventions. (Author)
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International Nuclear Information System (INIS)
Müller, Adrienne; Krämer, Stefanie D.; Meletta, Romana; Beck, Katharina; Selivanova, Svetlana V.; Rancic, Zoran; Kaufmann, Philipp A.; Vos, Bernhard; Meding, Jörg; Stellfeld, Timo; Heinrich, Tobias K.; Bauser, Marcus; Hütter, Joachim; Dinkelborg, Ludger M.; Schibli, Roger; Ametamey, Simon M.
2014-01-01
Introduction: Atherosclerotic plaque rupture is the primary cause for myocardial infarction and stroke. During plaque progression macrophages and mast cells secrete matrix-degrading proteolytic enzymes, such as matrix metalloproteinases (MMPs). We studied levels of MMPs and tissue inhibitor of metalloproteinases-3 (TIMP-3) in relation to the characteristics of carotid plaques. We evaluated in vitro two radiolabeled probes targeting active MMPs towards non-invasive imaging of rupture-prone plaques. Methods: Human carotid plaques obtained from endarterectomy were classified into stable and vulnerable by visual and histological analysis. MMP-1, MMP-2, MMP-8, MMP-9, MMP-10, MMP-12, MMP-14, TIMP-3, and CD68 levels were investigated by quantitative polymerase chain reaction. Immunohistochemistry was used to localize MMP-2 and MMP-9 with respect to CD68-expressing macrophages. Western blotting was applied to detect their active forms. A fluorine-18-labeled MMP-2/MMP-9 inhibitor and a tritiated selective MMP-9 inhibitor were evaluated by in vitro autoradiography as potential lead structures for non-invasive imaging. Results: Gene expression levels of all MMPs and CD68 were elevated in plaques. MMP-1, MMP-9, MMP-12 and MMP-14 were significantly higher in vulnerable than stable plaques. TIMP-3 expression was highest in stable and low in vulnerable plaques. Immunohistochemistry revealed intensive staining of MMP-9 in vulnerable plaques. Western blotting confirmed presence of the active form in plaque lysates. In vitro autoradiography showed binding of both inhibitors to stable and vulnerable plaques. Conclusions: MMPs differed in their expression patterns among plaque phenotypes, providing possible imaging targets. The two tested MMP-2/MMP-9 and MMP-9 inhibitors may be useful to detect atherosclerotic plaques, but not the vulnerable lesions selectively
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Experts' perspectives on SwissDRG: Second class care for vulnerable patient groups?
Leu, A; Wepf, H; Elger, B; Wangmo, T
2018-03-14
On the 1st of January 2012, Switzerland introduced the diagnosis-related group hospital tariff structure (SwissDRG). It was recognised that healthcare provided to the most vulnerable patient groups would be a challenge for the new SwissDRG. Coincident with the implementation of SwissDRG, we explored hospital experts' perceptions of which patient groups are vulnerable under the SwissDRG system, what has changed for this group, as well as solutions to ensure adequate access to health care for them. We interviewed 43 experts from 40 Swiss hospitals. Participating experts named several vulnerable patient groups who share some common characteristics. These hospital experts were concerned about the patient groups that are not financially profitable and questioned the practicability of the current regulation. At the same time, they highlighted the complexity associated with caring for this group under the new SwissDRG and reported measures at the macro, meso, and micro levels to protect vulnerable patient groups from negative effects. To curb negative outcomes for vulnerable patient groups after the introduction of the SwissDRG, the Swiss legislation has introduced various instruments including the acute and transitional care (ATC) measures. We conclude that ATC measures do not produce the expected effect the legislators had hoped for. More health data is needed to identify situations where vulnerable patient groups are more susceptible to inadequate health care access in Switzerland. Copyright © 2018 Elsevier B.V. All rights reserved.
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Perspectives on contextual vulnerability in discourses of climate conflict
Okpara, U. T.; Stringer, L. C.; Dougill, A. J.
2016-02-01
The science of climate security and conflict is replete with controversies. Yet the increasing vulnerability of politically fragile countries to the security consequences of climate change is widely acknowledged. Although climate conflict reflects a continuum of conditional forces that coalesce around the notion of vulnerability, how different portrayals of vulnerability influence the discursive formation of climate conflict relations remains an exceptional but under-researched issue. This paper combines a systematic discourse analysis with a vulnerability interpretation diagnostic tool to explore (i) how discourses of climate conflict are constructed and represented, (ii) how vulnerability is communicated across discourse lines, and (iii) the strength of contextual vulnerability against a deterministic narrative of scarcity-induced conflict, such as that pertaining to land. Systematically characterising climate conflict discourses based on the central issues constructed, assumptions about mechanistic relationships, implicit normative judgements and vulnerability portrayals, provides a useful way of understanding where discourses differ. While discourses show a wide range of opinions "for" and "against" climate conflict relations, engagement with vulnerability has been less pronounced - except for the dominant context centrism discourse concerned about human security (particularly in Africa). In exploring this discourse, we observe an increasing sense of contextual vulnerability that is oriented towards a concern for complexity rather than predictability. The article concludes by illustrating that a turn towards contextual vulnerability thinking will help advance a constructivist theory-informed climate conflict scholarship that recognises historicity, specificity, and variability as crucial elements of contextual totalities of any area affected by climate conflict.
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Casas-Zamora, Juan Antonio
2002-01-01
The issue of the reciprocal relationship between health and development has recently taken on greater importance in Latin America and the Caribbean (LAC), given the persistence of extreme poverty and the political and social difficulties due to macroeconomic imbalances and crises of governance. This piece reviews concepts of sustainable human development, social determinants of health in general and of health inequities in particular (gender, ethnic group, income level), and the relationship between health and economic growth in the medium term and the long term. An analysis is made of how persistent poverty in countries of LAC relates to disparities in health conditions, access to health services, and health care financing, as well as to such health determinants as nutrition and environmental sanitation. Health inequities most strongly affect the most excluded and vulnerable sectors of the population. In the face of this situation, the author stresses that putting a priority on health inequities is vital to safeguarding the governability and the social and political stability of countries in LAC in the next decade.
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Overactive bladder in the vulnerable elderly
Directory of Open Access Journals (Sweden)
Wolff GF
2014-10-01
Full Text Available Gillian F Wolff,1 George A Kuchel,2 Phillip P Smith1,21Division of Urology, Department of Surgery, 2UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USAAbstract: Overactive bladder (OAB is a common problem that may occur in individuals of all ages. It has a considerable impact on patient quality of life, and although moderately effective management strategies do exist, this condition often remains undiagnosed and untreated. OAB needs to be viewed as a symptom complex. Its presentation and management are complicated in the vulnerable elderly by the presence of baseline frailty and multiple coexisting chronic conditions. Furthermore, and beyond a simple understanding of symptomatology, providers must address patient goals and motivations as well as the expectations of caretakers. These multiple levels of perception, function, expectations, and treatment efficacy/risks must be tailored to the individual patient. While the vulnerable elderly patient may often have evidence of urinary tract dysfunction, OAB and urge urinary incontinence in this population must be understood as a multifactorial geriatric syndrome and viewed in the context of medical and functional baseline and precipitating risk factors. Expectations and goals must be tailored to the resources of vulnerable elderly patients and their caregivers, and care must be coordinated with other medical care providers. The management of OAB in the vulnerable elderly often poses significant management challenges. Nonetheless, with a thoughtful approach and an aim towards future research specifically for this population, significant reductions in morbidity and mortality long with enhancement in health-related quality of life are possible.Keywords: urinary incontinence, urgency, antispasmodics, aging, frailty
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Hopkins, Debbie
2015-03-01
Conceptualisations of 'vulnerability' vary amongst scholarly communities, contributing to a wide variety of applications. Research investigating vulnerability to climate change has often excluded non-climatic changes which may contribute to degrees of vulnerability perceived or experienced. This paper introduces a comprehensive contextual vulnerability framework which incorporates physical, social, economic and political factors which could amplify or reduce vulnerability. The framework is applied to New Zealand's tourism industry to explore its value in interpreting a complex, human-natural environment system with multiple competing vulnerabilities. The comprehensive contextual framework can inform government policy and industry decision making, integrating understandings of climate change within the broader context of internal and external social, physical, economic, and institutional stressors.
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Methamphetamine use and dependence in vulnerable female populations.
Kittirattanapaiboon, Phunnapa; Srikosai, Soontaree; Wittayanookulluk, Apisak
2017-07-01
The study reviews recent publications on methamphetamine use and dependence women in term of their epidemic, physical health impact, psychosocial impacts, and also in the identified vulnerable issues. Studies of vulnerable populations of women are wide ranging and include sex workers, sexual minorities, homeless, psychiatric patients, suburban women, and pregnant women, in which amphetamine type stimulants (ATSs) are the most commonly reported illicit drug used among them. The prenatal exposure of ATS demonstrated the small for gestational age and low birth weight; however, more research is needed on long-term studies of methamphetamine-exposed children. Intimate partner violence (IPV) is commonly reported by female methamphetamine users as perpetrators and victims. However, statistics and gendered power dynamics suggest that methamphetamine-related IPV indicates a higher chance of femicide. Methamphetamine-abusing women often have unresolved childhood trauma and are introduced to ATS through families or partners. Vulnerable populations of women at risk of methamphetamine abuse and dependence. Impacts on their physical and mental health, IPV, and pregnancy have been reported continuing, which guide that empowering and holistic substance abuse are necessary for specific group.
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International Nuclear Information System (INIS)
1994-09-01
Environmental safety and health (ES and H) vulnerabilities are defined as conditions or weaknesses that may lead to unnecessary or increased radiation exposure of the workers, release of radioactive materials to the environment, or radiation exposure of the public. In response to the initiative by the Secretary of Energy, Los Alamos National Laboratory (LANL) has performed a self assessment of the ES and H vulnerabilities of plutonium inventories at the laboratory. The objective of this site-specific self assessment is to identify and report ES and H vulnerabilities associated with the storage, handling, and processing of plutonium and maintenance of plutonium-contaminated facilities. This self-assessment of ES and H vulnerabilities and validation by a peer group is not another compliance audit or fault-finding exercise. It has a fact finding mission to develop a database of potential environment, safety, and health vulnerabilities that may lead to unnecessary or increased radiation exposure of the workers, release of radioactive materials to the environment, or radiation exposure of the public
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Issa, Sahar; van der Molen, Irna; Stel, Nora
2015-01-01
This chapter reviews the literature on vulnerability. Together with Chapter 3, that offers a literature review specifically focused on resilience, it lays the conceptual foundations for the empirical chapters in this edited volume. Vulnerability symbolizes the susceptibility of a certain system to
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Idrovo, Alvaro Javier
2004-01-01
The potential adverse effects on human health associated with pesticides used in the program of eradication of illicit crops in Colombia are controversial. From the beginning of the 80's the pesticides paraquat, triclopyr, imazapyr, glyphosate and tebuthiuron have been used in eradication programs or experimentally. The objective of this study was to identify a reasonable approach which could be adopted by public health on this problem. A qualitative content analysis was carried out of the speeches of social actors involved in this debate, to classify them according to Suppes' expectations, or lay approach to risk. Social actors were identified by means of available documents in hard copies or on the internet; afterwards, ideally typical texts were selected and analysed. Skin lesions, conjunctivitis, and gastrointestinal and respiratory infections were identified as the most frequent illnesses. The analysis of speeches identified the affected groups as vulnerable populations. The Colombian and American governments present reports, based on the "medical model", which indicate no association between glyphosate exposure and human health. Guerrilla groups do not show a clear relationship between pesticides and effects on health; the national and international scientific communities criticize the eradication program based on concepts from ecology and the Latin American Social Medicine; environmentalist groups criticize any use of pesticides, and human right defenders point out that sprayings violate Colombian and American laws. In conclusion the different positions are opposed and none can be considered irrefutable. A rational position from the public health standpoint is to support the adoption of the precaution principle.
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Husbands, Winston; Oakes, Wesley; Mbulaheni, Tola; Ongoïba, Fanta; Pierre-Pierre, Valérie; Luyombya, Henry
2017-10-29
Heterosexually active Black men are alleged to endorse masculine norms that increase their and their female partners' vulnerability to HIV. These norms include Black men's inability or reluctance to productively engage their own health-related personal and interpersonal vulnerabilities. We draw on data from the iSpeak research study in Ontario, Canada, to assess whether and how heterosexual Black men cope with personal and inter-personal vulnerability, namely that heterosexual Black men: avoid emotionally supportive relationships with other men (and women), which diminishes their capacity to productively acknowledge and resolve their health-related challenges; are reticent to productively acknowledge and address HIV and health on a personal level; and are pathologically secretive about their health, which compounds their vulnerability and precipitates poor health outcomes. iSpeak was implemented in 2011 to 2013, and included two focus groups with HIV-positive and HIV-negative self-identified heterosexual men (N = 14) in Toronto and London, a focus group with community-based health promotion practitioners who provide HIV-related services to Black communities in Ontario (N = 6), and one-on-one interviews with four researchers distinguished for their scholarship with/among Black communities in Toronto. Participants in the men's focus group were recruited discretely through word-of-mouth. Focus groups were audiotaped and transcribed verbatim. Team members independently read the transcripts, and then met to identify, discuss and agree on the emerging themes. We demonstrate that iSpeak participants (a) engage their personal and interpersonal vulnerabilities creatively and strategically, (b) complicate and challenge familiar interpretations of Black men's allegedly transgressive masculinity through their emotional and practical investment in their health, and (c) demonstrate a form of resourceful masculinity that ambiguously aligns with patriarchy. We conclude
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Public health nursing, ethics and human rights.
Ivanov, Luba L; Oden, Tami L
2013-05-01
Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations. © 2013 Wiley Periodicals, Inc.
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Rylander, Charlotta; Odland, Jon Øyvind; Sandanger, Torkjel Manning
2013-03-11
In 2007, the Intergovernmental Panel on Climate Change (IPCC) presented a large amount of evidence about global warming and the impact of human activities on global climate change. The Lancet Commission have identified a number of ways in which climate change can influence human health: lack of food and safe drinking water, poor sanitation, population migration, changing disease patterns and morbidity, more frequent extreme weather events, and lack of shelter. Pregnant women, the developing fetus, and young children are considered the most vulnerable members of our species and are already marginalized in many countries. Therefore, they may have increased sensitivity to the effects of climate change. Published literature in the fields of climate change, human health, tropical diseases, and direct heat exposure were assessed through the regular search engines. This article demonstrates that climate change will increase the risk of infant and maternal mortality, birth complications, and poorer reproductive health, especially in tropical, developing countries. Thus, climate change will have a substantial impact on the health and survival of the next generation among already challenged populations. There is limited knowledge regarding which regions will be most heavily affected. Research efforts are therefore required to identify the most vulnerable populations, fill knowledge gaps, and coordinate efforts to reduce negative health consequences. The effects of malnutrition, infectious diseases, environmental problems, and direct heat exposure on maternal health outcomes will lead to severe health risks for mothers and children. Increased focus on antenatal care is recommended to prevent worsening maternal health and perinatal mortality and morbidity. Interventions to reduce the negative health impacts caused by climate change are also crucial. Every effort should be made to develop and maintain good antenatal care during extreme life conditions as a result of climate
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Adapting to health impacts of climate change: a study of UNFCCC Annex I parties
International Nuclear Information System (INIS)
Lesnikowski, A C; Ford, J D; Berrang-Ford, L; Paterson, J A; Barrera, M; Heymann, S J
2011-01-01
Adapting to the health effects of climate change is one of the key challenges facing public health this century. Our knowledge of progress on adaptation, however, remains in its infancy. Using the Fifth National Communications of Annex I parties to the UNFCCC, 1912 initiatives are systematically identified and analyzed. 80% of the actions identified consist of groundwork (i.e. preparatory) action, with only 20% constituting tangible adaptations. No health vulnerability was recognized by all 38 Annex I countries. Furthermore, while all initiatives affect at least one health vulnerability, only 15% had an explicit human health component. Consideration for the special needs of vulnerable groups is uneven and underdeveloped. Climate change is directly motivating 71% of groundwork actions, and 61% of adaptation initiatives are being mainstreamed into existing institutions or programs. We conclude that the adaptation responses to the health risks of climate change remain piecemeal. Policymakers in the health sector must engage with stakeholders to implement adaptation that considers how climate change will impact the health of each segment of the population, particularly within those groups already considered most vulnerable to poor health outcomes.
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Directory of Open Access Journals (Sweden)
Mónica Cecilia De la Torre Ugarte Guanilo
2014-08-01
Full Text Available Objective To construct and validate markers of vulnerability of women to STDs/HIV, taking into consideration the importance of STDs/HIV. Method Methodological study carried out in three stages: 1 systematic review and identification of elements of vulnerability in the scientific production; 2 selection of elements of vulnerability, and development of markers; 3 establishment of the expert group and validation of the markers (content validity. Results Five markers were validated: no openness in the relationship to discuss aspects related to prevention of STDs/HIV; no perception of vulnerability to STDs/HIV; disregard of vulnerability to STDs/ HIV; not recognizing herself as the subject of sexual and reproductive rights; actions of health professionals that limit women’s access to prevention of STDs/HIV. Each marker contains three to eleven components. Conclusion The construction of such markers constituted an instrument, presented in another publication, which can contribute to support the identification of vulnerabilities of women in relation to STDs/HIV in the context of primary health care services. The markers constitute an important tool for the operationalization of the concept of vulnerability in primary health care and to promote inter/multidisciplinary and inter/multi-sectoral work processes.
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Blanton, Hart; Gerrard, Meg; McClive-Reed, Kimberly P
2013-01-01
Health interventions often draw attention to the risks associated with unhealthy choice but in the process produce a boomerang effect such that those targeted become more committed to risky behavior. In 2 studies designed to promote condom use among sexually active college students, the authors document strategies for highlighting risk while promoting healthy choices. Study 1 demonstrated that optimistic perceptions regarding the likelihood of contracting sexually transmitted diseases (STDs) can be counteracted by drawing attention to the emotional consequences of contracting STDs, instead of its likelihood. Rather than promoting condom use, however, this procedure generated a boomerang effect: It decreased commitment to using condoms, especially among high self-esteem individuals. Study 2 showed that this unwanted effect could be reversed when emotional vulnerability was paired with a self-affirmation. This finding suggests that there can be benefits to adding threatening content to health interventions, provided that the message also contains elements designed to protect feelings of self-worth.
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Building capacity and wellbeing in vulnerable/marginalised mothers: A qualitative study.
Balaam, Marie-Clare; Thomson, Gill
2018-01-19
The persistence of health inequalities in pregnancy and infancy amongst vulnerable/marginalised groups in the UK. During pregnancy and early motherhood some women experience severe and multiple psychosocial and economic disadvantages that negatively affect their wellbeing and make them at increased risk of poor maternal and infant health outcomes. To explore vulnerable/marginalised women's views and experiences of receiving targeted support from a specialist midwifery service and/or a charity. A mixed-methods study was undertaken that involved analysis of routinely collected birth-related/outcome data and interviews with a sample of vulnerable/marginalised women who had/had not received targeted support from a specialist midwifery service and/or a charity. In this paper we present in-depth insights from the 11 women who had received targeted support. Four key themes were identified; 'enabling needs-led care and support', 'empowering through knowledge, trust and acceptance', 'the value of a supportive presence' and 'developing capabilities, motivation and confidence'. Support provided by a specialist midwifery service and/or charity improved the maternity and parenting experiences of vulnerable/marginalised women. This was primarily achieved by developing a provider-woman relationship built on mutual trust and understanding and through which needs-led care and support was provided - leading to improved confidence, skills and capacities for positive parenting and health. The collaborative, multiagency, targeted intervention provides a useful model for further research and development. It offers a creative, salutogenic and health promoting approach to provide support for the most vulnerable/marginalised women as they make the journey into parenthood. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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Tallman, Paula Skye
2016-08-01
Researchers need measures of vulnerability that are grounded in explicit theoretical and conceptual frameworks, that are sensitive to local contexts, and that are easy to collect. This paper presents the Index of Vulnerability (IoV), a quantitative yet anthropologically-informed method connecting social-ecological systems to mental and physical health outcomes. The IoV combines measures of five life domains; food insecurity, water insecurity, access to healthcare, social support, and social status. Scores on this index increase for each life domain where the individual falls into a "high risk" category. Thus, individuals with the highest IoV scores are those who are at risk across multiple life domains. This approach makes the IoV malleable to local contexts, as scholars can choose which measure of each life domain is most appropriate for their study population. An anthropological study conducted among 225 Awajún adults living in the Peruvian Amazon from March to November of 2013 showed that men with higher IoV scores had significantly lower summary fat skinfolds, lower triglyceride levels, and a greater probability of reporting moderate to severe somatic symptoms and poor perceived health. Awajún women with higher IoV scores had significantly elevated perceived stress levels and a greater probability of reporting poor perceived health and moderate to severe somatic and depressive symptoms. Importantly, comparing the IoV to its constituent parts shows that it predicts a wider range of mental and physical health outcomes than any of the life domains alone. The IoV is presented here in relation to the broader political-economic and cultural context of the Awajún, forwarding a critical biocultural approach within anthropology, and demonstrating the IoV's utility for other scholars and practitioners. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Singham, Timothy; Viding, Essi; Schoeler, Tabea; Arseneault, Louise; Ronald, Angelica; Cecil, Charlotte M; McCrory, Eamon; Rijsdijk, Frülhing; Pingault, Jean-Baptiste
2017-11-01
Exposure to bullying is associated with poor mental health. However, the degree to which observed associations reflect direct detrimental contributions of exposure to bullying to mental health remains uncertain, as noncausal relationships may arise from genetic and environmental confounding (eg, preexisting vulnerabilities). Determining to what extent exposure to bullying contributes to mental health is an important concern, with implications for primary and secondary interventions. To characterize the concurrent and longitudinal contribution of exposure to bullying to mental health in childhood and adolescence using a twin differences design to strengthen causal inference. Participants were drawn from the Twins Early Development Study, a population-based cohort recruited from population records of births in England and Wales between January 1, 1994, and December 31, 1996. Data collection took place when the participants were between 11 and 16 years of age from December 1, 2005, to January 31, 2013. Data analysis was conducted from January 1, 2016, to June 20, 2017. Participants completed the Multidimensional Peer-Victimization Scale at 11 and 14 years of age. Mental health assessments at 11 and 16 years of age included anxiety, depression, hyperactivity and impulsivity, inattention, conduct problems, and psychotic-like experiences (eg, paranoid thoughts or cognitive disorganization). The 11 108 twins included in the final sample (5894 girls and 5214 boys) were a mean age of 11.3 years at the first assessment and 16.3 years at the last assessment. The most stringent twin differences estimates (monozygotic) were consistent with causal contribution of exposure to bullying at 11 years to concurrent anxiety, depression, hyperactivity and impulsivity, inattention, and conduct problems. Effects decreased over time; that is, substantial concurrent contributions to anxiety (β = 0.27; 95% CI, 0.22-0.33) persisted for 2 years (β = 0.12; 95% CI, 0.04-0.20) but not
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Human Health Countermeasures (HHC) Element Management Plan: Human Research Program. Revision B
Norsk, Peter; Baumann, David
2012-01-01
NASA s Human Research Program (HRP) is an applied research and technology program within the Human Exploration and Operations Mission Directorate (HEOMD) that addresses human health and performance risk mitigation strategies in support of exploration missions. The HRP research and technology development is focused on the highest priority risks to crew health and safety with the goal of ensuring mission success and maintaining long-term crew health. Crew health and performance standards, defined by the NASA Chief Health and Medical Officer (CHMO), set the acceptable risk level for exploration missions. The HRP conducts research to inform these standards as well as provide deliverables, such as countermeasures, that ensure standards can be met to maximize human performance and mission success. The Human Health Countermeasures (HHC) Element was formed as part of the HRP to develop a scientifically-based, integrated approach to understanding and mitigating the health risks associated with human spaceflight. These health risks have been organized into four research portfolios that group similar or related risks. A fifth portfolio exists for managing technology developments and infrastructure projects. The HHC Element portfolios consist of: a) Vision and Cardiovascular; b) Exercise and Performance; c) Multisystem; d) Bone; and e) Technology and Infrastructure. The HHC identifies gaps associated with the health risks and plans human physiology research that will result in knowledge required to more fully understand risks and will result in validated countermeasures to mitigate risks.
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Applicability of vulnerability maps
International Nuclear Information System (INIS)
Andersen, L.J.; Gosk, E.
1989-01-01
A number of aspects to vulnerability maps are discussed: the vulnerability concept, mapping purposes, possible users, and applicability of vulnerability maps. Problems associated with general-type vulnerability mapping, including large-scale maps, universal pollutant, and universal pollution scenario are also discussed. An alternative approach to vulnerability assessment - specific vulnerability mapping for limited areas, specific pollutant, and predefined pollution scenario - is suggested. A simplification of the vulnerability concept is proposed in order to make vulnerability mapping more objective and by this means more comparable. An extension of the vulnerability concept to the rest of the hydrogeological cycle (lakes, rivers, and the sea) is proposed. Some recommendations regarding future activities are given
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Assessment of the Health Impacts of Climate Change in Kiribati
McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven
2014-01-01
Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452
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Biodiversity, air quality and human health
David J. Nowak; Sarah Jovan; Christina Branquinho; Sofia Augusto; Manuel C. Ribeiro; Conor E. Kretsch
2015-01-01
Air pollution is a significant problem in cities across the world. It affects human health and well-being, ecosystem health, crops, climate, visibility and human-made materials. Health effects related to air pollution include its impact on the pulmonary, cardiac, vascular and neurological systems (Section 2). Trees affect air quality through a number of means (Section...
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Onyango, Esther Achieng; Sahin, Oz; Awiti, Alex; Chu, Cordia; Mackey, Brendan
2016-11-11
Malaria is one of the key research concerns in climate change-health relationships. Numerous risk assessments and modelling studies provide evidence that the transmission range of malaria will expand with rising temperatures, adversely impacting on vulnerable communities in the East African highlands. While there exist multiple lines of evidence for the influence of climate change on malaria transmission, there is insufficient understanding of the complex and interdependent factors that determine the risk and vulnerability of human populations at the community level. Moreover, existing studies have had limited focus on the nature of the impacts on vulnerable communities or how well they are prepared to cope. In order to address these gaps, a systems approach was used to present an integrated risk and vulnerability assessment framework for studies of community level risk and vulnerability to malaria due to climate change. Drawing upon published literature on existing frameworks, a systems approach was applied to characterize the factors influencing the interactions between climate change and malaria transmission. This involved structural analysis to determine influential, relay, dependent and autonomous variables in order to construct a detailed causal loop conceptual model that illustrates the relationships among key variables. An integrated assessment framework that considers indicators of both biophysical and social vulnerability was proposed based on the conceptual model. A major conclusion was that this integrated assessment framework can be implemented using Bayesian Belief Networks, and applied at a community level using both quantitative and qualitative methods with stakeholder engagement. The approach enables a robust assessment of community level risk and vulnerability to malaria, along with contextually relevant and targeted adaptation strategies for dealing with malaria transmission that incorporate both scientific and community perspectives.
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Dawson, A J; Nkowane, A M; Whelan, A
2015-12-18
Despite considerable evidence showing the importance of the nursing and midwifery workforce, there are no systematic reviews outlining how these cadres are best supported to provide universal access and reduce health care disparities at the primary health care (PHC) level. This review aims to identify nursing and midwifery policy, staffing, education and training interventions, collaborative efforts and strategies that have improved the quantity, quality and relevance of the nursing and midwifery workforce leading to health improvements for vulnerable populations. We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyse the interventions and findings of included studies using a conceptual framework. Thirty-six papers were included in the review, the majority (25) from high-income countries and nursing settings (32). Eleven papers defined leadership and governance approaches that had impacted upon the health outcomes of disadvantaged groups including policies at the national and state level that had led to an increased supply and coverage of nursing and midwifery staff and scope of practice. Twenty-seven papers outlined human resource management strategies to support the expansion of nurse's and midwives' roles that often involved task shifting and task sharing. These included approaches to managing staffing supply, distribution and skills mix; workloads; supervision; performance management; and remuneration, financial incentives and staffing costs. Education and training activities were described in 14 papers to assist nurses and midwives to perform new or expanded roles and prepare nurses for inclusive practice. This review identified collaboration between
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Nyantakyi-Frimpong, Hanson; Kangmennaang, Joseph; Bezner Kerr, Rachel; Luginaah, Isaac; Dakishoni, Laifolo; Lupafya, Esther; Shumba, Lizzie; Katundu, Mangani
2017-11-01
This paper assesses the relationship between agroecology, food security, and human health. Specifically, we ask if agroecology can lead to improved food security and human health among vulnerable smallholder farmers in semi-humid tropical Africa. The empirical evidence comes from a cross-sectional household survey (n=1000) in two districts in Malawi, a small country in semi-humid, tropical Africa. The survey consisted of 571 agroecology-adoption and 429 non-agroecology-adoption households. Ordered logistics regression and average treatment effects models were used to determine the effect of agroecology adoption on self-reported health. Our results show that agroecology-adoption households (OR=1.37, p=0.05) were more likely to report optimal health status, and the average treatment effect shows that adopters were 12% more likely to be in optimal health. Furthermore, being moderately food insecure (OR=0.59, p=0.05) and severely food insecure (OR=0.89, p=0.10) were associated with less likelihood of reporting optimal health status. The paper concludes that with the adoption of agroecology in the semi-humid tropics, it is possible for households to diversify their crops and diets, a condition that has strong implications for improved food security, good nutrition and human health. Copyright © 2016 Elsevier B.V. All rights reserved.
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Integrated flash flood vulnerability assessment: Insights from East Attica, Greece
Karagiorgos, Konstantinos; Thaler, Thomas; Heiser, Micha; Hübl, Johannes; Fuchs, Sven
2016-10-01
In the framework of flood risk assessment, vulnerability is a key concept to assess the susceptibility of elements at risk. Besides the increasing amount of studies on flash floods available, in-depth information on vulnerability in Mediterranean countries was missing so far. Moreover, current approaches in vulnerability research are driven by a divide between social scientists who tend to view vulnerability as representing a set of socio-economic factors, and natural scientists who view vulnerability in terms of the degree of loss to an element at risk. Further, vulnerability studies in response to flash flood processes are rarely answered in the literature. In order to close this gap, this paper implemented an integrated vulnerability approach focusing on residential buildings exposed to flash floods in Greece. In general, both physical and social vulnerability was comparable low, which is interpreted as a result from (a) specific building regulations in Greece as well as general design principles leading to less structural susceptibility of elements at risk exposed, and (b) relatively low economic losses leading to less social vulnerability of citizens exposed. The population show high risk awareness and coping capacity to response to natural hazards event and in the same time the impact of the events are quite low, because of the already high use of local protection measures. The low vulnerability score for East Attica can be attributed especially to the low physical vulnerability and the moderate socio-economic well-being of the area. The consequence is to focus risk management strategies mainly in the reduction of the social vulnerability. By analysing both physical and social vulnerability an attempt was made to bridge the gap between scholars from sciences and humanities, and to integrate the results of the analysis into the broader vulnerability context.
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Analysis of the NIST database towards the composition of vulnerabilities in attack scenarios
Nunes Leal Franqueira, V.; van Keulen, Maurice
The composition of vulnerabilities in attack scenarios has been traditionally performed based on detailed pre- and post-conditions. Although very precise, this approach is dependent on human analysis, is time consuming, and not at all scalable. We investigate the NIST National Vulnerability Database
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Public health ethics and more-than-human solidarity.
Rock, Melanie J; Degeling, Chris
2015-03-01
This article contributes to the literature on One Health and public health ethics by expanding the principle of solidarity. We conceptualise solidarity to encompass not only practices intended to assist other people, but also practices intended to assist non-human others, including animals, plants, or places. To illustrate how manifestations of humanist and more-than-human solidarity may selectively complement one another, or collide, recent responses to Hendra virus in Australia and Rabies virus in Canada serve as case examples. Given that caring relationships are foundational to health promotion, people's efforts to care for non-human others are highly relevant to public health, even when these efforts conflict with edicts issued in the name of public health. In its most optimistic explication, One Health aims to attain optimal health for humans, non-human animals and their shared environments. As a field, public health ethics needs to move beyond an exclusive preoccupation with humans, so as to account for moral complexity arising from people's diverse connections with places, plants, and non-human animals. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Jongeneel, Sophie
2008-01-01
Human health is influenced by pollutants in the air. Since people spend over 80% of their time indoors, indoor air quality may be more related to health problems than outdoor air qual-ity. Indoor air quality is deteriorating because of energy conservation
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Landslide Vulnerability Assessment (LVAs: A Case Study from Kota Kinabalu, Sabah, Malaysia
Directory of Open Access Journals (Sweden)
Rodeano Roslee
2016-12-01
Full Text Available DOI: 10.17014/ijog.4.1.49-59The topic on Landslide Vulnerability Assessment (LVAs in Malaysia is relatively new and received little attention from geoscientists and engineers. This research paper tries to formulate the concept of LVAs by taking into account the science and socio-economic aspects. A new approach in vulnerability concept is also introduced herein. To achieve this goal, a framework was designed for assessing the LVAs. The framework was formulated semiquantitatively through the development of database for the risk elements (human and properties based on information from secondary data (technical reports, extensive review of literature, and field observations. The vulnerability parameters included in assessing LVAs are 1 physical implication (building structures, internal materials, property damage, infrastructural facilities, and stabilization actions, 2 social status (injury, fatalities, safety, loss of accommodation, and public awareness, and 3 interference on environment (affected period, daily operation, and diversity. Each considered parameter in the vulnerability assessment is allocated with a certain index value ranges from 0 (0 % damage/victims/period, 0.25 (1 - 25% damage/victims/period, 0.50 (26 - 50% damage/victims/period, 0.75 (51 - 75% damage/victims/period, and 1.00 (75 - 100% damage/victims/period. All of these parameters are compiled and analyzed with “Landslide Distribution Map” (LDM to generate a “Landslide Vulnerability Degree map (LVD”. The LDM was produced based on field studies and satellite image interpretations in order to locate the landslide locations in the studied area. Finally, three types of physical, human, and environment vulnerabilities were then classified into five classes of vulnerabilities, namely: Class 1 (< 0.20: Very Low Vulnerability; Class 2 (0.21 - 0.40: Low Vulnerability; Class 3 (0.41 - 0.60: Medium Vulnerability; Class 4 (0.61 - 0.80: High Vulnerability; and Class 5 (> 0.81: Very
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Foley, Perry; Steinberg, Dori; Levine, Erica; Askew, Sandy; Batch, Bryan C; Puleo, Elaine M; Svetkey, Laura P; Bosworth, Hayden B; DeVries, Abigail; Miranda, Heather; Bennett, Gary G
2016-05-01
Obesity continues to disproportionately affect medically vulnerable populations. Digital health interventions may be effective for delivering obesity treatment in low-resource primary care settings. Track is a 12-month randomized controlled trial of a digital health weight loss intervention in a community health center system. Participants are 351 obese men and women aged 21 to 65years with an obesity-related comorbidity. Track participants are randomized to usual primary care or to a 12-month intervention consisting of algorithm-generated tailored behavior change goals, self-monitoring via mobile technologies, daily self-weighing using a network-connected scale, skills training materials, 18 counseling phone calls with a Track coach, and primary care provider counseling. Participants are followed over 12months, with study visits at baseline, 6, and 12months. Anthropometric data, blood pressure, fasting lipids, glucose and HbA1C and self-administered surveys are collected. Follow-up data will be collected from the medical record at 24months. Participants are 68% female and on average 50.7years old with a mean BMI of 35.9kg/m(2). Participants are mainly black (54%) or white (33%); 12.5% are Hispanic. Participants are mostly employed and low-income. Over 20% of the sample has hypertension, diabetes and hyperlipidemia. Almost 27% of participants currently smoke and almost 20% score above the clinical threshold for depression. Track utilizes an innovative, digital health approach to reduce obesity and chronic disease risk among medically vulnerable adults in the primary care setting. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk patient population in need of evidence-based obesity treatment. Copyright © 2016 Elsevier Inc. All rights reserved.
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Decreasing Human Trafficking through Sex Work Decriminalization.
Albright, Erin; D'Adamo, Kate
2017-01-01
In order to decrease human trafficking, health care workers should support the full decriminalization of prostitution. Similar to trafficking in other forms of labor, preventing trafficking in the sex trade requires addressing the different forms of marginalization that create vulnerable communities. By removing punitive laws that prevent reporting of exploitation and abuse, decriminalization allows sex workers to work more safely, thereby reducing marginalization and vulnerability. Decriminalization can also help destigmatize sex work and help resist political, social, and cultural marginalization of sex workers. © 2017 American Medical Association. All Rights Reserved.
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International Nuclear Information System (INIS)
1994-09-01
The Hanford Site Self Assessment of Plutonium Environmental Safety and Health (ES and H) Vulnerabilities was conducted in accordance with the US Department of Energy (DOE) Secretary's directive of February 1994. The implementation plans to carry out this directive are contained in the Project Plan and the Assessment Plan. For this assessment, vulnerabilities are defined as conditions or weaknesses that may lead to unnecessary or increased radiation exposure of the workers, release of radioactive materials to the environment, or radiation exposure of the public. The purpose for the Assessment is to evaluate environmental, safety and health vulnerabilities from plutonium operations and storage activities. Acts of sabotage or diversion of plutonium which obviously may have ES and H implications are excluded from this study because separate DOE programs evaluate those issues on a continuing basis. Security and safeguards activities which may have negative impacts on safety are included in the evaluation
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Soil, Food Security and Human Health
Oliver, Margaret
2017-04-01
"Upon this handful of soil our survival depends. Husband it and it will grow food, our fuel, and our shelter and surround us with beauty. Abuse it and the soil will collapse and die, taking humanity with it" Vedas Sanskrit Scripture, 1500 BC. As the world's population increases issues of food security become more pressing as does the need to sustain soil fertility and to minimize soil degradation. Soil and land are finite resources, and agricultural land is under severe competition from many other uses. Lack of adequate food and food of poor nutritional quality lead to under-nutrition of different degrees, all of which can cause ill- or suboptimal-health. The soil can affect human health directly and indirectly. Direct effects of soil or its constituents result from its ingestion, inhalation or absorption. For example, hook worms enter the body through the skin and cause anaemia, and fungi and dust can be inhaled resulting in respiratory problems. The soil is the source of actinomycetes on which our earliest antibiotics are based (actinomycin, neomycin and streptomycin). Furthermore, it is a potential reservoir of new antibiotics with methods such as functional metagenomics to identify antibiotic resistant genes. Indirect effects of soil arise from the quantity and quality of food that humans consume. Trace elements can have both beneficial and toxic effects on humans, especially where the range for optimal intake is narrow as for selenium. Deficiencies of four trace elements, iodine, iron, selenium and zinc, will be considered because of their substantial effects on human health. Relations between soil and human health are often difficult to extricate because of the many confounding factors present such as the source of food, social factors and so on. Nevertheless, recent scientific understanding of soil processes and factors that affect human health are enabling greater insight into the effects of soil on our health. Multidisciplinary research that includes soil
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Meier, B M; Onzivu, W
2014-02-01
The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Charlotta Rylander
2013-03-01
Full Text Available In 2007, the Intergovernmental Panel on Climate Change (IPCC presented a large amount of evidence about global warming and the impact of human activities on global climate change. The Lancet Commission have identified a number of ways in which climate change can influence human health: lack of food and safe drinking water, poor sanitation, population migration, changing disease patterns and morbidity, more frequent extreme weather events, and lack of shelter. Pregnant women, the developing fetus, and young children are considered the most vulnerable members of our species and are already marginalized in many countries. Therefore, they may have increased sensitivity to the effects of climate change. Published literature in the fields of climate change, human health, tropical diseases, and direct heat exposure were assessed through the regular search engines. This article demonstrates that climate change will increase the risk of infant and maternal mortality, birth complications, and poorer reproductive health, especially in tropical, developing countries. Thus, climate change will have a substantial impact on the health and survival of the next generation among already challenged populations. There is limited knowledge regarding which regions will be most heavily affected. Research efforts are therefore required to identify the most vulnerable populations, fill knowledge gaps, and coordinate efforts to reduce negative health consequences. The effects of malnutrition, infectious diseases, environmental problems, and direct heat exposure on maternal health outcomes will lead to severe health risks for mothers and children. Increased focus on antenatal care is recommended to prevent worsening maternal health and perinatal mortality and morbidity. Interventions to reduce the negative health impacts caused by climate change are also crucial. Every effort should be made to develop and maintain good antenatal care during extreme life conditions as a
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Downs, Timothy J.; Ross, Laurie; Goble, Robert; Subedi, Rajendra; Greenberg, Sara; Taylor, Octavia
2010-01-01
Millions of low-income people of diverse ethnicities inhabit stressful old urban industrial neighborhoods. Yet we know little about the health impacts of built-environment stressors and risk perceptions in such settings; we lack even basic health profiles. Difficult access is one reason (it took us 30 months to survey 80 households); the lack of multifaceted survey tools is another. We designed and implemented a pilot vulnerability assessment tool in Worcester, Massachusetts. We answer: (1) H...
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Assessment of Coastal Vulnerability Through the Use of GIS Tools in South Sicily (Italy)
Anfuso, Giorgio; Martínez Del Pozo, José Ángel
2009-03-01
This study assessed coastal erosion vulnerability along a 90-km sector, which included both erosional and accretionary beaches, and different levels of human occupation. Two aerial photogrammetric flights were used to reconstruct coastal evolution between 1977 and 1999. During this period, extensive accretion was recorded updrift of human structures at harbors and ports, e.g., Scoglitti (105.6 m), Donnalucata (52.8 m), and Pozzallo (94.6 m). Conversely, erosion was recorded in downdrift areas, with maximum values at Modica Stream mouth (63.8 m) and Point Castellazzo (35.2 m). Assessments were subsequently divided into four categories ranging from “high erosion” to “accretion.” Several sources were examined to assess human activities and land use. The latter was mapped and divided into four categories, ranging from “very high” to “no capital” land use. Subsequently, coastal erosion vulnerability was assessed by combining land use categories with recorded coastline behavior. Results showed “very high” to “high” vulnerability along 5.8% and 16.6%, respectively, of the littoral, while 20.9% and 56.7%, respectively, was found to exhibit “medium” and “low/very low” vulnerability. A very good agreement between predicted coastal vulnerability and coastal trend had been observed over recent years. Furthermore, several human structures and activities are located within the “imminent collapse zone (ICZ)” which reached maximum values of 17.5 m at Modica Stream and 13.5 m at Point Braccetto.
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Eddy, Christopher; Sase, Eriko
2015-01-01
The objective of this article was to examine the environmental health implications of the 2011 Fukushima nuclear disaster from an all-hazards perspective. The authors performed a literature review that included Japanese and international nuclear guidance and policy, scientific papers, and reports on the Chernobyl and Three Mile Island disasters while also considering all-hazards preparedness rubrics in the U.S. The examination of the literature resulted in the following: a) the authors' "All-Hazards Planning Reference Model" that distinguishes three planning categories-Disaster Trigger Event, Man-Made Hazards, and Vulnerability Factors; b) the generalization of their model to other countries; and c) advocacy for environmental health end fate to be considered in planning phases to minimize risk to environmental health. This article discusses inconsistencies in disaster planning and nomenclature existing in the studied materials and international guidance and proposes new opportunity for developing predisaster risk assessment, risk communication, and prevention capacity building.
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Burak, S.; Meddeb, R.
2012-04-01
The Comoros Islands are part of the Small Island Developing States (SIDS) located in the Indian Ocean. SIDS are islands and low-lying coastal nations that face common barriers to sustainable development, including limited resources, poor economic resilience, and vulnerability to sea level rise and natural disasters. The Comoros Archipelago is made up of four islands but the present study was conducted on three islands, namely Mwali (Mohéli), Ngazidja (Grande Comore) and Dzwani (Anjouan) that are aligned in the Mozambique Channel and spread over a surface area of 1862 km2. These islands are exposed to natural disaster coupled with human-induced pressure on natural resources. The major natural disaster vulnerability has been identified by the National AdaptationProgramme of Action (NAPA, 2006) as climate change, whose likely adverse impacts on the Comoros Islands are: i) changes in rainfall patterns; ii) increases in temperature; iii) salinization of coastal aquifers as a result of salt water intrusion due to sea level rise; and iv) increased frequency of severe weather conditions (such as tropical cyclones, droughts, heavy rainfall and flooding). In addition, existing practices related to natural resources management (primarily land, forest and water management) are very poor and this failure is increasingly threatening water and food security, resulting in a decline of economic growth and standards of living within the Comoros. Human-induced pressure combined with climate change impact is the inherent vulnerabilities of these islands. The government of the Union of the Comoros is aware of the alarming nature of climate change impact and has put in place several projects aiming at implementing adaptation measures in order to help increase the resilience of the vulnerable population in the face of this threat. These projects involve strengthening institutions, policy and regulations so as to improve the management of natural resources, among other measures. The
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International Nuclear Information System (INIS)
1994-09-01
The objective of the Plutonium Environment, Safety, and Health (ES ampersand H) Vulnerability Assessment Project was to conduct a comprehensive assessment of the ES ampersand H vulnerabilities arising from the Department of Energy (DOE) storage and handling of its current plutonium holdings. The purpose of this assessment was to identify and prioritize ES ampersand H vulnerabilities that could lead to unnecessary or increased radiation exposure of workers, release of radioactive materials to the environment, or radiation exposure of the public. The results will serve as an information base for identifying interim corrective actions and options for the safe management of fissile materials
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Flood vulnerability of critical infrastructure in Cork, Ireland
Directory of Open Access Journals (Sweden)
de Bruijn Karin M.
2016-01-01
Full Text Available Recent flood events in Ireland and particularly in County Cork have caused significant disruption to health service provisions, interruption of water and power supplies, and damage to roads and other transportation infrastructure, affecting the lives of hundreds of thousands of people over a prolonged period of weeks. These events clearly reveal- the vulnerability of the critical infrastructure to flooding and the dependence of society on critical infrastructure. In order to reduce the flood vulnerability and increase the resilience of the critical infrastructure networks in the future, detailed evidence-based analysis and assessment is essential. To this end a case study has been carried out on Cork City which analyses this vulnerability as it was in 2009, and as it is currently, and identifies adaptation options to reduce the future vulnerability of critical infrastructure to flooding and to build a more resilient society. This paper describes the storyline approach and CIrcle tool and their application to Cork City which focused on the analysis of the flood vulnerability of critical infrastructure and the impacts of failure of the infrastructure for other critical functions and on society.
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[Agrochemicals and human health: contributions of healthcare professionals].
de Siqueira, Soraia Lemos; Kruse, Maria Henriqueta Luce
2008-09-01
This paper focuses on the scientific production of health professionals, especially nurses, about agrochemicals and human health. The essay combines and presents information by means of literature review, with a view to acknowledge the contribution of each author and their use for the human health field. Thirty-two research articles, published in Brazilian journals, were located. The analysis of these articles highlights that healthcare professionals' contributions focus on human health, especially, workers' health and food quality. With a view to minimize the effects from agrochemicals on human and environmental health, the authors exposes action suggestions both for health professionals and for the institutions associated.
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Vulnerable populations: cultural and spiritual direction.
Quest, Tammie E; Franks, Nicole M
2006-08-01
Cultural, spiritual, and religious diversity of emergency department patients is increasing while that of emergency physicians in particular remains predominantly homogeneous. With a discordance of cultural, race, and ethnicity exist, in the case of ethical conflict -resolution becomes that much more difficult. Patients may feel vulnerable when their emergency care provider does not understand his or her cultural, spiritual, and religious uniqueness as it relates to the patient-doctor interaction and health care decision making. This review will examine (1) language differences; (2) cultural, religious, and spiritual differences between patient and provider; (3) differing explanatory models of disease between patient and provider; and (4) diverse bioethical models of decision making of differing cultures in an effort to reduce vulnerabilities.
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Kim, Kyounghae; Choi, Janet S; Choi, Eunsuk; Nieman, Carrie L; Joo, Jin Hui; Lin, Frank R; Gitlin, Laura N; Han, Hae-Ra
2016-04-01
Community-based health workers (CBHWs) are frontline public health workers who are trusted members of the community they serve. Recently, considerable attention has been drawn to CBHWs in promoting healthy behaviors and health outcomes among vulnerable populations who often face health inequities. We performed a systematic review to synthesize evidence concerning the types of CBHW interventions, the qualification and characteristics of CBHWs, and patient outcomes and cost-effectiveness of such interventions in vulnerable populations with chronic, noncommunicable conditions. We undertook 4 electronic database searches-PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane-and hand searched reference collections to identify randomized controlled trials published in English before August 2014. We screened a total of 934 unique citations initially for titles and abstracts. Two reviewers then independently evaluated 166 full-text articles that were passed onto review processes. Sixty-one studies and 6 companion articles (e.g., cost-effectiveness analysis) met eligibility criteria for inclusion. Four trained research assistants extracted data by using a standardized data extraction form developed by the authors. Subsequently, an independent research assistant reviewed extracted data to check accuracy. Discrepancies were resolved through discussions among the study team members. Each study was evaluated for its quality by 2 research assistants who extracted relevant study information. Interrater agreement rates ranged from 61% to 91% (average 86%). Any discrepancies in terms of quality rating were resolved through team discussions. All but 4 studies were conducted in the United States. The 2 most common areas for CBHW interventions were cancer prevention (n = 30) and cardiovascular disease risk reduction (n = 26). The roles assumed by CBHWs included health education (n = 48), counseling (n = 36), navigation assistance (n
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NASA Space Flight Human-System Standard Human Factors, Habitability, and Environmental Health
Holubec, Keith; Connolly, Janis
2010-01-01
This slide presentation reviews the history, and development of NASA-STD-3001, NASA Space Flight Human-System Standard Human Factors, Habitability, and Environmental Health, and the related Human Integration Design Handbook. Currently being developed from NASA-STD-3000, this project standard currently in review will be available in two volumes, (i.e., Volume 1 -- VCrew Health and Volume 2 -- Human Factors, Habitability, and Environmental Health) and the handbook will be both available as a pdf file and as a interactive website.
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Human rights, health and the state in Bangladesh
Directory of Open Access Journals (Sweden)
Rahman Redwanur M
2006-04-01
Full Text Available Abstract Background This paper broadly discusses the role of the State of Bangladesh in the context of the health system and human rights. The interrelation between human rights, health and development are well documented. The recognition of health as a fundamental right by WHO and subsequent approval of health as an instrument of welfare by the Universal Declaration of Human Rights (UDHR and the International Covenant on Social, Economic and Cultural Rights (ICSECR further enhances the idea. Moreover, human rights are also recognized as an expedient of human development. The state is entrusted to realize the rights enunciated in the ICSECR. Discussion In exploring the relationship of the human rights and health situation in Bangladesh, it is argued, in this paper, that the constitution and major policy documents of the Bangladesh government have recognized the health rights and development. Bangladesh has ratified most of the international treaties and covenants including ICCPR, ICESCR; and a signatory of international declarations including Alma-Ata, ICPD, Beijing declarations, and Millennium Development Goals. However the implementation of government policies and plans in the development of health institutions, human resources, accessibility and availability, resource distribution, rural-urban disparity, the male-female gap has put the health system in a dismal state. Neither the right to health nor the right to development has been established in the development of health system or in providing health care. Summary The development and service pattern of the health system have negative correlation with human rights and contributed to the underdevelopment of Bangladesh. The government should take comprehensive approach in prioritizing the health rights of the citizens and progressive realization of these rights.
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Human and animal sentinels for shared health risks
Directory of Open Access Journals (Sweden)
Peter Rabinowitz, MD, MPH
2009-03-01
Full Text Available The tracking of sentinel health events in humans in order to detect and manage disease risks facing a larger population is a well accepted technique applied to influenza, occupational conditions and emerging infectious diseases. Similarly, animal health professionals routinely track disease events in sentinel animal colonies and sentinel herds. The use of animals as sentinels for human health threats, or of humans as sentinels for animal disease risk, dates back at least to the era when coal miners brought caged canaries into mines to provide early warning of toxic gases. Yet the full potential of linking animal and human health information to provide warning of such ‘shared risks’ from environmental hazards has not been realised. Reasons appear to include the professional segregation of human and animal health communities, the separation of human and animal surveillance data and evidence gaps in the linkages between human and animal responses to environmental health hazards. The ‘One Health initiative’ and growing international collaboration in response to pandemic threats, coupled with development in the fields of informatics and genomics, hold promise for improved sentinel event coordination in order to detect and reduce environmental health threats shared between species.
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Sequeira, Carlos Alberto da Cruz; Barbosa, Elsa Natalina Mendes; Nogueira, Maria José Carvalho; Sampaio, Francisco Miguel Correia
2017-10-01
Translate, adapt the language, and assess the psychometric properties of the Mental Vulnerability Questionnaire (MVQ) in a Portuguese population sample of young adults. A psychometric validation study was performed. The sample comprised 166 undergraduate students. Factor analysis was applied to extract three indicators. The MVQ showed divergent validity with the Positive Mental Health Questionnaire (p Mental Health Inventory including five items (p mental vulnerability. © 2016 Wiley Periodicals, Inc.
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Proposing a Health Humanities Minor: Some Lessons.
Engholm, Virginia Bucurel; Boria, Damon
2017-12-01
For those interested in developing baccalaureate programs in health humanities, this essay draws on our experience of developing a minor in health humanities to share insights on what to expect, strategies that work well, and how to deal with obstacles. These insights range from how to explain the concept of health humanities to stakeholders (faculty, administrators, and community partners) to how to decide where to house a health humanities program. We share our insights in a way that promises to translate well to different institutional contexts. That said, this paper is more relevant for institutional contexts where budgets are stressed and, consequently, proposals to invest in humanities programs are a difficult sell. This paper is divided into sections addressing how to (a) earn institutional support, (b) gain campus buy-in, (c) identify benefits of the proposed program, (d) decide where to house the program, (e) calculate program cost, and (f) secure external funding. We conclude with some final reflections on the current status of our program and why we are committed to health humanities education.
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Vulnerability and Knowledge of Sexually Transmitted Infections ...
African Journals Online (AJOL)
Vulnerability and Knowledge of Sexually Transmitted Infections Among Female Traders of Reproductive Age in Enugu, Nigeria. ... Conclusion: The inclusion of health education in schools' curricula to ensure that adolescents are adequately aware of STIs, their modes of transmission, prevention and treatment before ...
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Directory of Open Access Journals (Sweden)
Sharon Low
2014-09-01
Full Text Available Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods: A case study method was used to document how existing human resources for health (HRH reach the vulnerable population in the ethnic health organizations’ (EHOs and community-based organizations’ (CBHOs service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings: Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion: Despite the chronic conflict in
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Low, Sharon; Tun, Kyaw Thura; Mhote, Naw Pue Pue; Htoo, Saw Nay; Maung, Cynthia; Kyaw, Saw Win; Shwe Oo, Saw Eh Kalu; Pocock, Nicola Suyin
2014-01-01
Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations' (EHOs) and community-based organizations' (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Despite the chronic conflict in Burma/Myanmar, this report provides evidence of the substantive
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[Folate, vitamin B12 and human health].
Brito, Alex; Hertrampf, Eva; Olivares, Manuel; Gaitán, Diego; Sánchez, Hugo; Allen, Lindsay H; Uauy, Ricardo
2012-11-01
During the past decade the role of folate and vitamin B12 in human nutrition have been under constant re-examination. Basic knowledge on the metabolism and interactions between these essential nutrients has expanded and multiple complexities have been unraveled. These micronutrients have shared functions and intertwined metabolic pathways that define the size of the "methyl donor" pool utilized in multiple metabolic pathways; these include DNA methylation and synthesis of nucleic acids. In Chile, folate deficiency is virtually nonexistent, while vitamin B12 deficiency affects approximately 8.5-51% depending on the cut-off value used to define deficiency. Folate is found naturally mainly in vegetables or added as folic acid to staple foods. Vitamin B12 in its natural form is present only in foods of animal origin, which is why deficit is more common among strict vegetarians and populations with a low intake of animal foods. Poor folate status in vulnerable women of childbearing age increases the risk of neural tube birth defects, so the critical time for the contribution of folic acid is several months before conception since neural tube closure occurs during the first weeks of life. The absorption of vitamin B12 from food is lower in older adults, who are considered to have higher risk of gastric mucosa atrophy, altered production of intrinsic factor and acid secretion. Deficiency of these vitamins is associated with hematological disorders. Vitamin B12 deficiency can also induce clinical and sub-clinical neurological and of other disorders. The purpose of this review is to provide an update on recent advances in the basic and applied knowledge of these vitamins relative to human health.
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Hosking, Jamie; Campbell-Lendrum, Diarmid
2012-08-01
In 2008, the World Health Organization (WHO) Member States passed a World Health Assembly resolution that identified the following five priority areas for research and pilot projects on climate change and human health: health vulnerability, health protection, health impacts of mitigation and adaptation policies, decision-support and other tools, and costs of health protection from climate change. To assess the extent to which recently published research corresponds to these priorities, we undertook a scoping review of original research on climate change and human health. Scoping reviews address topics that are too broad for a systematic review and commonly aim to identify research gaps in existing literature. We also assessed recent publication trends for climate change and health research. We searched for original quantitative research published from 2008 onward. We included disease burden studies that were specific to climate change and health and included intervention studies that focused on climate change and measured health outcomes. We used MEDLINE, Embase, and Web of Science databases and extracted data on research priority areas, geographic regions, health fields, and equity (systematic differences between advantaged and disadvantaged social groups). We identified 40 eligible studies. Compared with other health topics, the number of climate change publications has grown rapidly, with a larger proportion of reviews or editorials. Recent original research addressed four of the five priority areas identified by the WHO Member States, but we found no eligible studies of health adaptation interventions, and most of the studies focused on high-income countries. Climate change and health is a rapidly growing area of research, but quantitative studies remain rare. Among recently published studies, we found gaps in adaptation research and a deficit of studies in most developing regions. Funders and researchers should monitor and respond to research gaps to help
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Human Rights and Health Services
DEFF Research Database (Denmark)
Skitsou, Alexandra; Bekos, Christos; Charalambous, George
2016-01-01
Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions of the Ombuds......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......, ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...
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Intrinsic vulnerability assessment of Sette Comuni Plateau aquifer (Veneto Region, Italy).
Cucchi, Franco; Franceschini, Giuliana; Zini, Luca; Aurighi, Marina
2008-09-01
Maps illustrating the different degrees of vulnerability within a given area are integral to environmental protection and management policies. The assessment of the intrinsic vulnerability of karst areas is difficult since the type and stage of karst development and the related underground discharge behavior are difficult to determine and quantify. Geographic Information Systems techniques are applied to the evaluation of the vulnerability of an aquifer in the alpine karst area of the Sette Comuni Plateau, in the Veneto Region of northern Italy. The water resources of the studied aquifer are of particular importance to the local communities. This aquifer must therefore be protected from both inappropriate use as well as possible pollution. The SINTACS and SINTACS P(RO) K(ARST) vulnerability assessment methods have been utilized here to create the vulnerability map. SINTACS P(RO) K(ARST) is an adaptation of the parametric managerial model (SINTACS) to karst hydrostructures. The vulnerability map reveals vast zones (81% of the analyzed areas) with a high degree of vulnerability. The presence of well-developed karst structures in these highly vulnerable areas facilitate water percolation, thereby enhancing the groundwater vulnerability risk. Only 1.5 of the studied aquifer have extremely high-vulnerability levels, however these areas include all of the major springs utilized for human consumption. This vulnerability map of the Sette Comuni Plateau aquifer is an indispensable tool for both the effective management of water resources and as support to environmental planning in the Sette Comuni Plateau area.
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Rodak, C. M.; Silliman, S. E.; Bolster, D.
2012-12-01
A hypothetical case study of groundwater contaminant protection was carried out using time-dependent health risk calculations. The case study focuses on a hypothetical zoning project for parcels of land around a well field in northern Indiana, where the control of cancer risk relative to a mandated cancer risk threshold is of concern in the management strategy. Within our analysis, we include both uncertainty in the subsurface transport and variability in population behavior in the calculation of time-dependent health risks. From these results we introduce risk maps, a visual representation of the probability of an unacceptable health risk as a function of population behavior and the time at which exposure to the contaminant begins. We also evaluate the time-dependent risks with three criteria from water resource literature: reliability, resilience, and vulnerability (RRV). With respect to health risk from a groundwater well, the three criteria determine: the probability that a well produces safe water (reliability), the probability that a contaminated well returns to an uncontaminated state within a specified time interval (resilience), and the overall severity in terms of health impact of the contamination at a well head (vulnerability). The results demonstrate that the distributions of RRV values for each parcel of land are linked to the time-dependent concentration profile of the contaminant at the well, and the toxicological characteristics of the contaminant. The proposed time-dependent risk calculation expands on current techniques to include a continuous exposure start time, capable of reproducing the maximum risk while providing information on the severity and duration of health risks. Overall this study suggests that, especially in light of the inherent complexity of health-groundwater systems, RRV are viable criteria for relatively simple and effective evaluation of time-dependent health risk. It is argued that the RRV approach, as applied to
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Thumbi, S. M.; Njenga, M. Kariuki; Marsh, Thomas L.; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M.; Bigogo, Godfrey; Breiman, Robert F.; Palmer, Guy H.; McElwain, Terry F.
2015-01-01
Background For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. Method We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Findings Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling
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Directory of Open Access Journals (Sweden)
John Ogony Odiyo
2018-02-01
Full Text Available Due to inaccessibility of potable water, rural communities drill boreholes within their homesteads despite vulnerability to groundwater contamination and associated health risks. This study assessed the quality of groundwater, identified potential sources of contamination and potential human health risks in Siloam Village, South Africa. Statistical difference between similar water quality parameters at different sites was determined at a significance level (α of 0.05. Water quality parameters with serious potential health effects on human beings were correlated with selected water quality parameters to understand the nature of correlation and possible sources of contamination. Fluorides and nitrates had excessively high concentrations associated with tooth damage and pronounced skeletal fluorosis, and methaemoglobinaemia in infants and mucous membrane irritation in adults, respectively. There were statistically significant differences between means of most water quality parameters. Contrasting correlation of fluoride with calcium and pH indicated the need to further identify local sources and fluoride control mechanisms. Correlation of nitrate with chloride mostly indicated that faecal contamination is the potential source of high nitrates in groundwater. This requires further verification. Presence of total coliforms and E. coli in most boreholes indicated potential presence of faecal contamination. The need to educate borehole owners’ on possible strategies to minimise groundwater pollution was identified.
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Transformative combinations: women's health and human rights.
Yamin, A E
1997-01-01
From the human rights perspective proposed in this article, a woman's good or ill health reflects more than biology or individual behaviors; it reflects her enjoyment (or lack thereof) of fundamental human rights that enable her to exercise basic power over the course and quality of her life. The "structural" view of health that such a human rights perspective suggests is concerned first with identifying the effects of social, economic, and political relations on women's health and then with promoting "interventions" aimed at transforming the laws, institutions, and structures that deny women's rights and well-being. Yet, traditional human rights law and practice have been limited to narrowly defined abuses by public officials against individuals that fail to capture the most pervasive denials of women's rights, which, though rooted in systematic discrimination, are frequently played out in so-called "private" institutions, primarily within the family. The experiences of women's health advocates in addressing complex women's health issues makes it clear that women's lack of access to economic and political power in the public sphere creates the conditions under which they are discriminated against and physically and sexually abused in the private sphere. Combining the pragmatic understanding of women's health professionals with an expansive conception of human rights norms has the potential to transform the fields of women's health and human rights.
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Directory of Open Access Journals (Sweden)
ARMEAN ANDREEA
2013-06-01
Full Text Available In present, the study of vulnerability of companies is increasing in every field due to the unstable economic environment influences. The object of this research is to define and identify vulnerabilities of companies and the establishment of evaluation methods at their level. This article emphasizes the importance and usefulness of one of the best known model in this way, from our point of view, namely Băileşteanu, Negrila Pattern. This pattern covers both external factors and internal ones, that increase vulnerabilities of companies, and fit the companies in which the state of vulnerability are (vitality, viability, vulnerability, high vulnerability, difficulty and high difficulty, with a matrix. The result of the research is that any company belonging to any field, can be analyzed using this model, and assigned to one of the conditions defined within.
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Virtuous aging and existential vulnerability.
Laceulle, Hanne
2017-12-01
In its efforts to overcome problematic views that associate aging with inevitable decline, contemporary gerontology shows a tendency to focus predominantly on age-related vulnerabilities that science may try to remedy and control. However, gerontology should also offer languages to address vulnerabilities that cannot be remedied because they intrinsically belong to the human condition. After all, these are increasingly radically encountered in later life and should therefore be reflected upon in the study of aging. Humanistic gerontology seems to be the most promising field to look for languages capable of contemplating such existential vulnerabilities. The potential contribution of philosophy in this field remains underdeveloped so far, however. This article therefore aims to introduce insights from the philosophical tradition to (humanistic) gerontology. More specifically, it focuses on the tradition of virtue ethics, arguing that virtue is a particularly relevant notion to explore in dealing with existential vulnerability in later life. The notion of virtue is clarified by discussing a selection of philosophical perspectives on this topic, by Aristotle, MacIntyre and Swanton. Next a brief overview will be given of some of the ways the notion of virtue has found its way into gerontological discourse so far. The article ends with an analysis of the merits of virtue-ethical discourse for the study of aging and later life, and pleads for more inclusion of philosophical ideas such as virtue in gerontology, as these can enrich our conceptual frameworks and help us relate to deep existential questions regarding the experience of aging. Copyright © 2017 Elsevier Inc. All rights reserved.
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Sakiko Fukuda-Parr
2007-01-01
Poverty is an important human rights concern. Human rights are claims that people have for social arrangements to guarantee their substantive freedoms; poverty reflects failures in these social arrangements and in the actions of duty bearers. It is the poorest people in society --- those with low incomes, education, insecure health, and political power --- who are most vulnerable to severe abuse of their human rights in multiple areas. At the same time, it is lack of human rights protection t...
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Interpreting the International Right to Health in a Human Rights-Based Approach to Health
Hunt, Paul
2016-01-01
Abstract This article tracks the shifting place of the international right to health, and human rights-based approaches to health, in the scholarly literature and United Nations (UN). From 1993 to 1994, the focus began to move from the right to health toward human rights-based approaches to health, including human rights guidance adopted by UN agencies in relation to specific health issues. There is a compelling case for a human rights-based approach to health, but it runs the risk of playing...
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VuWiki: An Ontology-Based Semantic Wiki for Vulnerability Assessments
Khazai, Bijan; Kunz-Plapp, Tina; Büscher, Christian; Wegner, Antje
2014-05-01
The concept of vulnerability, as well as its implementation in vulnerability assessments, is used in various disciplines and contexts ranging from disaster management and reduction to ecology, public health or climate change and adaptation, and a corresponding multitude of ideas about how to conceptualize and measure vulnerability exists. Three decades of research in vulnerability have generated a complex and growing body of knowledge that challenges newcomers, practitioners and even experienced researchers. To provide a structured representation of the knowledge field "vulnerability assessment", we have set up an ontology-based semantic wiki for reviewing and representing vulnerability assessments: VuWiki, www.vuwiki.org. Based on a survey of 55 vulnerability assessment studies, we first developed an ontology as an explicit reference system for describing vulnerability assessments. We developed the ontology in a theoretically controlled manner based on general systems theory and guided by principles for ontology development in the field of earth and environment (Raskin and Pan 2005). Four key questions form the first level "branches" or categories of the developed ontology: (1) Vulnerability of what? (2) Vulnerability to what? (3) What reference framework was used in the vulnerability assessment?, and (4) What methodological approach was used in the vulnerability assessment? These questions correspond to the basic, abstract structure of the knowledge domain of vulnerability assessments and have been deduced from theories and concepts of various disciplines. The ontology was then implemented in a semantic wiki which allows for the classification and annotation of vulnerability assessments. As a semantic wiki, VuWiki does not aim at "synthesizing" a holistic and overarching model of vulnerability. Instead, it provides both scientists and practitioners with a uniform ontology as a reference system and offers easy and structured access to the knowledge field of
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Akerlof, Karen; Debono, Roberto; Berry, Peter; Leiserowitz, Anthony; Roser-Renouf, Connie; Clarke, Kaila-Lea; Rogaeva, Anastasia; Nisbet, Matthew C; Weathers, Melinda R; Maibach, Edward W
2010-06-01
We used data from nationally representative surveys conducted in the United States, Canada and Malta between 2008 and 2009 to answer three questions: Does the public believe that climate change poses human health risks, and if so, are they seen as current or future risks? Whose health does the public think will be harmed? In what specific ways does the public believe climate change will harm human health? When asked directly about the potential impacts of climate change on health and well-being, a majority of people in all three nations said that it poses significant risks; moreover, about one third of Americans, one half of Canadians, and two-thirds of Maltese said that people are already being harmed. About a third or more of people in the United States and Canada saw themselves (United States, 32%; Canada, 67%), their family (United States, 35%; Canada, 46%), and people in their community (United States, 39%; Canada, 76%) as being vulnerable to at least moderate harm from climate change. About one third of Maltese (31%) said they were most concerned about the risk to themselves and their families. Many Canadians said that the elderly (45%) and children (33%) are at heightened risk of harm, while Americans were more likely to see people in developing countries as being at risk than people in their own nation. When prompted, large numbers of Canadians and Maltese said that climate change can cause respiratory problems (78-91%), heat-related problems (75-84%), cancer (61-90%), and infectious diseases (49-62%). Canadians also named sunburn (79%) and injuries from extreme weather events (73%), and Maltese cited allergies (84%). However, climate change appears to lack salience as a health issue in all three countries: relatively few people answered open-ended questions in a manner that indicated clear top-of-mind associations between climate change and human health risks. We recommend mounting public health communication initiatives that increase the salience of the
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Directory of Open Access Journals (Sweden)
Karen Akerlof
2010-06-01
Full Text Available We used data from nationally representative surveys conducted in the United States, Canada and Malta between 2008 and 2009 to answer three questions: Does the public believe that climate change poses human health risks, and if so, are they seen as current or future risks? Whose health does the public think will be harmed? In what specific ways does the public believe climate change will harm human health? When asked directly about the potential impacts of climate change on health and well-being, a majority of people in all three nations said that it poses significant risks; moreover, about one third of Americans, one half of Canadians, and two-thirds of Maltese said that people are already being harmed. About a third or more of people in the United States and Canada saw themselves (United States, 32%; Canada, 67%, their family (United States, 35%; Canada, 46%, and people in their community (United States, 39%; Canada, 76% as being vulnerable to at least moderate harm from climate change. About one third of Maltese (31% said they were most concerned about the risk to themselves and their families. Many Canadians said that the elderly (45% and children (33% are at heightened risk of harm, while Americans were more likely to see people in developing countries as being at risk than people in their own nation. When prompted, large numbers of Canadians and Maltese said that climate change can cause respiratory problems (78–91%, heat-related problems (75–84%, cancer (61–90%, and infectious diseases (49–62%. Canadians also named sunburn (79% and injuries from extreme weather events (73%, and Maltese cited allergies (84%. However, climate change appears to lack salience as a health issue in all three countries: relatively few people answered open-ended questions in a manner that indicated clear top-of-mind associations between climate change and human health risks. We recommend mounting public health communication initiatives that increase the
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The human microbiota associated with overall health.
Xu, Xiaofei; Wang, Zhujun; Zhang, Xuewu
2015-03-01
Human body harbors diverse microbes, the main components include bacteria, eukaryotes and viruses. Emerging evidences show that the human microbiota is intrinsically linked with overall health. The development of next-generation sequencing provides an unprecedented opportunity to investigate the complex microbial communities that are associated with the human body. Many factors like host genetics and environmental factors have a major impact on the composition and dynamic changes of human microbiota. The purpose of this paper is to present an overview of the relationship between human health and human microbiota (skin, nasal, throat, oral, vaginal and gut microbiota), then to focus on the factors modulating the composition of the microbiota and the future challenges to manipulate the microbiota for personalized health.
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Associations Between Social Vulnerabilities and Dietary Patterns in European Children
DEFF Research Database (Denmark)
Iguacel, Isabel; Fernandez-Alvira, Juan M.; Bammann, Karin
2016-01-01
-up by applying the K-means clustering algorithm based on a higher frequency of consumption of snacks and fast food (processed), sweet foods and drinks (sweet), and fruits and vegetables (healthy). Vulnerable groups were defined at baseline as follows: children whose parents lacked a social network, children from...... single-parent families, children of migrant origin and children with unemployed parents. Multinomial mixed models were used to assess the associations between social vulnerabilities and children’s dietary patterns at baseline and follow-up. Children whose parents lacked a social network (OR 1·31; 99 % CI......Socio-economic inequalities in childhood can determine dietary patterns, and therefore future health. This study aimed to explore associations between social vulnerabilities and dietary patterns assessed at two time points, and to investigate the association between accumulation of vulnerabilities...
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Directory of Open Access Journals (Sweden)
Jonathan E. Suk
2014-02-01
Full Text Available A wide range of infectious diseases may change their geographic range, seasonality and incidence due to climate change, but there is limited research exploring health vulnerabilities to climate change. In order to address this gap, pan-European vulnerability indices were developed for 2035 and 2055, based upon the definition vulnerability = impact/adaptive capacity. Future impacts were projected based upon changes in temperature and precipitation patterns, whilst adaptive capacity was developed from the results of a previous pan-European study. The results were plotted via ArcGISTM to EU regional (NUTS2 levels for 2035 and 2055 and ranked according to quintiles. The models demonstrate regional variations with respect to projected climate-related infectious disease challenges that they will face, and with respect to projected vulnerabilities after accounting for regional adaptive capacities. Regions with higher adaptive capacities, such as in Scandinavia and central Europe, will likely be better able to offset any climate change impacts and are thus generally less vulnerable than areas with lower adaptive capacities. The indices developed here provide public health planners with information to guide prioritisation of activities aimed at strengthening regional preparedness for the health impacts of climate change. There are, however, many limitations and uncertainties when modeling health vulnerabilities. To further advance the field, the importance of variables such as coping capacity and governance should be better accounted for, and there is the need to systematically collect and analyse the interlinkages between the numerous and ever-expanding environmental, socioeconomic, demographic and epidemiologic datasets so as to promote the public health capacity to detect, forecast, and prepare for the health threats due to climate change.
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Suk, Jonathan E; Ebi, Kristie L; Vose, David; Wint, Willy; Alexander, Neil; Mintiens, Koen; Semenza, Jan C
2014-02-21
A wide range of infectious diseases may change their geographic range, seasonality and incidence due to climate change, but there is limited research exploring health vulnerabilities to climate change. In order to address this gap, pan-European vulnerability indices were developed for 2035 and 2055, based upon the definition vulnerability = impact/adaptive capacity. Future impacts were projected based upon changes in temperature and precipitation patterns, whilst adaptive capacity was developed from the results of a previous pan-European study. The results were plotted via ArcGISTM to EU regional (NUTS2) levels for 2035 and 2055 and ranked according to quintiles. The models demonstrate regional variations with respect to projected climate-related infectious disease challenges that they will face, and with respect to projected vulnerabilities after accounting for regional adaptive capacities. Regions with higher adaptive capacities, such as in Scandinavia and central Europe, will likely be better able to offset any climate change impacts and are thus generally less vulnerable than areas with lower adaptive capacities. The indices developed here provide public health planners with information to guide prioritisation of activities aimed at strengthening regional preparedness for the health impacts of climate change. There are, however, many limitations and uncertainties when modeling health vulnerabilities. To further advance the field, the importance of variables such as coping capacity and governance should be better accounted for, and there is the need to systematically collect and analyse the interlinkages between the numerous and ever-expanding environmental, socioeconomic, demographic and epidemiologic datasets so as to promote the public health capacity to detect, forecast, and prepare for the health threats due to climate change.
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Environmental contaminants, ecosystems and human health
Energy Technology Data Exchange (ETDEWEB)
Majumdar, S.K.; Miller, E.W.; Brenner, F.J. [eds.] [Lafayette College, Easton, PA (United States). Dept. of Biology
1995-12-31
The authors cover a variety of concerns regarding the adverse impacts of contaminants on ecosystems and human health. The twelve chapters in the first section of the text address the impact of contaminants on ecosystem function, and ten of the remaining twenty-two chapters are devoted to the effects of contaminants on human health. Part three presents eight case studies in humans, while the final four chapters provide the reader with an assessment of environmental problems and analyses. Two chapters, on the health effects of power plant generated air pollution and on black lung disease, have been abstracted separately for the IEA Coal Research CD-ROM.
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Balbus, John M; Boxall, Alistair B A; Fenske, Richard A; McKone, Thomas E; Zeise, Lauren
2013-01-01
Global climate change (GCC) is likely to alter the degree of human exposure to pollutants and the response of human populations to these exposures, meaning that risks of pollutants could change in the future. The present study, therefore, explores how GCC might affect the different steps in the pathway from a chemical source in the environment through to impacts on human health and evaluates the implications for existing risk-assessment and management practices. In certain parts of the world, GCC is predicted to increase the level of exposure of many environmental pollutants due to direct and indirect effects on the use patterns and transport and fate of chemicals. Changes in human behavior will also affect how humans come into contact with contaminated air, water, and food. Dietary changes, psychosocial stress, and coexposure to stressors such as high temperatures are likely to increase the vulnerability of humans to chemicals. These changes are likely to have significant implications for current practices for chemical assessment. Assumptions used in current exposure-assessment models may no longer apply, and existing monitoring methods may not be robust enough to detect adverse episodic changes in exposures. Organizations responsible for the assessment and management of health risks of chemicals therefore need to be more proactive and consider the implications of GCC for their procedures and processes. Copyright © 2012 SETAC.
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Health, vital goals, and central human capabilities.
Venkatapuram, Sridhar
2013-06-01
I argue for a conception of health as a person's ability to achieve or exercise a cluster of basic human activities. These basic activities are in turn specified through free-standing ethical reasoning about what constitutes a minimal conception of a human life with equal human dignity in the modern world. I arrive at this conception of health by closely following and modifying Lennart Nordenfelt's theory of health which presents health as the ability to achieve vital goals. Despite its strengths I transform Nordenfelt's argument in order to overcome three significant drawbacks. Nordenfelt makes vital goals relative to each community or context and significantly reflective of personal preferences. By doing so, Nordenfelt's conception of health faces problems with both socially relative concepts of health and subjectively defined wellbeing. Moreover, Nordenfelt does not ever explicitly specify a set of vital goals. The theory of health advanced here replaces Nordenfelt's (seemingly) empty set of preferences and society-relative vital goals with a human species-wide conception of basic vital goals, or 'central human capabilities and functionings'. These central human capabilities come out of the capabilities approach (CA) now familiar in political philosophy and economics, and particularly reflect the work of Martha Nussbaum. As a result, the health of an individual should be understood as the ability to achieve a basic cluster of beings and doings-or having the overarching capability, a meta-capability, to achieve a set of central or vital inter-related capabilities and functionings. © 2012 John Wiley & Sons Ltd.
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International Nuclear Information System (INIS)
1994-09-01
Based on the site visit and walkdowns, the Working Group Assessment Team (WGAT) considers the Site Assessment Team (SAT) report and question sets to be a factual assessment of the facilities. As a result of the Site and WGAT's reviews, six vulnerabilities were identified for further consideration by the Department of Energy (DOE) Plutonium Vulnerability Working Group preparing the final report. All six vulnerabilities were discussed among the respective site teams members and facility experts and agreement was reached. The vulnerabilities by facility identified by the SAT and WGAT are described below. No ranking or priority is implied by the order in which they are listed. In addition the WGAT identified and included issues for the Argonne National Laboratory-West (ANL-W) and DOE line management organizations that are not explicit Environment Safety ampersand Health (ES ampersand H) vulnerabilities
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Tarantola, D; Mann, J
1995-01-01
HIV/AIDS is a health problem that is inseparable from individual and collective behavior and social forces, particularly linked with societal respect for human rights and dignity. In its second decade, the HIV/AIDS pandemic continues to thrive. Where organized communities have access to adequate information, education, and services, the incidence of infection has begun to decline. Elsewhere, HIV continues to reach new populations and new geographic areas. Lessons learned in more than a decade of prevention work point to new directions for expanding national responses, at a time when the UNAIDS program, to be launched in January 1996, offers opportunities for innovative, broad-based, coordinated, and expanded global action. Prevention activities have shown that the spread of HIV can be effectively reduced. Public health interventions, including providing information and applying prevention methods, reduce the probability of infection, the risk of transmission, and the chances of not accessing appropriate care or support once infection has set in. These are proximal interventions that yield the short-term benefits of the decline of incidence and improved quality and duration of life for those infected. Societal vulnerability translates today into the focus the pandemic has on individuals, communities, and nations that are disadvantaged, marginalized, or discriminated against for reasons of gender, age, race, sexual orientation, economic status, or cultural, religious, or political affiliation. A fully expanded response to HIV/AIDS requires a combination of risk-reduction (proximal) and contextual interventions--those directed at reducing vulnerability through social change to enable people to exert control over their own health. Contextual actions can be implemented in the short term (changing laws, policies, practices that discriminate, promoting human rights, developing the most vulnerable communities) and in the long term (cultural changes, gender equality in
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Emerging Technology Update Intravascular Photoacoustic Imaging of Vulnerable Atherosclerotic Plaque.
Wu, Min; Fw van der Steen, Antonius; Regar, Evelyn; van Soest, Gijs
2016-10-01
The identification of vulnerable atherosclerotic plaques in the coronary arteries is emerging as an important tool for guiding atherosclerosis diagnosis and interventions. Assessment of plaque vulnerability requires knowledge of both the structure and composition of the plaque. Intravascular photoacoustic (IVPA) imaging is able to show the morphology and composition of atherosclerotic plaque. With imminent improvements in IVPA imaging, it is becoming possible to assess human coronary artery disease in vivo . Although some challenges remain, IVPA imaging is on its way to being a powerful tool for visualising coronary atherosclerotic features that have been specifically associated with plaque vulnerability and clinical syndromes, and thus such imaging might become valuable for clinical risk assessment in the catheterisation laboratory.
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Vulnerability of Normal Human Mammary Epithelial Cells to Oncogenic Transformation
2012-04-01
control expression of many of these miRNA genes. Many of the epigenetically regulated miRNAs identified are deregulated in breast cancer-derived...review board and Health Insurance Portability and Accountability Act regulations. At the time of surgery, a 1 to 3 cm section of the tumor was immediately...transformation process for- ward; the early deregulation of the HOX gene family clusters, which are decisively linked to human carcinogenesis, are one clear
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We know what makes us vulnerable: Female learners, their health ...
African Journals Online (AJOL)
It has been widely illustrated that participation in physical activities can benefit young people. Furthermore, as an alternative form of leisure, physical education and school sports (PESS) may challenge less healthy options of entertainment for young people, thereby reducing their vulnerability to risk-taking behaviours.
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ETHICS IN HEALTH CARE: INDUCEMENT AND HUMAN SUBJECTS
Directory of Open Access Journals (Sweden)
MUNIR HOSSAIN TALUKDER
2011-05-01
Full Text Available Currently, most health researchers or donor organizations considerinducement as a vital part in promoting research. They propose benefits, such as post research free medical treatment, food, insurance facilities, or even cash, in order to meet sufficient number of subjects. So, inducement may influence one to participate in a research. Is it ethical to offer inducement to human subjects? What are the risks in such practice? What will happen if the donor agencies use subjects by hiding possible risks from them? When an inducement can satisfy ethical criteria? The CIOMS, FDA, and other ethical guidelines hold that inducement is unethical because it involves enough risk for voluntary informed consent. Supporting this position, a group of ethicists has argued that inducement undermines voluntariness especially when subjects are poor and vulnerable, and thus, unethical. In contrast to them, others argue that inducement contributes to discover new knowledge which can improve miserable condition of the poor. In their view, an inducement maintains all ethical criteria including subject’s autonomy, and therefore, morally permissible. The paper focuses this debate and analyzes both types ofargument. It examines whether inducement invalidate informed consent.Even if inducement may not violate the basic components of informedconsent, the paper concludes, subjects may claim a prima facie right to enjoy research outcomes.
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Rethinking Vulnerability in the Age of Anthropocene: Toward Ecologizing Education
Li, Huey-li
2017-01-01
In this essay, Huey-li Li argues that, although precariousness has always been embedded in human existence, our human vulnerability has been heightened by seemingly omnipresent and omnipotent risks in the modern era, ranging from the 9/11 terroristic attacks and nuclear meltdowns to infectious disease outbreaks and climate change. Li unravels some…
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González-Riancho, P.; Aliaga, B.; Hettiarachchi, S.; González, M.; Medina, R.
2015-07-01
After several tsunami events with disastrous consequences around the world, coastal countries have realized the need to be prepared to minimize human mortality and damage to coastal infrastructures, livelihoods and resources. The international scientific community is striving to develop and validate methodologies for tsunami hazard and vulnerability and risk assessments. The vulnerability of coastal communities is usually assessed through the definition of sets of indicators based on previous literature and/or post-tsunami reports, as well as on the available data for the study site. The aim of this work is to validate, in light of past tsunami events, the indicators currently proposed by the scientific community to measure human vulnerability, to improve their definition and selection as well as to analyse their validity for different country development profiles. The events analysed are the 2011 Great Tohoku tsunami, the 2010 Chilean tsunami, the 2009 Samoan tsunami and the 2004 Indian Ocean tsunami. The results obtained highlight the need for considering both permanent and temporal human exposure, the former requiring some hazard numerical modelling, while the latter is related to site-specific livelihoods, cultural traditions and gender roles. The most vulnerable age groups are the elderly and children, the former having much higher mortality rates. Female mortality is not always higher than male mortality and not always related to dependency issues. Higher numbers of disabled people do not always translate into higher numbers of victims. Besides, it is clear that mortality is not only related to the characteristics of the population but also of the buildings. A high correlation has been found between the affected buildings and the number of victims, being very high for completely damaged buildings. Distance to the sea, building materials and expected water depths are important determining factors regarding the type of damage to buildings.
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Directory of Open Access Journals (Sweden)
M Abedi
2013-04-01
Full Text Available Introduction: Selenium is an essential element for human health and it is toxic at high concentrations. Selenium is a constituent component of selenoproteins that have enzymatic and structural roles in human biochemistry. Selenium is a best antioxidant and catalyst for production of thyroid hormone. This element has the key role in the immune function; prevention of AIDS progression and the deactivity of toxins. Furthermore, selenium is essential for sperm motility and can reduce abortions. Selenium deficiency was also associated with adverse mood states. The findings regarding cardiovascular disease risk related to selenium deficiency is unclear, though other conditions such as vascular inflammation, oxidative stress and selenium deficiency can cause this disease too. Moreover, consuming of 60 mg of selenium per day may be associated with reduction of cancer risk. In this study, a review of studies has been performed on the biochemical function of selenium toxicity, and its effects on human health. Furthermore, certain identified cancers associated with selenium have been discussed to absorb more attention to the status of this element and also as a guide for further studies. Selenium plays the dual character (useful and harmful in human health, and then it is necessary to determine the concentration of this element in body fluids and tissues. An appropriate method for routine measurement of selenium in clinical laboratories is electro thermal atomic absorption spectrometry (ETAAS with very low detection limit and good precision.
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A Preliminary Tsunami Vulnerability Analysis for Yenikapi Region in Istanbul
Ceren Cankaya, Zeynep; Suzen, Lutfi; Cevdet Yalciner, Ahmet; Kolat, Cagil; Aytore, Betul; Zaytsev, Andrey
2015-04-01
One of the main requirements during post disaster recovery operations is to maintain proper transportation and fluent communication at the disaster areas. Ports and harbors are the main transportation hubs which must work with proper performance at all times especially after the disasters. Resilience of coastal utilities after earthquakes and tsunamis have major importance for efficient and proper rescue and recovery operations soon after the disasters. Istanbul is a mega city with its various coastal utilities located at the north coast of the Sea of Marmara. At Yenikapi region of Istanbul, there are critical coastal utilities and vulnerable coastal structures and critical activities occur daily. Fishery ports, commercial ports, small craft harbors, passenger terminals of intercity maritime transportation, water front commercial and/or recreational structures are some of the examples of coastal utilization which are vulnerable against marine disasters. Therefore their vulnerability under tsunami or any other marine hazard to Yenikapi region of Istanbul is an important issue. In this study, a methodology of vulnerability analysis under tsunami attack is proposed with the applications to Yenikapi region. In the study, high resolution (1m) GIS database of Istanbul Metropolitan Municipality (IMM) is used and analyzed by using GIS implementation. The bathymetry and topography database and the vector dataset containing all buildings/structures/infrastructures in the study area are obtained for tsunami numerical modeling for the study area. GIS based tsunami vulnerability assessment is conducted by applying the Multi-criteria Decision Making Analysis (MCDA). The tsunami parameters from deterministically defined worst case scenarios are computed from the simulations using tsunami numerical model NAMI DANCE. The vulnerability parameters in the region due to two different classifications i) vulnerability of buildings/structures and ii) vulnerability of (human) evacuation
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Regular-fat dairy and human health
DEFF Research Database (Denmark)
Astrup, Arne; Bradley, Beth H Rice; Brenna, J Thomas
2016-01-01
In recent history, some dietary recommendations have treated dairy fat as an unnecessary source of calories and saturated fat in the human diet. These assumptions, however, have recently been brought into question by current research on regular fat dairy products and human health. In an effort to......, cheese and yogurt, can be important components of an overall healthy dietary pattern. Systematic examination of the effects of dietary patterns that include regular-fat milk, cheese and yogurt on human health is warranted....
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Comprehensiveness and programmatic vulnerability to stds/hiv/aids in primary care
Directory of Open Access Journals (Sweden)
Luciane Ferreira do Val
2014-08-01
Full Text Available This study aimed to identify programmatic vulnerability to STDs/HIV/AIDS in primary health centers (PHCs. This is a descrip - tive and quantitative study carried out in the city of São Paulo. An online survey was applied (FormSUS platform, involving administrators from 442 PHCs in the city, with responses received from 328 of them (74.2%, of which 53.6% were nurses. At - tention was raised in relation to program - matic vulnerability in the PHCs regarding certain items of infrastructure, prevention, treatment, prenatal care and integration among services on STDs/HIV/AIDS care. It was concluded that in order to reach comprehensiveness of actions for HIV/ AIDS in primary health care, it is necessary to consider programmatic vulnerability, in addition to more investment and reor - ganization of services in a dialogue with the stakeholders (users, multidisciplinary teams, and managers, among others.
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Development of a heat vulnerability index for New York State.
Nayak, S G; Shrestha, S; Kinney, P L; Ross, Z; Sheridan, S C; Pantea, C I; Hsu, W H; Muscatiello, N; Hwang, S A
2017-12-01
The frequency and intensity of extreme heat events are increasing in New York State (NYS) and have been linked with increased heat-related morbidity and mortality. But these effects are not uniform across the state and can vary across large regions due to regional sociodemographic and environmental factors which impact an individual's response or adaptive capacity to heat and in turn contribute to vulnerability among certain populations. We developed a heat vulnerability index (HVI) to identify heat-vulnerable populations and regions in NYS. Census tract level environmental and sociodemographic heat-vulnerability variables were used to develop the HVI to identify heat-vulnerable populations and areas. Variables were identified from a comprehensive literature review and climate-health research in NYS. We obtained data from 2010 US Census Bureau and 2011 National Land Cover Database. We used principal component analysis to reduce correlated variables to fewer uncorrelated components, and then calculated the cumulative HVI for each census tract by summing up the scores across the components. The HVI was then mapped across NYS (excluding New York City) to display spatial vulnerability. The prevalence rates of heat stress were compared across HVI score categories. Thirteen variables were reduced to four meaningful components representing 1) social/language vulnerability; 2) socioeconomic vulnerability; 3) environmental/urban vulnerability; and 4) elderly/ social isolation. Vulnerability to heat varied spatially in NYS with the HVI showing that metropolitan areas were most vulnerable, with language barriers and socioeconomic disadvantage contributing to the most vulnerability. Reliability of the HVI was supported by preliminary results where higher rates of heat stress were collocated in the regions with the highest HVI. The NYS HVI showed spatial variability in heat vulnerability across the state. Mapping the HVI allows quick identification of regions in NYS that could
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Directory of Open Access Journals (Sweden)
Prokop Pavol
2011-01-01
Full Text Available Infectious diseases that influence human survival are responsible for the evolved emotional, cognitive and behavioural strategies that reduce the risk of disease transmission. The preference for spices in foods of contemporary humans was thought to be an antipathogen strategy that could reduce disease transmission. We investigated the possible associations between reported health and anti-pathogen strategies in a sample of Slovak high school students. We found that the reported consumption of spices and ectoparasite avoidance was positively associated with the total number of reported illnesses in the last year and hand washing was negatively associated with this. This means that immunologically compromised people prefer spices more and avoid contact with disease-relevant insect vectors more than their healthier counterparts. Females engaged in anti-pathogen behaviours more than males, but consumed spicy foods less frequently, suggesting their evolutionary role in the maternal investment to their offspring or different susceptibility to certain diseases. Our results suggest that people vulnerable to diseases are more disgust sensitive and prefer foods with antimicrobial properties more than healthy people, supporting an idea that human emotions and behaviour are influenced by the threat of parasites.
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Sex-driven vulnerability in stress and drug abuse.
Berry, Alessandra; Raggi, Carla; Borgi, Marta; Cirulli, Francesca
2016-01-01
A growing body of literature shows that a link exists between substance abuse and stress and that the crosstalk of sex hormones with the neuroendocrine system might differently prime vulnerability to drug addiction in male and female subjects. Thus, understanding the neurobiological mechanisms of addiction and the identification of sex-driven determinants in vulnerability to drug abuse may help to better devise and/or implement strategic (pharmacological, behavioural, social) interventions to prevent or face the issue of addiction. Differences between sexes can be found at all stages of life (in both the animal model and human studies) and may account for genetic, epigenetic and environmental/hormonal factors that in turn affect the functionality of the whole organism leading also to a sex-driven differential vulnerability or resilience to non-communicable pathologies. These include the onset and precipitation of stress-related psychiatric disorders as well as "substance-related and addictive disorders" (as defined in the DSM-V). This paper reviews the scientific literature highlighting significant differences in male and female subjects in stress and neuroendocrine function and the implications for sex-dependent differential vulnerability to drug addiction.
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Spatial vulnerability of Australian urban populations to extreme heat events
Loughnan, Margaret; Tapper, Nigel; Phan, Thu; Lynch, Kellie; McInnes, Judith
2013-04-01
Extreme heat events pose a risk to the health of all individuals, especially the elderly and the chronically ill, and are associated with an increased demand for healthcare services. In order to address this problem, policy makers' need information about temperatures above which mortality and morbidity of the exposed population is likely to increase, where the vulnerable groups in the community are located, and how the risks from extreme heat events are likely to change in the future. This study identified threshold temperatures for all Australian capital cities, developed a spatial index of population vulnerability, and used climate model output to predict changes in the number of days exceeding temperature thresholds in the future, as well as changes in risk related to changes in urban density and an ageing population. The study has shown that daily maximum and minimum temperatures from the Bureau of Meteorology forecasts can be used to calculate temperature thresholds for heat alert days. The key risk factors related to adverse health outcomes were found to be areas with intense urban heat islands, areas with higher proportions of older people, and areas with ethnic communities. Maps of spatial vulnerability have been developed to provide information to assist emergency managers, healthcare professionals, and ancillary services develop heatwave preparedness plans at a local scale that target vulnerable groups and address heat-related health risks. The numbers of days exceeding current heat thresholds are predicted to increase over the next 20 to 40 years in all Australian capital cities.
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Assessing Vulnerability to Heat: A Geospatial Analysis for the City of Philadelphia
Directory of Open Access Journals (Sweden)
Laura Barron
2018-04-01
Full Text Available Urban heat island (UHI effect is an increasingly prominent health and environmental hazard that is linked to urbanization and climate change. Greening reduces the negative impacts of UHI; trees specifically are the most effective in ambient temperature reduction. This paper investigates vulnerability to heat in the Philadelphia, Pennsylvania and identifies where street trees can be planted as a public intervention. We used geospatial information systems (GIS software to map a validated Heat Vulnerability Index to identify vulnerability at the block level. Using a high-low geospatial cluster analysis, we assessed where the City of Philadelphia can most effectively plant street trees to address UHI. This information was then aggregated to the neighborhood level for more effective citizen communication and policymaking. We identified that 26 of 48 (54% neighborhoods that were vulnerable to heat also lacked street trees. Of 158 Philadelphia neighborhoods, 63 (40% contained block groups of high vulnerability to either heat or street tree infrastructure. Neighborhoods that were ranked highest in both classifications were identified in two adjacent West Philadelphia neighborhoods. Planting street trees is a public service a city can potentially reduce the negative health impacts of UHI. GIS can be used to identify and recommend street tree plantings to reduce urban heat.
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Tran, Kathy V; Azhar, Gulrez S; Nair, Rajesh; Knowlton, Kim; Jaiswal, Anjali; Sheffield, Perry; Mavalankar, Dileep; Hess, Jeremy
2013-06-18
Extreme heat is a significant public health concern in India; extreme heat hazards are projected to increase in frequency and severity with climate change. Few of the factors driving population heat vulnerability are documented, though poverty is a presumed risk factor. To facilitate public health preparedness, an assessment of factors affecting vulnerability among slum dwellers was conducted in summer 2011 in Ahmedabad, Gujarat, India. Indicators of heat exposure, susceptibility to heat illness, and adaptive capacity, all of which feed into heat vulnerability, was assessed through a cross-sectional household survey using randomized multistage cluster sampling. Associations between heat-related morbidity and vulnerability factors were identified using multivariate logistic regression with generalized estimating equations to account for clustering effects. Age, preexisting medical conditions, work location, and access to health information and resources were associated with self-reported heat illness. Several of these variables were unique to this study. As sociodemographics, occupational heat exposure, and access to resources were shown to increase vulnerability, future interventions (e.g., health education) might target specific populations among Ahmedabad urban slum dwellers to reduce vulnerability to extreme heat. Surveillance and evaluations of future interventions may also be worthwhile.
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Does the vulnerability paradox in PTSD apply to women and men? An exploratory study.
Dückers, M.L.A.; Olff, M.
2017-01-01
Recent research suggests that greater country vulnerability is associated with a decreased, rather than increased, risk of mental health problems. Because societal parameters may have gender-specific implications, our objective was to explore whether the "vulnerability paradox" equally applies to
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Gontijo, Daniela; Medeiros, Marcelo
2009-01-01
The concept of vulnerability is being discussed in the public health area as a potential tool toward the transformation of the health practices for allowing an articulation individual-community. Understanding health as a process of subjectivation determined by social, cultural and historical contexts, this article aims to approach the question children and adolescents in street situation on the basis of the concept of civil vulnerability, using the theoretical background presented by Robert Castel. This author understands the social marginalization lived by different individuals and social groups in a dynamic form, determined by the association of work and social insertion. As refers to children and adolescents in street situation, we believe that they are reflecting a process of intensified vulnerability (culminating in disaffiliation) to which thousands of Brazilian families are subject due to the extreme social inequalities in our country. We hope that our theoretical discussion will be able to contribute to the development of a theoretical reference in public health and to the planning and implementation of health actions directed to this population.
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Where Public Health Meets Human Rights
Kiragu, Karusa; Sawicki, Olga; Smith, Sally; Brion, Sophie; Sharma, Aditi; Mworeko, Lilian; Iovita, Alexandrina
2017-01-01
Abstract In 2014, the World Health Organization (WHO) initiated a process for validation of the elimination of mother-to-child transmission (EMTCT) of HIV and syphilis by countries. For the first time in such a process for the validation of disease elimination, WHO introduced norms and approaches that are grounded in human rights, gender equality, and community engagement. This human rights-based validation process can serve as a key opportunity to enhance accountability for human rights protection by evaluating EMTCT programs against human rights norms and standards, including in relation to gender equality and by ensuring the provision of discrimination-free quality services. The rights-based validation process also involves the assessment of participation of affected communities in EMTCT program development, implementation, and monitoring and evaluation. It brings awareness to the types of human rights abuses and inequalities faced by women living with, at risk of, or affected by HIV and syphilis, and commits governments to eliminate those barriers. This process demonstrates the importance and feasibility of integrating human rights, gender, and community into key public health interventions in a manner that improves health outcomes, legitimizes the participation of affected communities, and advances the human rights of women living with HIV. PMID:29302179
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Children of Darfur: a vulnerable population.
Chaikin, Jennifer
2008-02-01
Four years of intense war in Darfur has created an entire generation of children who might never recover. Children in this region are particularly vulnerable and suffer from issues including physical and psychological illness, malnutrition, rape and unlawful military recruitment. This international crisis is among the most important public health issues in the world. The responsibility of the international community to these children is significant and required to break this cycle. This paper will discuss the concerns surrounding these children, how current strategies are failing and proposed public health nursing interventions.
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MacLachlan, Malcolm; Mannan, Hasheem; Huss, Tessy; Munthali, Alister; Amin, Mutamad
2015-11-16
The application of EquiFrame in the analysis of sexual and reproductive health policies by Ivanova et al to a new thematic area, their selection of only some of the Core Concepts of human rights in health service provision and the addition of new vulnerable groups relevant to the purpose of their analysis, are all very welcome developments. We also applaud their application of EquiFrame to policies in countries where it has not previously been used, along with their use of interviews with policy-makers to produce a deeper understanding of policy processes. We argue that clear justification for the inclusion of additional, or replacement of some exiting vulnerable groups within EquiFrame should be accompanied by clear definitions of such groups, along with the evidence-base that justifies their classification as a vulnerable or marginalised group. To illustrate the versatility of EquiFrame, we summarise a range of ways in which it has been used across a number of regions; including a brief Case Study of its use to develop the National Health Policy of Malawi. While EquiFrame focuses on policy content, we preview a new policy analysis tool - Equity and Inclusion in Policy Processes (EquIPP) - which assesses the extent of equity and inclusion in broader policy processes. Together, EquiFrame and EquIPP can be used to help governments and civil society ensure that policies are addressing the much stronger emphasis on social inclusion, now apparent in the Sustainable Development Goals (SDGs). © 2016 by Kerman University of Medical Sciences.
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Human resources for health in Europe
National Research Council Canada - National Science Library
McKee, Martin; Dubois, Carl-Ardy; Nolte, Ellen
2006-01-01
... systems in the field of personnel. The authors also identify which strategies are most likely to lead to the optimal management of health professionals in the future. Human Resources for Health in Europe is key reading for health policymakers and postgraduates taking courses in health services management, health policy and health economics. It is also ...
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[The social vulnerability index regarding Medellín's disabled population].
Cardona-Arango, Doris; Agudelo-Martínez, Alejandra; Restrepo-Molina, Lucas; Segura-Cardona, Angela M
2014-01-01
Constructing a social vulnerability index (SVI) for Medellín's disabled population during 2008 aimed at determining areas which were reducing opportunities for this population to use their tangible and intangible assets, thus impairing their quality of life. This descriptive cross-sectional study drew on a source of secondary information regarding people having some kind of limitation recorded in the Quality of Life Survey, 2008. Physical, human and social variables were grouped when constructing the SVI; the models were run in principal component analysis to determine their degree of vulnerability, defined by the number of negative factors identified (high category=4 or 5, medium=2 or 3 and low=1 or none). Such classification led to identifying non-causal relationships with demographic variables through Mann-Whitney, Chi-square and Kruskal-Wallis tests (5.0 % statistical significance level); multinomial logistic regression was used for calculating adjusted measures for epidemiological measurement, such as opportunity ratios and confidence intervals. A degree of medium vulnerability predominated in disabled people living in Medellín (60.3 %) followed by low vulnerability (28.7 %) and high vulnerability populations (11.0 %). The proposed ISV classified the city's communes according to high, medium or low vulnerability, supported by the use of statistical and spatial location techniques.
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Mapping the Drivers of Climate Change Vulnerability for Australia's Threatened Species.
Directory of Open Access Journals (Sweden)
Jasmine R Lee
Full Text Available Effective conservation management for climate adaptation rests on understanding the factors driving species' vulnerability in a spatially explicit manner so as to direct on-ground action. However, there have been only few attempts to map the spatial distribution of the factors driving vulnerability to climate change. Here we conduct a species-level assessment of climate change vulnerability for a sample of Australia's threatened species and map the distribution of species affected by each factor driving climate change vulnerability across the continent. Almost half of the threatened species assessed were considered vulnerable to the impacts of climate change: amphibians being the most vulnerable group, followed by plants, reptiles, mammals and birds. Species with more restricted distributions were more likely to show high climate change vulnerability than widespread species. The main factors driving climate change vulnerability were low genetic variation, dependence on a particular disturbance regime and reliance on a particular moisture regime or habitat. The geographic distribution of the species impacted by each driver varies markedly across the continent, for example species impacted by low genetic variation are prevalent across the human-dominated south-east of the country, while reliance on particular moisture regimes is prevalent across northern Australia. Our results show that actions to address climate adaptation will need to be spatially appropriate, and that in some regions a complex suite of factors driving climate change vulnerability will need to be addressed. Taxonomic and geographic variation in the factors driving climate change vulnerability highlights an urgent need for a spatial prioritisation of climate adaptation actions for threatened species.
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Chen, Qian; Ding, Mingjun; Yang, Xuchao; Hu, Kejia; Qi, Jiaguo
2018-05-25
The increase in the frequency and intensity of extreme heat events, which are potentially associated with climate change in the near future, highlights the importance of heat health risk assessment, a significant reference for heat-related death reduction and intervention. However, a spatiotemporal mismatch exists between gridded heat hazard and human exposure in risk assessment, which hinders the identification of high-risk areas at finer scales. A human settlement index integrated by nighttime light images, enhanced vegetation index, and digital elevation model data was utilized to assess the human exposure at high spatial resolution. Heat hazard and vulnerability index were generated by land surface temperature and demographic and socioeconomic census data, respectively. Spatially explicit assessment of heat health risk and its driving factors was conducted in the Yangtze River Delta (YRD), east China at 250 m pixel level. High-risk areas were mainly distributed in the urbanized areas of YRD, which were mostly driven by high human exposure and heat hazard index. In some less-urbanized cities and suburban and rural areas of mega-cities, the heat health risks are in second priority. The risks in some less-developed areas were high despite the low human exposure index because of high heat hazard and vulnerability index. This study illustrated a methodology for identifying high-risk areas by combining freely available multi-source data. Highly urbanized areas were considered hotspots of high heat health risks, which were largely driven by the increasing urban heat island effects and population density in urban areas. Repercussions of overheating were weakened due to the low social vulnerability in some central areas benefitting from the low proportion of sensitive population or the high level of socioeconomic development. By contrast, high social vulnerability intensifies heat health risks in some less-urbanized cities and suburban areas of mega-cities.
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Human-Robot Interaction in High Vulnerability Domains
Gore, Brian F.
2016-01-01
Future NASA missions will require successful integration of the human with highly complex systems. Highly complex systems are likely to involve humans, automation, and some level of robotic assistance. The complex environments will require successful integration of the human with automation, with robots, and with human-automation-robot teams to accomplish mission critical goals. Many challenges exist for the human performing in these types of operational environments with these kinds of systems. Systems must be designed to optimally integrate various levels of inputs and outputs based on the roles and responsibilities of the human, the automation, and the robots; from direct manual control, shared human-robotic control, or no active human control (i.e. human supervisory control). It is assumed that the human will remain involved at some level. Technologies that vary based on contextual demands and on operator characteristics (workload, situation awareness) will be needed when the human integrates into these systems. Predictive models that estimate the impact of the technologies on the system performance and the on the human operator are also needed to meet the challenges associated with such future complex human-automation-robot systems in extreme environments.
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Ecosystems and human well-being: health synthesis : a report of the Millennium Ecosystem Assessment
National Research Council Canada - National Science Library
Hales, Simon; Corvalan, Carlos; McMichael, Anthony (Tony) J
2005-01-01
... 36 4 What actions are required to address the health consequences of ecosystem change? 4.1 Reducing vulnerability 4.2 The Millennium Development Goals 38 38 39 5 How can priorities be established for actions to address the health consequences of ecosystem change? 5.1 What considerations are important when setting priorities and what...
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Jones, Martin; Ferguson, Monika; Walsh, Sandra; Martinez, Lee; Marsh, Michael; Cronin, Kathryn; Procter, Nicolas
2018-05-01
There are well-established training programmes available to support health and human services professionals working with people vulnerable to suicide. However, little is known about involving people with lived experience in the delivery of suicide prevention training with communities with increased rates of suicide. The aim of this paper was to report on a formative dialogical evaluation that explored the views of health and human services workers with regard to a suicide prevention training programme in regional (including rural and remote areas) South Australia which included meaningful involvement of a person with lived experience in the development and delivery of the training. In 2015, eight suicide prevention training workshops were conducted with health and human services workers. All 248 participants lived and worked in South Australian regional communities. We interviewed a subsample of 24 participants across eight sites. A thematic analysis of the interviews identified five themes: Coproduction is key, It is okay to ask the question, Caring for my community, I can make a difference and Learning for future training. The overall meta-theme was "Involvement of a person with lived experience in suicide prevention training supports regional communities to look out for people at risk of suicide." This paper highlights the need for suicide prevention training and other workforce development programmes to include lived experience participation as a core component in development and delivery. © 2018 John Wiley & Sons Ltd.
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Wilderness, biodiversity, and human health
Daniel L. Dustin; Keri A. Schwab; Kelly S. Bricker
2015-01-01
This paper illustrates how wilderness, biodiversity, and human health are intertwined. Proceeding from the assumption that humankind is part of, rather than apart from, nature, health is re-imagined as a dynamic relationship that can best be conceived in broad ecological terms. Health, from an ecological perspective, is a measure of the wellness of the individual and...
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'Only connect': the case for public health humanities.
Saffran, Lise
2014-12-01
Humanities in health has until now been primarily understood to mean humanities in medicine and has generally failed to include public health. I will argue in this paper that the common justifications for the former--including increased empathy among practitioners--are at least as applicable, if not more, to the latter. Growing emphasis on the social determinants of health and cultural competency in public health require public health students and professionals to develop a nuanced understanding of the influence of social context on health behaviour and to empathise with people in difficult circumstances. Literary fiction has been demonstrated to have an impact on skills related to empathy and social intelligence. Further, translating epidemiological evidence into public policy is a core task of public health and there is a growing body of research to indicate that statistical evidence is more persuasive when combined with narrative evidence. In this article I explore similarities and differences between proposed humanities in public health and programmes in humanities in medicine and highlight research gaps and possible implications of a more expansive view of humanities in health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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A Quiescent Phase in Human Mortality? Exploring the Ages of Least Vulnerability.
Engelman, Michal; Seplaki, Christopher L; Varadhan, Ravi
2017-06-01
Demographic studies of mortality often emphasize the two ends of the lifespan, focusing on the declining hazard after birth or the increasing risk of death at older ages. We call attention to the intervening phase, when humans are least vulnerable to the force of mortality, and consider its features in both evolutionary and historical perspectives. We define this quiescent phase (Q-phase) formally, estimate its bounds using life tables for Swedish cohorts born between 1800 and 1920, and describe changes in the morphology of the Q-phase. We show that for cohorts aging during Sweden's demographic and epidemiological transitions, the Q-phase became longer and more pronounced, reflecting the retreat of infections and maternal mortality as key causes of death. These changes revealed an underlying hazard trajectory that remains relatively low and constant during the prime ages for reproduction and investment in both personal capital and relationships with others. Our characterization of the Q-phase highlights it as a unique, dynamic, and historically contingent cohort feature, whose increased visibility was made possible by the rapid pace of survival improvements in the nineteenth and twentieth centuries. This visibility may be reduced or sustained under subsequent demographic regimes.
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Optimization of human, animal, and environmental health by using the One Health approach.
Sleeman, Jonathan M; DeLiberto, Thomas; Nguyen, Natalie
2017-08-31
Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.
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Optimization of human, animal, and environmental health by using the One Health approach
Sleeman, Jonathan M.; DeLiberto, Thomas; Nguyen, Natalie T.
2017-01-01
Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.
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Prisoners as Living Donors: A Vulnerabilities Analysis.
Ross, Lainie Friedman; Thistlethwaite, J Richard
2018-01-01
Although national guidelines exist for evaluating the eligibility of potential living donors and for procuring their informed consent, no special protections or considerations exist for potential living donors who are incarcerated. Human research subject protections in the United States are codified in the Federal Regulations, 45 CFR 46, and special protections are given to prisoners. Living donor transplantation has parallels with human subject research in that both activities are performed with the primary goal of benefiting third parties. In this article, we describe what special considerations should be provided to prisoners as potential living donors using a vulnerabilities approach adapted from the human research subject protection literature.
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Jones, Patricia S; Zhang, Xinwei Esther; Meleis, Afaf I
2003-11-01
Asian American immigrant women engaged in filial caregiving are at special risk for health problems due to complex contextual factors related to immigration, cultural traditions, and role transition. This study examines the experience of two groups of immigrant Asian American women who are caring for older parents. A total of 41 women (22 Chinese American and 19 Filipino American) were interviewed in a study based on Strauss and Corbin's grounded theory methodology. The women were determined to be loyal to their traditional culture, which included strong filial values, while adapting to a new culture. Through the struggle of meeting role expectations and coping with paradox, the women mobilized personal and family resources to transform vulnerability into strength and well-being.
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Assessing the social vulnerability to malaria in Rwanda.
Bizimana, Jean-Pierre; Twarabamenye, Emmanuel; Kienberger, Stefan
2015-01-07
indicates which indicators need to be addressed and in which districts. The results from this study are salient for public health policy- and decision makers in malaria control in Rwanda and timely support the national integrated malaria initiative. Future research development should focus on spatial explicit vulnerability assessment by combining environmental and social drivers to achieve an integrated and complete assessment of vulnerability to malaria.
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The New HIT: Human Health Information Technology.
Leung, Tiffany I; Goldstein, Mary K; Musen, Mark A; Cronkite, Ruth; Chen, Jonathan H; Gottlieb, Assaf; Leitersdorf, Eran
2017-01-01
Humanism in medicine is defined as health care providers' attitudes and actions that demonstrate respect for patients' values and concerns in relation to their social, psychological and spiritual life domains. Specifically, humanistic clinical medicine involves showing respect for the patient, building a personal connection, and eliciting and addressing a patient's emotional response to illness. Health information technology (IT) often interferes with humanistic clinical practice, potentially disabling these core aspects of the therapeutic patient-physician relationship. Health IT has evolved rapidly in recent years - and the imperative to maintain humanism in practice has never been greater. In this vision paper, we aim to discuss why preserving humanism is imperative in the design and implementation of health IT systems.
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EVA Health and Human Performance Benchmarking Study
Abercromby, A. F.; Norcross, J.; Jarvis, S. L.
2016-01-01
Multiple HRP Risks and Gaps require detailed characterization of human health and performance during exploration extravehicular activity (EVA) tasks; however, a rigorous and comprehensive methodology for characterizing and comparing the health and human performance implications of current and future EVA spacesuit designs does not exist. This study will identify and implement functional tasks and metrics, both objective and subjective, that are relevant to health and human performance, such as metabolic expenditure, suit fit, discomfort, suited postural stability, cognitive performance, and potentially biochemical responses for humans working inside different EVA suits doing functional tasks under the appropriate simulated reduced gravity environments. This study will provide health and human performance benchmark data for humans working in current EVA suits (EMU, Mark III, and Z2) as well as shirtsleeves using a standard set of tasks and metrics with quantified reliability. Results and methodologies developed during this test will provide benchmark data against which future EVA suits, and different suit configurations (eg, varied pressure, mass, CG) may be reliably compared in subsequent tests. Results will also inform fitness for duty standards as well as design requirements and operations concepts for future EVA suits and other exploration systems.
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A Brief History of Soils and Human Health Studies
Brevik, Eric C.; Sauer, Thomas J.
2013-04-01
The idea that there are links between soils and human health is an ancient one. The Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people in approximately 1400 B.C. as they entered Canaan, and in 400 B.C. Hippocrates provided a list of things that should be considered in a proper medical evaluation, including the ground. Moving into the 18th and 19th Centuries, some North American farmers have been documented as recognizing a link between soils and human vitality. However, the recognition of links between soils and human health by these early people was based on casual observations leading to logical conclusions rather than scientific investigation. In the 1900s the idea that soils influence human health gained considerable traction. At least three chapters in the 1938 USDA Yearbook of Agriculture included recognition of the importance of soil as the origin of many of the mineral elements necessary for human health and in the 1957 USDA Yearbook of Agriculture scientists realized that soils were not only important in the supply of essential nutrients, but that they could also supply toxic levels of elements to the human diet. The U.S. Department of Agriculture established the Plant, Soil and Nutrition Research Unit (PSNRU) on the Cornell University campus in 1940 with a mission to conduct research at the interface of human nutrition and agriculture to improve the nutritional quality and health-promoting properties of food crops. A major human health breakthrough in 1940 was the isolation of antibiotic compounds from soil organisms by the research group at Rutgers University lead by Selman Waksman. Soil microorganisms create antibiotic compounds in an effort to gain a competitive advantage in the soil ecosystem. Humans have been able to isolate those compounds and use them advantageously in the fight against bacterial infections. Waksman was awarded the Nobel Prize in Physiology or Medicine in 1952, the only soil
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International Nuclear Information System (INIS)
1994-09-01
The most important vulnerability on a frequency basis is that liquids containing plutonium are stored in containers that are being attacked by the solutions. These containers are presently failing on a random basis. The most important vulnerability on a material at risk basis is that solid plutonium is packaged for short-term storage. These conditions are presently degrading the containers, potentially to failure, which allows release of the material in the building. This assessment comprehensively evaluated environmental, safety and health vulnerabilities resulting from the storage and handling of plutonium at the Rocky Flats Plant. The term ES and H vulnerability, for the purpose of this assessment, means any condition, other than diversion of material, that could lead to unnecessary or increased exposure of workers and the public to radiation or to the release of radioactive materials to the environment
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An holistic view on aquifer vulnerability based on a distinction of different types of vulnerability
De Luca, Domenico Antonio; Lasagna, Manuela; Franchino, Elisa
2016-04-01
AN HOLISTIC VIEW ON AQUIFER VULNERABILITY BASED ON A DISTINCTION OF DIFFERENT TYPES OF VULNERABILITY D.A. De Luca1 , M. Lasagna1, E. Franchino1 1Department of Earth Sciences, University of Turin The concept of vulnerability is certainly useful in the field of groundwater protection. Nevertheless, within the scientific community, the definition of groundwater vulnerability is still debatable and not clear and conclusive. This is probably due to the fact that researchers often have very different experiences and education. A positive effect of it is a constant exchange of ideas, but there are also negative consequences and difficulties in deepening the issue. The different approaches are very important but they are usable only if the concept of vulnerability is standardized: thus, for the sake of clarity, a number of definitions should be laid down, based on the different types of vulnerability. These definitions can then provide the necessary holistic view for the aquifer vulnerability assessment. Nowadays vulnerability methods focus on the degree of vulnerability and the parameters needed for its evaluation, often neglecting to clarify what is the type of vulnerability the proposed methods are referred. The type of vulnerability, indeed, is both logically and hierarchically superior to the degree of vulnerability. More specifically the type of vulnerability represents the evaluation of the hydrogeological conditions considered in the vulnerability assessment and able to influence the way in which the contamination can take place. Currently the only distinction, based on of the type of vulnerability, is referred to intrinsic and specific vulnerability. Intrinsic vulnerability assesses the susceptibility of the receptor based on the natural properties of the land and subsurface; specific vulnerability also includes properties of the analyzed contaminant. This distinction is useful but not exhaustive. In addition to this, e.g., a distinction of vertical vulnerability
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Terroir as a Concept to Improve Human Health
Brevik, Eric C.; Steffan, Joshua J.; Burgess, Lynn C.; Cerdà, Artemi; Pereg, Lily
2017-04-01
Soil is important to human health because of the ability of healthy soils to supply nutrients through food products, medications derived from soil, its ability to clean water, and for many other positive reasons. On the other hand, degraded soils can have negative impacts on human health through processes such as dust generation and by acting as a point of human contact with heavy metals, organic chemicals, and pathogens. Despite the definite links between soil and human health, it is likely that most people don't think about soil when considering human health issues. In fact, there appears to be a disconnect between most people in our modern society and soil, and when people do notice soil it often seems to be in a negative context, leading to terms such as "soiled", "dirty", "dirt poor", etc. People pay attention to and care for things that matter to them, and creating a more positive public image of soil has the possibility of improving human health by leading to careful and caring treatment of the soil resource. The concept of terroir is a good example of a setting within which soils have a more positive image. While terroir originally established a connection between those who love wine and the soils that produce those wines, the concept has been expanded to many additional products such as cacao, cheese, coffee, fruits, olive oil, and vegetables. If the terroir concept could be expanded to include additional products that are important to people and expanded into parts of the world where it is not currently well known, that may provide an increased positive perception of soil, and thereby indirectly improve human health. It may even be possible to provide a terroir link to direct health benefits, such as medications derived from a given soil environment, and therefore provide a very focused emphasis on soil and human health issues. Therefore, we advocate a concerted effort to expand the terroir concept as a means to improve overall human health.
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Ramulifho, P. A.; Rivers-Moore, N. A.; Dallas, H. F.; Foord, S. H.
2018-01-01
The thermal regime of rivers plays an important role in the overall health and composition of aquatic ecosystems, and together with flow, is recognised as one of the most influential abiotic drivers of aquatic ecosystem processes affecting species distribution. Changes in thermal conditions in aquatic systems are driven by on-going human-induced climate change, hydrological, regional and structural factors. Here, we quantified the impact of instream impoundments on the natural longitudinal connectivity and estimated thermal vulnerability of catchments based on the functional relationship between changing temperature and the profile gradient of rivers in the eastern portion of South Africa. We identified catchments that are most vulnerable to thermal stress based on cold-water adapted species' tolerance to thermal changes. More than half of all studied catchments include rivers that are relatively intact longitudinally, with notable exceptions being rivers in the central portion of the study area. Thermal condition of high elevation sites is more heavily impacted by impoundments and consequently thermal vulnerability of these sites are higher. Blephariceridae and Notonemouridae, the most thermophobic families, are likely to become locally threatened or extinct, in the absence of connectivity. The quantification of stream connectivity and vulnerability of organisms to thermal changes in river systems are important decision making tools for effective adaptive and holistic conservation planning strategies.
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Wu, Xiaoyu; Li, Bin; Ma, Chuanming
2018-05-01
This study assesses vulnerability of groundwater to pollution in Beihai City, China, as a support of groundwater resource protection. The assessment result not only objectively reflects potential possibility of groundwater to contamination but also provides scientific basis for the planning and utilization of groundwater resources. This study optimizes the parameters consisting of natural factors and human factors upon the DRASTIC model and modifies the ratings of these parameters, based on the local environmental conditions for the study area. And a weight of each parameter is assigned by the analytic hierarchy process (AHP) to reduce the subjectivity of humans to vulnerability assessment. The resulting scientific ratings and weights of modified DRASTIC model (AHP-DRASTLE model) contribute to obtain the more realistic assessment of vulnerability of groundwater to contaminant. The comparison analysis validates the accuracy and rationality of the AHP-DRASTLE model and shows it suits the particularity of the study area. The new assessment method (AHP-DRASTLE model) can provide a guide for other scholars to assess the vulnerability of groundwater to contamination. The final vulnerability map for the AHP-DRASTLE model shows four classes: highest (2%), high (29%), low (55%), and lowest (14%). The vulnerability map serves as a guide for decision makers on groundwater resource protection and land use planning at the regional scale and that it is adapted to a specific area.
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Climate change and health: new challenges for epidemiology and public health
International Nuclear Information System (INIS)
Pascal, Mathilde; Beaudeau, Pascal; Laaidi, Karine; Pirard, Philippe; Vautard, Robert
2015-01-01
Climate change contributes to a rapid and deep modification of the environment. In the same time, other factors such as population increase, ageing or urbanization increase the vulnerability to various environmental and health risks. Chains of complex interactions are impacting populations' health and well-being. Developing prevention measures is an asset to reduce the health impacts of present climate change (through adaptation measures) and to limit the intensity of future impacts (through mitigation measures). Mitigation will result in major changes in several sectors, for instance housing, transports or agriculture. Taking into account the potential health impacts is important to avoid choices impairing human health, and to maximize health co-benefits. In this paper we propose a reflection on how present and future climate change in France challenges epidemiology and public health in the next few years. While many questions remain unanswered, there is a consensus on the importance of the links between climate change and human health, that can be summarized into three points: 1) climate change already impacts human health, 2) adaptation and mitigation are needed to reduce those impacts, 3) adaptation and mitigation can rely on immediate measures that would be beneficial for health and for climate. An integrated and interdisciplinary approach is essential to tackle the complexity of the issue, of its implications for public health, for research, surveillance and intervention. (authors)
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Role of Plastics on Human Health.
Kumar, Pramod
2018-05-01
Plastics, currently the universal workhorse materials of modern economy, because of their low cost and varied functional properties are posing serious threat to environment and consumer's health in many direct and indirect ways. Rising concern about the impact of plastics on environment and human health, has forced the industry to look for alternatives. This review studies current understanding of benefits and concerns surrounding use of plastics, reviews literature about health effects in humans and discusses the current state of evidence, as well as future research trends. There is increasing concern regarding additives in plastics to which most people are exposed, such as phthalates, bisphenol A or polybrominated diphenyl ethers (PBDE), and their detection in humans, leading to harmful impact on health. The studies are divided, among many other issues on the fact of considering these additives as carcinogens or toxicants, but there is a consensus that these chemicals have the ability to alter the endocrine system. Human data are limited compared to large body of experimental evidence documenting reproductive or developmental toxicity in relation to these compounds in animals. The concentrations of these additives in young children, a segment particularly sensitive to exogenous insults, are typically higher, indicating the need to decrease exposure to these compounds. The rapid increase in usage of plastics and increased awareness about its health hazard has lent urgency to the whole issue.
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Papathoma-Köhle, Maria
2016-08-01
The assessment of the physical vulnerability of elements at risk as part of the risk analysis is an essential aspect for the development of strategies and structural measures for risk reduction. Understanding, analysing and, if possible, quantifying physical vulnerability is a prerequisite for designing strategies and adopting tools for its reduction. The most common methods for assessing physical vulnerability are vulnerability matrices, vulnerability curves and vulnerability indicators; however, in most of the cases, these methods are used in a conflicting way rather than in combination. The article focuses on two of these methods: vulnerability curves and vulnerability indicators. Vulnerability curves express physical vulnerability as a function of the intensity of the process and the degree of loss, considering, in individual cases only, some structural characteristics of the affected buildings. However, a considerable amount of studies argue that vulnerability assessment should focus on the identification of these variables that influence the vulnerability of an element at risk (vulnerability indicators). In this study, an indicator-based methodology (IBM) for mountain hazards including debris flow (Kappes et al., 2012) is applied to a case study for debris flows in South Tyrol, where in the past a vulnerability curve has been developed. The relatively "new" indicator-based method is being scrutinised and recommendations for its improvement are outlined. The comparison of the two methodological approaches and their results is challenging since both methodological approaches deal with vulnerability in a different way. However, it is still possible to highlight their weaknesses and strengths, show clearly that both methodologies are necessary for the assessment of physical vulnerability and provide a preliminary "holistic methodological framework" for physical vulnerability assessment showing how the two approaches may be used in combination in the future.
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Livelihood Cycle and Vulnerability of Rural Households to Climate Change and Hazards in Bangladesh
Alam, G. M. Monirul
2017-05-01
Rural riverine households in Bangladesh are confronted with many climate-driven hazards, including riverbank erosion, which results in loss of productive land and other natural resources of the riverine households, and thus threatens their livelihoods and food security. This study assesses the main drivers of vulnerability and livelihood cycle of vulnerable riparian households in Bangladesh. The study utilises the IPCC framework of vulnerability and develops a weighted approach by employing the livelihood vulnerability index and the climate vulnerability index. The results reveal that the livelihood vulnerability index and the climate vulnerability index differ across locations, however, a high index value for both measures indicates the households' high livelihood vulnerability to climate change and hazards. The main drivers that influence the vulnerability dimensions are livelihood strategies and access to food, water and health facilities. These hazard-prone households are also vulnerable due to their existing low livelihood status that leads to a vicious cycle of poverty. The findings of this study are crucial for policymakers to formulate and implement effective strategies and programs to minimise vulnerability and to enhance the local adaptation processes in order to improve such households' livelihood across Bangladesh.
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Livelihood Cycle and Vulnerability of Rural Households to Climate Change and Hazards in Bangladesh.
Alam, G M Monirul
2017-05-01
Rural riverine households in Bangladesh are confronted with many climate-driven hazards, including riverbank erosion, which results in loss of productive land and other natural resources of the riverine households, and thus threatens their livelihoods and food security. This study assesses the main drivers of vulnerability and livelihood cycle of vulnerable riparian households in Bangladesh. The study utilises the IPCC framework of vulnerability and develops a weighted approach by employing the livelihood vulnerability index and the climate vulnerability index. The results reveal that the livelihood vulnerability index and the climate vulnerability index differ across locations, however, a high index value for both measures indicates the households' high livelihood vulnerability to climate change and hazards. The main drivers that influence the vulnerability dimensions are livelihood strategies and access to food, water and health facilities. These hazard-prone households are also vulnerable due to their existing low livelihood status that leads to a vicious cycle of poverty. The findings of this study are crucial for policymakers to formulate and implement effective strategies and programs to minimise vulnerability and to enhance the local adaptation processes in order to improve such households' livelihood across Bangladesh.
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Identification and ranking of environmental threats with ecosystem vulnerability distributions.
Zijp, Michiel C; Huijbregts, Mark A J; Schipper, Aafke M; Mulder, Christian; Posthuma, Leo
2017-08-24
Responses of ecosystems to human-induced stress vary in space and time, because both stressors and ecosystem vulnerabilities vary in space and time. Presently, ecosystem impact assessments mainly take into account variation in stressors, without considering variation in ecosystem vulnerability. We developed a method to address ecosystem vulnerability variation by quantifying ecosystem vulnerability distributions (EVDs) based on monitoring data of local species compositions and environmental conditions. The method incorporates spatial variation of both abiotic and biotic variables to quantify variation in responses among species and ecosystems. We show that EVDs can be derived based on a selection of locations, existing monitoring data and a selected impact boundary, and can be used in stressor identification and ranking for a region. A case study on Ohio's freshwater ecosystems, with freshwater fish as target species group, showed that physical habitat impairment and nutrient loads ranked highest as current stressors, with species losses higher than 5% for at least 6% of the locations. EVDs complement existing approaches of stressor assessment and management, which typically account only for variability in stressors, by accounting for variation in the vulnerability of the responding ecosystems.
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Daskalakis, Nikolaos P; Bagot, Rosemary C; Parker, Karen J; Vinkers, Christiaan H; de Kloet, E R
2013-09-01
Stressful experiences during early-life can modulate the genetic programming of specific brain circuits underlying emotional and cognitive aspects of behavioral adaptation to stressful experiences later in life. Although this programming effect exerted by experience-related factors is an important determinant of mental health, its outcome depends on cognitive inputs and hence the valence an individual assigns to a given environmental context. From this perspective we will highlight, with studies in rodents, non-human primates and humans, the three-hit concept of vulnerability and resilience to stress-related mental disorders, which is based on gene-environment interactions during critical phases of perinatal and juvenile brain development. The three-hit (i.e., hit-1: genetic predisposition, hit-2: early-life environment, and hit-3: later-life environment) concept accommodates the cumulative stress hypothesis stating that in a given context vulnerability is enhanced when failure to cope with adversity accumulates. Alternatively, the concept also points to the individual's predictive adaptive capacity, which underlies the stress inoculation and match/mismatch hypotheses. The latter hypotheses propose that the experience of relatively mild early-life adversity prepares for the future and promotes resilience to similar challenges in later-life; when a mismatch occurs between early and later-life experience, coping is compromised and vulnerability is enhanced. The three-hit concept is fundamental for understanding how individuals can either be prepared for coping with life to come and remain resilient or are unable to do so and succumb to a stress-related mental disorder, under seemingly identical circumstances. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Zhang, Yang; Shen, Jing; Li, Yu
2018-02-01
This paper presents an atmospheric vulnerability assessment framework based on CAMx that should be helpful to assess potential impacts of changes in human, atmospheric environment, and social economic elements of atmospheric vulnerability. It is also a useful and effective tool that can provide policy-guidance for environmental protection and management to reduce the atmospheric vulnerability. The developed framework was applied to evaluate the atmospheric environment vulnerability of 13 cities in the Beijing-Tianjin-Hebei (BTH) region for verification. The results indicated that regional disparity of the atmospheric vulnerability existed in the study site. More specifically, the central and southern regions show more atmospheric environment vulnerability than the northern regions. The impact factors of atmospheric environment vulnerability in the BTH region mainly derived from increasing population press, frequently unfavorable meteorological conditions, extensive economic growth of secondary industry, increased environmental pollution, and accelerating population aging. The framework shown in this paper is an interpretative and heuristic tool for a better understanding of atmospheric vulnerability. This framework can also be replicated at different spatial and temporal scales using context-specific datasets to straightly support environmental managers with decision-making. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Impact of climate change on human infectious diseases: Empirical evidence and human adaptation.
Wu, Xiaoxu; Lu, Yongmei; Zhou, Sen; Chen, Lifan; Xu, Bing
2016-01-01
Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing health problems. This review examines the scientific evidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects--the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial-temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Health at risk in immigration detention facilities
Directory of Open Access Journals (Sweden)
Ioanna Kotsioni
2013-09-01
Full Text Available Since 2004 Médecins Sans Frontières (MSF has provided medical and psychosocial support for asylum seekers and migrants held in different immigration detention facilities across Europe (in Greece, Malta, Italy and Belgium where the life, health and human dignity of vulnerable people are being put at risk.
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Plastic and Human Health: A Micro Issue?
Wright, Stephanie L; Kelly, Frank J
2017-06-20
Microplastics are a pollutant of environmental concern. Their presence in food destined for human consumption and in air samples has been reported. Thus, microplastic exposure via diet or inhalation could occur, the human health effects of which are unknown. The current review article draws upon cross-disciplinary scientific literature to discuss and evaluate the potential human health impacts of microplastics and outlines urgent areas for future research. Key literature up to September 2016 relating to accumulation, particle toxicity, and chemical and microbial contaminants was critically examined. Although microplastics and human health is an emerging field, complementary existing fields indicate potential particle, chemical and microbial hazards. If inhaled or ingested, microplastics may accumulate and exert localized particle toxicity by inducing or enhancing an immune response. Chemical toxicity could occur due to the localized leaching of component monomers, endogenous additives, and adsorbed environmental pollutants. Chronic exposure is anticipated to be of greater concern due to the accumulative effect that could occur. This is expected to be dose-dependent, and a robust evidence-base of exposure levels is currently lacking. Although there is potential for microplastics to impact human health, assessing current exposure levels and burdens is key. This information will guide future research into the potential mechanisms of toxicity and hence therein possible health effects.
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Directory of Open Access Journals (Sweden)
Zh. Z. Trumova
2015-01-01
Full Text Available The human immunodeficiency virus (HIV epidemic continues to expand in Eastern Europe and Central Asia according to UNAIDS data (2012, Geneva. The rate of new HIV infections AIDS – related mortality has increased by 25 % from 2001 to 2009 in Kazakhstan (WHO data, 2012. The number of new HIV infections among newly diagnosed patients attributed to heteroand homosexual contact has been steadily increasing. There is also higher rate of HIV among Injecting Drug Users. There is an increase incidence of co-infections especially sexually transmitted diseases. In fact, comorbid STIs increase patients' susceptibility of acquiring and transmitting HIV (Guenthner PC, Secor WE, Dezzutti CS., 2005; Kissinger P, Amedee A, Clark RA, et al. , 2009. HIV/AIDS shares transmission characteristics with other sexual and blood-borne agents. Higher sexual mixing rates and lack of condom use are conspicuous risk factors (Vermund et al. 2009. However, while all groups are affected by HIV, some are more vulnerable than others: sex workers (SWs, men who have sex with men (MSM, injecting drug users (IDU. All these findings determined to set up the goal of this research. The purpose of the study is еpidemiologic situation of human immunodeficiency virus (HIV/AIDS and related STIs in the Republic of Kazakhstan and in some vulnerable population groups to HIV infection. Materials and methods. To study the dynamics of HIV/STIs in Kazakhstan (cumulatively an analysis of 2012–2013 years statistics was conducted. Testing for HIV/STI of blood samples of the vulnerable groups was carried out in the laboratories of AIDS centers. The algorithm of confirming the diagnosis of HIV infection included a twofold enzyme immunoassay (EIA study of blood samples. Samples with positive results of the first EIA were retested using expert test systems; in case with a positive result of the second EIA a confirmatory test was conducted using a method of HIV-1 Western blot in the reference
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Meier, Benjamin Mason; Ayala, Ana S
2014-01-01
In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. © 2014 American Society of Law, Medicine & Ethics, Inc.
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Iguacel, Isabel; Fernández-Alvira, Juan M; Bammann, Karin; De Clercq, Bart; Eiben, Gabriele; Gwozdz, Wencke; Molnar, Dénes; Pala, Valeria; Papoutsou, Stalo; Russo, Paola; Veidebaum, Toomas; Wolters, Maike; Börnhorst, Claudia; Moreno, Luis A
2016-10-01
Socio-economic inequalities in childhood can determine dietary patterns, and therefore future health. This study aimed to explore associations between social vulnerabilities and dietary patterns assessed at two time points, and to investigate the association between accumulation of vulnerabilities and dietary patterns. A total of 9301 children aged 2-9 years participated at baseline and 2-year follow-up examinations of the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS study. In all, three dietary patterns were identified at baseline and follow-up by applying the K-means clustering algorithm based on a higher frequency of consumption of snacks and fast food (processed), sweet foods and drinks (sweet), and fruits and vegetables (healthy). Vulnerable groups were defined at baseline as follows: children whose parents lacked a social network, children from single-parent families, children of migrant origin and children with unemployed parents. Multinomial mixed models were used to assess the associations between social vulnerabilities and children's dietary patterns at baseline and follow-up. Children whose parents lacked a social network (OR 1·31; 99 % CI 1·01, 1·70) and migrants (OR 1·45; 99 % CI 1·15, 1·83) were more likely to be in the processed cluster at baseline and follow-up. Children whose parents were homemakers (OR 0·74; 99 % CI 0·60, 0·92) were less likely to be in the processed cluster at baseline. A higher number of vulnerabilities was associated with a higher probability of children being in the processed cluster (OR 1·78; 99 % CI 1·21, 2·62). Therefore, special attention should be paid to children of vulnerable groups as they present unhealthier dietary patterns.
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Physician Encounters with Human Trafficking: Legal Consequences and Ethical Considerations.
Todres, Jonathan
2017-01-01
There is growing recognition and evidence that health care professionals regularly encounter-though they may not identify-victims of human trafficking in a variety of health care settings. Identifying and responding appropriately to trafficking victims or survivors requires not only training in trauma-informed care but also consideration of the legal and ethical issues that arise when serving this vulnerable population. This essay examines three areas of law that are relevant to this case scenario: criminal law, with a focus on conspiracy; service provider regulations, with a focus on mandatory reporting laws; and human rights law. In addition to imposing a legal mandate, the law can inform ethical considerations about how health care professionals should respond to human trafficking. © 2017 American Medical Association. All Rights Reserved.
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Declining vulnerability to river floods and the global benefits of adaptation.
Jongman, Brenden; Winsemius, Hessel C; Aerts, Jeroen C J H; Coughlan de Perez, Erin; van Aalst, Maarten K; Kron, Wolfgang; Ward, Philip J
2015-05-05
The global impacts of river floods are substantial and rising. Effective adaptation to the increasing risks requires an in-depth understanding of the physical and socioeconomic drivers of risk. Whereas the modeling of flood hazard and exposure has improved greatly, compelling evidence on spatiotemporal patterns in vulnerability of societies around the world is still lacking. Due to this knowledge gap, the effects of vulnerability on global flood risk are not fully understood, and future projections of fatalities and losses available today are based on simplistic assumptions or do not include vulnerability. We show for the first time (to our knowledge) that trends and fluctuations in vulnerability to river floods around the world can be estimated by dynamic high-resolution modeling of flood hazard and exposure. We find that rising per-capita income coincided with a global decline in vulnerability between 1980 and 2010, which is reflected in decreasing mortality and losses as a share of the people and gross domestic product exposed to inundation. The results also demonstrate that vulnerability levels in low- and high-income countries have been converging, due to a relatively strong trend of vulnerability reduction in developing countries. Finally, we present projections of flood losses and fatalities under 100 individual scenario and model combinations, and three possible global vulnerability scenarios. The projections emphasize that materialized flood risk largely results from human behavior and that future risk increases can be largely contained using effective disaster risk reduction strategies.
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Psychic wear and social vulnerability of Zapotlenses women: A descriptive study
Directory of Open Access Journals (Sweden)
Claudia Saldaña-Orozco
2017-12-01
Full Text Available Introduction: Numerous studies have documented the impact of psychosocial risks, and particularly the psychic wear on workers’ health. However, women in a situation of social vulnerability have not been the subject of exploration. Objective: To characterize the psychic wear in a sample of vulnerable women. Materials and methods: An exploratory, descriptive and correlational study was conducted. The dimension number 4 from the Battery for the study of the working conditions of psychosocial character was applied (CTCPS-MAC, which evaluates psychological wear and 3 particular factors (cognitive-emotional response; behavioral response and physiological response at 99 Vulnerable women of Zapotlán el Grande. Results: A 75.8 % of the participants presented optimal conditions with ratings between good and very good, 24.2% between normal and harmful, which indicates that they require immediate assistance. The most affected factor was number 1 (cognitive-emotional response, 52,5% presented negative symptomatology. There were no significant associations between the sociodemographic variables studied and the psychic wear. Conclusions: The results allow to open doors for deeper investigations with the population studied in order to guarantee mental health and quality of life for women with social vulnerability in Zapotlán el Grande.
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Interdependence, Human Rights and Global Health Law.
Viens, A M
2015-12-01
The connection between health and human rights continues to play a prominent role within global health law. In particular, a number of theorists rely on the claim that there is a relation of interdependence between health and human rights. The nature and extent of this relation, however, is rarely defined, developed or defended in a conceptually robust way. This paper seeks to explore the source, scope and strength of this putative relation and what role it might play in developing a global health law framework.
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Social Vulnerability to Climate Change and the Architecture of Entitlements
International Nuclear Information System (INIS)
Adger, W.N.; Kelly, P.M.
1999-01-01
The objective of this paper is to outline a conceptual model of vulnerability to climate change as the first step in appraising and understanding the social and economic processes which facilitate and constrain adaptation. Vulnerability as defined here pertains to individuals and social groups. It is the state of individuals, of groups, of communities defined in terms of their ability to cope with and adapt to any external stress placed on their livelihoods and well-being. This proposed approach puts the social and economic well-being of society at the centre of the analysis, thereby reversing the central focus of approaches to climate impact assessment based on impacts on and the adaptability of natural resources or ecosystems and which only subsequently address consequences for human well-being. The vulnerability or security of any group is determined by the availability of resources and, crucially, by the entitlement of individuals and groups to call on these resources. This perspective extends the concept of entitlements developed within neoclassical and institutional economics. Within this conceptual framework, vulnerability can be seen as a socially-constructed phenomenon influenced by institutional and economic dynamics. The study develops proxy indicators of vulnerability related to the structure of economic relations and the entitlements which govern them, and shows how these can be applied to a District in coastal lowland Vietnam. This paper outlines the lessons of such an approach to social vulnerability for the assessment of climate change at the global scale. We argue that the socio-economic and biophysical processes that determine vulnerability are manifest at the local, national, regional and global level but the state of vulnerability itself is associated with a specific population. Aggregation one level to another is therefore not appropriate and global-scale analysis is meaningful only in so far as it deals with the vulnerability of the global
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International Nuclear Information System (INIS)
Jouffe, Yves; Massot, Marie-Helene; Noble, Cyprien
2015-01-01
Extensive expansion of urban areas generates transportation needs and energy expenses for mobility. Households already impacted by fuel poverty also suffer from energy vulnerability in their mobility. This report was prepared in the framework of the study of fuel poverty in France in the light of several indicators from existing inquiries, databases and modeling tools. The report is organised in 4 parts dealing with: the definition of energy vulnerability in mobility, its measurement, the possible remedial actions, and the discussions about energy vulnerability in mobility through working group meetings, respectively
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Living with Familiar Hazards: Flood Experiences and Human Vulnerability in Accra, Ghana
Directory of Open Access Journals (Sweden)
Dacosta Aboagye
2012-10-01
Full Text Available The paper explores demographic characteristics, migration history, and impact of flooding on households and communities. The main objective is to explore the different ways in which floods impact households and communities in Accra. Specifically, the paper analyzes how floods alter the set of resources available to households and communities. The results indicate that urbanization and governmental policies have rendered more people, especially the poor and recent migrants, homeless. These homeless people have become more vulnerable to flooding than the average Accra resident. The results also show that the homeless community contrast with the fixed community in terms of socio-economic characteristics, degree of social cohesion, and physical location. The paper concludes that the unchanging pattern of vulnerability shows the inability of a society to cope and adjust to familiar hazards.
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Discrimination, vulnerability, and justice in the face of risk.
Satterfield, Terre A; Mertz, C K; Slovic, Paul
2004-02-01
Recent research finds that perceived risk is closely associated with race and gender. In surveys of the American public a subset of white males stand out for their uniformly low perceptions of environmental health risks, while most nonwhite and nonmale respondents reveal higher perceived risk. Such findings have been attributed to the advantageous position of white males in American social life. This article explores the linked possibility that this demographic pattern is driven not simply by the social advantages or disadvantages embodied in race or gender, but by the subjective experience of vulnerability and by sociopolitical evaluations pertaining to environmental injustice. Indices of environmental injustice and social vulnerability were developed as part of a U.S. National Risk Survey (n= 1,192) in order to examine their effect on perceived risk. It was found that those who regarded themselves as vulnerable and supported belief statements consistent with the environmental justice thesis offered higher risk ratings across a range of hazards. Multivariate analysis indicates that our measures of vulnerability and environmental injustice predict perceived risk but do not account for all of the effects of race and gender. The article closes with a discussion of the implications of these findings for further work on vulnerability and risk, risk communication, and risk management practices generally.
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Proteomic approach in human health and disease: Preventive and cure studies
Directory of Open Access Journals (Sweden)
Khaled MM Koriem
2018-01-01
Full Text Available Proteomic is a branch of science that deals with various numbers of proteins where proteins are essential human constituents. Proteomic has a lot of functions inside the human and animal living organisms. This review helps to make a thought on the importance of proteomic application in human health and disease with special reference to preventive and cure studies. The human health can be divided into physical and mental health. The physical health relates to keeping human body state in a good health and to nutritional type and environmental factors. The mental health correlates to human psychological state. The main factors that affect the status of human health are human diet, exercise and sleep. The healthy diet is very important and needs to maintain the human health. The training program exercise improves human fitness and overall health and wellness. The sleep is a vital factor to sustain the human health. The human disease indicates abnormal human condition which influences the specific human part or the whole human body. There are external and internal factors which induce human disease. The external factors include pathogens while internal factors include allergies and autoimmunity. There are 4 principle types of human diseases: (1 infectious disease, (2 deficiency disease, (3 genetic disease and (4 physiological disease. There are many and various external microbes' factors that induce human infectious disease and these agents include viruses, bacteria, fungi and protozoa. The lack of necessary and vital dietary rudiments such as vitamins and minerals is the main cause of human deficiency disease. The genetic disease is initiated by hereditary disturbances that occur in the human genetic map. The physiological disease occurs when the normal human function body is affected due to human organs become malfunction. In conclusion, proteomic plays a vital and significant role in human health and disease.
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Social vulnerability and climate change: synthesis of literature
Kathy Lynn; Katharine MacKendrick; Ellen M. Donoghue
2011-01-01
The effects of climate change are expected to be more severe for some segments of society than others because of geographic location, the degree of association with climate-sensitive environments, and unique cultural, economic, or political characteristics of particular landscapes and human populations. Social vulnerability and equity in the context of climate change...
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Human health effects of air pollution
International Nuclear Information System (INIS)
Kampa, Marilena; Castanas, Elias
2008-01-01
Hazardous chemicals escape to the environment by a number of natural and/or anthropogenic activities and may cause adverse effects on human health and the environment. Increased combustion of fossil fuels in the last century is responsible for the progressive change in the atmospheric composition. Air pollutants, such as carbon monoxide (CO), sulfur dioxide (SO 2 ), nitrogen oxides (NOx), volatile organic compounds (VOCs), ozone (O 3 ), heavy metals, and respirable particulate matter (PM2.5 and PM10), differ in their chemical composition, reaction properties, emission, time of disintegration and ability to diffuse in long or short distances. Air pollution has both acute and chronic effects on human health, affecting a number of different systems and organs. It ranges from minor upper respiratory irritation to chronic respiratory and heart disease, lung cancer, acute respiratory infections in children and chronic bronchitis in adults, aggravating pre-existing heart and lung disease, or asthmatic attacks. In addition, short- and long-term exposures have also been linked with premature mortality and reduced life expectancy. These effects of air pollutants on human health and their mechanism of action are briefly discussed. - The effect of air pollutants on human health and underlying mechanisms of cellular action are discussed
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Economics of human trafficking.
Wheaton, Elizabeth M; Schauer, Edward J; Galli, Thomas V
2010-01-01
Because freedom of choice and economic gain are at the heart of productivity, human trafficking impedes national and international economic growth. Within the next 10 years, crime experts expect human trafficking to surpass drug and arms trafficking in its incidence, cost to human well-being, and profitability to criminals (Schauer and Wheaton, 2006: 164-165). The loss of agency from human trafficking as well as from modern slavery is the result of human vulnerability (Bales, 2000: 15). As people become vulnerable to exploitation and businesses continually seek the lowest-cost labour sources, trafficking human beings generates profit and a market for human trafficking is created. This paper presents an economic model of human trafficking that encompasses all known economic factors that affect human trafficking both across and within national borders. We envision human trafficking as a monopolistically competitive industry in which traffickers act as intermediaries between vulnerable individuals and employers by supplying differentiated products to employers. In the human trafficking market, the consumers are employers of trafficked labour and the products are human beings. Using a rational-choice framework of human trafficking we explain the social situations that shape relocation and working decisions of vulnerable populations leading to human trafficking, the impetus for being a trafficker, and the decisions by employers of trafficked individuals. The goal of this paper is to provide a common ground upon which policymakers and researchers can collaborate to decrease the incidence of trafficking in humans.
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Nutritional vulnerability seen within asylum seekers in Australia.
O'Reilly, Sharleen; O'Shea, Tess; Bhusumane, Sibusiso
2012-04-01
To examine the extent of nutritional vulnerability seen in a cohort of asylum seekers in Australia. Twenty-one asylum seekers (15 males, 6 females) that used a food bank were interviewed over a 6 week period at the Melbourne based Asylum Seeker Resource Centre about foods consumed in the previous 24-h and any non food bank foods obtained. A basket audit was conducted after participants accessed the food bank on the day of interview, Participants obtained significantly less than the minimum requirements for the Australian Guide to Healthy Eating in the vegetables and legumes (P bank, their primary or sole food source. A high level of nutritional vulnerability was seen in this cohort due to their inability to meet minimum nutritional requirements from their primary food access point. Health professionals working with asylum seeker populations need to be aware of this issue and the resulting potential for longer term ill health as a consequence.
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People who use drugs, HIV, and human rights.
Jürgens, Ralf; Csete, Joanne; Amon, Joseph J; Baral, Stefan; Beyrer, Chris
2010-08-07
We reviewed evidence from more than 900 studies and reports on the link between human rights abuses experienced by people who use drugs and vulnerability to HIV infection and access to services. Published work documents widespread abuses of human rights, which increase vulnerability to HIV infection and negatively affect delivery of HIV programmes. These abuses include denial of harm-reduction services, discriminatory access to antiretroviral therapy, abusive law enforcement practices, and coercion in the guise of treatment for drug dependence. Protection of the human rights of people who use drugs therefore is important not only because their rights must be respected, protected, and fulfilled, but also because it is an essential precondition to improving the health of people who use drugs. Rights-based responses to HIV and drug use have had good outcomes where they have been implemented, and they should be replicated in other countries. Copyright 2010 Elsevier Ltd. All rights reserved.
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Climate Change, Human Rights, and Social Justice.
Levy, Barry S; Patz, Jonathan A
2015-01-01
The environmental and health consequences of climate change, which disproportionately affect low-income countries and poor people in high-income countries, profoundly affect human rights and social justice. Environmental consequences include increased temperature, excess precipitation in some areas and droughts in others, extreme weather events, and increased sea level. These consequences adversely affect agricultural production, access to safe water, and worker productivity, and, by inundating land or making land uninhabitable and uncultivatable, will force many people to become environmental refugees. Adverse health effects caused by climate change include heat-related disorders, vector-borne diseases, foodborne and waterborne diseases, respiratory and allergic disorders, malnutrition, collective violence, and mental health problems. These environmental and health consequences threaten civil and political rights and economic, social, and cultural rights, including rights to life, access to safe food and water, health, security, shelter, and culture. On a national or local level, those people who are most vulnerable to the adverse environmental and health consequences of climate change include poor people, members of minority groups, women, children, older people, people with chronic diseases and disabilities, those residing in areas with a high prevalence of climate-related diseases, and workers exposed to extreme heat or increased weather variability. On a global level, there is much inequity, with low-income countries, which produce the least greenhouse gases (GHGs), being more adversely affected by climate change than high-income countries, which produce substantially higher amounts of GHGs yet are less immediately affected. In addition, low-income countries have far less capability to adapt to climate change than high-income countries. Adaptation and mitigation measures to address climate change needed to protect human society must also be planned to protect
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Vilcu, Ileana; Probst, Lilli; Dorjsuren, Bayarsaikhan; Mathauer, Inke
2016-10-04
Many low- and middle-income countries with a social health insurance system face challenges on their road towards universal health coverage (UHC), especially for people in the informal sector and vulnerable population groups or the informally employed. One way to address this is to subsidize their contributions through general government revenue transfers to the health insurance fund. This paper provides an overview of such health financing arrangements in Asian low- and middle-income countries. The purpose is to assess the institutional design features of government subsidized health insurance type arrangements for vulnerable and informally employed population groups and to explore how these features contribute to UHC progress. This regional study is based on a literature search to collect country information on the specific institutional design features of such subsidization arrangements and data related to UHC progress indicators, i.e. population coverage, financial protection and access to care. The institutional design analysis focuses on eligibility rules, targeting and enrolment procedures; financing arrangements; the pooling architecture; and benefit entitlements. Such financing arrangements currently exist in 8 countries with a total of 14 subsidization schemes. The most frequent groups covered are the poor, older persons and children. Membership in these arrangements is mostly mandatory as is full subsidization. An integrated pool for both the subsidized and the contributors exists in half of the countries, which is one of the most decisive features for equitable access and financial protection. Nonetheless, in most schemes, utilization rates of the subsidized are higher compared to the uninsured, but still lower compared to insured formal sector employees. Total population coverage rates, as well as a higher share of the subsidized in the total insured population are related with broader eligibility criteria. Overall, government subsidized health
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Sirois, Fuschia M
2015-06-01
Personality is an important epidemiological factor for understanding health outcomes. This study investigated the associations of trait procrastination with hypertension and cardiovascular disease (HT/CVD) and maladaptive coping by testing an extension of the procrastination-health model among individuals with and without HT/CVD. Individuals with self-reported HT/CVD (N = 182) and healthy controls (N = 564), from a community sample, completed an online survey including measures of personality, coping, and health outcomes. Logistic regression analysis controlling for demographic and higher order personality factors found that older age, lower education level and higher procrastination scores were associated with HT/CVD. Moderated mediation analyses with bootstrapping revealed that procrastination was more strongly associated with maladaptive coping behaviours in participants with HT/CVD than the healthy controls, and the indirect effects on stress through maladaptive coping were larger for the HT/CVD sample. Results suggest procrastination is a vulnerability factor for poor adjustment to and management of HT/CVD.
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Exploitation of the vulnerable in research: Responses to lessons learnt in history.
Dhai, Amaboo
2017-05-24
The Nuremberg Trials raised insightful issues on how and why doctors who were trained in the Hippocratic tradition were able to commit such egregious and heinous medical crimes. The vulnerable were considered to be subhuman, of decreased intelligence, of no moral status and lacking human dignity. The reputation of the medical profession had been undermined, professionalism questioned and the doctor-patient relationship damaged as a result of the Nazi medical experiments. The World Medical Association's Declaration of Helsinki has been hailed as one of the most successful efforts in rescuing medical research from the darkness of the scandals and tragedies in health research. The first Research Ethics Committee in South Africa was established in 1966 at the University of the Witwatersrand. From the mid-1970s other institutions followed suit. The promulgation of the National Health Act No. 61 of 2003, in 2004, resulted in strong protectionism for research participants in the country.
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Exploitation of the vulnerable in research: Responses to lessons learnt in history
Directory of Open Access Journals (Sweden)
Amaboo Dhai
2017-06-01
Full Text Available The Nuremberg Trials raised insightful issues on how and why doctors who were trained in the Hippocratic tradition were able to commit such egregious and heinous medical crimes. The vulnerable were considered to be subhuman, of decreased intelligence, of no moral status and lacking human dignity. The reputation of the medical profession had been undermined, professionalism questioned and the doctor-patient relationship damaged as a result of the Nazi medical experiments. The World Medical Association’s Declaration of Helsinki has been hailed as one of the most successful efforts in rescuing medical research from the darkness of the scandals and tragedies in health research. The first Research Ethics Committee in South Africa was established in 1966 at the University of the Witwatersrand. From the mid-1970s other institutions followed suit. The promulgation of the National Health Act No. 61 of 2003, in 2004, resulted in strong protectionism for research participants in the country.
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Exposure to UV radiation and human health
Kimlin, Michael G.
2005-08-01
This paper will overview the significant issues facing researchers in relating the impact of exposure to sunlight and human health. Exposure to solar ultraviolet radiation is the major causative factor in most sun-related skin and eye disorders, however, very little is known quantitatively about human UV exposures. Interestingly, human exposure to sunlight also has a nutritional impact, namely the development of pre-Vitamin D, which is an important nutrient in bone health. New research suggest that low vitamin D status may be a causative factor in the development of selective types of cancer and autoimminue diseases, as well as a contributing factor in bone health. The 'health duality' aspect of sunlight exposure is an interesting and controversial topic that is a research focus of Kimlin's research group.
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Mental health legislation and human rights in England, Wales and the Republic of Ireland.
Kelly, Brendan D
2011-01-01
In 2005, the World Health Organization (WHO) published its Resource Book on Mental Health, Human Rights and Legislation (Geneva: WHO) presenting a detailed statement of human rights issues which need to be addressed in national legislation relating to mental health. The purpose of this paper is to determine the extent to which revised mental health legislation in England, Wales (2007) and Ireland (2001) accords with these standards (excluding standards relating solely to children or mentally-ill offenders). Legislation in England and Wales meets 90 (54.2%) of the 166 WHO standards examined, while legislation in Ireland meets 80 standards (48.2%). Areas of high compliance include definitions of mental disorder, relatively robust procedures for involuntary admission and treatment (although provision of information remains suboptimal) and clarity regarding offences and penalties Areas of medium compliance relate to competence, capacity and consent (with a particular deficit in capacity legislation in Ireland), oversight and review (which exclude long-term voluntary patients and require more robust complaints procedures), and rules governing special treatments, seclusion and restraint. Areas of low compliance relate to promoting rights (impacting on other areas within legislation, such as information management), voluntary patients (especially non-protesting, incapacitated patients), protection of vulnerable groups and emergency treatment. The greatest single deficit in both jurisdictions relates to economic and social rights. There are four key areas in need of rectification and clarification in relation to mental health legislation in England, Wales and Ireland; these relate to (1) measures to protect and promote the rights of voluntary patients; (2) issues relating to competence, capacity and consent (especially in Ireland); (3) the role of "common law" in relation to mental health law (especially in England and Wales); and (4) the extent to which each jurisdiction
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One health security: an important component of the global health security agenda.
Gronvall, Gigi; Boddie, Crystal; Knutsson, Rickard; Colby, Michelle
2014-01-01
The objectives of the Global Health Security Agenda (GHSA) will require not only a "One Health" approach to counter natural disease threats against humans, animals, and the environment, but also a security focus to counter deliberate threats to human, animal, and agricultural health and to nations' economies. We have termed this merged approach "One Health Security." It will require the integration of professionals with expertise in security, law enforcement, and intelligence to join the veterinary, agricultural, environmental, and human health experts essential to One Health and the GHSA. Working across such different professions, which occasionally have conflicting aims and different professional cultures, poses multiple challenges, but a multidisciplinary and multisectoral approach is necessary to prevent disease threats; detect them as early as possible (when responses are likely to be most effective); and, in the case of deliberate threats, find who may be responsible. This article describes 2 project areas that exemplify One Health Security that were presented at a workshop in January 2014: the US government and private industry efforts to reduce vulnerabilities to foreign animal diseases, especially foot-and-mouth disease; and AniBioThreat, an EU project to counter deliberate threats to agriculture by raising awareness and implementing prevention and response policies and practices.
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VULNERABILITY AND RISK OF CONTAMINATION KARSTIC AQUIFERS
Directory of Open Access Journals (Sweden)
Yameli Aguilar
2013-08-01
Full Text Available Karstic systems occupy nearly 20% of the surface of the earth and are inhabited by numerous human communities. Karstic aquifers are the most exposed to pollution from human activities. Pollution of karstic aquifers is a severe environmental problem worldwide. In order to face the vulnerability of karstic aquifers to pollution, researchers have created a diversity of study approaches and models, each one having their own strengths and weaknesses depending on the discipline from which they were originated, thus requiring a thorough discussion within the required multidisciplinary character. The objective of this article was to analyze the theoretical and methodological approaches applied to the pollution of karstic aquifers. The European hydrogeological, land evaluation, hydropedological and a geographic approach were analyzed. The relevance of a geomorphological analysis as a cartographic basis for the analysis of vulnerability and risks were emphasized. From the analysis of models, approaches and methodologies discussed the following recommendation is made: to form an interdisciplinary work team, to elaborate a conceptual model according to the site and the working scale and to e, apply and validate the model.
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Directory of Open Access Journals (Sweden)
M. Catarina Silva
2016-09-01
Full Text Available Frontotemporal dementia (FTD and other tauopathies characterized by focal brain neurodegeneration and pathological accumulation of proteins are commonly associated with tau mutations. However, the mechanism of neuronal loss is not fully understood. To identify molecular events associated with tauopathy, we studied induced pluripotent stem cell (iPSC-derived neurons from individuals carrying the tau-A152T variant. We highlight the potential of in-depth phenotyping of human neuronal cell models for pre-clinical studies and identification of modulators of endogenous tau toxicity. Through a panel of biochemical and cellular assays, A152T neurons showed accumulation, redistribution, and decreased solubility of tau. Upregulation of tau was coupled to enhanced stress-inducible markers and cell vulnerability to proteotoxic, excitotoxic, and mitochondrial stressors, which was rescued upon CRISPR/Cas9-mediated targeting of tau or by pharmacological activation of autophagy. Our findings unmask tau-mediated perturbations of specific pathways associated with neuronal vulnerability, revealing potential early disease biomarkers and therapeutic targets for FTD and other tauopathies.
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Directory of Open Access Journals (Sweden)
Julia A. Sung
2017-09-01
Full Text Available Latently human immunodeficiency virus (HIV-infected cells are transcriptionally quiescent and invisible to clearance by the immune system. To demonstrate that the latency reversing agent vorinostat (VOR induces a window of vulnerability in the latent HIV reservoir, defined as the triggering of viral antigen production sufficient in quantity and duration to allow for recognition and clearance of persisting infection, we developed a latency clearance assay (LCA. The LCA is a quantitative viral outgrowth assay (QVOA that includes the addition of immune effectors capable of clearing cells expressing viral antigen. Here we show a reduction in the recovery of replication-competent virus from VOR exposed resting CD4 T cells following addition of immune effectors for a discrete period. Take home message: VOR exposure leads to sufficient production of viral protein on the cell surface, creating a window of vulnerability within this latent reservoir in antiretroviral therapy (ART-suppressed HIV-infected individuals that allows the clearance of latently infected cells by an array of effector mechanisms.
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Oceans and human health: Emerging public health risks n the marine environment
Fleming, L.E.; Broad, K.; Clement, A.; Dewailly, E.; Elmir, S.; Knap, A.; Pomponi, S.A.; Smith, S.; Gabriele, H. Solo; Walsh, P.
2008-01-01
There has been an increasing recognition of the inter-relationship between human health and the oceans. Traditionally, the focus of research and concern has been on the impact of human activities on the oceans, particularly through anthropogenic pollution and the exploitation of marine resources. More recently, there has been recognition of the potential direct impact of the oceans on human health, both detrimental and beneficial. Areas identified include: global change, harmful algal blooms (HABs), microbial and chemical contamination of marine waters and seafood, and marine models and natural products from the seas. It is hoped that through the recognition of the inter-dependence of the health of both humans and the oceans, efforts will be made to restore and preserve the oceans. PMID:16996542
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The Human Right to Equal Access to Health Care
M. San Giorgi (Maite)
2012-01-01
textabstractThe right to equal access to health care is a fundamental principle that is part of the human right to health care. For victims of a violation of the human right to equal access to health care it is important that a judicial or quasi-judicial human rights body can adjudicate their
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CADYRI, a dynamic mapping tool of human risk associated with flooding in urban areas
Tanguy, M.; Chokmani, K.; Bernier, M.; Poulin, J.
2013-12-01
When a flood affects an urban area, the managers and services responsible for public safety need precise and real time information on the localization of the flooded areas, on the submersion heights in those areas, but also on the vulnerability of people exposed to this hazard. Such information is essential for an effective crisis management. Despite a growing interest in this topic over the last 15 years, the development of flood risk assessment tools mainly focused on quantitative modeling of the monetary damages caused by floods to residential buildings or to critical infrastructures. Little attention was paid to the vulnerability of people exposed to flooding but also to the effects of the failure or destruction of critical infrastructures and residential building on people health and security during the disaster. Moreover, these models do not integrate the dynamic features of the flood (extent, submersion heights) and the evolution of human vulnerability in the same mapping tool. Thus, an accurate and precise evaluation of human risk induced by urban flooding is hardly feasible using such models. This study presents CADYRI, a dynamic mapping tool of human risk associated with flooding in urban areas, which fills the actual needs in terms of flood risk evaluation and management. This innovative tool integrates a methodology of flood hazard mapping that simulates, for a given discharge, the associated water level, and subsequently determines the extent of the flooded area and the submersion heights at each point of the flooded area, using a DEM. The dynamics of human vulnerability is then mapped at the household level, according to the characteristics of the flood hazard. Three key components of human vulnerability have been identified and are integrated to CADYRI: 1, the intrinsic vulnerability of the population, estimated by specific socio-economic indicators; 2, the vulnerability of buildings, assessed by their structural features; 3, the vulnerability of
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A Heat Vulnerability Index and Adaptation Solutions for Pittsburgh, Pennsylvania.
Bradford, Kathryn; Abrahams, Leslie; Hegglin, Miriam; Klima, Kelly
2015-10-06
With increasing evidence of global warming, many cities have focused attention on response plans to address their populations' vulnerabilities. Despite expected increased frequency and intensity of heat waves, the health impacts of such events in urban areas can be minimized with careful policy and economic investments. We focus on Pittsburgh, Pennsylvania and ask two questions. First, what are the top factors contributing to heat vulnerability and how do these characteristics manifest geospatially throughout Pittsburgh? Second, assuming the City wishes to deploy additional cooling centers, what placement will optimally address the vulnerability of the at risk populations? We use national census data, ArcGIS geospatial modeling, and statistical analysis to determine a range of heat vulnerability indices and optimal cooling center placement. We find that while different studies use different data and statistical calculations, all methods tested locate additional cooling centers at the confluence of the three rivers (Downtown), the northeast side of Pittsburgh (Shadyside/Highland Park), and the southeast side of Pittsburgh (Squirrel Hill). This suggests that for Pittsburgh, a researcher could apply the same factor analysis procedure to compare data sets for different locations and times; factor analyses for heat vulnerability are more robust than previously thought.
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Directory of Open Access Journals (Sweden)
Agnes Binagwaho
2017-08-01
Full Text Available The inadequate supply of health workers and demand-side barriers due to clinical practice that heeds too little attention to cultural context are serious obstacles to achieving universal health coverage and the fulfillment of the human rights to health, especially for the poor and vulnerable living in remote rural areas. A number of strategies have been deployed to increase both the supply of healthcare workers and the demand for healthcare services. However, more can be done to improve service delivery as well as mitigate the geographic inequalities that exist in this field. To contribute to overcoming these barriers and increasing access to health services, especially for the most vulnerable, Partners In Health (PIH, a US non-governmental organization specializing in equitable health service delivery, has created the University of Global Health Equity (UGHE in a remote rural district of Rwanda. The act of building this university in such a rural setting signals a commitment to create opportunities where there have traditionally been few. Furthermore, through its state-of-the-art educational approach in a rural setting and its focus on cultural competency, UGHE is contributing to progress in the quest for equitable access to quality health services.