WorldWideScience

Sample records for hypothesis linking health

  1. The Link between Health Complaints and Wind Turbines: Support for the Nocebo Expectations Hypothesis.

    Science.gov (United States)

    Crichton, Fiona; Chapman, Simon; Cundy, Tim; Petrie, Keith J

    2014-01-01

    The worldwide expansion of wind energy has met with opposition based on concerns that the infrasound generated by wind turbines causes health problems in nearby residents. In this paper, we argue that health complaints are more likely to be explained by the nocebo response, whereby adverse effects are generated by negative expectations. When individuals expect a feature of their environment or medical treatment to produce illness or symptoms, then this may start a process where the individual looks for symptoms or signs of illness to confirm these negative expectations. As physical symptoms are common in healthy people, there is considerable scope for people to match symptoms with their negative expectations. To support this hypothesis, we draw an evidence from experimental studies that show that, during exposure to wind farm sound, expectations about infrasound can influence symptoms and mood in both positive and negative directions, depending on how expectations are framed. We also consider epidemiological work showing that health complaints have primarily been located in areas that have received the most negative publicity about the harmful effects of turbines. The social aspect of symptom complaints in a community is also discussed as an important process in increasing symptom reports. Media stories, publicity, or social discourse about the reported health effects of wind turbines are likely to trigger reports of similar symptoms, regardless of exposure. Finally, we present evidence to show that the same pattern of health complaints following negative information about wind turbines has also been found in other types of environmental concerns and scares.

  2. Born to yawn? Cortisol linked to yawning: a new hypothesis.

    Science.gov (United States)

    Thompson, Simon B N

    2011-11-01

    Yawning has become an interesting and curious scientific conundrum. Links between several neurological disorders can be found through the commonality of yawning episodes and contagious yawning. However, the reasons why we yawn are uncertain. Cortisol levels are known to rise during stress and fatigue; yawning may occur when we are under stress or tired. We do not know whether cortisol levels fluctuate during yawning. Potentially, yawning and cortisol levels may provide a valuable diagnostic tool and warning of untoward underlying neurological problems. A new hypothesis is proposed that links cortisol levels with yawning episodes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Consumer health information seeking as hypothesis testing.

    Science.gov (United States)

    Keselman, Alla; Browne, Allen C; Kaufman, David R

    2008-01-01

    Despite the proliferation of consumer health sites, lay individuals often experience difficulty finding health information online. The present study attempts to understand users' information seeking difficulties by drawing on a hypothesis testing explanatory framework. It also addresses the role of user competencies and their interaction with internet resources. Twenty participants were interviewed about their understanding of a hypothetical scenario about a family member suffering from stable angina and then searched MedlinePlus consumer health information portal for information on the problem presented in the scenario. Participants' understanding of heart disease was analyzed via semantic analysis. Thematic coding was used to describe information seeking trajectories in terms of three key strategies: verification of the primary hypothesis, narrowing search within the general hypothesis area and bottom-up search. Compared to an expert model, participants' understanding of heart disease involved different key concepts, which were also differently grouped and defined. This understanding provided the framework for search-guiding hypotheses and results interpretation. Incorrect or imprecise domain knowledge led individuals to search for information on irrelevant sites, often seeking out data to confirm their incorrect initial hypotheses. Online search skills enhanced search efficiency, but did not eliminate these difficulties. Regardless of their web experience and general search skills, lay individuals may experience difficulty with health information searches. These difficulties may be related to formulating and evaluating hypotheses that are rooted in their domain knowledge. Informatics can provide support at the levels of health information portals, individual websites, and consumer education tools.

  4. More Use Almost Always Means a Smaller Frequency Effect: Aging, Bilingualism, and the Weaker Links Hypothesis

    Science.gov (United States)

    Gollan, Tamar H.; Montoya, Rosa I.; Cera, Cynthia; Sandoval, Tiffany C.

    2008-01-01

    The "weaker links" hypothesis proposes that bilinguals are disadvantaged relative to monolinguals on speaking tasks because they divide frequency-of-use between two languages. To test this proposal, we contrasted the effects of increased word use associated with monolingualism, language dominance, and increased age on picture naming times. In two…

  5. Testing the phenotype-linked fertility hypothesis in the presence and absence of inbreeding

    Czech Academy of Sciences Publication Activity Database

    Forstmeier, W.; Ihle, M.; Opatová, Pavlína; Martin, K.; Knief, U.; Albrechtová, Jana; Albrecht, Tomáš; Kempenaers, B.

    2017-01-01

    Roč. 30, č. 5 (2017), s. 968-976 ISSN 1010-061X R&D Projects: GA ČR(CZ) GAP506/12/2472 Institutional support: RVO:68081766 Keywords : display behaviour * mate choice * phenotype-linked fertility hypothesis * precopulatory traits * sexual selection * sperm abnormalities * sperm quality * sperm velocity Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Genetics and heredity (medical genetics to be 3) Impact factor: 2.792, year: 2016

  6. Global variations in health: evaluating Wilkinson's income inequality hypothesis using the World Values Survey.

    Science.gov (United States)

    Jen, Min Hua; Jones, Kelvyn; Johnston, Ron

    2009-02-01

    This international comparative study analyses individual-level data derived from the World Values Survey to evaluate Wilkinson's [(1996). Unhealthy societies: The afflictions of inequality. London: Routledge; (1998). Mortality and distribution of income. Low relative income affects mortality [letter; comment]. British Medical Journal, 316, 1611-1612] income inequality hypothesis regarding variations in health status. Random-coefficient, multilevel modelling provides a direct test of Wilkinson's hypothesis using micro-data on individuals and macro-data on income inequalities analysed simultaneously. This overcomes the ecological fallacy that has troubled previous research into links between individual self-rated health, individual income, country income and income inequality data. Logic regression analysis reveals that there are substantial differences between countries in self-rated health after taking account of age and gender, and individual income has a clear effect in that poorer people report experiencing worse health. The Wilkinson hypothesis is not supported, however, since there is no significant relationship between health and income inequality when individual factors are taken into account. Substantial differences between countries remain even after taking account of micro- and macro-variables; in particular the former communist countries report high levels of poor health.

  7. Proform-Antecedent Linking in Individuals with Agrammatic Aphasia: A Test of the Intervener Hypothesis.

    Science.gov (United States)

    Engel, Samantha; Shapiro, Lewis P; Love, Tracy

    2018-02-01

    To evaluate processing and comprehension of pronouns and reflexives in individuals with agrammatic (Broca's) aphasia and age-matched control participants. Specifically, we evaluate processing and comprehension patterns in terms of a specific hypothesis -- the Intervener Hypothesis - that posits that the difficulty of individuals with agrammatic (Broca's) aphasia results from similarity-based interference caused by the presence of an intervening NP between two elements of a dependency chain. We used an eye tracking-while-listening paradigm to investigate real-time processing (Experiment 1) and a sentence-picture matching task to investigate final interpretive comprehension (Experiment 2) of sentences containing proforms in complement phrase and subject relative constructions. Individuals with agrammatic aphasia demonstrated a greater proportion of gazes to the correct referent of reflexives relative to pronouns and significantly greater comprehension accuracy of reflexives relative to pronouns. These results provide support for the Intervener Hypothesis, previous support for which comes from studies of Wh- questions and unaccusative verbs, and we argue that this account provides an explanation for the deficits of individuals with agrammatic aphasia across a growing set of sentence constructions. The current study extends this hypothesis beyond filler-gap dependencies to referential dependencies and allows us to refine the hypothesis in terms of the structural constraints that meet the description of the Intervener Hypothesis.

  8. Forging Links for Health Research

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

    The central objective of GFHR is "to help correct the 10/90 gap" (GFHR 1999, p. ...... reports on health inequities as mediated by gender, ethnic group, and geography, ...... Yet, research with strong elements of community participation may be ...

  9. Health Impact Assessment: Linking Public Health to ...

    Science.gov (United States)

    The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

  10. Are Cardiometabolic and Endocrine Abnormalities Linked to Sleep Difficulties in Schizophrenia? A Hypothesis Driven Review

    Science.gov (United States)

    Robillard, Rébecca; Rogers, Naomi L.; Whitwell, Bradley G.

    2012-01-01

    Schizophrenia is a psychiatric disorder that includes symptoms such as hallucinations, disordered thoughts, disorganized or catatonic behaviour, cognitive dysfunction and sleep-wake disturbance. In addition to these symptoms, cardiometabolic dysfunction is common in patients with schizophrenia. While previously it has been thought that cardiometabolic symptoms in patients with schizophrenia were associated with medications used to manage this disorder, more recently it has been demonstrated that these symptoms are present in drug naive and unmedicated patients. Sleep-wake disturbance, resulting in chronic sleep loss has also been demonstrated to induce changes in cardiometabolic function. Chronic sleep loss has been associated with an increased risk for weight gain, obesity and cardiac and metabolic disorders, independent of other potentially contributing factors, such as smoking and body mass index. We hypothesise that the sleep-wake disturbance comorbid with schizophrenia may play a significant role in the high prevalence of cardiometabolic dysfunction observed in this patient population. Here we present a critical review of the evidence that supports this hypothesis. PMID:23429436

  11. Linking neurogenetics and individual differences in language learning: the dopamine hypothesis.

    Science.gov (United States)

    Wong, Patrick C M; Morgan-Short, Kara; Ettlinger, Marc; Zheng, Jing

    2012-10-01

    Fundamental advances in neuroscience have come from investigations into neuroplasticity and learning. These investigations often focus on identifying universal principles across different individuals of the same species. Increasingly, individual differences in learning success have also been observed, such that any seemingly universal principle might only be applicable to a certain extent within a particular learner. One potential source of this variation is individuals' genetic differences. Adult language learning provides a unique opportunity for understanding individual differences and genetic bases of neuroplasticity because of the large individual differences in learning success that have already been documented, and because of the body of empirical work connecting language learning and neurocognition. In this article, we review the literature on the genetic bases of neurocognition, especially studies examining polymorphisms of dopamine (DA)-related genes and procedural learning. This review leads us to hypothesize that there may be an association between DA-related genetic variation and language learning differences. If this hypothesis is supported by future empirical findings we suggest that it may point to neurogenetic markers that allow for language learning to be personalized. Copyright © 2012 Elsevier Srl. All rights reserved.

  12. Contextual effects on the perceived health benefits of exercise: the exercise rank hypothesis.

    Science.gov (United States)

    Maltby, John; Wood, Alex M; Vlaev, Ivo; Taylor, Michael J; Brown, Gordon D A

    2012-12-01

    Many accounts of social influences on exercise participation describe how people compare their behaviors to those of others. We develop and test a novel hypothesis, the exercise rank hypothesis, of how this comparison can occur. The exercise rank hypothesis, derived from evolutionary theory and the decision by sampling model of judgment, suggests that individuals' perceptions of the health benefits of exercise are influenced by how individuals believe the amount of exercise ranks in comparison with other people's amounts of exercise. Study 1 demonstrated that individuals' perceptions of the health benefits of their own current exercise amounts were as predicted by the exercise rank hypothesis. Study 2 demonstrated that the perceptions of the health benefits of an amount of exercise can be manipulated by experimentally changing the ranked position of the amount within a comparison context. The discussion focuses on how social norm-based interventions could benefit from using rank information.

  13. Income-related inequality in health and health-related behaviour: exploring the equalisation hypothesis.

    Science.gov (United States)

    Vallejo-Torres, Laura; Hale, Daniel; Morris, Stephen; Viner, Russell M

    2014-07-01

    Previous studies have found the socioeconomic gradient in health among adolescents to be lower than that observed during childhood and adulthood. The aim of this study was to examine income-related inequalities in health and health-related behaviour across the lifespan in England to explore 'equalisation' in adolescence. We used five years of data (2006-2010) from the Health Survey for England to explore inequalities in six indicators: self-assessed general health, longstanding illness, limiting longstanding illness, psychosocial wellbeing, obesity and smoking status. We ran separate analyses by age/gender groups. Inequality was measured using concentration indices. Our findings for longstanding illnesses, psychosocial wellbeing and obesity were consistent with the equalisation hypothesis. For these indicators, the extent of income-related inequality was lower among late adolescents (16-19 years) and young adults (20-24 years) compared to children and young adolescents (under 15 years), mid- and late-adults (25-44 and 45-64 years) and the elderly (65+ years). The remaining indicators showed lower inequality among adolescents compared to adults, but higher inequality when compared with children. Our work shows that inequalities occur across the life-course but that for some health issues there may be a period of equalisation in late adolescence and early adulthood. 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.

  14. Word frequency effects in immediate serial recall of pure and mixed lists: tests of the associative link hypothesis.

    Science.gov (United States)

    Saint-Aubin, Jean; LeBlanc, Jacinthe

    2005-12-01

    In immediate serial recall, high-frequency words are better recalled than low-frequency words. Recently, it has been suggested that high-frequency words are better recalled because of their better long-term associative links, and not because of the intrinsic properties of their long-term representations. In the experiment reported here, recall performance was compared for pure lists of high- and low-frequency words, and for mixed lists composed of either one low- and five high-frequency words or the reverse. The usual advantage of high-frequency words was found with pure lists and this advantage was reduced, but still significant with mixed lists composed of five low-frequency words. However, the low-frequency word included in a high-frequency list was recalled just as well as high-frequency words. Results are challenging for the associative link hypothesis and are best interpreted within an item-based reconstruction hypothesis, along with a distinctiveness account.

  15. Mining Electronic Health Records using Linked Data.

    Science.gov (United States)

    Odgers, David J; Dumontier, Michel

    2015-01-01

    Meaningful Use guidelines have pushed the United States Healthcare System to adopt electronic health record systems (EHRs) at an unprecedented rate. Hospitals and medical centers are providing access to clinical data via clinical data warehouses such as i2b2, or Stanford's STRIDE database. In order to realize the potential of using these data for translational research, clinical data warehouses must be interoperable with standardized health terminologies, biomedical ontologies, and growing networks of Linked Open Data such as Bio2RDF. Applying the principles of Linked Data, we transformed a de-identified version of the STRIDE into a semantic clinical data warehouse containing visits, labs, diagnoses, prescriptions, and annotated clinical notes. We demonstrate the utility of this system though basic cohort selection, phenotypic profiling, and identification of disease genes. This work is significant in that it demonstrates the feasibility of using semantic web technologies to directly exploit existing biomedical ontologies and Linked Open Data.

  16. Why is parental lifespan linked to children's chances of reaching a high age? A transgenerational hypothesis.

    Science.gov (United States)

    Vågerö, Denny; Aronsson, Vanda; Modin, Bitte

    2018-04-01

    Transgenerational determinants of longevity are poorly understood. We used data from four linked generations (G0, G1, G2 and G3) of the Uppsala Birth Cohort Multigeneration Study to address this issue. Mortality in G1 (N = 9565) was followed from 1961-2015 and analysed in relation to tertiles of their parents' (G0) age-at-death using Cox regression. Parental social class and marital status were adjusted for in the analyses, as was G1's birth order and adult social class. For an almost entirely deceased segment of G1 (n = 1149), born 1915-1917, we compared exact age-at-death with G0 parents' age-at-death. Finally, we explored 'resilience' as a potentially important mechanism for intergenerational transmission of longevity, using conscript information from psychological interviews of G2 and G3 men. G0 men's and women's ages-at-death were independently associated with G1 midlife and old age mortality. This association was robust and minimally reduced when G0 and G1 social class were adjusted for. We observed an increased lifespan in all social groups. Median difference in age-at-death for sons compared to fathers was + 3.9 years, and + 6.9 years for daughters compared to mothers.Parents' and maternal grandmother's longevity were associated with resilience in subsequent generations. Resilience scores of G2 men were also associated with those of their G3 sons and with their own mortality in midlife. The chance of reaching a high age is transmitted from parents to children in a modest, but robust way. Longevity inheritance is paralleled by the inheritance of individual resilience. Individual resilience, we propose, develops in the first part of life as a response to adversity and early experience in general. This gives rise to a transgenerational pathway, distinct from social class trajectories. A theory of longevity inheritance should bring together previous thinking around general susceptibility, frailty and resilience with new insights from epigenetics and social

  17. Fetal Origins of Mental Health: The Developmental Origins of Health and Disease Hypothesis.

    Science.gov (United States)

    O'Donnell, Kieran J; Meaney, Michael J

    2017-04-01

    The quality of fetal growth and development predicts the risk for a range of noncommunicable, chronic illnesses. These observations form the basis of the "developmental origins of health and disease" hypothesis, which suggests that the intrauterine signals that compromise fetal growth also act to "program" tissue differentiation in a manner that predisposes to later illness. Fetal growth also predicts the risk for later psychopathology. These findings parallel studies showing that antenatal maternal emotional well-being likewise predicts the risk for later psychopathology. Taken together, these findings form the basis for integrative models of fetal neurodevelopment, which propose that antenatal maternal adversity operates through the biological pathways associated with fetal growth to program neurodevelopment. The authors review the literature and find little support for such integrated models. Maternal anxiety, depression, and stress all influence neurodevelopment but show modest, weak, or no associations with known stress mediators (e.g., glucocorticoids) or with fetal growth. Rather, compromised fetal development appears to establish a "meta-plastic" state that increases sensitivity to postnatal influences. There also remain serious concerns that observational studies associating either fetal growth or maternal mental health with neurodevelopmental outcomes fail to account for underlying genetic factors. Finally, while the observed relation between fetal growth and adult health has garnered considerable attention, the clinical relevance of these associations remains to be determined. There are both considerable promise and important challenges for future studies of the fetal origins of mental health.

  18. The dynamic relationship between health expenditure and economic growth: is the health-led growth hypothesis valid for Turkey?

    Science.gov (United States)

    Atilgan, Emre; Kilic, Dilek; Ertugrul, Hasan Murat

    2017-06-01

    The well-known health-led growth hypothesis claims a positive correlation between health expenditure and economic growth. The aim of this paper is to empirically investigate the health-led growth hypothesis for the Turkish economy. The bound test approach, autoregressive-distributed lag approach (ARDL) and Kalman filter modeling are employed for the 1975-2013 period to examine the co-integration relationship between economic growth and health expenditure. The ARDL model is employed in order to investigate the long-term and short-term static relationship between health expenditure and economic growth. The results show that a 1 % increase in per-capita health expenditure will lead to a 0.434 % increase in per-capita gross domestic product. These findings are also supported by the Kalman filter model's results. Our findings show that the health-led growth hypothesis is supported for Turkey.

  19. Revisiting the 'self-medication' hypothesis in light of the new data linking low striatal dopamine to comorbid addictive behavior.

    Science.gov (United States)

    Awad, A George; Voruganti, Lakshmi L N P

    2015-06-01

    Persons with schizophrenia are at a high risk, almost 4.6 times more likely, of having drug abuse problems than persons without psychiatric illness. Among the influential proposals to explain such a high comorbidity rate, the 'self-medication hypothesis' proposed that persons with schizophrenia take to drugs in an effort to cope with the illness and medication side effects. In support of the self-medication hypothesis, data from our earlier clinical study confirmed the strong association between neuroleptic dysphoria and negative subjective responses and comorbid drug abuse. Though dopamine has been consistently suspected as one of the major culprits for the development of neuroleptic dysphoria, it is only recently our neuroimaging studies correlated the emergence of neuroleptic dysphoria to the low level of striatal dopamine functioning. Similarly, more evidence has recently emerged linking low striatal dopamine with the development of vulnerability for drug addictive states in schizophrenia. The convergence of evidence from both the dysphoria and comorbidity research, implicating the role of low striatal dopamine in both conditions, has led us to propose that the person with schizophrenia who develops dysphoria and comorbid addictive disorder is likely to be one and the same.

  20. LINKING PUBLIC HEALTH AND AIR QUALITY DATA FOR ACCOUNTABILITY

    Science.gov (United States)

    Program Area: Environmental HealthTopic Area: Linking Public Health Data into ActionTitle of Presentation: Linking Public Health and Air Quality Data for AccountabilityBackground and Significance Tracking environmental exposures to air pollutan...

  1. Linked Health Data: how linked data can help provide better health decisions.

    Science.gov (United States)

    Farinelli, Fernanda; Barcellos de Almeida, Maurício; Linhares de Souza, Yóris

    2015-01-01

    This paper provides a brief survey about the use of linked data in healthcare to foster better health decisions and increase health knowledge. We present real cases from the Brazilian experience and emphasize some issues in research. This paper is not intending to be fully comprehensive, we discuss some open issues and research challenges in linked data and the technologies involved. We conclude that even though linked data has been adopted in many countries, some challenges have to be overcome, for example, interoperability between different standards. A defined solution able to foster the semantic interoperability between different standards must be developed. Benefits contributed through linked health data involve better decision making on diagnostics, assertive treatments, knowledge acquisition, improvements in quality healthcare service to citizens.

  2. Civilian health during WWI and the causes of German defeat: a reexamination of the winter hypothesis.

    Science.gov (United States)

    Voth, H J

    1995-01-01

    This paper is a reexamination of the Winter hypothesis, which holds that there was a marked difference in the development of civilian health during the First World War between the central powers and the Western allies. Ultimate success on the battlefield, according to Winter, required balancing the needs of the military with civilian demands; Germany lost because it failed to achieve such a balance. The resulting decline in health standards undermined the war effort and eventually led to defeat. This article proceeds in two steps. First, it demonstrates that Winter's data does not allow him to make a proper comparison between the two camps. Second, I argue that his hypothesis can be refuted once a truly comparable source is used--infant mortality rated. There is as yet no convincing evidence to suggest that the outcome of the First world War was determined by public health policy.

  3. Strengthening health systems through linking research evidence to ...

    African Journals Online (AJOL)

    informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

  4. Antioxidant micronutrients as intersectoral link between health and ...

    African Journals Online (AJOL)

    Antioxidant micronutrients as intersectoral link between health and agriculture. ... desirable by helping to prevent disease, promoting health and improving the ... for sustainable development of which health should be a goal (Afr. J. Biomed.

  5. Linked Data Paves the Way to Improved Health Care

    Directory of Open Access Journals (Sweden)

    Michael Gaucher

    2017-04-01

    This presentation demonstrates how new knowledge created using linked data can inform decision and policy makers, and lead to action within the health system. Several examples are presented to illustrate the approach and types of data being linked.

  6. Income-related inequality in health and health-related behaviour: exploring the equalisation hypothesis

    OpenAIRE

    Vallejo-Torres, Laura; Hale, Daniel; Morris, Stephen; Viner, Russell M

    2014-01-01

    Background Previous studies have found the socioeconomic gradient in health among adolescents to be lower than that observed during childhood and adulthood. The aim of this study was to examine income-related inequalities in health and health-related behaviour across the lifespan in England to explore ‘equalisation’ in adolescence. Methods We used five years of data (2006–2010) from the Health Survey for England to explore inequalities in six indicators: self-assessed general health, longstan...

  7. Exploring pathways linking greenspace to health

    NARCIS (Netherlands)

    Markevych, Iana; Schoierer, Julia; Hartig, Terry; Chudnovsky, Alexandra; Hystad, Perry; Dzhambov, Angel M.; Vries, de Sjerp; Triguero-Mas, Margarita; Brauer, Michael; Nieuwenhuijsen, Mark J.; Lupp, Gerd; Richardson, Elizabeth A.; Astell-Burt, Thomas; Dimitrova, Donka; Feng, Xiaoqi; Sadeh, Maya; Standl, Marie; Heinrich, Joachim; Fuertes, Elaine

    2017-01-01

    Background In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is beneficial to health. However, the processes generating these benefits and how they can

  8. Beyond the income inequality hypothesis and human health: a worldwide exploration.

    Science.gov (United States)

    Idrovo, Alvaro J; Ruiz-Rodríguez, Myriam; Manzano-Patiño, Abigail P

    2010-08-01

    To analyze whether the relationship between income inequality and human health is mediated through social capital, and whether political regime determines differences in income inequality and social capital among countries. Path analysis of cross sectional ecological data from 110 countries. Life expectancy at birth was the outcome variable, and income inequality (measured by the Gini coefficient), social capital (measured by the Corruption Perceptions Index or generalized trust), and political regime (measured by the Index of Freedom) were the predictor variables. Corruption Perceptions Index (an indirect indicator of social capital) was used to include more developing countries in the analysis. The correlation between Gini coefficient and predictor variables was calculated using Spearman's coefficients. The path analysis was designed to assess the effect of income inequality, social capital proxies and political regime on life expectancy. The path coefficients suggest that income inequality has a greater direct effect on life expectancy at birth than through social capital. Political regime acts on life expectancy at birth through income inequality. Income inequality and social capital have direct effects on life expectancy at birth. The "class/welfare regime model" can be useful for understanding social and health inequalities between countries, whereas the "income inequality hypothesis" which is only a partial approach is especially useful for analyzing differences within countries.

  9. Toronto air quality index health links analysis

    Energy Technology Data Exchange (ETDEWEB)

    Pengelly, D [McMaster Inst. of Environment and Health, Hamilton, ON (Canada); Campbell, M; Macfarlane, R; Li-Muller, A [Toronto Public Health, ON (Canada)

    2001-10-01

    Based on data acquired in the year 1995, Toronto Public Health published a report called Air Pollution Burden of Illness in Toronto. In that report, it was estimated that up to 1000 Toronto residents die prematurely each year while another 5500 are admitted to hospitals due to six smog-related air pollutants. In the present document, the authors examined the air quality classifications of the Ontario Air Quality Index (AQI) in an attempt to determine whether the values adequately reflect the state of air quality and the associated burden of illness in Toronto. After careful examination of the results, it became apparent that 92 per cent of the premature mortality and hospitalization took place at times when the Air Quality Index was in the very good or good range. At times when the Air Quality Index was in the moderate or poor-very poor range, an estimated 8 per cent of the burden of illness occurred. These results indicate that the concentration range of a pollutant used to classify the good and very good categories is not always in agreement with the pollutant levels responsible for the adverse health effects. As demonstrated by this study, the air quality associated with the very good or good range described by the AQI is responsible for negative health effects in Toronto, and are lower than the provincial criteria of Ontario. The air quality conditions that may have an impact on health are not always correctly identified by the current AQI system. The authors are recommending a review of the provincial criteria for several air pollutants, and the current AQI system needs to be modified. 16 refs., tabs., figs.

  10. Linking Health Records for Federated Query Processing

    Directory of Open Access Journals (Sweden)

    Dewri Rinku

    2016-07-01

    Full Text Available A federated query portal in an electronic health record infrastructure enables large epidemiology studies by combining data from geographically dispersed medical institutions. However, an individual’s health record has been found to be distributed across multiple carrier databases in local settings. Privacy regulations may prohibit a data source from revealing clear text identifiers, thereby making it non-trivial for a query aggregator to determine which records correspond to the same underlying individual. In this paper, we explore this problem of privately detecting and tracking the health records of an individual in a distributed infrastructure. We begin with a secure set intersection protocol based on commutative encryption, and show how to make it practical on comparison spaces as large as 1010 pairs. Using bigram matching, precomputed tables, and data parallelism, we successfully reduced the execution time to a matter of minutes, while retaining a high degree of accuracy even in records with data entry errors. We also propose techniques to prevent the inference of identifier information when knowledge of underlying data distributions is known to an adversary. Finally, we discuss how records can be tracked utilizing the detection results during query processing.

  11. Linking Health Information Systems for Effective Decision Making ...

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

    The CBHIS will consist of village registers prepared and updated every six months by volunteer community health workers (CHWs). The registers will be summarized on chalkboards and used in deliberative dialogue sessions at the community and health facility levels. The HIS will be linked to the CBHIS by including village ...

  12. A review of linked health data in Australian nephrology.

    Science.gov (United States)

    Kotwal, Sradha; Webster, Angela C; Cass, Alan; Gallagher, Martin

    2016-06-01

    Linked health data bring together data about one person from varying sources such as administrative health datasets, death registries and clinical registries using a process that maintains patient privacy. Linked health data have been used for burden of disease estimates and health-care planning and is being increasingly use as a research methodology to study health service utilisation and patient outcomes. Within Australian nephrology, there has been limited understanding and use of linked health data so far, but we expect that with the increasing availability of data and the growing complexity of health care, the use of such data will expand. This is especially pertinent for the growing elderly population with advanced kidney disease, who are poorly represented in other types of research studies. This article summarizes the history of linked health data in Australia, the nature of available datasets in Australia, the methods of access to these data, privacy and ethical issues, along with strengths, limitations and implications for the future. © 2016 Asian Pacific Society of Nephrology.

  13. Future Directions in the Study of Early-Life Stress and Physical and Emotional Health: Implications of the Neuroimmune Network Hypothesis.

    Science.gov (United States)

    Hostinar, Camelia E; Nusslock, Robin; Miller, Gregory E

    2018-01-01

    Early-life stress is associated with increased vulnerability to physical and emotional health problems across the lifespan. The recently developed neuroimmune network hypothesis proposes that one of the underlying mechanisms for these associations is that early-life stress amplifies bidirectional crosstalk between the brain and the immune system, contributing to several mental and physical health conditions that have inflammatory underpinnings, such as depression and coronary heart disease. Neuroimmune crosstalk is thought to perpetuate inflammation and neural alterations linked to early-life stress exposure, and also foster behaviors that can further compromise health, such as smoking, drug abuse and consumption of high-fat diets. The goal of the present review is to briefly summarize the neuroimmune network hypothesis and use it as a starting point for generating new questions about the role of early-life stress in establishing a dysregulated relationship between neural and immune signaling, with consequences for lifespan physical and emotional health. Specifically, we aim to discuss implications and future directions for theory and empirical research on early-life stress, as well as for interventions that may improve the health and well-being of children and adolescents living in adverse conditions.

  14. Linking oral health, general health, and quality of life

    NARCIS (Netherlands)

    Kieffer, J.M.; Hoogstraten, J.

    2008-01-01

    The aim of this work was to assess the association among oral health, general health, and quality of life (QoL). The Oral Health Impact Profile (OHIP-49) and the RAND-36 were distributed amongst 118 psychology freshmen. Additionally, two single items self-rated general health (SRGH) and self-rated

  15. Linking oral health, general health, and quality of life.

    Science.gov (United States)

    Kieffer, Jacobien M; Hoogstraten, Johan

    2008-10-01

    The aim of this work was to assess the association among oral health, general health, and quality of life (QoL). The Oral Health Impact Profile (OHIP-49) and the RAND-36 were distributed amongst 118 psychology freshmen. Additionally, two single items self-rated general health (SRGH) and self-rated oral health (SROH) - were administered. Kruskal-Wallis and Mann-Whitney U-tests were used to evaluate differences between SRGH and SROH categories, regarding OHIP subscale scores and RAND subscale scores. More than 75% of the subjects rated their oral and general health as good. Mean OHIP scores and RAND scores indicated a relatively good oral- and general health-related QoL respectively. The correlation between oral and general health was weak. Significant differences were found between SRGH categories regarding RAND subscale scores, except for the 'role emotional' and 'mental health' subscales. Significant differences were also found between SROH categories regarding OHIP subscale scores, except for the 'psychological disability' subscale. However, no significant differences were found between SRGH categories regarding OHIP subscale scores, or between SROH categories regarding RAND subscale scores. The findings suggest that oral health, general health, and QoL have different determinants. Furthermore, oral health and general health appear to be mostly unrelated in this seemingly healthy population. It is proposed that if no apparent disease is present, oral and general health must be regarded as separate constructs.

  16. Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital.

    Science.gov (United States)

    Musinguzi, Laban Kashaija; Turinawe, Emmanueil Benon; Rwemisisi, Jude T; de Vries, Daniel H; Mafigiri, David K; Muhangi, Denis; de Groot, Marije; Katamba, Achilles; Pool, Robert

    2017-01-11

    Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services. Data were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis. The ability of VHTs to link communities with formal health care was affected by the stakeholders' perception of their roles. Community members perceive VHTs as working for and under instructions of "others", which makes them powerless in the formal health care system. One of the challenges associated with VHTs' linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not "experts". For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health

  17. Global diets link environmental sustainability and human health

    Science.gov (United States)

    Tilman, David; Clark, Michael

    2014-11-01

    Diets link environmental and human health. Rising incomes and urbanization are driving a global dietary transition in which traditional diets are replaced by diets higher in refined sugars, refined fats, oils and meats. By 2050 these dietary trends, if unchecked, would be a major contributor to an estimated 80 per cent increase in global agricultural greenhouse gas emissions from food production and to global land clearing. Moreover, these dietary shifts are greatly increasing the incidence of type II diabetes, coronary heart disease and other chronic non-communicable diseases that lower global life expectancies. Alternative diets that offer substantial health benefits could, if widely adopted, reduce global agricultural greenhouse gas emissions, reduce land clearing and resultant species extinctions, and help prevent such diet-related chronic non-communicable diseases. The implementation of dietary solutions to the tightly linked diet-environment-health trilemma is a global challenge, and opportunity, of great environmental and public health importance.

  18. Gaming well: links between videogames and flourishing mental health.

    Science.gov (United States)

    Jones, Christian M; Scholes, Laura; Johnson, Daniel; Katsikitis, Mary; Carras, Michelle C

    2014-01-01

    This paper is a review of the state of play of research linking videogaming and flourishing, and explores the role of videogames and technology to improve mental health and well-being. Its purpose is to develop understandings about the positive intersection of gaming and well-being, to document evidence regarding links between videogames and positive mental health, and to provide guidelines for use by other researchers as they design and use tools and games to improve mental health and well-being. Using Huppert's (Huppert and So, 2013) proposition that to flourish is more than the absence of mental disorder but rather a combination of feeling good and functioning effectively, resulting in high levels of mental well-being, and Seligman's (Seligman, 2011) PERMA theory of well-being, the paper identifies strengths in existing games that generate positive affect, positive functioning, and positive social functioning, contributing to, and supporting mental health and well-being.

  19. Psychosocial health mediates the gratitude-physical health link.

    Science.gov (United States)

    O'Connell, Brenda H; Killeen-Byrt, Mary

    2018-04-29

    There is now a growing body of research demonstrating the physical health benefits of being grateful. However, research has only just began to explore the mechanisms accounting for this gratitude-health relationship. This study examines the relationship between dispositional gratitude and self-reported physical health symptoms, and explores whether this relationship is explained through reduced levels of perceived loneliness and stress. This study employed a cross-sectional design with a sample of 607 healthy adults. Serial mediation analysis revealed that the positive effect of gratitude on physical health was significantly mediated by lower reported levels of perceived loneliness and stress. These findings are important given evidence that gratitude can be cultivated, and may serve to buffer against stress and loneliness and improve somatic health symptoms in the general population.

  20. Linking Cultural Competence to Functional Life Outcomes in Mental Health Care Settings.

    Science.gov (United States)

    Michalopoulou, Georgia; Falzarano, Pamela; Butkus, Michael; Zeman, Lori; Vershave, Judy; Arfken, Cynthia

    2014-01-01

    Minorities in the United States have well-documented health disparities. Cultural barriers and biases by health care providers may contribute to lower quality of services which may contribute to these disparities. However, evidence linking cultural competency and health outcomes is lacking. This study, part of an ongoing quality improvement effort, tested the mediation hypothesis that patients' perception of provider cultural competency indirectly influences patients' health outcomes through process of care. Data were from patient satisfaction surveys collected in seven mental health clinics (n=94 minority patients). Consistent with our hypothesis, patients' perception of clinicians' cultural competency was indirectly associated with patients' self-reported improvements in social interactions, improvements in performance at work or school, and improvements in managing life problems through the patients' experience of respect, trust, and communication with the clinician. These findings indicate that process of care characteristics during the clinical encounter influence patients' perceptions of clinicians' cultural competency and affect functional outcomes. © 2013 National Medical Association. Published by Elsevier Inc. All rights reserved.

  1. [Linking: relationships between health professionals in the informal health networks].

    Science.gov (United States)

    Sarradon-Eck, A; Vega, A; Faure, M; Humbert-Gaudart, A; Lustman, M

    2008-07-01

    During the last years, the french health system has been developing formal health networks. So, it was necessary to study informal health networks as networks. More precisely, we studied the nature of relationships between various stakeholders around general practionners wich are commonly considering as the stakeholder of the health system private sector. Fieldwork (ethnography based on direct observations and interviews) was conducted between October 2002 and april 2004, in the South-East of France. Ten monographs of general practioner's offices were achieved in a rural area; then, we achieved fieldwork of the informal health networks identified. There is a cultural frame wich is common to all private professionals. This frame includes a triple ideal (teamwork built up the hospital model, independance, and an relational approach with patients). This frame does not square with the real practices. In fact, regulation mechanisms preserve the balance of relashionships between professionnal groups, by restricting/promoting exchanges and complex alliance strategies. These mecanisms include: (1) a few professionnal's rule as disponibility (to the patients and to the professionnals), as communication about patient, as patient's reference, as obligation to communicate between professionals; (2) some constraints such as territory superposition and competition with other professional groups; (3) some needs for: rileiving (of emotions and worries connected to work), sharing (decisions, responsabilities), of delegation (medical treatment, practices), protection against social and legal risk through the creation of trust relationships. These trust relationships are based on several logics (affinity, solidarity, similarity). The study shows the major place of the patient who is often the main organizer of his network, and even though he makes an important structuring work between medical staff, and an information transfer (on his diagnosis, on his treatment, and professionals

  2. US HealthLink: a national information resource for health care professionals.

    Science.gov (United States)

    Yasnoff, W A

    1992-06-01

    US HealthLink is a new, comprehensive online medical information system designed specifically for health care professionals. Available to individuals for a fixed fee, it includes literature, news, diagnostic decision support, drug interactions, electronic mail, and bulletin boards. It also provides user-specific current awareness via clipping service, and fax delivery of both clipping and electronic mail information. US HealthLink can now be utilized to access a wide variety of medical information sources inexpensively.

  3. Linking better shiftwork arrangements with safety and health management systems

    OpenAIRE

    Kogi, Kazutaka

    2004-01-01

    OBJECTIVE: Various support measures useful for promoting joint change approaches to the improvement of both shiftworking arrangements and safety and health management systems were reviewed. A particular focus was placed on enterprise-level risk reduction measures linking working hours and management systems. METHODS: Voluntary industry-based guidelines on night and shift work for department stores and the chemical, automobile and electrical equipment industries were examined. Survey results t...

  4. [Professional stressors and common mental health disorders: Causal links?

    Science.gov (United States)

    Nicolas, C; Chawky, N; Jourdan-Ionescu, C; Drouin, M-S; Page, C; Houlfort, N; Beauchamp, G; Séguin, M

    2017-03-22

    According to the World Health Organization, depression has become the leading cause of disability in the world, contributing significantly to the burden of health issues especially in the industrialized countries. This is a major public health problem, with potential impact on work climates, productivity at work and the continued existence of the organizations. Some recent studies have examined potential links between professional factors and common mental health disorders, but none have demonstrated a direct causal link. In the present study, we explored possible links between work-related stressors and common mental health disorders, with the objective of determining priority mental health prevention axes. The study used a life trajectory method. We compared professional stressors and difficulties present in other spheres of life in the last five years between two groups: a group of 29 participants with common mental health disorders during the last five years (depression, anxiety disorders, eating disorders, substance use disorders, pathological gambling), and a group of 29 participants who have not experienced a mental health disorder in the last five years. Data were collected from semi-structured interviews with the participants using a life course analysis method. Each participant was interviewed during two or three meetings of two to three hour duration. Questions regarding difficulties in different spheres of life and mental health were asked. More precisely, data were collected with regards to the presence or absence of mental health disorders in the last five years and the nature of mental health disorders and difficulties. Moreover, we collected data pertaining to the most important positive and negative events in different spheres of life that were present in the last five years, including family life, romantic relationships, social life, academic difficulties, losses and separations, episodes of personal difficulties, financial difficulties as well as

  5. Exploring pathways linking greenspace to health: Theoretical and methodological guidance.

    Science.gov (United States)

    Markevych, Iana; Schoierer, Julia; Hartig, Terry; Chudnovsky, Alexandra; Hystad, Perry; Dzhambov, Angel M; de Vries, Sjerp; Triguero-Mas, Margarita; Brauer, Michael; Nieuwenhuijsen, Mark J; Lupp, Gerd; Richardson, Elizabeth A; Astell-Burt, Thomas; Dimitrova, Donka; Feng, Xiaoqi; Sadeh, Maya; Standl, Marie; Heinrich, Joachim; Fuertes, Elaine

    2017-10-01

    In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is beneficial to health. However, the processes generating these benefits and how they can be best promoted remain unclear. During an Expert Workshop held in September 2016, the evidence linking greenspace and health was reviewed from a transdisciplinary standpoint, with a particular focus on potential underlying biopsychosocial pathways and how these can be explored and organized to support policy-relevant population health research. Potential pathways linking greenspace to health are here presented in three domains, which emphasize three general functions of greenspace: reducing harm (e.g. reducing exposure to air pollution, noise and heat), restoring capacities (e.g. attention restoration and physiological stress recovery) and building capacities (e.g. encouraging physical activity and facilitating social cohesion). Interrelations between among the three domains are also noted. Among several recommendations, future studies should: use greenspace and behavioural measures that are relevant to hypothesized pathways; include assessment of presence, access and use of greenspace; use longitudinal, interventional and (quasi)experimental study designs to assess causation; and include low and middle income countries given their absence in the existing literature. Cultural, climatic, geographic and other contextual factors also need further consideration. While the existing evidence affirms beneficial impacts of greenspace on health, much remains to be learned about the specific pathways and functional form of such relationships, and how these may vary by context, population groups and health outcomes. This Report provides guidance for further epidemiological research with the goal of creating new evidence upon which to develop policy recommendations. Copyright © 2017 Elsevier Inc

  6. Stress transgenerationally programs metabolic pathways linked to altered mental health.

    Science.gov (United States)

    Kiss, Douglas; Ambeskovic, Mirela; Montina, Tony; Metz, Gerlinde A S

    2016-12-01

    Stress is among the primary causes of mental health disorders, which are the most common reason for disability worldwide. The ubiquity of these disorders, and the costs associated with them, lends a sense of urgency to the efforts to improve prediction and prevention. Down-stream metabolic changes are highly feasible and accessible indicators of pathophysiological processes underlying mental health disorders. Here, we show that remote and cumulative ancestral stress programs central metabolic pathways linked to mental health disorders. The studies used a rat model consisting of a multigenerational stress lineage (the great-great-grandmother and each subsequent generation experienced stress during pregnancy) and a transgenerational stress lineage (only the great-great-grandmother was stressed during pregnancy). Urine samples were collected from adult male F4 offspring and analyzed using 1 H NMR spectroscopy. The results of variable importance analysis based on random variable combination were used for unsupervised multivariate principal component analysis and hierarchical clustering analysis, as well as metabolite set enrichment analysis (MSEA) and pathway analysis. We identified distinct metabolic profiles associated with the multigenerational and transgenerational stress phenotype, with consistent upregulation of hippurate and downregulation of tyrosine, threonine, and histamine. MSEA and pathway analysis showed that these metabolites are involved in catecholamine biosynthesis, immune responses, and microbial host interactions. The identification of metabolic signatures linked to ancestral programming assists in the discovery of gene targets for future studies of epigenetic regulation in pathogenic processes. Ultimately, this research can lead to biomarker discovery for better prediction and prevention of mental health disorders.

  7. Gaming well: links between videogames and flourishing mental health

    Directory of Open Access Journals (Sweden)

    Christian eJones

    2014-03-01

    Full Text Available This paper is a review of the state of play of research linking videogaming and flourishing, and explores the role of videogames and technology to improve mental health and well-being. Its purpose is to develop understandings about the positive intersection of gaming and well-being, to document evidence regarding links between videogames and positive mental health, and to provide guidelines for use by other researchers as they design and use tools and games to improve mental health and well-being. Using Huppert’s (Huppert & So, 2013 proposition that to flourish is more than the absence of mental disorder but rather a combination of feeling good and functioning effectively resulting in high levels of mental well-being, and Seligman’s (Seligman, 2011 PERMA theory of well-being, the paper identifies strengths in existing games that generate positive affect, positive functioning and positive social functioning, contributing to, and supporting mental health and well-being.

  8. Testing the Developmental Origins of Health and Disease Hypothesis for Psychopathology Using Family-Based Quasi-Experimental Designs

    Science.gov (United States)

    D’Onofrio, Brian M.; Class, Quetzal A.; Lahey, Benjamin B.; Larsson, Henrik

    2014-01-01

    The Developmental Origin of Health and Disease (DOHaD) hypothesis is a broad theoretical framework that emphasizes how early risk factors have a causal influence on psychopathology. Researchers have raised concerns about the causal interpretation of statistical associations between early risk factors and later psychopathology because most existing studies have been unable to rule out the possibility of environmental and genetic confounding. In this paper we illustrate how family-based quasi-experimental designs can test the DOHaD hypothesis by ruling out alternative hypotheses. We review the logic underlying sibling-comparison, co-twin control, offspring of siblings/twins, adoption, and in vitro fertilization designs. We then present results from studies using these designs focused on broad indices of fetal development (low birth weight and gestational age) and a particular teratogen, smoking during pregnancy. The results provide mixed support for the DOHaD hypothesis for psychopathology, illustrating the critical need to use design features that rule out unmeasured confounding. PMID:25364377

  9. Guinea pig models for translation of the developmental origins of health and disease hypothesis into the clinic.

    Science.gov (United States)

    Morrison, Janna L; Botting, Kimberley J; Darby, Jack R T; David, Anna L; Dyson, Rebecca M; Gatford, Kathryn L; Gray, Clint; Herrera, Emilio A; Hirst, Jonathan J; Kim, Bona; Kind, Karen L; Krause, Bernardo J; Matthews, Stephen G; Palliser, Hannah K; Regnault, Timothy R H; Richardson, Bryan S; Sasaki, Aya; Thompson, Loren P; Berry, Mary J

    2018-04-06

    Over 30 years ago Professor David Barker first proposed the theory that events in early life could explain an individual's risk of non-communicable disease in later life: the developmental origins of health and disease (DOHaD) hypothesis. During the 1990s the validity of the DOHaD hypothesis was extensively tested in a number of human populations and the mechanisms underpinning it characterised in a range of experimental animal models. Over the past decade, researchers have sought to use this mechanistic understanding of DOHaD to develop therapeutic interventions during pregnancy and early life to improve adult health. A variety of animal models have been used to develop and evaluate interventions, each with strengths and limitations. It is becoming apparent that effective translational research requires that the animal paradigm selected mirrors the tempo of human fetal growth and development as closely as possible so that the effect of a perinatal insult and/or therapeutic intervention can be fully assessed. The guinea pig is one such animal model that over the past two decades has demonstrated itself to be a very useful platform for these important reproductive studies. This review highlights similarities in the in utero development between humans and guinea pigs, the strengths and limitations of the guinea pig as an experimental model of DOHaD and the guinea pig's potential to enhance clinical therapeutic innovation to improve human health. © 2018 The Authors. The Journal of Physiology © 2018 The Physiological Society.

  10. FERTILITY INTENTIONS AND EARLY LIFE HEALTH STRESS AMONG WOMEN IN EIGHT INDIAN CITIES: TESTING THE REPRODUCTIVE ACCELERATION HYPOTHESIS.

    Science.gov (United States)

    Kulathinal, Sangita; Säävälä, Minna

    2015-09-01

    In life history theory, early life adversity is associated with an accelerated reproductive tempo. In harsh and unpredictable conditions in developing societies fertility is generally higher and the reproductive tempo faster than in more secure environments. This paper examines whether differences in female anthropometry, particularly adult height, are associated with fertility intentions of women in urban environments in India. The study population consists of women aged 15-29 (N=4485) in slums and non-slums of eight Indian cities in the National Family Health Survey (NFHS) of 2005-2006. Adult height is taken as a proxy for early childhood health and nutritional condition. Fertility intentions are examined by using two variables: the desire to have a child or another child, and to have it relatively soon, as indicative of accelerated reproductive scheduling. Evidence supporting the acceleration hypothesis is found in two urban frames out of 26 examined in a two-staged multinomial logistic model. In three cases, the relationship between fertility intentions and height is the opposite than expected by the acceleration hypothesis: taller women have a higher predictive probability of desiring a(nother) child and/or narrower birth spacing. Potential explanations for the partly contradictory relationship between the childhood health indicator and fertility intentions are discussed.

  11. Transitioning to a Data Driven Mental Health Practice : Collaborative Expert Sessions for Knowledge and Hypothesis Finding

    NARCIS (Netherlands)

    Menger, Vincent; Spruit, Marco; Hagoort, Karin; Scheepers, Floor

    2016-01-01

    The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard

  12. Rationality, practice variation and person?centred health policy: a threshold hypothesis

    OpenAIRE

    Djulbegovic, Benjamin; Hamm, Robert M.; Mayrhofer, Thomas; Hozo, Iztok; Van den Ende, Jef

    2015-01-01

    Abstract Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability threshol...

  13. Transitioning to a Data Driven Mental Health Practice: Collaborative Expert Sessions for Knowledge and Hypothesis Finding

    Directory of Open Access Journals (Sweden)

    Vincent Menger

    2016-01-01

    Full Text Available The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard Process for Data Mining (CRISP-DM, suitable for conducting expert sessions that focus on finding new knowledge and hypotheses in collaboration with local workforce. Our proposed specification that we name CRISP-IDM is evaluated in a case study at the psychiatry department of the University Medical Center Utrecht. Expert interviews were conducted to identify seven research themes in the psychiatry department, which were researched in cooperation with local health care professionals using data visualization as a modeling tool. During 19 expert sessions, two results that were directly implemented and 29 hypotheses for further research were found, of which 24 were not imagined during the initial expert interviews. Our work demonstrates the viability and benefits of involving work floor people in the analyses and the possibility to effectively find new knowledge and hypotheses using our CRISP-IDM method.

  14. Transitioning to a Data Driven Mental Health Practice: Collaborative Expert Sessions for Knowledge and Hypothesis Finding.

    Science.gov (United States)

    Menger, Vincent; Spruit, Marco; Hagoort, Karin; Scheepers, Floor

    2016-01-01

    The surge in the amount of available data in health care enables a novel, exploratory research approach that revolves around finding new knowledge and unexpected hypotheses from data instead of carrying out well-defined data analysis tasks. We propose a specification of the Cross Industry Standard Process for Data Mining (CRISP-DM), suitable for conducting expert sessions that focus on finding new knowledge and hypotheses in collaboration with local workforce. Our proposed specification that we name CRISP-IDM is evaluated in a case study at the psychiatry department of the University Medical Center Utrecht. Expert interviews were conducted to identify seven research themes in the psychiatry department, which were researched in cooperation with local health care professionals using data visualization as a modeling tool. During 19 expert sessions, two results that were directly implemented and 29 hypotheses for further research were found, of which 24 were not imagined during the initial expert interviews. Our work demonstrates the viability and benefits of involving work floor people in the analyses and the possibility to effectively find new knowledge and hypotheses using our CRISP-IDM method.

  15. Linking better shiftwork arrangements with safety and health management systems.

    Science.gov (United States)

    Kogi, Kazutaka

    2004-12-01

    Various support measures useful for promoting joint change approaches to the improvement of both shiftworking arrangements and safety and health management systems were reviewed. A particular focus was placed on enterprise-level risk reduction measures linking working hours and management systems. Voluntary industry-based guidelines on night and shift work for department stores and the chemical, automobile and electrical equipment industries were examined. Survey results that had led to the compilation of practicable measures to be included in these guidelines were also examined. The common support measures were then compared with ergonomic checkpoints for plant maintenance work involving irregular nightshifts. On the basis of this analysis, a new night and shift work checklist was designed. Both the guidelines and the plant maintenance work checkpoints were found to commonly cover multiple issues including work schedules and various job-related risks. This close link between shiftwork arrangements and risk management was important as shiftworkers in these industries considered teamwork and welfare services to be essential for managing risks associated with night and shift work. Four areas found suitable for participatory improvement by managers and workers were work schedules, ergonomic work tasks, work environment and training. The checklist designed to facilitate participatory change processes covered all these areas. The checklist developed to describe feasible workplace actions was suitable for integration with comprehensive safety and health management systems and offered valuable opportunities for improving working time arrangements and job content together.

  16. The urban health transition hypothesis: empirical evidence of an avian influenza Kuznets curve in Vietnam?

    Science.gov (United States)

    Spencer, James Herbert

    2013-04-01

    The literature on development has focused on the concept of transition in understanding the emergent challenges facing poor but rapidly developing countries. Scholars have focused extensively on the health and urban transitions associated with this change and, in particular, its use for understanding emerging infectious diseases. However, few have developed explicit empirical measures to quantify the extent to which a transitions focus is useful for theory, policy, and practice. Using open source data on avian influenza in 2004 and 2005 and the Vietnam Census of Population and Housing, this paper introduces the Kuznets curve as a tool for empirically estimating transition and disease. Findings suggest that the Kuznets curve is a viable tool for empirically assessing the role of transitional dynamics in the emergence of new infectious diseases.

  17. Rationality, practice variation and person-centred health policy: a threshold hypothesis.

    Science.gov (United States)

    Djulbegovic, Benjamin; Hamm, Robert M; Mayrhofer, Thomas; Hozo, Iztok; Van den Ende, Jef

    2015-12-01

    Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability thresholds at which physicians decide to act: contextual social and clinical factors and emotions such as regret affect the threshold by influencing the way doctors integrate objective data related to treatment and testing. However, depending on a theoretical construct each of the physician's behaviour can be considered rational. In fact, we showed that the current regulatory policies lead to predictably low thresholds for most decisions in contemporary practice. As a result, we may expect continuing motivation for overuse of treatment and diagnostic tests. We argue that rationality should take into account both formal principles of rationality and human intuitions about good decisions along the lines of Rawls' 'reflective equilibrium/considered judgment'. In turn, this can help define a threshold model that is empirically testable. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  18. The role of physical activity in bone health: a new hypothesis to reduce risk of vertebral fracture.

    Science.gov (United States)

    Sinaki, Mehrsheed

    2007-08-01

    Locomotion has always been a major criterion for human survival. Thus, it is no surprise that science supports the dependence of bone health on weight-bearing physical activities. The effect of physical activity on bone is site-specific. Determining how to perform osteogenic exercises, especially in individuals who have osteopenia or osteoporosis, without exceeding the biomechanical competence of bone always poses a dilemma and must occur under medical advice. This article presents the hypothesis that back exercises performed in a prone position, rather than a vertical position, may have a greater effect on decreasing the risk for vertebral fractures without resulting in compression fracture. The risk for vertebral fractures can be reduced through improvement in the horizontal trabecular connection of vertebral bodies.

  19. The SAIL databank: linking multiple health and social care datasets

    Directory of Open Access Journals (Sweden)

    Ford David V

    2009-01-01

    Full Text Available Abstract Background Vast amounts of data are collected about patients and service users in the course of health and social care service delivery. Electronic data systems for patient records have the potential to revolutionise service delivery and research. But in order to achieve this, it is essential that the ability to link the data at the individual record level be retained whilst adhering to the principles of information governance. The SAIL (Secure Anonymised Information Linkage databank has been established using disparate datasets, and over 500 million records from multiple health and social care service providers have been loaded to date, with further growth in progress. Methods Having established the infrastructure of the databank, the aim of this work was to develop and implement an accurate matching process to enable the assignment of a unique Anonymous Linking Field (ALF to person-based records to make the databank ready for record-linkage research studies. An SQL-based matching algorithm (MACRAL, Matching Algorithm for Consistent Results in Anonymised Linkage was developed for this purpose. Firstly the suitability of using a valid NHS number as the basis of a unique identifier was assessed using MACRAL. Secondly, MACRAL was applied in turn to match primary care, secondary care and social services datasets to the NHS Administrative Register (NHSAR, to assess the efficacy of this process, and the optimum matching technique. Results The validation of using the NHS number yielded specificity values > 99.8% and sensitivity values > 94.6% using probabilistic record linkage (PRL at the 50% threshold, and error rates were Conclusion With the infrastructure that has been put in place, the reliable matching process that has been developed enables an ALF to be consistently allocated to records in the databank. The SAIL databank represents a research-ready platform for record-linkage studies.

  20. The SAIL databank: linking multiple health and social care datasets.

    Science.gov (United States)

    Lyons, Ronan A; Jones, Kerina H; John, Gareth; Brooks, Caroline J; Verplancke, Jean-Philippe; Ford, David V; Brown, Ginevra; Leake, Ken

    2009-01-16

    Vast amounts of data are collected about patients and service users in the course of health and social care service delivery. Electronic data systems for patient records have the potential to revolutionise service delivery and research. But in order to achieve this, it is essential that the ability to link the data at the individual record level be retained whilst adhering to the principles of information governance. The SAIL (Secure Anonymised Information Linkage) databank has been established using disparate datasets, and over 500 million records from multiple health and social care service providers have been loaded to date, with further growth in progress. Having established the infrastructure of the databank, the aim of this work was to develop and implement an accurate matching process to enable the assignment of a unique Anonymous Linking Field (ALF) to person-based records to make the databank ready for record-linkage research studies. An SQL-based matching algorithm (MACRAL, Matching Algorithm for Consistent Results in Anonymised Linkage) was developed for this purpose. Firstly the suitability of using a valid NHS number as the basis of a unique identifier was assessed using MACRAL. Secondly, MACRAL was applied in turn to match primary care, secondary care and social services datasets to the NHS Administrative Register (NHSAR), to assess the efficacy of this process, and the optimum matching technique. The validation of using the NHS number yielded specificity values > 99.8% and sensitivity values > 94.6% using probabilistic record linkage (PRL) at the 50% threshold, and error rates were SAIL databank represents a research-ready platform for record-linkage studies.

  1. Building a partnership to evaluate school-linked health services: the Cincinnati School Health Demonstration Project.

    Science.gov (United States)

    Rose, Barbara L; Mansour, Mona; Kohake, Kelli

    2005-12-01

    The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater Cincinnati wanted to determine if levels of school-linked care made a difference in student quality of life, school connectedness, attendance, emergency department use, and volume of referrals to health care specialists. School nurses, principals and school staff, parents and students, upper-level managers, and health service researchers worked together over a 2.5-year period to learn about and use new technology to collect information on student health, well-being, and outcome measures. Varying levels of school health care intervention models were instituted and evaluated. A standard model of care was compared with 2 models of enhanced care and service. The information collected from students, parents, nurses, and the school system provided a rich database on the health of urban children. School facilities, staffing, and computer technology, relationship building among stakeholders, extensive communication, and high student mobility were factors that influenced success and findings of the project. Funding for district-wide computerization and addition of school health staff was not secured by the end of the demonstration project; however, relationships among the partners endured and paved the way for future collaborations designed to better serve urban school children in Cincinnati.

  2. Panel discussion on health effects of low-dose ionizing radiation. Scientific findings and non-threshold hypothesis

    International Nuclear Information System (INIS)

    1995-06-01

    This is a record of a panel discussion in the IAEA Interregional Training Course. In current radiation work, protection measures are taken on the assumption that any amount of radiation, however small, entails a risk of deleterious effects. This so-called non-threshold assumption of radiation effects, on the one hand, creates public distrust of radiation use. However, because the health effects of low-dose ionizing radiation are difficult to verify, wide views ranging from the non-threshold hypothesis to one which sees small amounts of radiation as rather useful and necessary are presented. In this panel discussion, how the health effects of low-dose ionizing radiation should be considered from the standpoint of radiation protection was discussed. Panelists included such eminent scientists as Dr. Sugahara and Dr. Okada, who are deeply interested in this field and are playing leading parts in radiobiology research in Japan, and Dr. Stather, deputy Director of NRPB, UK, who, in UNSCEAR and ICRP, is actively participating in the international review of radiation effects and the preparation of reports on radiation protection recommendations. They agreed with each other that although it is reasonable, under the current scientific understanding, to follow the recommendation of ICRP, research in this area should be strongly promoted hereafter, for basing radiation protection on firm scientific grounds. Many participants actively asked about and discussed problems in their own field. (author)

  3. Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the 'red states v. blue states' hypothesis.

    Science.gov (United States)

    Bessett, Danielle; Gerdts, Caitlin; Littman, Lisa L; Kavanaugh, Megan L; Norris, Alison

    2015-01-01

    Recently, the hypothesis that state-level political context influences individuals' cultural values--the 'red states v. blue states' hypothesis--has been invoked to explain the hyper-polarisation of politics in the USA. To test this hypothesis, we examined individuals' knowledge about abortion in relation to the political context of their current state of residence. Drawing from an internet-survey of 586 reproductive-age individuals in the USA, we assessed two types of abortion knowledge: health-related and legality. We found that state-level conservatism does not modify the existing relationships between individual predictors and each of the two types of abortion knowledge. Hence, our findings do not support the 'red states' versus 'blue states' hypothesis. Additionally, we find that knowledge about abortion's health effects in the USA is low: 7% of our sample thought abortion before 12 weeks gestation was illegal.

  4. Comments on "The "Elevated Heat Pump" Hypothesis for the Aerosol-Monsoon Hydroclimate Link: "Grounded" in Observations?" by S. Nigam and M. Bollasina

    Science.gov (United States)

    Lau, K. M.; Kim, K. M.

    2010-01-01

    In their recent paper Nigam and Bollasina [2010, hereafter NB] claimed to have found observational evidences that are at variance with the Elevated Heat Pump (EHP) hypothesis regarding the possible impacts of absorbing aerosols on the South Asian summer monsoon [Lau et al., 2006; Lau and Km 2006). We found NB's arguments and inferences against the EHP hypothesis flawed, stemming from a lack of understanding and an out-of-context interpretation of the hypothesis. It was argued that the simultaneous negative correlation of aerosol with rainfall, and correlations with other quantities in May as evidences against the EHP hypothesis. They cannot be more wrong in that argument. First, Lau and Kim [2006, hereafter, LKO6] never stated that the main rainfall response to EHP is in May. Second, the EHP is about responses of the entire Indian monsoon system that are non-local in space and time with respect to the aerosol forcing. Third, the correlation maps shown in NB, including the increased convection over the Bay of Bengal is not the response to EHP but rather represents the large-scale circulation that provides the build-up of the aerosols, before the onset of the monsoon rainfall over India. Because aerosol can only accumulate where there is little or no wash-out by rain, the negative correlation is a necessary condition for increased atmospheric loading of aerosols.

  5. Preeclampsia and health risks later in life: an immunological link.

    Science.gov (United States)

    Cheng, Shi-Bin; Sharma, Surendra

    2016-11-01

    Pregnancy represents a period of physiological stress, and although this stress is experienced for a very modest portion of life, it is now recognized as a window to women's future health, often by unmasking predispositions to conditions that only become symptomatic later in life. In normal pregnancy, the mother experiences mild metabolic syndrome-like condition through week 20 of gestation. A pronounced phenotype of metabolic syndrome may program pregnancy complications such as preeclampsia. Preeclampsia is a serious complication with a myriad of manifestations for mother and offspring. This pregnancy syndrome is a polygenic disease and has been now linked to higher incidence of cardiovascular disease, diabetes, and several other disorders associated with vulnerable organs. Furthermore, the offspring born to preeclamptic mothers also exhibit an elevated risk of cardiovascular disease, stroke, and mental disorders during adulthood. This suggests that preeclampsia not only exposes the mother and the fetus to complications during pregnancy but also programs chronic diseases in later life. The etiology of preeclampsia is thought to be primarily associated with poor placentation and entails excessive maternal inflammation and endothelial dysfunction. It is well established now that the maternal immune system and the placenta are involved in a highly choreographed cross-talk that underlies adequate spiral artery remodeling required for uteroplacental perfusion and free flow of nutrients to the fetus. Since normal pregnancy is associated with a sequence of events represented by temporal events of inflammation (implantation), anti-inflammation (gestation), and inflammation (parturition), it is quite possible that unscheduled alterations in these regulatory responses may lead to pathologic consequences. Although it is not clear whether immunological alterations occur early in pregnancy, it is proposed that dysregulated systemic and placental immunity contribute to impaired

  6. Comment on "'Elevated Heat Pump' Hypothesis for the Aerosol-Monsoon Hydroclimate Link: 'Grounded' in Observations?" by S. Nigam and M. Bollasina

    Science.gov (United States)

    Lau, K. M.; Kim, K. M.

    2011-01-01

    In their recent paper, Nigam and Bollasina [2010] (hereinafter NB) claimed to have found observational evidences that are at variance with the elevated heat pump (EHP) hypothesis regarding the possible impacts of absorbing aerosols on the South Asian summer monsoon [Lau et al., 2006; Lau and Kim, 2006]. We found NB's arguments and inferences against the EHP hypothesis flawed, stemming from their own out of context interpretation of the hypothesis. NB argued that the simultaneous negative correlation of aerosol with rainfall, and correlations with other quantities in May, are evidence against the EHP hypothesis. Their argument cannot be justified. First, Lau and Kim [2006] (hereinafter LK06) never stated that the main rainfall response to EHP is in May. Second, the EHP is about responses of the entire Indian monsoon system that are nonlocal in space and time with respect to the aerosol forcing. As shown in Figure 4 of LK06, while the aerosol anomalies are strongest in April-May, the strongest rainfall response is in June-July, with the enhanced rainfall fed by an induced thermally driven circulation which brings additional moisture from the ocean to the Indian subcontinent. Third, the increased rainfall over the Bay of Bengal as shown in Figure 1a of NB and the increased low-level convergence in Figure 1f of NB do not necessarily reflect responses associated with EHP but rather the large ]scale circulation that provides the buildup of the aerosols before the onset of the monsoon rainfall over India. Because aerosol can only accumulate where there is little or no washout by rain, the negative correlation is a necessary condition for increased atmospheric loading of aerosols. For the same reason, the spatial distributions of rainfall and aerosol generally are offset with each other, i.e., high aerosol in regions of low rainfall. This is evident in Figure 1, which shows the climatological mean of the MODIS aerosol optical depth (AOD), and TRMM rainfall over India in

  7. Linking Compensation and Health Surveillance Data Sets to Improve Knowledge of US Coal Miners' Health.

    Science.gov (United States)

    Almberg, Kirsten S; Cohen, Robert A; Blackley, David J; Laney, Anthony S; Storey, Eileen; Halldin, Cara N

    2017-10-01

    Increase knowledge of US coal miners' respiratory health by linking data from the black lung benefits program (BLBP) and the coal workers' health surveillance program (CWHSP). BLBP claims data from 2000 through 2013 was linked to CWHSP data from 1970 through 2016. Overall, 273,644 miners participated in CWHSP, 37,548 in BLBP, and 22,903 in both programs. Median age of miners at their time of first/only participation in CWHSP was 28 and 32 years, respectively. BLBP claimants were older (median age 59). Thirty-nine percent of BLBP claimants had not participated in CWHSP. The relative contributions of states to participation differed between CWHSP and BLBP. For example, Kentucky miners accounted for 18% of CWHSP participants, but 36% of BLPB participants. Many BLBP claimants never appeared in CWHSP, indicating missed opportunities for secondary prevention.

  8. Tracking Master of Public Health graduates: Linking higher ...

    African Journals Online (AJOL)

    Background. Master of Public Health (MPH) students come from a wide range of health professional backgrounds. Graduate programmes in public health should equip alumni with knowledge and skills to analyse and integrate health research findings, and have a practical approach to current public health issues. In South ...

  9. Role of the police in linking individuals experiencing mental health crises with mental health services

    Science.gov (United States)

    2012-01-01

    Background The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact. Methods Police records were searched for calls regarding individuals with acute mental health needs and police handling of these calls. Mental healthcare contact data were retrieved from a Psychiatric Case Register. Results The police were called upon for mental health crisis situations 492 times within the study year, involving 336 individuals (i.e. 1.7 per 1000 inhabitants per year). Half of these individuals (N=162) were disengaged from mental health services, lacking regular care contact in the year prior to the crisis (apart from contact for crisis intervention). In the month following the crisis, 21% of those who were previously disengaged from services had regular care contact, and this was more frequent (49%) if the police had contacted the mental health services during the crisis. The influence of police referral to the services was still present the following year. However, for the majority (58%) of disengaged individuals police did not contact the mental health services at the time of crisis. Conclusions The police deal with a substantial number of individuals experiencing a mental health crisis, half of whom are out of contact with mental health services, and police play an important role in linking these individuals to services. Training police officers to recognise and handle mental health crises, and implementing practical models of cooperation between the police and mental health services in dealing with such crises may further improve police referral of individuals disengaged from mental health services. PMID:23072687

  10. Linking better shiftwork arrangements with safety and health management systems

    Directory of Open Access Journals (Sweden)

    Kazutaka Kogi

    2004-12-01

    Full Text Available OBJECTIVE: Various support measures useful for promoting joint change approaches to the improvement of both shiftworking arrangements and safety and health management systems were reviewed. A particular focus was placed on enterprise-level risk reduction measures linking working hours and management systems. METHODS: Voluntary industry-based guidelines on night and shift work for department stores and the chemical, automobile and electrical equipment industries were examined. Survey results that had led to the compilation of practicable measures to be included in these guidelines were also examined. The common support measures were then compared with ergonomic checkpoints for plant maintenance work involving irregular nightshifts. On the basis of this analysis, a new night and shift work checklist was designed. RESULTS: Both the guidelines and the plant maintenance work checkpoints were found to commonly cover multiple issues including work schedules and various job-related risks. This close link between shiftwork arrangements and risk management was important as shiftworkers in these industries considered teamwork and welfare services to be essential for managing risks associated with night and shift work. Four areas found suitable for participatory improvement by managers and workers were work schedules, ergonomic work tasks, work environment and training. The checklist designed to facilitate participatory change processes covered all these areas. CONCLUSIONS: The checklist developed to describe feasible workplace actions was suitable for integration with comprehensive safety and health management systems and offered valuable opportunities for improving working time arrangements and job content together.OBJETIVOS: Foram revisados diversas medidas de apoio úteis para incentivar abordagens conjuntas para a melhoria na organização do trabalho por turnos e os processos de gestão de saúde e segurança. As medidas para redução de risco em n

  11. Multinational Population-Based Health Surveys Linked to Outcome Data: An Untapped Resource

    Directory of Open Access Journals (Sweden)

    Stacey Fisher

    2017-04-01

    This study provides initial support for the methodological feasibility of pooling linked population health surveys however, challenges introduced by dissimilarities will require the use of innovative methodologies, and discussions regarding how to manage jurisdictional data restrictions and privacy issues are needed. Pooled population health data has the potential to improve national and international health surveillance and public health.

  12. A hypothesis linking sub-optimal seawater pCO2 conditions for cnidarian-Symbiodinium symbioses with the exceedence of the interglacial threshold (>260 ppmv

    Directory of Open Access Journals (Sweden)

    S. A. Wooldridge

    2012-05-01

    Full Text Available Most scleractinian corals and many other cnidarians host intracellular photosynthetic dinoflagellate symbionts ("zooxanthellae". The zooxanthellae contribute to host metabolism and skeletogenesis to such an extent that this symbiosis is well recognised for its contribution in creating the coral reef ecosystem. The stable functioning of cnidarian symbioses is however dependent upon the host's ability to maintain demographic control of its algal partner. In this review, I explain how the modern envelope of seawater conditions found within many coral reef ecosystems (characterised by elevated temperatures, rising pCO2, and enriched nutrient levels are antagonistic toward the dominant host processes that restrict excessive symbiont proliferation. Moreover, I outline a new hypothesis and initial evidence base, which support the suggestion that the additional "excess" zooxanthellae fraction permitted by seawater pCO2 levels beyond 260 ppmv significantly increases the propensity for symbiosis breakdown ("bleaching" in response to temperature and irradiance extremes. The relevance of this biological threshold is discussed in terms of historical reef extinction events, glacial-interglacial climate cycles and the modern decline of coral reef ecosystems.

  13. A hypothesis linking sub-optimal seawater pCO2 conditions for cnidarian-Symbiodinium symbioses with the exceedence of the interglacial threshold (>260 ppmv)

    Science.gov (United States)

    Wooldridge, S. A.

    2012-05-01

    Most scleractinian corals and many other cnidarians host intracellular photosynthetic dinoflagellate symbionts ("zooxanthellae"). The zooxanthellae contribute to host metabolism and skeletogenesis to such an extent that this symbiosis is well recognised for its contribution in creating the coral reef ecosystem. The stable functioning of cnidarian symbioses is however dependent upon the host's ability to maintain demographic control of its algal partner. In this review, I explain how the modern envelope of seawater conditions found within many coral reef ecosystems (characterised by elevated temperatures, rising pCO2, and enriched nutrient levels) are antagonistic toward the dominant host processes that restrict excessive symbiont proliferation. Moreover, I outline a new hypothesis and initial evidence base, which support the suggestion that the additional "excess" zooxanthellae fraction permitted by seawater pCO2 levels beyond 260 ppmv significantly increases the propensity for symbiosis breakdown ("bleaching") in response to temperature and irradiance extremes. The relevance of this biological threshold is discussed in terms of historical reef extinction events, glacial-interglacial climate cycles and the modern decline of coral reef ecosystems.

  14. The Union Health Center: a working model of clinical care linked to preventive occupational health services.

    Science.gov (United States)

    Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J

    1997-03-01

    As health care provision in the United States shifts to primary care settings, it is vital that new models of occupational health services be developed that link clinical care to prevention. The model program described in this paper was developed at the Union Health Center (UHC), a comprehensive health care center supported by the International Ladies Garment Workers Union (now the Union of Needletrades, Industrial and Textile Employees) serving a population of approximately 50,000 primarily minority, female garment workers in New York City. The objective of this paper is to describe a model occupational medicine program in a union-based comprehensive health center linking accessible clinical care with primary and secondary disease prevention efforts. To assess the presence of symptoms suggestive of occupational disease, a health status questionnaire was administered to female workers attending the UHC for routine health maintenance. Based on the results of this survey, an occupational medicine clinic was developed that integrated direct clinical care with worker and employer education and workplace hazard abatement. To assess the success of this new approach, selected cases of sentinel health events were tracked and a chart review was conducted after 3 years of clinic operation. Prior to initiation of the occupational medicine clinic, 64% (648) of the workers surveyed reported symptoms indicative of occupational illnesses. However, only 42 (4%) reported having been told by a physician that they had an occupational illness and only 4 (.4%) reported having field a workers' compensation claim for an occupational disease. In the occupational medicine clinic established at the UHC, a health and safety specialist acts as a case manager, coordinating worker and employer education as well as workplace hazard abatement focused on disease prevention, ensuring that every case of occupational disease is treated as a potential sentinel health event. As examples of the success

  15. Blood-borne biomarkers and bioindicators for linking exposure to health effects in environmental health science.

    Science.gov (United States)

    Wallace, M Ariel Geer; Kormos, Tzipporah M; Pleil, Joachim D

    2016-01-01

    Environmental health science aims to link environmental pollution sources to adverse health outcomes to develop effective exposure intervention strategies that reduce long-term disease risks. Over the past few decades, the public health community recognized that health risk is driven by interaction between the human genome and external environment. Now that the human genetic code has been sequenced, establishing this "G × E" (gene-environment) interaction requires a similar effort to decode the human exposome, which is the accumulation of an individual's environmental exposures and metabolic responses throughout the person's lifetime. The exposome is composed of endogenous and exogenous chemicals, many of which are measurable as biomarkers in blood, breath, and urine. Exposure to pollutants is assessed by analyzing biofluids for the pollutant itself or its metabolic products. New methods are being developed to use a subset of biomarkers, termed bioindicators, to demonstrate biological changes indicative of future adverse health effects. Typically, environmental biomarkers are assessed using noninvasive (excreted) media, such as breath and urine. Blood is often avoided for biomonitoring due to practical reasons such as medical personnel, infectious waste, or clinical setting, despite the fact that blood represents the central compartment that interacts with every living cell and is the most relevant biofluid for certain applications and analyses. The aims of this study were to (1) review the current use of blood samples in environmental health research, (2) briefly contrast blood with other biological media, and (3) propose additional applications for blood analysis in human exposure research.

  16. A model linking clinical workforce skill mix planning to health and health care dynamics

    Directory of Open Access Journals (Sweden)

    McDonnell Geoff

    2010-04-01

    Full Text Available Abstract Background In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Methods Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. Results We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. Conclusion We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  17. A model linking clinical workforce skill mix planning to health and health care dynamics.

    Science.gov (United States)

    Masnick, Keith; McDonnell, Geoff

    2010-04-30

    In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  18. Multiple chronic health conditions and their link with wealth assets.

    Science.gov (United States)

    Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Passey, Megan E; Kelly, Simon J; Percival, Richard

    2015-04-01

    There has been little research on the economic status of those with multiple health conditions, particularly on the relationship between multiple health conditions and wealth. This paper will assess the difference in the value and type of wealth assets held by Australians who have multiple chronic health conditions. Using Health&WealthMOD, a microsimulation model of the 45-64-year-old Australian population in 2009, a counterfactual analysis was undertaken. The actual proportion of people with different numbers of chronic health conditions with any wealth, and the value of this wealth was estimated. This was compared with the counterfactual values had the individuals had no chronic health conditions. There was no change in the proportion of people with one health condition who actually had any wealth, compared to the counterfactual proportion had they had no chronic health conditions. Ninety-four percent of those with four or more health conditions had some accumulated wealth; however, under the counterfactual, 100% would have had some accumulated wealth. There was little change in the value of non-income-producing assets under the counterfactual, regardless of number of health conditions. Those with four or more chronic health conditions had a mean value of $17 000 in income-producing assets; under the counterfactual, the average would have been $78 000. This study has highlighted the variation in the value of wealth according to number of chronic health conditions, and hence the importance of considering multiple morbidities when discussing the relationship between health and wealth. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Health instruction in Nigerian schools: what are the missing links?

    Science.gov (United States)

    Olatunya, Oladele Simeon; Oseni, Saheed Babajide; Oyelami, Oyeku Akibu; Adegbenro, Caleb; Akani, Nwadiuto

    2014-01-01

    School health instruction (SHI) is the instructional aspects of school health programme. It provides information on key health issues to school children who are in their formative years. A cross sectional descriptive study of all the primary schools in a focal Local Government Area in Nigeria was carried out to ascertain the implementation of SHI with regards to the contents, methods of delivery and teachers preparation for health teaching using an evaluation checklist for SHI. There were more female pupils enrolled in the study area compared to their male counterparts with a male to female ratio of 0.9:1.0 and only 3.0% of the teachers had In-service training on health related issues in the previous five years preceding the study. 79.4% of the teachers had the recommended qualification to work in the schools. Teachings on emotional health, communicable diseases and safety education were sparingly given by 1.6%, 4.7% and 56% schools respectively. Only three (4.7%) schools (all private) had health instruction given by designated health education staff. No school gave health instruction at least thrice a week as recommended. Compliance with the implementation of SHI was very poor in the study area.

  20. Explaining health care expenditure variation: large-sample evidence using linked survey and health administrative data.

    Science.gov (United States)

    Ellis, Randall P; Fiebig, Denzil G; Johar, Meliyanni; Jones, Glenn; Savage, Elizabeth

    2013-09-01

    Explaining individual, regional, and provider variation in health care spending is of enormous value to policymakers but is often hampered by the lack of individual level detail in universal public health systems because budgeted spending is often not attributable to specific individuals. Even rarer is self-reported survey information that helps explain this variation in large samples. In this paper, we link a cross-sectional survey of 267 188 Australians age 45 and over to a panel dataset of annual healthcare costs calculated from several years of hospital, medical and pharmaceutical records. We use this data to distinguish between cost variations due to health shocks and those that are intrinsic (fixed) to an individual over three years. We find that high fixed expenditures are positively associated with age, especially older males, poor health, obesity, smoking, cancer, stroke and heart conditions. Being foreign born, speaking a foreign language at home and low income are more strongly associated with higher time-varying expenditures, suggesting greater exposure to adverse health shocks. Copyright © 2013 John Wiley & Sons, Ltd.

  1. Infecting academic conferences: brands linked to ill health

    OpenAIRE

    Stuart W Flint

    2015-01-01

    Empirical evidence shows the links between sweetened soft drinks (1,2) or fast food (3) and chronic illness such as obesity and diabetes. However, as a researcher investigating the causes of obesity, I have become disappointed at the presence of brands of unhealthy products at major conferences relating to obesity, physical activity, and nutrition. In recent years, brands such as Coca Cola Inc and McDonalds Corp have sponsored several conference events.

  2. Forging Links for Health Research: Perspectives from the Council on ...

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

    ... and organizations in the area of capacity building for health system reform, with a ... the design of culturally appropriate AIDS educational interventions in Zimbabwe; ... maternal/child health programs for Latin American immigrants in Hamilton, ... Le CRDI, l'Israel Science Foundation, la Fondation Azrieli et les Instituts de ...

  3. Forging Links for Health Research: Perspectives from the Council on ...

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

    As part of the lead up to the October 2000 International Conference on Health Research for Development in Bangkok, the Council on Health Research for Development (COHRED) called upon its associates around the world to reflect on achievements and setbacks in the 1990s. This book is the result of those reflections.

  4. Psychological Perspectives on Pathways Linking Socioeconomic Status and Physical Health

    Science.gov (United States)

    Matthews, Karen A.; Gallo, Linda C.

    2011-01-01

    Low socioeconomic status (SES) is a reliable correlate of poor physical health. Rather than treat SES as a covariate, health psychology has increasingly focused on the psychobiological pathways that inform understanding why SES is related to physical health. This review assesses the status of research that has examined stress and its associated distress, and social and personal resources as pathways. It highlights work on biomarkers and biological pathways related to SES that can serve as intermediate outcomes in future studies. Recent emphasis on the accumulation of psychobiological risks across the life course is summarized and represents an important direction for future research. Studies that test pathways from SES to candidate psychosocial pathways to health outcomes are few in number but promising. Future research should test integrated models rather than taking piecemeal approaches to evidence. Much work remains to be done, but the questions are of great health significance. PMID:20636127

  5. Visualising linked health data to explore health events around preventable hospitalisations in NSW Australia.

    Science.gov (United States)

    Falster, Michael O; Jorm, Louisa R; Leyland, Alastair H

    2016-09-07

    To explore patterns of health service use in the lead-up to, and following, admission for a 'preventable' hospitalisation. 266 950 participants in the 45 and Up Study, New South Wales (NSW) Australia Linked data on hospital admissions, general practitioner (GP) visits and other health events were used to create visual representations of health service use. For each participant, health events were plotted against time, with different events juxtaposed using different markers and panels of data. Various visualisations were explored by patient characteristics, and compared with a cohort of non-admitted participants matched on sociodemographic and health characteristics. Health events were displayed over calendar year and in the 90 days surrounding first preventable hospitalisation. The visualisations revealed patterns of clustering of GP consultations in the lead-up to, and following, preventable hospitalisation, with 14% of patients having a consultation on the day of admission and 27% in the prior week. There was a clustering of deaths and other hospitalisations following discharge, particularly for patients with a long length of stay, suggesting patients may have been in a state of health deterioration. Specialist consultations were primarily clustered during the period of hospitalisation. Rates of all health events were higher in patients admitted for a preventable hospitalisation than the matched non-admitted cohort. We did not find evidence of limited use of primary care services in the lead-up to a preventable hospitalisation, rather people with preventable hospitalisations tended to have high levels of engagement with multiple elements of the healthcare system. As such, preventable hospitalisations might be better used as a tool for identifying sicker patients for managed care programmes. Visualising longitudinal health data was found to be a powerful strategy for uncovering patterns of health service use, and such visualisations have potential to be more

  6. Platform links clinical data with electronic health records

    Science.gov (United States)

    To make data gathered from patients in clinical trials available for use in standard care, NCI has created a new computer tool to support interoperability between clinical research and electronic health record systems. This new software represents an inno

  7. Links between social environment and health care utilization and costs.

    Science.gov (United States)

    Brault, Marie A; Brewster, Amanda L; Bradley, Elizabeth H; Keene, Danya; Tan, Annabel X; Curry, Leslie A

    2018-01-01

    The social environment influences health outcomes for older adults and could be an important target for interventions to reduce costly medical care. We sought to understand which elements of the social environment distinguish communities that achieve lower health care utilization and costs from communities that experience higher health care utilization and costs for older adults with complex needs. We used a sequential explanatory mixed methods approach. We classified community performance based on three outcomes: rate of hospitalizations for ambulatory care sensitive conditions, all-cause risk-standardized hospital readmission rates, and Medicare spending per beneficiary. We conducted in-depth interviews with key informants (N = 245) from organizations providing health or social services. Higher performing communities were distinguished by several aspects of social environment, and these features were lacking in lower performing communities: 1) strong informal support networks; 2) partnerships between faith-based organizations and health care and social service organizations; and 3) grassroots organizing and advocacy efforts. Higher performing communities share similar social environmental features that complement the work of health care and social service organizations. Many of the supportive features and programs identified in the higher performing communities were developed locally and with limited governmental funding, providing opportunities for improvement.

  8. Psychosocial mechanisms linking the social environment to mental health in African Americans

    Science.gov (United States)

    Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African Amer...

  9. Eco-Health Linkages: evidence base and socio-economic considerations for linking ecosystem goods and services to human health

    Science.gov (United States)

    Ecosystem goods and services (EGS) are thought to play a role in protecting human health, but the empirical evidence directly linking EGS to human health outcomes is limited, and our ability to detect Eco-Health linkages is confounded by socio-economic factors. These limitations ...

  10. Linking health education and sustainability education in schools

    DEFF Research Database (Denmark)

    Madsen, Katrine Dahl; Nordin, Lone Lindegard; Simovska, Venka

    2015-01-01

    , the focus is on transformation processes occurring on the trajectory from international policy frameworks to the national context. The chapter considers the consequences of these transformation processes for educational practices within schools in light of the current major reform of basic general education......This chapter addresses the relationships between international and national (Danish) policies regarding sustainability and health promotion which have the potential to affect school-based health education/promotion and education for sustainable development. Based on policy mapping and analysis...... in Denmark with its aims of ensuring overall school improvement, increasing pupil wellbeing and improving academic outcomes. Analysis of international policy documents, as well as of research literature in both fields, shows that school-based health education (HE) and education for sustainable development...

  11. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

    Science.gov (United States)

    Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

  12. Happy and healthy: The hypothesis of correlation between subjective well-being and psychological health and its role in late adulthood

    Directory of Open Access Journals (Sweden)

    Iryna Horbal

    2012-12-01

    Full Text Available Subjective well-being as an emotional-cognitive assessment of person’s life is an important aspect of psychological health and positive functioning in general. The hypothesis of connection between subjective well-being, psychological well-being and psychological health is presented. This correlation is very important in late adulthood for ensuring happy obsolescence but has some specifi c peculiarities due to the elderly people’s age and individual traits. Subjective well-being is a background for effective inner work of summarizing person’s previous life that is the main purpose in old age.

  13. Neighborhood-health links: Differences between rural-to-urban migrants and natives in Shanghai

    Directory of Open Access Journals (Sweden)

    Danan Gu

    2015-09-01

    Full Text Available Background: It is well known that migrant workers tend to have different perceptions of neighborhood environments than urban natives. However, less is known about how these differences in perception may be linked to the health of members of these two groups. Objective: We investigated differences in links between perceived neighborhood social and physical environments and three health outcomes, self-rated health, social stress, and chronic conditions, between rural-to-urban migrants (migrant workers and Shanghai-born native urban residents in China. Methods: Data used in this study were based on a survey of 477 rural-to-urban migrants and 546 native urban residents aged 18-64, conducted in Shanghai in 2008. Logistic regression analyses were performed to model relationships for migrant workers and native residents. Results: We found that among migrant workers, more positive perceptions of neighborhood social environments (social cohesion and safety were linked to better self-rated health and lower levels of perceived stress but were not linked to chronic disease conditions; there were also no links between perceptions of physical environments and any of the three health outcomes of this study among migrant workers. By contrast, among urban natives, more positive perceptions of neighborhood social environments were linked to lower odds of chronic disease conditions but were not linked to self-rated health and perceived stress; more positive perceptions of physical environments (amenities and air quality were linked with lower odds of social stress and of chronic disease conditions. Conclusions: Neighborhood social and physical environments affected the health of migrant workers and urban natives differently.

  14. Links between economic and financial theory in graduate health administration education.

    Science.gov (United States)

    Pink, G H; Coyte, P C

    1989-01-01

    The curricula of graduate health administration programs have, historically, not articulated the theoretical links between health economics and health finance, although an understanding of these links could enhance comprehension of both disciplines. We provide a pedagogical approach that can be used to clarify these interconnections. It compares the standard neoclassical microeconomic concept of the hospital with the financial concept of the hospital, for the purpose of relating the optimal output decision in microeconomic theory to the optimal investment decision in financial theory. This approach can be taught in an advanced course in either economics or finance.

  15. The Linked CENTURY Study: linking three decades of clinical and public health data to examine disparities in childhood obesity.

    Science.gov (United States)

    Hawkins, Summer Sherburne; Gillman, Matthew W; Rifas-Shiman, Sheryl L; Kleinman, Ken P; Mariotti, Megan; Taveras, Elsie M

    2016-03-09

    Despite the need to identify the causes of disparities in childhood obesity, the existing epidemiologic studies of early life risk factors have several limitations. We report on the construction of the Linked CENTURY database, incorporating CENTURY (Collecting Electronic Nutrition Trajectory Data Using Records of Youth) Study data with birth certificates; and discuss the potential implications of combining clinical and public health data sources in examining the etiology of disparities in childhood obesity. We linked the existing CENTURY Study, a database of 269,959 singleton children from birth to age 18 years with measured heights and weights, with each child's Massachusetts birth certificate, which captures information on their mothers' pregnancy history and detailed socio-demographic information of both mothers and fathers. Overall, 74.2 % were matched, resulting in 200,343 children in the Linked CENTURY Study with 1,580,597 well child visits. Among this cohort, 94.0 % (188,334) of children have some father information available on the birth certificate and 60.9 % (121,917) of children have at least one other sibling in the dataset. Using maternal race/ethnicity from the birth certificate as an indicator of children's race/ethnicity, 75.7 % of children were white, 11.6 % black, 4.6 % Hispanic, and 5.7 % Asian. Based on socio-demographic information from the birth certificate, 20.0 % of mothers were non-US born, 5.9 % smoked during pregnancy, 76.3 % initiated breastfeeding, and 11.0 % of mothers had their delivery paid for by public health insurance. Using clinical data from the CENTURY Study, 22.7 % of children had a weight-for-length ≥ 95(th) percentile between 1 and 24 months and 12.0 % of children had a body mass index ≥ 95(th) percentile at ages 5 and 17 years. By linking routinely-collected data sources, it is possible to address research questions that could not be answered with either source alone. Linkage between a clinical

  16. Associations between Mental Health Problems and Challenging Behavior in Adults with Intellectual Disabilities: A Test of the Behavioral Equivalents Hypothesis

    Science.gov (United States)

    Painter, Jon; Hastings, Richard; Ingham, Barry; Trevithick, Liam; Roy, Ashok

    2018-01-01

    Introduction: Current research findings in the field of intellectual disabilities (ID) regarding the relationship between mental health problems and challenging behavior are inconclusive and/or contradictory. The aim of this study was to further investigate the putative association between these two highly prevalent phenomena in people with ID,…

  17. Linking individual medicare health claims data with work-life claims and other administrative data.

    Science.gov (United States)

    Mokyr Horner, Elizabeth; Cullen, Mark R

    2015-09-30

    Researchers investigating health outcomes for populations over age 65 can utilize Medicare claims data, but these data include no direct information about individuals' health prior to age 65 and are not typically linkable to files containing data on exposures and behaviors during their worklives. The current paper is a proof-of-concept, of merging employers' administrative data and private, employment-based health claims with Medicare data. Characteristics of the linked data, including sensitivity and specificity, are evaluated with an eye toward potential uses of such linked data. This paper uses a sample of former manufacturing workers from an industrial cohort as a test case. The dataset created by this integration could be useful to research in areas such as social epidemiology and occupational health. Medicare and employment administrative data were linked for a large cohort of manufacturing workers (employed at some point during 1996-2008) who transitioned onto Medicare between 2001-2009. Data on work-life health, including biometric indicators, were used to predict health at age 65 and to investigate the concordance of employment-based insurance claims with subsequent Medicare insurance claims. Chronic diseases were found to have relatively high levels of concordance between employment-based private insurance and subsequent Medicare insurance. Information about patient health prior to receipt of Medicare, including biometric indicators, were found to predict health at age 65. Combining these data allows for evaluation of continuous health trajectories, as well as modeling later-life health as a function of work-life behaviors and exposures. It also provides a potential endpoint for occupational health research. This is the first harmonization of its kind, providing a proof-of-concept. The dataset created by this integration could be useful for research in areas such as social epidemiology and occupational health.

  18. Socioeconomic inequalities in informal payments for health care: An assessment of the 'Robin Hood' hypothesis in 33 African countries.

    Science.gov (United States)

    Kankeu, Hyacinthe Tchewonpi; Ventelou, Bruno

    2016-02-01

    In almost all African countries, informal payments are frequently made when accessing health care. Some literature suggests that the informal payment system could lead to quasi-redistribution among patients, with physicians playing a 'Robin Hood' role, subsidizing the poor at the expense of the rich. We empirically tested this assumption with data from the rounds 3 and 5 of the Afrobarometer surveys conducted in 18 and 33 African countries respectively, from 2005 to 2006 for round 3 and from 2011 to 2013 for round 5. In these surveys, nationally representative samples of people aged 18 years or more were randomly selected in each country, with sizes varying between 1048 and 2400 for round 3 and between 1190 and 2407 for round 5. We used the 'normalized' concentration index, the poor/rich gap and the odds ratio to assess the level of inequality in the payment of bribes to access care at the local public health facility and implemented two decomposition techniques to identify the contributors to the observed inequalities. We obtained that: i) the socioeconomic gradient in informal payments is in favor of the rich in almost all countries, indicating a rather regressive system; ii) this is mainly due to the socioeconomic disadvantage itself, to poor/rich differences in supply side factors like lack of medicines, absence of doctors and long waiting times, as well as regional disparities. Although essentially empirical, the paper highlights the need for African health systems to undergo substantial country-specific reforms in order to better protect the worse-off from financial risk when they seek care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Making effective links to decision-making: Key challenges for health impact assessment

    International Nuclear Information System (INIS)

    Elliott, Eva; Francis, Sarah

    2005-01-01

    This paper draws on an exploratory research study to examine the effectiveness of health impact assessments in Wales. Through the review of five case study health impact assessments the research identified a number of benefits of the process in terms of skills and knowledge development amongst participants. The indirect contributions to decision-making were also evident including the way in which health impact assessment provided useful insights into the local community's perspective and raised awareness about the wider determinants of health. The process was also useful in establishing a dialogue between different stakeholders, which indirectly assisted decision-making and implementation. The direct links between health impact assessment and decision-making were more difficult to trace and this paper puts forward a number of suggestions for making those links more transparent. Suggestions include integrating decision-makers and clarifying the intended links to decision-making at the start of the health impact assessment process. Mainstreaming health impact assessment so that it is triggered as a routine part of all decision-making would help ensure it stands the best chance of informing decisions

  20. Exposure to bisphenol A and gender differences: from rodents to humans evidences and hypothesis about the health effects

    Directory of Open Access Journals (Sweden)

    Lidia Caporossi

    2015-11-01

    Full Text Available Bisphenol A (BPA interacts with the endocrine system and seems to produce different effects in relation to gender. The objective of the study was to clarify the possible health effects of exposure to BPA in relation to gender. A literature search was performed using three different search engines: Medline, PubMed and Scopus. Data on both animals and humans showed that BPA acts as a xenoestrogen and interacts with the androgens’ metabolism, producing different outcomes: uterotropic effects, decreasing sperm production, stimulation of prolactin release. Gender difference plays a key role in understanding the real toxic effects, the BPA serum concentrations were, all the time, higher in male subjects, possibly due to the difference in androgen-related enzyme activity levels, compared with the healthly female subjects, to equal levels of exposure; while higher BPA levels in women have been associated with a variety of conditions including obesity, endometrial hyperplasia, recurrent miscarriages, and polycystic ovarian syndrome. The data collected are sufficiently robust to raise concerns about the potentially deleterious impact of BPA on humans, even with some methodological limitations; the different impact of BPA in men and in women is documented and of a certain interest. In toxicology it is necessary to assess effects in relation to gender differences, in order to set up prevention plans in the work environment targeting the specific risk.

  1. Investigating the work-family conflict and health link: Repetitive thought as a mechanism.

    Science.gov (United States)

    Davis, Kelly D; Gere, Judith; Sliwinski, Martin J

    2017-10-01

    Research is needed to investigate mechanisms linking work-family conflict to poor health in working adults. We took a novel approach to build on extant studies by testing a potential mechanism in these associations - repetitive thought. Data came from a sample of 203 partnered working adults. There were significant direct effects of work-family conflict with lower life satisfaction, positive affect, and perceived health as well as greater fatigue. As for total effects, work-family conflict was significantly associated with all health outcomes - life satisfaction, positive affect, negative affect, fatigue, perceived health, and chronic health conditions - in the expected directions through repetitive thought. This study provides support that repetitive thought is one potential mechanism of how work-family conflict can take a toll on psychological and physical health. Findings are discussed in relation to improving workplace policies to improve the health of working adults managing work-family conflict. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Public views on the links between air pollution and health in Northeast England

    International Nuclear Information System (INIS)

    Howel, Denise; Moffatt, Suzanne; Bush, Judith; Unn, C.E.; Prince, Helen

    2003-01-01

    We investigated how public perceptions of the links between air pollution and health varied with contextual factors describing individuals and their locality. Information was collected via postal surveys on 2744 adults resident in five neighborhoods in Northeast England. Perceptions were compared by individual factors (health status, age, and gender) and locality actors (relative deprivation, proximity to industry and district--Teesside r Sunderland, with different amounts of heavy industry). There was relatively little variation in views about air pollution and health links between neighborhoods. The greatest contrasts were found when comparing those living near or further from industry and between the two districts. Any differences were related more to awareness of illness in the neighborhood thought to be affected by air pollution, rather than belief that a particular disease was linked to air pollution. Chronic illness status and age were sometimes found to be associated with perceptions of disease affected by air pollution, but gender and material deprivation were not central to differences in risk perceptions among the population studied. In understanding public perceptions about the links between air quality and health, research should focus on the characteristics of places as well as of people

  3. Understanding the links between ecosystem health and social system well-being: an annotated bibliography.

    Science.gov (United States)

    Dawn M. Elmer; Harriet H. Christensen; Ellen M. Donoghue; [Compilers].

    2002-01-01

    This bibliography focuses on the links between social system well-being and ecosystem health. It is intended for public land managers and scientists and students of social and natural sciences. Multidisciplinary science that addresses the interconnections between the social system and the ecosystem is presented. Some of the themes and strategies presented are policy...

  4. Establishing the link between Ostreopsis cf.ovata blooms and human health impacts using ecology and epidemiology

    Directory of Open Access Journals (Sweden)

    Magda Vila

    2016-09-01

    Full Text Available Blooms of the benthic dinoflagellate Ostreopsis have been related to sporadic acute respiratory symptoms and general malaise in people exposed to marine aerosols on some Mediterranean beaches. However, the direct link between recurrent Ostreopsis blooms and health problems has not been clearly established. In order to establish and elucidate the connection, we conducted a joint ecology and epidemiology study in an Ostreopsis hot spot. Throughout the bloom, which extended from the end of June until the end of October 2013, 81% of the human cohort that we studied experienced at least one Ostreopsis-related symptom. Paradoxically, the time when the effects were greatest was during a short time window in early August. This corresponded to the transition from the exponential growth to the stationary phase of the bloom. Negligible symptoms were reported from August to mid-October, during the stationary period of the proliferation, when O. cf. ovata maintained high concentrations of epiphytic cells. No clear patterns in the landward wind component were noted during the time when health effects were greatest. Our main hypothesis is that the irritants present in the aerosol are produced during a particular physiological phase of the Ostreopsis cells during the bloom.

  5. Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans.

    Science.gov (United States)

    Mama, Scherezade K; Li, Yisheng; Basen-Engquist, Karen; Lee, Rebecca E; Thompson, Deborah; Wetter, David W; Nguyen, Nga T; Reitzel, Lorraine R; McNeill, Lorna H

    2016-01-01

    Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans.

  6. Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans.

    Directory of Open Access Journals (Sweden)

    Scherezade K Mama

    Full Text Available Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467 completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination, and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p < .001 and U.S. (p < .001 and low social support (p < .001 were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans.

  7. Examining age-related shared variance between face cognition, vision, and self-reported physical health: a test of the common cause hypothesis for social cognition

    Science.gov (United States)

    Olderbak, Sally; Hildebrandt, Andrea; Wilhelm, Oliver

    2015-01-01

    The shared decline in cognitive abilities, sensory functions (e.g., vision and hearing), and physical health with increasing age is well documented with some research attributing this shared age-related decline to a single common cause (e.g., aging brain). We evaluate the extent to which the common cause hypothesis predicts associations between vision and physical health with social cognition abilities specifically face perception and face memory. Based on a sample of 443 adults (17–88 years old), we test a series of structural equation models, including Multiple Indicator Multiple Cause (MIMIC) models, and estimate the extent to which vision and self-reported physical health are related to face perception and face memory through a common factor, before and after controlling for their fluid cognitive component and the linear effects of age. Results suggest significant shared variance amongst these constructs, with a common factor explaining some, but not all, of the shared age-related variance. Also, we found that the relations of face perception, but not face memory, with vision and physical health could be completely explained by fluid cognition. Overall, results suggest that a single common cause explains most, but not all age-related shared variance with domain specific aging mechanisms evident. PMID:26321998

  8. Examining Age-Related Shared Variance Between Face Cognition, Vision, and Self-Reported Physical Health: A Test of the Common Cause Hypothesis for Social Cognition

    Directory of Open Access Journals (Sweden)

    Sally eOlderbak

    2015-08-01

    Full Text Available The shared decline in cognitive abilities, sensory functions (e.g., vision and hearing, and physical health with increasing age is well documented with some research attributing this shared age-related decline to a single common cause (e.g., aging brain. We evaluate the extent to which the common cause hypothesis predicts associations between vision and physical health with social cognition abilities, specifically face perception and face memory. Based on a sample of 443 adults (17 to 88 years old, we test a series of structural equation models, including Multiple Indicator Multiple Cause (MIMIC models, and estimate the extent to which vision and self-reported physical health are related to face perception and face memory through a common factor, before and after controlling for their fluid cognitive component and the linear effects of age. Results suggest significant shared variance amongst these constructs, with a common factor explaining some, but not all, of the shared age-related variance. Also, we found that the relations of face perception, but not face memory, with vision and physical health could be completely explained by fluid cognition. Overall, results suggest that a single common cause explains most, but not all age-related shared variance with domain specific aging mechanisms evident.

  9. Clarifying the links between social support and health: culture, stress, and neuroticism matter.

    Science.gov (United States)

    Park, Jiyoung; Kitayama, Shinobu; Karasawa, Mayumi; Curhan, Katherine; Markus, Hazel R; Kawakami, Norito; Miyamoto, Yuri; Love, Gayle D; Coe, Christopher L; Ryff, Carol D

    2013-02-01

    Although it is commonly assumed that social support positively predicts health, the empirical evidence has been inconsistent. We argue that three moderating factors must be considered: (1) support-approving norms (cultural context); (2) support-requiring situations (stressful events); and (3) support-accepting personal style (low neuroticism). Our large-scale cross-cultural survey of Japanese and US adults found significant associations between perceived support and health. The association was more strongly evident among Japanese (from a support-approving cultural context) who reported high life stress (in a support-requiring situation). Moreover, the link between support and health was especially pronounced if these Japanese were low in neuroticism.

  10. Health risk assessment linked with purified biogas injection in a natural gas distribution system

    International Nuclear Information System (INIS)

    Leroux, Carole; Modelon, Hugues; Rousselle, Christophe; Zdanevitch, Isabelle; Evanno, Sebastien

    2009-06-01

    This document provides for the opinion of the French Agency for Environmental and Occupational Health and Safety (Afsset) expressed after the collective expertise carried out for the evaluation of the health risk linked with biogas injection in the natural gas distribution system. Following the recommendations issued by the Afsset, works have been started in order to collect the sludge-derived biogas and to analyse its composition. These data will be used to assess accidental risks (resulting from biogas valorisation, pipeline transport, industrial and domestic energy valorisation) as well as health risks for users (resulting from the injection in the natural gas distribution system)

  11. Pathway Linking Internet Health Information Seeking to Better Health: A Moderated Mediation Study.

    Science.gov (United States)

    Jiang, Shaohai; Street, Richard L

    2017-08-01

    The Internet increasingly has been recognized as an important medium with respect to population health. However, little is known about the mechanisms that underlie the potential impact of health-related Internet use on health outcomes. Based on the three-stage model of health promotion using interactive media, this study empirically tested a moderated mediation pathway model. Results showed that the effect of Internet health information seeking on three health outcomes (general, emotional, and physical) was completely mediated by respondents' access to social support resources. In addition, users' online health information seeking experience positively moderated this mediation path. The findings have significant theoretical and practical implications for the design of Internet-based health promotion resources to improve health outcomes.

  12. The link between health governance models and global health innovation: an exploration of OECD nations.

    Science.gov (United States)

    Schnarr, Karin; Snowdon, Anne; Cramm, Heidi; Cohen, Jason; Alessi, Charles

    2015-01-01

    While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations. We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, The Netherlands, Switzerland, and the United States). Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition. Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.

  13. THE FRACTAL MARKET HYPOTHESIS

    OpenAIRE

    FELICIA RAMONA BIRAU

    2012-01-01

    In this article, the concept of capital market is analysed using Fractal Market Hypothesis which is a modern, complex and unconventional alternative to classical finance methods. Fractal Market Hypothesis is in sharp opposition to Efficient Market Hypothesis and it explores the application of chaos theory and fractal geometry to finance. Fractal Market Hypothesis is based on certain assumption. Thus, it is emphasized that investors did not react immediately to the information they receive and...

  14. Variability: A Pernicious Hypothesis.

    Science.gov (United States)

    Noddings, Nel

    1992-01-01

    The hypothesis of greater male variability in test results is discussed in its historical context, and reasons feminists have objected to the hypothesis are considered. The hypothesis acquires political importance if it is considered that variability results from biological, rather than cultural, differences. (SLD)

  15. Making the links: do we connect climate change with health? A qualitative case study from Canada.

    Science.gov (United States)

    Cardwell, Francesca S; Elliott, Susan J

    2013-03-08

    Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an environmental to a health issue. This paper builds on calls for increased understanding of the public's views of human health risks associated with climate change, focusing on facilitators and barriers to behaviour change. Semi-structured in-depth interviews (n = 22) with residents of the Golden Horseshoe region of Southern Ontario were conducted between August 2010 and January 2011. Topics included individual and community health, climate change, and facilitators and barriers to behaviour change. Few participants recognized the role of the environment in the context of either individual and community health. When asked about health concerns specific to their community, however, environmental issues were mentioned frequently. Health effects as possible impacts of global environmental change were mentioned by 77% of participants when prompted, but this link was not described in great detail or within the context of impacting their communities or themselves. Participants were willing to act in environmentally friendly ways, and possible incentives to undertake behaviour change such as decreasing cost were described. Health co-benefits were not identified as incentives to engaging in mitigative or adaptive behaviours. The results support recent calls for reframing the impact of climate change from an environmental to a public health issue in order to increase public engagement in adaptive and mitigative behaviour change. While previous research has touched on public awareness of the

  16. Operative Links

    DEFF Research Database (Denmark)

    Wistoft, Karen; Højlund, Holger

    2012-01-01

    educational goals, learning content, or value clarification. Health pedagogy is often a matter of retrospective rationalization rather than the starting point of planning. Health and risk behaviour approaches override health educational approaches. Conclusions: Operational links between health education......, health professionalism, and management strategies pose the foremost challenge. Operational links indicates cooperative levels that facilitate a creative and innovative effort across traditional professional boundaries. It is proposed that such links are supported by network structures, shared semantics...

  17. Linking human health and livestock health: a "one-health" platform for integrated analysis of human health, livestock health, and economic welfare in livestock dependent communities.

    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

  18. Linking human health and livestock health: a "one-health" platform for integrated analysis of human health, livestock health, and economic welfare in livestock dependent communities.

    Science.gov (United States)

    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

  19. THE FRACTAL MARKET HYPOTHESIS

    Directory of Open Access Journals (Sweden)

    FELICIA RAMONA BIRAU

    2012-05-01

    Full Text Available In this article, the concept of capital market is analysed using Fractal Market Hypothesis which is a modern, complex and unconventional alternative to classical finance methods. Fractal Market Hypothesis is in sharp opposition to Efficient Market Hypothesis and it explores the application of chaos theory and fractal geometry to finance. Fractal Market Hypothesis is based on certain assumption. Thus, it is emphasized that investors did not react immediately to the information they receive and of course, the manner in which they interpret that information may be different. Also, Fractal Market Hypothesis refers to the way that liquidity and investment horizons influence the behaviour of financial investors.

  20. Health and Environment Linked for Information Exchange in Atlanta (HELIX-Atlanta): A Pilot Tracking System

    Science.gov (United States)

    Rickman, Doug; Shire, J.; Qualters, J.; Mitchell, K.; Pollard, S.; Rao, R.; Kajumba, N.; Quattrochi, D.; Estes, M., Jr.; Meyer, P.; hide

    2009-01-01

    Objectives. To provide an overview of four environmental public health surveillance projects developed by CDC and its partners for the Health and Environment Linked for Information Exchange, Atlanta (HELIX-Atlanta) and to illustrate common issues and challenges encountered in developing an environmental public health tracking system. Methods. HELIX-Atlanta, initiated in October 2003 to develop data linkage and analysis methods that can be used by the National Environmental Public Health Tracking Network (Tracking Network), conducted four projects. We highlight the projects' work, assess attainment of the HELIX-Atlanta goals and discuss three surveillance attributes. Results. Among the major challenges was the complexity of analytic issues which required multidiscipline teams with technical expertise. This expertise and the data resided across multiple organizations. Conclusions:Establishing formal procedures for sharing data, defining data analysis standards and automating analyses, and committing staff with appropriate expertise is needed to support wide implementation of environmental public health tracking.

  1. Oceans and Human Health: Linking Ocean, Organism, and Human Health for Sustainable Management of Coastal Ecosystems

    Science.gov (United States)

    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

  2. MedlinePlus Connect: Linking Patient Portals and Electronic Health Records to Health Information

    Science.gov (United States)

    ... Here: Home → MedlinePlus Connect URL of this page: https://medlineplus.gov/connect/overview.html MedlinePlus Connect Linking ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  3. Health literacy: the missing link in improving the health of Somali immigrant women in Oslo.

    Science.gov (United States)

    Gele, Abdi A; Pettersen, Kjell Sverre; Torheim, Liv Elin; Kumar, Bernadette

    2016-11-03

    Existing studies report a positive association between inadequate health literacy and immigrant's adverse health outcomes. Despite substantial research on this topic among immigrants, little is known about the level of health literacy among Somali women in Europe, and particularly in Norway. A cross sectional study using respondent driven sampling was conducted in Oslo, Norway. A sample of 302 Somali women, 25 years and older, was interviewed using the short version of the European Health Literacy Questionnaire. Data was analysed using logistic regression. Findings revealed that 71 % of Somali women in Oslo lack the ability to obtain, understand and act upon health information and services, and to make appropriate health decisions. Being unemployed (OR 3.66, CI 1.08-12.3) and socially less integrated (OR 8.17, CI 1.21-54.8) were independent predictors of an inadequate health literacy among Somali women. Enhanced health literacy will most likely increase the chance to better health outcomes for immigrants, thereby moving towards health equity in the Norwegian society. Therefore, policies and programs are required to focus and improve health literacy of immigrant communities.

  4. Health literacy: the missing link in improving the health of Somali immigrant women in Oslo

    Directory of Open Access Journals (Sweden)

    Abdi A. Gele

    2016-11-01

    Full Text Available Abstract Background Existing studies report a positive association between inadequate health literacy and immigrant’s adverse health outcomes. Despite substantial research on this topic among immigrants, little is known about the level of health literacy among Somali women in Europe, and particularly in Norway. Methods A cross sectional study using respondent driven sampling was conducted in Oslo, Norway. A sample of 302 Somali women, 25 years and older, was interviewed using the short version of the European Health Literacy Questionnaire. Data was analysed using logistic regression. Results Findings revealed that 71 % of Somali women in Oslo lack the ability to obtain, understand and act upon health information and services, and to make appropriate health decisions. Being unemployed (OR 3.66, CI 1.08–12.3 and socially less integrated (OR 8.17, CI 1.21–54.8 were independent predictors of an inadequate health literacy among Somali women. Conclusions Enhanced health literacy will most likely increase the chance to better health outcomes for immigrants, thereby moving towards health equity in the Norwegian society. Therefore, policies and programs are required to focus and improve health literacy of immigrant communities.

  5. Linking data sources for measurement of effective coverage in maternal and newborn health: what do we learn from individual- vs ecological-linking methods?

    Science.gov (United States)

    Willey, Barbara; Waiswa, Peter; Kajjo, Darious; Munos, Melinda; Akuze, Joseph; Allen, Elizabeth; Marchant, Tanya

    2018-06-01

    Improving maternal and newborn health requires improvements in the quality of facility-based care. This is challenging to measure: routine data may be unreliable; respondents in population surveys may be unable to accurately report on quality indicators; and facility assessments lack population level denominators. We explored methods for linking access to skilled birth attendance (SBA) from household surveys to data on provision of care from facility surveys with the aim of estimating population level effective coverage reflecting access to quality care. We used data from Mayuge District, Uganda. Data from household surveys on access to SBA were linked to health facility assessment census data on readiness to provide basic emergency obstetric and newborn care (BEmONC) in the same district. One individual- and two ecological-linking methods were applied. All methods used household survey reports on where care at birth was accessed. The individual-linking method linked this to data about facility readiness from the specific facility where each woman delivered. The first ecological-linking approach used a district-wide mean estimate of facility readiness. The second used an estimate of facility readiness adjusted by level of health facility accessed. Absolute differences between estimates derived from the different linking methods were calculated, and agreement examined using Lin's concordance correlation coefficient. A total of 1177 women resident in Mayuge reported a birth during 2012-13. Of these, 664 took place in facilities within Mayuge, and were eligible for linking to the census of the district's 38 facilities. 55% were assisted by a SBA in a facility. Using the individual-linking method, effective coverage of births that took place with an SBA in a facility ready to provide BEmONC was just 10% (95% confidence interval CI 3-17). The absolute difference between the individual- and ecological-level linking method adjusting for facility level was one percentage

  6. Linking Environmental Sustainability, Health, and Safety Data in Health Care: A Research Roadmap.

    Science.gov (United States)

    Kaplan, Susan B; Forst, Linda

    2017-08-01

    Limited but growing evidence demonstrates that environmental sustainability in the health-care sector can improve worker and patient health and safety. Yet these connections are not appreciated or understood by decision makers in health-care organizations or oversight agencies. Several studies demonstrate improvements in quality of care, staff satisfaction, and work productivity related to environmental improvements in the health-care sector. A pilot study conducted by the authors found that already-collected data could be used to evaluate impacts of environmental sustainability initiatives on worker and patient health and safety, yet few hospitals do so. Future research should include a policy analysis of laws that could drive efforts to integrate these areas, elucidation of organizational models that promote sharing of environmental and health and safety data, and development of tools and methods to enable systematic linkage and evaluation of these data to expand the evidence base and improve the hospital environment.

  7. The rise of global health diplomacy: An interdisciplinary concept linking health and international relations.

    Science.gov (United States)

    Chattu, Vijay Kumar

    2017-01-01

    Global health diplomacy (GHD) is relatively a very new field that has yet to be clearly defined and developed though there are various definitions given by different experts from foreign policy, global health, diplomacy, international relations, governance, and law. With the intensification of globalization and increasing gaps between countries, new and reemerging health threats such as HIV/AIDS, tuberculosis, influenza, severe acute respiratory syndrome, Ebola, and Zika and a gradual rethinking on security concepts framed a new political context. The health problems addressed diplomatically have also become diverse ranging from neglected tropical diseases, infectious diseases, sale of unsafe, counterfeit drugs to brain drain crisis. We see that global health has become more diverse as the actors widened and also the interests appealing not only to the traditional humanitarian ideals associated with health but also to the principles grounded in national and global security. Recently, we are witnessing the increased priority given to the GHD because the issue of health is discussed by various actors outside the WHO to shape the global policy for health determinants. In fact, the area of health has become the part of UN Summit Diplomacy involving the G8, G20, BRICS, and the EU. The recent WHO Pandemic Influenza Framework, UN High Level Framework on Prevention and Control of Noncommunicable Diseases, and the WHO Framework Convention on Tobacco Control are some of the examples of long-term negotiation processes for agreements that took place.

  8. Carbohydrates, Dietary Fiber, and Resistant Starch in White Vegetables: Links to Health Outcomes12

    OpenAIRE

    Slavin, Joanne L.

    2013-01-01

    Vegetables are universally promoted as healthy. Dietary Guidelines for Americans 2010 recommend that you make half of your plate fruits and vegetables. Vegetables are diverse plants that vary greatly in energy content and nutrients. Vegetables supply carbohydrates, dietary fiber, and resistant starch in the diet, all of which have been linked to positive health outcomes. Fiber lowers the incidence of cardiovascular disease and obesity. In this paper, the important role of white vegetables in ...

  9. Role of the police in linking individuals experiencing mental health crises with mental health services

    NARCIS (Netherlands)

    van den Brink, Rob H. S.; Broer, Jan; Tholen, Alfons J.; Winthorst, Wim H.; Visser, Ellen; Wiersma, Durk

    2012-01-01

    Background: The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing

  10. The link between workforce health and safety and the health of the bottom line: tracking market performance of companies that nurture a "culture of health".

    Science.gov (United States)

    Fabius, Raymond; Thayer, R Dixon; Konicki, Doris L; Yarborough, Charles M; Peterson, Kent W; Isaac, Fikry; Loeppke, Ronald R; Eisenberg, Barry S; Dreger, Marianne

    2013-09-01

    To test the hypothesis that comprehensive efforts to reduce a workforce's health and safety risks can be associated with a company's stock market performance. Stock market performance of Corporate Health Achievement Award winners was tracked under four different scenarios using simulation and past market performance. A portfolio of companies recognized as award winning for their approach to the health and safety of their workforce outperformed the market. Evidence seems to support that building cultures of health and safety provides a competitive advantage in the marketplace. This research may have also identified an association between companies that focus on health and safety and companies that manage other aspects of their business equally well. Companies that build a culture of health by focusing on the well-being and safety of their workforce yield greater value for their investors.

  11. A framework linking community empowerment and health equity: it is a matter of CHOICE.

    Science.gov (United States)

    Rifkin, Susan B

    2003-09-01

    This paper presents a framework to explore the relationship between health equity and community empowerment. It traces the progression of the concept of participation to the present term of empowerment and the links among empowerment, equity, and health outcomes. It argues that the relationship can best be described by using the acronym CHOICE (Capacity-building, Human rights, Organizational sustainability, Institutional accountability, Contribution, and Enabling environment). Based on the concept of development as freedom put forward by Nobel Laureate Amartya Sen, the paper describes how each factor illustrates the relationship between equity and empowerment in positive health outcomes, giving appropriate examples. In conclusion, it is suggested that these factors might form the basis of a tool to assess the relationship between equity and empowerment and its impact on health outcomes.

  12. Linking Illness in Parents to Health Anxiety in Offspring: Do Beliefs about Health Play a Role?

    Science.gov (United States)

    Alberts, Nicole M; Hadjistavropoulos, Heather D; Sherry, Simon B; Stewart, Sherry H

    2016-01-01

    The cognitive behavioural (CB) model of health anxiety proposes parental illness leads to elevated health anxiety in offspring by promoting the acquisition of specific health beliefs (e.g. overestimation of the likelihood of illness). Our study tested this central tenet of the CB model. Participants were 444 emerging adults (18-25-years-old) who completed online measures and were categorized into those with healthy parents (n = 328) or seriously ill parents (n = 116). Small (d = .21), but significant, elevations in health anxiety, and small to medium (d = .40) elevations in beliefs about the likelihood of illness were found among those with ill vs. healthy parents. Mediation analyses indicated the relationship between parental illness and health anxiety was mediated by beliefs regarding the likelihood of future illness. Our study incrementally advances knowledge by testing and supporting a central proposition of the CB model. The findings add further specificity to the CB model by highlighting the importance of a specific health belief as a central contributor to health anxiety among offspring with a history of serious parental illness.

  13. Linking international research to global health equity: the limited contribution of bioethics.

    Science.gov (United States)

    Pratt, Bridget; Loff, Bebe

    2013-05-01

    Health research has been identified as a vehicle for advancing global justice in health. However, in bioethics, issues of global justice are mainly discussed within an ongoing debate on the conditions under which international clinical research is permissible. As a result, current ethical guidance predominantly links one type of international research (biomedical) to advancing one aspect of health equity (access to new treatments). International guidelines largely fail to connect international research to promoting broader aspects of health equity - namely, healthier social environments and stronger health systems. Bioethical frameworks such as the human development approach do consider how international clinical research is connected to the social determinants of health but, again, do so to address the question of when international clinical research is permissible. It is suggested that the narrow focus of this debate is shaped by high-income countries' economic strategies. The article further argues that the debate's focus obscures a stronger imperative to consider how other types of international research might advance justice in global health. Bioethics should consider the need for non-clinical health research and its contribution to advancing global justice. © 2011 Blackwell Publishing Ltd.

  14. Linking mothers and infants within electronic health records: a comparison of deterministic and probabilistic algorithms.

    Science.gov (United States)

    Baldwin, Eric; Johnson, Karin; Berthoud, Heidi; Dublin, Sascha

    2015-01-01

    To compare probabilistic and deterministic algorithms for linking mothers and infants within electronic health records (EHRs) to support pregnancy outcomes research. The study population was women enrolled in Group Health (Washington State, USA) delivering a liveborn infant from 2001 through 2008 (N = 33,093 deliveries) and infant members born in these years. We linked women to infants by surname, address, and dates of birth and delivery using deterministic and probabilistic algorithms. In a subset previously linked using "gold standard" identifiers (N = 14,449), we assessed each approach's sensitivity and positive predictive value (PPV). For deliveries with no "gold standard" linkage (N = 18,644), we compared the algorithms' linkage proportions. We repeated our analyses in an independent test set of deliveries from 2009 through 2013. We reviewed medical records to validate a sample of pairs apparently linked by one algorithm but not the other (N = 51 or 1.4% of discordant pairs). In the 2001-2008 "gold standard" population, the probabilistic algorithm's sensitivity was 84.1% (95% CI, 83.5-84.7) and PPV 99.3% (99.1-99.4), while the deterministic algorithm had sensitivity 74.5% (73.8-75.2) and PPV 95.7% (95.4-96.0). In the test set, the probabilistic algorithm again had higher sensitivity and PPV. For deliveries in 2001-2008 with no "gold standard" linkage, the probabilistic algorithm found matched infants for 58.3% and the deterministic algorithm, 52.8%. On medical record review, 100% of linked pairs appeared valid. A probabilistic algorithm improved linkage proportion and accuracy compared to a deterministic algorithm. Better linkage methods can increase the value of EHRs for pregnancy outcomes research. Copyright © 2014 John Wiley & Sons, Ltd.

  15. Physiopathological Hypothesis of Cellulite

    Science.gov (United States)

    de Godoy, José Maria Pereira; de Godoy, Maria de Fátima Guerreiro

    2009-01-01

    A series of questions are asked concerning this condition including as regards to its name, the consensus about the histopathological findings, physiological hypothesis and treatment of the disease. We established a hypothesis for cellulite and confirmed that the clinical response is compatible with this hypothesis. Hence this novel approach brings a modern physiological concept with physiopathologic basis and clinical proof of the hypothesis. We emphasize that the choice of patient, correct diagnosis of cellulite and the technique employed are fundamental to success. PMID:19756187

  16. Life Origination Hydrate Hypothesis (LOH-Hypothesis

    Directory of Open Access Journals (Sweden)

    Victor Ostrovskii

    2012-01-01

    Full Text Available The paper develops the Life Origination Hydrate Hypothesis (LOH-hypothesis, according to which living-matter simplest elements (LMSEs, which are N-bases, riboses, nucleosides, nucleotides, DNA- and RNA-like molecules, amino-acids, and proto-cells repeatedly originated on the basis of thermodynamically controlled, natural, and inevitable processes governed by universal physical and chemical laws from CH4, niters, and phosphates under the Earth's surface or seabed within the crystal cavities of the honeycomb methane-hydrate structure at low temperatures; the chemical processes passed slowly through all successive chemical steps in the direction that is determined by a gradual decrease in the Gibbs free energy of reacting systems. The hypothesis formulation method is based on the thermodynamic directedness of natural movement and consists ofan attempt to mentally backtrack on the progression of nature and thus reveal principal milestones alongits route. The changes in Gibbs free energy are estimated for different steps of the living-matter origination process; special attention is paid to the processes of proto-cell formation. Just the occurrence of the gas-hydrate periodic honeycomb matrix filled with LMSEs almost completely in its final state accounts for size limitation in the DNA functional groups and the nonrandom location of N-bases in the DNA chains. The slowness of the low-temperature chemical transformations and their “thermodynamic front” guide the gross process of living matter origination and its successive steps. It is shown that the hypothesis is thermodynamically justified and testable and that many observed natural phenomena count in its favor.

  17. Building policy capacities: an interactive approach for linking knowledge to action in health promotion.

    Science.gov (United States)

    Rütten, Alfred; Gelius, Peter

    2014-09-01

    This article outlines a theoretical framework for an interactive, research-driven approach to building policy capacities in health promotion. First, it illustrates how two important issues in the recent public health debate, capacity building and linking scientific knowledge to policy action, are connected to each other theoretically. It then introduces an international study on an interactive approach to capacity building in health promotion policy. The approach combines the ADEPT model of policy capacities with a co-operative planning process to foster the exchange of knowledge between policy-makers and researchers, thus improving intra- and inter-organizational capacities. A regional-level physical activity promotion project involving governmental and public-law institutions, NGOs and university researchers serves as a case study to illustrate the potential of the approach for capacity building. Analysis and comparison with a similar local-level project indicate that the approach provides an effective means of linking scientific knowledge to policy action and to planning concrete measures for capacity building in health promotion, but that it requires sufficiently long timelines and adequate resources to achieve adequate implementation and sustainability. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Whiplash and the compensation hypothesis.

    Science.gov (United States)

    Spearing, Natalie M; Connelly, Luke B

    2011-12-01

    Review article. To explain why the evidence that compensation-related factors lead to worse health outcomes is not compelling, either in general, or in the specific case of whiplash. There is a common view that compensation-related factors lead to worse health outcomes ("the compensation hypothesis"), despite the presence of important, and unresolved sources of bias. The empirical evidence on this question has ramifications for the design of compensation schemes. Using studies on whiplash, this article outlines the methodological problems that impede attempts to confirm or refute the compensation hypothesis. Compensation studies are prone to measurement bias, reverse causation bias, and selection bias. Errors in measurement are largely due to the latent nature of whiplash injuries and health itself, a lack of clarity over the unit of measurement (specific factors, or "compensation"), and a lack of appreciation for the heterogeneous qualities of compensation-related factors and schemes. There has been a failure to acknowledge and empirically address reverse causation bias, or the likelihood that poor health influences the decision to pursue compensation: it is unclear if compensation is a cause or a consequence of poor health, or both. Finally, unresolved selection bias (and hence, confounding) is evident in longitudinal studies and natural experiments. In both cases, between-group differences have not been addressed convincingly. The nature of the relationship between compensation-related factors and health is unclear. Current approaches to testing the compensation hypothesis are prone to several important sources of bias, which compromise the validity of their results. Methods that explicitly test the hypothesis and establish whether or not a causal relationship exists between compensation factors and prolonged whiplash symptoms are needed in future studies.

  19. Data Mashups: Linking Human Health and Wellbeing with Weather, Climate and the Environment

    Science.gov (United States)

    Fleming, L. E.; Sarran, C.; Golding, B.; Haines, A.; Kessel, A.; Djennad, M.; Hajat, S.; Nichols, G.; Gordon Brown, H.; Depledge, M.

    2016-12-01

    A large part of the global disease burden can be linked to environmental factors, underpinned by unhealthy behaviours. Research into these linkages suffers from lack of common tools and databases for investigations across many different scientific disciplines to explore these complex associations. The MEDMI (Medical and Environmental Data-a Mash-up Infrastructure) Partnership brings together leading organisations and researchers in climate, weather, environment, and human health. We have created a proof-of-concept central data and analysis system with the UK Met Office and Public Health England data as the internet-based MEDMI Platform (www.data-mashup.org.uk) to serve as a common resource for researchers to link and analyse complex meteorological, environmental and epidemiological data in the UK. The Platform is hosted on its own dedicated server, with secure internet and in-person access with appropriate safeguards for ethical, copyright, security, preservation, and data sharing issues. Via the Platform, there is a demonstration Browser Application with access to user-selected subsets of the data for: a) analyses using time series (e.g. mortality/environmental variables), and b) data visualizations (e.g. infectious diseases/environmental variables). One demonstration project is linking climate change, harmful algal blooms and oceanographic modelling building on the hydrodynamic-biogeochemical coupled models; in situ and satellite observations as well as UK HAB data and hospital episode statistics data are being used for model verification and future forecasting. The MEDMI Project provides a demonstration of the potential, barriers and challenges, of these "data mashups" of environment and health data. Although there remain many challenges to creating and sustaining such a shared resource, these activities and resources are essential to truly explore the complex interactions between climate and other environmental change and health at the local and global scale.

  20. "What We Breathe Impacts Our Health: Improving Understanding of the Link between Air Pollution and Health".

    Science.gov (United States)

    West, J Jason; Cohen, Aaron; Dentener, Frank; Brunekreef, Bert; Zhu, Tong; Armstrong, Ben; Bell, Michelle L; Brauer, Michael; Carmichael, Gregory; Costa, Dan L; Dockery, Douglas W; Kleeman, Michael; Krzyzanowski, Michal; Künzli, Nino; Liousse, Catherine; Lung, Shih-Chun Candice; Martin, Randall V; Pöschl, Ulrich; Pope, C Arden; Roberts, James M; Russell, Armistead G; Wiedinmyer, Christine

    2016-05-17

    Air pollution contributes to the premature deaths of millions of people each year around the world, and air quality problems are growing in many developing nations. While past policy efforts have succeeded in reducing particulate matter and trace gases in North America and Europe, adverse health effects are found at even these lower levels of air pollution. Future policy actions will benefit from improved understanding of the interactions and health effects of different chemical species and source categories. Achieving this new understanding requires air pollution scientists and engineers to work increasingly closely with health scientists. In particular, research is needed to better understand the chemical and physical properties of complex air pollutant mixtures, and to use new observations provided by satellites, advanced in situ measurement techniques, and distributed micro monitoring networks, coupled with models, to better characterize air pollution exposure for epidemiological and toxicological research, and to better quantify the effects of specific source sectors and mitigation strategies.

  1. Clarifying the links between social support and health: Culture, stress, and neuroticism matter

    Science.gov (United States)

    Park, Jiyoung; Kitayama, Shinobu; Karasawa, Mayumi; Curhan, Katherine; Markus, Hazel R; Kawakami, Norito; Miyamoto, Yuri; Love, Gayle D; Coe, Christopher L; Ryff, Carol D

    2012-01-01

    Although it is commonly assumed that social support positively predicts health, the empirical evidence has been inconsistent. We argue that three moderating factors must be considered: (1) support-approving norms (cultural context); (2) support-requiring situations (stressful events); and (3) support-accepting personal style (low neuroticism). Our large-scale cross-cultural survey of Japanese and US adults found significant associations between perceived support and health. The association was more strongly evident among Japanese (from a support-approving cultural context) who reported high life stress (in a support-requiring situation). Moreover, the link between support and health was especially pronounced if these Japanese were low in neuroticism. PMID:22419414

  2. Culture as a problem in linking material inequality to health: on residential crowding in the Arctic.

    Science.gov (United States)

    Lauster, Nathanael; Tester, Frank

    2010-05-01

    Two problems are noted in the process of measuring material inequality and linking it to health across cultural boundaries. First, comparative measurements may be used as the basis for policy making, which ends up disciplining cultural minorities. In this way, policies intended to relieve disparities can actually have the effect of extending the power of the dominant group to define appropriate cultural understanding of the world for the minority group. Second, comparative measurements may inaccurately inform theories of how inequality works to influence health and well-being. To the extent that culture mediates the relationship between inequality and outcomes of interest to researchers, those ignoring cultural differences will fail to adequately assess the impact and significance of material inequality. In this paper we discuss and illustrate these problems with reference to the study and measurement of overcrowding and its effects on health and well-being for Inuit communities in Nunavut, Canada. Copyright 2010 Elsevier Ltd. All rights reserved.

  3. Using linked electronic data to validate algorithms for health outcomes in administrative databases.

    Science.gov (United States)

    Lee, Wan-Ju; Lee, Todd A; Pickard, Alan Simon; Shoaibi, Azadeh; Schumock, Glen T

    2015-08-01

    The validity of algorithms used to identify health outcomes in claims-based and administrative data is critical to the reliability of findings from observational studies. The traditional approach to algorithm validation, using medical charts, is expensive and time-consuming. An alternative method is to link the claims data to an external, electronic data source that contains information allowing confirmation of the event of interest. In this paper, we describe this external linkage validation method and delineate important considerations to assess the feasibility and appropriateness of validating health outcomes using this approach. This framework can help investigators decide whether to pursue an external linkage validation method for identifying health outcomes in administrative/claims data.

  4. Neighborhood Environments: Links to Health Behaviors and Obesity Status in Vulnerable Children.

    Science.gov (United States)

    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.

  5. "What We Breathe Impacts Our Health : Improving Understanding of the Link between Air Pollution and Health"

    NARCIS (Netherlands)

    West, J Jason; Cohen, Aaron; Dentener, Frank; Brunekreef, Bert; Zhu, Tong; Armstrong, Ben; Bell, Michelle L; Brauer, Michael; Carmichael, Gregory; Costa, Dan L; Dockery, Douglas W; Kleeman, Michael; Krzyzanowski, Michal; Künzli, Nino; Liousse, Catherine; Lung, Shih-Chun Candice; Martin, Randall V; Pöschl, Ulrich; Pope, C Arden; Roberts, James M; Russell, Armistead G; Wiedinmyer, Christine

    2016-01-01

    Air pollution contributes to the premature deaths of millions of people each year around the world, and air quality problems are growing in many developing nations. While past policy efforts have succeeded in reducing particulate matter and trace gases in North America and Europe, adverse health

  6. A Brief Review of the Link between Environment and Male Reproductive Health

    DEFF Research Database (Denmark)

    Skakkebaek, Niels E

    2016-01-01

    . There is little doubt that environmental factors associated with modern lifestyles have - in a broad sense - had an adverse influence on male reproductive health. The hypothesis that exposure to endocrine-disrupting chemicals plays a fundamental role in this trend is plausible. This is based on evidence from......During the past few decades there has been a significantly increasing trend in germ cell tumours all over the world, particularly in countries with Caucasian populations. The changes in incidence have occurred so fast that only environmental factors can explain this development. This review focuses...... animal studies that demonstrate adverse reproductive effects caused by a number of endocrine-disrupting chemicals to which humans are exposed as part of our modern lifestyle....

  7. Water-Food-Nutrition-Health Nexus: Linking Water to Improving Food, Nutrition and Health in Sub-Saharan Africa.

    Science.gov (United States)

    Mabhaudhi, Tafadzwanashe; Chibarabada, Tendai; Modi, Albert

    2016-01-06

    Whereas sub-Saharan Africa's (SSA) water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region's agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.

  8. Water-Food-Nutrition-Health Nexus: Linking Water to Improving Food, Nutrition and Health in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Tafadzwanashe Mabhaudhi

    2016-01-01

    Full Text Available Whereas sub-Saharan Africa’s (SSA water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region’s agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.

  9. Assimilation and Health: Evidence From Linked Birth Records of Second- and Third-Generation Hispanics.

    Science.gov (United States)

    Giuntella, Osea

    2016-12-01

    This study explores the effects of assimilation on the health of Hispanics in the United States, using ethnic intermarriage as a metric of acculturation. I exploit a unique data set of linked confidential use birth records in California and Florida from 1970-2009. The confidential data allow me to link mothers giving birth in 1989-2009 to their own birth certificate records in 1970-1985 and to identify second-generation siblings. Thus, I can analyze the relationship between the parental exogamy of second-generation Hispanic women and the birth outcomes of their offspring controlling for grandmother fixed effects as well as indicators for second generation's birth weight. Despite their higher socioeconomic status, third-generation children of second-generation intermarried Hispanic women are more likely to have poor health at birth, even after I account for second-generation health at birth and employ only within-family variations in the extent of assimilation. I find that a second-generation Hispanic woman married to a non-Hispanic man is 9 % more likely to have a child with low birth weight relative to a second-generation woman married to another Hispanic. These results largely reflect the higher incidence of risky behaviors (e.g., smoking during pregnancy) among intermarried Hispanic women.

  10. Introduction of a child and adolescent mental health link worker: education and health staff focus group findings.

    Science.gov (United States)

    Hunter, A; Playle, J; Sanchez, P; Cahill, J; McGowan, L

    2008-10-01

    Policy guidance suggests that outcomes for adolescents with mental health problems can be improved by secondary education services (SES) and child and adolescent mental health services (CAMHS) working more closely. This study reports on staff experiences of the introduction of a mental health link worker (MHLW). The findings of two focus groups are presented, conducted with staff from CAMHS and SES. These focus groups formed part of the overall wider evaluation of the MHLW role. The groups explored staff perceptions and experiences following the introduction of the MHLW, and elicited their views on the effectiveness of this innovative role. Qualitative methods were employed, and analysis was conducted using the principles of grounded theory and the constant comparative method. The findings revealed that the MHLW was well received by both groups, despite the identification of potential barriers. A number of key themes emerged, which included the ability of the link worker to improve communication and to encourage mutual understanding between services. The issues raised by these themes are discussed and recommendations are made for future practice and research.

  11. Hypothesis analysis methods, hypothesis analysis devices, and articles of manufacture

    Science.gov (United States)

    Sanfilippo, Antonio P [Richland, WA; Cowell, Andrew J [Kennewick, WA; Gregory, Michelle L [Richland, WA; Baddeley, Robert L [Richland, WA; Paulson, Patrick R [Pasco, WA; Tratz, Stephen C [Richland, WA; Hohimer, Ryan E [West Richland, WA

    2012-03-20

    Hypothesis analysis methods, hypothesis analysis devices, and articles of manufacture are described according to some aspects. In one aspect, a hypothesis analysis method includes providing a hypothesis, providing an indicator which at least one of supports and refutes the hypothesis, using the indicator, associating evidence with the hypothesis, weighting the association of the evidence with the hypothesis, and using the weighting, providing information regarding the accuracy of the hypothesis.

  12. On the Keyhole Hypothesis

    DEFF Research Database (Denmark)

    Mikkelsen, Kaare B.; Kidmose, Preben; Hansen, Lars Kai

    2017-01-01

    simultaneously recorded scalp EEG. A cross-validation procedure was employed to ensure unbiased estimates. We present several pieces of evidence in support of the keyhole hypothesis: There is a high mutual information between data acquired at scalp electrodes and through the ear-EEG "keyhole," furthermore we......We propose and test the keyhole hypothesis that measurements from low dimensional EEG, such as ear-EEG reflect a broadly distributed set of neural processes. We formulate the keyhole hypothesis in information theoretical terms. The experimental investigation is based on legacy data consisting of 10...

  13. Using Linked Electronic Health Records to Estimate Healthcare Costs: Key Challenges and Opportunities.

    Science.gov (United States)

    Asaria, Miqdad; Grasic, Katja; Walker, Simon

    2016-02-01

    This paper discusses key challenges and opportunities that arise when using linked electronic health records (EHR) in health economics and outcomes research (HEOR), with a particular focus on estimating healthcare costs. These challenges and opportunities are framed in the context of a case study modelling the costs of stable coronary artery disease in England. The challenges and opportunities discussed fall broadly into the categories of (1) handling and organising data of this size and sensitivity; (2) extracting clinical endpoints from datasets that have not been designed and collected with such endpoints in mind; and (3) the principles and practice of costing resource use from routinely collected data. We find that there are a number of new challenges and opportunities that arise when working with EHR compared with more traditional sources of data for HEOR. These call for greater clinician involvement and intelligent use of sensitivity analysis.

  14. Health behaviors and quality of life predictors for risk of hospitalization in an electronic health record-linked biobank

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2015-08-01

    Full Text Available Paul Y Takahashi,1,2 Euijung Ryu,3 Janet E Olson,3 Erin M Winkler,4 Matthew A Hathcock,3 Ruchi Gupta,3 Jeff A Sloan,3 Jyotishman Pathak,3 Suzette J Bielinski,3 James R Cerhan3 1Division of Primary Care Internal Medicine, 2Department of Internal Medicine, 3Department of Health Sciences Research, 4Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA Background: Hospital risk stratification models using electronic health records (EHRs often use age and comorbid health burden. Our primary aim was to determine if quality of life or health behaviors captured in an EHR-linked biobank can predict future risk of hospitalization. Methods: Participants in the Mayo Clinic Biobank completed self-administered questionnaires at enrollment that included quality of life and health behaviors. Participants enrolled as of December 31, 2010 were followed for one year to ascertain hospitalization. Data on comorbidities and hospitalization were derived from the Mayo Clinic EHR. Hazard ratios (HR and 95% confidence interval (CI were used, adjusted for age and sex. We used gradient boosting machines models to integrate multiple factors. Different models were compared using C-statistic. Results: Of the 8,927 eligible Mayo Clinic Biobank participants, 834 (9.3% were hospitalized. Self-perceived health status and alcohol use had the strongest associations with risk of hospitalization. Compared to participants with excellent self-perceived health, those reporting poor/fair health had higher risk of hospitalization (HR =3.66, 95% CI 2.74–4.88. Alcohol use was inversely associated with hospitalization (HR =0.57 95% CI 0.45–0.72. The gradient boosting machines model estimated self-perceived health as the most influential factor (relative influence =16%. The predictive ability of the model based on comorbidities was slightly higher than the one based on the self-perceived health (C-statistic =0.67 vs 0.65. Conclusion: This study demonstrates that self

  15. Age differences at sexual debut and subsequent reproductive health: Is there a link?

    Directory of Open Access Journals (Sweden)

    Reynolds Heidi

    2008-10-01

    Full Text Available Abstract Background Experiences at sexual debut may be linked to reproductive health later in life. Additionally, young women with older sexual partners may be at greater risk for HIV and sexually transmitted infections. This study examines sexual debut with an older partner and subsequent reproductive health outcomes among 599 sexually experienced women aged 15–24 who utilized voluntary counseling and testing or reproductive health services in Port-au-Prince, Haiti. Methods Logistic regression models, controlling for socioeconomic and demographic factors, examined whether age differences at first sex were significantly associated with STI diagnosis in the previous 12 months and family planning method use at last intercourse. Results Sixty-five percent of women reported sexual initiation with a partner younger or less than 5 years older, 28% with a partner 5 to 10 years older, and 7% with a partner 10 or more years older. There was a trend towards decreased likelihood of recent use of family planning methods in women who had first sexual intercourse with a partner 5 to 9 years older compared to women with partners who were younger or less than 5 years older. Age differences were not linked to recent STI diagnosis. Conclusion Programs focusing on delaying sexual debut should consider age and gender-based power differentials between younger women and older men. Future research should examine whether wide age differences at sexual debut are predictive of continued involvement in cross-generational relationships and risky sexual behaviors and explore the mechanisms by which cross-generational first sex and subsequent reproductive health may be connected.

  16. Health and Environment Linked for Information Exchange (HELIX)-Atlanta: A CDC-NASA Joint Environmental Public Health Tracking Collaborative Project

    Science.gov (United States)

    Al-Hamdan, Mohammad; Luvall, Jeff; Crosson, Bill; Estes, Maury; Limaye, Ashutosh; Quattrochi, Dale; Rickman, Doug

    2008-01-01

    HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstration projects which could be part of the CDC EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance public health surveillance. The use of NASA technology creates value added geospatial products from existing environmental data sources to facilitate public health linkages. Proving the feasibility of the approach is the main objective

  17. The health-development link: travel as a public health issue.

    Science.gov (United States)

    Rodriguez-Garcia, R

    2001-04-01

    The process of globalization has rendered societies interdependent on one another and has fostered the movement of people, goods and ideas at unprecedented speed and volume. Global travel has grown from 25 million in 1950 to 500 million in 1993, and estimations by 2010 reach 1 billion. The increased intensity and quantity of travel has resulted in greater vulnerability to the domino-type spread of old, new and re-emerging infectious diseases. Travelers and local populations are also vulnerable to death and disability due to accidents, violence and injuries, chronic diseases such as those due to substance abuse (tobacco, alcohol and others), and to undesirable behaviors such as those related to sex-tourism. This article argues that tourism, understood as any type of travel, is one of the most important sectors of the economy in many countries and, therefore, can contribute to community and national development. It also asserts that travel, as a factor in the spread of disease, lies in the realm of public health inquiry. It calls for greater collaboration between the tourism-travel industry and community, national and global leaders to promote and enforce "responsible tourism."

  18. Pathways Linking Childhood SES and Adult Health Behaviors and Psychological Resources in Black and White Men.

    Science.gov (United States)

    Boylan, Jennifer Morozink; Cundiff, Jenny M; Jakubowski, Karen P; Pardini, Dustin A; Matthews, Karen A

    2018-03-13

    Exposure to low socioeconomic status (SES) in childhood predicts increased morbidity and mortality. However, little prospective evidence is available to test pathways linking low childhood SES to adult health. In the current study, indirect effects through positive parenting in adolescence and adult SES were tested in the association between childhood SES and adult health behaviors and psychological resources. Men (n = 305; 53% Black) were followed longitudinally from ages 7 to 32. SES was measured annually in childhood (ages 7-9) and again in adulthood (age 32) using the Hollingshead index. Parenting was assessed annually (ages 13-16) using caregivers' and boys' self-report of supervision, communication, and expectations for their son's future. Health behaviors (cigarette and alcohol use, fruit and vegetable consumption, and physical activity) and psychological resources (optimism, purpose in life, self-mastery, and self-esteem) were assessed in adulthood (age 32). Structural equation modeling showed that higher childhood SES was associated with more positive parenting in adolescence and higher adult SES. Higher childhood SES was indirectly associated with healthier behaviors and higher psychological resources in adulthood through pathways involving positive parenting during adolescence and SES in adulthood. Findings were consistent in both racial groups. Positive parenting in adolescence was an important pathway in understanding associations among childhood SES and health behaviors and psychological resources in adulthood. Low childhood SES was prospectively associated with healthier behaviors and greater psychological resources in part through more positive parenting in adolescence.

  19. Preparing linked population data for research: cohort study of prisoner perinatal health outcomes

    Directory of Open Access Journals (Sweden)

    Lisa Hilder

    2016-06-01

    Full Text Available Abstract Background A study of pregnancy outcomes related to pregnancy in prison in New South Wales, Australia, designed a two stage linkage to add maternal history of incarceration and serious mental health morbidity, neonatal hospital admission and infant congenital anomaly diagnosis to birth data. Linkage was performed by a dedicated state-wide data linkage authority. This paper describes use of the linked data to determine pregnancy prison exposure pregnancy for a representative population of mothers. Methods Researchers assessed the quality of linked records; resolved multiple-matched identities; transformed event-based incarceration records into person-based prisoner records and birth records into maternity records. Inconsistent or incomplete records were censored. Interrogation of the temporal relationships of all incarceration periods from the prisoner record with pregnancies from birth records identified prisoner maternities. Interrogation of maternities for each mother distinguished prisoner mothers who were incarcerated during pregnancy, from prisoner control mothers with pregnancies wholly in the community and a subset of prisoner mothers with maternities both types of maternity. Standard descriptive statistics are used to provide population prevalence of exposures and compare data quality across study populations stratified by mental health morbidity. Results Women incarcerated between 1998 and 2006 accounted for less than 1 % of the 404,000 women who gave birth in NSW between 2000 and 2006, while women with serious mental health morbidity accounted for 7 % overall and 68 % of prisoners. Rates of false positive linkage were within the predicted limits set by the linkage authority for non-prisoners, but were tenfold higher among prisoners (RR 9.9; 95%CI 8.2, 11.9 and twice as high for women with serious mental health morbidity (RR 2.2; 95%CI 1.9, 2.6. This case series of 597 maternities for 558 prisoners pregnant while in prison

  20. Preparing linked population data for research: cohort study of prisoner perinatal health outcomes.

    Science.gov (United States)

    Hilder, Lisa; Walker, Jane R; Levy, Michael H; Sullivan, Elizabeth A

    2016-06-16

    A study of pregnancy outcomes related to pregnancy in prison in New South Wales, Australia, designed a two stage linkage to add maternal history of incarceration and serious mental health morbidity, neonatal hospital admission and infant congenital anomaly diagnosis to birth data. Linkage was performed by a dedicated state-wide data linkage authority. This paper describes use of the linked data to determine pregnancy prison exposure pregnancy for a representative population of mothers. Researchers assessed the quality of linked records; resolved multiple-matched identities; transformed event-based incarceration records into person-based prisoner records and birth records into maternity records. Inconsistent or incomplete records were censored. Interrogation of the temporal relationships of all incarceration periods from the prisoner record with pregnancies from birth records identified prisoner maternities. Interrogation of maternities for each mother distinguished prisoner mothers who were incarcerated during pregnancy, from prisoner control mothers with pregnancies wholly in the community and a subset of prisoner mothers with maternities both types of maternity. Standard descriptive statistics are used to provide population prevalence of exposures and compare data quality across study populations stratified by mental health morbidity. Women incarcerated between 1998 and 2006 accounted for less than 1 % of the 404,000 women who gave birth in NSW between 2000 and 2006, while women with serious mental health morbidity accounted for 7 % overall and 68 % of prisoners. Rates of false positive linkage were within the predicted limits set by the linkage authority for non-prisoners, but were tenfold higher among prisoners (RR 9.9; 95%CI 8.2, 11.9) and twice as high for women with serious mental health morbidity (RR 2.2; 95%CI 1.9, 2.6). This case series of 597 maternities for 558 prisoners pregnant while in prison (of whom 128 gave birth in prison); and 2

  1. Does cognitive ability buffer the link between childhood disadvantage and adult health?

    Science.gov (United States)

    Bridger, Emma; Daly, Michael

    2017-10-01

    Individual differences in childhood cognitive ability have been neglected in the study of how early life psychosocial factors may buffer the long-term health consequences of social disadvantage. In this study, we drew on rich data from two large British cohorts to test whether high levels of cognitive ability may protect children from experiencing the physical and mental health consequences of early life socioeconomic disadvantage. Participants from the 1970 British Cohort Study (BCS; N = 11,522) were followed from birth to age 42, and those from the 1958 National Child Development Study (NCDS; N = 13,213) were followed from birth to age 50. Childhood social disadvantage was indexed using 6 indicators gauging parental education, occupational prestige, and housing characteristics (i.e., housing tenure and home crowding). Standardized assessments of cognitive ability were completed at ages 10 (BCS) and 11 (NCDS) years. Psychological distress, self-rated health, and all-cause mortality were examined from early adulthood to midlife in both cohorts. Early social disadvantage predicted elevated levels of psychological distress and lower levels of self-rated health in both cohorts and higher mortality risk in the NCDS. Childhood cognitive ability moderated each of these relationships such that the link between early life social disadvantage and poor health in adulthood was markedly stronger at low (-1 SD) compared to high (+1 SD) levels of childhood cognitive ability. This study provides evidence that high childhood cognitive ability is associated with a decrease in the strength of socioeconomic status-driven health inequalities. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. The Fiscal Consequences Attributed to Changes in Morbidity and Mortality Linked to Investments in Health Care: A Government Perspective Analytic Framework.

    Science.gov (United States)

    Connolly, Mark P; Kotsopoulos, Nikolaos; Postma, Maarten J; Bhatt, Aomesh

    2017-02-01

    Governments have an enormous economic and political stake in the health of their populations. Population health is not only fundamental to economic growth but also affects short-term and long-term government expenditure on health care, disability, and other social programs and influences direct and indirect tax receipts. Fiscal transfers between citizen and state are mostly ignored in conventional welfare economics analyses based on the hypothesis that there are no winners or losers through transference of wealth. However, from the government perspective, this position is flawed, as disability costs and lost taxes attributed to poor health and reduced productive output represent real costs that pose budgetary and growth implications. To address the value of health and health care investments for government, we have developed a fiscal health analytic framework that captures how changes in morbidity and mortality influence tax revenue and transfer costs (e.g., disability, allowances, ongoing health costs). The framework can be used to evaluate the marginal impact of discrete investments or a mix of interventions in health care to inform governmental budgetary consequences. In this context, the framework can be considered as a fiscal budget impact and/or cost-benefit analysis model that accounts for how morbidity and mortality linked to specific programs represent both ongoing costs and tax revenue for government. Mathematical models identical to those used in cost-effectiveness analyses can be employed in fiscal analysis to reflect how disease progression influences public accounts (e.g., tax revenue and transfers). Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. Linking Human Health and Livestock Health: A “One-Health” Platform for Integrated Analysis of Human Health, Livestock Health, and Economic Welfare in Livestock Dependent Communities

    Science.gov (United States)

    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

  4. The Qualitative Expectations Hypothesis

    DEFF Research Database (Denmark)

    Frydman, Roman; Johansen, Søren; Rahbek, Anders

    2017-01-01

    We introduce the Qualitative Expectations Hypothesis (QEH) as a new approach to modeling macroeconomic and financial outcomes. Building on John Muth's seminal insight underpinning the Rational Expectations Hypothesis (REH), QEH represents the market's forecasts to be consistent with the predictions...... of an economistís model. However, by assuming that outcomes lie within stochastic intervals, QEH, unlike REH, recognizes the ambiguity faced by an economist and market participants alike. Moreover, QEH leaves the model open to ambiguity by not specifying a mechanism determining specific values that outcomes take...

  5. The Qualitative Expectations Hypothesis

    DEFF Research Database (Denmark)

    Frydman, Roman; Johansen, Søren; Rahbek, Anders

    We introduce the Qualitative Expectations Hypothesis (QEH) as a new approach to modeling macroeconomic and financial outcomes. Building on John Muth's seminal insight underpinning the Rational Expectations Hypothesis (REH), QEH represents the market's forecasts to be consistent with the predictions...... of an economist's model. However, by assuming that outcomes lie within stochastic intervals, QEH, unlike REH, recognizes the ambiguity faced by an economist and market participants alike. Moreover, QEH leaves the model open to ambiguity by not specifying a mechanism determining specific values that outcomes take...

  6. Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments

    Energy Technology Data Exchange (ETDEWEB)

    Perrodin, Yves, E-mail: yves.perrodin@entpe.fr [Université de Lyon, ENTPE, UMR CNRS 5023, Laboratoire LEHNA, 2 rue Maurice Audin, 69518 Vaulx-en-Velin (France); Donguy, Gilles [Université de Lyon, ENTPE, UMR CNRS 5023, Laboratoire LEHNA, 2 rue Maurice Audin, 69518 Vaulx-en-Velin (France); Emmanuel, Evens [Laboratoire de Qualité de l' Eau et de l' Environnement, Université Quisqueya, BP 796 Port-au-Prince (Haiti); Winiarski, Thierry [Université de Lyon, ENTPE, UMR CNRS 5023, Laboratoire LEHNA, 2 rue Maurice Audin, 69518 Vaulx-en-Velin (France)

    2014-07-01

    Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a “threshold effect” (risk quotient < 1), and an acceptable risk for substances having a “non-threshold effect”, with the notable exception of arsenic (individual risk equal to 3.10{sup −6}). - Highlights: • The release of polluted dredged seaport sediments into the sea must be avoided. • Their use after treatment for the filling-up of quarries is proposed by managers. • An original health risk assessment methodology was created to validate this option. • It includes the use of a lysimeter and a georadar for the exposure assessment stage. • The example studied concludes to a health risk linked to arsenic in the groundwater.

  7. Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments

    International Nuclear Information System (INIS)

    Perrodin, Yves; Donguy, Gilles; Emmanuel, Evens; Winiarski, Thierry

    2014-01-01

    Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a “threshold effect” (risk quotient −6 ). - Highlights: • The release of polluted dredged seaport sediments into the sea must be avoided. • Their use after treatment for the filling-up of quarries is proposed by managers. • An original health risk assessment methodology was created to validate this option. • It includes the use of a lysimeter and a georadar for the exposure assessment stage. • The example studied concludes to a health risk linked to arsenic in the groundwater

  8. Day-to-day inconsistency in parent knowledge: links with youth health and parents' stress.

    Science.gov (United States)

    Lippold, Melissa A; McHale, Susan M; Davis, Kelly D; Kossek, Ellen Ernst

    2015-03-01

    Considerable evidence documents the linkages between higher levels of parental knowledge about youth activities and positive youth outcomes. This study investigated how day-to-day inconsistency in parental knowledge of youth activities was linked to youth behavioral, psychological, and physical health and parents' stress. Participants were employees in the Information Technology Division of a Fortune 500 company and their children (N = 129, mean age of youth = 13.39 years, 55% female). Data were collected from parents and youth via separate workplace and in-home surveys as well as telephone diary surveys on eight consecutive evenings. We assessed day-to-day inconsistency in parental knowledge across these eight calls. Parents differed in their knowledge from day to day almost as much as their average knowledge scores differed from those of other parents. Controlling for mean levels of knowledge, youth whose parents exhibited more knowledge inconsistency reported more physical health symptoms (e.g., colds and flu). Knowledge inconsistency was also associated with more risky behavior for girls but greater psychological well-being for older adolescents. Parents who reported more stressors also had higher knowledge inconsistency. Assessing only average levels of parental knowledge does not fully capture how this parenting dimension is associated with youth health. Consistent knowledge may promote youth physical health and less risky behavior for girls. Yet knowledge inconsistency also may reflect normative increases in autonomy as it was positively associated with psychological well-being for older adolescents. Given the linkages between parental stress and knowledge inconsistency, parent interventions should include stress management components. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Indigenous Māori perspectives on urban transport patterns linked to health and wellbeing.

    Science.gov (United States)

    Raerino Ngāti Awa Te Arawa, K; Macmillan, Alex K; Jones Ngāti Kahungunu, Rhys G

    2013-09-01

    There is a growing body of research linking urban transport systems to inequities in health. However, there is a lack of research providing evidence of the effect of transport systems on indigenous family wellbeing. We examined the connections between urban transport and the health and wellbeing of Māori, the indigenous people of New Zealand. We provide an indigenous exploration of current urban transport systems, with a particular focus on the impacts of car dependence and the need for culturally relevant travel. We interviewed nineteen Māori participants utilising qualitative research techniques underpinned by an indigenous research methodology (Kaupapa Māori). The data highlighted the importance of accessing cultural activities and sites relevant to 'being Māori', and issues with affordability and safety of public transport. Understanding the relationship between indigenous wellbeing and transport systems that goes further than limited discourses of inequity is essential to improving transport for indigenous wellbeing. Providing an indigenous voice in transport decision-making will make it more likely that indigenous health and wellbeing is prioritised in transport planning. Copyright © 2013. Published by Elsevier Ltd.

  10. Linking Asthma Exacerbation and Air Pollution Data: A Step Toward Public Health and Environmental Data Integration

    Science.gov (United States)

    Faruque, Fazlay; Finley, Richard; Marshall, Gailen; Brackin, Bruce; Li, Hui; Williams, Worth; Al-Hamdan, Mohammad; Luvall, Jeffrey; Rickman, Doug; Crosson, Bill

    2006-01-01

    Studies have shown that reducing exposure to triggers such as air pollutants can reduce symptoms and the need for medication in asthma patients. However, systems that track asthma are generally not integrated with those that track environmental hazards related to asthma. Tlvs lack of integration hinders public health awareness and responsiveness to these environmental triggers. The current study is a collaboration between health and environmental professionals to utilize NASA-derived environmental data to develop a decision support system (DSS) for asthma prediction, surveillance, and intervention. The investigators link asthma morbidity data from the University of Mississippi Medical Center (UMMC) and Mississippi Department of Health (MDH) with air quality data from the Mississippi Department of Environmental Quality (MDEQ) and remote sensing data from NASA. Daily ambient environmental hazard data for PM2.5 and ozone are obtained from the MDEQ air quality monitoring locations and are combined with remotely sensed data from NASA to develop a state-wide spatial and time series profile of environmental air quality. These data are then used to study the correlation of these measures of air quality variation with the asthma exacerbation incidence throughout the state over time. The goal is to utilize these readily available measures to allow real-time risk assessment for asthma exacerbations. GeoMedStat, a DSS previously developed for biosurveillance, will integrate these measures to monitor, analyze and report the real-time risk assessment for asthma exacerbation throughout the state.

  11. A Network Analysis Perspective to Implementation: The Example of Health Links to Promote Coordinated Care.

    Science.gov (United States)

    Yousefi Nooraie, Reza; Khan, Sobia; Gutberg, Jennifer; Baker, G Ross

    2018-01-01

    Although implementation models broadly recognize the importance of social relationships, our knowledge about applying social network analysis (SNA) to formative, process, and outcome evaluations of health system interventions is limited. We explored applications of adopting an SNA lens to inform implementation planning, engagement and execution, and evaluation. We used Health Links, a province-wide program in Canada aiming to improve care coordination among multiple providers of high-needs patients, as an example of a health system intervention. At the planning phase, an SNA can depict the structure, network influencers, and composition of clusters at various levels. It can inform the engagement and execution by identifying potential targets (e.g., opinion leaders) and by revealing structural gaps and clusters. It can also be used to assess the outcomes of the intervention, such as its success in increasing network connectivity; changing the position of certain actors; and bridging across specialties, organizations, and sectors. We provided an overview of how an SNA lens can shed light on the complexity of implementation along the entire implementation pathway, by revealing the relational barriers and facilitators, the application of network-informed and network-altering interventions, and testing hypotheses on network consequences of the implementation.

  12. Relational Regulation Theory : A New Approach to Explain the Link Between Perceived Social Support and Mental Health

    NARCIS (Netherlands)

    Lakey, Brian; Orehek, Edward

    Perceived support is consistently linked to good mental health, which is typically explained as resulting from objectively supportive actions that buffer stress. Yet this explanation has difficulty accounting for the often-observed main effects between support and mental health. Relational

  13. Infection Control Link Nurse Program: An interdisciplinary approach n targeting health care-acquired infection

    Science.gov (United States)

    Sopirala, Madhuri M.; Yahle-Dunbar, Lisa; Smyer, Justin; Wellington, Linda; Dickman, Jeanne; Zikri, Nancy; Martin, Jennifer; Kulich, Pat; Taylor, David; Mekhjian, Hagop; Nash, Mary; Mansfield, Jerry; Pancholi, Preeti; Howard, Mary; Chase, Linda; Brown, Susan; Kipp, Kristopher; Lefeld, Kristen; Myers, Amber; Pan, Xueliang; Mangino, Julie E.

    2014-01-01

    Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed. Results A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62–0.83, P Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP. Conclusion Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing reeducation for the nurses by IP personnel helped drive these results. PMID:24548456

  14. Exploring the link between ambulatory care and avoidable hospitalizations at the Veteran Health Administration.

    Science.gov (United States)

    Pracht, Etienne E; Bass, Elizabeth

    2011-01-01

    This paper explores the link between utilization of ambulatory care and the likelihood of rehospitalization for an avoidable reason in veterans served by the Veteran Health Administration (VA). The analysis used administrative data containing healthcare utilization and patient characteristics stored at the national VA data warehouse, the Corporate Franchise Data Center. The study sample consisted of 284 veterans residing in Florida who had been hospitalized at least once for an avoidable reason. A bivariate probit model with instrumental variables was used to estimate the probability of rehospitalization. Veterans who had at least 1 ambulatory care visit per month experienced a significant reduction in the probability of rehospitalization for the same avoidable hospitalization condition. The findings suggest that ambulatory care can serve as an important substitute for more expensive hospitalization for the conditions characterized as avoidable. © 2011 National Association for Healthcare Quality.

  15. Carbohydrates, Dietary Fiber, and Resistant Starch in White Vegetables: Links to Health Outcomes12

    Science.gov (United States)

    Slavin, Joanne L.

    2013-01-01

    Vegetables are universally promoted as healthy. Dietary Guidelines for Americans 2010 recommend that you make half of your plate fruits and vegetables. Vegetables are diverse plants that vary greatly in energy content and nutrients. Vegetables supply carbohydrates, dietary fiber, and resistant starch in the diet, all of which have been linked to positive health outcomes. Fiber lowers the incidence of cardiovascular disease and obesity. In this paper, the important role of white vegetables in the human diet is described, with a focus on the dietary fiber and resistant starch content of white vegetables. Misguided efforts to reduce consumption of white vegetables will lower intakes of dietary fiber and resistant starch, nutrients already in short supply in our diets. PMID:23674804

  16. Revisiting the Dutch hypothesis

    NARCIS (Netherlands)

    Postma, Dirkje S.; Weiss, Scott T.; van den Berge, Maarten; Kerstjens, Huib A. M.; Koppelman, Gerard H.

    The Dutch hypothesis was first articulated in 1961, when many novel and advanced scientific techniques were not available, such as genomics techniques for pinpointing genes, gene expression, lipid and protein profiles, and the microbiome. In addition, computed tomographic scans and advanced analysis

  17. The Lehman Sisters Hypothesis

    NARCIS (Netherlands)

    I.P. van Staveren (Irene)

    2014-01-01

    markdownabstract__Abstract__ This article explores the Lehman Sisters Hypothesis. It reviews empirical literature about gender differences in behavioral, experimental, and neuro-economics as well as in other fields of behavioral research. It discusses gender differences along three dimensions of

  18. Interdisciplinary pharmacometrics linking oseltamivir pharmacology, influenza epidemiology and health economics to inform antiviral use in pandemics.

    Science.gov (United States)

    Kamal, Mohamed A; Smith, Patrick F; Chaiyakunapruk, Nathorn; Wu, David B C; Pratoomsoot, Chayanin; Lee, Kenneth K C; Chong, Huey Yi; Nelson, Richard E; Nieforth, Keith; Dall, Georgina; Toovey, Stephen; Kong, David C M; Kamauu, Aaron; Kirkpatrick, Carl M; Rayner, Craig R

    2017-07-01

    A modular interdisciplinary platform was developed to investigate the economic impact of oseltamivir treatment by dosage regimen under simulated influenza pandemic scenarios. The pharmacology module consisted of a pharmacokinetic distribution of oseltamivir carboxylate daily area under the concentration-time curve at steady state (simulated for 75 mg and 150 mg twice daily regimens for 5 days) and a pharmacodynamic distribution of viral shedding duration obtained from phase II influenza inoculation data. The epidemiological module comprised a susceptible, exposed, infected, recovered (SEIR) model to which drug effect on the basic reproductive number (R 0 ), a measure of transmissibility, was linked by reduction of viral shedding duration. The number of infected patients per population of 100 000 susceptible individuals was simulated for a series of pandemic scenarios, varying oseltamivir dose, R 0 (1.9 vs. 2.7), and drug uptake (25%, 50%, and 80%). The number of infected patients for each scenario was entered into the health economics module, a decision analytic model populated with branch probabilities, disease utility, costs of hospitalized patients developing complications, and case-fatality rates. Change in quality-adjusted life years was determined relative to base case. Oseltamivir 75 mg relative to no treatment reduced the median number of infected patients, increased change in quality-adjusted life years by deaths averted, and was cost-saving under all scenarios; 150 mg relative to 75 mg was not cost effective in low transmissibility scenarios but was cost saving in high transmissibility scenarios. This methodological study demonstrates proof of concept that the disciplines of pharmacology, disease epidemiology and health economics can be linked in a single quantitative framework. © 2017 The British Pharmacological Society.

  19. Improving public health training and research capacity in Africa: a replicable model for linking training to health and socio-demographic surveillance data

    Directory of Open Access Journals (Sweden)

    Jill R. Williams

    2010-08-01

    Full Text Available Background: Research training for public health professionals is key to the future of public health and policy in Africa. A growing number of schools of public health are connected to health and socio-demographic surveillance system field sites in developing countries, in Africa and Asia in particular. Linking training programs with these sites provides important opportunities to improve training, build local research capacity, foreground local health priorities, and increase the relevance of research to local health policy. Objective: To increase research training capacity in public health programs by providing targeted training to students and increasing the accessibility of existing data. Design: This report is a case study of an approach to linking public health research and training at the University of the Witwatersrand. We discuss the development of a sample training database from the Agincourt Health and Socio-demographic Surveillance System in South Africa and outline a concordant transnational intensive short course on longitudinal data analysis offered by the University of the Witwatersrand and the University of Colorado-Boulder. This case study highlights ways common barriers to linking research and training can be overcome. Results and Conclusions: This collaborative effort demonstrates that linking training to ongoing data collection can improve student research, accelerate student training, and connect students to an international network of scholars. Importantly, the approach can be adapted to other partnerships between schools of public health and longitudinal research sites.

  20. Identifying paediatric nursing-sensitive outcomes in linked administrative health data

    Directory of Open Access Journals (Sweden)

    Wilson Sally

    2012-07-01

    Full Text Available Abstract Background There is increasing interest in the contribution of the quality of nursing care to patient outcomes. Due to different casemix and risk profiles, algorithms for administrative health data that identify nursing-sensitive outcomes in adult hospitalised patients may not be applicable to paediatric patients. The study purpose was to test adult algorithms in a paediatric hospital population and make amendments to increase the accuracy of identification of hospital acquired events. The study also aimed to determine whether the use of linked hospital records improved the likelihood of correctly identifying patient outcomes as nursing sensitive rather than being related to their pre-morbid conditions. Methods Using algorithms developed by Needleman et al. (2001, proportions and rates of records that identified nursing-sensitive outcomes for pressure ulcers, pneumonia and surgical wound infections were determined from administrative hospitalisation data for all paediatric patients discharged from a tertiary paediatric hospital in Western Australia between July 1999 and June 2009. The effects of changes to inclusion and exclusion criteria for each algorithm on the calculated proportion or rate in the paediatric population were explored. Linked records were used to identify comorbid conditions that increased nursing-sensitive outcome risk. Rates were calculated using algorithms revised for paediatric patients. Results Linked records of 129,719 hospital separations for 79,016 children were analysed. Identification of comorbid conditions was enhanced through access to prior and/or subsequent hospitalisation records (43% of children with pressure ulcers had a form of paralysis recorded only on a previous admission. Readmissions with a surgical wound infection were identified for 103 (4.8/1,000 surgical separations using linked data. After amendment of each algorithm for paediatric patients, rates of pressure ulcers and pneumonia reduced by

  1. Identifying paediatric nursing-sensitive outcomes in linked administrative health data.

    Science.gov (United States)

    Wilson, Sally; Bremner, Alexandra P; Hauck, Yvonne; Finn, Judith

    2012-07-20

    There is increasing interest in the contribution of the quality of nursing care to patient outcomes. Due to different casemix and risk profiles, algorithms for administrative health data that identify nursing-sensitive outcomes in adult hospitalised patients may not be applicable to paediatric patients. The study purpose was to test adult algorithms in a paediatric hospital population and make amendments to increase the accuracy of identification of hospital acquired events. The study also aimed to determine whether the use of linked hospital records improved the likelihood of correctly identifying patient outcomes as nursing sensitive rather than being related to their pre-morbid conditions. Using algorithms developed by Needleman et al. (2001), proportions and rates of records that identified nursing-sensitive outcomes for pressure ulcers, pneumonia and surgical wound infections were determined from administrative hospitalisation data for all paediatric patients discharged from a tertiary paediatric hospital in Western Australia between July 1999 and June 2009. The effects of changes to inclusion and exclusion criteria for each algorithm on the calculated proportion or rate in the paediatric population were explored. Linked records were used to identify comorbid conditions that increased nursing-sensitive outcome risk. Rates were calculated using algorithms revised for paediatric patients. Linked records of 129,719 hospital separations for 79,016 children were analysed. Identification of comorbid conditions was enhanced through access to prior and/or subsequent hospitalisation records (43% of children with pressure ulcers had a form of paralysis recorded only on a previous admission). Readmissions with a surgical wound infection were identified for 103 (4.8/1,000) surgical separations using linked data. After amendment of each algorithm for paediatric patients, rates of pressure ulcers and pneumonia reduced by 53% and 15% (from 1.3 to 0.6 and from 9.1 to 7.7 per

  2. Day-to-Day Inconsistency in Parent Knowledge: Links with Youth Health and Parents’ Stress

    Science.gov (United States)

    Lippold, Melissa A.; McHale, Susan M.; Davis, Kelly D.; Kossek, Ellen Ernst

    2015-01-01

    Purpose Considerable evidence documents the linkages between higher levels of parental knowledge about youth activities and positive youth outcomes. This study investigated how day-to-day inconsistency in parental knowledge of youth activities was linked to youth behavioral, psychological, and physical health as well as parents’ stress. Methods Participants were employees in the Information Technology division of a Fortune 500 company and their children (N =129, Mean age youth = 13.39 years, 55% female). Data were collected from parents and youth via separate workplace and in-home surveys as well as telephone diary surveys on 8 consecutive evenings. We assessed day-to-day inconsistency in parental knowledge across these eight calls. Results Parents differed in their knowledge from day to day almost as much as their average knowledge scores differed from those of other parents. Controlling for mean levels of knowledge, youth whose parents exhibited more knowledge inconsistency reported more physical health symptoms (e.g., colds, flu). Knowledge inconsistency was also associated with more risky behavior for girls but greater psychological well-being for older adolescents. Parents who reported more stressors also had higher knowledge inconsistency. Conclusions Assessing only average levels of parental knowledge does not fully capture how this parenting dimension is associated with youth health. Consistent knowledge may promote youth physical health and less risky behavior for girls. Yet knowledge inconsistency also may reflect normative increases in autonomy as it was positively associated with psychological well-being for older adolescents. Given the linkages between parental stress and knowledge inconsistency, parent interventions should include stress-management components. PMID:25703318

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Awareness regarding dengue fever among the link workers of urban health centres of Bengaluru CitySouth India

    Directory of Open Access Journals (Sweden)

    Gowda Giriyanna

    2015-06-01

    Full Text Available Objective: To assess awareness of link workers regarding dengue fever and its prevention and the effect of health education about dengue and its prevention. Methods: Prospective interventional study was conducted in selected urban health centers of Bengaluru. About 106 link workers selected by systematic random sampling were interviewed by trained investigators. Health education was given to all of them and awareness was reassessed after a gap of one month. Results: Mean age of link workers was (36.95 ± 5.88 years. A total of 49.06% of link workers were aware that dengue is caused by virus, 74.53% were aware of complications of dengue, 87.74 % were aware that dengue is spread by Aedes mosquito. After health education the above observations increased to 81.4%, 87.63%, and 90.72% respectively. Difference between mean preand post-test score was statistically significant (P < 0.05. Conclusions: Awareness regarding dengue fever and its prevention was poor among link workers, which improved significantly after health education.

  5. Bayesian Hypothesis Testing

    Energy Technology Data Exchange (ETDEWEB)

    Andrews, Stephen A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sigeti, David E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-11-15

    These are a set of slides about Bayesian hypothesis testing, where many hypotheses are tested. The conclusions are the following: The value of the Bayes factor obtained when using the median of the posterior marginal is almost the minimum value of the Bayes factor. The value of τ2 which minimizes the Bayes factor is a reasonable choice for this parameter. This allows a likelihood ratio to be computed with is the least favorable to H0.

  6. The Drift Burst Hypothesis

    OpenAIRE

    Christensen, Kim; Oomen, Roel; Renò, Roberto

    2016-01-01

    The Drift Burst Hypothesis postulates the existence of short-lived locally explosive trends in the price paths of financial assets. The recent US equity and Treasury flash crashes can be viewed as two high profile manifestations of such dynamics, but we argue that drift bursts of varying magnitude are an expected and regular occurrence in financial markets that can arise through established mechanisms such as feedback trading. At a theoretical level, we show how to build drift bursts into the...

  7. Hypothesis in research

    Directory of Open Access Journals (Sweden)

    Eudaldo Enrique Espinoza Freire

    2018-01-01

    Full Text Available It is intended with this work to have a material with the fundamental contents, which enable the university professor to formulate the hypothesis, for the development of an investigation, taking into account the problem to be solved. For its elaboration, the search of information in primary documents was carried out, such as thesis of degree and reports of research results, selected on the basis of its relevance with the analyzed subject, current and reliability, secondary documents, as scientific articles published in journals of recognized prestige, the selection was made with the same terms as in the previous documents. It presents a conceptualization of the updated hypothesis, its characterization and an analysis of the structure of the hypothesis in which the determination of the variables is deepened. The involvement of the university professor in the teaching-research process currently faces some difficulties, which are manifested, among other aspects, in an unstable balance between teaching and research, which leads to a separation between them.

  8. Bonding, Bridging, and Linking Social Capital and Self-Rated Health among Chinese Adults: Use of the Anchoring Vignettes Technique.

    Directory of Open Access Journals (Sweden)

    He Chen

    Full Text Available Three main opposing camps exist over how social capital relates to population health, namely the social support perspective, the inequality thesis, and the political economy approach. The distinction among bonding, bridging, and linking social capital probably helps close the debates between these three camps, which is rarely investigated in existing literatures. Moreover, although self-rated health is a frequently used health indicator in studies on the relationship between social capital and health, the interpersonal incomparability of this measure has been largely neglected. This study has two main objectives. Firstly, we aim to investigate the relationship between bonding, bridging, and linking social capital and self-rated health among Chinese adults. Secondly, we aim to improve the interpersonal comparability in self-rated health measurement. We use data from a nationally representative survey in China. Self-rated health was adjusted using the anchoring vignettes technique to improve comparability. Two-level ordinal logistic regression was performed to model the association between social capital and self-rated health at both individual and community levels. The interaction between residence and social capital was included to examine urban/rural disparities in the relationship. We found that most social capital indicators had a significant relationship with adjusted self-rated health of Chinese adults, but the relationships were mixed. Individual-level bonding, linking social capital, and community-level bridging social capital were positively related with health. Significant urban/rural disparities appeared in the association between community-level bonding, linking social capital, and adjusted self-rated health. For example, people living in communities with higher bonding social capital tended to report poorer adjusted self-rated health in urban areas, but the opposite tendency held for rural areas. Furthermore, the comparison between

  9. Bonding, Bridging, and Linking Social Capital and Self-Rated Health among Chinese Adults: Use of the Anchoring Vignettes Technique.

    Science.gov (United States)

    Chen, He; Meng, Tianguang

    2015-01-01

    Three main opposing camps exist over how social capital relates to population health, namely the social support perspective, the inequality thesis, and the political economy approach. The distinction among bonding, bridging, and linking social capital probably helps close the debates between these three camps, which is rarely investigated in existing literatures. Moreover, although self-rated health is a frequently used health indicator in studies on the relationship between social capital and health, the interpersonal incomparability of this measure has been largely neglected. This study has two main objectives. Firstly, we aim to investigate the relationship between bonding, bridging, and linking social capital and self-rated health among Chinese adults. Secondly, we aim to improve the interpersonal comparability in self-rated health measurement. We use data from a nationally representative survey in China. Self-rated health was adjusted using the anchoring vignettes technique to improve comparability. Two-level ordinal logistic regression was performed to model the association between social capital and self-rated health at both individual and community levels. The interaction between residence and social capital was included to examine urban/rural disparities in the relationship. We found that most social capital indicators had a significant relationship with adjusted self-rated health of Chinese adults, but the relationships were mixed. Individual-level bonding, linking social capital, and community-level bridging social capital were positively related with health. Significant urban/rural disparities appeared in the association between community-level bonding, linking social capital, and adjusted self-rated health. For example, people living in communities with higher bonding social capital tended to report poorer adjusted self-rated health in urban areas, but the opposite tendency held for rural areas. Furthermore, the comparison between multivariate analyses

  10. Design and Development of a Linked Open Data-Based Health Information Representation and Visualization System: Potentials and Preliminary Evaluation

    Science.gov (United States)

    Kauppinen, Tomi; Keßler, Carsten; Fritz, Fleur

    2014-01-01

    Background Healthcare organizations around the world are challenged by pressures to reduce cost, improve coordination and outcome, and provide more with less. This requires effective planning and evidence-based practice by generating important information from available data. Thus, flexible and user-friendly ways to represent, query, and visualize health data becomes increasingly important. International organizations such as the World Health Organization (WHO) regularly publish vital data on priority health topics that can be utilized for public health policy and health service development. However, the data in most portals is displayed in either Excel or PDF formats, which makes information discovery and reuse difficult. Linked Open Data (LOD)—a new Semantic Web set of best practice of standards to publish and link heterogeneous data—can be applied to the representation and management of public level health data to alleviate such challenges. However, the technologies behind building LOD systems and their effectiveness for health data are yet to be assessed. Objective The objective of this study is to evaluate whether Linked Data technologies are potential options for health information representation, visualization, and retrieval systems development and to identify the available tools and methodologies to build Linked Data-based health information systems. Methods We used the Resource Description Framework (RDF) for data representation, Fuseki triple store for data storage, and Sgvizler for information visualization. Additionally, we integrated SPARQL query interface for interacting with the data. We primarily use the WHO health observatory dataset to test the system. All the data were represented using RDF and interlinked with other related datasets on the Web of Data using Silk—a link discovery framework for Web of Data. A preliminary usability assessment was conducted following the System Usability Scale (SUS) method. Results We developed an LOD

  11. Design and development of a linked open data-based health information representation and visualization system: potentials and preliminary evaluation.

    Science.gov (United States)

    Tilahun, Binyam; Kauppinen, Tomi; Keßler, Carsten; Fritz, Fleur

    2014-10-25

    Healthcare organizations around the world are challenged by pressures to reduce cost, improve coordination and outcome, and provide more with less. This requires effective planning and evidence-based practice by generating important information from available data. Thus, flexible and user-friendly ways to represent, query, and visualize health data becomes increasingly important. International organizations such as the World Health Organization (WHO) regularly publish vital data on priority health topics that can be utilized for public health policy and health service development. However, the data in most portals is displayed in either Excel or PDF formats, which makes information discovery and reuse difficult. Linked Open Data (LOD)-a new Semantic Web set of best practice of standards to publish and link heterogeneous data-can be applied to the representation and management of public level health data to alleviate such challenges. However, the technologies behind building LOD systems and their effectiveness for health data are yet to be assessed. The objective of this study is to evaluate whether Linked Data technologies are potential options for health information representation, visualization, and retrieval systems development and to identify the available tools and methodologies to build Linked Data-based health information systems. We used the Resource Description Framework (RDF) for data representation, Fuseki triple store for data storage, and Sgvizler for information visualization. Additionally, we integrated SPARQL query interface for interacting with the data. We primarily use the WHO health observatory dataset to test the system. All the data were represented using RDF and interlinked with other related datasets on the Web of Data using Silk-a link discovery framework for Web of Data. A preliminary usability assessment was conducted following the System Usability Scale (SUS) method. We developed an LOD-based health information representation, querying

  12. Mental health and psychosocial support in humanitarian settings: linking practice and research.

    Science.gov (United States)

    Tol, Wietse A; Barbui, Corrado; Galappatti, Ananda; Silove, Derrick; Betancourt, Theresa S; Souza, Renato; Golaz, Anne; van Ommeren, Mark

    2011-10-29

    This review links practice, funding, and evidence for interventions for mental health and psychosocial wellbeing in humanitarian settings. We studied practice by reviewing reports of mental health and psychosocial support activities (2007-10); funding by analysis of the financial tracking service and the creditor reporting system (2007-09); and interventions by systematic review and meta-analysis. In 160 reports, the five most commonly reported activities were basic counselling for individuals (39%); facilitation of community support of vulnerable individuals (23%); provision of child-friendly spaces (21%); support of community-initiated social support (21%); and basic counselling for groups and families (20%). Most interventions took place and were funded outside national mental health and protection systems. 32 controlled studies of interventions were identified, 13 of which were randomised controlled trials (RCTs) that met the criteria for meta-analysis. Two studies showed promising effects for strengthening community and family supports. Psychosocial wellbeing was not included as an outcome in the meta-analysis, because its definition varied across studies. In adults with symptoms of post-traumatic stress disorder (PTSD), meta-analysis of seven RCTs showed beneficial effects for several interventions (psychotherapy and psychosocial supports) compared with usual care or waiting list (standardised mean difference [SMD] -0·38, 95% CI -0·55 to -0·20). In children, meta-analysis of four RCTs failed to show an effect for symptoms of PTSD (-0·36, -0·83 to 0·10), but showed a beneficial effect of interventions (group psychotherapy, school-based support, and other psychosocial support) for internalising symptoms (six RCTs; SMD -0·24, -0·40 to -0·09). Overall, research and evidence focuses on interventions that are infrequently implemented, whereas the most commonly used interventions have had little rigorous scrutiny. Copyright © 2011 Elsevier Ltd. All

  13. Mental health and psychosocial support in humanitarian settings: linking practice and research

    Science.gov (United States)

    Tol, Wietse A; Barbui, Corrado; Galappatti, Ananda; Silove, Derrick; Betancourt, Theresa S; Souza, Renato; Golaz, Anne; van Ommeren, Mark

    2014-01-01

    This review links practice, funding, and evidence for interventions for mental health and psychosocial wellbeing in humanitarian settings. We studied practice by reviewing reports of mental health and psychosocial support activities (2007–10); funding by analysis of the financial tracking service and the creditor reporting system (2007–09); and interventions by systematic review and meta-analysis. In 160 reports, the five most commonly reported activities were basic counselling for individuals (39%); facilitation of community support of vulnerable individuals (23%); provision of child-friendly spaces (21%); support of community-initiated social support (21%); and basic counselling for groups and families (20%). Most interventions took place and were funded outside national mental health and protection systems. 32 controlled studies of interventions were identified, 13 of which were randomised controlled trials (RCTs) that met the criteria for meta-analysis. Two studies showed promising effects for strengthening community and family supports. Psychosocial wellbeing was not included as an outcome in the meta-analysis, because its definition varied across studies. In adults with symptoms of post-traumatic stress disorder (PTSD), meta-analysis of seven RCTs showed beneficial effects for several interventions (psychotherapy and psychosocial supports) compared with usual care or waiting list (standardised mean difference [SMD] −0.38, 95% CI −0.55 to −0.20). In children, meta-analysis of four RCTs failed to show an effect for symptoms of PTSD (−0.36, −0.83 to 0.10), but showed a beneficial effect of interventions (group psychotherapy, school-based support, and other psychosocial support) for internalising symptoms (six RCTs; SMD −0.24, −0.40 to −0.09). Overall, research and evidence focuses on interventions that are infrequently implemented, whereas the most commonly used interventions have had little rigorous scrutiny. PMID:22008428

  14. Multi-purpose HealthCare Telemedicine Systems with mobile communication link support

    Directory of Open Access Journals (Sweden)

    Karayiannis D

    2003-03-01

    Full Text Available Abstract The provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rural Health Centers (RHC or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to support the above different growing application fields we created a combined real-time and store and forward facility that consists of a base unit and a telemedicine (mobile unit. This integrated system: can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site, enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3–12 lead ECG, SPO2, NIBP, IBP, Temp and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available or through Plain Old Telephony Systems (POTS where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Due to the need of storing and archiving of all data interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the system. The performance of the system has been technically tested over several telecommunication means; in addition the system has been clinically validated in three

  15. Patients' online access to their electronic health records and linked online services: a systematic interpretative review.

    Science.gov (United States)

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-09-08

    To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO

  16. Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

    Science.gov (United States)

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-01-01

    Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of

  17. The Income Inequality Hypothesis Revisited : Assessing the Hypothesis Using Four Methodological Approaches

    NARCIS (Netherlands)

    Kragten, N.; Rözer, J.

    The income inequality hypothesis states that income inequality has a negative effect on individual’s health, partially because it reduces social trust. This article aims to critically assess the income inequality hypothesis by comparing several analytical strategies, namely OLS regression,

  18. Aminoglycoside antibiotics and autism: a speculative hypothesis

    Directory of Open Access Journals (Sweden)

    Manev Hari

    2001-10-01

    Full Text Available Abstract Background Recently, it has been suspected that there is a relationship between therapy with some antibiotics and the onset of autism; but even more curious, some children benefited transiently from a subsequent treatment with a different antibiotic. Here, we speculate how aminoglycoside antibiotics might be associated with autism. Presentation We hypothesize that aminoglycoside antibiotics could a trigger the autism syndrome in susceptible infants by causing the stop codon readthrough, i.e., a misreading of the genetic code of a hypothetical critical gene, and/or b improve autism symptoms by correcting the premature stop codon mutation in a hypothetical polymorphic gene linked to autism. Testing Investigate, retrospectively, whether a link exists between aminoglycoside use (which is not extensive in children and the onset of autism symptoms (hypothesis "a", or between amino glycoside use and improvement of these symptoms (hypothesis "b". Whereas a prospective study to test hypothesis "a" is not ethically justifiable, a study could be designed to test hypothesis "b". Implications It should be stressed that at this stage no direct evidence supports our speculative hypothesis and that its main purpose is to initiate development of new ideas that, eventually, would improve our understanding of the pathobiology of autism.

  19. Linking geology and health sciences to assess childhood lead poisoning from artisanal gold mining in Nigeria

    Science.gov (United States)

    Plumlee, Geoffrey S.; Durant, James T.; Morman, Suzette A.; Neri, Antonio; Wolf, Ruth E.; Dooyema, Carrie A.; Hageman, Philip L.; Lowers, Heather; Fernette, Gregory L.; Meeker, Gregory P.; Benzel, William M.; Driscoll, Rhonda L.; Berry, Cyrus J.; Crock, James G.; Goldstein, Harland L.; Adams, Monique; Bartrem, Casey L.; Tirima, Simba; Behrooz, Behbod; von Lindern, Ian; Brown, Mary Jean

    2013-01-01

    Background: In 2010, Médecins Sans Frontières discovered a lead poisoning outbreak linked to artisanal gold processing in northwestern Nigeria. The outbreak has killed approximately 400 young children and affected thousands more. Objectives: Our aim was to undertake an interdisciplinary geological- and health-science assessment to clarify lead sources and exposure pathways, identify additional toxicants of concern and populations at risk, and examine potential for similar lead poisoning globally. Methods: We applied diverse analytical methods to ore samples, soil and sweep samples from villages and family compounds, and plant foodstuff samples. Results: Natural weathering of lead-rich gold ores before mining formed abundant, highly gastric-bioaccessible lead carbonates. The same fingerprint of lead minerals found in all sample types confirms that ore processing caused extreme contamination, with up to 185,000 ppm lead in soils/sweep samples and up to 145 ppm lead in plant foodstuffs. Incidental ingestion of soils via hand-to-mouth transmission and of dusts cleared from the respiratory tract is the dominant exposure pathway. Consumption of water and foodstuffs contaminated by the processing is likely lesser, but these are still significant exposure pathways. Although young children suffered the most immediate and severe consequences, results indicate that older children, adult workers, pregnant women, and breastfed infants are also at risk for lead poisoning. Mercury, arsenic, manganese, antimony, and crystalline silica exposures pose additional health threats. Conclusions: Results inform ongoing efforts in Nigeria to assess lead contamination and poisoning, treat victims, mitigate exposures, and remediate contamination. Ore deposit geology, pre-mining weathering, and burgeoning artisanal mining may combine to cause similar lead poisoning disasters elsewhere globally.

  20. Linking geological and health sciences to assess childhood lead poisoning from artisanal gold mining in Nigeria.

    Science.gov (United States)

    Plumlee, Geoffrey S; Durant, James T; Morman, Suzette A; Neri, Antonio; Wolf, Ruth E; Dooyema, Carrie A; Hageman, Philip L; Lowers, Heather A; Fernette, Gregory L; Meeker, Gregory P; Benzel, William M; Driscoll, Rhonda L; Berry, Cyrus J; Crock, James G; Goldstein, Harland L; Adams, Monique; Bartrem, Casey L; Tirima, Simba; Behbod, Behrooz; von Lindern, Ian; Brown, Mary Jean

    2013-06-01

    In 2010, Médecins Sans Frontières discovered a lead poisoning outbreak linked to artisanal gold processing in northwestern Nigeria. The outbreak has killed approximately 400 young children and affected thousands more. Our aim was to undertake an interdisciplinary geological- and health-science assessment to clarify lead sources and exposure pathways, identify additional toxicants of concern and populations at risk, and examine potential for similar lead poisoning globally. We applied diverse analytical methods to ore samples, soil and sweep samples from villages and family compounds, and plant foodstuff samples. Natural weathering of lead-rich gold ores before mining formed abundant, highly gastric-bioaccessible lead carbonates. The same fingerprint of lead minerals found in all sample types confirms that ore processing caused extreme contamination, with up to 185,000 ppm lead in soils/sweep samples and up to 145 ppm lead in plant foodstuffs. Incidental ingestion of soils via hand-to-mouth transmission and of dusts cleared from the respiratory tract is the dominant exposure pathway. Consumption of water and foodstuffs contaminated by the processing is likely lesser, but these are still significant exposure pathways. Although young children suffered the most immediate and severe consequences, results indicate that older children, adult workers, pregnant women, and breastfed infants are also at risk for lead poisoning. Mercury, arsenic, manganese, antimony, and crystalline silica exposures pose additional health threats. Results inform ongoing efforts in Nigeria to assess lead contamination and poisoning, treat victims, mitigate exposures, and remediate contamination. Ore deposit geology, pre-mining weathering, and burgeoning artisanal mining may combine to cause similar lead poisoning disasters elsewhere globally.

  1. Linking Geological and Health Sciences to Assess Childhood Lead Poisoning from Artisanal Gold Mining in Nigeria

    Science.gov (United States)

    Durant, James T.; Morman, Suzette A.; Neri, Antonio; Wolf, Ruth E.; Dooyema, Carrie A.; Hageman, Philip L.; Lowers, Heather A.; Fernette, Gregory L.; Meeker, Gregory P.; Benzel, William M.; Driscoll, Rhonda L.; Berry, Cyrus J.; Crock, James G.; Goldstein, Harland L.; Adams, Monique; Bartrem, Casey L.; Tirima, Simba; Behbod, Behrooz; von Lindern, Ian; Brown, Mary Jean

    2013-01-01

    Background: In 2010, Médecins Sans Frontières discovered a lead poisoning outbreak linked to artisanal gold processing in northwestern Nigeria. The outbreak has killed approximately 400 young children and affected thousands more. Objectives: Our aim was to undertake an interdisciplinary geological- and health-science assessment to clarify lead sources and exposure pathways, identify additional toxicants of concern and populations at risk, and examine potential for similar lead poisoning globally. Methods: We applied diverse analytical methods to ore samples, soil and sweep samples from villages and family compounds, and plant foodstuff samples. Results: Natural weathering of lead-rich gold ores before mining formed abundant, highly gastric-bioaccessible lead carbonates. The same fingerprint of lead minerals found in all sample types confirms that ore processing caused extreme contamination, with up to 185,000 ppm lead in soils/sweep samples and up to 145 ppm lead in plant foodstuffs. Incidental ingestion of soils via hand-to-mouth transmission and of dusts cleared from the respiratory tract is the dominant exposure pathway. Consumption of water and foodstuffs contaminated by the processing is likely lesser, but these are still significant exposure pathways. Although young children suffered the most immediate and severe consequences, results indicate that older children, adult workers, pregnant women, and breastfed infants are also at risk for lead poisoning. Mercury, arsenic, manganese, antimony, and crystalline silica exposures pose additional health threats. Conclusions: Results inform ongoing efforts in Nigeria to assess lead contamination and poisoning, treat victims, mitigate exposures, and remediate contamination. Ore deposit geology, pre-mining weathering, and burgeoning artisanal mining may combine to cause similar lead poisoning disasters elsewhere globally. PMID:23524139

  2. The Link between Dietary Protein Intake, Skeletal Muscle Function and Health in Older Adults

    Directory of Open Access Journals (Sweden)

    Jamie I. Baum

    2015-07-01

    Full Text Available Skeletal muscle mass and function are progressively lost with age, a condition referred to as sarcopenia. By the age of 60, many older adults begin to be affected by muscle loss. There is a link between decreased muscle mass and strength and adverse health outcomes such as obesity, diabetes and cardiovascular disease. Data suggest that increasing dietary protein intake at meals may counterbalance muscle loss in older individuals due to the increased availability of amino acids, which stimulate muscle protein synthesis by activating the mammalian target of rapamycin (mTORC1. Increased muscle protein synthesis can lead to increased muscle mass, strength and function over time. This review aims to address the current recommended dietary allowance (RDA for protein and whether or not this value meets the needs for older adults based upon current scientific evidence. The current RDA for protein is 0.8 g/kg body weight/day. However, literature suggests that consuming protein in amounts greater than the RDA can improve muscle mass, strength and function in older adults.

  3. Links between teacher assessment and child self-assessment of mental health and behavior among children affected by HIV/AIDS.

    Science.gov (United States)

    Du, Hongfei; Li, Xiaoming; Weinstein, Traci L; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2015-01-01

    Teachers are considered to be one of the most important influences in the lives of students. Teachers' assessments of students may be a primary source of information on children's mental and behavioral health; however, this topic has received little attention in research. We examined this issue through linking teachers' ratings of students and mental and behavioral outcomes of children affected by HIV. The hypothesis is that teacher ratings will be predictive of specific child mental and behavioral health outcomes. A quantitative cross-sectional design with self-administered paper-and-pencil instruments was used. The sample included 1221 children (aged 6-18, grades 1-11) affected by HIV including 755 orphans who lost one or both parents to AIDS and 466 vulnerable children living with HIV-infected parents in a central province of China. The corresponding teacher sample included 185 participants. Each child completed an assessment inventory of demographic information and mental and behavioral health measures. Teachers completed a questionnaire about children's school performance. SEM analyses revealed a good model fit according to all fit indices: comparative fit index = 0.93, root mean square error of approximation = 0.07, and standardized root mean square residual = 0.04. Structural equation modeling revealed that problem ratings by teachers were positively associated with child loneliness and behavioral problems, social competence ratings by teachers were negatively related to child depression, and personal growth and social interaction ratings by teachers were negatively related to child loneliness, depression, and trauma. The current study represents a unique contribution to the field in that it recognizes that teachers can be a valuable source of information on children's psychological health. Results from this study have implications for health prevention and intervention for children and families suffering from HIV/AIDS.

  4. [Dilemma of null hypothesis in ecological hypothesis's experiment test.

    Science.gov (United States)

    Li, Ji

    2016-06-01

    Experimental test is one of the major test methods of ecological hypothesis, though there are many arguments due to null hypothesis. Quinn and Dunham (1983) analyzed the hypothesis deduction model from Platt (1964) and thus stated that there is no null hypothesis in ecology that can be strictly tested by experiments. Fisher's falsificationism and Neyman-Pearson (N-P)'s non-decisivity inhibit statistical null hypothesis from being strictly tested. Moreover, since the null hypothesis H 0 (α=1, β=0) and alternative hypothesis H 1 '(α'=1, β'=0) in ecological progresses are diffe-rent from classic physics, the ecological null hypothesis can neither be strictly tested experimentally. These dilemmas of null hypothesis could be relieved via the reduction of P value, careful selection of null hypothesis, non-centralization of non-null hypothesis, and two-tailed test. However, the statistical null hypothesis significance testing (NHST) should not to be equivalent to the causality logistical test in ecological hypothesis. Hence, the findings and conclusions about methodological studies and experimental tests based on NHST are not always logically reliable.

  5. Immunolocalization of a Histidine-Rich Epidermal Differentiation Protein in the Chicken Supports the Hypothesis of an Evolutionary Developmental Link between the Embryonic Subperiderm and Feather Barbs and Barbules.

    Science.gov (United States)

    Alibardi, Lorenzo; Holthaus, Karin Brigit; Sukseree, Supawadee; Hermann, Marcela; Tschachler, Erwin; Eckhart, Leopold

    2016-01-01

    The morphogenesis of feathers is a complex process that depends on a tight spatiotemporal regulation of gene expression and assembly of the protein components of mature feathers. Recent comparative genomics and gene transcription studies have indicated that genes within the epidermal differentiation complex (EDC) encode numerous structural proteins of cornifying skin cells in amniotes including birds. Here, we determined the localization of one of these proteins, termed EDMTFH (Epidermal Differentiation Protein starting with a MTF motif and rich in Histidine), which belongs to a group of EDC-encoded proteins rich in aromatic amino acid residues. We raised an antibody against an EDMTFH-specific epitope and performed immunohistochemical investigations by light microscopy and immunogold labeling by electron microscopy of chicken embryos at days 14-18 of development. EDMTFH was specifically present in the subperiderm, a transient layer of the embryonic epidermis, and in barbs and barbules of feathers. In the latter, it partially localized to bundles of so-called feather beta-keratins (corneous beta-proteins, CBPs). Cells of the embryonic periderm, the epidermis proper, and the feather sheath were immunonegative for EDMTFH. The results of this study indicate that EDMTFH may contribute to the unique mechanical properties of feathers and define EDMTFH as a common marker of the subperiderm and the feather barbules. This expression pattern of EDMTFH resembles that of epidermal differentiation cysteine-rich protein (EDCRP) and feather CBPs and is in accordance with the hypothesis that a major part of the cyclically regenerating feather follicle is topologically, developmentally and evolutionarily related to the embryonic subperiderm.

  6. Immunolocalization of a Histidine-Rich Epidermal Differentiation Protein in the Chicken Supports the Hypothesis of an Evolutionary Developmental Link between the Embryonic Subperiderm and Feather Barbs and Barbules.

    Directory of Open Access Journals (Sweden)

    Lorenzo Alibardi

    Full Text Available The morphogenesis of feathers is a complex process that depends on a tight spatiotemporal regulation of gene expression and assembly of the protein components of mature feathers. Recent comparative genomics and gene transcription studies have indicated that genes within the epidermal differentiation complex (EDC encode numerous structural proteins of cornifying skin cells in amniotes including birds. Here, we determined the localization of one of these proteins, termed EDMTFH (Epidermal Differentiation Protein starting with a MTF motif and rich in Histidine, which belongs to a group of EDC-encoded proteins rich in aromatic amino acid residues. We raised an antibody against an EDMTFH-specific epitope and performed immunohistochemical investigations by light microscopy and immunogold labeling by electron microscopy of chicken embryos at days 14-18 of development. EDMTFH was specifically present in the subperiderm, a transient layer of the embryonic epidermis, and in barbs and barbules of feathers. In the latter, it partially localized to bundles of so-called feather beta-keratins (corneous beta-proteins, CBPs. Cells of the embryonic periderm, the epidermis proper, and the feather sheath were immunonegative for EDMTFH. The results of this study indicate that EDMTFH may contribute to the unique mechanical properties of feathers and define EDMTFH as a common marker of the subperiderm and the feather barbules. This expression pattern of EDMTFH resembles that of epidermal differentiation cysteine-rich protein (EDCRP and feather CBPs and is in accordance with the hypothesis that a major part of the cyclically regenerating feather follicle is topologically, developmentally and evolutionarily related to the embryonic subperiderm.

  7. Mechanistic links between gut microbial community dynamics, microbial functions and metabolic health

    Science.gov (United States)

    Ha, Connie WY; Lam, Yan Y; Holmes, Andrew J

    2014-01-01

    Gut microbes comprise a high density, biologically active community that lies at the interface of an animal with its nutritional environment. Consequently their activity profoundly influences many aspects of the physiology and metabolism of the host animal. A range of microbial structural components and metabolites directly interact with host intestinal cells and tissues to influence nutrient uptake and epithelial health. Endocrine, neuronal and lymphoid cells in the gut also integrate signals from these microbial factors to influence systemic responses. Dysregulation of these host-microbe interactions is now recognised as a major risk factor in the development of metabolic dysfunction. This is a two-way process and understanding the factors that tip host-microbiome homeostasis over to dysbiosis requires greater appreciation of the host feedbacks that contribute to regulation of microbial community composition. To date, numerous studies have employed taxonomic profiling approaches to explore the links between microbial composition and host outcomes (especially obesity and its comorbidities), but inconsistent host-microbe associations have been reported. Available data indicates multiple factors have contributed to discrepancies between studies. These include the high level of functional redundancy in host-microbiome interactions combined with individual variation in microbiome composition; differences in study design, diet composition and host system between studies; and inherent limitations to the resolution of rRNA-based community profiling. Accounting for these factors allows for recognition of the common microbial and host factors driving community composition and development of dysbiosis on high fat diets. New therapeutic intervention options are now emerging. PMID:25469018

  8. Defining disease phenotypes using national linked electronic health records: a case study of atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Katherine I Morley

    Full Text Available National electronic health records (EHR are increasingly used for research but identifying disease cases is challenging due to differences in information captured between sources (e.g. primary and secondary care. Our objective was to provide a transparent, reproducible model for integrating these data using atrial fibrillation (AF, a chronic condition diagnosed and managed in multiple ways in different healthcare settings, as a case study.Potentially relevant codes for AF screening, diagnosis, and management were identified in four coding systems: Read (primary care diagnoses and procedures, British National Formulary (BNF; primary care prescriptions, ICD-10 (secondary care diagnoses and OPCS-4 (secondary care procedures. From these we developed a phenotype algorithm via expert review and analysis of linked EHR data from 1998 to 2010 for a cohort of 2.14 million UK patients aged ≥ 30 years. The cohort was also used to evaluate the phenotype by examining associations between incident AF and known risk factors.The phenotype algorithm incorporated 286 codes: 201 Read, 63 BNF, 18 ICD-10, and four OPCS-4. Incident AF diagnoses were recorded for 72,793 patients, but only 39.6% (N = 28,795 were recorded in primary care and secondary care. An additional 7,468 potential cases were inferred from data on treatment and pre-existing conditions. The proportion of cases identified from each source differed by diagnosis age; inferred diagnoses contributed a greater proportion of younger cases (≤ 60 years, while older patients (≥ 80 years were mainly diagnosed in SC. Associations of risk factors (hypertension, myocardial infarction, heart failure with incident AF defined using different EHR sources were comparable in magnitude to those from traditional consented cohorts.A single EHR source is not sufficient to identify all patients, nor will it provide a representative sample. Combining multiple data sources and integrating information on treatment and

  9. The prevalence of periodontopathogenic bacteria in saliva is linked to periodontal health status and oral malodour.

    Science.gov (United States)

    Kurata, Hiroshi; Awano, Shuji; Yoshida, Akihiro; Ansai, Toshihiro; Takehara, Tadamichi

    2008-05-01

    This study investigated whether an improvement in periodontal health resulted in changes in the prevalence of periodontopathogenic bacteria in saliva and tongue coatings and a reduction in volatile sulfur compounds (VSCs: H(2)S and CH(3)SH) linked to oral malodour. The subjects were 35 patients who visited the breath odour clinic of Kyushu Dental College, Japan. Their mean age was 51.2+/-18.3 years (mean+/-sd). A clinical examination performed at baseline and 2 months after periodontal treatment assessed VSCs in mouth air using gas chromatography, periodontal probing depth and bleeding on probing (BOP) in all subjects; saliva and tongue coatings were also collected. Genomic DNA was isolated from the samples, and the proportions of five periodontopathogenic bacteria (Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Prevotella intermedia and Prevotella nigrescens) were investigated using quantitative real-time PCR. The subjects were classified into four groups based on the presence of a periodontal pocket of more than 4 mm (PD) and VSCs above the organoleptic threshold level (VSCT) as follows: -PD/-VSCT group, subjects without PD or VSCT; -PD/+VSCT group, those without PD but with VSCT; +PD/-VSCT group, those with PD but without VSCT; and +PD/+VSCT group, those with PD and VSCT. Although the mean PD values in the +PD/-VSCT and +PD/+VSCT groups, BOP in the +PD/+VSCT group, and H(2)S and CH(3)SH concentrations in the -PD/+VSCT and +PD/+VSCT groups were greater than in the other groups at baseline, we found no significant difference among the four groups after periodontal treatment. The proportion of periodontopathogenic bacteria in saliva was higher in the +PD/-VSCT and +PD/+VSCT groups than in the -PD/-VSCT and -PD/+VSCT groups at baseline and after treatment, but the proportions of bacteria in saliva after treatment were reduced compared to the baseline. Furthermore, the differences in the proportions of the five target bacteria in the tongue

  10. Evaluation of a Pilot Surveillance System: Health and Environment Linked for Information Exchange in Atlanta (HELIX-Atlanta)

    Science.gov (United States)

    Meyer, P.; Shire, J.; Qualters, Judy; Daley, Randolph; Fiero, Leslie Todorov; Autry, Andy; Avchen, Rachel; Stock, Allison; Correa, Adolofo; Siffel, Csaba; hide

    2007-01-01

    CDC and its partners established the Health and Environment Linked for Information Exchange, Atlanta (HELIX-Atlanta) demonstration project, to develop linking and analysis methods that could be used by the National Environmental Public Health Tracking (EPHT) Network. Initiated in October 2003, the Metropolitan Atlanta-based collaborative conducted four projects: asthma and particulate air pollution, birth defects and ozone and particulate air pollution, childhood leukemia and traffic emissions, and children's blood lead testing and neighborhood risk factors for lead poisoning. This report provides an overview of the HELIX-Atlanta projects' goals, methods and outcomes. We discuss priority attributes and common issues and challenges and offer recommendations for implementation of the nascent national environmental public health tracking network.

  11. Antiaging therapy: a prospective hypothesis

    Directory of Open Access Journals (Sweden)

    Shahidi Bonjar MR

    2015-01-01

    Full Text Available Mohammad Rashid Shahidi Bonjar,1 Leyla Shahidi Bonjar2 1School of Dentistry, Kerman University of Medical Sciences, Kerman Iran; 2Department of Pharmacology, College of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran Abstract: This hypothesis proposes a new prospective approach to slow the aging process in older humans. The hypothesis could lead to developing new treatments for age-related illnesses and help humans to live longer. This hypothesis has no previous documentation in scientific media and has no protocol. Scientists have presented evidence that systemic aging is influenced by peculiar molecules in the blood. Researchers at Albert Einstein College of Medicine, New York, and Harvard University in Cambridge discovered elevated titer of aging-related molecules (ARMs in blood, which trigger cascade of aging process in mice; they also indicated that the process can be reduced or even reversed. By inhibiting the production of ARMs, they could reduce age-related cognitive and physical declines. The present hypothesis offers a new approach to translate these findings into medical treatment: extracorporeal adjustment of ARMs would lead to slower rates of aging. A prospective “antiaging blood filtration column” (AABFC is a nanotechnological device that would fulfill the central role in this approach. An AABFC would set a near-youth homeostatic titer of ARMs in the blood. In this regard, the AABFC immobilizes ARMs from the blood while blood passes through the column. The AABFC harbors antibodies against ARMs. ARM antibodies would be conjugated irreversibly to ARMs on contact surfaces of the reaction platforms inside the AABFC till near-youth homeostasis is attained. The treatment is performed with the aid of a blood-circulating pump. Similar to a renal dialysis machine, blood would circulate from the body to the AABFC and from there back to the body in a closed circuit until ARMs were sufficiently depleted from the blood. The

  12. The Bergschrund Hypothesis Revisited

    Science.gov (United States)

    Sanders, J. W.; Cuffey, K. M.; MacGregor, K. R.

    2009-12-01

    After Willard Johnson descended into the Lyell Glacier bergschrund nearly 140 years ago, he proposed that the presence of the bergschrund modulated daily air temperature fluctuations and enhanced freeze-thaw processes. He posited that glaciers, through their ability to birth bergschrunds, are thus able to induce rapid cirque headwall retreat. In subsequent years, many researchers challenged the bergschrund hypothesis on grounds that freeze-thaw events did not occur at depth in bergschrunds. We propose a modified version of Johnson’s original hypothesis: that bergschrunds maintain subfreezing temperatures at values that encourage rock fracture via ice lensing because they act as a cold air trap in areas that would otherwise be held near zero by temperate glacial ice. In support of this claim we investigated three sections of the bergschrund at the West Washmawapta Glacier, British Columbia, Canada, which sits in an east-facing cirque. During our bergschrund reconnaissance we installed temperature sensors at multiple elevations, light sensors at depth in 2 of the 3 locations and painted two 1 m2 sections of the headwall. We first emphasize bergschrunds are not wanting for ice: verglas covers significant fractions of the headwall and icicles dangle from the base of bödens or overhanging rocks. If temperature, rather than water availability, is the limiting factor governing ice-lensing rates, our temperature records demonstrate that the bergschrund provides a suitable environment for considerable rock fracture. At the three sites (north, west, and south walls), the average temperature at depth from 9/3/2006 to 8/6/2007 was -3.6, -3.6, and -2.0 °C, respectively. During spring, when we observed vast amounts of snow melt trickle in to the bergschrund, temperatures averaged -3.7, -3.8, and -2.2 °C, respectively. Winter temperatures are even lower: -8.5, -7.3, and -2.4 °C, respectively. Values during the following year were similar. During the fall, diurnal

  13. Operative Links

    DEFF Research Database (Denmark)

    Wistoft, Karen; Højlund, Holger

    2012-01-01

    and have been the object of great expectations concerning the ability to incorporate health concerns into every welfare area through health promotion strategies. The paper draws on results and analyses of a collective research project funded by the Danish National Research Council and carried out...... links' that indicate cooperative levels which facilitate a creative and innovative effort in disease prevention and health promotion targeted at children and adolescents - across traditional professional boundaries. It is proposed that such links are supported by network structures, shared semantics...

  14. Stretching the Stress Boundary: Linking Air Pollution Health Effects to a Neurohormonal Stress Response

    Science.gov (United States)

    Inhaled pollutants produce effects in virtually all organ systems in our body and have been linked to chronic diseases including hypertension, atherosclerosis, Alzheimer’s and diabetes. A neurohormonal stress response (referred here as a systemic response produced by activation ...

  15. Linking governance mechanisms to health outcomes: a review of the literature in low- and middle-income countries.

    Science.gov (United States)

    Ciccone, Dana Karen; Vian, Taryn; Maurer, Lydia; Bradley, Elizabeth H

    2014-09-01

    We conducted a synthesis of peer-reviewed literature to shed light on links between governance mechanisms and health outcomes in low- and middle-income countries. Our review yielded 30 studies, highlighting four key governance mechanisms by which governance may influence health outcomes in these settings: Health system decentralization that enables responsiveness to local needs and values; health policymaking that aligns and empowers diverse stakeholders; enhanced community engagement; and strengthened social capital. Most, but not all, studies found a positive association between governance and health. Additionally, the nature of the association between governance mechanisms and health differed across studies. In some studies (N = 9), the governance effect was direct and positive, while in others (N = 5), the effect was indirect or modified by contextual factors. In still other studies (N = 4), governance was found to have a moderating effect, indicating that governance mechanisms influenced other system processes or structures that improved health. The remaining studies reported mixed findings about the association between governance and health (N = 6), no association between governance and health (N = 4), or had inconclusive results (N = 2). Further exploration is needed to fully understand the relationship between governance and health and to inform the design and delivery of evidence-based, effective governance interventions around the world. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey.

    Science.gov (United States)

    Teckle, P; Hannaford, P; Sutton, M

    2012-02-17

    To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics. Mortality and hospital record data linked to two cross sectional health surveys. Respondents in the community-based 1995 and 1998 Scottish Health Survey who consented to record-linkage follow-up. Hypertension, all-cause premature mortality, total hospital stays and admissions due to coronary heart disease (CHD). Older age and lower social class were strongly associated with an increased risk of each of the four health outcomes measured. After adjustment for individual and practice characteristics, no consistent pattern of better or poorer health in people living in rural areas was found, compared to primary cities. However, individuals living in remote small towns had a lower risk of a hospital admission for CHD and those in very remote rural had lower mortality, both compared with those living in primary cities. This study has shown how linked data can be used to explore the possible influence of area of residence on health. We were unable to find a consistent pattern that people living in rural areas have materially different health to that of those living in primary cities. Instead, we found stronger relationships between compositional determinants (age, gender and socio-economic status) and health than contextual factors (including rurality).

  17. Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey

    Directory of Open Access Journals (Sweden)

    Teckle P

    2012-02-01

    Full Text Available Abstract Background To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics. Methods Design: Mortality and hospital record data linked to two cross sectional health surveys. Setting: Respondents in the community-based 1995 and 1998 Scottish Health Survey who consented to record-linkage follow-up. Main outcome measures: Hypertension, all-cause premature mortality, total hospital stays and admissions due to coronary heart disease (CHD. Results Older age and lower social class were strongly associated with an increased risk of each of the four health outcomes measured. After adjustment for individual and practice characteristics, no consistent pattern of better or poorer health in people living in rural areas was found, compared to primary cities. However, individuals living in remote small towns had a lower risk of a hospital admission for CHD and those in very remote rural had lower mortality, both compared with those living in primary cities. Conclusion This study has shown how linked data can be used to explore the possible influence of area of residence on health. We were unable to find a consistent pattern that people living in rural areas have materially different health to that of those living in primary cities. Instead, we found stronger relationships between compositional determinants (age, gender and socio-economic status and health than contextual factors (including rurality.

  18. Exploring the link between clinical managers involvement in budgeting and performance: Insights from the Italian public health care sector.

    Science.gov (United States)

    Macinati, Manuela S; Rizzo, Marco G

    2016-01-01

    The public health care sector has had an increase in initiatives, mostly inspired by New Public Management principles, aimed at assigning financial accountability to clinical managers. However, clinical managers might experience a scarce alignment between professional values and organizational requirements, which is a potentially important phenomena that may result in negative consequences on clinical managers' job performance. Building on Psychological Ownership Theory and adopting a psychology-based management accounting research approach, we focus on the managerial (nonmedical) role the clinical manager fulfills and explore the budgetary participation-performance link via the indirect effects of job-based psychological ownership, role clarity, and clinical managers' affective commitment toward managerial roles. The data were collected by a survey conducted in an Italian hospital. The research hypotheses were tested employing a path model. Our study revealed new insights that shed some light on underexplored processes through which mental states mediate the participation-performance link. Among these latter, the findings demonstrate that (a) budgetary participation has a direct effect on job-based psychological ownership; (b) role clarity mediates participation- and job-based psychological ownership link; (c) role clarity and job-based psychological ownership partially mediate the participation-commitment link; and (d) job-based psychological ownership, role clarity, and commitment fully mediate the participation-performance link. From a managerial viewpoint, an understanding of how clinical managers' feelings of ownership toward managerial roles could be enhanced is imperative in health care because ownership accounts for important attitudinal and organizational consequences. Results suggest that health care organizations that invest in budgetary participation will directly and indirectly affect clinical managers' psychological ownership, and this, along with

  19. Does Anger Regulation Mediate the Discrimination-Mental Health Link among Mexican-Origin Adolescents? A Longitudinal Mediation Analysis Using Multilevel Modeling

    Science.gov (United States)

    Park, Irene J. K.; Wang, Lijuan; Williams, David R.; Alegría, Margarita

    2017-01-01

    Although prior research has consistently documented the association between racial/ethnic discrimination and poor mental health outcomes, the mechanisms that underlie this link are still unclear. The present 3-wave longitudinal study tested the mediating role of anger regulation in the discrimination-mental health link among 269 Mexican-origin…

  20. Yoga Therapy as a Complement to Astronaut Health and Emotional Fitness Stress Reduction and Countermeasure Effectiveness Before, During, and in Post-Flight Rehabilitation: a Hypothesis

    Science.gov (United States)

    2012-04-01

    School of Integrative Medicine (SIM), Hampton, VA; 4Department of Health and Kinesiology , The University of Texas at San Antonio, TX; ⁵US Army Institute...gene expression regulating stress and glucocorticoid receptors. Journal of Cellular Biochemistry . 110: 372-381. Lee, F.J., Stewart, M., and Brown

  1. Linking Data for Mothers and Babies in De-Identified Electronic Health Data.

    Directory of Open Access Journals (Sweden)

    Katie Harron

    Full Text Available Linkage of longitudinal administrative data for mothers and babies supports research and service evaluation in several populations around the world. We established a linked mother-baby cohort using pseudonymised, population-level data for England.Retrospective linkage study using electronic hospital records of mothers and babies admitted to NHS hospitals in England, captured in Hospital Episode Statistics between April 2001 and March 2013.Of 672,955 baby records in 2012/13, 280,470 (42% linked deterministically to a maternal record using hospital, GP practice, maternal age, birthweight, gestation, birth order and sex. A further 380,164 (56% records linked using probabilistic methods incorporating additional variables that could differ between mother/baby records (admission dates, ethnicity, 3/4-character postcode district or that include missing values (delivery variables. The false-match rate was estimated at 0.15% using synthetic data. Data quality improved over time: for 2001/02, 91% of baby records were linked (holding the estimated false-match rate at 0.15%. The linked cohort was representative of national distributions of gender, gestation, birth weight and maternal age, and captured approximately 97% of births in England.Probabilistic linkage of maternal and baby healthcare characteristics offers an efficient way to enrich maternity data, improve data quality, and create longitudinal cohorts for research and service evaluation. This approach could be extended to linkage of other datasets that have non-disclosive characteristics in common.

  2. Linking Data for Mothers and Babies in De-Identified Electronic Health Data

    Science.gov (United States)

    Gilbert, Ruth; Cromwell, David; van der Meulen, Jan

    2016-01-01

    Objective Linkage of longitudinal administrative data for mothers and babies supports research and service evaluation in several populations around the world. We established a linked mother-baby cohort using pseudonymised, population-level data for England. Design and Setting Retrospective linkage study using electronic hospital records of mothers and babies admitted to NHS hospitals in England, captured in Hospital Episode Statistics between April 2001 and March 2013. Results Of 672,955 baby records in 2012/13, 280,470 (42%) linked deterministically to a maternal record using hospital, GP practice, maternal age, birthweight, gestation, birth order and sex. A further 380,164 (56%) records linked using probabilistic methods incorporating additional variables that could differ between mother/baby records (admission dates, ethnicity, 3/4-character postcode district) or that include missing values (delivery variables). The false-match rate was estimated at 0.15% using synthetic data. Data quality improved over time: for 2001/02, 91% of baby records were linked (holding the estimated false-match rate at 0.15%). The linked cohort was representative of national distributions of gender, gestation, birth weight and maternal age, and captured approximately 97% of births in England. Conclusion Probabilistic linkage of maternal and baby healthcare characteristics offers an efficient way to enrich maternity data, improve data quality, and create longitudinal cohorts for research and service evaluation. This approach could be extended to linkage of other datasets that have non-disclosive characteristics in common. PMID:27764135

  3. Linking Data for Mothers and Babies in De-Identified Electronic Health Data.

    Science.gov (United States)

    Harron, Katie; Gilbert, Ruth; Cromwell, David; van der Meulen, Jan

    2016-01-01

    Linkage of longitudinal administrative data for mothers and babies supports research and service evaluation in several populations around the world. We established a linked mother-baby cohort using pseudonymised, population-level data for England. Retrospective linkage study using electronic hospital records of mothers and babies admitted to NHS hospitals in England, captured in Hospital Episode Statistics between April 2001 and March 2013. Of 672,955 baby records in 2012/13, 280,470 (42%) linked deterministically to a maternal record using hospital, GP practice, maternal age, birthweight, gestation, birth order and sex. A further 380,164 (56%) records linked using probabilistic methods incorporating additional variables that could differ between mother/baby records (admission dates, ethnicity, 3/4-character postcode district) or that include missing values (delivery variables). The false-match rate was estimated at 0.15% using synthetic data. Data quality improved over time: for 2001/02, 91% of baby records were linked (holding the estimated false-match rate at 0.15%). The linked cohort was representative of national distributions of gender, gestation, birth weight and maternal age, and captured approximately 97% of births in England. Probabilistic linkage of maternal and baby healthcare characteristics offers an efficient way to enrich maternity data, improve data quality, and create longitudinal cohorts for research and service evaluation. This approach could be extended to linkage of other datasets that have non-disclosive characteristics in common.

  4. Realising the Value of Linked Data to Health Economic Analyses of Cancer Care: A Case Study of Cancer 2015.

    Science.gov (United States)

    Lorgelly, Paula K; Doble, Brett; Knott, Rachel J

    2016-02-01

    There is a growing appetite for large complex databases that integrate a range of personal, socio-demographic, health, genetic and financial information on individuals. It has been argued that 'Big Data' will provide the necessary catalyst to advance both biomedical research and health economics and outcomes research. However, it is important that we do not succumb to being data rich but information poor. This paper discusses the benefits and challenges of building Big Data, analysing Big Data and making appropriate inferences in order to advance cancer care, using Cancer 2015 (a prospective, longitudinal, genomic cohort study in Victoria, Australia) as a case study. Cancer 2015 has been linked to State and Commonwealth reimbursement databases that have known limitations. This partly reflects the funding arrangements in Australia, a country with both public and private provision, including public funding of private healthcare, and partly the legislative frameworks that govern data linkage. Additionally, linkage is not without time delays and, as such, achieving a contemporaneous database is challenging. Despite these limitations, there is clear value in using linked data and creating Big Data. This paper describes the linked Cancer 2015 dataset, discusses estimation issues given the nature of the data and presents panel regression results that allow us to make possible inferences regarding which patient, disease, genomic and treatment characteristics explain variation in health expenditure.

  5. Housing conditions affecting interior moisture levels: links to mould growth and children's respiratory health

    Energy Technology Data Exchange (ETDEWEB)

    Wells, John A. [Crosier Kilgour and Partners Ltd. (Canada)], email: john.w@ckpeng.com; Polyzois, Dimos [Department of Civil Engineering, University of Manitoba (Canada)], email: polyzoi@cc.umanitoba.ca; Polyzoi, Eleoussa [Faculty of Education, University of Winnipeg (Canada)], email: l.polyzoi@uwinnipeg.ca

    2011-07-01

    Previous research has demonstrated that a person's respiratory health is affected by high indoor moisture content in their house. The aim of this paper is to provide a better understanding of the link between housing conditions and respiratory health, so that strategies can be implemented to improve the quality of life of children. This study was carried out through the completion of a survey by 3,423 parents in Winnipeg, Canada, the collection of 715 air samples from the residences of 715 parents, and an engineering audit of their homes. This study showed that a strong relationship exists between building moisture content and common home maintenance and that routine maintenance is efficient in significantly reducing the growth of mould which impacts children's respiratory health. This paper provided useful information on the relation between housing conditions and respiratory health problems and the rest of the study will aim at determining which building conditions impact mould growth most.

  6. Establishing links between health and productivity in the New Zealand workforce.

    Science.gov (United States)

    Williden, Micalla; Schofield, Grant; Duncan, Scott

    2012-05-01

    To provide the first investigation of individual health behaviors and measures of work performance in New Zealand. Health risk assessments were completed by 747 adults aged 18 to 65 years. Associations between measures of productivity and health risk factors were assessed using multiple stepwise regression. Participants with low to moderate psychological distress levels and who were physically active reported a work performance 6.5% (P productivity suggests that employers may benefit from contributing to health promotion within the workplace.

  7. Mental Health and Social Emotional Programming in Schools: Missing Link or Misappropriation?

    Science.gov (United States)

    Even, Trigg A.; Quast, Heather L.

    2017-01-01

    While differences of opinion exist on whether mental health services fall within the scope of public education, schools may represent the best opportunity to provide young people with necessary access to mental health care. Professional school counselors are uniquely qualified by training and experience to address the mental health and social…

  8. Physical Activity and Health Perception in Aging: Do Body Mass and Satisfaction Matter? A Three-Path Mediated Link.

    Science.gov (United States)

    Condello, Giancarlo; Capranica, Laura; Stager, Joel; Forte, Roberta; Falbo, Simone; Di Baldassarre, Angela; Segura-Garcia, Cristina; Pesce, Caterina

    2016-01-01

    Although ageing people could benefit from healthy diet and physical activity to maintain health and quality of life, further understandings of the diet- and physical activity-related mechanisms that may cause changes in health and quality of life perception are necessary. The purpose of the study was to investigate the effect of eating attitudes, body mass and image satisfaction, and exercise dependence in the relationship between physical activity and health and quality of life perception in older individuals. Hundred and seventy-nine late middle-aged, (55-64 yrs), young-old (65-74 yrs), and old (75-84 yrs) senior athletes (n = 56), physically active (n = 58) or sedentary adults (n = 65) were submitted to anthropometric evaluations (body mass, height) and self-reported questionnaires: Body Image Dimensional Assessment, Exercise Dependence Scale, Eating Attitude Test, and Short Form Health Survey (Physical Component Summary [PCS] and Mental Component Summary [MCS] of and health and quality of life perception). Senior athletes, physically active, and sedentary participants subgroups differed (Psatisfaction. Findings confirm the relevant role of physically active life habits for older individuals to perceive good physical and mental health. The novelty of the three-path mediated link between physical activity level and mental health perception suggests that the beneficial effect of a physically active lifestyle on weight control can positively impinge on the cognitive-emotional dimension of mental health by ensuring the maintenance, also at older age, of a satisfactory body image.

  9. Facilitating mental health help-seeking by young adults with a dedicated online program: a feasibility study of Link.

    Science.gov (United States)

    Kauer, Sylvia D; Buhagiar, Kerrie; Blake, Victoria; Cotton, Sue; Sanci, Lena

    2017-07-09

    To explore the feasibility of a dedicated online youth mental health help-seeking intervention and to evaluate using a randomised controlled trial (RCT) study design in order to identify any modifications needed before commencement of the full-scale RCT. A pilot RCT with 1:1 randomisation to either the intervention or comparison arm. An online study conducted Australia-wide. 18-25 year olds living in Australia were recruited via social media. Link is a dedicated online mental health help-seeking navigation tool that matches user's mental health issues, severity and service-type preferences (online, phone and face-to-face) with appropriate youth-friendly services. The comparison arm was usual help-seeking strategies with a link to Google.com. The primary outcome was the number of acceptability and feasibility criteria successfully met. Intervention and study design acceptability and feasibility were assessed by nine criteria. Secondary outcomes, via online surveys (at baseline, 1 week and 1 month) measured service use, help-seeking intentions, psychological distress, barriers to help-seeking, attitudes towards mental health help-seeking, mental health literacy, satisfaction and trust. Fifty-one participants were randomised (intervention: n=24; comparison: n=27). Three out of four of the intervention and two out of five of the study design criteria were met. Unmet criteria could be addressed by modifications to the study design. Qualitative analysis demonstrated that Link was useful to participants and may have increased their positive experiences towards help-seeking. There were no observable differences between arms in any outcome measures and no harms were detected. Generally, the Link intervention and study design were acceptable and feasible with modifications suggested for the four out of nine unmet criteria. The main trial will hence have shorter surveys and a simpler recruitment process, use positive affect as the primary outcome and will not link to

  10. Context matters (but how and why?) A hypothesis-led literature review of performance based financing in fragile and conflict-affected health systems.

    Science.gov (United States)

    Bertone, Maria Paola; Falisse, Jean-Benoît; Russo, Giuliano; Witter, Sophie

    2018-01-01

    Performance-based financing (PBF) schemes have been expanding rapidly across low and middle income countries in the past decade, with considerable external financing from multilateral, bilateral and global health initiatives. Many of these countries have been fragile and conflict-affected (FCAS), but while the influence of context is acknowledged to be important to the operation of PBF, there has been little examination of how it affects adoption and implementation of PBF. This article lays out initial hypotheses about how FCAS contexts may influence the adoption, adaption, implementation and health system effects of PBF. These are then interrogated through a review of available grey and published literature (140 documents in total, covering 23 PBF schemes). We find that PBF has been more common in FCAS contexts, which were also more commonly early adopters. Very little explanation of the rationale for its adoption, in particular in relation with the contextual features, is given in programme documents. However, there are a number of factors which could explain this, including the greater role of external actors and donors, a greater openness to institutional reform, and lower levels of trust within the public system and between government and donors, all of which favour more contractual approaches. These suggest that rather than emerging despite fragility, conditions of fragility may favour the rapid emergence of PBF. We also document few emerging adaptations of PBF to humanitarian settings and limited evidence of health system effects which may be contextually driven, but these require more in-depth analysis. Another area meriting more study is the political economy of PBF and its diffusion across contexts.

  11. Advocating for Health and Safety through Social Media--Linked In!

    Science.gov (United States)

    Carreon, Amie Klein; Peoples, JaNiene; Shipley, Meagan; Wilson, Kelly; Ramirez, Cameron

    2016-01-01

    Excessive drinking among college students, which is influenced by an array of factors ranging from campus norms to membership in student organizations, has been linked to consequences including motor vehicle accidents, cognitive deficits, arrests, overdoses, assaults, and death. Considering the severity of consequences related to drinking,…

  12. International health policy and stagnating maternal mortality: is there a causal link?

    Science.gov (United States)

    Unger, Jean-Pierre; Van Dessel, Patrick; Sen, Kasturi; De Paepe, Pierre

    2009-05-01

    This paper examines why progress towards Millennium Development Goal 5 on maternal health appears to have stagnated in much of the global south. We contend that besides the widely recognised existence of weak health systems, including weak services, low staffing levels, managerial weaknesses, and lack of infrastructure and information, this stagnation relates to the inability of most countries to meet two essential conditions: to develop access to publicly funded, comprehensive health care, and to provide the not-for-profit sector with needed political, technical and financial support. This paper offers a critical perspective on the past 15 years of international health policies as a possible cofactor of high maternal mortality, because of their emphasis on disease control in public health services at the expense of access to comprehensive health care, and failures of contracting out and public-private partnerships in health care. Health care delivery cannot be an issue both of trade and of right. Without policies to make health systems in the global south more publicly-oriented and accountable, the current standards of maternal and child health care are likely to remain poor, and maternal deaths will continue to affect women and their families at an intolerably high level.

  13. Is the Aluminum Hypothesis Dead?

    Science.gov (United States)

    2014-01-01

    The Aluminum Hypothesis, the idea that aluminum exposure is involved in the etiology of Alzheimer disease, dates back to a 1965 demonstration that aluminum causes neurofibrillary tangles in the brains of rabbits. Initially the focus of intensive research, the Aluminum Hypothesis has gradually been abandoned by most researchers. Yet, despite this current indifference, the Aluminum Hypothesis continues to attract the attention of a small group of scientists and aluminum continues to be viewed with concern by some of the public. This review article discusses reasons that mainstream science has largely abandoned the Aluminum Hypothesis and explores a possible reason for some in the general public continuing to view aluminum with mistrust. PMID:24806729

  14. Linking Measures of Colony and Individual Honey Bee Health to Survival among Apiaries Exposed to Varying Agricultural Land Use.

    Science.gov (United States)

    Smart, Matthew; Pettis, Jeff; Rice, Nathan; Browning, Zac; Spivak, Marla

    2016-01-01

    We previously characterized and quantified the influence of land use on survival and productivity of colonies positioned in six apiaries and found that colonies in apiaries surrounded by more land in uncultivated forage experienced greater annual survival, and generally more honey production. Here, detailed metrics of honey bee health were assessed over three years in colonies positioned in the same six apiaries. The colonies were located in North Dakota during the summer months and were transported to California for almond pollination every winter. Our aim was to identify relationships among measures of colony and individual bee health that impacted and predicted overwintering survival of colonies. We tested the hypothesis that colonies in apiaries surrounded by more favorable land use conditions would experience improved health. We modeled colony and individual bee health indices at a critical time point (autumn, prior to overwintering) and related them to eventual spring survival for California almond pollination. Colony measures that predicted overwintering apiary survival included the amount of pollen collected, brood production, and Varroa destructor mite levels. At the individual bee level, expression of vitellogenin, defensin1, and lysozyme2 were important markers of overwinter survival. This study is a novel first step toward identifying pertinent physiological responses in honey bees that result from their positioning near varying landscape features in intensive agricultural environments.

  15. Linking Measures of Colony and Individual Honey Bee Health to Survival among Apiaries Exposed to Varying Agricultural Land Use

    Science.gov (United States)

    Smart, Matthew; Pettis, Jeff; Rice, Nathan; Browning, Zac; Spivak, Marla

    2016-01-01

    We previously characterized and quantified the influence of land use on survival and productivity of colonies positioned in six apiaries and found that colonies in apiaries surrounded by more land in uncultivated forage experienced greater annual survival, and generally more honey production. Here, detailed metrics of honey bee health were assessed over three years in colonies positioned in the same six apiaries. The colonies were located in North Dakota during the summer months and were transported to California for almond pollination every winter. Our aim was to identify relationships among measures of colony and individual bee health that impacted and predicted overwintering survival of colonies. We tested the hypothesis that colonies in apiaries surrounded by more favorable land use conditions would experience improved health. We modeled colony and individual bee health indices at a critical time point (autumn, prior to overwintering) and related them to eventual spring survival for California almond pollination. Colony measures that predicted overwintering apiary survival included the amount of pollen collected, brood production, and Varroa destructor mite levels. At the individual bee level, expression of vitellogenin, defensin1, and lysozyme2 were important markers of overwinter survival. This study is a novel first step toward identifying pertinent physiological responses in honey bees that result from their positioning near varying landscape features in intensive agricultural environments. PMID:27027871

  16. Linking Measures of Colony and Individual Honey Bee Health to Survival among Apiaries Exposed to Varying Agricultural Land Use.

    Directory of Open Access Journals (Sweden)

    Matthew Smart

    Full Text Available We previously characterized and quantified the influence of land use on survival and productivity of colonies positioned in six apiaries and found that colonies in apiaries surrounded by more land in uncultivated forage experienced greater annual survival, and generally more honey production. Here, detailed metrics of honey bee health were assessed over three years in colonies positioned in the same six apiaries. The colonies were located in North Dakota during the summer months and were transported to California for almond pollination every winter. Our aim was to identify relationships among measures of colony and individual bee health that impacted and predicted overwintering survival of colonies. We tested the hypothesis that colonies in apiaries surrounded by more favorable land use conditions would experience improved health. We modeled colony and individual bee health indices at a critical time point (autumn, prior to overwintering and related them to eventual spring survival for California almond pollination. Colony measures that predicted overwintering apiary survival included the amount of pollen collected, brood production, and Varroa destructor mite levels. At the individual bee level, expression of vitellogenin, defensin1, and lysozyme2 were important markers of overwinter survival. This study is a novel first step toward identifying pertinent physiological responses in honey bees that result from their positioning near varying landscape features in intensive agricultural environments.

  17. Linking public relations processes and organizational effectiveness at a state health department.

    Science.gov (United States)

    Wise, Kurt

    2003-01-01

    This qualitative case study explored a state health department's relationships with strategic constituencies from a public relations perspective. The relationships were explored within the theoretical framework of the Excellence Theory, the dominant paradigm in public research. Findings indicate application of the Excellence Theory has the potential to increase organizational effectiveness at public health entities. With respect to the case investigated, findings indicate that the state health department could increase its organizational effectiveness through the adoption of recommendations based on the Excellence Theory.

  18. Linking public health nursing competencies and service-learning in a global setting.

    Science.gov (United States)

    Brown, Cynthia L

    2017-09-01

    Nurse educators in baccalaureate programs are charged with addressing student competence in public health nursing practice. These educators are also responsible for creating nursing student opportunities for civic engagement and development of critical thinking skills. The IOM report (2010) on the Future of Nursing emphasizes the nurse educator's role in promoting collaborative partnerships that incorporate interdisciplinary and intraprofessional efforts to promote health. The purpose of this article is to describe an innovative approach to address public health nursing competencies and to improve the health and well-being of indigenous populations in a global setting through promotion of collaboration and service- learning principles. As part of a hybrid elective course, baccalaureate nursing students from various nursing tracks participated in a 2 week immersion experience in Belize that included preimmersion preparation. These students were to collaborate among themselves and with Belizean communities to address identified health knowledge deficits and health-related needs for school-aged children and adult populations. Students successfully collaborated in order to meet health-related needs and to engage in health promotion activities in the Toledo district of Belize. They also gained practice in developing public health nursing competencies for entry-level nursing practice. Implementation of service-learning principles provided students with opportunities for civic engagement and self-reflection. Some challenges existed from the students', faculty, and global community's perspectives. Lack of culturally appropriate and country specific health education materials was difficult for students and the community. Faculty encountered challenges in communicating and collaborating with the Belizean partners. Commonalities exist between entry-level public health nursing competencies and service-learning principles. Using service-learning principles in the development of

  19. Linked health data for pharmacovigilance in children: perceived legal and ethical issues for stakeholders and data guardians.

    Science.gov (United States)

    Hopf, Yvonne Marina; Bond, Christine B; Francis, Jill J; Haughney, John; Helms, Peter J

    2014-02-12

    The inclusion of the Community Health Index in the recording of National Health Service (NHS) contacts in Scotland facilitates national linkage of data such as prescribing and healthcare utilisation. This linkage could be the basis for identification of adverse drug reactions. The aim of this article is to report the views of healthcare professionals on data sharing, ownership and the legal and other applicable frameworks relevant to linkage of routinely collected paediatric healthcare data. Qualitative study using semistructured face-to-face interviews addressing the study aims. Purposive sample of professional stakeholders (n=25) including experts on ethics, data protection, pharmacovigilance, data linkage, legal issues and prescribing. Interviews were audio-recorded, transcribed and thematically analysed using a framework approach. Participants identified existing data sharing systems in the UK. Access to healthcare data should be approved by the data owners. The definition of data ownership and associated legal responsibilities for linked healthcare data were seen as important factors to ensure accountability for the use of linked data. Yet data owners were seen as facilitators of the proposed data linkage. Twelve frameworks (legal, regulatory and governance) applicable to the linkage of healthcare data were identified. A large number of potentially relevant legal and regulatory frameworks were identified. Ownership of the linked data was seen as an extension of responsibility for, or guardianship of, the source datasets. The consensus emerging from the present study was that clarity is required on the definition of data sharing, data ownership and responsibilities of data owners.

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

    Science.gov (United States)

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

    2008-11-07

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

  1. Parental Control of the Time Preadolescents Spend on Social Media: Links with Preadolescents' Social Media Appearance Comparisons and Mental Health.

    Science.gov (United States)

    Fardouly, Jasmine; Magson, Natasha R; Johnco, Carly J; Oar, Ella L; Rapee, Ronald M

    2018-07-01

    Time spent on social media and making online comparisons with others may influence users' mental health. This study examined links between parental control over the time their child spends on social media, preadolescents' time spent browsing social media, preadolescents' appearance comparisons on social media, and preadolescents' appearance satisfaction, depressive symptoms, and life satisfaction. Preadolescent social media users (N = 284, 49.1% female; aged 10-12) and one of their parents completed online surveys. Preadolescents, whose parents reported greater control over their child's time on social media, reported better mental health. This relationship was mediated by preadolescents spending less time browsing and making fewer appearance comparisons on social media. Parental control over time spent on social media may be associated with benefits for mental health among preadolescents.

  2. A Critical Interpretive Synthesis of the Literature Linking Music and Adolescent Mental Health

    Science.gov (United States)

    McFerran, Katrina Skewes; Garrido, Sandra; Saarikallio, Suvi

    2016-01-01

    There is a diverse literature that explores the relationship between youth, music, and mental health, with few attempts at systematic synthesis. This critical interpretive review included 33 studies published between 2000 and 2012 investigating the relationship between music and the mental health of young people, particularly targeting depression.…

  3. Prevention of public health risks linked to bullying: A need for a whole community approach

    DEFF Research Database (Denmark)

    Schrabstein, Jorge; Joshi, Paramjit; Due, Pernille

    2008-01-01

    Bullying is a very toxic psychosocial stressor associated with serious health problems and death, affecting both the victims and the bullies. This form of abuse or maltreatment occurs around the world and along the lifespan. Health professionals have the unique responsibility of promoting...

  4. Linking Health Concepts in the Assessment and Evaluation of Water Distribution Systems

    Science.gov (United States)

    Karney, Bryan W.; Filion, Yves R.

    2005-01-01

    The concept of health is not only a specific criterion for evaluation of water quality delivered by a distribution system but also a suitable paradigm for overall functioning of the hydraulic and structural components of the system. This article views health, despite its complexities, as the only criterion with suitable depth and breadth to allow…

  5. Personas: The Linking Pin in Holistic Design for eHealth

    NARCIS (Netherlands)

    van Velsen, Lex Stefan; van Gemert-Pijnen, Julia E.W.C.; Nijland, N.; Beaujean, Desirée; van Steenbergen, Jim

    2012-01-01

    Personas, lively descriptions of distinctive user groups for a technology, have the potential to be a useful tool for designing useful and usable eHealth services. In this paper we discuss the role of personas in a holistic design approach for eHealth: the CeHRes roadmap. We show, using the case of

  6. What Do We Know about the Link between Marriage and Health?

    Science.gov (United States)

    Koball, Heather L.; Moiduddin, Emily; Henderson, Jamila; Goesling, Brian; Besculides, Melanie

    2010-01-01

    Married people enjoy better physical and mental health than those who are not married, and the children of married parents experience better health than do children raised in single-parent families. Furthermore, married parents and their children have longer life expectancies than do members of single-parent or divorced families. Most studies have…

  7. Linking NASA Environmental Data with a National Public Health Cohort Study and a CDC On-Line System to Enhance Public Health Decision Making

    Science.gov (United States)

    Al-Hamdan, Mohammad; Crosson, William; Economou, Sigrid; Estes, Maurice, Jr.; Estes, Sue; Hemmings, Sarah; Kent, Shia; Puckett, Mark; Quattrochi, Dale; Wade, Gina; hide

    2012-01-01

    The overall goal of this study is to address issues of environmental health and enhance public health decision making by utilizing NASA remotely-sensed data and products. This study is a collaboration between NASA Marshall Space Flight Center, Universities Space Research Association (USRA), the University of Alabama at Birmingham (UAB) School of Public Health and the Centers for Disease Control and Prevention (CDC) National Center for Public Health Informatics. The objectives of this study are to develop high-quality spatial data sets of environmental variables, link these with public health data from a national cohort study, and deliver the linked data sets and associated analyses to local, state and federal end-user groups. Three daily environmental data sets were developed for the conterminous U.S. on different spatial resolutions for the period 2003-2008: (1) spatial surfaces of estimated fine particulate matter (PM2.5) exposures on a 10-km grid utilizing the US Environmental Protection Agency (EPA) ground observations and NASA s MODerate-resolution Imaging Spectroradiometer (MODIS) data; (2) a 1-km grid of Land Surface Temperature (LST) using MODIS data; and (3) a 12-km grid of daily Solar Insolation (SI) and maximum and minimum air temperature using the North American Land Data Assimilation System (NLDAS) forcing data. These environmental datasets were linked with public health data from the UAB REasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort study to determine whether exposures to these environmental risk factors are related to cognitive decline and other health outcomes. These environmental national datasets will also be made available to public health professionals, researchers and the general public via the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) system, where they can be aggregated to the county, state or regional level as per users need and downloaded in tabular, graphical, and map formats. The

  8. A Social Network Analysis of the Financial Links Backing Health and Fitness Apps.

    Science.gov (United States)

    Grundy, Quinn; Held, Fabian; Bero, Lisa

    2017-11-01

    To identify the major stakeholders in mobile health app development and to describe their financial relationships using social network analysis. We conducted a structured content analysis of a purposive sample of prominent health and fitness apps available in November 2015 in the United States, Canada, and Australia. We conducted a social network analysis of apps' developers, investors, other funding sources, and content advisors to describe the financial relationships underpinning health app development. Prominent health and fitness apps are largely developed by private companies based in North America, with an average of 4.7 (SD = 5.5) financial relations, including founders, external investors, acquiring companies, and commercial partnerships. Network analysis revealed a core of 41 sampled apps connected to 415 other entities by 466 financial relations. This core largely comprised apps published by major technology, pharmaceutical, and fashion corporations. About one third of apps named advisors, many of whom had commercial affiliations. Public health needs to extend its scrutiny and advocacy beyond the health messages contained within apps to understanding commercial influences on health and, when necessary, challenging them.

  9. Broken English, broken bones? Mechanisms linking language proficiency and occupational health in a Montreal garment factory.

    Science.gov (United States)

    Premji, Stéphanie; Messing, Karen; Lippel, Katherine

    2008-01-01

    Language barriers are often cited as a factor contributing to ethnic inequalities in occupational health; however, little information is available about the mechanisms at play. The authors describe the multiple ways in which language influences occupational health in a large garment factory employing many immigrants in Montreal. Between 2004 and 2006, individual, semi-structured interviews were conducted with 15 women and 10 men from 14 countries of birth. Interviews were conducted in French and English, Canada's official languages, as well as in non-official languages with the help of colleague-interpreters. Observation within the workplace was also carried out at various times during the project. The authors describe how proficiency in the official languages influences occupational health by affecting workers' ability to understand and communicate information, and supporting relationships that can affect work-related health. They also describe workers' strategies to address communication barriers and discuss the implications of these strategies from an occupational health standpoint. Along with the longer-term objectives of integrating immigrants into the linguistic majority and addressing structural conditions that can affect health, policies and practices need to be put in place to protect the health and well-being of those who face language barriers in the short term.

  10. Lesbian, gay, & bisexual older adults: linking internal minority stressors, chronic health conditions, and depression.

    Science.gov (United States)

    Hoy-Ellis, Charles P; Fredriksen-Goldsen, Karen I

    2016-11-01

    This study aims to: (1) test whether the minority stressors disclosure of sexual orientation; and (2) internalized heterosexism are predictive of chronic physical health conditions; and (3) depression; (4) to test direct and indirect relationships between these variables; and (5) whether chronic physical health conditions are further predictive of depression, net of disclosure of sexual orientation and internalized heterosexism. Secondary analysis of national, community-based surveys of 2349 lesbian, gay, and bisexual adults aged 50 and older residing in the US utilizing structural equation modeling. Congruent with minority stress theory, disclosure of sexual orientation is indirectly associated with chronic physical health conditions and depression, mediated by internalized heterosexism with a suppressor effect. Internalized heterosexism is directly associated with chronic physical health conditions and depression, and further indirectly associated with depression mediated by chronic physical health conditions. Finally, chronic physical health conditions have an additional direct relationship with depression, net of other predictor variables. Minority stressors and chronic physical health conditions independently and collectively predict depression, possibly a synergistic effect. Implications for depression among older sexual minority adults are discussed.

  11. Mortality In Rural China Declined As Health Insurance Coverage Increased, But No Evidence The Two Are Linked.

    Science.gov (United States)

    Zhou, Maigeng; Liu, Shiwei; Kate Bundorf, M; Eggleston, Karen; Zhou, Sen

    2017-09-01

    Health insurance holds the promise of improving population health and survival and protecting people from catastrophic health spending. Yet evidence from lower- and middle-income countries on the impact of health insurance is limited. We investigated whether insurance expansion reduced adult mortality in rural China, taking advantage of differences across Chinese counties in the timing of the introduction of the New Cooperative Medical Scheme (NCMS). We assembled and analyzed newly collected data on NCMS implementation, linked to data from the Chinese Center for Disease Control and Prevention on cause-specific, age-standardized death rates and variables specific to county-year combinations for seventy-two counties in the period 2004-12. While mortality rates declined among rural residents during this period, we found little evidence that the expansion of health insurance through the NCMS contributed to this decline. However, our relatively large standard errors leave open the possibility that the NCMS had effects on mortality that we could not detect. Moreover, mortality benefits might arise only after many years of accumulated coverage. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Caring for children with physical disability in Kenya: potential links between caregiving and carers' physical health.

    Science.gov (United States)

    Geere, J L; Gona, J; Omondi, F O; Kifalu, M K; Newton, C R; Hartley, S

    2013-05-01

    The health of a carer is a key factor which can affect the well-being of the child with disabilities for whom they care. In low-income countries, many carers of children with disabilities contend with poverty, limited public services and lack assistive devices. In these situations caregiving may require more physical work than in high-income countries and so carry greater risk of physical injury or health problems. There is some evidence that poverty and limited access to health care and equipment may affect the physical health of those who care for children with disabilities. This study seeks to understand this relationship more clearly. A mixed methods study design was used to identify the potential physical health effects of caring for a child with moderate-severe motor impairments in Kilifi, Kenya. Qualitative data from in-depth interviews were thematically analysed and triangulated with data collected during structured physiotherapy assessment. Carers commonly reported chronic spinal pain of moderate to severe intensity, which affected essential activities. However, carers differed in how they perceived their physical health to be affected by caregiving, also reporting positive benefits or denying detrimental effects. Carers focussed on support in two key areas; the provision of simple equipment and support for their children to physically access and attend school. Carers of children with moderate-severe motor impairments live with their own physical health challenges. While routine assessments lead to diagnosis of simple musculoskeletal pain syndromes, the overall health status and situation of carers may be more complex. As a consequence, the role of rehabilitation therapists may need to be expanded to effectively evaluate and support carers' health needs. The provision of equipment to improve their child's mobility, respite care or transport to enable school attendance is likely to be helpful to carers and children alike. © 2012 Blackwell Publishing Ltd.

  13. Sexual orientation of trans adults is not linked to outcome of transition-related health care, but worth asking.

    Science.gov (United States)

    Nieder, Timo O; Elaut, Els; Richards, Christina; Dekker, Arne

    2016-01-01

    Since the beginning of contemporary transition-related care at the outset of the 20th century, sexual orientation has ben considered to be closely connected with gender identity and the developmental trajectories of trans people. Specifically, health professionals have regarded the anticipated post-transitional heterosexual behaviour of trans adults as predictive of a good outcome of cross-sex hormones and gender-confirming surgeries. This article reviews the current literature according to the question of whether the sexual orientation of trans people is linked to outcome measures following transition-related interventions. A comprehensive review was undertaken using the Medline database, searching for empirical studies published between 2010 and 2015. Out of a total of 474 studies, only 10 studies reported a follow-up of trans adults and assessed sexual orientation in the study protocol at all. Sexual orientation was predominantly assessed as homosexual versus non-homosexual related to sex assigned at birth. Only one 1 of 10 follow-up studies found a significant association according to the outcome between groups differentiated by sexual orientation. Empirically there is no link between sexual orientation and outcome of transition-related health care for trans adults. In order to provide comprehensive health care, we recommend asking for sexual behaviours, attractions and identities, as well as for gender experiences and expressions; however, this knowledge should not drive, but simply inform, such comprehensive care.

  14. Framing Mechanisms Linking HIV-Related Stigma, Adherence to Treatment, and Health Outcomes

    Science.gov (United States)

    Hatcher, Abigail M.; Weiser, Sheri D.; Johnson, Mallory O.; Rice, Whitney S.; Turan, Janet M.

    2017-01-01

    We present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. HIV-related stigma is recognized as a barrier to both HIV prevention and engagement in HIV care, but little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes. Our conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways. A conceptual framework that encompasses recent advances in stigma science can inform future research and interventions aiming to address stigma as a driver of HIV-related health. PMID:28426316

  15. The health risk linked to oil activities in the Ecuadorian Amazon: From alerts to decisions

    International Nuclear Information System (INIS)

    Bissardon, Pauline; Becerra, Sylvia; Maurice, Laurence

    2013-01-01

    This article traces the long and difficult process of demonstrating the health impact associated with environmental contamination caused by the oil exploration and production underway in the Ecuadorian Amazon for the past 40 years. Contamination in the areas affected by oil activities is both accidental and chronic. The latter is more complex to perceive and demonstrate, due to the lack of visual evidence of oil products. Currently, the health consequences to local populations of environmental exposures have neither been described with precision, nor managed by public authorities. The history of governance in the Ecuadorian Amazon helps to illuminate the pathway that weak signals of environmental contamination and their health consequences have travelled through the public space, as well as the political conditions which explain the negligible impact. We demonstrate that public policy remains limited to repairing the social and environmental impact of oil contamination and that the health risks have not yet reached the political agenda despite their recent legal recognition. (authors)

  16. The missing link between human ecology and public health: the case of cancer.

    Science.gov (United States)

    Modonesi, Carlo; Oddone, Enrico; Panizza, Celestino; Imbriani, Marcello

    2017-11-01

    The primary role played by the 'ecological context' in clarifying the causes and dynamics of human health and disease is the topic of this article. It emphasizes that the challenging incidence of cancer and other diseases can be charged primarily to the effects of the worldwide dominant economic model. Human culture may act as a powerful force affecting the environment, biology and health of humans and other species. Human culture can be viewed as a special and extreme case of 'niche construction', where human-specific traits, technologies and beliefs act together. The feedback between human activities and the environment can promote different trends in public health. This should provide the opportunity to rethink the consequences that our economic model produces both on the environment and on physical, mental and social health of our species. Copyright© by Aracne Editrice, Roma, Italy.

  17. Making the links: do we connect climate change with health? A qualitative case study from Canada

    OpenAIRE

    Cardwell, Francesca S; Elliott, Susan J

    2013-01-01

    Background Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an ...

  18. In search of links between social capital, mental health and sociotherapy: a longitudinal study in Rwanda.

    Science.gov (United States)

    Verduin, Femke; Smid, Geert E; Wind, Tim R; Scholte, Willem F

    2014-11-01

    To date, reviews show inconclusive results on the association between social capital and mental health. Evidence that social capital can intentionally be promoted is also scarce. Promotion of social capital may impact post-conflict recovery through both increased social cohesion and better mental health. However, studies on community interventions and social capital have mostly relied on cross-sectional study designs. We present a longitudinal study in Rwanda on the effect on social capital and mental health of sociotherapy, a community-based psychosocial group intervention consisting of fifteen weekly group sessions. We hypothesized that the intervention would impact social capital and, as a result of that, mental health. We used a quasi-experimental study design with measurement points pre- and post-intervention and at eight months follow-up (2007-2008). Considering sex and living situation, we selected 100 adults for our experimental group. We formed a control group of 100 respondents with similar symptom score distribution, age, and sex from a random community sample in the same region. Mental health was assessed by use of the Self Reporting Questionnaire, and social capital through a locally adapted version of the short Adapted Social Capital Assessment Tool. It measures three elements of social capital: cognitive social capital, support, and civic participation. Latent growth models were used to examine whether effects of sociotherapy on mental health and social capital were related. Civic participation increased with 7% in the intervention group versus 2% in controls; mental health improved with 10% versus 5% (both: p social capital did not show consistent changes. These findings hint at the possibility to foster social capital and simultaneously impact mental health. Further identification of pathways of influence may contribute to the designing of psychosocial interventions that effectively promote recovery in war-affected populations. Nederlands Trial

  19. How Economic Analysis Can Contribute to Understanding the Links between Housing and Health.

    Science.gov (United States)

    Chapman, Ralph; Preval, Nicholas; Howden-Chapman, Philippa

    2017-08-31

    An economic analysis of housing's linkages to health can assist policy makers and researchers to make better decisions about which housing interventions and policies are the most cost-beneficial. The challenge is to include cobenefits. The adoption in 2015 of the UN Sustainable Development Goals underscores the importance of understanding how policies interact, and the merit of comprehensively evaluating cobenefits. We explain our approach to the empirical assessment of such cobenefits in the housing and health context, and consider lessons from empirical economic appraisals of the impact of housing on health outcomes. Critical assumptions relating to cobenefits are explicitly examined. A key finding is that when wider policy outcome measures are included, such as mental health impacts and carbon emission reductions, it is important that effects of assumptions on outcomes are considered. Another is that differing values underlie appraisal, for example, the weight given to future generations through the discount rate. Cost-benefit analyses (CBAs) can better facilitate meaningful debate when they are based on explicit assumptions about values. In short, the insights drawn from an economic framework for housing-and-health studies are valuable, but nonetheless contingent. Given that housing interventions typically have both health and other cobenefits, and incorporate social value judgements, it is important to take a broad view but be explicit about how such interventions are assessed.

  20. Interpretando correctamente en salud pública estimaciones puntuales, intervalos de confianza y contrastes de hipótesis Accurate interpretation of point estimates, confidence intervals, and hypothesis tests in public health

    Directory of Open Access Journals (Sweden)

    Manuel G Scotto

    2003-12-01

    Full Text Available El presente ensayo trata de aclarar algunos conceptos utilizados habitualmente en el campo de investigación de la salud pública, que en numerosas situaciones son interpretados de manera incorrecta. Entre ellos encontramos la estimación puntual, los intervalos de confianza, y los contrastes de hipótesis. Estableciendo un paralelismo entre estos tres conceptos, podemos observar cuáles son sus diferencias más importantes a la hora de ser interpretados, tanto desde el punto de vista del enfoque clásico como desde la óptica bayesiana.This essay reviews some statistical concepts frequently used in public health research that are commonly misinterpreted. These include point estimates, confidence intervals, and hypothesis tests. By comparing them using the classical and the Bayesian perspectives, their interpretation becomes clearer.

  1. Linking evidence to action on social determinants of health using Urban HEART in the Americas.

    Science.gov (United States)

    Prasad, Amit; Groot, Ana Maria Mahecha; Monteiro, Teofilo; Murphy, Kelly; O'Campo, Patricia; Broide, Emilia Estivalet; Kano, Megumi

    2013-12-01

    To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART) launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH) approach. The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil), Toronto (Canada), and Bogotá and Medellín (Colombia). Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps. In three cities, local governments spearheaded the process, while in the fourth (Toronto), academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights. Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  2. Linking evidence to action on social determinants of health using Urban HEART in the Americas

    Directory of Open Access Journals (Sweden)

    Amit Prasad

    2013-12-01

    Full Text Available OBJECTIVE: To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH approach METHODS: The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil, Toronto (Canada, and Bogotá and Medellín (Colombia. Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps RESULTS: In three cities, local governments spearheaded the process, while in the fourth (Toronto, academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights CONCLUSIONS: Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  3. Hypothesis Designs for Three-Hypothesis Test Problems

    OpenAIRE

    Yan Li; Xiaolong Pu

    2010-01-01

    As a helpful guide for applications, the alternative hypotheses of the three-hypothesis test problems are designed under the required error probabilities and average sample number in this paper. The asymptotic formulas and the proposed numerical quadrature formulas are adopted, respectively, to obtain the hypothesis designs and the corresponding sequential test schemes under the Koopman-Darmois distributions. The example of the normal mean test shows that our methods are qu...

  4. A Dopamine Hypothesis of Autism Spectrum Disorder.

    Science.gov (United States)

    Pavăl, Denis

    2017-01-01

    Autism spectrum disorder (ASD) comprises a group of neurodevelopmental disorders characterized by social deficits and stereotyped behaviors. While several theories have emerged, the pathogenesis of ASD remains unknown. Although studies report dopamine signaling abnormalities in autistic patients, a coherent dopamine hypothesis which could link neurobiology to behavior in ASD is currently lacking. In this paper, we present such a hypothesis by proposing that autistic behavior arises from dysfunctions in the midbrain dopaminergic system. We hypothesize that a dysfunction of the mesocorticolimbic circuit leads to social deficits, while a dysfunction of the nigrostriatal circuit leads to stereotyped behaviors. Furthermore, we discuss 2 key predictions of our hypothesis, with emphasis on clinical and therapeutic aspects. First, we argue that dopaminergic dysfunctions in the same circuits should associate with autistic-like behavior in nonautistic subjects. Concerning this, we discuss the case of PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections) which displays behaviors similar to those of ASD, presumed to arise from dopaminergic dysfunctions. Second, we argue that providing dopamine modulators to autistic subjects should lead to a behavioral improvement. Regarding this, we present clinical studies of dopamine antagonists which seem to have improving effects on autistic behavior. Furthermore, we explore the means of testing our hypothesis by using neuroreceptor imaging, which could provide comprehensive evidence for dopamine signaling dysfunctions in autistic subjects. Lastly, we discuss the limitations of our hypothesis. Along these lines, we aim to provide a dopaminergic model of ASD which might lead to a better understanding of the ASD pathogenesis. © 2017 S. Karger AG, Basel.

  5. Physical Activity and Health Perception in Aging: Do Body Mass and Satisfaction Matter? A Three-Path Mediated Link.

    Directory of Open Access Journals (Sweden)

    Giancarlo Condello

    Full Text Available Although ageing people could benefit from healthy diet and physical activity to maintain health and quality of life, further understandings of the diet- and physical activity-related mechanisms that may cause changes in health and quality of life perception are necessary. The purpose of the study was to investigate the effect of eating attitudes, body mass and image satisfaction, and exercise dependence in the relationship between physical activity and health and quality of life perception in older individuals. Hundred and seventy-nine late middle-aged, (55-64 yrs, young-old (65-74 yrs, and old (75-84 yrs senior athletes (n = 56, physically active (n = 58 or sedentary adults (n = 65 were submitted to anthropometric evaluations (body mass, height and self-reported questionnaires: Body Image Dimensional Assessment, Exercise Dependence Scale, Eating Attitude Test, and Short Form Health Survey (Physical Component Summary [PCS] and Mental Component Summary [MCS] of and health and quality of life perception. Senior athletes, physically active, and sedentary participants subgroups differed (P<0.05 from each other in body mass index (BMI and several components of body image and exercise dependence. Senior athletes showed, compared to their sedentary counterparts, further differences (P<0.05 in eating attitudes and in both PCS and MCS. Mediation analysis showed that the relationship between physical activity habit and MCS, but not PCS, was indirectly explained by a serial mediation chain composed of objective BMI and subjective body image (dissatisfaction. Findings confirm the relevant role of physically active life habits for older individuals to perceive good physical and mental health. The novelty of the three-path mediated link between physical activity level and mental health perception suggests that the beneficial effect of a physically active lifestyle on weight control can positively impinge on the cognitive-emotional dimension of mental health

  6. Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Seixas AA

    2015-09-01

    Full Text Available Azizi A Seixas,1 Joao V Nunes,2 Collins O Airhihenbuwa,3 Natasha J Williams,1 Seithikurippu Ratnas Pandi-Perumal,1 Caryl C James,4 Girardin Jean-Louis11Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, 2Sophie Davis School of Biomedical Education, City College of New York, New York, NY, USA; 3Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA; 4Department of Sociology, Psychology and Social Work, The University of the West Indies, Mona, JamaicaObjective: The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours.Methods: Data from the 2009 National Health Interview Survey (NHIS, a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis.Participants: A total of 27,731 participants (age range 18–85 years from the NHIS 2009 dataset were interviewed.Measures: Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7–8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period.Results: Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001.Conclusion: Emotional distress, an important proxy for

  7. Distress Tolerance Links Sleep Problems with Stress and Health in Homeless.

    Science.gov (United States)

    Reitzel, Lorraine R; Short, Nicole A; Schmidt, Norman B; Garey, Lorra; Zvolensky, Michael J; Moisiuc, Alexis; Reddick, Carrie; Kendzor, Darla E; Businelle, Michael S

    2017-11-01

    We examined associations between sleep problems, distress intolerance, and perceived stress and health in a convenience sample of homeless adults. Participants (N = 513, 36% women, Mage = 44.5 ±11.9) self-reported sleep adequacy, sleep duration, unintentional sleep during the daytime, distress tolerance, urban stress, and days of poor mental health and days of poor physical health over the last month. The indirect effects of sleep problems on stress and health through distress tolerance were examined using a non-parametric, bias-corrected bootstrapping procedure. Sleep problems were prevalent (eg, 13.0 ±11.4 days of inadequate sleep and 4.7 ±7.9 days of unintentionally falling asleep during the preceding month). Distress intolerance partially accounted for the associations of inadequate sleep and unintentionally falling asleep, but not sleep duration, with urban stress and more days of poor mental and physical health. Many homeless individuals endure sleep problems. Given the connections between sleep and morbidity and mortality, results further support the need for more attention directed toward facilitating improvements in sleep quality to improve the quality of life of homeless adults, potentially including attention to improving distress tolerance skills.

  8. Effects of the Residential Environment on Health in Japan Linked with Travel Behavior.

    Science.gov (United States)

    Perez Barbosa, David; Zhang, Junyi; Seya, Hajime

    2016-02-03

    This paper aims to clarify how the residential environment is associated with overall health-related quality of life (QOL) via active travel (walking and cycling), by reflecting the influence of different trip purposes in Japan. The health-related QOL includes physical, mental, and social dimensions. For this study we implemented a questionnaire survey in 20 cities in Japan in 2010 and obtained valid answers from 1202 respondents. The residential environment is defined in terms of distances to and densities of different daily facilities extracted from both the survey and external GIS data. We found that the effects of residential environment on active travel behavior are mixed and limited, depending on types of trip makers. Unexpectedly, travel behavior has no direct effects on the health-related QOL. The residential environment, which is only observed indirectly via lifestyle habits for commuters, has limited effects on health. As for noncommuters, neither their travel behavior nor the residential environment influences their health-related QOL.

  9. Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

    Directory of Open Access Journals (Sweden)

    Freda Mold

    2015-12-01

    Full Text Available Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1 Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2 Whether online access to records improves patient safety and health outcomes; (3 Whether record access increases disparities across social classes and between genders; and (4 Improving efficiency. The challenges for practice are: (1 How to incorporate online access into clinical workflow; (2 The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

  10. The Cow in the Room: Public Knowledge of the Links Between Dietary Choices and Health and Environmental Impacts

    Directory of Open Access Journals (Sweden)

    Andrew W Joyce

    2008-01-01

    Full Text Available Issue Addressed: This paper describes results of a survey comparing people’s knowledge of health and environmental impacts of dietary choices. Dietary choice is one of the key ways in which individuals can reduce their environmental impact in relation to water use and greenhouse gas emissions but this may not be widely known amongst the public due to limited press coverage.Methods: A street intercept survey was conducted asking open ended questions on how people can help the environment, maintain or improve health and basic demographics. The sample size was 107 with a refusal rate of 51%.Results: Only 3.2% of the sample made a link between dietary choice and environmental impact whereas 85.6% of the sample referred to dietary choice in relation to personal health. Transport options and keeping active were popular responses to both health and environmental categories.Conclusions: It seems that very few people are aware that the livestock sector is the second largest contributor to equivalent greenhouse gas emissions and one of the largest users of fresh water. Reduction in red meat consumption could have both important positive health and environmental impacts.

  11. Tests of the lunar hypothesis

    Science.gov (United States)

    Taylor, S. R.

    1984-01-01

    The concept that the Moon was fissioned from the Earth after core separation is the most readily testable hypothesis of lunar origin, since direct comparisons of lunar and terrestrial compositions can be made. Differences found in such comparisons introduce so many ad hoc adjustments to the fission hypothesis that it becomes untestable. Further constraints may be obtained from attempting to date the volatile-refractory element fractionation. The combination of chemical and isotopic problems suggests that the fission hypothesis is no longer viable, and separate terrestrial and lunar accretion from a population of fractionated precursor planetesimals provides a more reasonable explanation.

  12. Air pollution around schools is linked to poorer student health and academic performance.

    Science.gov (United States)

    Mohai, Paul; Kweon, Byoung-Suk; Lee, Sangyun; Ard, Kerry

    2011-05-01

    Exposing children to environmental pollutants during important times of physiological development can lead to long-lasting health problems, dysfunction, and disease. The location of children's schools can increase their exposure. We examined the extent of air pollution from industrial sources around public schools in Michigan to find out whether air pollution jeopardizes children's health and academic success. We found that schools located in areas with the highest air pollution levels had the lowest attendance rates-a potential indicator of poor health-and the highest proportions of students who failed to meet state educational testing standards. Michigan and many other states currently do not require officials considering a site for a new school to analyze its environmental quality. Our results show that such requirements are needed. For schools already in existence, we recommend that their environmental quality should be investigated and improved if necessary.

  13. Health care providers: a missing link in understanding acceptability of the female condom.

    Science.gov (United States)

    Mantell, Joanne E; West, Brooke S; Sue, Kimberly; Hoffman, Susie; Exner, Theresa M; Kelvin, Elizabeth; Stein, Zena A

    2011-02-01

    Health care providers can play a key role in influencing clients to initiate and maintain use of the female condom, an underused method for HIV/STI and pregnancy prevention. In 2001-2002, based on semistructured interviews with 78 health care providers from four types of settings in New York City, we found that most providers had seen the female condom, but they had not used it and did not propose the method to clients. They lacked details about the method-when to insert it, where it can be obtained, and its cost. Gender of provider, provider level of training, and setting appeared to influence their attitudes. Unless and until provider training on the female condom is greatly improved, broader acceptance of this significant public health contribution to preventing HIV/AIDS and unwanted pregnancy will not be achieved.

  14. Differences between individual and societal health state valuations: any link with personality?

    Science.gov (United States)

    Chapman, Benjamin P; Franks, Peter; Duberstein, Paul R; Jerant, Anthony

    2009-08-01

    The concept of "adaptation" has been proposed to account for differences between individual and societal valuations of specific health states in patients with chronic diseases. Little is known about psychological indices of adaptational capacity, which may predict differences in individual and societal valuations of health states. We investigated whether such differences were partially explained by personality traits in chronic disease patients. Analysis of baseline data of randomized controlled trial. Three hundred seventy patients with chronic disease. The NEO-five factor inventory measure of personality, EuroQoL-5D (EQ-5D) societal-based, and the EQ visual analogue scale individually-based measures of health valuation. Regression analyses modeled Dev, a measure of difference between the EQ-Visual Analogue Scale and EQ-5D, as a function of personality traits, sociodemographic factors, and chronic diseases. Individual valuations were significantly and clinically higher than societal valuations among patients in the second and third quartile of conscientiousness (Dev = 0.08, P = 0.01); among covariates, only depression (Dev = -0.04, P = 0.046) was also associated with Dev. Compared with societal valuations of a given health state, persons at higher quartiles of conscientiousness report less disutility associated with poor health. The effect is roughly twice that of some estimates of minimally important clinical differences on the EQ-5D and of depression. Although useful at the aggregate level, societal preference measures may systematically undervalue the health states of more conscientious individuals. Future work should examine the impact this has on individual patient outcome evaluation in clinical studies.

  15. Links between biogas technology adoption and health status of households in rural Tigray, Northern Ethiopia

    International Nuclear Information System (INIS)

    Abadi, Nigussie; Gebrehiwot, Kindeya; Techane, Ataklti; Nerea, Hailish

    2017-01-01

    Many Ethiopians face quality of life and livelihood challenges associated with sub-optimal sanitation, dependence on biomass energy, and decreasing agricultural productivity. To mitigate these livelihood challenges, the government of Ethiopia has recognized the need for a national policy framework, which encourages the uptake of biogas technology. However, despite expectations of improved health and livelihood outcomes from biogas technology, rigorous impact evaluations of existing biogas interventions in Ethiopia do not exist. In this paper, we investigated the impact of biogas technology adoption on indoor air pollution (IAP) health symptoms in a sample of 200 households in the Tigray Region of Ethiopia. The average treatment effect results of the study revealed that households with small-scale biogas technology have significantly lower incidence of IAP-related illness than comparison (non-adopter) households in the matched sample. Consequently, small-scale biogas adopters spent less money for medication and had less absentee days from work due to illness. Results also show that biogas adopters spent less time per year collecting fuel energy. Overall, these findings are grounds for optimism about the potential for small-scale biogas to improve human capital formation through better health, which is one the major targets of the UN Sustainable Development Goals. - Highlights: • We critically investigate the impact of biogas technology on human health. • We employ Propensity score matching methods. • We found biogas technology enhancing human health and welfare. • We advise to stress on monetizing health benefits of biogas. • We recommend innovative financing for promotion of biogas technology.

  16. Constrained choices? Linking employees' and spouses' work time to health behaviors.

    Science.gov (United States)

    Fan, Wen; Lam, Jack; Moen, Phyllis; Kelly, Erin; King, Rosalind; McHale, Susan

    2015-02-01

    There are extensive literatures on work conditions and health and on family contexts and health, but less research asking how a spouse or partners' work conditions may affect health behaviors. Drawing on the constrained choices framework, we theorized health behaviors as a product of one's own time and spouses' work time as well as gender expectations. We examined fast food consumption and exercise behaviors using survey data from 429 employees in an Information Technology (IT) division of a U.S. Fortune 500 firm and from their spouses. We found fast food consumption is affected by men's work hours-both male employees' own work hours and the hours worked by husbands of women respondents-in a nonlinear way. The groups most likely to eat fast food are men working 50 h/week and women whose husbands work 45-50 h/week. Second, exercise is better explained if work time is conceptualized at the couple, rather than individual, level. In particular, neo-traditional arrangements (where husbands work longer than their wives) constrain women's ability to engage in exercise but increase odds of men exercising. Women in couples where both partners are working long hours have the highest odds of exercise. In addition, women working long hours with high schedule control are more apt to exercise and men working long hours whose wives have high schedule flexibility are as well. Our findings suggest different health behaviors may have distinct antecedents but gendered work-family expectations shape time allocations in ways that promote men's and constrain women's health behaviors. They also suggest the need to expand the constrained choices framework to recognize that long hours may encourage exercise if both partners are looking to sustain long work hours and that work resources, specifically schedule control, of one partner may expand the choices of the other. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Psychological Pathways Linking Social Support to Health Outcomes: A Visit with the “Ghosts” of Research Past, Present, and Future

    Science.gov (United States)

    Uchino, Bert N.; Bowen, Kimberly; Carlisle, McKenzie; Birmingham, Wendy

    2012-01-01

    Contemporary models postulate the importance of psychological mechanisms linking perceived and received social support to physical health outcomes. In this review, we examine studies that directly tested the potential psychological mechanisms responsible for links between social support and health-relevant physiological processes (1980s to 2010). Inconsistent with existing theoretical models, no evidence was found that psychological mechanisms such as depression, perceived stress, and other affective processes are directly responsible for links between support and health. We discuss the importance of considering statistical/design issues, emerging conceptual perspectives, and limitations of our existing models for future research aimed at elucidating the psychological mechanisms responsible for links between social support and physical health outcomes. PMID:22326104

  18. Linking Child Welfare and Mental Health Using Trauma-Informed Screening and Assessment Practices

    Science.gov (United States)

    Conradi, Lisa; Wherry, Jeffrey; Kisiel, Cassandra

    2011-01-01

    An abundance of research suggests that children in the child welfare system (CWS) have experienced numerous traumatic events and are exhibiting traumatic stress symptoms. Therefore, it is critical that the CWS work closely with the mental health system to ensure that these children receive the appropriate trauma screening, trauma-focused…

  19. The link between odors and illness : how health cognitions affect odor perception

    NARCIS (Netherlands)

    Bulsing, P.J.

    2009-01-01

    Some people report health effects after exposure to relatively low levels of odorous chemicals, levels which are often well tolerated by the majority of the population. The research in this thesis was aimed at investigating the role of cognitive influences in this phenomenon. Could it be possible

  20. The weakest link: inter-organisational communication about (near-) incidents in the health care chain

    NARCIS (Netherlands)

    van der Kaap, G.

    2012-01-01

    Where people work, things go wrong, mistakes happen, and systems fail. The health care system is an example of a complex environment in which mistakes happen. Worst-case scenario, patients die because of things that go wrong, because of (near-) incidents. Central to this study, is the 'exchange of

  1. Linking databases on perinatal health: A review of the literature and current practices in Europe

    NARCIS (Netherlands)

    Delnord, M.; Szamotulska, K.; Hindori-Mohangoo, A.D.; Blondel, B.; Macfarlane, A.J.; Dattani, N.; Barona, C.; Berrut, S.; Zile, I.; Wood, R.; Sakkeus, L.; Gissler, M.; Zeitlin, J.

    2016-01-01

    Background: International comparisons of perinatal health indicators are complicated by the heterogeneity of data sources on pregnancy, maternal and neonatal outcomes. Record linkage can extend the range of data items available and thus can improve the validity and quality of routine data. We sought

  2. Linking the Gut Microbial Ecosystem with the Environment: Does Gut Health Depend on Where We Live?

    Directory of Open Access Journals (Sweden)

    Nishat Tasnim

    2017-10-01

    Full Text Available Global comparisons reveal a decrease in gut microbiota diversity attributed to Western diets, lifestyle practices such as caesarian section, antibiotic use and formula-feeding of infants, and sanitation of the living environment. While gut microbial diversity is decreasing, the prevalence of chronic inflammatory diseases such as inflammatory bowel disease, diabetes, obesity, allergies and asthma is on the rise in Westernized societies. Since the immune system development is influenced by microbial components, early microbial colonization may be a key factor in determining disease susceptibility patterns later in life. Evidence indicates that the gut microbiota is vertically transmitted from the mother and this affects offspring immunity. However, the role of the external environment in gut microbiome and immune development is poorly understood. Studies show that growing up in microbe-rich environments, such as traditional farms, can have protective health effects on children. These health-effects may be ablated due to changes in the human lifestyle, diet, living environment and environmental biodiversity as a result of urbanization. Importantly, if early-life exposure to environmental microbes increases gut microbiota diversity by influencing patterns of gut microbial assembly, then soil biodiversity loss due to land-use changes such as urbanization could be a public health threat. Here, we summarize key questions in environmental health research and discuss some of the challenges that have hindered progress toward a better understanding of the role of the environment on gut microbiome development.

  3. Keep It Simple: A Lesson in Linking Teens to Health Care

    Science.gov (United States)

    Eisler, Alexandra; Avellino, Lia; Chilcoat, Deborah; Schlanger, Karen

    2016-01-01

    The "Keep It Simple" package, which includes a short animated film (available online for streaming or download), a lesson plan, and supporting materials, was designed to be used with adolescents ages 15-19 to empower them to seek sexual and reproductive health care, and emphasize the availability of long-acting reversible contraception…

  4. Linking Essential Learning Outcomes and Interprofessional Collaborative Practice Competency in Health Science Undergraduates

    Science.gov (United States)

    Reed, Carole-Rae; Garcia, Luis Ivan; Slusser, Margaret M.; Konowitz, Sharon; Yep, Jewelry

    2017-01-01

    Assessing student learning outcomes and determining achievement of the Interprofessional Collaborative Practice (IPCEP) Core Competency of Values/Ethics in a generic pre-professional Bachelor of Science in Health Science (BSHS) program is challenging. A course level Student Learning Outcome (SLO) is: "….articulate the impact of personal…

  5. Linking research to practice: the rise of evidence-based health sciences librarianship.

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.

  6. Linking Returning Veterans in Rural Community Colleges to Mental Health Care

    Science.gov (United States)

    2015-01-01

    post - traumatic stress disorder ( PTSD ), depression, or traumatic brain...a 4-item screener for post - traumatic stress ( PTSD ). Forty-Four percent of the student Veterans screened positive on at least one mental health...administered screeners for depression (PHQ-9), generalized anxiety (GAD-7), posttraumatic stress disorder (PC- PTSD ), non-lethal self-injury,

  7. Does non-standard work mean non-standard health? Exploring links between non-standard work schedules, health behavior, and well-being

    Directory of Open Access Journals (Sweden)

    Megan R. Winkler

    2018-04-01

    Full Text Available The last century has seen dramatic shifts in population work circumstances, leading to an increasing normalization of non-standard work schedules (NSWSs, defined as non-daytime, irregular hours. An ever-growing body of evidence links NSWSs to a host of non-communicable chronic conditions; yet, these associations primarily concentrate on the physiologic mechanisms created by circadian disruption and insufficient sleep. While important, not all NSWSs create such chronobiologic disruption, and other aspects of working time and synchronization could be important to the relationships between work schedules and chronic disease. Leveraging survey data from Project EAT, a population-based study with health-related behavioral and psychological data from U.S. adults aged 25–36 years, this study explored the risks for a broad range of less healthful behavioral and well-being outcomes among NSWS workers compared to standard schedule workers (n = 1402. Variations across different NSWSs (evening, night/rotating, and irregular schedules were also explored. Results indicated that, relative to standard schedule workers, workers with NSWSs are at increased risk for non-optimal sleep, substance use, greater recreational screen time, worse dietary practices, obesity, and depression. There was minimal evidence to support differences in relative risks across workers with different types of NSWSs. The findings provide insight into the potential links between NSWSs and chronic disease and indicate the relevancy social disruption and daily health practices may play in the production of health and well-being outcomes among working populations. Keywords: United States, Work schedule tolerance, Health behavior, Mental health, Substance abuse, Obesity

  8. The link between UHC reforms and health system governance: lessons from Asia.

    Science.gov (United States)

    Hort, Krishna; Jayasuriya, Rohan; Dayal, Prarthna

    2017-05-15

    Purpose The purpose of this paper is to examine how and to what extent the design and implementation of universal health coverage (UHC) reforms have been influenced by the governance arrangements of health systems in low- and middle-income countries (LMIC); and how governments in these countries have or have not responded to the challenges of governance for UHC. Design/methodology/approach Comparative case study analysis of three Asian countries with substantial experience of UHC reforms (Thailand, Vietnam and China) was undertaken using data from published studies and grey literature. Studies included were those which described the modifications and adaptations that occurred during design and implementation of the UHC programme, the actors and institutions involved and how these changes related to the governance of the health system. Findings Each country adapted the design of their UHC programmes to accommodate their specific institutional arrangements, and then made further modifications in response to issues arising during implementation. The authors found that these modifications were often related to the impacts on governance of the institutional changes inherent in UHC reforms. Governments varied in their response to these governance impacts, with Thailand prepared to adopt new governance modes (which the authors termed as an "adaptive" response), while China and Vietnam have tended to persist with traditional hierarchical governance modes ("reactive" responses). Originality/value This study addresses a gap in current knowledge on UHC reform, and finds evidence of a complex interaction between substantive health sector reform and governance reform in the LMIC context in Asia, confirming recent similar observations on health reforms in high-income countries.

  9. Evaluating the Stage Learning Hypothesis.

    Science.gov (United States)

    Thomas, Hoben

    1980-01-01

    A procedure for evaluating the Genevan stage learning hypothesis is illustrated by analyzing Inhelder, Sinclair, and Bovet's guided learning experiments (in "Learning and the Development of Cognition." Cambridge: Harvard University Press, 1974). (Author/MP)

  10. The Purchasing Power Parity Hypothesis:

    African Journals Online (AJOL)

    2011-10-02

    Oct 2, 2011 ... reject the unit root hypothesis in real exchange rates may simply be due to the shortness ..... Violations of Purchasing Power Parity and Their Implications for Efficient ... Official Intervention in the Foreign Exchange Market:.

  11. Fungal-bacterial interactions and their relevance to oral health: linking the clinic and the bench.

    Science.gov (United States)

    Diaz, Patricia I; Strausbaugh, Linda D; Dongari-Bagtzoglou, Anna

    2014-01-01

    High throughput sequencing has accelerated knowledge on the oral microbiome. While the bacterial component of oral communities has been extensively characterized, the role of the fungal microbiota in the oral cavity is largely unknown. Interactions among fungi and bacteria are likely to influence oral health as exemplified by the synergistic relationship between Candida albicans and oral streptococci. In this perspective, we discuss the current state of the field of fungal-bacterial interactions in the context of the oral cavity. We highlight the need to conduct longitudinal clinical studies to simultaneously characterize the bacterial and fungal components of the human oral microbiome in health and during disease progression. Such studies need to be coupled with investigations using disease-relevant models to mechanistically test the associations observed in humans and eventually identify fungal-bacterial interactions that could serve as preventive or therapeutic targets for oral diseases.

  12. Are Biophilic-Designed Site Office Buildings Linked to Health Benefits and High Performing Occupants?

    Directory of Open Access Journals (Sweden)

    Tonia Gray

    2014-11-01

    Full Text Available This paper discusses the first phase of a longitudinal study underway in Australia to ascertain the broad health benefits of specific types of biophilic design for workers in a building site office. A bespoke site design was formulated to include open plan workspace, natural lighting, ventilation, significant plants, prospect and views, recycled materials and use of non-synthetic materials. Initial data in the first three months was gathered from a series of demographic questions and from interviews and observations of site workers. Preliminary data indicates a strong positive effect from incorporating aspects of biophilic design to boost productivity, ameliorate stress, enhance well-being, foster a collaborative work environment and promote workplace satisfaction, thus contributing towards a high performance workspace. The longitudinal study spanning over two years will track human-plant interactions in a biophilic influenced space, whilst also assessing the concomitant cognitive, social, psychological and physical health benefits for workers.

  13. Fungal-bacterial interactions and their relevance to oral health: linking the clinic and the bench

    Directory of Open Access Journals (Sweden)

    Patricia I Diaz

    2014-07-01

    Full Text Available High throughput sequencing has accelerated knowledge on the oral microbiome. While the bacterial component of oral communities has been extensively characterized, the role of the fungal microbiota in the oral cavity is largely unknown. Interactions among fungi and bacteria are likely to influence oral health as exemplified by the synergistic relationship between Candida albicans and oral streptococci. In this perspective, we discuss the current state of the field of fungal-bacterial interactions in the context of the oral cavity. We highlight the need to conduct longitudinal clinical studies to simultaneously characterize the bacterial and fungal components of the human oral microbiome in health and during disease progression. Such studies need to be coupled with investigations using disease-relevant models to mechanistically test the associations observed in humans and eventually identify fungal-bacterial interactions that could serve as preventive or therapeutic targets for oral diseases.

  14. Processes linking cultural ingroup bonds and mental health: the roles of social connection and emotion regulation

    OpenAIRE

    Roberts, Nicole A.; Burleson, Mary H.

    2013-01-01

    Cultural and ethnic identities influence the relationships individuals seek out and how they feel and behave in these relationships, which can strongly affect mental and physical health through their impacts on emotions, physiology, and behavior. We proposed and tested a model in which ethnocultural identifications and ingroup affiliations were hypothesized explicitly to enhance social connectedness, which would in turn promote expectancy for effective regulation of negative emotions and redu...

  15. Novel insights linking ecological health to biogeochemical hotspots in mixed land use stream systems

    DEFF Research Database (Denmark)

    McKnight, Ursula S.; Sonne, Anne Thobo; Rasmussen, Jes J.

    Increasing modifications in land use and water management have resulted in multiple stressors impacting freshwater ecosystems globally. Chemicals with the potential to impact aquatic habitats are still often evaluated individually for their adverse effects on ecosystem health. This may lead...... pollution sources included two contaminated sites (factory, landfill), aquaculture, wastewater/industrial discharges, and diffuse sources from agriculture and urban areas (Sonne et al., 2017). Ecological status was determined by monitoring meiobenthic and macrobenthic invertebrate communities. The stream...

  16. Saramago’s Death with Interruptions: A Path to Reconsider Essential Dilemmas Linked to Health Law

    OpenAIRE

    Sandra Mabel Wierzba

    2014-01-01

    What would happen if somewhere people would stop dying? In Saramago’s Death with interruptions, after the initial joy associated to the possibility of eternal life, anxiety and conflict invade the community. The end of death not only shakes Philosophy and Religion foundations, but it impacts on various legal institutions as well. In this paper, we consider the notion of Justice from the Right to Health perspective. In particular, we analyse the concept of “euthanasia" and the curr...

  17. Linking research to practice: the rise of evidence-based health sciences librarianship*

    Science.gov (United States)

    Marshall, Joanne Gard

    2014-01-01

    Purpose: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. Methods: Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. Results: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Implications: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. PMID:24415915

  18. The link between erectile and cardiovascular health: the canary in the coal mine.

    Science.gov (United States)

    Meldrum, David R; Gambone, Joseph C; Morris, Marge A; Meldrum, Donald A N; Esposito, Katherine; Ignarro, Louis J

    2011-08-15

    Lifestyle and nutrition have been increasingly recognized as central factors influencing vascular nitric oxide (NO) production and erectile function. This review underscores the importance of NO as the principal mediator influencing cardiovascular health and erectile function. Erectile dysfunction (ED) is associated with smoking, excessive alcohol intake, physical inactivity, abdominal obesity, diabetes, hypertension, and decreased antioxidant defenses, all of which reduce NO production. Better lifestyle choices; physical exercise; improved nutrition and weight control; adequate intake of or supplementation with omega-3 fatty acids, antioxidants, calcium, and folic acid; and replacement of any testosterone deficiency will all improve vascular and erectile function and the response to phosphodiesterase-5 inhibitors, which also increase vascular NO production. More frequent penile-specific exercise improves local endothelial NO production. Excessive intake of vitamin E, calcium, l-arginine, or l-citrulline may impart significant cardiovascular risks. Interventions discussed also lower blood pressure or prevent hypertension. Certain angiotensin II receptor blockers improve erectile function and reduce oxidative stress. In men aged acids may be particularly crucial for these men at greatest risk for sudden death. In conclusion, by better understanding the complex factors influencing erectile and overall vascular health, physicians can help their patients prevent vascular disease and improve erectile function, which provides more immediate motivation for men to improve their lifestyle habits and cardiovascular health. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Health risk assessment linked to filling coastal quarries with treated dredged seaport sediments.

    Science.gov (United States)

    Perrodin, Yves; Donguy, Gilles; Emmanuel, Evens; Winiarski, Thierry

    2014-07-01

    Dredged seaport sediments raise complex management problems since it is no longer possible to discharge them into the sea. Traditional waste treatments are poorly adapted for these materials in terms of absorbable volumes and cost. In this context, filling quarries with treated sediments appears interesting but its safety regarding human health must be demonstrated. To achieve this, a specific methodology for assessing health risks has been developed and tested on three seaport sediments. This methodology includes the development of a conceptual model of the global scenario studied and the definition of specific protocols for each of its major steps. The approach proposed includes in particular the use of metrological and experimental tools that are new in this context: (i) an experimental lysimeter for characterizing the deposit emissions, and (ii) a geological radar for identifying potential preferential pathways between the sediment deposit and the groundwater. The application of this approach on the three sediments tested for the scenario studied showed the absence of health risk associated with the consumption of groundwater for substances having a "threshold effect" (risk quotient risk for substances having a "non-threshold effect", with the notable exception of arsenic (individual risk equal to 3.10(-6)). Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Problematic mobile phone use of Swiss adolescents: is it linked with mental health or behaviour?

    Science.gov (United States)

    Roser, Katharina; Schoeni, Anna; Foerster, Milena; Röösli, Martin

    2016-04-01

    To investigate the associations between problematic mobile phone use and mental health and behavioural problems in 412 Swiss adolescents owning a mobile phone while controlling for amount of mobile phone use. Problematic mobile phone use was determined by the MPPUS-10 (Mobile Phone Problem Use Scale) and related to health and behavioural problems by means of multivariable regression modelling. MPPUS-10 was 4.7 (95 % CI 1.8, 7.6) units higher in girls than in boys, increased significantly with age and was significantly decreased with increasing educational level of the parents. Furthermore, problematic mobile phone use was associated with impaired psychological well-being, impaired parent and school relationships and more behavioural problems but was not related to peer support and social acceptance. Our study indicates that problematic mobile phone use is associated with external factors such as worse home and school environment and internal factors such as impaired mental health and behavioural problems of the adolescents and thus problematic mobile phone use should be addressed, in particular when dealing with adolescents showing behavioural or emotional problems.

  1. [Common sense, science and philosophy: the links of knowledge necessary for promoting health care].

    Science.gov (United States)

    Rios, Ediara Rabello Girão; Franchi, Kristiane Mesquita Barros; da Silva, Raimunda Magalhães; de Amorim, Rosendo Freitas; Costa, Nhandeyjara de Carvalho

    2007-01-01

    In its evolution, humanity has accumulated data which were systematized as knowledge. Philosophy through self examination helps us in its practical and theoretical functions to reach a concept of the universe. Common sense helps science evolve. People's daily difficulties stir up the need for research, for deepening data interpretation and to propose solutions to overcome the population's problems. Science exists to explain difficult aspects of common sense, to support questions, as well as to substantiate knowledge produced as a response to demands. Thus, knowledge involved in this reflection sets out to foster an articulation between basic forms of knowledge and to develop a satisfactory understanding of the health care process, through a shared and critically consciousness view of the changes in the health system's paradigm. We understand that health education is an essential component within this process, provided that it is focused primarily on an individual belonging to a community with its multiple relationships, especially between the community context and the subjective dimension, which can provide citizenship empowerment redemption.

  2. Variation in the link between parental divorce and children's health disadvantage in low and high divorce settings.

    Science.gov (United States)

    Smith-Greenaway, Emily; Clark, Shelley

    2017-12-01

    Like in other world regions, children with divorced parents in sub-Saharan Africa experience significant heath disadvantages relative to their peers with married parents. Preliminary evidence suggests this disadvantage may not be uniform across the subcontinent's diverse settings. Research from other world regions shows that the childhood health consequences of divorce vary across different contexts. Specifically, we hypothesize that the childhood disadvantages associated with divorce are more severe in regions of sub-Saharan Africa where divorce is rare, and less so where divorce is a more common family experience. Using Demographic and Health Survey data from 290 subnational regions within 31 sub-Saharan African countries, multilevel models document the previously shown link between having a divorced mother and child morbidity and mortality. The study results further demonstrate that the childhood health disadvantage is accentuated in subnational African regions where fewer women are divorced and muted in areas where more women are divorced. The findings demonstrate that the broader context can powerfully moderate childhood health inequalities traditionally thought of as operating at the family or individual level.

  3. Variation in the link between parental divorce and children’s health disadvantage in low and high divorce settings

    Directory of Open Access Journals (Sweden)

    Emily Smith-Greenaway

    2017-12-01

    Full Text Available Like in other world regions, children with divorced parents in sub-Saharan Africa experience significant heath disadvantages relative to their peers with married parents. Preliminary evidence suggests this disadvantage may not be uniform across the subcontinent’s diverse settings. Research from other world regions shows that the childhood health consequences of divorce vary across different contexts. Specifically, we hypothesize that the childhood disadvantages associated with divorce are more severe in regions of sub-Saharan Africa where divorce is rare, and less so where divorce is a more common family experience. Using Demographic and Health Survey data from 290 subnational regions within 31 sub-Saharan African countries, multilevel models document the previously shown link between having a divorced mother and child morbidity and mortality. The study results further demonstrate that the childhood health disadvantage is accentuated in subnational African regions where fewer women are divorced and muted in areas where more women are divorced. The findings demonstrate that the broader context can powerfully moderate childhood health inequalities traditionally thought of as operating at the family or individual level.

  4. Leisure activities are linked to mental health benefits by providing time structure: comparing employed, unemployed and homemakers.

    Science.gov (United States)

    Goodman, William K; Geiger, Ashley M; Wolf, Jutta M

    2017-01-01

    Unemployment has consistently been linked to negative mental health outcomes, emphasising the need to characterise the underlying mechanisms. The current study aimed at testing whether compared with other employment groups, fewer leisure activities observed in unemployment may contribute to elevated risk for negative mental health via loss of time structure. Depressive symptoms (Center for Epidemiologic Studies Depression), leisure activities (exercise, self-focused, social), and time structure (Time Structure Questionnaire (TSQ)) were assessed cross-sectionally in 406 participants (unemployed=155, employed=140, homemakers=111) recruited through Amazon Mechanical Turk. Controlling for gender and age, structural equation modelling revealed time structure partially (employed, homemakers) and fully (unemployed) mediated the relationship between leisure activities and depressive symptoms. With the exception of differential effects for structured routines, all other TSQ factors (sense of purpose, present orientation, effective organisation and persistence) contributed significantly to all models. These findings support the idea that especially for the unemployed, leisure activities impose their mental health benefits through increasing individuals' perception of spending their time effectively. Social leisure activities that provide a sense of daily structure may thereby be a particularly promising low-cost intervention to improve mental health in this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. [Communication in the Family Health Program: the health agent as an integrating link between the team and the community].

    Science.gov (United States)

    Cardoso, Andréia dos Santos; Nascimento, Marilene Cabral do

    2010-06-01

    This study is part of the project Evaluation of the Family Health Strategy in Rio de Janeiro, developed at Estácio de Sá University with support of the National Advice of Scientific and Technological Development (CNPq). The study aimed to identify and analyze the perception of the health communitarian agents (HCA) about their main interlocutors, the impact of these interlocutors and the predominant communication forms in their work process. It is a descriptive study, with a qualitative approach, based on theoretical-methodological categories of the popular education and the symbolic market communication model. The data was collected in four teams of the Family Health Program. The results show the communication maps elaborated with the HCA which identifies the group of technical support, the technician team, the HCA themselves and the old inhabitants of the community as their main interlocutors. The communication with the other professionals of the team is acknowledged in a predominantly verticalized way with authoritarianism traces. The results highlight the importance of extending the dialogue and negotiation in the established communication within the team and with the community.

  6. Chernobyl emissions linked to a variety of adverse health effects in the U.S

    International Nuclear Information System (INIS)

    Mangano, J.J.; Gould, J.M.; Sternglass, E.J.

    2001-01-01

    Until 1995, no disease-specific excesses in the U.S. associated with low-level fallout from the Chernobyl accident had been documented. However, several such connections have since been made for thyroid cancer, hypothyroidism, leukemia, and all cancers combined. Each unexpected increase occurred in infants and children, whose cell membranes and genetic material are most susceptible to the damages caused by radiation. We would expect that, in the future, similar trends will occur for adults in America. Each increase in disease rates is statistically linked with rises in radioactive substances present in the Chernobyl fallout. For example, thyroid cancer and hypothyroidism may be mostly the result of the rise in Iodine-131 or other radioactive iodine isotopes, which existed in greater concentrations in the American diet following the Chernobyl accident on April 26, 1986. Although rates were elevated in mid-1986, they were only three to four times higher than normal; thus, the question arises whether very low levels of increased radioactivity in the American diet are causing excessive cases of disease and deaths for certain immune-related diseases. (orig.)

  7. Chernobyl emissions linked to a variety of adverse health effects in the U.S.

    Energy Technology Data Exchange (ETDEWEB)

    Mangano, J.J.; Gould, J.M. [Radiation and Public Health Project, New York, NY (United States); Sternglass, E.J. [Dept. of Radiology, Pittsburgh Univ. School of Medicine, PA (United States)

    2001-07-01

    Until 1995, no disease-specific excesses in the U.S. associated with low-level fallout from the Chernobyl accident had been documented. However, several such connections have since been made for thyroid cancer, hypothyroidism, leukemia, and all cancers combined. Each unexpected increase occurred in infants and children, whose cell membranes and genetic material are most susceptible to the damages caused by radiation. We would expect that, in the future, similar trends will occur for adults in America. Each increase in disease rates is statistically linked with rises in radioactive substances present in the Chernobyl fallout. For example, thyroid cancer and hypothyroidism may be mostly the result of the rise in Iodine-131 or other radioactive iodine isotopes, which existed in greater concentrations in the American diet following the Chernobyl accident on April 26, 1986. Although rates were elevated in mid-1986, they were only three to four times higher than normal; thus, the question arises whether very low levels of increased radioactivity in the American diet are causing excessive cases of disease and deaths for certain immune-related diseases. (orig.)

  8. Processes linking cultural ingroup bonds and mental health: the roles of social connection and emotion regulation.

    Science.gov (United States)

    Roberts, Nicole A; Burleson, Mary H

    2013-01-01

    Cultural and ethnic identities influence the relationships individuals seek out and how they feel and behave in these relationships, which can strongly affect mental and physical health through their impacts on emotions, physiology, and behavior. We proposed and tested a model in which ethnocultural identifications and ingroup affiliations were hypothesized explicitly to enhance social connectedness, which would in turn promote expectancy for effective regulation of negative emotions and reduce self-reported symptoms of depression and anxiety. Our sample comprised women aged 18-30 currently attending college in the Southwestern US, who self-identified as Hispanic of Mexican descent (MAs; n = 82) or as non-Hispanic White/European American (EAs; n = 234) and who completed an online survey. In the full sample and in each subgroup, stronger ethnocultural group identity and greater comfort with mainstream American culture were associated with higher social connectedness, which in turn was associated with expectancy for more effective regulation of negative emotions, fewer depressive symptoms, and less anxiety. Unexpectedly, preference for ingroup affiliation predicted lower social connectedness in both groups. In addition to indirect effects through social connection, direct paths from mainstream comfort and preference for ingroup affiliation to emotion regulation expectancy were found for EAs. Models of our data underscore that social connection is a central mechanism through which ethnocultural identities-including with one's own group and the mainstream cultural group-relate to mental health, and that emotion regulation may be a key aspect of this linkage. We use the term ethnocultural social connection to make explicit a process that, we believe, has been implied in the ethnic identity literature for many years, and that may have consequential implications for mental health and conceptualizations of processes underlying mental disorders.

  9. Processes linking cultural ingroup bonds and mental health: the roles of social connection and emotion regulation

    Science.gov (United States)

    Roberts, Nicole A.; Burleson, Mary H.

    2013-01-01

    Cultural and ethnic identities influence the relationships individuals seek out and how they feel and behave in these relationships, which can strongly affect mental and physical health through their impacts on emotions, physiology, and behavior. We proposed and tested a model in which ethnocultural identifications and ingroup affiliations were hypothesized explicitly to enhance social connectedness, which would in turn promote expectancy for effective regulation of negative emotions and reduce self-reported symptoms of depression and anxiety. Our sample comprised women aged 18–30 currently attending college in the Southwestern US, who self-identified as Hispanic of Mexican descent (MAs; n = 82) or as non-Hispanic White/European American (EAs; n = 234) and who completed an online survey. In the full sample and in each subgroup, stronger ethnocultural group identity and greater comfort with mainstream American culture were associated with higher social connectedness, which in turn was associated with expectancy for more effective regulation of negative emotions, fewer depressive symptoms, and less anxiety. Unexpectedly, preference for ingroup affiliation predicted lower social connectedness in both groups. In addition to indirect effects through social connection, direct paths from mainstream comfort and preference for ingroup affiliation to emotion regulation expectancy were found for EAs. Models of our data underscore that social connection is a central mechanism through which ethnocultural identities—including with one's own group and the mainstream cultural group—relate to mental health, and that emotion regulation may be a key aspect of this linkage. We use the term ethnocultural social connection to make explicit a process that, we believe, has been implied in the ethnic identity literature for many years, and that may have consequential implications for mental health and conceptualizations of processes underlying mental disorders. PMID:23450647

  10. Processes linking cultural ingroup bonds and mental health: The roles of social connection and emotion regulation

    Directory of Open Access Journals (Sweden)

    Nicole A Roberts

    2013-02-01

    Full Text Available Cultural and ethnic identities influence the relationships individuals seek out and how they feel and behave in these relationships, which can strongly affect mental and physical health through their impacts on emotions, physiology, and behavior. We proposed and tested a model in which ethnocultural identifications and ingroup affiliations were hypothesized explicitly to enhance social connectedness, which would in turn promote expectancy for effective regulation of negative emotions and reduce self-reported symptoms of depression and anxiety. Our sample comprised women aged 18 to 30 currently attending college in the Southwestern US, who self-identified as Hispanic of Mexican descent (n=82; MAs or as non-Hispanic White/European American (EAs; n=234 and who completed an online survey. In the full sample and in each subgroup, stronger ethnocultural group identity and greater comfort with mainstream American culture were associated with higher social connectedness, which in turn was associated with expectancy for more effective regulation of negative emotions, fewer depressive symptoms, and less anxiety. Unexpectedly, preference for ingroup affiliation predicted lower social connectedness in both groups. In addition to indirect effects through social connection, direct paths from mainstream comfort and preference for ingroup affiliation to emotion regulation expectancy were found for EAs. Models of our data underscore that social connection is a central mechanism through which ethnocultural identities—including with one’s own group and the mainstream cultural group—relate to mental health, and that emotion regulation may be a key aspect of this linkage. We use the term ethnocultural social connection to make explicit a process that, we believe, has been implied in the ethnic identity literature for many years, and that may have consequential implications for mental health and conceptualizations of processes underlying mental disorders.

  11. [The midwife-child health nurse collaboration, a link between the maternity unit and neonatology].

    Science.gov (United States)

    Pallaro, Audrey; Polzin, Karine

    2016-01-01

    Collaborative work forms part of the well-treatment and improvement of quality of care approach. It is also of benefit to the medical and paramedical teams. Within the parent-child unit of Libourne hospital, the midwife and child health nurse collaborate throughout the pregnancy, and especially during the post-partum period. The teams work together notably around the care of "high-risk" births and in particular when the newborn is hospitalised in a kangaroo care unit. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Examining the links between employed mothers' work characteristics, physical activity, and child health.

    Science.gov (United States)

    Johnson, Ryan C; Allen, Tammy D

    2013-01-01

    The present study tested a process model through which the strain-based (job control and role ambiguity) and time-based (work hours) job demands of employed mothers relate to child health via child modeling of mother's physical activity. Support was found for a model of these relationships using dyadic mother-child data (N = 359) from a large, multi-wave nationwide data set and job demands data from the Occupational Information Network (O*Net). Theoretical and practical implications, as well as future research directions, are also discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  13. Stretching the stress boundary: Linking air pollution health effects to a neurohormonal stress response.

    Science.gov (United States)

    Kodavanti, Urmila P

    2016-12-01

    Inhaled pollutants produce effects in virtually all organ systems in our body and have been linked to chronic diseases including hypertension, atherosclerosis, Alzheimer's and diabetes. A neurohormonal stress response (referred to here as a systemic response produced by activation of the sympathetic nervous system and hypothalamus-pituitary-adrenal (HPA)-axis) has been implicated in a variety of psychological and physical stresses, which involves immune and metabolic homeostatic mechanisms affecting all organs in the body. In this review, we provide new evidence for the involvement of this well-characterized neurohormonal stress response in mediating systemic and pulmonary effects of a prototypic air pollutant - ozone. A plethora of systemic metabolic and immune effects are induced in animals exposed to inhaled pollutants, which could result from increased circulating stress hormones. The release of adrenal-derived stress hormones in response to ozone exposure not only mediates systemic immune and metabolic responses, but by doing so, also modulates pulmonary injury and inflammation. With recurring pollutant exposures, these effects can contribute to multi-organ chronic conditions associated with air pollution. This review will cover, 1) the potential mechanisms by which air pollutants can initiate the relay of signals from respiratory tract to brain through trigeminal and vagus nerves, and activate stress responsive regions including hypothalamus; and 2) the contribution of sympathetic and HPA-axis activation in mediating systemic homeostatic metabolic and immune effects of ozone in various organs. The potential contribution of chronic environmental stress in cardiovascular, neurological, reproductive and metabolic diseases, and the knowledge gaps are also discussed. This article is part of a Special Issue entitled Air Pollution, edited by Wenjun Ding, Andrew J. Ghio and Weidong Wu. Published by Elsevier B.V.

  14. Time perspective and socioeconomic status: a link to socioeconomic disparities in health?

    Science.gov (United States)

    Guthrie, Lori C; Butler, Stephen C; Ward, Michael M

    2009-06-01

    Time perspective is a measure of the degree to which one's thinking is motivated by considerations of the future, present, or past. Time perspective has been proposed as a potential mediator of socioeconomic disparities in health because it has been associated with health behaviors and is presumed to vary with socioeconomic status. In this cross-sectional community-based survey of respondents recruited from hair salons and barber shops in a suburb of Washington DC, we examined the association between time perspective and both education level and occupation. We asked participants (N=525) to complete a questionnaire that included three subscales (future, present-fatalistic, and present-hedonistic) of the Zimbardo Time Perspective Inventory. Participants with more formal education and those with professional occupations had higher scores on the future time perspective subscale, and lower scores on the present-fatalistic subscale, than participants with less formal education or a non-professional occupation. Present-fatalistic scores were also higher among participants whose parents had less formal education. Present-hedonistic scores were not associated with either education level or professional occupation. Time perspective scores were not independently associated with the likelihood of obesity, smoking, or exercise. In this community sample, future time perspective was associated with current socioeconomic status, and past-fatalistic time perspective was associated with both current and childhood socioeconomic status.

  15. Polyphenols in Cocoa and Cocoa Products: Is There a Link between Antioxidant Properties and Health?

    Directory of Open Access Journals (Sweden)

    Amin Ismail

    2008-09-01

    Full Text Available Cocoa and cocoa products have received much attention due to their significant polyphenol contents. Cocoa and cocoa products, namely cocoa liquor, cocoa powder and chocolates (milk and dark chocolates may present varied polyphenol contents and possess different levels of antioxidant potentials. For the past ten years, at least 28 human studies have been conducted utilizing one of these cocoa products. However, questions arise on which of these products would deliver the best polyphenol contents and antioxidant effects. Moreover, the presence of methylxanthines, peptides, and minerals could synergistically enhance or reduce antioxidant properties of cocoa and cocoa products. To a greater extent, cocoa beans from different countries of origins and the methods of preparation (primary and secondary could also partially influence the antioxidant polyphenols of cocoa products. Hence, comprehensive studies on the aforementioned factors could provide the understanding of health-promoting activities of cocoa or cocoa products components.

  16. Linking Emotional Labor, Public Service Motivation, and Job Satisfaction: Social Workers in Health Care Settings.

    Science.gov (United States)

    Roh, Chul-Young; Moon, M Jae; Yang, Seung-Bum; Jung, Kwangho

    2016-01-01

    This study examines the determinants of emotional laborers'--social workers in health care organizations--job satisfaction and their public service motivation in using a structural equation model and provides empirical evidence regarding what contributes to job satisfaction or burnout in these workers. Among several latent variables, this study confirmed that false face significantly decreases the job satisfaction of social worker and is positively associated with burnout. In addition, commitment to public interest increases social workers' job satisfaction significantly. This study has implications for the management of emotional labor. By educating emotional laborers to reappraise situations to increase their job satisfaction and avoid burnout, reappraisal training and education are expected to result in increases in positive emotions and decreases in negative emotions, and to improve employees' performance in their organizations.

  17. Adaptive Capacity: An Evolutionary Neuroscience Model Linking Exercise, Cognition, and Brain Health.

    Science.gov (United States)

    Raichlen, David A; Alexander, Gene E

    2017-07-01

    The field of cognitive neuroscience was transformed by the discovery that exercise induces neurogenesis in the adult brain, with the potential to improve brain health and stave off the effects of neurodegenerative disease. However, the basic mechanisms underlying exercise-brain connections are not well understood. We use an evolutionary neuroscience approach to develop the adaptive capacity model (ACM), detailing how and why physical activity improves brain function based on an energy-minimizing strategy. Building on studies showing a combined benefit of exercise and cognitive challenge to enhance neuroplasticity, our ACM addresses two fundamental questions: (i) what are the proximate and ultimate mechanisms underlying age-related brain atrophy, and (ii) how do lifestyle changes influence the trajectory of healthy and pathological aging? Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Household disposables as breeding habitats of dengue vectors: Linking wastes and public health

    Energy Technology Data Exchange (ETDEWEB)

    Banerjee, Soumyajit, E-mail: soumyajitb@gmail.com [Department of Zoology, University of Calcutta, 35 Ballygunge Circular Road, Kolkata 700 019 (India); Aditya, Gautam, E-mail: gautamaditya2001@gmail.com [Department of Zoology, University of Calcutta, 35 Ballygunge Circular Road, Kolkata 700 019 (India); Department of Zoology, The University of Burdwan, Golapbag, Burdwan 713 104 (India); Saha, Goutam K, E-mail: gkszoo@rediffmail.com [Department of Zoology, University of Calcutta, 35 Ballygunge Circular Road, Kolkata 700 019 (India)

    2013-01-15

    are most frequently disposed off contributed largely to the sustenance of Aedes mosquito population in the city. This calls for a strict legislation towards disposal as well as enhanced management of the household wastes. A link between the wastes disposed and subsequent conversion to the mosquito larval habitats cautions for continuance of Aedes population and possibility of dengue epidemics if the existing management practices are not improved.

  19. Household disposables as breeding habitats of dengue vectors: Linking wastes and public health

    International Nuclear Information System (INIS)

    Banerjee, Soumyajit; Aditya, Gautam; Saha, Goutam K

    2013-01-01

    in the city. This calls for a strict legislation towards disposal as well as enhanced management of the household wastes. A link between the wastes disposed and subsequent conversion to the mosquito larval habitats cautions for continuance of Aedes population and possibility of dengue epidemics if the existing management practices are not improved.

  20. Microbial pathways in colonic sulfur metabolism and links with health and disease

    Directory of Open Access Journals (Sweden)

    Franck eCarbonero

    2012-11-01

    Full Text Available Sulfur is both crucial to life and a potential threat to health. While colonic sulfur metabolism mediated by eukaryotic cells is relatively well studied, much less is known about sulfur metabolism within gastrointestinal microbes. Sulfated compounds in the colon are either of inorganic (e.g., sulfates, sulfites or organic (e.g., dietary amino acids and host mucins origin. The most extensively studied of the microbes involved in colonic sulfur metabolism are the sulfate-reducing bacteria, which are common colonic inhabitants. Many other microbial pathways are likely to shape colonic sulfur metabolism as well as the composition and availability of sulfated compounds, and these interactions need to be examined in more detail. Hydrogen sulfide is the sulfur derivative that has attracted the most attention in the context of colonic health, and the extent to which it is detrimental or beneficial remains in debate. Several lines of evidence point to sulfate-reducing bacteria or exogenous hydrogen sulfide as potential players in the etiology of intestinal disorders, inflammatory bowel diseases and colorectal cancer in particular. Generation of hydrogen sulfide via pathways other than dissimilatory sulfate reduction may be as, or more, important than those involving the sulfate-reducing bacteria. We suggest here that a novel axis of research is to assess the effects of hydrogen sulfide in shaping colonic microbiome structure. Clearly, in-depth characterization of the microbial pathways involved in colonic sulfur metabolism is necessary for a better understanding of its contribution to colonic disorders and development of therapeutic strategies.

  1. Agricultural biodiversity as a link between traditional food systems and contemporary development, social integrity and ecological health.

    Science.gov (United States)

    Johns, Timothy; Powell, Bronwen; Maundu, Patrick; Eyzaguirre, Pablo B

    2013-11-01

    Traditional food systems offer a key link between the social and economic resilience of smallholder farmers and pastoralists and the sustainable food and nutrition security of global populations. This paper addresses issues related to socio-cultural diversity and the continuing complex engagement of traditional and modern communities with the plants and animals that sustain them. In light of some of the unhealthful consequences of the 'nutrition transition' to globalized modern diets, the authors define and propose a process for a more successful food system transition that balances agro-biodiversity and processed commodities to support diet diversity, health and social equity alongside sustainable economic growth. We review empirical research in support of practice and policy changes in agriculture, economic development and health domains as well as cross-sectoral and community-based innovation. High-value food crops within domestic and global value chains can be an entry point for smallholders' participation as contributors and beneficiaries of development, while sustainable small farms, as purveyors of environmental and public health services, diversify global options for long-term adaptation in the face of environmental uncertainty. © 2013 Society of Chemical Industry.

  2. Linking payment to health outcomes: a taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers.

    Science.gov (United States)

    Carlson, Josh J; Sullivan, Sean D; Garrison, Louis P; Neumann, Peter J; Veenstra, David L

    2010-08-01

    To identify, categorize and examine performance-based health outcomes reimbursement schemes for medical technology. We performed a review of performance-based health outcomes reimbursement schemes over the past 10 years (7/98-010/09) using publicly available databases, web and grey literature searches, and input from healthcare reimbursement experts. We developed a taxonomy of scheme types by inductively organizing the schemes identified according to the timing, execution, and health outcomes measured in the schemes. Our search yielded 34 coverage with evidence development schemes, 10 conditional treatment continuation schemes, and 14 performance-linked reimbursement schemes. The majority of schemes are in Europe and Australia, with an increasing number in Canada and the U.S. These schemes have the potential to alter the reimbursement and pricing landscape for medical technology, but significant challenges, including high transaction costs and insufficient information systems, may limit their long-term impact. Future studies regarding experiences and outcomes of implemented schemes are necessary. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Using nationwide ‘big data’ from linked electronic health records to help improve outcomes in cardiovascular diseases:33 studies using methods from epidemiology, informatics, economics and social science in the ClinicAl disease research using LInked Bespoke studies and Electronic health Records (CALIBER) programme

    OpenAIRE

    Hemingway, Harry; Feder, Gene; Fitzpatrick, Natalie; Denaxas, Spiros; Shah, Amit; Timmis, A D

    2017-01-01

    BACKGROUND:Electronic health records (EHRs), when linked across primary and secondary care and curated for research use, have the potential to improve our understanding of care quality and outcomes.OBJECTIVE:To evaluate new opportunities arising from linked EHRs for improving quality of care and outcomes for patients at risk of or with coronary disease across the patient journey.DESIGN:Epidemiological cohort, health informatics, health economics and ethnographic approaches were used.SETTING:2...

  4. The atomic hypothesis: physical consequences

    International Nuclear Information System (INIS)

    Rivas, Martin

    2008-01-01

    The hypothesis that matter is made of some ultimate and indivisible objects, together with the restricted relativity principle, establishes a constraint on the kind of variables we are allowed to use for the variational description of elementary particles. We consider that the atomic hypothesis not only states the indivisibility of elementary particles, but also that these ultimate objects, if not annihilated, cannot be modified by any interaction so that all allowed states of an elementary particle are only kinematical modifications of any one of them. Therefore, an elementary particle cannot have excited states. In this way, the kinematical group of spacetime symmetries not only defines the symmetries of the system, but also the variables in terms of which the mathematical description of the elementary particles can be expressed in either the classical or the quantum mechanical description. When considering the interaction of two Dirac particles, the atomic hypothesis restricts the interaction Lagrangian to a kind of minimal coupling interaction

  5. Multiple sclerosis: a geographical hypothesis.

    Science.gov (United States)

    Carlyle, I P

    1997-12-01

    Multiple sclerosis remains a rare neurological disease of unknown aetiology, with a unique distribution, both geographically and historically. Rare in equatorial regions, it becomes increasingly common in higher latitudes; historically, it was first clinically recognized in the early nineteenth century. A hypothesis, based on geographical reasoning, is here proposed: that the disease is the result of a specific vitamin deficiency. Different individuals suffer the deficiency in separate and often unique ways. Evidence to support the hypothesis exists in cultural considerations, in the global distribution of the disease, and in its historical prevalence.

  6. Discussion of the Porter hypothesis

    International Nuclear Information System (INIS)

    1999-11-01

    In the reaction to the long-range vision of RMNO, published in 1996, The Dutch government posed the question whether a far-going and progressive modernization policy will lead to competitive advantages of high-quality products on partly new markets. Such a question is connected to the so-called Porter hypothesis: 'By stimulating innovation, strict environmental regulations can actually enhance competitiveness', from which statement it can be concluded that environment and economy can work together quite well. A literature study has been carried out in order to determine under which conditions that hypothesis is endorsed in the scientific literature and policy documents. Recommendations are given for further studies. refs

  7. The thrifty phenotype hypothesis revisited

    DEFF Research Database (Denmark)

    Vaag, A A; Grunnet, L G; Arora, G P

    2012-01-01

    Twenty years ago, Hales and Barker along with their co-workers published some of their pioneering papers proposing the 'thrifty phenotype hypothesis' in Diabetologia (4;35:595-601 and 3;36:62-67). Their postulate that fetal programming could represent an important player in the origin of type 2...... of the underlying molecular mechanisms. Type 2 diabetes is a multiple-organ disease, and developmental programming, with its idea of organ plasticity, is a plausible hypothesis for a common basis for the widespread organ dysfunctions in type 2 diabetes and the metabolic syndrome. Only two among the 45 known type 2...

  8. Quantitative trait loci linked to PRNP gene controlling health and production traits in INRA 401 sheep

    Directory of Open Access Journals (Sweden)

    Brunel Jean-Claude

    2007-07-01

    Full Text Available Abstract In this study, the potential association of PrP genotypes with health and productive traits was investigated. Data were recorded on animals of the INRA 401 breed from the Bourges-La Sapinière INRA experimental farm. The population consisted of 30 rams and 852 ewes, which produced 1310 lambs. The animals were categorized into three PrP genotype classes: ARR homozygous, ARR heterozygous, and animals without any ARR allele. Two analyses differing in the approach considered were carried out. Firstly, the potential association of the PrP genotype with disease (Salmonella resistance and production (wool and carcass traits was studied. The data used included 1042, 1043 and 1013 genotyped animals for the Salmonella resistance, wool and carcass traits, respectively. The different traits were analyzed using an animal model, where the PrP genotype effect was included as a fixed effect. Association analyses do not indicate any evidence of an effect of PrP genotypes on traits studied in this breed. Secondly, a quantitative trait loci (QTL detection approach using the PRNP gene as a marker was applied on ovine chromosome 13. Interval mapping was used. Evidence for one QTL affecting mean fiber diameter was found at 25 cM from the PRNP gene. However, a linkage between PRNP and this QTL does not imply unfavorable linkage disequilibrium for PRNP selection purposes.

  9. Link between Motor Competence and Health Related Fitness in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Carlos Luz

    2017-06-01

    Full Text Available This study examined motor competence (MC behavior in 6- to 14-year-old children, and investigated the differences in health-related fitness (HRF between high and low MC groups, according to sex and age. A sample of 564 children (288 males participated in this study, divided into three age groups (6–8 years; 9–11 years; 12–14 years. Total MC and its three components (stability, locomotor, and manipulative were assessed with a quantitative instrument. HRF was evaluated using a maximal multistage 20-m shuttle-run test and the handgrip test. Participants were divided into tertiles according to their MC level and high and low MC groups were analyzed. Overall, MC increased across age groups for both sexes, but boys presented better results than girls. The high MC group outperformed their low MC peers in all HRF variables, independent of their age group. Although cardiovascular fitness increased with age for both the high and low MC groups, the differences between these groups were greater in older children compared to younger children, within the study age range. The findings suggest that MC interventions should be considered as an important strategy to enhance HRF, and girls at a young age should be a priority target.

  10. Link between Motor Competence and Health Related Fitness in Children and Adolescents.

    Science.gov (United States)

    Luz, Carlos; Cordovil, Rita; Almeida, Gabriela; Rodrigues, Luis P

    2017-06-15

    This study examined motor competence (MC) behavior in 6- to 14-year-old children, and investigated the differences in health-related fitness (HRF) between high and low MC groups, according to sex and age. A sample of 564 children (288 males) participated in this study, divided into three age groups (6⁻8 years; 9⁻11 years; 12⁻14 years). Total MC and its three components (stability, locomotor, and manipulative) were assessed with a quantitative instrument. HRF was evaluated using a maximal multistage 20-m shuttle-run test and the handgrip test. Participants were divided into tertiles according to their MC level and high and low MC groups were analyzed. Overall, MC increased across age groups for both sexes, but boys presented better results than girls. The high MC group outperformed their low MC peers in all HRF variables, independent of their age group. Although cardiovascular fitness increased with age for both the high and low MC groups, the differences between these groups were greater in older children compared to younger children, within the study age range. The findings suggest that MC interventions should be considered as an important strategy to enhance HRF, and girls at a young age should be a priority target.

  11. Epigenetic Matters: The Link between Early Nutrition, Microbiome, and Long-term Health Development

    Directory of Open Access Journals (Sweden)

    Flavia Indrio

    2017-08-01

    Full Text Available Epigenetic modifications are among the most important mechanisms by which environmental factors can influence early cellular differentiation and create new phenotypic traits during pregnancy and within the neonatal period without altering the deoxyribonucleic acid sequence. A number of antenatal and postnatal factors, such as maternal and neonatal nutrition, pollutant exposure, and the composition of microbiota, contribute to the establishment of epigenetic changes that can not only modulate the individual adaptation to the environment but also have an influence on lifelong health and disease by modifying inflammatory molecular pathways and the immune response. Postnatal intestinal colonization, in turn determined by maternal flora, mode of delivery, early skin-to-skin contact and neonatal diet, leads to specific epigenetic signatures that can affect the barrier properties of gut mucosa and their protective role against later insults, thus potentially predisposing to the development of late-onset inflammatory diseases. The aim of this review is to outline the epigenetic mechanisms of programming and development acting within early-life stages and to examine in detail the role of maternal and neonatal nutrition, microbiota composition, and other environmental factors in determining epigenetic changes and their short- and long-term effects.

  12. Examining the links between therapeutic jurisprudence and mental health court completion.

    Science.gov (United States)

    Redlich, Allison D; Han, Woojae

    2014-04-01

    Research demonstrates that mental health courts (MHCs) lead to improved outcomes compared to traditional criminal court processes. An underlying premise of MHCs is therapeutic jurisprudence (TJ). However, no research, to our knowledge, has examined whether MHC outcomes are predicted by TJ principles as theorized. In the present study, we examined whether principles measured at the onset of MHC enrollment (knowledge, perceived voluntariness, and procedural justice) predicted MHC completion (graduation). Using structural equation modeling with MHC participants from four courts, a significant, direct relationship between TJ and MHC completion was found, such that higher levels of TJ were associated with higher rates of success. Although this direct effect became nonsignificant when mediator variables were included, a significant indirect path remained, such that increased levels of initial perceived voluntariness and procedural justice, and MHC knowledge, led to decreased rates of new arrests, prison, MHC bench warrants, and increased court compliance, which, in turn, led to a higher likelihood of MHC graduation. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  13. Intestinal short chain fatty acids and their link with diet and human health

    Directory of Open Access Journals (Sweden)

    David eRios-Covian

    2016-02-01

    Full Text Available The colon is inhabited by a dense population of microorganisms, the so-called gut microbiota, able to ferment carbohydrates and proteins that escape absorption in the small intestine during digestion. This microbiota produces a wide range of metabolites, including short chain fatty acids (SCFA. These compounds are absorbed in the large bowel and are defined as 1-6 carbon volatile fatty acids which can present straight or branched-chain conformation. Their production is influenced by the pattern of food intake and diet-mediated changes in the gut microbiota. SCFA have distinct physiological effects: they contribute to shaping the gut environment, influence the physiology of the colon, they can be used as energy sources by host cells and the intestinal microbiota and they also participate in different host-signalling mechanisms. We summarize the current knowledge about the production of SCFA, including bacterial cross-feedings interactions, and the biological properties of these metabolites with impact on the human health

  14. Epigenetic Matters: The Link between Early Nutrition, Microbiome, and Long-term Health Development

    Science.gov (United States)

    Indrio, Flavia; Martini, Silvia; Francavilla, Ruggiero; Corvaglia, Luigi; Cristofori, Fernanda; Mastrolia, Salvatore Andrea; Neu, Josef; Rautava, Samuli; Russo Spena, Giovanna; Raimondi, Francesco; Loverro, Giuseppe

    2017-01-01

    Epigenetic modifications are among the most important mechanisms by which environmental factors can influence early cellular differentiation and create new phenotypic traits during pregnancy and within the neonatal period without altering the deoxyribonucleic acid sequence. A number of antenatal and postnatal factors, such as maternal and neonatal nutrition, pollutant exposure, and the composition of microbiota, contribute to the establishment of epigenetic changes that can not only modulate the individual adaptation to the environment but also have an influence on lifelong health and disease by modifying inflammatory molecular pathways and the immune response. Postnatal intestinal colonization, in turn determined by maternal flora, mode of delivery, early skin-to-skin contact and neonatal diet, leads to specific epigenetic signatures that can affect the barrier properties of gut mucosa and their protective role against later insults, thus potentially predisposing to the development of late-onset inflammatory diseases. The aim of this review is to outline the epigenetic mechanisms of programming and development acting within early-life stages and to examine in detail the role of maternal and neonatal nutrition, microbiota composition, and other environmental factors in determining epigenetic changes and their short- and long-term effects. PMID:28879172

  15. Causal pathways linking environmental change with health behaviour change: Natural experimental study of new transport infrastructure and cycling to work.

    Science.gov (United States)

    Prins, R G; Panter, J; Heinen, E; Griffin, S J; Ogilvie, D B

    2016-06-01

    Mechanisms linking changes to the environment with changes in physical activity are poorly understood. Insights into mechanisms of interventions can help strengthen causal attribution and improve understanding of divergent response patterns. We examined the causal pathways linking exposure to new transport infrastructure with changes in cycling to work. We used baseline (2009) and follow-up (2012) data (N=469) from the Commuting and Health in Cambridge natural experimental study (Cambridge, UK). Exposure to new infrastructure in the form of the Cambridgeshire Guided Busway was defined using residential proximity. Mediators studied were changes in perceptions of the route to work, theory of planned behaviour constructs and self-reported use of the new infrastructure. Outcomes were modelled as an increase, decrease or no change in weekly cycle commuting time. We used regression analyses to identify combinations of mediators forming potential pathways between exposure and outcome. We then tested these pathways in a path model and stratified analyses by baseline level of active commuting. We identified changes in perceptions of the route to work, and use of the cycle path, as potential mediators. Of these potential mediators, only use of the path significantly explained (85%) the effect of the infrastructure in increasing cycling. Path use also explained a decrease in cycling among more active commuters. The findings strengthen the causal argument that changing the environment led to changes in health-related behaviour via use of the new infrastructure, but also show how some commuters may have spent less time cycling as a result. Copyright © 2016. Published by Elsevier Inc.

  16. Addiction to sugar and its link to health morbidity: a primer for newer primary care and public health initiatives in Malaysia.

    Science.gov (United States)

    Swarna Nantha, Yogarabindranath

    2014-10-01

    The average consumption of sugar in the Malaysian population has reached an alarming rate, exceeding the benchmark recommended by experts. This article argues the need of a paradigm shift in the management of sugar consumption in the country through evidence derived from addiction research. "Food addiction" could lead to high levels of sugar consumption. This probable link could accelerate the development of diabetes and obesity in the community. A total of 94 reports and studies that describe the importance of addiction theory-based interventions were found through a search on PubMed, Google Scholar, and Academic Search Complete. Research in the field of addiction medicine has revealed the addictive potential of high levels of sugar intake. Preexisting health promotion strategies could benefit from the integration of the concept of sugar addiction. A targeted intervention could yield more positive results in health outcomes within the country. Current literature seems to support food environment changes, targeted health policies, and special consultation skills as cost-effective remedies to curb the rise of sugar-related health morbidities. © The Author(s) 2014.

  17. Saramago’s Death with Interruptions: A Path to Reconsider Essential Dilemmas Linked to Health Law

    Directory of Open Access Journals (Sweden)

    Sandra Mabel Wierzba

    2014-12-01

    Full Text Available What would happen if somewhere people would stop dying? In Saramago’s Death with interruptions, after the initial joy associated to the possibility of eternal life, anxiety and conflict invade the community. The end of death not only shakes Philosophy and Religion foundations, but it impacts on various legal institutions as well. In this paper, we consider the notion of Justice from the Right to Health perspective. In particular, we analyse the concept of “euthanasia" and the current role of insurance from the private law viewpoint, taking into account its “constitutionalization" process. We remark the wisdom of the parable built by the author because of the simplicity, sharpness and versatility when addressing dilemmas that Law cannot fully solve. ¿Qué ocurriría si en algún lugar la gente dejara de morir? En Las intermitencias de la muerte de Saramago, tras la alegría inicial por la posibilidad de la vida eterna, la ansiedad y el conflicto predominan en la comunidad. El final de la muerte no sólo sacude los cimientos de la Filosofía y Religión, pero también afecta a diversas instituciones jurídicas. En este artículo se considera el concepto de Justicia desde la perspectiva de derecho a la salud. En particular, se analiza el concepto de “eutanasia” y el papel actual de los seguros desde el punto de vista del derecho privado, teniendo en cuenta su proceso de “constitucionalización”. Se destaca la sensatez de la parábola construida por el autor por su simplicidad, nitidez y versatilidad al abordar los dilemas que la Ley no puede resolver completamente. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=2520437

  18. Sports and energy drink consumption are linked to health-risk behaviours among young adults.

    Science.gov (United States)

    Larson, Nicole; Laska, Melissa N; Story, Mary; Neumark-Sztainer, Dianne

    2015-10-01

    National data for the USA show increases in sports and energy drink consumption over the past decade with the largest increases among young adults aged 20-34 years. The present study aimed to identify sociodemographic factors and health-risk behaviours associated with sports and energy drink consumption among young adults. Cross-sectional analysis of survey data from the third wave of a cohort study (Project EAT-III: Eating and Activity in Teens and Young Adults). Regression models stratified on gender and adjusted for sociodemographic characteristics were used to examine associations of sports and energy drink consumption with eating behaviours, physical activity, media use, weight-control behaviours, sleep patterns and substance use. Participants completed baseline surveys in 1998-1999 as students at public secondary schools in Minneapolis/St. Paul, Minnesota, USA and the EAT-III surveys online or by mail in 2008-2009. The sample consisted of 2287 participants (55% female, mean age 25·3 years). Results showed 31·0% of young adults consumed sports drinks and 18·8% consumed energy drinks at least weekly. Among men and women, sports drink consumption was associated with higher sugar-sweetened soda and fruit juice intake, video game use and use of muscle-enhancing substances like creatine (P≤0·01). Energy drink consumption was associated with lower breakfast frequency and higher sugar-sweetened soda intake, video game use, use of unhealthy weight-control behaviours, trouble sleeping and substance use among men and women (Psports and energy drink consumption with other unhealthy behaviours in the design of programmes and services for young adults.

  19. Potential biological pathways linking Type-D personality and poor health: A cross-sectional investigation.

    Directory of Open Access Journals (Sweden)

    Vera K Jandackova

    Full Text Available Type-D personality, defined as a combination of high negative affect and high social isolation, has been associated with poor health outcomes. However, pathways underlying this association are largely unknown. We investigated the relationship between Type-D personality and several biological and behavioral pathways including the autonomic nervous system, the immune system, glucose regulation and sleep in a large, apparently healthy sample.Data from a total of 646 respondents (age 41.6±11.5, 12,2% women were available for analysis. Persons with Type-D (negative affect and social isolation score ≥10 were contrasted with those without Type-D. Measures of plasma fibrinogen levels, white blood cell count, high sensitivity C-reactive protein, fasting plasma glucose (FPG, cholesterol, high-density and low-density lipoprotein, glycated hemoglobin (HbA1c, creatinine, triglycerides, and albumin were derived from fasting blood samples. Urine norepinephrine and free cortisol were determined by high-performance liquid chromatography. Time-domain heart rate variability (HRV measures were calculated for the 24hr recording period and for nighttime separately.Persons with Type-D had higher HbA1c, FPG, and fibrinogen, and lower nighttime HRV than those without Type-D, suggesting worse glycemic control, systemic inflammation and poorer autonomic nervous system modulation in Type-D persons. In addition, those with Type-D reported less social support and greater sleep difficulties while no group differences were observed for alcohol and cigarette consumption, physical activity and body mass index.Findings provide some of the first evidence for multiple possible biological and behavioral pathways between Type-D personality and increased morbidity and mortality.

  20. Linking human health, climate change, and food security through ecological-based sanitation systems

    Science.gov (United States)

    Ryals, R.; Kramer, S.; Porder, S.; Andersen, G. L.

    2015-12-01

    Ensuring access to clean, safe sanitation for the world's population remains a challenging, yet critical, global sustainability goal. Ecological-based sanitation (EcoSan) technology is a promising strategy for improving sanitation, particularly in areas where financial resources and infrastructure are limiting. The composting of human waste and its use as an agricultural soil amendment can tackle three important challenges in developing countries - providing improved sanitation for vulnerable communities, reducing the spread of intestinal-born pathogens, and returning nutrients and organic matter to degraded agricultural soils. The extent of these benefits and potential tradeoffs are not well known, but have important implications for the widespread adoption of this strategy to promote healthy communities and enhance food security. We quantified the effects of EcoSan on the climate and human health in partnership with Sustainable Organic Integrated Livelihoods (SOIL) in Haiti. We measured greenhouse gas emissions (nitrous oxide, methane, and carbon dioxide) from compost piles that ranged in age from 0 to 14 months (i.e. finished) from two compost facilities managed with or without cement lining. We also measured emissions from a government-operated waste treatment pond and a grass field where waste has been illegally dumped. The highest methane emissions were observed from the anaerobic waste pond, whereas the dump site and compost piles had higher nitrous oxide emissions. Net greenhouse gases (CO2-equivalents) from unlined compost piles were 8x lower than lined compost piles and 20 and 30x lower than the dump and waste pond, respectively. We screened finished compost for fecal pathogens using bacterial 16S sequencing. Bacterial pathogens were eliminated regardless of the type of composting process. Pilot trials indicate that the application of compost to crops has a large potential for increasing food production. This research suggests that EcoSan systems are

  1. Development of a browser application to foster research on linking climate and health datasets: Challenges and opportunities.

    Science.gov (United States)

    Hajat, Shakoor; Whitmore, Ceri; Sarran, Christophe; Haines, Andy; Golding, Brian; Gordon-Brown, Harriet; Kessel, Anthony; Fleming, Lora E

    2017-01-01

    Improved data linkages between diverse environment and health datasets have the potential to provide new insights into the health impacts of environmental exposures, including complex climate change processes. Initiatives that link and explore big data in the environment and health arenas are now being established. To encourage advances in this nascent field, this article documents the development of a web browser application to facilitate such future research, the challenges encountered to date, and how they were addressed. A 'storyboard approach' was used to aid the initial design and development of the application. The application followed a 3-tier architecture: a spatial database server for storing and querying data, server-side code for processing and running models, and client-side browser code for user interaction and for displaying data and results. The browser was validated by reproducing previously published results from a regression analysis of time-series datasets of daily mortality, air pollution and temperature in London. Data visualisation and analysis options of the application are presented. The main factors that shaped the development of the browser were: accessibility, open-source software, flexibility, efficiency, user-friendliness, licensing restrictions and data confidentiality, visualisation limitations, cost-effectiveness, and sustainability. Creating dedicated data and analysis resources, such as the one described here, will become an increasingly vital step in improving understanding of the complex interconnections between the environment and human health and wellbeing, whilst still ensuring appropriate confidentiality safeguards. The issues raised in this paper can inform the future development of similar tools by other researchers working in this field. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Regular moderate intake of red wine is linked to a better women's sexual health.

    Science.gov (United States)

    Mondaini, Nicola; Cai, Tommaso; Gontero, Paolo; Gavazzi, Andrea; Lombardi, Giuseppe; Boddi, Vieri; Bartoletti, Riccardo

    2009-10-01

    While some evidence does exist for a positive correlation between moderate wine intake and men's sexual health, there is no study addressing the potential correlation between red wine intake and women's sexual function. The aim of our study was to assess whether there is a tie between daily red wine intake and sexual function in a sample of healthy Italian women, living in the Chianti area (Tuscany) not complaining of any sexual disorders. We recruited 798 women (age 18-50), living in the Chianti area (Tuscany), not complaining of any sexual disorders. We divided the participants into three groups: daily moderate (one to two glasses) red wine intake (group 1); teetotallers (group 2); and daily intake of more than two glasses of red wine and/or other types of alcoholic drinks (including white wine), as well as of those reporting occasional drinking (group 3). All participants completed anonymously the Female Sexual Function Index (FSFI) questionnaire and were asked to report on their amount and type of alcohol consumption. Group 1 had significantly higher total (P = 0.001), as well as desire and lubrication domain (P = 0.001 and P = 0.001, respectively) FSFI scores than participants in groups 2 and 3. No significant differences between the groups were observed concerning sexual arousal, satisfaction, pain, and orgasm. Univariate analysis showed a significant correlation between age, alcohol consumption (P = 0.009), and a better score at questionnaire examination. During multivariate analysis, alcohol consumption was identified as an independent prognostic parameter (P = 0.002) in predicting the better score at questionnaire examination. The finding that regular moderate intake of red wine is associated with higher FSFI scores for both sexual desire, lubrication, and overall sexual function as compared to the teetotaller status is intriguing. While this finding needs to be interpreted with some caution, because of the small sample size, self-reported data, and the

  3. Profiles of Maternal Parenting Practices: Exploring the Link With Maternal Delinquency, Offending, Mental Health, and Children's Physical Aggression.

    Science.gov (United States)

    Tzoumakis, Stacy; Lussier, Patrick; Corrado, Raymond R

    2015-11-01

    Studies have often linked parenting to children's subsequent antisocial behavior; however, the circumstances under which this might occur are less clear. The current study explores patterns in mothers' parenting practices, and associated correlates including maternal delinquency and offending, mental health, and children's physical aggression. This study is based on the first wave of the ongoing Vancouver Longitudinal Study; the objective of this prospective study is to identify the early risk and protective factors for aggression and violence from the earliest developmental periods. Parenting practices of 287 mothers with preschoolers are examined using a series of latent class analyses. Three different patterns of parenting emerged: Positive, Negative, and Intermittent. Patterns identified are associated with several key criminogenic, socio-demographic, historical, and developmental factors including current maternal adult offending, mothers' mental health, ethnicity, and frequency of children's physical aggression. Importantly, mothers who show parenting in line with the more negative classes also rely on a number of positive practices. Implications of the study suggest that parenting is influenced by mothers' immediate situations and contexts (e.g., current offending rather that past delinquency), which can be targeted for intervention. © The Author(s) 2014.

  4. Etiology of common childhood acute lymphoblastic leukemia: the adrenal hypothesis

    DEFF Research Database (Denmark)

    Schmiegelow, K.; Vestergaard, T.; Nielsen, S.M.

    2008-01-01

    The pattern of infections in the first years of life modulates our immune system, and a low incidence of infections has been linked to an increased risk of common childhood acute lymphoblastic leukemia (ALL). We here present a new interpretation of these observations--the adrenal hypothesis...

  5. Patients' online access to their electronic health records and linked online services: a systematic review in primary care.

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-03-01

    Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups

  6. Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-01-01

    Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of

  7. Questioning the social intelligence hypothesis.

    Science.gov (United States)

    Holekamp, Kay E

    2007-02-01

    The social intelligence hypothesis posits that complex cognition and enlarged "executive brains" evolved in response to challenges that are associated with social complexity. This hypothesis has been well supported, but some recent data are inconsistent with its predictions. It is becoming increasingly clear that multiple selective agents, and non-selective constraints, must have acted to shape cognitive abilities in humans and other animals. The task now is to develop a larger theoretical framework that takes into account both inter-specific differences and similarities in cognition. This new framework should facilitate consideration of how selection pressures that are associated with sociality interact with those that are imposed by non-social forms of environmental complexity, and how both types of functional demands interact with phylogenetic and developmental constraints.

  8. Gaussian Hypothesis Testing and Quantum Illumination.

    Science.gov (United States)

    Wilde, Mark M; Tomamichel, Marco; Lloyd, Seth; Berta, Mario

    2017-09-22

    Quantum hypothesis testing is one of the most basic tasks in quantum information theory and has fundamental links with quantum communication and estimation theory. In this paper, we establish a formula that characterizes the decay rate of the minimal type-II error probability in a quantum hypothesis test of two Gaussian states given a fixed constraint on the type-I error probability. This formula is a direct function of the mean vectors and covariance matrices of the quantum Gaussian states in question. We give an application to quantum illumination, which is the task of determining whether there is a low-reflectivity object embedded in a target region with a bright thermal-noise bath. For the asymmetric-error setting, we find that a quantum illumination transmitter can achieve an error probability exponent stronger than a coherent-state transmitter of the same mean photon number, and furthermore, that it requires far fewer trials to do so. This occurs when the background thermal noise is either low or bright, which means that a quantum advantage is even easier to witness than in the symmetric-error setting because it occurs for a larger range of parameters. Going forward from here, we expect our formula to have applications in settings well beyond those considered in this paper, especially to quantum communication tasks involving quantum Gaussian channels.

  9. Meaning in Life: One Link in the Chain from Religiousness to Well-Being

    Science.gov (United States)

    Steger, Michael F.; Frazier, Patricia

    2005-01-01

    Meaning in life has been identified as a potential mediator of the link between religiousness and psychological health. The authors tested this hypothesis in 2 studies, using multiple methods and measures of religiousness and well-being. In the studies, meaning in life mediated the relation between religiousness and life satisfaction (Study 1A),…

  10. A Molecular–Structure Hypothesis

    Directory of Open Access Journals (Sweden)

    Jan C. A. Boeyens

    2010-11-01

    Full Text Available The self-similar symmetry that occurs between atomic nuclei, biological growth structures, the solar system, globular clusters and spiral galaxies suggests that a similar pattern should characterize atomic and molecular structures. This possibility is explored in terms of the current molecular structure-hypothesis and its extension into four-dimensional space-time. It is concluded that a quantum molecule only has structure in four dimensions and that classical (Newtonian structure, which occurs in three dimensions, cannot be simulated by quantum-chemical computation.

  11. Did the perils of abdominal obesity affect depiction of feminine beauty in the sixteenth to eighteenth century British literature? Exploring the health and beauty link

    OpenAIRE

    Singh, Devendra; Renn, Peter; Singh, Adrian

    2007-01-01

    ‘Good gene’ mate selection theory proposes that all individuals share evolved mental mechanisms that identify specific parts of a woman's body as indicators of fertility and health. Depiction of feminine beauty, across time and culture, should therefore emphasize the physical traits indicative of health and fertility. Abdominal obesity, as measured by waist size, is reliably linked to decreased oestrogen, reduced fecundity and increased risk for major diseases. Systematic searches of British ...

  12. Considerations for the analysis of longitudinal electronic health records linked to claims data to study the effectiveness and safety of drugs.

    Science.gov (United States)

    Lin, K J; Schneeweiss, S

    2016-08-01

    Health insurance claims and electronic health records (EHR) databases have been considered the preferred data sources with which to study drug safety and effectiveness in routine care. Linking claims data to EHR allows researchers to leverage the complementary advantages of each data source to enhance study validity. We propose a framework to evaluate the need for supplementing claims data with EHR and vice versa to optimize outcome ascertainment, exposure assessment, and confounding adjustment. © 2016 American Society for Clinical Pharmacology and Therapeutics.

  13. The future of population registers: linking routine health datasets to assess a population's current glycaemic status for quality improvement.

    Science.gov (United States)

    Chan, Wing Cheuk; Jackson, Gary; Wright, Craig Shawe; Orr-Walker, Brandon; Drury, Paul L; Boswell, D Ross; Lee, Mildred Ai Wei; Papa, Dean; Jackson, Rod

    2014-04-28

    To determine the diabetes screening levels and known glycaemic status of all individuals by age, gender and ethnicity within a defined geographic location in a timely and consistent way to potentially facilitate systematic disease prevention and management. Retrospective observational study. Auckland region of New Zealand. 1 475 347 people who had utilised publicly funded health service in New Zealand and domicile in the Auckland region of New Zealand in 2010. The health service utilisation population was individually linked to a comprehensive regional laboratory repository dating back to 2004. The two outcomes measures were glycaemia-related blood testing coverage (glycated haemoglobin (HbA1c), fasting and random glucose and glucose tolerance tests), and the proportions and number of people with known dysglycaemia in 2010 using modified American Diabetes Association (ADA) and WHO criteria. Within the health service utilisation population, 792 560 people had had at least one glucose or HbA1c blood test in the previous 5.5 years. Overall, 81% of males (n=198 086) and 87% of females (n=128 982) in the recommended age groups for diabetes screening had a blood test to assess their glycaemic status. The estimated age-standardised prevalence of dysglycaemia was highest in people of Pacific Island ethnicity at 11.4% (95% CI 11.2% to 11.5%) for males and 11.6% (11.4% to 11.8%) for females, followed closely by people of Indian ethnicity at 10.8% (10.6% to 11.1%) and 9.3% (9.1% to 9.6%), respectively. Among the indigenous Maori population, the prevalence was 8.2% (7.9% to 8.4%) and 7% (6.8% to 7.2%), while for 'Others' (mainly Europeans) it was 3% (3% to 3.1%) and 2.2% (2.1% to 2.2%), respectively. We have demonstrated that the data linkage between a laboratory repository and national administrative datasets has the potential to provide a systematic and consistent individual level clinical information that is relevant to medical auditing for a large geographically defined

  14. Is PMI the Hypothesis or the Null Hypothesis?

    Science.gov (United States)

    Tarone, Aaron M; Sanford, Michelle R

    2017-09-01

    Over the past several decades, there have been several strident exchanges regarding whether forensic entomologists estimate the postmortem interval (PMI), minimum PMI, or something else. During that time, there has been a proliferation of terminology reflecting this concern regarding "what we do." This has been a frustrating conversation for some in the community because much of this debate appears to be centered on what assumptions are acknowledged directly and which are embedded within a list of assumptions (or ignored altogether) in the literature and in case reports. An additional component of the conversation centers on a concern that moving away from the use of certain terminology like PMI acknowledges limitations and problems that would make the application of entomology appear less useful in court-a problem for lawyers, but one that should not be problematic for scientists in the forensic entomology community, as uncertainty is part of science that should and can be presented effectively in the courtroom (e.g., population genetic concepts in forensics). Unfortunately, a consequence of the way this conversation is conducted is that even as all involved in the debate acknowledge the concerns of their colleagues, parties continue to talk past one another advocating their preferred terminology. Progress will not be made until the community recognizes that all of the terms under consideration take the form of null hypothesis statements and that thinking about "what we do" as a null hypothesis has useful legal and scientific ramifications that transcend arguments over the usage of preferred terminology. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. The Stoichiometric Divisome: A Hypothesis

    Directory of Open Access Journals (Sweden)

    Waldemar eVollmer

    2015-05-01

    Full Text Available Dividing Escherichia coli cells simultaneously constrict the inner membrane, peptidoglycan layer and outer membrane to synthesize the new poles of the daughter cells. For this, more than 30 proteins localize to mid-cell where they form a large, ring-like assembly, the divisome, facilitating division. Although the precise function of most divisome proteins is unknown, it became apparent in recent years that dynamic protein-protein interactions are essential for divisome assembly and function. However, little is known about the nature of the interactions involved and the stoichiometry of the proteins within the divisome. A recent study (Li et al., 2014 used ribosome profiling to measure the absolute protein synthesis rates in E. coli. Interestingly, they observed that most proteins which participate in known multiprotein complexes are synthesized proportional to their stoichiometry. Based on this principle we present a hypothesis for the stoichiometry of the core of the divisome, taking into account known protein-protein interactions. From this hypothesis we infer a possible mechanism for PG synthesis during division.

  16. The ties that bind: Ingroup ties are linked with diminished inflammatory immune responses and fewer mental health symptoms through less rumination.

    Science.gov (United States)

    Ysseldyk, Renate; McQuaid, Robyn J; McInnis, Opal A; Anisman, Hymie; Matheson, Kimberly

    2018-01-01

    The present research explored whether components of social identity, namely ingroup ties, affect, and centrality, were differentially linked to mental health and inflammatory immune responses, and whether rumination mediated those relations. Study 1 (N = 138) indicated that stronger ingroup ties were associated with fewer mental health (depressive and post-traumatic stress) symptoms; those relations were mediated by the tendency for individuals with strong ties to rely less on ruminative coping to deal with a stressful life event. Study 2 (N = 54) demonstrated that ingroup ties were negatively associated with depressive symptoms, dispositional rumination, as well as stress-linked inflammatory elements at the physiological level. Consistent associations for centrality and ingroup affect were absent, suggesting that ingroup ties may have unique health benefits.

  17. The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers

    DEFF Research Database (Denmark)

    Kirkeskov, Lilli; Kristiansen, Eva; Bøggild, Henrik

    2010-01-01

    Kirkeskov L, Kristiansen E, Bøggild H, von Platen-Hallermund F, Sckerl H, Carlsen A, Larsen MJ, Poulsen S. The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers. Community...... Dent Oral Epidemiol 2010. (c) 2010 John Wiley & Sons A/S Abstract - Objectives: To study the association between fluoride concentration in drinking water and dental caries in Danish children. Methods: The study linked registry data on fluoride concentration in drinking water over a 10-year period...... with data on dental caries from the Danish National Board of Health database on child dental health for 5-year-old children born in 1989 and 1999, and for 15-year-old children born in 1979 and 1989. The number of children included in the cohorts varied between 41.000 and 48.000. Logistic regression was used...

  18. Interrelationships between Health Behaviors and Coping Strategies among Informal Caregivers of Cancer Survivors

    Science.gov (United States)

    Litzelman, Kristin; Kent, Erin E.; Rowland, Julia H.

    2018-01-01

    Background: Recent research among cancer survivors suggests that health behaviors and coping are intertwined, with important implications for positive behavior change and health. Informal caregivers may have poor health behaviors, and caregivers' health behaviors have been linked to those of survivors. Aims: This hypothesis generating study…

  19. Memory in astrocytes: a hypothesis

    Directory of Open Access Journals (Sweden)

    Caudle Robert M

    2006-01-01

    Full Text Available Abstract Background Recent work has indicated an increasingly complex role for astrocytes in the central nervous system. Astrocytes are now known to exchange information with neurons at synaptic junctions and to alter the information processing capabilities of the neurons. As an extension of this trend a hypothesis was proposed that astrocytes function to store information. To explore this idea the ion channels in biological membranes were compared to models known as cellular automata. These comparisons were made to test the hypothesis that ion channels in the membranes of astrocytes form a dynamic information storage device. Results Two dimensional cellular automata were found to behave similarly to ion channels in a membrane when they function at the boundary between order and chaos. The length of time information is stored in this class of cellular automata is exponentially related to the number of units. Therefore the length of time biological ion channels store information was plotted versus the estimated number of ion channels in the tissue. This analysis indicates that there is an exponential relationship between memory and the number of ion channels. Extrapolation of this relationship to the estimated number of ion channels in the astrocytes of a human brain indicates that memory can be stored in this system for an entire life span. Interestingly, this information is not affixed to any physical structure, but is stored as an organization of the activity of the ion channels. Further analysis of two dimensional cellular automata also demonstrates that these systems have both associative and temporal memory capabilities. Conclusion It is concluded that astrocytes may serve as a dynamic information sink for neurons. The memory in the astrocytes is stored by organizing the activity of ion channels and is not associated with a physical location such as a synapse. In order for this form of memory to be of significant duration it is necessary

  20. From animal cruelty to serial murder: applying the graduation hypothesis.

    Science.gov (United States)

    Wright, Jeremy; Hensley, Christopher

    2003-02-01

    Although serial murder has been recorded for centuries, limited academic attention has been given to this important topic. Scholars have attempted to examine the causality and motivations behind the rare phenomenon of serial murder. However, scant research exists which delves into the childhood characteristics of serial murderers. Using social learning theory, some of these studies present supporting evidence for a link between childhood animal cruelty and adult aggression toward humans. Based on five case studies of serial murderers, we contribute to the existing literature by exploring the possible link between childhood cruelty toward animals and serial murder with the application of the graduation hypothesis.

  1. Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data.

    Science.gov (United States)

    Jaglal, Susan B; Guilcher, Sara J T; Hawker, Gillian; Lou, Wendy; Salbach, Nancy M; Manno, Michael; Zwarenstein, Merrick

    2014-05-01

    Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups.

  2. Robust and distributed hypothesis testing

    CERN Document Server

    Gül, Gökhan

    2017-01-01

    This book generalizes and extends the available theory in robust and decentralized hypothesis testing. In particular, it presents a robust test for modeling errors which is independent from the assumptions that a sufficiently large number of samples is available, and that the distance is the KL-divergence. Here, the distance can be chosen from a much general model, which includes the KL-divergence as a very special case. This is then extended by various means. A minimax robust test that is robust against both outliers as well as modeling errors is presented. Minimax robustness properties of the given tests are also explicitly proven for fixed sample size and sequential probability ratio tests. The theory of robust detection is extended to robust estimation and the theory of robust distributed detection is extended to classes of distributions, which are not necessarily stochastically bounded. It is shown that the quantization functions for the decision rules can also be chosen as non-monotone. Finally, the boo...

  3. The venom optimization hypothesis revisited.

    Science.gov (United States)

    Morgenstern, David; King, Glenn F

    2013-03-01

    Animal venoms are complex chemical mixtures that typically contain hundreds of proteins and non-proteinaceous compounds, resulting in a potent weapon for prey immobilization and predator deterrence. However, because venoms are protein-rich, they come with a high metabolic price tag. The metabolic cost of venom is sufficiently high to result in secondary loss of venom whenever its use becomes non-essential to survival of the animal. The high metabolic cost of venom leads to the prediction that venomous animals may have evolved strategies for minimizing venom expenditure. Indeed, various behaviors have been identified that appear consistent with frugality of venom use. This has led to formulation of the "venom optimization hypothesis" (Wigger et al. (2002) Toxicon 40, 749-752), also known as "venom metering", which postulates that venom is metabolically expensive and therefore used frugally through behavioral control. Here, we review the available data concerning economy of venom use by animals with either ancient or more recently evolved venom systems. We conclude that the convergent nature of the evidence in multiple taxa strongly suggests the existence of evolutionary pressures favoring frugal use of venom. However, there remains an unresolved dichotomy between this economy of venom use and the lavish biochemical complexity of venom, which includes a high degree of functional redundancy. We discuss the evidence for biochemical optimization of venom as a means of resolving this conundrum. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Alien abduction: a medical hypothesis.

    Science.gov (United States)

    Forrest, David V

    2008-01-01

    In response to a new psychological study of persons who believe they have been abducted by space aliens that found that sleep paralysis, a history of being hypnotized, and preoccupation with the paranormal and extraterrestrial were predisposing experiences, I noted that many of the frequently reported particulars of the abduction experience bear more than a passing resemblance to medical-surgical procedures and propose that experience with these may also be contributory. There is the altered state of consciousness, uniformly colored figures with prominent eyes, in a high-tech room under a round bright saucerlike object; there is nakedness, pain and a loss of control while the body's boundaries are being probed; and yet the figures are thought benevolent. No medical-surgical history was apparently taken in the above mentioned study, but psychological laboratory work evaluated false memory formation. I discuss problems in assessing intraoperative awareness and ways in which the medical hypothesis could be elaborated and tested. If physicians are causing this syndrome in a percentage of patients, we should know about it; and persons who feel they have been abducted should be encouraged to inform their surgeons and anesthesiologists without challenging their beliefs.

  5. The oxidative hypothesis of senescence

    Directory of Open Access Journals (Sweden)

    Gilca M

    2007-01-01

    Full Text Available The oxidative hypothesis of senescence, since its origin in 1956, has garnered significant evidence and growing support among scientists for the notion that free radicals play an important role in ageing, either as "damaging" molecules or as signaling molecules. Age-increasing oxidative injuries induced by free radicals, higher susceptibility to oxidative stress in short-lived organisms, genetic manipulations that alter both oxidative resistance and longevity and the anti-ageing effect of caloric restriction and intermittent fasting are a few examples of accepted scientific facts that support the oxidative theory of senescence. Though not completely understood due to the complex "network" of redox regulatory systems, the implication of oxidative stress in the ageing process is now well documented. Moreover, it is compatible with other current ageing theories (e.g., those implicating the mitochondrial damage/mitochondrial-lysosomal axis, stress-induced premature senescence, biological "garbage" accumulation, etc. This review is intended to summarize and critically discuss the redox mechanisms involved during the ageing process: sources of oxidant agents in ageing (mitochondrial -electron transport chain, nitric oxide synthase reaction- and non-mitochondrial- Fenton reaction, microsomal cytochrome P450 enzymes, peroxisomal β -oxidation and respiratory burst of phagocytic cells, antioxidant changes in ageing (enzymatic- superoxide dismutase, glutathione-reductase, glutathion peroxidase, catalase- and non-enzymatic glutathione, ascorbate, urate, bilirubine, melatonin, tocopherols, carotenoids, ubiquinol, alteration of oxidative damage repairing mechanisms and the role of free radicals as signaling molecules in ageing.

  6. The linear hypothesis - an idea whose time has passed

    International Nuclear Information System (INIS)

    Tschaeche, A.N.

    1995-01-01

    The linear no-threshold hypothesis is the basis for radiation protection standards in the United States. In the words of the National Council on Radiation Protection and Measurements (NCRP), the hypothesis is: open-quotes In the interest of estimating effects in humans conservatively, it is not unreasonable to follow the assumption of a linear relationship between dose and effect in the low dose regions for which direct observational data are not available.close quotes The International Commission on Radiological Protection (ICRP) stated the hypothesis in a slightly different manner: open-quotes One such basic assumption ... is that ... there is ... a linear relationship without threshold between dose and the probability of an effect. The hypothesis was necessary 50 yr ago when it was first enunciated because the dose-effect curve for ionizing radiation for effects in humans was not known. The ICRP and NCRP needed a model to extrapolate high-dose effects to low-dose effects. So the linear no-threshold hypothesis was born. Certain details of the history of the development and use of the linear hypothesis are presented. In particular, use of the hypothesis by the U.S. regulatory agencies is examined. Over time, the sense of the hypothesis has been corrupted. The corruption of the hypothesis into the current paradigm of open-quote a little radiation, no matter how small, can and will harm youclose quotes is presented. The reasons the corruption occurred are proposed. The effects of the corruption are enumerated, specifically, the use of the corruption by the antinuclear forces in the United States and some of the huge costs to U.S. taxpayers due to the corruption. An alternative basis for radiation protection standards to assure public safety, based on the weight of scientific evidence on radiation health effects, is proposed

  7. Yawning, fatigue and cortisol: expanding the Thompson Cortisol Hypothesis.

    OpenAIRE

    Thompson, Simon

    2014-01-01

    Yawning and its involvement in neurological disorders has become the new scientific conundrum. Cortisol levels are known to rise during stress and fatigue; yawning may occur when we are under stress or tired. However, the link between yawning, fatigue, and cortisol has not been fully understood. Expansion of the Thompson Cortisol Hypothesis proposes that the stress hormone, cortisol, is responsible for yawning and fatigue especially in people with incomplete innervation such as multiple sclero...

  8. Hypothesis test for synchronization: twin surrogates revisited.

    Science.gov (United States)

    Romano, M Carmen; Thiel, Marco; Kurths, Jürgen; Mergenthaler, Konstantin; Engbert, Ralf

    2009-03-01

    The method of twin surrogates has been introduced to test for phase synchronization of complex systems in the case of passive experiments. In this paper we derive new analytical expressions for the number of twins depending on the size of the neighborhood, as well as on the length of the trajectory. This allows us to determine the optimal parameters for the generation of twin surrogates. Furthermore, we determine the quality of the twin surrogates with respect to several linear and nonlinear statistics depending on the parameters of the method. In the second part of the paper we perform a hypothesis test for phase synchronization in the case of experimental data from fixational eye movements. These miniature eye movements have been shown to play a central role in neural information processing underlying the perception of static visual scenes. The high number of data sets (21 subjects and 30 trials per person) allows us to compare the generated twin surrogates with the "natural" surrogates that correspond to the different trials. We show that the generated twin surrogates reproduce very well all linear and nonlinear characteristics of the underlying experimental system. The synchronization analysis of fixational eye movements by means of twin surrogates reveals that the synchronization between the left and right eye is significant, indicating that either the centers in the brain stem generating fixational eye movements are closely linked, or, alternatively that there is only one center controlling both eyes.

  9. DAMPs, ageing, and cancer: The 'DAMP Hypothesis'.

    Science.gov (United States)

    Huang, Jin; Xie, Yangchun; Sun, Xiaofang; Zeh, Herbert J; Kang, Rui; Lotze, Michael T; Tang, Daolin

    2015-11-01

    Ageing is a complex and multifactorial process characterized by the accumulation of many forms of damage at the molecular, cellular, and tissue level with advancing age. Ageing increases the risk of the onset of chronic inflammation-associated diseases such as cancer, diabetes, stroke, and neurodegenerative disease. In particular, ageing and cancer share some common origins and hallmarks such as genomic instability, epigenetic alteration, aberrant telomeres, inflammation and immune injury, reprogrammed metabolism, and degradation system impairment (including within the ubiquitin-proteasome system and the autophagic machinery). Recent advances indicate that damage-associated molecular pattern molecules (DAMPs) such as high mobility group box 1, histones, S100, and heat shock proteins play location-dependent roles inside and outside the cell. These provide interaction platforms at molecular levels linked to common hallmarks of ageing and cancer. They can act as inducers, sensors, and mediators of stress through individual plasma membrane receptors, intracellular recognition receptors (e.g., advanced glycosylation end product-specific receptors, AIM2-like receptors, RIG-I-like receptors, and NOD1-like receptors, and toll-like receptors), or following endocytic uptake. Thus, the DAMP Hypothesis is novel and complements other theories that explain the features of ageing. DAMPs represent ideal biomarkers of ageing and provide an attractive target for interventions in ageing and age-associated diseases. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Disparities in health, poverty, incarceration, and social justice among racial groups in the United States: a critical review of evidence of close links with neoliberalism.

    Science.gov (United States)

    Nkansah-Amankra, Stephen; Agbanu, Samuel Kwami; Miller, Reuben Jonathan

    2013-01-01

    Problems of poverty, poor health, and incarceration are unevenly distributed among racial and ethnic minorities in the United States. We argue that this is due, in part, to the ascendance of United States-style neoliberalism, a prevailing political and economic doctrine that shapes social policy, including public health and anti-poverty intervention strategies. Public health research most often associates inequalities in health outcomes, poverty, and incarceration with individual and cultural risk factors. Contextual links to structural inequality and the neoliberal doctrine animating state-sanctioned interventions are given less attention. The interrelationships among these are not clear in the extant literature. Less is known about public health and incarceration. Thus, the authors describe the linkages between neoliberalism, public health, and criminal justice outcomes. We suggest that neoliberalism exacerbates racial disparities in health, poverty, and incarceration in the United States. We conclude by calling for a new direction in public health research that advances a pro-poor public health agenda to improve the general well-being of disadvantaged groups.

  11. The zinc dyshomeostasis hypothesis of Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Travis J A Craddock

    Full Text Available Alzheimer's disease (AD is the most common form of dementia in the elderly. Hallmark AD neuropathology includes extracellular amyloid plaques composed largely of the amyloid-β protein (Aβ, intracellular neurofibrillary tangles (NFTs composed of hyper-phosphorylated microtubule-associated protein tau (MAP-tau, and microtubule destabilization. Early-onset autosomal dominant AD genes are associated with excessive Aβ accumulation, however cognitive impairment best correlates with NFTs and disrupted microtubules. The mechanisms linking Aβ and NFT pathologies in AD are unknown. Here, we propose that sequestration of zinc by Aβ-amyloid deposits (Aβ oligomers and plaques not only drives Aβ aggregation, but also disrupts zinc homeostasis in zinc-enriched brain regions important for memory and vulnerable to AD pathology, resulting in intra-neuronal zinc levels, which are either too low, or excessively high. To evaluate this hypothesis, we 1 used molecular modeling of zinc binding to the microtubule component protein tubulin, identifying specific, high-affinity zinc binding sites that influence side-to-side tubulin interaction, the sensitive link in microtubule polymerization and stability. We also 2 performed kinetic modeling showing zinc distribution in extra-neuronal Aβ deposits can reduce intra-neuronal zinc binding to microtubules, destabilizing microtubules. Finally, we 3 used metallomic imaging mass spectrometry (MIMS to show anatomically-localized and age-dependent zinc dyshomeostasis in specific brain regions of Tg2576 transgenic, mice, a model for AD. We found excess zinc in brain regions associated with memory processing and NFT pathology. Overall, we present a theoretical framework and support for a new theory of AD linking extra-neuronal Aβ amyloid to intra-neuronal NFTs and cognitive dysfunction. The connection, we propose, is based on β-amyloid-induced alterations in zinc ion concentration inside neurons affecting stability of

  12. The zinc dyshomeostasis hypothesis of Alzheimer's disease.

    Science.gov (United States)

    Craddock, Travis J A; Tuszynski, Jack A; Chopra, Deepak; Casey, Noel; Goldstein, Lee E; Hameroff, Stuart R; Tanzi, Rudolph E

    2012-01-01

    Alzheimer's disease (AD) is the most common form of dementia in the elderly. Hallmark AD neuropathology includes extracellular amyloid plaques composed largely of the amyloid-β protein (Aβ), intracellular neurofibrillary tangles (NFTs) composed of hyper-phosphorylated microtubule-associated protein tau (MAP-tau), and microtubule destabilization. Early-onset autosomal dominant AD genes are associated with excessive Aβ accumulation, however cognitive impairment best correlates with NFTs and disrupted microtubules. The mechanisms linking Aβ and NFT pathologies in AD are unknown. Here, we propose that sequestration of zinc by Aβ-amyloid deposits (Aβ oligomers and plaques) not only drives Aβ aggregation, but also disrupts zinc homeostasis in zinc-enriched brain regions important for memory and vulnerable to AD pathology, resulting in intra-neuronal zinc levels, which are either too low, or excessively high. To evaluate this hypothesis, we 1) used molecular modeling of zinc binding to the microtubule component protein tubulin, identifying specific, high-affinity zinc binding sites that influence side-to-side tubulin interaction, the sensitive link in microtubule polymerization and stability. We also 2) performed kinetic modeling showing zinc distribution in extra-neuronal Aβ deposits can reduce intra-neuronal zinc binding to microtubules, destabilizing microtubules. Finally, we 3) used metallomic imaging mass spectrometry (MIMS) to show anatomically-localized and age-dependent zinc dyshomeostasis in specific brain regions of Tg2576 transgenic, mice, a model for AD. We found excess zinc in brain regions associated with memory processing and NFT pathology. Overall, we present a theoretical framework and support for a new theory of AD linking extra-neuronal Aβ amyloid to intra-neuronal NFTs and cognitive dysfunction. The connection, we propose, is based on β-amyloid-induced alterations in zinc ion concentration inside neurons affecting stability of polymerized

  13. Environmental Public Health Tracking: Health and Environment Linked for Information Exchange-Atlanta (HEXIX-Atlanta: A cooperative Program Between CDC and NASA for Development of an Environmental Public Health Tracking Network in the Atlanta Metropolitan Area

    Science.gov (United States)

    Quattrochi, Dale A.; Niskar, Amanda Sue

    2005-01-01

    The Centers for Disease Control and Prevention (CDC) is coordinating HELIX- Atlanta to provide information regarding the five-county Metropolitan Atlanta Area (Clayton, Cobb, DeKalb, Fulton, and Gwinett) via a network of integrated environmental monitoring and public health data systems so that all sectors can take action to prevent and control environmentally related health effects. The HELIX-Atlanta Network is a tool to access interoperable information systems with optional information technology linkage functionality driven by scientific rationale. HELIX-Atlanta is a collaborative effort with local, state, federal, and academic partners, including the NASA Marshall Space Flight Center. The HELIX-Atlanta Partners identified the following HELIX-Atlanta initial focus areas: childhood lead poisoning, short-latency cancers, developmental disabilities, birth defects, vital records, respiratory health, age of housing, remote sensing data, and environmental monitoring, HELIX-Atlanta Partners identified and evaluated information systems containing information on the above focus areas. The information system evaluations resulted in recommendations for what resources would be needed to interoperate selected information systems in compliance with the CDC Public Health Information Network (PHIN). This presentation will discuss the collaborative process of building a network that links health and environment data for information exchange, including NASA remote sensing data, for use in HELIX-Atlanta.

  14. Examining the link between women’s exposure to stressful life events prior to conception and infant and toddler health: The role of birthweight

    Science.gov (United States)

    Cheng, Erika R.; Park, Hyojun; Wisk, Lauren E.; Mandell, Kara C.; Wakeel, Fathima; Litzelman, Kristin; Chatterjee, Debanjana; Witt, Whitney P.

    2015-01-01

    Background The lifecourse perspective suggests a pathway may exist among maternal exposure to stressful life events prior to conception (PSLEs), infant birthweight, and subsequent offspring health, whereby PLSEs are part of a “chains-of-risk” that set children on a certain health pathway. No prior study has examined the link between PSLEs and offspring health in a nationally-representative sample of US mothers and their children. We used longitudinal, nationally-representative data to evaluate the relation between maternal exposure to PSLEs and subsequent measures of infant and toddler health, taking both maternal and obstetric characteristics into account. Methods We examined 6,900 mother-child dyads participating in two waves of the nationally-representative Early Childhood Longitudinal Study-Birth Cohort (n=6,900). Infant and toddler health outcomes assessed at 9 and 24 months included overall health status, special health care needs, and severe health conditions. Adjusted path analyses examined associations between PSLEs, birthweight, and child health outcomes. Results In adjusted analyses, PSLEs increased the risk for very low birthweight (VLBW, <1,500 grams), which, in turn, predicted poor health at both 9 and 24 months of age. Path analyses demonstrated that PSLEs had small indirect effects on children’s subsequent health that operated through VLBW. Conclusion Our analysis suggests a chains-of-risk model in which women’s exposure to PSLEs increases the risk for giving birth to a VLBW infant, which, in turn, adversely affects infant and toddler health. Addressing women’s preconception health may have important downstream benefits for their children, although more research is needed to replicate these findings. PMID:26500337

  15. Community strengthening and mental health system linking after flooding in two informal human settlements in Peru: a model for small-scale disaster response.

    Science.gov (United States)

    Contreras, C; Aguilar, M; Eappen, B; Guzmán, C; Carrasco, P; Millones, A K; Galea, J T

    2018-01-01

    Mental health is an important factor in responding to natural disasters. Observations of unmet mental health needs motivated the subsequent development of a community-based mental health intervention following one such disaster affecting Peru in 2017. Two informal human settlements on the outskirts of Lima were selected for a mental health intervention that included: (1) screening for depression and domestic violence, (2) children's activities to strengthen social and emotional skills and diminish stress, (3) participatory theater activities to support conflict resolution and community resilience, and (4) community health worker (CHW) accompaniment to government health services. A total of 129 people were screened across both conditions, of whom 12/116 (10%) presented with depression and 21/58 (36%) reported domestic violence. 27 unique individuals were identified with at least one problem. Thirteen people (48%) initially accepted CHW accompaniment to government-provided services. This intervention provides a model for a small-scale response to disasters that can effectively and acceptably identify individuals in need of mental health services and link them to a health system that may otherwise remain inaccessible.

  16. The Stress Acceleration Hypothesis of Nightmares

    Directory of Open Access Journals (Sweden)

    Tore Nielsen

    2017-06-01

    Full Text Available Adverse childhood experiences can deleteriously affect future physical and mental health, increasing risk for many illnesses, including psychiatric problems, sleep disorders, and, according to the present hypothesis, idiopathic nightmares. Much like post-traumatic nightmares, which are triggered by trauma and lead to recurrent emotional dreaming about the trauma, idiopathic nightmares are hypothesized to originate in early adverse experiences that lead in later life to the expression of early memories and emotions in dream content. Accordingly, the objectives of this paper are to (1 review existing literature on sleep, dreaming and nightmares in relation to early adverse experiences, drawing upon both empirical studies of dreaming and nightmares and books and chapters by recognized nightmare experts and (2 propose a new approach to explaining nightmares that is based upon the Stress Acceleration Hypothesis of mental illness. The latter stipulates that susceptibility to mental illness is increased by adversity occurring during a developmentally sensitive window for emotional maturation—the infantile amnesia period—that ends around age 3½. Early adversity accelerates the neural and behavioral maturation of emotional systems governing the expression, learning, and extinction of fear memories and may afford short-term adaptive value. But it also engenders long-term dysfunctional consequences including an increased risk for nightmares. Two mechanisms are proposed: (1 disruption of infantile amnesia allows normally forgotten early childhood memories to influence later emotions, cognitions and behavior, including the common expression of threats in nightmares; (2 alterations of normal emotion regulation processes of both waking and sleep lead to increased fear sensitivity and less effective fear extinction. These changes influence an affect network previously hypothesized to regulate fear extinction during REM sleep, disruption of which leads to

  17. Animal Models for Testing the DOHaD Hypothesis

    Science.gov (United States)

    Since the seminal work in human populations by David Barker and colleagues, several species of animals have been used in the laboratory to test the Developmental Origins of Health and Disease (DOHaD) hypothesis. Rats, mice, guinea pigs, sheep, pigs and non-human primates have bee...

  18. Optimising case detection within UK electronic health records : use of multiple linked databases for detecting liver injury

    NARCIS (Netherlands)

    Wing, Kevin; Bhaskaran, Krishnan; Smeeth, Liam; van Staa, Tjeerd P|info:eu-repo/dai/nl/304827762; Klungel, Olaf H|info:eu-repo/dai/nl/181447649; Reynolds, Robert F; Douglas, Ian

    2016-01-01

    OBJECTIVES: We aimed to create a 'multidatabase' algorithm for identification of cholestatic liver injury using multiple linked UK databases, before (1) assessing the improvement in case ascertainment compared to using a single database and (2) developing a new single-database case-definition

  19. Individually Linked Household and Health Facility Vaccination Survey in 12 At-risk Districts in Kinshasa Province, Democratic Republic of Congo: Methods and Metadata.

    Science.gov (United States)

    Burnett, Eleanor; Wannemuehler, Kathleen; Ngoie Mwamba, Guillaume; Yolande, Masembe; Guylain, Kaya; Muriel, Nzazi Nsambu; Cathy, Nzuzi; Patrice, Tshekoya; Wilkins, Karen; Yoloyolo, Norbert

    2017-07-01

    Health facility (HF) and household (HH) data can complement each other to provide a better understanding of the factors that contribute to vaccination status. In 12 zones with low vaccination coverage within Kinshasa Province, Democratic Republic of Congo, we conducted 2 surveys: (1) a linked HH and HF survey among 6-11-month-old infants, and (2) a HH survey among 12-23-month-old children. Linked survey objectives were to identify factors associated with vaccination status and to explore methodological considerations for linked survey implementation. To provide linked HH and HF data, we enrolled 6-11-month-old infants in HH clusters in each zone and then surveyed HFs located within the 12 zones and cited by caregivers of the enrolled infants as the most recent HF visited for vaccination or curative care. To provide vaccination coverage estimates for the 12-zone area, we enrolled 12-23-month-old children in every fourth HH. Of the HHs with a child aged 6-23 months, 16% were ineligible because they had resided in the neighborhood for one of the 182 surveyed HFs. For the coverage survey, 710 children aged 12-23 months participated. Home-based vaccination cards were available for 1210 of 1934 children (63%) surveyed. The surveys were successful in assessing HH information for 2 age groups, documenting written vaccination history for a large proportion of 6-23-month-old children, linking the majority of infants with their most recently visited HF, and surveying identified HFs. The implementation of the individually linked survey also highlighted the need for a comprehensive list of HFs and an analysis plan that addresses cross-classified clusters with only 1 child. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. Linking primary study data with administrative and claims data in a German cohort study on work, age, health and work participation: is there a consent bias?

    Science.gov (United States)

    Stallmann, C; Swart, E; Robra, B-P; March, S

    2017-09-01

    We analysed the degree and impact of consent bias in the prospective study 'leben in der Arbeit (lidA)' after linking primary interview data with claims data from German statutory health insurance funds as well as with administrative data provided by the German Federal Employment Agency. Prospective cohort study. Within two study waves (2011, 2014) primary data were collected based on computer-assisted personal interviews. During interview informed consent to data linkage was obtained. We used binary logistic regression analyses with participants' consent for record linkage as the dependent variable calculating odds ratios (ORs) and 95% confidence intervals (95% CIs) for independent variables. Several sociodemographic, socio-economic and work-related factors were modelled as potential determinants of consent. A total of 4244 participants took part in both waves. After excluding invalid consent, 4178 participants were included in the analysis. About 3918 (93.8%) of these participants gave their consent to link their primary data with data from at least one source. Within regression analyses only moderate bias was found due to region of residence, apprenticeship, professional affiliations, income and number of diseases. Participants from former West Germany were less likely to have their study data linked with both data sources (OR 0.63 [95% CI 0.42-0.96]) than those from the former East Germany. Participants with no information on income were more likely to refuse consent to both data sources compared to the reference group (net income: under EUR 1000; OR 0.15 [95% CI 0.08-0.30]). Respondents with two (OR 1.37 [95% CI 1.06-1.77]) or three and more diseases (OR 1.30 [95% CI 1.02-1.66]) diagnosed by a doctor agreed more frequently to linking both data sources than participants without disease. There is just a small proportion of variance in consenting explained by the models (R 2 : 0.063-0.085). Also, only small changes of factors' prevalence were observed in

  1. Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in Sweden

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    Pär Bjelkmar

    2017-04-01

    Full Text Available Abstract Background In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s and the potential for earlier detection using calls to a health advice line. Methods The investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas. Results Our analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant. Conclusions We conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

  2. Health literacy as the missing link in the provision of immigrant health care: A qualitative study of Southeast Asian immigrant women in Taiwan.

    Science.gov (United States)

    Tsai, Tzu-I; Lee, Shoou-Yih D

    2016-02-01

    Language and communication barrier are main contributors to poor health outcomes and improper use of health care among immigrants. The purpose of this study was to explore and understand specific language and communication problems experiences by Southeast Asian immigrant women in Taiwan. This qualitative study used focus groups and in-depth interviews to uncover the experiences of immigrant women regarding their access to and utilization of health care in Taiwan. Eight focus groups were conducted with 62 Southeast Asian immigrant women and 23 individual in-depth interviews with a wide range of stakeholders who had diverse background and intimate knowledge of immigrant-relating health care issues were performed. Directed content analysis was applied and identified four major themes concerning conditions that influenced immigrant women's use of health information and services: (1) gaining access to health information, (2) navigating in health care delivery system, (3) interactions during health care encounters, and (4) capability of using health information and services. Findings from this study suggest that, without basic language and literate skills, the majority of immigrant women had inadequate health literacy to manage health information and navigate the Taiwan health care system. Interpersonal communication gap between immigrant women and health care providers exists because of lack of health literacy in addition al language and cultural barriers. With limited language and health literacy skills, immigrant women face numerous challenges in navigating the health care system, interacting with health care providers, and gaining access to proper health care. Future efforts are necessary to enhance individual's health literacy and establish health literate environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. LINKING CHILD HEALTH, MATERNAL LABOUR FORCE PARTICIPATION AND HOUSEHOLD ASSET ENDOWMENTS IN CAMEROON: WHAT THE PEOPLE SAY

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    Mbu Daniel Tambi

    2014-10-01

    Full Text Available This paper is targeted objectives: to document the determinants of child health as informed by focus group discussion, to analyze what the people say concerning the relationship between child health and maternal labour force participation, to explore the perception of the people on the effects of child health on asset accumulation and to suggest public policies on the basis of the findings. We used seven focus groups to explore what the people say based on different health domains: access to public goods; inputs to health; benefits from better health; better child health and complementary activities; benefits of maternity leave and better child health, decision making concerning family health. Each focus group was made of eight participants: housewife, traders, farmers, drivers, teachers, technicians, medical personnel and military drawn from different religious groups: catholic, protestant mainline, protestant non-mainline, other protestant, Muslim, systemic and traditional belief. We observed that, parents make used of the extra time accrue to them due to better health for their children and family to do extra work that fetched them money. The increased family income is use to send their children to better schools, carter for their wellbeing as well as to promote asset growth and redistribution, thus, improving economic well-being and reducing poverty. In case of retirement or sudden retrenchment from the labour market, parents make use of the accumulated assets to increase their family income and maintain well-being, hence, reducing the psychological trauma on parents due to poverty. Based on these findings, we recommend that decision makers and actors concern with child health issues should considered, ease and promote child health outcomes. This is a key to narrowing the poverty and inequality gap between the poor and non-poor, rural and urban household residence, married and unmarried, employed and the unemployed, promote maternal labour

  4. Stages of change concept of the transtheoretical model for healthy eating links health literacy and diabetes knowledge to glycemic control in people with type 2 diabetes.

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    Tseng, Hsu-Min; Liao, Shu-Fen; Wen, Yu-Ping; Chuang, Yuh-Jue

    2017-02-01

    Health literacy has been recognized as a key construct associated with clinical outcomes; however, few studies have explored the mechanism underlying the association. The transtheoretical model (TTM) has long been considered a useful conceptualization in the process of intentional behavior change. Stages of change lies at the heart of the TTM as studies of change have found that people move through a series of stages when modifying behavior. This study focuses on the role of knowledge and stages of change (SOC) as serial mediators linking health literacy to glycemic control. In this cross-sectional survey, a total of 232 patients with type 2 diabetes participated in this study. Participants completed questionnaires for assessing health literacy, readiness to consume healthy foods, and a dietary knowledge test specific to diabetes. Low health literacy was significantly associated with worse glycemic control. Statistical evaluation supported the serial mediation model, in which knowledge and SOC formed a serial mediation chain that accounted for the indirect effect of health literacy on glycemic control. In other words, dietary knowledge significantly motivated participants to move into the later stages of behavior change, which in turn improved the outcome of glycemic control. The results indicate that the ordering of mediators in the pathway between health literacy and health outcome may be complex, help explain the conflicting results of the past, and form a basis for the development of interventions promoting self-management of diabetes through glycemic control. Copyright © 2016. Published by Elsevier Ltd.

  5. Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal.

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    Le Pogam, Marie-Annick; Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard

    2017-05-11

    Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide. Anticoagulant-related adverse events and the quality of anticoagulation management should thus be routinely assessed to improve patient safety in vulnerable older inpatients. This project aims to develop and validate a set of outcome and process indicators based on linked administrative health data (ie, insurance claims data linked to hospital discharge data) assessing older inpatient safety related to anticoagulation in both Switzerland and France, and enabling comparisons across time and among hospitals, health territories, and countries. Geriatric patient safety indicators (GPSIs) will assess anticoagulant-related adverse events. Geriatric quality indicators (GQIs) will evaluate the management of anticoagulants for the prevention and treatment of arterial or venous thromboembolism in older inpatients. GPSIs will measure cumulative incidences of thromboembolic and bleeding adverse events based on hospital discharge data linked to insurance claims data. Using linked administrative health data will improve GPSI risk adjustment on patients' conditions that are present at admission and will capture in-hospital and postdischarge adverse events. GQIs will estimate the proportion of index hospital stays resulting in recommended anticoagulation at discharge and up to various time frames based on the same electronic health data. The GPSI and GQI development and validation process will comprise 6 stages: (1) selection and specification of candidate indicators, (2) definition of administrative data

  6. U.S. Citizen Children of Undocumented Parents: The Link Between State Immigration Policy and the Health of Latino Children.

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    Vargas, Edward D; Ybarra, Vickie D

    2017-08-01

    We examine Latino citizen children in mixed-status families and how their physical health status compares to their U.S. citizen, co-ethnic counterparts. We also examine Latino parents' perceptions of state immigration policy and its implications for child health status. Using the 2015 Latino National Health and Immigration Survey (n = 1493), we estimate a series of multivariate ordered logistic regression models with mixed-status family and perceptions of state immigration policy as primary predictors. We find that mixed-status families report worse physical health for their children as compared to their U.S. citizen co-ethnics. We also find that parental perceptions of their states' immigration status further exacerbate health disparities between families. These findings have implications for scholars and policy makers interested in immigrant health, family wellbeing, and health disparities in complex family structures. They contribute to the scholarship on Latino child health and on the erosion of the Latino immigrant health advantage.

  7. Linking Health System Responsiveness to Political Rights and Civil Liberties: A Multilevel Analysis Using Data From 44 Countries.

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    Witvliet, Margot I; Stronks, Karien; Kunst, Anton E; Mahapatra, Tanmay; Arah, Onyebuchi A

    2015-01-01

    Responsiveness is a dimension of health system functioning and might be dependent upon contextual factors related to politics. Given this, we performed cross-national comparisons with the aim of investigating: 1) the associations of political factors with patients' reports of health system responsiveness and 2) the extent to which health input and output might explain these associations. World Health Survey data were analyzed for 44 countries (n = 103 541). Main outcomes included, respectively, 8 and 7 responsiveness domains for inpatient and outpatient care. Linear multilevel regressions were used to assess the associations of politics (namely, civil liberties and political rights), socioeconomic development, health system input, and health system output (measured by maternal mortality) with responsiveness domains, adjusted for demographic factors. Political rights showed positive associations with dignity (regression coefficient = 0.086 [standard error = 0.039]), quality (0.092 [0.049]), and support (0.113 [0.048]) for inpatient care and with dignity (0.075 [0.040]), confidentiality (0.089 [0.043]), and quality (0.124 [0.053]) for outpatient care. Positive associations were observed for civil liberties as well. Health system input and output reduced observed associations. Results tentatively suggest that strengthening political rights and, to a certain extent, civil liberties might improve health system responsiveness, in part through their effect on health system input and output. © The Author(s) 2015.

  8. Updating the mild encephalitis hypothesis of schizophrenia.

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    Bechter, K

    2013-04-05

    Schizophrenia seems to be a heterogeneous disorder. Emerging evidence indicates that low level neuroinflammation (LLNI) may not occur infrequently. Many infectious agents with low overall pathogenicity are risk factors for psychoses including schizophrenia and for autoimmune disorders. According to the mild encephalitis (ME) hypothesis, LLNI represents the core pathogenetic mechanism in a schizophrenia subgroup that has syndromal overlap with other psychiatric disorders. ME may be triggered by infections, autoimmunity, toxicity, or trauma. A 'late hit' and gene-environment interaction are required to explain major findings about schizophrenia, and both aspects would be consistent with the ME hypothesis. Schizophrenia risk genes stay rather constant within populations despite a resulting low number of progeny; this may result from advantages associated with risk genes, e.g., an improved immune response, which may act protectively within changing environments, although they are associated with the disadvantage of increased susceptibility to psychotic disorders. Specific schizophrenic symptoms may arise with instances of LLNI when certain brain functional systems are involved, in addition to being shaped by pre-existing liability factors. Prodrome phase and the transition to a diseased status may be related to LLNI processes emerging and varying over time. The variability in the course of schizophrenia resembles the varying courses of autoimmune disorders, which result from three required factors: genes, the environment, and the immune system. Preliminary criteria for subgrouping neurodevelopmental, genetic, ME, and other types of schizophrenias are provided. A rare example of ME schizophrenia may be observed in Borna disease virus infection. Neurodevelopmental schizophrenia due to early infections has been estimated by others to explain approximately 30% of cases, but the underlying pathomechanisms of transition to disease remain in question. LLNI (e.g. from

  9. Validity of Linder Hypothesis in Bric Countries

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    Rana Atabay

    2016-03-01

    Full Text Available In this study, the theory of similarity in preferences (Linder hypothesis has been introduced and trade in BRIC countries has been examined whether the trade between these countries was valid for this hypothesis. Using the data for the period 1996 – 2010, the study applies to panel data analysis in order to provide evidence regarding the empirical validity of the Linder hypothesis for BRIC countries’ international trade. Empirical findings show that the trade between BRIC countries is in support of Linder hypothesis.

  10. Public and private maternal health service capacity and patient flows in Southern Tanzania: using a geographic information system to link hospital and national census data.

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M E; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase

  11. The link between inequality and population health in low and middle income countries: policy myth or social reality?

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    Ioana van Deurzen

    Full Text Available An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs. Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMICs, and we examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers and the women' experience of child mortality. Based on multi-level analyses, we found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when we took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. We conclude that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services.

  12. The link between inequality and population health in low and middle income countries: policy myth or social reality?

    Science.gov (United States)

    van Deurzen, Ioana; van Oorschot, Wim; van Ingen, Erik

    2014-01-01

    An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52 LMICs, and we examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers) and the women' experience of child mortality. Based on multi-level analyses, we found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when we took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. We conclude that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services.

  13. The link between inequality and population health in low and middle income countries : Policy myth or social reality?

    NARCIS (Netherlands)

    van Deurzen, I.A.; van Oorschot, W.J.H.; van Ingen, E.J.

    2014-01-01

    An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). Our study provides an empirical test of this idea: we utilized data collected by the Demographic and Health Surveys between 2000 and 2011 in as much as 52

  14. Insulin resistance as key factor for linking modulation of gut microbiome to health claims and dietary recommendations to tackle obesity

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    Loman, S.; Kamp, J.W. van der

    2016-01-01

    Background: Current dietary and public health recommendations addressing obesity do not as yet include recommendations pertaining to the gut microbiome. As a corollary, no microbiome-related health claims made on foods have as yet been proposed. Scope: The MyNewGut project aims, amongst others, to

  15. Linking Meteorology, Air Quality Models and Observations to Characterize Human Exposures in Support of the Environmental Health Studies

    Science.gov (United States)

    Epidemiologic studies are critical in establishing the association between exposure to air pollutants and adverse health effects. Results of epidemiologic studies are used by U.S. EPA in developing air quality standards to protect the public from the health effects of air polluta...

  16. The Role of Health Extension Workers in Linking Pregnant Women With Health Facilities for Delivery in Rural and Pastoralist Areas of Ethiopia.

    Science.gov (United States)

    Jackson, Ruth; Hailemariam, Assefa

    2016-09-01

    Women's preference to give birth at home is deeply embedded in Ethiopian culture. Many women only go to health facilities if they have complications during birth. Health Extension Workers (HEWs) have been deployed to improve the utilization of maternal health services by bridging the gap between communities and health facilities. This study examined the barriers and facilitators for HEWs as they refer women to mid-level health facilities for birth. A qualitative study was conducted in three regions: Afar Region, Southern Nations Nationalities and People's Region and Tigray Region between March to December 2014. Interviews and focus group discussions were conducted with 45 HEWs, 14 women extension workers (employed by Afar Pastoralist Development Association, Afar Region) and 11 other health workers from health centers, hospitals or health offices. Data analysis was done based on collating the data and identifying key themes. Barriers to health facilities included distance, lack of transportation, sociocultural factors and disrespectful care. Facilitators for facility-based deliveries included liaising with Health Development Army (HDA) leaders to refer women before their expected due date or if labour starts at home; the introduction of ambulance services; and, provision of health services that are culturally more acceptable for women. HEWs can effectively refer more women to give birth in health facilities when the HDA is well established, when health staff provide respectful care, and when ambulance is available at any time.

  17. A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions

    Science.gov (United States)

    2011-01-01

    Background This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. Methods Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. Results Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. Conclusions Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. PMID:21787394

  18. The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review.

    Science.gov (United States)

    Shoman, Haitham; Karafillakis, Emilie; Rawaf, Salman

    2017-01-04

    An Ebola outbreak started in December 2013 in Guinea and spread to Liberia and Sierra Leone in 2014. The health systems in place in the three countries lacked the infrastructure and the preparation to respond to the outbreak quickly and the World Health Organisation (WHO) declared a public health emergency of international concern on August 8 2014. The aim of this study was to determine the effects of health systems' organisation and performance on the West African Ebola outbreak in Guinea, Liberia and Sierra Leone and lessons learned. The WHO health system building blocks were used to evaluate the performance of the health systems in these countries. A systematic review of articles published from inception until July 2015 was conducted following the PRISMA guidelines. Electronic databases including Medline, Embase, Global Health, and the Cochrane library were searched for relevant literature. Grey literature was also searched through Google Scholar and Scopus. Articles were exported and selected based on a set of inclusion and exclusion criteria. Data was then extracted into a spreadsheet and a descriptive analysis was performed. Each study was critically appraised using the Crowe Critical Appraisal Tool. The review was supplemented with expert interviews where participants were identified from reference lists and using the snowball method. Thirteen articles were included in the study and six experts from different organisations were interviewed. Findings were analysed based on the WHO health system building blocks. Shortage of health workforce had an important effect on the control of Ebola but also suffered the most from the outbreak. This was followed by information and research, medical products and technologies, health financing and leadership and governance. Poor surveillance and lack of proper communication also contributed to the outbreak. Lack of available funds jeopardised payments and purchase of essential resources and medicines. Leadership and

  19. Self-focused and other-focused resiliency: Plausible mechanisms linking early family adversity to health problems in college women.

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    Coleman, Sulamunn R M; Zawadzki, Matthew J; Heron, Kristin E; Vartanian, Lenny R; Smyth, Joshua M

    2016-01-01

    This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. Female students (N = 795) participated between October 2009 and May 2010. Participants completed self-report measures of early family adversity, self-focused (self-esteem, personal growth initiative) and other-focused (perceived social support, gratitude) resiliency, stress, subjective health, and health behaviors. Using structural equation modeling, self-focused resiliency associated with less stress, better subjective health, more sleep, less smoking, and less weekend alcohol consumption. Other-focused resiliency associated with more exercise, greater stress, and more weekend alcohol consumption. Early family adversity was indirectly related to all health outcomes, except smoking, via self-focused and other-focused resiliency. Self-focused and other-focused resiliency represent plausible mechanisms through which early family adversity relates to stress and health in college women. This highlights areas for future research in disease prevention and management.

  20. Patterns of cumulative abuse among female survivors of intimate partner violence: links to women's health and socioeconomic status.

    Science.gov (United States)

    Davies, Lorraine; Ford-Gilboe, Marilyn; Willson, Andrea; Varcoe, Colleen; Wuest, Judith; Campbell, Jacquelyn; Scott-Storey, Kelly

    2015-01-01

    Drawing on the Women's Health Effects Study, a community sample of women (N = 309) who recently left an abusive partner, this study examines patterns of cumulative abuse experiences over the life course, their socioeconomic correlates, and associations with a range of health outcomes. Latent class analysis identified four groups of women with differing cumulative abuse profiles: Intimate Partner Violence (IPV) Dominant, Child Abuse and IPV, All Forms, and All Forms Extreme. We find a relationship pattern between cumulative abuse and socioeconomic circumstances, and significantly worse health outcomes among women with the All Forms Extreme profile. Implications for research and practice are discussed. © The Author(s) 2014.

  1. The Impact of a Diabetes Self-Management Education Program Provided through a Telemedicine Link to Rural California Health Care Clinics

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    Jim Nuovo

    2013-01-01

    Full Text Available Background This project investigated the impact of a DM self-management education program provided through a telemedicine link at nine rural health clinics in Northern California. Methods Two hundred thirty nine patients were provided with a single 2-hour class on DM delivered through a live televideo connection. Patients provided pre-intervention information on: demographics and overall health, self-care behaviors, and knowledge about DM. All participants completed a post-education survey on knowledge and self-care behaviors. Results There was a significant decrease in the number of patients who felt overwhelmed with their DM; pre-intervention 18.8%; post-intervention 5.4% ( P < 0.0001. Patients increased the number of days they exercised; pre-intervention 3.4 days; post-intervention 3.9 days ( P = 0.02. Patients increased the number of days they checked their feet; pre-intervention 4.2 days; post-intervention 5.6 days ( P < 0.01. Knowledge about DM improved over the study period ( P < 0.01. Conclusions A single 2-hour class on DM administered through a telemedicine link to patients in rural health clinics resulted in feeling less overwhelmed, more knowledgeable about DM, and demonstrated an increase in self-care behavior; ie, exercise and foot care.

  2. Is reporting on interventions a weak link in understanding how and why they work? A preliminary exploration using community heart health exemplars

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    Kurtz Donna

    2008-05-01

    Full Text Available Abstract Background The persistent gap between research and practice compromises the impact of multi-level and multi-strategy community health interventions. Part of the problem is a limited understanding of how and why interventions produce change in population health outcomes. Systematic investigation of these intervention processes across studies requires sufficient reporting about interventions. Guided by a set of best processes related to the design, implementation, and evaluation of community health interventions, this article presents preliminary findings of intervention reporting in the published literature using community heart health exemplars as case examples. Methods The process to assess intervention reporting involved three steps: selection of a sample of community health intervention studies and their publications; development of a data extraction tool; and data extraction from the publications. Publications from three well-resourced community heart health exemplars were included in the study: the North Karelia Project, the Minnesota Heart Health Program, and Heartbeat Wales. Results Results are organized according to six themes that reflect best intervention processes: integrating theory, creating synergy, achieving adequate implementation, creating enabling structures and conditions, modifying interventions during implementation, and facilitating sustainability. In the publications for the three heart health programs, reporting on the intervention processes was variable across studies and across processes. Conclusion Study findings suggest that limited reporting on intervention processes is a weak link in research on multiple intervention programs in community health. While it would be premature to generalize these results to other programs, important next steps will be to develop a standard tool to guide systematic reporting of multiple intervention programs, and to explore reasons for limited reporting on intervention

  3. Is reporting on interventions a weak link in understanding how and why they work? A preliminary exploration using community heart health exemplars.

    Science.gov (United States)

    Riley, Barbara L; MacDonald, JoAnne; Mansi, Omaima; Kothari, Anita; Kurtz, Donna; vonTettenborn, Linda I; Edwards, Nancy C

    2008-05-20

    The persistent gap between research and practice compromises the impact of multi-level and multi-strategy community health interventions. Part of the problem is a limited understanding of how and why interventions produce change in population health outcomes. Systematic investigation of these intervention processes across studies requires sufficient reporting about interventions. Guided by a set of best processes related to the design, implementation, and evaluation of community health interventions, this article presents preliminary findings of intervention reporting in the published literature using community heart health exemplars as case examples. The process to assess intervention reporting involved three steps: selection of a sample of community health intervention studies and their publications; development of a data extraction tool; and data extraction from the publications. Publications from three well-resourced community heart health exemplars were included in the study: the North Karelia Project, the Minnesota Heart Health Program, and Heartbeat Wales. Results are organized according to six themes that reflect best intervention processes: integrating theory, creating synergy, achieving adequate implementation, creating enabling structures and conditions, modifying interventions during implementation, and facilitating sustainability. In the publications for the three heart health programs, reporting on the intervention processes was variable across studies and across processes. Study findings suggest that limited reporting on intervention processes is a weak link in research on multiple intervention programs in community health. While it would be premature to generalize these results to other programs, important next steps will be to develop a standard tool to guide systematic reporting of multiple intervention programs, and to explore reasons for limited reporting on intervention processes. It is our contention that a shift to more inclusive reporting of

  4. Can formalizing links among community health workers, accredited drug dispensing outlet dispensers, and health facility staff increase their collaboration to improve prompt access to maternal and child care? A qualitative study in Tanzania.

    Science.gov (United States)

    Dillip, Angel; Kimatta, Suleiman; Embrey, Martha; Chalker, John C; Valimba, Richard; Malliwah, Mariam; Meena, John; Lieber, Rachel; Johnson, Keith

    2017-06-19

    In Tanzania, progress toward achieving the 2015 Millennium Development Goals for maternal and newborn health was slow. An intervention brought together community health workers, health facility staff, and accredited drug dispensing outlet (ADDO) dispensers to improve maternal and newborn health through a mechanism of collaboration and referral. This study explored barriers, successes, and promising approaches to increasing timely access to care by linking the three levels of health care provision. The study was conducted in the Kibaha district, where we applied qualitative approaches with in-depth interviews and focus group discussions. In-depth interview participants included retail drug shop dispensers (36), community health workers (45), and health facility staff members (15). We conducted one focus group discussion with district officials and four with mothers of newborns and children under 5 years old. Relationships among the three levels of care improved after the linkage intervention, especially for ADDO dispensers and health facility staff who previously had no formal communication pathway. The study participants perceptions of success included improved knowledge of case management and relationships among the three levels of care, more timely access to care, increased numbers of patients/customers, more meetings between community health workers and health facility staff, and a decrease in child and maternal mortality. Reported challenges included stock-outs of medicines at the health facility, participating ADDO dispensers who left to work in other regions, documentation of referrals, and lack of treatment available at health facilities on the weekend. The primary issue that threatens the sustainability of the intervention is that local council health management team members, who are responsible for facilitating the linkage, had not made any supervision visits and were therefore unaware of how the program was running. The study highlights the benefits of

  5. Developmental Trajectories of Acculturation: Links with Family Functioning and Mental Health in Recent-Immigrant Hispanic Adolescents

    Science.gov (United States)

    Schwartz, Seth J.; Unger, Jennifer B.; Zamboanga, Byron L.; Córdova, David; Mason, Craig A.; Huang, Shi; Baezconde-Garbanati, Lourdes; Lorenzo-Blanco, Elma I.; Des Rosiers, Sabrina; Soto, Daniel W.; Villamar, Juan A.; Pattarroyo, Monica; Lizzi, Karina M.; Szapocznik, José

    2014-01-01

    The present study was designed to examine acculturative changes, and their effects on mental health and family functioning, in recent-immigrant Hispanic adolescents. A sample of 302 Hispanic adolescents was assessed five times over a 2½-year period. Participants completed measures of Hispanic and U.S. practices, collectivist and individualist values, and ethnic and U.S. identity at each timepoint. Baseline and Time 5 levels of mental health and family functioning were also assessed. Latent class growth analyses produced two-class solutions for practices, values, and identifications. Adolescents who increased over time in practices and values reported the most adaptive mental health and family functioning. Adolescents who did not change in any acculturation domain reported the least favorable mental health and family functioning. PMID:25644262

  6. Linking a research register to clinical records in older adults' mental health services:a mixed-methods study

    OpenAIRE

    Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

    2015-01-01

    INTRODUCTION: Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities.METHODS: This was a two-stage cross-s...

  7. Justice Is the Missing Link in One Health: Results of a Mixed Methods Study in an Urban City State.

    Directory of Open Access Journals (Sweden)

    Tamra Lysaght

    Full Text Available One Health (OH is an interdisciplinary collaborative approach to human and animal health that aims to break down conventional research and policy 'silos'. OH has been used to develop strategies for zoonotic Emerging Infectious Diseases (EID. However, the ethical case for OH as an alternative to more traditional public health approaches is largely absent from the discourse. To study the ethics of OH, we examined perceptions of the human health and ecological priorities for the management of zoonotic EID in the Southeast Asia country of Singapore.We conducted a mixed methods study using a modified Delphi technique with a panel of 32 opinion leaders and 11 semi-structured interviews with a sub-set of those experts in Singapore. Panellists rated concepts of OH and priorities for zoonotic EID preparedness planning using a series of scenarios developed through the study. Interview data were examined qualitatively using thematic analysis.We found that panellists agreed that OH is a cross-disciplinary collaboration among the veterinary, medical, and ecological sciences, as well as relevant government agencies encompassing animal, human, and environmental health. Although human health was often framed as the most important priority in zoonotic EID planning, our qualitative analysis suggested that consideration of non-human animal health and welfare was also important for an effective and ethical response. The panellists also suggested that effective pandemic planning demands regional leadership and investment from wealthier countries to better enable international cooperation.We argue that EID planning under an OH approach would benefit greatly from an ethical ecological framework that accounts for justice in human, animal, and environmental health.

  8. Justice Is the Missing Link in One Health: Results of a Mixed Methods Study in an Urban City State.

    Science.gov (United States)

    Lysaght, Tamra; Capps, Benjamin; Bailey, Michele; Bickford, David; Coker, Richard; Lederman, Zohar; Watson, Sangeetha; Tambyah, Paul Anantharajah

    2017-01-01

    One Health (OH) is an interdisciplinary collaborative approach to human and animal health that aims to break down conventional research and policy 'silos'. OH has been used to develop strategies for zoonotic Emerging Infectious Diseases (EID). However, the ethical case for OH as an alternative to more traditional public health approaches is largely absent from the discourse. To study the ethics of OH, we examined perceptions of the human health and ecological priorities for the management of zoonotic EID in the Southeast Asia country of Singapore. We conducted a mixed methods study using a modified Delphi technique with a panel of 32 opinion leaders and 11 semi-structured interviews with a sub-set of those experts in Singapore. Panellists rated concepts of OH and priorities for zoonotic EID preparedness planning using a series of scenarios developed through the study. Interview data were examined qualitatively using thematic analysis. We found that panellists agreed that OH is a cross-disciplinary collaboration among the veterinary, medical, and ecological sciences, as well as relevant government agencies encompassing animal, human, and environmental health. Although human health was often framed as the most important priority in zoonotic EID planning, our qualitative analysis suggested that consideration of non-human animal health and welfare was also important for an effective and ethical response. The panellists also suggested that effective pandemic planning demands regional leadership and investment from wealthier countries to better enable international cooperation. We argue that EID planning under an OH approach would benefit greatly from an ethical ecological framework that accounts for justice in human, animal, and environmental health.

  9. Hypothesis Testing in the Real World

    Science.gov (United States)

    Miller, Jeff

    2017-01-01

    Critics of null hypothesis significance testing suggest that (a) its basic logic is invalid and (b) it addresses a question that is of no interest. In contrast to (a), I argue that the underlying logic of hypothesis testing is actually extremely straightforward and compelling. To substantiate that, I present examples showing that hypothesis…

  10. Error probabilities in default Bayesian hypothesis testing

    NARCIS (Netherlands)

    Gu, Xin; Hoijtink, Herbert; Mulder, J,

    2016-01-01

    This paper investigates the classical type I and type II error probabilities of default Bayes factors for a Bayesian t test. Default Bayes factors quantify the relative evidence between the null hypothesis and the unrestricted alternative hypothesis without needing to specify prior distributions for

  11. Reassessing the Trade-off Hypothesis

    DEFF Research Database (Denmark)

    Rosas, Guillermo; Manzetti, Luigi

    2015-01-01

    Do economic conditions drive voters to punish politicians that tolerate corruption? Previous scholarly work contends that citizens in young democracies support corrupt governments that are capable of promoting good economic outcomes, the so-called trade-off hypothesis. We test this hypothesis based...

  12. Mastery Learning and the Decreasing Variability Hypothesis.

    Science.gov (United States)

    Livingston, Jennifer A.; Gentile, J. Ronald

    1996-01-01

    This report results from studies that tested two variations of Bloom's decreasing variability hypothesis using performance on successive units of achievement in four graduate classrooms that used mastery learning procedures. Data do not support the decreasing variability hypothesis; rather, they show no change over time. (SM)

  13. Construction of a multisite DataLink using electronic health records for the identification, surveillance, prevention, and management of diabetes mellitus: the SUPREME-DM project.

    Science.gov (United States)

    Nichols, Gregory A; Desai, Jay; Elston Lafata, Jennifer; Lawrence, Jean M; O'Connor, Patrick J; Pathak, Ram D; Raebel, Marsha A; Reid, Robert J; Selby, Joseph V; Silverman, Barbara G; Steiner, John F; Stewart, W F; Vupputuri, Suma; Waitzfelder, Beth

    2012-01-01

    Electronic health record (EHR) data enhance opportunities for conducting surveillance of diabetes. The objective of this study was to identify the number of people with diabetes from a diabetes DataLink developed as part of the SUPREME-DM (SUrveillance, PREvention, and ManagEment of Diabetes Mellitus) project, a consortium of 11 integrated health systems that use comprehensive EHR data for research. We identified all members of 11 health care systems who had any enrollment from January 2005 through December 2009. For these members, we searched inpatient and outpatient diagnosis codes, laboratory test results, and pharmaceutical dispensings from January 2000 through December 2009 to create indicator variables that could potentially identify a person with diabetes. Using this information, we estimated the number of people with diabetes and among them, the number of incident cases, defined as indication of diabetes after at least 2 years of continuous health system enrollment. The 11 health systems contributed 15,765,529 unique members, of whom 1,085,947 (6.9%) met 1 or more study criteria for diabetes. The nonstandardized proportion meeting study criteria for diabetes ranged from 4.2% to 12.4% across sites. Most members with diabetes (88%) met multiple criteria. Of the members with diabetes, 428,349 (39.4%) were incident cases. The SUPREME-DM DataLink is a unique resource that provides an opportunity to conduct comparative effectiveness research, epidemiologic surveillance including longitudinal analyses, and population-based care management studies of people with diabetes. It also provides a useful data source for pragmatic clinical trials of prevention or treatment interventions.

  14. Construction of a Multisite DataLink Using Electronic Health Records for the Identification, Surveillance, Prevention, and Management of Diabetes Mellitus: The SUPREME-DM Project

    Science.gov (United States)

    Desai, Jay; Elston Lafata, Jennifer; Lawrence, Jean M.; O’Connor, Patrick J.; Pathak, Ram D.; Raebel, Marsha A.; Reid, Robert J.; Selby, Joseph V.; Silverman, Barbara G.; Steiner, John F.; Stewart, W.F.; Vupputuri, Suma; Waitzfelder, Beth

    2012-01-01

    Introduction Electronic health record (EHR) data enhance opportunities for conducting surveillance of diabetes. The objective of this study was to identify the number of people with diabetes from a diabetes DataLink developed as part of the SUPREME-DM (SUrveillance, PREvention, and ManagEment of Diabetes Mellitus) project, a consortium of 11 integrated health systems that use comprehensive EHR data for research. Methods We identified all members of 11 health care systems who had any enrollment from January 2005 through December 2009. For these members, we searched inpatient and outpatient diagnosis codes, laboratory test results, and pharmaceutical dispensings from January 2000 through December 2009 to create indicator variables that could potentially identify a person with diabetes. Using this information, we estimated the number of people with diabetes and among them, the number of incident cases, defined as indication of diabetes after at least 2 years of continuous health system enrollment. Results The 11 health systems contributed 15,765,529 unique members, of whom 1,085,947 (6.9%) met 1 or more study criteria for diabetes. The nonstandardized proportion meeting study criteria for diabetes ranged from 4.2% to 12.4% across sites. Most members with diabetes (88%) met multiple criteria. Of the members with diabetes, 428,349 (39.4%) were incident cases. Conclusion The SUPREME-DM DataLink is a unique resource that provides an opportunity to conduct comparative effectiveness research, epidemiologic surveillance including longitudinal analyses, and population-based care management studies of people with diabetes. It also provides a useful data source for pragmatic clinical trials of prevention or treatment interventions. PMID:22677160

  15. "Does anger regulation mediate the discrimination-mental health link among Mexican-origin adolescents? A longitudinal mediation analysis using multilevel modeling": Correction to Park et al. (2016).

    Science.gov (United States)

    2017-02-01

    Reports an error in "Does Anger Regulation Mediate the Discrimination-Mental Health Link Among Mexican-Origin Adolescents? A Longitudinal Mediation Analysis Using Multilevel Modeling" by Irene J. K. Park, Lijuan Wang, David R. Williams and Margarita Alegría ( Developmental Psychology , Advanced Online Publication, Nov 28, 2016, np). In the article, there were several typographical errors in the Recruitment and Procedures section. The percentage of mothers who responded to survey items should have been 99.3%. Additionally, the youths surveyed at T2 and T3 should have been n=246 . Accordingly, the percentage of youths surveyed in T2 and T3 should have been 91.4% and the percentage of mothers surveyed at T2 and T3 should have been 90.7%. Finally, the youths missing at T2 should have been n= 23, and therefore the attrition rate for youth participants should have been 8.6. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2016-57671-001.) Although prior research has consistently documented the association between racial/ethnic discrimination and poor mental health outcomes, the mechanisms that underlie this link are still unclear. The present 3-wave longitudinal study tested the mediating role of anger regulation in the discrimination-mental health link among 269 Mexican-origin adolescents ( M age = 14.1 years, SD = 1.6; 57% girls), 12 to 17 years old. Three competing anger regulation variables were tested as potential mediators: outward anger expression, anger suppression, and anger control. Longitudinal mediation analyses were conducted using multilevel modeling that disaggregated within-person effects from between-person effects. Results indicated that outward anger expression was a significant mediator; anger suppression and anger control were not significant mediators. Within a given individual, greater racial/ethnic discrimination was associated with more frequent outward anger expression. In turn

  16. Vertical equity of healthcare in Taiwan: health services were distributed according to need

    OpenAIRE

    Wang, Shiow-Ing; Yaung, Chih-Liang

    2013-01-01

    Abstract Introduction To test the hypothesis that the distribution of healthcare services is according to health need can be achieved under a rather open access system. Methods The 2001 National Health Interview Survey of Taiwan and National Health Insurance claims data were linked in the study. Health need was defined by self-perceived health status. We used Concentration index to measure need-related inequality in healthcare utilization and expenditure. Results People with greater health ne...

  17. A two-state comparative implementation of peer-support intervention to link veterans to health-related services after incarceration: a study protocol.

    Science.gov (United States)

    Simmons, Molly M; Fincke, Benjamin G; Drainoni, Mari-Lynn; Kim, Bo; Byrne, Tom; Smelson, David; Casey, Kevin; Ellison, Marsha L; Visher, Christy; Blue-Howells, Jessica; McInnes, D Keith

    2017-09-12

    Approximately 600,000 persons are released from prison annually in the United States. Relatively few receive sufficient re-entry services and are at risk for unemployment, homelessness, poverty, substance abuse relapse and recidivism. Persons leaving prison who have a mental illness and/or a substance use disorder are particularly challenged. This project aims to create a peer mentor program to extend the reach and effectiveness of reentry services provided by the Department of Veterans' Affairs (VA). We will implement a peer support for reentry veterans sequentially in two states. Our outcome measures are 1) fidelity of the intervention, 2) linkage to VA health care and, 3) continued engagement in health care. The aims for this project are as follows: (1) Conduct contextual analysis to identify VA and community reentry resources, and describe how reentry veterans use them. (2) Implement peer-support, in one state, to link reentry veterans to Veterans' Health Administration (VHA) primary care, mental health, and SUD services. (3) Port the peer-support intervention to another, geographically, and contextually different state. This intervention involves a 2-state sequential implementation study (Massachusetts, followed by Pennsylvania) using a Facilitation Implementation strategy. We will conduct formative and summative analyses, including assessment of fidelity, and a matched comparison group to evaluate the intervention's outcomes of veteran linkage and engagement in VHA health care (using health care utilization measures). The study proceeds in 3 phases. We anticipate that a peer support program will be effective at improving the reentry process for veterans, particularly in linking them to health, mental health, and SUD services and helping them to stay engaged in those services. It will fill a gap by providing veterans with access to a trusted individual, who understands their experience as a veteran and who has experienced justice involvement. The outputs from

  18. Links between the built environment, climate and population health: interdisciplinary environmental change research in New York City.

    Science.gov (United States)

    Rosenthal, Joyce Klein; Sclar, Elliott D; Kinney, Patrick L; Knowlton, Kim; Crauderueff, Robert; Brandt-Rauf, Paul W

    2007-10-01

    Global climate change is expected to pose increasing challenges for cities in the following decades, placing greater stress and impacts on multiple social and biophysical systems, including population health, coastal development, urban infrastructure, energy demand, and water supplies. Simultaneously, a strong global trend towards urbanisation of poverty exists, with increased challenges for urban populations and local governance to protect and sustain the wellbeing of growing cities. In the context of these 2 overarching trends, interdisciplinary research at the city scale is prioritised for understanding the social impacts of climate change and variability and for the evaluation of strategies in the built environment that might serve as adaptive responses to climate change. This article discusses 2 recent initiatives of The Earth Institute at Columbia University (EI) as examples of research that integrates the methods and objectives of several disciplines, including environmental health science and urban planning, to understand the potential public health impacts of global climate change and mitigative measures for the more localised effects of the urban heat island in the New York City metropolitan region. These efforts embody 2 distinct research approaches. The New York Climate & Health Project created a new integrated modeling system to assess the public health impacts of climate and land use change in the metropolitan region. The Cool City Project aims for more applied policy-oriented research that incorporates the local knowledge of community residents to understand the costs and benefits of interventions in the built environment that might serve to mitigate the harmful impacts of climate change and variability, and protect urban populations from health stressors associated with summertime heat. Both types of research are potentially useful for understanding the impacts of environmental change at the urban scale, the policies needed to address these

  19. Linking household and health facility surveys to assess obstetric service availability, readiness and coverage: evidence from 17 low- and middle-income countries.

    Science.gov (United States)

    Kanyangarara, Mufaro; Chou, Victoria B; Creanga, Andreea A; Walker, Neff

    2018-06-01

    Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Based on performance of obstetric signal functions, we defined four levels of facility emergency obstetric care (EmOC) functionality: comprehensive (CEmOC), basic (BEmOC), BEmOC-2, and low/substandard. Facility readiness was evaluated based on the direct observation of 23 essential items; facilities "ready to provide obstetric services" had ≥20 of 23 items available. Across countries, we used medians to characterize service availability and readiness, overall and by urban-rural location; analyses also adjusted for care-seeking patterns to estimate population-level coverage of obstetric services. Of the 111 500 health facilities surveyed, 7545 offered obstetric services and were included in the analysis. The median percentages of facilities offering EmOC and "ready to provide obstetric services" were 19% and 10%, respectively. There were considerable urban-rural differences, with absolute differences of 19% and 29% in the availability of facilities offering EmOC and "ready to provide obstetric services", respectively. Adjusting for care-seeking patterns, results from the linking approach indicated that among women delivering in a facility, a median of 40% delivered in facilities offering EmOC, and 28% delivered in facilities "ready to provide obstetric services". Relatively higher coverage of facility deliveries (≥65%) and coverage of deliveries in facilities "ready to provide obstetric

  20. Early Microbes Modify Immune System Development and Metabolic Homeostasis-The "Restaurant" Hypothesis Revisited.

    Science.gov (United States)

    Nash, Michael J; Frank, Daniel N; Friedman, Jacob E

    2017-01-01

    The developing infant gut microbiome affects metabolism, maturation of the gastrointestinal tract, immune system function, and brain development. Initial seeding of the neonatal microbiota occurs through maternal and environmental contact. Maternal diet, antibiotic use, and cesarean section alter the offspring microbiota composition, at least temporarily. Nutrients are thought to regulate initial perinatal microbial colonization, a paradigm known as the "Restaurant" hypothesis. This hypothesis proposes that early nutritional stresses alter both the initial colonizing bacteria and the development of signaling pathways controlled by microbial mediators. These stresses fine-tune the immune system and metabolic homeostasis in early life, potentially setting the stage for long-term metabolic and immune health. Dysbiosis, an imbalance or a maladaptation in the microbiota, can be caused by several factors including dietary alterations and antibiotics. Dysbiosis can alter biological processes in the gut and in tissues and organs throughout the body. Misregulated development and activity of both the innate and adaptive immune systems, driven by early dysbiosis, could have long-lasting pathologic consequences such as increased autoimmunity, increased adiposity, and non-alcoholic fatty liver disease (NAFLD). This review will focus on factors during pregnancy and the neonatal period that impact a neonate's gut microbiome, as well as the mechanisms and possible links from early infancy that can drive increased risk for diseases including obesity and NAFLD. The complex pathways that connect diet, the microbiota, immune system development, and metabolism, particularly in early life, present exciting new frontiers for biomedical research.

  1. Early Microbes Modify Immune System Development and Metabolic Homeostasis—The “Restaurant” Hypothesis Revisited

    Directory of Open Access Journals (Sweden)

    Michael J. Nash

    2017-12-01

    Full Text Available The developing infant gut microbiome affects metabolism, maturation of the gastrointestinal tract, immune system function, and brain development. Initial seeding of the neonatal microbiota occurs through maternal and environmental contact. Maternal diet, antibiotic use, and cesarean section alter the offspring microbiota composition, at least temporarily. Nutrients are thought to regulate initial perinatal microbial colonization, a paradigm known as the “Restaurant” hypothesis. This hypothesis proposes that early nutritional stresses alter both the initial colonizing bacteria and the development of signaling pathways controlled by microbial mediators. These stresses fine-tune the immune system and metabolic homeostasis in early life, potentially setting the stage for long-term metabolic and immune health. Dysbiosis, an imbalance or a maladaptation in the microbiota, can be caused by several factors including dietary alterations and antibiotics. Dysbiosis can alter biological processes in the gut and in tissues and organs throughout the body. Misregulated development and activity of both the innate and adaptive immune systems, driven by early dysbiosis, could have long-lasting pathologic consequences such as increased autoimmunity, increased adiposity, and non-alcoholic fatty liver disease (NAFLD. This review will focus on factors during pregnancy and the neonatal period that impact a neonate’s gut microbiome, as well as the mechanisms and possible links from early infancy that can drive increased risk for diseases including obesity and NAFLD. The complex pathways that connect diet, the microbiota, immune system development, and metabolism, particularly in early life, present exciting new frontiers for biomedical research.

  2. Early Microbes Modify Immune System Development and Metabolic Homeostasis—The “Restaurant” Hypothesis Revisited

    Science.gov (United States)

    Nash, Michael J.; Frank, Daniel N.; Friedman, Jacob E.

    2017-01-01

    The developing infant gut microbiome affects metabolism, maturation of the gastrointestinal tract, immune system function, and brain development. Initial seeding of the neonatal microbiota occurs through maternal and environmental contact. Maternal diet, antibiotic use, and cesarean section alter the offspring microbiota composition, at least temporarily. Nutrients are thought to regulate initial perinatal microbial colonization, a paradigm known as the “Restaurant” hypothesis. This hypothesis proposes that early nutritional stresses alter both the initial colonizing bacteria and the development of signaling pathways controlled by microbial mediators. These stresses fine-tune the immune system and metabolic homeostasis in early life, potentially setting the stage for long-term metabolic and immune health. Dysbiosis, an imbalance or a maladaptation in the microbiota, can be caused by several factors including dietary alterations and antibiotics. Dysbiosis can alter biological processes in the gut and in tissues and organs throughout the body. Misregulated development and activity of both the innate and adaptive immune systems, driven by early dysbiosis, could have long-lasting pathologic consequences such as increased autoimmunity, increased adiposity, and non-alcoholic fatty liver disease (NAFLD). This review will focus on factors during pregnancy and the neonatal period that impact a neonate’s gut microbiome, as well as the mechanisms and possible links from early infancy that can drive increased risk for diseases including obesity and NAFLD. The complex pathways that connect diet, the microbiota, immune system development, and metabolism, particularly in early life, present exciting new frontiers for biomedical research. PMID:29326657

  3. Sources of information about mental health and links to help seeking: findings from the 2007 Australian National Survey of Mental Health and Wellbeing.

    Science.gov (United States)

    Reavley, Nicola J; Cvetkovski, Stefan; Jorm, Anthony F

    2011-12-01

    The aim of this paper is to provide an analysis of data from the National Survey of Mental Health and Wellbeing (NSMHWB) on the factors associated with the use of sources of information on mental health. A further aim is to examine the associations between the use of information sources and professional help-seeking. Data from the 2007 NSMHWB were used. The survey sample comprised 8,841 residents of private dwellings across Australia aged 16-85 years. Television was the most common source of information about mental health issues in the previous 12 months (accessed by 20.5% of respondents) followed by pamphlets and brochures (accessed by 15.6% of respondents). Having an anxiety or affective disorder, female gender, higher levels of education and having a family member with a mental health problem was associated with the seeking of information on mental health issues from the internet, non-fiction books and brochures/pamphlets. Accessing information on the internet was associated with increased use of any mental health services, GPs and mental health professionals (MHPs). The results suggest that promotion of internet resources may offer the opportunity to increase help seeking for mental health problems and may offer the opportunity to engage those least likely to seek professional help, notably young males.

  4. Building multi-country collaboration on watershed management: lessons on linking environment and public health from the Western Balkans

    Science.gov (United States)

    Community-based watershed resilience programs that bridge public health and environmental outcomes often require cross-boundary, multi-country collaboration. The CRESSIDA project, led by the Regional Environmental Center for Central and Eastern Europe (REC) and supported by the U...

  5. Linking research to practice: the organisation and implementation of The Netherlands health and social care improvement programmes

    NARCIS (Netherlands)

    Ovretveit, John; Klazinga, Niek

    2013-01-01

    Both public and private health and social care services are facing increased and changing demands to improve quality and reduce costs. To enable local services to respond to these demands, governments and other organisations have established large scale improvement programmes. These usually seek to

  6. Linking social and built environmental factors to the health of public housing residents: a focus group study.

    Science.gov (United States)

    Hayward, Erin; Ibe, Chidinma; Young, Jeffery Hunter; Potti, Karthya; Jones, Paul; Pollack, Craig Evan; Gudzune, Kimberly A

    2015-04-10

    Public housing residents have a high risk of chronic disease, which may be related to neighborhood environmental factors. Our objective was to understand how public housing residents perceive that the social and built environments might influence their health and wellbeing. We conducted focus groups of residents from a low-income public housing community in Baltimore, MD to assess their perceptions of health and neighborhood attributes, resources, and social structure. Focus groups were audio-recorded and transcribed verbatim. Two investigators independently coded transcripts for thematic content using editing style analysis technique. Twenty-eight residents participated in six focus groups. All were African American and the majority were women. Most had lived in public housing for more than 5 years. We identified four themes: public housing's unhealthy physical environment limits health and wellbeing, the city environment limits opportunities for healthy lifestyle choices, lack of trust in relationships contributes to social isolation, and increased neighborhood social capital could improve wellbeing. Changes in housing and city policies might lead to improved environmental health conditions for public housing residents. Policymakers and researchers may consider promoting community cohesiveness to attempt to empower residents in facilitating neighborhood change.

  7. Use of Integrated Landscape Indicators to Evaluate the Health of Linked Watersheds and Coral Reef Environments in the Hawaiian Islands

    Science.gov (United States)

    Rodgers, Ku`ulei S.; Kido, Michael H.; Jokiel, Paul L.; Edmonds, Tim; Brown, Eric K.

    2012-07-01

    A linkage between the condition of watersheds and adjacent nearshore coral reef communities is an assumed paradigm in the concept of integrated coastal management. However, quantitative evidence for this "catchment to sea" or "ridge to reef" relationship on oceanic islands is lacking and would benefit from the use of appropriate marine and terrestrial landscape indicators to quantify and evaluate ecological status on a large spatial scale. To address this need, our study compared the Hawai`i Watershed Health Index (HI-WHI) and Reef Health Index (HI-RHI) derived independently of each other over the past decade. Comparisons were made across 170 coral reef stations at 52 reef sites adjacent to 42 watersheds throughout the main Hawaiian Islands. A significant positive relationship was shown between the health of watersheds and that of adjacent reef environments when all sites and depths were considered. This relationship was strongest for sites facing in a southerly direction, but diminished for north facing coasts exposed to persistent high surf. High surf conditions along the north shore increase local wave driven currents and flush watershed-derived materials away from nearshore waters. Consequently, reefs in these locales are less vulnerable to the deposition of land derived sediments, nutrients and pollutants transported from watersheds to ocean. Use of integrated landscape health indices can be applied to improve regional-scale conservation and resource management.

  8. The adaptive and maladaptive faces of dependency in later life: links to physical and psychological health outcomes.

    Science.gov (United States)

    Fiori, Katherine; Consedine, Nathan; Magai, Carol

    2008-11-01

    Negotiating the balance between reliance on others and desires for autonomy is a fundamental task of successful aging. The purpose of the present study was to replicate and extend a three-factor model of interpersonal dependency in a sample of older adults, and to examine the physical and psychological health correlates of this multifaceted construct. Data come from the third wave of a population-based study of older Americans (n = 166; mean age 80 years). We conducted an exploratory factor analysis of selected dependency items from two scales, and then conducted logistic and hierarchical linear regressions to analyze the association of dependency factors with self-reported health, use of hypertension medication, depressed affect and positive affect. We found three factors closely paralleling those of Bornstein and Languirand's (Psychological Bulletin, 112(1), 3-23, 2004) measure: destructive overdependence, healthy dependency and dysfunctional detachment, as well as a fourth factor we labeled 'healthy independence'. Healthy dependency was associated with better self-reported health. Dysfunctional detachment was related to a greater likelihood and healthy independence a lesser likelihood of taking hypertension medication. Whereas both healthy independence and healthy dependency were positively related to positive affect and negatively related to depressed affect, destructive overdependence was positively related to depressed affect. Understanding the complex nature of interpersonal dependency and autonomy in old age, as well as their implications for health and wellbeing, may enable practitioners to assist older adults in negotiating the task of balancing these needs.

  9. Linking Indigenous Peoplesr Health-Related Decision Making to Information Communication Technology: Insights from an Emerging Economy

    Directory of Open Access Journals (Sweden)

    Md. Jahir Uddin Palas

    2017-04-01

    Full Text Available Indigenous peoples are being marginalised globally from a socioeconomic perspective and are often excluded from mainstream communities for social and/or geographic reasons. Historically, they tend to have lower living standards, including poor health conditions as compared to the rest of the population. Literature suggests that information and communication technologies (ICTs have the potential to improve awareness about how to improve health and wellbeing. In order to both deepen and broaden the understanding of how ICTs can influence Indigenous peoplesr health-related decision-making, this study has developed a conceptual framework based on the capability approach, focusing on the five dimensions of freedoms suggested by Amartya Sen. Data collected from a sample of members of an Indigenous community in Bangladesh, using a purposive sampling method, were analysed through qualitative techniques to identify ways in which a mobile-based health system have influenced the lives of indigenous people. The findings revealed that the mobile healthcare system explored in this study addressed a number of factors pertaining to indigenous peoplesr quality of life. These findings are useful for policy formulation related to the design and implementation of healthcare strategies in Bangladesh. The conceptual framework, following further validation, could serve as a platform for the advancement of research towards understanding how mobile healthcare systems can improve the wellbeing of individuals in indigenous communities.

  10. PREVENTION OF ONCOLOGICAL DISEASES AS THE BASIS OF INTERACTION OF ONCOLOGICAL SERVICE WITH PRIMARY LINK OF HEALTH CARE

    Directory of Open Access Journals (Sweden)

    L. M. Aleksandrova

    2017-01-01

    Full Text Available Malignant neoplasms (MN are the second cause of death for the population of Russia, resulted in 15.5% of all deaths in 2015. Their share in the structure of the male population mortality rate was 16.4%, female — 14.4%. Among both sexes, deaths of working age, the proportion of deaths from MN was 16.0%, among women of reproductive age — 16.3%. More than half of the working age population of deaths in Russia falls on the disease from the group of preventable death, and a third — to preventable causes, depending on the primary and secondary prevention, quality of care, along with a high prevalence of behavioral risk factors (RF, demographic characteristics, marked medical and social reasons for the high mortality rate of the MN: late uptake of the population for health care, lack of alertness in oncology healthcare professionals, patients defects in routing.The leading factor in increasing life expectancy is prevention. Today, prevention is regarded as active method of strengthening and preservation of health, and the currently existing approaches in promoting healthy life mostly only directed at the prevention of behavioral risk factors: tobacco use, poor diet, physical inactivity and harmful use of alcohol. Experts estimate the impact on them will prevent, at least 40% of the cases of MN.In Russia we have a 3-step system of health care. In general preventive health orientation is implemented on the 1st level: in the provision of primary health care. In this regard, particular attention should be paid to the implementation of measures for specific clinical examination of the adult population, which plays an important role in the early detection of both the disease and the risk factors for their development. Properly organized conduct of the clinical examination can provide a substantial, up to 30%, the contribution to the reduction of total mortality, including mortality from MN. The necessity of increasing the role of the oncology service

  11. First experiences in the implementation of biometric technology to link data from Health and Demographic Surveillance Systems with health facility data

    Directory of Open Access Journals (Sweden)

    Adwoa Serwaa-Bonsu

    2010-02-01

    Full Text Available Background: In developing countries, Health and Demographic Surveillance Systems (HDSSs provide a framework for tracking demographic and health dynamics over time in a defined geographical area. Many HDSSs co-exist with facility-based data sources in the form of Health Management Information Systems (HMIS. Integrating both data sources through reliable record linkage could provide both numerator and denominator populations to estimate disease prevalence and incidence rates in the population and enable determination of accurate health service coverage. Objective: To measure the acceptability and performance of fingerprint biometrics to identify individuals in demographic surveillance populations and those attending health care facilities serving the surveillance populations. Methodology: Two HDSS sites used fingerprint biometrics for patient and/or surveillance population participant identification. The proportion of individuals for whom a fingerprint could be successfully enrolled were characterised in terms of age and sex. Results: Adult (18–65 years fingerprint enrolment rates varied between 94.1% (95% CI 93.6–94.5 for facility-based fingerprint data collection at the Africa Centre site to 96.7% (95% CI 95.9–97.6 for population-based fingerprint data collection at the Agincourt site. Fingerprint enrolment rates in children under 1 year old (Africa Centre site were only 55.1% (95% CI 52.7–57.4. By age 5, child fingerprint enrolment rates were comparable to those of adults. Conclusion: This work demonstrates the feasibility of fingerprint-based individual identification for population-based research in developing countries. Record linkage between demographic surveillance population databases and health care facility data based on biometric identification systems would allow for a more comprehensive evaluation of population health, including the ability to study health service utilisation from a population perspective, rather than the

  12. First experiences in the implementation of biometric technology to link data from Health and Demographic Surveillance Systems with health facility data.

    Science.gov (United States)

    Serwaa-Bonsu, Adwoa; Herbst, Abraham J; Reniers, Georges; Ijaa, Wilfred; Clark, Benjamin; Kabudula, Chodziwadziwa; Sankoh, Osman

    2010-02-24

    In developing countries, Health and Demographic Surveillance Systems (HDSSs) provide a framework for tracking demographic and health dynamics over time in a defined geographical area. Many HDSSs co-exist with facility-based data sources in the form of Health Management Information Systems (HMIS). Integrating both data sources through reliable record linkage could provide both numerator and denominator populations to estimate disease prevalence and incidence rates in the population and enable determination of accurate health service coverage. To measure the acceptability and performance of fingerprint biometrics to identify individuals in demographic surveillance populations and those attending health care facilities serving the surveillance populations. Two HDSS sites used fingerprint biometrics for patient and/or surveillance population participant identification. The proportion of individuals for whom a fingerprint could be successfully enrolled were characterised in terms of age and sex. Adult (18-65 years) fingerprint enrolment rates varied between 94.1% (95% CI 93.6-94.5) for facility-based fingerprint data collection at the Africa Centre site to 96.7% (95% CI 95.9-97.6) for population-based fingerprint data collection at the Agincourt site. Fingerprint enrolment rates in children under 1 year old (Africa Centre site) were only 55.1% (95% CI 52.7-57.4). By age 5, child fingerprint enrolment rates were comparable to those of adults. This work demonstrates the feasibility of fingerprint-based individual identification for population-based research in developing countries. Record linkage between demographic surveillance population databases and health care facility data based on biometric identification systems would allow for a more comprehensive evaluation of population health, including the ability to study health service utilisation from a population perspective, rather than the more restrictive health service perspective.

  13. Moving beyond hunger and nutrition: a systematic review of the evidence linking food insecurity and mental health in developing countries.

    Science.gov (United States)

    Weaver, Lesley Jo; Hadley, Craig

    2009-01-01

    Food insecurity is a significant problem in the developing world, and one that is likely to increase given the current global food crisis spurred by rising oil prices, conversion of food to biofuels, and reduced harvests in the wake of natural disasters. The impacts of food insecurity on nutrition status, growth, and development are well substantiated; less is known about the non-nutritional impacts of food insecurity, such as its effects on mental health. This systematic review assesses current findings regarding the impacts of food insecurity on mental health in developing countries. Both qualitative and quantitative studies are considered. The results of the search reveal that little work has examined these issues directly, and serious methodological flaws are present in many of the existing studies. Gaps in the literature, implications, and research priorities are discussed.

  14. [Usefulness of local health reports to link the incidence rate of diarrhea with the quality of drinking water].

    Science.gov (United States)

    Rodriguez-Alvarez, María S; Moraña, Liliana B; Salusso, María M; Gil, José; Seghezzo, Lucas

    2018-03-20

    In this study, we analyzed the reports of the health care center located in Vaqueros (Salta, Argentina) over an 8-month period. Moreover, we determined the concentration of Escherichia coli and Giardia spp. cysts in samples from four different drinking water sources. A statistical relationship between water quality and cases of diarrhea could not be found. However, using an odds ratio calculation, it was possible to determine that one of the studied drinking water systems acts as a protection factor in cases of diarrhea. The present work provides useful information for planning preventive measures by the local health system. Copyright © 2018 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. On the links between religion, mental health and inter-religious conflict: a brief summary of empirical research.

    Science.gov (United States)

    Abu-Raiya, Hisham

    2013-01-01

    Recently, the field of psychology has begun to display a growing interest in the influence of religion on people's psychological well-being. By and large, the empirical findings of this body of inquiry have revealed positive associations between religious beliefs and practices and different indices of health and well-being and demonstrated that religion serves as a valuable tool for individuals dealing with life stressors. Yet, there is ample data to suggest that religion can also have a negative influence on the psychological well-being of the individual. This duality of religion is the focus of this summary paper which consists of two main sections. The first considers the potential constructive and destructive sides of religion with regard to general health and well- being. The second section refers to religious variables that promote or mitigate prejudice and perceived conflict with others.

  16. Acceptance sampling for attributes via hypothesis testing and the hypergeometric distribution

    Science.gov (United States)

    Samohyl, Robert Wayne

    2017-10-01

    This paper questions some aspects of attribute acceptance sampling in light of the original concepts of hypothesis testing from Neyman and Pearson (NP). Attribute acceptance sampling in industry, as developed by Dodge and Romig (DR), generally follows the international standards of ISO 2859, and similarly the Brazilian standards NBR 5425 to NBR 5427 and the United States Standards ANSI/ASQC Z1.4. The paper evaluates and extends the area of acceptance sampling in two directions. First, by suggesting the use of the hypergeometric distribution to calculate the parameters of sampling plans avoiding the unnecessary use of approximations such as the binomial or Poisson distributions. We show that, under usual conditions, discrepancies can be large. The conclusion is that the hypergeometric distribution, ubiquitously available in commonly used software, is more appropriate than other distributions for acceptance sampling. Second, and more importantly, we elaborate the theory of acceptance sampling in terms of hypothesis testing rigorously following the original concepts of NP. By offering a common theoretical structure, hypothesis testing from NP can produce a better understanding of applications even beyond the usual areas of industry and commerce such as public health and political polling. With the new procedures, both sample size and sample error can be reduced. What is unclear in traditional acceptance sampling is the necessity of linking the acceptable quality limit (AQL) exclusively to the producer and the lot quality percent defective (LTPD) exclusively to the consumer. In reality, the consumer should also be preoccupied with a value of AQL, as should the producer with LTPD. Furthermore, we can also question why type I error is always uniquely associated with the producer as producer risk, and likewise, the same question arises with consumer risk which is necessarily associated with type II error. The resolution of these questions is new to the literature. The

  17. Indicators for early assessment of palliative care in lung cancer patients: a population study using linked health data.

    Science.gov (United States)

    Kelly, Maria; O'Brien, Katie M; Lucey, Michael; Clough-Gorr, Kerri; Hannigan, Ailish

    2018-02-26

    Analysing linked, routinely collected data may be useful to identify characteristics of patients with suspected lung cancer who could benefit from early assessment for palliative care. The aim of this study was to compare characteristics of newly diagnosed lung cancer patients dying within 30 days of diagnosis (short term survivors) with those surviving more than 30 days. To identify indicators for early palliative care assessment we distinguished between characteristics available at diagnosis (age, gender, smoking status, marital status, comorbid disease, admission type, tumour stage and histology) from those available post diagnosis. A second aim was to examine the association between receiving any tumour-directed treatment, place of death and survival time. A retrospective observational population based study comparing lung cancer patients who died within 30 days of diagnosis (short term survivors) with those who survived longer using Chi-squared tests and logistic regression. Incident lung cancer (ICD-03:C34) patients diagnosed 2005-2012 inclusive who died before 01-01-2014 (n = 14,228) were identified from the National Cancer Registry of Ireland linked to death certificate data and acute hospital episode data. One in five newly diagnosed lung cancer patients died within 30 days of diagnosis. After adjusting for stage and histology, death within 30 days was higher in patients who were aged 80 years or older (adjusted OR 2.46; 95%CI 2.05-3.96; p < 0.001), patients with emergency admissions at diagnosis (adjusted OR 2.96; 95%CI 2.61-3.37; p < 0.001) and patients with any comorbidities at diagnosis (adjusted OR 1.32 95%CI 1.15-1.52; p < 0.001). Overall, 75% of those who died within 30 days died in hospital compared to 43% of longer term survivors. We have shown a high proportion of lung cancer patients who die within 30 days of diagnosis are older, have comorbidities and are admitted through the emergency department. These characteristics

  18. Variation in the link between parental divorce and children’s health disadvantage in low and high divorce settings

    OpenAIRE

    Smith-Greenaway, Emily; Clark, Shelley

    2017-01-01

    Like in other world regions, children with divorced parents in sub-Saharan Africa experience significant heath disadvantages relative to their peers with married parents. Preliminary evidence suggests this disadvantage may not be uniform across the subcontinent’s diverse settings. Research from other world regions shows that the childhood health consequences of divorce vary across different contexts. Specifically, we hypothesize that the childhood disadvantages associated with divorce are mor...

  19. The Index of Vulnerability: An anthropological method linking social-ecological systems to mental and physical health outcomes.

    Science.gov (United States)

    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.

  20. When the Nose Doesn’t Know: Canine Olfactory Function Associated With Health, Management, and Potential Links to Microbiota

    OpenAIRE

    Eileen K. Jenkins; Mallory T. DeChant; Erin B. Perry

    2018-01-01

    The impact of health, management, and microbiota on olfactory function in canines has not been examined in review. The most important characteristic of the detection canine is its sense of smell. Olfactory receptors are primarily located on the ethmoturbinates of the nasal cavity. The vomeronasal organ is an additional site of odor detection that detects chemical signals that stimulate behavioral and/or physiological changes. Recent advances in the genetics of olfaction suggest that genetic c...

  1. Commentary: linking health equity with economic development: insights from my year as Chairman of the Board of the Chamber of Commerce.

    Science.gov (United States)

    Clancy, Gerard P

    2012-12-01

    Many urban areas struggle with significant health disparities. In Tulsa, Oklahoma, there is a 14-year difference in life expectancy between the predominantly African American population in north Tulsa and the predominantly Caucasian population in south Tulsa. The roots of Tulsa's health disparities can be linked, in part, to a long history of racial mistrust stemming from the 1921 Tulsa Race Riot, arguably one of the worst race riots in U.S. history. In 2011, the author served as both a university campus president and chairman of the board of the Tulsa region's chamber of commerce. Through his work with the chamber, he discovered the business community's substantial resources and advocacy abilities. He also found that regional business leaders strongly supported health equity, diversity, and inclusion initiatives, both as moral obligations and regional economic development imperatives. After sharing the lessons he learned from working closely with business leaders, the author encourages other academic health centers (AHCs) to reach out to their business communities, which are likely willing and able to help them undertake similar initiatives. In doing so, AHCs and businesses can work together to improve the economic vitality of their regions.

  2. How perceptions of community environment influence health behaviours: using the Analysis Grid for Environments Linked to Obesity Framework as a mechanism for exploration.

    Science.gov (United States)

    Nieuwendyk, L M; Belon, A P; Vallianatos, H; Raine, K D; Schopflocher, D; Spence, J C; Plotnikoff, R C; Nykiforuk, C I

    2016-09-01

    Overweight and obesity are influenced by a complex interplay of individual and environmental factors that affect physical activity and healthy eating. Nevertheless, little has been reported on people's perceptions of those factors. Addressing this critical gap and community partner needs, this study explored how people perceived the influence of micro- and macroenvironmental factors on physical activity and healthy eating. Community partners wanted the study results in a format that would be readily and easily used by local decision makers. We used photovoice to engage 35 community members across four municipalities in Alberta, Canada, and to share their narratives about their physical activity and healthy eating. A combination of inductive and deductive analysis categorized data by environmental level (micro vs. macro) and type (physical, political, economic, and sociocultural), guided by the Analysis Grid for Environments Linked to Obesity Framework. Participants conceptualized health-influencing factors more broadly than physical activity and healthy eating to include "community social health." Participants spoke most often about the influence of the microenvironment (n = 792 ANGELO Framework coding tallies) on their physical activity, healthy eating and community social health in comparison to the macroenvironment (n = 93). Photovoice results provided a visual narrative to community partners and decision makers about how people's ability to make healthy choices can be limited by macroenvironmental forces beyond their control. Focussing future research on macro- and microenvironmental influences and localized community social health can inform practice by providing strategies on how to implement healthy changes within communities, while ensuring that research and interventions echo diverse people's perceptions.

  3. Implications of the Bohm-Aharonov hypothesis

    International Nuclear Information System (INIS)

    Ghirardi, G.C.; Rimini, A.; Weber, T.

    1976-01-01

    It is proved that the Bohm-Aharonov hypothesis concerning largerly separated subsystems of composite quantum systems implies that it is impossible to express the dynamical evolution in terms of the density operator

  4. Multi-agent sequential hypothesis testing

    KAUST Repository

    Kim, Kwang-Ki K.; Shamma, Jeff S.

    2014-01-01

    incorporate costs of taking private/public measurements, costs of time-difference and disagreement in actions of agents, and costs of false declaration/choices in the sequential hypothesis testing. The corresponding sequential decision processes have well

  5. How to link health research to policy makers, practitioners and patients: use of Dutch health services by non-Dutch patients

    NARCIS (Netherlands)

    de Graaff, F.

    2009-01-01

    This article presents experiences with research-related implementation activities in the field of intercultural communication in palliative health care in the Netherlands. It is argued that sharing research aims with relevant stakeholders, organizing resulting feedback, translating findings into

  6. Correction of nutrition test errors for more accurate quantification of the link between dental health and malnutrition.

    Science.gov (United States)

    Dion, Nathalie; Cotart, Jean-Louis; Rabilloud, Muriel

    2007-04-01

    We quantified the link between tooth deterioration and malnutrition in institutionalized elderly subjects, taking into account the major risk factors for malnutrition and adjusting for the measurement error made in using the Mini Nutritional Assessment questionnaire. Data stem from a survey conducted in 2005 in 1094 subjects >or=60 y of age from a large sample of 100 institutions of the Rhône-Alpes region of France. A Bayesian approach was used to quantify the effect of tooth deterioration on malnutrition through a two-level logistic regression. This approach allowed taking into account the uncertainty on sensitivity and specificity of the Mini Nutritional Assessment questionnaire to adjust for the measurement error of that test. After adjustment for other risk factors, the risk of malnutrition increased significantly and continuously 1.15 times (odds ratio 1.15, 95% credibility interval 1.06-1.25) whenever the masticatory percentage decreased by 10 points, which is equivalent to the loss of two molars. The strongest factors that augmented the probability of malnutrition were deglutition disorders, depression, and verbal inconsistency. Dependency was also an important factor; the odds of malnutrition nearly doubled for each additional grade of dependency (graded 6 to 1). Diabetes, central neurodegenerative disease, and carcinoma tended to increase the probability of malnutrition but their effect was not statistically significant. Dental status should be considered a serious risk factor for malnutrition. Regular dental examination and care should preserve functional dental integrity to prevent malnutrition in institutionalized elderly people.

  7. Possible links between extreme levels of space weather changes and human health state in middle latitudes: direct and indirect indicators

    Science.gov (United States)

    Safaraly-Oghlu Babayev, Elchin

    The Sun is the main driver of space weather. The possibility that solar activity variations and related changes in the Earth's magnetosphere can affect human life and health has been debated for many decades. This problem is being studied extensively in the late 20th and early 21st centuries and it is still being contradictory in some cases. The relations between space weather changes and the human health have global implications, but they are especially significant for habitants living at high geomagnetic latitudes where the geomagnetic disturbances have larger amplitudes. Nevertheless, the relevant researches are also important for humans living at any geomagnetic latitudes with different levels of geomagnetic activity; recent researches show that weak geomagnetic disturbances can also have adverse effects. Unfortunately, limited comparison of results of investigations on possible effects to humans from geomagnetic activity exists between studies conducted in high, middle and low latitudes. Knowledge about the relationship between solar and geomagnetic activity and the human health would allow to get better prepared beforehand for any future geomagnetic event and its impacts anywhere. For these purposes there are conducted collaborative (jointly with scientists from Israel, Bulgaria, Russia and Belgium) and cross-disciplinary space weather studies in the Azerbaijan National Academy of Sciences for revealing possible effects of solar, geomagnetic and cosmic ray variability on certain technological, biological and ecological systems in different phases of solar cycle 23. This paper describes some recently obtained results of the complex (theoretical, experimental and statistical) studies of influence of the periodical and aperiodical changes of solar, geomagnetic and cosmic ray activities upon human cardio-health state as well as human physiological and psycho-emotional state. It also covers the conclusions of studies on influence of violent solar events and severe

  8. The (not so) Immortal Strand Hypothesis

    OpenAIRE

    Tomasetti, Cristian; Bozic, Ivana

    2015-01-01

    Background: Non-random segregation of DNA strands during stem cell replication has been proposed as a mechanism to minimize accumulated genetic errors in stem cells of rapidly dividing tissues. According to this hypothesis, an “immortal” DNA strand is passed to the stem cell daughter and not the more differentiated cell, keeping the stem cell lineage replication error-free. After it was introduced, experimental evidence both in favor and against the hypothesis has been presented. Principal...

  9. Association between home visiting interventions and First Nations families' health and social outcomes in Manitoba, Canada: protocol for a study of linked population-based administrative data.

    Science.gov (United States)

    Brownell, Marni D; Nickel, Nathan C; Enns, Jennifer E; Chartier, Mariette; Campbell, Rhonda; Phillips-Beck, Wanda; Chateau, Dan; Burland, Elaine; Santos, Rob; Katz, Alan

    2017-10-10

    First Nations people are descendants of Canada's original inhabitants. In consequence of historical and ongoing structural injustices, many First Nations families struggle with challenging living conditions, including high rates of poverty, poor housing conditions, mental illness and social isolation. These risk factors impede caregivers' abilities to meet their children's basic physical and psychosocial needs. Home visiting programmes were developed to support child developmental health in families facing parenting challenges. However, whether home visiting is an effective intervention for First Nations families has not been examined. We are evaluating two home visiting programmes in Manitoba, Canada, to determine whether they promote nurturing family environments for First Nations children. This research builds on new and established relationships among academic researchers, government decision-makers and First Nations stakeholders. We will link health, education and social services data from the Manitoba Population Research Data Repository to data from two home visiting programmes in Manitoba. Logistic regression modelling will be used to assess whether programme participation is associated with improved child developmental health, better connections between families and social services, reduced instances of child maltreatment and being taken into out-of-home care by child welfare and reduced inequities for First Nations families. Non-participating individuals with similar sociodemographic characteristics will serve as comparators. We will use an interrupted time series approach to test for differences in outcomes before and after programme implementation and a propensity score analysis to compare differences between participants and non-participants. Approvals were granted by the Health Information Research Governance Committee of the First Nations Health and Social Secretariat of Manitoba and the University of Manitoba Health Research Ethics Board. Our

  10. Reducing Tick-Borne Disease in Alabama: Linking Health Risk Perception with Spatial Analysis Using the NASA Earth Observing System

    Science.gov (United States)

    Hemmings, S.; Renneboog, N.; Firsing, S.; Capilouto, E.; Harden, J.; Hyden, R.; Tipre, M.; Zhang, Y.

    2010-01-01

    Lyme disease (LD) accounts for most vector-borne disease reports in the U.S., and although its existence in Alabama remains controversial, other tick-borne illnesses (TBI) such as Southern Tick-Associated Rash Illness (STARI) pose a health concern in the state. Phase One of the Marshall Space Flight Center-UAB DEVELOP study of TBI identified the presence of the chain of infection for LD (Ixodes scapularis ticks carrying Borrelia burgdorferi bacteria) and STARI (Amblyomma americanum ticks and an as-yet-unconfirmed agent) in Alabama. Both LD and STARI are associated with the development of erythema migrans rashes around an infected tick bite, and while treatable with oral antibiotics, a review of educational resources available to state residents revealed low levels of prevention information. To improve prevention, recognition, and treatment of TBI in Alabama, Phase Two builds a health communication campaign based on vector habitat mapping and risk perception assessment. NASA Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) satellite imagery identified likely tick habitats using remotely sensed measurements of vegetation vigor (Normalized Difference Vegetation Index) and soil moisture. Likely tick habitats, identified as those containing both high vegetation density and soil moisture, included Oak Mountain State Park, Bankhead National Forest, and Talladega National Forest. To target a high-risk group -- outdoor recreation program participants at Alabama universities -- the study developed a behavior survey instrument based on existing studies of LD risk factors and theoretical constructs from the Social Ecological Model and Health Belief Model. The survey instrument was amended to include geographic variables in the assessment of TBI knowledge, attitudes, and prevention behaviors, and the vector habitat model will be expanded to incorporate additional environmental variables and in situ data. Remotely sensed environmental data combined with

  11. The Scottish Mental Survey 1932 linked to the Midspan studies: a prospective investigation of childhood intelligence and future health

    OpenAIRE

    Hart, C.L.; Deary, I.J.; MacKinnon, P.L.; Davey Smith, G.; Whalley, L.J.; Wilson, V.; Hole, D.J.; Starr, J.M.

    2003-01-01

    The Scottish Mental Survey of 1932 (SMS1932) recorded mental ability test scores for nearly all of the age group of children born in 1921 and at school in Scotland on 1st June 1932. The Collaborative and Renfrew/Paisley studies, two of the Midspan studies, obtained health and social data by questionnaire and a physical examination in the 1970s. Some Midspan participants were born in 1921 and may have taken part in the SMS1932, so might have mental ability data available from childhood. The 19...

  12. Assessing the link between implementation fidelity and health outcomes for a trial of intensive case management by community health workers: a mixed methods study protocol.

    Science.gov (United States)

    Schmidt, Barbara; Watt, Kerrianne; McDermott, Robyn; Mills, Jane

    2017-07-17

    Better systems of care are required to address chronic disease in Indigenous people to ensure they can access all their care needs. Health research has produced evidence about effective models of care and chronic disease strategies to address Indigenous health, however the transfer of research findings into routine clinical practice has proven challenging. Complex interventions, such as those related to chronic disease, have many components that are often poorly implemented and hence rarely achieve implementation fidelity. Implementation fidelity is "the degree to which programs are implemented as intended by the program developer". Knowing if an intervention was implemented as planned is fundamental to knowing what has contributed to the success of an intervention. The aim of this study is to adapt the implementation fidelity framework developed by Keith et al. and apply it to the intervention implemented in phase 1 of the Getting Better at Chronic Care in North Queensland study. The objectives are to quantify the level of implementation fidelity achieved during phase 1 of the study, measure the association between implementation fidelity and health outcomes and to explore the features of the primary health care system that contributed to improved health outcomes. A convergent parallel mixed methods study design will be used to develop a process for assessing implementation fidelity. Information collected via a questionnaire and routine data generated during phase 1 of the study will be used to explain the context for the intervention in each site and develop an implementation fidelity score for each component of the intervention. A weighting will be applied to each component of the intervention to calculate the overall implementation score for each participating community. Statistical analysis will assess the level of association between implementation fidelity scores and health outcomes. Health services research seeks to find solutions to social and technical

  13. The World Health Organisation Disability Assessment Scale (WHODAS II: Links between self-rated health and objectively defined and clinical parameters in the population of spinal cord injury

    Directory of Open Access Journals (Sweden)

    Steinerte V.

    2016-01-01

    Full Text Available There are many clinical and objectively defined parameters that are used to evaluate a person's disability. Since the World Health Organisation has presented the WHODAS II as a means of objectively measuring subjectively defined functions, greater attention has been focused on self-rated health. Only a few studies, however, have been conducted about differences between self-rated health and objectively defined parameters. The survey for this study was conducted on the basis of WHODAS II and the population in Latvia with spinal cord injury. Respondents were between 18 and 65, and 98 questionnaires were analysed. The results show that people with spinal cord injury on average rate their functioning as limited (33–40 points of 100. Most respondents have been declared to be disabled, which is defined as very serious or severe functional disorders. More than 40% have paid jobs, while one-third do not work for reasons of health. The research shows that there is a close coherence (p< 0.05 between individual, objectively and clinically defined indicators on the one hand and the aspects of the questionnaire in which physical functioning was an important factor on the other hand. In order to understand the real functional abilities of patients and the individual factors that influence those abilities, it is necessary to define functional self-rated health in addition to objectively defined indicators.

  14. Toward human resource management in inter-professional health practice: linking organizational culture, group identity and individual autonomy.

    Science.gov (United States)

    Tataw, David

    2012-01-01

    The literature on team and inter-professional care practice describes numerous barriers to the institutionalization of inter-professional healthcare. Responses to slow institutionalization of inter-professional healthcare practice have failed to describe change variables and to identify change agents relevant to inter-professional healthcare practice. The purpose of this paper is to (1) describe individual and organizational level barriers to collaborative practice in healthcare; (2) identify change variables relevant to the institutionalization of inter-professional practice at individual and organizational levels of analysis; and (3) identify human resource professionals as change agents and describe how the strategic use of the human resource function could transform individual and organizational level change variables and therefore facilitate the healthcare system's shift toward inter-professional practice. A proposed program of institutionalization includes the following components: a strategic plan to align human resource functions with organizational level inter-professional healthcare strategies, activities to enhance professional competencies and the organizational position of human resource personnel, activities to integrate inter-professional healthcare practices into the daily routines of institutional and individual providers, activities to stand up health provider champions as permanent leaders of inter-professional teams with human resource professionals as consultants and activities to bring all key players to the table including health providers. Copyright © 2012 John Wiley & Sons, Ltd.

  15. Children and Nature: Linking Accessibility of Natural Environments and Children’s Health-Related Quality of Life

    Directory of Open Access Journals (Sweden)

    Suzanne Tillmann

    2018-05-01

    Full Text Available A growing body of research suggests that increasing children’s nature interactions can have positive benefits for their health-related quality of life (HRQOL; however, researchers have yet to examine how geographical context influences this relationship. The purpose of this study was to examine individual-level and environmental factors that are associated with HRQOL of children from different geographical contexts. Data were collected for 851 children from 34 elementary schools in Ontario, Canada. The natural environments around each child’s home were computed using geospatial analyses in a geographic information system. Natural environment measures were combined with HRQOL and the demographics from child surveys to be used in a series of step-wise linear regression models. These models explored the relationship between children’s HRQOL and the natural environment in urban/suburban and rural populations. In addition to important individual-level determinants, the findings revealed that characteristics of the natural environment, including the amount of greenness, park, and water, show significant relationships in the urban/suburban population. Interpersonal variables were the key predictors of HRQOL in the rural population. Where children live influences relationships between nature and HRQOL. These findings have implications for policymakers, health practitioners, educators, and parents in the design and the promotion of nature for children’s HRQOL.

  16. When the Nose Doesn’t Know: Canine Olfactory Function Associated With Health, Management, and Potential Links to Microbiota

    Science.gov (United States)

    Jenkins, Eileen K.; DeChant, Mallory T.; Perry, Erin B.

    2018-01-01

    The impact of health, management, and microbiota on olfactory function in canines has not been examined in review. The most important characteristic of the detection canine is its sense of smell. Olfactory receptors are primarily located on the ethmoturbinates of the nasal cavity. The vomeronasal organ is an additional site of odor detection that detects chemical signals that stimulate behavioral and/or physiological changes. Recent advances in the genetics of olfaction suggest that genetic changes, along with the unique anatomy and airflow of the canine nose, are responsible for the macrosmia of the species. Inflammation, alterations in blood flow and hydration, and systemic diseases alter olfaction and may impact working efficiency of detection canines. The scientific literature contains abundant information on the potential impact of pharmaceuticals on olfaction in humans, but only steroids, antibiotics, and anesthetic agents have been studied in the canine. Physical stressors including exercise, lack of conditioning, and high ambient temperature impact olfaction directly or indirectly in the canine. Dietary fat content, amount of food per meal, and timing of meals have been demonstrated to impact olfaction in mice and dogs. Gastrointestinal (GI) microbiota likely impacts olfaction via bidirectional communication between the GI tract and brain, and the microbiota is impacted by exercise, diet, and stress. The objective of this literature review is to discuss the specific effects of health, management, and microbiota shifts on olfactory performance in working canines. PMID:29651421

  17. When the Nose Doesn’t Know: Canine Olfactory Function Associated With Health, Management, and Potential Links to Microbiota

    Directory of Open Access Journals (Sweden)

    Eileen K. Jenkins

    2018-03-01

    Full Text Available The impact of health, management, and microbiota on olfactory function in canines has not been examined in review. The most important characteristic of the detection canine is its sense of smell. Olfactory receptors are primarily located on the ethmoturbinates of the nasal cavity. The vomeronasal organ is an additional site of odor detection that detects chemical signals that stimulate behavioral and/or physiological changes. Recent advances in the genetics of olfaction suggest that genetic changes, along with the unique anatomy and airflow of the canine nose, are responsible for the macrosmia of the species. Inflammation, alterations in blood flow and hydration, and systemic diseases alter olfaction and may impact working efficiency of detection canines. The scientific literature contains abundant information on the potential impact of pharmaceuticals on olfaction in humans, but only steroids, antibiotics, and anesthetic agents have been studied in the canine. Physical stressors including exercise, lack of conditioning, and high ambient temperature impact olfaction directly or indirectly in the canine. Dietary fat content, amount of food per meal, and timing of meals have been demonstrated to impact olfaction in mice and dogs. Gastrointestinal (GI microbiota likely impacts olfaction via bidirectional communication between the GI tract and brain, and the microbiota is impacted by exercise, diet, and stress. The objective of this literature review is to discuss the specific effects of health, management, and microbiota shifts on olfactory performance in working canines.

  18. Uranium Speciation in Drinking Water from Drilled Wells in Southern Finland and Its Potential Links to Health Effects

    International Nuclear Information System (INIS)

    Prat, O.; Vercouter, Th.; Ansoborlo, E.; Fichet, P.; Perret, P.; Kurttio, P.; Salonen, L.

    2009-01-01

    Exceptionally high concentrations of natural uranium have been found in drinking water originating from drilled wells in Southern Finland. However, no clear clinical symptoms have been observed among the exposed population. Hence a question arose as to whether uranium speciation could be one reason for the lack of significant adverse health effects. Uranium species were determined using time-resolved laser-induced-fluorescence-spectroscopy. We performed multi-element chemical analyses in these water samples, and predictive calculations were carried out using up-to-date thermodynamic data. The results indicated good agreement between measurements and modeling. The low toxicity of Finnish bedrock water may be due to the predominance of two calcium dependent species, Ca 2 UO 2 (CO 3 ) 3 (aq) and CaUO 2 (CO 3 ) 3 2- , whose non toxicity for cells has been described previously. This interdisciplinary study describes chemical speciation of drinking water with elevated uranium concentrations and the potential consequence on health. From these results, it appears that modeling could be used for a better understanding of uranium toxicity of drinking water in the event of contamination. (authors)

  19. When the Nose Doesn't Know: Canine Olfactory Function Associated With Health, Management, and Potential Links to Microbiota.

    Science.gov (United States)

    Jenkins, Eileen K; DeChant, Mallory T; Perry, Erin B

    2018-01-01

    The impact of health, management, and microbiota on olfactory function in canines has not been examined in review. The most important characteristic of the detection canine is its sense of smell. Olfactory receptors are primarily located on the ethmoturbinates of the nasal cavity. The vomeronasal organ is an additional site of odor detection that detects chemical signals that stimulate behavioral and/or physiological changes. Recent advances in the genetics of olfaction suggest that genetic changes, along with the unique anatomy and airflow of the canine nose, are responsible for the macrosmia of the species. Inflammation, alterations in blood flow and hydration, and systemic diseases alter olfaction and may impact working efficiency of detection canines. The scientific literature contains abundant information on the potential impact of pharmaceuticals on olfaction in humans, but only steroids, antibiotics, and anesthetic agents have been studied in the canine. Physical stressors including exercise, lack of conditioning, and high ambient temperature impact olfaction directly or indirectly in the canine. Dietary fat content, amount of food per meal, and timing of meals have been demonstrated to impact olfaction in mice and dogs. Gastrointestinal (GI) microbiota likely impacts olfaction via bidirectional communication between the GI tract and brain, and the microbiota is impacted by exercise, diet, and stress. The objective of this literature review is to discuss the specific effects of health, management, and microbiota shifts on olfactory performance in working canines.

  20. IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK.

    Science.gov (United States)

    Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M; O'Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J Michael; Casper, Lynne

    Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals' perceptions of their job conditions are better predictors of individuals' work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees' mental health. We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a "private trouble" and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work.

  1. IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK

    Science.gov (United States)

    Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M.; O’Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J. Michael; Casper, Lynne

    2015-01-01

    Purpose Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. Methodology/approach This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). Findings We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals’ perceptions of their job conditions are better predictors of individuals’ work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Practical implications Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees’ mental health. Originality/value of the chapter We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a “private trouble” and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work. PMID:25866431

  2. Does anger regulation mediate the discrimination-mental health link among Mexican-origin adolescents? A longitudinal mediation analysis using multilevel modeling.

    Science.gov (United States)

    Park, Irene J K; Wang, Lijuan; Williams, David R; Alegría, Margarita

    2017-02-01

    [Correction Notice: An Erratum for this article was reported in Vol 53(2) of Developmental Psychology (see record 2017-04475-001). In the article, there were several typographical errors in the Recruitment and Procedures section. The percentage of mothers who responded to survey items should have been 99.3%. Additionally, the youths surveyed at T2 and T3 should have been n 246. Accordingly, the percentage of youths surveyed in T2 and T3 should have been 91.4% and the percentage of mothers surveyed at T2 and T3 should have been 90.7%. Finally, the youths missing at T2 should have been n 23, and therefore the attrition rate for youth participants should have been 8.6. All versions of this article have been corrected.] Although prior research has consistently documented the association between racial/ethnic discrimination and poor mental health outcomes, the mechanisms that underlie this link are still unclear. The present 3-wave longitudinal study tested the mediating role of anger regulation in the discrimination-mental health link among 269 Mexican-origin adolescents ( M age = 14.1 years, SD = 1.6; 57% girls), 12 to 17 years old. Three competing anger regulation variables were tested as potential mediators: outward anger expression, anger suppression, and anger control. Longitudinal mediation analyses were conducted using multilevel modeling that disaggregated within-person effects from between-person effects. Results indicated that outward anger expression was a significant mediator; anger suppression and anger control were not significant mediators. Within a given individual, greater racial/ethnic discrimination was associated with more frequent outward anger expression. In turn, more frequent outward anger expression was associated with higher levels of anxiety and depression at a given time point. Gender, age, and nativity status were not significant moderators of the hypothesized mediation models. By identifying outward anger expression as an explanatory

  3. Tracking and unpacking rapid Arctic change: Indicators of community health and sustainability in northern Alaska and links to cryospheric change

    Science.gov (United States)

    Eicken, H.; Sam, J. M.; Mueller-stoffels, M.; Lovecraft, A. L.; Fresco, N. L.

    2017-12-01

    Tracking and responding to rapid Arctic change benefits from time series of indicator variables that describe the state of the system and can inform anticipatory action. A key challenge is to identify and monitor sets of indicators that capture relevant variability, trends, and transitions in social-environmental systems. We present findings from participatory scenarios focused on community health and sustainability in northern Alaska. In a series of workshops in 2015 and 2016 (Kotzebue workshop photo shown below), over 50 experts, mostly local, identified determinants of community health and sustainability by 2040 in the Northwest Arctic and North Slope Boroughs, Alaska. Drawing on further research, an initial set of factors and uncertainties was refined and prioritized into a total of 20 key drivers, ranging from governance issues to socio-economic and environmental factors. The research team then developed sets of future projections that describe plausible outcomes by mid-century for each of these drivers. A plausibility and consistency analysis of all pairwise combinations of these projections (following Mueller-Stoffels and Eicken, In: North by 2020 - Perspectives on Alaska's Changing Social-Ecological Systems, University of Alaska Press, 2011) resulted in the identification of robust scenarios. The latter were further reviewed by workshop participants, and a set of indicator variables, including indicators of relevant cryospheric change, was identified to help track trajectories towards plausible future states. Publically accessible recorded data only exist for a subset of the more than 70 indicators, reaching back a few years to several decades. For several indicators, the sampling rate or time series length are insufficient for tracking of and response to change. A core set of variables has been identified that meets indicator requirements and can serve as a tool for Alaska Arctic communities in adapting to or mitigating rapid change affecting community

  4. Assessing the link between health care utilisation in general practice and morbidity patterns in the elderly in the Nordic countries

    DEFF Research Database (Denmark)

    Halling, Anders; Kristensen, Troels; Ranstad, Karin

    important areas of healthcare utilisation in general practice in the Nordic countries. In the future, this demand for healthcare services among the elderly is expected to increase. For instance, it is likely that people live longer and advanced technologies continue to be developed, affecting demand...... and diabetes). Today we have limited information on the need for social services and health care services for the elderly in the Nordic countries. There is a need for improved understanding of variation in healthcare utilization and methods to measure the actual need for healthcare services among older......Objectives: The objective is to describe and analyze the prevalence of comorbidity and multimorbidity among older people with extensive and complex care needs. Next, the main objective is to present and discuss papers on the association between healthcare utilisation in general practice...

  5. Linking a research register to clinical records in older adults' mental health services: a mixed-methods study.

    Science.gov (United States)

    Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

    2015-01-01

    Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities. This was a two-stage cross-sectional observational study. In phase one, focus groups with service users, carers and clinicians informed a framework for clinicians to explain C4C to those on their caseload. In phase two, clinicians explained C4C to 26 service users (and carers where applicable). These conversations were recorded, and their content was analysed. Service users and carers were then interviewed to provide further feedback on their conversations with clinicians. A total of 31 service users, 24 carers and 13 clinical staff took part across the two phases. In phase one, service users and carers sought assurance of the right to refuse participation in further studies (after joining C4C). Clinicians expressed concerns over legal and practical implications of ascertaining mental capacity and best interest. In phase two, clinicians' explanations were less thorough than similar explanations given to younger adults with psychosis. Clinicians omitted details of service users' right to stipulate contact arrangements, which was significantly associated with whether service users/carers agreed to join. Common reasons for joining C4C included altruism and the chance to speak to new people. Few participants refused to join, but reasons included avoidance of stress (potentially alleviated through the presence of a carer). Implementing C4C in older adults' services requires clinicians to deliver concise, simple explanations to individuals and their carers where applicable. Older adults can be suspicious of unsolicited contact; thus

  6. Development and early experience from an intervention to facilitate teamwork between general practices and allied health providers: the Team-link study.

    Science.gov (United States)

    Harris, Mark F; Chan, Bibiana C; Daniel, Christopher; Wan, Qing; Zwar, Nick; Davies, Gawaine Powell

    2010-04-27

    This paper describes the development and implementation of an intervention to facilitate teamwork between general practice and outside allied and community health services and providers. A review of organizational theory and a qualitative study of 9 practices was used to design an intervention which was applied in four Divisions of General Practice and 26 urban practices. Clinical record review and qualitative interviews with participants were used to determine the key lessons from its implementation. Facilitating teamwork across organizational boundaries was very challenging. The quality of the relationship between professionals was of key importance. This was enabled by joint education and direct communication between providers. Practice nurses were key links between general practices and allied and community health services. Current arrangements for Team Care planning provide increased opportunities for access to allied health. However the current paper based system is insufficient to build relationships or effectively share roles as part of a patient care team. Facilitation is feasible but constrained by barriers to communication and trust.

  7. Digital technology ownership, usage, and factors predicting downloading health apps among caucasian, filipino, korean, and latino americans: the digital link to health survey.

    Science.gov (United States)

    Bender, Melinda S; Choi, JiWon; Arai, Shoshana; Paul, Steven M; Gonzalez, Prisila; Fukuoka, Yoshimi

    2014-10-22

    Interventions using mobile health (mHealth) apps have been effective in promoting healthy lifestyle behavior change and hold promise in improving health outcomes to thereby reduce health disparities among diverse racial/ethnic populations, particularly Latino and Asian American subgroups (Filipinos and Koreans) at high risk for diabetes and cardiovascular disease. Latinos and Asian Americans are avid digital technology owners and users. However, limited datasets exist regarding digital technology ownership and use, especially among specific racial/ethnic subgroups. Such information is needed to inform development of culturally tailored mHealth tools for use with lifestyle interventions promoting healthy behaviors for these at-risk racial/ethnic populations. The intent of the study was to examine (1) digital technology ownership and usage, and (2) factors predicting downloading health apps for Caucasian, Filipino, Korean, and Latino American subgroups. A cross-sectional survey conducted in August 2013 through December 2013 recruited 904 participants (Caucasians n=172, Filipinos n=250, Koreans n=234, and Latinos n=248), age >18 years, from California community events, clinics, churches, and online. English, Spanish, and Korean surveys were administered via paper or online. Descriptive statistics characterized the sociodemographics and digital technology ownership/usage of the 904 participants. Differences among groups in categorical variables were examined using chi-square statistics. Logistic regression was used to determine factors predicting downloading health apps. Overall, mean age was 44 years (SD 16.1), with 64.3% (581/904) female. Only 44.7% (404/904) of all participants reported English as their primary language (Caucasian 98.3%, 169/172; Filipino 67.6%, 169/250; Korean 9.4%, 22/234, and Latino 17.7%, 44/248. Overall, mobile phone ownership was 92.8% (839/904). Compared to all groups, Koreans were more likely to own a mobile phone (82.8%, 194/234), computer

  8. Multiple hypothesis tracking for the cyber domain

    Science.gov (United States)

    Schwoegler, Stefan; Blackman, Sam; Holsopple, Jared; Hirsch, Michael J.

    2011-09-01

    This paper discusses how methods used for conventional multiple hypothesis tracking (MHT) can be extended to domain-agnostic tracking of entities from non-kinematic constraints such as those imposed by cyber attacks in a potentially dense false alarm background. MHT is widely recognized as the premier method to avoid corrupting tracks with spurious data in the kinematic domain but it has not been extensively applied to other problem domains. The traditional approach is to tightly couple track maintenance (prediction, gating, filtering, probabilistic pruning, and target confirmation) with hypothesis management (clustering, incompatibility maintenance, hypothesis formation, and Nassociation pruning). However, by separating the domain specific track maintenance portion from the domain agnostic hypothesis management piece, we can begin to apply the wealth of knowledge gained from ground and air tracking solutions to the cyber (and other) domains. These realizations led to the creation of Raytheon's Multiple Hypothesis Extensible Tracking Architecture (MHETA). In this paper, we showcase MHETA for the cyber domain, plugging in a well established method, CUBRC's INFormation Engine for Real-time Decision making, (INFERD), for the association portion of the MHT. The result is a CyberMHT. We demonstrate the power of MHETA-INFERD using simulated data. Using metrics from both the tracking and cyber domains, we show that while no tracker is perfect, by applying MHETA-INFERD, advanced nonkinematic tracks can be captured in an automated way, perform better than non-MHT approaches, and decrease analyst response time to cyber threats.

  9. Does health facility service environment matter for the receipt of essential newborn care? Linking health facility and household survey data in Malawi.

    Science.gov (United States)

    Carvajal-Aguirre, Liliana; Mehra, Vrinda; Amouzou, Agbessi; Khan, Shane M; Vaz, Lara; Guenther, Tanya; Kalino, Maggie; Zaka, Nabila

    2017-12-01

    Health facility service environment is an important factor for newborns survival and well-being in general and in particular in high mortality settings such as Malawi where despite high coverage of essential interventions, neonatal mortality remains high. The aim of this study is to assess whether the quality of the health service environment at birth is associated with quality of care received by the newborn. We used data from the Malawi Millennium Development Goals Endline household survey conducted as part of MICS survey program and Service Provision Assessment Survey carried out in 2014. The analysis is based on 6218 facility births that occurred during the past 2 years. Descriptive statistics, bivariate and multivariate random effect models are used to assess the association of health facility service readiness score for normal deliveries and newborn care with newborns receiving appropriate newborn care, defined for this analysis as receiving 5 out of 6 recommended interventions during the first 2 days after birth. Newborns in districts with top facility service readiness score have 1.5 higher odds of receiving appropriate newborn care (adjusted odds ratio (aOR) = 1.52, 95% confidence interval CI = 1.19-1.95, P  = 0.001), as compared to newborns in districts with a lower facility score after adjusting for potential confounders. Newborns in the Northern region were two times more likely to receive 5 newborn care interventions as compared to newborns in the Southern region (aOR = 2.06, 95% CI = 1.50-2.83, P  < 0.001). Living in urban or rural areas did not have an impact on receiving appropriate newborn care. There is need to increase the level of service readiness across all facilities, so that all newborns irrespective of the health facility, district or region of delivery are able to receive all recommended essential interventions. Investments in health systems in Malawi should concentrate on increasing training and availability of

  10. Completing the Link between Exposure Science and Toxicology for Improved Environmental Health Decision Making: The Aggregate Exposure Pathway Framework.

    Science.gov (United States)

    Teeguarden, Justin G; Tan, Yu-Mei; Edwards, Stephen W; Leonard, Jeremy A; Anderson, Kim A; Corley, Richard A; Kile, Molly L; Simonich, Staci M; Stone, David; Tanguay, Robert L; Waters, Katrina M; Harper, Stacey L; Williams, David E

    2016-05-03

    Driven by major scientific advances in analytical methods, biomonitoring, computation, and a newly articulated vision for a greater impact in public health, the field of exposure science is undergoing a rapid transition from a field of observation to a field of prediction. Deployment of an organizational and predictive framework for exposure science analogous to the "systems approaches" used in the biological sciences is a necessary step in this evolution. Here we propose the aggregate exposure pathway (AEP) concept as the natural and complementary companion in the exposure sciences to the adverse outcome pathway (AOP) concept in the toxicological sciences. Aggregate exposure pathways offer an intuitive framework to organize exposure data within individual units of prediction common to the field, setting the stage for exposure forecasting. Looking farther ahead, we envision direct linkages between aggregate exposure pathways and adverse outcome pathways, completing the source to outcome continuum for more meaningful integration of exposure assessment and hazard identification. Together, the two frameworks form and inform a decision-making framework with the flexibility for risk-based, hazard-based, or exposure-based decision making.

  11. Water resource protection in Australia: Links between land use and river health with a focus on stubble farming systems

    Science.gov (United States)

    Bowmer, Kathleen H.

    2011-06-01

    SummaryStubble farming (conservation farming, minimum tillage, zero tillage) has increased in Australia over several decades with claims of improved productivity, landscape stability and environmental benefit including ecosystem services downstream, yet recent audits show a dramatic and general decline in river health. This review explores explanations for this apparent anomaly. Many confounding factors complicate interactions between land use and river condition and may disguise or over-ride the potential benefits of adoption of stubble systems or other improvements in agricultural land use practice. These factors include climate change and variability; land use changes including an increase in bushfires, growth of farm dams and afforestation; lag times between land use change and expression of benefits in river systems; use of inappropriate scale that disguises local benefit; variations in the extent of ecosystem resilience; impacts of river regulation; and impacts of introduced species. Additionally, the value of river condition and utility is complicated by different local or regional perceptions and by contrasting rural and urban outlooks. The use of indicators, risk frameworks and biophysical modelling may help elucidate the complex relationships between land use and downstream ecosystem impact. The strengthening of local, regional and catchment scale approaches is advocated. This includes the re-integration of land management and governance with water management and planning. It is encouraging that farmers are themselves developing systems to optimise trade-offs between on-farm activities and ecosystem service benefits. This approach needs to be supported and extended.

  12. Modelling health care processes for eliciting user requirements: a way to link a quality paradigm and clinical information system design.

    Science.gov (United States)

    Staccini, P; Joubert, M; Quaranta, J F; Fieschi, D; Fieschi, M

    2001-12-01

    Healthcare institutions are looking at ways to increase their efficiency by reducing costs while providing care services with a high level of safety. Thus, hospital information systems have to support quality improvement objectives. The elicitation of the requirements has to meet users' needs in relation to both the quality (efficacy, safety) and the monitoring of all health care activities (traceability). Information analysts need methods to conceptualise clinical information systems that provide actors with individual benefits and guide behavioural changes. A methodology is proposed to elicit and structure users' requirements using a process-oriented analysis, and it is applied to the blood transfusion process. An object-oriented data model of a process has been defined in order to organise the data dictionary. Although some aspects of activity, such as 'where', 'what else', and 'why' are poorly represented by the data model alone, this method of requirement elicitation fits the dynamic of data input for the process to be traced. A hierarchical representation of hospital activities has to be found for the processes to be interrelated, and for their characteristics to be shared, in order to avoid data redundancy and to fit the gathering of data with the provision of care.

  13. An Analysis of natural mentoring relationship profiles and associations with mentees’ mental health: considering links via support from important others

    Science.gov (United States)

    Hurd, Noelle M.; Zimmerman, Marc A.

    2015-01-01

    We explored associations between natural mentoring relationship profiles and young adults’ life satisfaction and symptoms of depression via participants’ perceived support from important others accounting for participants’ perceived support and mental health prior to the onset of their natural mentoring relationships. Participants included 396 young adults (57% female; mean age = 30.97, SD = .6), the majority of whom identified as Black or African American (79% Black, 18% White, 3% Biracial). Most participants had completed high school but few participants (13%) had completed degrees from 4-year institutions. We used a latent profile approach to identify natural mentoring relationship profiles and employed structural equation modeling to test our study hypotheses. Slightly over half of study participants (53%) reported the presence of a natural mentor in their lives since the age of 14. Results suggest that natural mentoring relationships characterized by high levels of relational closeness and either extended relationship duration or frequent contact may promote improvements in psychological well-being among mentees over time via greater experiences of social support from important others. PMID:24132713

  14. Linking climate change and health outcomes: Examining the relationship between temperature, precipitation and birth weight in Africa

    Science.gov (United States)

    Grace, Kathryn; Davenport, Frank; Hanson, Heidi; Funk, Christopher C.; Shukla, Shraddhanand

    2015-01-01

    This paper examined the relationship between birth weight, precipitation, and temperature in 19 African countries. We matched recorded birth weights from Demographic and Health Surveys covering 1986 through 2010 with gridded monthly precipitation and temperature data derived from satellite and ground-based weather stations. Observed weather patterns during various stages of pregnancy were also used to examine the effect of temperature and precipitation on birth weight outcomes. In our empirical model we allowed the effect of weather factors to vary by the dominant food production strategy (livelihood zone) in a given region as well as by household wealth, mother's education and birth season. This allowed us to determine if certain populations are more or less vulnerable to unexpected weather changes after adjusting for known covariates. Finally we measured effect size by observing differences in birth weight outcomes in women who have one low birth weight experience and at least one