Public health and medicine in an age of energy scarcity: the case of petroleum

EXPRESS: Experiencing misinformation: The effect of pre-exposure warnings and debunking on psychic beliefs

Misinformation can have a detrimental impact on our beliefs, and it is therefore necessary to understand the cognitive mechanism by which false information is integrated or can be changed. In two experiments, we worked with fake psychic demonstrations, because observers easily adopt the experience as reflecting a « true » psychic event. We manipulated the availability of alternative explanations by providing a general warning that the performer is a magician with no psychic abilities (Experiment 1), or disclosing afterwards how the fake demonstration had been staged (Experiment 2). In experiment 1, witnessing the psychic demonstration significantly increased participants' psychic beliefs, even though they had been warned. However, providing the alternative explanation about the deceptive method mitigated this effect. In experiment 2, the realization of deception significantly reduced participants' psychic beliefs directly after the performance, and remained reduced at the one week later.

Microfluidics device for drug discovery, screening and delivery

Microfluidics and lab-on-chip are two progressive technologies widely used for drug discovery, screening and delivery. It has been designed in a way to act as a platform for sample preparations, culturing, incubation and screening through multi-channels. These devices require a small amount of reagent in about micro- to nanolitre volume. Microfluidics has the capacity to perform operations in a programmable manner and is easy to fine tune the size, shape and composition of drugs by changing flow rate and precise manipulations. Microfluidics platform comes with the advantage of mixing fluid in droplet reactors. Microfluidics is used in the field of chemistry, biomedical, biology and nanotechnology due to its high-throughput performance in various assays. It is potent enough to be used in microreactors for synthesis of particles and encapsulation of many biological entities for biological and drug delivery applications. Microfluidics therefore has the scope to be uplifted from basic to advanced diagnostic and therapeutic applications.

Catalytic C-H aerobic and oxidant-induced oxidation of alkylbenzenes (including toluene derivatives) over VO2+ immobilized on core-shell Fe3O4@SiO2 at room temperature in water

Direct C–H bond oxidation of organic materials, and producing the necessary oxygenated compounds under mild conditions, has attracted increasing interest. The selective oxidation of various alkylbenzenes was carried out by means of a new catalyst containing VO²⁺ species supported on silica-coated Fe₃O₄ nanoparticles using t-butyl hydroperoxide as an oxidant at room temperature in H₂O or solvent-free media. The chemical and structural characterization of the catalyst using several methods such as FTIR spectroscopy, XRD, FETEM, FESEM, SAED, EDX and XPS showed that VO²⁺ is covalently bonded to the silica surface. High selectivity and excellent conversion of various toluene derivatives, with less reactive aliphatic (sp³) C–H bonds, to related benzoic acids were quite noticeable. The aerobic oxygenation reaction of these alkylbenzenes was studied under the same conditions. All the results accompanied by sustainability of the inexpensive and simple magnetically separable heterogeneous catalyst proved the important criteria for commercial applications.

A highly efficient, recoverable, sustainable, economic and eco-friendly catalyst containing VO²⁺ species supported on SiO₂@Fe₃O₄ nanoparticles for selective oxidation of alkylbenzenes using TBHP or O₂ at room temperature in H₂O or solvent-free media.

Trends in Automobile Travel, Motor Vehicle Fatalities, and Physical Activity: 2003-2015

INTRODUCTION

Annual per-capita automobile travel declined by 600 miles from 2003 to 2014 with decreases greatest among young adults. This article tests whether the decline has been accompanied by public health co-benefits of increased physical activity and decreased motor vehicle fatalities.

METHODS

Minutes of auto travel and physical activity derived from active travel, sports, and exercise were obtained from the American Time Use Survey. Fatalities were measured using the Fatality Analysis Reporting System. Longitudinal change was assessed for adults aged 20-59 years by age group and sex. Significance of changes was assessed by absolute differences and unadjusted and adjusted linear trends. Analyses were conducted in 2016.

RESULTS

Daily auto travel decreased by 9.2 minutes from 2003 to 2014 for all ages (p<0.001) with the largest decrease among men aged 20-29 years (Δ= -21.7, p<0.001). No significant changes were observed in total minutes of physical activity. Motor vehicle occupant fatalities per 100,000 population showed significant declines for all ages (Δ=-5.8, p<0.001) with the largest for young men (Δ= -15.3, p<0.001). Fatalities per million minutes of auto travel showed only modest declines across age groups and, for men aged 20-29 years, varied from 10.9 (95% CI=10.0, 11.7) in 2003 to 9.7 (95% CI=8.7, 10.8) in 2014.

CONCLUSIONS

Reduced motor vehicle fatalities are a public health co-benefit of decreased driving, especially for male millennials. Despite suggestions to the contrary, individuals did not switch from cars to active modes nor spend more time in sports and exercise. Maintenance of the safety benefits requires additional attention to road safety efforts, particularly as auto travel increases.

Misinformation and Its Correction: Continued Influence and Successful Debiasing

The widespread prevalence and persistence of misinformation in contemporary societies, such as the false belief that there is a link between childhood vaccinations and autism, is a matter of public concern. For example, the myths surrounding vaccinations, which prompted some parents to withhold immunization from their children, have led to a marked increase in vaccine-preventable disease, as well as unnecessary public expenditure on research and public-information campaigns aimed at rectifying the situation. We first examine the mechanisms by which such misinformation is disseminated in society, both inadvertently and purposely. Misinformation can originate from rumors but also from works of fiction, governments and politicians, and vested interests. Moreover, changes in the media landscape, including the arrival of the Internet, have fundamentally influenced the ways in which information is communicated and misinformation is spread. We next move to misinformation at the level of the individual, and review the cognitive factors that often render misinformation resistant to correction. We consider how people assess the truth of statements and what makes people believe certain things but not others. We look at people's memory for misinformation and answer the questions of why retractions of misinformation are so ineffective in memory updating and why efforts to retract misinformation can even backfire and, ironically, increase misbelief. Though ideology and personal worldviews can be major obstacles for debiasing, there nonetheless are a number of effective techniques for reducing the impact of misinformation, and we pay special attention to these factors that aid in debiasing. We conclude by providing specific recommendations for the debunking of misinformation. These recommendations pertain to the ways in which corrections should be designed, structured, and applied in order to maximize their impact. Grounded in cognitive psychological theory, these recommendations may help practitioners-including journalists, health professionals, educators, and science communicators-design effective misinformation retractions, educational tools, and public-information campaigns.

Sustainable emergency medical service systems: how much energy do we need?

OBJECTIVE

Modern emergency medical service (EMS) systems are vulnerable to both rising energy prices and potential energy shortages. Ensuring the sustainability of EMS systems requires an empirical understanding of the total energy requirements of EMS operations. This study was undertaken to determine the life cycle energy requirements of US EMS systems.

METHODS

Input-output-based energy requirement multipliers for the US economy were applied to the annual budgets for a random sample of 19 metropolitan or county-wide EMS systems. Calculated per capita energy requirements of the EMS systems were used to estimate nationwide EMS energy requirements, and the leading energy sinks of the EMS supply chain were determined.

RESULTS

Total US EMS-related energy requirements are estimated at 30 to 60 petajoules (10(15) J) annually. Direct ("scope 1") energy consumption, primarily in the form of vehicle fuels but also in the form of natural gas and heating oil, accounts for 49% of all EMS-related energy requirements. The energy supply chain-including system electricity consumption ("scope 2") as well as the upstream ("scope 3") energy required to generate and distribute liquid fuels and natural gas-accounts for 18% of EMS energy requirements. Scope 3 energy consumption in the materials supply chain accounts for 33% of EMS energy requirements. Vehicle purchases, leases, maintenance, and repair are the most energy-intense components of the non-energy EMS supply chain (23%), followed by medical supplies and equipment (21%).

CONCLUSION

Although less energy intense than other aspects of the US healthcare system, ground EMS systems require substantial amounts of energy each year.

Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices

External challenges to health systems, such as those caused by global economic, social and environmental changes, have received little attention in recent debates on health systems’ performance in low-and middle-income countries (LMICs). One such challenge in coming years will be increasing prices for petroleum-based products as production from conventional petroleum reserves peaks and demand steadily increases in rapidly-growing LMICs. Health systems are significant consumers of fossil fuels in the form of petroleum-based medical supplies; transportation of goods, personnel and patients; and fuel for lighting, heating, cooling and medical equipment. Long-term increases in petroleum prices in the global market will have potentially devastating effects on health sectors in LMICs who already struggle to deliver services to remote parts of their catchment areas. We propose the concept of “localization,” originating in the environmental sustainability literature, as one element of response to these challenges. Localization assigns people at the local level a greater role in the production of goods and services, thereby decreasing reliance on fossil fuels and other external inputs. Effective localization will require changes to governance structures within the health sector in LMICs, empowering local communities to participate in their own health in ways that have remained elusive since this goal was first put forth in the Alma-Ata Declaration on Primary Health Care in 1978. Experiences with decentralization policies in the decades following Alma-Ata offer lessons on defining roles and responsibilities, building capacity at the local level, and designing appropriate policies to target inequities, all of which can guide health systems to adapt to a changing environmental and energy landscape.

Higher energy prices are associated with diminished resources, performance and safety in Australian ambulance systems

OBJECTIVE

To evaluate the impact of changing energy prices on Australian ambulance systems.

METHODS

Generalised estimating equations were used to analyse contemporaneous and lagged relationships between changes in energy prices and ambulance system performance measures in all Australian State/Territory ambulance systems for the years 2000-2010. Measures included: expenditures per response; labour-to-total expenditure ratio; full-time equivalent employees (FTE) per 10,000 responses; average salary; median and 90th percentile response time; and injury compensation claims. Energy price data included State average diesel price, State average electricity price, and world crude oil price.

RESULTS

Changes in diesel prices were inversely associated with changes in salaries, and positively associated with changes in ambulance response times; changes in oil prices were also inversely associated with changes in salaries, as well with staffing levels and expenditures per ambulance response. Changes in electricity prices were positively associated with changes in expenditures per response and changes in salaries; they were also positively associated with changes in injury compensation claims per 100 FTE.

CONCLUSION

Changes in energy prices are associated with changes in Australian ambulance systems' resource, performance and safety characteristics in ways that could affect both patients and personnel. Further research is needed to explore the mechanisms of, and strategies for mitigating, these impacts. The impacts of energy prices on other aspects of the health system should also be investigated.

Framing peak petroleum as a public health problem: audience research and participatory engagement in the United States

Between December 2009 and January 2010, we conducted a nationally representative telephone survey of US adults (n = 1001; completion rate = 52.9%) to explore perceptions of risks associated with peak petroleum. We asked respondents to assess the likelihood that oil prices would triple over the next 5 years and then to estimate the economic and health consequences of that event. Nearly half (48%) indicated that oil prices were likely to triple, causing harm to human health; an additional 16% said dramatic price increases were unlikely but would harm health if they did occur. A large minority (44%) said sharp increases in oil prices would be "very harmful" to health. Respondents who self-identified as very conservative and those who were strongly dismissive of climate change were the respondents most likely to perceive very harmful health consequences.

Peak oil and health in low- and middle-income countries: impacts and potential responses

Peak oil refers to the predicted peak and subsequent decline in global production of petroleum products over the coming decades. We describe how peak oil will affect health, nutrition, and health systems in low- and middle-income countries along 5 pathways. The negative effects of peak oil on health and nutrition will be felt most acutely in the 58 low-income countries experiencing minimal or negative economic growth because of their patterns of sociopolitical, geographic, and economic vulnerability. The global health community needs to take additional steps to build resilience among the residents of low- and middle-income countries and maintain access to maternal and other health services in the face of predicted changes in availability and price of fossil fuels.

Petroleum and health care: evaluating and managing health care's vulnerability to petroleum supply shifts

Petroleum is used widely in health care-primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies-and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services.

Petroleum scarcity and public health: considerations for local health departments

Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and public health. Local health departments represent a critical yet highly vulnerable component of the public health infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local public health service approaches. We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential Public Health Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts.