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Sánchez González MP, Escribano Sotos F, Tejada Ponce Á. [Analysis of the determinants of cost savings in traffic accidents on interurban roads in Spain]. Rev Esp Salud Publica 2019; 93:e201911111. [PMID: 31719517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/31/2019] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE The increase in traffic accidents depends on multiple factors; it generates an economic and public health problem that must be analyzed jointly by agents involved in road safety. The aim of the work was to quantify the effect of various factors in the cost savings due to traffic accidents on interurban roads in Spain. METHODS It was analyzed, through a lineal regression with panel data model and in the period 2000-2017, how different factors affected cost savings due to the risk of mortality or injury avoided on Spanish interurban roads. RESULTS A 1% increase in traffic volume led to a reduction in costs per MVKT (million vehiclekilometres travelled) of €162.46 referring to the risk of mortality, €115.32 for serious injuries and €10.10 for mild injuries. This increase in unemployment caused a cost reduction of €31.43, €10.76 and €0.98, respectively. The same increase in the investment in replacement implied a reduction of these costs of €11 for any risk. A 1% increase in the ageing index led to an increase in costs of €276.83 in terms of mortality risk and €257.49 in terms of injury. Foreign tourism generated a cost of more than €40 for any risk. A 1% increase in GDP per capita led to an increase in costs of €155.50, €138.09 and €8.21 for defined risks. The points driving license led to an increase in costs of €785.50 per MVKR when referring to mortality risks. CONCLUSIONS Determining factors for cost savings: motorization rate, unemployment rate and investment in replacement interurban roads. Determining factors that increased costs: expiry of the effect of the penalty - points driving licence, ageing index of the population, increase in GDP or proportion of foreign travelers.
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Affiliation(s)
| | - Francisco Escribano Sotos
- Facultad de Ciencias Económicas y Empresariales. Universidad de Castilla - La Mancha. Albacete. España
| | - Ángel Tejada Ponce
- Facultad de Ciencias Económicas y Empresariales. Universidad de Castilla - La Mancha. Albacete. España
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Zapata ME, Rovirosa A, Carmuega E. [Urban and rural: differences in the diet of Argentine households according to income level and area of residence]. Salud Colect 2019; 15:e2201. [PMID: 31829400 DOI: 10.18294/sc.2019.2201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/05/2019] [Accepted: 06/18/2019] [Indexed: 11/24/2022] Open
Abstract
The environment and the socioeconomic level are determinants of eating behavior because they affect availability, accessibility and food preferences. In order to describe the apparent consumption of food and the availability of energy and nutrients in urban and rural households in Argentina according to their income level, the 2004-2005 National Household Expenditure Survey was analyzed. The average apparent consumption of food and beverages was calculated in grams or milliliters of net weight per adult equivalent per day, for urban and rural households, and by household income per capita quintiles. Rural households made up 7% of the sample, and had a higher proportion of low-income families than urban households. There is different pattern of apparent consumption of food and beverages among rural and urban households in Argentina, and there are also differences between households according to the level of income in both environments. Knowing the content and magnitude of these contrasts is of great use in looking for strategies to improve the population's diet.
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Affiliation(s)
- María Elisa Zapata
- Magíster en Nutrición Humana y Calidad de los Alimentos. Investigadora adjunta, Centro de Estudios sobre Nutrición Infantil Dr. Alejandro O'Donnell (CESNI), Ciudad Autónoma de Buenos Aires, Argentina.
| | - Alicia Rovirosa
- Bioquímica. Investigadora adjunta, Centro de Estudios sobre Nutrición Infantil Dr. Alejandro O'Donnell (CESNI), Ciudad Autónoma de Buenos Aires, Argentina.
| | - Esteban Carmuega
- Médico Pediatra. Director, Centro de Estudios sobre Nutrición Infantil Dr. Alejandro O'Donnell (CESNI), Ciudad Autónoma de Buenos Aires, Argentina.
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Rock K, Hayward RD, Edhayan E. Obesity and hospital outcomes following traumatic injury: Associations in 9 years of patient data from a single metropolitan area. Clin Obes 2019; 9:e12293. [PMID: 30657640 DOI: 10.1111/cob.12293] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/19/2018] [Accepted: 12/06/2018] [Indexed: 02/06/2023]
Abstract
Traumatic injury is a leading cause of death and disability worldwide. Obesity may put trauma patients at risk for complications leading to negative clinical outcomes. Data on all hospital admissions due to traumatic injury in the Detroit metropolitan area between 2006 and 2014 were obtained from the Michigan State Inpatient Database. Generalized linear modelling was used to compare patients with and without obesity on three outcomes: mortality, length of hospital stay and total charges for care. Adjusting for demographics, patients with obesity had 26% longer hospitalization. Adjusting for demographics and length of stay, charges were 8% higher. Obesity was unrelated to mortality. Obesity had greater impact on length of stay among younger adults; its relationship with charges emerged only among older adults. Obesity has significant clinical implications for trauma care. Demands for trauma care resources, and the charges associated with providing care, are likely to increase as obesity rates rise.
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Affiliation(s)
- Kathryn Rock
- Department of Surgery, Ascension St. John Hospital, Detroit, MI, USA
| | - Richard D Hayward
- Department of Surgery, Ascension St. John Hospital, Detroit, MI, USA
| | - Elango Edhayan
- Department of Surgery, Ascension St. John Hospital, Detroit, MI, USA
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Campeau L, Degroote S, Ridde V, Carabali M, Zinszer K. Containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings: a scoping review. Infect Dis Poverty 2018; 7:95. [PMID: 30173673 PMCID: PMC6120079 DOI: 10.1186/s40249-018-0478-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The emergence and re-emergence of vector-borne and other infectious diseases of poverty pose a threat to the health of populations living in urban and low-income settings. A detailed understanding of intervention strategies, including effectiveness of past outbreak containment, is necessary to improve future practices. The objective was to determine what is known about the effectiveness of containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings and identify research gaps and implications for public health practice. MAIN BODY We conducted a scoping review and systematically searched peer-reviewed and grey literature published between 2000 and 2016. Different data extraction tools were used for data coding and extraction, and data on implementation process and transferability were extracted from all studies. A quality assessment was conducted for each included study. We screened 205 full-text articles and reports for a total of 31 articles included in the review. The quality of the studies was generally low to moderate. The largest body of evidence concerned control activities for Ebola virus and dengue fever. The majority of interventions (87%) relied on multiple types of measures, which were grouped into four categories: 1) healthcare provision; 2) epidemiological investigation and/or surveillance; 3) environmental or sanitary interventions; and 4) community-based interventions. The quality of the majority of studies (90%) was poor or moderate, and one-third of the studies did not provide a clear description of the outcomes and of the procedures and/or tools used for the intervention. CONCLUSIONS Our results highlight the difficulty of establishing causation when assessing the effect of containment measures. Studies that extend beyond solely reporting on effectiveness and take into account the complexity of real-world settings are urgently needed. We recommend the allocation of research efforts to the evaluation of the implementation processes of interventions as well as their comprehensive and systematic description using validated checklists.
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Affiliation(s)
- Laurence Campeau
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada
| | - Stéphanie Degroote
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada.
| | - Valery Ridde
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada
- French Institute For Research on sustainable Development (IRD), IRD-Paris Descartes University (CEPED), Paris Sorbonne Cités University, Erl Inserm Sagesud, Paris, France
| | | | - Kate Zinszer
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada
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Otmani del Barrio M, Simard F, Caprara A. Supporting and strengthening research on urban health interventions for the prevention and control of vector-borne and other infectious diseases of poverty: scoping reviews and research gap analysis. Infect Dis Poverty 2018; 7:94. [PMID: 30173669 PMCID: PMC6120070 DOI: 10.1186/s40249-018-0462-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than half of the world's population currently lives in urban settlements that grow both in size and number. By 2050, approximately 70% of the global population will be living in urban conglomerations, mainly in low- and middle-income countries. Mobility, poverty, different layers of inequalities as well as climate variability and change are some of the social and environmental factors that influence the exposure of human populations in urban settings to vector-borne diseases, which pose eminent public health threats. Accurate, consistent, and evidence-based interventions for prevention and control of vector-borne and other infectious diseases of poverty in urban settings are needed to implement innovative and cost-effective public policy and to promote inclusive and equitable urban health services. MAIN BODY While there is growing awareness of vector-borne diseases epidemiology at the urban level, there is still a paucity of research and action being undertaken in this area, hindering evidence-based public health policy decisions and practice and strategies for active community engagement. This paper describes the collaboration and partnership of the Special Programme for Research and Training in Tropical Diseases (TDR) hosted by the World Health Organization (WHO) and the "VEctor boRne DiseAses Scoping reviews" (VERDAS) Research Consortium as they joined efforts in response to filling this gap in knowledge and evidence by supporting the development of a series of scoping reviews that highlight priority research gaps and policy implications to address vector-borne and other infectious diseases at the urban level. CONCLUSIONS The set of scoping reviews proposed in this special issue presents a critical analysis of the state-of-the-art of research on urban health interventions for the prevention and control of vector-borne and other infectious diseases of poverty. The authors of the 6 reviews highlighted severe gaps in knowledge and identified organizational and theoretical limitations that need to be urgently tackled to improve cities preparedness and vector control response. The more pressing need at present is to ensure that more implementation research on vector-borne diseases in urban settings is conducted, addressing policy and practice implications and calling for more political commitment and social mobilization through adequate citizen engagement strategies.
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Affiliation(s)
- Mariam Otmani del Barrio
- Vectors, Environment and Society Unit, Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization (WHO), 20, avenue Appia, CH-1211 Geneva 27, Switzerland
| | - Frédéric Simard
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Controle (MIVEGEC), IRD-CNRS University of Montpellier, Montpellier, France
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Osorio L, Garcia JA, Parra LG, Garcia V, Torres L, Degroote S, Ridde V. A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas. Infect Dis Poverty 2018; 7:87. [PMID: 30173662 PMCID: PMC6120097 DOI: 10.1186/s40249-018-0474-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/01/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Health personnel face challenges in diagnosing vector-borne and other diseases of poverty in urban settings. There is a need to know what rapid diagnostic technologies are available, have been properly assessed, and are being implemented to improve control of these diseases in the urban context. This paper characterizes evidence on the field validation and implementation in urban areas of rapid diagnostics for vector-borne diseases and other diseases of poverty. MAIN BODY A scoping review was conducted. Peer-reviewed and grey literature were searched using terms describing the targeted infectious diseases, diagnostics evaluations, rapid tests, and urban setting. The review was limited to studies published between 2000 and 2016 in English, Spanish, French, and Portuguese. Inclusion and exclusion criteria were refined post hoc to identify relevant literature regardless of study design and geography. A total of 179 documents of the 7806 initially screened were included in the analysis. Malaria (n = 100) and tuberculosis (n = 47) accounted for the majority of studies that reported diagnostics performance, impact, and implementation outcomes. Fewer studies, assessing mainly performance, were identified for visceral leishmaniasis (n = 9), filariasis and leptospirosis (each n = 5), enteric fever and schistosomiasis (each n = 3), dengue and leprosy (each n = 2), and Chagas disease, human African trypanosomiasis, and cholera (each n = 1). Reported sensitivity of rapid tests was variable depending on several factors. Overall, specificities were high (> 80%), except for schistosomiasis and cholera. Impact and implementation outcomes, mainly acceptability and cost, followed by adoption, feasibility, and sustainability of rapid tests are being evaluated in the field. Challenges to implementing rapid tests range from cultural to technical and administrative issues. CONCLUSIONS Rapid diagnostic tests for vector-borne and other diseases of poverty are being used in the urban context with demonstrated impact on case detection. However, most evidence comes from malaria rapid diagnostics, with variable results. While rapid tests for tuberculosis and visceral leishmaniasis require further implementation studies, more evidence on performance of current tests or development of new alternatives is needed for dengue, Chagas disease, filariasis, leptospirosis, enteric fever, human African trypanosomiasis, schistosomiasis and cholera.
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Affiliation(s)
- Lyda Osorio
- Epidemiology and Population Health Research Group, School of Public Health, Universidad del Valle, Calle 4B No. 36-00 Edif 118 Escuela de Salud Pública, Universidad del Valle Campus San Fernando, Cali, Colombia
| | - Jonny Alejandro Garcia
- Epidemiology and Population Health Research Group, School of Public Health, Universidad del Valle, Calle 4B No. 36-00 Edif 118 Escuela de Salud Pública, Universidad del Valle Campus San Fernando, Cali, Colombia
- School of Medicine, Universidad del Valle, Cali, Colombia
| | - Luis Gabriel Parra
- Epidemiology and Population Health Research Group, School of Public Health, Universidad del Valle, Calle 4B No. 36-00 Edif 118 Escuela de Salud Pública, Universidad del Valle Campus San Fernando, Cali, Colombia
- School of Medicine, Universidad del Valle, Cali, Colombia
| | - Victor Garcia
- Epidemiology and Population Health Research Group, School of Public Health, Universidad del Valle, Calle 4B No. 36-00 Edif 118 Escuela de Salud Pública, Universidad del Valle Campus San Fernando, Cali, Colombia
| | - Laura Torres
- Epidemiology and Population Health Research Group, School of Public Health, Universidad del Valle, Calle 4B No. 36-00 Edif 118 Escuela de Salud Pública, Universidad del Valle Campus San Fernando, Cali, Colombia
| | - Stéphanie Degroote
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Canada
| | - Valéry Ridde
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Canada
- French Institute for Research on Sustainable Development (IRD), Paris Descartes University, Population and Development Center (CEPED), Université Paris Sorbonne Cité, National Institute of Health and Medical Research (INSERM), Health, Vulnerabilities and Gender Relations South (SAGESUD), Paris, France
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Degroote S, Bermudez-Tamayo C, Ridde V. Approach to identifying research gaps on vector-borne and other infectious diseases of poverty in urban settings: scoping review protocol from the VERDAS consortium and reflections on the project's implementation. Infect Dis Poverty 2018; 7:98. [PMID: 30173674 PMCID: PMC6120063 DOI: 10.1186/s40249-018-0479-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper presents the overall approach undertaken by the "VEctor boRne DiseAses Scoping reviews" (VERDAS) consortium in response to a call issued by the Vectors, Environment and Society unit of the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization. The aim of the project was to undertake a broad knowledge synthesis and identify knowledge gaps regarding the control and prevention of vector-borne diseases in urban settings. METHODS The consortium consists of 14 researchers, 13 research assistants, and one research coordinator from seven different institutions in Canada, Colombia, Brazil, France, Spain, and Burkina Faso. A six-step protocol was developed for the scoping reviews undertaken by the consortium, based on the framework developed by Arksey and O'Malley and improved by Levac et al. In the first step, six topics were identified through an international eDelphi consultation. In the next four steps, the scoping reviews were conducted. The sixth step was the VERDAS workshop held in Colombia in March 2017. DISCUSSION In this article, we discuss several methodological issues encountered and share our reflections on this work. We believe this protocol provides a strong example of an exhaustive and rigorous process for performing broad knowledge synthesis for any given topic and should be considered for future research initiatives and donor agendas in multiple fields to highlight research needs scientifically.
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Affiliation(s)
- Stéphanie Degroote
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada.
| | - Clara Bermudez-Tamayo
- Andalusian School of Public Health, Granada, Spain
- Biomedical Research Network Centre for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Valéry Ridde
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada
- French Institute for Research on Sustainable Development (IRD), Paris Descartes University (CEPED), Paris Sorbonne Cities University, Erl Inserm Sagesud, Paris, France
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Yang Y, Luo L, Song C, Yin H, Yang J. Spatiotemporal Assessment of PM 2.5-Related Economic Losses from Health Impacts during 2014⁻2016 in China. Int J Environ Res Public Health 2018; 15:ijerph15061278. [PMID: 29914184 PMCID: PMC6024949 DOI: 10.3390/ijerph15061278] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 06/06/2018] [Accepted: 06/14/2018] [Indexed: 01/02/2023]
Abstract
Background: Particulate air pollution, especially PM2.5, is highly correlated with various adverse health impacts and, ultimately, economic losses for society, however, few studies have undertaken a spatiotemporal assessment of PM2.5-related economic losses from health impacts covering all of the main cities in China. Methods: PM2.5 concentration data were retrieved for 190 Chinese cities for the period 2014–2016. We used a log-linear exposure–response model and monetary valuation methods, such as value of a statistical life (VSL), amended human capital (AHC), and cost of illness to evaluate PM2.5-related economic losses from health impacts at the city level. In addition, Monte Carlo simulation was used to analyze uncertainty. Results: The average economic loss was 0.3% (AHC) to 1% (VSL) of the total gross domestic product (GDP) of 190 Chinese cities from 2014 to 2016. Overall, China experienced a downward trend in total economic losses over the three-year period, but the Beijing–Tianjin–Hebei, Shandong Peninsula, Yangtze River Delta, and Chengdu-Chongqing regions experienced greater annual economic losses. Conclusions: Exploration of spatiotemporal variations in PM2.5-related economic losses from long-term health impacts could provide new information for policymakers regarding priority areas for PM2.5 pollution prevention and control in China.
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Affiliation(s)
- Yang Yang
- School of Geoscience and Technology, Southwest Petroleum University, Chengdu 610500, China.
| | - Liwen Luo
- School of Geoscience and Technology, Southwest Petroleum University, Chengdu 610500, China.
| | - Chao Song
- School of Geoscience and Technology, Southwest Petroleum University, Chengdu 610500, China.
- State Key Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing 100875, China.
- Department of Geography, Dartmouth College, Hanover, NH 03755, USA.
| | - Hao Yin
- State Key Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing 100875, China.
- Department of Planning, Danish Centre for Environmental Assessment, Aalborg University, Rendsburggade 14, 9000 Aalborg, Denmark.
| | - Jintao Yang
- School of Geoscience and Technology, Southwest Petroleum University, Chengdu 610500, China.
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Abstract
How to effectively solve traffic congestion and transportation pollution in urban development is a main research emphasis for transportation management agencies. A carbon emissions tax can affect travelers’ generalized costs and will lead to changes in passenger demand, mode choice and traffic flow equilibrium in road networks, which are of significance in green travel and low-carbon transportation management. This paper first established a mesoscopic model to calculate the carbon emissions tax and determined the value of this charge in China, which was based on road traffic flow, vehicle speed, and carbon emissions. Referring to existing research results to calibrate the value of time, this paper modified the traveler’s generalized cost function, including the carbon emissions tax, fuel surcharge and travel time cost, which can be used in the travel impedance model with the consideration of the carbon emissions tax. Then, a method for analyzing urban road network traffic flow distribution was put forward, and a joint traffic distribution model was established, which considered the relationship between private cars and taxis. Finally, this paper took the city of Panjin as an example to analyze the road traffic carbon emissions tax’s impact. The results illustrated that the carbon emissions tax has a positive effect on road network flow equilibrium and carbon emission reduction. This paper will have good reference value and practical significance for the calculation and implementation of urban traffic carbon emissions taxes in China.
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Affiliation(s)
- Longhai Yang
- School of Transportation Science and Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Xiaowei Hu
- School of Transportation Science and Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, China
- * E-mail:
| | - Lin Fang
- Shanghai Municipal Planning Design Research Institute, Shanghai, China
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Abstract
The primary goals of the study were a critical analysis of the concepts associated with health from the perspective of sustainable development, and empirical analysis of health and health- related issues among the rural and urban residents of Eastern Poland in the context of the sustainable development of the region. The study was based on the following research methods: a systemic approach, selection and analysis of the literature and statistical data, developing a special questionnaire concerning socio-economic and health inequalities among the population in the studied area, field research with an interview questionnaire conducted on randomly-selected respondents (N=1,103) in randomly selected areas of the Lubelskie, Podkarpackie, Podlaskie and eastern part of Mazowieckie Provinces (with the division between provincial capital cities - county capital cities - other cities - rural areas). The results of statistical surveys in the studied area with the use of chi-square test and contingence quotients indicated a correlation between the state of health and the following independent variables: age, life quality, social position and financial situation (C-Pearson's coefficient over 0,300); a statistically significant yet weak correlation was recorded for gender, household size, place of residence and amount of free time. The conducted analysis proved the existence of a huge gap between state of health of the population in urban and rural areas. In order to eliminate unfavourable differences in the state iof health among the residents of Eastern Poland, and provide equal sustainable development in urban and rural areas of the examined areas, special preventive programmes aimed at the residents of peripheral, marginalized rural areas should be implemented. In these programmes, attention should be paid to preventive measures, early diagnosis of basic civilization and social diseases, and better accessibility to medical services for the residents.
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Affiliation(s)
- Viktoriya Pantyley
- School of Socio-Economic Geography Department of Earth Sciences and Spatial Management Maria Curie-Sklodowska University in Lublin, Poland
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McCrory C, White CM, Bowman C, Fenton N, Reid JL, Hammond D. Perceptions and Knowledge of Caffeinated Energy Drinks: Results of Focus Groups With Canadian Youth. J Nutr Educ Behav 2017; 49:304-311.e6. [PMID: 28162866 DOI: 10.1016/j.jneb.2016.11.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 11/22/2016] [Accepted: 11/28/2016] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine use, knowledge, and perceptions of caffeinated energy drinks (CEDs) among youth. DESIGN Qualitative research using focus group discussions (n = 4). SETTING Two Canadian cities (Toronto and Montreal). PARTICIPANTS Youth aged 12-18 years (n = 41). PHENOMENON OF INTEREST Perceived definitions of CEDs, reasons for use, knowledge of health effects, use with alcohol, marketing perceptions, and use and understanding of cautionary statements on packaging. ANALYSIS Data were analyzed using a modified grounded-theory approach. RESULTS Youth identified CEDs as products that provide energy and contain caffeine and sugar. Compared with mainstream CED brands and energy shots, youth were less likely to perceive Gatorade, Coca-Cola, and a Starbucks beverage as energy drinks, despite some ambiguity. The majority of participants believed that CEDs, including mixed with alcohol, were not necessarily harmful in moderation and that marketing was targeted toward older youth and young adults. Awareness of cautionary statements on CEDs was low; cautionary statements were perceived as difficult to find and read owing to the design and small font. CONCLUSIONS AND IMPLICATIONS Findings suggest a need to increase public education regarding the potential risks of CED consumption, including enhancements to the mandated cautionary statements, with greater attention to the impact of CED marketing on youth.
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Affiliation(s)
- Cassondra McCrory
- School of Public Health and Health Systems, University of Waterloo, Canada
| | - Christine M White
- School of Public Health and Health Systems, University of Waterloo, Canada
| | - Carolyn Bowman
- School of Public Health and Health Systems, University of Waterloo, Canada
| | - Nancy Fenton
- School of Public Health and Health Systems, University of Waterloo, Canada
| | - Jessica L Reid
- Propel Centre for Population Health Impact, University of Waterloo, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Canada.
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Machín L, Cabrera M, Curutchet MR, Martínez J, Giménez A, Ares G. Consumer Perception of the Healthfulness of Ultra-processed Products Featuring Different Front-of-Pack Nutrition Labeling Schemes. J Nutr Educ Behav 2017; 49:330-338.e1. [PMID: 28185813 DOI: 10.1016/j.jneb.2016.12.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/08/2016] [Accepted: 12/12/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine the influence of front-of-pack nutrition information on the perception of healthfulness of ultra-processed products across 2 income levels. DESIGN A between-participants design was used to compare healthfulness perception of ultra-processed products featuring different front-of-pack nutrition information schemes (guideline daily amount system, traffic light system, and monochromatic traffic light system). PARTICIPANTS A total of 300 people (aged 18-70 years, 75% female) from Montevideo, Uruguay, participated in the study; half were middle- or high-income people and the other half were low-income people. MAIN OUTCOME MEASURES Participants were shown the labels of each product and asked to rate their perceived healthfulness and the frequency with which each product should be consumed. ANALYSIS Results were analyzed using analysis of variance for statistical significance (P < .05). RESULTS Low-income participants perceived ultra-processed products to be significantly (P < .05) more healthful than did middle- and high-income participants. The lowest perceived healthfulness scores for low-income participants were obtained for products featuring the colored and monochromatic traffic light system whereas no significant differences (P > .05) among schemes were found for middle- and high-income participants. CONCLUSIONS AND IMPLICATIONS Nutrition education programs aimed at increasing low-income people's knowledge of the nutritional composition of these products and their potential negative effects on health seem to be necessary. Although the inclusion of semidirective front-of-pack nutrition information decreased the perceived healthfulness of low-income people, it seemed unlikely to influence how they perceive these products.
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Affiliation(s)
- Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Manuel Cabrera
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | | | | | - Ana Giménez
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay; Sensometría y Ciencia del Consumidor, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Canelones, Uruguay
| | - Gastón Ares
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay; Sensometría y Ciencia del Consumidor, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Canelones, Uruguay.
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Silveira C, Roebeling P, Lopes M, Ferreira J, Costa S, Teixeira JP, Borrego C, Miranda AI. Assessment of health benefits related to air quality improvement strategies in urban areas: An Impact Pathway Approach. J Environ Manage 2016; 183:694-702. [PMID: 27641656 DOI: 10.1016/j.jenvman.2016.08.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/09/2016] [Accepted: 08/30/2016] [Indexed: 06/06/2023]
Abstract
Air pollution is, increasingly, a concern to our society given the threats to human health and the environment. Concerted actions to improve air quality have been taken at different levels, such as through the development of Air Quality Plans (AQPs). However, air quality impacts associated with the implementation of abatement measures included in AQPs are often neglected. In order to identify the major gaps and strengths in current knowledge, a literature review has been performed on existing methodologies to estimate air pollution-related health impacts and subsequent external costs. Based on this review, the Impact Pathway Approach was adopted and applied within the context of the MAPLIA research project to assess the health impacts and benefits (or avoided external costs) derived from improvements in air quality. Seven emission abatement scenarios, based on individual and combined abatement measures, were tested for the major activity sectors (traffic, residential and industrial combustion and production processes) of a Portuguese urban area (Grande Porto) with severe particular matter (PM10) air pollution problems. Results revealed a strong positive correlation between population density and health benefits obtained from the assessed reduction scenarios. As a consequence, potential health benefits from reduction scenarios are largest in densely populated areas with high anthropic activity and, thus, where air pollution problems are most alarming. Implementation of all measures resulted in a reduction in PM10 emissions by almost 8%, improving air quality by about 1% and contributing to a benefit of 8.8 million €/year for the entire study domain. The introduction of PM10 reduction technologies in industrial units was the most beneficial abatement measure. This study intends to contribute to policy support for decision-making on air quality management.
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Affiliation(s)
- Carlos Silveira
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - Peter Roebeling
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Myriam Lopes
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Joana Ferreira
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Solange Costa
- EPIUnit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; National Institute of Health, Environmental Health Department, 4000-055 Porto, Portugal
| | - João P Teixeira
- EPIUnit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; National Institute of Health, Environmental Health Department, 4000-055 Porto, Portugal
| | - Carlos Borrego
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ana I Miranda
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
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Barker AR, Kemper LM, McBride TD, Meuller KJ. Health Insurance Marketplaces: Premium Trends in Rural Areas. Rural Policy Brief 2016:1-4. [PMID: 27416649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Since 2014, when the Health Insurance Marketplaces (HIMs) authorized by the Patient Protection and Affordable Care Act (ACA) were implemented, considerable premium changes have been observed in the marketplaces across the 50 states and the District of Columbia. This policy brief assesses the changes in average HIM plan premiums from 2014 to 2016, before accounting for subsidies, with an emphasis on the widening variation across rural and urban places. Since this brief focuses on premiums without accounting for subsidies, this is not intended to be an analysis of the "affordability" of ACA premiums, as that would require assessment of premiums, cost-sharing adjustments, and other factors.
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Workneh MH, Bjune GA, Yimer SA. Assessment of health system challenges and opportunities for possible integration of diabetes mellitus and tuberculosis services in South-Eastern Amhara Region, Ethiopia: a qualitative study. BMC Health Serv Res 2016; 16:135. [PMID: 27095028 PMCID: PMC4837556 DOI: 10.1186/s12913-016-1378-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/12/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The double burden of tuberculosis (TB) and diabetes mellitus (DM) is a significant public health problem in low and middle income countries. However, despite the known synergy between the two disease conditions, services for TB and DM have separately been provided. The objective of this study was to explore health system challenges and opportunities for possible integration of DM and TB services. METHODS This was a descriptive qualitative study which was conducted in South-Eastern Amhara Region, Ethiopia. Study participants included health workers (HWs), program managers and other stakeholders involved in TB and DM prevention and control activities. Purposive sampling was applied to select respondents. In order to capture diversity of opinions among participants, maximum variation sampling strategy was applied in the recruitment of study subjects. Data were collected by conducting four focus group discussions and 12 in-depth interviews. Collected data were transcribed verbatim and were thematically analyzed using NVivo 10 software program. RESULT A total of 44 (12 in-depth interviews and 32 focus group discussion) participants were included in the study. The study participants identified a number of health system challenges and opportunities affecting the integration of TB-DM services. The main themes identified were: 1. Unavailability of system for continuity of DM care. 2. Inadequate knowledge and skills of health workers. 3. Frequent stockouts of DM supplies. 4. Patient's inability to pay for DM services. 5. Poor DM data management. 6. Less attention given to DM care. 7. Presence of a well-established TB control program up to the community level. 8. High level of interest and readiness among HWs, program managers and leaders at different levels of the health care delivery system. CONCLUSION The study provided insights into potential health systems challenges and opportunities that need to be considered in the integration of TB-DM services. Piloting TB and DM integrated services in selected HFs of the study area is needed to assess feasibility for possible full scale integration of services for the two comorbid conditions.
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Affiliation(s)
- Mahteme Haile Workneh
- />Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- />Amhara Regional State Health Bureau, Bahir-Dar, Ethiopia
| | - Gunnar Aksel Bjune
- />Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Solomon Abebe Yimer
- />Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- />Amhara Regional State Health Bureau, Bahir-Dar, Ethiopia
- />Department of Microbiology, Oslo University Hospital, Oslo, Norway
- />Department of Bacteriology and Immunology, Norwegian Institute of Public Health, Oslo, Norway
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Thalagala N, Tissera H, Palihawadana P, Amarasinghe A, Ambagahawita A, Wilder-Smith A, Shepard DS, Tozan Y. Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka. PLoS Negl Trop Dis 2016; 10:e0004466. [PMID: 26910907 PMCID: PMC4766086 DOI: 10.1371/journal.pntd.0004466] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 01/26/2016] [Indexed: 12/29/2022] Open
Abstract
Background Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. Methods We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health’s perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. Results The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216–609 for pediatric cases and between US$196–866 for adult cases according to disease severity and treatment setting. Conclusions This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka. Dengue is a major public health problem affecting more than half of the world’s population living in tropical and subtropical regions of the world. The disease is estimated to place a heavy socio-economic burden on households, health care systems, and governments, particularly during outbreaks; however, country-specific reliable estimates of burden of disease and cost data are limited. This study estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo district—the most heavily populated and urbanized district in Sri Lanka—during the epidemic year of 2012 from the Ministry of Health’s perspective. Results revealed that the Ministry’s cost of dengue control and hospitalizations totaled US$3.45 million (US$1.50 per capita), of which US$971,360 (US$0.42 per capita) was for dengue control activities. Personnel costs accounted for the largest shares of the costs of dengue control activities (79%) and of hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs of hospitalization ranged between US$216–609 for pediatric cases and between US$196–866 for adult cases according to disease severity and treatment setting. These results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka.
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Affiliation(s)
- Neil Thalagala
- National Child Health Programme, Family Health Bureau, Ministry of Health, Colombo, Sri Lanka
| | - Hasitha Tissera
- Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka
- National Dengue Control Unit, Colombo, Sri Lanka
| | | | | | | | - Annelies Wilder-Smith
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Donald S. Shepard
- Brandeis University, The Heller School for Social Policy and Management, Waltham, Massachusetts, United States of America
| | - Yeşim Tozan
- Institute of Public Health, Heidelberg University Medical School, Heidelberg, Germany
- College of Global Public Health, New York University, New York, New York, United States of America
- * E-mail:
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Hagan JE, Moraga P, Costa F, Capian N, Ribeiro GS, Wunder EA, Felzemburgh RDM, Reis RB, Nery N, Santana FS, Fraga D, dos Santos BL, Santos AC, Queiroz A, Tassinari W, Carvalho MS, Reis MG, Diggle PJ, Ko AI. Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil. PLoS Negl Trop Dis 2016; 10:e0004275. [PMID: 26771379 PMCID: PMC4714915 DOI: 10.1371/journal.pntd.0004275] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 11/11/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent. METHODOLOGY/PRINCIPAL FINDINGS We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003-2007) and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86%) individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7-40.6) per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00-2.16), contact with mud (OR 1.57, 95% CI 1.17-2.17) and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82-1.04). The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific "hot-spots" consistently had higher transmission risk during study years. CONCLUSIONS/SIGNIFICANCE The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings indicate that topographic factors such as household elevation and inadequate drainage increase risk by promoting contact with mud and suggest that the soil-water interface serves as the environmental reservoir for spillover transmission. The use of a spatiotemporal approach allowed the identification of geographic outliers with unexplained risk patterns. This approach, in addition to guiding targeted community-based interventions and identifying new hypotheses, may have general applicability towards addressing environmentally-transmitted diseases that have emerged in complex urban slum settings.
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Affiliation(s)
- José E. Hagan
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Paula Moraga
- Division of Medicine, Lancaster University, Lancaster, United Kingdom
| | - Federico Costa
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saude Coletiva, Federal University of Bahia, Salvador, Brazil
| | - Nicolas Capian
- Division of Medicine, Lancaster University, Lancaster, United Kingdom
| | - Guilherme S. Ribeiro
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saude Coletiva, Federal University of Bahia, Salvador, Brazil
| | - Elsio A. Wunder
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | | | - Renato B. Reis
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Nivison Nery
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Francisco S. Santana
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Deborah Fraga
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Balbino L. dos Santos
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Andréia C. Santos
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Adriano Queiroz
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Wagner Tassinari
- Escola Nacional da Saúde Pública, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro, Brazil
| | - Marilia S. Carvalho
- Escola Nacional da Saúde Pública, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro, Brazil
| | - Mitermayer G. Reis
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Peter J. Diggle
- Division of Medicine, Lancaster University, Lancaster, United Kingdom
| | - Albert I. Ko
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
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Khopkar S, Kulathinal S, Virtanen SM, Säävälä M. Age at menarche and diet among adolescents in slums of Nashik, India. Int J Adolesc Med Health 2015; 27:451-456. [PMID: 25781516 DOI: 10.1515/ijamh-2014-0056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/01/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND AIM The role of dietary patterns in determining age at menarche is insufficiently understood in low-income countries. The relationship between dietary patterns, particularly the consumption of oil, and age at menarche in a slum-dwelling adolescent population in India is examined. METHODS Data were derived from a cross-sectional baseline survey and anthropometric measurements among 10- to 19-year-old adolescents (n=545, female respondents 272, of whom 160 were post-menarcheal) and a household survey in two slums in the city of Nashik, Western India. By using mixed effects linear regression models, the association between age at menarche and household-wise use of sources of animal protein and oil and fat is examined. RESULTS Age at menarche (mean 13.7 years) in the slums studied was relatively high according to Indian standards. Age at menarche and the consumption of dairy products, meat, fish and eggs were not associated. The household per capita consumption of vegetable oil had an inverse association with a girl's age at menarche, and there was an indication of a positive association between use of ghee (clarified butter) and age at menarche. These associations did not disappear when controlling for anthropometric status and socio-economic characteristics. CONCLUSION Intake of fats and foods that are important sources of protein among underprivileged households in India is low and reflected in the relatively late age at menarche. The potential differences in the association between various types of fatty acids, energy intake and age at menarche in conditions of undernutrition requires further prospective study.
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Naidoo I, Charlton KE, Esterhuizen TM, Cassim B. High risk of malnutrition associated with depressive symptoms in older South Africans living in KwaZulu-Natal, South Africa: a cross-sectional survey. J Health Popul Nutr 2015; 33:19. [PMID: 26825267 PMCID: PMC5026002 DOI: 10.1186/s41043-015-0030-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/02/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Malnutrition contributes to functional and cognitive decline in older adults, which results in decreased quality of life and loss of independence. This study aimed to identify determinants of nutritional risk among community-dwelling adults in KwaZulu-Natal, South Africa. METHODS A cross-sectional survey was undertaken in 1008 subjects aged 60 years and over who were randomly selected by systematic sampling. Demographics, socioeconomic data and self-reported history of medical conditions were recorded. The Mini Nutritional Assessment-Short Form (MNA-SF) was used to screen for nutritional risk, and the Centre for Epidemiologic Studies Depression scale was administered to all subjects. Descriptive statistics and the Pearson chi-square and Kruskal-Wallis tests were used for statistical analysis. Logistic regression modelling determined predictors of nutritional risk. RESULTS Of the 984 participants (mean age = 68.8 ± 7.4 years; range 60-103 years) who completed the MNA-SF, 51% were classified as having a normal nutritional status, 43.4% at risk for malnutrition and 5.5% classified as malnourished. Men were more likely to be either at risk for malnutrition or be malnourished than women (p = 0.008), as were subjects with a monthly household income of ≤R1600 per month (~133 USD) (p = 0.003). In logistic regression models, depressed people were 2.803 (p < 0.001) times more likely to be at risk or be malnourished than those not depressed. CONCLUSION A high prevalence of risk of malnutrition was identified in older South Africans living in an urban area with poor infrastructure. Further investigations are warranted to determine whether the higher prevalence of depressive symptomatology in nutritionally at risk individuals is a determinant or a consequence of malnutrition, in order to develop targeted nutritional interventions in this age group.
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Affiliation(s)
- I Naidoo
- Department of Geriatrics, University of KwaZulu-Natal, Durban, South Africa
| | - Karen E Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
| | - T M Esterhuizen
- Centre for Evidence Based Health Care, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - B Cassim
- Department of Geriatrics, University of KwaZulu-Natal, Durban, South Africa
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Abstract
Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health insurance schemes in fund level and benefit package. Political commitments, institutional innovations, and a feasible implementation plan are the major elements needed for success in consolidation. Achievement of universal health coverage in China needs systemic strategies including consolidation of the social health insurance schemes.
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Affiliation(s)
- Qingyue Meng
- China Centre for Health Development Studies, Peking University, Beijing, China.
| | - Hai Fang
- China Centre for Health Development Studies, Peking University, Beijing, China
| | - Xiaoyun Liu
- China Centre for Health Development Studies, Peking University, Beijing, China
| | - Beibei Yuan
- China Centre for Health Development Studies, Peking University, Beijing, China
| | - Jin Xu
- China Centre for Health Development Studies, Peking University, Beijing, China
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Brown J. Who bears the cost for the CPS dental program? CDS Rev 2015; 108:14-15. [PMID: 26591240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Tawara Y, Senjyu H, Tanaka K, Tanaka T, Asai M, Kozu R, Tabusadani M, Honda S, Sawai T. Value of systematic intervention for chronic obstructive pulmonary disease in a regional Japanese city based on case detection rate and medical cost. Int J Chron Obstruct Pulmon Dis 2015; 10:1531-42. [PMID: 26347397 PMCID: PMC4529261 DOI: 10.2147/copd.s82872] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE We established a COPD taskforce for early detection, diagnosis, treatment, and intervention. We implemented a pilot intervention with a prospective and longitudinal design in a regional city. This study evaluates the usefulness of the COPD taskforce and intervention based on COPD case detection rate and per capita medical costs. METHOD We distributed a questionnaire to all 8,878 inhabitants aged 50-89 years, resident in Matsuura, Nagasaki Prefecture in 2006. Potentially COPD-positive persons received a pulmonary function test and diagnosis. We implemented ongoing detection, examination, education, and treatment interventions, performed follow-up examinations or respiratory lessons yearly, and supported the health maintenance of each patient. We compared COPD medical costs in Matsuura and in the rest of Nagasaki Prefecture using data from 2004 to 2013 recorded by the association of Nagasaki National Health Insurance Organization, assessing 10-year means and annual change. RESULTS As of 2014, 256 people have received a definitive diagnosis of COPD; representing 31% of the estimated total number of COPD patients. Of the cases detected, 87.5% were mild or moderate in severity. COPD medical costs per patient in Matsuura were significantly lower than the rest of Nagasaki Prefecture, as was rate of increase in cost over time. CONCLUSION The COPD program in Matsuura enabled early detection and treatment of COPD patients and helped to lower the associated burden of medical costs. The success of this program suggests that a similar program could reduce the economic and human costs of COPD morbidity throughout Japan.
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Affiliation(s)
- Yuichi Tawara
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideaki Senjyu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kenichiro Tanaka
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takako Tanaka
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaharu Asai
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryo Kozu
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Mitsuru Tabusadani
- Center for Industry, University and Government Cooperation, Nagasaki University, Nagasaki, Japan
| | - Sumihisa Honda
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Terumitsu Sawai
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Abstract
OBJECTIVES While the benefits of Seguro Popular health insurance in Mexico relative to no insurance have been widely documented, little has been reported on its effects relative to the pre-existing Social Security health insurance. We analyse the effects of Social Security and Seguro Popular health insurances in Mexico on access to healthcare of older adults, and on financial risk protection to their households, compared with older adults without health insurance. SETTING Secondary data analysis was performed using the 2012 Mexican Survey of Health and Nutrition (ENSANUT). PARTICIPANTS The study population comprised 18,847 older adults and 13,180 households that have an elderly member. OUTCOME MEASURES The dependent variables were access to healthcare given the reported need, the financial burden imposed by health expenditures measured through catastrophic health-related expenditures, and using savings for health-related expenditures. Separate propensity score matching analyses were conducted for each comparison. The analysis for access was performed at the individual level, and the analysis for financial burden at the household level. In each case, matching on a wide set of relevant characteristics was achieved. RESULTS Seguro Popular showed a protective effect against lack of access to healthcare for older adults compared with those with no insurance. The average treatment effect on the treated (ATET) was ascertained through using the nearest-neighbour matching (-8.1%, t-stat -2.305) analysis. However, Seguro Popular did not show a protective effect against catastrophic expenditures in a household where an older adult lived. Social Security showed increased access to healthcare (ATET -11.3%, t-stat -3.138), and protective effect against catastrophic expenditures for households with an elderly member (ATET -1.9%, t-stat -2.178). CONCLUSIONS Seguro Popular increased access to healthcare for Mexican older adults. Social Security showed a significant protective effect against lack of access and catastrophic expenditures compared with those without health insurance.
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Affiliation(s)
- Svetlana V Doubova
- Takemi Program in International Health. Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Inter-American Development Bank, Mexico City, Mexico
| | - David Canning
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael R Reich
- Takemi Program in International Health. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Wolf KL, Robbins AST. Metro nature, environmental health, and economic value. Environ Health Perspect 2015; 123:390-8. [PMID: 25626137 PMCID: PMC4421766 DOI: 10.1289/ehp.1408216] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 01/26/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities. OBJECTIVES We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. METHODS We reviewed the literature on urban nature-based health and well-being benefits. In this review, we provide a classification schematic and propose potential economic values associated with metro nature services. DISCUSSION Economic valuation of benefits derived from urban green systems has largely been undertaken in the fields of environmental and natural resource economics, but studies have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces, and other nearby nature elements-collectively termed metro nature-generate many positive externalities that have been largely overlooked in urban economics and policy. Here, we present a range of health benefits, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed. CONCLUSIONS Metro nature provides diverse and substantial benefits to human populations in cities. In this review, we begin to address the need for development of valuation methodologies and new approaches to understanding the potential economic outcomes of these benefits.
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Affiliation(s)
- Kathleen L Wolf
- College of the Environment, University of Washington, Seattle, Washington, USA
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Hussain MI, Naqvi BS. Current trends in treatment of obesity in Karachi and possibilities of cost minimization. Pak J Pharm Sci 2015; 28:765-772. [PMID: 25796152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Our study finds out drug usage trends in over weight and obese patients without any compelling indications in Karachi, looks for deviations of current practices from evidence based antihypertensive therapeutic guidelines and identifies not only cost minimization opportunities but also communication strategies to improve patients' awareness and compliance to achieve therapeutic goal. In present study two sets were used. Randomized stratified independent surveys were conducted in hospital doctors and family physicians (general practitioners), using pretested questionnaires. Sample size was 100. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Opportunities of cost minimization were also analyzed. One the basis of doctors' feedback, preference is given to non-pharmacologic management of obesity. Mass media campaign and media usage were recommended to increase patients awareness and patients' education along with strengthening family support systems was recommended for better compliance of the patients to doctor's advice. Local therapeutic guidelines for weight reduction were not found. Feedbacks showed that global therapeutic guidelines were followed by the doctors practicing in the community and hospitals in Karachi. However, high price branded drugs were used instead of low priced generic therapeutic equivalents. Patient's education is required for better awareness and improving patients' compliance. The doctors found preferring brand leaders instead of low cost options. This trend increases cost of therapy by 0.59 to 4.17 times. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.
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Affiliation(s)
- Mirza Izhar Hussain
- Institute of Business Administration, IBA City Campus, Garden / Kiyani Shaheed Road, Karachi, Pakistan
| | - Baqir Shyum Naqvi
- Department of Pharmaceutics, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan
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Cheng Y, Li X, Lou C, Sonenstein FL, Kalamar A, Jejeebhoy S, Delany-Moretlwe S, Brahmbhatt H, Olumide AO, Ojengbede O. The association between social support and mental health among vulnerable adolescents in five cities: findings from the study of the well-being of adolescents in vulnerable environments. J Adolesc Health 2014. [PMID: 25454000 DOI: 10.1016/j.adohealth.2014.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
PURPOSE Globally, adolescents are at risk of depression, traumatic stress, and suicide, especially those living in vulnerable environments. This article examines the mental health of 15- to 19-year-old youth in five cities and identifies the social support correlates of mental health. METHODS A total of 2,393 adolescents aged 15-19 years in economically distressed neighborhoods in Baltimore, MD; New Delhi, India; Ibadan, Nigeria; Johannesburg, South Africa; and Shanghai, China were recruited in 2013 via respondent-driven sampling to participate in a survey using an audio computer-assisted self-interview. Weighted logistic regression and general linear models were used to explore the associations between mental health and social supports. RESULTS The highest levels of depression and posttraumatic stress symptoms were displayed in Johannesburg among females (44.6% and 67.0%, respectively), whereas the lowest were among New Delhi females and males (13.0% and 16.3%, respectively). The prevalence of suicidal ideation ranged from 7.9% (New Delhi female adolescents) to 39.6% (Johannesburg female adolescents); the 12-month prevalence of suicide attempts ranged from 1.8% (New Delhi females) to 18.3% (Ibadan males). Elevated perceptions of having a caring female adult in the home and feeling connected to their neighborhoods were positively associated with adolescents' levels of hope across the sites while negatively associated with depression and posttraumatic stress symptoms with some variation across sites and gender. CONCLUSIONS Adolescents living in the very economically distressed areas studied register high levels of depression and posttraumatic stress. Improving social supports in families and neighborhoods may alleviate distress and foster hope. In particular, strengthening supports from female caretakers to their adolescents at home may improve the outlooks of their daughters.
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Affiliation(s)
- Yan Cheng
- Department of Epidemiology and Social Science Research on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, People's Republic of China
| | - XianChen Li
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Chaohua Lou
- Department of Epidemiology and Social Science Research on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, People's Republic of China.
| | - Freya L Sonenstein
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Amanda Kalamar
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Sinead Delany-Moretlwe
- Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Heena Brahmbhatt
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Adesola Oluwafunmilola Olumide
- Institute of Child Health, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria
| | - Oladosu Ojengbede
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Oyo State, Nigeria
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Zenk SN, Horoi I, McDonald A, Corte C, Riley B, Odoms-Young AM. Ecological momentary assessment of environmental and personal factors and snack food intake in African American women. Appetite 2014; 83:333-341. [PMID: 25239402 PMCID: PMC4376474 DOI: 10.1016/j.appet.2014.09.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/14/2014] [Accepted: 09/14/2014] [Indexed: 10/24/2022]
Abstract
This study examined contributions of environmental and personal factors (specifically, food availability and expense, daily hassles, self-efficacy, positive and negative affect) to within-person and between-person variations in snack food intake in 100 African American women. Participants were signaled at random five times daily for seven days to complete a survey on a study-provided smartphone. Women reported consuming snack foods at 35.2% of signals. Easier food availability accounting for one's usual level was associated with higher snack food intake. Being near outlets that predominately sell snacks (e.g., convenience stores), while accounting for one's usual proximity to them, was associated with higher snack food intake. Accounting for one's usual daily hassle level, we found that on days with more frequent daily hassles snack food intake was higher. The positive association between within-person daily hassles frequency and snack food intake was stronger when foods were easily available. Public and private policies to curb ubiquitous food availability and mobile health interventions that take into account time-varying influences on food choices and provide real-time assistance in dealing with easy food availability and coping with stressors may be beneficial in improving African American women's day to day food choices.
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Affiliation(s)
- Shannon N Zenk
- Department of Health Systems Science, University of Illinois at Chicago, USA.
| | - Irina Horoi
- Department of Economics, University of Illinois at Chicago, USA
| | - Ashley McDonald
- Department of Psychology, The Pennsylvania State University, USA
| | - Colleen Corte
- Department of Health Systems Science, University of Illinois at Chicago, USA
| | - Barth Riley
- Department of Health Systems Science, University of Illinois at Chicago, USA
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Mmari K, Lantos H, Blum RW, Brahmbhatt H, Sangowawa A, Yu C, Delany-Moretlwe S. A global study on the influence of neighborhood contextual factors on adolescent health. J Adolesc Health 2014; 55:S13-20. [PMID: 25453998 PMCID: PMC4330007 DOI: 10.1016/j.jadohealth.2014.08.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/15/2014] [Accepted: 08/20/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE This study uses data collected as part of the Well-Being of Adolescents in Vulnerable Environments study to (1) compare the perceptions of neighborhood-level factors among adolescents across five different urban sites; (2) examine the associations between factors within the physical and social environments; and (3) examine the influence of neighborhood-level factors on two different health outcomes-violence victimization in the past 12 months and ever smoked. METHODS Across five urban sites (Baltimore, New Delhi, Johannesburg, Ibadan, and Shanghai), 2,320 adolescents aged 15-19 years completed a survey using audio computer-assisted self-interview technology. To recruit adolescents, each site used a respondent-driven sampling method, which consisted of selecting adolescents as "seeds" to serve as the initial contacts for recruiting the entire adolescent sample. All analyses were conducted with Stata 13.1 statistical software, using complex survey design procedures. To examine associations between neighborhood-level factors and among our two outcomes, violence victimization and ever smoked, bivariate and multivariate analyses were conducted. RESULTS Across sites, there was great variability in how adolescents perceived their neighborhoods. Overall, adolescents from Ibadan and Shanghai held the most positive perceptions about their neighborhoods, whereas adolescents from Baltimore and Johannesburg held the poorest. In New Delhi, despite females having positive perceptions about their safety and sense of social cohesion, they had the highest sense of fear and the poorest perceptions about their physical environment. The study also found that one of the most consistent neighborhood-level factors across sites and outcomes was witnessing community violence, which was significantly associated with smoking among adolescents in New Delhi and Johannesburg and with violence victimization across nearly every site except Baltimore. No other neighborhood-level factor exerted greater influence. CONCLUSIONS This study confirms the important associations between perceptions of a neighborhood and adolescent health. At the same time, it demonstrates that not all neighborhood-level factors are associated with adolescent health outcomes in the same way across different urban contexts. Further longitudinal research is needed to examine the direction of causation between adolescent health neighborhood contexts and health outcomes and the reasons for why different urban contexts may exert varying levels of influence on the health of adolescents.
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Affiliation(s)
- Kristin Mmari
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Hannah Lantos
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Robert W Blum
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Heena Brahmbhatt
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Adesola Sangowawa
- Institute of Child Health, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Chunyan Yu
- Department of Epidemiology and Social Science, Shanghai Institute of Planned Parenthood Research, Shanghai China
| | - Sinead Delany-Moretlwe
- Wits Reproductive Health and HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Herring SJ, Cruice JF, Bennett GG, Davey A, Foster GD. Using technology to promote postpartum weight loss in urban, low-income mothers: a pilot randomized controlled trial. J Nutr Educ Behav 2014; 46:610-5. [PMID: 25069621 PMCID: PMC4254220 DOI: 10.1016/j.jneb.2014.06.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/28/2014] [Accepted: 06/02/2014] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To examine the feasibility, acceptability, and initial efficacy of a technology-based weight loss intervention for urban, low-income mothers. METHODS Eighteen obese, ethnic minority, socioeconomically disadvantaged mothers in the first year after childbirth were randomly assigned to either: 1) technology-based intervention, which included empirically supported behavior-change strategies, daily skills, and self-monitoring text messages with personalized feedback, biweekly counseling calls from a health coach, and access to a Facebook support group, or 2) usual-care control. RESULTS After 14 weeks of treatment, the technology-based intervention participants had significantly greater weight loss (-2.9 ± 3.6 kg) than usual care (0.5 ± 2.3 kg; adjusted mean difference: -3.2 kg, 95% confidence interval -6.2 to -0.1 kg, P = .04). One-third of intervention participants (3 of 9) and no control participants lost > 5% of their initial body weight at follow up. CONCLUSIONS AND IMPLICATIONS Results suggest the potential for using technology to deliver a postpartum weight loss intervention among low-income racial/ethnic minorities.
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Affiliation(s)
- Sharon J Herring
- Department of Medicine, Center for Obesity Research and Education, Temple University, Philadelphia, PA; Department of Public Health, Temple University, Philadelphia, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University, Philadelphia, PA.
| | - Jane F Cruice
- Department of Medicine, Center for Obesity Research and Education, Temple University, Philadelphia, PA
| | - Gary G Bennett
- Department of Psychology and Neuroscience, Duke University, Durham, NC; Duke Obesity Prevention Program, Duke University, Durham, NC
| | - Adam Davey
- Department of Public Health, Temple University, Philadelphia, PA
| | - Gary D Foster
- Department of Medicine, Center for Obesity Research and Education, Temple University, Philadelphia, PA; Department of Public Health, Temple University, Philadelphia, PA
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Phipps EJ, Kumanyika SK, Stites SD, Singletary SB, Cooblall C, DiSantis KI. Buying food on sale: a mixed methods study with shoppers at an urban supermarket, Philadelphia, Pennsylvania, 2010-2012. Prev Chronic Dis 2014; 11:E151. [PMID: 25188276 PMCID: PMC4157594 DOI: 10.5888/pcd11.140174] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The obesity epidemic has drawn attention to food marketing practices that may increase the likelihood of caloric overconsumption and weight gain. We explored the associations of discounted prices on supermarket purchases of selected high-calorie foods (HCF) and more healthful, low-calorie foods (LCF) by a demographic group at high risk of obesity. METHODS Our mixed methods design used electronic supermarket purchase data from 82 low-income (primarily African American female) shoppers for households with children and qualitative data from focus groups with demographically similar shoppers. RESULTS In analyses of 6,493 food purchase transactions over 65 weeks, the odds of buying foods on sale versus at full price were higher for grain-based snacks, sweet snacks, and sugar-sweetened beverages (odds ratios: 6.6, 5.9, and 2.6, respectively; all P < .001) but not for savory snacks. The odds of buying foods on sale versus full price were not higher for any of any of the LCF (P ≥ .07). Without controlling for quantities purchased, we found that spending increased as percentage saved from the full price increased for all HCF and for fruits and vegetables (P ≤ .002). Focus group participants emphasized the lure of sale items and took advantage of sales to stock up. CONCLUSION Strategies that shift supermarket sales promotions from price reductions for HCF to price reductions for LCF might help prevent obesity by decreasing purchases of HCF.
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Affiliation(s)
- Etienne J Phipps
- Einstein Healthcare Network, Director, Center for Urban Health Policy and Research, 5501 Old York Rd, Philadelphia, PA 19141. Telephone: 215-456-1122. E-mail:
| | - Shiriki K Kumanyika
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Brunst KJ, Wright RO, DiGioia K, Enlow MB, Fernandez H, Wright RJ, Kannan S. Racial/ethnic and sociodemographic factors associated with micronutrient intakes and inadequacies among pregnant women in an urban US population. Public Health Nutr 2014; 17:1960-70. [PMID: 24476840 PMCID: PMC4071127 DOI: 10.1017/s1368980013003224] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess sociodemographic correlates of micronutrient intakes from food and dietary supplements in an urban, ethnically diverse sample of pregnant women in the USA. DESIGN Cross-sectional analyses of data collected using a validated semi-quantitative FFQ. Associations between racial, ethnic and sociodemographic factors and micronutrient intakes were examined using logistic regression controlling for pre-pregnancy BMI, maternal age and smoking status. SETTING Prenatal clinics, Boston, MA, USA. SUBJECTS Analyses included pregnant women (n 274) in the PRogramming of Intergenerational Stress Mechanisms (PRISM) study, an urban longitudinal cohort designed to examine how stress influences respiratory health in children when controlling for other environmental exposures (chemical stressors, nutrition). RESULTS High frequencies of vitamin E (52 %), Mg (38 %), Fe (57 %) and vitamin D (77 %) inadequacies as well as suboptimal intakes of choline (95 %) and K (99 %) were observed. Factors associated with multiple antioxidant inadequacies included being Hispanic or African American, lower education and self-reported economic-related food insecurity. Hispanics had a higher prevalence of multiple methyl-nutrient inadequacies compared with African Americans; both had suboptimal betaine intakes and higher odds for vitamin B₆ and Fe inadequacies compared with Caucasians. Nearly all women (98 %) reported Na intakes above the tolerable upper limit; excessive intakes of Mg (35 %), folate (37 %) and niacin (38 %) were also observed. Women reporting excessive intakes of these nutrients were more likely Caucasian or Hispanic, more highly educated, US-born and did not report food insecurity. CONCLUSIONS Racial/ethnic and other sociodemographic factors should be considered when tailoring periconceptional dietary interventions for urban ethnic women in the USA.
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Affiliation(s)
- Kelly J Brunst
- Kravis Children’s Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1198, New York, NY 10029, USA
| | - Robert O Wright
- Kravis Children’s Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1198, New York, NY 10029, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kimberly DiGioia
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard School of Public Health, Boston, MA, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Harriet Fernandez
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard School of Public Health, Boston, MA, USA
| | - Rosalind J Wright
- Kravis Children’s Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1198, New York, NY 10029, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Srimathi Kannan
- Department of Animal Science, Food and Nutrition College of Agricultural Sciences, Southern Illinois University, Carbondale, IL, USA
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Abdellah AM, Balla QI. Domestic solid waste management and its impacts on human health and the environment in Sharg El Neel Locality, Khartoum State, Sudan. Pak J Biol Sci 2013; 16:1538-1544. [PMID: 24511697 DOI: 10.3923/pjbs.2013.1538.1544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Due to rapid urbanization in Khartoum State, Domestic Solid Waste (DSW) management remains the biggest obsession that recurrently attracts the attention of the concern authorities and stakeholders. As one of the seven localities comprised the state, the Sharg El Neel Locality was chosen to study the DSW management efficiency. The materials and methods employed in collection of data is a package of techniques, one of which was by conducting interviews using structured and unstructured questions mainly directed to appropriate persons i.e., householders and particular government employees directly engaged in DSW management operations. The main findings reached in this study were that local authorities lack the necessary capacities to handle the immense problems of DSW management. Shortages of funds, inadequate number of workers, lack of transport and facilities and weakness of attitudes of respondents found to be among factors hindering the DSW management. Accordingly, proper scheduled and timing, well-trained public health officers and sanitary overseers and strict sustainable program to controlling flies, rodents, cockroach and other disease vectors are essential to properly managing DSW. Otherwise, problems resulting from solid waste generation in the study area will be magnitudized and the surrounding environment will definitely be deteriorated.
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Affiliation(s)
- A M Abdellah
- Al-Lahawi for Research Consultation and Investment, Safa Trading Center, West of Saad Gishra, Khartoum North, Sudan
| | - Q I Balla
- Sharg Al Neel Locality, Khartoum State, Sudan
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Martínez ML, Guevel CG. [Social inequalities in cervical cancer mortality in the Autonomous City of Buenos Aires, 1999-2003 and 2004-2006]. Salud Colect 2013; 9:169-182. [PMID: 23989624 DOI: 10.1590/s1851-82652013000200004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 02/10/2013] [Indexed: 06/02/2023] Open
Abstract
The aim of this study was to describe the spatial distribution of cervical cancer mortality in the Autonomous City of Buenos Aires during the period 1999-2003 and its relationship to the socioeconomic conditions of the population, as well as to compare the distribution during this period with that of the triennium 2004-2006. This ecological study used electoral districts as the unit of analysis. The selected socioeconomic indicators were educational deficit, lack of health insurance and the Material Deprivation of Households Index (Índice de Privación Material de Hogares), taken from the National Population and Housing Census (Censo Nacional de Población, Hogares y Viviendas) of 2001. The stratification of the city into areas according to these conditions and the analysis of standardized mortality ratios showed an increased risk of dying from cervical cancer associated with worse socioeconomic conditions. The stratification and death risks demonstrated a clear spatial pattern, with the south of the city presenting the highest death risks, and the northern and central areas presenting the lowest risks.
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Affiliation(s)
- María Laura Martínez
- Dirección de Estadísticas e Información en Salud, Ministerio de Salud de la Nación, Argentina.
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Abstract
Rapid urbanization globally threatens to increase the risk to mental health and requires a rethinking of the relationship between urban poverty and mental health. The aim of this article is to reveal the cyclic nature of this relationship: Concentrated urban poverty cultivates mental illness, while the resulting mental illness reinforces poverty. The authors used theories about social disorganization and crime to explore the mechanisms through which the urban environment can contribute to mental health problems. They present some data on crime, substance abuse, and social control to support their claim that mental illness reinforces poverty. The authors argue that, to interrupt this cycle and improve outcomes, social workers and policymakers must work together to implement a comprehensive mental health care system that emphasizes prevention, reaches young people, crosses traditional health care provision boundaries, and involves the entire community to break this cycle and improve the outcomes of those living in urban poverty.
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Arbiol J, Borja M, Yabe M, Nomura H, Gloriani N, Yoshida S. Valuing human leptospirosis prevention using the opportunity cost of labor. Int J Environ Res Public Health 2013; 10:1845-60. [PMID: 23644831 PMCID: PMC3709352 DOI: 10.3390/ijerph10051845] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/24/2013] [Accepted: 04/25/2013] [Indexed: 11/16/2022]
Abstract
Leptospirosis is a serious public health concern in the Philippines, not only because of its increasing incidence rate, but also because of its significant health and economic impacts. Despite its relatively high seroprevalence, knowledge on the economic burden of disease, particularly on the value that the society places on disease prevention remains limited. Obtaining such information is important within the context of public health policy. This study was conducted in Metro Manila to determine the economic burden of leptospirosis, by asking respondents about their willingness to contribute to labor (WTCL) for the prevention of leptospirosis. The respondents pledged an average labor contribution of 10.66 h/month. The average WTCL corresponded to a monetary value of US$4.01 per month when valued using the opportunity cost of labor (leisure rate of time). From the monetized labor contribution, the total economic value of preventing leptospirosis was estimated at US$124.97 million per annum, which represents 1.13% of Metro Manila's gross domestic product (GDP). Estimates from a Tobit regression model identified the respondents' knowledge regarding leptospirosis, the susceptibility of their homes to flooding, and the proximity of their homes to sewers as significant factors to consider when developing resource contribution programs for leptospirosis prevention. More efforts need to be made in developing community level preventive programs, and in improving public's knowledge and awareness about leptospirosis.
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Affiliation(s)
- Joseph Arbiol
- Laboratory of Environmental Economics, Graduate School of Bio-resources and Bio-environmental Science, Kyushu University, Fukuoka 812-8581, Japan; E-Mail:
| | - Maridel Borja
- Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines-Manila, Manila 1000, Philippines; E-Mail:
| | - Mitsuyasu Yabe
- Laboratory of Environmental Economics, Department of Agricultural and Resource Economics, Faculty of Agriculture, Kyushu University, Fukuoka 812-8581, Japan
| | - Hisako Nomura
- International Education Center, Kyushu University, Fukuoka 812-8581, Japan; E-Mail: hnomura@ agr.kyushu-u.ac.jp
| | - Nina Gloriani
- Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, Manila 1000, Philippines; E-Mail:
| | - Shinichi Yoshida
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; E-Mail:
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Colombara DV, Cowgill KD, Faruque ASG. Risk factors for severe cholera among children under five in rural and urban Bangladesh, 2000-2008: a hospital-based surveillance study. PLoS One 2013; 8:e54395. [PMID: 23349875 PMCID: PMC3548801 DOI: 10.1371/journal.pone.0054395] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 12/11/2012] [Indexed: 11/19/2022] Open
Abstract
Background Children under five bear the largest cholera burden. We therefore sought to identify modifiable risk factors among Bangladeshi children. Methodology/Principal Findings We used multivariate Poisson regression to assess risk factors for severe cholera among diarrheal patients presenting at hospitals in Matlab (rural) and Dhaka (urban), Bangladesh. Risk increased with age. Compared to those under one, rural and urban four-year-olds had adjusted risk ratios (aRR) of 4.17 (95% confidence interval (CI) 2.43–7.15) and 6.32 (95% CI: 4.63–8.63), respectively. Breastfeeding halved the risk in both rural (aRR = 0.49, 95% CI: 0.35–0.67) and urban (aRR = 0.51, 95% CI: 0.41–0.62) settings. Rural children’s risk decreased with maternal education (P-trend: <0.001) and increased among those with a family member with diarrhea in the past week (aRR = 1.61, 95% CI: 1.22–2.14) and those with prior vitamin A supplementation (aRR = 1.65, 95% CI: 1.12–2.43). Urban children whose mothers daily (aRR = 0.41, 95% CI: 0.21–0.79) or occasionally (aRR = 0.55, 95% CI: 0.36–0.84) read a newspaper experienced reduced risk. Urban children from households with incomes between 34–84 USD/month had a 30% increased risk compared to those from households with incomes >84 USD/month. Conclusion/Significance Increasing age, lower socioeconomic status, and lack of breastfeeding are key correlates of increased risk for cholera hospitalization among those under five in rural and urban Bangladesh. In addition, having a family member with diarrhea in the past week was associated with increased risk among rural children. Continued attention should be directed to the promotion of breastfeeding. Further research is needed to elucidate the relationship between maternal education and cholera risk. Renewed research regarding the use of chemoprophylaxis among family members of cholera cases may be warranted in rural endemic settings.
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Affiliation(s)
- Danny V Colombara
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.
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Vangeepuram N, Galvez MP, Teitelbaum SL, Brenner B, Wolff MS. The association between parental perception of neighborhood safety and asthma diagnosis in ethnic minority urban children. J Urban Health 2012; 89:758-68. [PMID: 22669642 PMCID: PMC3462829 DOI: 10.1007/s11524-012-9679-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Low-income populations, minorities, and children living in inner cities have high rates of asthma. Recent studies have emphasized the role of psychosocial stress in development of asthma. Residence in unsafe neighborhoods is one potential source of increased stress. The study objective was to examine the association between parental perception of neighborhood safety and asthma diagnosis among inner city, minority children. Cross-sectional data from a community-based study of 6-8-year-old New York City children were used. Asthma was defined as parental report of physician-diagnosed asthma and at least one asthma-related symptom. Parental perceptions of neighborhood safety were assessed with a questionnaire. Associations between perceived neighborhood safety and asthma were examined using chi-squared tests. Multivariate logistic regression analyses were then performed. Five hundred four children were included with 79% female, 26.5% non-Hispanic Black, and 73.5% Hispanic. Asthma was present in 23.8% of children. There was an inverse association between feeling safe walking in the neighborhood and asthma with 45.7% of parents of asthmatic children reporting they felt safe compared to 60.9% of parents of non-asthmatic children (p = 0.006). Fewer parents of asthmatic children than of non-asthmatic children reported that their neighborhood was safe from crime (21.7% versus 33.9%, p = 0.018). In multivariate analyses adjusting for race/ethnicity, age, gender, socioeconomic status, number of smokers in the home and breastfeeding history, parents reporting feeling unsafe walking in the neighborhood were more likely to have a child diagnosed with asthma (OR = 1.89, 95%CI 1.13-3.14). Psychosocial stressors such as living in unsafe neighborhoods may be associated with asthma diagnosis in urban ethnic minority children. Addressing the increased asthma burden in certain communities may require interventions to decrease urban stressors.
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Affiliation(s)
- N Vangeepuram
- Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Bian B, Gorevski E, Kelton CM, Guo JJ, Boone JEM. Long-term Medicaid excess payments from alleged price manipulation of generic lorazepam. J Manag Care Pharm 2012; 18:506-15. [PMID: 22971204 PMCID: PMC10437366 DOI: 10.18553/jmcp.2012.18.7.506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Cost savings from the use of generic drugs versus brand-name drugs are well known. Both private and public prescription drug plans encourage the use of generic drugs through a variety of mechanisms. The magnitude of cost savings for a given generic drug is dependent on the degree to which the generic market is competitive. Should the competitive structure become compromised, higher prices and reduced cost savings may result. An alleged conspiracy between Mylan Laboratories and its active-ingredient suppliers in 1997 was associated with an increase in seller concentration in the generic lorazepam market. The Federal Trade Commission (FTC) alleged that Mylan raised costs to consumers by $120 million because of price increases for generic lorazepam from March through December 1998 and for generic clorazepate from January through December 1998. In November 2002, a settlement with Mylan was approved by the FTC, and a federal district court required Mylan to pay $147 million, including $28.2 million to state agencies including Medicaid. OBJECTIVES To (a) describe the seller concentration in the national Medicaid generic lorazepam market over a 19-year period from January 1991 through December 2009, (b) estimate the excess payments for generic lorazepam by Medicaid between 1998 and 2009, and (c) investigate potentially increased utilization and prices of 2 substitute pharmaceuticals: branded lorazepam (Ativan) and generic alprazolam (another widely used intermediate-acting benzodiazepine). METHODS Using Medicaid State Drug Utilization Data from the Centers for Medicare Medicaid Services, we calculated the 4-firm concentration ratio (CR₄) and the Herfindahl-Hirschman Index (HHI) for the Medicaid generic lorazepam market, along with pre-rebate reimbursement for pharmacy claims, number of claims (utilization), and average pre-rebate reimbursement per claim (average "price") for generic lorazepam, from 1991 through 2009. Medicaid's excess payments were estimated under 2 different assumptions regarding what the average generic lorazepam price would have been in the absence of the alleged conspiracy. To find counterfactual prices, the average per-claim reimbursement for lorazepam for the 4 quarters prior to the alleged conspiracy, $6.80, was inflated using (a) the quarterly change in the average per-claim reimbursement for generic alprazolam and (b) the Consumer Price Index (CPI) for all urban consumers, all goods. Potential impact of the alleged conspiracy on the branded lorazepam and generic alprazolam markets was investigated. RESULTS The average pre-rebate reimbursements per claim for generic lorazepam were $10.25, $23.12, and $8.48 in 1991, 1998, and 2009, respectively. For the same 3 years, CR₄ = 52.80, 76.02, and 86.74, while HHI = 905.71, 2,166.25, and 2,233.36. Medicaid's excess payments from 1998-2009 were estimated at approximately $625-$657 million. The data also suggest the possibility of small impacts on the utilization of branded lorazepam and the price of generic alprazolam. CONCLUSIONS Prior to the alleged conspiracy in 1997, average pre-rebate reimbursement per claim for generic lorazepam was declining, while seller concentration was rising. After a jump in average payment per claim in the years immediately following the alleged conspiracy, prices have gradually returned to their pre-1998 levels. However, the generic lorazepam market was more concentrated in 2009 than prior to the alleged conspiracy.
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Affiliation(s)
- Boyang Bian
- University of Cincinnati, Carl H. Lindner College of Business, 414 Lindner Hall, 2925 Campus Green Dr., P.O. Box 210195, Cincinnati, OH. USA.
| | - Elizabeth Gorevski
- University of Cincinnati, Carl H. Lindner College of Business, 414 Lindner Hall, 2925 Campus Green Dr., P.O. Box 210195, Cincinnati, OH. USA.
| | - Christina M.L. Kelton
- University of Cincinnati, Carl H. Lindner College of Business, 414 Lindner Hall, 2925 Campus Green Dr., P.O. Box 210195, Cincinnati, OH. USA.
| | - Jeff J. Guo
- University of Cincinnati, Carl H. Lindner College of Business, 414 Lindner Hall, 2925 Campus Green Dr., P.O. Box 210195, Cincinnati, OH. USA.
| | - Jill E. Martin Boone
- University of Cincinnati, Carl H. Lindner College of Business, 414 Lindner Hall, 2925 Campus Green Dr., P.O. Box 210195, Cincinnati, OH. USA.
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Azadi H, Van Acker V, Zarafshani K, Witlox F. Food systems: New-Ruralism versus New-Urbanism. J Sci Food Agric 2012; 92:2224-2226. [PMID: 22505213 DOI: 10.1002/jsfa.5694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Revised: 03/05/2012] [Accepted: 03/07/2012] [Indexed: 05/31/2023]
Abstract
There is a growing debate on whether agricultural land in urban fringes should be maintained or converted to other uses. While 'pro-ruralists' believe agricultural land conversion can threaten food security and cause rural-urban migration, 'pro-urbanists' find it a necessary change for transition from a primitive agricultural-based community to an advanced industrial-based society which has the capacity to create mass productions. New-Ruralists follow an agricultural-based development approach that promotes small-medium farming and acknowledges rural lifestyle while New-Urbanists give a priority to large industrial-based sectors and encourage urban lifestyle. Given the unlike concerns of different societies, the paper concludes that the approaches might have different priorities in the less developed, developing, and developed world.
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Affiliation(s)
- Hossein Azadi
- Department of Geography, Ghent University, Ghent, Belgium.
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Webb-Girard A, Cherobon A, Mbugua S, Kamau-Mbuthia E, Amin A, Sellen DW. Food insecurity is associated with attitudes towards exclusive breastfeeding among women in urban Kenya. Matern Child Nutr 2012; 8:199-214. [PMID: 20874844 PMCID: PMC6860665 DOI: 10.1111/j.1740-8709.2010.00272.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study aimed to document whether food insecurity was associated with beliefs and attitudes towards exclusive breastfeeding (EBF) among urban Kenyan women. We conducted structured interviews with 75 human immunodeficiency virus (HIV)-affected and 75 HIV-status unknown, low-income women who were either pregnant or with a child ≤24 months and residing in Nakuru, Kenya to generate categorical and open-ended responses on knowledge, attitudes and beliefs towards EBF and food insecurity. We facilitated six focus group discussions (FGD) with HIV-affected and HIV-status unknown mothers (n = 50 women) to assess barriers and facilitators to EBF. Of 148 women with complete interview data, 77% were moderately or severely food insecure (FIS). Women in FIS households had significantly greater odds of believing that breast milk would be insufficient for 6 months [odds ratio (OR), 2.6; 95% confidence interval (95% CI), 1.0, 6.8], that women who EBF for 6 months would experience health or social problems (OR, 2.7; 95% CI, 1.0, 7.3), that women need adequate food to support EBF for 6 months (OR, 2.6; 95% CI, 1.0, 6.7) and that they themselves would be unable to follow a counsellor's advice to EBF for 6 months (OR, 3.2; 95% CI, 1.3, 8.3). Qualitative analysis of interview and FGD transcripts indicated that the maternal experience of hunger contributes to perceived milk insufficiency, anxiety about infant hunger and a perception that access to adequate food is necessary for successful breastfeeding. The lived experience of food insecurity among a sample of low-income, commonly FIS, urban Kenyan women reduces their capacity to implement at least one key recommended infant feeding practices, that of EBF for 6 months.
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Affiliation(s)
- Aimee Webb-Girard
- Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, Georgia 30322, USA.
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Musorina IV, Doskin VA, Shestakova VN, Khudobkina TA. [The sociomedical portrait of girls studying at a secondary special educational establishment]. Gig Sanit 2012:80-82. [PMID: 22834275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this investigation was to study a social portrait in 15-17-year-old girls studying at secondary specialized educational establishments and the characteristics of their families. The urban girls have better living conditions than the rural ones. The income of the families of first- and second-year students from other towns was significantly more frequently lower (63.9 and 57.5%, respectively) versus that of the urban students (14.7 and 20.8%). The urban students had more conflicts with their parents (66.1% versus 52.6%). There are also differences in the professional and educational level of their parents. The parents living in the rural areas had a lower education level and more frequently belong to a class of workers and, accordingly, had more often occupational harms and heavy working conditions than the urban dwellers. The spread of bad habits in the families of urban and rural inhabitants is rather high. Nearly one-third of the students of Moscow and other towns experienced emotional violence by the members of their families.
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Abstract
This article presents an analysis of social sustainability in comparative theoretical context and as a challenge to the post-political interpretation of sustainability in policy practice at the urban and regional scales. Metro Vancouver provides a case study for improving our understanding of the meaning of social sustainability as a framework for social policy in that it is among the handful of cities around the world currently working to define and enact social sustainability in governance terms. Results of this participant research provide evidence that some cities are politically engaging alternative development pathways using the concept of social sustainability. For sustainable development to retain its promise as an alternative policy framework for cities, social sustainability must be at the forefront.
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Adams J, Sibbritt D, Broom A, Loxton D, Pirotta M, Humphreys J, Lui CW. A comparison of complementary and alternative medicine users and use across geographical areas: a national survey of 1,427 women. BMC Complement Altern Med 2011; 11:85. [PMID: 21981986 PMCID: PMC3198987 DOI: 10.1186/1472-6882-11-85] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 10/07/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors. METHODS A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009. RESULTS The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas. CONCLUSION It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic.
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Affiliation(s)
- Jon Adams
- Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
| | - David Sibbritt
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
| | - Alex Broom
- School of Social Science, University of Queensland, Brisbane, Queensland, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
| | - Deborah Loxton
- Priority Research Centre for Gender, Health and Ageing, University of Newcastle, New South Wales, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Victoria, Australia
| | - John Humphreys
- School of Rural Health, Monash University, Bendigo, Victoria, Australia
| | - Chi-Wai Lui
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Faculty of Nursing, Midwifery and Health, University of Technology, Level 7 Building 10, 235-253 Jones St, Ultimo New South Wales, 2007, Australia
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Abstract
In the San Francisco Bay Area, where residential rent is among the highest in the United States, an analysis of data from several sources demonstrates that high rent cannot be accounted for by higher quality, higher operating costs, or higher construction costs. At least one-third of the total rent paid is land rent. Despite increases in real incomes, very-low-income tenants in the Bay Area today have less income remaining after payment of rent than tenants did in 1960. High land rent is a long-term feature of the Bay Area rental market that results mostly from its geography, the density of its urban centers, and a strong economy, rather than from regulatory barriers to new multifamily construction. Deregulation is not a sufficient response to the effects of land rent on low-income tenants. Government should subsidize non-profit housing organizations, particularly land trusts that remove residential land from the market. Taxes on land rent would be a particularly appropriate funding source.
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Varley A, Jones GA, Tiepolo M. [Decentralization or fragmentation? Reflections on urban land reform in Mexico]. Stor Urbana 1999; 23:93-117. [PMID: 22451993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Rodríguez P. [Family and daily urban life in colonial Spanish America: Cartagena de Indias in the 18th century]. Tempo (Rio J) 1999; 4:111-121. [PMID: 22523769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Massard-Guilbaud G. [Regulating urban industrial pollution, 1800-1940]. Vingtieme Siecle 1999:53-65. [PMID: 22574346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Koguruma P. [To Saracura: social rhythms and the metropolitan temporalities, 1890-1920]. Rev Bras Hist 1999; 19:81-99. [PMID: 22106493 DOI: 10.1590/s0102-01881999000200004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Este artigo discute alguns aspectos do processo de urbanização da cidade de São Paulo entre os anos de 1890 e 1920. Em especial, as singularidades da configuração de um ambiente cosmopolita peculiar, onde se nota, sob a face europeizada e moderna de São Paulo, a existência de outros ritmos sociais e temporalidades. Trata-se de uma reflexão sobre as especificidades do processo de urbanização da Paulicéia em que se é possível perceber as múltiplas tensões que perpassavam a configuração de uma paisagem caracterizada pelo movimento das ruas, bem com pelas instabilidades dos seus padrões sociais e culturais.
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Franchi M. [Public housing in Parma during two decades of Fascism]. Stor Urbana 1999; 23:75-101. [PMID: 22451994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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