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Archive for the ‘health and health care’ Category

A Guide to Regional Transportation Planning for Disasters, Emergencies, and Significant Events

August 1, 2014 Comments off

A Guide to Regional Transportation Planning for Disasters, Emergencies, and Significant Events
Source: Transportation Research Board

TRB’s National Cooperative Highway Research Program (NCHRP) Report 777: A Guide to Regional Transportation Planning for Disasters, Emergencies, and Significant Events uses foundational planning principles, case studies, tips, and tools to explain implementation of transportation planning for possible multijurisdictional disasters, emergencies, and other major events. In addition to the guide, there is a research report and a PowerPoint presentation describing the entire project.

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The comparative recall of Google Scholar versus PubMed in identical searches for biomedical systematic reviews: a review of searches used in systematic reviews

August 1, 2014 Comments off

The comparative recall of Google Scholar versus PubMed in identical searches for biomedical systematic reviews: a review of searches used in systematic reviews
Source: Systematic Reviews

Background
The usefulness of Google Scholar (GS) as a bibliographic database for biomedical systematic review (SR) searching is a subject of current interest and debate in research circles. Recent research has suggested GS might even be used alone in SR searching. This assertion is challenged here by testing whether GS can locate all studies included in 21 previously published SRs. Second, it examines the recall of GS, taking into account the maximum number of items that can be viewed, and tests whether more complete searches created by an information specialist will improve recall compared to the searches used in the 21 published SRs.

Methods
The authors identified 21 biomedical SRs that had used GS and PubMed as information sources and reported their use of identical, reproducible search strategies in both databases. These search strategies were rerun in GS and PubMed, and analyzed as to their coverage and recall. Efforts were made to improve searches that underperformed in each database.

Results
GS’ overall coverage was higher than PubMed (98% versus 91%) and overall recall is higher in GS: 80% of the references included in the 21 SRs were returned by the original searches in GS versus 68% in PubMed. Only 72% of the included references could be used as they were listed among the first 1,000 hits (the maximum number shown). Practical precision (the number of included references retrieved in the first 1,000, divided by 1,000) was on average 1.9%, which is only slightly lower than in other published SRs. Improving searches with the lowest recall resulted in an increase in recall from 48% to 66% in GS and, in PubMed, from 60% to 85%.

Conclusions
Although its coverage and precision are acceptable, GS, because of its incomplete recall, should not be used as a single source in SR searching. A specialized, curated medical database such as PubMed provides experienced searchers with tools and functionality that help improve recall, and numerous options in order to optimize precision. Searches for SRs should be performed by experienced searchers creating searches that maximize recall for as many databases as deemed necessary by the search expert.

Decriminalizing Indoor Prostitution: Implications for Sexual Violence and Public Health

August 1, 2014 Comments off

Decriminalizing Indoor Prostitution: Implications for Sexual Violence and Public Health
Source: Social Science Research Network/National Bureau of Economic Research

Most governments in the world including the United States prohibit prostitution. Given these types of laws rarely change and are fairly uniform across regions, our knowledge about the impact of decriminalizing sex work is largely conjectural. We exploit the fact that a Rhode Island District Court judge unexpectedly decriminalized indoor prostitution in 2003 to provide the first causal estimates of the impact of decriminalization on the composition of the sex market, rape offenses, and sexually transmitted infection outcomes. Not surprisingly, we find that decriminalization increased the size of the indoor market. However, we also find that decriminalization caused both forcible rape offenses and gonorrhea incidence to decline for the overall population. Our synthetic control model finds 824 fewer reported rape offenses (31 percent decrease) and 1,035 fewer cases of female gonorrhea (39 percent decrease) from 2004 to 2009.

Impact of Time of Presentation on Process Performance and Outcomes in ST-Segment–Elevation Myocardial Infarction

August 1, 2014 Comments off

Impact of Time of Presentation on Process Performance and Outcomes in ST-Segment–Elevation Myocardial Infarction
Source: Circulation: Cardiovascular Quality and Outcomes

Background—
Prior studies demonstrated that patients with ST-segment–elevation myocardial infarction presenting during off-hours (weeknights, weekends, and holidays) have slower reperfusion times. Recent nationwide initiatives have emphasized 24/7 quality care in ST-segment–elevation myocardial infarction. It remains unclear whether patients presenting off-hours versus on-hours receive similar quality care in contemporary practice.

Methods and Results—
Using Acute Coronary Treatment and Intervention Outcomes Network-Get With The Guidelines (ACTION-GWTG) database, we examined ST-segment–elevation myocardial infarction performance measures in patients presenting off-hours (n=27 270) versus on-hours (n=15 972; January 2007 to September 2010) at 447 US centers. Key quality measures assessed were aspirin use within first 24 hours, door-to-balloon time, door-to-ECG time, and door-to-needle time. In-hospital risk-adjusted all-cause mortality was calculated. Baseline demographic and clinical characteristics were similar. Aspirin use within 24 hours approached 99% in both groups. Among patients undergoing primary percutaneous coronary intervention (n=41 979; 97.1%), median door-to-balloon times were 56 versus 72 minutes (P<0.0001) for on-hours versus off-hours. The proportion of patients achieving door-to-balloon time ≤90 minutes was 87.8% versus 79.2% (P<0.0001), respectively. There were no differences attaining door-to-ECG time ≤10 minutes (73.4% versus 74.3%, P=0.09) and door-to-needle time ≤30 minutes (62.3% versus 58.7%; P=0.44) between on-hours versus off-hours. Although in-hospital all-cause mortality was similar (4.2%) in both groups, the risk-adjusted all-cause mortality was higher for patients presenting off-hours (odds ratio, 1.13; 95% confidence interval, 1.02–1.26).

Conclusions—
In contemporary community practice, achievement of quality performance measures in patients presenting with ST-segment–elevation myocardial infarction was high, regardless of time of presentation. Door-to-balloon time was, however, slightly delayed (by an average of 16 minutes), and risk-adjusted in-hospital mortality was 13% higher in patients presenting off-hours.

See: Time of arrival at hospital impacts time to treatment and survival of heart attack patients (EurekAlert!)
Hat tip: PW

Deep-Sea Octopus (Graneledone boreopacifica) Conducts the Longest-Known Egg-Brooding Period of Any Animal

July 31, 2014 Comments off

Deep-Sea Octopus (Graneledone boreopacifica) Conducts the Longest-Known Egg-Brooding Period of Any Animal
Source: PLoS ONE

Octopuses typically have a single reproductive period and then they die (semelparity). Once a clutch of fertilized eggs has been produced, the female protects and tends them until they hatch. In most shallow-water species this period of parental care can last from 1 to 3 months, but very little is known about the brooding of deep-living species. In the cold, dark waters of the deep ocean, metabolic processes are often slower than their counterparts at shallower depths. Extrapolations from data on shallow-water octopus species suggest that lower temperatures would prolong embryonic development periods. Likewise, laboratory studies have linked lower temperatures to longer brooding periods in cephalopods, but direct evidence has not been available. We found an opportunity to directly measure the brooding period of the deep-sea octopus Graneledone boreopacifica, in its natural habitat. At 53 months, it is by far the longest egg-brooding period ever reported for any animal species. These surprising results emphasize the selective value of prolonged embryonic development in order to produce competitive hatchlings. They also extend the known boundaries of physiological adaptations for life in the deep sea.

Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010

July 31, 2014 Comments off

Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010 (PDF)
Source: National Center for Health Statistics

Objectives—
This report examines heat-related mortality, cold-related mortality, and other weather-related mortality during 2006–2010 among subgroups of U.S. residents.

Methods—
Weather-related death rates for demographic and area-based subgroups were computed using death certificate information. Adjusted odds ratios for weather-related deaths among subgroups were estimated using logistic regression.

Results and Conclusions—
During 2006–2010, about 2,000 U.S. residents died each year from weather-related causes of death. About 31% of these deaths were attributed to exposure to excessive natural heat, heat stroke, sun stroke, or all; 63% were attributed to exposure to excessive natural cold, hypothermia, or both; and the remaining 6% were attributed to floods, storms, or lightning. Weather-related death rates varied by age, race and ethnicity, sex, and characteristics of decedent’s county of residence (median income, region, and urbanization level). Adjustment for region and urbanization decreased the risk of heat-related mortality among Hispanic persons and increased the risk of cold-related mortality among non-Hispanic black persons, compared with non-Hispanic white persons. Adjustment also increased the risk of heat-related mortality and attenuated the risk of cold-related mortality for counties in the lower three income quartiles.

The differentials in weather-related mortality observed among demographic subgroups during 2006–2010 in the United States were consistent with those observed in previous national studies. This study demonstrated that a better understanding of subpopulations at risk from weather-related mortality can be obtained by considering area-based variables (county median household income, region, and urbanization level) when examining weather-related mortality patterns.

New From the GAO

July 31, 2014 Comments off

New GAO Reports and Testimonies
Source: Government Accountability Office

Reports

1. Air Force Working Capital Fund: Actions Needed to Manage Cash Balances to Required Levels. GAO-14-480, July 31.
http://www.gao.gov/products/GAO-14-480
Highlights – http://www.gao.gov/assets/670/665138.pdf

2. Large Bank Holding Companies: Expectations of Government Support. GAO-14-621, July 31.
http://www.gao.gov/products/GAO-14-621
Highlights – http://www.gao.gov/assets/670/665163.pdf
Podcast – http://www.gao.gov/multimedia/podcasts/665108

3. Defense Health Care Reform: Actions Needed to Help Realize Potential Cost Savings from Medical Education and Training. GAO-14-630, July 31.
http://www.gao.gov/products/GAO-14-630
Highlights – http://www.gao.gov/assets/670/665157.pdf

4. Defense Management: DOD Needs to Improve Future Assessments of Roles and Missions. GAO-14-668, July 31.
http://www.gao.gov/products/GAO-14-668
Highlights – http://www.gao.gov/assets/670/665191.pdf

5. Defense Health Care: US Family Health Plan is Duplicative and Should be Eliminated. GAO-14-684, July 31.
http://www.gao.gov/products/GAO-14-684
Highlights – http://www.gao.gov/assets/670/665150.pdf

6. Healthcare.gov: Ineffective Planning and Oversight Practices Underscore the Need for Improved Contract Management. GAO-14-694, July 30.
http://www.gao.gov/products/GAO-14-694
Highlights – http://www.gao.gov/assets/670/665178.pdf

7. Active and Reserve Unit Costs: DOD Report to Congress Generally Addressed the Statutory Requirements but Lacks Detail. GAO-14-711R, July 31.
http://www.gao.gov/products/GAO-14-711R

Testimonies

1. Healthcare.gov: Contract Planning and Oversight Practices Were Ineffective Given the Challenges and Risks, by William T. Woods, director, acquisition and sourcing management, before the Subcommittee on Oversight and Investigations, House Committee on Energy and Commerce. GAO-14-824T, July 31.
http://www.gao.gov/products/GAO-14-824T

2. Department of Homeland Security: Continued Actions Needed to Strengthen Oversight and Coordination of Research and Development, by David C. Maurer, director, homeland security and justice, before the Subcommittee on Research and Technology and the Subcommittee on Oversight, House Committee on Science, Space, and Technology. GAO-14-813T, July 31.
http://www.gao.gov/products/GAO-14-813T
Highlights – http://www.gao.gov/assets/670/665129.pdf

3. Aviation Manufacturing: Status of FAA’s Efforts to Improve Certification and Regulatory Consistency, by Gerald L. Dillingham, Ph.D., director, physical infrastructure issues, before the Subcommittee on Aviation Operations, Safety, and Security, Senate Committee on Commerce, Science, and Transportation. GAO-14-829T, July 31.
http://www.gao.gov/products/GAO-14-829T
Highlights – http://www.gao.gov/assets/670/665132.pdf

4. Large Bank Holding Companies: Expectations of Government Support, by Lawrance L. Evans, Jr., Ph.D., director, financial markets and community investment, before the Subcommittee on Financial Institutions and Consumer Protection, Senate Committee on Banking, Housing and Urban Affairs. GAO-14-809T, July 31.
http://www.gao.gov/products/GAO-14-809T

DHS OIG — Oversight of Unaccompanied Alien Children

July 31, 2014 Comments off

Oversight of Unaccompanied Alien Children (PDF)
Source: U.S. Department of Homeland Security, Office of Inspector General
From press release (PDF):

The Office of Inspector General (OIG), Department of Homeland Security (DHS), today issued the first of a series of reports on conditions at detention centers being used to temporarily house unaccompanied alien children.

The report is based on 87 unannounced site visits conducted by OIG agents from July 1-16 at 63 detention centers in Texas, Arizona and California, largely operated by Customs and Border Protection. The OIG’s oversight of the detention centers is ongoing and reports will be issued monthly.

The OIG’s findings are contained in a memorandum from Inspector General John Roth to Homeland Security Secretary Jeh C. Johnson.

OIG Agents checked the sites for sanitation, availability of medical care, food services and other factors. Sites and their staff were found to be largely in compliance with rules and regulations. Some problems were identified, including children requiring treatment for communicable diseases and DHS employees who have become ill from contact with their charges.

CDC — Outbreak of Ebola in Guinea, Liberia, and Sierra Leone

July 31, 2014 Comments off

Outbreak of Ebola in Guinea, Liberia, and Sierra Leone
Source: Centers for Disease Control and Prevention

Highlights

  • July 23, 2014, the Guinea Ministry of Health announced a total of 427 suspect and confirmed cases of Ebola virus disease (EVD), including 319 fatal cases.
  • Affected districts include Conakry, Guéckédou, Macenta, Kissidougou, Dabola, Djingaraye, Télimélé, Boffa, Kouroussa, Dubreka, Fria, and Siguiri; several are no longer active areas of EVD transmission (see map).
  • 311 cases across Guinea have been confirmed by laboratory testing to be positive for Ebola virus infection.
  • In Guinea’s capital city, Conakry, 73 suspect cases have been reported to meet the clinical definition for EVD, including 37 fatal cases.
  • July 23, 2014, the Ministry of Health and Sanitation of Sierra Leone and WHO reported a cumulative total of 525 suspect and confirmed cases, including 419 laboratory confirmations and 224 reported fatal cases.
  • Cases have been reported from 6 Sierra Leone districts: Kailahun, Kambia, Port Loko, Kenema, Bo, and Western.
  • July 23, 2014, the Ministry of Health and Social Welfare of Liberia and WHO have reported 249 suspect and confirmed EHF cases (including 84 laboratory confirmations) and 129 reported fatalities.
  • Genetic analysis of the virus indicates that it is closely related (97% identical) to variants of Ebola virus (species Zaire ebolavirus) identified earlier in the Democratic
  • Republic of the Congo and Gabon (Baize et al. 2014External Web Site Icon).
  • The Guinean Ministry of Health, the Ministry of Health and Sanitation of Sierra Leone, and the Ministry of Health and Social Welfare of Liberia are working with national and international partners to investigate and respond to the outbreak.

Medicaid and the Elderly

July 31, 2014 Comments off

Medicaid and the Elderly
Source: Center for Retirement Research at Boston College

The brief’s key findings are:

  • Medicaid covers not only the low-income elderly but also those with higher incomes who become impoverished by health costs, such as nursing home care.
  • The percentage of high-income single retirees receiving Medicaid rises with age – from near zero for those in their 70s to 20 percent for those in their late 90s.
  • Even higher-income retirees who never receive Medicaid benefit from the insurance value that it provides, which allows them to maintain smaller reserves.
  • The analysis suggests that single retirees of all incomes value current Medicaid benefits at more than their cost but an expansion at less than its cost.

The Surgeon General’s Call to Action to Prevent Skin Cancer

July 31, 2014 Comments off

The Surgeon General’s Call to Action to Prevent Skin Cancer
Source: Surgeon General of the United States
From Executive Summary:

The Surgeon General’s Call to Action to Prevent Skin Cancer calls on partners in prevention from various sectors across the nation to address skin cancer as a major public health problem. Federal, state, tribal, local, and territorial governments; members of the business, health care, and education sectors; community, nonprofit, and faith-based organizations; and individuals and families are all essential partners in this effort. The goal of this document is to increase awareness of skin cancer and to call for actions to reduce its risk. The Call to Action presents the following five strategic goals to support skin cancer prevention in the United States: increase opportunities for sun protection in outdoor settings; provide individuals with the information they need to make informed, healthy choices about ultraviolet (UV) radiation exposure; promote policies that advance the national goal of preventing skin cancer; reduce harms from indoor tanning; and strengthen research, surveillance, monitoring, and evaluation related to skin cancer prevention.

Dirty Work: The Effects of Viewing Disturbing Media on Military Attorneys

July 30, 2014 Comments off

Dirty Work: The Effects of Viewing Disturbing Media on Military Attorneys
Source: Minnesota State University-Mankato (Sokol)

This study examines the psychological effects of viewing disturbing media on military attorneys who are part of the JAG Corps. Twenty seven legal professionals who work with cases involving child pornography and sexual violence completed measures of secondary traumatic stress disorder (STSD), burnout, perceptions of social stigma, and feelings of protectiveness and distrust towards others. A substantial number of participants reported poor well-being, though exposure to disturbing media was not predictive of these outcomes. However, defense attorneys and prosecuting attorneys differed significantly in severity of their perception of social stigma, which was linked to increased negative outcomes. Furthermore, qualitative results added to the growing pool of data related to effective methods of coping with exposure to disturbing media which may have important practical implications for the legal professionals who engage in this work.

Human Papillomavirus Vaccination Coverage Among Adolescents, 2007–2013, and Postlicensure Vaccine Safety Monitoring, 2006–2014 — United States

July 30, 2014 Comments off

Human Papillomavirus Vaccination Coverage Among Adolescents, 2007–2013, and Postlicensure Vaccine Safety Monitoring, 2006–2014 — United States
Source: Morbidity and Mortality Weekly Report (CDC)

Since mid-2006, a licensed human papillomavirus (HPV) vaccine has been available and recommended by the Advisory Committee on Immunization Practices (ACIP) for routine vaccination of adolescent girls at ages 11 or 12 years (1). Two vaccines that protect against HPV infection are currently available in the United States. Both the quadrivalent (HPV4) and bivalent (HPV2) vaccines protect against HPV types 16 and 18, which cause 70% of cervical cancers; HPV4 also protects against HPV types 6 and 11, which cause 90% of genital warts (1,2). In 2011, the ACIP also recommended HPV4 for the routine vaccination of adolescent boys at ages 11 or 12 years (3). HPV vaccines can be safely co-administered with other routinely recommended vaccines, and ACIP recommends administration of all age-appropriate vaccines during a single visit (4). To assess progress with HPV vaccination coverage among adolescents aged 13–17 years,* characterize adherence with recommendations for HPV vaccination by the 13th birthday, and describe HPV vaccine adverse reports received postlicensure, CDC analyzed data from the 2007–2013 National Immunization Survey-Teen (NIS-Teen) and national postlicensure vaccine safety data among females and males. Vaccination coverage with ≥1 dose of any HPV vaccine increased significantly from 53.8% (2012) to 57.3% (2013) among adolescent girls and from 20.8% (2012) to 34.6% (2013) among adolescent boys. Receipt of ≥1 dose of HPV among girls by age 13 years increased with each birth cohort; however, missed vaccination opportunities were common. Had HPV vaccine been administered to adolescent girls born in 2000 during health care visits when they received another vaccine, vaccination coverage for ≥1 dose by age 13 years for this cohort could have reached 91.3%. Postlicensure monitoring data continue to indicate that HPV4 is safe. Improving practice patterns so that clinicians use every opportunity to recommend HPV vaccines and address questions from parents can help realize reductions in vaccine-preventable infections and cancers caused by HPV.

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2013

July 30, 2014 Comments off

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2013
Source: Morbidity and Mortality Weekly Report (CDC)

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents routinely receive 1 dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, 2 doses of meningococcal conjugate (MenACWY) vaccine, and 3 doses of human papillomavirus (HPV) vaccine (1,2).* ACIP also recommends administration of “catch-up”† vaccinations, such as measles, mumps, and rubella (MMR), hepatitis B, and varicella, and, for all persons aged ≥6 months, an annual influenza vaccination (1). ACIP recommends administration of all age-appropriate vaccines during a single visit (3). To assess vaccination coverage among adolescents aged 13–17 years, CDC analyzed data from the 2013 National Immunization Survey-Teen (NIS-Teen).§ This report summarizes the results of that analysis, which show that from 2012 to 2013, coverage increased for each of the vaccines routinely recommended for adolescents: from 84.6% to 86.0% for ≥1 Tdap dose; from 74.0% to 77.8% for ≥1 MenACWY dose; from 53.8% to 57.3% for ≥1 HPV dose among females, and from 20.8% to 34.6% for ≥1 HPV dose among males. Coverage varied by state and local jurisdictions and by U.S. Department of Health and Human Services (HHS) region. Healthy People 2020 vaccination targets for adolescents aged 13–15 years (4) were reached in 42 states for ≥1 Tdap dose, 18 for ≥1 MenACWY dose, and 11 for ≥2 varicella doses. No state met the target for ≥3 HPV doses.¶ Use of patient reminder and recall systems, immunization information systems, coverage assessment and feedback to clinicians, clinician reminders, standing orders, and other interventions can help make use of every health care visit to ensure that adolescents are fully protected from vaccine-preventable infections and cancers (5), especially when such interventions are coupled with clinicians’ vaccination recommendations.

Climate Change Could Alter Range of Caribou and May Impact Hunters’ Access

July 30, 2014 Comments off

Climate Change Could Alter Range of Caribou and May Impact Hunters’ Access
Source: USGS (PLoS ONE)

Due to climate change, some communities in rural Alaska and the Yukon Territory of Canada may face a future with fewer caribou according to new research published by the U.S. Geological Survey and the University of Alaska, Fairbanks in the recent issue of PLoS ONE. Scientists examined the future effects of fires on winter habitats of caribou herds and determined that wildfires will reduce the amount of winter habitat for caribou, thus caribou may need to shift their wintering grounds

Warming temperatures will increase the flammability of lichen-producing boreal forests, which are important winter habitat for caribou herds. Caribou serve as nutritional as well as cultural sustenance for certain communities. Caribou avoid burned areas in winter and the changes in their distribution can persist across multiple generations of hunters. Those who rely on caribou in fire-prone areas may therefore have fewer available as climate change increases the number and sizes of fires in the boreal forests.

State Prison Health Care Spending

July 30, 2014 Comments off

State Prison Health Care Spending
Source: Pew Charitable Trusts

This report finds that state spending on prisoner health care increased from fiscal 2007 to 2011, but began trending downward from its peak in 2009. Nationwide, prison health care spending totaled $7.7 billion in fiscal 2011, down from a peak of $8.2 billion in fiscal 2009. In a majority of states, correctional health care spending and per-inmate health care spending peaked before fiscal 2011. But a steadily aging prison population is a primary challenge that threatens to drive costs back up. The share of older inmates rose in all but two of the 42 states that submitted prisoner age data. States where older inmates represented a relatively large share of the total prisoner population tended to incur higher per-inmate health care spending.

Body Mass Index, Sex, and Cardiovascular Disease Risk Factors Among Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos

July 30, 2014 Comments off

Body Mass Index, Sex, and Cardiovascular Disease Risk Factors Among Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos
Source: Journal of the American Heart Association

Background
All major Hispanic/Latino groups in the United States have a high prevalence of obesity, which is often severe. Little is known about cardiovascular disease (CVD) risk factors among those at very high levels of body mass index (BMI).

Methods and Results
Among US Hispanic men (N=6547) and women (N=9797), we described gradients across the range of BMI and age in CVD risk factors including hypertension, serum lipids, diabetes, and C‐reactive protein. Sex differences in CVD risk factor prevalences were determined at each level of BMI, after adjustment for age and other demographic and socioeconomic variables. Among those with class II or III obesity (BMI ≥35 kg/m2, 18% women and 12% men), prevalences of hypertension, diabetes, low high‐density lipoprotein cholesterol level, and high C‐reactive protein level approached or exceeded 40% during the fourth decade of life. While women had a higher prevalence of class III obesity (BMI ≥40 kg/m2) than did men (7% and 4%, respectively), within this highest BMI category there was a >50% greater relative prevalence of diabetes, hypertension, and hyperlipidemia in men versus women, while sex differences in prevalence of these CVD risk factors were ≈20% or less at other BMI levels.

Conclusions
Elevated BMI is common in Hispanic/Latino adults and is associated with a considerable excess of CVD risk factors. At the highest BMI levels, CVD risk factors often emerge in the earliest decades of adulthood and they affect men more often than women.

Health, Work and Working Conditions: A Review of the European Economic Literature

July 30, 2014 Comments off

Health, Work and Working Conditions: A Review of the European Economic Literature
Source: OECD

Economists have traditionally been very cautious when studying the interaction between employment and health because of the two-way causal relationship between these two variables: health status influences the probability of being employed and, at the same time, working affects the health status. Because these two variables are determined simultaneously, researchers control endogeneity bias (e.g., reverse causality, omitted variables) when conducting empirical analysis. With these caveats in mind, the literature finds that a favourable work environment and high job security lead to better health conditions. Being employed with appropriate working conditions plays a protective role on physical health and psychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment, and overemployment has a negative effect on health. These findings stress the importance of employment and of adequate working conditions for the health of workers. In this context, it is a concern that a significant proportion of European workers (29%) would like to work fewer hours because unwanted long hours are likely to signal a poor level of job satisfaction and inadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to job sustainability and job satisfaction. The literature clearly invites employers to take better account of the worker preferences when setting the number of hours worked. Overall, a specific “flexicurity” (combination of high employment protection, job satisfaction and active labour-market policies) is likely to have a positive effect on health. This Working Paper relates to the 2014 OECD Economic Survey of the United States (www.oecd.org/eco/surveys/United States ).

Out-of-Pocket Health Care Expenses by Age and Insurance Coverage, 2011

July 29, 2014 Comments off

Out-of-Pocket Health Care Expenses by Age and Insurance Coverage, 2011
Source: Agency for Healthcare Research and Quality

Highlights

  • In 2011, an average of $703 was paid out of pocket for health care among people with some health care expenses. However, the median out-of-pocket amount was notably lower ($237).
  • Nearly one-fifth of people with some health care expenses had out-of-pocket expenses greater than $1,000 while 8.2 percent had out-of-pocket expenses greater than $2,000.
  • Average out-of-pocket expenses increased with age, ranging from $283 for children under 18 to $1,215 for people age 65 and older.
  • On average, the uninsured paid nearly two-thirds of their health care expenses out of pocket while people under age 65 covered by public insurance and people age 65 and older covered by Medicare and other public insurance paid a substantially lower percentage (only 9–11 percent).

Tree and forest effects on air quality and human health in the United States

July 29, 2014 Comments off

Tree and forest effects on air quality and human health in the United States
Source: U.S. Forest Service

Trees remove air pollution by the interception of particulate matter on plant surfaces and the absorption of gaseous pollutants through the leaf stomata. However, the magnitude and value of the effects of trees and forests on air quality and human health across the United States remains unknown. Computer simulations with local environmental data reveal that trees and forests in the conterminous United States removed 17.4 million tonnes (t) of air pollution in 2010 (range: 9.0-23.2 million t), with human health effects valued at 6.8 billion U.S. dollars (range: $1.5-13.0 billion). This pollution removal equated to an average air quality improvement of less than one percent. Most of the pollution removal occurred in rural areas, while most of the health impacts and values were within urban areas. Health impacts included the avoidance of more than 850 incidences of human mortality and 670,000 incidences of acute respiratory symptoms.

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