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Emergency Hospitalizations for Unsupervised Prescription Medication Ingestions by Young Children

September 16, 2014 Comments off

Emergency Hospitalizations for Unsupervised Prescription Medication Ingestions by Young Children
Source: Pediatrics

BACKGROUND: Emergency department visits and subsequent hospitalizations of young children after unsupervised ingestions of prescription medications are increasing despite widespread use of child-resistant packaging and caregiver education efforts. Data on the medications implicated in ingestions are limited but could help identify prevention priorities and intervention strategies.

METHODS: We used nationally representative adverse drug event data from the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance project and national retail pharmacy prescription data from IMS Health to estimate the frequency and rates of emergency hospitalizations for unsupervised prescription medication ingestions by young children (2007–2011).

RESULTS: On the basis of 1513 surveillance cases, 9490 estimated emergency hospitalizations (95% confidence interval: 6420–12 560) occurred annually in the United States for unsupervised prescription medication ingestions among children aged <6 years from 2007 through 2011; 75.4% involved 1- or 2-year old children. Opioids (17.6%) and benzodiazepines (10.1%) were the most commonly implicated medication classes. The most commonly implicated active ingredients were buprenorphine (7.7%) and clonidine (7.4%). The top 12 active ingredients, alone or in combination with others, were implicated in nearly half (45.0%) of hospitalizations. Accounting for the number of unique patients who received dispensed prescriptions, the hospitalization rate for unsupervised ingestion of buprenorphine products was significantly higher than rates for all other commonly implicated medications and 97-fold higher than the rate for oxycodone products (200.1 vs 2.1 hospitalizations per 100 000 unique patients).

CONCLUSIONS: Focusing unsupervised ingestion prevention efforts on medications with the highest hospitalization rates may efficiently achieve large public health impact.

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Medical Aspects of Transgender Military Service

September 16, 2014 Comments off

Medical Aspects of Transgender Military Service
Source: Armed Forces & Society

At least eighteen countries allow transgender personnel to serve openly, but the United States is not among them. In this article, we assess whether US military policies that ban transgender service members are based on medically sound rationales. To do so, we analyze Defense Department regulations and consider a wide range of medical data. Our conclusion is that there is no compelling medical reason for the ban on service by transgender personnel, that the ban is an unnecessary barrier to health care access for transgender personnel, and that medical care for transgender individuals should be managed using the same standards that apply to all others. Removal of the military’s ban on transgender service would improve health outcomes, enable commanders to better care for their troops, and reflect the military’s commitment to providing outstanding medical care for all military personnel.

Fiction or Not? Fifty Shades is Associated with Health Risks in Adolescent and Young Adult Females

September 12, 2014 Comments off

Fiction or Not? Fifty Shades is Associated with Health Risks in Adolescent and Young Adult Females
Source: Journal of Women’s Health

Background:
No prior study has empirically characterized the association between health risks and reading popular fiction depicting violence against women. Fifty Shades—a blockbuster fiction series—depicts pervasive violence against women, perpetuating a broader social narrative that normalizes these types of risks and behaviors in women’s lives. The present study characterized the association between health risks in women who read and did not read Fifty Shades; while our cross-sectional study design precluded causal determinations, an empirical representation of the health risks in women consuming the problematic messages in Fifty Shades is made.

Methods:
Females ages 18 to 24 (n=715), who were enrolled in a large Midwestern university, completed a cross-sectional online survey about their health behaviors and Fifty Shades’ readership. The analysis included 655 females (219 who read at least the first Fifty Shades novel and 436 who did not read any part of Fifty Shades). Age- and race-adjusted multivariable models characterized Fifty Shades’ readers and nonreaders on intimate partner violence victimization (experiencing physical, sexual and psychological abuse, including cyber-abuse, at some point during their lifetime); binge drinking (consuming five or more alcoholic beverages on six or more days in the last month); sexual practices (having five or more intercourse partners and/or one or more anal sex partner during their lifetime); and using diet aids or fasting for 24 or more hours at some point during their lifetime.

Results:
One-third of subjects read Fifty Shades (18.6%, or 122/655, read all three novels, and 14.8%, or 97/655, read at least the first novel but not all three). In age- and race-adjusted models, compared with nonreaders, females who read at least the first novel (but not all three) were more likely than nonreaders to have had, during their lifetime, a partner who shouted, yelled, or swore at them (relative risk [RR]=1.25) and who delivered unwanted calls/text messages (RR=1.34); they were also more likely to report fasting (RR=1.80) and using diet aids (RR=1.77) at some point during their lifetime. Compared with nonreaders, females who read all three novels were more likely to report binge drinking in the last month (RR=1.65) and to report using diet aids (RR=1.65) and having five or more intercourse partners during their lifetime (RR=1.63).

Conclusions:
Problematic depictions of violence against women in popular culture—such as in film, novels, music, or pornography—create a broader social narrative that normalizes these risks and behaviors in women’s lives. Our study showed strong correlations between health risks in women’s lives—including violence victimization—and consumption of Fifty Shades, a fiction series that portrays violence against women. While our cross-sectional study cannot determine temporality, the order of the relationship may be inconsequential; for example, if women experienced adverse health behaviors first (e.g., disordered eating), reading Fifty Shades might reaffirm those experiences and potentially aggravate related trauma. Likewise, if women read Fifty Shades before experiencing the health behaviors assessed in our study, it is possible that the book influenced the onset of these behaviors by creating an underlying context for the behaviors.

Pesticides in U.S. Streams and Rivers: Occurrence and Trends during 1992–2011

September 12, 2014 Comments off

Pesticides in U.S. Streams and Rivers: Occurrence and Trends during 1992–2011
Source: Environmental Science & Technology

During the 20 years from 1992 to 2011, pesticides were found at concentrations that exceeded aquatic-life benchmarks in many rivers and streams that drain agricultural, urban, and mixed-land use watersheds. Overall, the proportions of assessed streams with one or more pesticides that exceeded an aquatic-life benchmark were very similar between the two decades for agricultural (69% during 1992−2001 compared to 61% during 2002−2011) and mixed-land-use streams (45% compared to 46%). Urban streams, in contrast, increased from 53% during 1992−2011 to 90% during 2002−2011, largely because of fipronil and dichlorvos. The potential for adverse effects on aquatic life is likely greater than these results indicate because potentially important pesticide compounds were not included in the assessment. Human-health benchmarks were much less frequently exceeded, and during 2002−2011, only one agricultural stream and no urban or mixed-land-use streams exceeded human-health benchmarks for any of the measured pesticides. Widespread trends in pesticide concentrations, some downward and some upward, occurred in response to shifts in use patterns primarily driven by regulatory changes and introductions of new pesticides.

Planning for Marijuana: The Cannabis Conundrum

September 11, 2014 Comments off

Planning for Marijuana: The Cannabis Conundrum
Source: Journal of the American Planning Association

Problem, research strategy, and findings:
Twenty-three states and Washington, DC, have legalized medical marijuana, raising difficult land use questions for planners regarding allowable locations, buffering from sensitive uses, and distribution of facilities. We know little about how local jurisdictions regulate medical marijuana dispensary (MMD) location and operation and how equitably different regulatory models distribute these facilities. We begin with an overview of MMD impacts related to crime, property values, and quality of life. We then review emerging local regulation of MMDs with a particular emphasis on land use controls, and find that most authorities regulate MMD location like they do other locally unwanted land uses (LULUs) such as sex-oriented businesses and liquor stores. Given a history of siting LULUs in less-affluent neighborhoods and communities of color, we conduct a case study of Denver and show that four common regulatory models concentrate land that permits MMDs in socioeconomically disadvantaged tracts and areas with high proportions of persons of color.

Takeaway for practice:
Local planners are often caught unprepared for the land use implications of medical marijuana legalization. This outline of common land use regulatory models and a replicable analytical model help practitioners develop ordinances that square with their own communities’ goals, values, and attributes.

The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010

September 11, 2014 Comments off

The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010
Source: Preventing Chronic Disease (CDC)

Introduction
Differences in risk for death from diseases and other causes among racial/ethnic groups likely contributed to the limited improvement in the state of health in the United States in the last few decades. The objective of this study was to identify causes of death that are the largest contributors to health disparities among racial/ethnic groups.

Methods
Using data from WONDER system, we measured the relative (age-adjusted mortality ratio [AAMR]) and absolute (difference in years of life lost [dYLL]) differences in mortality risk between the non-Hispanic white population and the black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander populations for the 25 leading causes of death.

Results
Many causes contributed to disparities between non-Hispanic whites and blacks, led by assault (AAMR, 7.56; dYLL, 4.5 million). Malignant neoplasms were the second largest absolute contributor (dYLL, 3.8 million) to black–white disparities; we also found substantial relative and absolute differences for several cardiovascular diseases. Only assault, diabetes, and diseases of the liver contributed substantially to disparities between non-Hispanic whites and Hispanics (AAMR ≥ 1.65; dYLL ≥ 325,000). Many causes of death, led by assault (AAMR, 3.25; dYLL, 98,000), contributed to disparities between non-Hispanic whites and American Indians/Alaska Natives; Asian/Pacific Islanders did not have a higher risk than non-Hispanic whites for death from any disease.

Conclusion
Assault was a substantial contributor to disparities in mortality among non-Asian racial/ethnic minority populations. Research and intervention resources need to target diseases (such as diabetes and diseases of the liver) that affect certain racial/ethnic populations.

Remotely Piloted Aircraft and War in the Public Relations Domain

September 11, 2014 Comments off

Remotely Piloted Aircraft and War in the Public Relations Domain (PDF)
Source: Air & Space Power Journal

Many of the RPA articles, opinions, and interviews produced over the last decade are either based on false premises (option a) or employ a logical fallacy of analogy (option c); therefore, many of their conclusions are invalid. This article does not attempt to show that most of the writing on RPAs over the last decade contains fallacies of some kind. Rather, it recognizes the ease with which sincere people can commit such errors as a result of the epistemic problem inherent in any discussion of RPA operations.

The argument, then, begins by asserting that such a problem exists and suggesting that it has three causes. First, enemy forces (here referring specifically to al-Qaeda and the Taliban) have an effective public relations (PR) campaign against RPAs. Second, the United States conducts an ineffective PR campaign in support of RPAs. Third, RPA operations are necessarily concealed by security classifications and national security precautions. The article expounds upon the significance of these causes and provides evidence for them—evidence that will demonstrate not only the three causes but also the reality of the epistemic problem. Its conclusion offers two ways that individuals can mitigate the dilemma and one means by which the US government can rectify it.

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