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2.
N Engl J Med ; 382(23): 2220-2229, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32492303

RESUMO

BACKGROUND: Research has consistently identified firearm availability as a risk factor for suicide. However, existing studies are relatively small in scale, estimates vary widely, and no study appears to have tracked risks from commencement of firearm ownership. METHODS: We identified handgun acquisitions and deaths in a cohort of 26.3 million male and female residents of California, 21 years old or older, who had not previously acquired handguns. Cohort members were followed for up to 12 years 2 months (from October 18, 2004, to December 31, 2016). We used survival analysis to estimate the relationship between handgun ownership and both all-cause mortality and suicide (by firearm and by other methods) among men and women. The analysis allowed the baseline hazard to vary according to neighborhood and was adjusted for age, race and ethnic group, and ownership of long guns (i.e., rifles or shotguns). RESULTS: A total of 676,425 cohort members acquired one or more handguns, and 1,457,981 died; 17,894 died by suicide, of which 6691 were suicides by firearm. Rates of suicide by any method were higher among handgun owners, with an adjusted hazard ratio of 3.34 for all male owners as compared with male nonowners (95% confidence interval [CI], 3.13 to 3.56) and 7.16 for female owners as compared with female nonowners (95% CI, 6.22 to 8.24). These rates were driven by much higher rates of suicide by firearm among both male and female handgun owners, with a hazard ratio of 7.82 for men (95% CI, 7.26 to 8.43) and 35.15 for women (95% CI, 29.56 to 41.79). Handgun owners did not have higher rates of suicide by other methods or higher all-cause mortality. The risk of suicide by firearm among handgun owners peaked immediately after the first acquisition, but 52% of all suicides by firearm among handgun owners occurred more than 1 year after acquisition. CONCLUSIONS: Handgun ownership is associated with a greatly elevated and enduring risk of suicide by firearm. (Funded by the Fund for a Safer Future and others.).


Assuntos
Armas de Fogo , Violência com Arma de Fogo/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , California/epidemiologia , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Propriedade , Fatores de Risco , Suicídio/prevenção & controle , Análise de Sobrevida , Adulto Jovem
4.
PLoS One ; 15(4): e0232252, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353022

RESUMO

INTRODUCTION AND OBJECTIVE: The United States (US) has the highest rate of firearm suicides in the world. The US and Canada are comparable countries with markedly different rates of firearm ownership, providing an opportunity to estimate suicide fatalities that could be averted in the US with a lower rate of firearm ownership. METHODS: We compared 2016 US suicide fatality rates-standardized within fourteen sex-specific age groups to reflect the ethnic composition of Canada-to 2016 Canadian suicide rates. We then calculated the number and proportion of suicides that could be averted in the US if the US had the same rates of suicide as in Canada. RESULTS: If the US had the same suicide rates as in Canada, we estimate there would be approximately 25.9% fewer US suicide fatalities, equivalent to 11,630 suicide fatalities averted each year. This decline would be driven by a 79.3% lower rate of firearm-specific suicide fatalities. The male suicide fatality rate would be 28.8% lower and equivalent to 9,992 fewer suicide fatalities each year. The female suicide fatality rate would be 16.0% lower and equivalent to 1,638 fewer suicide fatalities each year. While 36% of firearm suicide fatalities could be replaced by non-firearm suicide fatalities, 64% of firearm fatalities could be averted entirely. CONCLUSIONS: US policymakers may wish to consider policies that would reduce rates of firearm ownership, given that that about 26% of US suicide fatalities might be averted if the US had the same suicide rates as in Canada, a country with drastically lower firearm ownership rates.


Assuntos
Armas de Fogo/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Canadá , Criança , Pré-Escolar , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Propriedade/estatística & dados numéricos , Gravidez , Estados Unidos , Adulto Jovem
6.
Am J Trop Med Hyg ; 102(6): 1175-1177, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32314697

RESUMO

Two decades of growing resource availability from agencies and foundations in wealthy countries has transformed approaches to health in poorly resourced nations. This progress looks increasingly unstable as climate change, social unrest, and, now, disruptive pandemics present threats not only to health but also to the mechanisms that manage it, and to funding itself. The growth in "global health" schools, technology development laboratories, nongovernmental organizations and multilateral institutions in donor countries has delivered not only successes but also disappointment, and reflect a paradigm that is in many ways contrary to the principles of population-based ownership that they espouse. Although the COVID-19 crisis has underlined the importance of health access and health service capacity, we may have a limited window of opportunity in which to rethink the current model and improve both efficiency and effectiveness. With a dose of humility, we may all benefit from studying our own rhetoric on human-centered design and applying these principles across global health to ensure that our approach is effective, efficient, and defensible.


Assuntos
Betacoronavirus/patogenicidade , Técnicas de Laboratório Clínico/economia , Infecções por Coronavirus/epidemiologia , Saúde Global/economia , Acesso aos Serviços de Saúde/economia , Pandemias , Pneumonia Viral/epidemiologia , Distúrbios Civis/economia , Técnicas de Laboratório Clínico/tendências , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/economia , Infecções por Coronavirus/prevenção & controle , Países Desenvolvidos/economia , Países em Desenvolvimento/economia , Saúde Global/tendências , Humanos , Cooperação Internacional , Propriedade/economia , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/economia , Pneumonia Viral/prevenção & controle , Pobreza/economia , Fatores de Tempo
7.
PLoS One ; 15(4): e0230999, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294083

RESUMO

Identifying and preventing the occurrence of separation-related problems (SRP) in companion animals are relevant to animal welfare and the quality of human-pet interactions. The SRP are defined as a set of behaviors and physiological signs displayed by the animal when separated from its attachment person. In cats, SRP has been insufficiently studied. Thus, the objective of this study was to develop a questionnaire for cat owners which identifies behaviors that may indicate SRP, as well as relates the occurrence of SRP to the management practices applied in the sampled cats. The associations of SRP with cats' characteristics, as well as owner, environmental, and management traits were investigated. The questionnaire was developed based on the scientific literature about separation anxiety syndrome in dogs and a few papers in cats, and it was completed by 130 owners of 223 cats. Analysis of owners' answers was done through categorization and acquisition of relative frequencies of each response category, followed by Fisher's exact test, chi-square tests in contingency table and Multiple Correspondence Analysis. Among the sampled animals, 13.45% (30 / 223) met at least one of the behavioral criteria we used to define SRP. Destructive behavior was the most frequently reported behavior (66.67%, 20 / 30), followed by excessive vocalization (63.33%, 19 / 30), urination in inappropriate places (60.00%, 18 / 30), depression-apathy (53.33%, 16 / 30), aggressiveness (36.67%, 11 / 30) and agitation-anxiety (36.67%, 11 / 30) and, in lower frequency, defecation in inappropriate places (23.33%, 7 / 30). The occurrence of SRP was associated with the number of females living in the residence (P = 0.01), with not having access to toys (P = 0.04), and no other animal residing in the house (P = 0.04). Separation-related problems in domestic cats are difficult to identify due to the limited amount of knowledge regarding the issue. The questionnaire developed in this study supported identification of the main behaviors likely related to SRP in cats and could be used as a starting point for future research.


Assuntos
Comportamento Animal , Vínculo Homem-Animal de Estimação , Gatos/psicologia , Bem-Estar do Animal , Animais , Ansiedade de Separação , Brasil , Doenças do Gato/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Transtornos Mentais/veterinária , Propriedade , Inquéritos e Questionários
8.
PLoS One ; 15(4): e0231275, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32287295

RESUMO

The present study aimed to explore the motivations of Brazilian dog owners and their knowledge about the risks related to raw meat-based diets (RMBD) as well as to evaluate important enteropathogens such as Salmonella spp., C. perfringens, and C. difficile, in feces of dogs fed different diets. The majority of the pet owners (69.3%) reported to have chosen this diet for their dogs, considering it to be more "natural". A large number of owners declared that RMBD do not pose health risks for their animals (87.9%) or humans (98.8%), even though almost one third of the respondents (34.8%) declared having at least one individual at high risk of infection in contact with RMBD-fed dogs. Stool samples from 46 RMBD-fed dogs and 192 dogs fed commercial dry feed were collected. The present study revealed that dogs fed raw meat diets were almost 30 times more likely to be positive for Salmonella spp. than dogs on a conventional diet. Some of the serovars detected were commonly associated with human salmonellosis, such as S. Typhimurium and S. Saintpaul, and were multidrug resistant. RMBD-fed dogs were more likely to be positive for C. perfringens type A (p = 0.008) and one C. perfringens type F was isolated from these animals. Two toxigenic strains (4.3%) of C. difficile were isolated only from raw meat-fed dogs, all of which were under antibiotic therapy. These toxigenic C. difficile isolates were classified as RT106/ST54 and RT600/ST149, previously associated with infection in dogs and humans. The present work revealed that the owners have a tendency to ignore or are unaware of the risks associated with raw meat diets for dogs. Also, the higher fecal shedding of important enteropathogens in dogs fed RMBD suggests that this diet poses a risk for the animals and the people in contact with them.


Assuntos
Derrame de Bactérias , Clostridium difficile/isolamento & purificação , Clostridium perfringens/isolamento & purificação , Dieta/veterinária , Microbiologia de Alimentos , Carne/microbiologia , Alimentos Crus/microbiologia , Salmonella/isolamento & purificação , Animais , Brasil , Dieta/psicologia , Cães , Fezes/microbiologia , Humanos , Motivação , Propriedade
9.
PLoS One ; 15(4): e0230525, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32240191

RESUMO

Conserving forests to provide ecosystem services and biodiversity will be a key environmental challenge as society strives to adapt to climate change. The ecosystem services and biodiversity that forests provide will be influenced by the behaviors of numerous individual private landowners as they alter their use of forests in response to climate change and any future carbon pricing policies that emerge. We evaluated the impact of forest landowners' likely adaptation behaviors on potential habitat for 35 terrestrial, forest-dependent vertebrates across three U.S. Pacific states. In particular, we couple a previously estimated empirical-economic model of forest management with spatially explicit species' range and habitat associations to quantify the effects of adaptation to climate change and carbon pricing on potential habitat for our focal species (amphibians, birds and mammals) drawn from state agency lists of species of conservation concern. We show that both climate change and carbon pricing policies would likely encourage adaptation away from currently prevalent coniferous forest types, such as Douglas-fir, largely through harvest and planting decisions. This would reduce potential habitat for a majority of the focal species we studied across all three vertebrate taxa. The total anticipated habitat loss for amphibians, birds and mammals considered species of state concern would exceed total habitat gained, and the net loss in habitat per decade would accelerate over time. Carbon payments to forest landowners likely would lead to unintended localized habitat losses especially in Douglas-fir dominant forest types, and encourage more hardwoods on private forest lands. Our study highlights potential tradeoffs that could arise from pricing one ecosystem service (e.g., carbon) while leaving others (e.g., wildlife habitat) unpriced. Our study demonstrates the importance of anticipating potential changes in ecosystem services and biodiversity resulting from forest landowners' climate adaptation behavior and accounting for a broader set of environmental benefits and costs when designing policies to address climate change.


Assuntos
Adaptação Fisiológica , Biodiversidade , Carbono/metabolismo , Mudança Climática , Conservação dos Recursos Naturais , Ecossistema , Agricultura Florestal/métodos , Animais , Animais Selvagens , Florestas , Propriedade , Políticas
10.
PLoS One ; 15(4): e0230832, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32310949

RESUMO

One of the core objectives of many animal-welfare organisations is to achieve improvements in animal welfare through school education programmes. However, whilst many charities and organisations develop and deliver these educational activities, impact relating to specific animal welfare attitudes and behaviours remains largely undescribed. This study evaluated the effects of an hour-long dog welfare workshop delivered to children aged 7-11, evaluating 2732 learners in state primary schools across the UK. Two types of workshop were evaluated; "Be Dog Smart" (BDS) and "Responsible Dog Ownership" (RDO). This study assessed short-term impact on attitude outcomes, as a first step in developing a full education monitoring and evaluation framework. Learners within each class were randomly assigned to two groups; one completing an attitude-based questionnaire before (control) and the other after the workshop (treatment). Dog ownership status, age, gender, and social deprivation (measured as access to free school meals) were collected for all participants. Questionnaire scores were compared between treatment and control groups. Mean scores were significantly different (BDS p<0.001; Cohen's D 0.65; RDO p<0.001; Cohen's D 0.51) between control (BDS 13.57 ± 3.15; RDO 22.97 ± 4.78) and treatment groups (BDS 15.61 ± 3.10; RDO 25.47 ± 5.06) for both workshops, suggesting workshops effectively convey key messages and improve learner attitudes concerning dogs. Gender, age and social deprivation were found to significantly influence questionnaire responses. These findings contribute to a broader effort to improve canine welfare via childhood education while also demonstrating the feasibility of effective monitoring and evaluation during operational delivery of a schools workshop programme. Ongoing impact assessment is important in ensuring successful development, delivery and refinement of educational programmes to maximise the probabilty of positive changes in participants. Further work is needed to evaluate longer term impact, and ensure that desired influences on human behaviour change, and animal welfare, are achieved.


Assuntos
Bem-Estar do Animal , Atitude , Educação , Propriedade , Animais , Criança , Cães , Feminino , Humanos , Masculino , Reino Unido
12.
Bull World Health Organ ; 98(3): 170-176, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32132751

RESUMO

Objective: To assess the effect of a permanent gun-carrying restriction on gun-related mortality in Colombia between 2008 and 2014, and determine differences in the effect of the restriction by place of death and sex. Methods: In 2012, Bogotá and Medellín introduced a permanent gun-carrying restriction. We compared gun-related mortality rates in these cities (intervention cities) with the rates in all other Colombian cities with more than 500 000 inhabitants (control cities). We used data from the Colombian National Department of Statistics to calculate monthly gun-related mortality rates between 2008 and 2014 for intervention and control cities. We used a differences-in-differences method with fixed effects to assess differences in gun-related mortality in intervention and control cities before and after the introduction of the gun-carrying restriction. We stratified effects by place of death (public area or residence) and sex. We made robustness checks to test the assumptions of the models. Findings: Gun-related deaths in the control and intervention cities decreased between 2008 and 2014; however, the decrease was greater in the intervention cities (from 20.29 to 14.93 per 100 000 population; 26.4%) than in the control cities (from 37.88 to 34.56 per 100 000 population; 8.8%). The restriction led to a 22.3% reduction in the monthly gun-related mortality rate in Bogotá and Medellín. The reduction was greater in public areas and for males. Robustness checks supported the assumptions of the models. Conclusion: The permanent restriction on carrying guns reduced gun-related deaths. This policy could be used to reduce gun-related injuries in urban centres of other countries with large numbers of gun-related deaths.


Assuntos
Armas de Fogo/legislação & jurisprudência , Homicídio/estatística & dados numéricos , Mortalidade , Suicídio/estatística & dados numéricos , Ferimentos por Arma de Fogo/mortalidade , Colômbia , Feminino , Humanos , Masculino , Propriedade
14.
PLoS One ; 15(3): e0228946, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134937

RESUMO

Current targets for protected area network coverage call for increased protection but lack specificity in terms of criteria for parcel type, placement, and landscape connectivity. We assessed land conservation achieved by protected area networks in the contiguous United States, and assessed whether private lands contributed substantially to network coverage and connectivity given species dispersal abilities. On average, states have 4.1% (range: 0.2% to 15.8%, n = 48) protected area coverage with connectivity ≤10 km. Terrain ruggedness, percent farmland, and population density are the primary determinants of protected area placement, leading to biased representation of land features currently under protection. On average, private protected areas contribute <1.1% (range 0.0% to 9.2%) to current protected area coverage across the United States. We conclude that current levels of protection and connectivity are inadequate to support a functional protected area network, and that increased and strategic selection of private protected areas is necessary to meet conservation planning goals.


Assuntos
Conservação dos Recursos Naturais/métodos , Biodiversidade , Fazendas , Humanos , Redes Neurais de Computação , Propriedade , Densidade Demográfica , Dinâmica Populacional , Setor Privado , Estados Unidos
17.
Sci Total Environ ; 715: 136859, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32014767

RESUMO

BACKGROUND: Little is known about whether exposure to pets influences the association between hypertension and environmental tobacco smoke (ETS). The current study aims to examine the interaction of pet ownership on ETS exposure and the development of hypertension in children. METHODS: From 2012 to 2013, a total of 9354 children, 5 to 17 years of age, were recruited from 62 schools in seven northeastern cities. BP in children was measured and hypertension was defined as an average diastolic blood pressure (DBP) or systolic blood pressure (SBP) at or above the 95th percentile for that child's age, sex, and height. Pet ownership in three different time periods (in utero, past 2 years, and currently) and ETS exposure data were collected from parents via a questionnaire. Two-level regressions were used for the data analyses. RESULTS: The data show consistent, significant interactions between exposure to pets and effects from ETS. Children who were not exposed to pets experienced stronger effects from ETS on hypertension when compared to those exposed to pets, and the protective effect of pet ownership became stronger with a greater number of pets in the home. Exposure to in utero ETS was associated with hypertension [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI): 1.13-1.54] only for those children without pet exposure in utero but not for those with pets (aOR = 0.75; 95% CI: 0.49-1.15) (pinteraction < 0.05). Moreover, household dog ownership was related to significantly lower effects of current ETS on hypertension (aOR = 0.80, 95% CI: 0.61-1.05) compared with children without dogs (aOR = 1.26, 95% CI: 1.11-1.44) (pinteraction = 0.001). Interaction associations between ETS and pet ownership were more robust for girls than for boys and for younger than older children. CONCLUSION: This study indicates an inverse relationship between pet ownership and ETS, potentially pointing to pet ownership as protecting against the development of hypertension in children.


Assuntos
Hipertensão , Poluição por Fumaça de Tabaco , Animais , Criança , Cidades , Estudos de Coortes , Cães , Exposição Ambiental , Feminino , Humanos , Masculino , Propriedade , Animais de Estimação
18.
Pediatrics ; 145(3)2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32098787

RESUMO

Behavioral economics applies key principles from psychology and economics to address obstacles to behavior change. The important topic of pediatric firearm injuries has not yet been explored through a behavioral economic lens. Pediatric firearm-related injuries are a significant public health problem in the United States. Despite American Academy of Pediatrics guidelines advising that firearms be stored unloaded, in a locked box or with a locking device, and separate from ammunition, estimates suggest that ∼4.6 million children live in homes with at least 1 loaded and unlocked firearm. In this article, we use behavioral economic theory to identify specific cognitive biases (ie, present bias; in-group, out-group bias; and the availability heuristic) that may influence parental decision-making around firearm storage. We illustrate situations in which these biases may occur and highlight implementation prompts, in-group messengers, and increased salience as behaviorally informed strategies that may counter these biases and subsequently enhance safe firearm storage. We also describe other opportunities to leverage the behavioral economic tool kit. By better understanding the individual behavioral levers that may impact decision-making around firearm storage, behavioral scientists, pediatric providers, and public health practitioners can partner to design and test tailored interventions aimed at decreasing pediatric firearm injuries. Further empirical study is warranted to identify the presence of specific biases and heuristics and determine the most effective behavior change strategies for different subpopulations.


Assuntos
Economia Comportamental , Armas de Fogo , Propriedade , Segurança , Acidentes Domésticos/prevenção & controle , Humanos , Ferimentos por Arma de Fogo/prevenção & controle
20.
N Z Med J ; 133(1510): 23-34, 2020 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-32078598

RESUMO

AIM: To explore associations between tenure and the health service use of older New Zealanders. METHODS: Analysis of pooled data for adults aged 55+ from three New Zealand Health Surveys (2013/14, 2014/15, 2015/16) comparing owner-occupiers, private renters and public renters. RESULTS: Public renters, and in some age groups private renters, reported more visits to the GP and a higher proportion reported using a public hospital service in the last year. Renters were less likely than owner-occupiers to have used some privately paid services (visiting a dental health worker or optician). Renters averaged lower co-payments for their last GP visit, but financial barriers to accessing a GP, after-hours medical centre use and not collecting prescriptions were more likely to be reported by renters than owner-occupiers-particularly those that rent publicly. CONCLUSIONS: New Zealanders are simultaneously living longer while having declining opportunities to enter home ownership. Older renters are more likely to live in poorer health and, overall, are more likely to use some (public) health services than owner-occupiers yet are more likely to have unmet health needs. The increasing reliance on renting among older people has implications for population health and wellbeing, health service delivery and transitions to residential care.


Assuntos
Utilização de Instalações e Serviços/estatística & dados numéricos , Nível de Saúde , Habitação/estatística & dados numéricos , Propriedade/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Utilização de Instalações e Serviços/economia , Feminino , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Habitação/economia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Propriedade/economia , Autorrelato
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