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4.
Epidemiol Psychiatr Sci ; 29: e113, 2020 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-32248873

RESUMEN

AIMS: Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. METHODS: We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score). RESULTS: Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose-response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36-3.13) and 1.99 (p < 0.01; 95% CI = 1.26-3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16-3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19-0.96). CONCLUSIONS: Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.


Asunto(s)
Abastecimiento de Alimentos/estadística & datos numéricos , Infecciones por VIH/psicología , Trastornos Mentales/tratamiento farmacológico , Psicotrópicos/uso terapéutico , Calidad de Vida , Trastornos Relacionados con Sustancias/psicología , Adulto , Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Ansiedad/tratamiento farmacológico , Ansiedad/psicología , Estudios de Cohortes , Estudios Transversales , Depresión/tratamiento farmacológico , Depresión/psicología , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos , Hipnóticos y Sedantes/uso terapéutico , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Salud Mental , Pobreza , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/complicaciones , Estados Unidos/epidemiología
8.
J Environ Manage ; 261: 110231, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32148301

RESUMEN

Owing to uneven development and unbalanced resource endowments within China, ensuring reliable energy, water and food supply is a core challenge to regional socio-economic development. This study makes a first attempt to examine and compare demand-driven energy, water and arable land (E-W-L) resource outsourcings within China based on the latest multi-regional input-output model. Results show that interprovincial trade reallocated 73.4%, 33.9% and 38.1% of the national total E-W-L resource inputs in 2012, respectively. Investment was the dominant final demand category for driving energy requirements, while consumption was the leading final demand category for water and arable land requirements. Important provincial regions and critical transmission sectors for the trade of embodied E-W-L resources are identified. Substantial E-W-L resources were transferred from the central and western regions to the eastern regions. Especially, Inner Mongolia was the top interregional net exporter of embodied energy, while Jiangsu topped the net importer list. Regarding virtual water transfer, Xinjiang and Shandong were the biggest interregional net exporters and net importers, respectively, while Heilongjiang and Guangdong stood out in the net trade of embodied arable land. Owing to the impact of interprovincial trade, the resource occupancy levels of the eastern developed area were much higher than those of the northeastern, central and western areas. The imbalances in the levels of socio-economic development amongst provincial regions are mirrored by their patterns of E-W-L uses and related trade transfer. Understanding the synchronal outsourcings of E-W-L resource requirements provides important implications for targeted resource management in Chinese interprovincial supply chains.


Asunto(s)
Abastecimiento de Agua , Agua , China , Desarrollo Económico , Abastecimiento de Alimentos
12.
J Environ Manage ; 264: 110430, 2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32217318

RESUMEN

Africa's food systems are among the most vulnerable sectors to climate risk. Unfortunately, numerous activities along food supply chains (production, processing, storage, marketing and consumption) are also important contributors to climate change. Despite the differential effect of climate events on activities along food supply chains and vice versa, most climate change perception studies in agriculture focus on producers, particularly crop farmers. This study adopts a value chain perspective to examine climate change perceptions among economic agents all along the maize-poultry value chain in Nigeria. We find that economic agents perceive those climate events that have a direct effect on their economic activity and this is not restricted to crop farmers. We also find that very few actors along the maize-poultry value chain believe that their economic activity negatively affects the environment and contributes to climate change. Though African countries might currently not be major contributors to climate change, this indicates a need for more awareness among economic agents about the effects of various agriculture-related activities on the environment and their contributions to climate change to encourage practices and technologies that can reduce agriculture's negative effect on the environment and contribution to climate change.


Asunto(s)
Agricultura , Cambio Climático , Agricultores , Abastecimiento de Alimentos , Humanos , Nigeria
13.
Sr Care Pharm ; 35(2): 56-67, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32019640

RESUMEN

Increasingly, public policy makers, professional organizations, and academics are discussing social determinants of health-the conditions in which people live, work, and age. The impetus for the discussion is a growing awareness that medication and any type of health care is a poor substitute for improving a patient's living conditions. Health care is a necessary but insufficient intervention when people develop chronic disease. Addressing the social determinants of health that include poverty, food insecurity, health literacy, neighborhoods, and the environment is essential if we are to improve an individual's overall health. This is the focus of population health, and to address social determinants of health adequately, the medical team needs to expand to give all team members overlapping duties. It also needs to include social workers and legal representatives. Pharmacists may wonder how the theories associated with social determinants of health can be incorporated into their practices. This article discusses a number of different approaches.


Asunto(s)
Alfabetización en Salud , Determinantes Sociales de la Salud , Prestación de Atención de Salud , Abastecimiento de Alimentos , Humanos , Política Pública
16.
PLoS Biol ; 18(2): e3000641, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32058997

RESUMEN

Ex situ seed banking was first conceptualized and implemented in the early 20th century to maintain and protect crop lines. Today, ex situ seed banking is important for the preservation of heirloom strains, biodiversity conservation and ecosystem restoration, and diverse research applications. However, these efforts primarily target microalgae and terrestrial plants. Although some collections include macroalgae (i.e., seaweeds), they are relatively few and have yet to be connected via any international, coordinated initiative. In this piece, we provide a brief introduction to macroalgal germplasm banking and its application to conservation, industry, and mariculture. We argue that concerted effort should be made globally in germline preservation of marine algal species via germplasm banking with an overview of the technical advances for feasibility and ensured success.


Asunto(s)
Algas Marinas , Banco de Semillas , Acuicultura , Conservación de los Recursos Naturales , Ecosistema , Abastecimiento de Alimentos , Variación Genética , Células Germinativas de las Plantas/crecimiento & desarrollo , Cooperación Internacional , Algas Marinas/clasificación , Algas Marinas/genética , Algas Marinas/crecimiento & desarrollo
17.
Am J Public Health ; 110(4): 567-573, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32078348

RESUMEN

Objectives. To describe the types of social services provided at community health centers (CHCs), characteristics of CHCs providing these services, and the association between on-site provision and health care quality.Methods. We surveyed CHCs in 12 US states and the District of Columbia during summer 2017 (n = 208) to identify referral to and provision of services to address 8 social needs. Regression models estimated factors associated with the provision of social services by CHCs and the association between providing services and health care quality (an 8-item composite).Results. CHCs most often offered on-site assistance for needs related to food or nutrition (43%), interpersonal violence (32%), and housing (30%). Participation in projects with community-based organizations was associated with providing services on-site (odds ratio = 2.48; P = .018). On-site provision was associated with better performance on measures of health care quality (e.g., each additional social service was associated with a 4.3 percentage point increase in colorectal cancer screenings).Conclusions. Some CHCs provide social services on-site, and this was associated with better performance on measures of health care quality.Public Health Implications. Health care providers are increasingly seeking to identify and address patients' unmet social needs, and on-site provision of services is 1 strategy to consider.


Asunto(s)
Centros Comunitarios de Salud/estadística & datos numéricos , Calidad de la Atención de Salud/estadística & datos numéricos , Servicio Social/estadística & datos numéricos , Centros Comunitarios de Salud/organización & administración , Violencia Doméstica , Abastecimiento de Alimentos , Vivienda , Humanos , Encuestas y Cuestionarios , Estados Unidos
19.
Public Health Rep ; 135(2): 270-281, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32031921

RESUMEN

OBJECTIVES: Food insecurity is linked to poor sexual health outcomes, especially among persons engaged in sexual behaviors that are associated with the risk of acquiring sexually transmitted infections (STIs). We examined this link using nationally representative data. METHODS: We used data on adolescents and adults aged 15-44 who reported sexual activity in the past year from 6 years (September 2011-September 2017) of cross-sectional, weighted public-use data from the National Survey of Family Growth. We compared data on persons who did and did not report food insecurity, accounting for demographic characteristics, markers of poverty, and past-year STI risk indicators (ie, engaged in 1 of 4 high-risk activities or diagnosed with chlamydia or gonorrhea). RESULTS: Respondents who reported at least 1 past-year STI risk indicator were significantly more likely to report food insecurity (females: adjusted risk ratio [ARR] = 1.63; 95% confidence interval [CI], 1.35-1.97; P < .001; males: ARR = 1.46; 95% CI, 1.16-1.85) than respondents who did not report food insecurity. This finding was independent of the association between food insecurity and markers of poverty (≤100% federal poverty level [females: ARR = 1.46; 95% CI, 1.23-1.72; P < .001; males: ARR = 1.81; 95% CI, 1.49-2.20; P < .001]; if the respondent or someone in the household had received Special Supplemental Nutrition Program for Women, Infants, and Children or Supplemental Nutrition Assistance Program benefits in the past year [females: ARR = 3.37; 95% CI, 2.81-4.02; P < .001; males: ARR = 3.27; 95% CI, 2.76-3.87; P < .001]). Sex with opposite- and same-sex partners in the past year was significantly associated with food insecurity (females: ARR = 1.44; 95% CI, 1.11-1.85; P = .01; males: ARR = 1.99; 95% CI, 1.15-3.42; P = .02). CONCLUSIONS: Food insecurity should be considered a social determinant of health independent of poverty, and its effect on persons at highest risk for STIs, including HIV, should be considered when planning interventions designed to decrease engagement in higher-risk sexual behaviors.


Asunto(s)
Abastecimiento de Alimentos/estadística & datos numéricos , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Infecciones por Chlamydia/epidemiología , Estudios Transversales , Femenino , Gonorrea/epidemiología , Humanos , Masculino , Pobreza/estadística & datos numéricos , Factores de Riesgo , Estados Unidos/epidemiología
20.
Exp Parasitol ; 210: 107832, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32004854

RESUMEN

Despite food technology advancements, food safety policies and alert systems, foodborne diseases are still a relevant concern for consumers and public health authorities, with great impacts on the economy and the society. Evaluating the cost of foodborne diseases may support the design and the implementation of policy interventions. This paper proposes a simple method for cost identification of foodborne diseases, accessible to researchers and practitioners who are not specialist in economics. The method is based on the assumption that epidemiological and economic models can be integrated to understand how the burden of disease determines costs in a wider socio-economic perspective. Systems thinking and interdisciplinary approach are the pivotal conceptual tools of the method. Systems thinking allows for the understanding of the complex relationships working among the elementary units of a system (e.g. wildlife, bred animals, consumers, environment, agro-food industry) in the occurrence of a health problem such foodborne diseases. Complex systemic relationships usually cross the traditional boundaries of scientific knowledge (human medicine, veterinary science, economics) and sectoral institutional responsibilities (e.g. ministry of health, ministry of agriculture). For these reasons more scientific disciplines, institutional competences and social bodies need to work together to face complex health problems, in an interdisciplinary framework. The first step of the proposed method is the identification of the potential cost of the disease. To this aim, the authors first focus on the links between epidemiological and economic models, based on the fact that foodborne diseases, likewise other diseases, hit people's and animals' aptitude to produce utility and goods for the society (e.g. wellbeing, revenue, safe food). These utility losses are real economic costs. Then they show how simple economic models, such as the food supply chain, can help understand the way costs spread across the economic sectors and the society. It should be underlined that the authors adopt already existing and well rooted scientific tools, focusing in particular that their integration in an interdisciplinary framework can effectively contribute to increase the understanding of complex health problems in a viable way.


Asunto(s)
Costo de Enfermedad , Enfermedades Transmitidas por los Alimentos/economía , Enfermedades Transmitidas por los Alimentos/epidemiología , Modelos Biológicos , Modelos Económicos , Animales , Análisis Costo-Beneficio , Inocuidad de los Alimentos , Abastecimiento de Alimentos/economía , Abastecimiento de Alimentos/estadística & datos numéricos , Tecnología de Alimentos/economía , Tecnología de Alimentos/tendencias , Humanos , Investigación Interdisciplinaria , Salud Única/economía , Años de Vida Ajustados por Calidad de Vida , Análisis de Sistemas
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