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1.
New Sci ; 246(3282): 12, 2020 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-32501337

RESUMO

There is still time to protect the world's most fragile countries, David Miliband, the head of the International Rescue Committee, tells Adam Vaughan.

2.
New Sci ; 246(3282): 13, 2020 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-32501338
3.
New Sci ; 246(3283): 7, 2020 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-32501347

RESUMO

The covid-19 pandemic could lead to extreme poverty that leaves many struggling to afford food, reports Adam Vaughan.

4.
Arch Suicide Res ; : 1-33, 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32169027

RESUMO

Informed by psychological and sociological perspectives, the present study aimed to improve knowledge on the nature of suicidal thoughts and attempted suicide among adult prisoners. Analyzing data from a nationally representative sample of 18,185 prisoners housed in 287 state and 39 federal prisons across the United States highlight: (a) key micro-level factors associated with suicidal thoughts and attempted suicide, along with some distinct predictive patterns for suicidal thoughts versus attempted suicide; (b) similarities and differences between male and female prisoners concerning the predictive patterns of suicidal thoughts and attempted suicide; (c) the relationship between macro-level prison characteristics and prisoner suicidality. Discussion points toward a direction for future research on prisoner suicidality, as well as recommendations for managing at-risk prisoners.

5.
Artigo em Inglês | MEDLINE | ID: mdl-32075062

RESUMO

Public Safety Personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent leadership styles) and operational elements (e.g., shift work, public scrutiny). The current research quantified occupational stressors across PSP categories and assessed for relationships with PPTEs and mental health disorders (e.g., anxiety, depression). The participants were 4820 PSP (31.7% women) responding to established self-report measures for PPTEs, occupational stressors, and mental disorder symptoms. PPTEs and occupational stressors were associated with mental health disorder symptoms (ps < 0.001). PSP reported substantial difficulties with occupational stressors associated with mental health disorder symptoms, even after accounting for diverse PPTE exposures. PPTEs may be inevitable for PSP and are related to mental health; however, leadership style, organizational engagement, stigma, sleep, and social environment are modifiable variables that appear significantly related to mental health.

6.
Cogn Behav Ther ; 49(1): 55-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30794073

RESUMO

Public Safety Personnel (PSP; e.g. correctional workers, dispatchers, firefighters, paramedics, police) are frequently exposed to potentially traumatic events (PTEs). Several mental health training program categories (e.g. critical incident stress management (CISM), debriefing, peer support, psychoeducation, mental health first aid, Road to Mental Readiness [R2MR]) exist as efforts to minimize the impact of exposures, often using cognitive behavioral therapy model content, but with limited effectiveness research. The current study assessed PSP perceptions of access to professional (i.e. physicians, psychologists, psychiatrists, employee assistance programs, chaplains) and non-professional (i.e. spouse, friends, colleagues, leadership) support, and associations between training and mental health. Participants included 4,020 currently serving PSP participants. Data were analyzed using cross-tabulations and logistic regressions. Most PSP reported access to professional and non-professional support; nevertheless, most would first access a spouse (74%) and many would never, or only as a last resort, access professional support (43-60%) or PSP leaders (67%). Participation in any mental health training category was associated with lower (p < .01) rates for some, but not all, mental disorders, with no robust differences across categories. Revisions to training programs may improve willingness to access professional support; in the interim, training and support for PSP spouses and leaders may also be beneficial.

7.
Stroke ; 50(12): 3355-3359, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31694505

RESUMO

Background and Purpose- Recent national and state-level trends show a stalling or reversal of previously declining stroke death rates. These national trends may mask local geographic variation and changes in stroke mortality. We assessed county-level trends in stroke mortality among adults aged 35 to 64 and ≥65 years. Methods- We used data from National Vital Statistics Systems and a Bayesian multivariate space-time conditional autoregressive model to estimate age-standardized annual stroke death rates for 2010 through 2016 among middle-aged adults (35-64 years) and older adults (≥65 years) in US counties. We used log-linear regression models to estimate average annual and total percent change in stroke mortality during the period. Results- Nationally, the annual percent change in stroke mortality from 2010 to 2016 was -0.7% (95% CI, -4.2% to 3.0%) among middle-aged adults and -3.5% (95% CI, -10.7% to 4.3%) among older adults, resulting in 2016 rates of 15.0 per 100 000 and 259.8 per 100 000, respectively. Increasing county-level stroke mortality was more prevalent among middle-aged adults (56.6% of counties) compared with among older adults (26.1% of counties). About half (48.3%) of middle-aged adults, representing 60.2 million individuals, lived in counties in which stroke mortality increased. Conclusions- County-level increases in stroke mortality clarify previously reported national and state-level trends, particularly among middle-aged adults. Roughly 3×as many counties experienced increases in stroke death rates for middle-aged adults compared with older adults. This highlights a need to address stroke prevention and treatment for middle-aged adults while continuing efforts to reduce stroke mortality among the more highly burdened older adults. Efforts to reverse these troubling local trends will likely require joint public health and clinical efforts to develop innovative and integrated approaches for stroke prevention and care, with a focus on community-level characteristics that support stroke-free living for all.


Assuntos
Acidente Vascular Cerebral/mortalidade , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Estados Unidos/epidemiologia
9.
Environ Sci Technol ; 53(11): 6587-6596, 2019 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-31094196

RESUMO

Diesel-powered road vehicles are important sources for nitrogen oxide (NO x) emissions, and the European passenger fleet is highly dieselised, which has resulted in many European roadside environments being noncompliant with legal air quality standards for nitrogen dioxide (NO2). On the basis of vehicle emission remote sensing data for 300000 light-duty vehicles across the United Kingdom, light-duty diesel NO x emissions were found to be highly dependent on ambient temperature with low temperatures resulting in higher NO x emissions, i.e., a "low temperature NO x emission penalty" was identified. This feature was not observed for gasoline-powered vehicles. Older Euro 3 to 5 diesel vehicles emitted NO x similarly, but vehicles compliant with the latest Euro 6 emission standard emitted less NO x than older vehicles and demonstrated less of an ambient temperature dependence. This ambient temperature dependence is overlooked in current emission inventories but is of importance from an air quality perspective. Owing to Europe's climate, a predicted average of 38% more NO x emissions have burdened Europe when compared to temperatures encountered in laboratory test cycles. However, owing to the progressive elimination of vehicles demonstrating the most severe low temperature NO x penalty, light-duty diesel NO x emissions are likely to decrease more rapidly throughout Europe than currently thought.


Assuntos
Poluentes Atmosféricos , Emissões de Veículos , Monitoramento Ambiental , Europa (Continente) , Gasolina , Veículos Automotores , Temperatura , Reino Unido
11.
Prev Chronic Dis ; 16: E38, 2019 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-30925140

RESUMO

Accurate and precise estimates of local-level epidemiologic measures are critical to informing policy and program decisions, but they often require advanced statistical knowledge, programming/coding skills, and extensive computing power. In response, we developed the Rate Stabilizing Tool (RST), an ArcGIS-based tool that enables users to input their own record-level data to generate more reliable age-standardized measures of chronic disease (eg, prevalence rates, mortality rates) or other population health outcomes at the county or census tract levels. The RST uses 2 forms of empirical Bayesian modeling (nonspatial and spatial) to estimate age-standardized rates and 95% credible intervals for user-specified geographic units. The RST also provides indicators of the reliability of point estimates. In addition to reviewing the RST's statistical techniques, we present results from a simulation study that illustrates the key benefit of smoothing. We demonstrate the dramatic reduction in root mean-squared error (rMSE), indicating a better compromise between accuracy and stability for both smoothing approaches relative to the unsmoothed estimates. Finally, we provide an example of the RST's use. This example uses heart disease mortality data for North Carolina census tracts to map the RST output, including reliability of estimates, and demonstrates a subsequent statistical test.


Assuntos
Disparidades nos Níveis de Saúde , Modelos Estatísticos , Análise Espacial , Fatores Etários , Teorema de Bayes , Doença Crônica/epidemiologia , Sistemas de Informação Geográfica , Cardiopatias/mortalidade , Humanos , North Carolina/epidemiologia , Reprodutibilidade dos Testes
12.
SSM Popul Health ; 7: 100334, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30581967

RESUMO

A holistic view of racial and gender disparities that simultaneously compares multiple groups can suggest associated underlying contextual factors. Therefore, to more comprehensively understand temporal changes in combined racial and gender disparities, we examine variations in the orders of county-level race-gender specific heart disease death rates by age group from 1973-2015. We estimated county-level heart disease death rates by race, gender, and age group (35-44, 45-54, 55-64, 65-74, 75-84, ≥ 85, and ≥ 35) from the National Vital Statistics System of the National Center for Health Statistics from 1973-2015. We then ordered these rates from lowest to highest for each county and year. The predominant national rate order (i.e., white women (WW) < black women (BW) < white men (WM) < black men (BM)) was most common in younger age groups. Inverted rates for black women and white men (WW

13.
Soc Sci Med ; 217: 97-105, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30300762

RESUMO

One hypothesized explanation for the recent slowing of declines in heart disease death rates is the generational shift in the timing and accumulation of risk factors. However, directly testing this hypothesis requires historical age-group-specific risk factor data that do not exist. Using national death records, we compared spatiotemporal patterns of heart disease death rates by age group, time period, and birth cohort to provide insight into possible drivers of trends. To do this, we calculated county-level percent change for five time periods (1973-1980, 1980-1990, 1990-2000, 2000-2010, 2010-2015) for four age groups (35-44, 45-54, 55-64, 65-74), resulting in eight birth cohorts for each decade from the 1900s through the 1970s. From 1973 through 1990, few counties experienced increased heart disease death rates. In 1990-2000, 49.0% of counties for ages 35-44 were increasing, while all other age groups continued to decrease. In 2000-2010, heart disease death rates for ages 45-54 increased in 30.4% of counties. In 2010-2015, all four age groups showed widespread increasing county-level heart disease death rates. Likewise, birth cohorts from the 1900s through the 1930s experienced consistently decreasing heart disease death rates in almost all counties. Similarly, with the exception of 2010-2015, most counties experienced decreases for the 1940s birth cohort. For birth cohorts in the 1950s, 1960s, and 1970s, increases were common and geographically widespread for all age groups and calendar years. This analysis revealed variation in trends across age groups and across counties. However, trends in heart disease death rates tended to be generally decreasing and increasing for early and late birth cohorts, respectively. These findings are consistent with the hypothesis that recent increases in heart disease mortality stem from the beginnings of the obesity and diabetes epidemics. However, the common geographic patterns within the earliest and latest time periods support the importance of place-based macro-level factors.


Assuntos
Cardiopatias/epidemiologia , Cardiopatias/mortalidade , Adulto , Distribuição por Idade , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Fatores de Risco , Fatores de Tempo , Estados Unidos/epidemiologia
14.
MMWR Surveill Summ ; 67(5): 1-11, 2018 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-29596406

RESUMO

PROBLEM/CONDITION: Heart disease is the leading cause of death in the United States. In 2015, heart disease accounted for approximately 630,000 deaths, representing one in four deaths in the United States. Although heart disease death rates decreased 68% for the total population from 1968 to 2015, marked disparities in decreases exist by race and state. PERIOD COVERED: 1968-2015. DESCRIPTION OF SYSTEM: The National Vital Statistics System (NVSS) data on deaths in the United States were abstracted for heart disease using diagnosis codes from the eighth, ninth, and tenth revisions of the International Classification of Diseases (ICD-8, ICD-9, and ICD-10) for 1968-2015. Population estimates were obtained from NVSS files. National and state-specific heart disease death rates for the total population and by race for adults aged ≥35 years were calculated for 1968-2015. National and state-specific black-white heart disease mortality ratios also were calculated. Death rates were age standardized to the 2000 U.S. standard population. Joinpoint regression was used to perform time trend analyses. RESULTS: From 1968 to 2015, heart disease death rates decreased for the total U.S. population among adults aged ≥35 years, from 1,034.5 to 327.2 per 100,000 population, respectively, with variations in the magnitude of decreases by race and state. Rates decreased for the total population an average of 2.4% per year, with greater average decreases among whites (2.4% per year) than blacks (2.2% per year). At the national level, heart disease death rates for blacks and whites were similar at the start of the study period (1968) but began to diverge in the late 1970s, when rates for blacks plateaued while rates for whites continued to decrease. Heart disease death rates among blacks remained higher than among whites for the remainder of the study period. Nationwide, the black-white ratio of heart disease death rates increased from 1.04 in 1968 to 1.21 in 2015, with large increases occurring during the 1970s and 1980s followed by small but steady increases until approximately 2005. Since 2005, modest decreases have occurred in the black-white ratio of heart disease death rates at the national level. The majority of states had increases in black-white mortality ratios from 1968 to 2015. The number of states with black-white mortality ratios >1 increased from 16 (40%) to 27 (67.5%). INTERPRETATION: Although heart disease death rates decreased both for blacks and whites from 1968 to 2015, substantial differences in decreases were found by race and state. At the national level and in most states, blacks experienced smaller decreases in heart disease death rates than whites for the majority of the period. Overall, the black-white disparity in heart disease death rates increased from 1968 to 2005, with a modest decrease from 2005 to 2015. PUBLIC HEALTH ACTION: Since 1968, substantial increases have occurred in black-white disparities of heart disease death rates in the United States at the national level and in many states. These increases appear to be due to faster decreases in heart disease death rates for whites than blacks, particularly from the late 1970s until the mid-2000s. Despite modest decreases in black-white disparities at the national level since 2005, in 2015, heart disease death rates were 21% higher among blacks than among whites. This study demonstrates the use of NVSS data to conduct surveillance of heart disease death rates by race and of black-white disparities in heart disease death rates. Continued surveillance of temporal trends in heart disease death rates by race can provide valuable information to policy makers and public health practitioners working to reduce heart disease death rates both for blacks and whites and disparities between blacks and whites.


Assuntos
Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Cardiopatias/etnologia , Cardiopatias/mortalidade , Adulto , Causas de Morte , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
15.
Ann Epidemiol ; 27(12): 796-800, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29122432

RESUMO

PURPOSE: Recent national trends show decelerating declines in heart disease mortality, especially among younger adults. National trends may mask variation by geography and age. We examined recent county-level trends in heart disease mortality by age group. METHODS: Using a Bayesian statistical model and National Vital Statistics Systems data, we estimated overall rates and percent change in heart disease mortality from 2010 through 2015 for four age groups (35-44, 45-54, 55-64, and 65-74 years) in 3098 US counties. RESULTS: Nationally, heart disease mortality declined in every age group except ages 55-64 years. County-level trends by age group showed geographically widespread increases, with 52.3%, 58.5%, 69.1%, and 42.0% of counties experiencing increases with median percent changes of 0.6%, 2.2%, 4.6%, and -1.5% for ages 35-44, 45-54, 55-64, and 65-74 years, respectively. Increases were more likely in counties with initially high heart disease mortality and outside large metropolitan areas. CONCLUSIONS: Recent national trends have masked local increases in heart disease mortality. These increases, especially among adults younger than age 65 years, represent challenges to communities across the country. Reversing these trends may require intensification of primary and secondary prevention-focusing policies, strategies, and interventions on younger populations, especially those living in less urban counties.


Assuntos
Causas de Morte/tendências , Cardiopatias/mortalidade , Mortalidade/tendências , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Feminino , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos
16.
MMWR Morb Mortal Wkly Rep ; 66(35): 933-939, 2017 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-28880858

RESUMO

INTRODUCTION: The prominent decline in U.S. stroke death rates observed for more than 4 decades has slowed in recent years. CDC examined trends and patterns in recent stroke death rates among U.S. adults aged ≥35 years by age, sex, race/ethnicity, state, and census region. METHODS: Trends in the rates of stroke as the underlying cause of death during 2000-2015 were analyzed using data from the National Vital Statistics System. Joinpoint software was used to identify trends in stroke death rates, and the excess number of stroke deaths resulting from unfavorable changes in trends was estimated. RESULTS: Among adults aged ≥35 years, age-standardized stroke death rates declined 38%, from 118.4 per 100,000 persons in 2000 to 73.3 per 100,000 persons in 2015. The annual percent change (APC) in stroke death rates changed from 2000 to 2015, from a 3.4% decrease per year during 2000-2003, to a 6.6% decrease per year during 2003-2006, a 3.1% decrease per year during 2006-2013, and a 2.5% (nonsignificant) increase per year during 2013-2015. The last trend segment indicated a reversal from a decrease to a statistically significant increase among Hispanics (APC = 5.8%) and among persons in the South Census Region (APC = 4.2%). Declines in stroke death rates failed to continue in 38 states, and during 2013-2015, an estimated 32,593 excess stroke deaths might not have occurred if the previous rate of decline could have been sustained. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Prior declines in stroke death rates have not continued in recent years, and substantial variations exist in timing and magnitude of change by demographic and geographic characteristics. These findings suggest the importance of strategically identifying opportunities for prevention and intervening in vulnerable populations, especially because effective and underused interventions to prevent stroke incidence and death are known to exist.


Assuntos
Acidente Vascular Cerebral/mortalidade , Estatísticas Vitais , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Estados Unidos/epidemiologia
18.
Faraday Discuss ; 200: 599-620, 2017 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-28580967

RESUMO

Volatile organic compounds (VOCs) originate from a variety of sources, and play an intrinsic role in influencing air quality. Some VOCs, including benzene, are carcinogens and so directly affect human health, while others, such as isoprene, are very reactive in the atmosphere and play an important role in the formation of secondary pollutants such as ozone and particles. Here we report spatially-resolved measurements of the surface-to-atmosphere fluxes of VOCs across London and SE England made in 2013 and 2014. High-frequency 3-D wind velocities and VOC volume mixing ratios (made by proton transfer reaction - mass spectrometry) were obtained from a low-flying aircraft and used to calculate fluxes using the technique of eddy covariance. A footprint model was then used to quantify the flux contribution from the ground surface at spatial resolution of 100 m, averaged to 1 km. Measured fluxes of benzene over Greater London showed positive agreement with the UK's National Atmospheric Emissions Inventory, with the highest fluxes originating from central London. Comparison of MTBE and toluene fluxes suggest that petroleum evaporation is an important emission source of toluene in central London. Outside London, increased isoprene emissions were observed over wooded areas, at rates greater than those predicted by a UK regional application of the European Monitoring and Evaluation Programme model (EMEP4UK). This work demonstrates the applicability of the airborne eddy covariance method to the determination of anthropogenic and biogenic VOC fluxes and the possibility of validating emission inventories through measurements.

19.
J Forensic Leg Med ; 48: 1-8, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28364642

RESUMO

Highly publicized incidents of in-custody deaths have drawn attention to the well-being of individuals who are held in custodial settings and have contributed to questions surrounding the role played by mental illness and substance use. The data for this descriptive study consist of administrative records from the Office of the Chief Coroner of Ontario. Section 10(4) jury verdicts filed from January 1, 1996 through December 31, 2010 were drawn for analysis. The final sample includes 478 males who died while in custody. Logistic and multinomial regressions were conducted to assess how a history of mental illness and substance use is related to deaths in custody and how those deaths vary across custodial jurisdictions. Approximately half of all deaths in custody occurred among those with a history of mental illness or substance use and those deaths disproportionately occurred in local police or provincial custody, compared to those held in federal custody. Further, the joint effects of a co-occurring history of mental illness and substance use were found to be statistically significant with the strongest effects observed in local police custody. The results from this study underscore concerns surrounding the well-being of individuals with a history of mental illness or substance use and who come into contact with the criminal justice system. With more offenders presenting with complex mental-health and substance-use problems, the implications for local police become apparent in the context of developing policies and practices directed towards preventing deaths.


Assuntos
Transtornos Mentais/epidemiologia , Mortalidade , Prisioneiros/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Polícia , Adulto Jovem
20.
Soc Sci Med ; 175: 1-10, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28040577

RESUMO

Theory and research on HIV and among men who have sex with men (MSM) have long suggested the importance of non-residential locations in defining structural exposures. Despite this, most studies within these fields define place as a residential context, neglecting the potential influence of non-residential locations on HIV-related outcomes. The concept of activity spaces, defined as a set of locations to which an individual is routinely exposed, represents one theoretical basis for addressing this potential imbalance. Using a one-time online survey to collect demographic, behavioral, and spatial data from MSM, this paper describes activity spaces and examines correlates of this spatial variation. We used latent class analysis to identify categories of activity spaces using spatial data on home, routine, potential sexual risk, and HIV prevention locations. We then assessed individual and area-level covariates for their associations with these categories. Classes were distinguished by the degree of spatial variation in routine and prevention behaviors (which were the same within each class) and in sexual risk behaviors (i.e., sex locations and locations of meeting sex partners). Partner type (e.g. casual or main) represented a key correlate of the activity space. In this early examination of activity spaces in an online sample of MSM, patterns of spatial behavior represent further evidence of significant spatial variation in locations of routine, potential HIV sexual risk, and HIV prevention behaviors among MSM. Although prevention behaviors tend to have similar geographic variation as routine behaviors, locations where men engage in potentially high-risk behaviors may be more spatially focused for some MSM than for others.


Assuntos
Geografia , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologia
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