Mortality Risk Related to Heatwaves in Dezful City, Southwest of Iran.

Background: We aimed to evaluate the impact of heatwaves on daily deaths due to non-accidental, cardiovascular and respiratory causes in the city of Dezful in Iran from 2013 to 2019. Method: We collected daily ambient temperature and mortality and defined 2 types of heatwaves by combining daily temperature ⩾90th in each month of the study period or since 30 years with duration ⩾2 and 3 days. We used a distributed lag non-linear model to study the association between each type of heatwave definition, and deaths due to non-accidental, cardiovascular and respiratory causes with lags up to 13 days. Results: There was no discernible correlation in this area, despite the fact that heatwaves raised the risk of death from cardiovascular causes and lowered the risk from respiratory causes. On the other hand, the risk of total non-accidental mortality on days with the heatwaves is significantly higher than normal days. In main effects, the heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, Cumulative Excess Risk (CER) in lag0-2 was 10.4 and in second heatwave definition, CER values in lag0, 0-2, and 0-6 were 12.4, 29.2, and 38.8 respectively). Also, in added effects, heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, CER in lag0 and 0-2 were 1.79 and 4.11 and in the second heatwave definition, CER values in lag0, 0-2, and 0-6 were 7.76, 18.35 and 24.87 respectively). In addition, heatwaves appeared to contribute to a cumulative excess risk of non-accidental death among the male group as well as the older adults. Conclusion: However, the results showed that heatwaves could have detrimental effects on health, even in populations accustomed to the extreme heat. Therefore, early warning systems which monitor heatwaves should provide the necessary warnings to the population, especially the most vulnerable groups.

Urban inequities; urban rights: a conceptual analysis and review of impacts on children, and policies to address them.

This paper explores current conceptual understanding of urban social, environmental, and health inequality and inequity, and looks at the impact of these processes on urban children and young people in the 21st century. This conceptual analysis was commissioned for a discussion paper for UNICEF's flagship publication: State of the World's Children 2012: Children in an Urban World. The aim of the paper is to examine evidence on the meaning of urban inequality and inequity for urban children and young people. It further looks at the controversial policies of targeting "vulnerable" young people, and policies to achieve the urban MDGs. Finally, the paper looks briefly at the potential of concepts such as environment justice and rights to change our understanding of urban inequality and inequity.

Global Health Impacts of Dust Storms: A Systematic Review.

BACKGROUND: Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue. METHOD: In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table. RESULTS: The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular. CONCLUSION: The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts.Registration: PROSPERO registration number CRD42018093325.

Effect of Dust Storms on Non-Accidental, Cardiovascular, and Respiratory Mortality: A Case of Dezful City in Iran.

BACKGROUND: Despite the fact that Iran has been exposed to severe dust storms during the past 2 decades, few studies have investigated the health effects of these events in Iran. This study was conducted to assess the association between dust storms and daily non-accidental, cardiovascular, and respiratory mortality in Dezful City (Khuzestan Province, Iran) during 2014 to 2019. METHODS: In this study, mortality, meteorological, and climatological data were obtained from the Dezful University of Medical Sciences, Iranian Meteorological Organization, and Department of Environment in Khuzestan Province, respectively. Days of dust storm were identified based on the daily concentration threshold of particulate matter with an aerodynamic diameter of less than 10 µm (PM10) according to Hoffmanns҆ definition, and then an ecological time-series was used to estimate the short-term effects of dust storms on daily mortality. Statistical analysis was performed using a distributed lag linear model (DLM) and a distributed lag non-linear model (DLNM) packages by R software and the study results were reported as excess mortality. RESULTS: During the study period, 15 223 deaths were recorded, and 139 dust storms occurred in Dezful city. In addition, there was statistically significant excess risk of mortality due to dust storms in Dezful City (mortality in the group under 15 years of age, lag4: 34.17% and 15-64 years of age groups, lag5: 32.19%, lag6: 3.28%), also dust storms had statistically significant effects on respiratory mortality (lag6: 5.49%). CONCLUSION: The findings of the current study indicate that dust storms increase the risk of mortality with some lags. An evidence-based early warning system may be able to aware the people of the health effects of dust storms.

Spontaneous imitation by children with autism during a repetitive musical play routine.

Joint-attention-type intervention strategies have been identified as effective scaffolds for increasing social engagement in children with autism. Imitating children with autism within child-led social routines has increased children's attention and active participation in social interaction. The current study expands on this research by establishing a musical social milieu using repetitive imitation routines for four children with autism. Results were evaluated using an MPD across three behaviors and four children with an ABAB reversal for one child. Children increased spontaneous imitation of the researcher's models after being imitated with only social reinforcement for increased imitation. However, experimental control was weakened with carry-over effects for two children and failure to fully replicate results across participants and behaviors. The accumulation of evidence from varied studies, despite some mixed results, encourages further study into the effects of imitating children with autism to increase spontaneous social engagement.

Indigenous health in Latin America and the Caribbean.

This review is the second in a series on Indigenous health, covering different regions and issues. We look briefly at the current state of Indigenous health in Latin America and the Caribbean, a region with over 400 different indigenous groups and a total population of 45 to 48 million people. We describe the complex history and current reality of Indigenous peoples' situation within the American continent. We discuss the importance of Indigenous health systems and medicines, and look at changing political environments in the region. The paper concludes with a discussion of the changing political and legislative environment in Latin American countries.

Disappearing, displaced, and undervalued: a call to action for Indigenous health worldwide.

"What sets worlds in motion is the interplay of differences, their attractions and repulsions. Life is plurality, death is uniformity. By suppressing differences and peculiarities, by eliminating different civilisations and cultures, progress weakens life and favours death. The ideal of a single civilisation for everyone implicit in the cult of progress and technique, impoverishes and mutilates us. Every view of the world that becomes extinct, every culture that disappears, diminishes a possibility of life!"

Assessing and communicating risk with communities living on contaminated land.

The U.K. government has emphasized redeveloping derelict land for housing. As a result, tools for assessing brownfield sites are well developed. However, there are many potentially contaminated sites on which people live, often not to the people's knowledge. For these situations, statutory guidance for risk communication is underdeveloped and, in certain situations, inadequate. This paper illustrates limitations of current methods using a heavily populated site where levels of specific contaminants exceed statutory limits. The authors describe how residents were involved in the site assessment process and how the process may be improved, and propose a framework to incorporate risk communication into the contaminated-land use strategy.

Outcomes of pregnancy among women living in the proximity of oil fields in the Amazon basin of Ecuador.

Oil companies have released billions of gallons of untreated wastes and oil directly into the environment of the Ecuadorian Amazon. This cross-sectional study investigated the environmental conditions and reproductive health of women living in rural communities surrounded by oil fields in the Amazon basin and in unexposed communities. Water from local streams was analyzed for total petroleum hydrocarbons (TPH). The women, aged 17 to 45 years, had resided for at least three years in the study communities. Socioeconomic and reproductive histories of the last three pregnancies were obtained from interviews. Information from the questionnaire was available for 365 exposed and 283 non-exposed women. The study was conducted from November 1998 to April 1999. Streams of exposed communities had TPH concentrations above the allowable limit. After adjustment for potential confounders, the pregnancies of women in exposed communities were more likely to end in spontaneous abortion (OR: 2.47; 95% CI: 1.61-3.79; p < 0.01). No association was found between stillbirth and exposure. An environmental system to control and eliminate the sources of pollution in the area is needed.

Return on investment of a pharmacy residency training program.

PURPOSE: The return on investment of pharmacy residency training at a Veterans Affairs hospital was estimated. METHODS: The financial costs and benefits associated with one year's training of eight residents were estimated retrospectively. The costs were compared with estimated costs for training newly hired pharmacists without institutional experience. The residents' work output as measured by notations in progress notes was compared with that of their pharmacist preceptors, and this ratio was used in establishing an amount the institution would be willing to pay for a resident's output. RESULTS: The estimated benefit-to-cost ratio for the residency program was favorable. Hiring its residents rather than new, untrained pharmacists for full-time positions was estimated to benefit the hospital. CONCLUSION: The benefit-to-cost ratio of the residency training program was estimated to be 1.5:1. Resident productivity was estimated to save the institution $563,936 annually.