A study of morbidity on a new housing estate reveals a higher prevalence rate of both physical and mental illness. Much of this is due to physical factors associated with the estate which could have been avoided in the light of previous experience had more attention been given to detail. The proposals embodied in the management arrangements for the reorganised National Health Service should provide the machinery to prevent these faults recurring. (+info)
A health impact assessment model for environmental changes attributable to development projects.
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STUDY OBJECTIVE: European Union legislation requires large industrial and civil development projects to undergo environmental impact assessment. The study objective was to identify environmental health risk estimates for these developments from the epidemiological literature and to develop, and apply these within, a mathematical health impact assessment model. DESIGN AND RESULTS: In the UK, good practice guidelines have set out environmental issues to be considered in development projects, but little attention is given to direct health effects. Broad quantifiable risks were identified for four-air, chemicals, noise, and road traffic-of 14 standard environmental effects. A mathematical model was constructed that is based on people moving between different health states over their lifetime. Age related hazard functions are applied to cause specific measures of mortality and morbidity. A hypothetical example for a development creating air and chemical pollutants is given. CONCLUSIONS: A mathematical model applying epidemiological risks to an exposed population can provide quantification of environmental health effects. The approach may in future find application during project development, and by public health regulatory authorities for environmental health impact assessment. (+info)
Epidemic of health care reforms.
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An epidemic of health care reforms is spreading through the world. The basic reason behind the epidemic is the concept of these reforms. Namely, at the time in which Modernity (the main context of mechanicism) has worn out its potentials, they are based on the principles of mechanistic paradigm. Epidemic could fade away if health care reformers would abandon their role of engeneers and turn to catalist role. In that role they could work on reforms which would rely on priciples of evolution. The first result of this reform orientation would be creation of the germ of pluralistic health care systems. (+info)
The aging of Israel's Arab population: needs, existing responses, and dilemmas in the development of services for a society in transition.
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The Arab population of Israel is relatively young. However, a significant increase is expected in the number of elderly Arabs in the coming years. At the end of 2001 there were 38,500 Arab elderly, but their number is expected to reach 92,100 by 2020. This will represent a nearly 2.5-fold increase in absolute numbers. As the population ages, the number and percentage of people with chronic diseases and related disabilities will rise significantly. While the Arab elderly are much younger than the Jewish elderly, they are more disabled and therefore have greater medical and nursing needs. An extremely important measure of the need for formal services is an elderly person's functional ability, especially the ability to live independently. The percentage of Arab elderly who are disabled and need help with activities of daily living is twice as high as that of the Jewish elderly population. At present, 30% of the Arab elderly (39% of the women and 20% of the men), compared to 14% of Jewish elderly (17% of the women and 11% of the men), need help in at least one ADL (bathing, dressing, eating, mobility in the home, rising and sitting, getting in and out of bed). Concomitant with demographic changes are forces that affect the ability of informal support systems to provide care. For example, the rising number of Arab women in the labor force together with changes in elderly peoples' living arrangements have increased the need for formal services to share responsibility for the elderly with families. As services are developed, questions arise regarding the extent to which they have been adapted to the culture and norms of Arab society and meet that society's unique needs. This paper elaborates on some of these issues. (+info)
Reestablishing public health and land use planning to protect public water supplies.
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OBJECTIVES: This study measured the extent to which land use, design, and engineering practices could reduce contamination of major public water supplies. METHODS: Key parcels of land were identified in New Jersey, and the potential uncontrolled loading of contaminants was estimated with the US Environmental Protection Agency's Long-Term Hydrologic Impact Assessment model for a variety of land use, design, and engineering scenarios. RESULTS: High-density per-acre development and engineering controls, along with housing and light commercial activity near main railroads, would substantially reduce runoff. CONCLUSIONS: In New Jersey, government and purveyor action is being taken as a result of, and in support of, these findings. (+info)
The science and politics of targeting: who gets what, when, and how.
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Targeting has been defined as a method by which goods, services, or other programmatic actions are delivered to groups or individuals who have specific characteristics. Similarly, politics refers to the social processes that determine who gets what, when, and how. This similarity suggests there may be utility in undertaking an explicit analysis of how the science and the politics of targeting relate to one another. Accordingly, this article outlines a technical/scientific framework regarding targeting and, using one element of this framework [sensitivity and specificity analysis], demonstrates that recent shifts in politics and policy in the United States can be more clearly understood when viewed from this angle. Then, the article outlines a basic framework on politics and uses it to demonstrate that one of the most fundamental features of our training, practices, and outlook (specialization) holds obvious benefits for advancing research but has three undesirable effects in the realm of policy: 1) it directly or indirectly encourages narrow, partial solutions to complex problems, some of which may have unintended effects on health or well-being for the very people we seek to help; 2) it creates a cumulative demand for research dollars, specialized interventions, and policy attention that far exceeds available resources and capabilities; and 3) it often prevents us from developing and advancing the common agendas and mutual support required to be effective in political and policy realms. The article concludes that more explicit analysis along these lines could strengthen our effectiveness in the policy realm. (+info)
Environmental change and infectious disease: how new roads affect the transmission of diarrheal pathogens in rural Ecuador.
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Environmental change plays a large role in the emergence of infectious disease. The construction of a new road in a previously roadless area of northern coastal Ecuador provides a valuable natural experiment to examine how changes in the social and natural environment, mediated by road construction, affect the epidemiology of diarrheal diseases. Twenty-one villages were randomly selected to capture the full distribution of village population size and distance from a main road (remoteness), and these were compared with the major population center of the region, Borbon, that lies on the road. Estimates of enteric pathogen infection rates were obtained from case-control studies at the village level. Higher rates of infection were found in nonremote vs. remote villages [pathogenic Escherichia coli: odds ratio (OR) = 8.4, confidence interval (CI) 1.6, 43.5; rotavirus: OR = 4.0, CI 1.3, 12.1; and Giardia: OR = 1.9, CI 1.3, 2.7]. Higher rates of all-cause diarrhea were found in Borbon compared with the 21 villages (RR = 2.0, CI 1.5, 2.8), as well as when comparing nonremote and remote villages (OR = 2.7, CI 1.5, 4.8). Social network data collected in parallel offered a causal link between remoteness and disease. The significant and consistent trends across viral, bacterial, and protozoan pathogens suggest the importance of considering a broad range of pathogens with differing epidemiological patterns when assessing the environmental impact of new roads. This study provides insight into the initial health impacts that roads have on communities and into the social and environmental processes that create these impacts. (+info)
Development of Sindbis viruses encoding nsP2/GFP chimeric proteins and their application for studying nsP2 functioning.
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Sindbis virus (SINV) is one of almost 30 currently known alphaviruses. In infected cells, it produces only a few proteins that function in virus replication and interfere with the development of the antiviral response. One of the viral nonstructural proteins, nsP2, not only exhibits protease and RNA helicase activities that are directly involved in viral RNA replication but also plays critical roles in the development of transcriptional and translational shutoffs in the SINV-infected cells. These multiple activities of nsP2 complicate investigations of this protein's functions and further understanding of its structure. Using a transposon-based approach, we generated a cDNA library of SINV genomes with a green fluorescent protein (GFP) gene randomly inserted into nsP2 and identified a number of sites that can be used for GFP cloning without a strong effect on virus replication. Recombinant SIN viruses encoding nsP2/GFP chimeric protein were capable of growth in tissue culture and interfering with cellular functions. SINV, expressing GFP in the nsP2, was used to isolate nsP2-specific protein complexes formed in the cytoplasm of the infected cells. These complexes contained viral nsPs, all of the cellular proteins that we previously coisolated with SINV nsP3, and some additional protein factors that were not found before in detectable concentrations. The random insertion library-based approach, followed by the selection of the viable variants expressing heterologous proteins, can be applied for mapping the domain structure of the viral nonstructural and structural proteins, cloning of peptide tags for isolation of the protein-specific complexes, and studying their formation by using live-cell imaging. This approach may also be applicable to presentation of additional antigens and retargeting of viruses to new receptors. (+info)