Urban trees and the risk of poor birth outcomes Donovan, Geoffrey H.; Michael, Yvonne L.; Butry, David T. ...
Health & place,
January 2011, 2011-Jan, 2011-01-00, 20110101, Letnik:
17, Številka:
1
Journal Article
Recenzirano
This paper investigated whether greater tree-canopy cover is associated with reduced risk of poor birth outcomes in Portland, Oregon. Residential addresses were geocoded and linked to ...classified-aerial imagery to calculate tree-canopy cover in 50, 100, and 200m buffers around each home in our sample (n=5696). Detailed data on maternal characteristics and additional neighborhood variables were obtained from birth certificates and tax records. We found that a 10% increase in tree-canopy cover within 50m of a house reduced the number of small for gestational age births by 1.42 per 1000 births (95% CI—0.11–2.72). Results suggest that the natural environment may affect pregnancy outcomes and should be evaluated in future research.
Interferon-gamma release assays have potentially been transformative to screening programs focused on latent tuberculosis infection (LTBI) in foreign-born persons. We sought to add to this assessment ...by presenting the impact of a well-established refugee screening and treatment program switching from skin testing to Quantiferon ®-TB Gold (QFT). We completed a retrospective cohort of refugees screened for tuberculosis between November 1, 2009–April 30, 2011 (pre-QFT) and May 1, 2011–October 31, 2012 (post-QFT). Among 2244 refugees screened that met the inclusion criteria, there was a significant difference in the proportion of refugees diagnosed with LTBI between the two time periods (p = >0.0001). In multivariate analysis, refugees tested with QFT had a greater odds of treatment initiation (adjusted odds ratio 1.53; 95 % CI 1.02–2.29, p = 0.040). However, test type had no impact on treatment completion (odds ratio 0.88; 95 % CI 0.57–1.36, p = 0.560). Although we demonstrated increased efficiency in LTBI diagnosis in this group, treatment completion rates indicate other barriers to treatment that must be addressed.
In 1997, Oregon passed the Death with Dignity Act, which legalized physician-assisted suicide.
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With legalization came concern that physician-assisted suicide might be forced on poor, uneducated, or ...uninsured patients or that it might be disproportionately chosen by patients receiving inadequate care at the end of life.
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,
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We have previously reported that in 1998, the first year after implementation of the act, information on 23 persons who received prescriptions for lethal medications was reported to the Oregon Health Division.
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Of the 23, 15 died from taking the lethal medications. According to their physicians, the patients requested assistance with suicide because . . .
Sexual orientation-related discrimination is common among sexual minority individuals, but its influence on romantic relationship functioning remains unclear. Further, exposure to potentially ...traumatic events may influence the association between discrimination and relationship functioning, but this has not been tested among sexual minority individuals in relationships to date. The current study examines breadth of lifetime trauma exposure as a moderator of the associations between recent discrimination and changes in relationship functioning (satisfaction, commitment, and trust) over 12 months among 86 racially/ethnically diverse sexual minority young adults in relationships. For those with low trauma exposure, discrimination was associated with increases in satisfaction and commitment, but not trust. In contrast, for those with high trauma exposure, discrimination was not associated with changes in relationship functioning. Thus, some partnered sexual minority young adults may experience resilience in the face of discrimination, such that discrimination may promote positive relationship functioning. However, this does not appear to extend to those with more extensive trauma exposure histories. With an eye toward informing interventions, these findings call for additional research on individual differences in responses to discrimination, such as support seeking and dyadic coping.
Public Significance Statement
This study found that some partnered sexual minority young adults experience resilience subsequent to discrimination, such that discrimination is associated with increases in positive romantic relationship functioning. However, this does not appear to extend to sexual minority young adults with more extensive trauma histories. These findings suggest that additional research can inform interventions designed to promote support seeking and relationship enhancement in response to discrimination, especially among trauma survivors.
Malaria infections during pregnancy can lead to the delivery of low-birth-weight infants. In this study, cytokine mRNA was measured in placentas from 23 malaria-infected and 21 uninfected primigravid ...women who had delivered in Mangochi, Malawi, a region with a high rate of transmission of falciparum malaria. Significantly increased expression of interleukin (IL)—1β, IL-8, and tumor necrosis factor (TNF)—α and decreased expression of IL-6 and transforming growth factor-β1 were found in malaria-infected compared with uninfected placentas. TNF-α and IL-8 were produced by maternally derived hemozoin-laden placental macrophages. Increased TNF-α expression was associated with increased placental hemozoin concentrations. Increased TNF-α or IL-8 expression in the placenta was associated with intrauterine growth retardation but not with preterm delivery. The results suggest that malaria infections induce a potentially harmful proinflammatory response in the placenta.
Although data suggest that physical activity is associated with decreased insulin resistance, recommendations for exercise training are not specific for age or level of obesity. Therefore, we ...examined the influence of moderate-intensity (50% of VO2max) exercise training (MI) versus high-intensity (75% of VO2max) exercise training (HI) on insulin-stimulated glucose disposal (ISGD) in elderly individuals.
Following medical examinations, 21 overweight (body mass index = 29 +/- 1 kg x m(-2)) elderly (74 +/- 1 yr) subjects were randomized to 1) HI, 2) MI, or a 3) nonexercising control group. Subjects enrolled in HI or MI completed a 12-wk exercise training regimen designed to expend 1000 kcal x wk. ISGD was assessed using a hyperinsulinemic, euglycemic clamp pre- and postintervention. ISGD was corrected for hepatic glucose production (glucose Ra) using a constant rate infusion of 6,6-H2glucose and determined during the last 30 min of the clamp by subtracting glucose Ra from the exogenous glucose infusion rate. Nonoxidative glucose disposal was calculated using indirect calorimetry. Body composition testing was completed using dual energy x-ray absorptiometry.
ISGD increased by approximately 20% with HI (Delta of 1.4 +/- 0.5 mg x kg(-1) FFM.min(-1)). However, ISGD did not change (Delta of -0.4 +/- 0.1 mg x kg(-1) FFM.min(-1)) with MI and was not different (Delta of -0.2 +/- 0.1 mg x kg(-1) FFM.min(-1)) in the control group. Nonoxidative glucose disposal increased with HI (Delta of 1.4 +/- 0.5 mg x kg(-1) FFM.min(-1)), but there was no change in nonoxidative glucose disposal with MI or in the control group. No change in body weight or percentage of body fat was observed in any group.
In weight-stable subjects, MI resulted in no change in ISGD, and the improvement in ISGD with HI was completely reliant on improvements in nonoxidative glucose disposal.
Legalized Physician-Assisted Suicide in Oregon, 1998–2000 Sullivan, Amy D; Hedberg, Katrina; Hopkins, David
New England journal of medicine/The New England journal of medicine,
02/2001, Letnik:
344, Številka:
8
Journal Article
Recenzirano
Odprti dostop
To the Editor:
In 1997, Oregon legalized physician-assisted suicide.
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In a follow-up to our previous reports,
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,
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we assessed whether the numbers and characteristics of patients who died after the ...ingestion of legally prescribed lethal medications in 2000 differed from those of patients who did so in 1998 and 1999.
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Patients who chose physician-assisted suicide were identified through required physician reporting of legally prescribed lethal medications. Data were obtained from these reports, interviews with physicians, and death certificates. We also compared patients who chose physician-assisted suicide in 2000 with a cohort assembled from 1999 death certificates of state residents who . . .
In sub-Saharan Africa, malaria infection in pregnancy contributes to low birth weight through intrauterine growth retardation (IUGR) and preterm delivery (PTD). It was hypothesized that ...malaria-associated PTD and IUGR have differing etiologies due to timing of infection. In a prospective cohort of primigravid women enrolled at the antenatal clinic of Mangochi District Hospital in Malawi, the associations were investigated between antenatal or delivery parasitemias and IUGR or PTD. Among 178 singleton deliveries, 35% of infants were preterm or had IUGR. Cord blood parasitemia (odds ratio OR = 3.34; 95% confidence interval CI, 1.3–8.8, placental parasitemia (OR = 2.43; 95% CI, 1.2–5.1), and postdelivery maternal peripheral parasitemia (OR = 2.78; 95% CI, 1.3–6.1) were associated with PTD. Parasitemia and/or clinically diagnosed malaria in the antenatal period was associated with IUGR (OR = 5.13; 95% CI, 1.4–19.4). Delivery parasitemias had borderline associations with IUGR. The risk patterns observed suggest that the timing and severity of infection influences the occurrence of IUGR or PTD.
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