The #ecology of #human – #nature #interactions (Proc Roy Soc B., abstract)

[Source: Proceedings of the Royal Society, Biological Sciences, full page: (LINK). Abstract, edited.]

The ecology of human–nature interactions

Masashi Soga and Kevin J. Gaston

Published: 15 January 2020 / DOI: https://doi.org/10.1098/rspb.2019.1882

 

Abstract

The direct interactions between people and nature are critically important in many ways, with growing attention particularly on their impacts on human health and wellbeing (both positive and negative), on people’s attitudes and behaviour towards nature, and on the benefits and hazards to wildlife. A growing evidence base is accelerating the understanding of different forms that these direct human–nature interactions take, novel analyses are revealing the importance of the opportunity and orientation of individual people as key drivers of these interactions, and methodological developments are increasingly making apparent their spatial, temporal and socio-economic dynamics. Here, we provide a roadmap of these advances and identify key, often interdisciplinary, research challenges that remain to be met. We identified several key challenges, including the need to characterize individual people’s nature interactions through their life course, to determine in a comparable fashion how these interactions vary across much more diverse geographical, cultural and socio-economic contexts that have been explored to date, and to quantify how the relative contributions of people’s opportunity and orientation vary in shaping their nature interactions. A robust research effort, guided by a focus on such unanswered questions, has the potential to yield high-impact insights into the fundamental nature of human–nature interactions and contribute to developing strategies for their appropriate management.

Keywords: Environmental pollution; Society.

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Characteristics Associated With #US #Outpatient #Opioid Analgesic #Prescribing and #Gabapentinoid Co-Prescribing (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Characteristics Associated With U.S. Outpatient Opioid Analgesic Prescribing and Gabapentinoid Co-Prescribing

Christopher O. St. Clair, PharmD1,Natalia I. Golub, MD, PhD, MPH2,Yong Ma, PhD1,Jaejoon Song, PhD1,Scott K. Winiecki, MD1,David L. Menschik, MD, MPH1

DOI: https://doi.org/10.1016/j.amepre.2019.08.029

 

Abstract

Introduction

A considerable burden of prescription and illicit opioid-related mortality and morbidity in the U.S. is attributable to potentially unnecessary or excessive opioid prescribing, and co-prescribing gabapentinoids may increase risk of harm. Data are needed regarding physician and patient characteristics associated with opioid analgesic and opioid analgesic–gabapentinoid co-prescriptions to elucidate targets for reducing preventable harm.

Methods

Multiple logistic regression was utilized to examine patient and physician predictors of opioid analgesic prescriptions and opioid analgesic–gabapentinoid co-prescriptions in adult noncancer patients using the National Ambulatory Medical Care Survey 2015 public use data set. Potential predictors were selected based on literature review, clinical relevance, and random forest machine learning algorithms.

Results

Among the 11.8% (95% CI=9.8%, 13.9%) of medical encounters with an opioid prescription, 16.2% (95% CI=12.6%, 19.8%) had a gabapentinoid co-prescription. Among all gabapentinoid encounters, 40.7% (95% CI=32.6%, 48.7%) had an opioid co-prescription. Predictors of opioid prescription included arthritis (OR=1.87, 95% CI=1.30, 2.69). Predictors of new opioid prescription included physician status as an independent contractor (OR=3.67, 95% CI=1.38, 9.81) or part owner of the practice (OR=3.34, 95% CI=1.74, 6.42). Predictors of opioid–gabapentinoid co-prescription included patient age (peaking at age 55–64 years; OR=35.67, 95% CI=4.32, 294.43).

Conclusions

Predictors of opioid analgesic prescriptions with and without gabapentinoid co-prescriptions were identified. These predictors can help inform and reinforce (e.g., educational) interventions seeking to reduce preventable harm, help identify populations for elucidating opioid–gabapentinoid risk–benefit profiles, and provide a baseline for evaluating subsequent public health measures.

Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

Keywords: USA; Psychiatry; Opioids; Gabapentin; Society.

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Uncrewed #aircraft #systems versus #motorcycles to deliver laboratory #samples in west #Africa: a comparative economic study (Lancet Glob Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Lancet Glob Health. 2020 Jan;8(1):e143-e151. doi: 10.1016/S2214-109X(19)30464-4.

Uncrewed aircraft systems versus motorcycles to deliver laboratory samples in west Africa: a comparative economic study.

Ochieng WO1, Ye T2, Scheel C2, Lor A2, Saindon J3, Yee SL2, Meltzer MI4, Kapil V2, Karem K2.

Author information: 1 Karna LLC, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: ocu9@cdc.gov. 2 Office of the Director, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. 3 Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4 Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

 

Abstract

BACKGROUND:

Transportation of laboratory samples in low-income and middle-income countries is often constrained by poor road conditions, difficult geographical terrain, and insecurity. These constraints can lead to long turnaround times for laboratory diagnostic tests and hamper epidemic control or patient treatment efforts. Although uncrewed aircraft systems (UAS)-ie, drones-can mitigate some of these transportation constraints, their cost-effectiveness compared with land-based transportation systems is unclear.

METHODS:

We did a comparative economic study of the costs and cost-effectiveness of UAS versus motorcycles in Liberia (west Africa) for transportation of laboratory samples under simulated routine conditions and public health emergency conditions (based on the 2013-16 west African Ebola virus disease epidemic). We modelled three UAS with operational ranges of 30 km, 65 km, and 100 km (UAS30, UAS65, and UAS100) and lifespans of 1000 to 10 000 h, and compared the costs and number of samples transported with an established motorcycle transportation programme (most commonly used by the Liberian Ministry of Health and the charity Riders for Health). Data for UAS were obtained from Skyfire (a UAS consultancy), Vayu (a UAS manufacturer), and Sandia National Laboratories (a private company with UAS research experience). Motorcycle operational data were obtained from Riders for Health. In our model, we included costs for personnel, equipment, maintenance, and training, and did univariate and probabilistic sensitivity analyses for UAS lifespans, range, and accident or failures.

FINDINGS:

Under the routine scenario, the per sample transport costs were US$0·65 (95% CI 0·01-2·85) and $0·82 (0·56-5·05) for motorcycles and UAS65, respectively. Per-sample transport costs under the emergency scenario were $24·06 (95% CI 21·14-28·20) for motorcycles, $27·42 (95% CI 19·25-136·75) for an unadjusted UAS model with insufficient geographical coverage, and $34·09 (95% CI 26·70-127·40) for an adjusted UAS model with complementary motorcycles. Motorcycles were more cost-effective than short-range UAS (ie, UAS30). However, with increasing range and operational lifespans, UAS became increasingly more cost-effective.

INTERPRETATION:

Given the current level of technology, purchase prices, equipment lifespans, and operational flying ranges, UAS are not a viable option for routine transport of laboratory samples in west Africa. Field studies are required to generate evidence about UAS lifespan, failure rates, and performance under different weather conditions and payloads.

FUNDING:

None.

Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

PMID: 31839129 DOI: 10.1016/S2214-109X(19)30464-4

Keywords: West Africa; Infectious diseases; Society.

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#Gaps in #Sexual #Assault Health #Care Among #Homeless Young Adults (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Gaps in Sexual Assault Health Care Among Homeless Young Adults

Diane M. Santa Maria, DrPH, RN1, Khara Breeden, DNP, RN2, Stacy A. Drake, PhD, MPH, RN1, Sarah C. Narendorf, PhD3, Anamika Barman-Adhikari, PhD4, Robin Petering, PhD5, Hsun-Ta Hsu, PhD6, Jama Shelton, PhD7, Kristin Ferguson-Colvin, PhD8, Kimberly Bender, PhD4

Open Access / DOI: https://doi.org/10.1016/j.amepre.2019.09.023

Published online: December 16, 2019

 

Abstract

Introduction

Young adults experiencing homelessness are at increased risk for sexual assault. Receiving a post–sexual assault examination has important implications for HIV and unintended pregnancy prevention; yet, utilization is not well understood. In a population at elevated risk for HIV, unintended pregnancy, and sexual violence, identifying barriers and facilitators to post–sexual assault examination is imperative.

Methods

As part of a large, multisite study to assess youth experiencing homelessness across 7 cities in the U.S, a cross-sectional survey was conducted between June 2016 and July 2017. Data were analyzed in 2019 to determine the prevalence and correlates of sexual violence and examine the correlates of post–sexual assault examination utilization.

Results

Respondents (n=1,405), aged 18–26 years, were mainly youth of color (38% black, 17% Latinx) and identified as cisgender male (59%) and lesbian, gay, bisexual, or queer (29%). HIV risks were high: 23% of participants had engaged in trade sex, 32% had experienced sexual assault as a minor, and 39% had experienced sexual exploitation. Young adults reported high rates of sexual assault (22%) and forced sex (24%). Yet, only 29% of participants who were forced to have sex received a post–sexual assault examination. Latinx young adults were more likely than other races/ethnicities to receive post-assault care. Participants frequently said they did not get a post–sexual assault exam because they did not want to involve the legal system and did not think it was important.

Conclusions

Interventions are needed to increase use of preventive care after experiencing sexual assault among young adults experiencing homelessness.

© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc.

Keywords: USA; Society; Poverty; Violence.

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Five-Year #US #Trends in the North American #Cancer #Survival Index, 2005–2014 (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Five-Year U.S. Trends in the North American Cancer Survival Index, 2005–2014

Bożena M. Morawski, PhD1,2, Hannah K. Weir, PhD3, Christopher J. Johnson, MPH2

DOI: https://doi.org/10.1016/j.amepre.2019.10.001

Published online: December 10, 2019

 

Abstract

Introduction

Progress in U.S. 5-year survival trends for all cancers combined was assessed using the North American Cancer Survival Index, a sum of age-, sex-, and cancer site–standardized relative survival ratios.

Methods

In January 2019, authors calculated 5-year cancer survival indices and 95% CIs by race and sex for 2005–2011, 2006–2012, 2007–2013, and 2008–2014 diagnosis cohorts with data from 42 cancer registries.

Results

Overall 5-year survival increased from 63.5% (95% CI=63.4, 63.5) in 2005–2011 to 64.1% (95% CI=64.1, 64.2) in 2008–2014. Survival increased 0.9 and 0.5 percentage points in female and male patients, respectively; the survival disparity among blacks versus whites decreased by 0.5%. In 2008–2014, the Cancer Survival Index was 7.7% higher for whites (64.6%; 95% CI=64.6, 64.7) than for blacks (56.9%; 95% CI=56.7, 57.1).

Conclusions

Cancer Survival Index survival estimates increased among all race and sex subpopulations during 2005–2014. A substantial but decreasing survival gap persisted between blacks and whites. The Cancer Survival Index can assist decision makers and others in comparing cancer survival among populations and over time and in monitoring progress toward national cancer surveillance objectives.

Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

Keywords: USA; Cancer.

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The #Justinianic #Plague: An inconsequential #pandemic? (Proc Natl Acad Sci USA, abstract)

[Source: Proceedings of the National Academy of Sciences of the United States of America, full page: (LINK). Abstract, edited.]

The Justinianic Plague: An inconsequential pandemic?

Lee Mordechai, Merle Eisenberg, Timothy P. Newfield, Adam Izdebski, Janet E. Kay, and Hendrik Poinar

PNAS first published December 2, 2019 / DOI: https://doi.org/10.1073/pnas.1903797116

Edited by Noel Lenski, Yale University, New Haven, CT, and accepted by Editorial Board Member Elsa M. Redmond October 7, 2019 (received for review March 4, 2019)

 

Significance

The Justinianic Plague (circa 541 to 750 CE) has recently featured prominently in scholarly and popular discussions. Current consensus accepts that it resulted in the deaths of between a quarter and half of the population of the Mediterranean, playing a key role in the fall of the Roman Empire. Our contribution argues that earlier estimates are founded on a small subset of textual evidence and are not supported by many other independent types of evidence (e.g., papyri, coins, inscriptions, and pollen archaeology). We therefore conclude that earlier analyses of the mortality and social effects of the plague are exaggerated, and that the nontextual evidence suggests plague did not play a significant role in the transformation of the Mediterranean world or Europe.

 

Abstract

Existing mortality estimates assert that the Justinianic Plague (circa 541 to 750 CE) caused tens of millions of deaths throughout the Mediterranean world and Europe, helping to end antiquity and start the Middle Ages. In this article, we argue that this paradigm does not fit the evidence. We examine a series of independent quantitative and qualitative datasets that are directly or indirectly linked to demographic and economic trends during this two-century period: Written sources, legislation, coinage, papyri, inscriptions, pollen, ancient DNA, and mortuary archaeology. Individually or together, they fail to support the maximalist paradigm: None has a clear independent link to plague outbreaks and none supports maximalist reconstructions of late antique plague. Instead of large-scale, disruptive mortality, when contextualized and examined together, the datasets suggest continuity across the plague period. Although demographic, economic, and political changes continued between the 6th and 8th centuries, the evidence does not support the now commonplace claim that the Justinianic Plague was a primary causal factor of them.

Justinianic Plague – first plague pandemic – Late Antiquity – plague – Yersinia pestis

Keywords: European Region; Plague; History; Society.

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Initiation of #Colorectal #Cancer #Screening Among #Medicaid Enrollees (Am J Prev Med., abstract)

[Source: American Journal of Preventive Medicine, full page: (LINK). Abstract, edited.]

Initiation of Colorectal Cancer Screening Among Medicaid Enrollees

Cynthia M. Mojica, PhD1, Savannah M. Bradley, MPH2, Bonnie K. Lind, PhD3, Yifan Gu, MS3, Gloria D. Coronado, PhD4, Melinda M. Davis, PhD5,6,7

DOI: https://doi.org/10.1016/j.amepre.2019.09.015

Published online: November 27, 2019

 

Abstract

Introduction

Few studies have explored how individual- and practice-level factors influence colorectal cancer screening initiation among Medicaid enrollees newly age eligible for colorectal cancer screening (i.e., turning 50 years). This study explored colorectal cancer screening initiation among newly age-eligible Medicaid enrollees in Oregon.

Methods

Medicaid claims data (January 2013 to June 2015) were used to conduct multivariable logistic regression (in 2018 and 2019) to explore individual- and practice-level factors associated with colorectal cancer screening initiation among 9,032 Medicaid enrollees.

Results

A total of 17% of Medicaid enrollees initiated colorectal cancer screening; of these, 64% received a colonoscopy (versus fecal testing). Colorectal cancer screening initiation was positively associated with turning 50 years in 2014 (versus 2013; OR=1.21), being Hispanic (versus non-Hispanic white; OR=1.41), urban residence (versus rural; OR=1.23), and having 4 to 7 (OR=1.90) and 8 or more (OR=2.64) primary care visits compared with 1 to 3 visits in the year after turning 50 years. Having 3 or more comorbidities was inversely associated with initiation (OR=0.75). The odds of screening initiation were also higher for practices with 3 to 4 (OR=1.26) and 8 or more (OR=1.34) providers compared with 1 to 2 providers, and negatively associated with percentage of Medicaid panel age eligible for colorectal cancer screening (OR=0.92).

Conclusions

Both individual- and practice-level factors are associated with disparities in colorectal cancer screening initiation among Oregon Medicaid enrollees. Future work promoting colorectal cancer screening might focus on additional barriers to the timely initiation of colorectal cancer screening and explore the effect of practice in-reach and population outreach strategies.

© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Keywords: Cancer; USA; Society.

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