Population health

BACKGROUND: Bariatric surgery markedly reduces fat mass with beneficial effects on cardiometabolic health but the mechanisms involved are not fully understood. Extracellular vesicles (EVs) are secreted by a variety of cells, including adipocytes, and may mediate some of these benefits. However, the effects of bariatric surgery on circulating EVs are unclear. METHODS: Concentration of plasma EVs isolated by ultracentrifugation at baseline, 1 and 6 months post-bariatric surgery (n = 20) was established using Nanoparticle Tracking Analysis...

PURPOSE: Worldwide, the most frequent cause of visual impairment is uncorrected refractive error. This analysis focused on the distribution and associations of refractive, corneal and ocular residual astigmatism. METHODS: As part of the Gutenberg Health study, a population-based cross-sectional study was conducted in the general population of Germany. A comprehensive ophthalmological examination including refraction, tonometry, and Scheimpflug imaging of the anterior cornea (Pachycam) was performed...

Organochlorine contaminants were measured in livers of wild mink (Neovison vison) trapped in the lower Great Lakes basin from 1998 to 2006. To assess exposure and potential risk in mink feeding on Great Lakes biota, concentrations of contaminants were compared in mink trapped within 7.8 km of the shoreline as well as at inland sites (i.e., 8-40 km). Overall, significant spatial variation in mean hepatic concentrations of sum PCBs and seven other organochlorines was found in mink from 13 Great Lakes sites, many of which are within the Great Lakes Areas of Concern...

This study analyzed the temporal dynamics of total microcystin LR concentrations between the years of 2012 and 2015 in the Bonete, Baygorria and Palmar hydroelectric generation reservoirs in the central region of the Negro River, Uruguay. The three reservoirs showed differents total microcystin LR concentration, with no significant differences among them. Over 20 sampling dates, the three reservoirs exhibited total microcystin LR concentrations on eight occasions that corresponded to a slight to moderate human health risk according to WHO guideline values for recreational waters...

BACKGROUND: Japan, which currently maintains the highest life expectancy in the world and has experienced an impressive gain in adult height over the past century, has suffered a dramatic twofold increase in low birth weight (LBW) births since the 1970s. METHODS: We observed secular trends in birth characteristics using 64 115 249 live births included the vital statistics (1969-2014), as well as trends in average height among 3 145 521 adults born between 1969 and 1996, included in 79 surveys conducted among a national, subnational or community population in Japan...

BACKGROUND: The introduction of 'smoke-free laws' has reduced the population's exposure to second-hand smoke (SHS), although SHS is still an issue in homes and other public places. Children are vulnerable to its health effects, and their greatest exposure occurs at home. OBJECTIVES: To assess airborne nicotine concentration of the living room and children's bedroom of homes with children under 13 years of age, and to analyse factors associated with these levels...

BACKGROUND: On-pack tobacco warnings can deter smoking initiation and provide powerful cessation cues. However, these warnings typically feature graphic health images, which many young adults dismiss as irrelevant. We estimated responses to more diverse warnings and examined how these performed relative to each other. METHODS: We conducted a behavioural likelihood experiment and a choice modelling experiment in which 474 smokers and 476 susceptible non-smokers aged between 16 and 30 years evaluated 12 warnings featuring health, social, financial and cosmetic themes...

AIMS: Reports into standards in the National Health Service and quality in pathology have focused on the way we work in pathology and how to provide assurance that this is of a high standard. There are a number of external quality assurance schemes covering pathology and histopathology specifically; however, there is no scheme covering the process of histological surgical dissection. This is an area undergoing development, emerging from the sole preserve of medically qualified pathologists to a field populated by a number of highly trained biomedical scientists, but remains without any formal quality assurance...

World Health Organization (WHO) has identified diabetes as one of the fastest growing non-communicable diseases with 422 million patients around the world in 2014. Diabetes, a metabolic disease, is characterized primarily by hyperglycemia which results in various macrovascular and microvascular complications like cardiovascular disease and neuropathies which can significantly deteriorate the quality of life. The body either does not manufactures enough insulin (type 1 diabetes or T1DM) or becomes insensitive to physiologically secreted insulin or both (type 2 diabetes or T2DM)...

Heatwaves can lead to a range of adverse impacts including increased risk of illness and mortality; the heatwave in August 2003 has been associated with ~70,000 deaths across Europe. Due to climate change, heatwaves are likely to become more intense, more frequent and last longer in the future. A number of factors may influence risks associated with heat exposure, such as population age, housing type, and location within the Urban Heat Island, and such factors may not be evenly distributed spatially across a region...

The hydrogen sulphide (H2S) levels from wastewater treatment plants (WWTPs) in Curitiba, Brazil have been quantified for the first time. H2S generated by anaerobic decomposition of organic matter in WWTPs is a cause for concern because it is an air pollutant, which can cause eye and respiratory irritation, headaches, and nausea. Considering the requirement for WWTPs in all communities, it is necessary to assess the concentrations and effects of gases such as H2S on populations living and/or working near WWTPs...

OBJECTIVE: Disability affects older adults' quality of life. This study aimed to examine the socio-demographic characteristics of disability in older adults in China. METHOD: Data was obtained from the China Comprehensive Geriatric Assessment Study (CCGAS). The sample comprised 6864 people aged 60 years and above from seven provinces in China. A door-to-door survey was conducted by formally trained interviewers using a unified questionnaire. Disability was assessed with physical health assessment comprising activities of daily living (ADL), and independent activities of daily living (IADL)...

BACKGROUND: Chronic obstructive pulmonary disease (COPD) and asthma are common diseases with a heterogeneous distribution worldwide. Here, we present methods and disease and risk estimates for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD study provides annual updates on estimates of deaths, prevalence, and disability-adjusted life years (DALYs), a summary measure of fatal and non-fatal disease outcomes, for over 300 diseases and injuries, for 188 countries from 1990 to the most recent year...

BACKGROUND: Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. METHODS: For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016...

BACKGROUND: The Dietary Screening Tool (DST) has been validated as a dietary screening instrument for older adults defining three categories of potential nutritional risk based on DST score cutoffs. Previous research has found that older adults classified as being "at risk" differed from those categorized as being "not at risk" for a limited number of health-related variables. The relationship between risk categories and a wide variety of variables has not yet been explored. This research will contribute to an increased understanding of clustering of multiple health concerns in this population...

INTRODUCTION: Infiltration and extravasation account for 23-78 % of the complications stemming from peripheral venous perfusions in neonatal intensive care units. Their consequences, sometimes dramatic, can be pain, infections, or even loss of skin, which can lead to nerve and/or muscle damage, particularly severe for preterm neonates. Today there are no recommendations on the care of these lesions, which can lead to an erroneous choice or to a delay in the possible treatments. OBJECTIVE: This review of the literature aims to explore and propose elements of therapeutic care collected in the scientific literature...

Care coordination programs are important in caring for medically complex pediatric patients, particularly for children with special health care needs. This study is a retrospective financial analysis of a hospital-based care coordination program involving one procedural subgroup of children with special health care needs: those receiving pediatric tracheostomy. Hospital records were reviewed for patients who received a tracheostomy at a large Midwestern U.S. hospital from 1999 through 2015. The population was divided into two subgroups: patients who received a tracheostomy before the development of a care coordination program and patients who received a tracheostomy after enrollment in the care coordination program...

In England, primary care providers use standardised coding systems to record health events such as vaccination as well as patient characteristics. This information can be automatically extracted to estimate coverage for vaccine programmes delivered through primary care, in the general population as well as in specific geographical, ethnic, age or clinical groups. This system provides timely vaccine coverage estimates as well as the flexibility to extract tailored data in order to directly inform a continuously evolving national vaccine programme...

BACKGROUND: Depression has been correlated with suboptimal adherence to antidiabetic drugs (ADs). Most studies on this topic were cross-sectional; thus, the directionality of this relationship could not be established. The objective of this study was to measure the association between incident depression and AD nonadherence among newly treated patients with diabetes. METHODS: We performed a population-based cohort study among new AD users using the Quebec public health insurance data...

The human microbiota is a complex ecosystem of diverse microorganisms consisting of bacteria, viruses, and fungi residing predominantly in epidermal and mucosal habitats across the body, such as skin, oral cavity, lung, intestine and vagina. These symbiotic communities in health, or dysbiotic communities in disease, display tremendous interaction with the local environment and systemic responses, playing a critical role in the host's nutrition, immunity, metabolism and diseases including cancers. While the profiling of normal microbiota in healthy populations is useful and necessary, more recent studies have focused on the microbiota associated with disease, particularly cancers...