Who suffers from indoor air pollution? Evidence from Bangladesh

In this paper, we investigate individuals' exposure to indoor air pollution. Using new survey data from Bangladesh, average hours spent by members of households in the cooking area, living area and outdoors in a typical day are combined with the estimates of pollution concentration in different locations in order to estimate exposure. We analyse exposure at two levels: differences within households attributable to family roles, and differences across households attributable to income and education. Within households, we relate individuals' exposure to pollution in different locations during their daily round of activities. We find high levels of exposure for children and adolescents of both sexes, with particularly serious exposure for children under 5 years. Among prime-age adults, we find that men have half the exposure of women (whose exposure is similar to that of children and adolescents). We also find that elderly men have significantly lower exposure than elderly women. Across households, we draw on results from a previous paper, which relate pollution variation across households to choices of cooking fuel, cooking locations, construction materials and ventilation practices. We find that these choices are significantly affected by family income and adult education levels (particularly for women). Overall, we find that the poorest, least-educated households have twice the pollution levels of relatively high-income households with highly educated adults. Our findings further suggest that young children and poorly educated women in poor households face pollution exposures that are four times those for men in higher income households organized by more highly educated women. Since infants and young children suffer the worst mortality and morbidity from indoor air pollution, in this paper we consider measures for reducing their exposure. Our recommendations for reducing the exposure of infants and young children are based on a few simple, robust findings. Hourly pollution levels in cooking and living areas are quite similar because cooking smoke diffuses rapidly and nearly completely into living areas. However, outdoor pollution is far lower. At present, young children are only outside for an average of 3 hours per day. For children in a typical household, pollution exposure can be halved by adopting two simple measures: increasing their outdoor time from 3 to 5 or 6 hours per day, and concentrating outdoor time during peak cooking periods.     

Antimitotic peptide characterized from soybean: role in protection from cancer?

Cell proliferation, or mitosis, is believed to play a central role in the multistep process of carcinogenesis. The recent identification, cloning, and characterization of a potent antimitotic peptide from soybeans is, therefore, of interest in view of epidemiologic associations between intake of soy products and reduced cancer risk. Several questions must be resolved, however, before the biochemistry and epidemiology can be linked.     

Where to from here?

The intention of making RAWP a blanket, consistent formula has created a system too inflexible to reflect the oblique demand on services in areas of social deprivation and decline.     

Learning from their mistakes?

Embracing competition American style could turn out to be an expensive mistake, says Donald Light. In the first of a series of five articles he explains how bad advice and underfunding could turn the American dream into a British nightmare.     

Bride price payment and women’s autonomy: Findings from qualitative interviews from Nigeria

Marriage involving a man and a woman is a universal social institution, but its practices vary among cultures. In Nigeria, a marriage is recognized after gifts are given, and a bride price is paid by the groom’s family to the bride’s family. Understanding the bride price will reduce the challenges women face in their marital homes. Women’s autonomy is important for them to address matters affecting their health. We examined married Ikwerre women’s perspectives on bride price and its impact on their autonomy using qualitative methods. From December 2014 to March 2015, 34 in-depth interviews and six focus group discussions were conducted with married Ikwerre women. Participants reported that patriarchy and a culture of absolute respect for men, not the bride price, was the reason for women’s diminished autonomy. Participants noted that payment of the bride price was critical for validating marriage to give women respectable status in society as wives. Patriarchal rule and the demand for absolute respect for men need to be addressed in the Ikwerre culture. A woman’s capability to address her health needs and use health care is largely dependent on her ability to act autonomously. Thus, educational interventions to enable women’s decision-making are critical.     

Policy lessons from physicians’ strikes

Drawing upon the literature on physicians’ strikes from other OECD countries, the experience with physician strikes in Israel is put into comparative perspective. There are both structural and ideological factors that help to explain why there have been more strikes in Israel relative to other countries. At the same time, the dynamics of the strike and divisions within the medical profession in Israel, may be contributing to policy drift. This is a commentary on http://www.ijhpr.org/content/2/1/33.     

far from kid＇s blues

在刚刚结束的第28届国际心理学大会上公布了一组数据：中国目前约有20％的儿童出现抑郁症状，其中4％为临床抑郁，即需要接受临床治疗的重症抑郁。     

Who really profits from not-for-profits?

In a Harvard Business Review (1987) article, Herzlinger and Krasker suggested that not-for-profit hospitals do not return more benefit to society than do for-profit hospitals, and the authors questioned the legitimacy of social subsidization of not-for-profits. Our article reports findings from an empirical reconsideration of the question, "Who profits from nonprofits?" We used hospital data from the same time period (1982) as that used by Herzlinger and Krasker; however, our investigation analyzed a larger data set (including both system and nonsystem hospitals) and used a different statistical technique (discriminant analysis). Our findings suggest that not-for-profits return more social benefit (e.g., in the areas of services provided, access to care, and involvement in professional education) than do for-profits. Like Herzlinger and Krasker, we find that for-profit hospitals may be more efficient than not-for-profits. We caution that public policy regarding social subsidization of not-for-profit hospitals should be made only after more intensive study and thoughtful consideration.     

Do the elderly benefit from annual physical examination? An example from Kaohsiung City,Taiwan

BACKGROUND: This study evaluates the impact of free annual health examinations on survival of elderly (> or =65 years of age) residents in Kaohsiung City, Taiwan. METHODS: A stratified random sample scheme was used in each of the 11 districts of Kaohsiung City. A total of 1,193 elderly people were selected and interviewed in 1993; deaths and results of health check-ups were recorded through 1998. RESULTS: While over 50% of the subjects received at least one health examination between 1993 and 1998, only 18% received three or more. Most (60%) subjects who received examinations in a given year also received examinations the subsequent year; most (over 70%) who did not receive examinations in a given year did not receive check-ups the following year. Cox proportional hazards model showed that those who utilized the examination service had better survival probability than those who did not, given the same age, sex, education, marital status, living arrangements, and number of chronic diseases at baseline: The relative risk (RR) of mortality for those who ever utilized the health examination service was 0.50 (P < 0.0001). CONCLUSIONS: Elderly subjects who received annual health examinations had lower mortality than those who did not. This finding should be interpreted cautiously, however, as the difference in survival may reflect better general health behaviors among those who participated in the program.     

Can We Distinguish Age-Related Frailty from Frailty Related to Diseases? Data from the MAPT Study

The journal of nutrition, health & aging - No study has tried to distinguish subjects that become frail due to diseases (frailty related to diseases) or in the absence of specific medical...