Recalled Sex-typed Behavior in Childhood and Sports’ Preferences in Adulthood of Heterosexual,Bisexual, and Homosexual Men from Brazil,Turkey, and Thailand

This research used interview and questionnaire data from homosexual (n = 177), bisexual (n = 157), and heterosexual (n = 544) men between 20 and 30 years of age among lower class men and university students in three countries: Brazil, Thailand, and Turkey. The main goal of the study was to examine the recalled childhood sex-typed behavior and adult sports preferences that distinguish homosexuals from bisexuals and heterosexuals. In all three cultures and both social groups, homosexual men were almost always more likely as children to have wanted to be a girl, to cross-dress, to play with girls, to do girls’ tasks, and to practice fewer sports. They were also less likely to bully others or to engage in physical fights. As children, homosexual men were more likely to prefer swimming and playing volleyball rather than soccer and, as adults, they preferred watching gymnastics and swimming over soccer. The bisexuals scored intermediate mostly in “desire to be a girl” and “cross-dressing,” although they were much closer to the heterosexuals. These results, coupled with previous cross-cultural research, suggest that cross-gender behavior in childhood may characterize most male homosexuals regardless of their cultural milieu.     

Neonatal mortality in Londrina, Paraná State, Brazil, in 1994, 1999, and 2002

Despite technological progress in recent decades, neonatal mortality accounts for some two-thirds of infant deaths where the infant mortality rates are low. This study analyzes neonatal deaths in Londrina, Paraná, Brazil, during three periods, beginning with 1994, the year when pediatric and neonatal intensive care beds were created in the city. The data were collected from live birth certificates in the National Information System on Live Births (SINASC) and individual analysis of neonatal death certificates. Births declined in the city, but the low birthweight rate increased from 7.7 to 8.8% and the preterm birth rate from 6.3 to 8.4%. Multiple births also increased. Caesarian sections varied from 48 to 52%. The percentage of deaths from congenital malformations increased. The vast majority of neonatal deaths are preventable, mainly by providing specialized care during pregnancy. The neonatal mortality rate has declined recently, from 10.1 to 6.4 per 1,000 live births. The authors conclude that neonatal care is improving in Londrina.     

Same drugs,valued differently? Comparing comparators and methods used in reimbursement recommendations in Australia,Canada, and Korea

To investigate whether the value of the same drug is evaluated differently across jurisdictions, publicly available reimbursement recommendation data from the Health Insurance Review and Assessment Service (HIRA, Korea) from January 2007 until July 2012 were compared with reimbursement recommendation data from the Pharmaceutical Benefit Advisory Committee (PBAC) of Australia, and the Common Drug Review (CDR) and the pan-Canadian Oncology Drug review (pCODR) of Canada. The most recent guidelines from the three agencies regarding the recommended methods of economic evaluation and comparator selection were also compared. During the observation period, 25 products were evaluated by all three countries. No significant differences in the comparator(s)’ selection or methods of economic evaluation were found, but the CDR was significantly less likely to positively recommend products compared with the other agencies (p = 0.023). The agreement between agencies on selected comparator(s) was moderate to significant (kappa statistics = 0.590–0.669), whereas the reimbursement decisions (kappa statistics = 0.042–0.296) and the methods of economic evaluation (kappa statistics = 0.138–0.525) showed slight to fair agreement. We illustrated that the divergence in reimbursement decisions across jurisdictions is less related to comparator selection or the level of clinical evidence considered and more related to country-specific issues.     

Does Vaping in E-Cigarette Advertisements Affect Tobacco Smoking Urge,Intentions, and Perceptions in Daily,Intermittent, and Former Smokers?

Visual depictions of vaping in electronic cigarette advertisements may serve as smoking cues to smokers and former smokers, increasing urge to smoke and smoking behavior, and decreasing self-efficacy, attitudes, and intentions to quit or abstain. After assessing baseline urge to smoke, 301 daily smokers, 272 intermittent smokers, and 311 former smokers were randomly assigned to view three e-cigarette commercials with vaping visuals (the cue condition) or without vaping visuals (the no-cue condition), or to answer unrelated media use questions (the no-ad condition). Participants then answered a posttest questionnaire assessing the outcome variables of interest. Relative to other conditions, in the cue condition, daily smokers reported greater urge to smoke a tobacco cigarette and a marginally significantly greater incidence of actually smoking a tobacco cigarette during the experiment. Former smokers in the cue condition reported lower intentions to abstain from smoking than former smokers in other conditions. No significant differences emerged among intermittent smokers across conditions. These data suggest that visual depictions of vaping in e-cigarette commercials increase daily smokers’ urge to smoke cigarettes and may lead to more actual smoking behavior. For former smokers, these cues in advertising may undermine abstinence efforts. Intermittent smokers did not appear to be reactive to these cues. A lack of significant differences between participants in the no-cue and no-ad conditions compared to the cue condition suggests that visual depictions of e-cigarettes and vaping function as smoking cues, and cue reactivity is the mechanism through which these effects were obtained.     

Infant mortality and sociodemographic conditions in Ceará, Brazil, 1991 and 2000

OBJECTIVE: To assess ecological models to describe infant mortality rate in Ceara (Northeastern Brazil) in two different periods of time. METHODS: This was a cross-sectional ecologic study of two years, 1991 and 2000, using non-matching information per municipalities. Estimates on the infant mortality rate of the Instituto de Pesquisas Econ?micas Aplicadas (Institute of Applied Economic Research) have been used. For the remaining indicators different sources of the System of Health Information were used. The main risk factors were assessed using multiple linear regression. RESULTS: In 1991, the variables that predicted infant mortality rate (R2=0.3575) were: small houses (beta=0.0043; rho=0.010), proportion of inhabitants with tap water in the household (beta=-0.0029; rho=0.024), urbanization rate (beta=0.0032; rho=0.004), fecundity rate (beta=0.0351; rho=0.024), the proportion of children working at 10-14 years (beta=0.0049; rho=0.017), proportion of families with income < 1/2 minimum wage (beta=0.0056; rho=0.000), that can read and write (beta=-0.0062; rho=0.031). In the year 2000, the following possible determinants were identified (R2=0.3236): the proportion of children <2 years of age with malnutrition (beta=0.0064; rho=0.024), proportion of households with adequate sanitation (beta=-0.0024; rho=0.010), proportion of women who could read and write (beta=-0.0068; rho=0.044), expenses on health human resources regarding total health expenses (beta=-0.0024; rho=0.027), proportion of the value of the vegetal production in relation to the total of the state (beta=-0.1090; rho=0.001), intensity of poverty (beta=0.0065; rho=0.002), and ageing index (beta=-0.0100; rho=0.006). CONCLUSIONS: Although the variables have not been exactly the same for the evaluated period, determiners of infant mortality have been changing, except for indicators of education, income and sanitation. The overall decrease in fecundity led to a reduction in its discriminating power, and it was replaced by the ageing index. Another tendency observed was the replace of several demographic variables by health care indicators.     

Residues of organochlorine insecticides,industrial chemicals,and mercury in eggs and in tissues taken from healthy and emaciated common loons,Ontario, Canada, 1968–1980

Between 1968 and 1980, 98 eggs were collected from active nests of the common loon (Gavia immer) in Ontario. Residues of ?DDT and PCB declined over this period while dieldrin and Hg appeared unchanged. Eggs collected in 1969 and 1970 had significantly thinner shells than eggs from a collection made before 1947. Between 1969 and 1979, 215 common loon carcasses were collected across Ontario, the result of having been drowned or shot or having died of diseases or unknown causes. Chemical analyses of 174 carcasses taken from healthy birds showed that adult loons accumulated higher levels of organochlorine and Hg residues than did juveniles. Tissues with high fat contents contained higher organochlorine levels while kidney, liver, and feathers had the highest Hg levels. Thirty loons were found to be emaciated with visibly lesser amounts of body fat and significantly lower levels of lipids in pectoral muscle tissue. Organochlorine but not Hg residues were one to two orders of magnitude higher in the wet tissues of emaciated birds than healthy birds. Higher residues of organochlorine chemicals were found in the uropygial gland, the oil secreted by this gland and belly and back feathers of emaciated birds when compared to healthy birds. It was concluded that losses of organochlorine chemical residues could occur through this gland. While Hg levels in feathers were elevated, Hg did not accumulate in the uropygial gland or in the secreted oil and was not the route for Hg content in feathers. In emaciated birds, mean brain levels of ?DDT (primarily DDE) were between 25 and 49 Μg/g, dieldrin 0.5 to 1.2 Μg/g, PCB 39 to 63 Μg/g, and mercury 1.0 to 1.8 Μg/g. The mean brain levels in healthy birds were between 0.2 and 0.9 Μg/g ?DDT, 0.01 and 0.05 Μg/g dieldrin, 0.6 and 2.0 Μg/g PCB, and 0.4 and 0.6 Μg/g mercury.     

Sex Differences in Adults’ Relative Visual Interest in Female and Male Faces, Toys, and Play Styles

An individual’s reproductive potential appears to influence response to attractive faces of the opposite sex. Otherwise, relatively little is known about the characteristics of the adult observer that may influence his or her affective evaluation of male and female faces. An untested hypothesis (based on the proposed role of attractive faces in mate selection) is that most women would show greater interest in male faces whereas most men would show greater interest in female faces. Further, evidence from individuals with preferences for same-sex sexual partners suggests that response to attractive male and female faces may be influenced by gender-linked play preferences. To test these hypotheses, visual attention directed to sex-linked stimuli (faces, toys, play styles) was measured in 39 men and 44 women using eye tracking technology. Consistent with our predictions, men directed greater visual attention to all male-typical stimuli and visual attention to male and female faces was associated with visual attention to gender conforming or nonconforming stimuli in a manner consistent with previous research on sexual orientation. In contrast, women showed a visual preference for female-typical toys, but no visual preference for male faces or female-typical play styles. These findings indicate that sex differences in visual processing extend beyond stimuli associated with adult sexual behavior. We speculate that sex differences in visual processing are a component of the expression of gender phenotypes across the lifespan that may reflect sex differences in the motivational properties of gender-linked stimuli.

What's in a country average? Wealth, gender, and regional inequalities in immunization in India

Recent attention to Millennium Development Goals by the international development community has led to the formation of targets to measure country-level achievements, including achievements on health status indicators such as childhood immunization. Using the example of immunization in India, this paper demonstrates the importance of disaggregating national averages for a better understanding of social disparities in health. Specifically, the paper uses data from the India National Family Health Survey 1992-93 to analyze socioeconomic, gender, urban-rural and regional inequalities in immunization in India for each of the 17 largest states. Results show that, on average, southern states have better immunization levels and lower immunization inequalities than many northern states. Wealth and regional inequalities are correlated with overall levels of immunization in a non-linear fashion. Gender inequalities persist in most states, including in the south, and seem unrelated to overall immunization or the levels of other inequalities measured here. This suggests that the gender differentials reflect deep-seated societal factors rather than health system issues per se. The disaggregated information and analysis used in this paper allows for setting more meaningful targets than country averages. Additionally, it helps policy makers and planners to understand programmatic constraints and needs by identifying disparities between sub-groups of the population, including strong and weak performers at the state and regional levels.     

Maternal age, social changes, and pregnancy outcome in Ribeirão Preto, southeast Brazil, in 1978-79 and 1994

This study focused on changes in demographic, social, and health-care patterns and pregnancy outcome related to maternal age from 1978-79 to 1994 in Ribeir?o Preto, S?o Paulo State, Brazil. Information on pregnancy outcome was obtained from two cohorts of singleton live births, 6,681 births in 1978/79 and 2,839 births in 1994. A standardized questionnaire was submitted to mothers after delivery, and demographic information was collected from official records. There was a significant increase in teenage pregnancies (from 5.1% to 7.4%) and a decrease in infant mortality (36/1,000 to 17/1,000). There were significant decreases in the proportion of mothers with low schooling (24.5% to 14.4%), smoking (28.9% to 21.%), and multiparity (14.7% to 9.0%). Prenatal coverage improved (from 23.4% to 9.0% of patients with fewer than 4 prenatal visits), while cesareans increased (from 30.6% to 50.8%), as did preterm delivery (7.2% to 13.6%) and low birthweight (7.2% to 10.6%). Despite significant improvements in some maternal characteristics, the proportion of teenage pregnancies, preterm deliveries, low birthweight, and cesareans increased, raising concerns about the health costs and consequences for mothers and infants.     

Frailty,Polypharmacy, and Health Outcomes in Older Adults: The Frailty and Dependence in Albacete Study

Background/Objectives

To investigate if polypharmacy modifies the association between frailty and health outcomes in older adults.

Otitis,rhinitis, and atopy in relation to domestic endotoxin and β-glucan exposure among children in Singapore

Background  

Exposure to microbial cell wall agents (MCWAs) has been related to the risk for atopy, otitis, and rhinitis.     

Lead, mercury, and organochlorine compound levels in cord blood in Québec, Canada

We conducted this study to evaluate blood levels of lead, mercury, and organochlorine compounds in newborns in the Province of Quebec. During 1993 to 1995, we carried out a survey in 10 hospitals located in southern Quebec. During that time, umbilical cord blood samples were obtained from 1109 newborns, and we analyzed each for lead, mercury, 14 polychlorinated biphenyl congeners, and 11 chlorinated pesticides. We used the geometric mean and 95% confidence interval (CI) to describe the results. Mean concentrations of lead and mercury in cord blood were 0.076 micromol/l (95% CI = 0.074, 0.079) and 4.82 nmol/l (95% CI = 4.56, 5.08), respectively. The mean concentrations of total polychlorinated biphenyls (Aroclor 1260) and dichlorodiphenyl dichloroethylene were 0.514 microg/I (95% CI = .493, 0.536) and 0.412 microg/l (95% CI = 0.390, 0.435), respectively. We observed a statistically significant relationship between maternal age and cord blood concentrations of (a) lead, (b) mercury, (c) polychlorinated biphenyls, and (d) dichlorodiphenyl dichloroethylene. In addition, maternal smoking during pregnancy was associated with cord blood lead levels. The cord blood concentrations of lead, mercury, polychlorinated biphenyls, and dichlorodiphenyl dichloroethylene we measured in our study were the lowest levels recently reported in industrialized countries. The results of this study underline the role of public health authorities in the evaluation of biological levels of environmental contaminants among children for the assessment of risk of adverse health effects.     

Rural–Urban Trends and Patterns in Cervical Cancer Mortality, Incidence, Stage, and Survival in the United States, 1950–2008

This study examined disparities in cervical cancer mortality rates among US women in metropolitan and non-metropolitan areas from 1950 through 2007. Inequalities in incidence, stage of disease at diagnosis, and patient survival were analyzed during 2000–2008. Age-adjusted mortality, incidence, and 5-year relative survival rates were calculated for women in metropolitan and non-metropolitan areas, and differences in relative risks were tested for statistical significance. Log-linear regression was used to analyze annual rates of change in mortality over time. During the last five decades, women in non-metropolitan areas had significantly higher cervical cancer mortality than those in metropolitan areas. Disparities persisted against a backdrop of consistently declining mortality rates. Throughout 1969–2007, both white and black women in non-metropolitan areas maintained significantly higher cervical cancer mortality rates than their metropolitan counterparts. Among black women, cervical cancer mortality declined at a faster pace in metropolitan than in non-metropolitan areas. In both metropolitan and non-metropolitan areas, black women had twice the mortality rate of white women. During 2000–2008, white, black, and American Indian women in non-metropolitan areas had significantly higher cervical cancer incidence rates than their metropolitan counterparts. Survival rates were significantly lower in non-metropolitan areas, particularly among rural black women. The 5-year survival rate for black women diagnosed with cervical cancer was 50.8% in non-metropolitan areas, compared with 60.2% for black women and 71.0% for white women in metropolitan areas. Disparities in survival existed after controlling for disease stage. Rural–urban disparities in cervical cancer have persisted despite steep declines in incidence and mortality rates.     

α-Tocopherol supplementation and the oxidative stress,homocysteine, and antioxidants in lead exposure

To investigate whether α-tocopherol supplementation in workers exposed to lead would reduce the oxidative stress intensity and decrease homocysteine level, the examined population was randomly divided into two groups. Workers in the first group (n = 49, reference group) were not administered any drugs. Workers in the second group (n = 34) were administered orally α-tocopherol, 200 mg per day for 12 weeks. The level of α-tocopherol significantly increased compared to the baseline and the reference group. The level of thiol groups significantly increased compared to the reference group. However, the levels of malondialdehyde and homocysteine did not significantly change. Animal studies suggest the ability of α-tocopherol administration to reverse adverse health effects of lead exposure, such as oxidative stress; however, the results of this study on humans do not confirm these protective effects.     

Temporal trends in disability evaluation and retirement in the Army,Navy, and Marine Corps: 2005–2011

BackgroundSurveillance of trends in disability is necessary to determine the burden of disability on the U.S. military, the most common types of disability conditions, and the prevalence of combat exposures in the disability population. Previous studies of disability in the U.S. military have focused on a particular service or condition rather than examining the epidemiology of disability in the military overall.ObjectiveThis study's objective is to describe rates of disability evaluation and retirement in U.S. Army, Navy, and Marine Corps.MethodsA cross-sectional study of 126,170 service members evaluated for disability discharge from the U.S. military in fiscal years 2005–2011 was conducted. Crude and standardized rates of disability evaluation and retirement were calculated per 10,000 service members by year of disability, demographic characteristics, and type of disability evaluation or retirement. Temporal trends in the prevalence of combat-related disability in the disability evaluated and retired population were also examined.ResultsRates of disability evaluation and retirement were highest among female, enlisted, and active duty service members. Overall rates of disability evaluation significantly decreased, while rates of disability retirement increased. Rates of psychiatric disability evaluation and retirement significantly increased in all services during the same time period from 2005 to 2011. Combat-related disability evaluations and retirements have substantially increased in all services particularly among psychiatric disability cases.ConclusionsPsychiatric disability, combat-related disability, and disability retirement continue to increase in the military, despite observed decreases in the rates of disability the Department of Defense since 2005.