Waterpipe cafés are hazardous to your health: Determination of a waterpipe specific calibration factor

Introduction

The use of a waterpipe to smoke tobacco has emerged as a popular trend in the United States. Waterpipe smoking establishments have had an increasing presence in the U.S., despite smoke-free air legislation. Dangers of waterpipe smoking have been documented, but less data has been gathered about the waterpipe café itself. This project sought to determine a waterpipe-specific calibration factor (CF) for measuring waterpipe aerosol, and field-test this CF by conducting surveillance on the existing waterpipe cafés of western and central New York.

Is universal health coverage the practical expression of the right to health care?

Background

Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma.

Methods

A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma.

Results

Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (±0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. β?=?0.43, P?<?0.001) than urban residents. As the number of perceived signs (std. β?=?-0.07, P?<?0.05), perceived supernatural (std. β?=?-0.12, P?<?0.01) and psychosocial and biological (std. β?=?-0.11, P?<?0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status.

Conclusions

Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented.     

Is globalization good for your health?

Four points are made about globalization and health. First, economic integration is a powerful force for raising the incomes of poor countries. In the past 20 years several large developing countries have opened up to trade and investment, and they are growing well--faster than the rich countries. Second, there is no tendency for income inequality to increase in countries that open up. The higher growth that accompanies globalization in developing countries generally benefits poor people. Since there is a large literature linking income of the poor to health status, we can be reasonably confident that globalization has indirect positive effects on nutrition, infant mortality and other health issues related to income. Third, economic integration can obviously have adverse health effects as well: the transmission of AIDS through migration and travel is a dramatic recent example. However, both relatively closed and relatively open developing countries have severe AIDS problems. The practical solution lies in health policies, not in policies on economic integration. Likewise, free trade in tobacco will lead to increased smoking unless health-motivated disincentives are put in place. Global integration requires supporting institutions and policies. Fourth, the international architecture can be improved so that it is more beneficial to poor countries. For example, with regard to intellectual property rights, it may be practical for pharmaceutical innovators to choose to have intellectual property rights in either rich country markets or poor country ones, but not both. In this way incentives could be strong for research on diseases in both rich and poor countries.     

Is service with the parachute regiment bad for your health?

Military parachuting is perceived to be a 'high risk' activity. The estimate of risk should be based on a comparison of injury rates between soldiers who are military parachutists and soldiers who are not military parachutists rather than the rate of injury per parachute descent. Since other aspects of military life also have an inherent risk of injury the risk attributable to military parachuting must be assessed in this context. The aim of this paper is to determine whether Parachute Regiment soldiers have a greater risk of injury as compared with non-Parachute Regiment infantry soldiers by comparing rates of hospital admission and medical discharge between the two groups. Records at the Defence Analytical Services Agency were analysed for the 10-year period 1987-96. The mean rate of hospital admission for Parachute Regiment soldiers was 50.1 per 1,000 and for infantry soldiers was 50.8 per 1,000 [relative risk (RR) = 0.98; 95% confidence interval (CI) = 0.92-1.04). The mean rate of medical discharge for Parachute Regiment soldiers was 4.9 per 1,000 and for infantry the mean rate was 2.8 per 1,000 (RR = 1.76; CI = 1.45-2.15). This study has shown a methodology for comparing occupational exposure to risk that could be extended to other groups if they can be separated by appropriate criteria.     

Is employer-based health insurance a barrier to entrepreneurship?

The focus on employer-provided health insurance in the United States may restrict business creation. We address the limited research on the topic of “entrepreneurship lock” by using recent panel data from matched Current Population Surveys. We use difference-in-difference models to estimate the interaction between having a spouse with employer-based health insurance and potential demand for health care. We find evidence of a larger negative effect of health insurance demand on business creation for those without spousal coverage than for those with spousal coverage. We also take a new approach in the literature to examine the question of whether employer-based health insurance discourages business creation by exploiting the discontinuity created at age 65 through the qualification for Medicare. Using a novel procedure of identifying age in months from matched monthly CPS data, we compare the probability of business ownership among male workers in the months just before turning age 65 and in the months just after turning age 65. We find that business ownership rates increase from just under age 65 to just over age 65, whereas we find no change in business ownership rates from just before to just after for other ages 55-75. We also do not find evidence from the previous literature and additional estimates that other confounding factors such as retirement, partial retirement, social security and pension eligibility are responsible for the increase in business ownership in the month individuals turn 65. Our estimates provide some evidence that “entrepreneurship lock” exists, which raises concerns that the bundling of health insurance and employment may create an inefficient level of business creation.     

Is fragmented financing bad for your health?

Americans finance health care through a variety of private insurance plans and public programs. This organizational fragmentation could threaten continuity of care and adversely affect outcomes. Using a large sample of veterans who were eligible for mixtures of Veterans Health Administration- and Medicare-financed care, we estimate a system of equations to account for simultaneity in the determination of financing configuration and the probability of hospitalization for an ambulatory care sensitive condition. We find that a change of one standard deviation in financing fragmentation increases the risk of an adverse outcome by one-fifth.     

Is the cultural context of MMR rejection a key to an effective public health discourse?

OBJECTIVES: (1) To explore the social and cultural influences, and health beliefs associated with low uptake of MMR (measles, mumps and rubella vaccine). (2) To describe and explore the prevalence of health beliefs associated with non-compliance with MMR, with a view to improving the personal relevance and impact of information for parents, in the context of persisting low uptake following public controversy. METHODS: We undertook a survey of mothers' experiences of and attitudes to the MMR, developed through ethnographic study, which was linked to maternal and child information on the Child Health Database in Brighton, England. RESULTS: Mothers interpret MMR risk through concepts of child health embedded in family health history, with a majority both of compliers and non-compliers holding that each child's immune system is unique. Cultural 'risk factors' for non-compliance relate strongly to the use of complementary healthcare, such as homeopathy, with evidence that rejection of vitamin K is associated with MMR non-compliance. Forty per cent, both of compliers and non-compliers, did not consider the possible benefits to other children of MMR. CONCLUSIONS: These findings have paradoxical and challenging consequences for the promotion of immunization in the policy context of increasing emphasis on healthy choices. They demonstrate the need for immunization information that acknowledges and addresses lay concepts of immunity.     

Is your doctor a groupie?

What characteristics do you perceive as being most important when recruiting new physicians for your medical group? While technical competence is of course necessary, the medical group must also consider how well the candidate will fit into the group. By understanding the characteristics that will make a candidate fit into the organization and by carefully assessing the prevalence of these characteristics in physician candidates, the perceptive administrator can select the candidate that will best contribute to the long-term success of the organization. A specialist in physician recruitment offers her advice.