Climate Change: Effects on the Older Adult

The effects of climate change include floods, hurricanes, heat waves, and fires; these natural disasters can result in respiratory, cardiovascular, and psychological harm in older adults, who experience the highest morbidity and mortality during heat waves. Advanced practice registered nurses (APRNs) need education on preparing, assessing, and treating older adults for climate-change disasters, especially heat waves. This article will help APRNs understand the effects of climate-change events on the vulnerable older adults and advocates for the need to integrate health effects of climate change into curricula, practicums, policy, and research agendas.     

Patients seeking symmetrical recontouring for “Perceived” deformities in the width of the face and skull

This article describes plastic surgery patients who sought symmetrical recontouring of the width of the face and skull. The basic demographic and personality characteristics of these facial width deformity (FWD) patients and the surgical procedures performed on them are discussed. Details of the surgical and psychological management of three representative cases are given. Speculative conclusions regarding the general characteristics of the FWD population are offered. Suggestions are proposed for a combined surgical-medical psychotherapeutic collaboration in managing these patients.     

再论医院后勤服务社会化的可行性

目前，经济高速发展，服务体系和水准相对滞后，加上管理者素质的提高，现代管理技术的应用，以及后勤管理体制的改革，为医院后勤工作向社会分离提供了条件，也为推进医院后勤服务社会化提供了机遇。但规范卫生服务市场体系是后勤服务社会化的保障，故要建立：卫生物质流通、后勤人才流动、经济信息市场及卫生建设筹资机构。在推进后勤服务社会化时尚需解决：①支持条件；②实施集团联盟；③注意经营定位等问题。     

Chronic exposure by ingestion of environmentally relevant doses of 226Ra leads to transient growth perturbations in fathead minnow (Pimephales promelas,Rafinesque, 1820)

Abstract

Purpose: To assess the impact of environmentally relevant levels of ingested ²²⁶Ra on a common freshwater fish species.

Methods: Fathead minnow (Pimephales promelas, Rafinesque) were obtained at the first feeding stage and established on a commercial fish food diet containing ²²⁶Ra in the activity range 10 mBq/g^?1, –10,000 mBq/g^?1. They remained on this diet for 24 months and were sampled invasively at 1,6,18 and 24 months to assess growth, biochemical indices and accumulated dose and non-invasively also at 12 and 15 months to assess growth.

Results: Fish fed 10 and 100 mBq/g^?1 diet showed a small transitory deregulation of growth at 6 and 12 months. Fish fed higher activities showed less significant or insignificant effects. There was a trend at 18 months which was stronger at 24 months for the population distribution to change in all of the ²²⁶Ra fed groups so that smaller fish were smaller and bigger fish were bigger than the controls. There were also significant differences in the ratios of protein:DNA at 24 months which were seen as a trend but were not significant at earlier time points.

Conclusions: Fish fed a radium diet for 2 years show a small and transitory growth dysregulation at 6 and 12 months. The effects predominate at the lower activities suggesting hormetic or homeostatic adjustments. There was no effect on growth of exposure to the high activities ²²⁶Ra. This suggests that radium does not have a serious impact on the ecology of the system and the level of radium that would be transferred to humans is very low. The results may be important in the assessment of long-term environmental impacts of ²²⁶Ra exposure.     

The health impacts of international migration on Mexican women

Abstract

Mexican migration to the USA is a phenomenon that affects a significant number of Mexican households. In the area of health, considerable research has been devoted to international migrants, but less is known about the health impacts of migration on other household members, particularly the wives of migrants. I used data from the Mexican Migration Project to investigate the health impacts of having a migrant husband. As part of my analysis I explored the relationship between the husbands’ migration and several health conditions and behaviours among the wives. In contrast to existing research on the subject, I also considered whether the amount of time the husband spent in the US mediates the relationship between migration and health. Finally, I addressed the possibility that the wives of migrants differ in their initial health endowments from the wives of non-migrants. I found that despite having similar initial health endowments, the wives of migrants have poorer mental health, a higher prevalence of heart disease, and they are more likely to be obese or overweight than the wives of non-migrants.     

Do self‐efficacy and depression predict oral impacts on daily performances across time? A 2‐yr follow‐up of students in Tanzania

This study aimed to assess the longitudinal validity of the oral impacts on daily performance (OIDP) and to identify psychosocial determinants, in terms of self‐efficacy and depressive symptoms, of the OIDP across time. Following conceptual frameworks of oral health, it was hypothesized that sociodemographic, clinical, and psychosocial factors predict oral impacts across time at both population‐ averaged and person‐specific levels. Whether the effects of sociodemographic and clinical factors were accounted for, totally or in part, by psychosocial factors were also investigated. Self administered questionnaires and oral clinical examinations at baseline (2009) and follow‐up (2011) were completed by 1,714 and 727 secondary school students, respectively. Generalized equalized equations and a random intercept model were used to account for the dependency in repeated observations. Mean OIDP change scores were negative (worsened) among those who reported worsened self‐reported oral health. Psychosocial, clinical, and sociodemographic factors were independently associated with oral impacts at the population‐averaged and person‐specific levels. Mediation of sociodemographic and clinical variables according to psychosocial variables was not observed. Satisfactory longitudinal evaluative properties of the OIDP, and independent effects of psychosocial factors on oral impacts across time, were confirmed among secondary school students in Tanzania.     

A Fully Coupled Simulation of Planar Deposition Flow and Fiber Orientation in Polymer Composites Additive Manufacturing

Numerical studies for polymer composites deposition additive manufacturing have provided significant insight promoting the rapid development of the technology. However, little of existing literature addresses the complex yet important polymer composite melt flow–fiber orientation coupling during deposition. This paper explores the effect of flow–fiber interaction for polymer deposition of 13 wt.% Carbon Fiber filled Acrylonitrile Butadiene Styrene (CF/ABS) composites through a finite-element-based numerical approach. The molten composite flow in the extrusion die plus a strand of the deposited bead contacting the deposition substrate is modelled using a 2D isothermal and incompressible Newtonian planar flow model, where the material deposition rate is ~110 mm/s simulating a large scale additive manufacturing process. The Folgar–Tucker model associated with the Advani–Tucker orientation tensor approach is adopted for the evaluation of the fiber orientation state, where the orthotropic fitted closure is applied. By comparing the computed results between the uncoupled and fully coupled solutions, it is found that the flow-orientation effects are mostly seen in the nozzle convergence zone and the extrusion-deposition transition zone of the flow domain. Further, the fully coupled fiber orientation solution is highly sensitive to the choice of the fiber–fiber interaction coefficient CI, e.g., assigning CI as 0.01 and 0.001 results in a 23% partial relative difference in the predicted elastic modulus along deposition direction. In addition, Structural properties of deposited CF/ABS beads based on our predicted fiber orientation results show favorable agreements with related experimental studies.     

后路半椎体切除矫治先天性脊柱侧后凸的临床疗效分析

目的：探讨后路半椎体切除矫治先天性脊柱侧后凸的临床疗效。方法选取该院收治的先天性脊柱侧后凸患者50例,全部患者均行后路半椎体切除矫治术治疗,比较术前、术后,X线片中测量的侧凸Cobb角、后凸Cobb角,分析后路半椎体切除矫治术治疗的临床效果。结果全部50例患者,术后侧凸Cobb角（10.4±2.3）o,明显小于术前侧凸Cobb角（52.5±6.6）o,比较差异有统计学意义（P<0.05）;术后后凸Cobb角（8.3±1.6）o,明显小于术前后凸Cobb角（31.9±5.2）o,比较差异有统计学意义（P<0.05）。结论后路半椎体切除矫治先天性脊柱侧后凸具有明显的手术效果,患者术后侧、后凸Cobb角均得到了较好的矫正,临床效果明显,值得临床上推广应用。     

The changing risk and burden of wildfire in the United States

Recent dramatic and deadly increases in global wildfire activity have increased attention on the causes of wildfires, their consequences, and how risk from wildfire might be mitigated. Here we bring together data on the changing risk and societal burden of wildfire in the United States. We estimate that nearly 50 million homes are currently in the wildland–urban interface in the United States, a number increasing by 1 million houses every 3 y. To illustrate how changes in wildfire activity might affect air pollution and related health outcomes, and how these linkages might guide future science and policy, we develop a statistical model that relates satellite-based fire and smoke data to information from pollution monitoring stations. Using the model, we estimate that wildfires have accounted for up to 25% of PM_2.5 (particulate matter with diameter <2.5 μm) in recent years across the United States, and up to half in some Western regions, with spatial patterns in ambient smoke exposure that do not follow traditional socioeconomic pollution exposure gradients. We combine the model with stylized scenarios to show that fuel management interventions could have large health benefits and that future health impacts from climate-change–induced wildfire smoke could approach projected overall increases in temperature-related mortality from climate change—but that both estimates remain uncertain. We use model results to highlight important areas for future research and to draw lessons for policy.