Saving Lives and Dollars Through Comprehensive Preventive Health Care

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68280/2/10_1111_j_1741-6248_1993_00163_x.pd

A family set method for estimating heredity and stress--I : A pilot survey of blood pressure among Negroes in high and low stress areas, Detroit, 1966-1967

A pilot survey designed to test the feasibility of measuring genetic and stress variables as they relate to blood pressure levels was carried out among Negroes residing in high and low stress census tracts in Detroit, 1966-1967. Fifty-six "family sets" or 280 persons were interviewed and blood pressure recordings were taken by trained nurses. Each family set was composed of an index, a spouse, a sibling and a first cousin of index, and an unrelated person in the census tract matched to index. The method and findings of obtaining such family sets is discussed and found to be encouraging enough to initiate a larger study. It was also found that proportions of persons with hypertensive levels were significantly greater in the high stress tract (32 per cent; N = 102) than in the low stress tract (19 per cent; N = 113).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32720/1/0000088.pd

A family set method for estimating heredity and stress--II : Preliminary results of the genetic methodology in a pilot survey of Negro blood pressure, Detroit, 1966-1967

A prior article described in detail a pilot survey designed to measure the effects of heredity and stress on blood pressures among Negroes residing in high and low stress census tracts in Detroit. This report outlines the construction of a genetic variable to analyze the heritable component in blood pressure variability using a family set composed of an index and spouse, a sibling and a first cousin of index, and an unrelated person in the tract matched to index. Given the theoretical proportions describing the degree to which genes are shared between siblings and first cousins, then it follows that variability of a given trait will increase predictably within each family set. Findings from a limited sample of 56 family sets indicate support for a genetic distance scale when measured against variables such as height and skin color; however, the relationship with blood pressure levels is inconclusive. A study now underway will more critically test the tentative findings from this pilot survey.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32721/1/0000089.pd

Impact of rough substrates on hydrogen doped indium oxides for the application in CIGS devices

Indium oxide based transparent conductive oxides TCOs are promising contact layers in solar cells due totheir outstanding electrical and optical properties. However, when applied in Cu In,Ga Se2or Si hetero junctionsolar cells the specific roughness of the material beneath can affect the growth and the properties of the TCO.We investigated the electrical properties of hydrogen doped and hydrogen tungsten co doped indium oxidesgrown on rough Cu In,Ga Se2samples as well as on textured and planar glass. At sharp ridges and V shapedvalleys crack shaped voids form inside the indium oxide films, which limit the effective electron mobilityof the In2O3 H and In2O3 H,W thin films. This was found for films deposited by magnetron sputtering andreactive plasma deposition at several deposition parameters, before as well as after annealing and solid phasecrystallization. This suggests universal behavior that will have a wide impact on solar cell device

Active Hydrothermal Features as Tourist Attractions

Tourists are looking increasingly for adventurous experiences by exploring unusual and interesting landscapes. Active volcanic and hydrothermal landscapes and their remarkable manifestations of geysers, fumaroles and boiling mud ponds are some of the surface features that fascinate visitors of National Parks, Geoparks and World Heritage areas worldwide. The uniqueness of hydrothermal activity based on volcanism has provided popular tourist attractions in many countries for several thousand years. The Romans for example have used hydrothermal springs on the Italian island Ischia and visited the Campi Flegrei for recreational purposes. In Iceland the original Geysir already attracted international visitors over 150 years ago, who came to observe this spectacular hydrothermal phenomenon. In Greece and Turkey volcanic hot springs have historically provided attractive destinations, as well as in New Zealand, Japan and the Americas. The fact that locations with hydrothermal activity based on active volcanism have acquired various forms of protected site status, adds a further dimension to their attraction and demonstrates a significant contribution to sustainable and nature based tourism. Countries such as Iceland, New Zealand and Japan have a long tradition of using hydrothermal activity in its various forms to offer tourists a unique natural experience. These environments however are also known for their unpredictable and potentially hostile nature, as the use of hydrothermal features as a natural resource for tourism does harbour certain risks with the potential to affect human health and safety. Hydrothermal systems have erupted in the past, thereby causing the destruction of their immediate environment. Depending on the level of magnitude explosions of super heated water and steam mixed with fractured rocks and hot mud can be violent enough to create craters varying in size from a few metres to several hundred metres in diameter. Apart from unexpected eruptions of hydrothermal vents with the potential to cause thermal burns, further risk factors include seismic activity such as earthquakes, lethal gas emissions of hydrogen sulphide (H2S) as well as ground instability through hydrothermal alteration. While it is essential to prevent injuries to tourists the management of hydrothermal hazards remains problematic. Precursory signs are not well understood by the general public and the communication of imminent danger is frequently unachievable. As a consequence serious thought needs to be given to the risk factors and the potential danger of areas in the proximity of active hydrothermal manifestations such as extreme hot springs and geysers. To improve the safety standards in hydrothermal landscapes that are used as main features in tourism, strategic guidelines for best practice management must cover ALL active volcanic and hydrothermal areas. This chapter looks at management issues at hydrothermal destinations with special consideration of areas where these unique features are integrated as tourist attractions. Examples from destinations traditionally based on active volcanic and hydrothermal phenomena are presented as case studies to highlight the risk management processes in individual countries. Potential hazards in volcanic and hydrothermal areas are assessed with a focus on the prevention of accidents and injuries to tourists

Panta Rhei benchmark dataset: socio-hydrological data of paired events of floods and droughts

As the adverse impacts of hydrological extremes increase in many regions of the world, a better understanding of the drivers of changes in risk and impacts is essential for effective flood and drought risk management and climate adaptation. However, there is currently a lack of comprehensive, empirical data about the processes, interactions, and feedbacks in complex human–water systems leading to flood and drought impacts. Here we present a benchmark dataset containing socio-hydrological data of paired events, i.e. two floods or two droughts that occurred in the same area. The 45 paired events occurred in 42 different study areas and cover a wide range of socio-economic and hydro-climatic conditions. The dataset is unique in covering both floods and droughts, in the number of cases assessed and in the quantity of socio-hydrological data. The benchmark dataset comprises (1) detailed review-style reports about the events and key processes between the two events of a pair; (2) the key data table containing variables that assess the indicators which characterize management shortcomings, hazard, exposure, vulnerability, and impacts of all events; and (3) a table of the indicators of change that indicate the differences between the first and second event of a pair. The advantages of the dataset are that it enables comparative analyses across all the paired events based on the indicators of change and allows for detailed context- and location-specific assessments based on the extensive data and reports of the individual study areas. The dataset can be used by the scientific community for exploratory data analyses, e.g. focused on causal links between risk management; changes in hazard, exposure and vulnerability; and flood or drought impacts. The data can also be used for the development, calibration, and validation of sociohydrological models. The dataset is available to the public through the GFZ Data Services (Kreibich et al., 2023, https://doi.org/10.5880/GFZ.4.4.2023.001)

The challenge of unprecedented floods and droughts in risk management

Risk management has reduced vulnerability to floods and droughts globally1,2, yet their impacts are still increasing3. An improved understanding of the causes of changing impacts is therefore needed, but has been hampered by a lack of empirical data4,5. On the basis of a global dataset of 45 pairs of events that occurred within the same area, we show that risk management generally reduces the impacts of floods and droughts but faces difficulties in reducing the impacts of unprecedented events of a magnitude not previously experienced. If the second event was much more hazardous than the first, its impact was almost always higher. This is because management was not designed to deal with such extreme events: for example, they exceeded the design levels of levees and reservoirs. In two success stories, the impact of the second, more hazardous, event was lower, as a result of improved risk management governance and high investment in integrated management. The observed difficulty of managing unprecedented events is alarming, given that more extreme hydrological events are projected owing to climate change3

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Socioecological stressor areas and black-white blood pressure: Detroit

1. 1. Blood pressure does appear to vary with `socioecological niches' or combinations of sex, race and residence, which reflect social class position as well as degree of social stressor conditions. Black High Stress males had higher adjusted levels than Black Low Stress males, while White High Stress females had higher adjusted pressures than White Low Stress females. Black High Stress females had significantly higher observed levels than Black Low Stress females.2. 2. Black High Stress males had a significantly higher per cent of Borderline and Hypertensive blood pressure than other male race-area groups; White Low Stress females had the lowest of all eight sex-race-stress area groups.3. 3. For Black males, the younger, overweight High Stress residents had significantly higher Borderline and Hypertensive levels than did a similar Black Low Stress subgroup. Further, for both groups, being raised in Detroit and not migrating from elsewhere was related to higher readings. Tests for age-stress area interaction, however, were not significant.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33823/1/0000080.pd