2,712 research outputs found
Book Review of Heather McCrea, Diseased Relations: Epidemic, Public Health, and State-Building in Yucatán, Mexico, 1847-1924
Diseased Relations is an impressive work succinct in its focus on the topic of public health history in the Mexican state of Yucatán. Adding to a growing body of scholarship on the nineteenth and early twentieth centuries, this book offers a new lens through which to consider the mechanics of state formation. In this turn to the study of disease and public health, McCrea pulls in the unfolding story of science’s understanding of the origin and spread of diseases and reflects upon the dialogue between national officials and state or local officials in the Yucatán. By choosing to focus on specific disease campaigns, McCrea extends the common discussion of state formation and casts it into a light of intimacy and personal level as she explores the ways in which disease prevention touched and changed the lives of individuals. Instead of viewing ‘nation-building’ through abstractions, she adroitly pursues the palpable and deadly topic of disease and efforts to combat epidemics as a clear implementation of the long-arm of the state into the private lives of individuals
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Aerosols from biomass burning over the tropical South Atlantic region: Distributions and impacts
The NASA Global Tropospheric Experiment (GTE) Transport and Atmospheric Chemistry Near the Equator-Atlantic (TRACE A) expedition was conducted September 21 through October 26, 1992, to investigate factors responsible for creating the seasonal South Atlantic tropospheric ozone maximum. During these flights, fine aerosol (0.1-3.0 μm) number densities were observed to be enhanced roughly tenfold over remote regions of the tropical South Atlantic and greater over adjacent continental areas, relative to northern hemisphere observations and to measurements recorded in the same area during Ac wet season. Chemical and meteorological analyses as well as visual observations indicate that the primary source of these enhancements was biomass burning occurring within grassland regions of north central Brazil and southeastern Africa. These fires exhibited fine aerosol (N) emission ratios relative to CO (dN/dCO) of 22.5 ± 9.7 and 23.6 ± 15.1 cm-3 parts per billion by volume (ppbv)-1 over Brazil and Africa, respectively. Convection coupled with counterclockwise flow around the South Atlantic subtropical anticyclone subsequently distributed these aerosols throughout the remote South Atlantic troposphere. We calculate that dilute smoke from biomass burning produced an average tenfold enhancement in optical depth over the continental regions as well as a 50% increase in this parameter over the middle South Atlantic Ocean; these changes correspond to an estimated net cooling of up to 25 W m-2 and 2.4 W m-2 during clear-sky conditions over savannas and ocean respectively. Over the ocean our analyses suggest that modification of CCN concentrations within the persistent eastern Atlantic marine stratocumulus clouds by entrainment of subsiding haze layers could significantly increase cloud albedo resulting in an additional surface radiative cooling potentially greater in magnitude than that caused by direct extinction of solar radiation by the aerosol particles themselves
Multiple uncontrolled conditions and blood pressure medication intensification: an observational study
Abstract Background Multiple uncontrolled medical conditions may act as competing demands for clinical decision making. We hypothesized that multiple uncontrolled cardiovascular risk factors would decrease blood pressure (BP) medication intensification among uncontrolled hypertensive patients. Methods We observed 946 encounters at two VA primary care clinics from May through August 2006. After each encounter, clinicians recorded BP medication intensification (BP medication was added or titrated). Demographic, clinical, and laboratory information were collected from the medical record. We examined BP medication intensification by presence and control of diabetes and/or hyperlipidemia. 'Uncontrolled' was defined as hemoglobin A1c ≥ for diabetes, BP ≥ 140/90 mmHg (≥ 130/80 mmHg if diabetes present) for hypertension, and low density lipoprotein cholesterol (LDL-c) ≥ 130 mg/dl (≥ 100 mg/dl if diabetes present) for hyperlipidemia. Hierarchical regression models accounted for patient clustering and adjusted medication intensification for age, systolic BP, and number of medications. Results Among 387 patients with uncontrolled hypertension, 51.4% had diabetes (25.3% were uncontrolled) and 73.4% had hyperlipidemia (22.7% were uncontrolled). The BP medication intensification rate was 34.9% overall, but higher in individuals with uncontrolled diabetes and uncontrolled hyperlipidemia: 52.8% overall and 70.6% if systolic BP ≥ 10 mmHg above goal. Intensification rates were lowest if diabetes or hyperlipidemia were controlled, lower than if diabetes or hyperlipidemia were not present. Multivariable adjustment yielded similar results. Conclusions The presence of uncontrolled diabetes and hyperlipidemia was associated with more guideline-concordant hypertension care, particularly if BP was far from goal. Efforts to understand and improve BP medication intensification in patients with controlled diabetes and/or hyperlipidemia are warranted.http://deepblue.lib.umich.edu/bitstream/2027.42/78266/1/1748-5908-5-55.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78266/2/1748-5908-5-55.pdfPeer Reviewe
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A case study of transport of tropical marine boundary layer and lower tropospheric air masses to the northern midlatitude upper troposphere
Low-ozone (<20 ppbv) air masses were observed in the upper troposphere in northern midlatitudes over the eastern United States and the North Atlantic Ocean on several occasions in October 1997 during the NASA Subsonic Assessment, Ozone and Nitrogen Oxide Experiment (SONEX) mission. Three cases of low-ozone air masses were shown to have originated in the tropical Pacific marine boundary layer or lower troposphere and advected poleward along a warm conveyor belt during a synoptic-scale disturbance. The tropopause was elevated in the region with the low-ozone air mass. Stratospheric intrusions accompanied the disturbances. On the basis of storm track and stratospheric intrusion climatologies, such events appear to be more frequent from September through March than the rest of the year. Copyright 2000 by the American Geophysical Union
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