2,904 research outputs found

    Disability and disaster recovery: a tale of two cities?

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    This paper examines the connections between disability and disaster from a global perspective. Concepts from the research and policy literature are used to distinguish between individual and social models of disability, and between natural hazards and human disasters. These concepts are then employed to investigate data on the response to disabled people’s recovery needs in two recent case studies: the Asian tsunami and Hurricane Katrina. The analysis combines primary, secondary and tertiary sources to explore disability issues in the reconstruction of inclusive communities and the lessons that may be learned about disaster preparedness in poor communities. The conclusions suggest that more attention should be paid to social model approaches, particularly in understand global links with poverty, and that disabled people’s organisations should be resourced as agents of disaster recovery and preparedness

    Evidence based cardiology - Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies

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    Summary points: In healthy populations, prospective cohort studies show a possible aetiological role for type A/hostility (6/14 studies), depression and anxiety (11/11 studies), psychosocial work characteristics (6/10 studies), social support (5/8 studies). In populations of patients with coronary heart disease, prospective studies show a prognostic role for depression and anxiety (6/6 studies), psychosocial work characteristics (1/2 studies), and social support (9/10 studies); none of five studies showed a prognostic role for type A/hostility. Although this review can not discount the possibility of publication bias, prospective cohort studies provide strong evidence that psychosocial factors, particularly depression and social support, are independent aetiological and prognostic factors for coronary heart disease

    Does access to cardiac investigation and treatment contribute to social and ethnic differences in coronary heart disease? Whitehall II prospective cohort study

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    Objective: To determine whether access to cardiac procedures and drugs contributes to social and ethnic differences in coronary heart disease in a population setting. Design: Prospective study with follow up over 15 years. Civil service employment grade was used as a measure of individual socioeconomic position. Need for cardiac care was determined by the presence of angina, myocardial infarction, and coronary risk factors. Setting: 20 civil service departments originally located in London. Participants: 10 308 civil servants (3414 women; 560 South Asian) aged 35-55 years at baseline in 1985-8. Main outcome measures: Use of exercise electrocardiography, coronary angiography, and coronary revascularisation procedures and secondary prevention drugs. Results: Inverse social gradients existed in incident coronary morbidity and mortality. South Asian participants also had higher rates than white participants. After adjustment for clinical need, social position showed no association with the use of cardiac procedures or secondary prevention drugs. For example, men in the low versus high employment grade had an age adjusted odds ratio for angiography of 1.87 (95% confidence interval 1.32 to 2.64), which decreased to 1.27 (0.83 to 1.94) on adjustment for clinical need. South Asians tended to be more likely to have cardiac procedures and to be taking more secondary prevention drugs than white participants, even after adjustment for clinical need. Conclusion: This population based study, which shows the widely observed social and ethnic patterning of coronary heart disease, found no evidence that low social position or South Asian ethnicity was associated with lower use of cardiac procedures or drugs, independently of clinical need. Differences in medical care are unlikely to contribute to social or ethnic differences in coronary heart disease in this cohort

    Does autonomic function link social position to coronary risk? The Whitehall II study.

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    BACKGROUND: Laboratory and clinical studies suggest that the autonomic nervous system responds to chronic behavioral and psychosocial stressors with adverse metabolic consequences and that this may explain the relation between low social position and high coronary risk. We sought to test this hypothesis in a healthy occupational cohort. METHODS AND RESULTS: This study comprised 2197 male civil servants 45 to 68 years of age in the Whitehall II study who were undergoing standardized assessments of social position (employment grade) and the psychosocial, behavioral, and metabolic risk factors for coronary disease previously found to be associated with low social position. Five-minute recordings of heart rate variability (HRV) were used to assess cardiac parasympathetic function (SD of N-N intervals and high-frequency power [0.15 to 0.40 Hz]) and the influence of sympathetic and parasympathetic function (low-frequency power [0.04 to 0.15 Hz]). Low employment grade was associated with low HRV (age-adjusted trend for each modality, P< or =0.02). Adverse behavioral factors (smoking, exercise, alcohol, and diet) and psychosocial factors (job control) showed age-adjusted associations with low HRV (P<0.03). The age-adjusted mean low-frequency power was 319 ms2 among those participants in the bottom tertile of job control compared with 379 ms2 in the other participants (P=0.004). HRV showed strong (P<0.001) linear associations with components of the metabolic syndrome (waist circumference, systolic blood pressure, HDL cholesterol, triglycerides, and fasting and 2-hour postload glucose). The social gradient in prevalence of metabolic syndrome was explained statistically by adjustment for low-frequency power, behavioral factors, and job control. CONCLUSIONS: Chronically impaired autonomic function may link social position to different components of coronary risk in the general population

    Organisational downsizing and musculoskeletal problems in employees: a prospective study

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    Objectives: To study the association between organisational downsizing and subsequent musculoskeletal problems in employees and to determine the association with changes in psychosocial and behavioural risk factors. Methods: Participants were 764 municipal employees working in Raisio, Finland before and after an organisational downsizing carried out between 1991 and 1993. The outcome measures were self reports of severity and sites of musculoskeletal pain at the end of 1993 and medically certified musculoskeletal sickness absence for 1993-5. The contribution of changes in psychosocial work characteristics and health related behaviour between the 1990 and 1993 surveys was assessed by adjustment. Results: After adjustment for age, sex, and income, the odds ratio (OR) for severe musculoskeletal pain between major and minor downsizing and the corresponding rate ratios for musculoskeletal sickness absence were 2.59 (95% confidence interval (95% CI) 1.5 to 4.5) and 5.50 (3.6 to 7.6), respectively. Differences between the mean number of sites of pain after major and minor downsizing was 0.99 (0.4 to 1.6). The largest contribution from changes in work characteristics and health related behaviour to the association between downsizing and musculoskeletal problems was from increases in physical demands, particularly in women and low income employees. Additional contributory factors were reduction of skill discretion (relative to musculoskeletal pain) and job insecurity. The results were little different when analyses were confined to initially healthy participants. Conclusions: Downsizing is a risk factor for musculoskeletal problems among those who remain in employment. Much of this risk is attributable to increased physical demands, but adverse changes in other psychosocial factors may also play a part

    Editorial

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    Editorial

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    Edge Fracture in Complex Fluids

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    We study theoretically the edge fracture instability in sheared complex fluids, by means of linear stability analysis and direct nonlinear simulations. We derive an exact analytical expression for the onset of edge fracture in terms of the shear-rate derivative of the fluid’s second normal stress difference, the shear-rate derivative of the shear stress, the jump in shear stress across the interface between the fluid and the outside medium (usually air), the surface tension of that interface, and the rheometer gap size. We provide a full mechanistic understanding of the edge fracture instability, carefully validated against our simulations. These findings, which are robust with respect to choice of rheological constitutive model, also suggest a possible route to mitigating edge fracture, potentially allowing experimentalists to achieve and accurately measure flows stronger than hitherto possible

    Polyparameter linear free energy relationship for wood char–water sorption coefficients of organic sorbates

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    Author Posting. © The Author(s), 2015. This is the author's version of the work. It is posted here by permission of John Wiley & Sons for personal use, not for redistribution. The definitive version was published in Environmental Toxicology and Chemistry 34 (2015): 1464-1471, doi:10.1002/etc.2951.Black carbons (BCs), including soots, chars, activated carbons, and engineered nanocarbons, have different surface properties, but we do not know to what extent these affect their sorbent properties. To evaluate this for an environmentally ubiquitous form of BC, biomass char, we probed the surface of a well-studied wood char using 14 sorbates exhibiting diverse functional groups and then fit the data with a polyparameter linear free energy relationship (ppLFER) to assess the importance of the various possible sorbate-char surface interactions. Sorption from water to water-wet char evolved with the sorbate's degree of surface saturation and depended on only a few sorbate parameters: log Kd(L/kg) = [(4.03 ± 0.14) + (-0.15 ± 0.04) log ai)] V + [(-0.28 ± 0.04) log ai)] S + (-5.20 ± 0.21) B where ai is the aqueous saturation of the sorbate i, V is McGowan’s characteristic volume, S reflects polarity, and B represents the electron-donation basicity. As generally observed for activated carbon, the sorbate’s size encouraged sorption from water to the char, while its electron donation/proton acceptance discouraged sorption from water. However, the magnitude and saturation dependence differed significantly from what has been seen for activated carbons, presumably reflecting the unique surface chemistries of these two BC materials and suggesting BC-specific sorption coefficients will yield more accurate assessments of contaminant mobility and bioavailability and evaluation of a site's response to remediation.This material is based upon work supported by the U.S. Army Corps of Engineering, Humphreys Engineer Center Support Activity under Contract No. W912HQ-10-C-0005 awarded as part of the SERDP program.2016-05-1
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