Effect of Occupational and Recreational Activity on the Risk of Colorectal Cancer among Males: A Case-Control Study

Epidemiological studies have consistently demonstrated that either occupational or recreational physical activity is pro tective against colon cancer. However, it is unclear whether recreational activity is similarly protective among those who engage in high or low occupational activity. We therefore compared 440 male cases of colorectal cancer with 1164 male hospital patients. Occupational activity was defined according to job title, while recreational activity was assessed by questionnaire for three different periods of life. Occupational activity was protective with respect to colorectal cancer irrespective of whether one engaged in recreational activity at any different period of life. In contrast, recrea tional activity, performed at 20-44 years of age appeared to decrease colon cancer risk by 10-25% irrespective of the in tensity of job activity. The present results suggest that, although we observed a larger effect with occupational activity than with recreational activity, middle-aged men may reduce their risk of colorectal cancer if they exercise when they are not working. These findings need to be confirmed in other population

Can A Rational Choice Framework Make Sense of Anorexia Nervosa?

Can a rational choice modeling framework help broaden our understanding of anorexia nervosa? This question is interesting because anorexia nervosa is a serious health concern, and because of the following issue: could a rational choice approach shed useful light on a condition which appears to involve "choosing" to be ill? We present a model of weight choice and dieting applicable to anorexia nervosa, and the sometimes-associated purging behavior. We also present empirical evidence about factors possibly contributing to anorexia nervosa. We offer this analysis as a consciousness-raising way of thinking about the condition.

Medical costs of cancer attributable to work in the Basque Country (Spain) in 2008

AbstractObjetivesUnderreporting of work-related cancer in the Basque Country (Spain) is massive. The aim of our study is to estimate the job-related cancer in the Basque Country in 2008 treated by the Basque Public Health System-Osakidetza, as well as the medical costs derived from its treatment in the same year.MethodsScientific evidence from industrialised countries is used to estimate the number of processes of cancer attributable to work. Medical costs for specialised care (outpatient and hospital admissions) are derived from the National Health System cost accounts. Costs due to primary health care and pharmaceutical benefits are obtained from Spanish secondary sources. Figures were computed according to disease and sex.ResultsWe estimate 1,331 work-attributable cancers hospitalizations and 229 work-attributable cancers specialized ambulatory cases. Medical costs borne by public health care system exceed 10 million euros. Specialized care accounts for 64.2% of the total cost. Bronchus and lung cancer represents the largest percentage of total expenditure (27%), followed by the bladder cancer (12.6%), mesothelioma (8.6%), the colon cancer (7.3%), and stomach (6.7%).ConclusionsThe magnitude of cancer attributable to work in the Basque Country is much higher than reflected in the official Registry of Occupational Diseases. Underreporting of work-related cancers hampers prevention and shifts funding of medical costs from social security to the tax-financed public health system

976-14 Immediate Heart Rate Response to Orthostatic Stress During β-blocker Therapy for Vasodepressor Syncope

Although β-blockers are preferred agents for therapy of vasodepressor syncope (VDS), they are not uniformly effective and their mechanism of action is incompletely understood. Since we have previously shown a differential therapeutic response to β-blocker therapy between pts with isoproterenol-independent [iso(-)] and isoproterenol-dependent [iso(+)] VDS during tilt table testing we sought to determine whether this was due to a differential heart rate (HR) response to orthostasis during β-blockade. We therefore examined immediate HR and blood pressure responses to upright tilt before and after initiation of therapy with atenolol (12.5–50mg daily) in 62 pts with VDS and positive tilt tests. The protocol comprised upright tilt (60°) for up to 60min followed by repeat tilt for 15min during isoproterenol (iso) infusion. Supine HR, mean arterial pressure (MAP) and pulse pressure (PP) were determined as the mean of 3 consecutive 1-min samples during supine rest; orthostatic HR, MAP, and PP were the mean of the samples recorded in the first 3min after upright tilt (before infusion of iso). Response to atenolol required completion of tilt with and without infusion of iso. There were 15 iso(-) pts and 47 iso(+) pts. The groups did not differ significantly in blood pressure response (MAP, PP) to orthostasis. Supine HR fell and the ΔHR in response to orthostasis was blunted during therapy in both groups:Baseline (Mean ± SD)Rx (Mean ± SD)Iso(+)Iso(-)pIso(+)Iso(-)pSupine HR69±1368±9NS57±958±8NSOrthostatic ΔHR8±712±9NS3±53±4NS11 iso(-) pts (73%) had a therapeutic response to β-blockade compared with 46 iso(+) pts (98%, p=0.01); the orthostatic ΔHR in the iso(-) pts who failed β-blocker therapy was no different from the response in the patients with a therapeutic response.ConclusionsThe HR response to orthostasis is comparably blunted after β-blockade in pts with iso(-) and iso(+) VDS, indicating that failure to respond is not due to inadequate β-blockade and suggests that in some pts iso-independent VDS may be independent of a cardiac β1 receptor mediated mechanism

Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery, and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster

Background The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures. Objectives Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers’ children. Methods Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire. Results Of the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers. Conclusions Working in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed

Mean-variance optimization problems for an accumulation phase in a defined benefit plan

In this paper we deal with contribution rate and asset allocation strategies in a pre-retirement accumulation phase. We consider a single cohort of workers and investigate a retirement plan of a defined benefit type in which an accumulated fund is converted into a life annuity. Due to the random evolution of a mortality intensity, the future price of an annuity, and as a result, the liability of the fund, is uncertain. A manager has control over a contribution rate and an investment strategy and is concerned with covering the random claim. We consider two mean–variance optimization problems, which are quadratic control problems with an additional constraint on the expected value of the terminal surplus of the fund. This functional objectives can be related to the well-established financial theory of claim hedging. The financial market consists of a risk-free asset with a constant force of interest and a risky asset whose price is driven by a Lévy noise, whereas the evolution of a mortality intensity is described by a stochastic differential equation driven by a Brownian motion. Techniques from the stochastic control theory are applied in order to find optimal strategies

Development of an Objective Autism Risk Index Using Remote Eye Tracking

Abnormal eye gaze is a hallmark characteristic of autism spectrum disorder (ASD), and numerous studies have identified abnormal attention patterns in ASD. The primary aim of the present study was to create an objective, eye tracking-based autism risk index