A New Paradigm For Studying The Economic And Behavioral Consequences Of Framing Health-Related Decisions

Traditional attribute framing effects occur when the same object is evaluated differently depending on whether a particular attribute is labeled or framed in positive or negative terms.  For example, in one of our earlier studies, “80% lean ground beef” was evaluated more favorably and was “worth” 8 cents more per pound than “20% fat ground beef.”  In the present study of health-related judgments and decisions, attribute framing effects were extended to situations where consumers had to infer framing valence depending on whether one’s health status was described in comparison to a lower standard or a higher standard of reference.  For example, a person’s health status was rated higher when the same level of vitamin intake was stated in terms of its distance above an established low-protection level compared to when it was stated in terms of its distance below an established high-protection level

A New Paradigm For Studying The Economic And Behavioral Consequences Of Framing Health-Related Decisions

Traditional attribute framing effects occur when the same object is evaluated differently depending on whether a particular attribute is labeled or framed in positive or negative terms. For example, in one of our earlier studies, 80% lean ground beef was evaluated more favorably and was worth 8 cents more per pound than 20% fat ground beef. In the present study of health-related judgments and decisions, attribute framing effects were extended to situations where consumers had to infer framing valence depending on whether ones health status was described in comparison to a lower standard or a higher standard of reference. For example, a persons health status was rated higher when the same level of vitamin intake was stated in terms of its distance above an established low-protection level compared to when it was stated in terms of its distance below an established high-protection level

A critical analysis of the drivers of human migration patterns in the presence of climate change: A new conceptual model

Both climate change and migration present key concerns for global health progress. Despite this, a transparent method for identifying and understanding the relationship between climate change, migration and other contextual factors remains a knowledge gap. Existing conceptual models are useful in understanding the complexities of climate migration, but provide varying degrees of applicability to quantitative studies, resulting in non-homogenous transferability of knowledge in this important area. This paper attempts to provide a critical review of climate migration literature, as well as presenting a new conceptual model for the identification of the drivers of migration in the context of climate change. It focuses on the interactions and the dynamics of drivers over time, space and society. Through systematic, pan-disciplinary and homogenous application of theory to different geographical contexts, we aim to improve understanding of the impacts of climate change on migration. A brief case study of Malawi is provided to demonstrate how this global conceptual model can be applied into local contextual scenarios. In doing so, we hope to provide insights that help in the more homogenous applications of conceptual frameworks for this area and more generally

The 1,10-phenanthroline ligand enhances the antiproliferative activity of dna-intercalating thiourea-pd(Ii) and-pt(ii) complexes against cisplatin-sensitive and-resistant human ovarian cancer cell lines

Ovarian cancer is the most lethal gynecological malignancy, often because of the frequent insurgence of chemoresistance to the drugs currently used. Thus, new therapeutical agents are needed. We tested the toxicity of 16 new DNA-intercalating agents to cisplatin (cDDP)-sensitive human ovarian carcinoma cell lines and their resistant counterparts. The compounds were the complexes of Pt(II) or Pd(II) with bipyridyl (bipy) and phenanthrolyl (phen) and with four dierent thiourea ancillary ligands. Within each of the four series of complexes characterized by the same thiourea ligand, the Pd(phen) drugs invariably showed the highest anti-proliferative ecacy. This paralleled both a higher intracellular drug accumulation and a more ecient DNA intercalation than all the other metal-bidentate ligand combinations. The consequent inhibition of topoisomerase II activity led to the greatest inhibition of DNA metabolism, evidenced by the inhibition of the expression of the folate cycle enzymes and a marked perturbation of cell-cycle distribution in both cell lines. These findings indicate that the particular interaction of Pd(II) with phenanthroline confers the best pharmacokinetic and pharmacodynamic properties that make this class of DNA intercalators remarkable inhibitors, even of the resistant cell growth

Green Climate Fund adaptation's interventions on food security: metrics and health outcomes

Introduction: The Green Climate Fund (GCF) is the largest public climate fund, it claims to use an innovative approach in climate adaptation actions, however, it has faced significant criticism since its inception. 2016-2025 is the Decade of Action on Nutrition and climate change's impact on food security is one of the biggest threats to human health. Current models predict that Africa will be the most affected continent. Food security is a polyhedric concept that requires definitions and indicators to acquire meaning and provide in-field applications. Methods: Among the GCF's projects the ones that address the result area “health, food, and water security” in the African countries have been selected. The means of verification (MoV) has been searched in every funding proposal, simplified approval process, and other relevant documents, if not found, were requested to the Fund and local managers. Projects have been divided into ‘International’ or ‘Local’ based on GCF's definitions. The study also sought to identify the food security definition adopted by the Fund and reviewed available food security indicators. Results and discussion: 21 projects, amounting to an investment of $887.2 million, met the criteria. National projects accounted for 17$733 million. 7 of the 21 projects (circa 40% of the funds invested) did not provide measurable food security outcomes. The majority of the projects provided some measurable outcome but it is rarely possible to know how this will be measured, as only 3 projects, all from the World Food Program (WFP), declared their MoVs. The GCF seems to not adopt a clear definition of food security. The WFP's indicators, while validated for caloric adequacy, are not consistently validated for micronutrient deficiencies and other health outcomes. Conclusions: Insufficient information on monitoring and evaluation may raise further concerns about the GCF's governance. Key messages • Food security is a poliedric concept that requires defintions and indicators to acquire meaning and provide in-field applications, evaluation processes are essential to detect real adaptation. • The Green Climate Fund is the largest public climate fund, it claims to use an innovative approach in climate adaptation actions but it seems to lack robust monitoring and evaluation processes

Effect of combination therapy of hydroxychloroquine and azithromycin on mortality in patients with COVID-19

Conflicting evidence regarding the use of hydroxychloroquine (HCQ) and azithromycin for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection do exist. We performed a retrospective single-center cohort study including 377 consecutive patients admitted for pneumonia related to coronavirus disease 2019 (COVID-19). Of these, 297 were in combination treatment, 17 were on HCQ alone, and 63 did not receive either of these 2 drugs because of contraindications. The primary end point was in-hospital death. Mean age was 71.8 ± 13.4 years and 34.2% were women. We recorded 146 deaths: 35 in no treatment, 7 in HCQ treatment group, and 102 in HCQ + azithromycin treatment group (log rank test for Kaplan–Meier curve P < 0.001). At multivariable Cox proportional hazard regression analysis, age (hazard ratio (HR) 1.057, 95% confidence interval (CI) 1.035–1.079, P < 0.001), mechanical ventilation/continuous positive airway pressure (HR 2.726, 95% CI 1.823–4.074, P < 0.001), and C reactive protein above the median (HR 2.191, 95% CI 1.479–3.246, P < 0.001) were directly associated with death, whereas use of HCQ + azithromycin (vs. no treatment; HR 0.265, 95% CI 0.171–0.412, P < 0.001) was inversely associated. In this study, we found a reduced in-hospital mortality in patients treated with a combination of HCQ and azithromycin after adjustment for comorbidities. A large randomized trial is necessary to confirm these findings

Airborne transmission of COVID-19 and other coronaviruses in indoor and outdoor environments: a systematic literature review

Copyright © The Authors 2020. Most coronavirus infections are transmitted via respiratory droplets through the mucosa or direct inhalation route and are manifested as respiratory diseases. However, human coronaviruses such as SARS-CoV-2 (the COVID-19 virus) show environmental resistance that makes airborne transmission plausible. According to published evidence related to COVID-19, airborne transmission through droplet nuclei that propagate in air is limited to aerosol generating procedures during clinical care of COVID-19 patients. However, recent experimental studies have indicated that SARS-CoV-2 can remain viable in airborne aerosols potentially for hours. Studies in hospitals in Iran and China have reported undetectable levels of airborne SARS-CoV-2 RNA at distances over 2 m from patients’ beds or in well sanitised spaces. Although fine particles, pollen and dust in ambient air have all been linked to other infectious diseases in the past, their role in the transmission of COVID-19 and other coronaviruses has not been systematically reviewed so far. Theoretically, inhalation of virus-laden airborne particles could transport the virus deeper into alveolar regions, which could increase the risk of infective transmission. In this rapid systematic review, we analyse the evidence on airborne transmission of COVID-19 and other coronaviruses in outdoor and indoor settings. We investigate how aerosols, including droplets, droplet nuclei, smoke particles, dust, pollen and other aeroallergens may act as carriers of coronaviruses in the air and into the human respiratory system causing infection. We analyse peer-reviewed studies (published or accepted) reporting on airborne transmission of any human coronavirus, including SARS-CoV-2. We include experimental, epidemiological, and mathematical modelling studies in any human population. No restrictions are imposed on the health status or age of these populations or setting (outdoor, indoor, residential, occupational). The primary outcomes of the review are confirmed coronavirus infections as well as positive environmental samples. We searched PubMed, MEDLINE, Scopus, Cochrane Library, and relevant government agency databases

ETS exposure and PAH body burden in nonsmoking Italian adults

Active smoking is associated with increased body burden of polycyclic aromatic hydrocarbons (PAHs); the aim of this study was to assess whether environmental tobacco smoking (ETS) increases the internal dose of PAHs. In 344 nonsmoking Italian adults, out of 497 individuals selected as representative of the population of the town of Modena, ETS exposure was evaluated by a self-administered questionnaire and by the measurement of urinary cotinine (COT-U). PAH exposure was assessed by the measurement of urinary 1-hydroxypyrene (1-OHPYR) and of ten urinary PAHs. In all subjects, median (5th-95th percentile) COT-U was 0.47 (<0.1-3.91) mu g/L. While 58 subjects reported to be ETS exposed (ETSQUEST), 38 individuals were identified as ETS exposed on the basis of a COT-U value of 1.78 (90% confidence interval 1.75-1.80) mu g/L, previously derived as an upper reference value in not ETS exposed Italian adults (ETSCOT). Median COT-U levels were 1.38 (<0.1-9.06) and 3.63 (1.80-17.39) mu g/L in ETSQUEST and in ETSCOT subjects, respectively. Significant correlations between COT-U and 1-OHPYR, and urinary anthracene, fluoranthene, pyrene, and chrysene were found among all subjects. Significantly higher levels of 1-OHPYR, and urinary fluorene, anthracene, and pyrene were found in ETSCOT individuals. The results of multiple linear regression analyses, taking into consideration diet and other sources of PAHs exposures such as the residence area/characteristics and traffic, confirmed that 1-OHPYR and urinary fluorene were affected by ETS exposure, even if ETS played a minor role

Mortality and morbidity among people living close to incinerators: a cohort study based on dispersion modeling for exposure assessment

<p>Abstract</p> <p>Background</p> <p>Several studies have been conducted on the possible health effects for people living close to incinerators and well-conducted reviews are available. Nevertheless, several uncertainties limit the overall interpretation of the findings. We evaluated the health effects of emissions from two incinerators in a pilot cohort study.</p> <p>Methods</p> <p>The study area was defined as the 3.5 km radius around two incinerators located near Forlì (Italy). People who were residents in 1/1/1990, or subsequently became residents up to 31/12/2003, were enrolled in a longitudinal study (31,347 individuals). All the addresses were geocoded. Follow-up continued until 31/12/2003 by linking the mortality register, cancer registry and hospital admissions databases. Atmospheric Dispersion Model System (ADMS) software was used for exposure assessment; modelled concentration maps of heavy metals (annual average) were considered the indicators of exposure to atmospheric pollution from the incinerators, while concentration maps of nitrogen dioxide (NO₂) were considered for exposure to other pollution sources. Age and area-based socioeconomic status adjusted rate ratios and 95% Confidence Intervals were estimated with Poisson regression, using the lowest exposure category to heavy metals as reference.</p> <p>Results</p> <p>The mortality and morbidity experience of the whole cohort did not differ from the regional population. In the internal analysis, no association between pollution exposure from the incinerators and all-cause and cause-specific mortality outcomes was observed in men, with the exception of colon cancer. Exposure to the incinerators was associated with cancer mortality among women, in particular for all cancer sites (RR for the highest exposure level = 1.47, 95% CI: 1.09, 1.99), stomach, colon, liver and breast cancer. No clear trend was detected for cancer incidence. No association was found for hospitalizations related to major diseases. NO₂levels, as a proxy from other pollution sources (traffic in particular), did not exert an important confounding role.</p> <p>Conclusions</p> <p>No increased risk of mortality and morbidity was found in the entire area. The internal analysis of the cohort based on dispersion modeling found excesses of mortality for some cancer types in the highest exposure categories, especially in women. The interpretation of the findings is limited given the pilot nature of the study.</p

AIDS-Kaposi Sarcoma and Classic Kaposi Sarcoma: are different ultrasound patterns related to different variants?

<p>Abstract</p> <p>Background</p> <p>Kaposi Sarcoma (KS) is a malignancy of endothelial skin cells with multifocal localization on the skin, lymph nodes and visceral organs. Although all clinical variants are associated with HHV-8 infection, specific differences in the clinical onset and in the natural history of AIDS-KS and Classic-KS have been described. The present randomised prospective-observational study aimed to investigate whether the ultrasound pattern and color Doppler flow imaging of vascularisation of skin lesions of patients with Classic KS (CKS) or AIDS-KS could provide useful information to the evaluation of clinical activity of the disease.</p> <p>Methods</p> <p>Cutaneous lesions of 24 patients with histologically confirmed KS were investigated using very high frequency ultrasound probes; 16 patients had CKS and 8 had AIDS-KS. HHV-8 infection was confirmed in all patients by investigating the specific humoral response to viral antigens. Immunological and virological parameters were also assessed to monitor HIV or HHV-8 viral infection. For each patient, a target skin lesion was selected on the basis of size (diameter from 0.4 to 2 cm). Each lesion was analyzed in terms of size, depth and color Doppler pattern.</p> <p>Results</p> <p>The B-mode ultrasound patterns of skin lesions did not differ when comparing CKS patients to AIDS-KS patients, whereas the color Doppler signal, which is associated with vascular activity, was detected in the KS lesions of 6/8 AIDS-KS patients (75.0%) and in 2/16 CKS (16,7%); the latter two patients showed a clinically progressive and extensive disease stage (IV B).</p> <p>Conclusions</p> <p>Our preliminary results suggest that small cutaneous KS lesions - in both CKS and AIDS-KS patients- display similar B-mode ultrasound patterns ( hypoechoic, well defined, superficial lesions). However, the color Doppler signal, which is associated with endothelial activity and angiogenesis, which play a substantial role in KS progression, could constitute a useful tool for evaluating disease activity.</p