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1year.
MC is a comparatively better surgical procedure than HCSE in patients with internal derangement of the TMJ.
MC is a comparatively better surgical procedure than HCSE in patients with internal derangement of the TMJ.
The aim of this study was to demonstrate that the transition from a stand-alone radiology clerkship block to a longitudinally integrated radiology curriculum leverages newer teaching tools favored by today's learners.
In 2013 and 2014, medical students attended a dedicated 1-week radiology clerkship course. In 2015, the block clerkship model for radiology transitioned to a vertically integrated curriculum. By 2019, radiology content was integrated into many of the health illness and disease course blocks. Pre- and postcourse multiple-choice question tests as well as anonymous surveys were administered for both clerkship and integrated curriculum blocks. The student survey questions assessed perceptions regarding interpretation skills, imaging modality knowledge, and radiologists' roles.
Among 197 total students in the clerkship block, surveys were completed by 170 respondents, yielding a response rate of 86.3%. Among 106 students in the longitudinal course, surveys were completed by 71 respondents, yielding a response rate of 67%. For both clerkship and longitudinally integrated courses, the average number of correct responses after completion of the courses was significantly greater than the average number of correct precourse responses. Compared with students in the clerkship block curriculum, students in the longitudinal curriculum demonstrated a significantly greater frequency of agreement in response to survey questions regarding significant exposure to radiology, feeling comfortable interpreting CT images, and being familiar with how to use the ACR Appropriateness Criteria.
Transitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.
Transitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.
An alarming number of public health-care facilities in low-income and middle-income countries lack basic water, sanitation, hygiene (WASH), and waste management services. This study estimates the costs of achieving full coverage of basic WASH and waste services in existing public health facilities in the 46 UN designated least-developed countries (LDCs).
In this modelling study, in-need facilities were quantified by combining published counts of public facilities with estimated basic WASH and waste service coverage. Country-specific per-facility capital and recurrent costs to deliver basic services were collected via survey of country WASH experts and officials between Sept 24 and Dec 24, 2020. Baseline cost estimates were modelled and discounted by 5% per year. Key assumptions were adjusted to produce lower and upper estimates, including adjusting the discount rate to 8% and 3% per year, respectively.
An estimated US$6·5 billion to $9·6 billion from 2021 to 2030 is needed to achieve full coverage of babenefits. To sustain services and prevent degradation and early replacement, countries will need to routinely budget for operations and maintenance of WASH and waste management assets.
WHO (including underlying grants from the governments of Japan, the Netherlands, and the UK), World Bank (including an underlying grant from the Global Water Security and Sanitation Partnership), and UNICEF.
For the Arabic, French and Portuguese translations of the abstract see Supplementary Materials section.
For the Arabic, French and Portuguese translations of the abstract see Supplementary Materials section.Despite substantial attention within the fields of public and planetary health on developing an economic system that benefits both people's health and the environment, heterodox economic schools of thought have received little attention within these fields. Ecological economics is a school of thought with particular relevance to public and planetary health. In this article, we discuss implications of key ecological economics ideas for public and planetary health, especially those related to critiques of gross domestic product as a measure of progress and economic growth as the dominant goal for economic and policy decision making. We suggest that ecological economics aligns well with public health goals, including concern for equality and redistribution. Ecological economics offers an opportunity to make the transition to an economic system that is designed to promote human and planetary health from the outset, rather than one where social and environmental externalities must be constantly corrected after the fact. Important ideas from ecological economics include the use of a multidimensional framework to evaluate economic and social performance, the prioritisation of wellbeing and environmental goals in decision making, policy design and evaluation that take complex relationships into account, and the role of provisioning systems (the physical and social systems that link resource use and social outcomes). We discuss possible interventions at the national scale that could promote public health and that align with the prioritisation of social and ecological objectives, including universal basic income or services and sovereign money creation. Overall, we lay the foundations for additional integration of ecological economics principles and pluralist economic thinking into public and planetary health scholarship and practice.Climate change is directly and indirectly linked to human health, including through access to treatment and care. Our systematic review presents a systems understanding of the nexus between drought and antiretroviral therapy (ART) adherence in HIV-positive individuals in the African setting. Narrative synthesis of 111 studies retrieved from Web of Science, PubMed/MEDLINE, and PsycINFO suggests that livelihoods and economic conditions, comorbidities and ART regimens, human mobility, and psychobehavioural dispositions and support systems interact in complex ways in the drought-ART adherence nexus in Africa. Economic and livelihood-related challenges appear to impose the strongest impact on human interactions, actions, and systems that culminate in non-adherence. Indeed, the complex pathways identified by our systems approach emphasise the need for more integrated research approaches to understanding this phenomenon and developing interventions.
The influence of rising global temperatures on malaria dynamics and distribution remains controversial, especially in central highland regions. We aimed to address this subject by studying the spatiotemporal heterogeneity of malaria and the effect of climate change on malaria transmission over 27 years in Hainan, an island province in China.
For this longitudinal cohort study, we used a decades-long dataset of malaria incidence reports from Hainan, China, to investigate the pattern of malaria transmission in Hainan relative to temperature and the incidence at increasing altitudes. Climatic data were obtained from the local meteorological stations in Hainan during 1984-2010 and the WorldClim dataset. A temperature-dependent R
model and negative binomial generalised linear model were used to decipher the relationship between climate factors and malaria incidence in the tropical region.
Over the past few decades, the annual peak incidence has appeared earlier in the central highland regions but later in ional Natural Science Foundation of China, Beijing Natural Science Foundation, National Key Research and Development Program of China, Young Elite Scientist Sponsorship Program by CAST, Research on Key Technologies of Plague Prevention and Control in Inner Mongolia Autonomous Region, and Beijing Advanced Innovation Program for Land Surface Science.
Scientific and Technological Innovation 2030 Major Project of New Generation Artificial Intelligence, National Natural Science Foundation of China, Beijing Natural Science Foundation, National Key Research and Development Program of China, Young Elite Scientist Sponsorship Program by CAST, Research on Key Technologies of Plague Prevention and Control in Inner Mongolia Autonomous Region, and Beijing Advanced Innovation Program for Land Surface Science.
Human impacts on earth-system processes are overshooting several planetary boundaries, driving a crisis of ecological breakdown. This crisis is being caused in large part by global resource extraction, which has increased dramatically over the past half century. We propose a novel method for quantifying national responsibility for ecological breakdown by assessing nations' cumulative material use in excess of equitable and sustainable boundaries.
For this analysis, we derived national fair shares of a sustainable resource corridor. These fair shares were then subtracted from countries' actual resource use to determine the extent to which each country has overshot its fair share over the period 1970-2017. Through this approach, each country's share of responsibility for global excess resource use was calculated.
High-income nations are responsible for 74% of global excess material use, driven primarily by the USA (27%) and the EU-28 high-income countries (25%). China is responsible for 15% of global excess material use, and the rest of the Global South (ie, the low-income and middle-income countries of Latin America and the Caribbean, Africa, the Middle East, and Asia) is responsible for only 8%. Overshoot in higher-income nations is driven disproportionately by the use of abiotic materials, whereas in lower-income nations it is driven disproportionately by the use of biomass.
These results show that high-income nations are the primary drivers of global ecological breakdown and they need to urgently reduce their resource use to fair and sustainable levels. Achieving sufficient reductions will likely require high-income nations to adopt transformative post-growth and degrowth approaches.
None.
None.
Little is known about the associations between ambient environmental exposures and the risk of acute episodes of psychiatric disorders. We aimed to estimate the link between short-term exposure to atmospheric pollutants, temperature, and acute psychiatric hospital admissions in adults aged 65 years and older in the USA.
For this study, we included all people (aged ≥65 years) enrolled in the Medicare programme in the USA who had an emergency or urgent hospital admission for a psychiatric disorder recorded between Jan 31, 2000, and Dec 31, 2016. We applied a case-crossover design to study the associations between short-term exposure to air pollution (fine particulate matter [PM
], ozone, and nitrogen dioxide [NO
]), ambient temperature, and the risk of acute hospital admissions for depression, schizophrenia, and bipolar disorder in this population. The percentage change in the risk of hospital admission and annual absolute risk differences were estimated.
For each 5°C increase in short-term exposure to ficantly associated with an increased risk of hospital admissions for psychiatric disorders. Considering the increasing burden of psychiatric disorders in the US population, these findings suggest that intervening on air pollution and ambient temperature levels through stricter environmental regulations or climate mitigation could help ease the psychiatric health-care burden.
US National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.
US National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.
Homepage:
1year.
MC is a comparatively better surgical procedure than HCSE in patients with internal derangement of the TMJ.
MC is a comparatively better surgical procedure than HCSE in patients with internal derangement of the TMJ.
The aim of this study was to demonstrate that the transition from a stand-alone radiology clerkship block to a longitudinally integrated radiology curriculum leverages newer teaching tools favored by today's learners.
In 2013 and 2014, medical students attended a dedicated 1-week radiology clerkship course. In 2015, the block clerkship model for radiology transitioned to a vertically integrated curriculum. By 2019, radiology content was integrated into many of the health illness and disease course blocks. Pre- and postcourse multiple-choice question tests as well as anonymous surveys were administered for both clerkship and integrated curriculum blocks. The student survey questions assessed perceptions regarding interpretation skills, imaging modality knowledge, and radiologists' roles.
Among 197 total students in the clerkship block, surveys were completed by 170 respondents, yielding a response rate of 86.3%. Among 106 students in the longitudinal course, surveys were completed by 71 respondents, yielding a response rate of 67%. For both clerkship and longitudinally integrated courses, the average number of correct responses after completion of the courses was significantly greater than the average number of correct precourse responses. Compared with students in the clerkship block curriculum, students in the longitudinal curriculum demonstrated a significantly greater frequency of agreement in response to survey questions regarding significant exposure to radiology, feeling comfortable interpreting CT images, and being familiar with how to use the ACR Appropriateness Criteria.
Transitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.
Transitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.
An alarming number of public health-care facilities in low-income and middle-income countries lack basic water, sanitation, hygiene (WASH), and waste management services. This study estimates the costs of achieving full coverage of basic WASH and waste services in existing public health facilities in the 46 UN designated least-developed countries (LDCs).
In this modelling study, in-need facilities were quantified by combining published counts of public facilities with estimated basic WASH and waste service coverage. Country-specific per-facility capital and recurrent costs to deliver basic services were collected via survey of country WASH experts and officials between Sept 24 and Dec 24, 2020. Baseline cost estimates were modelled and discounted by 5% per year. Key assumptions were adjusted to produce lower and upper estimates, including adjusting the discount rate to 8% and 3% per year, respectively.
An estimated US$6·5 billion to $9·6 billion from 2021 to 2030 is needed to achieve full coverage of babenefits. To sustain services and prevent degradation and early replacement, countries will need to routinely budget for operations and maintenance of WASH and waste management assets.
WHO (including underlying grants from the governments of Japan, the Netherlands, and the UK), World Bank (including an underlying grant from the Global Water Security and Sanitation Partnership), and UNICEF.
For the Arabic, French and Portuguese translations of the abstract see Supplementary Materials section.
For the Arabic, French and Portuguese translations of the abstract see Supplementary Materials section.Despite substantial attention within the fields of public and planetary health on developing an economic system that benefits both people's health and the environment, heterodox economic schools of thought have received little attention within these fields. Ecological economics is a school of thought with particular relevance to public and planetary health. In this article, we discuss implications of key ecological economics ideas for public and planetary health, especially those related to critiques of gross domestic product as a measure of progress and economic growth as the dominant goal for economic and policy decision making. We suggest that ecological economics aligns well with public health goals, including concern for equality and redistribution. Ecological economics offers an opportunity to make the transition to an economic system that is designed to promote human and planetary health from the outset, rather than one where social and environmental externalities must be constantly corrected after the fact. Important ideas from ecological economics include the use of a multidimensional framework to evaluate economic and social performance, the prioritisation of wellbeing and environmental goals in decision making, policy design and evaluation that take complex relationships into account, and the role of provisioning systems (the physical and social systems that link resource use and social outcomes). We discuss possible interventions at the national scale that could promote public health and that align with the prioritisation of social and ecological objectives, including universal basic income or services and sovereign money creation. Overall, we lay the foundations for additional integration of ecological economics principles and pluralist economic thinking into public and planetary health scholarship and practice.Climate change is directly and indirectly linked to human health, including through access to treatment and care. Our systematic review presents a systems understanding of the nexus between drought and antiretroviral therapy (ART) adherence in HIV-positive individuals in the African setting. Narrative synthesis of 111 studies retrieved from Web of Science, PubMed/MEDLINE, and PsycINFO suggests that livelihoods and economic conditions, comorbidities and ART regimens, human mobility, and psychobehavioural dispositions and support systems interact in complex ways in the drought-ART adherence nexus in Africa. Economic and livelihood-related challenges appear to impose the strongest impact on human interactions, actions, and systems that culminate in non-adherence. Indeed, the complex pathways identified by our systems approach emphasise the need for more integrated research approaches to understanding this phenomenon and developing interventions.
The influence of rising global temperatures on malaria dynamics and distribution remains controversial, especially in central highland regions. We aimed to address this subject by studying the spatiotemporal heterogeneity of malaria and the effect of climate change on malaria transmission over 27 years in Hainan, an island province in China.
For this longitudinal cohort study, we used a decades-long dataset of malaria incidence reports from Hainan, China, to investigate the pattern of malaria transmission in Hainan relative to temperature and the incidence at increasing altitudes. Climatic data were obtained from the local meteorological stations in Hainan during 1984-2010 and the WorldClim dataset. A temperature-dependent R
model and negative binomial generalised linear model were used to decipher the relationship between climate factors and malaria incidence in the tropical region.
Over the past few decades, the annual peak incidence has appeared earlier in the central highland regions but later in ional Natural Science Foundation of China, Beijing Natural Science Foundation, National Key Research and Development Program of China, Young Elite Scientist Sponsorship Program by CAST, Research on Key Technologies of Plague Prevention and Control in Inner Mongolia Autonomous Region, and Beijing Advanced Innovation Program for Land Surface Science.
Scientific and Technological Innovation 2030 Major Project of New Generation Artificial Intelligence, National Natural Science Foundation of China, Beijing Natural Science Foundation, National Key Research and Development Program of China, Young Elite Scientist Sponsorship Program by CAST, Research on Key Technologies of Plague Prevention and Control in Inner Mongolia Autonomous Region, and Beijing Advanced Innovation Program for Land Surface Science.
Human impacts on earth-system processes are overshooting several planetary boundaries, driving a crisis of ecological breakdown. This crisis is being caused in large part by global resource extraction, which has increased dramatically over the past half century. We propose a novel method for quantifying national responsibility for ecological breakdown by assessing nations' cumulative material use in excess of equitable and sustainable boundaries.
For this analysis, we derived national fair shares of a sustainable resource corridor. These fair shares were then subtracted from countries' actual resource use to determine the extent to which each country has overshot its fair share over the period 1970-2017. Through this approach, each country's share of responsibility for global excess resource use was calculated.
High-income nations are responsible for 74% of global excess material use, driven primarily by the USA (27%) and the EU-28 high-income countries (25%). China is responsible for 15% of global excess material use, and the rest of the Global South (ie, the low-income and middle-income countries of Latin America and the Caribbean, Africa, the Middle East, and Asia) is responsible for only 8%. Overshoot in higher-income nations is driven disproportionately by the use of abiotic materials, whereas in lower-income nations it is driven disproportionately by the use of biomass.
These results show that high-income nations are the primary drivers of global ecological breakdown and they need to urgently reduce their resource use to fair and sustainable levels. Achieving sufficient reductions will likely require high-income nations to adopt transformative post-growth and degrowth approaches.
None.
None.
Little is known about the associations between ambient environmental exposures and the risk of acute episodes of psychiatric disorders. We aimed to estimate the link between short-term exposure to atmospheric pollutants, temperature, and acute psychiatric hospital admissions in adults aged 65 years and older in the USA.
For this study, we included all people (aged ≥65 years) enrolled in the Medicare programme in the USA who had an emergency or urgent hospital admission for a psychiatric disorder recorded between Jan 31, 2000, and Dec 31, 2016. We applied a case-crossover design to study the associations between short-term exposure to air pollution (fine particulate matter [PM
], ozone, and nitrogen dioxide [NO
]), ambient temperature, and the risk of acute hospital admissions for depression, schizophrenia, and bipolar disorder in this population. The percentage change in the risk of hospital admission and annual absolute risk differences were estimated.
For each 5°C increase in short-term exposure to ficantly associated with an increased risk of hospital admissions for psychiatric disorders. Considering the increasing burden of psychiatric disorders in the US population, these findings suggest that intervening on air pollution and ambient temperature levels through stricter environmental regulations or climate mitigation could help ease the psychiatric health-care burden.
US National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.
US National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.
Homepage:
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