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In the framework of the multicenter ESCAPE (European Study of Cohorts for Air Pollution Effects) and TRANSPHORM (Transport related Air Pollution and Health impacts–Integrated Methodologies for Assessing Particulate Matter) projects, we added standardized exposure assessment for air pollution to mortality data from 19 ongoing cohort studies across Europe. Associations of particle mass (PM2.5, PM10, PMcoarse, and PM2.5 absorbance) and nitrogen oxides (NO2 and NOx) with natural-cause mortality in the same cohorts have been reported previously (). We found a statistically significant elevated hazard ratio for PM2.5 of 1.07 [95% confidence interval (CI): 1.02, 1.13] per 5 μg/m3. In this paper we report associations with particle elemental composition in 19 European cohorts to assess whether specific components are associated with natural-cause mortality. A second aim was to assess whether the previously reported association with PM2.5 mass was explained by specific elements. Associations of particle composition and cardiovascular mortality have been published separately ().
The role of public health nurses is to focus on population centered care with the outcome of promoting health, preventing disability and disease, and improving the quality of life.
With the incidence rate for the Human Papillomavirus (HPV) on the rise, it is important to address the public health concerns that are associated with disease....
The research recommendations of the inter-EHSCC working group are similar to those proposed by others (; ; ) with one significant difference: We advocate for a CBPR approach in communities affected by UNGDO. Implementation of these recommendations would inform the debate on the potential environmental health affects of UNGDO and lead to decisions by individuals, communities, agencies, and industry that would protect human health. Implementation requires dedicated funding sources that are insulated from conflicts of interest so that the science generated is trustworthy. One trusted model is federal agencies funding research that is conducted at academic institutions. Oversight by a single organization would avoid duplication of effort and unnecessary expenditure of resources. There should be harmonization of study designs, data collection, and analytical procedures, which may require a data coordination center that could also assess data quality and missing data. There should also be a publicly available data repository so that all stakeholders, including industry and communities, can access data, and appropriate firewalls and limited access should be in place for patient- or population-based health data. Implementation of these recommendations would permit a risk assessment of UNGDO, enabling decision makers to identify and reduce the most serious environmental health threats.
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Although the NIH currently provides multiple opportunities to develop research careers and improve participation for individuals from groups with low representation in the biomedical and behavioral sciences, reports from the National Science Foundation (NSF), (see ) and others, provide strong evidence that the lack of diversity remains an important problem that the entire research enterprise must actively address. There is evidence that the biomedical and educational enterprise will directly benefit from broader inclusion. Recent studies have supported the argument that diversity enhances the quality of education in multiple settings. Studies have suggested that racially and culturally concordant scientific staff may be more successful in recruiting individuals from minority groups into clinical trials. Racially similar physician-patient dyads also may be related to greater patient satisfaction in ways that could enhance communication and participation in clinical research settings. The need for a diverse workforce permeates all aspects of the nation's health-related research effort.
It is important to promote the professional role of the nurse to provide health promotion and disease preventive care. Collaborating with other health care professionals and consumer groups in the community in redesigning health care can help meet the goals for Healthy People 2020.
on on why and how legislators can engage citizens in ways that are more participatory and more productive was written by NCDD director Sandy Heierbacher at the request of Yes! Magazine (and on August 21, 2009), during the contentious August 2009 town hall meetings on health care. With the involvement and input of many NCDD members, Sandy also created two abbreviated versions of this article and a one-page ready-to-print , encouraging NCDD members and others to use the resources freely for blog posts and letters to the editor.
Created by NCDD director Sandy Heierbacher in collaboration with Martin Carcasson, Will Friedman and Alison Kadlec (and based on Carcasson’s paper , which we highly recommend), the Goals of Dialogue & Deliberation graphic pictured here outlines 3 types of goals for public problem-solving work. In a nutshell, the three tiers of goals are individual and knowledge-based goals, immediate group/community outcomes, and longer-term capacity building and community change. for more details on this resource.
C. Assessment Background
The information that is studied in psychology, sociology and communication is utilized in the health asessment process. For example, verbal and non-verbal cues could tell the nurse if there is something that is being omitted from the answers. For example, if one is asked whether or not he smokes, and says no, but scratches the side of his nose and turns to the side, a well-trained nurse might suspect that the patient is lying, and therefore either do a follow-up question or note how the question was answered. Non-verbal cues might be useful to the nurse when she is treating a victim of domestic violence. Subtle expressions in the face and body positioning by the patient while explaining the situation at home, for example, might give away that the victim is saying one thing, but is thinking of another, yet he/she is just too afraid to say anything, even in the comfort of a medical professional. Of course, physical cues like bruises on the face or hands will signal a red flag and the interview will turn into a search for why the patient might be bruised or have soars. This in turn might prove, abuse, neglect, physical harassment, etc. (Jill Fuller, 1990) From another perspective, cultural differences must be addressed in order to maintain a well-rounded rapport with the patient. Depending on the culture the patient is from, a nurse’s behavior can prove to be the straw that broke the camel’s back during the interview, thus rendering it not as successful as it could be, or it can prove to be a vital asset which will provide the nurse with valuable information. Depending on the culture, some patients might be uncomfortable shaking a woman’ or a man’s hand, or might find it disrespectful if someone across from the crosses their legs. In situations like these the art of nursing comes into play where a skilled nurse will be able to adjust her behavior accordingly so as not to make the patient feel uncomfortable or disrespected. In some cases, the best thing a nurse can do is to stay silent; case in point being after a nurse asks a question and only gets a partial answer, some silence might be useful in order to let the patient collect his or her thoughts and continue answering. As stressed earlier, however, the nurse’s communication never gave way. (Weber, 2009)