National Average Level Research Articles

Assessing equity in the distribution of high-technology medical equipment in Guangxi: evidence from an ethnic minority region in Southern China

BackgroundHigh-technology medical equipment (HTME) are important health resources. However, there is unequal distribution of these equipment in favor of metropolis and well equipped health facilities. This study sought to examine the equity gaps in the distribution of HTME in Guangxi. The results of this study could shed light on the future HTME allocation in Guangxi Zhuang Autonomous Region.MethodsData related to HTME was sourced from a general investigation of all the hospitals of Guangxi. Concentration index was used to assess the equity status of HTME in Guangxi.ResultsOver all, the total amount of HTME in Guangxi had been increasing from 2011 to 2015, and the per million population HTME of five kinds were all increased at the same time. Meanwhile, the concentration indices ranged between 0.1020 and 0.4617. The five medical equipment were all concentrated among the rich.ConclusionsThe possession of SPECT per million population in Guangxi is lower than the national average level while it is superior to the national average level for CT, MRI, DSA and LA. The equity status in the distribution of the five medical equipment has deteriorated since 2011. In 2015, the equity status of CT was the best, while the equity status of MRI was the worst. Meanwhile, 45.1% of HTME were concentrated in Nanning, Guilin, and Liuzhou.

Long-term yield trends of insect-pollinated crops vary regionally and are linked to neonicotinoid use, landscape complexity, and availability of pollinators

Time series data on crop yields for two main wind-pollinated crops (barley and wheat) and for three crops benefitting from insect pollination (turnip rapeseed, caraway, and black currant), were compiled from official agricultural statistics. In Finland, these statistics are available at aggregate national level, and at the level of each of the 15 provinces of the country. Yields of wind-pollinated crops have steadily increased in Finland, while yields of insect-pollinated crops have been highly variable. The largest crop benefitting from insect pollination is turnip rapeseed, which shows first a clear tendency to increased yields from 1980 to 1993, after which there has been a continuous decline in yields at the national average level. Regionally, the trends in turnip rapeseed yield show large variation, so that in six provinces of Finland, the trend has been significantly decreasing; in five provinces, there has been no significant trend; and in two provinces, there has been a significant linear increase in yields. Yield trends in the two other insect-pollinated crops, caraway and black currants, show similar trend variations. However, at the national average level, caraway yields show no significant trend, while black currant yields have increased during the past 6 years. The possible impact on the trends of insect-pollinated crops of three explanatory variables was analyzed. Significant linear correlation was found between the yield trends (slope of the trends) in rapeseed, and the extent of using neonicotinoid seed dressing in the provinces; the magnitude of yield decline in turnip rapeseed increased, as the use of neonicotinoid seed dressing increased. Similar significant linear correlation was found for the magnitude of yield decline in turnip rapeseed and the complexity of the agricultural landscape in each province; yield trend changed from negative to positive as the proportion of agricultural land of the total terrestrial land area declined from 28% to below 10%. The availability of honey bee colonies with respect to the growing area of crops benefitting from insect pollination also had a linear, significant impact on turnip rapeseed yield trends: yields tended to decline in provinces, where the supply of managed pollinators with respect to demand was low, but tended to increase in provinces, where the number of honey bee colonies were over 30% of the estimated demand. As neither the landscape complexity (proportion of arable land of total terrestrial land area), nor the number of honey bee colonies for pollination have changed significantly over the past 10–20 years, these factors cannot explain the observed differences in the yield trends of the examined insect-pollinated crops. It appears that only the uptake of neonicotinoid insecticide seed dressing about 15 years ago can explain the crop yield declines in several provinces, and at the national level for turnip rapeseed, most likely via disruption of pollination services by wild pollinators.

Study on the Health Status and Health Service Utilization of the Elderly of a Remote and Poor Village in a Mountainous Area in Jinzhai, Anhui.

Background: Despite the rapid development of China’s economy, a number of poor areas in China continue to exist. The health status of the elderly in the poor areas is a matter of concern. This study aims to explore the status of the elderly in terms of their health status, health service needs, and utilization among rural residents of a remote and poor village in a mountainous area in Jinzhai, Anhui. Furthermore, this study aims to explore the differences between the nation rural area average level and the remote and poor village in the mountainous area in terms of health status and health service utilization. Methods: Cluster sampling was used to obtain the sample. A total of 110 elderly people were selected from the village, and face-to-face interviews were conducted with questionnaires by trained investigators to collect data. Results: All items except vision, language disability, and self-care disability were found to be higher than the national average level. In terms of mental health, Zishu Village has a ratio of 44.1% for the symptoms of anxiety and depression, which is higher than the average for the national rural areas. The two-week prevalence rate, prevalence of chronic diseases, and non-hospitalization rate of those who need hospitalization (%) in Zishu Village was 62.7%, 88.2%, and 47.6% respectively, which was higher than the rural values of the National Survey (2008). Most of the outpatient visits were to the village clinics, while the hospitalizations were mainly to county hospitals. The two-week visiting rate was 24.1%, which was lower than 2008. The hospitalization rate in Zishu Village was 10.8%, which is similar to the level of 2008. Conclusions: The health level and the utilization of health services of the people in Zishu Village, Jinzhai, are generally lower than the national average. Financial difficulties continue to remain the major factor affecting the utilization of hospitalization services of this remote and poor village in Jinzhai, Anhui.

Relationship between reproductive history and preterm births in the last pregnancy, in Shaanxi province

Objective: To analyze the incidence of preterm delivery among single live neonates and the association between maternal reproductive history and preterm birth. Methods: A questionnaire survey was conducted on reproductive history among women at childbearing age who were selected through multi-stage stratified random sampling method in Shaanxi, during 2010-2013. Samples would include women at childbearing age and in pregnancy or having had definite pregnancy outcomes. Results: A total of 29 608 women at childbearing age with their infants, were studied. The overall incidence of premature delivery among the single live birth neonates under this study, was 2.7% during 2010-2013. Results from the logistic regression model showed that factors as: having had history with preterm delivery (OR=7.99, 95%CI: 5.59-11.43), age of the mothers, older than 35 (OR= 2.03, 95% CI: 1.59-2.59) and with history of birth defects (OR=1.54, 95% CI: 1.01-2.34) were at higher risks for premature delivery in neonates. Intervals on pregnancies between 3-4 years (compared with ≤2 years, OR=0.74, 95% CI: 0.58-0.93), between 5-6 years (compared with ≤2 years, OR=0.66, 95%CI: 0.52-0.82), or> 6 years (compared with ≤2 years, OR=0.48, 95%CI:0.37-0.61) together with numbers of parity as 1 (compared with primiparas, OR=0.80, 95%CI: 0.67-0.95), as ≥2 (compared with primiparas, OR=0.62, 95% CI: 0.39-0.97) etc. were protective factors to preterm delivery. Factors as: history of preterm delivery, mothers age (older than 35 years) and intervals of pregnancy, appeared influential to the age of gestation, under the ordinal polytomous logistic regression analysis. Conclusion: The incidence of preterm births among single live birth neonates in Shaanxi was lower than the average national level. Programs related to health care services prior to conception and during pregnancy, together with increasing the self-care consciousness of childbearing aged women etc, should all be strengthened in order to reduce the occurrence of preterm birth, in Shaanxi province.

The Mental Health Condition of Manufacturing Front-line Workers: The Interrelationship of Personal Resources, Professional Tasks and Mental Health

Manufacturing front-line workers were more likely to experience mental health problems. Personal resources and professional tasks were the major factors of workers’ mental health. Therefore, this study was to explore the interrelationship of these three key factors. A questionnaire including the revised Occupational Stress Inventory (OSI-R) and the Symptom Checklist (SCL-90) covered 480 manufacturing front-line workers to measure their personal resources, professional tasks and mental health. Results showed that among manufacturing front-line workers, the status of mental health and professional tasks were below the national average level, and the personal resources were relatively deficient as well. Correlation analysis indicated a negative relation between the indicators of mental health and professional tasks (except responsibility), while personal resources and mental health were significantly positive correlation. These findings suggested that personal resources and professional tasks were highly related to mental health in manufacturing front-line workers.

Meteorological factors affect the epidemiology of hemorrhagic fever with renal syndrome via altering the breeding and hantavirus-carrying states of rodents and mites: a 9 years’ longitudinal study

The incidence of hemorrhagic fever with renal syndrome (HFRS) in Qingdao, China was three times higher than that of the average national level. Here we characterized the epidemiology, ecological determinants and pathogen evolution of HFRS in Qingdao during 2007–2015. In this longitudinal study, a total of 1846 HFRS patients and 41 HFRS-related deaths were reported. HFRS in Qingdao peaked once a year in the fourth quarter. We built a time series generalized additive model, and found that meteorological factors in the previous quarter could accurately predict HFRS occurrence. To explore how meteorological factors influenced the epidemic of HFRS, we analyzed the relationship between meteorological factors and hantavirus-carrying states of the hosts (including rodents and shrews). Comprehensive analysis showed humidity was correlated to high host densities in the third quarter and high hantavirus-carrying rates of animal hosts in the third to fourth quarters, which might contribute to HFRS peak in the fourth quarter. We further compared the L segments of hantaviruses from HFRS patients, animal hosts and ectoparasites. Phylogenetic analysis showed that hantaviruses in gamasid and trombiculid mites were the same as those from the hosts. This indicated mites also contributed to the transmission of hantavirus. Furthermore, Hantaan virus from HFRS patients, hosts and mites in Qingdao formed a distinct phylogenetic cluster. A new clade of Seoul virus was also identified in the hosts. Overall, meteorological factors increase HFRS incidence possibly via facilitating hosts’ reproduction and consequent mite-mediated hantavirus transmission. New hantavirus subtypes evolved in Qingdao represent new challenges of fighting against HFRS.Emerging Microbes & Infections (2017) 6, e104; doi:10.1038/emi.2017.92; published online 29 November 2017

Update of Ireland's national average indoor radon concentration – Application of a new survey protocol

In 2002, a National Radon Survey (NRS) in Ireland established that the geographically weighted national average indoor radon concentration was 89 Bq m−3. Since then a number of developments have taken place which are likely to have impacted on the national average radon level. Key among these was the introduction of amending Building Regulations in 1998 requiring radon preventive measures in new buildings in High Radon Areas (HRAs). In 2014, the Irish Government adopted the National Radon Control Strategy (NRCS) for Ireland. A knowledge gap identified in the NRCS was to update the national average for Ireland given the developments since 2002. The updated national average would also be used as a baseline metric to assess the effectiveness of the NRCS over time.A new national survey protocol was required that would measure radon in a sample of homes representative of radon risk and geographical location. The design of the survey protocol took into account that it is not feasible to repeat the 11,319 measurements carried out for the 2002 NRS due to time and resource constraints. However, the existence of that comprehensive survey allowed for a new protocol to be developed, involving measurements carried out in unbiased randomly selected volunteer homes. This paper sets out the development and application of that survey protocol. The results of the 2015 survey showed that the current national average indoor radon concentration for homes in Ireland is 77 Bq m−3, a decrease from the 89 Bq m−3 reported in the 2002 NRS. Analysis of the results by build date demonstrate that the introduction of the amending Building Regulations in 1998 have led to a reduction in the average indoor radon level in Ireland.

Epidemiology and etiology of bacillary dysentery in Xinjiang Uigur Autonomous Region, 2004-2014

Objective: To understand the epidemiological and etiological characteristics of bacillary dysentery in Xinjiang Uigur Autonomous Region (Xinjiang) during 2004-2014, and provide evidence for the prevention and control of bacillary dysentery. Methods: Descriptive epidemiological analysis was conducted by using the incidence data of bacillary dysentery in Xinjiang during 2004-2014 and the serotyping and the antibiotic susceptibility test of the pathogens isolated were performed. Results: A total of 123 238 cases of bacillary dysentery were reported in Xinjiang from 2004 to 2014. The average annual incidence of bacillary dysentery ranged from 25.91 per 100 000 to 76.04 per 100 000 and the average annual mortality ranged from 0.00 to 46.90 per 100 000. The incidence of bacillary dysentery was higher in eastern Xinjiang than other areas. The incidence peak was during July-September. The incidence of bacillary dysentery in males was higher than that in females. The incidence was highest in infants and young children under five years old. Most cases were children outside child care settings, farmers and students. Shigella flexneri was the predominant pathogen and F2a was the most frequently detected subtype. The isolated strains were highly resistant to streptomycin, penicillin, doxycycline and tetracycline. The resistant rates to penicillin, tetracycline, doxycycline and streptomycin increased with year. Up to 71.43% of the strains were resistant to more than five antibiotics. Conclusion: The incidence of bacillary dysentery was in decrease in Xinjiang from 2004 to 2014, but in some area, the incidence of bacterial dysentery was higher than national average level. It is necessary to strengthen the surveillance and conduct targeted prevention and control in areas and population at high risk and in season with high incidence. The serious drug resistance and multi drug resistance of the pathogens have posed challenge to the prevention and treatment of bacillary dysentery in Xinjiang.

Interaction between smoking and indoor air pollution on chronic obstructive pulmonary diseases

Objective: To investigate the prevalence of chronic obstructive pulmonary diseases (COPD) in Tongxiang, Zhejiang province, and analyze the interaction between smoking and indoor air pollution on COPD. Methods: Townships of Chongfu, Zhouquan, Gaoqiao, Shimen, Wuzhen were randomly selected from Tongxiang. All the local people aged 30-79 years were asked to receive questionnaire survey, physical examination and pulmonary function testing. FEV1max/FVC max≤0.7 was the criterion of COPD diagnosis. Logistic regression model was used to analyze the relationship between smoking/indoor air pollution and COPD, multiplied interaction between smoking and indoor air pollution was evaluated, Excel table prepared by Andersson et al. was used to calculate the adding interaction. Results: The overall prevalence of COPD was 6.6%, and adjusted for age, educational level, occupation, marriage, income level, BMI, waist-to-hip and other factors, multivariate logistic regression analysis showed that males who had quit smoking, started smoking at age of <25 years had a high risk of COPD; females who smoked every day <15 g, inhaled smoke into mouth or throat had high risk of COPD. Interaction analysis showed that using fuel of firewood/charcoal/coal, briquettes for cooking and regular smoking had multiplied interaction on COPD. Use no chimney or exhaust system in cooking and regular smoking had adding interaction in females. Conclusion: The prevalence of COPD in Tongxiang was close to the national average level. Female smokers had higher risk for COPD than male smokers. Improving kitchen ventilation, using natural gas or fuel gas for cooking and active tobacco control would facilitate the prevention of COPD.

Analysis of Indicators of in Patient Surgical Care at the Health Care Facilities in Ivano-Frankivsk Region for 2005-2015

Surgical inpatient care is one of the most capital-intensive types of care. Therefore, the health care system task is to ensure public access to this type of care, to guarantee the safety and quality of its provision on the background of resources rational use.The objective of the research was to analyze the basic parameters of inpatient surgical care quality provided at Ivano-Frankivsk region health care facilities. Materials and methods. The data of statistical reports (17 and 20) of health care facilities in Ivano-Frankivsk region for 2005-2015 were analyzed. Sociological survey of 530 patients treated at the surgical units of inpatient facilities was conducted. Results of the research. Resources for surgical inpatient care in terms of quantity in Ivano-Frankivsk region including beds and staff were determined to be higher than the average national level. However, the quality of staffing of the regional health care facilities (secondary employment coefficient is less than one point, one third of surgeons is with the second qualifying category or is not certified) does not meet modern requirements. Low-duty health care facilities were detected to be characterized by low operational activity (60.6%, 114.0 operations per surgeon per year on average), insufficient relevance of hospitalization (40% of operations may be performed on an outpatient basis), low attractiveness for a significant per cent of patients (46.2%).Conclusions. Regional program for optimization of surgical care provision should be developed.

Analysis of the SLC26A4 mutation from 230 deafness patients in Guangxi region

Objective:To investigate the mutation characteristics of SLC26A4 gene from 230 hearing loss patients in Guangxi region.Method:Two hundred thirty patients with hearing loss were enrolled in the study. Eight mutation sites in SLC26A4 gene were tested; the types of gene mutation and the inner ear CT features of the mutationpositive patients were analyzed.Result:Among 230 deafness patients,the total mutation rate of SLC26A4 gene is 2.61%(6/230). The types of gene mutation include SLC26A4 IVS7-2A> G heterozygous in 2 case(0.87%).1226G> A homozygous in 1 cases(0.43%),IVS7-2A>G，IVS11+47T>C and 1548insC mutations in 2 cases(0.87%).Conclusion:The mutation rate of SLC26A4 gene in Guangxi region is lower than the national average level. The main mutation type in Guangxi region is SLC26A4 IVS7 2A>G. In this study, two gene mutations (SLC26A4 IVS11+47T> C and 1548insC) are firstly found, suggesting that some rare mutation types of SLC26A4 may exist in patients living in Guangxi region.

Analysis of neonatal hyperphenylalaninemia screening and therapeutic effect in Xuzhou from 2003 to 2015

Objective To investigate the prevalence, clinical classification, treatment and prognosis of neonatal hyperphenylalaninemia(HPA) in Xuzhou area, China. Methods Infants born between July 1, 2003 and July 1, 2015 in Xuzhou area were investigated. Heel blood samples of neonates were collected at 72 hours after birth, and the concentration of blood phenylalanine(Phe) was determined by fluorescent quantitative method in Xuzhou Maternity and Child Health Care Station Neonatal Disease Screening Center. Differential diagnosis was performed in all 265 cases diagnosed as HPA by urinary pterin analysis and dihydropteridine reductase activity determination. The blood Phe concentration and mental development were followed up regularly in infants with HPA. Mutations of phenylalanine hydroxylase (PAH) gene were analyzed by gene sequencing. The relationship between blood Phe concentration and mental development was analyzed by Bivariate correlation analysis. Results (1) The prevalence of HPA in neonates in Xuzhou was l/4 635. Among the 265 confirmed HPA cases, 260 cases(98.11%) had PAH deficiency, including 90(33.96%) classical phenylketonuria(PKU), 84(31.70%) mild PKU and 86(32.45%) mild HPA. The other five patients(1.89%) diagnosed with tetrahydrobiopterin (BH4) deficiency all had 6-pyruvoyl tetrahydropteirn synthase(PTPS) deficiency. (2) Among the 265 HPA cases, 26 cases refused any treatment, including five cases of PTPS deficiency and 21 cases of PKU. Of the five patients with PTPS deficiency, two died and the other three had normal mental and physical development. Twenty-one PKU patients who refused treatment had mental retardation of various degrees. Among 153 PKU patients who received medical treatment, three died and 12 were lost to follow-up. (3) For 138 PKU patients who received dietary treatment and follow-up, the ages at the last visit were two months to 12 years, 116 of them had normal mental development, the remaining 22 patients had mental retardation, and a negative correlation was observed between mental development and the average Phe concentration. (4) Thirty-five patients with PAH deficiency underwent gene sequencing, and 22 kinds of mutations of PAH gene were detected. Conclusions The prevalence of HPA in Xuzhou area is higher than the average national level. With early diagnosis and standard treatment, most of PKU neonates can have normal mental development. Phe level control is an important factor for mental development. Key words: Phenylketonurias; Phenylalanine hydroxylase; Biopterin; Neonatal screening; Intelligence; Treatment outcome

Spatial patterns and environmental constraints on ecosystem services at a catchment scale

Improved understanding and prediction of the fundamental environmental controls on ecosystem service supply across the landscape will help to inform decisions made by policy makers and land-water managers. To evaluate this issue for a local catchment case study, we explored metrics and spatial patterns of service supply for water quality regulation, agriculture production, carbon storage, and biodiversity for the Macronutrient Conwy catchment. Methods included using ecosystem models such as LUCI and JULES, integration of national scale field survey datasets, earth observation products and plant trait databases, to produce finely resolved maps of species richness and primary production. Analyses were done with both 1×1km gridded and subcatchment data. A common single gradient characterised catchment scale ecosystem services supply with agricultural production and carbon storage at opposing ends of the gradient as reported for a national-scale assessment. Species diversity was positively related to production due to the below national average productivity levels in the Conwy combined with the unimodal relationship between biodiversity and productivity at the national scale. In contrast to the national scale assessment, a strong reduction in water quality as production increased was observed in these low productive systems. Various soil variables were tested for their predictive power of ecosystem service supply. Soil carbon, nitrogen, their ratio and soil pH all had double the power of rainfall and altitude, each explaining around 45% of variation but soil pH is proposed as a potential metric for ecosystem service supply potential as it is a simple and practical metric which can be carried out in the field with crowd-sourcing technologies now available. The study emphasises the importance of considering multiple ecosystem services together due to the complexity of covariation at local and national scales, and the benefits of exploiting a wide range of metrics for each service to enhance data robustness.

Epidemiologic investigation of dyslipidemia in middle-aged and elderly adults in Guiyang urban area

Objective To investigate the prevalence and the risk factors of dyslipidemia in residents aged 40 to 80 years in Guiyang. Methods A total of 10 022 adults(2 694 men and 7 328 women)aged 40 and over were selected from Yunyan community in Guiyang urban area for this population based cross-sectional study. Data were obtained by questionnaire survey, physical examination, fasting blood glucose, and lipid measurements. The association between influential factors and dyslipidemia was analyzed by logistic regression analysis. Results The standardized prevalence of dyslipidemia in residents aged 40 years and over in Guiyang was 46.9%, with low high-density lipoprotein cholesterol(HDL-C)29.0%, hypertriglyceridemia 19.3%, high total cholesterol(TC)9.3%, and high low-density lipoprotein cholesterol(LDL-C)4.3%. Logistic regression analysis indicated that age, gender, smoking, and alcohol abuse were the risk factors of high TC and high LDL-C. Abdominal obesity was a main risk factor for both hypertriglyceridemia and low HDL-C. Conclusion The prevalence of dyslipidemia of middle-aged and aged residents in urban districts of Guiyang was on the national average level. Hypertriglyceridemia and low HDL-C were the most common types. Age and abdominal obesity were important risk factors of dyslipidemia. (Chin J Endocrinol Metab, 2016, 32: 286-291) Key words: Dyslipidemias; Prevalence; Epidemiologic studies

A detailed analysis of the embodied energy and carbon emissions of steel-construction residential buildings in China

Some previous studies on the embodied energy of the residential buildings in China show that the percentage of embodied energy in the building total energy use varies from 20% to 50%. It is believed that the accuracy of data acquisition, the differences in the definition of the embodied energy boundaries and the lack of building life cycle inventory (LCI) standards contribute to the large variation in findings. Often researchers should acquire data through typical process technology (national average level), engineering estimation and the professional judgments. There is a need to further study on embodied energy and carbon emissions of building, in this study, an embodied energy consumption and carbon emissions of the residential buildings model was created to study three steel-construction residential buildings in China. This model includes the materials production phase, transportation phase, construction phase, recycle and demolition phase as well as upstream of energy. The direct materials and energy consumption of these three residential buildings with different volumes are investigated on site. The results show that the embodied energy consumption of steel members, concrete and cement account for more than 60% of the total energy consumption of all building components, the proportion of energy consumption of steel members increases with the increasing of the floors, while the proportion of energy consumption of concrete and cement decreases, the embodied energy and environment issues of the building components of the steel-construction buildings is sensitive to building height rather than building volumes.

Social capital in Croatia: measurement and regional distribution

By using partial least squares path modeling, this paper develops a complex index of social capital, selects Croatia as the case for testing and validating the index, and investigates the regional distribution of social capital. The social capital index is defined as a complex hierarchical structured construct of third-order with social trust, participation, and civism as its core dimensions. The main results indicate that civism is the most important cause of social capital followed by active participation and social trust. As far as the regional distribution of social capital is concerned, there are statistically significant differences across the Croatian regions. Although the lowest or below the national average level of social capital and its dimensions can be mostly found in the least developed regions (with the exception of the capital), the highest level of social capital and its particular dimensions is not achieved in the most developed regions.

Disability adjusted life years of type 2 diabetes in population in Zhejiang province, 2013

To estimate the disease burden of type 2 diabetes in population in Zhejiang in 2013. According to the method in global burden of disease study (GBD) 2010, the related disability adjusted life years (DALYs), years of life lost (YLL) and years lived with disability (YLD) were calculated by using the incidence, prevalence and mortality data of type 2 diabetes in population in Zhejiang and DISMODⅡ. The overall DALYs of type 2 diabetes was 5.36 per 1000 population, which was higher in women (5.49 per 1000) than in men (5.24 per 1000), The population in urban area had higher DALYs (5.47 per 1000) than those in rural area (5.42 per 1000). The DALYs in old population was high, which peaked in age group 80-84 years (32.63 per 1000) with YLL/YLD of 0.62. The disease burden of type 2 diabetes was mainly caused by disability. The YLL of type 2 diabetes in Zhejiang was higher than the national average level.

Household Food Insecurity and Health among African American Women in Black Belt Counties of Alabama: Evidence from Mixed-Methods Research

Background: African Americans are more vulnerable to food insecurity than the American population overall. In Alabama’s Black Belt, food insecurity is more than three times the national average level. Yet, little is known about the association between food insecurity and health among African American women in the region. The purpose of this study is to assess the relationship between food insecurity and health among African American low income mothers in Alabama’s Black Belt. Method: We conducted qualitative and quantitative research among 220 low-income African American mothers in a five-county area of Alabama’s Black Belt region that included Bullock, Dallas, Lowndes, Macon and Wilcox counties. Household food insecurity was measured with the United States Department of Agriculture Household Food Security Survey Module. Bivariate and multiple regression analysis were used to estimate the association between household food insecurity and health status. Results: Over 51% of the mothers and their children live in food insecure households. We present qualitative and quantitative evidence that food insecurity is significantly associated with self-rated health. The mothers living in food insecure household are more likely to report poor general health. Nearly one-fifth of the women interviewed complained of health problems, including high blood pressure, back pain, depression and asthma. Conclusion: The association of food insecurity with health, regardless of causal direction, shows the precarious situations poor single mothers in rural areas face. Reducing food insecurity among these mothers may improve their health status. The future direction of food insecurity research must go beyond just monitoring food insecurity to linking it with medical related out outcomes including health status.

Dietary calcium intake and the risk of colorectal cancer: a case control study.

BackgroundHigh intake of dietary calcium has been thought to be a protective factor against colorectal cancer. To explore the dose-response relationship in the associations between dietary calcium intake and colorectal cancer risk by cancer location, we conducted a case-control study among Korean population, whose dietary calcium intake levels are relatively low.MethodsThe colorectal cancer cases and controls were recruited from the National Cancer Center in Korea between August 2010 and August 2013. Information on dietary calcium intake was assessed using a semi-quantitative food frequency questionnaire and locations of the colorectal cancers were classified as proximal colon cancer, distal colon cancer, and rectal cancer. Binary and polytomous logistic regression models were used to evaluate the association between dietary calcium intake and risk of colorectal cancer.ResultsA total of 922 colorectal cancer cases and 2766 controls were included in the final analysis. Compared with the lowest calcium intake quartile, the highest quartile group showed a significantly reduced risk of colorectal cancer in both men and women. (Odds ratio (OR): 0.16, 95 % confidence interval (CI): 0.11–0.24 for men; OR: 0.16, 95 % CI: 0.09–0.29 for women). Among the highest calcium intake groups, decrease in cancer risk was observed across all sub-sites of colorectum in both men and women.ConclusionIn conclusion, calcium consumption was inversely related to colorectal cancer risk in Korean population where national average calcium intake level is relatively lower than Western countries. A decreased risk of colorectal cancer by calcium intake was observed in all sub-sites in men and women.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1963-9) contains supplementary material, which is available to authorized users.

The impacts of migrant workers consumption on energy use and CO2 emissions in China

China has a large number of rural–urban migrant workers in the “semi-urban” states, and their consumption pattern differs from that of rural residents and urban residents. To ensure that society develops sustainably and stably, it is necessary to be concerned about the issues of migrant workers. Based on the data gathered and processed, this paper focuses on the impacts of the consumption of China’s migrant workers on energy use and CO2 emissions using the input–output method. The results show that: the living conditions, health care and allocation of educational resources have not been effectively ensured for migrant workers. The total CO2 emission per capita of migrant workers is relatively low, at two-thirds of the national average and less than one-third that of urban residents. Marginal energy consumption and marginal carbon emission coefficients of migrant workers are slightly lower than the national average level, at 4.9 tce (tonne of standard coal equivalent) per million yuan and 11.6 t CO2 per million yuan lower than those of urban residents. The sectors of food manufacture, and production and distribution of electricity make the greatest contributions to the total carbon emissions of migrant workers, at up to 36.3 %. The citizenization of migrant workers will lead to an increase of 272 million tons of CO2 emissions of primary energy, and the top ten sectors, led by the sectors of electricity production and distribution, and health, will produce more than 60 % of the total increase in carbon emissions. With the acceleration of urbanization and citizenization, the total carbon emissions embodied in the consumption of migrant workers are likely to rise. Further efforts are required to control and reduce the indirect carbon emission, such as by improving energy price mechanism and optimization of the power structure.