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PubMed2003

Emancipatory responses to oppression: the template of land-use planning and the Old Order Amish of Ontario.

In this paper I discuss the clash of values between the Old Order Amish community of Ontario and the dominant social paradigm in agriculture. Land-use and agricultural regulations, designed for an industrial style of agriculture, are experienced as a threat to the survival of the Old Order Amish agricultural social economy and community. The paper describes how I have worked with the Old Order Amish to respond to these challenges and to create public policies that will allow them to maintain their human and agricultural diversity and small-scale sustainable farm practices. Four case studies illuminating the oppressive land-use regulations along with the emancipatory responses to the oppression are examined. The social transformation themes include principles and processes for community psychologists, land-use planners, and community economic development practitioners to consider. The article has heuristic value for a practice-based approach to social change.

Agriculture↗
PubMed2003

Tobacco and alcohol consumption, sedentary lifestyle and overweightness in France: a multilevel analysis of individual and area-level determinants.

Using a representative sample of the French population, a multilevel analysis allowed us to examine the effect of the level of consumerism, expressed as the gross domestic product (GDP) per capita in the broad area of residence, on the risks of smoking, drinking, sedentary behaviour and overweightness. After adjustment for potential confounders, we found no GDP effect on the odds of being a moderate smoker. Conversely, the risk of being a highly dependent smoker as opposed to a moderate consumer or an abstainer increased with the area-level GDP per capita (OR: 1.13; 95% CI: 1.04-1.23 for an increment of one standard deviation). A similar pattern was found for alcohol consumption: the odds of being a moderate consumer were not related to the GDP per capita, but a positive effect of the GDP on the odds of being an alcohol-dependent drinker as opposed to a moderate consumer or an abstainer was found among women (OR: 1.14; 95% CI: 1.02-1.28). The gap between the sexes with respect to alcohol-dependency therefore appeared to be narrower when the GDP per capita was high. On the other hand, the risk of overweightness was found to increase with the area-level GDP per capita among blue-collar workers only (OR: 1.21; 95% CI: 1.03-1.43). Beyond the well-documented socioeconomic effects operating at both the individual and the local neighbourhood levels, our study suggests that broader areas of residence, through their level of economic development, may also have an independent impact on health-related behaviour.

Alcohol Drinking↗
PubMed2004

Public psychiatrists' perceptions of changes over the past five years.

This study examines which issues public psychiatrists perceive as having most impacted their careers over the past five years and whether this impact was differentially experienced by staff psychiatrists and medical directors. The authors sent a questionnaire to all members of the American Association of Community Psychiatrists (AACP) in clinical practice for at least 5 years. Surprisingly, public psychiatrists report that the impact of recent changes have been primarily positive, except in the domain of economic developments. Both program and agency medical directors report experiencing about the same amount of change, though significantly more positive overall impact, compared to staff psychiatrists. This finding should encourage psychiatrists to become program medical directors, a feasible next step for many staff psychiatrists.

Administrative Personnel↗
PubMed2002

The rise of atopy and links to infection.

Atopy is the state of allergy to common environmental antigens. Genetic and environmental factors promote the disorder. The impressive rise in prevalence, mainly centred on socio-economically developed communities around the world, emphasizes the potent action of environmental factors in moulding this immune disorder which is characterized by inadequately restrained Th-2 immune mechanisms and IgE production. Reversing the epidemiological trend depends on our identifying the major environmental inputs and acting against these. As yet, the nature of these environmental factors remains to be clarified. Candidate factors include changes in diet, chemical air pollution and microbial exposures in developed countries. This article limits its scope to changing microbial exposures as a potential mechanism. (a) It records epidemiological data that have associated atopic status with less natural exposure to pathogens, parasites and commensal micro-organisms, but with more exposure to certain antibiotics and public health immunizations in early life. (b) It records studies in mice that support the concept that certain microbial exposures can inhibit experimental allergy. (c) It considers potential immune mechanisms for such an action, including the possibility that certain natural infections promote immune regulatory processes that can restrain atopy. It is concluded that the hypothesis that changing patterns of microbial exposure may have promoted the rise in atopy is viable, and that exciting possibilities for reversing the rise of atopy may be derived from further studies.

Animals↗
PubMed1991

Psychology and rural America. Current status and future directions.

Rural people constitute about one fourth of the U.S. population, and their special mental health needs have been largely neglected. For a variety of reasons psychologists have focused little attention on this group. Recent economic developments affecting agriculture, farm families, and rural communities have increased awareness of problems facing rural areas. Psychologists can respond to the unique challenges created by rural mental health needs through research on stress, psychopathology, and community well-being. Training programs should be encouraged to recognize rural concerns. Psychologists are needed to practice in rural areas and to help develop effective rural service models. They can also support the development of state and federal policies that address rural needs.

Community Mental Health Centers↗
PubMed1994

A Head Start for the 21st century.

Social and economic conditions since the creation of Head Start in 1965 have worsened. The stresses of economic restructuring in America and the pervasiveness of violence have severely eroded the capacity of many families to provide safe and caring homes in strong communities. The necessary adaptation of Head Start to these new conditions involves the essential linkage of early childhood and family support approaches with community economic development. This strategy must include a reappraisal of mental health paradigms that will enable children, youth, and families to be healthy and productive members of their neighborhoods and country. Although public support for Head Start remains strong, considerable rethinking about a Head Start for the 21st century is now occurring; results will affect the quality of life for the entire society.

Adolescent↗
PubMed2005

Personality profiles of cultures: aggregate personality traits.

Personality profiles of cultures can be operationalized as the mean trait levels of culture members. College students from 51 cultures rated an individual from their country whom they knew well (N=12,156). Aggregate scores on Revised NEO Personality Inventory (NEO-PI-R) scales generalized across age and sex groups, approximated the individual-level 5-factor model, and correlated with aggregate self-report personality scores and other culture-level variables. Results were not attributable to national differences in economic development or to acquiescence. Geographical differences in scale variances and mean levels were replicated, with Europeans and Americans generally scoring higher in Extraversion than Asians and Africans. Findings support the rough scalar equivalence of NEO-PI-R factors and facets across cultures and suggest that aggregate personality profiles provide insight into cultural differences.

Adult↗
PubMed2000

Rainfall and drought in equatorial east Africa during the past 1,100 years.

Knowledge of natural long-term rainfall variability is essential for water-resource and land-use management in sub-humid regions of the world. In tropical Africa, data relevant to determining this variability are scarce because of the lack of long instrumental climate records and the limited potential of standard high-resolution proxy records such as tree rings and ice cores. Here we present a decade-scale reconstruction of rainfall and drought in equatorial east Africa over the past 1,100 years, based on lake-level and salinity fluctuations of Lake Naivasha (Kenya) inferred from three different palaeolimnological proxies: sediment stratigraphy and the species compositions of fossil diatom and midge assemblages. Our data indicate that, over the past millennium, equatorial east Africa has alternated between contrasting climate conditions, with significantly drier climate than today during the 'Medieval Warm Period' (approximately AD 1000-1270) and a relatively wet climate during the 'Little Ice Age' (approximately AD 1270-1850) which was interrupted by three prolonged dry episodes. We also find strong chronological links between the reconstructed history of natural long-term rainfall variation and the pre-colonial cultural history of east Africa, highlighting the importance of a detailed knowledge of natural long-term rainfall fluctuations for sustainable socio-economic development.

Africa, Eastern↗
PubMed2001

The end of world population growth.

There has been enormous concern about the consequences of human population growth for the environment and for social and economic development. But this growth is likely to come to an end in the foreseeable future. Improving on earlier methods of probabilistic forecasting, here we show that there is around an 85 per cent chance that the world's population will stop growing before the end of the century. There is a 60 per cent probability that the world's population will not exceed 10 billion people before 2100, and around a 15 per cent probability that the world's population at the end of the century will be lower than it is today. For different regions, the date and size of the peak population will vary considerably.

Fertility↗
PubMed1994

Penetrating keratoplasty in the West Bank and Gaza.

Four hundred and sixteen penetrating keratoplasties performed at St John Ophthalmic Hospital, Jerusalem, between January 1988 and July 1992 were reviewed retrospectively. The leading indications were keratoconus, microbial keratitis, trachomatous corneal scarring and herpes simplex keratitis. After a mean follow-up of 12.4 months (> 1-48 months) 79.8% of the grafts remained clear. The results in terms of graft clarity and visual improvement varied among the different diagnostic groups. No relationship was found between donor age, cadaver time or storage time and graft survival. This series demonstrates the viability of penetrating keratoplasty in this area of low economic development but highlights the need for strict patient selection to ensure optimal use of scarce donor material.

Adolescent↗
PubMed2005

Increase in tropospheric nitrogen dioxide over China observed from space.

Emissions from fossil fuel combustion and biomass burning reduce local air quality and affect global tropospheric chemistry. Nitrogen oxides are emitted by all combustion processes and play a key part in the photochemically induced catalytic production of ozone, which results in summer smog and has increased levels of tropospheric ozone globally. Release of nitrogen oxide also results in nitric acid deposition, and--at least locally--increases radiative forcing effects due to the absorption of downward propagating visible light. Nitrogen oxide concentrations in many industrialized countries are expected to decrease, but rapid economic development has the potential to increase significantly the emissions of nitrogen oxides in parts of Asia. Here we present the tropospheric column amounts of nitrogen dioxide retrieved from two satellite instruments GOME and SCIAMACHY over the years 1996-2004. We find substantial reductions in nitrogen dioxide concentrations over some areas of Europe and the USA, but a highly significant increase of about 50 per cent-with an accelerating trend in annual growth rate-over the industrial areas of China, more than recent bottom-up inventories suggest.

Air Pollutants↗
PubMed1990

Neurological complications of endemic skeletal fluorosis, with special emphasis on radiculo-myelopathy.

The results of surveys carried out between 1976 and 1985 in the fluorosis-endemic area of the Ethiopian Rift Valley is summarised, with emphasis on the neurological complications resulting from the crippling osteofluorosis. The neurological manifestations in the forms of myelopathy with and without radiculopathy (respectively 72% and 28%) occurred after exposure to high fluoride (greater than 4 ppm) for longer than 10 years. These deficits were clearly found to be a consequence of fluoride deposition in bones, resulting in generalised sclerosis and osteophytosis, with reduction in the diameter of the intervertebral foramina and of the spinal conal. Advanced osteosclerosis commonly causes severe spastic quadriparesis in flexion, accompanied by distressing spasms and urinary incontinence. The dilemma of these medical problems in relation to the agro-industrial economic developments of the Ethiopian Rift Valley is discussed.

Agriculture↗
PubMed1998

The nutritional status and dietary pattern of Chinese adolescents, 1991 and 1993.

OBJECTIVE: To increase understanding about current dietary patterns and short-term relationships between economic change and adolescent nutrition in a lower-income country, using the 1991 and 1993 China Health and Nutrition Survey data. DESIGN: Cross-sectional study. SETTING: Eight provinces in China that vary substantially in geography, economic development, public resources, and health indicators. SUBJECTS: 2236 and 2018 adolescents aged 10-18 years who completed three 24-hour recalls in the 1991 and 1993 survey, respectively. RESULTS: Chinese adolescents experienced an improvement of diet and nutritional status. The prevalence of stunting declined from 23% in 1991 to 19% in 1993. Under-nutrition was a problem of concern although the prevalence (12-13%) was relatively low. Overweight was emerging as a problem associated with young, high-income and urban adolescents, but the prevalence (4%) was quite low compared with developed countries. Chinese adolescents' energy and protein intakes were adequate compared with the American RDA. About 27% of the participants derived more than 30% of their dietary energy from fat and 16% of them derived over 10% of energy from saturated fat by 1993. CONCLUSION: Chinese adolescents have experienced an improvement in diet and nutritional status, but undernutrition is still an important nutrition problem, especially among young and poor groups. More attention should focus on the increase of dietary fat intake and obesity.

Adolescent↗
PubMed2003

Associations between reproduction and maternal body weight: examining the component parts of a full reproductive cycle.

OBJECTIVE: Many transitional societies currently face both extremes of nutritional status, undernutrition and overnutrition. Women of reproductive age are at high risk of these conditions. The purpose of this review is to consider evidence for relationships between reproduction and nutritional status in women from societies of varying economic development, using body weight or weight-for-height as indicators of maternal nutritional status. DESIGN: The conceptual framework guiding this review is that the duration of the reproductive cycle varies as a function of its component parts, which include (i) pregnancy, (ii) lactation, (iii) the non-pregnant/non-lactating (NP/NL) interval or, possibly, (iv) an overlap between lactation and next pregnancy. All component parts of the complete cycle vary in length and are associated with changes in nutritional status. A variety of factors ('proximal and distal determinants') influence the duration of the component parts of the reproductive cycle. This framework is used to examine current knowledge of changes in maternal nutritional status during each of these parts. RESULTS: Women in affluent societies retain some weight with each pregnancy, beyond that of non-pregnant women. Women in less affluent societies retain less weight with each pregnancy. During lactation, women in both affluent and less affluent societies experience only modest weight loss. During the NP/NL interval, women in affluent societies tend to gain weight, whereas weight of women in less affluent societies is likely to fluctuate. CONCLUSIONS: We conclude that there is a dearth of information on certain parts of the cycle, particularly the periods of overlap of lactation with pregnancy and the NP/NL interval.

Adult↗
PubMed2006

The effect of economic status on height, insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations in healthy Turkish children.

OBJECTIVES: The effect of economic status (ES) on growth, insulin-like growth factor (IGF)-I and IGF-binding protein (IGFBP)-3 in healthy children is not well characterized. We aimed to study the interrelationship between height, weight, IGF-I, IGFBP-3, mid-parental height (MPH) and ES. DESIGN/SUBJECTS: Eight hundred and fourteen healthy children (428 boys, 386 girls; age 3-18 years) were classified according to income of the families as low, middle and high. Standard deviation scores (SDSs) of height, weight, MPH, IGF-I and IGFBP-3 were compared between the groups. The combined effect of these parameters and ES on height SDS was investigated with complex statistical models. RESULTS: There was a significant trend for height and weight SDSs to increase with higher income levels in boys, but not in girls. Body mass index (BMI) SDSs were similar in three groups. There was a general trend for MPH SDS to increase with income levels in both sexes. In boys, IGF-I SDS was significantly higher in high ES group than low ES. In girls, IGFBP-3 SDSs were significantly higher in high ES group than in middle ES group. For both genders, height SDS was highly correlated with weight SDS and moderately correlated with BMI SDS, MPH SDS and IGF-1 SDS. All correlations were significant and positive. Complex models showed that MPH (19%), IGF-I (13%) and ES (3%) in boys, and MPH (16%) and IGF-I (7%) in girls have significant contribution to height SDSs. CONCLUSIONS: ES per se, independent of overt malnutrition, affects height, weight, IGF-I and IGFBP-3 with some gender differences in healthy children. Influence of income on height and weight show sexual dimorphism, a slight but significant effect is observed only in boys. MPH is the most prominent variable effecting height in healthy children. Higher height and MPH SDSs observed in higher income groups suggest that secular trend in growth still exists, at least in boys, in a country of favorable economic development.

Adolescent↗
PubMed2000

The Trp64Arg polymorphism of the beta3-adrenergic receptor gene and obesity in Chinese subjects with components of the metabolic syndrome.

BACKGROUND: In regions such as Hong Kong, rapid economic development has led to lifestyle alterations characterized by increases in energy and fat intake and reduction in physical activity. These changes have been associated with a dramatic increase in the prevalence of diabetes and related diseases of the metabolic syndrome. OBJECTIVE: To investigate if a common polymorphism (Trp64Arg) of the beta3-adrenergic receptor gene, previously implicated as predisposing to type 2 diabetes mellitus or obesity in other populations, has a role in the apparent susceptibility of Hong Kong Chinese to diabetes and related disorders. METHOD: A PCR-based protocol was used to genotype 802 Southern Chinese subjects who were either healthy or had one or more of the metabolic disorders including diabetes, hypertension or dyslipidaemia. RESULTS: The frequencies of the mutant A allele (12.7%) and AA genotype (1.7%) did not differ, by the chi2 test, in any patient group with diabetes, hypertension or dyslipidaemia, alone or in combination, compared to healthy controls. Using the t-test in the 802 subjects, those carrying the mutant A allele had evidence of increased obesity with a significantly (all P<0.05) higher body mass index (BMI, kg/m2) and also lower HDL-cholesterol. BMI was also elevated in subjects with the A allele in the separate groups with diabetes, dyslipidaemia or hypertension. Stepwise multiple regression showed this polymorphism to be an independent predictor of BMI. CONCLUSION: These data do not support any direct involvement of the Trp64Arg polymorphism in the development of diabetes, hypertension or dyslipidaemia in Chinese subjects, but do suggest a relationship with obesity.

Adult↗
PubMed2006

Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China.

BACKGROUND: Over the past two decades, China has enjoyed impressive economic development, and her citizens have experienced many remarked changes in their lifestyle. These changes are often associated with an increase in obesity and chronic disease. METHODS: In this meta-analysis, based on nationally representative data, we studied the current prevalence of obesity and the trends in obesity, mortality and morbidity in China. RESULTS: Between 1992 and 2002, the prevalence of overweight and obesity increased in all gender and age groups and in all geographic areas. Using the World Health Organization body mass index cut points, the combined prevalence of overweight and obesity increased from 14.6 to 21.8%. The Chinese obesity standard shows an increase from 20.0 to 29.9%. The annual increase rate was highest in men aged 18-44 years and women aged 45-59 years (approximately 1.6 and 1.0% points, respectively). In general, male subjects, urban residents, and high-income groups had a greater increase. With the increase in overweight and obesity, obesity-, and diet-related chronic diseases (e.g., hypertension, cardiovascular disease (CVD), and type 2 diabetes) also increased over the past decade and became a more important preventable cause of death. Hypertension increased from 14.4% in 1991 to 18.8% in 2002 in adults; in older adults aged 35-74 years, it increased from 19.7 to 28.6%. Between 1993 and 2003, the prevalence of CVD increased from 31.4 to 50.0%; diabetes increased from 1.9 to 5.6%. During 1990-2003, although total mortality rate (per 100 000) decreased, overall the mortality rate and contribution (as percentages) to total death of obesity-related chronic disease increased, in particular, in rural areas. Mortality rate (per 100 000) of CVD increased from 128 to 145 and its contribution to total death, 27 to 32%, in rural areas; the figures decreased slightly in urban areas. The mortality rate of 'nutrition, endocrinology and metabolism-related disease' (NEMD) increased in both rural and urban areas between 1990 and 2000, 8.0 to 10.6 and 4.9 to 5.3, respectively. The current prevalence of hypertension, dyslipidaemia, metabolic syndrome, and diabetes among Chinese adults is approximately 20, 20, 15, and 3%, respectively. CONCLUSION: The prevalence of overweight and obesity and obesity-related chronic diseases have increased in China in the past decade. Our findings provide useful information for the projection of future trends and the formulation of national strategies and programmes that can address the challenges of the growing obesity and chronic disease epidemic.

Adolescent↗
PubMed2001

Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan.

We studied the prevalence and determinants of hypertension among adults in mountainous rural villages in the Ghizar district Northern Areas of Pakistan, an area that recently has undergone substantial economic development. We selected a stratified random sample of 4203 adults (age > 18 years) from 16 villages in Punial Valley of Ghizar district where the number of study subjects from each village was proportionate to the size of the village. We obtained blood pressure (BP) records by taking the mean of the second and third BP measurement, using a standard mercury sphygmomanometer, and assessed risk factors for hypertension in the study subjects. The mean +/- s.d. blood pressures (mm Hg) were 125 +/- 19 systolic and 80 +/- 12 diastolic in men and 125 +/- 22 systolic and 78 +/- 14 diastolic in women. The 125 +/- 22 systolic and 78 +/- 14 diastolic in women. The mm Hg, or systolic BP > or = 140 mm Hg or currently taking antihypertensive medication) was 15%, increasing from 4% in the 18-29 year age group to 36% among persons 60 years of age or older. The age-standardised prevalence of hypertension was 14% (12.5% among men and 14% among women). There was no significant difference in prevalence of hypertension in males, and in females. Multivariate analysis revealed that age, and higher body mass index (overweight and obesity) were independently associated with higher prevalence of hypertension. People with hypertension were more likely to have a first-degree relative with physician-diagnosed hypertension (OR = 1.90, 95% CI 1.49, 2). Hypertension is a significant health problem in rural northern Pakistan. The primary health care programme in the Northern Areas of Pakistan needs to address this problem, especially identifying people at risk.

Adolescent↗