The aim of the Task Force was to derive continuous prediction equations and their lower limits of normal for spirometric indices, which are applicable globally. Over 160,000 data points from 72 centres in 33 countries were shared with the European Respiratory Society Global Lung Function Initiative. Eliminating data that could not be used (mostly missing ethnic group, some outliers) left 97,759 records of healthy nonsmokers (55.3% females) aged 2.5-95 yrs. Lung function data were collated and prediction equations derived using the LMS method, which allows simultaneous modelling of the mean (mu), the coefficient of variation (sigma) and skewness (lambda) of a distribution family. After discarding 23,572 records, mostly because they could not be combined with other ethnic or geographic groups, reference equations were derived for healthy individuals aged 3-95 yrs for Caucasians (n=57,395), African-Americans (n=3,545), and North (n=4,992) and South East Asians (n=8,255). Forced expiratory value in 1 s (FEV(1)) and forced vital capacity (FVC) between ethnic groups differed proportionally from that in Caucasians, such that FEV(1)/FVC remained virtually independent of ethnic group. For individuals not represented by these four groups, or of mixed ethnic origins, a composite equation taken as the average of the above equations is provided to facilitate interpretation until a more appropriate solution is developed. Spirometric prediction equations for the 3-95-age range are now available that include appropriate age-dependent lower limits of normal. They can be applied globally to different ethnic groups. Additional data from the Indian subcontinent and Arabic, Polynesian and Latin American countries, as well as Africa will further improve these equations in the future.

https://erj.ersjournals.com/content/erj/40/6/1324.full.pdf

Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations

The goals of this chapter are (1) to outline and substantiate a broad conceptualization of what it means to think mathematically, (2) to summarize the literature relevant to understanding mathematical thinking and problem solving, and (3) to point to new directions in research, development, and assessment consonant with an emerging understanding of mathematical thinking and the goals for instruction outlined here. The use of the phrase “learning to think mathematically” in this chapter’s title is deliberately broad. Although the original charter for this chapter was to review the literature on problem solving and metacognition, the literature itself is somewhat ill defined and poorly grounded. As the literature summary will make clear, problem solving has been used with multiple meanings that range from “working rote exercises” to “doing mathematics as a professional”; metacognition has multiple and almost disjoint meanings (from knowledge about one’s thought processes to self-regulation during problem solving) that make it difficult to use as a concept. This chapter outlines the various meanings that have been ascribed to these terms and discusses their role in mathematical thinking. The discussion will not have the character of a classic literature review, which is typically encyclopedic in its references and telegraphic in its discussions of individual papers or results. It will, instead, be selective and illustrative, with main points illustrated by extended discussions of pertinent examples. Problem solving has, as predicted in the 1980 Yearbook of the National Council of Teachers of Mathematics (Krulik, 1980, p. xiv), been the theme of the 1980s. The decade began with NCTM’s widely heralded statement, in its Agenda for Action, that “problem solving must be the focus of school mathematics” (NCTM, 1980, p. 1). It concluded with the publication of Everybody Counts (National Research Council, 1989) and the Curriculum and Evaluation Standards for School Mathematics (NCTM, 1989), both of which emphasize problem solving. One might infer, then, that there is general acceptance of the idea that the primary goal of mathematics instruction should be to have students become competent problem solvers. Yet, given the multiple interpretations of the term, the goal is hardly clear. Equally unclear is the role that problem solving, once adequately characterized, should play in the larger context of school mathematics. What are the goals for mathematics instruction, and how does problem solving fit within those goals? Such questions are complex. Goals for mathematics instruction depend on one’s conceptualization of what mathematics is, and what it means to understand mathematics. Such conceptualizations vary widely. At one end of the spectrum, mathematical knowledge is seen as a body of facts and procedures dealing with quantities, magnitudes, and forms, and the relationships among them; knowing mathematics is seen as having mastered these facts and procedures. At the other end of the spectrum, mathematics is conceptualized as the “science of patterns,” an (almost) empirical discipline closely akin to the sciences in its emphasis on pattern-seeking on the basis of empirical evidence. The author’s view is that the former perspective trivializes mathematics; that a curriculum based on mastering a corpus of mathematical facts and procedures is severely impoverished—in much the same way that an English curriculum would be considered impoverished if it focused largely, if not exclusively, on issues of grammar. The author characterizes the mathematical enterprise as follows:

Learning to Think Mathematically: Problem Solving, Metacognition, and Sense Making in Mathematics (Reprint):

Health promotion programs often lack a clearly specified theoretical foundation or are based on narrowly conceived conceptual models. For example, lifestyle modification programs typically emphasize individually focused behavior change strategies, while neglecting the environmental underpinnings of health and illness. This article compares three distinct, yet complementary, theoretical perspectives on health promotion: behavioral change, environmental enhancement, and social ecological models. Key strengths and limitations of each perspective are examined, and core principles of social ecological theory are used to derive practical guidelines for designing and evaluating community health promotion programs. Directions for future health promotion research are discussed, including studies examining the role of intermediaries (e.g., corporate decision-makers, legislators) in promoting the well-being of others, and those evaluating the duration and scope of intervention outcomes.

/pdf/translating-social-ecological-theory-into-guidelines-for-4py1s5d6ul.pdf

Translating social ecological theory into guidelines for community health promotion.

The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and as such, they represent the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines include recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or interferes with healthy behaviors. Community efforts are essential to create a social environment that promotes healthy food choices and physical activity. Therefore, this committee presents one key recommendation for community action to accompany the four recommendations for individual choices to reduce cancer risk. This recommendation for community action recognizes that a supportive social environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the Department of Health and Human Services' 2005 Dietary Guidelines for Americans.

http://www.iacld.ir/DL/elm/ajcguidelinesonnutritionandphysicalactivityforcancerprevention.pdf

American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)17870-2.pdf

Alcohol and public health

Recent epidemiological and social studies have increasingly pointed to the importance of drinking patterns in explaining consequences of alcohol consumption This paper presents recommendations for research in the area based on the presentations and discussions of the first "International Conference on Social and Health Effects of Different Drinking Patterns" held in Toronto in November 1995 In particular, the social dimension in pattern research, and the relationship between patterns of drinking and casualties as well as social harm, are stressed The paper also argues for better theories, incorporating knowledge from related basic disciplines In addition, we emphasize the need for improved methodologies and standardized methods for assessing drinking patterns Finally, implications of research on drinking patterns for policy and programme development are discussed

On the emerging paradigm of drinking patterns and their social and health consequences.

The physical disease profiles of 135 female and 736 male inpatient alcoholics, similar in age, social class, and referral pattern, were compared to further clarify the widespread clinical impression that female alcoholics are more illness-prone. Although the women had been drinking hazardously for fewer years, at admission the prevalence of most diseases was similar in men and women. There was, however, an excess of anemia in women and of fatty liver and chronic obstructive lung disease in men. Furthermore, the average duration of hazardous drinking before the first recorded occurrence of almost all illness events was shorter in women, the sex differences being statistically significant for fatty liver, hypertension, obesity, anemia, malnutrition, gastrointestinal hemorrhage, and an ulcer requiring surgery. These findings suggest that the development of physical morbidity in relation to hazardous drinking may be accelerated in women. (Arch Intern Med137:883-887, 1977)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=intemed&articleId=586803&pdfFileName=archinte_137_7_012.pdf

Morbidity in Alcoholics: Evidence for Accelerated Development of Physical Disease in Women

In 1997 the Addiction Research Foundation of Ontario and Canadian Centre on Substance Abuse released updated guidelines for low-risk alcohol consumption. This paper presents the scientific rationale behind this statement. Important comprehensive overviews on the consequences of alcohol use were studied. Formal meta-analyses on morbidity and mortality were examined wherever possible. Individual elements from similar guidelines were investigated for their scientific foundation. Limited original analyses defined risk levels by average weekly consumption. The evidence reviewed demonstrated that placing limits on both daily intake and cumulative intake over the typical week is justifiable for the prevention of important causes of morbidity and mortality. Gender-specific limits on weekly consumption were also indicated. In these updated guidelines intended for primary prevention, days of abstinence are not necessarily recommended. Intoxication should be avoided and abstinence is sometimes advisable. Available evidence does not strongly favour one alcoholic beverage over another for cardiovascular health benefits.

/pdf/low-risk-drinking-guidelines-the-scientific-evidence-2oweevuhir.pdf

Low-risk drinking guidelines: the scientific evidence.

It is now well established that children's exposure to environmental tobacco smoke (ETS) results in substantial public health and economic impacts. Children are more likely than adults to suffer health effects from ETS exposure, and the home is the most important site of such exposure.
  Although the responsibility and authority of the community and health professionals to protect children from harm are entrenched in North American society, social, economic, legal, and political factors contribute to a lower level of support for ETS control measures in homes compared with workplaces and public places. It is now clear that ETS control in home environments must be a priority on the public health agenda. Programme and policy options and strategies for ETS control in home environments are outlined. We conclude that the current research base is inadequate to fully support programme and policy development in this area and priorities for research are identified.


Keywords: environmental tobacco smoke; homes; children

https://tobaccocontrol.bmj.com/content/tobaccocontrol/7/1/61.full.pdf

Reducing children’s exposure to environmental tobacco smoke in homes: issues and strategies

The policy conclusions of this Report can be tailored to the widely varying circumstances of developing countries. This chapter highlights the priority policy issues and actions that are likely to be most relevant for three groups of countries: lowincome countries in Africa and South Asia, middle-income countries in Latin America and East Asia, and the formerly socialist countries of Europe and Central Asia. It describes the reforms needed in the health sector and assesses their feasibility, examines the principal obstacles to reform, and outlines possible strategies for overcoming these obstacles. Although policy reform must deal with difficult underlying problems, the experience of a number of developing countries with implementing significant policy changes shows that success is possible. This chapter also examines the role of the international community in supporting improvements in health policies and programs in developing countries. Despite widespread calls for more donor investment in human resources and in poverty reduction programs, aid flows to the health sector declined from 7 percent of total development assistance in the early 1980s to 6 percent in the latter half of the 1980s. Donors need to match their verbal commitments with actions: the share of aid for health should be restored to its previous level immediately and should be increased substantially over the next five years. An additional $2 billion in aid would help to finance the transitional cost of health policy reforms, as well as priority programs, including AIDS prevention. At the same time, donors and developing countries need to focus on measures to improve the effectiveness of external assistance for health. Doing so will re-

Mary Jane Ashley

Papers

On the emerging paradigm of drinking patterns and their social and health consequences.

Morbidity in Alcoholics: Evidence for Accelerated Development of Physical Disease in Women

Low-risk drinking guidelines: the scientific evidence.

Reducing children’s exposure to environmental tobacco smoke in homes: issues and strategies

An agenda for action.