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Showing papers on "Poison control published in 2016"


Journal ArticleDOI
11 Feb 2016-Nature
TL;DR: It is found that many structurally diverse alleles of the complement component 4 (C4) genes generated widely varying levels of C4A and C4B expression in the brain, with each common C4 allele associating with schizophrenia in proportion to its tendency to generate greater expression of C 4A.
Abstract: Schizophrenia is a heritable brain illness with unknown pathogenic mechanisms. Schizophrenia's strongest genetic association at a population level involves variation in the major histocompatibility complex (MHC) locus, but the genes and molecular mechanisms accounting for this have been challenging to identify. Here we show that this association arises in part from many structurally diverse alleles of the complement component 4 (C4) genes. We found that these alleles generated widely varying levels of C4A and C4B expression in the brain, with each common C4 allele associating with schizophrenia in proportion to its tendency to generate greater expression of C4A. Human C4 protein localized to neuronal synapses, dendrites, axons, and cell bodies. In mice, C4 mediated synapse elimination during postnatal development. These results implicate excessive complement activity in the development of schizophrenia and may help explain the reduced numbers of synapses in the brains of individuals with schizophrenia.

1,826 citations


Journal ArticleDOI
TL;DR: Findings indicate that the opioid overdose epidemic is worsening and there is a need for continued action to prevent opioid abuse, dependence, and death, improve treatment capacity for opioid use disorders, and reduce the supply of illicit opioids, particularly heroin and illicit fentanyl.
Abstract: The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin). CDC analyzed recent multiple cause-of-death mortality data to examine current trends and characteristics of drug overdose deaths, including the types of opioids associated with drug overdose deaths. During 2014, a total of 47,055 drug overdose deaths occurred in the United States, representing a 1-year increase of 6.5%, from 13.8 per 100,000 persons in 2013 to 14.7 per 100,000 persons in 2014. The rate of drug overdose deaths increased significantly for both sexes, persons aged 25-44 years and ≥55 years, non-Hispanic whites and non-Hispanic blacks, and in the Northeastern, Midwestern, and Southern regions of the United States. Rates of opioid overdose deaths also increased significantly, from 7.9 per 100,000 in 2013 to 9.0 per 100,000 in 2014, a 14% increase. Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as "prescription" opioid overdoses (1). Between 2013 and 2014, the age-adjusted rate of death involving methadone remained unchanged; however, the age-adjusted rate of death involving natural and semisynthetic opioid pain relievers, heroin, and synthetic opioids, other than methadone (e.g., fentanyl) increased 9%, 26%, and 80%, respectively. The sharp increase in deaths involving synthetic opioids, other than methadone, in 2014 coincided with law enforcement reports of increased availability of illicitly manufactured fentanyl, a synthetic opioid; however, illicitly manufactured fentanyl cannot be distinguished from prescription fentanyl in death certificate data. These findings indicate that the opioid overdose epidemic is worsening. There is a need for continued action to prevent opioid abuse, dependence, and death, improve treatment capacity for opioid use disorders, and reduce the supply of illicit opioids, particularly heroin and illicit fentanyl.

1,559 citations


Journal ArticleDOI
TL;DR: It is argued that the global burden of mental illness is underestimated and the reasons for under-estimation are examined to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes.

1,444 citations


Journal ArticleDOI
TL;DR: Improved recognition and understanding of clinical, psychological, sociological, and biological factors might help the detection of high-risk individuals and assist in treatment selection.

1,254 citations



Journal ArticleDOI
TL;DR: This paper presents a review of recent research articles related to defining and quantifying resilience in various disciplines, with a focus on engineering systems and provides a classification scheme to the approaches, focusing on qualitative and quantitative approaches and their subcategories.

1,072 citations


Journal ArticleDOI
TL;DR: The most common non-communicable diseases, including ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and cancers (liver, stomach, and lung), contributed much more to YLLs in 2013 compared with 1990, and road injuries have become a top ten cause of death in all provinces in mainland China.

1,044 citations


Journal ArticleDOI
24 Jun 2016-Science
TL;DR: Even though participants approve of autonomous vehicles that might sacrifice passengers to save others, respondents would prefer not to ride in such vehicles, and regulating for utilitarian algorithms may paradoxically increase casualties by postponing the adoption of a safer technology.
Abstract: Autonomous vehicles (AVs) should reduce traffic accidents, but they will sometimes have to choose between two evils, such as running over pedestrians or sacrificing themselves and their passenger to save the pedestrians. Defining the algorithms that will help AVs make these moral decisions is a formidable challenge. We found that participants in six Amazon Mechanical Turk studies approved of utilitarian AVs (that is, AVs that sacrifice their passengers for the greater good) and would like others to buy them, but they would themselves prefer to ride in AVs that protect their passengers at all costs. The study participants disapprove of enforcing utilitarian regulations for AVs and would be less willing to buy such an AV. Accordingly, regulating for utilitarian algorithms may paradoxically increase casualties by postponing the adoption of a safer technology.

994 citations


Journal ArticleDOI
TL;DR: This Review explores whether these alterations reflect toxic effects of early-life stress or potentially adaptive modifications, the relationship between psychopathology and brain changes, and the distinction between resilience, susceptibility and compensation.
Abstract: Maltreatment-related childhood adversity is the leading preventable risk factor for mental illness and substance abuse. Although the association between maltreatment and psychopathology is compelling, there is a pressing need to understand how maltreatment increases the risk of psychiatric disorders. Emerging evidence suggests that maltreatment alters trajectories of brain development to affect sensory systems, network architecture and circuits involved in threat detection, emotional regulation and reward anticipation. This Review explores whether these alterations reflect toxic effects of early-life stress or potentially adaptive modifications, the relationship between psychopathology and brain changes, and the distinction between resilience, susceptibility and compensation.

982 citations


Journal ArticleDOI
TL;DR: The appropriately graded prescription of high training loads should improve players’ fitness, which in turn may protect against injury, ultimately leading to greater physical outputs and resilience in competition, and a greater proportion of the squad available for selection each week.
Abstract: Background There is dogma that higher training load causes higher injury rates. However, there is also evidence that training has a protective effect against injury. For example, team sport athletes who performed more than 18 weeks of training before sustaining their initial injuries were at reduced risk of sustaining a subsequent injury, while high chronic workloads have been shown to decrease the risk of injury. Second, across a wide range of sports, well-developed physical qualities are associated with a reduced risk of injury. Clearly, for athletes to develop the physical capacities required to provide a protective effect against injury, they must be prepared to train hard. Finally, there is also evidence that under-training may increase injury risk. Collectively, these results emphasise that reductions in workloads may not always be the best approach to protect against injury. Main thesis This paper describes the ‘Training-Injury Prevention Paradox’ model; a phenomenon whereby athletes accustomed to high training loads have fewer injuries than athletes training at lower workloads. The Model is based on evidence that non-contact injuries are not caused by training per se , but more likely by an inappropriate training programme. Excessive and rapid increases in training loads are likely responsible for a large proportion of non-contact, soft-tissue injuries. If training load is an important determinant of injury, it must be accurately measured up to twice daily and over periods of weeks and months (a season). This paper outlines ways of monitoring training load (‘internal’ and ‘external’ loads) and suggests capturing both recent (‘acute’) training loads and more medium-term (‘chronic’) training loads to best capture the player's training burden. I describe the critical variable—acute:chronic workload ratio—as a best practice predictor of training-related injuries. This provides the foundation for interventions to reduce players risk, and thus, time-loss injuries. Summary The appropriately graded prescription of high training loads should improve players’ fitness, which in turn may protect against injury, ultimately leading to (1) greater physical outputs and resilience in competition, and (2) a greater proportion of the squad available for selection each week.

971 citations


Journal ArticleDOI
10 Jun 2016
TL;DR: Results from the 2015 national YRBS indicated that many high school students are engaged in priority health-risk behaviors associated with the leading causes of death among persons aged 10-24 years in the United States.
Abstract: PROBLEM: Priority health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults. Population-based data on these behaviors at the national, state, and local levels can help monitor the effectiveness of public health interventions designed to protect and promote the health of youth nationwide. REPORTING PERIOD COVERED: September 2014-December 2015. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors related to unintended pregnancy and sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma and other priority health behaviors. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. This report summarizes results for 118 health behaviors plus obesity, overweight, and asthma from the 2015 national survey, 37 state surveys, and 19 large urban school district surveys conducted among students in grades 9-12. RESULTS: Results from the 2015 national YRBS indicated that many high school students are engaged in priority health-risk behaviors associated with the leading causes of death among persons aged 10-24 years in the United States. During the 30 days before the survey, 41.5% of high school students nationwide among the 61.3% who drove a car or other vehicle during the 30 days before the survey had texted or e-mailed while driving, 32.8% had drunk alcohol, and 21.7% had used marijuana. During the 12 months before the survey, 15.5% had been electronically bullied, 20.2% had been bullied on school property, and 8.6% had attempted suicide. Many high school students are engaged in sexual risk behaviors that relate to unintended pregnancies and STIs, including HIV infection. Nationwide, 41.2% of students had ever had sexual intercourse, 30.1% had had sexual intercourse during the 3 months before the survey (i.e., currently sexually active), and 11.5% had had sexual intercourse with four or more persons during their life. Among currently sexually active students, 56.9% had used a condom during their last sexual intercourse. RESULTS from the 2015 national YRBS also indicated many high school students are engaged in behaviors associated with chronic diseases, such as cardiovascular disease, cancer, and diabetes. During the 30 days before the survey, 10.8% of high school students had smoked cigarettes and 7.3% had used smokeless tobacco. During the 7 days before the survey, 5.2% of high school students had not eaten fruit or drunk 100% fruit juices and 6.7% had not eaten vegetables. More than one third (41.7%) had played video or computer games or used a computer for something that was not school work for 3 or more hours per day on an average school day and 14.3% had not participated in at least 60 minutes of any kind of physical activity that increased their heart rate and made them breathe hard on at least 1 day during the 7 days before the survey. Further, 13.9% had obesity and 16.0% were overweight. INTERPRETATION: Many high school students engage in behaviors that place them at risk for the leading causes of morbidity and mortality. The prevalence of most health behaviors varies by sex, race/ethnicity, and grade and across states and large urban school districts. Long-term temporal changes also have occurred. Since the earliest year of data collection, the prevalence of most health-risk behaviors has decreased (e.g., riding with a driver who had been drinking alcohol, physical fighting, current cigarette use, current alcohol use, and current sexual activity), but the prevalence of other behaviors and health outcomes has not changed (e.g., suicide attempts treated by a doctor or nurse, smokeless tobacco use, having ever used marijuana, and attending physical education classes) or has increased (e.g., having not gone to school because of safety concerns, obesity, overweight, not eating vegetables, and not drinking milk). Monitoring emerging risk behaviors (e.g., texting and driving, bullying, and electronic vapor product use) is important to understand how they might vary over time. PUBLIC HEALTH ACTION: YRBSS data are used widely to compare the prevalence of health behaviors among subpopulations of students; assess trends in health behaviors over time; monitor progress toward achieving 21 national health objectives for Healthy People 2020 and one of the 26 leading health indicators; provide comparable state and large urban school district data; and help develop and evaluate school and community policies, programs, and practices designed to decrease health-risk behaviors and improve health outcomes among youth. Language: en

Journal ArticleDOI
Juanita A. Haagsma1, Nicholas Graetz1, Ian Bolliger1, Mohsen Naghavi1, Hideki Higashi1, Erin C Mullany1, Semaw Ferede Abera2, Jerry Puthenpurakal Abraham3, Koranteng Adofo4, Ubai Alsharif5, Emmanuel A. Ameh6, Walid Ammar, Carl Abelardo T. Antonio7, Lope H Barrero8, Tolesa Bekele9, Dipan Bose10, Alexandra Brazinova, Ferrán Catalá-López, Lalit Dandona1, Rakhi Dandona11, Paul I. Dargan12, Diego De Leo13, Louisa Degenhardt14, Sarah Derrett15, Samath D Dharmaratne16, Tim Driscoll17, Leilei Duan18, Sergey Petrovich Ermakov19, Farshad Farzadfar20, Valery L. Feigin21, Richard C. Franklin22, Belinda J. Gabbe23, Richard A. Gosselin24, Nima Hafezi-Nejad20, Randah R. Hamadeh25, Martha Híjar, Guoqing Hu26, Sudha Jayaraman27, Guohong Jiang, Yousef Khader28, Ejaz Ahmad Khan29, Sanjay Krishnaswami30, Chanda Kulkarni, Fiona Lecky31, Ricky Leung32, Raimundas Lunevicius33, Ronan A Lyons34, Marek Majdan, Amanda J. Mason-Jones35, Richard Matzopoulos36, Peter A. Meaney37, Wubegzier Mekonnen38, Ted R. Miller39, Charles Mock40, Rosana E. Norman41, Ricardo Orozco, Suzanne Polinder, Farshad Pourmalek42, Vafa Rahimi-Movaghar20, Amany H. Refaat43, David Rojas-Rueda, Nobhojit Roy44, David C. Schwebel45, Amira Shaheen46, Saeid Shahraz47, Vegard Skirbekk48, Kjetil Søreide49, Sergey Soshnikov, Dan J. Stein50, Bryan L. Sykes51, Karen M. Tabb52, Awoke Misganaw Temesgen, Eric Y. Tenkorang53, Alice Theadom21, Bach Xuan Tran54, Bach Xuan Tran55, Tommi Vasankari, Monica S. Vavilala40, Vasiliy Victorovich Vlassov56, Solomon Meseret Woldeyohannes57, Paul S. F. Yip58, Naohiro Yonemoto, Mustafa Z. Younis59, Chuanhua Yu60, Christopher J L Murray1, Theo Vos1 
Institute for Health Metrics and Evaluation1, College of Health Sciences, Bahrain2, Harvard University3, Kwame Nkrumah University of Science and Technology4, Charité5, Ahmadu Bello University6, University of the Philippines Manila7, Pontifical Xavierian University8, Madawalabu University9, World Bank10, Public Health Foundation of India11, Guy's and St Thomas' NHS Foundation Trust12, Griffith University13, University of New South Wales14, Massey University15, University of Peradeniya16, University of Sydney17, Chinese Center for Disease Control and Prevention18, Russian Academy of Sciences19, Tehran University of Medical Sciences20, Auckland University of Technology21, James Cook University22, Monash University23, University of California, San Francisco24, Arabian Gulf University25, Central South University26, Virginia Commonwealth University27, Jordan University of Science and Technology28, Health Services Academy29, Oregon Health & Science University30, University of Sheffield31, University at Albany, SUNY32, Aintree University Hospitals NHS Foundation Trust33, Swansea University34, University of York35, South African Medical Research Council36, Children's Hospital of Philadelphia37, Addis Ababa University38, Curtin University39, University of Washington40, Queensland University of Technology41, University of British Columbia42, Suez Canal University43, Karolinska Institutet44, University of Alabama at Birmingham45, An-Najah National University46, Tufts Medical Center47, Norwegian Institute of Public Health48, Stavanger University Hospital49, University of Cape Town50, University of California, Irvine51, University of Illinois at Urbana–Champaign52, St. John's University53, Johns Hopkins University54, Hanoi Medical University55, National Research University – Higher School of Economics56, University of Gondar57, University of Hong Kong58, Jackson State University59, Wuhan University60
TL;DR: An overview of injury estimates from the 2013 update of GBD is provided, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country.
Abstract: Background The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country. Methods Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures. Results In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries. Conclusions Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.

Journal ArticleDOI
TL;DR: The data strongly support the claim that exercise is an evidence-based treatment for depression, and previous meta-analyses may have underestimated the benefits of exercise due to publication bias.

Journal ArticleDOI
TL;DR: In this article, a detailed discussion of the unobserved heterogeneity in highway accident data and analysis is presented along with their strengths and weaknesses, as well as a summary of the fundamental issues and directions for future methodological work that address this problem.

Journal ArticleDOI
TL;DR: The ideation-to-action framework stipulates that the development of suicidal ideation and the progression from ideation to suicide attempts are distinct phenomena with distinct explanations and predictors.
Abstract: Suicidal behavior is a leading cause of death and disability worldwide. Fortunately, recent developments in suicide theory and research promise to meaningfully advance knowledge and prevention. One key development is the ideation-to-action framework, which stipulates that (a) the development of suicidal ideation and (b) the progression from ideation to suicide attempts are distinct phenomena with distinct explanations and predictors. A second key development is a growing body of research distinguishing factors that predict ideation from those that predict suicide attempts. For example, it is becoming clear that depression, hopelessness, most mental disorders, and even impulsivity predict ideation, but these factors struggle to distinguish those who have attempted suicide from those who have only considered suicide. Means restriction is also emerging as a highly effective way to block progression from ideation to attempt. A third key development is the proliferation of theories of suicide that are positioned within the ideation-to-action framework. These include the interpersonal theory, the integrated motivational-volitional model, and the three-step theory. These perspectives can and should inform the next generation of suicide research and prevention.

Journal ArticleDOI
TL;DR: To estimate the numbers, percentages, and rates of falls and fall injuries among older adults by selected characteristics and state, CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey.
Abstract: Falls are the leading cause of fatal and nonfatal injuries among adults aged ≥65 years (older adults). During 2014, approximately 27,000 older adults died because of falls; 2.8 million were treated in emergency departments for fall-related injuries, and approximately 800,000 of these patients were subsequently hospitalized.* To estimate the numbers, percentages, and rates of falls and fall injuries among older adults by selected characteristics and state, CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey. In 2014, 28.7% of older adults reported falling; the estimated 29.0 million falls resulted in 7.0 million injuries. Known effective strategies for reducing the number of older adult falls include a multifactorial clinical approach (e.g., gait and balance assessment, strength and balance exercises, and medication review). Health care providers can play an important role in fall prevention by screening older adults for fall risk, reviewing and managing medications linked to falls, and recommending vitamin D supplements to improve bone, muscle, and nerve health and reduce the risk for falls.

Journal ArticleDOI
TL;DR: Prior SITBs confer risk for later suicidal thoughts and behaviors, however, they only provide a marginal improvement in diagnostic accuracy above chance, and addressing gaps in study design, assessment, and underlying mechanisms may prove useful in improving prediction and prevention of suicidal thought and behaviors.
Abstract: Background A history of self-injurious thoughts and behaviors (SITBs) is consistently cited as one of the strongest predictors of future suicidal behavior. However, stark discrepancies in the literature raise questions about the true magnitude of these associations. The objective of this study is to examine the magnitude and clinical utility of the associations between SITBs and subsequent suicide ideation, attempts, and death. Method We searched PubMed, PsycInfo, and Google Scholar for papers published through December 2014. Inclusion required that studies include at least one longitudinal analysis predicting suicide ideation, attempts, or death using any SITB variable. We identified 2179 longitudinal studies; 172 met inclusion criteria. Results The most common outcome was suicide attempt (47.80%), followed by death (40.50%) and ideation (11.60%). Median follow-up was 52 months (mean = 82.52, s.d. = 102.29). Overall prediction was weak, with weighted mean odds ratios (ORs) of 2.07 [95% confidence interval (CI) 1.76–2.43] for ideation, 2.14 (95% CI 2.00–2.30) for attempts, and 1.54 (95% CI 1.39–1.71) for death. Adjusting for publication bias further reduced estimates. Diagnostic accuracy analyses indicated acceptable specificity (86–87%) and poor sensitivity (10–26%), with areas under the curve marginally above chance (0.60–0.62). Most risk factors generated OR estimates of <2.0 and no risk factor exceeded 4.5. Effects were consistent regardless of sample severity, sample age groups, or follow-up length. Conclusions Prior SITBs confer risk for later suicidal thoughts and behaviors. However, they only provide a marginal improvement in diagnostic accuracy above chance. Addressing gaps in study design, assessment, and underlying mechanisms may prove useful in improving prediction and prevention of suicidal thoughts and behaviors.

Journal ArticleDOI
TL;DR: Exposure to interpersonal violence had the strongest associations with subsequent traumatic events, and limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence.
Abstract: BACKGROUND: Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs. METHOD: General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure. RESULTS: Over 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types - witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury - accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events. CONCLUSIONS: Given the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization. Language: en

Journal ArticleDOI
TL;DR: The physiological rationale for physical activity, risks of adverse events, societal and psychological factors are discussed with a view to inform public health initiatives for the relatively healthy older person as well as those with physical frailty.
Abstract: Regular physical activity helps to improve physical and mental functions as well as reverse some effects of chronic disease to keep older people mobile and independent. Despite the highly publicised benefits of physical activity, the overwhelming majority of older people in the United Kingdom do not meet the minimum physical activity levels needed to maintain health. The sedentary lifestyles that predominate in older age results in premature onset of ill health, disease and frailty. Local authorities have a responsibility to promote physical activity amongst older people, but knowing how to stimulate regular activity at the population-level is challenging. The physiological rationale for physical activity, risks of adverse events, societal and psychological factors are discussed with a view to inform public health initiatives for the relatively healthy older person as well as those with physical frailty. The evidence shows that regular physical activity is safe for healthy and for frail older people and the risks of developing major cardiovascular and metabolic diseases, obesity, falls, cognitive impairments, osteoporosis and muscular weakness are decreased by regularly completing activities ranging from low intensity walking through to more vigorous sports and resistance exercises. Yet, participation in physical activities remains low amongst older adults, particularly those living in less affluent areas. Older people may be encouraged to increase their activities if influenced by clinicians, family or friends, keeping costs low and enjoyment high, facilitating group-based activities and raising self-efficacy for exercise.

Journal ArticleDOI
TL;DR: Expanded population-based surveillance of violence against children is essential to target prevention and drive the urgent investment in action endorsed in the United Nations 2030 Sustainable Development Agenda.
Abstract: CONTEXT: Evidence confirms associations between childhood violence and major causes of mortality in adulthood. A synthesis of data on past-year prevalence of violence against children will help advance the United Nations’ call to end all violence against children. OBJECTIVES: Investigators systematically reviewed population-based surveys on the prevalence of past-year violence against children and synthesized the best available evidence to generate minimum regional and global estimates. DATA SOURCES: We searched Medline, PubMed, Global Health, NBASE, CINAHL, and the World Wide Web for reports of representative surveys estimating prevalences of violence against children. STUDY SELECTION: Two investigators independently assessed surveys against inclusion criteria and rated those included on indicators of quality. DATA EXTRACTION: Investigators extracted data on past-year prevalences of violent victimization by country, age group, and type (physical, sexual, emotional, or multiple types). We used a triangulation approach which synthesized data to generate minimum regional prevalences, derived from population-weighted averages of the country-specific prevalences. RESULTS: Thirty-eight reports provided quality data for 96 countries on past-year prevalences of violence against children. Base case estimates showed a minimum of 50% or more of children in Asia, Africa, and Northern America experienced past-year violence, and that globally over half of all children—1 billion children, ages 2–17 years—experienced such violence. LIMITATIONS: Due to variations in timing and types of violence reported, triangulation could only be used to generate minimum prevalence estimates. CONCLUSIONS: Expanded population-based surveillance of violence against children is essential to target prevention and drive the urgent investment in action endorsed in the United Nations 2030 Sustainable Development Agenda.

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TL;DR: This work suggests that none of these hundreds of studies – either individually or collectively – provides compelling evidence for true top-down effects on perception, or “cognitive penetrability,” and suggests that these studies all fall prey to only a handful of pitfalls.
Abstract: What determines what we see? In contrast to the traditional "modular" understanding of perception, according to which visual processing is encapsulated from higher-level cognition, a tidal wave of recent research alleges that states such as beliefs, desires, emotions, motivations, intentions, and linguistic representations exert direct top-down influences on what we see. There is a growing consensus that such effects are ubiquitous, and that the distinction between perception and cognition may itself be unsustainable. We argue otherwise: none of these hundreds of studies - either individually or collectively - provide compelling evidence for true top-down effects on perception, or "cognitive penetrability". In particular, and despite their variety, we suggest that these studies all fall prey to only a handful of pitfalls. And whereas abstract theoretical challenges have failed to resolve this debate in the past, our presentation of these pitfalls is empirically anchored: in each case, we show not only how certain studies could be susceptible to the pitfall (in principle), but how several alleged top-down effects actually are explained by the pitfall (in practice). Moreover, these pitfalls are perfectly general, with each applying to dozens of other top-down effects. We conclude by extracting the lessons provided by these pitfalls into a checklist that future work could use to convincingly demonstrate top-down effects on visual perception. The discovery of substantive top-down effects of cognition on perception would revolutionize our understanding of how the mind is organized; but without addressing these pitfalls, no such empirical report will license such exciting conclusions. Language: en

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TL;DR: The past, present, and anticipated burden of disease in young people aged 10-24 years from 1990 to 2013 is reported using data on mortality, disability, injuries, and health risk factors.

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TL;DR: The results show that crash causation has shifted dramatically in recent years, with driver-related factors present in almost 90% of crashes, and definitively show that distraction is detrimental to driver safety, with handheld electronic devices having high use rates and risk.
Abstract: The accurate evaluation of crash causal factors can provide fundamental information for effective transportation policy, vehicle design, and driver education. Naturalistic driving (ND) data collected with multiple onboard video cameras and sensors provide a unique opportunity to evaluate risk factors during the seconds leading up to a crash. This paper uses a National Academy of Sciences-sponsored ND dataset comprising 905 injurious and property damage crash events, the magnitude of which allows the first direct analysis (to our knowledge) of causal factors using crashes only. The results show that crash causation has shifted dramatically in recent years, with driver-related factors (i.e., error, impairment, fatigue, and distraction) present in almost 90% of crashes. The results also definitively show that distraction is detrimental to driver safety, with handheld electronic devices having high use rates and risk.

Journal ArticleDOI
09 Sep 2016-Science
TL;DR: It is pointed out that society may also benefit from attending to ongoing impacts of climate in the present, because current climatic conditions impose economic and social burdens on populations today that rival in magnitude the projected end-of-century impacts ofClimate change.
Abstract: For centuries, thinkers have considered whether and how climatic conditions-such as temperature, rainfall, and violent storms-influence the nature of societies and the performance of economies. A multidisciplinary renaissance of quantitative empirical research is illuminating important linkages in the coupled climate-human system. We highlight key methodological innovations and results describing effects of climate on health, economics, conflict, migration, and demographics. Because of persistent "adaptation gaps," current climate conditions continue to play a substantial role in shaping modern society, and future climate changes will likely have additional impact. For example, we compute that temperature depresses current U.S. maize yields by ~48%, warming since 1980 elevated conflict risk in Africa by ~11%, and future warming may slow global economic growth rates by ~0.28 percentage points per year. In general, we estimate that the economic and social burden of current climates tends to be comparable in magnitude to the additional projected impact caused by future anthropogenic climate changes. Overall, findings from this literature point to climate as an important influence on the historical evolution of the global economy, they should inform how we respond to modern climatic conditions, and they can guide how we predict the consequences of future climate changes.

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TL;DR: This technical report reviews the literature regarding opportunities and risks of digital and social media for children from birth to adulthood, and recommends an appropriate balance between screen time/online time and other activities.
Abstract: Today's children and adolescents are immersed in both traditional and new forms of digital media. Research on traditional media, such as television, has identified health concerns and negative outcomes that correlate with the duration and content of viewing. Over the past decade, the use of digital media, including interactive and social media, has grown, and research evidence suggests that these newer media offer both benefits and risks to the health of children and teenagers. Evidence-based benefits identified from the use of digital and social media include early learning, exposure to new ideas and knowledge, increased opportunities for social contact and support, and new opportunities to access health promotion messages and information. Risks of such media include negative health effects on sleep, attention, and learning; a higher incidence of obesity and depression; exposure to inaccurate, inappropriate, or unsafe content and contacts; and compromised privacy and confidentiality. This technical report reviews the literature regarding these opportunities and risks, framed around clinical questions, for children from birth to adulthood. To promote health and wellness in children and adolescents, it is important to maintain adequate physical activity, healthy nutrition, good sleep hygiene, and a nurturing social environment. A healthy Family Media Use Plan (www.healthychildren.org/MediaUsePlan) that is individualized for a specific child, teenager, or family can identify an appropriate balance between screen time/online time and other activities, set boundaries for accessing content, guide displays of personal information, encourage age-appropriate critical thinking and digital literacy, and support open family communication and implementation of consistent rules about media use.

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TL;DR: Preliminary neuropathological criteria were used by 7 neuropathologists to blindly evaluate 25 cases of various tauopathies, including CTE, Alzheimer’s disease, progressive supranuclear palsy, argyrophilic grain disease, corticobasal degeneration, primary age-related tauopathy, and parkinsonism dementia complex of Guam to pave the way towards future clinical and mechanistic studies.
Abstract: Chronic traumatic encephalopathy (CTE) is a neurodegeneration characterized by the abnormal accumulation of hyperphosphorylated tau protein within the brain. Like many other neurodegenerative conditions, at present, CTE can only be definitively diagnosed by post-mortem examination of brain tissue. As the first part of a series of consensus panels funded by the NINDS/NIBIB to define the neuropathological criteria for CTE, preliminary neuropathological criteria were used by 7 neuropathologists to blindly evaluate 25 cases of various tauopathies, including CTE, Alzheimer’s disease, progressive supranuclear palsy, argyrophilic grain disease, corticobasal degeneration, primary age-related tauopathy, and parkinsonism dementia complex of Guam. The results demonstrated that there was good agreement among the neuropathologists who reviewed the cases (Cohen’s kappa, 0.67) and even better agreement between reviewers and the diagnosis of CTE (Cohen’s kappa, 0.78). Based on these results, the panel defined the pathognomonic lesion of CTE as an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern. The group also defined supportive but non-specific p-tau-immunoreactive features of CTE as: pretangles and NFTs affecting superficial layers (layers II–III) of cerebral cortex; pretangles, NFTs or extracellular tangles in CA2 and pretangles and proximal dendritic swellings in CA4 of the hippocampus; neuronal and astrocytic aggregates in subcortical nuclei; thorn-shaped astrocytes at the glial limitans of the subpial and periventricular regions; and large grain-like and dot-like structures. Supportive non-p-tau pathologies include TDP-43 immunoreactive neuronal cytoplasmic inclusions and dot-like structures in the hippocampus, anteromedial temporal cortex and amygdala. The panel also recommended a minimum blocking and staining scheme for pathological evaluation and made recommendations for future study. This study provides the first step towards the development of validated neuropathological criteria for CTE and will pave the way towards future clinical and mechanistic studies.

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TL;DR: A theoretical framework is suggested that focuses on the overarching role of oxytocin in regulating the salience of social cues through its interaction with the dopaminergic system and is dependent on baseline individual differences such as gender, personality traits, and degree of psychopathology.

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17 Feb 2016-PLOS ONE
TL;DR: A statistical model is developed that quantifies the effect of the majority illusion and shows that the illusion is exacerbated in networks with a heterogeneous degree distribution and disassortative structure.
Abstract: Individual’s decisions, from what product to buy to whether to engage in risky behavior, often depend on the choices, behaviors, or states of other people. People, however, rarely have global knowledge of the states of others, but must estimate them from the local observations of their social contacts. Network structure can significantly distort individual’s local observations. Under some conditions, a state that is globally rare in a network may be dramatically over-represented in the local neighborhoods of many individuals. This effect, which we call the “majority illusion,” leads individuals to systematically overestimate the prevalence of that state, which may accelerate the spread of social contagions. We develop a statistical model that quantifies this effect and validate it with measurements in synthetic and real-world networks. We show that the illusion is exacerbated in networks with a heterogeneous degree distribution and disassortative structure.

Journal Article
TL;DR: Suicide rates increased from 1999 through 2014 for both males and females and for all ages 10-74, and the percent increase in suicide rates for females was greatest for those aged 10-14, and for males, those aged 45-64.
Abstract: Suicide is increasing against the backdrop of generally declining mortality, and is currently one of the 10 leading causes of death overall and within each age group 10-64 (4). This report highlights increases in suicide mortality from 1999 through 2014 and shows that while the rate increased almost steadily over the period, the average annual percent increase was greater for the second half of this period (2006-2014) than for the first half (1999-2006). Increases in suicide rates occurred for both males and females in all but the oldest age group (75 and over). Percent increases in rates were greatest for females aged 10-14 and for males, those aged 45-64. The male-female disparity in suicide rates (as measured by rate ratios) narrowed slightly over the period. Poisoning was the most common suicide method for females in 2014, and firearms were the most frequent for males, but both sexes showed increases since 1999 in the percentage of suicides attributable to suffocation. Suicide numbers and rates for females and males by Hispanic origin and race for 1999 and 2014 are also available. Data sources and methods Mortality and population data are from the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics 1999-2014 multiple cause-of-death mortality files (6). Suicide deaths are those classified with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) underlying cause-of-death codes U03, X60-X84, and Y87.0 (7). Suicide deaths are categorized by method of injury using the following ICD-10 codes: firearm (X72-X74), suffocation (X70), poisoning (X60-X69), and other methods (U03, X71, X75-X84, and Y87.0). Age-adjusted death rates were calculated using the direct method and the 2000 standard population (8). Demographic information comes from death certificates. Population data for 2000 and 2010 are April 1 bridged-race census counts, and for 1999, 2001-2009, and 2011-2014 are July 1 bridged-race estimates from the vintage 2014 postcensal series. Trends in age-adjusted death rates were evaluated using the Joinpoint Regression Program (9). Suicide rates by age group were analyzed by comparing 1999 and 2014 only; trends during this time period were not analyzed and may have varied by subgroup. The small number of suicides during 1999-2014 for persons aged 5-9 years (79) were included in the total age-adjusted rates and in the percentages by method. Male-female differences in suicide rates were based on rate ratios calculated as male age-adjusted rate divided by female age-adjusted rate. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. Language: en

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TL;DR: Medically treated falls among older adults, especially among older women, are associated with substantial economic costs, and implementing evidence-based interventions for fall prevention is essential to decrease the incidence and healthcare costs associated with these injuries.