Ethnicity, migration and health: A population-based study of 338 refugees from Latin America, 396 nonrefugee immigrants from Finland and 161 from southern Europe and 996 age-, sex- and education-matched controls from Sweden

This article shows the influence of being a refugee from Latin America or a nonrefugee immigrant from southern Europe or Finland on self-reported illness, controlling for social factors and lifestyle. The study population consisted of 338 Latin American refugees, a random sample of 396 Finnish and 161 southern European immigrants and 996 age-, sex- and education-matched Swedish controls. The data were analysed unmatched with logistic regression (multivariate analysis) in main effect models. The strongest independent risk indicator for long-term illness was being a Latin American refugee (estimated odds ratio (OR)=2.96, 95% confidence interval (CI)=2.19–3.82). There was a significant association between being a Latin American refugee and period prevalence, ill health and unsatisfied need for care. Being a southern European or Finnish immigrant was a risk indicator of ill health but was not associated with the other dependent factors. Not feeling secure in daily life was a strong risk indicator for long-term illness and ill health (estimated OR=1.89, 95% CI=1.26–2.76 and OR=3.04, 95% CI= 1.97–4.48) respectively). Being a Latin American refugee was equal in importance to traditional risk factors such as overweight and not taking regular exercise for long-term illness and ill health.     

对大学生课外体育锻炼中加强自我医务监督的思考

通过对大学生课外体育锻炼中运动性伤病产生原因的分析,提出了大学生应加强科学锻炼和自我医务监督的思考,以期达到指导大学生科学锻炼身体,减少运动性伤病的发生,有效增强体质,不断提高健康水平和学习效率的目的。     

Predictive Bayesian Microbial Dose-Response Assessment Based on Suggested Self-Organization in Primary Illness Response: Cryptosporidium parvum

The probability of illness caused by very low doses of pathogens cannot generally be tested due to the numbers of subjects that would be needed, though such assessments of illness dose response are needed to evaluate drinking water standards. A predictive Bayesian dose-response assessment method was proposed previously to assess the unconditional probability of illness from available information and avoid the inconsistencies of confidence-based approaches. However, the method uses knowledge of the conditional dose-response form, and this form is not well established for the illness endpoint. A conditional parametric dose-response function for gastroenteric illness is proposed here based on simple numerical models of self-organized host-pathogen systems and probabilistic arguments. In the models, illnesses terminate when the host evolves by processes of natural selection to a self-organized critical value of wellness. A generalized beta-Poisson illness dose-response form emerges for the population as a whole. Use of this form is demonstrated in a predictive Bayesian dose-response assessment for cryptosporidiosis. Results suggest that a maximum allowable dose of 5.0 x 10(-7) oocysts/exposure (e.g., 2.5 x 10(-7) oocysts/L water) would correspond with the original goals of the U.S. Environmental Protection Agency Surface Water Treatment Rule, considering only primary illnesses resulting from Poisson-distributed pathogen counts. This estimate should be revised to account for non-Poisson distributions of Cryptosporidium parvum in drinking water and total response, considering secondary illness propagation in the population.     

基因编辑的刑法规制 ——兼论非法植入基因编辑、克隆胚胎罪中的“情节严重”

CRISPR-Cas9基因编辑技术的主要特点在于操作简便、准确性高以及可遗传等,该技术在造福人类的同时也催生了基因编辑的风险。按照基因编辑的目的,可将基因编辑分为治疗型、预防型和增效型三种。增效型基因编辑以及将人类胚胎植入动物体内或将动物胚胎植入人体内的行为,严重违背医学伦理且造成人类毁灭危险,应属于刑法非法植入基因编辑、克隆胚胎罪中的情节严重。其他基因编辑行为也应视情况构成毁坏财物罪、侵犯公民个人信息罪、盗窃罪等。此外,为实现罪责刑相适应,需在相关行政法规中制定明确的技术标准,出现重伤或死亡结果时,根据行为人主观罪过视情况认定为非法植入基因编辑、克隆胚胎罪,故意伤害致人死亡或故意杀人罪。     

Socioeconomic Status and Mental Illness in Japan*

Abstract Since the pioneering work of Faris and Dunham (1938), a number of studies in the United States have documented an inverse association between socioeconomic status (SES) and mental illness both at the aggregate and the individual levels, and both for the treated and the general population. However, there are few studies of whether this relationship holds in other countries. This study examines socioeconomic characteristics and mental illness in Japan, which has a very different social stratification system from that of the United States. It was found that, at the aggregate level, the “inverse” association between socioeconomic characteristics and the rate of treated mental illness does not hold in Japan. Instead, the relationship is curvilinear: mental illness is higher in districts with large numbers of blue collar and upper white collar workers than in districts with large numbers of lower white collar workers. The effect of SES on mental illness operates through economic stress embedded in the macro social context. Because different social structures lead to different patterns of economic stress, the inverse relationship between socioeconomic status and mental health cannot be assumed to hold in all countries.     

Pharmacovigilance in Clinical Trials: Current Practice and Challenges

In view of the MENA increasing participation in multinational trials and the increasing number of national/regional trials, this article explores potential areas of pharmacovigilance, requiring reform and provides recommendations for building a robust safety reporting system. Regulatory silence on expedited reporting requirements creates confusion for local sites that are part of multinational trials. Not allowing waiver for serious adverse events that are protocol specified or are study endpoints, along with lack of emphasis on causality as reporting criteria, adds substantial burden of uninformative cases for regulatory review. Despite global focus on Development Safety Update Report, local regulators are not yet insistent on real-time update of a drug’s cumulative safety profile. Issues like reporting requirements for generic trials, pregnancy reporting and lenient timeline for death/life-threatening events need attention. Finally, the need to formulate an all-encompassing local pharmacovigilance guideline, in sync with global practice cannot be overemphasized.     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

Justice involvement among homeless individuals with mental illnesses: Are self-report and administrative measures comparable?

Individuals with mental illnesses who experience homelessness have frequent interactions with the criminal justice system. Correctly measuring this involvement is essential to develop and evaluate the efficacy of intervention programs. Criminal justice involvement is typically assessed through administrative records or self-reported accounts. The aims of this study are to: 1) assess agreement between self-report and administrative data related to court appearances, and 2) identify individual characteristics that affect discrepancies between sources. Participants were 468 homeless persons with mental illness from the Montreal site of the At Home/Chez Soi randomized controlled trial, in Canada. Self-reported data was collected through an interviewer-administered questionnaire. Administrative data was collected through provincial and municipal court databases. Overall, agreement was good. Discrepancies were more common among those with a diagnosis of mood disorder with psychotic features, and those with a criminal history. Increased age and interviewer’s perception of sincerity and interest increased likelihood of concordance. Generally, high agreement between self-report and administrative data suggests that either source can provide reliable information. Further work to understand predictors of discrepancies could further enhance the quality of data collected through these different sources.     

Schizotypal Personality Disorder: A Clinical Social Work Perspective

Schizotypal personality disorder (SPD) is considered to be a “schizophrenia spectrum disorder” as evidenced in part by its cross-listing in that chapter of the DSM-5. SPD is considered to be a condition with limited potential for positive change because one of its major features is the presence of a biologically based cognitive deficit. This assumption, however, is an example of the medical model’s creating a bias against psychosocial features that are always involved in character development. The social work profession’s bio-psycho-social perspectives focus more comprehensively on all features of the condition and promote a more optimistic view of clients’ change potentials. The purposes of this paper are to examine SPD from a social work perspective and to demonstrate, with a case example, how effective intervention can be organized and delivered.