scholarly journals “Placebo Tests” for the Impacts of Air Pollution on Health: The Challenge of Limited Health Care Infrastructure

2021 ◽  
Vol 111 ◽  
pp. 371-375
Author(s):  
Bruna Guidetti ◽  
Paula Pereda ◽  
Edson Severnini
Keyword(s):  
Health Care ◽  
Air Pollution ◽  
Public Hospitals ◽  
Health Care Demand ◽  
Hospital Capacity ◽  
Pediatric Hospitalization ◽  
Health Care Infrastructure ◽  
Limited Health ◽  
Pollution Impacts ◽  
Pollution Exposure

"Placebo tests" are normally used to support evidence of pollution impacts on health outcomes. In this study, we argue that one should be cautious to proceed with falsification tests. We examine how a large metropolitan area in Brazil copes with increased health-care demand due to high air pollution under hospital capacity constraints. Using wind as an instrument, we find that the pollution exposure increases pediatric hospitalization for respiratory diseases while the number of planned procedures decreases in public hospitals. On average, for every four additional pollution-related admissions, one elective care procedure is displaced. Urgent procedures are not displaced.

scholarly journals Health Care Needs and Services for Elder and Disabled Population: Findings from a Barcelona Study

2020 ◽  
Vol 17 (21) ◽  
pp. 8071
Author(s):  
Jessica Rodriguez-Pereira ◽  
Jesica de Armas ◽  
Lorenzo Garbujo ◽  
Helena Ramalhinho
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Modern Society ◽  
Health Care Needs ◽  
Health Care Demand ◽  
Care Needs ◽  
Care Services ◽  
Health Care Infrastructure ◽  
The Relationship ◽  
Population Segment

Health care is a pillar of modern society. This study focuses on the use of descriptive analytics to provide demographic and territorial insights that will be of strategic importance in planning subsequent projects meant to improve health care services. We especially focus on the assessment of the elder and disabled population health care needs in Barcelona, and evaluate to what extent the current health care infrastructure is successful in covering the demand of these fragile population segment. This work is developed around three main assessments in the municipality of Barcelona: the elder and disabled health care demand, the available health care services, and the relationship between demand and services, showing that territorial and demographic aspects are relevant in assessing the health needs of the population.

scholarly journals Differential Effect of Ambient Air Pollution Exposure on Risk of Gestational Hypertension and Preeclampsia

Hypertension ◽  
2019 ◽  
Vol 74 (2) ◽  
pp. 384-390 ◽  
Author(s):  
Carrie J. Nobles ◽  
Andrew Williams ◽  
Marion Ouidir ◽  
Seth Sherman ◽  
Pauline Mendola
Keyword(s):  
Air Pollution ◽  
Differential Effect ◽  
Gestational Hypertension ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Air Pollution Exposure ◽  
Pollution Exposure

scholarly journals Maternal immune response and air pollution exposure during pregnancy: insights from the Early Markers for Autism (EMA) study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Heather E. Volk ◽  
Bo Park ◽  
Calliope Hollingue ◽  
Karen L. Jones ◽  
Paul Ashwood ◽  
...  
Keyword(s):  
Air Pollution ◽  
Intellectual Disability ◽  
Prenatal Screening ◽  
Maternal Serum ◽  
Serum Samples ◽  
Maternal Immune Activation ◽  
Early Markers ◽  
Air Pollution Exposure ◽  
Pollution Exposure ◽  
The Relationship

Abstract Background Perinatal exposure to air pollution and immune system dysregulation are two factors consistently associated with autism spectrum disorders (ASD) and other neurodevelopmental outcomes. However, little is known about how air pollution may influence maternal immune function during pregnancy. Objectives To assess the relationship between mid-gestational circulating levels of maternal cytokines/chemokines and previous month air pollution exposure across neurodevelopmental groups, and to assess whether cytokines/chemokines mediate the relationship between air pollution exposures and risk of ASD and/or intellectual disability (ID) in the Early Markers for Autism (EMA) study. Methods EMA is a population-based, nested case–control study which linked archived maternal serum samples collected during weeks 15–19 of gestation for routine prenatal screening, birth records, and Department of Developmental Services (DDS) records. Children receiving DDS services for ASD without intellectual disability (ASD without ID; n = 199), ASD with ID (ASD with ID; n = 180), ID without ASD (ID; n = 164), and children from the general population (GP; n = 414) with no DDS services were included in this analysis. Serum samples were quantified for 22 cytokines/chemokines using Luminex multiplex analysis technology. Air pollution exposure for the month prior to maternal serum collection was assigned based on the Environmental Protection Agency’s Air Quality System data using the maternal residential address reported during the prenatal screening visit. Results Previous month air pollution exposure and mid-gestational maternal cytokine and chemokine levels were significantly correlated, though weak in magnitude (ranging from − 0.16 to 0.13). Ten pairs of mid-pregnancy immune markers and previous month air pollutants were significantly associated within one of the child neurodevelopmental groups, adjusted for covariates (p < 0.001). Mid-pregnancy air pollution was not associated with any neurodevelopmental outcome. IL-6 remained associated with ASD with ID even after adjusting for air pollution exposure. Conclusion This study suggests that maternal immune activation is associated with risk for neurodevelopmental disorders. Furthermore, that prenatal air pollution exposure is associated with small, but perhaps biologically relevant, effects on maternal immune system function during pregnancy. Additional studies are needed to better evaluate how prenatal exposure to air pollution affects the trajectory of maternal immune activation during pregnancy, if windows of heightened susceptibility can be identified, and how these factors influence neurodevelopment of the offspring.

scholarly journals Implementing an Integrated Large-Scale Clinical Information System for ISSSTE’s Hospital Network in Mexico

2021 ◽  
Vol 3 (2) ◽  
pp. 444-453
Author(s):  
Arturo Cervantes Trejo ◽  
Sophie Domenge Treuille ◽  
Isaac Castañeda Alcántara
Keyword(s):  
Health Care ◽  
Information System ◽  
Health Care Services ◽  
Large Scale ◽  
Clinical Information System ◽  
Clinical Information ◽  
Public Hospitals ◽  
Care Services ◽  
Cost Reductions

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.

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