Climate Change Adaptation Case Study: Benefit-Cost Analysis of Coastal Flooding Hazard Mitigation

The damage Hurricane Sandy caused had far-reaching repercussions up and down the East Coast of the United States. Vast coastal flooding accompanied the storm, inundating homes, businesses, and utility and emergency facilities. Since the storm, projects to mitigate similar future floods have been scrutinized. Such projects not only need to keep out floodwaters but also be designed to withstand the effect that climate change might have on rising sea levels and increased flood risk. In this study, we develop an economic model to assess the costs and benefits of a berm (sea wall) to mitigate the effects of flooding from a large storm. We account for the lifecycle costs of the project, which include those for the upfront construction of the berm, ongoing maintenance, land acquisition, and wetland and recreation zone construction. Benefits of the project include avoided fatalities, avoided residential and commercial damages, avoided utility and municipal damages, recreational and health benefits, avoided debris removal expenses, and avoided loss of function of key transportation and commercial infrastructure located in the area. Our estimate of the beneficial effects of the berm includes ecosystem services from wetlands and health benefits to the surrounding community from a park and nature system constructed along the berm. To account for the effects of climate change and verify that the project will maintain its effectiveness over the long term, we allow the risk of flooding to increase over time. Over our 50-year time horizon, we double the risk of 100- and 500-year flood events to account for the effects of sea level rise on coastal flooding. Based on the economic analysis, the project is highly cost beneficial over its 50-year timeframe. This analysis demonstrates that climate change adaptation investments can be cost beneficial even though they mitigate the impacts of low-probability, high-consequence events.

Citrus as a component of the Mediterranean Diet

Citrus are native to southeastern Asia, but are present in the Mediterranean basin for centuries. This group of species has reached great importance in some of the Mediterranean countries and, in the case of orange, mandarin and lemon trees, they found here soil and climatic conditions which allows them to achieve a high level of fruit quality, even better than in the regions where they came from. Citrus fruits are present in the diet of the peoples living on the Mediterranean basin, at least since the time of the Roman Empire. In the 20th century they became the main crop in various agricultural areas of the Mediterranean, playing an important role in the landscape, in the diet of the overall population, and also in international trade. They are present in the gardens of palaces and monasteries, but also in the courtyards and orchards of the poorest families. Their fruits are not only a refreshing dessert, but also a condiment, or even a major component of many dishes. Citrus fruits have well-documented nutritional and health benefits. They can actually help prevent and cure some diseases and, above all, they are essential in a balanced and tasty diet.

Handgrip strength cut-off for cardiometabolic risk index among Colombian children and adolescents : the FUPRECOL study

Abstract Objective: Evidence shows an association between muscular strength (MS) and health among youth, however low muscular strength cut-points for the detection of high metabolic risk in Latin-American populations are scarce. The aim of this study was two-fold: to explore potential age- and sex-specific thresholds of MS, for optimal cardiometabolic risk categorization among Colombian children and adolescents; and to investigate if cardiometabolic risk differed by MS group by applying the receiver operating characteristic curve (ROC) cut point. Methods: This is a secondary analysis of a cross-sectional study (the FUPRECOL study), published elsewhere. The FUPRECOL study assessments were conducted during the 2014– 2015 school year. MS was estimated by a handle dynamometer on 1,950 children and adolescents from Colombia, using the MS relative to weight (handgrip strength/body mass). A metabolic risk score was computed from the following components: waist circumference, triglycerides, HDL-c, glucose, systolic and diastolic blood pressure. ROC analysis showed a significant discriminatory accuracy of MS in identifying the low/high metabolic risk in children and adolescents and both gender. Results: In children, handgrip strength/body mass level for a low metabolic risk were 0.359 and 0.376 in girls and boys, respectively. In adolescents, these points were 0.440 and 0.447 in girls and boys, respectively. Conclusion: In conclusion, the results suggest a hypothetical MS level relative to weight for having a low metabolic risk, which could be used to identify youths at risk.

Methodology of Care Humanitude in Promoting Self-care in Dependent People: An Integrative Review

Abstract. The aging of the population has led to an increase in the prevalence of chronic degenerative diseases and dependence. We need to implement humanized health care that will improve the quality of life and well-being of these people and help maintain their autonomy and self-care. Objective: To identify the implications of the caring in Humanitude in promoting self-care in the dependent person. Methods: Integrative review of the literature of the period between 2007 and 2015, using the databases Medline, EBSCO and Google Scholar. In using the PI[C]OD methodology and criteria for inclusion and exclusion, we obtained 54 items where 7 were selected for analysis. Results: There are several health benefits in the promotion of self-care, by ap-plying the Humanitude caring philosophy, mainly regarding the relationship be-tween the nurse and the patient. Conclusions: It is essential to develop further studies focused on the implications of caring in Humanitude in self-care in the dependent person.

Natural variation in expression of genes associated with carotenoid biosynthesis and accumulation in cassava (Manihot esculenta Crantz) storage root.

ABSTRACT: BACKGROUND: Cassava (Manihot esculenta Crantz) storage root provides a staple food source for millions of people worldwide. Increasing the carotenoid content in storage root of cassava could provide improved nutritional and health benefits. Because carotenoid accumulation has been associated with storage root color, this study characterized carotenoid profiles, and abundance of key transcripts associated with carotenoid biosynthesis, from 23 landraces of cassava storage root ranging in color from white-to-yellow-to-pink. This study provides important information to plant breeding programs aimed at improving cassava storage root nutritional quality. RESULTS: Among the 23 landraces, five carotenoid types were detected in storage root with white color, while carotenoid types ranged from 1 to 21 in storage root with pink and yellow color. The majority of storage root in these landraces ranged in color from pale-to-intense yellow. In this color group, total ß-carotene, containing all-E-, 9-Z-, and 13-Z-ß-carotene isomers, was the major carotenoid type detected, varying from 26.13 to 76.72 %. Although no ?-carotene was observed, variable amounts of a ?-ring derived xanthophyll, lutein, was detected; with greater accumulation of ?-ring xanthophylls than of ß-ring xanthophyll. Lycopene was detected in a landrace (Cas51) with pink color storage root, but it was not detected in storage root with yellow color. Based on microarray and qRT-PCR analyses, abundance of transcripts coding for enzymes involved in carotenoid biosynthesis were consistent with carotenoid composition determined by contrasting HPLC-Diode Array profiles from storage root of landraces IAC12, Cas64, and Cas51. Abundance of transcripts encoding for proteins regulating plastid division were also consistent with the observed differences in total ß-carotene accumulation. CONCLUSIONS: Among the 23 cassava landraces with varying storage root color and diverse carotenoid types and profiles, landrace Cas51 (pink color storage root) had low LYCb transcript abundance, whereas landrace Cas64 (intense yellow storage root) had decreased HYb transcript abundance. These results may explain the increased amounts of lycopene and total ß-carotene observed in landraces Cas51 and Cas64, respectively. Overall, total carotenoid content in cassava storage root of color class representatives were associated with spatial patterns of secondary growth, color, and abundance of transcripts linked to plastid division. Finally, a partial carotenoid biosynthesis pathway is proposed.

Qualidade da carne de ovinos puros e cruzados criados no Semiárido Nordestino brasileiro.

Resumo: A procura por carne de qualidade tem proporcionado ao setor de ovinocultura a adoção por técnicas de produção que possam contribuir para disponibilizar ao mercado produtos que atendam as necessidades dos consumidores, que se tornam cada vez mais exigentes quanto à aquisição de produtos que possam trazer benefícios a saúde. Assim, objetivou-se determinar a qualidade da carne de ovinos puros e cruzados criados no semiárido Nordestino. Utilizaram-se 30 cordeiros machos e fêmeas, oriundos dos cruzamentos Morada Nova x Morada Nova, Rabo Largo x Morada Nova e Santa Inês x Morada Nova, alojados em baias e alimentados com dieta a base de capim Canarana, milho farelo de soja e calcário. Os animais foram abatidos com peso médio de 24 kg de peso vivo e as carcaças mantidas em câmara frigorífica a 4?C, por 24 horas. Após esse período, foi seccionado o músculo Longissimus dorsi que foi embalado, identificado e armazenado a 20?C. Foram determinados os atributos físicos de capacidade de retenção de água, perda de peso por cocção e força de cisalhamento; os atributos químicos como umidade, proteína, cinza, lipídios e colesterol; avaliações subjetivas da carcaça como cor, marmoreio, textura da carne, distribuição da gordura, espessura da gordura e área de olho de lombo; os sensoriais de dureza, suculência, sabor, aroma e aceitação global e o perfil de ácidos graxos. O delineamento utilizado foi em esquema fatorial 3x2 (três grupos genéticos e dois sexos) e as médias comparadas pelo teste de Duncan a 5%. Não houve diferença (p>0,05) entre os genótipos para a composição química da carne, exceto para a variável lipídio (p<0,05). Para as características subjetivas da carcaça o genótipo influenciou (p<0,05) nas variáveis cor, marmoreio e textura da carne. O genótipo promoveu efeito (p<0,05) para as características físicas de capacidade de retenção de água e perda de peso por cocção. Os atributos sensoriais não sofreram efeitos (p>0,05) dos genótipos avaliados. Os genótipos influenciaram (p<0,05) as concentrações dos ácidos graxos saturados, monoinsaturados e poli-insaturados assim como, nas relações ?3:?6 e AGM:AGS. O fator sexo influenciou (p<0,05) nas variáveis umidade, força de cisalhamento, dureza, ácidos graxos desejáveis e relação ?3:?6. O cruzamento entre raças nativas mostrou-se com potencial para a produção de carne de qualidade, a raça Morada Nova melhorou os atributos físico-químicos da carne e em seu perfil lipídico e, o fator sexo melhorou o atributo maciez dando destaque a carne das fêmeas. Abstract: The demand for quality meat products has given the sheep industry sector productions techniques that can contribute providing the market with products that supply the needs of consumers require, who are becoming more demanding as the acquisition of differentiated and bring health benefits. The objective was to evaluate the quality of the pure sheep meat and cross bred in the semiarid Northeast of Brazil. It was used 30 male lambs and female, that came from crosses Morada Nova x Morada Nova, Rabo Largo x Morada Nova and Santa Ines x Morada Nova, housed in pens and fed a diet of grass Canarana, corn soybean meal and limestone. The animals were slaughtered at average weight of 24 kg, live weight, and carcasses kept in refrigeration chamber at 4 ° C for 24 hours. After this period the Longissimus dorsi muscle was selected, packaged, labeled and stored at 20˚C. The physical attributes were determined such as water holding capacity, cooking weight loss and shear force; the chemical attributes such as moisture, protein, ash, lipids and cholesterol; Subjective evaluations such as color, marbling, meat texture, fat distribution, fat thickness and loin eye area; the hardness sensory, juiciness, flavor, aroma and global acceptance and fatty acid profile. The design was a 3x2 factorial arrangement (three genetic groups and two genders) and the measures compared by Duncan test at 5%. There was no difference (p> 0.05) between genotypes for the chemical composition of meat, except for the lipid variable (p <0.05). To the subjective characteristics of the carcass, the genotype influenced (p <0.05) in the variables color, marbling and meat texture. The genotype promoted significant effect (p <0.05) for the physical characteristics, water retention capacity and weight loss on cooking. The sensory attributes did not suffer significant effects (p> 0.05) of the evaluated genotypes. The genotypes influenced (p <0.05) in the concentrations of saturated fatty acids, monounsaturated and polyunsaturated as well as in the relations ω3: ω6 and AGM:AGS. The gender factor influenced (P <0.05) in the variables moisture, shear strength, hardness, desirable fatty acids and relation ω3: ω6. The cross between native breeds showed up with potential for quality meat production, the Morada Nova improved the physical and chemical attributes of the flesh and in their lipid profiles and sex factor improved softness attribute highlighting the meat of females.

Exercise for health : a breast cancer recovery program - quality of life benefits [Conference Abstract]

Introduction: Five-year survival from breast cancer in Australia is 87%. Hence, ensuring a good quality of life (QOL) has become a focal point of cancer research and clinical interest. Exercise during and after treatment has been identified as a potential strategy to optimise QOL of women diagnosed with breast cancer.----- Methods: Exercise for Health is a randomised controlled trial of an eight-month, exercise intervention delivered by Exercise Physiologists. An objective of this study was to assess the impact of the exercise program during and following treatment on QOL. Queensland women diagnosed with unilateral breast cancer in 2006/07 were eligible to participate. Those living in urban-Brisbane (n=194) were allocated to either the face-to-face exercise group, the telephone exercise group, or the usual-care group, and those living in rural Queensland (n=143) were allocated to the telephone exercise group or the usual-care group. QOL, as assessed by the Functional Assessment of Cancer Therapy-Breast (FACT-B+4) questionnaire, was measured at 4-6 weeks (pre-intervention), 6 months (mid-intervention) and 12 months (three months post-intervention) post-surgery.----- Results: Significant (P<0.01) increases in QOL were observed between pre-intervention and three months post-intervention 12 months post-surgery for all women. Women in the exercise groups experienced greater mean positive changes in QOL during this time (+10 points) compared with the usual-care groups (+5 to +7 points) after adjusting for baseline QOL. Although all groups experienced an overall increase in QOL, approximately 20% of urban and rural women in the usual-care groups reported a decline in QOL, compared with 10% of women in the exercise groups.----- Conclusions: This work highlights the potential importance of participating in physical activity to optimise QOL following a diagnosis of breast cancer. Results suggest that the telephone may be an effective medium for delivering exercise counselling to newly diagnosed breast cancer patients.

The benefits and challenges of conducting an overview of systematic reviews in public health: a focus on physical activity

Introduction The ultimate aim of Cochrane systematic reviews is to inform policy and practice decisions for better health outcomes. However, due to the increasing numbers of scientific publications, wading through the available evidence of both individual studies and systematic reviews can be challenging and overwhelming even for avid authors and readers. This paper briefly describes the first overview (a systematic review of reviews) of the Cochrane Public Health Group (CPHG) in development and proposes a way forward for the methodologies under consideration.

Health and medicinal benefits of persimmon fruit: A review

The anti-oxidant activity of persimmon fruit appears to be mainly due to its high-molecular-weight tannin content. Antioxidant activity is variety specific with some astringent varieties showing very high antioxidant activity, comparable to strawberry and blueberry. In vitro, and limited animal studies, have shown that condensed tannins in the fruit may reduce the risk of cardiovascular disease, hypertension, diabetes and a wide range of cancers. Persimmon has an unusual property in that it appears to alter and reduce the rate of alcohol absorption and metabolism and thus ameliorate the symptoms of a hangover. The health and medicinal benefits of persimmon are considerable and should be further researched and promoted by persimmon industries around the world.

The health professional behind the syringe: Benefits of a pharmacist vaccination program

Background: The Queensland Pharmacist Immunisation Pilot (QPIP) which ran in 2014 was Australia’s first to allow pharmacists to administer vaccinations. An aim of QPIP was to investigate the benefits of trained pharmacists administering vaccinations in a community pharmacy setting. Methods: Participant demographics and previous influenza vaccination experiences were recorded using GuildCare software. Participants also completed a ‘post-vaccination satisfaction survey’ following their influenza vaccination. Results: A total of 10,889 participant records and 8,737 satisfaction surveys were analysed. Overall, 1.9% of the participants reported living with a chronic illness, and 22.5% were taking concomitant medications. As part of the consultation before receiving the vaccine, participants acknowledged the opportunity to discuss other aspects of their health with the pharmacist, including concerns about their general health, allergies, and other medications they were taking. It was worth noting that 17.5% of people would not have received an influenza vaccination if the QPIP service was unavailable. Additionally, approximately 10% of all participants were eligible to receive a free vaccination from the National Immunisation Program, but still opted to receive their vaccine from a pharmacist. Conclusion: The findings from this pilot demonstrate the benefit of a pharmacist vaccination program in increasing vaccination rates, and have helped pave the way for expanding the scope of practice for pharmacists.

Women’s Wellness after Cancer Program Study (WWACP)– A multi centre randomised controlled trial examining the benefits and cost effectiveness of an Evidenced Based, e-health intervention

Background Advances in cancer diagnosis and treatment have significantly improved survival rates, through their subsequent health needs are often not adequately addressed by current health services. National Health and Medical Research Council (NHMRC) Partnerships Project awarded a national collaborative project to develop, trial and evaluate clinical benefits and cost effectiveness of an e-health enabled structured health promotion intervention - The Women’s Wellness after Cancer Program (WWACP). The aim of this e-health enabled multimodal intervention is to improve health related quality of life in women previously treated for target cancers. Aim The WWACP is a 12-week web based, interactive, holistic program. Primary outcomes for this project are to promote a positive change in health-related quality of life (HRQoL) and reduction in Body Mass Index (BMI) in the women undertaking WWACP compared to women who receive usual care. Secondary outcomes include managing other side effects of cancer treatment through evidence-based nutrition and exercise practices, dealing with stress, sleep, menopause and sexuality issues. Methods The single-blinded multi-center randomized controlled trial recruited a toatl of 330 women within 24 months of completion of chemotherapy and /or radiotherapy. Women were randomly assigned to either a usual care or intervention group. Women provided with the intervention were provided with an interactive iBook and journal, web interface, and three virtual consultations by experienced cancer nurses. A variety of methods were utilized, to enable positive self- efficacy and lifestyle changes. These include online coaching with a registered nurse trained in the intervention, plus written educational and health promotional information. The program has been delivered through the e-health enabled interfaces, which enables virtual delivery via desktop and mobile computing devices. Importantly this enables accessibility for rural and regional women in Australia who are frequently geographically disadvantaged in terms of health care provision. Results Research focusing on alternative methods of delivering post treatment / or survivorship care in cancer utilizing web based interfaces is limited, but emerging evidence suggests that Internet interventions can increase psychological and physical wellbeing in cancer patients. The WWACP trial aims to establish the effectiveness of delivery of the program in terms of positive patient outcomes and cost effective, flexibility. The trial will be completed in September and results will be presented at the conference. Conclusions Women after acute hematological, breast and gynecological cancer treatments demonstrate good cancer survival rates and face residual health problems which are amenable to behavioral interventions. The conclusion of active treatment is a key 'teachable moment' in which sustainable positive lifestyle change can be achieved if patients receive education and psychological support which targets key treatment related health problems and known chronic disease risk factors.

The benefits of a health impact assessment in relation to fuel poverty: assessing Luton's affordable warmth strategy and the need for a national strategy

The links between fuel poverty and poor health are well documented, yet there is no statutory requirement on local authorities to develop fuel poverty strategies, which tend to be patchy nationally and differ substantially in quality. Fuel poverty starts from the perspective of income, even though interventions can improve health. The current public health agenda calls for more partnership-based, cost-effective strategies based on sound evidence. Fuel poverty represents a key area where there is currently little local evidence quantifying and qualifying health gain arising from strategic interventions. As a result, this initial study sought to apply the principles of a health impact assessment to Luton’s Affordable Warmth Strategy, exploring the potential to identify health impact arising – as a baseline for future research – in the context of the public health agenda. A national strategy would help ensure the promotion of targeted fuel poverty strategies.