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Thu Dec 9 03:57:02 EST 2010


Soup, Pasta, Baby Formula. In the most comprehensive U.S. tests for an
industrial chemical used to line cans of foods, an independent
laboratory found a compound linked to birth defects (animal models) in
more than half of the samples of canned fruit, vegetables, soda, and
baby formula from supermarket shelves, according to an Environmental
Working Group (EWG) report. The lab tests conducted for EWG found
bisphenol A, or BPA, in 55 of 97 cans of food purchased from major
supermarket chains in California, Connecticut and Georgia. The lab
tested 27 national name brands and three store brands. To learn more
about these tests and what foods may contain BPA go to
http://www.ewg.org/reports/bisphenola/newsrelease.php 

New from the National Institute on Drug Addiction: NIDA has published a
new report on addiction that they say will increased understanding of
the basics of addiction and will empower people to make informed choices
in their own lives, adopt science-based policies and programs that
reduce drug abuse and addiction in their communities, and support
scientific research that improves the Nation's well-being. To read the
report, go to http://www.nida.nih.gov/scienceofaddiction/ 

ARTICLES:
Ahnquist J et al. Is cumulative exposure to economic hardships more
hazardous to women*s health than men*s? A 16-year follow-up study of
the Swedish Survey of Living Conditions. Journal of Epidemiology and
Community Health 2007;61:331-336

These Swedish authors set out to study the cumulative effects of
economic hardships in regard to gender differences.   They followed up
on 1981 women and 1799 men over a period of 16 years (1981-1997), using
data from the Swedish Survey of Living Conditions panel study. The
temporal association between economic hardships and self-rated health,
psychological distress and musculoskeletal disorders was analyzed. 
The authors found a dose-response effect on women*s health with
increasing scores of cumulative exposure to financial stress but not
with low income. Women exposed to financial stress at both had an
increased risk of 1.4-1.6 for all health measures compared with those
who were not exposed. A similar consistent dose-response effect was not
observed among men. 
The authors conclude that there is a temporal relationship between
cumulative economic hardships and health outcomes, and health effects
differ by gender. Financial stress seems to be a stronger predictor of
poor health outcomes than low income, particularly among women. The
authors suggest that policies geared towards reducing health
inequalities should recognize that long-term exposure to economic
hardships damages health, and actions need to be taken with a gender
perspective. 
 	

Campbell-Lendrum D et al. Global climate change: implications for
international public health policy Bulletin of the World Health
Organization Volume 85: 2007  Volume 85, Number 3, March 2007, 161-244
The authors outline four key characteristics of the health risks
generated by a global warming and a more variable climate: 

1) These hazards are diverse, global and probably irreversible over
human time scales. They range from increased risks of extreme weather,
such as fatal heat waves, floods and storms, to less dramatic but
potentially more serious effects on infectious disease dynamics, shifts
to long-term drought conditions in many regions, melting of glaciers
that supply freshwater to large population centres, and sea level
increases leading to salination of sources of agriculture and drinking
water. Lack of potable drinking water may become a main issue for some
parts of the world.

2) The health impacts of climate change are potentially huge. Many of
the most important global killers are highly sensitive to climatic
conditions. Malaria, diarrhoea and protein-energy malnutrition together
cause more than 3 million deaths each year. These diseases may increase
as the climate rises.
3) These above risks are thought to be inequitable, in that the
greenhouse gases that cause climate change originate mainly from
developed countries, but the health risks are concentrated in the
poorest nations, which have contributed least to the problem. 

4) The authors say that many of the projected impacts on health are
still avoidable, through a combination of public health interventions in
the short term, support for adaptation measures in health-related
sectors such as agriculture and water management, and a long-term
strategy to reduce human impacts on climate.
Read the entire article free of charge at
http://www.who.int/bulletin/volumes/85/3/06-039503/en/index.html 


Hauenstein, E J and Peddada S. Prevalence of Major Depressive Episodes
in Rural Women Using Primary Care. Journal of Health Care for the Poor
and Underserved - Volume 18, Number 1, February 2007, pp. 185-202

The authors say that women carry a disproportionate burden of
depression in part because situational and other factors enhance their
risk. Rural women may be at particular risk because of poverty and lack
of treatment opportunities. The authors set out to investigate the rate
of current major depressive episodes (MDE) in impoverished rural women
seeking care in a community health center (CHC) in the rural South. They
screened 982 women for MDE during a routine primary care visit: about
half were positive for depressive symptoms. Of women positive at
screening, 194 were then assessed for psychiatric disorder. A current
MDE was observed in 14.3% of women screened for depression and 72.2% of
women assessed for psychiatric disorder. Recognizing that neither of
these percentages reflects the likely rate of MDE among the larger
population of rural impoverished women, the authors used probability
theory and binary logistic regression to estimate a depression rate that
could be applied as one factor associated with unmet need in this
population of women. They estimated that 44.3% of the population of
women using the CHC had MDE. The authors conclude that their findings
underscore the need for mental health services in rural primary care,
especially in facilities serving impoverished women.

NB: FIMR programs have found that after delivery, rural women may be
isolated from family and friends, not able to travel due to long
distances and the high cost of gasoline. This might also contribute to
depression. 


Dubowitz H et al. Screening for Depression in an Urban Pediatric
Primary Care Clinic PEDIATRICS Vol. 119 No. 3 March 2007, pp. 435-443

The authors set out to goals estimate the prevalence of parental
depressive symptoms among parents at a pediatric primary care clinic and
to evaluate the stability, sensitivity, specificity, and positive and
negative predictive values of a very brief screen for parental
depression. 
A total of 216 mothers bringing in children <6 years of age for child
health supervision completed a parent screening questionnaire in a
primary care clinic. The parent screening questionnaire, a brief screen
for psychosocial problems developed for the study, includes 2 questions
on depressive symptoms: * Lately, do you feel down, depressed and
hopeless? During the past month, have you felt little interest or
pleasure in the things you used to enjoy?*

The authors found that twelve percent of the mothers met the Beck
Depression Inventory II clinical cutoff value for at least moderate
depressive symptoms. There was moderate stability of the screening
questions. When a positive response to either or both of the 2 questions
was considered, the sensitivity was 74%, the specificity was 80%, the
positive predictive value was 36%, and the negative predictive value was
95%. 
The authors conclude that maternal depressive symptoms are prevalent.
They say that a very brief screen can identify reasonably those who
could benefit from additional evaluation and possible treatment. This
should benefit mothers, families, and children. 
NB Nice 20 item psychosocial screening tool for pediatric providers!

Quote sent from our readers:

*Our lives begin to end the day we become silent about things that
matter.*
Rev. Martin Luther King, Jr
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The National Fetal and Infant Mortality Review Program is a partnership
between ACOG and federal MCHB.

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