Matching Items (40)

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Menopause Symptoms in Underserved and Homeless Women living in the Extreme Temperatures of Arizona

Description

Regional and geographical differences may explain variability in menopausal symptom occurrence due to development of climate-specific thermoneutral zones leading to population-specific hot flash frequencies. Limited information available regarding menopausal symptoms in underserved women living in extreme heat.

Understanding the perception of

Regional and geographical differences may explain variability in menopausal symptom occurrence due to development of climate-specific thermoneutral zones leading to population-specific hot flash frequencies. Limited information available regarding menopausal symptoms in underserved women living in extreme heat.

Understanding the perception of menopausal symptoms in underserved women living in extreme heat regions to identify if heat impacts perception of menopausal symptoms was the objective of this study. Women in free, low-income, and homeless clinics in Phoenix were surveyed during summer and winter months using a self-administered, written questionnaire including demographic, climate and menopause related questions, including the Green Climacteric Scale (GCS).

A total of 139 predominantly Hispanic (56 %), uninsured (53 %), menopausal (56 %), mid-aged (mean 49.9, SD 10.3) women were surveyed— 36% were homeless or in shelters. Most women were not on menopausal hormone therapy (98 %). Twenty-two percent reported hot flashes and 26% night sweats. Twenty-five percent of women reported previously becoming ill from heat. More women thought season influenced menopausal symptoms during summer than winter (41 % vs. 14 %, p = 0.0009). However, majority of women did not think temperature outside influenced their menopausal symptoms and that did not differ by season (73 % in winter vs. 60% in summer, p=0.1094). No statistically significant differences seen for vasomotor symptoms between winter and summer months.

Regional and geographical differences may be key in understanding the variability in menopausal symptoms. Regardless of season, the menopausal, underserved and homeless women living in Arizona reported few vasomotor symptoms. In the summer, they were more likely to report that the season influenced their menopausal symptoms rather than temperature suggesting an influence of the season on symptom perception.

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Created

Date Created
2018-05

Walking and Transit and Heat, Oh My!: An Exposure Study of Phoenix Pedestrians

Description

Many people use public transportation in their daily lives, which is often praised at as a healthy and sustainable choice to make. However, in extreme temperatures this also puts people at a greater risk for negative consequences resulting from such

Many people use public transportation in their daily lives, which is often praised at as a healthy and sustainable choice to make. However, in extreme temperatures this also puts people at a greater risk for negative consequences resulting from such exposure to heat. In Phoenix, public transportation riders are faced with extreme heat in the summer along with the increased internal heat production caused by the physical activity required to use public transportation. In this study, I estimated total exposure and average exposure per rider for six stops in Phoenix. To do this I used City of Phoenix ridership data, weather data, and survey responses from an ASU City of Phoenix Bus Stop Survey conducted in summer 2016. These data sets were combined by multiplying different metrics to produce various exposure values. During analysis two sets of calculations were made. One keeping weather constant and another keeping ridership constant. I found that there was a large range of exposure between the selected stops and that the thermal environment influences the amount of exposure depending on the time of day the exposure is occurring. During the morning a greener location leads to less exposure, while in the afternoon an urban location leads to less exposure. Know detailed information about exposure at these stops I was also able to evaluate survey participants' thermal comfort at each stop and how it may relate to exposure. These findings are useful in making educated transportation planning decisions and improving the quality of life for people living in places with extreme summer temperatures.

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Created

Date Created
2018-05

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Heat-Related Morbidity in Brisbane, Australia: Spatial Variation and Area-Level Predictors

Description

Background: Extreme heat is a leading weather-related cause of illness and death in many locations across the globe, including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could

Background: Extreme heat is a leading weather-related cause of illness and death in many locations across the globe, including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could be accomplished by targeting intervention measures toward the most vulnerable communities.

Objectives: We sought to quantify spatial variability in heat-related morbidity in Brisbane, Australia, to highlight regions of the city with the greatest risk. We also aimed to find area-level social and environmental determinants of high risk within Brisbane.

Methods: We used a series of hierarchical Bayesian models to examine city-wide and intracity associations between temperature and morbidity using a 2007–2011 time series of geographically referenced hospital admissions data. The models accounted for long-term time trends, seasonality, and day of week and holiday effects.

Results: On average, a 10°C increase in daily maximum temperature during the summer was associated with a 7.2% increase in hospital admissions (95% CI: 4.7, 9.8%) on the following day. Positive statistically significant relationships between admissions and temperature were found for 16 of the city’s 158 areas; negative relationships were found for 5 areas. High-risk areas were associated with a lack of high income earners and higher population density.

Conclusions: Geographically targeted public health strategies for extreme heat may be effective in Brisbane, because morbidity risk was found to be spatially variable. Emergency responders, health officials, and city planners could focus on short- and long-term intervention measures that reach communities in the city with lower incomes and higher population densities, including reduction of urban heat island effects.

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Created

Date Created
2014-08-01

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Adaptation to Climate Change: A Comparative Analysis of Modeling Methods for Heat-Related Mortality

Description

Background: Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the

Background: Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to “adaptation uncertainty” (i.e., the inclusion/exclusion of adaptation modeling) relative to using multiple climate models and emissions scenarios.

Objectives: This study had three aims: a) Compare the range in projected impacts that arises from using different adaptation modeling methods; b) compare the range in impacts that arises from adaptation uncertainty with ranges from using multiple climate models and emissions scenarios; c) recommend modeling method(s) to use in future impact assessments.

Methods: We estimated impacts for 2070–2099 for 14 European cities, applying six different methods for modeling adaptation; we also estimated impacts with five climate models run under two emissions scenarios to explore the relative effects of climate modeling and emissions uncertainty.

Results: The range of the difference (percent) in impacts between including and excluding adaptation, irrespective of climate modeling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities, the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modeling and emissions uncertainty.

Conclusions: Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modeling. We recommend absolute threshold shifts and reductions in slope.

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Created

Date Created
2017-08-16

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Multiple Trigger Points for Quantifying Heat-Health Impacts: New Evidence From a Hot Climate

Description

Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed

Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.

Objectives: This quantitative study was designed to link temperature with mortality and morbidity events in Maricopa County, Arizona, USA, with a focus on the summer season.
Methods: Using Poisson regression models that controlled for temporal confounders, we assessed daily temperature–health associations for a suite of mortality and morbidity events, diagnoses, and temperature metrics. Minimum risk temperatures, increasing risk temperatures, and excess risk temperatures were statistically identified to represent different “trigger points” at which heat-health intervention measures might be activated.

Results: We found significant and consistent associations of high environmental temperature with all-cause mortality, cardiovascular mortality, heat-related mortality, and mortality resulting from conditions that are consequences of heat and dehydration. Hospitalizations and emergency department visits due to heat-related conditions and conditions associated with consequences of heat and dehydration were also strongly associated with high temperatures, and there were several times more of those events than there were deaths. For each temperature metric, we observed large contrasts in trigger points (up to 22°C) across multiple health events and diagnoses.

Conclusion: Consideration of multiple health events and diagnoses together with a comprehensive approach to identifying threshold temperatures revealed large differences in trigger points for possible interventions related to heat. Providing an array of heat trigger points applicable for different end-users may improve the public health response to a problem that is projected to worsen in the coming decades.

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Created

Date Created
2015-07-28

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Opportunities and Challenges for Personal Heat Exposure Research

Description

Background: Environmental heat exposure is a public health concern. The impacts of environmental heat on mortality and morbidity at the population scale are well documented, but little is known about specific exposures that individuals experience.

Objectives: The first objective of this

Background: Environmental heat exposure is a public health concern. The impacts of environmental heat on mortality and morbidity at the population scale are well documented, but little is known about specific exposures that individuals experience.

Objectives: The first objective of this work was to catalyze discussion of the role of personal heat exposure information in research and risk assessment. The second objective was to provide guidance regarding the operationalization of personal heat exposure research methods.

Discussion: We define personal heat exposure as realized contact between a person and an indoor or outdoor environment that poses a risk of increases in body core temperature and/or perceived discomfort. Personal heat exposure can be measured directly with wearable monitors or estimated indirectly through the combination of time–activity and meteorological data sets. Complementary information to understand individual-scale drivers of behavior, susceptibility, and health and comfort outcomes can be collected from additional monitors, surveys, interviews, ethnographic approaches, and additional social and health data sets. Personal exposure research can help reveal the extent of exposure misclassification that occurs when individual exposure to heat is estimated using ambient temperature measured at fixed sites and can provide insights for epidemiological risk assessment concerning extreme heat.

Conclusions: Personal heat exposure research provides more valid and precise insights into how often people encounter heat conditions and when, where, to whom, and why these encounters occur. Published literature on personal heat exposure is limited to date, but existing studies point to opportunities to inform public health practice regarding extreme heat, particularly where fine-scale precision is needed to reduce health consequences of heat exposure.

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Created

Date Created
2017-08-01

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On the Association Between Weather Variability and Total and Cause-Specific Mortality Before and During Industrialization in Sweden

Description

Background: While there is ample evidence for health risks associated with heat and other extreme weather events today, little is known about the impact of weather patterns on population health in preindustrial societies.

Objective: To investigate the impact of weather patterns

Background: While there is ample evidence for health risks associated with heat and other extreme weather events today, little is known about the impact of weather patterns on population health in preindustrial societies.

Objective: To investigate the impact of weather patterns on population health in Sweden before and during industrialization.

Methods: We obtained records of monthly mortality and of monthly mean temperatures and precipitation for Skellefteå parish, northern Sweden, for the period 1800-1950. The associations between monthly total mortality, as well as monthly mortality due to infectious and cardiovascular diseases, and monthly mean temperature and cumulative precipitation were modelled using a time series approach for three separate periods, 1800−1859, 1860-1909, and 1910-1950.

Results: We found higher temperatures and higher amounts of precipitation to be associated with lower mortality both in the medium term (same month and two-months lag) and in the long run (lag of six months up to a year). Similar patterns were found for mortality due to infectious and cardiovascular diseases. Furthermore, the effect of temperature and precipitation decreased over time.

Conclusions: Higher temperature and precipitation amounts were associated with reduced death counts with a lag of up to 12 months. The decreased effect over time may be due to improvements in nutritional status, decreased infant deaths, and other changes in society that occurred in the course of the demographic and epidemiological transition.

Contribution: The study contributes to a better understanding of the complex relationship between weather and mortality and, in particular, historical weather-related mortality.

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Created

Date Created
2016-10-05

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A Proposed Case-Control Framework to Probabilistically Classify Individual Deaths as Expected or Excess During Extreme Hot Weather Events

Description

Background: Most excess deaths that occur during extreme hot weather events do not have natural heat recorded as an underlying or contributing cause. This study aims to identify the specific individuals who died because of hot weather using only secondary data.

Background: Most excess deaths that occur during extreme hot weather events do not have natural heat recorded as an underlying or contributing cause. This study aims to identify the specific individuals who died because of hot weather using only secondary data. A novel approach was developed in which the expected number of deaths was repeatedly sampled from all deaths that occurred during a hot weather event, and compared with deaths during a control period. The deaths were compared with respect to five factors known to be associated with hot weather mortality. Individuals were ranked by their presence in significant models over 100 trials of 10,000 repetitions. Those with the highest rankings were identified as probable excess deaths. Sensitivity analyses were performed on a range of model combinations. These methods were applied to a 2009 hot weather event in greater Vancouver, Canada.

Results: The excess deaths identified were sensitive to differences in model combinations, particularly between univariate and multivariate approaches. One multivariate and one univariate combination were chosen as the best models for further analyses. The individuals identified by multiple combinations suggest that marginalized populations in greater Vancouver are at higher risk of death during hot weather.

Conclusions: This study proposes novel methods for classifying specific deaths as expected or excess during a hot weather event. Further work is needed to evaluate performance of the methods in simulation studies and against clinically identified cases. If confirmed, these methods could be applied to a wide range of populations and events of interest.

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Created

Date Created
2016-11-15

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Air Quality, Community Engagement, and Emerging Technologies

Description

Maricopa County is the home of the Phoenix metropolitan area, an expansive city with serious air quality concerns. To ameliorate air quality in the county, the Maricopa County Air Quality Department developed a website and mobile application called "Clean Air

Maricopa County is the home of the Phoenix metropolitan area, an expansive city with serious air quality concerns. To ameliorate air quality in the county, the Maricopa County Air Quality Department developed a website and mobile application called "Clean Air Make More" as a means of outreach and engagement. In doing this, the county has found a way to engender a bilateral relationship between individuals and their government agency. This study analyzes the effectiveness of Clean Air Make More in establishing this relationship and engaging the community in efforts to improve air quality. It concludes that the design of the application effectively meets user needs, but marketing efforts should target populations disposed to taking action regarding air quality.

Contributors

Created

Date Created
2015-05

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Temperature Observation Time and Type Influence Estimates of Heat-Related Mortality in Seven U.S. Cities

Description

Background: Extreme heat is a leading weather-related cause of mortality in the United States, but little guidance is available regarding how temperature variable selection impacts heat–mortality relationships.
Objectives: We examined how the strength of the relationship between daily heat-related mortality

Background: Extreme heat is a leading weather-related cause of mortality in the United States, but little guidance is available regarding how temperature variable selection impacts heat–mortality relationships.
Objectives: We examined how the strength of the relationship between daily heat-related mortality and temperature varies as a function of temperature observation time, lag, and calculation method.
Methods: Long time series of daily mortality counts and hourly temperature for seven U.S. cities with different climates were examined using a generalized additive model. The temperature effect was modeled separately for each hour of the day (with up to 3-day lags) along with different methods of calculating daily maximum, minimum, and mean temperature. We estimated the temperature effect on mortality for each variable by comparing the 99th versus 85th temperature percentiles, as determined from the annual time series.

Results: In three northern cities (Boston, MA; Philadelphia, PA; and Seattle, WA) that appeared to have the greatest sensitivity to heat, hourly estimates were consistent with a diurnal pattern in the heat-mortality response, with strongest associations for afternoon or maximum temperature at lag 0 (day of death) or afternoon and evening of lag 1 (day before death). In warmer, southern cities, stronger associations were found with morning temperatures, but overall the relationships were weaker. The strongest temperature–mortality relationships were associated with maximum temperature, although mean temperature results were comparable.

Conclusions: There were systematic and substantial differences in the association between temperature and mortality based on the time and type of temperature observation. Because the strongest hourly temperature–mortality relationships were not always found at times typically associated with daily maximum temperatures, temperature variables should be selected independently for each study location. In general, heat-mortality was more closely coupled to afternoon and maximum temperatures in most cities we examined, particularly those typically prone to heat-related mortality.

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Created

Date Created
2015-12-04