Water and air pollution, exercise, stress, bio statistics, epidemiology

1. MISAMIS UNIVERSITY
GRADUATE SCHOOL
UPDATES ON:
Air Pollution,
Water Pollution,
Stress,
Exercise,
Bio Statistics,
and Epidemiology
Submitted to:
Prof. Maricar M. Mutia
Submitted by:
Reynel Dan L. Galicinao
02/26/2011

2. Air Pollution Claims 5,000 Filipino Lives Annually
–JEFFERSON ANTIPORDA
Manila Times
July 14, 2010
A t least 5,000 Filipinos are dying every year because of pulmonary diseases caused by
poor air quality in the country, a clean air advocate organization said on Tuesday.
During a news forum held at Annabel’s Restaurant on Tomas Morato Street in
Quezon City, lawyer Glynda Bathan of the Clean Air Initiative for Asian Cities said that their figure of
5,000 was based on a study they conducted on effects of air pollution mostly caused by motor
vehicles.
Respiratory illnesses such as asthma, bronchitis and pneumonia as well as heart disease, are
among the results of prolonged exposure to air pollutants, which are fatal to very young and very
old individuals.
Based on the study, pulmonary and respiratory illnesses are among the top 10 leading
causes of mortality in the Philippines while heart disease is still the No. 1 killer in the country.
Bathan said that her group has called the attention of President Benigno Aquino 3rd through
an open letter for his administration to make a priority the campaign against air pollution as he did
that on unauthorized use of blaring sirens and blinkers.
The government in the past imposed measures to help eliminate if not minimize air pollution
in the country, including compulsory emission testing for vehicles, banning of incinerators and
closing of open dumps.
Vehicles are the major source of air pollution particularly in Metro Manila while faulty
driving habits and poor vehicle maintenance contribute to the increase in harmful pollutants
released into the air.
The Coalition for Clean Air Advocates (CCAA) said that it will be offering free emission testing
specifically to public utility vehicles as their contribution to help promote the Clean Air Act.
Henry Tan, the head of the CCAA, announced that they have started the free emission
testing but have been implementing it on a voluntary basis.
CCAA member Alex Loinaz reminded motorists to maintain their vehicles regularly by getting
a tune-up, changing oil and checking the radiator.
He said that motorists should use their vehicles’ air-conditioning system only when needed,
and to avoid overloading and engine idling for a long period of time.
http://www.tucp.org.ph/news/index.php/2010/07/air-pollution-claims-5000-filipino-lives-annually/
REACTION:
The situation presented is very alarming.. Air pollution exacerbates, if
not causes, some respiratory disorders. We see the rise in the number of
these respiratory disorders such as asthma, pneumonia, and bronchitis. The
government must employ measures to strictly implement the provisions of
the Clean Air Act to minimize air pollution in the Philippines. The
vehicle owners must also be responsible in the maintenance of their
vehicles to avoid contributing to air pollution.
Air Pollution & Pregnancy
-Bob Hirshon for AAAS, the Science Society
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3. P olluting young minds. Exposing pregnant women to a common air pollutant may
impact their children's intelligence. Air pollution may adversely affect a child's
intelligence—starting in the womb. This according to a new study in Krakow, Poland,
led by Columbia University environmental health scientist Frederica Perera. Her team monitored
healthy, non-smoking pregnant women for exposure to common air pollutants called polycyclic
aromatic hydrocarbons, or PAH's. The children of women with higher PAH exposure scored lower on
cognitive tests at age five. And that's of concern because of the link between such tests and future
academic performance.
The study controlled for such factors as the mother's education, and exposure to
secondhand smoke and lead. Perera says the only real way to reduce the risk of PAH's is to produce
less of them, by burning less fossil fuel.
It's obvious that air pollution can negatively impact people's health—by aggravating asthma,
for example, or in more extreme cases, contributing to lung cancer. However, this study shows that
the effects of air pollution aren't limited to those who actually breathe it in directly. Rather, it shows
these pollutants can find their way into a developing fetus, with measurable consequences later in
life.
Polycyclic aromatic hydrocarbons, or PAH's, are a by-product of burning fossil fuels like coal
and oil. It's hard to escape them entirely, but some areas have higher concentrations of PAH
pollution than others. This study tracked pregnant women's exposure to PAH in two ways: First, the
researchers gave the women a small, backpack-mounted air sampling device, which they wore at all
times during their pregnancy. Second, the women came in for regular checkups, and blood and
urine samples were taken to look for chemical signatures of PAH exposure.
The researchers continued to follow the women's children after they were born. At the age
of five, each child took a test of intellectual ability, similar to an IQ test. They then divided the group
of children in half, with those of higher prenatal PAH exposure in one group, and lower PAH
exposure in the other group. High-exposure children scored worse on the cognitive test than closely
matched low-exposure children, even after accounting for many potential confounding factors,
including PAH exposure after birth.
The difference was small but statistically significant: the equivalent of about 2.8 IQ points.
That may not seem like much, but consider that a small difference in a score on a standardized test
could make the difference between qualifying for a scholarship or not, getting into a particular
college, and so forth. And the findings raise larger concerns about chronic PAH exposure, which
continues throughout one's life from both air pollutants (especially in urban areas) and dietary
sources (like smoked or barbecued foods). On the flip side, if PAH pollutants can impact a
developing fetus, it stands to reason that other environmental pollutants also may have a significant
impact in the womb.
http://www.sciencenetlinks.com/sci_update.php?DocID=411
REACTION:
As presented in this study, air pollution not only affects the people
inhaling the polluted air but also the fetuses inside their mother’s wombs.
The study found out that it affects the intelligence of the babies. The
government must enforce measures to prevent air pollution from factories,
vehicles, and other sources.
Fences reduce water pollution
October 20, 2010
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4. T here are plenty of high-tech ideas to tackle pollution, but recent research suggests that
some of the biggest gains in keeping our waterways clean could come from a more
traditional technology – fences.
Simply fencing off streams and drainage ditches so farm animals can’t deposit manure in and
around them could cut levels of faecal pollution dramatically, according to scientists. This would
protect the health of people exposed to river water and help Britain comply with EU rules on water
quality.
The researchers created a model of the various factors that lead to faecal pollution – and the
harmful bacteria it contains – in rivers. They then used the model to work out how effective
different methods aimed at cutting faecal pollution would be, using the Humber river basin as a
case study.
Fencing off streams came out ahead by a big margin – the model suggests that by the time
water flows out of a region of intensive dairy farming, its E. coli concentrations would be 58.59 per
cent lower with fenced streams than without. As well as keeping animals away, the fences
encourage the development of an overgrown riverbank zone which can help filter out faecal matter
that’s washed off fields.
This is just one of several possible ways to address the problem. ‘But animals having direct
access to the water seems to be one of the major risks,’ saysDanyel Hampson, a PhD student at the
University of East Anglia and lead author of the paper, published in Water Research. ‘The simple
solution of fencing off cattle from rivers is probably one of the most effective ways farmers have of
reducing faecal matter contaminating watercourses. From the farmer’s point of view, it is a solution
that they can get on and do.’
Alternatives may be less effective, more expensive and more disruptive for farmers. For
example, reducing the number of dairy cows in the area, the second-most-effective measure, would
only lead to an 11.58 per cent reduction. The third-most-effective, cutting fertiliser use by 20 per
cent to make grass less nutritious so that fewer cows can be kept on it, would cut bacterial rates by
less than ten per cent. Both these measures would probably be much more painful for farmers.
Human sewage and farm manure are the two main causes of faecal pollution in the UK.
Improvements in sanitation mean the former is rarely a problem unless heavy rain overloads sewers.
Manure from livestock, and especially from dairy cows, is now thought to be the main source of
pollution.
This endangers people enjoying the water. Illnesses range from nausea and diarrhoea to
debilitation and, in extreme cases, death. Contaminated water also does major economic damage;
it’s estimated that exposure to polluted waters, as well as damage to shellfish beds and other
productive areas, costs some $12 billion around the world each year.
Britain doesn’t have such a culture of spending leisure time on rivers as some other nations,
but stomach upsets caused by faecal pollution are all too familiar to canoeists and other
watersports enthusiasts. Pollution can also affect bathers at coastal beaches near the mouths of
contaminated rivers.
In many rivers, there can be so much faecal pollution that a drop of 60 per cent or so will still
leave dangerous concentrations. An earlier piece of research, based on a study of water quality at
Brighouse Bay on Scotland’s west coast, showed that bacterial levels in many rivers can be so high
that no feasible measures would be enough to make rivers comply with WFD requirements. The
main benefit of reducing faecal pollution in rivers is that bathers at nearby beaches will be at greatly
reduced risk.
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5. This earlier study, in Environmental Pollution, also provided empirical support for the new
model’s conclusions; it concurred that stream-bank fencing was likely to be one of the most
effective methods to tackle the problem. Others possible measures include taking more care when
storing manure and applying slurry as a fertiliser.
The model will also help policy-makers understand how responsibility for episodes of faecal
pollution is divided between the agricultural and water and sewage sectors. ‘We need to find out
exactly where the pollution is coming from,’ says Hampson. ‘Neither the wastewater industry nor
the agricultural sector wants to pay for dealing with this problem if it isn’t responsible for creating
it.’
The research was carried out under the Rural Economy and Land Use (Relu) programme by
researchers from UEA, the University of Wales in Lampeter, the University of Aberystwyth and the
University of Reading.
Relu is a multidisciplinary research initiative bringing together research to illuminate the
challenges faced by rural areas due to environmental, economic and social change.
It is a collaboration between the Economic and Social Research Council, the Biotechnology
and Biological Sciences Research Council and the Natural Environment Research Council, with
further funding provided by the Scottish Government and the Department for Environment, Food
and Rural Affairs.
http://planetearth.nerc.ac.uk/news/story.aspx?id=847
REACTION:
Water pollution is another major problem in our environment in the
Philippines. Although this study is done in UK, this method of reducing
water pollution can be useful in our country. Many people, especially in
rural areas, still use the river to take a bath and wash their clothes.
However, some farmers also bring their animals near the rivers to eat the
grass and drink water from it. This causes the increase in the number of
Escherechia coli in the rivers which makes the water dangerous for
people. It can cause diarrhea, nausea and vomiting, and dehydration,
among others, which may lead to death. The use of fences prevents
the animals from going close to the river and depositing their
manure. People living near the river must also discipline
themselves as not to throw human waste on the river or riverbanks
thereby decreasing water pollution.
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6. Beach Pollution
How serious and extensive is beach pollution in the United States?
P ast monitoring studies have shown that beach pollution is usually infrequent or
confined to local areas. Problems can develop in areas near pollution sources after a
heavy rainfall or when a sewage treatment plant malfunctions. Pollution can also
occur from disruption or damage to wastewater collection and treatment infrastructure due to
severe natural events like hurricanes or flooding.
There is not enough information available now to define the extent of beach pollution
throughout the country. A few states have comprehensive beach monitoring programs to test the
safety of water for swimming. Many other states have only limited beach monitoring programs, and
some states have no monitoring programs linked directly to water safety at swimming beaches.
What we do know is that beach pollution is a persistent problem, based on the number of
beach closings and swimming advisories that continue to be issued annually. Nearly 4000 beach
closings and swimming advisories were issued by state and local governments in 1995. Most
problems with beach pollution have been reported for ocean, bay, and Great Lakes beaches, but
these problems are not limited to coastal areas. However, we currently do not have access to
information about the safety of swimming beaches at rivers and other lakes across the country.
A primary goal of the Beaches Environmental Assessment, Closure, and Health (BEACH)
Program is to work with state, tribal, and local governments to compile information on beach
pollution to define the national extent of the problem.
What are the primary causes and sources of water pollution at beaches?
The majority of beach closings in the United States are due to indications of the presence of
high levels of harmful microorganisms found in untreated or partially treated sewage. Most of this
sewage enters the water from combined sewer overflows, sanitary sewer overflows, and
malfunctioning sewage treatment plants. Untreated storm water runoff from cities and rural areas
can be another significant source of beach water pollution. In some areas, boating wastes and
malfunctioning septic systems can also be important local sources of beach water pollution.
Combined sewer systems are designed to carry both raw sewage and storm water runoff to
sewage treatment plants. During heavy rainstorms, these systems can become hydraulically
overloaded and discharge a mixture of raw sewage and polluted runoff from streets into local
waterways. The discharges pollute water around the outfalls and at downstream beaches.
Heavy rainfall can also hydraulically overload separate sanitary sewer systems which carry
raw sewage to sewage treatment plants. This is especially a problem for systems with excess
infiltration of rainfall through the ground into leaky sanitary sewers and with large inflows from
sources such as roof drains connected directly to sewers. When flows exceed the capacity of the
system, sewers can overflow and discharge untreated sewage from manholes and bypasses at pump
stations and sewage treatment plants. The discharges flow into local waterways and pollute the
water.
People who swim in water near storm drains can become ill. A recent Southern California
epidemiological study, for example, revealed that individuals who swim in areas adjacent to flowing
storm drains were 50 percent more likely to develop a variety of symptoms than those who swim
further away from the same drain. Swimmers who did not avoid the drains experienced an
increased risk for a broad range of adverse health effects. These include fever, nausea, and
gastroenteritis; flu-like symptoms -- such as nasal congestion, sore throat, fever, and/or coughing--
are also possible. Storm drains can even be a source of problems during drier weather because
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7. broken pipes or connections to sanitary disposal systems may contribute pathogens to the storm
drains.
What harmful microorganisms can be found in polluted water and what illnesses do they cause?
Polluted runoff and untreated sewage released into the water can expose swimmers to
bacteria, viruses, and protozoans. These pathogens (disease-causing organisms) can be present at or
near the site where polluted discharges enter the water. Children, the elderly, and people with
weakened immune systems are most likely to develop illnesses or infections after swimming in
polluted water.
Swimming-related illnesses are typically minor. This means that they require little or no
treatment, respond readily to treatment, and have no long-term health effects. The most common
illness associated with swimming in water polluted by sewage is gastroenteritis. It occurs in a variety
of forms that can have one or more of the following symptoms: nausea, vomiting, stomachache,
diarrhea, headache, and fever. Other minor illnesses associated with swimming include ear, eye,
nose, and throat infections. In highly polluted water, swimmers may occasionally be exposed to
more serious diseases like dysentery, hepatitis, cholera, and typhoid fever.
Agencies monitoring for beach water pollution usually analyze the water samples they
collect for indicator species to assess the water for harmful levels of pathogens. Collecting and
measuring the pathogens directly can be difficult and potentially hazardous. Good indicator species
are microorganisms that are easy to collect and analyze for, safe to handle, representative of the
pathogen of concern for characteristics like growth, and always present when pathogens are
present or vice versa.
http://water.epa.gov/type/oceb/beaches/pollution.cfm
REACTION:
Beaches are wonderful places to go and relax because of its fresh
air, clean water, and serenity. However, beaches are becoming more and
more polluted. As the number of people going to the beaches increase, the
wastes left in the beach also increases. Some people living in the
seashore also make the water a giant urinal and toilet. Some factories
also throw their wastes in the seas. This factors lead to beach pollution
and makes the water unfit and dangerous for swimming. The government must
continually monitor the safety of the seawater for swimming and implement
measures to prevent water pollution. Beach-goers must also take
responsibility by maintaining the cleanliness of the beaches. As one sign
says “Take only pictures and leave only footprints.”
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8. Effects of Exercise and Stress Management Training on Markers
of Cardiovascular Risk in Patients with Ischemic Heart Disease:
A Randomized Controlled Trial
JAMA. 293(13):1626-1634.
Background
O bservational studies have shown that psychosocial factors are associated with
increased risk for cardiovascular morbidity and mortality, but the effects of
behavioral interventions on psychosocial and medical endpoints remain uncertain.
Objective
To determine the effect of the addition of aerobic exercise training or stress management
training to routine medical care on psychosocial functioning and markers of cardiovascular risk in
patients with known ischemic heart disease (IHD).
Methods
134 patients with documented IHD and evidence of exercise-induced myocardial ischemia
within the past year were enrolled. Patients underwent mental stress testing and a cycle ergometer
exercise stress test. Gated equilibrium radionuclide ventriculography was performed prior to and
during each of the stress tests to assess for segmental wall motion abnormalities. Flow-mediated
dilation of the brachial artery, heart rate variability, and baroreflex sensitivity were also measured.
Patients were then randomized to usual care, usual care plus supervised aerobic exercise training
(35 minutes at 3 times per week), or usual care plus stress management training (1.5-hour weekly
sessions). After 16 weeks, baseline measurements were repeated.
Results
124 (93%) patients completed the study. Improvement in treadmill duration was 19% for the
exercise training group, 9% for the stress management arm, and 1% for the usual care group.
Patients in the exercise and stress management training groups showed lower depression scores,
reduced distress scores, smaller reductions in left ventricular function during mental stress testing,
and lower mean wall motion abnormality scores compared with the usual care group. These groups
also showed significant improvements in flow-mediated dilation of the brachial artery versus the
control group. Only the stress management training group showed improvements in heart rate
variability and baroreflex sensitivity when compared with the usual care group.
Conclusion
This study showed that behavioral treatments provide added benefits to routine medical
care in patients with ischemic heart disease. Patients who underwent 4 months of either aerobic
exercise or stress management training showed improvements in psychosocial functioning, less
emotional distress, lower levels of depression, and improved markers of cardiovascular risk. This the
first study to demonstrate favorable effects of stress reduction on vascular endothelial function.
Comments
This study was not designed to evaluate the effects of exercise or stress management on
morbidity and mortality, and improvements in the cardiovascular markers studied may not
necessarily translate to reduced clinical events. Nevertheless, this study adds to the body of
evidence regarding the beneficial effects of exercise and stress reduction in patients with IHD.
Perhaps, future studies could look at the effects of alternative exercise regimen that also target
stress reduction, such as yoga, Pilates, and tai chi. These alternative exercise regimens may be more
attractive to some of our elderly, obese, or more debilitated patients.-ST
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=594794
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9. REACTION:
This study added to the many studies showing the beneficial effects
of exercise and stress management. Indeed, exercise and stress management
helps not only in healthy people but also people with diseases. In the
study conducted, people with ischemic heart disease demonstrated
improvements in psychosocial functioning, less emotional distress, lower
levels of depression, and improved markers of cardiovascular risk when
they exercised and managed their stresses. People must be encouraged to
practice these healthy behaviors for its many benefits. We as nurses can
help by encouraging and educating our patients about the importance of
stress management and exercise to maintain health.
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10. APA Stress Survey: Children are more stressed than parents
realize
For the first time, APA's Stress in America survey included results of a survey of young
people on what causes their stress and how that stress manifests itself
by Public Relations Staff
S tress related to school pressure and family finances has a greater impact on young
people than parents believe, according to the American Psychological Association's
(APA) 2009 Stress in America survey. Building on past research indicating that stress is
a top health concern for U.S. high school students, psychologists say that if teens don't learn healthy
ways to manage that stress now, it could have serious long-term health implications.
The third annual Stress in America survey polled 1,568 adults from around the nation on the
stress in their lives and its effects. This year, for the first time, the report also included the results of
a YouthQuery survey among 1,206 young people aged 8-17 years old on what causes their stress
and how it manifests itself, among other things.
The surveys, conducted online by Harris Interactive on behalf of APA between July and
August 2009, are a key component of APA's Mind/Body Health public education campaign. The
campaign emphasizes the role of psychologists in health promotion and how they help people with
behavioral and emotional issues.
APA released the survey on November 3 at a well-attended media event in New York City.
More than 20 prominent outlets-most of which share the campaign's target audience of women and
families-attended the event, including the Wall Street Journal, Prevention, Self, Ladies Home Journal,
Family Circle, Women's Day and Redbook.
APA Executive Director for Professional Practice Katherine C. Nordal, PhD, health
psychologist Helen Coons, PhD, and Barbara Roth, national director for youth and family programs
at the YMCA of the USA, addressed the audience.
The YMCA and APA are partnering to provide families with resources and strategies for
healthy living. The partnership addresses the impact individual behaviors such as healthy eating and
regular physical activity can have on reducing risk factors for chronic diseases and managing stress.
Roth spoke about the importance of family-strengthening activities, such as eating meals together
or taking walks, to enhance communications in a family, ultimately helping to increase parental
awareness of kids' stress and worries.
According to the survey, many parents don't realize how stressed their children are. Nearly
half (45 percent) of teens ages 13-17 said that they worried more this year, but only 28 percent of
parents think their teen's stress increased.
And while a quarter (26 percent) of tweens ages 8-12 said they worried more this year, only
17 percent of parents believed their tween's stress had increased. Similarly, only 2-5 percent of
parents rated their child's stress as extreme (an 8, 9 or 10 on a 10-point scale) when 14 percent of
tweens and 28 percent of teens said they worry "a lot" or "a great deal."
Parents' responses about sources of stress for their children were out of sync with what
children reported as sources of worry. Children were more likely to say they worried about their
family's financial difficulties than parents were to say this was a source of stress for their children
(30 percent vs. 18 percent of parents). In addition:
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11.  Tweens (30 percent) and teens (42 percent) said they get headaches vs. 13 percent of
parents saying that their children get headaches,
 Tweens (39 percent) and teens (49 percent) cited difficulty sleeping vs. 13 percent of
parents saying that their children have difficulty sleeping, and
 Tweens (27 percent) and teens (39 percent) reported eating too much or too little vs. 8
percent of parents saying that their children eat too much or too little.
http://www.apapracticecentral.org/update/2009/11-23/stress-survey.aspx
REACTION:
Stress is experienced by everyone. Not only among adults but even
teens and children. The study showed the various causes the stress of the
young people. It also showed how stress manifests itself. Children are
also affected by the affairs of their parents including financial problems.
The children’s stresses are often neglected or underestimated by their
parents. Teens and children also manifests stress by headache, difficulty
sleeping, and eating too much or too little. Parents must also listen to
their children and consider the stresses they are facing. We as nurses can
assess the stresses of pediatric patients and help or facilitate them in
finding ways to handle or resolve the stresses.
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12. Effects of Prior Moderate Exercise
on Postprandial Metabolism and Vascular Function
in Lean and Centrally Obese Men
J Am Coll Cardiol. 44(12):2375-2382.
Background
Objective
E ndothelial function is impaired after fat ingestion, the degree of which appears to be
proportional to the increase in postprandial lipemia. It has been suggested that
moderate exercise can reduce postprandial lipemia.
The authors hypothesized that a session of exercise prior to fat ingestion can also attenuate
the impairment of endothelial function seen in the postprandial state. A secondary aim was to
investigate whether these exercise-induced changes would differ between 2 groups of subjects with
different metabolic profiles.
Methods
Two groups of middle-aged men-10 centrally obese and 10 lean-were enrolled in the study.
These subjects differed in insulin sensitivity and insulin-regulated postprandial glucose and lipid
metabolism. Subjects underwent 2 oral fat tolerance tests; subjects walked on a treadmill for 90
minutes at an intensity of 50% of the maximal oxygen uptake before one test, and were sedentary
before the other test (control). Endothelium-dependent and endothelium-independent forearm
microvascular function was assessed using laser Doppler imaging.
Results
Exercise significantly reduced (by 25%) postprandial triglyceride concentrations in both the
lean and centrally obese groups. Fasting and postprandial microvascular responses to acetylcholine
(endothelium-dependent) were 25% and 15% higher, respectively, after exercise compared to
control. On the other hand, response to 1% sodium nitroprusside (endothelium-independent) was
not different in the fasted state but was 20% higher postprandially after exercise compared to
control. Exercise-induced improvement in endothelial function did not differ between the 2 groups
and was sustained up to the day after a single exercise session.
Conclusion
This study showed that a single session of moderate exercise significantly improved small
vessel vasodilator function in both the fasted and postprandial states in centrally obese and lean
middle-aged men. This effect was sustained up to 24 hours after exercise. This study suggests that
moderate exercise is effective in attenuating many of the adverse metabolic and vascular changes
seen after ingestion of dietary fat.
Comments
The novel finding in this study is that the beneficial effects of exercise on postprandial
endothelial function can be sustained up to 24 hours after a single session of moderate exercise.
Extrapolating this finding would suggest that moderate exercise performed regularly could result in
maintenance of endothelial health, which may impact on cardiovascular risk. Even inactive centrally
obese subjects were able to tolerate the moderate exercise session used in this study. As clinicians,
we can use studies such as this in helping to motivate our patients to engage in an active lifestyle.
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=579564
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13. REACTION:
This study shows that moderate exercise is effective in attenuating
many of the adverse metabolic and vascular changes seen after ingestion of
dietary fat. People must exercise to maintain physical health and achieve
the many benefits of exercise. In the study, exercise was found to
increase metabolism thereby preventing weight gain. In today’s society
more and more people are becoming overweight and obese. We as nurses play
a big role in educating patients and the public about exercise and its
many benefits. We ourselves must be model of regular exercise and healthy
weight.
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14. Periodical Exercise Therapeutics Update & Commentary:
Exercise and Cortisol
Sports Med 823(2): 106
Resistance exercise overtraining and overreaching: neuroendocrine responses
P hysiological effects of weight training are not nearly as well studied as those of aerobic
exercise. This lengthy article reviews the neuroendocrine responses to weight training
and overtraining. Only the section of the article dealing with cortisol will be
summarized. For the purpose of this article the authors will be defining overtraining as an increase
in number of repetitions or number of circuits or amount of weight lifted, leading to strength
decrements. Often this decrease in performance is accompanied by generalized fatigue.
The direct stimulus for release of cortisol from the adrenal gland is ACTH
(adrenocorticotropic hormone) from the anterior pituitary. ACTH is released due to CRH
(corticotropin releasing hormone) from the hypothalamus. CRH is released regardless of the type of
stress, i.e. physical, emotional. traumatic, etc. This cascade of hormonal responses to stress is
known as the HPA axis (hypothalamic, pituitary, adrenal). Overtraining of any sort may lead to
dysfunction of the HPA axis.
The release of cortisol in response to an exercise bout (moderate to high intensity for
aerobic exercise and for all types of weight training bouts) is seen as beneficial. Cortisol is needed to
help maintain blood glucose, while facilitating the metabolic shift towards greater fat oxidation.
Typically, the greater the amount of weight being lifted (i.e. greater stress), the higher the
rise in cortisol during training. Moving to greater training volumes (more repetitions per exercise) or
higher intensities (lifting greater weights) too quickly, may lead to higher resting cortisol levels. Yet
when weight lifting is undertaken, cortisol levels may actually decline during the exercise bout.
Commentary:
Cortisol is the classic "stress" hormone. Dr. Hans Selye, a pioneering stress physiologist,
clearly established the essentiality of cortisol in allowing the body to withstand all types of
stresses.(1) Selye found that if the adrenal glands were removed from animals they would quickly
die, unable to deal with normal life stresses.
It would appear that some amount of cortisol is beneficial during a stress (e.g. weight
training bout), while too much cortisol can become detrimental. When the volume of weight
training is too great, it appears that even during rest, cortisol blood levels remain high. Cortisol can
cause muscle tissue to break down thereby explaining why strength might actually start to decrease
with higher levels of training (i.e. overtraining).
http://www.encognitive.com/node/12817
REACTION:
A saying goes this way, “Too much of a good thing is bad”. That is
proven in this study. Physical exercise has its many benefits. Weight
training improves strength, endurance, and overall body physique. However,
when the volume of weight training os too great, it becomes detrimental to
the body. Cortisol, the hormone released during stress, causes muscle
tissue to breakdown when it is in excessive amounts as a result of too
much weight training or overtraining. We must do weight training regularly
and begin with lighter weights to prevent over exertion and fatigue to the
muscles and excessive release of cortisol.
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15. A Filipino family consumed 8.9 kg of
ordinary rice a week
(Results from the Family Income and Expenditure Survey (FIES)
A ccording to the 2006
Family Income
ordinary rice was consumed by
approximately 15 million families at an
and
Expenditure Survey (FIES),
average of 463 kg per family per year or
8.9 kg a week (Table 1). Classified as
ordinary rice are regular commercial
varieties like C-4, Intan, Macan and IR-8.
For special rice, the average consumption
by about 4.1 million families consuming it
was 329 kg per family annually, or 6.3 kg
a week. Special rice includes well-milled
commercial varieties of rice like Wag-wag
(1st class), Milagrosa, Sinandomeng,
Dinorado, 7Tonner and other fancy varieties. On the other hand, the average consumption by
approximately 2.2 million families for NFA rice was 255 kg per family per year or 4.9 kg a week.
Meanwhile, a family belonging to the bottom 30 percent income group consumed 390 kg of
ordinary rice in a year or a 7.5 kg weekly, on the average. This consumption is lower compared to
the average consumption of a family in the upper 70 percent income group which was estimated at
494 kg a year or 9.5 kg a week. The average annual consumption of special rice and NFA rice by
families in the bottom 30 percent income group was almost the same (238 kg per family and 237
per family, respectively). For families in the upper 70 percent income group, the annual average
consumed was higher for special rice (343 kg per family) than NFA rice (273 kg per family).
For the rice consumption by
income decile, the average
consumption of ordinary rice ranged
from 287 kg a year or 5.5 kg a week for
the first income decile to 500 kg a year
or 9.6 kg a week for the seventh
income decile. The consumption of
ordinary rice by families in the eight to
the tenth decile income groups was
somewhat lower compared to families
in seventh income decile, with an
average annual consumption of 494 kg
per family per year for the eight income
decile, 498 kg for the ninth income
decile and 492 kg for the tenth income
decile. The average consumption of
special rice ranged from 183 kg per
family a year or 3.5 kg a week for the
first decile to 413 kg a year or 7.9 kg a
week for the tenth decile. The
consumption of NFA rice was noted to be higher among families in the third income decile (285 kg a
year on the average) and fourth income decile (297 kg a year on the average) than among families
belonging to other income groups (Figure 2).
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16. Source: Income and Employment Statistics Division (IESD)
National Statistics Office
Manila, Philippines
Page last revised: December 29, 2010
http://www.census.gov.ph/data/sectordata/sr10559tx.html
REACTION:
This study proves that rice is main staple food among majority of
Filipinos. 8.9 kg of ordinary rice is consumed by a Filipino family per
week. It is a mojor source of carbohydrates in a typical Filipino diet.
The price of rice must be continually guarded by the concerned government
agencies, that is Department of Trade and Industry and National Food
Authority.. Rice supply must also be maintained by the government to
prevent rice shortages, which has happened in the past, and over
importation leading to excessive rice supply in which some are already
unfit for human consumption due to the long storage period.
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17. PHILIPPINE POPULATION WENT UP BY
12 MILLION PERSONS
Date Released: November 25, 2010
Total population grew by 2.04 percent annually
A s of August 1, 2007, the
Philippines had a total
population
88,566,732 persons, an increase of
12,062,655 persons over the May 1,
of
2000 population count of 76,504,077
persons. The 2007 census figure is
almost twelve times the Philippine
population in 1903 (7,635,426
persons), when the first census was
conducted.
The increase in Philippine
population translated to an average
population growth rate (PGR) of 2.04
percent annually during the period
2000 to 2007. The annual PGR
recorded during the period 1995 to
2000 was 2.36 percent.
The household population of the country in 2007 was 88,304,615 persons, higher by
11,991,134 persons from the household population of 76,313,481 persons in 2000. The number of
households, meanwhile, increased by 21.4 percent from 15,275,046 in 2000 to 18,539,769 in 2007.
The average household size in 2007 was 4.8 persons, lower than the average household size of 5.0
persons in 2000.
Average household size of the country in 2007 was 4.8 persons
The average household size in the Philippines in 2007 was 4.8 persons. Seven regions had
average household sizes higher than the national figure, namely: the Autonomous Region in Muslim
Mindanao (ARMM), 5.8 persons; Region XIII (Caraga), Region IX (Zamboanga Peninsula), and Region
V (Bicol), each with 5.0 persons per household; and Region X (Northern Mindanao), Region VI
(Western Visayas), and Region VIII (Eastern Visayas), each with 4.9 persons per household.
Meanwhile, the NCR had the lowest average household size of 4.4 persons.
Males outnumbered females
Of the 88,304,615 household population, 50.5 percent were males while 49.5 percent were
females. This resulted to a sex ratio of 102 males for every 100 females, slightly higher than the sex
ratio of 101 males per 100 females in 2000. Regions VIII and XIII posted the highest sex ratio of 106
each. Moreover, NCR, Region IV-A, and ARMM were the only three regions which reported more
females than males, that is, with sex ratios of less than 100.
Median age increased to 22 years
In 2007, the median age of the country's household population was 22 years, which means
that half of the household population was below 22 years old. The median age in 2000 was 21 years.
Median age was highest in the NCR (24 years) and lowest in ARMM (18 years).
Children aged 0 to 4 years and 5 to 9 years comprised the largest age groups, each making
up 12.0 percent of the total household population, followed by age groups 10 to 14 years (11.6
percent) and 15 to 19 years (10.5 percent).
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18. The age-sex distribution of the household population showed more males than females in
age groups 0 to 54 years. Females outnumbered their male counterparts in the older age groups (55
years old and over).
Higher proportion of females than males among the voting-age population
At the national level, the voting-
age population (18 years old and over)
in 2007 numbered 51.1 million,
accounting for 57.9 percent of the total
household population. The size of the
voting-age population recorded in 2000
was 43.4 million, or 56.8 percent of the
total household population. There were
more females (50.1 percent) than males
(49.9 percent) among the voting-age
population.
The five regions with the highest
proportion of voting-age population
were all located in Luzon: NCR (63.6
percent), Region I (59.9 percent), Region
IV-A (59.7 percent), and Regions II and III
(59.6 percent each). ARMM had the
lowest proportion of voting-age
population with 50.1 percent.
Dependency ratio decreased to 66 dependents per 100 persons in the working-age group
Of the total household population, 60.3 percent belonged to the working-age population (15
to 64 years). Young dependents (below 15 years) comprised 35.5 percent while old dependents (65
years and over) accounted for 4.1 percent.
The overall dependency ratio of the Philippines in 2007 was 66 dependents for every 100
persons in the working age group, down from 69 dependents in 2000. Of the 66 dependents, 59
were young dependents while seven were old dependents.
Across the country, 10 regions posted a dependency ratio higher than the national figure:
Region V (83.7 percent), Region IV-B (83.0 percent), ARMM (80.6 percent), Region VIII (80.4
percent), Region XIII (74.0 percent), Region IX (70.5 percent), Region VI (69.6 percent), Region X
(69.3 percent), Region XII (67.7 percent), and Region VII (67.4 percent). NCR had the lowest
reported overall dependency ratio of 51 dependents for every 100 persons in the working age group.
More males than females among never-married
Of the household population 10 years old and over, 45.3 percent were married while 44.3
percent were never married. The rest of the household population was categorized as follows:
widowed (4.3 percent), divorced/separated (1.2 percent), in common law/live-in marital
arrangement (4.5 percent), and had unknown marital status (0.4 percent).
Among never-married persons, a higher proportion of males (53.8 percent) than females
(46.2 percent) was reported in 2007. Meanwhile, the proportion of females was higher than males
among married persons (50.4 percent), widowed (76.0 percent), divorced/separated (62.7 percent),
and those in common law/live-in marital arrangement (50.7 percent).
Across regions, CAR (47.4 percent) had the highest proportion of never-married persons
while Region II (51.9 percent) had the highest proportion of married individuals. Moreover, it is
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19. observed that Region I (5.4 percent) reported the largest proportion of widowed while NCR had the
largest proportions of common law/live-in (7.3 percent) and divorced/separated (1.9 percent)
persons.
Females outnumbered males among academic degree holders
Of the household population 5 years old and over, 36.7 percent had attended or completed
elementary education, 32.5 percent had reached or finished high school, 8.0 percent were college
undergraduates, and 8.6 percent were academic degree holders.
Among those with academic degrees, there were more females (56.2 percent) than males
(43.8 percent). Similarly, among those with post baccalaureate courses, females (56.3 percent)
outnumbered males (43.7 percent).
Moreover, the highest proportion of household population 5 years old and over who had not
reached nor completed any grade level was in ARMM. Similarly, ARMM had a population with the
least proportion of academic degree holders (3.4 percent). The NCR had the least proportion of
household population with no grade completed (3.7 percent) and the highest proportion with
academic degree holders (15.1 percent). The region with the highest proportion of household
population with post baccalaureate course was CAR (0.3 percent) and the least was Region III (0.1
percent).
School attendance was higher among females than among males
About three out of five persons (63.3 percent) in the household population 5 to 24 years old
had attended school at anytime during the School Year 2007 to 2008. School attendance was higher
among females (64.0 percent of all females aged 5 to 24 years) than among males (62.7 percent of
all males aged 5 to 24 years) during the said school year.
For the whole Philippines, the top five regions in terms of school attendance among persons
5 to 24 years old during the School Year 2007 to 2008 were CAR (68.9 percent), Region V (67.2
percent), Region VI (66.9 percent), Region I (66.0 percent), and Region IV-B (65.6 percent). ARMM
had the lowest in terms of school attendance with 55.5 percent.
102 households per 100 occupied housing units
In 2007, there were 18.2 million occupied housing units in the country. This number is 22.0
percent higher than the 14.9 million occupied housing units recorded in 2000. A ratio of 102
households per 100 occupied housing units was recorded in 2007, slightly lower than the ratio of
103 households per 100 occupied housing units posted in 2000. The number of persons per
occupied housing unit was 4.9 persons in 2007, lower than the ratio of 5.1 persons per occupied
housing unit in 2000.
Majority of occupied housing units had outer walls and roof made of strong construction
materials
Among the 18.2 million occupied housing units in the Philippines in 2007, the most common
construction materials used for outer walls were concrete/brick/stone (36.8 percent), half
concrete/brick/stone and half wood (20.8 percent), and bamboo/sawali/cogon/nipa (19.8 percent).
In 2000, the most common construction materials used for the outer walls were
concrete/brick/stone (30.8 percent), bamboo/sawali/cogon/nipa (22.8 percent), and wood (22.7
percent).
As to the construction materials of the roof, 75.0 percent of occupied housing units had
roofs made of galvanized iron/aluminum in 2007. In 2000, galvanized iron/aluminum was also the
main construction material used for the roof with 67.6 percent of all occupied housing units in the
country.
Source: Household Statistics Department
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20. National Statistics Office
Manila, Philippines
Page last revised: December 15, 2010
http://www.census.gov.ph/data/pressrelease/2010/pr10162tx.html
REACTION:
The article discussed about the population in the Philippines.
Our population is obviously on the rise and if it continues this
way, there might come a time where the resources would not be
enough for every Filipino The rise of the population would mean an
increase in poverty.. It is now the proper time to pass the
Reproductive health bill in order to halt or slow down the increase
of our population. We as nurses can serve as advocates for maternal
health by promoting contraception and presenting the choice to the
couple for them to decide which method would be ideal for them.
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21. Epidemiology of Tuberculosis
C Robert Horsburgh, Jr, MD, MUS
Introduction
A n understanding of the epidemiology of tuberculosis (TB) is critical for effective
control. The global burden of tuberculosis, risk factors for transmission, and the
epidemiology of tuberculosis in the United States will be reviewed here. The
epidemiology of drug-resistant tuberculosis is discussed separately.
Global Burden
More than 2 billion people (about one-third of the world population) are estimated to be
infected with tuberculosis. The global incidence of TB peaked around 2003 and now appears to be
declining slowly. In 2006 the World Health Organization (WHO) issued the following estimates:
 The prevalence of active infection was 14.4 million, corresponding to a prevalence rate of
219/100,000 persons.
 The incidence of new cases was estimated to be 9.2 million, corresponding to an incidence rate
of 139/100,000.
 Twelve of the 15 countries with the highest estimated TB incidence are in Africa, where the TB
incidence rate was 363/100,000
 In 2006 there were 1.7 million deaths from TB worldwide, a death rate of 25/100,000.
The epidemiology of tuberculosis varies substantially around the world. The highest rates
(100/100,000 or higher) are observed in sub-Saharan Africa, India, China, and the islands of
Southeast Asia and Micronesia. Intermediate rates of tuberculosis (26 to 100 cases/100,000) occur
in Central and South America, Eastern Europe, and northern Africa. Low rates (less than 25 cases per
100,000 inhabitants) occur in the United States, Western Europe, Canada, Japan, and Australia.
Poverty, HIV and drug resistance are major contributors to the resurging global TB epidemic.
Approximately 95 percent of TB cases occur in developing countries. Approximately 1 in 14 new TB
cases occur in individuals who are infected with HIV; 85 percent of these cases occur in Africa. An
estimated half million cases of multidrug resistant (MDR)-TB also occur annual in Africans; even
higher rates of drug resistant infections occur in Eastern Europe.
http://www.uptodate.com/contents/epidemiology-of-tuberculosis
REACTION:
The incidence of tuberculosis is increasing not only in the
Philippines but throughout the world. The rate of deaths related to TB is
also alarming. Nurses can play a great role in the control of TB. We must
encourage and educate patients to finish the course of treatment to
prevent multi-drug resistant strain of TB. We must also educate the public
about the disease including preventive strategies. Nurses, as front liners
in healthcare, have direct contact with patients with active TB disease
that may be communicable. . We must also employ the necessary measures to
avoid contracting the disease while caring for our patients.
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22. Epidemiology, Prevention and Treatment of Cervical Cancer in
the Philippines
Efren J. Domingo and Ana Victoria V. Dy Echo
Department of Obstetrics and Gynecology, University of the Philippines College of Medicine,
Manila, Philippines
C ervical cancer remains to be one of the leading malignancies among Filipino women.
High-risk human papillomavirus (HPV) types, such as 16 and 18, are consistently
identified in Filipino women with cervical cancer. Factors identified to increase the
likelihood of HPV infection and subsequent development of cervical cancer include young age at
first intercourse, low socioeconomic status, high parity, smoking, use of oral contraception and risky
sexual behaviors. Cancer screening programs presently available in the Philippines include Pap
smears, single visit approach utilizing visual inspection with acetic acid followed by cryotherapy, as
well as colposcopy. However, the uptake of screening remains low and is further compounded by
the lack of basic knowledge women have regarding screening as an opportunity for prevention of
cervical cancer. Prophylactic HPV vaccination of both quadrivalent and bivalent vaccines has already
been approved in the Philippines and is gaining popularity among the Filipinos. However, there has
been no national or government vaccination policy implemented as of yet. The standard of
treatment of cervical cancer is radiotherapy concurrent with chemotherapy. Current researches are
directed towards improving availability of both preventive and curative measures of cervical cancer
management.
Cervical cancer is the second most common malignancy and is the most common cause of
cancer-related mortality among Filipino women. Although considered as a preventable disease, the
burden of cervical cancer in the Philippines remains to be moderately high, where the cost of
nationwide organized cytology screening has been a significant limitation. In a country where
existing health infrastructure is not sufficiently developed to support cytology-based screening
program, the use of alternative screening modalities, such as visual inspection of the cervix aided by
acetic acid (VIA) with or without magnification, is currently under evaluation. In addition,
prophylactic human papillomavirus (HPV) vaccination for the prevention of infection and related
disease is being considered as an additional cervical cancer control strategy.
Burden of Cervical Cancer in the Philippines
According to the Filipino cancer registry 2005 annual report,1 the incidence of cervical cancer
remained stable from 1980 to 2005, with an annual age-standardized incidence rate of 22.5 cases
per 100,000 women.2 In 2005, there were 7,277 new cases of cervical cancer, with 3,807 reported
deaths. The overall 5-year survival rate was 44% and mortality rate was 1 per 10,000 women.1 The
high mortality rate was attributed to the fact that 75% of women were diagnosed at late stage
disease with treatment being frequently unavailable, inaccessible or non-affordable.
The Philippine General Hospital (PGH) has been the country's government tertiary center reporting
the highest number of new cervical cancer cases. In 2006, 466 new cases were reported, of which
68% were squamous cell carcinoma, 21% adenocarcinoma, 3% adenosquamous and 8% of other
histology. Among these cases, more than half (52%) were diagnosed as stage III.
HPV Prevalence in the Philippines
HPV prelavence in cervical cancer
The strong association between HPV and cervical cancer is well established. The reported
prevalence of all HPV types is 93.8% in squamous cell carcinoma and 90.9% in adenocarcinomas.4
HPV 16 and 18 are the 2 most common HPV types, although HPV 18 alone is relatively more
frequent in the Philippines compared to the type distribution estimates in the world. Other common
HPV types in decreasing frequency are 45, 52, 51. For women with squamous cell carcinoma, the
most common HPV type is 16, followed by types 18, 45, 52 and 51; whereas for women with
adenocarcinoma, HPV type 18 is the most common,4 followed by types 16 and 45.
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23. HPV prevalence in women with normal cytology
For Filipino with normal cervices, the reported incidence of HPV of any type is 9.2%. HPV
type 45 is the most common, followed by HPV types 16 and 18.
Conclusion
Cervical cancer has remained a leading cancer in women in the Philippines. For close to five
decades, standard Pap screening has been available for opportunistic screening, but organized
programs have yet to be implemented, largely due to high costs and needs for infrastructure within
the health system. Recently, alternatives to Pap smear screening have been introduced, where VIA-
cryotherapy programs are being actively evaluated. HPV vaccination has been approved in the
Philippines with new efforts to integrate primary prevention at the forefront of cervical cancer
control. Since the NIH recommendation in 1999, concurrent chemoradiation is still the standard
treatment for cervical cancer. Though it may be a challenge, future directions should be towards
improving availability of both preventive and curative measures of cervical cancer management to
the general population.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676501/
REACTION:
Human Papilloma Virus (HPV) is highly preventable by immunization.
It is alarming to note however that the incidence rate is high in the
Philippines. We must remember that HPV can cause cervical cancer. The
government must ensure availability of the HPV vaccine to all women. Those
who cannot afford the immunization must be subsidized by the government,
especially the at risk population. Nurses can offer valuable help by
informing the public about the disease and its prevention, i.e. by
immunization, and be role models by getting the vaccine themselves.
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