Atrium Health Wake Forest Baptist
Publishes on Climate Change and Health Impacts, Global Public Health Policies and Epidemiology, Air Quality and Health Impacts. 479 papers and 36.9k citations.
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\n\t\t\t\t\t■ Human well-being has several key components: the basic material needs for a good life, freedom and choice, health, good social relations, and personal security. Well-being exists on a continuum with poverty, which has been defined as&quot;pronounced deprivation in well-being.&quot; <br />■ How well-being and ill-being, or poverty, are expressed and experienced is context- and situation-dependent, reflecting local social and personal factors such as geography, ecology, age, gender,and culture.These concepts are complex and value-laden. <br />■ Ecosystems are essential for human well-being through their provisioning, regulating, cultural, and supporting services. Evidence in recent decades of escalating human impacts. on ecological systems worldwide raises concerns about the consequences of ecosystem changes for human well-being. <br />■ Human well-being can be enhanced through sustainable human interaction with ecosystems with the support of appropriate instruments, institutions, organizations, and technology. creation of these through participation and transparency may contribute to people's freedoms and choices and to increased economic, social,and ecological security. <br />■ Some believe that the problems from the depletion and degradation of ecological capital can be largely overcome by the substitution of physical and human capital. Others believe that there are more significant limits to such substitutions.The scope for substitutions varies by socioeconomic status. <br />■ We identify direct and indirect pathways between ecosystem change and human well-being,whether it be positive or negative.lndirect effects are characterized by more complex webs of causation, involving social, economic, and political threads. Threshold points exist beyond which rapid changes to human well-being can occur. <br />■ Indigent poorly resourced, and otherwise disadvantaged communities are generally the most vulnerable to adverse ecosystem change. Spirals, both positive and negative, can occur for any population, but the poor are more vulnerable.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <br />■ Functioning institutions are vital to enable equitable access to ecosystem services. lnstitutions sometimes fail or remain undeveloped because of powerful individuals or groups. Bodies that mediate the distribution of goods and services may also be appropriated for the benefit of powerful minorities. <br />■ For poor people, the greatest gains in well-being will occur through more equitable and secure access to ecosystem services. In the long run, the rich can contribute greatly to human well-being by reducing their substantial impacts on ecosystems and by facilitating greater access to ecosystem services by the poor. <br />■ We argue ecological security warrants recognition as a sixth freedom of equal weight with participative freedom, economic&nbsp;&nbsp; facilities, social opportunities, transparency guarantees, and protective security.<br />\n\t\t\t\t
Lack of bias in the estimation of relative effect in epidemiologic studies depends on the internal validity of the study. This paper conveys in graphic and tabular form the direction and magnitude of bias due to misclassification of study subjects. A series of computer-generated graphs shows that the departure of the estimate of effect (relative risk or odds ratio) from its true value is a function of sensitivity and specificity (measures of classification validity), disease frequency, and exposure frequency. The discussion of bias emphasizes misclassification of the "outcome" variable; i.e., disease occurrence in a cohort study and exposure rate in a case-control study. Examples are used to illustrate that the magnitude of the bias can be large under circumstances which occur readily in epidemiologic research. When misclassification is equal for the two compared groups, the estimate is biased toward the null value, and in some instances beyond; when differential misclassification occurs (as in selective recall in case-control studies) the bias can be in either direction, and may be great. Formulas are derived to estimate the underlying true value of the relative risk or odds ratio using the investigator's observations together with the estimated sensitivity and specificity of the classification procedure.
The Ecological Society of America has evaluated current U.S. national policies and practices on biological invasions in light of current scientific knowledge. Invasions by harmful nonnative species are increasing in number and area affected; the damages to ecosystems, economic activity, and human welfare are accumulating. Without improved strategies based on recent scientific advances and increased investments to counter invasions, harm from invasive species is likely to accelerate. Federal leadership, with the cooperation of state and local governments, is required to increase the effectiveness of prevention of invasions, detect and respond quickly to new potentially harmful invasions, control and slow the spread of existing invasions, and provide a national center to ensure that these efforts are coordinated and cost effective. Specifically, the Ecological Society of America recommends that the federal government take the following six actions: (1) Use new information and practices to better manage commercial and other pathways to reduce the transport and release of potentially harmful species; (2) Adopt more quantitative procedures for risk analysis and apply them to every species proposed for importation into the country; (3) Use new cost-effective diagnostic technologies to increase active surveillance and sharing of information about invasive species so that responses to new invasions can be more rapid and effective; (4) Create new legal authority and provide emergency funding to support rapid responses to emerging invasions; (5) Provide funding and incentives for cost-effective programs to slow the spread of existing invasive species in order to protect still uninvaded ecosystems, social and industrial infrastructure, and human welfare; and (6) Establish a National Center for Invasive Species Management (under the existing National Invasive Species Council) to coordinate and lead improvements in federal, state, and international policies on invasive species. Recent scientific and technical advances provide a sound basis for more cost-effective national responses to invasive species. Greater investments in improved technology and management practices would be more than repaid by reduced damages from current and future invasive species. The Ecological Society of America is committed to assist all levels of government and provide scientific advice to improve all aspects of invasive-species management.