ALTERNATE FUEL

Viking Line Sees Improved Supplies of Bio-LNG on the Market

Viking Grace (Courtesy Viking)

PUBLISHED APR 14, 2024 11:18 PM BY THE MARITIME EXECUTIVE

 

Finnish ro/pax operator Viking Line began offering passengers the opportunity to pay for bio-LNG on its voyages last year, and the possibilities for using this sustainable fuel have been growing, the company reported last week. 

"We made sure that Viking Glory, which was completed in 2021, and Viking Grace, which was completed in 2013, were built with the technological readiness to use biogas and synthetic fuels produced from renewable energy," said Viking Line’s Sustainability Manager, Dani Lindberg. "There is now enough biogas being produced in the market so that we can start to use this fuel together with liquefied natural gas for these two climate-smart vessels."

Under Viking's low-carbon pricing program, passengers on the Turku route are offered the option of buying biofuel to cover their journey. This adds a manageable fee of up to €5 in addition to the fare, which ranges between €45-55. The price is based on the typical fuel usage per passenger, and effectively reduces the passenger’s carbon footprint by up to 90 percent. The two passenger ferries make two sailings each day on the same route, and the voyage takes eight to 12 hours depending on the vessel. 

Last year, Lindberg said that the local supply of bio-LNG was limited, constraining the amount that Viking could access. Subsidies may be required to expand production, according to the International Council on Clean Transportion (ICCT); with the right policies, 98 billion cubic meters (bcm) of biomethane could be produced in Europe by 2050, according to an industry-backed study for Gas for Climate. This would be enough to replace about 30 percent of current European demand for pipeline gas. 

Viking also uses electricity from renewable energy at all of the ports where it uses shore power, which reduces the company’s annual greenhouse gas emissions by about 780 tonnes. Last year it also sold its largest and most emissions-intensive vessel, the M/S Rosella. 

For the second time, Viking Line was named the most sustainable company in maritime transport service between Finland and Sweden last year, based on a passenger survey.

Methanol-Fuelled MAN 21/31DF-M GenSet Secures First Propulsion Order

Three MAN 21/31DF-M units are bound for a chemical tanker

PUBLISHED APR 15, 2024 9:38 AM BY THE MARITIME EXECUTIVE

 

[By: MAN Energy Solutions]

MAN Energy Solutions has received an order for 3 × MAN 6L21/31DF-M (Dual Fuel-Methanol) GenSets capable of running on methanol in connection with the construction of a 7,990 dwt IMO Type II chemical bunker tanker.

The dual-fuel engines will form part of a diesel-electric propulsion system on board the vessel with electrical motors driving twin fixed-pitch propellers via gearboxes; an onboard battery-storage system will optimise the use of the dual-fuelled generators. MAN Energy Solutions’ licensee, CMP – an engine-manufacturing division of Chinese State Shipbuilding Corporation (CSSC) – will build the engines in China and the vessel is scheduled for delivery during Q4, 2025.

The newbuild will operate at the port of Singapore under charter to deliver marine fuels. The port itself is reported as laying plans for the steady supply of methanol from 2025 onwards in order to meet future, anticipated bunkering requirements for methanol-fuelled vessels. 

Bjarne Foldager – Country Manager, Denmark – MAN Energy Solutions, said: “Seeing our trusted MAN L21/31 GenSets go into these ships as a methanol-fuelled version shows that maritime decarbonisation is a prominent consideration for shipowners in all vessel segments and sizes. It also clearly illustrates, regardless of the market one serves as shipowner, that our broad, dual-fuel portfolio enables everyone to take part in the green transition.”

Thomas S. Hansen – Head of Sales and Promotion – MAN Energy Solutions, said: “The MAN L21/31 engine is well-established in the market having racked up some 2,750 sales. The reliability of its cost-effective, port fuel-injection concept now prominently positions the 21/31DF-M as the preferred, medium-speed, small-bore engine for GenSet and diesel-electric propulsion solutions, while also meeting market demands to balance both CAPEX and OPEX. With the shipping market currently experiencing an increased interest in methanol as marine fuel, and orders for methanol-fuelled ships steadily growing as part of many companies’ decarbonisation strategy, we feel that the introduction of this dual-fuel engine is timely.”

The products and services herein described in this press release are not endorsed by The Maritime Executive.

Thinking outside the doctor’s office: Poll looks at older US adults’ use of urgent care, retail clinics and more

Majority have gotten health care at an “alternative” site in the past two years, but survey of people ages 50 to 80 shows variations in use, motivations and attitudes

Reports and Proceedings

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

When today’s older adults were growing up, urgent care centers and clinics inside retail stores didn’t exist. But most of them have now embraced these non-traditional sites for getting medical care, a new national poll finds.

 

In the past two years, 60% of people age 50 to 80 have visited an urgent care clinic, or a clinic based in a retail store, workplace or vehicle, according to new findings from the University of Michigan National Poll on Healthy Aging.

 

Urgent care clinics were the most common alternative source of care, with 47% of adults age 50-80 visiting one at least once, and 23% going more than once, in the past two years.

 

Many of those who went to any alternative site said they did so to avoid going to the emergency room (44%) or to get a vaccine, a test or an exam (35%). They went for a variety of health reasons, including getting immediate attention for symptoms and injuries, getting vaccinated, and receiving tests or treatments for COVID-19 infections.

 

And 75% of those who have gone to such a site recently say they’re likely to go again in the next two years.

 

But even as they sought care at these sites, most older adults who also have a primary care provider preferred the quality of care and sense of connection at their regular clinic. Among those who say they’re not likely to go to an alternative site for care in the future, 74% said it’s because they prefer to go to their regular provider.

 

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, U-M’s academic medical center. Two members of AARP’s Public Policy Institute worked with the poll team on the poll questions and report.

 

“The rapid rise in availability of these kinds of clinics, which typically offer walk-in convenience, expanded hours, and self-scheduling of appointments in locations close to home, work or shopping, has transformed the American health care landscape in less than two decades,” said poll director Jeffrey Kullgren, M.D., M.P.H., M.S. “With the nationwide shortage of primary care providers, it’s important to understand how this age group, with generally higher medical needs, views and uses this type of care.”

 

Kullgren is a primary care physician at the VA Ann Arbor Healthcare System and associate professor of internal medicine at U-M.

 

“Access to timely and convenient care was critical for older adults during the pandemic, and our research shows alternative care options will continue to be in demand for the long-term,” said Susan Reinhard, senior vice president and director of AARP Public Policy Institute. “Policymakers and clinicians must ensure that patients receive high quality care at sites like urgent care clinics that is well-coordinated with their usual health care provider.”

 

Other key findings from the poll:

 

• The percentage of older adults who had gone to a retail clinic was half that of the proportion who had gone to an urgent care center, at 28% vs 47%. Only 9% had gone to a clinic at their worksite, and 5% had gotten care from a traveling provider based in a bus or van.
• Those in their 50s and early 60s were more likely than those age 65 to 80 to have sought care from one of these types of alternative care sites, at 64% vs. 55%.
• Women were more likely than men to have gone to an alternative site for care in the last two years, at 63% vs. 57%.
• Older adults who live in urban or suburban areas with populations over 50,000 were more likely than those in less-populated areas to have gone to an alternative site for care, at 62% vs 52%.
• 61% of those who said they have a primary care provider said they visited an urgent care clinic, retail clinic or other alternative site in the past two years. The majority (64%) had let that regular provider know they had gone to an alternative site.
• Asked to compare the two, 43% of those who had gone to an alternative site for care said the alternative site was more convenient than their usual provider. But 52% said the quality of care was better at their usual provider’s clinic, and 67% said they felt more connection to their provider at their usual clinic.
• Cost does not seem to be a main driver for seeking care at a non-traditional site, with only 9% of alternative site users citing it as a reason. And 19% of those who had gone to an alternate care site said their alternative site was better on cost. Also, 23% of those who said they weren’t likely to go to an alternative site for care in the next two years said that they were concerned about cost or lack of insurance coverage for such care.
• 43% of those who haven’t gotten care at an alternative care site in the past two years say they are likely to do so in the next two years. 

 

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in July and August 2023 among 2,657 adults aged 50 to 80. The sample was subsequently weighted to reflect the U.S. population. Read past National Poll on Healthy Aging reports and about the poll methodology.

 

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METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

Experiencing racial discrimination impacts the mental health of teens in the U.S. (IN) justice system

Interventions need to consider adolescents' exposure to interpersonal racial discrimination alongside other forms of violence when providing care

SOUTHERN METHODIST UNIVERSITY

DALLAS (SMU) – A new study by SMU psychologists shows interpersonal racial discrimination and other forms of violence can impact the mental health of adolescents in the justice system.

The research advocates for a more holistic approach to mental health intervention, emphasizing the importance of considering adolescents' experiences of interpersonal racial discrimination alongside other more recognized forms of violence. By acknowledging and addressing these intersecting factors, stakeholders can better tailor support systems to meet the unique needs of adolescents of color in the justice system.

Published in the Journal of Interpersonal Violence, the study involves 118 adolescents of color, ages 14 to 17, and their mothers, comparing the effects of interpersonal racial discrimination together with experiences of harsh parenting, teen dating violence, and exposure to parental partner violence. The authors note that while interpersonal racial discrimination can be conceptualized as a type of interpersonal violence, it is seldom considered as such.

This can be a problem when trying to understand how a teen’s exposure to interpersonal violence, in various forms, relates to their mental health symptoms and subsequent acts of delinquency. The authors note that adolescents of color are disproportionately represented in the U.S. justice system, a disparity that previous studies have tied to racism and interpersonal racial discrimination.

“It is common for researchers to look at common adverse childhood experiences related to violence, but often racial discrimination is left out of the equation,” said lead author Ernest Jouriles, professor and director of clinical training in SMU’s Department of Psychology. “We found that experiencing interpersonal racial discrimination is as harmful, if not more harmful, than other commonly studied traumatic events.”

The research used 3-month, longitudinal data from a larger study that looked at how mother-adolescent communication about dating relationships is linked to adolescent dating violence and victimization. Participants in that study were recruited with flyers distributed at truancy courts, by probation offices, and through victim services offices.

Half of the teenagers reported experiencing violence from their parents, and more than half said they had experienced violence in their dating relationships. Some also reported they had seen their parents being physically violent with each other. About half noted they themselves had been mistreated because of their race. Many believed the unfair treatment stemmed from people perceiving the teens as lacking intelligence.

“Historically, this research has been very siloed, with racial discrimination in one area of research and interpersonal violence in another, but our results suggest they should be examined together,” said Melissa Sitton, a doctoral student in the SMU Clinical Psychology program and one of the paper’s authors. “Researchers, clinicians and others providing services must assess situations more broadly to provide more effective assistance.”

Sitton will present the research at the upcoming Society for Research in Child Development Anti-Racist Developmental Science Summit: Transforming Research, Practices, and Policies Summit, scheduled for May 15-17 in Panama City, Panama.

Additional research team members include SMU professors David Rosenfield and Renee McDonald and Pricilla Lui from the University of Washington. Research reported in this press release was supported by the Centers for Disease Control and Prevention under Award Number R01CE001432.

About SMU

SMU is the nationally ranked global research university in the dynamic city of Dallas. SMU’s alumni, faculty and more than 12,000 students in eight degree-granting schools demonstrate an entrepreneurial spirit as they lead change in their professions, communities and the world.

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JOURNAL

Journal of Interpersonal Violence

DOI

10.1177/08862605241227981 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Interpersonal Violence, Racial Discrimination, and Mental Health Symptoms Among Adolescents of Color in the Juvenile-Justice System

Visiting white parts of town make some Black kids feel less safe

Familiarity seems to reveal threats, new study finds

Peer-Reviewed Publication

OHIO STATE UNIVERSITY

COLUMBUS, Ohio – Some Black youth feel less safe when they visit predominantly white areas of their city, a new study in Columbus has found.

 

And it was those Black kids who spent the most time in white-dominated areas who felt less safe, said Christopher Browning, lead author of the study and professor of sociology at The Ohio State University.

 

“Familiarity with white neighborhoods doesn’t make Black kids feel more comfortable and safer. In fact, familiarity seems to reveal threats,” Browning said.

 

“It is not a terribly optimistic finding.”

 

The study was published online recently in the Journal of Adolescent Health.

 

The study is one of the first to examine racial differences in how urban youth perceive their safety in real time, Browning said.  Data came from the federally funded Adolescent Health and Development in Context study, which involved 1,405 11- to 17-year-old youths in Columbus.

 

Researchers gave participants smartphones, which they used to report on how safe they felt as they moved through the city over a one-week period.

 

Five random times a day, the youths received a mini-survey that asked them where they were, what they were doing, who they were with and social characteristics of the setting. The GPS on their phone also recorded their location.

 

Each survey also asked them to rate on a 5-point scale if the location they were in was a safe place to be.

 

Researchers classified the youth as being in a white-dominated area if the census-block they were in when they were surveyed was at least 70% non-Hispanic white.

 

The study also measured violent crime levels in the areas that the youth visited.

 

Results showed that youth generally felt safe when they were near their homes – those who were within 30 meters of their home had about a 14% greater probability than others of strongly agreeing they felt safe in the moment.

 

Not surprisingly, both Black and white youth were less likely to say they felt safe when they were in census blocks that had higher violent crime rates.

 

But it was the racial differences that were of greatest interest to the researchers.

 

“When white youth are in white-dominated spaces, they tended to feel a little safer,” said Browning, who is also a member of Ohio State’s Institute for Population Research. “But that’s not the case for Black youth.”

 

The issue that Black youth face in Columbus and most other cities is that the resources they want and need – such as shopping, entertainment, libraries and restaurants – are often located in predominantly white areas.

 

Results of the study showed that Black youth who live in segregated, predominantly Black neighborhoods spend an average of 40% of their non-home time in white-dominated neighborhoods – about twice as much time as they spend in their own neighborhoods.

 

And the unsafe feeling for Black participants in the study increased with more exposure to predominantly white neighborhoods.  For example, for teenagers exposed, on average, to 70% white neighborhoods, being outdoors in a white neighborhood reduced the probability of reporting strong agreement that the location was safe by about 26%.

 

“There is this complicated trade-off that Black youth have to navigate in which they want to take advantage of these organizational resources that are mainly available in white areas of the city,” Browning said. “But they also have to deal with feeling concerned about their safety.”

 

In order to keep the mini-surveys short, youth were not asked what led to their feelings of relative safety when they were in different parts of the city.  But other research points to why Black youth would feel less safe in white-dominated areas of the city, he noted.

 

There is the fear of being the victim of racial violence or having a potentially dangerous encounter with police, which, while rare, is always possible, he said.

 

“But there is also the sense of psychological safety.  We think of it as the sense of trust that Black youth have that they can be themselves and not be at risk of being excluded, which could include anything from microaggressions to outright discrimination,” he said.

 

This perception of being less safe in white neighborhoods may have real-life health consequences for Black youth. In a study published last year in the journal Psychoneuroendocrinology, Browning and colleagues measured hair cortisol concentrations in some of the same Black and white youths (690 total) involved in this research. High hair cortisol levels indicate elevated levels of chronic stress.

 

The findings showed that Black youth who perceived they were less safe also had higher levels of hair cortisol. Similar findings were not seen in white kids.

 

“We found that feelings of safety among Black kids predict this biological indicator of stress found in hair. High levels of chronic stress could have negative effects on health,” Browning said.

 

The results show the challenges that Black youth face living in American cities.

 

While a lot of attention has been paid to the problems Black youth face growing up in segregated neighborhoods, this study suggests that leaving those areas may present problems as well.

 

“Black youth face unique challenges when they try to use the resources that are often found only in white-dominated neighborhoods in their city,” Browning said.

 

Other co-authors were Bethany Boettner of Ohio State’s IPR; Nicolo Pinchak of the University of Oxford in the UK; and Catherin Calder of the University of Texas at Austin.

 

Funders of the study included the National Institute on Drug Abuse, the Eunice Kennedy Shriver National Institute on Child Health and Human Development, and the W.T. Grant Foundation.

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JOURNAL

Journal of Adolescent Health

DOI

10.1016/j.jadohealth.2024.01.022 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Racial Differences in Activity Space Exposures and Everyday Perceptions of Safety Among Urban Youth

 

Mental health disparities growing among transgender adults

AMERICAN PUBLIC HEALTH ASSOCIATION

In the U.S., transgender and gender non-conforming (TGNC) individuals represent a historically marginalized segment of society. They often report unfavorable outcomes in terms of both physical and mental health compared to their cisgender counterparts. Despite advancement in psychological and physical healthcare provisions for TGNC individuals over the years, they face significant barriers that hinder access to crucial services, including but not limited to, lengthy waiting lists, inconvenient travel requirements and a lack of insurance coverage.

In a recent study published in the May 2024 issue of the American Journal of Public Health, researchers examined changes in self-reported mental health from 2014 to 2021 among a nationally representative adult population. By analyzing data from the U.S. Behavioral Risk Factor Surveillance System Survey, researchers Donn Feir of the University of Victoria and Samuel Mann of the RAND Corporation found that mental health distress increased disproportionately among TGNC adults over this period, compared to cisgender adults.

The number of self-reported “poor mental health days” per month serves as a reliable indicator of mental health, correlating with other psychological and physical health indicators. While TGNC individuals reported more poor mental health days in 2014, the statistics worsened significantly over the next seven years. 

“In 2014, cisgender individuals reported a mean average of 3.68 poor mental health days, compared with a mean average of 5.42 poor mental health days among transgender respondents. The size of this disparity adjusted by differences in observable characteristics increased by 2.75 days over the sample period,” explained Mann.

Researchers also uncovered a disproportionate rise in the frequency of mental health distress reported by TGNC individuals during the seven-year study period. “In 2014, 11.4% of cisgender adults reported frequent mental distress compared with 18.9% of transgender adults. By 2021, [those numbers rose to] 14.6% of cisgender adults and 32.9% of transgender adults report[ing] frequent mental distress,” Feir noted.

The observed trend of rapidly increasing mental distress among TGNC adults indicates potential worsening of socioeconomic and other disparities, as well as an increase in the barriers that prevent them from accessing the support services they need. This increase in mental distress within the TGNC population could also stem from factors such as societal discrimination or lack of access to gender-affirming and mental health care resources.

The alarming increase in the frequency of self-reported mental distress among transgender individuals suggests an urgent need to recalibrate country-wide initiatives supporting TGNC individuals across the U.S. Resource allocation that enhances access to gender-affirming and mental health services may also be a crucial step in mitigating disparities in mental health between TGNC and cisgender people.

Finally, policy changes that promote overall well-being and inclusivity for TGNC individuals may help improve mental health outcomes for this underserved community in the long run. “Policies are needed to address the worsening mental health of transgender and gender-nonconforming people in the United States,” Mann concluded.
 

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JOURNAL

American Journal of Public Health

DOI

10.2105/AJPH.2024.307603 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Temporal Trends in Mental Health in the United States by Gender Identity, 2014–2021

ARTICLE PUBLICATION DATE

10-Apr-2024

EMOTIONAL PLAGUE

Economic burden of childhood verbal abuse by adults estimated at $300 billion globally

UNIVERSITY COLLEGE LONDON

Childhood verbal abuse by adults costs society an estimated $300 billion (£239 billion) a year globally, show findings presented at the first international conference on childhood verbal abuse, hosted by UCL, Words Matter and the World Health Organization (WHO).

The Words Matter: Impact and Prevention of Childhood Verbal Abuse conference marks the first time that experts from around the world have come together to focus attention on the lifetime damage of childhood verbal abuse and the need to develop solutions.

Childhood verbal abuse involves behaviours that can be detrimental to a child’s wellbeing, such as belittling, shouting and threatening language.

The new study, led by Professor Xiangming Fang (China Agricultural University and Georgia State University) used data from the US Centers for Disease Control and Prevention’s Violence Against Children Surveys, in four countries: Cambodia (1212 participants), Kenya (1099 participants), Colombia (1415 participants) and Moldova (906 participants), to analyse the effects of childhood verbal abuse on selected health outcomes, including mental distress, self-harm, drug use and problem drinking.

The study then estimated the Disability-Adjusted Life Years (DALY) lost (the total amount of healthy life years lost due to people dying prematurely or living with a disability caused by a common disease or health problem in the community) due to health outcomes attributed to childhood verbal abuse to estimate its economic burden.

These DALY losses were then converted into monetary value – assuming that one DALY was equal to the country’s per-capita Gross Domestic Product (GDP).

The mean economic burden of childhood verbal abuse across the four countries was found to be 0.34% of GDP. When this figure was applied to global GDP, it equated to approximately $300 billion every year.

Meanwhile, the DALY losses for outcomes attributed to childhood verbal abuse were significantly great than corresponding estimates for breast cancer and liver cancer in the four countries studied, and similar to the Disability-Adjusted Life Years lost to hypertensive heart disease.

Conference Chair, Professor Peter Fonagy (UCL Psychology & Language Sciences), said: “Verbal abuse of children by adults is all too common, but is one of the most significant modifiable causes of life-long mental health disorders.

“Tackling it gives us a powerful lever to prevent mental health disorders and their enormous cost to both the UK and global economy.

“I am delighted that with the Words Matter charity, we have an organisation finally focusing on this problem. Bringing greater awareness to childhood verbal abuse has the potential to dramatically reduce the economic and psychological burden of psychiatric disorders.”

Previous research from experts at UCL and Wingate University* found that childhood verbal abuse can be as harmful as other forms of abuse and have significant adverse impacts on children’s mental and physical health and development – leading to anxiety, depression, eating disorders, self-harm, substance abuse and even suicide.

Professor Xiangming Fang said: “The economic burden of childhood verbal abuse by adults that we have quantified clearly highlights the shocking hidden cost of the damage it causes to children throughout their lifetime. However, this is likely a considerable underestimate given the impact of childhood verbal abuse on several outcomes including healthcare utilisation costs and legal system expenses, which were not included in the analysis due to data unavailability.

“There is clearly a significant opportunity for economic growth by ending childhood verbal abuse, and by revealing these figures, we hope this form of childhood maltreatment will be given the attention it deserves. Vital now is undertaking more research and devoting funds and resources to preventing it, so the cost to society can be reduced.”

Jessica Bondy, Founder of Words Matter, said: “For too long, childhood verbal abuse by adults has gone under the radar, yet it is all around us. We hope this conference helps put the issue firmly on the map and galvanises action. It is possible to bring an end to childhood verbal abuse with greater awareness, understanding and collaboration across the globe to devise solutions. We must act now, given the lifelong impact on children’s mental and physical health and wellbeing and the monumental cost to society. Let’s build children up, not knock them down, and create a better future for children.”

Tim Loughton MP, Chair of the All-Party Parliamentary Group for Children and former Children’s Minister said: “By convening this conference, the work of Words Matter and its expert advisers is filling a gap in understanding the harms that can be inflicted on children from the way adults communicate with them and the routes for prevention. Whilst we are all too familiar with the damage done to children as a result of physical violence, verbal abuse is more insidious and pervasive, impacting so many whose mental health has already been deeply affected due to the Covid pandemic.

“We all have a duty of care to treat children with respect and that includes the words and language we use with them. This conference highlights how much words really do matter and how if used poorly, they can have lasting implications for children and our economy.”

Former Health Minister and Chief Executive of the NHS Confederation and currently Opposition Whip, Lord Philip Hunt of Kings Heath said: “All children deserve to grow up happy and healthy, but millions are suffering verbal abuse by adults which has for far too long been hidden in the shadows. Thanks to the work of Words Matter, we now know that this is not only impacting children's mental health and development but is also, as this new study shows, having a huge cost on society as a whole. We all want children to develop armed with the tools to lead confident and productive adult lives and the words they hear from adults are so important in building self-esteem and confidence. By shining a light on this abuse, lives can and will be changed.”

Study limitations

The $300 billion is likely a considerable underestimate given the impact of childhood verbal abuse on several outcomes, including healthcare utilisation costs and legal system expenses, which were not included in the analysis, due to data unavailability.

Additionally, costs associated with chronic illnesses such as diabetes, heart disease, and cancer were not taken into account.

Multiple risk factors can contribute to the occurrence of any disease. When attributing a disease to these factors the maximum attribution is capped at 100%. However, if multiple risk factors are involved and overlap, the sum of DALY estimates for all risk factors may exceed 100%. Failure to fully account for these inter-correlations could potentially result in overestimation of the figures instead.

The field lacks reliable longitudinal data to assess the long-term repercussions of childhood verbal abuse. 

The absence of high-quality cohort studies that adopt a lifetime perspective in economic data estimation may lead to a substantial underestimation of the economic impact of childhood verbal abuse. 

Prioritising the collection of longitudinal data on the consequences of childhood verbal abuse should be a primary focus of future efforts.

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METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

 

More than half a million global stroke deaths may be tied to climate change

Stroke-related deaths on rise in regions with high temperatures

AMERICAN ACADEMY OF NEUROLOGY

MINNEAPOLIS – A changing climate may be linked to growing death and disability from stroke in regions around the world, according to a study published in the April 10, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. Researchers found over three decades that non-optimal temperatures, those above or below temperatures associated with the lowest death rates, were increasingly linked to death and disability due to stroke. The study does not prove that climate change causes stroke. It only shows an association. The study also did not examine other risk factors such as high blood pressure and high cholesterol levels.

Researchers found that the majority of these strokes were due to lower than optimal temperatures, however they also found an increase in strokes tied to higher than optimal temperatures. With lower temperatures, a person’s blood vessels can constrict, increasing blood pressure. High blood pressure is a risk factor for stroke. Higher temperatures may cause dehydration, affecting cholesterol levels and resulting in slower blood flow, factors that can also lead to stroke.

“Dramatic temperature changes in recent years have affected human health and caused widespread concern,” said study author Quan Cheng, PhD, of Xiangya Hospital Central South University in Changsha, China. “Our study found that these changing temperatures may increase the burden of stroke worldwide, especially in older populations and areas with more health care disparities.

For the study, researchers looked at 30 years of health records for more than 200 countries and territories. They examined the number of stroke deaths and burden of stroke-related disability due to non-optimal temperatures.

They then divided the data to look at different regions, countries and territories. They also looked at age groups and genders.

In 2019, there were 521,031 stroke deaths linked to non-optimal temperatures. There were also 9.4 million disability-adjusted life years due to stroke linked to non-optimal temperatures. Disability-adjusted life years are the number of years of life lost due to premature death and years lived with illness.

When looking at low temperatures compared to high temperatures, they found that 474,002 of the total deaths were linked to low temperatures.

Researchers found that the rate of death from stroke from temperature changes for male participants was 7.7 per 100,000 compared to 5.9 per 100,000 for female participants.

When looking at regions, central Asia had the highest death rate for stroke linked to non-optimal temperatures with 18 per 100,000. At the national level, North Macedonia had the highest death rate with 33 per 100,000.

“More research is needed to determine the impact of temperature change on stroke and to target solutions to address health inequalities,” Cheng said. “Future research should aim to reduce this threat by finding effective health policies that address potential causes of climate change, such as the burning of fossil fuels, deforestation and industrial processes.”

The study was supported by Hunan Youth Science and Technology Talent Project.

Learn more about stroke at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, X and Instagram.

When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with over 40,000 members. The AAN’s mission is to enhance member career fulfillment and promote brain health for all. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, concussion, epilepsy, Parkinson's disease, multiple sclerosis, headache and migraine.

For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, X, Instagram, LinkedIn and YouTube.

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JOURNAL

Neurology

ChatGPT could help reduce vaccine hesitancy and provide helpful advice on STIs

ChatGPT responses to common questions about vaccination and STIs were on par with answers from professional organizations and guidelines

EUROPEAN SOCIETY OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES

Pilot study shows potential for using AI chatbots to assist public health campaigns in reducing vaccine hesitancy as well as providing helpful advice on STIs and access to care.

New research being presented at this year’s ESCMID Global Congress (formerly ECCMID) in Barcelona, Spain (27-30 April) suggests that the free-to-use, widely accessible ChatGPT could be an effective tool to help reduce vaccine hesitancy among the general public, as well as providing helpful advice on sexually transmitted infections (STIs) in conjunction with sexual health clinics, by improving knowledge and access to care.

“Our findings showed that ChatGPT displayed a remarkable ability to accurately respond to a wide breadth of commonly asked questions, encompassing topics such as misconceptions around mRNA vaccination and the importance of testing for STIs,” says lead author Dr Matthew Koh from the National University Health System (NUHS) in Singapore. “In the majority of instances, ChatGPT performed at the level of advice provided by professional organisations and guidelines.”

Since its unveiling in November 2022, millions of people have used AI (artificial intelligence) chatbots like ChatGPT for everything from making music to answering trivia to helping with homework. But ChatGPT has been mired in issues around its accuracy.

Vaccines have stopped epidemics and almost eradicated deadly diseases in the past such as polio, but vaccine hesitancy, directly linked to misinformation—false, inaccurate information promoted as factual—is on the rise, resulting in lower vaccine uptake. Since the public debut of ChatGPT, individuals with mistrust of health professionals may be using the technology to address their concerns.

Similarly, for individuals trying to access information on sexual health, or those worried about the stigma and embarrassment of attending a clinic, or with limited access to healthcare, could find using ChatGPT is a good way to get answers about STIs.

To find out more, researchers from the NUHS in Singapore tested ChatGPT to see whether it could successfully provide answers to common questions about vaccination and STIs.

A team of physicians who run infectious disease clinics asked ChatGPT to answer 15 commonly asked questions on vaccine hesitancy, including questions on doubts about the efficacy of vaccines, concerns about adverse effects, and cultural concerns relating to vaccines (see table in notes to editors).

They also asked ChatGPT 17 common questions on STIs based on general risk factors, access to care and diagnosis, and management and post-exposure prophylaxis (see table in notes to editors).

The AI-generated responses on vaccine hesitancy were then assessed by two independent infectious disease experts against recommendations from the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP), and the chatbot answers on STIs were assessed against the 2021 US CDC STI Treatment Guidelines. All responses were evaluated for their completeness, quality, and accuracy.

Factual responses to vaccine hesitancy concerns

The researchers found that overall ChatGPT’s output provided factual responses and reassurance to vaccine hesitancy concerns.

For example, ChatGPT accurately highlighted the indication for measles vaccination in low incidence settings, and discussed the potential benefits of male human papillomavirus (HPV) vaccination. However, the AI chatbot failed to acknowledge the suggested ACIP age cut-offs for HPV vaccination, or account for a specific individual’s situation such as how sexually active they are.

In addition, ChatGPT provided reassurances for people with an egg allergy and influenza vaccination, and addressed misconceptions around mRNA vaccination and permanent alterations in DNA with high accuracy. However, it did not offer the non-mRNA vaccine options for COVID-19, but did encourage further discussions with healthcare professionals.

ChatGPT also appropriately acknowledged the complexity of religious issues around vaccination and directed individuals to have further discussions with religious leaders. Importantly, however, the researchers found that without specific details of the religious concern and the specific vaccine, ChatGPT’s advice was generic and it did not provide a more detailed risk-benefit discussion.

“Overall, ChatGPT’s responses to vaccine hesitancy were accurate and may help individuals who have vaccine-related misconceptions”, says Dr Koh, who is also an infectious diseases physician at the National University Hospital in Singapore. “Our results demonstrate the potential power of AI models to assist in public health campaigns and aid health professionals in reducing vaccine hesitancy.”

STI responses generally accurate and concise

The researchers also found that overall, ChatGPT’s responses on STIs were mostly accurate and concise.

For example, when asked about how to prevent STIs, the chatbot recommended safe sex practices HPV vaccinations as well as abstinence, but it failed to provide guidance on other key elements such as HIV pre-exposure prophylaxis.

In addition, the AI chatbot was able to provide general reassurance about STI symptoms, such as noting that other possibilities exist, and recommended going for testing. It also consistently communicated the importance of partner testing and follow-up testing.

However, when asked about chlamydia treatment, ChatGPT suggested either azithromycin or doxycycline, although the CDC favours doxycycline as the first-line treatment. It also failed to highlight the importance of testing for other STIs.

“ChatGPT provided good general advice about STIs, but it lacked specificity and could not tailor its advice to individual’s risk of acquiring STIs”, says Dr Koh. “The goal of this project is to empower the general public. The hope is that individuals can educate themselves with ChatGPT by making accurate advice more accessible and increase vaccine uptake and protection from STIs.”

He continues “We believe that ChatGPT should be used in conjunction with, or in addition to, a physician consultation—the human response is still needed to contextualise the advice that is given to a specific individual’s situation and for it to make the most sense and be the most helpful for the patient.”

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ARTICLE PUBLICATION DATE

10-Apr-2024

COI STATEMENT

The authors declare no conflicts of interest.