Madelon Lubin Finkel

Sexual and Contraceptive Knowledge, Attitudes and Behavior of Male Adolescents

A 1974 profile of male adolescent sexuality and contraceptive knowledge is based on a survey of 421 students aged 12 to 19 from three urban high schools in a northeastern American city. 30% of the respondents were black 38% Hispanic and 32% white; mean age was 16.3. Male friends proved to be the most frequent sournce of sexual and contraceptive knowledge; less than 11% of the boys within each ethnic group had acquired information from a family member. A majority of the respondents understood the condoms contraceptive use but far fewer were aware of the protection it offers against veneral disease. 2/3 were aware of the contraceptive unreliability of the douche but only about 1/3 knew that pregnancy could result from the practice of withdrawal during coitus. While 2/3 knew of sperms survival time after ejaculation less than 1/2 could identify the conception phase of the menstrual cycle. Mean age for initial sexual experience was 12.8 years; subsequent sexual activity appeared sporadic. At last coitus 55% of the sexually active respondents used no contraception or relied on withdrawal or their partners douching. Among all sexually active males only 15% reported using a condom for each coitus while 50% reported hardly ever or never using one. The evidence that sexual activity may begin as early as age 13 among adolescent males indicates that many sex education courses are inappropriately times and designed. Sex education in junior high school would provide correct information especially concerning contraception before rather than after iniation to sexual activity.

The Rush to Drill for Natural Gas: A Public Health Cautionary Tale

Efforts to identify alternative sources of energy have focused on extracting natural gas from vast shale deposits. The Marcellus Shale, located in western New York, Pennsylvania, and Ohio, is estimated to contain enough natural gas to supply the United States for the next 45 years. New drilling technology-horizontal drilling and high-volume hydraulic fracturing of shale (fracking)-has made gas extraction much more economically feasible. However, this technique poses a threat to the environment and to the publics health. There is evidence that many of the chemicals used in fracking can damage the lungs, liver, kidneys, blood, and brain. We discuss the controversial technique of fracking and raise the issue of how to balance the need for energy with the protection of the publics health.

Environmental public health dimensions of shale and tight gas development.

Background: The United States has experienced a boom in natural gas production due to recent technological innovations that have enabled this resource to be produced from shale formations. Objectives: We reviewed the body of evidence related to exposure pathways in order to evaluate the potential environmental public health impacts of shale gas development. We highlight what is currently known and identify data gaps and research limitations by addressing matters of toxicity, exposure pathways, air quality, and water quality. Discussion: There is evidence of potential environmental public health risks associated with shale gas development. Several studies suggest that shale gas development contributes to ambient air concentrations of pollutants known to be associated with increased risk of morbidity and mortality. Similarly, an increasing body of studies suggest that water contamination risks exist through a variety of environmental pathways, most notably during wastewater transport and disposal, and via poor zonal isolation of gases and fluids due to structural integrity impairment of cement in gas wells. Conclusion: Despite a growing body of evidence, data gaps persist. Most important, there is a need for more epidemiological studies to assess associations between risk factors, such as air and water pollution, and health outcomes among populations living in close proximity to shale gas operations. Citation: Shonkoff SB, Hays J, Finkel ML. 2014. Environmental public health dimensions of shale and tight gas development. Environ Health Perspect 122:787–795; http://dx.doi.org/10.1289/ehp.1307866

Safety of Vendor-Prepared Foods: Evaluation of 10 Processing Mobile Food Vendors in Manhattan:

Objectives. Unsanitary food handling is a major public health hazard. There are over 4,100 mobile food vendors operating in New York City, and of these, approximately forty percent are processing vendors—mobile food units on which potentially hazardous food products are handled, prepared, or processed. This pilot study assesses the food handling practices of 10 processing mobile food vendors operating in a 38-block area of midtown Manhattan (New York City) from 43rd Street to 62nd Street between Madison and Sixth Avenues, and compares them to regulations stipulated in the New York City Health Code. Methods. Ten processing mobile food vendors located in midtown Manhattan were observed for a period of 20 minutes each. Unsanitary food handling practices, food storage at potentially unsafe temperatures, and food contamination with uncooked meat or poultry were recorded. Results. Over half of all vendors (67%) were found to contact served foods with bare hands. Four vendors were observed vending with visibly dirty hands or gloves and no vendor once washed his or her hands or changed gloves in the 20-minute observation period. Seven vendors had previously cooked meat products stored at unsafe temperatures on non-heating or non-cooking portions of the vendor cart for the duration of the observation. Four vendors were observed to contaminate served foods with uncooked meat or poultry. Conclusions. Each of these actions violates the New York City Code of Health and potentially jeopardizes the safety of these vendor-prepared foods. More stringent adherence to food safety regulations should be promoted by the New York City Department of Health.

The implications of unconventional drilling for natural gas: a global public health concern

Unconventional drilling for natural gas by means of high volume horizontal hydraulic fracturing (fracking) is an important global public health issue. Given that no sound epidemiologic study has been done to assess the extent of exposure-related adverse health effects among populations living in areas where natural gas extraction is going on, it is imperative that research be conducted to quantify the potential risks to the environment and to human health not just in the short-term, but over a longer time period since many diseases (i.e., cancers) appear years after exposure. It should not be concluded that an absence of data implies that no harm is being done.

The Efficacy of Second-Opinion Consultation Programs: A Cost???Benefit Perspective

This study evaluates a mandatory second-opinion consultation program administered on behalf of a large Taft-Hartley welfare fund providing medical care coverage for 120,000 beneficiaries and covered dependents. During a two-year intake period (1977-1978), 2,284 individuals received second-opinion consultations for an elective surgical procedure recommended by a first-contact physician or surgeon. Of this group, 366 received a nonconfirmation of their need for surgery. Medical claims data were available for 342 individuals in this group, and they constitute the base for the current analysis. A comparable number of individuals who received a positive confirmation were randomly selected and served as a control for estimating program savings. Both groups were followed for a one-year period from the date of their consultations. Total program savings were estimated at

The role of ethics in shale gas policies

534,791. Of this amount, medical care utilization savings were

The Elective Surgery Second Opinion Program.

361,756 and productivity savings were

Second opinion elective surgery programs: outcome status over time.

173,035. The cost of the program was

The Shale Gas Boom and the Need for Rational Policy

203,300, yielding a benefit—cost ratio of 2.63. These findings indicate that mandatory second-opinion consultation programs, which are consumer oriented and intervene before care is rendered, are clearly cost-effective.