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Human alteration of the nitrogen cycle has resulted in steadily accumulating nitrate in our water resources. The U.S. maximum contaminant level and World Health Organization guidelines for nitrate in drinking water were promulgated to protect infants from developing methemoglobinemia, an acute condition. Some scientists have recently suggested that the regulatory limit for nitrate is overly conservative; however, they have not thoroughly considered chronic health outcomes. In August 2004, a symposium on drinking-water nitrate and health was held at the International Society for Environmental Epidemiology meeting to evaluate nitrate exposures and associated health effects in relation to the current regulatory limit. The contribution of drinking-water nitrate toward endogenous formation of N-nitroso compounds was evaluated with a focus toward identifying subpopulations with increased rates of nitrosation. Adverse health effects may be the result of a complex interaction of the amount of nitrate ingested, the concomitant ingestion of nitrosation cofactors and precursors, and specific medical conditions that increase nitrosation. Workshop participants concluded that more experimental studies are needed and that a particularly fruitful approach may be to conduct epidemiologic studies among susceptible subgroups with increased endogenous nitrosation. The few epidemiologic studies that have evaluated intake of nitrosation precursors and/or nitrosation inhibitors have observed elevated risks for colon cancer and neural tube defects associated with drinking-water nitrate concentrations below the regulatory limit. The role of drinking-water nitrate exposure as a risk factor for specific cancers, reproductive outcomes, and other chronic health effects must be studied more thoroughly before changes to the regulatory level for nitrate in drinking water can be considered.

Objectives To provide direct estimates of risk of cancer after protracted low doses of ionising radiation and to strengthen the scientific basis of radiation protection standards for environmental, occupational, and medical diagnostic exposures. Design Multinational retrospective cohort study of cancer mortality. Setting Cohorts of workers in the nuclear industry in 15 countries. Participants 407 391 workers individually monitored for external radiation with a total follow-up of 5.2 million person years. Main outcome measurements Estimates of excess relative risks per sievert (Sv) of radiation dose for mortality from cancers other than leukaemia and from leukaemia excluding chronic lymphocytic leukaemia, the main causes of death considered by radiation protection authorities. Results The excess relative risk for cancers other than leukaemia was 0.97 per Sv, 95% confidence interval 0.14 to 1.97. Analyses of causes of death related or unrelated to smoking indicate that, although confounding by smoking may be present, it is unlikely to explain all of this increased risk. The excess relative risk for leukaemia excluding chronic lymphocytic leukaemia was 1.93 per Sv ( < 0 to 8.47). On the basis of these estimates, 1-2% of deaths from cancer among workers in this cohort may be attributable to radiation. Conclusions These estimates, from the largest study of nuclear workers ever conducted, are higher than, but statistically compatible with, the risk estimates used for current radiation protection standards. The results suggest that there is a small excess risk of cancer, even at the low doses and dose rates typically received by nuclear workers in this study.

The most informative low-dose radiation study to date provides little evidence for a relationship between mortality from non-malignant diseases and radiation dose. However, we cannot rule out risks per unit dose of the same order of magnitude as found in studies at higher doses.

Clear cause-effect relations could not be established owing to the ecological study design and issues concerning data availability. However, there are clear changes in suicide and transport accident mortality after onset of the crisis, and findings are consistent with previous work. As part of this work, a comprehensive framework was developed, which can be applied to analyse health effects of financial crises in more detail.

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Background:Health literacy is the ability to access, understand, and use health information for enhancing health. Health literacy research has led to the understanding of its associations with health outcomes and health-promoting behavior. Health literacy is essential to health promotion, but a gap exists in the knowledge of health literacy in Ghana, especially among university students.Objective:This study aimed to ascertain the levels of health literacy and its sociodemographic determinants among undergraduate university students of Kwame Nkrumah University of Science and Technology.Methods:A cross-sectional survey was conducted using multistage cluster sampling to select 500 students from six colleges of the University; of those, 485 were included for data analysis after exclusions. Health literacy was assessed using the 16-item short version of the European Consortium for Health Literacy Questionnaire.Key Results:About 55% of students were found to have limited health literacy (20.4% had “inadequate” health and 34.2% had “problematic” health literacy). Students performed low on health literacy dimensions dealing with the access and appraisal of health information, especially relating to mental health. Multivariate logistic regression showed that factors associated with limited health literacy differed for each gender but generally included college type, self-esteem, health status, and year of study.Conclusions:Interventions need to be implemented to improve students' health literacy. [HLRP: Health Literacy Research and Practice. 2019;3(4):e227–e237.]Plain Language Summary:The study reveals that health literacy may be a challenge even for the educated in Ghana especially among vulnerable people. University students should not be assumed to be health-literate and interventions that will help enhance their literacy in health should be implemented.

Important practical lessons can be drawn from this experience for other cities planning to introduce similar formal intersectoral health policies in order to increase the chance of successful intersectoral action in further development and implementation of the intersectoral health policy in varde in the future, the challenges and facilitating factors identified in this study should be considered more evidence is required on the long-term health impacts of such policies.