Health effects of home energy efficiency interventions in England: a modelling study

Objective: To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets. Design: Health impact modelling study. Setting: England. Participants: English household population. Intervention: Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met. (2) As with scenario (1) but with additional ventilation for homes at risk of poor ventilation. (3) As with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance. Main Outcome: Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including: second-hand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures. Results: The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2,241 (95% credible intervals (CI) 2,085 to 2,397) QALYs per 10,000 persons over 50 years due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor–generated PM2.5. Scenario (2) resulted in a negative impact of -728 (95% CI -864 to -592) QALYs per 10,000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in -539 (95% CI -678 to -399) QALYs per 10,000 persons over 50 years due to an increase in indoor exposures despite targeting. Conclusions: If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful understanding of the balance of changes in pollutant exposures, highlighting the importance of ventilation to mitigate the risk of poor indoor air quality

Remote Sensing Analysis of Recent Carbonate Platforms, East of Sabah: Potential Analogues for Miocene Carbonate Platforms of the South China Sea

DOI: 10.17014/ijog.v7i3.141Recent carbonate platforms may provide useful analogues for fossil platforms and reefs, and could allow the generation of quantitative tools for the prediction of facies distribution, reservoir volumes, and reservoir quality. Data from these modern analogues would greatly enhance our ability to construct more reliable and calibrated reservoir models for carbonate fossil fields, such as the Miocene carbonate platforms of Central Luconia Province, Sarawak. In this study, carbonate facies maps and quantitative reservoir data will be generated by using remote sensing techniques. Satellite imageries over the carbonate platforms east of Sabah have been acquired and processed for generating facies maps. In order to produce a reliable facies map, the composition and grain size distribution of the sediments that make up individual facies must be known in order to determine the classes that have been identified on the initial facies maps. Samples collected from the Gaya and Selekan platforms were analyzed and the results of grain size analysis are illustrated

Modelling uniformly porous façades to predict dwelling infiltration rates

It is important to limit dwelling infiltration to reduce energy demand and help meet national climate change commitments while concurrently providing sufficient ventilation to deliver adequate indoor air quality. DOMVENT3D is a model of infiltration and exfiltration that assumes a linear pressure distribution over any number of uniformly porous facades and integrates the airflow rate in the vertical plane to predict the theoretically correct airflow rate through them. DOMVENT3D is a new development of an existing two-dimensional model of infiltration that provides more opportunities for investigating a greater number of dwellings than was previously possible. Initial testing suggests that DOMVENT3D is mathematically robust and is suitable for modelling a wide variety of dwelling types and geometries to assist engineers and policy makers. Practical application: The modern building services engineer may be required to model airflow networks in a building to balance the conflicting needs of energy consumption reduction and occupant health. Limiting exfiltration is one method of reducing heat losses from a building and so there is a need to model it accurately. This article presents a new model of infiltration and exfiltration through a uniformly porous facade that can be incorporated within advanced complex airflow network tools or applied using a simple spreadsheet

A simulation model for diarrhoea and other common recurrent infections: a tool for exploring epidemiological methods

The measurement and analysis of common recurrent conditions such as diarrhoea, respiratory infections or fever pose methodological challenges with regard to case definition, disease surveillance and statistical analysis. In this paper we describe a flexible and robust model that can generate simulated longitudinal datasets for a range of recurrent infections, reflecting the stochastic processes that underpin the data collected in the field. It can be used to evaluate and compare alternative disease definitions, surveillance strategies and statistical methods under ‘controlled conditions’. Parameters in the model include: characterizing the distributions of the individual disease incidence and the duration of disease episodes; allowing the average disease duration to depend on an individual's number of episodes (simulating a correlation between incidence and duration); making the individual risk of disease depend on the occurrence of previous episodes (simulating autocorrelation of successive episodes); finally, incorporating seasonal variation of disease

Prevalence of electrocardiographic abnormalities in West-Asian and African male athletes

International audienceOBJECTIVES: To evaluate the electrocardiographic (ECG) characteristics of West-Asian, black and Caucasian male athletes competing in Qatar using the 2010 recommendations for 12-lead ECG interpretation by the European Society of Cardiology (ESC). DESIGN: Cardiovascular screening with resting 12-lead ECG analysis of 1220 national level athletes (800 West-Asian, 300 black and 120 Caucasian) and 135 West-Asian controls was performed. RESULTS: Ten per cent of athletes presented with 'uncommon' ECG findings. Black African descent was an independent predictor of 'uncommon' ECG changes when compared with West-Asian and Caucasian athletes (p0.05). Seven athletes (0.6%) were identified with a disease associated with sudden death; this prevalence was two times higher in black athletes than in West-Asian athletes (1% vs 0.5%), and no cases were reported in Caucasian athletes and West-Asian controls. Eighteen West-Asian and black athletes were identified with repolarisation abnormalities suggestive of a cardiomyopathy, but ultimately, none were diagnosed with a cardiac disease. CONCLUSION: West-Asian and Caucasian athletes demonstrate comparable rates of ECG findings. Black African ethnicity is positively associated with increased frequencies of 'uncommon' ECG traits. Future work should examine the genetic mechanisms behind ECG and myocardial adaptations in athletes of diverse ethnicity, aiding in the clinical differentiation between physiological remodelling and potential cardiomyopathy or ion channel disorders

Do big athletes have big hearts? Impact of extreme anthropometry upon cardiac hypertrophy in professional male athletes.

AIM: Differentiating physiological cardiac hypertrophy from pathology is challenging when the athlete presents with extreme anthropometry. While upper normal limits exist for maximal left ventricular (LV) wall thickness (14 mm) and LV internal diameter in diastole (LVIDd, 65 mm), it is unknown if these limits are applicable to athletes with a body surface area (BSA) >2.3 m(2). PURPOSE: To investigate cardiac structure in professional male athletes with a BSA>2.3 m(2), and to assess the validity of established upper normal limits for physiological cardiac hypertrophy. METHODS: 836 asymptomatic athletes without a family history of sudden death underwent ECG and echocardiographic screening. Athletes were grouped according to BSA (Group 1, BSA>2.3 m(2), n=100; Group 2, 2-2.29 m(2), n=244; Group 3, 13 mm, but in combination with an abnormal ECG suspicious of an inherited cardiac disease. CONCLUSION: Regardless of extreme anthropometry, established upper limits for physiological cardiac hypertrophy of 14 mm for maximal wall thickness and 65 mm for LVIDd are clinically appropriate for all athletes. However, the abnormal ECG is key to diagnosis and guides follow-up, particularly when cardiac dimensions are within accepted limits

A polymorphic transcriptional regulatory domain in the amyotrophic lateral sclerosis risk gene CFAP410 correlates with differential isoform expression

We describe the characterisation of a variable number tandem repeat (VNTR) domain within intron 1 of the amyotrophic lateral sclerosis (ALS) risk gene CFAP410 (Cilia and flagella associated protein 410) (previously known as C21orf2), providing insight into how this domain could support differential gene expression and thus be a modulator of ALS progression or risk. We demonstrated the VNTR was functional in a reporter gene assay in the HEK293 cell line, exhibiting both the properties of an activator domain and a transcriptional start site, and that the differential expression was directed by distinct repeat number in the VNTR. These properties embedded in the VNTR demonstrated the potential for this VNTR to modulate CFAP410 expression. We extrapolated these findings in silico by utilisation of tagging SNPs for the two most common VNTR alleles to establish a correlation with endogenous gene expression. Consistent with in vitro data, CFAP410 isoform expression was found to be variable in the brain. Furthermore, although the number of matched controls was low, there was evidence for one specific isoform being correlated with lower expression in those with ALS. To address if the genotype of the VNTR was associated with ALS risk, we characterised the variation of the CFAP410 VNTR in ALS cases and matched controls by PCR analysis of the VNTR length, defining eight alleles of the VNTR. No significant difference was observed between cases and controls, we noted, however, the cohort was unlikely to contain sufficient power to enable any firm conclusion to be drawn from this analysis. This data demonstrated that the VNTR domain has the potential to modulate CFAP410 expression as a regulatory element that could play a role in its tissue-specific and stimulus-inducible regulation that could impact the mechanism by which CFAP410 is involved in ALS

Local health and social care responses to implementing the national cold weather plan.

Background: The Cold Weather Plan (CWP) for England was launched by the Department of Health in 2011 to prevent avoidable harm to health by cold weather by enabling individuals to prepare and respond appropriately. This study sought the views of local decision makers involved in the implementation of the CWP in the winter of 2012/13 to establish the effects of the CWP on local planning. It was part of a multi-component independent evaluation of the CWP. Methods: Ten LA areas were purposively sampled which varied in level of deprivation and urbanism. Fifty-two semi-structured interviews were held with health and social care managers involved in local planning between November 2012 and May 2013. Results: Thematic analysis revealed that the CWP was considered a useful framework to formalize working arrangements between agencies though local leadership varied across localities. There were difficulties in engaging general practitioners, differences in defining vulnerable individuals and a lack of performance monitoring mechanisms. Conclusions: The CWP was welcomed by local health and social care managers, and improved proactive winter preparedness. Areas for improvement include better integration with general practice, and targeting resources at socially isolated individuals in cold homes with specific interventions aimed at reducing social isolation and building community resilience