Skin infection, housing and social circumstances in children living in remote Indigenous communities: testing conceptual and methodological approaches

BACKGROUND: Poor housing conditions in remote Indigenous communities in Australia are a major underlying factor in poor child health, including high rates of skin infections. The aim of this study is to test approaches to data collection, analysis and feedback for a follow-up study of the impact of housing conditions on child health. METHODS: Participation was negotiated in three communities with community councils and individual participants. Data were collected by survey of dwelling condition, interviews, and audit health centre records of children aged under seven years. Community feedback comprised immediate report of items requiring urgent repair followed by a summary descriptive report. Multivariate models were developed to calculate adjusted incidence rate ratios (IRR) for skin infections and their association with aspects of household infrastructure. RESULTS: There was a high level of participation in all communities. Health centre records were inadequate for audit in one community. The records of 138 children were available for development of multivariate analytic models. Rates of skin infection in dwellings that lacked functioning facilities for removing faeces or which had concrete floors may be up to twice as high as for other dwellings, and the latter association appears to be exacerbated by crowding. Younger children living in older dwellings may also be at approximately two-fold higher risk. A number of socioeconomic and socio-demographic variables also appear to be directly associated with high rates of skin infections. CONCLUSION: The methods used in the pilot study were generally feasible, and the analytic approach provides meaningful results. The study provides some evidence that new and modern housing is contributing to a reduction in skin infections in Aboriginal children in remote communities, particularly when this housing leads to a reduction in crowding and the effective removal of human waste

Community Management of Endemic Scabies in Remote Aboriginal Communities of Northern Australia: Low Treatment Uptake and High Ongoing Acquisition

Like many impoverished areas around the world, Aboriginal communities in Australia experience an unacceptably high burden of scabies, skin infections, and secondary complications. Young children are most at risk. Our study investigated scabies in a remote setting with very high rates of skin disease, a high level of household overcrowding, and limited infrastructure for sanitation and preventive health measures. We assessed uptake of scabies treatment and scabies acquisition following provision of treatment by a community-based skin program. In a household where scabies was present, we found that treatment with topical permethrin cream of all close contacts can significantly reduce a susceptible individual's risk of infection. Our findings also demonstrate the challenges of achieving a high level of treatment participation, with limited permethrin use observed among household contacts. This suggests an urgent need for a more practical treatment option. International efforts to reduce childhood morbidity and mortality have demonstrated the efficacy of numerous child health interventions but have also highlighted the deficits in their delivery and implementation. Experiences like this, where the effectiveness of a coordinated local program delivering an efficacious intervention is hampered by poor treatment uptake and ongoing transmission, are an important and timely message for researchers, program managers, and policy-makers

Cancer mortality by educational level in the city of Barcelona

The objective of this study was to examine the relationship between educational level and mortality from cancer in the city of Barcelona. The data were derived from a record linkage between the Barcelona Mortality Registry and the Municipal Census. The relative risks (RR) of death and 95% confidence intervals (CIs) according to level of education were derived from Poisson regression models. For all malignancies, men in the lowest educational level had a RR of death of 1.21 (95% CI 1.13–1.29) compared with men with a university degree, whereas for women a significant decreasing in risk was observed (RR 0.81; 95% CI 0.74–0.90). Among men, significant negative trends of increasing risk according to level of education were present for cancer of the mouth and pharynx (RR 1.70 for lowest vs. highest level of education), oesophagus (RR 2.14), stomach (RR 1.99), larynx (RR 2.56) and lung (RR 1.35). Among women, cervical cancer was negatively related to education (RR 2.62), whereas a positive trend was present for cancers of the colon (RR 0.76), pancreas (RR 0.59), lung (RR 0.55) and breast (RR 0.65). The present study confirms for the first time, at an individual level, the existence of socioeconomic differences in mortality for several cancer sites in Barcelona, Spain. There is a need to implement health programmes and public health policies to reduce these inequities. © 1999 Cancer Research Campaig

Indium-Free Perovskite Solar Cells Enabled by Impermeable Tin-Oxide Electron Extraction Layers

Corrosive precursors used for the preparation of organic-inorganic hybrid perovskite photoactive layers prevent the application of ultrathin metal layers as semitransparent bottom electrodes in perovskite solar cells (PVSCs). This study introduces tin-oxide (SnOx) grown by atomic layer deposition (ALD), whose outstanding permeation barrier properties enable the design of an indium-tin-oxide (ITO)-free semitransparent bottom electrode (SnOx/Ag or Cu/SnOx), in which the metal is efficiently protected against corrosion. Simultaneously, SnOx functions as an electron extraction layer. We unravel the spontaneous formation of a PbI2 interfacial layer between SnOx and the CH3NH3PbI3 perovskite. An interface dipole between SnOx and this PbI2 layer is found, which depends on the oxidant (water, ozone, or oxygen plasma) used for the ALD growth of SnOx. An electron extraction barrier between perovskite and PbI2 is identified, which is the lowest in devices based on SnOx grown with ozone. The resulting PVSCs are hysteresis-free with a stable power conversion efficiency (PCE) of 15.3% and a remarkably high open circuit voltage of 1.17 V. The ITO-free analogues still achieve a high PCE of 11%