641 research outputs found

    Modelling six sustainable development transformations in Australia and their accelerators, impediments, enablers, and interlinkages

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    There is an urgent need to accelerate progress on the Sustainable Development Goals (SDGs) and recent research has identified six critical transformations. It is important to demonstrate how these transformations could be practically accelerated in a national context and what their combined effects would be. Here we bridge national systems modelling with transformation storylines to provide an analysis of a Six Transformations Pathway for Australia. We explore important policies to accelerate progress, synergies and trade-offs, and conditions that determine policy success. We find that implementing policy packages to accelerate each transformation would boost performance on the SDGs by 2030 (+23% above the baseline). Policymakers can maximize transformation synergies through investments in energy decarbonization, resilience, social protection, and sustainable food systems, while managing trade-offs for income and employment. To overcome resistance to transformations, ambitious policy action will need to be underpinned by technological, social, and political enabling conditions

    The efficacy of intravitreal antivascular endothelial growth factor as primary treatment of retinopathy of prematurity: Experience from a tertiary hospital

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    Background. Retinopathy of prematurity (ROP) is a vasoproliferative disease affecting premature babies and a major cause of blindness in childhood. Appropriate screening and treatment can prevent blindness.Objective. To report on the efficacy of using antivascular endothelial growth factor (bevacizumab) as first-line therapy in ROP.Methods. This was a retrospective analysis of patients with ROP treated at St John Eye Hospital, Johannesburg, South Africa, over a 3-year period. Outcome measures were the clinical response to intravitreal bevacizumab (IVB) as well as the economic impact of IVB therapy.Results. Twenty-three patients were treated for active ROP or type 1 disease, in 44 eyes. Two patients required treatment in one eye only. The mean birth weight of these patients was 1 074 g (range 810 - 1 480). Response to treatment outcome was available for 22 patients (43 eyes). The mean follow-up period was 9 months (range 1 - 18). Forty-one eyes (95.3%) showed complete regression or non-progression of the disease. Two eyes (one eye each in two patients) progressed to advanced disease. There were no short-term adverse events. A cost-effective model showed that IVB treatment was much more economical than laser therapy.Conclusion. IVB is a safe and effective first-line treatment for ROP and should be considered in resource-limited centres

    The efficacy of intravitreal antivascular endothelial growth factor as primary treatment of retinopathy of prematurity: Experience from a tertiary hospital

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    Background. Retinopathy of prematurity (ROP) is a vasoproliferative disease affecting premature babies and a major cause of blindness in childhood. Appropriate screening and treatment can prevent blindness.Objective. To report on the efficacy of using antivascular endothelial growth factor (bevacizumab) as first-line therapy in ROP.Methods. This was a retrospective analysis of patients with ROP treated at St John Eye Hospital, Johannesburg, South Africa, over a 3-year period. Outcome measures were the clinical response to intravitreal bevacizumab (IVB) as well as the economic impact of IVB therapy.Results. Twenty-three patients were treated for active ROP or type 1 disease, in 44 eyes. Two patients required treatment in one eye only. The mean birth weight of these patients was 1 074 g (range 810 - 1 480). Response to treatment outcome was available for 22 patients (43 eyes). The mean follow-up period was 9 months (range 1 - 18). Forty-one eyes (95.3%) showed complete regression or non-progression of the disease. Two eyes (one eye each in two patients) progressed to advanced disease. There were no short-term adverse events. A cost-effective model showed that IVB treatment was much more economical than laser therapy.Conclusion. IVB is a safe and effective first-line treatment for ROP and should be considered in resource-limited centres

    Cohort Profile: The Health Survey for England

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    To monitor the health of the public in England, UK, the Central Health Monitoring Unit within the UK Department of Health commissioned an annual health examination survey, which became known as the Health Survey for England (HSE). The first survey was completed in 1991. The HSE covers all of England and is a nationally representative sample of those residing at private residential addresses. Each survey year consists of a new sample of private residential addresses and people. The HSE collects detailed information on mental and physical health, health-related behaviour, and objective physical and biological measures in relation to demographic and socio-economic characteristics of people aged 16 years and over at private residential addresses. There are two parts to the HSE; an interviewer visit, to conduct an interview and measure height and weight, then a nurse visit, to carry out further measurements and take biological samples. Since 1994, survey participants aged 16 years and over have been asked for consent to follow-up through linkage to mortality and cancer registration data, and from 2003, to the Hospital Episode Statistics database, thus converting annual cross-sectional survey data into a longitudinal study. Annual survey data (1994ā€“2009) are available through the UK Data Archive

    Indoor pm2.5 exposure in London's domestic stock: Modeling current and future exposures following energy efficient refurbishment

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    Simulations using CONTAM (a validated multi-zone indoor air quality (IAQ) model) are employed to predict indoor exposure to PM2.5 in London dwellings in both the present day housing stock and the same stock following energy efficient refurbishments to meet greenhouse gas emissions reduction targets for 2050. We modelled interventions that would contribute to the achievement of these targets by reducing the permeability of the dwellings to 3m3m-2hr-1 at 50 Pa, combined with the introduction of mechanical ventilation and heat recovery (MVHR) systems. It is assumed that the current mean outdoor PM2.5 concentration of 13?g.m-3 decreased to 9?g.m-3 by 2050 due to emission control policies. Our primary finding was that installation of (assumed perfectly functioning) MVHR systems with permeability reduction are associated with appreciable reductions in PM2.5 exposure in both smoking and non-smoking dwellings. Modelling of the future scenario for non-smoking dwellings show a reduction in annual average indoor exposure to PM2.5 of 18.8?g.m-3 (from 28.4 to 9.6?g.m-3) for a typical household member. Also of interest is that a larger reduction of 42.6?g.m-3 (from 60.5 to 17.9?g.m-3) was shown for members exposed primarily to cooking-related particle emissions in the kitchen (cooks). Reductions in envelope permeability without mechanical ventilation produced increases in indoor PM2.5 concentrations; 5.4?g.m-3 for typical household members and 9.8?g.m-3 for cooks. These estimates of changes in PM2.5 exposure are sensitive to assumptions about occupant behaviour, ventilation system usage and the distributions of input variables (Ā±72% for non-smoking and Ā±107% in smoking residences). However, if realised, they would result in significant health benefits

    Indoor PM2.5 exposure in London's domestic stock: Modelling current and future exposures following energy efficient refurbishment

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    Simulations using CONTAM (a validated multi-zone indoor air quality (IAQ) model) are employed to predict indoor exposure to PM2.5 in London dwellings in both the present day housing stock and the same stock following energy efficient refurbishments to meet greenhouse gas emissions reduction targets for 2050. We modelled interventions that would contribute to the achievement of these targets by reducing the permeability of the dwellings to 3 m3 māˆ’2 hāˆ’1 at 50 Pa, combined with the introduction of mechanical ventilation and heat recovery (MVHR) systems. It is assumed that the current mean outdoor PM2.5 concentration of 13 Ī¼g māˆ’3 decreased to 9 Ī¼g māˆ’3 by 2050 due to emission control policies. Our primary finding was that installation of (assumed perfectly functioning) MVHR systems with permeability reduction are associated with appreciable reductions in PM2.5 exposure in both smoking and non-smoking dwellings. Modelling of the future scenario for non-smoking dwellings show a reduction in annual average indoor exposure to PM2.5 of 18.8 Ī¼g māˆ’3 (from 28.4 to 9.6 Ī¼g māˆ’3) for a typical household member. Also of interest is that a larger reduction of 42.6 Ī¼g māˆ’3 (from 60.5 to 17.9 Ī¼g māˆ’3) was shown for members exposed primarily to cooking-related particle emissions in the kitchen (cooks). Reductions in envelope permeability without mechanical ventilation produced increases in indoor PM2.5 concentrations; 5.4 Ī¼g māˆ’3 for typical household members and 9.8 Ī¼g māˆ’3 for cooks. These estimates of changes in PM2.5 exposure are sensitive to assumptions about occupant behaviour, ventilation system usage and the distributions of input variables (Ā±72% for non-smoking and Ā±107% in smoking residences). However, if realised, they would result in significant health benefits

    The modifying effect of the building envelope on population exposure to PM2.5 from outdoor sources.

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    UNLABELLED: A number of studies have estimated population exposure to PM2.5 by examining modeled or measured outdoor PM2.5 levels. However, few have taken into account the mediating effects of building characteristics on the ingress of PM2.5 from outdoor sources and its impact on population exposure in the indoor domestic environment. This study describes how building simulation can be used to determine the indoor concentration of outdoor-sourced pollution for different housing typologies and how the results can be mapped using building stock models and Geographical Information Systems software to demonstrate the modifying effect of dwellings on occupant exposure to PM2.5 across London. Building archetypes broadly representative of those in the Greater London Authority were simulated for pollution infiltration using EnergyPlus. In addition, the influence of occupant behavior on indoor levels of PM2.5 from outdoor sources was examined using a temperature-dependent window-opening scenario. Results demonstrate a range of I/O ratios of PM2.5 , with detached and semi-detached dwellings most vulnerable to high levels of infiltration. When the results are mapped, central London shows lower I/O ratios of PM2.5 compared with outer London, an apparent inversion of exposure most likely caused by the prevalence of flats rather than detached or semi-detached properties. PRACTICAL IMPLICATIONS: Population exposure to air pollution is typically evaluated using the outdoor concentration of pollutants and does not account for the fact that people in London spend over 80% of their time indoors. In this article, building simulation is used to model the infiltration of outdoor PM2.5 into the domestic indoor environment for dwellings in a London building stock model, and the results mapped. The results show the variation in relative vulnerability of dwellings to pollution infiltration, as well as an estimated absolute indoor concentration across the Greater London Authority (GLA) scaled by local outdoor levels. The practical application of this work is a better understanding of the modifying effect of the building geometry and envelope design on pollution exposure, and how the London building stock may alter exposure. The results will be used to inform population exposure to PM2.5 in future environmental epidemiological studies

    Childcare, choice and social class: Caring for young children in the UK

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    This paper draws on the results of two qualitative research projects examining parental engagements with the childcare market in the UK. Both projects are located in the same two London localities. One project focuses on professional middle class parents, and the other on working class families, and we discuss the key importance of social class in shaping parents' differential engagement with the childcare market, and their understandings of the role childcare plays in their children's lives. We identify and discuss the different "circuits" of care (Ball et al 1995) available to and used by families living physically close to each other, but in social class terms living in different worlds. We also consider parents' relationships with carers, and their social networks. We conclude that in order to fully understand childcare policies and practices and families' experiences of care, an analysis which encompasses social class and the workings of the childcare market is needed
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