282 research outputs found

    Influence of immigration on prematurity in the context of a free healthcare system with universal coverage

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    We assessed the risk of preterm birth according to the mother’s place of origin in the context of a free and universal healthcare system. We analysed 75,292 newborn infants born between 2008-2011 in Alicante (Spain). The outcomes were: 1) very preterm (gestational age ≤32 weeks) and 2) moderate-to-late preterm (gestational age 33-37 weeks). Other variables: infant’s gender, maternal age and origin. We estimated adjusted odds ratios to analyse the relationship between the outcomes and the other variables. The distribution of the gestational age groups in our sample was: very preterm, 812; moderate-to-late preterm, 5,295; full-term, 69,997. There were no statistically significant differences between the mother’s place of origin and the outcomes in this free universal healthcare system, which is experiencing the recent phenomenon of immigration. This equality should be maintained throughout the time the immigrants remain in the country

    Stable isotope values and trophic analysis of invasive three-spined stickleback in Upper Lake Constance points to significant piscivory

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    The three-spined stickleback Gasterosteus aculeatus was introduced into Lake Constance in the 1940s and occupied a limited range until late 2012. Since then the species has expanded from a solely littoral habitat in Upper Lake Constance, but now makes seasonal migrations into the pelagic zone. This behavioral change has been accompanied by a drastic increase in stickleback abundance. In order to integrate information about feeding of sticklebacks in Upper Lake Constance over two consecutive years, stomach content analysis was combined with seasonal stable isotope analysis on two types of tissue (muscle and liver). Isotope values were also obtained for zooplankton, whitefish larvae and eggs. We calculated the contribution of potential food sources for sticklebacks’ diet using a Bayesian mixing model (SIMMR). Furthermore, we determined stickleback trophic position, and δ15N and δ13C values were compared with those of other fish species of Lake Constance. The results of the Bayesian model as well as the stomach content analysis showed clear evidence of stickleback predation on fish eggs and larvae. Stickleback δ15N values were elevated during winter and comparable to those of piscivorous pike, while δ15N values of zooplankton were reduced, and those of whitefish larvae were similar to those of sticklebacks after accounting trophic fractionation of N isotopes. Trophic position calculations further identified sticklebacks as piscivorous, while the δ13C values of the liver and stomach content analysis suggests that a benthic-pelagic species pair may exist in Lake Constance. These findings support the hypotheses that sticklebacks in Lake Constance can display piscivorous feeding behaviour on sympatric fish species, most likely whitefish larvae and eggs

    Do you see what I see? Identification of child protection concerns by hospital staff and general dental practitioners

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    Aim An exploration of the threshold that dentists, doctors and nurses recognise for dental and child protection (CP) actions in sample clinical cases, and any differences between these professional groups. Method We present a cross-sectional survey of dentists, doctors and nurses (50 each), who regularly examine children, utilised five fictitious vignettes, combining an oral examination image and clinical history reflecting dental and CP issues. Demographics were collected, and each participant gave their likely action for the cases presented. Results Dentists were significantly better at answering the dental element than the doctors and nurses, (P <0.0001) with no significant difference between these two; only 8% of the latter had undergone any training in assessment of dental health. Although 90.6% of all professionals had undergone CP training, dentists were significantly less accurate at identifying the CP component than doctors and nurses, (P <0.0001) between whom there were no significant differences. Those with higher levels of CP training were most accurate at identifying correct CP actions. Conclusions CP training is effective at improving recognition of child maltreatment, although there remains a worrying lack of knowledge about thresholds for action among dentists. Doctors and nurses have minimal training in, or knowledge of, dental health in children, thus precluding appropriate onward referrals

    The impacts of environmental warming on Odonata: a review

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    Climate change brings with it unprecedented rates of increase in environmental temperature, which will have major consequences for the earth's flora and fauna. The Odonata represent a taxon that has many strong links to this abiotic factor due to its tropical evolutionary history and adaptations to temperate climates. Temperature is known to affect odonate physiology including life-history traits such as developmental rate, phenology and seasonal regulation as well as immune function and the production of pigment for thermoregulation. A range of behaviours are likely to be affected which will, in turn, influence other parts of the aquatic ecosystem, primarily through trophic interactions. Temperature may influence changes in geographical distributions, through a shifting of species' fundamental niches, changes in the distribution of suitable habitat and variation in the dispersal ability of species. Finally, such a rapid change in the environment results in a strong selective pressure towards adaptation to cope and the inevitable loss of some populations and, potentially, species. Where data are lacking for odonates, studies on other invertebrate groups will be considered. Finally, directions for research are suggested, particularly laboratory studies that investigate underlying causes of climate-driven macroecological patterns

    The development of socio-economic health differences in childhood: results of the Dutch longitudinal PIAMA birth cohort

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    Background: People with higher socio-economic status (SES) are generally in better health. Less is known about when these socio-economic health differences set in during childhood and how they develop over time. The goal of this study was to prospectively study the development of socio-economic health differences in the Netherlands, and to investigate possible explanations for socio-economic variation in childhood health. Methods: Data from the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study were used for the analyses. The PIAMA study followed 3,963 Dutch children during their first eight years of life. Common childhood health problems (i.e. eczema, asthma symptoms, general health, frequent respiratory infections, overweight, and obesity) were assessed annually using questionnaires. Maternal educational level was used to indicate SES. Possible explanatory lifestyle determinants (breastfeeding, smoking during pregnancy, smoking during the first three months, and day-care centre attendance) and biological determinants (maternal age at birth, birthweight, and older siblings) were analysed using generalized estimating equations. Results: This study shows that socio-economic differences in a broad range of health problems are already present early in life, and persist during childhood. Children from families with low socio-economic backgrounds experience more asthma symptoms (odds ratio (OR) 1.27; 95% Confidence Interval (CI) 1.08-1.49), poorer general health (OR 1.36; 95% CI 1.16-1.60), more frequent respiratory infections (OR 1.57; 95% CI 1.35-1.83), more overweight (OR 1.42; 95% CI 1.16-1.73), and more obesity (OR 2.82; 95% CI 1.80-4.41). The most important contributors to the observed childhood socio-economic health disparities are socio-economic differences in maternal age at birth, breastfeeding, and day-care centre attendance. Conclusions: Socio-economic health disparities already occur very early in life. Socio-economic disadvantage takes its toll on child health before birth, and continues to do so during childhood. Therefore, action to reduce health disparities needs to start very early in life, and should also address socio-economic differences in maternal age at birth, breastfeeding habits, and day-care centre attendance

    Whether weather matters: Evidence of association between in utero meteorological exposures and foetal growth among Indigenous and non-Indigenous mothers in rural Uganda

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    Pregnancy and birth outcomes have been found to be sensitive to meteorological variation, yet few studies explore this relationship in sub-Saharan Africa where infant mortality rates are the highest in the world. We address this research gap by examining the association between meteorological factors and birth weight in a rural population in southwestern Uganda. Our study included hospital birth records (n = 3197) from 2012 to 2015, for which we extracted meteorological exposure data for the three trimesters preceding each birth. We used linear regression, controlling for key covariates, to estimate the timing, strength, and direction of meteorological effects on birth weight. Our results indicated that precipitation during the third trimester had a positive association with birth weight, with more frequent days of precipitation associated with higher birth weight: we observed a 3.1g (95% CI: 1.0–5.3g) increase in birth weight per additional day of exposure to rainfall over 5mm. Increases in average daily temperature during the third trimester were also associated with birth weight, with an increase of 41.8g (95% CI: 0.6–82.9g) per additional degree Celsius. When the sample was stratified by season of birth, only infants born between June and November experienced a significant associated between meteorological exposures and birth weight. The association of meteorological variation with foetal growth seemed to differ by ethnicity; effect sizes of meteorological were greater among an Indigenous subset of the population, in particular for variation in temperature. Effects in all populations in this study are higher than estimates of the African continental average, highlighting the heterogeneity in the vulnerability of infant health to meteorological variation in different contexts. Our results indicate that while there is an association between meteorological variation and birth weight, the magnitude of these associations may vary across ethnic groups with differential socioeconomic resources, with implications for interventions to reduce these gradients and offset the health impacts predicted under climate change

    Mass mortality events of invasive freshwater bivalves: Current understanding and potential directions for future research

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    Mass mortality events, the rapid, catastrophic die-off of organisms, have recently been recognized as important events in controlling population size, but are difficult to quantify given their infrequency. These events can lead to large inputs of animal carcasses into aquatic ecosystems, which can have ecosystem scale impacts. Invasive freshwater bivalves such as the Asian clam Corbicula fluminea, the zebra mussel Dreissena polymorpha, the golden mussel Limnoperna fortunei, and the Chinese pond mussel Sinanodonta woodiana can attain high densities and biomass and play important roles in aquatic ecosystems through filtration, bioturbation, and excretion. Invasive bivalve species can best be described as R-selected species and appear not to have the same tolerance to abiotic stressors as native species, causing them to be prone to mass mortality events in their invasive range. In contrast to their ecological effects while alive, the frequency and impacts of mass mortality events of invasive freshwater bivalves are not well-understood. Here we review the causes and impacts of mass mortality events, as well as identify important questions for future research. Extreme abiotic conditions, including both drought and flooding, as well as high and low temperatures were the primary drivers of mass mortality events. Short-term impacts of mass mortality events include large pulses of nitrogen and increased oxygen stress due to large amounts of soft tissue decomposition, while shells can impact habitat availability and nutrient cycling for decades. Impacts on biological communities (bacteria, fungi, and macroinvertebrates) are less studied but some examples exist concerning C. fluminea. Better documentation of mass mortality events, particularly their magnitude and frequency, is needed to fully understand the impacts invasive bivalve species have on ecosystems, especially as climate change may make mass mortality events more frequent and/or have a larger magnitude.This work was supported by funding from the School of Science and Engineering at Merrimack College
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