Using digital technology to protect health in prolonged poor air quality episodes: a case study of the AirRater App during the Australian 2019–20 fires

In the southern hemisphere summer of 2019–20, Australia experienced its most severe bushfire season on record. Smoke from fires affected 80% of the population, with large and prolonged exceedances of the Australian National Air Quality Standard for fine particulate matter (PM2.5) recorded in all major population centers. We examined if AirRater, a free smartphone app that reports air quality and tracks user symptoms in near real‐time, assisted those populations to reduce their smoke exposure and protect their health. We distributed an online survey to over 13,000 AirRater users to assess how they used this information during the 2019-20 bushfire season, and why it was helpful to aid decision‐making in reducing personal smoke exposure. We received responses from 1732 users (13.3%). Respondents reported the app was highly useful, supporting informed decision‐making regarding daily activities during the smoke‐affected period. Commonly reported activities supported by information provided through the app were staying inside (76%), rescheduling or planning outdoor activities (64%), changing locations to less affected areas (29%) and informing decisions on medication use (15%). Innovative and easy‐to‐use smartphone apps such as AirRater, that provide individual‐level and location‐specific data, can enable users to reduce their exposure to environmental hazards and therefore protect their health

The influence of fine-scale topography on the impacts of Holocene fire in a Tasmanian montane landscape

Copyright © 2019 John Wiley & Sons, Ltd. Tasmania's montane temperate rainforests contain some of Australia's most ancient and endemic flora. Recent landscape-scale fires have impacted a significant portion of these rainforest ecosystems. The complex and rugged topography of Tasmania results in a highly variable influence of fire across the landscape, rendering predictions of ecosystem response to fire difficult. We assess the role of topographic variation in buffering the influence of fire in these endemic rainforest communities. We developed a new 14000-year (14-ka) palaeoecological dataset from Lake Perry, southern Tasmania, and compared it to neighbouring Lake Osborne

A systematic review and meta-synthesis of the impact of low back pain on people's lives

Copyright @ 2014 Froud et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Background - Low back pain (LBP) is a common and costly problem that many interpret within a biopsychosocial model. There is renewed concern that core-sets of outcome measures do not capture what is important. To inform debate about the coverage of back pain outcome measure core-sets, and to suggest areas worthy of exploration within healthcare consultations, we have synthesised the qualitative literature on the impact of low back pain on people’s lives. Methods - Two reviewers searched CINAHL, Embase, PsycINFO, PEDro, and Medline, identifying qualitative studies of people’s experiences of non-specific LBP. Abstracted data were thematic coded and synthesised using a meta-ethnographic, and a meta-narrative approach. Results - We included 49 papers describing 42 studies. Patients are concerned with engagement in meaningful activities; but they also want to be believed and have their experiences and identity, as someone ‘doing battle’ with pain, validated. Patients seek diagnosis, treatment, and cure, but also reassurance of the absence of pathology. Some struggle to meet social expectations and obligations. When these are achieved, the credibility of their pain/disability claims can be jeopardised. Others withdraw, fearful of disapproval, or unable or unwilling to accommodate social demands. Patients generally seek to regain their pre-pain levels of health, and physical and emotional stability. After time, this can be perceived to become unrealistic and some adjust their expectations accordingly. Conclusions - The social component of the biopsychosocial model is not well represented in current core-sets of outcome measures. Clinicians should appreciate that the broader impact of low back pain includes social factors; this may be crucial to improving patients’ experiences of health care. Researchers should consider social factors to help develop a portfolio of more relevant outcome measures.Arthritis Research U

Cloning and Characterization of a Putative TAC1 Ortholog Associated with Leaf Angle in Maize (Zea mays L.)

BACKGROUND: Modifying plant architecture to increase photosynthesis efficiency and reduce shade avoidance response is very important for further yield improvement when crops are grown in high density. Identification of alleles controlling leaf angle in maize is needed to provide insight into molecular mechanism of leaf development and achieving ideal plant architecture to improve grain yield. METHODOLOGY/PRINCIPAL FINDINGS: The gene cloning was done by using comparative genomics, and then performing real-time polymerase chain reaction (RT-PCR) analysis to assay gene expression. The gene function was validated by sequence dissimilarity analysis and QTL mapping using a functional cleaved amplified polymorphism (CAP). CONCLUSIONS: The leaf angle is controlled by a major quantitative trait locus, ZmTAC1 (Zea mays L. Leaf Angle Control 1). ZmTAC1 has 4 exons encoding a protein with 263 amino acids, and its domains are the same as those of the rice OsTAC1 protein. ZmTAC1 was found to be located in the region of qLA2 by using the CAP marker and the F(2:3) families from the cross between Yu82 and Shen137. Real-time PCR analysis revealed ZmTAC1 expression was the highest in the leaf-sheath pulvinus, less in the leaf and shoot apical meristem, and the lowest in the root. A nucleotide difference in the 5'-untranslated region (UTR) between the compact inbred line Yu82 ("CTCC") and the expanded inbred line Shen137 ("CCCC") influences the expression level of ZmTAC1, further controlling the size of the leaf angle. Sequence verification of the change in the 5'-UTR revealed ZmTAC1 with "CTCC" was present in 13 compact inbred lines and ZmTAC1 with "CCCC" was present in 18 expanded inbred lines, indicating ZmTAC1 had been extensively utilized in breeding with regard to the improvement of the maize plant architecture

The Moral of the Tale: Stories, Trust, and Public Engagement with Clinical Ethics via Radio and Theatre.

Trust is frequently discussed with reference to the professional-patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the "public" and "experts." Public engagement activity in healthcare ethics may invoke "trust" in analysing a moral question or problem but less frequently conceives of trust as integral to "public engagement" itself. This paper explores the relationship between trust and the ways in which questions of healthcare ethics are identified and negotiated by both "experts" and the public. Drawing on two examples from the author's "public engagement" work-a radio programme for the British Broadcasting Corporation and work with a playwright and theatre-the paper interrogates the ways in which "public engagement" is often characterized. The author argues that the common approach to public engagement in questions of ethics is unhelpfully constrained by a systemic disposition which continues to privilege the professional or expert voice at the expense of meaningful exchange and dialogue. By creating space for novel interactions between the "expert" and the "public," authentic engagement is achieved that enables not only the participants to flourish but also contributes to trust itself

Differences in grass pollen allergen exposure across Australia

© 2015 The Authors © 2015 Public Health Association of Australia. Objective: Allergic rhinitis and allergic asthma are important chronic diseases posing serious public health issues in Australia with associated medical, economic, and societal burdens. Pollen are significant sources of clinically relevant outdoor aeroallergens, recognised as both a major trigger for, and cause of, allergic respiratory diseases. This study aimed to provide a national, and indeed international, perspective on the state of Australian pollen data using a large representative sample. Methods: Atmospheric grass pollen concentration is examined over a number of years within the period 1995 to 2013 for Brisbane, Canberra, Darwin, Hobart, Melbourne, and Sydney, including determination of the 'clinical' grass pollen season and grass pollen peak. Results: The results of this study describe, for the first time, a striking spatial and temporal variability in grass pollen seasons in Australia, with important implications for clinicians and public health professionals, and the Australian grass pollen-allergic community. Conclusions: These results demonstrate that static pollen calendars are of limited utility and in some cases misleading. This study also highlights significant deficiencies and limitations in the existing Australian pollen monitoring and data. Implications: Establishment of an Australian national pollen monitoring network would help facilitate advances in the clinical and public health management of the millions of Australians with asthma and allergic rhinitis

Using smartphone technology to reduce health impacts from atmospheric environmental hazards

Background: Global environmental change is exacerbating human vulnerability to adverse atmospheric conditions including air pollution, aeroallergens such as pollen, and extreme weather events. Public information and advisories are a central component of responses to mitigate the human impacts of environmental hazards. Digital technologies are emerging as a means of providing personalised, timely and accessible warnings. Method: We describe AirRater, an integrated online platform that combines symptom surveillance, environmental monitoring, and notifications of changing environmental conditions via a free smartphone app. It was developed and launched in Tasmania, Australia (population 510,000), with the aim of reducing health impacts and improving quality of life in people with conditions such as asthma and allergic rhinitis. We present environmental data, user uptake and results from three online evaluation surveys conducted during the first 22 months of operation, from October 2015 through August 2017.Results: There were 3,443 downloads of the app from all parts of Tasmania. Of the 1,959 individuals who registered, 79% reported having either asthma or allergic rhinitis. Downloads increased during adverse environmental conditions and following publicity. Symptom reports per active user were highest during spring (72%), lowest in autumn (37%) and spiked during periods of reduced air quality. In response to online surveys, most users reported that the app was useful and had improved their understanding of how environmental conditions affect their health, and in some cases had prompted action such as the timely use of medication.Conclusion: Active engagement and consistent positive feedback from users demonstrates the potential for considerable individual clinical and wider public health benefits from integrated and personalised monitoring systems such as AirRater. The perceived health benefits require objective verification, and such systems need to address several challenges in providing timely, reliable and valid environmental data

Bacillus thuringiensis Cry5B Protein Is Highly Efficacious as a Single-Dose Therapy against an Intestinal Roundworm Infection in Mice

Intestinal parasitic nematode diseases infect over one billion people and cause significant disease burden in children (growth and cognitive stunting, malnutrition), in pregnant women, and via their dampening of the immune system in infected individuals. In over thirty years, no new classes of anti-roundworm drugs (anthelmintics) for treating humans have been developed. Because of limitations of the current drugs and the threat of parasite resistance, new anthelmintics are needed. The soil bacterium Bacillus thuringiensis (Bt) produces crystal (Cry) proteins that specifically target and kill insects and nematodes and is used around the world as a safe insecticide. Here we test the effects of the Bt Cry protein Cry5B on a chronic, natural intestinal roundworm infection in mice, namely the helminth parasite Heligmosomoides bakeri. We find that a single dose of Cry5B can eliminate 70% of the parasites and can almost completely block the ability of the parasites to produce progeny. Comparisons of Cry5B's efficacy with known anthelmintics suggest its activity is as good as or perhaps even better than those currently used. Furthermore, this protein is rapidly digested by simulated stomach juices, suggesting that protecting it from these juices would reveal a superior anthelmintic

Visible and Invisible Trends in Black Men's Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health

Over the past two decades, there has been growing interest in improving black men's health and the health disparities affecting them. Yet, the health of black men consistently ranks lowest across nearly all groups in the United States. Evidence on the health and social causes of morbidity and mortality among black men has been narrowly concentrated on public health problems (e.g., violence, prostate cancer, and HIV/AIDS) and determinants of health (e.g., education and male gender socialization). This limited focus omits age-specific leading causes of death and other social determinants of health, such as discrimination, segregation, access to health care, employment, and income. This review discusses the leading causes of death for black men and the associated risk factors, as well as identifies gaps in the literature and presents a racialized and gendered framework to guide efforts to address the persistent inequities in health affecting black men