Use of Pulsed-UV Processes to Destroy NDMA

About five years ago, N-nitrosodimethylamine (NDMA) began to be detected in drinking water sources. Typically an oxidative degradation product of unsymmetrical dimethylhydrazine, NDMA is a component of rocket fuel and is also formed during numerous industrial manufacturing processes as a byproduct of reactions involving chemicals called alkylamines. The US Environmental Protection Agency has identified NDMA as a probable human carcinogen. However, because NDMA had not historically been considered a common drinking water contaminant, no federal or state drinking water standards were established for it until 1998 in California. In addition to its presence in drinking water, it has recently been suggested that NDMA may be present in sewage and reclaimed water after chlorination, as well as surface water processed by conventional drinking water treatment methods. The mechanisms of NDMA formation appear to be associated with the chlorination process. Therefore, an urgent need has developed for technologies that can remediate drinking water sources contaminated by this compound. This need sparked a growing interest in the potential of pulsed-ultraviolet (UV) and pulsed-UV/hydrogen peroxide treatment processes for removing NDMA from drinking water. The authors of this article evaluated the effectiveness of these treatments for NDMA removal. The results showed that NDMA can be reduced with UV light treatment. This finding will help drinking water utilities to better comply with state and federal standards and to more effectively protect public health

A critical analysis of the cycles of physical activity policy in England

BACKGROUND: There has been increasing focus on the importance of national policy to address population levels of physical inactivity. Components of a comprehensive national physical activity policy framework include: 1) national recommendations on physical activity levels; 2) setting population goals and targets; 3) surveillance or health monitoring systems; and 4) public education. The aim of the current paper was to analyse the policy actions which have addressed each of these elements in England and to identify areas of progress and remaining challenges.  METHODS: A literature search was undertaken to identify past and present documents relevant to physical activity policy in England. Each document was analysed to identify content relevant to the four key elements of policy which formed the focus of the current research.  RESULTS: Physical activity recommendations are an area where England has demonstrated a robust scientific approach and good practice; however, the physical activity campaigns in England have not been sufficiently sustained to achieve changes in social norms and behaviour. The setting of physical activity targets has been unrealistic and continuous changes to national surveillance measures have presented challenges for monitoring trends over time.  CONCLUSIONS: Overall, physical activity policy in England has fluctuated over the past two decades. The variations and cycles in policy reflect some of the challenges in implementing and sustaining physical activity policy in the face of political changes, changes in government direction, and changing opportunities to profile active lifestyles

Access to shops: The views of low-income shoppers

Concern is mounting as the retail stranglehold upon access to food grows. Research on the implications of restructuring retailing and health inequality has failed to involve low-income consumers in this debate. This paper reports on an exercise conducted for the UK Government's, Social Exclusion Unit's Policy Action Team on Access to Shops. The survey provides a useful baseline of the views of low-income groups in England. The choices that people on low income can make were found to be dominated by certain factors such as income and, most importantly, transport. Consumers reported varying levels of satisfaction with retail provision. The findings suggest gaps between what people have, what they want and what the planning process does and does not offer them. Better policy and processes are needed to include and represent the interests of low-income groups

Growing old in England: economic and social issues

This paper examines the economic and social impact of changes in the duration of working life for the 80 per cent of older adults living in urban England. While some people are experiencing extended retirement because of moving out of paid work in their fifties, a growing minority of those beyond the state retirement age continue in paid employment. This paper highlights the considerable challenges for urban policy makers in addressing the economic and social inclusion of all older adults

Radiotherapy waiting times for women with breast cancer: a population-based cohort study

Background: Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. Methods: 35,354 women resident in South East England and diagnosed with breast cancer between 1992 and 2001 who received radiotherapy within six months of diagnosis were identified from the Thames Cancer Registry. Time to radiotherapy was measured from either the date of diagnosis or the start of the previous treatment, whichever was shorter. Unadjusted and adjusted logistic regression models were fitted to examine whether patients received radiotherapy within 60 days of their diagnosis or previous treatment. Results: The adjusted proportions of patients receiving radiotherapy within 60 days varied significantly between different cancer networks (range: 43% to 81%), and decreased from 68% in 1992 to 33% in 2001. After adjustment there was no association between deprivation of area of residence, age or stage and radiotherapy wait. Median time waited to radiotherapy increased over the study period whether measured from the start of chemotherapy, hormone therapy, surgery or the date of diagnosis. Conclusion: This study covered a period of time before the investment following the Cancer Plan of 2000. Results are consistent with other findings suggesting variation between cancer networks and increasing waits over time. Further studies should examine different methods of measuring waiting time, the causes and consequences of waits for radiotherapy and the effect of current initiatives and investments

Review of school vision screening guidelines

Abstract: Background: Vision screenings are important in identifying visual anomalies likely to disrupt the physical, intellectual, social and emotional development of children. School health services globally include vision screenings, complementing a variety of associated screening services. Aim: This review article provides evidence for content, provision and efficacy of the vision screening services for children of school-going age and reports on the current practice of children’s vision screenings worldwide including in South Africa. Methods: Studies were identified from PubMed, Ebscohost and Science Direct with the search terms utilised during the selection of electronic articles and journals for the review. The target population includes children of school-going age from 6 to 19 years without previously known conditions associated with visual anomalies and learning-related problems. The quality of vision screening programmes and policies for the school-going age children in different countries were evaluated using Wilson and Jungner criteria.1 Results: Vision screening programmes worldwide appear to support comprehensive vision screening methods among pre-schoolers (from birth to ≤ 6 years vs. children of school-going age). The development of vision screening procedures in some countries in the United States of America (USA) was found to be grounded on epidemiologic findings and principles. These may have contributed towards the formulation of national vision screening guidelines for preschoolers that supported the detection of amblyopia and its associated conditions such as strabismus, anisometropia and myopia. School-going children’s vision screenings are not supported worldwide as research has shown that there is lack of benefits for detecting other visual anomalies such as vergence and accommodative dysfunctions. This is despite evidence provided by the literature reviewed that an association exists between prevalent accommodation and vergence dysfunctions including poor ocular motilities and poor near-vision, among children of school-going age with poor academic performance. Conclusion: The guidelines worldwide support school vision screenings, especially for the pre-schoolers by the school health nurses, with other programs having considered the teachers, optometrists or orthoptists as the appropriate personnel to conduct the school vision screenings. There is still a need for the effectiveness of the school vision-screening programmes to be investigated related to the importance of detecting convergence and accommodative dysfunctions for the school going age children

Friendship activities of adults with intellectual disability in supported accommodation in northern England

Background Despite there being considerable evidence to suggest that friendships are central to health and well-being, relatively little attention had been paid to the friendships of people with intellectual disabilities. Methods Friendship activities involving people with and without intellectual disabilities were measured over the preceding month in a sample of 1542 adults with intellectual disabilities receiving supported accommodation in nine geographical localities in Northern England. Results The results of the study indicate: (1) low levels of friendship activities among people with intellectual disabilities in supported accommodation; (2) people with intellectual disabilities are more likely to be involved in activities with friends who also have intel lectual disabilities than with friends who do not have intellectual disabilities; (3) most friendship activities take place in the public domain rather than in more private settings (e.g. at home); (4) the setting in which a person lives is a more significant determinant of the form and content of activities with their friends than the characteristics of participants. Conclusions Further attention needs to be given to research and practice initiatives aimed at increasing the levels of friendship activities of people with intellectual disabilities

Local Air Quality Management policy and practice in the UK: The case for greater Public Health integration and engagement

© 2016 Elsevier Ltd. The UK's Local Air Quality Management (LAQM) regime is designed to protect people's health from the ill-effects of air pollution, but it is failing to achieve its full potential. The Public Health aspects of, perspectives on, and integration and engagement in, LAQM have been poorly considered to date. This critical literature review assessed LAQM-related strengths and limitations in order to explore how Public Health, through greater integration and engagement, can add value to the regime.'Structure' and 'process' weaknesses were identified, including: A poorly defined Public Health role, a narrowly-scoped prescribed process, risk assessment uncertainties, ineffective communications, shallow evaluations and disconnected policies. Separately and cumulatively, these have hindered Public Health integration in LAQM policy and practice and stunted the regime's evolution. Engaging Public Health in LAQM future design and delivery can help solve these problems, by improving risk assessments and raising awareness of air pollution and other health-influencing relationships, targeting action in high-need areas, coordinating air pollution mitigation and health improvement interventions, and connecting different policy areas.Increasing Public Health integration and engagement in LAQM can enhance the existing regime. Acting now is timely from both LAQM and Public Health perspectives. This review's findings should be used to inform debates and decisions around the future development of Local Air Quality Management arrangements both in the UK and beyond