Biogeochemistry and Contaminant Geochemistry of Marine and Estuarine Sediments, New Haven, Connecticut (USA)

The urbanized shore areas of Long Island Sound in the vicinity of New Haven, Connecticut (USA) have a long history of exposure to point and non-point sources of pollution, New Haven having been one of the birthplaces of the industrial revolution. As an unintended consequence of such activities, the region\u27s sedimentary systems have incorporated a complex mixture of organic and inorganic contaminants. With its long and varied pollution history and the multiplicity of sedimentary environments (fluvial, estuarine, intertidal, marsh, etc.) present in a compact geographical area, the region is ideal natural laboratory for field testing new contamination assessment techniques. The residents of this densely-populated region continue to exploit the local waterways for recreation and economic benefit, including the harvest of seafood. A comprehensive, systematic evaluation of organic and inorganic contamination thus also addresses public health concerns. New Haven harbor, an embayment approximately 3 by 5 km, is an active terminus for international marine cargo. The tidally-influenced Quinnipiac, Mill and West Rivers empty into the harbor, the shoreline of which is the site of docking facilities, a petroleum tank farm, a power generation station, sewage treatment facilities, a busy interstate highway, housing and park land. The shipping channel leading into the inner harbor is maintained by periodic dredging. A series of shallow core samples were taken in open water, in the shipping channel, in the inner harbor and at the river mouths. For comparative purposes, several additional sediment samples were taken in waters near Guilford, a residential suburb of New Haven with low density housing and a pleasure boat marina. For molecular organic analysis, we employed pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS), using milligram quantities of dry, whole sediment. The compounds thus detected form a complex mixture of thermally extractable components, plus the products of the thermal decomposition of (bio)polymers present in the sample. The Py-GC/MS technique as used here offers a practical alternative to high cost, time-consuming standard analytical procedures, particularly in a regional survey employing a large number of specimens. The New Haven harbor samples were also analyzed for trace metals. The Py-GC/MS results indicate a predominance of aquatic organic matter (OM) in the open water sediment samples at both sites, as evidenced by the relatively high abundance of nitrogen compounds in the pyrolyzate, including pyrroles, pyridines and indoles. These compounds are characteristic pyrolysis products of proteins and degraded proteinaceous matter, in this case largely from marine algae and bacteria. In contrast, estuarine samples show a larger terrestrial OM component, including the phenolic pyrolysis products of lignin and thermally-extracted long chain, odd carbon-numbered normal alkanes. A subset of the samples (from the river mouths and, to a lesser extent, from the inner harbor in New Haven) shows significantly higher relative concentrations of thermally-extractable polycyclic aromatic hydrocarbons (PAHs) and petroleum-derived hopanes. The Guilford and open water New Haven harbor samples appear relatively uncontaminated by PAHs. Our analytical approach permits the recognition of biogeochemical differences indicative of the parent OM and the depositional environment, as well as potentially hazardous anthropogenic contributions to the sediment

Challenges related to the analytical process in realist evaluation and latest developments on the use of NVivo from a realist perspective

Realist evaluation (RE) is a research design increasingly used in program evaluation, that aims to explore and understand the influence of context and underlying mechanisms on intervention or program outcomes. Several methodological challenges, however, are associated with this approach. This article summarizes RE key principles and examines some documented challenges and solutions when analyzing RE data, including the development of Context-Mechanism-Outcome configurations. An analytic method using NVivo features is also presented. This method makes it possible to respond to certain analytic difficulties associated with RE by facilitating the identification of patterns and ensuring transparency in the analytical process. -- Keywords : Realist evaluation ; qualitative data analysis software ; NVivo ; C-M-O configuration

Implicaciones de los actores locales en las intervenciones para la promoción de la salud bucodental destinadas a niños de edad preescolar y escolar en entornos vulnerables

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Intersectoral oral health promotion interventions for schoolchildren living in remote rural Andean communities: a realist evaluation

Background: Intersectoral oral health promotion entails the participation of local communities. IOHP interventions were introduced in Peru in primary schools in 2013 but oral health among schoolchildren living in rural Andean communities remains suboptimal. Objectives: To understand the contextual elements and the underlying mechanisms associated with intersectoral oral health promotion interventions’ current effects on schoolchildren living in remote rural Andean communities. Method: A realist evaluation was carried out in three rural Andean communities where intersectoral oral health promotion interventions aimed at schoolchildren have been implemented. Following an evaluation of the effects among schoolchildren, contextual elements and mechanisms were explored with various stakeholders involved in intersectoral oral health promotion through focus groups and semi-structured interviews. Subsequently, an iterative data analysis and a validation process resulted in the identification of context-mechanism configurations. Results: Previous positive experiences of collaboration, a focus on communication, feelings of being respected and considered, and development of leadership and trust among stakeholders involved in intersectoral oral health promotion were elements of configurations that positively influence intersectoral oral health promotion. On the other hand, unfavorable physical, social and political environments, previous negative health experiences, feelings of not being respected or considered, demotivation, development of mistrust and insufficient leadership were shown to negatively influence outcomes. Conclusion: This research highlights the complexity associated with the deployment of intersectoral oral health promotion interventions in rural communities. Local stakeholders should be further involved to build trust, to facilitate coordination processes among remote rural communities and oral health professionals, and to optimize deployment of intersectoral oral health promotion interventions. -- Keywords : oral health promotion ; schoolchildren ; rural communities ; realist evaluation

Decision-making during gambling: an integration of cognitive and psychobiological approaches

Gambling is a widespread form of entertainment that may afford unique insights into the interaction between cognition and emotion in human decision-making. It is also a behaviour that can become harmful, and potentially addictive, in a minority of individuals. This article considers the status of two dominant approaches to gambling behaviour. The cognitive approach has identified a number of erroneous beliefs held by gamblers, which cause them to over-estimate their chances of winning. The psychobiological approach has examined case-control differences between groups of pathological gamblers and healthy controls, and has identified dysregulation of brain areas linked to reward and emotion, including the ventromedial prefrontal cortex (vmPFC) and striatum, as well as alterations in dopamine neurotransmission. In integrating these two approaches, recent data are discussed that reveal anomalous recruitment of the brain reward system (including the vmPFC and ventral striatum) during two common cognitive distortions in gambling games: the near-miss effect and the effect of personal control. In games of chance, near-misses and the presence of control have no objective influence on the likelihood of winning. These manipulations appear to harness a reward system that evolved to learn skill-oriented behaviours, and by modulating activity in this system, these cognitive distortions may promote continued, and potentially excessive, gambling

Student gambling, erroneous cognitions, and awareness of treatment in Scotland

Rates of probable pathological gambling in colleges and universities across Scotland were investigated with a nationally distributed sample consisting of students (n = 1,483) and members of staff (n = 492). Gambling-related erroneous cognitions (Gambling Beliefs Questionnaire [GBQ]) and gambling severity (South Oaks Gambling Screen [SOGS]) were measured, with additional questions enquiring about awareness of treatments available for gambling problems. Rates of past-year problem and probable pathological gambling for students were 4.0% and 3.9%, respectively. An exploratory factor analysis of the GBQ resulted in a 24-item five-factor model, with gambling severity (as indicated by SOGS scores), indices of increasing gambling involvement (gambling frequency and number of gambling activities), and male gender being positively correlated with higher levels of erroneous cognitions, suggesting erroneous cognitions may not be prominent for females with gambling problems. Less than a fifth of students were aware of where to go to receive help for gambling-related problems

Prevalent vertebral fractures among children initiating glucocorticoid therapy for the treatment of rheumatic disorders

Objective. Vertebral fractures are an under-recognized problem in children with inflammatory disorders. We studied spine health among 134 children (87 girls) with rheumatic conditions (median age 10 years) within 30 days of initiating glucocorticoid therapy. Methods. Children were categorized as follows: juvenile dermatomyositis (n = 30), juvenile idiopathic arthritis (n = 28), systemic lupus erythematosus and related conditions (n = 26), systemic arthritis (n = 22), systemic vasculitis (n = 16), and other conditions (n = 12). Thoracolumbar spine radiograph and dual x-ray absorptiometry for lumbar spine (L-spine) areal bone mineral density (BMD) were performed within 30 days of glucocorticoid initiation. Genant semiquantitative grading was used for vertebral morphometry. Second metacarpal morphometry was carried out on a hand radiograph. Clinical factors including disease and physical activity, calcium and vitamin D intake, cumulative glucocorticoid dose, underlying diagnosis, L-spine BMD Z score, and back pain were analyzed for association with vertebral fracture. Results. Thirteen vertebral fractures were noted in 9 children (7%). Of these, 6 patients had a single vertebral fracture and 3 had 2-3 fractures. Fractures were clustered in the mid-thoracic region (69%). Three vertebral fractures (23%) were moderate (grade 2); the others were mild (grade 1). For the entire cohort, mean ± SD L-spine BMD Z score was significantly different from zero (-0.55 ± 1.2, P \u3c 0.001) despite a mean height Z score that was similar to the healthy average (0.02 ± 1.0, P = 0.825). Back pain was highly associated with increased odds for fracture (odds ratio 10.6 [95% confidence interval 2.1-53.8], P = 0.004). Conclusion. In pediatric rheumatic conditions, vertebral fractures can be present prior to prolonged glucocorticoid exposure. © 2010, American College of Rheumatology

How effective is tetracaine 4% gel, before a venipuncture, in reducing procedural pain in infants: a randomized double-blind placebo controlled trial

BACKGROUND: Procedural pain relief is sub-optimal in neonates. Topical tetracaine provides pain relief in children. Evidence of its efficacy and safety in neonates is limited. The objective of this study was to assess the efficacy and safety of topical tetracaine on the pain response of neonates during a venipuncture. METHODS: Medically stable infants greater than or equal to 24 weeks gestation, requiring a venipuncture, were included. Following randomization and double blinding, 1.1 g of tetracaine or placebo was applied to the skin for 30 minutes. Participants received oral sucrose if they met local eligibility criteria. The venipuncture was performed according to a standard protocol. A medium effect size in the pain score (corresponding to about 2 point difference in the PIPP score) was considered clinically significant, leading to a sample size of 142 infants, with 80% statistical power. Local skin reactions and immediate adverse cardiorespiratory events were noted. The primary outcome, PIPP score at 1 minute, was analysed using an independent Student's t-test. RESULTS: One hundred and forty two infants were included, 33 +/- 4 weeks gestation, 2100 +/- 900 grams and 6 +/- 3 days of age. There was almost no difference in PIPP scores at 1 minute between groups (mean difference -0.09; 95% confidence interval [CI]: -1.68 to 1.50; P = . 91). Similarly, there were no differences in PIPP scores during the 2(nd), 3(rd )and 4th minute. Duration of cry did not differ between the groups (median difference, 0; 95% CI, -3 to 0; P = . 84). The majority of infants in both groups received sucrose 24%. Sucrose had a significant effect on the PIPP score, as assessed by an ANOVA model (p = 0.0026). Local skin erythema was observed transiently in 11 infants (7 in the tetracaine and 4 in the placebo group). No serious side effect was observed. CONCLUSION: Tetracaine did not significantly decrease procedural pain in infants undergoing a venipuncture, when used in combination with routine sucrose administration

How effective is tetracaine 4% gel, before a peripherally inserted central catheter, in reducing procedural pain in infants: a randomized double-blind placebo controlled trial [ISRCTN75884221]

BACKGROUND: Procedural pain relief is sub-optimal in infants, especially small and vulnerable ones. Tetracaine gel 4% (Ametop(®), Smith-Nephew) provides pain relief in children and larger infants, but its efficacy in smaller infants and for peripherally inserted central catheters (PICC) remains uncertain. The objective of this trial was to assess the safety and efficacy of tetracaine gel on the pain response of very low birth weight (VLBW) infants during insertion of a PICC. METHODS: Medically stable infants greater than or equal to 24 weeks gestation, requiring a non-urgent PICC, were included. Following randomization and double blinding, 1.1 g of tetracaine or placebo was applied to the skin for 30 minutes. The PICC was inserted according to a standard protocol. Pain was assessed using the Premature Infant Pain Profile (PIPP). A 3-point change in the pain score was considered clinically significant, leading to a sample size of 54 infants, with 90% statistical power. Local skin reactions and immediate adverse cardiorespiratory events were noted. The primary outcome, PIPP score at 1 minute, was analysed using an independent Student's t-test. RESULTS: Fifty-four infants were included, 27 +/- 2 weeks gestation, 916 +/- 292 grams and 6.5 +/- 3.2 days of age. Baseline characteristics were similar between groups. The mean PIPP score in the first minute was 10.88 in the treatment group as compared to 11.74 in the placebo group (difference 0.86, 95% CI -1.86, 3.58). Median duration of crying in non-intubated infants was 181 seconds in the tetracaine group compared to 68 seconds in the placebo group (difference -78, 95% CI -539, 117). Local skin erythema was observed transiently in 4 infants (3 in the treatment and 1 in the placebo group). No serious harms were observed. CONCLUSION: Tetracaine 4% when applied for 30 minutes was not beneficial in decreasing procedural pain associated with a PICC in very small infants