38 research outputs found

    Effects of Cadmium on Streams and Irrigated Agriculture in the Presence and Absence of Oil Shale Leachate

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    Artificial streams, soil perfusion columns, and potted plants were exposed to 20 ug Cd/l in the presence and absence of unretorted oil shale leachate. High cadmium accumulations occurred in the stream biota, but did not measurably affect community structure or function. The presence of oil shale leachate had no effect on bioaccumulation or ecosystem structure or function. Nitrification in soil columns was enhanced by the presence of the organic fraction of oil shale leachate, but this effect was not observed when cadmium was present. Crop accumulation of cadmium was somewhat higher in alfalfa and radishes irrigated with leachate, but did not cause plant concentrations that would be hazardous to livestock or human consumers

    Violent crime exposure classification and adverse birth outcomes: a geographically-defined cohort study

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    BACKGROUND: Area-level socioeconomic disparities have long been associated with adverse pregnancy outcomes. Crime is an important element of the neighborhood environment inadequately investigated in the reproductive and public health literature. When crime has been used in research, it has been variably defined, resulting in non-comparable associations across studies. METHODS: Using geocoded linked birth record, crime and census data in multilevel models, this paper explored the relevance of four spatial violent crime exposures: two proximal violent crime categorizations (count of violent crime within a one-half mile radius of maternal residence and distance from maternal residence to nearest violent crime) and two area-level crime categorizations (count of violent crimes within a block group and block group rate of violent crimes) for adverse birth events among women in living in the city of Raleigh NC crime report area in 1999–2001. Models were adjusted for maternal age and education and area-level deprivation. RESULTS: In black and white non-Hispanic race-stratified models, crime characterized as a proximal exposure was not able to distinguish between women experiencing adverse and women experiencing normal birth outcomes. Violent crime characterized as a neighborhood attribute was positively associated with preterm birth and low birth weight among non-Hispanic white and black women. No statistically significant interaction between area-deprivation and violent crime category was observed. CONCLUSION: Crime is variably categorized in the literature, with little rationale provided for crime type or categorization employed. This research represents the first time multiple crime categorizations have been directly compared in association with health outcomes. Finding an effect of area-level violent crime suggests crime may best be characterized as a neighborhood attribute with important implication for adverse birth outcomes

    Direct observation of neighborhood attributes in an urban area of the US south: characterizing the social context of pregnancy

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    BACKGROUND: Neighborhood characteristics have been associated with poor maternal and child health outcomes, yet conceptualization of potential mechanisms is still needed. Census data have long served as proxies for area level socioeconomic influences. Unique information captured by neighborhood inventories, mostly conducted in northern US and Canadian urban areas, has shown important aspects of the community environment that are not captured by the socioeconomic and demographic aggregated individual statistics of census data. In this paper, we describe a neighborhood data collection effort tailored to a southern urban area. METHODS: This study used data from the Pregnancy, Nutrition and Infection (PIN) prospective cohort study to describe neighborhoods where low- and moderate-income pregnant women reside. Women who participated in the PIN study and who resided in Raleigh, NC and its surrounding suburbs were included (n = 703). Neighborhood attributes captured by the inventory included litter, housing condition, road condition, and social interactions that informed theoretical constructs of physical incivility, territoriality and social spaces. US Housing and Population Census 2000 data at the block group level were also assessed to identify the unique contribution of directly observed data. We hypothesize that neighborhood environments can influence health through psychosocial mediated pathways that lead to increased stress, or through disadvantage leading to poor neighborhood resources, or by protective attributes through increased social control. RESULTS: Findings suggest that directly observed neighborhood attributes distinguished between different types of areas in which low-income pregnant non-Hispanic white and non-Hispanic black women lived. Theoretically informed scales of physical incivilities, territoriality and social spaces were constructed and found to be internally consistent. Scales were weakly associated indicating that these constructs capture distinct information about these neighborhoods. Physical incivilities, territoriality and social spaces scales were poorly explained by traditional census variables used to proxy neighborhood environment. CONCLUSION: If neighborhoods influence health through psychosocial mediated pathways then careful detailing of neighborhood attributes that contribute to stress or deterioration, beyond traditional socioeconomic status, are needed. We believe that measuring physical incivility, territoriality and social spaces as expressions of underlying issues of maintenance and social communication make important contributes to this field

    Reliability of variables on the North Carolina birth certificate: a comparison with directly queried values from a cohort study

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    Birth records are an important source of data for examining population-level birth outcomes, but questions about the reliability of these vital records exist. We sought to assess the reliability of birth certificate data by comparing them with data from a large prospective cohort. Pregnancy, Infection, and Nutrition cohort study participants were matched with their birth certificates to assess agreement for maternal demographics, health behaviours, previous pregnancies and major pregnancy events. Agreement among categorical variables was assessed using percentage agreement and kappa statistics; for continuous variables, Spearman’s correlations and concordance correlation coefficients were used

    Neighbourhood deprivation and small-for-gestational-age term births in the United States

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    Residential context has received increased attention as a possible contributing factor to race/ethnic and socioeconomic disparities in birth outcomes in the United States. Utilizing vital statistics birth record data, this study examined the association between neighbourhood deprivation and the risk of a term small-for-gestational-age (SGA) birth among non-Hispanic whites and non-Hispanic blacks in eight geographic areas: Baltimore City, Baltimore County, Montgomery County and Prince Georges County in Maryland, 16 pooled cities in Michigan, Durham County and Wake County in North Carolina, and Philadelphia, Pennsylvania. Multilevel random intercept logistic regression models were employed and statistical tests were performed to examine if the association between neighbourhood deprivation and SGA varied by race/ethnicity and study site. The risk of term SGA was higher among non-Hispanic blacks (range: 10.8%–17.5%) than non-Hispanic whites (range: 5.1%–9.2%) in all areas and it was higher in cities than in suburban locations. In all areas, non-Hispanic blacks lived in more deprived neighbourhoods than non-Hispanic whites. However, the adjusted associations between neighbourhood deprivation and term SGA did not vary significantly by race/ethnicity or study site. The summary fully-adjusted pooled odds ratios, indicating the effect of one standard deviation increase in the deprivation score, were 1.15 [95% CI: 1.08–1.22] for non-Hispanic whites and 1.09 [95% CI: 1.05–1.14] for non-Hispanic blacks. Thus, neighbourhood deprivation was weakly associated with term SGA among both non-Hispanic whites and non-Hispanic blacks

    Approach to radiation therapy in the Jehovah’s Witness patient: An overview

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    Jehovah’s Witnesses are well-known in the medical community for their inability to accept blood products. Novel methods of treatment are often needed to avoid anemia and hematologic toxicity as inability to receive blood products may increase the risk of treatment related complications. We provide an overview of radiation treatment for Jehovah’s Witness patients with an emphasis on bone marrow sparing strategies with intensity modulated radiation therapy (IMRT) to minimize hematologic toxicity
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