Linkages Between Extreme Precipitation, Water Quality, and Gastrointestinal Illness.

Background: The frequency, intensity, and duration of extreme weather events are expected to increase based on current climate model projections. Such changes, particularly those associated with extreme precipitation, will likely threaten water quality and exacerbate global health disparities. Vulnerable subpopulations include children, the elderly, and the poor. Objectives: This dissertation evaluates the association between extreme precipitation and hospital admissions among: 1) a population in Chennai, India during 2004-2007, 2) the elderly in the Great Lakes Region in relation to beach closures during 2000-2006, and 3) the elderly in 132 U.S. cities during 1992-2006. Methods: Daily hospital admissions were merged with daily meteorological data. Hospital admissions were examined for seasonal trends. Poisson regression and case-crossover models were fit to evaluate the association between extreme precipitation and daily hospital admissions. Season and age were explored as potential effect modifiers. Results: In India, extreme precipitation (greater than or equal to the 90th percentile) was positively associated with hospital admissions related to gastrointestinal illness (GI). The cumulative risk, estimated over a 15-day lag period, was 1.61 (95% confidence interval (CI): 1.29, 2.00) and was elevated among the young 2.65 (95% CI: 1.21, 5.80) and the old 1.68 (95% CI: 1.01, 2.80). Risk varied across seasons, peaking during pre-monsoon 1.58 (95% CI: 1.24, 1.90). In the Great Lakes Region, beaches were closed 10% of summer days. Precipitation above the 90th percentile at lag 1 significantly predicted (p <0.05) beach closures in 8 of the 12 cities. No consistent associations between beach closures and hospital admissions were seen when pooled across the 12 cities, 0.98 (95% CI: 0.94, 1.01). In 132 U.S. cities, nearly 1 million GI-related hospital admissions occurred. Overall, no positive associations between extreme precipitation and GI-related hospital admissions were observed. The overall national pooled estimate for risk of GI-related hospital admission at lag 15 was 1.01 (95% CI: 1.00, 1.02). Conclusions: This work highlights the potential impacts of climate change on waterborne disease in the U.S. and India. The threat of more extreme weather events necessitates further study of how climate and weather are associated with hospital admissions and overall health.Ph.D.Environmental Health SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/91518/1/kfbush_1.pd

Extreme precipitation and beach closures in the great lakes region: Evaluating risk among the elderly

Abstract: As a result of climate change, extreme precipitation events are expected to increase in frequency and intensity. Runoff from these extreme events poses threats to water quality and human health. We investigated the impact of extreme precipitation and beach closings on the risk of gastrointestinal illness (GI)-related hospital admissions among individuals 65 and older in 12 Great Lakes cities from 2000 to 2006. Poisson regression models were fit in each city, controlling for temperature and long-term time trends. City-specific estimates were combined to form an overall regional risk estimate. Approximately 40,000 GI-related hospital admissions and over 100 beach closure days were recorded from May through September during the study period. Extreme precipitation (≥90th percentile) occurring the previous day (lag 1) is significantly associated with beach closures in 8 of the 12 cities (p &lt; 0.05). However, no association was observed between OPEN ACCESS Int. J. Environ. Res. Public Health 2014, 11 2015 beach closures and GI-related hospital admissions. These results support previous work linking extreme precipitation to compromised recreational water quality

Prediction of chronic disability in work-related musculoskeletal disorders: a prospective, population-based study

BACKGROUND: Disability associated with work-related musculoskeletal disorders is an increasingly serious societal problem. Although most injured workers return quickly to work, a substantial number do not. The costs of chronic disability to the injured worker, his or her family, employers, and society are enormous. A means of accurate early identification of injured workers at risk for chronic disability could enable these individuals to be targeted for early intervention to promote return to work and normal functioning. The purpose of this study is to develop statistical models that accurately predict chronic work disability from data obtained from administrative databases and worker interviews soon after a work injury. Based on these models, we will develop a brief instrument that could be administered in medical or workers' compensation settings to screen injured workers for chronic disability risk. METHODS: This is a population-based, prospective study. The study population consists of workers who file claims for work-related back injuries or carpal tunnel syndrome (CTS) in Washington State. The Washington State Department of Labor and Industries claims database is reviewed weekly to identify workers with new claims for work-related back injuries and CTS, and these workers are telephoned and invited to participate. Workers who enroll complete a computer-assisted telephone interview at baseline and one year later. The baseline interview assesses sociodemographic, employment-related, biomedical/health care, legal, and psychosocial risk factors. The follow-up interview assesses pain, disability, and work status. The primary outcome is duration of work disability over the year after claim submission, as assessed by administrative data. Secondary outcomes include work disability status at one year, as assessed by both self-report and work disability compensation status (administrative records). A sample size of 1,800 workers with back injuries and 1,200 with CTS will provide adequate statistical power (0.96 for low back and 0.85 for CTS) to predict disability with an alpha of .05 (two-sided) and a hazard ratio of 1.2. Proportional hazards regression models will be constructed to determine the best combination of predictors of work disability duration at one year. Regression models will also be developed for the secondary outcomes

Factors affecting the identification of talented junior-elite footballers: a case study

The purpose of this study was to identify and examine factors associated with the identification of talented junior-elite footballers. Three data collection methods were employed: (1) document analysis (4 documents), (2) overt observation (~105 h) and (3) 12 semi-structured one-to-one interviews with staff responsible for player recruitment (M = 70 min). Data were analysed using a constant comparative approach, which allowed flexibility and reflexivity throughout the data collection period. Two core themes concerning the identification of talented players at this academy emerged: "structural issues", which were further categorised as: (1) financial; (2) educational; (3) philosophical or cultural; (4) competition amongst clubs; and (5) hours in practice; and "Current performance and potential talent" which covered issues around growth, maturation and development and psycho-social attributes. The paper concludes by suggesting that clubs should be more proactive in understanding the structural issues that affect talent identification processes, and better educating and supporting staff responsible for recruitment activity

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Trace metals in Northern New England streams: Evaluating the role of road salt across broad spatial scales with synoptic snapshots.

Mobilization of trace metals from soils to surface waters can impact both human and ecosystem health. This study resamples a water sample archive to explore the spatial pattern of streamwater total concentrations of arsenic, cadmium, copper, lead, and zinc and their associations with biogeochemical controls in northern New England. Road deicing appears to result in elevated trace metal concentrations, as trace metal concentrations are strongly related to sodium concentrations and are most elevated when the sodium: chloride ratio is near 1.0 (~halite). Our results are consistent with previous laboratory and field studies that indicate cation exchange as a metal mobilization mechanism when road salt is applied to soils containing metals. This study also documents associations among sodium, chloride, dissolved organic carbon, iron, and metal concentrations, suggesting cation exchange mechanisms related to road deicing are not the only mechanisms that increase trace metal concentrations in surface waters. In addition to cation exchange, this study considers dissolved organic carbon complexation and oxidation-reduction conditions affecting metal mobility from soils in a salt-rich environment. These observations demonstrate that road deicing has the potential to increase streamwater trace metal concentrations across broad spatial scales and increase risks to human and ecosystem health