The influence of childhood circumstances on adult health

Early childhood is acknowledged as the most crucial developmental period in a person’s life; it creates a foundation for the later years and offers a critical opportunity to establish good health and learning outcomes for a lifetime.  As part of our broader focus on chronic disease prevention policy, the Mitchell Institute is looking at the costs and benefits of action (and inaction) in early childhood and the evidence that indicates a much-needed shift in health policy. To inform this work, the Institute commissioned Dr Kim Sweeny of the Victoria Institute of Strategic Economic Studies to look at what is currently known about the relationship between socio-economic disadvantage in early childhood and poor health and education outcomes in adulthood

Scaling-up treatment of depression and anxiety: a global return on investment analysis

SummaryBackgroundDepression and anxiety disorders are highly prevalent and disabling disorders, which result not only in an enormous amount of human misery and lost health, but also lost economic output. Here we propose a global investment case for a scaled-up response to the public health and economic burden of depression and anxiety disorders.MethodsIn this global return on investment analysis, we used the mental health module of the OneHealth tool to calculate treatment costs and health outcomes in 36 countries between 2016 and 2030. We assumed a linear increase in treatment coverage. We factored in a modest improvement of 5% in both the ability to work and productivity at work as a result of treatment, subsequently mapped to the prevailing rates of labour participation and gross domestic product (GDP) per worker in each country.FindingsThe net present value of investment needed over the period 2016–30 to substantially scale up effective treatment coverage for depression and anxiety disorders is estimated to be US$147 billion. The expected returns to this investment are also substantial. In terms of health impact, scaled-up treatment leads to 43 million extra years of healthy life over the scale-up period. Placing an economic value on these healthy life-years produces a net present value of$310 billion. As well as these intrinsic benefits associated with improved health, scaled-up treatment of common mental disorders also leads to large economic productivity gains (a net present value of $230 billion for scaled-up depression treatment and$169 billion for anxiety disorders). Across country income groups, resulting benefit to cost ratios amount to 2·3–3·0 to 1 when economic benefits only are considered, and 3·3–5·7 to 1 when the value of health returns is also included.InterpretationReturn on investment analysis of the kind reported here can contribute strongly to a balanced investment case for enhanced action to address the large and growing burden of common mental disorders worldwide.FundingGrand Challenges Canada

The role of the Basic Public Health Service program in the control of hypertension in China: results from a cross-sectional health service interview survey

Objectives Non-communicable diseases (NCDs) have become the main cause of mortality in China. In 2009, the Chinese government introduced the Basic Public Health Service (BPHS) program to relieve the rising burden of NCDs through public health measures and delivery of essential medical care. The primary aim of this study was to evaluate the impact of the BPHS program on hypertension control. Methods The China National Health Development Research Center (CNHDRC) undertook a Cross-sectional Health Service Interview Survey (CHSIS) of 62,097 people from primary healthcare reform pilot areas across 17 provinces from eastern, central, and western parts of China in 2014. The current study is based on responses to the CHSIS survey from 7,867 participants, who had been diagnosed with hypertension. Multi-variable mixed logit regression analysis was used to estimate the association between BPHS management and uncontrolled hypertension. In a follow-up analysis, generalized structural equation modelling (GSEM) was used to test for mediation of the BPHS program effect through patient compliance with medication. Findings The estimated proportion of patients with uncontrolled hypertension was 30% lower (23.2% vs 31.5%) in those participants who were adequately managed under the BPHS program. Other predictors of hypertension control included compliance with medication, self-reported wellbeing, income, educational attainment and exercise; smoking was associated with reduced hypertension control. The significant inverse association between uncontrolled hypertension and age indicates poor outcomes for younger patients. Additional testing suggested that nearly 40% of the effect of BPHS management (95% CI: 28.2 to 51.7) could be mediated by improved compliance with medication; there was also an indication that the effect of management was 30% stronger in districts/counties with established digital information management systems (IMS). Conclusion Hypertension control improved markedly following active management through the BPHS program. Some of that improvement could be explained by greater compliance with medication among program participants. This study also identified the need to tailor the BPHS program to the needs of younger patients to achieve higher levels of control in this population. Future investigations should explore ways in which existing healthcare management influences the success of the BPHS program

Reactive Aramid Nanostructures as High‐Performance Polymeric Building Blocks for Advanced Composites

Traditionally, the field of advanced nanocomposites has relied on a fairly limited set of building blocks; many with low reactivity and of limited variability. These limitations have been addressed by the creation of functionalized nanometer‐scale aramid structures, in the form of nanofibers and nanosheets. These were obtained by deprotonating macroscale, commercial Kevlar yarns using potassium hydroxide in dimethyl sulfoxide to yield stable dispersions of nanometer‐scale aramid fibers that were then hydrolyzed using phosphoric acid (PA). To illustrate the use of these functionally‐active nanostructures as building blocks for nanocomposites, they were crosslinked by glutaraldehyde (GA), and formed into macroscopic thin films by vacuum‐assisted filtration. It was shown that the mechanical properties of these PA/GA treated films can be tuned by varying the amounts of PA and GA used during synthesis, adjusting the relative amounts of hydrolysis and polymerization. These results are the first demonstration that aramid nanometer‐scale fibers can be used to form versatile nanometer‐sized building blocks that can then be crosslinked to fabricate a wide variety of nanostructured aramid materials with tailorable properties. Because of the advantageously high surface‐to‐volume ratio at the nanometer‐scale , highly functionalized aramid building blocks are achieved in the form of nanofibers and nanosheets, both of which can form complex nanostructures with tailorable macroscopic properties through treatment using phosphoric acid and glutaraldehyde. An aramid nanofiber network is formed from functionalized Kevlar nanofiber building blocks by the chemical treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97475/1/adfm_201202466_sm_suppl.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/97475/2/2072_ftp.pd

Numerical study for the c-dependence of fractal dimension in two-dimensional quantum gravity

We numerically investigate the fractal structure of two-dimensional quantum gravity coupled to matter central charge c for $-2 \leq c \leq 1$. We reformulate Q-state Potts model into the model which can be identified as a weighted percolation cluster model and can make continuous change of Q, which relates c, on the dynamically triangulated lattice. The c-dependence of the critical coupling is measured from the percolation probability and susceptibility. The c-dependence of the string susceptibility of the quantum surface is evaluated and has very good agreement with the theoretical predictions. The c-dependence of the fractal dimension based on the finite size scaling hypothesis is measured and has excellent agreement with one of the theoretical predictions previously proposed except for the region near $c\approx 1$.Comment: 41 pages, 16 figure

Tethered Monte Carlo: computing the effective potential without critical slowing down

We present Tethered Monte Carlo, a simple, general purpose method of computing the effective potential of the order parameter (Helmholtz free energy). This formalism is based on a new statistical ensemble, closely related to the micromagnetic one, but with an extended configuration space (through Creutz-like demons). Canonical averages for arbitrary values of the external magnetic field are computed without additional simulations. The method is put to work in the two dimensional Ising model, where the existence of exact results enables us to perform high precision checks. A rather peculiar feature of our implementation, which employs a local Metropolis algorithm, is the total absence, within errors, of critical slowing down for magnetic observables. Indeed, high accuracy results are presented for lattices as large as L=1024.Comment: 32 pages, 8 eps figures. Corrected Eq. (36), which is wrong in the published pape

Quantum Monte Carlo Loop Algorithm for the t-J Model

We propose a generalization of the Quantum Monte Carlo loop algorithm to the t-J model by a mapping to three coupled six-vertex models. The autocorrelation times are reduced by orders of magnitude compared to the conventional local algorithms. The method is completely ergodic and can be formulated directly in continuous time. We introduce improved estimators for simulations with a local sign problem. Some first results of finite temperature simulations are presented for a t-J chain, a frustrated Heisenberg chain, and t-J ladder models.Comment: 22 pages, including 12 figures. RevTex v3.0, uses psf.te

Fabrication of a Multi-Walled Nanotube (MWNT) Ionic Liquid Electrode and Its Application for Sensing Phenolics in Red Wines

A multi-walled nanotube (MWNT) ionic liquid was prepared by the immobilization of 1-butylimidazole bromide onto an epoxy group on a poly(glycidyl methacrylate)-grafted MWNT, which was synthesized by radiation-induced graft polymerization of glycidyl methacrylate onto MWNT in an aqueous solution. Subsequently, a MWNT ionic liquid electrode was fabricated by hand-casting MWNT ionic liquid, tyrosinase, and chitosan solution as a binder on indium tin oxide (ITO) glass. The sensing ranges of the MWNT ionic liquid electrode with immobilized tyrosinase was in the range of 0.01-0.08 mM in a phosphate buffer solution. The optimal conditions such as pH, temperature, and effects of different phenolic compounds were determined. The total phenolic compounds of three commercial red wines were also determined on the tyrosinase-immobilized biosensor