The Changing Disease-Scape in the Third Epidemiological Transition

The epidemiological transition model describes the changing relationship between humans and their diseases. The first transition occurred with the shift to agriculture about 10,000 YBP, resulting in a pattern of infectious and nutritional diseases still evident today. In the last two centuries, some populations have undergone a second transition, characterized by a decline in infectious disease and rise in degenerative disease. We are now in the throes of a third epidemiological transition, in which a resurgence of familiar infections is accompanied by an array of novel diseases, all of which have the potential to spread rapidly due to globalization

Handling unobserved confounding in the relation between prenatal risk factors and child outcomes:a latent variable strategy

Abstract Background Several studies have examined maternal health behavior during pregnancy and child outcomes. Negative control variables have been used to address unobserved confounding in such studies. This approach assumes that confounders affect the exposure and the negative control to the same degree. The current study introduces a novel latent variable approach that relaxes this assumption by accommodating repeated measures of maternal health behavior during pregnancy. Methods Monte Carlo simulations were used to examine the performance of the latent variable approach. A real-life example is also provided, using data from the Norwegian Mother, Father, and Child Study (MoBa). Results Simulations: Regular regression analyses without a negative control variable worked poorly in the presence of unobserved confounding. Including a negative control variable improved result substantially. The latent variable approach provided unbiased results in several situations where the other analysis models worked poorly. Real-life data: Maternal alcohol use in the first trimester was associated with increased ADHD symptoms in the child in the standard regression model. This association was not present in the latent variable approach. Conclusion The current study showed that a latent variable approach with a negative control provided unbiased estimates of causal associations between repeated measures of maternal health behavior during pregnancy and child outcomes, even when the effect of the confounder differed in magnitude between the negative control and the exposures. The real-life example showed that inferences from the latent variable approach were incompatible with those from the standard regression approach. Limitations of the approach are discussed

Mapping Polar Bear Maternal Denning Habitat in the National Petroleum Reserve–Alaska with an IfSAR Digital Terrain Model

The National Petroleum Reserve–Alaska (NPR-A) in northeastern Alaska provides winter maternal denning habitat for polar bears (Ursus maritimus) and also has high potential for recoverable hydrocarbons. Denning polar bears exposed to human activities may abandon their dens before their young are able to survive the severity of Arctic winter weather. To ensure that wintertime petroleum activities do not threaten polar bears, managers need to know the distribution of landscape features in which maternal dens are likely to occur. Here, we present a map of potential denning habitat within the NPR-A. We used a fine-grain digital elevation model derived from Interferometric Synthetic Aperture Radar (IfSAR) to generate a map of putative denning habitat. We then tested the map’s ability to identify polar bear denning habitat on the landscape. Our final map correctly identified 82% of denning habitat estimated to be within the NPR-A. Mapped denning habitat comprised 19.7 km2 (0.1% of the study area) and was widely dispersed. Though mapping denning habitat with IfSAR data was as effective as mapping with the photogrammetric methods used for other regions of the Alaskan Arctic coastal plain, the use of GIS to analyze IfSAR data allowed greater objectivity and flexibility with less manual labor. Analytical advantages and performance equivalent to that of manual cartographic methods suggest that the use of IfSAR data to identify polar bear maternal denning habitat is a better management tool in the NPR-A and wherever such data may be available.La réserve pétrolière nationale–Alaska (NPR-A), située dans le nord-est de l’Alaska (NPR-A), constitue un habitat hivernal de tanières de mise bas pour l’ours polaire (Ursus maritimus) et présente de grandes possibilités du point de vue des hydrocarbures récupérables. Les ours polaires des tanières qui sont exposés aux activités de l’être humain peuvent abandonner leur tanière avant que leurs petits ne soient prêts à survivre les rigueurs de l’hiver de l’Arctique. Afin de faire en sorte que les activités d’exploitation pétrolière hivernales ne posent pas de menaces aux ours polaires, les gestionnaires doivent connaître la répartition des caractéristiques du paysage où les tanières de mise bas sont susceptibles de se trouver. Ici, nous présentons une carte sur laquelle sont indiqués des habitats de tanières possibles au sein de la NPR-A. Nous avons utilisé un système de modélisation numérique des hauteurs à haute définition dérivé du radar interférométrique à synthèse d’ouverture (IfSAR) pour produire une carte putative de l’habitat de tanières. Ensuite, nous avons mis la carte à l’épreuve pour déterminer son aptitude à repérer l’habitat de tanières de mise bas au sein du paysage. Notre carte finale a repéré avec exactitude 82 % de l’habitat de tanières qui se trouverait à l’intérieur de la NPR-A. L’habitat de tanières cartographié s’étendait sur 19,7 km2 (0,1 % de l’aire étudiée) et était largement dispersé. Même si la cartographie de l’habitat de tanières au moyen des données de l’IfSAR était aussi efficace que la cartographie des méthodes photogrammétriques employées dans d’autres régions de la plaine côtière arctique de l’Alaska, l’utilisation du SIG pour analyser les données de l’IfSAR a donné lieu à une plus grande objectivité et flexibilité, avec moins de main-d’oeuvre. Les avantages analytiques et l’exécution équivalant à celles des méthodes de carto-graphie manuelles suggèrent que le recours aux données de l’IfSAR pour repérer l’habitat de tanières de mise bas d’ours polaires constitue un outil de gestion supérieur au sein de la NPR-A et de n’importe quel autre endroit où ces données sont disponibles

Migrant Agricultural Workers' Experiences of Support in Three Migrant‐Intensive Communities in Canada

Canada has intensified its reliance on temporary foreign workers, including migrant agricultural workers (MAWs) who have contributed to its agriculture sector, rural economies, and food security for decades. These workers live and work in rural communities across Canada for up to two years. Thousands of MAWs engage in recurring cyclical migration, often returning to the same rural communities in Canada for decades, while others are undocumented. Yet MAWs do not have access to the supports and services provided for immigrant newcomers and pathways for permanent residence. The exclusion of these workers from such entitlements, including labour mobility, reinforces their precarity, inhibits their sense of belonging, and reflects the stratification built into Canada's migration regime. This article draws on interviews with 98 MAWs in three migrant‐intensive regions in southwestern Ontario to examine how workers construct and describe support in relation to co‐workers, employers, residents, and community organizations. Drawing on conceptualizations of support as an important vehicle for social connection and inclusion that comprises social and citizenship belonging, we document how the strategies MAWs employ to forge connections are enabled or undermined by Canada's Temporary Foreign Worker Program, community dynamics, and the broader forces of racialization, gender, and exclusion. This article contributes to the limited scholarship on the support landscape for MAWs, whose experiences foreground the contested nature of belonging and inclusion among migrant populations across smaller cities and rural areas

Social and Psychological Factors Associated with Health Care Transition for Young Adults Living with Sickle Cell Disease

Introduction: Due to advances in disease management, mortality rates in children with sickle cell disease (SCD) have decreased. However, mortality rates for young adults (YA) increased, and understanding of social and psychological factors is critical. The aim of this study was to explore factors associated with health care transition experiences for YA with SCD. Method: This was a qualitative descriptive study. A 45-minute semistructured interview was conducted with 13 YA (M = 21.5 years, SD = 1.73). Results: Results suggest that social and psychological factors and self-management experiences influence health care transition. Eight themes emerged: “need for accessible support”; “early assistance with goal setting”; “incongruence among expectations, experiences, and preparation”; “spiritual distress”; “stigma”; “need for collaboration”; “appreciation for caring providers”; and “feeling isolated.” Discussion: Consideration of cultural contexts will guide nurses in supporting health care transition. Designing culturally relevant interventions that address unique needs for YA living with SCD is warranted

Maternal caloric restriction partially rescues the deleterious effects of advanced maternal age on offspring

© The Author(s), 2014. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Aging Cell 13 (2014): 623–630, doi:10.1111/acel.12217.While many studies have focused on the detrimental effects of advanced maternal age and harmful prenatal environments on progeny, little is known about the role of beneficial non-Mendelian maternal inheritance on aging. Here, we report the effects of maternal age and maternal caloric restriction (CR) on the life span and health span of offspring for a clonal culture of the monogonont rotifer Brachionus manjavacas. Mothers on regimens of chronic CR (CCR) or intermittent fasting (IF) had increased life span compared with mothers fed ad libitum (AL). With increasing maternal age, life span and fecundity of female offspring of AL-fed mothers decreased significantly and life span of male offspring was unchanged, whereas body size of both male and female offspring increased. Maternal CR partially rescued these effects, increasing the mean life span of AL-fed female offspring but not male offspring and increasing the fecundity of AL-fed female offspring compared with offspring of mothers of the same age. Both maternal CR regimens decreased male offspring body size, but only maternal IF decreased body size of female offspring, whereas maternal CCR caused a slight increase. Understanding the genetic and biochemical basis of these different maternal effects on aging may guide effective interventions to improve health span and life span.This work was supported by the National Institute on Aging Division of Aging Biology (R01 AG037960-01), the Ellison Medical Foundation/ American Federation for Aging Research Postdoctoral Fellows in Aging Research Program and a Neil Cornell Career Development Award

Measurement of transient smoke emissions from diesel and biodiesel fuel blends in an agricultural tractor

Transient smoke emissions pose potential hazards to human health and the environment. With the increased popularity of biodiesel, there is a need to determine if these fuels produce different levels of particulate matter in exhaust emissions. This study examined the transient smoke emissions of three fuels: No. 2 petroleum diesel fuel (D2, ASTM D 975), a blend of 20% biodiesel and 80% petroleum diesel (B20, ASTM 6751), and a 100% pure biodiesel derived from animal fats (B100, ASTM D 6751). Measurements of smoke emissions were taken using the SAE J1677 snap acceleration test procedure on a John Deere 3203 compact utility tractor. The results indicate there were no statistically significant differences in smoke opacity between the three fuels (p\u3e0.05). The low, non-significant emissions may be due to the diesel engine being EPA Tier II-compliant and the use of ultra-low-sulfur diesel. Recommendations for further study include testing biofuels made of varying feed stocks rather than animal fats, testing steady state load conditions in addition to transient loads, and testing tractors manufactured prior to initiation of EPA tier-compliance standard

The Tanzanian Trauma patients' Prehospital Experience: A Qualitative Interview-based Study.

We sought to characterise the prehospital experience of Tanzanian trauma patients, and identify barriers and facilitators to implement community-based emergency medical systems (EMS). Our study was conducted in the emergency department of an urban national referral hospital in Tanzania. A convenience sample of 34 adult trauma patients, or surrogate family members, presenting or referred to an urban referral emergency department in Tanzania for treatment of injury, participated in the study. Participation in semistructured, iteratively developed interviews until saturation of responses was reached. A grounded theory-based approach to qualitative analysis was used to identify recurrent themes. We characterised numerous deficiencies within the existing clinic-to-hospital referral network, including missed/delayed diagnoses, limited management capabilities at pre-referral facilities and interfacility transfer delays. Potential barriers to EMS implementation include patient financial limitations and lack of insurance, limited public infrastructure and resources, and the credibility of potential first aid responders. Potential facilitators of EMS include communities' tendency to pool resources, individuals' trust of other community members to be first aid responders, and faith in community leaders to organise EMS response. Participants expressed a strong desire to learn first aid. The composite themes generated by the data suggest that there are myriad structural, financial, institutional and cultural barriers to the implementation of a formal prehospital system. However, our analysis also revealed potential facilitators to a first-responder system that takes advantage of close-knit local communities and the trust of recognised leaders in society. The results suggest favourable acceptability for community-based response by trained lay people. There is significant opportunity for care improvements with short trainings and low-cost supply planning. Further research looking at the effects of delay on outcomes in this population is needed