Variability of organophosphorous pesticide metabolite levels in spot and 24-hr urine samples collected from young children during 1 week.

Background: Dialkyl phosphate (DAP) metabolites in spot urine samples are frequently used to characterize children’s exposures to organophosphorous (OP) pesticides. However, variable exposure and short biological half-lives of OP pesticides could result in highly variable measurements, leading to exposure misclassification. Objective: We examined within- and between-child variability in DAP metabolites in urine samples collected during 1 week. Methods: We collected spot urine samples over 7 consecutive days from 25 children (3–6 years of age). On two of the days, we collected 24-hr voids. We assessed the reproducibility of urinary DAP metabolite concentrations and evaluated the sensitivity and specificity of spot urine samples as predictors of high (top 20%) or elevated (top 40%) weekly average DAP metabolite concentrations. Results: Within-child variance exceeded between-child variance by a factor of two to eight, depending on metabolite grouping. Although total DAP concentrations in single spot urine samples were moderately to strongly associated with concentrations in same-day 24-hr samples (r ≈ 0.6–0.8, p 1 day apart and in 24-hr samples collected 3 days apart were weakly correlated (r ≈ –0.21 to 0.38). Single spot samples predicted high (top 20%) and elevated (top 40%) full-week average total DAP excretion with only moderate sensitivity (≈ 0.52 and ≈ 0.67, respectively) but relatively high specificity (≈ 0.88 and ≈ 0.78, respectively). Conclusions: The high variability we observed in children’s DAP metabolite concentrations suggests that single-day urine samples provide only a brief snapshot of exposure. Sensitivity analyses suggest that classification of cumulative OP exposure based on spot samples is prone to type 2 classification errors.This research was supported by grant numbers RD 83171001 and RD 876709 from the U.S. Environmental Protection Agency (EPA), and PO1 ES009605 from the National Institute of Environmental Health Sciences (NIEHS)

The Affordable Care Act Attenuates Financial Strain According to Poverty Level

We use data from the 2011-2016 National Health Interview Survey to examine how the Patient Protection and Affordable Care Act (ACA) has influenced disparities in health care–related financial strain, access to care, and utilization of services by categories of the Federal Poverty Level (FPL). We use multivariable regression analyses to determine the ACA’s effects on these outcome measures, as well as to determine how changes in these measures varied across different FPL levels. We find that the national implementation of the ACA’s insurance expansion provisions in 2014 was associated with improvements in health care–related financial strain, access, and utilization. Relative to adults earning more than 400% of the FPL, the largest effects were observed among those earning between 0% to 124% and 125% to 199% of the FPL after the implementation of the ACA. Both groups experienced reductions in disparities in financial strain and uninsurance relative to the highest FPL group. Overall, the ACA has attenuated health care–related financial strain and improved access to and the utilization of health services for low- and middle-income adults who have traditionally not met income eligibility requirements for public insurance programs. Policy changes that would replace the ACA with less generous age-based tax subsidies and reductions in Medicaid funding could reverse these gains

Stacking Functions: Identifying Motivational Frames Guiding Urban Agriculture Organizations and Businesses in the United States and Canada

While a growing body of scholarship identifies urban agriculture\u27s broad suite of benefits and drivers, it remains unclear how motivations to engage in urban agriculture (UA) interrelate or how they differ across cities and types of organizations. In this paper, we draw on survey responses collected from more than 250 UA organizations and businesses from 84 cities across the United States and Canada. Synthesizing the results of our quantitative analysis of responses (including principal components analysis), qualitative analysis of textual data excerpted from open-ended responses, and a review of existing literature, we describe six motivational frames that appear to guide organizations and businesses in their UA practice: Entrepreneurial, Sustainable Development, Educational, Eco-Centric, DIY Secessionist, and Radical. Identifying how practitioners stack functions and frame their work is a first step in helping to differentiate the diverse and often contradictory efforts transforming urban food environments. We demonstrate that a wide range of objectives impact how urban agriculturalists practice UA and that political orientations and discourses differ across geographies, organizational type and size, and funding regime. These six paradigms provide a basic framework for understanding UA that can guide more in-depth studies of the gap between intentions and outcomes, while helping link historically and geographically specific insights to wider social and political economic processes