Demographic and socioeconomic inequalities in the risk of emergency hospital admission for violence: cross-sectional analysis of a national database in Wales

Objectives To investigate the risk of emergency hospital admissions for violence (EHAV) associated with demographic and socioeconomic factors in Wales between 2007/2008 and 2013/2014, and to describe the site of injury causing admission. Design Database analysis of 7 years’ hospital admissions using the Patient Episode Database for Wales (PEDW). Setting and participants Wales, UK, successive annual populations ∼2.8 million aged 0–74 years. Primary outcome The first emergency admission for violence in each year of the study, defined by the International Classification of Diseases V.10 (ICD-10) codes for assaults (X85-X99, Y00-Y09) in any coding position. Results A total of 11 033 admissions for assault. The majority of admissions resulted from head injuries. The overall crude admission rate declined over the study period, from 69.9 per 100 000 to 43.2 per 100 000, with the largest decrease in the most deprived quintile of deprivation. A generalised linear count model with a negative binomial log link, adjusted for year, age group, gender, deprivation quintile and settlement type, showed the relative risk was highest in age group 18–19 years (RR=6.75, 95% CI 5.88 to 7.75) compared with the reference category aged 10–14 years. The risk decreased with age after 25 years. Risk of admission was substantially higher in males (RR=4.55, 95% CI 4.31 to 4.81), for residents of the most deprived areas of Wales (RR=3.60, 95% CI 3.32 to 3.90) compared with the least deprived, and higher in cities (RR=1.37, 95% CI 1.27 to 1.49) and towns (RR=1.32, 95% CI 1.21 to 1.45) compared with villages. Conclusions Despite identifying a narrowing in the gap between prevalence of violence in richer and poorer communities, violence remains strongly associated with young men living in areas of socioeconomic deprivation. There is potential for a greater reduction, given that violence is mostly preventable. Recommendations for reducing inequalities in the risk of admission for violence are discussed

Progress toward an ambulatory pump-lung

ObjectivesCurrently available therapies for acute and chronic lung diseases have not been effective and have various problems associated with the technologies used. We present a novel active mixing pump-lung with the goal of providing total respiratory support to ambulatory patients.MethodsThe pump-lung is based on the concept of active mixing oxygenation within a constrained vortex. The rotation of hollow-fiber membranes disrupts the concentration boundary layer, increasing gas exchange efficiency, and simultaneously pumps the blood. Consequently, the amount of membranes required to achieve gas transfer sufficient for total respiratory support is considerably small. A series of studies, including computational design, experimental bench testing, and in vivo animal experiments, have been performed to implement this concept into a viable artificial pump-lung device.ResultsA series of pump-lung prototypes with a membrane surface area of 0.17 to 0.5 m2 were designed and characterized in vitro with bovine blood, demonstrating extremely high gas exchange efficiency. The prototype with a gas exchange surface area of 0.5 m2 was evaluated in calves. The device provided oxygen transfer of approximately 115 mL/min for respiratory support of an animal for up to 5 days.ConclusionsProgress to date suggests a high likelihood of success for an extracorporeal shorter-term lung that can be switched in and out like dialysis devices. Our device is unique in that it incorporates an integrated pumping and active mixing principle for excellent gas transfer and eliminates the need of the native right ventricle’s ability to power blood through the artificial and natural lungs

Chapter 5 Impacts and Environmental Risks of Oil Spills on Marine Invertebrates, Algae and Seagrass

Marine invertebrates and macrophytes are sensitive to the toxic effects of oil. Depending on the intensity, duration and circumstances of the exposure, they can suffer high levels of initial mortality together with prolonged sublethal effects that can act at individual, population and community levels. Under some circumstances, recovery from these impacts can take years to decades. However, effects are variable because some taxa are less sensitive than others, and many factors can mitigate the degree of exposure, meaning that impacts are moderate in many cases, and recovery occurs within a few years. Exposure is affected by a myriad of factors including: type and amount of oil, extent of weathering, persistence of exposure, application of dispersants or other clean-up measures, habitat type, temperature and depth, species present and their stage of development or maturity, and processes of recolonisation, particularly recruitment. Almost every oil spill is unique in terms of its impact because of differing levels of exposure and the type of habitats, communities and species assemblages in the receiving environment. Between 1970 and February 2017, there were 51 significant oil spills in Australia. Five occurred offshore with negligible likely or expected impacts. Of the others, only 24 of the spills were studied in detail, while 19 had only cursory or no assessment despite the potential for oil spills to impact the marine environment. The majority were limited to temperate waters, although 10 of the 14 spills since 2000 were in tropical coastal or offshore areas, seven were in north Queensland in areas close to the Great Barrier Reef. All four spills that have occurred from offshore petroleum industry infrastructure have occurred since 2009. In Australia, as elsewhere, a prespill need exists to assess the risk of a spill, establish environmental baselines, determine the likely exposure of the receiving environment, and test the toxicity of the oil against key animal and plant species in the area of potential impact. Subsequent to any spill, the baseline provides a reference for targeted impact monitoring

Mental health selection : common mental disorder and migration between multiple states of deprivation in a UK cohort

Funding Funding for this work was received from Public Health Wales NHS Trust as part of a report on migration and health. Support for the report was also received from the National Centre for Population Health and Wellbeing Research (NCPHWR). The eCATALYsT multiagency dataset and the baseline survey was supported by the Wales Office of Research and Development (SCC99/1/105 and R00/1/017). The follow-up survey was supported by a Welsh Assembly Government/Medical Research Council Health Research Partnership Award (H07-3-030), and the electronic cohort is supported by a National Institute for Social Care and Health Research Welsh Assembly Government Translational Health Research Platform Award (TPR08-020). Data availability statement Data may be obtained from a third party and are not publicly available. The electronic cohort is securely stored and maintained on the Secure Anonymised Information Linkage (SAIL) databank at Swansea University Medical School. The authors welcome general enquiries and ideas for new collaborations. Readers with an interest in further details should contact Professor Shantini Paranjothy, Principal Investigator.Peer reviewedPublisher PD

Understanding the impact of social networks on the spread of obesity

Previous research has highlighted the significant role social networks play in the spread of non-communicable chronic diseases. In our research, we seek to explore the impact of these networks in more detail and gain insight into the mechanisms that drive this. We use obesity as a case study. To achieve this, we develop a generalisable hybrid simulation and optimisation approach aimed at gaining qualitative and quantitative insights into the effect of social networks on the spread of obesity. Our simulation model has two components. Firstly, an agent-based component mimics the dynamic structure of the social network within which individuals are situated. Secondly, a system dynamics component replicates the relevant behaviours of those individuals. The parameters from the combined model are refined and optimised using longitudinal data from the United Kingdom. The simulation produces projections of Body Mass Index broken down by different age groups and gender over a 10-year period. These projections are used to explore a range of scenarios in a computational study designed to address our research aims. The study reveals that, for the youngest population sub-groups, the network acts to magnify the impact of external and social factors on changes in obesity, whereas, for older sub-groups, the network mitigates the impact of these factors. The magnitude of that impact is inversely correlated with age. Our approach can be used by public health decision makers as well as managers in adult weight management services to enhance initiatives and strategies intended to reduce obesity. Our approach is generalisable to understand the impact of social networks on similar non-communicable diseases

Cigarette smoking and e-cigarette use among university students in Queensland, Australia and New Zealand: results of two cross-sectional surveys

Objectives: Examine the patterns of cigarette smoking and e-cigarette use (vaping), the perceived harm of e-cigarettes compared with tobacco cigarettes, and associations between smoking and vaping with student characteristics. Design: Cross-sectional studies. Setting: The University of Queensland (UQ), Australia and eight New Zealand (NZ) universities. Participants: Students at UQ: 4957 (70.8% aged <25 years, 63.0% women) and NZ: 1854 (82.5% aged <25 years, 60.1% women). Methods: Χ2 tests compared smoking by age and gender, and vaping by age, gender and smoking status. Two-sided p<0.05 was considered significant and 95% CIs reported where appropriate. Multinomial logistic regression examined associations between smoking and vaping (exclusive smoking, exclusive vaping, dual use and non-use) with age, gender and student type (domestic vs international). Results: Smoking (UQ vs NZ, 95% CI): ever 45.2% (43.8% to 46.6%) vs 50.0% (47.7% to 52.3%), current 8.9% (8.1% to 9.7%) vs 10.4% (9.1% to 11.9%) and daily 5.2% (4.6% to 5.8%) vs 5.6% (4.6% to 6.7%), and not smoking in indoor 98.3% vs 87.7% or outdoor smoke-free spaces 83.8% vs 65.3%. Vaping (UQ vs NZ, 95% CI): ever 20.9% (19.8% to 22.1%) vs 37.6% (35.4% to 39.9%), current 1.8% (1.5% to 2.2%) vs 6.5% (5.4% to 7.7%) and daily 0.7% (0.5% to 1.0%) vs 2.5% (1.9% to 3.4%), and not vaping in indoor 91.4% vs 79.6% or outdoor smoke-free spaces 84.4% vs 71.3%. Of respondents, 71.7% (70.3% to 73.2%) vs 75.3% (72.9% to 77.6%) perceived e-cigarettes as less harmful than tobacco cigarettes. Men were more likely than women to smoke and vape, and to believe that e-cigarettes are less harmful. Regression models containing all predictors for smoking and vaping were significant and the effect of gender was significant for dual use, exclusive smoking and exclusive vaping (all p<0.01). Men had higher odds for smoking, vaping or dual use. Conclusions: Results suggest significant differences in patterns of smoking and vaping of university students in Australia and NZ, and a strong influence of gender on smoking and vaping

Storage versus substrate limitation to bole respiratory potential in two coniferous tree species of contrasting sapwood width

Abstract Two coniferous tree species of contrasting sapwood width (Pinus ponderosa L., ponderosa pine and Pseudotsuga menziesii Mirb., Douglas-fir) were compared to determine whether bole respiratory potential was correlated with available storage space in ray parenchyma cells and/or respiratory substrate concentration of tissues (total nitrogen content, N; and total non-structural carbohydrate content, TNC). An increment corebased, laboratory method under controlled temperature was used to measure tissue-level respiration (termed respiratory potential) from multiple positions in mature boles (&gt;100-years-old). The most significant tissue-level differences that occurred were that N and TNC were two to six times higher for inner bark than sapwood, TNC was about two times higher in ponderosa pine than Douglas-fir and there was significant seasonal variation in TNC. Ray cell abundance was not correlated with sapwood respiratory potential, whereas N and TNC often were, implying that respiratory potential tended to be more limited by substrate than storage space. When scaled from cores to whole boles (excluding branches), potential net CO 2 efflux correlated positively with live bole volume (inner bark plus sapwood), live bole ray volume, N mass, and TNC mass (adjusted R 2 &gt; &gt;0.4). This relationship did not differ between species for N mass, but did for live bole volume, live bole ray volume, and TNC mass. Therefore, N mass appeared to be a good predictor of bole respiratory potential. The differences in net CO 2 efflux between the species were largely explained by the species&apos; relative amounts of whole-bole storage space or substrate mass. For example, ponderosa pine&apos;s inner bark was thinner than Douglas-fir&apos;s, which had the greater concentration of ray cells and TNC compared with the sapwood. This resulted in ponderosa pine boles having 30-60% less ray volume and 10-30% less TNC mass, and caused ponderosa pine net CO 2 efflux/ray volume and net CO 2 efflux/ TNC mass to be 20-50% higher than Douglas-fir. In addition, because inner bark respiratory potential was 2-25 times higher than that of sapwood, ponderosa pine&apos;s thinner inner bark and deeper sapwood (relative to Douglas-fir) caused its bole net CO 2 efflux/live bole volume to be 20-25% lower than that of similarlysized Douglas-fir trees

Monitoring outdoor tobacco policies of Virginia colleges: A descriptive analysis

Purpose: The purpose of this study was to monitor current outdoor tobacco policies of colleges within the state of Virginia. Methods: The tobacco policies of 2-year public colleges, 4-year public colleges, and 4-year private non-profit colleges in Virginia were located online. The policies were then categorized according to the types of tobacco products that were prohibited (Smoking Policies, Tobacco Policies, and E-cigarette Policies) and where those products were prohibited outdoors (No Policy, Entrance Policy, Perimeter Policy, Designated Smoking Areas Policy, All Grounds Policy). Findings: From a final sample of 62 college policies, 2 (3%) had No Policy, 29 (47%) had an Entrance Policy, 12 (19%) had a Perimeter Policy, 10 (16%) had a Designated Smoking Areas Policy, and 9 (15%) had an All Grounds Policy. Conclusions: The far majority of colleges do not meet national recommendations for outdoor tobacco policies. Practical implications and suggestions for future research are discussed in the article