Assessing lifestyle risk factors and inequalities in health outcomes in most deprived communities in Wales

Introduction The Inverse Care Law (ICL) programme in Wales was piloted in Aneurin Bevan (AB) and Cwm Taf (CT) University Health Boards, chosen due to being located in areas of Wales which experience some of the most significant health inequalities and lower life expectancy and potential to effect change. Objectives and Approach The programme is aiming to address inequalities in health outcomes between the most and least deprived communities in Wales and implement targeted interventions towards lifestyle risk factors, such as poor diet, physical inactivity, smoking and high alcohol intake. The project collaborated with multiple stakeholders within the Health Boards, Swansea and Cardiff University and Public Health Wales to ensure the correct outcomes were identified and measured. The Welsh Longitudinal General Practice (WLGP) data held in Secure Anonymised Information Linkage (SAIL) databank was used to extract clinically relevant information for evaluation, with the Welsh Demographic Service Dataset (WDSD) providing demographic characteristics. Results Between AB and CT University Health Boards, from February 2015 to November 2016, over 7000 people who were offered a health check completed one at a participating General Practice. 96% of these were in the three most deprived Welsh Index of Multiple Deprivation (WIMD) quintiles. 51% were referred within primary care for follow up based on their health check results, 71% were overweight/obese, and 20% were identified as current smoker of within which 28% were referred to smoking sensation services. Alchohol usage and other health issues have also been investigated. For example, 20% of those tested for blood pressure had an elevated result and 24% were subsequently prescribed anti-hypertensive medication. Conclusion/Implications Results showed risks have been identified from health checks and targeted interventions were introduced based on the results. Repeated analysis in future should be used to further evaluate the effectiveness of the interventions longitudinally. Outcomes are reported back on a scheduled basis to monitor and improve the implementation across Wales

LEDAkem: a post-quantum key encapsulation mechanism based on QC-LDPC codes

This work presents a new code-based key encapsulation mechanism (KEM) called LEDAkem. It is built on the Niederreiter cryptosystem and relies on quasi-cyclic low-density parity-check codes as secret codes, providing high decoding speeds and compact keypairs. LEDAkem uses ephemeral keys to foil known statistical attacks, and takes advantage of a new decoding algorithm that provides faster decoding than the classical bit-flipping decoder commonly adopted in this kind of systems. The main attacks against LEDAkem are investigated, taking into account quantum speedups. Some instances of LEDAkem are designed to achieve different security levels against classical and quantum computers. Some performance figures obtained through an efficient C99 implementation of LEDAkem are provided.Comment: 21 pages, 3 table

New species of Tulasnella associated with terrestrial orchids in Australia

Recent studies using sequence data from eight sequence loci and coalescent-based species delimitation methods have revealed several species-level lineages of Tulasnella associated with the orchid genera Arthrochilus, Caleana, Chiloglottis, and Drakaea in Australia. Here we formally describe three of those species, Tulasnella prima, T. secunda, and T. warcupii spp. nov., as well as an additional Tulasnella species associated with Chiloglottis growing in Sphagnum, T. sphagneti sp. nov. Species were identified by phylogenetic analyses of the ITS with up to 1.3 % sequence divergence within taxa and a minimum of 7.6 % intraspecific divergence. These new Tulasnella (Tulasnellaceae, Cantharellales) species are currently only known from orchid hosts, with each fungal species showing a strong relationship with an orchid genus. In this study, T. prima and T. sphagneti associate with Chiloglottis, while T. secunda associates with Drakaea and Caleana, and T. warcupii associates with Arthrochilus oreophilu

Use of Rollover Protective Structures -- Iowa, Kentucky, New York, and Ohio, 1992-1997

Agriculture has one of the highest occupational fatality rates of all industries in the United States (1). Tractors and other types of agricultural equipment account for a large proportion of these fatalities, and farm-tractor rollovers account for approximately 130 work-related deaths each year in the United States (2). Although rollover protective structures (ROPS) are effective in protecting tractor operators from fatal injuries during rollovers (3-5), most tractors in the United States are not equipped with ROPS (4-7). Beginning in 1985, tractor manufacturers in the United Sates agreed to sell only tractors with ROPS; however, many older tractors without ROPS remain in use. To determine the prevalence of the use of ROPS, beginning in 1992, the Farm Family Health and Hazard Surveillance (FFHHS) program * collected state-based data on tractor age and use of ROPS from selected states. As of August 1997, four states had completed collection and analysis of data on farm tractors. This report summarizes the results of that survey, which indicates that 80%-90% of tractors in use in the four states were manufactured before 1985 and that less than 40% are equipped with ROPS

Vomocytosis: Too Much Booze, Base, or Calcium?

Macrophages are well known for their phagocytic activity and their role in innate immune responses. Macrophages eat non-self particles, via a variety of mechanisms, and typically break down internalized cargo into small macromolecules. However, some pathogenic agents have the ability to evade this endosomal degradation through a nonlytic exocytosis process termed vomocytosis. This phenomenon has been most often studied for Cryptococcus neoformans, a yeast that causes roughly 180,000 deaths per year, primarily in immunocompromised (e.g., human immunodeficiency virus [HIV]) patients. Existing dogma purports that vomocytosis involves distinctive cellular pathways and intracellular physicochemical cues in the host cell during phagosomal maturation. Moreover, it has been observed that the immunological state of the individual and macrophage phenotype affect vomocytosis outcomes. Here we compile the current knowledge on the factors (with respect to the phagocytic cell) that promote vomocytosis of C. neoformans from macrophages

The Inverse Care Law programme: evaluating a population based intervention in primary care within deprived communities in Wales.

Background The Inverse Care Law (ICL) programme was set up in South Wales valleys and aiming to achieve a measurable closing of the gap in health outcomes between the most and least deprived areas. Objectives People in deprived communities in Wales were invited for health checks to identify risks of cardiovascular disease followed by targeted interventions towards lifestyle risk factors, e.g. poor diet, physical inactivity, smoking and high alcohol intake, under the ICL programme piloted in Aneurin Bevan (AB) and Cwm Taf (CT) University Health Boards. Methods Welsh Longitudinal General Practice (WLGP) data held in Secure Anonymised Information Linkage (SAIL) databank was utilised to evaluate outcomes through project-specified clinical codes and uptake of the programme, linked with the Welsh Demographic Service Dataset (WDSD) providing demographic characteristics. Findings There were 7,094 people completing health checks in AB and CT University Health Boards between February 2015 and November 2016. 96% of these were in the three most deprived Welsh Index of Multiple Deprivation (WIMD) quintiles. 51% were referred within primary care for follow-up based on their health check results, 71% were overweight/obese, and 20% were identified as current smokers of within which 28% were referred to smoking sensation services, with further analyses to follow. Conclusions Implementations and effectiveness of the interventions and impact of health checks will be evaluated longitudinally on a scheduled basis with repeated analyses. Challenges and results will help refining the programme to be delivered across Wales

International differences in self-reported health measures in 33 major metropolitan areas in Europe.

The increasing concentration of populations into large conurbations in recent decades has not been matched by international health assessments, which remain largely focused at the country level. We aimed to demonstrate the use of routine survey data to compare the health of large metropolitan centres across Europe and determine the extent to which differences are due to socio-economic factors

The influence of treatment modality on illness perception and secondary prevention outcomes among patients with acute myocardial infarction

Objectives: This study aims to determine if patients with acute myocardial infarction differ in illness perception and secondary prevention outcomes depending on the treatment they received. Methods: A repeated measures design was used to compare patients with acute myocardial infarction receiving three different treatment modalities: ST-elevation myocardial infarction treated by primary percutaneous coronary intervention, ST-elevation myocardial infarction treated by thrombolytic therapy, and non ST-elevation myocardial infarction treated by medication. A convenient sampling technique was used to recruit 206 patients with acute myocardial infarction who agreed to participate in the current study. Patients' illness perception, physical activity, and demographical and clinical data were collected during hospital admission and again at 6 months. Results: A total of 186 patients completed the study. Results showed that the primary percutaneous coronary intervention group perceived their illness as acute rather than chronic (P = 0.034) and has lower personal control (P = 0.032), higher treatment control (P = 0.025), and higher perception of illness coherence (P = 0.022) compared with patients receiving thrombolytic therapy and treated after non-ST segment infarction. Moreover, they report low control of their blood pressure (P = 0.013) and less physical activity (P = 0.001). Conclusion: The results of this study revealed that patients' treated with primary percutaneous coronary intervention had negative illness perception and limited behavioral changes 6 months after hospitalization in comparison with other treatment modalities such as percutaneous coronary intervention and thrombolytic treatment. Further research is recommended to confirm this association with longer follow-up study and among different cultures

LEDAcrypt: QC-LDPC Code-Based Cryptosystems with Bounded Decryption Failure Rate

We consider the QC-LDPC code-based cryptosystems named LEDAcrypt, which are under consideration by NIST for the second round of the post-quantum cryptography standardization initiative. LEDAcrypt is the result of the merger of the key encapsulation mechanism LEDAkem and the public-key cryptosystem LEDApkc, which were submitted to the first round of the same competition. We provide a detailed quantification of the quantum and classical computational efforts needed to foil the cryptographic guarantees of these systems. To this end, we take into account the best known attacks that can be mounted against them employing both classical and quantum computers, and compare their computational complexities with the ones required to break AES, coherently with the NIST requirements. Assuming the original LEDAkem and LEDApkc parameters as a reference, we introduce an algorithmic optimization procedure to design new sets of parameters for LEDAcrypt. These novel sets match the security levels in the NIST call and make the C reference implementation of the systems exhibit significantly improved figures of merit, in terms of both running times and key sizes. As a further contribution, we develop a theoretical characterization of the decryption failure rate (DFR) of LEDAcrypt cryptosystems, which allows new instances of the systems with guaranteed low DFR to be designed. Such a characterization is crucial to withstand recent attacks exploiting the reactions of the legitimate recipient upon decrypting multiple ciphertexts with the same private key, and consequentially it is able to ensure a lifecycle of the corresponding key pairs which can be sufficient for the wide majority of practical purposes