Short term exposure patterns in time-series studies of air pollution and health

Background: Air pollution related risks on health are often reported using percentages. Hence, a 1% increase in mortality risk per 10 unit increase in pollution compares two days say with 2 and 12 units; the days need not be sequential. But a change from 2 to 12 could follow different patterns―increase by 2 units each day for 5 days, all in one go over 1 day, etc. As conventional studies don’t take into account such variation in exposure pattern, our study aims to assess its impact on risk estimates. Methods: Using data on particulate pollution (PM) from London we defined exposure patterns on each day by counting number of 1-Positive changes in PM between successive days (delta) 2-PM peaks 3-Delta peaks for the week just before the mortality day. We then investigated the association between PM and mortality accounting for exposure patterns. Results: For a 10 unit increase in PM, the percentage increases in mortality (with 95% confidence interval) were 1.81(1.21–2.41), 6.46(3.55–9.45) and 2.28(0.8–3.78) for number of positive deltas≥4, PM10 peaks=3 and delta peaks=3 respectively. These were well above conventional estimate, 0.82(0.45–1.18), which ignored exposure patterns. Conclusion: Allowing for exposure patterns could influence risk estimates

Parental use of and attitude towards corporal punishment in Dessie, Ethiopia

Text in English with questionnaire and consent form in English and AmharicThe main purpose of this study was to assess parental usage of and attitude towards corporal punishment. To achieve this purpose, the study utilized a cross-sectional survey design. Using a self-administered questionnaire, quantitative data were gathered from 544 (287M, 257F) participants who were selected using stratified random sampling technique. Frequencies, chi-square, independent samples t-test, one-way ANOVA, logistic regression, and multiple regressions were used to analyze and make meaning of the data. The result indicated that corporal punishment is highly prevalent and frequent in the current sample. The majority of parents (80%) reported they used corporal punishment on their children within the past 12 months, and most of them used it frequently. The responses given to each statement of the attitude scale indicated that the majority of the participants of the study have favourable attitude towards the use of corporal punishment. The most common types of punishment used by parents were found to be knocking on the head (90%), pinching between the thighs (89%), slapping on the face with an open hand (87), beating the arm, buttock, or leg with an open hand (81%), and beating with an object (80%). With respect to type of child misbhaviours, a large number of parents reported that they always used corporal punishment on their children for engaging in behaviours such as disobedience, lying, stealing, playing with dangerous objects, and quarrelling with siblings or other children. The study used an ecological approach to examine how multiple factors are related to parental use of and attitude toward corporal punishment. Accordingly, the result indicated that boys and younger children experience more frequent corporal punishment. Likewise, corporal punishment was found to be more prevalent and frequent among parents who were female in sex, younger in age, lower in education level, and those who had larger number of children. It was also indicated that rural residents than urban residents more frequently used corporal punishment. With regard to attitude towards corporal punishment, the study revealed that parents more likely to have positive attitude were female in sex, lower in education level, residents of rural area, and those who had larger number of children. Education level, number of children, place of residence, and gender, were found to be the variables that significantly predicted attitude towards corporal punishment and accounted for about 37% of the variation in attitude. The study also showed that the majority of participants are against the legal banning of either all or sever types of corporal punishment. Theoretically, the study findings provide evidence that the risk factors for the use of and attitude towards corporal punishment can be multi-level.PsychologyPh. D. (Psychology

Incidence of Myelodysplastic Syndrome in UK Petroleum Distribution and Oil Refinery Workers, 1995-2011.

The incidence of myelodysplastic syndrome (MDS) experienced by cohorts of 16,467 petroleum distribution workers and 28,554 oil refinery workers has been investigated. Study subjects were all those male employees first employed at one of 476 UK petroleum distribution centres or eight UK oil refineries in the period 1946-1974; all subjects had a minimum of twelve months employment with some employment after 1st January, 1951. Observed numbers (Obs) of MDS cases were compared with expectations based on national incidence rates for the period 1995-2011. The overall standardised registration ratio (SRR) was 73 (Obs = 17) in petroleum distribution workers for the age-range 15-84 years, and 77 (Obs = 21) for the age-range 15-99 years. The overall SRR was 81 (Obs = 29) in oil refinery workers for the age-range 15-84 years, and 83 (Obs = 36) for the age-range 15-99 years. More detailed analyses were carried out in terms of year of registration, period from hire, decade of hire, and duration of employment. The overall SRR findings did not provide clear evidence for the presence of an occupational cancer hazard, and provide no support for the hypothesis that low-level benzene exposure has an important effect on the risks of MDS

Role of Cooperatives in Rural Development, The Case of South Nations Nationalities and People Region, Ethiopia

For small land-holding, developing and agricultural based economic countries like Ethiopia, cooperative type of business is recommended as a solution to promote income distribution, reduce poverty and vulnerability, and improve quality of life and social welfare. Ethiopia is a second largest populace country in Africa and has nine regions and two city administrations. South Nations Nationalities and Peoples Region (SNNPR) state is third populace and most densely populated region in Ethiopia. Most of the farmers’ in this region have small plot of lands for their living, farming and rearing animals. It is obvious that such smallholder farmers are characterized by producing small amount of produce. They might bring small portion of their product to market, and the earnings might goes to cover their routine expenditure and might save the remaining for next farming. Taking this clear fact in to consideration, Since 1960s, the government of Ethiopia is promoting the significance of cooperatives as an organization that could enhance the development of small scale-farmers and other communities. Unlike other regions, SNNPR is the pioneer for starting cooperatives type of business and cooperatives are still flourishing in the region. These cooperatives are expected to serve farmers in providing agricultural inputs, marketing service for their produce, and mobilizing savings and providing credit services to their members. The objective of this paper is to show role of cooperatives in rural development the case of South Nations Nationalities and Peoples Region.  AS of June 2011, in South Nations Nationalities and Peoples Regional state there were about 8872 primary cooperatives, 44 Cooperative Unions and One Regional Farmers Cooperative federation established.  These cooperatives have a membership of male 693,898 (77%) and female 209, 861 (23%) totally 903, 759. From the total households of the region 30.3% are member of cooperatives. Despite its age, cooperatives in Ethiopia as well as in this region didn’t flourish as expected. The sector visage challenges across the districts in the region. Keywords: Cooperative, Agricultural Inputs, Marketing, Saving and Credi

Daily changes and short-term exposure patterns in time series studies of air pollution and acute health effects

This thesis investigated the effects of daily changes in exposure (delta) and short-term exposure patterns on the relationship between air pollution and health in time series studies. Using data from London and Hong Kong, delta was defined as the difference in particulate matter (PM10) concentration between successive days. Short-term exposure pattern series were defined based on number of peaks in PM10 within rolling weekly blocks. The mathematical equivalence of identifiable models for delta with conventional distributed lag model was derived and alternative model specifications were proposed. Measurement error and missing data exhibited more impact on delta than the absolute metrics in simulation studies. Evidence of association for delta PM10 with mortality was found only in Hong Kong which attenuated towards the null with more rigorous adjustment for weather. The pattern analysis approach hypothesized, in addition to amount (dose) and duration of exposure, epidemiological studies ought to take patterns of exposure into account. However, convincing evidence was not found for the effect of short-term exposure patterns on mortality risk estimates both in London and Hong Kong. Refining the definition of exposure patterns and methodological improvements including analysing data from multiple cities are highly recommended in related studies in the future

A preliminary assessment of the role of ambient nitric oxide exposure in hospitalization with respiratory syncytial virus bronchiolitis

Some in vitro studies have indicated a possible link between respiratory syncytial virus (RSV) infection and exposure to Nitric Oxide (NO). However, these studies used much higher NO concentrations than normally found in the ambient environment. This preliminary study explored whether an association was present with short-term exposure to NO in the environment. RSV-related admission data between November 2011 and February 2012 were obtained from Sheffield Children’s Hospital. The dates of admission were linked to contemporaneous ambient NO derived from sentinel air monitors. The case-crossover design was used to study the relationship between daily RSV admissions and NO, controlling for temperature and relative humidity. We found little evidence of association between daily RSV admission rates and exposure to ambient NO at different lags or average exposure across several lags. The findings should, however, be viewed with caution due to the low number of events observed during the time frame. It is possible that the apparent lack of association may be accounted for by the timing of the seasonal RSV epidemic in relation to peaks in NO concentrations. A larger study incorporating a wider range of RSV and NO peaks would determine whether said peaks enhanced the number of RSV hospitalizations in children

Clinically meaningful and lasting HbA1c improvement rarely occurs after 5 years of type 1 diabetes: an argument for early, targeted and aggressive intervention following diagnosis.

AIMS/HYPOTHESIS: Our objectives were to explore whether the phenomenon of HbA1c 'tracking' occurs in individuals with type 1 diabetes, how long after diagnosis does tracking take to stabilise, and whether there is an effect of sex and age at diagnosis on tracking. METHODS: A total of 4525 individuals diagnosed with type 1 diabetes between 1 January 1995 and 1 May 2015 were identified from The Health Improvement Network (THIN) database. Mixed models were applied to assess the variability of HbA1c levels over time with random effects on general practices (primary care units) and individuals within practices. RESULTS: 4525 individuals diagnosed with type 1 diabetes were identified in THIN over the study period. The greatest difference in mean HbA1c measurement (-7.0 [95% CI -8.0, -6.1] mmol/mol [0.6%]) was seen when comparing measurements made immediately after diagnosis (0-1 year since diagnosis) with those at 10 or more years (the reference category). The mean difference in HbA1c for the successive periods compared with 10 or more years after diagnosis declined and was no longer statistically significant after 5 years. In the stratified analysis using sex and age group there was considerable heterogeneity with adult onset type 1 diabetes appearing to track earlier and at a lower mean HbA1c. CONCLUSIONS/INTERPRETATION: In individuals with type 1 diabetes, glycaemic control measured by HbA1c settles onto a long-term 'track' and this occurs on average by 5 years following diagnosis. Age at diagnosis modifies both the rate at which individuals settle into their track and the absolute HbA1c tracking level for the next 10 years

Neonatal iron distribution and infection susceptibility in full term, preterm and low birthweight babies in urban Gambia: study protocol for an observational study.

Background: Neonatal infection is the third largest cause of death in children under five worldwide.  Nutritional immunity is the process by which the host innate immune system limits nutrient availability to invading organisms. Iron is an essential micronutrient for both microbial pathogens and their mammalian hosts. Changes in iron availability and distribution have significant effects on pathogen virulence and on the immune response to infection. Our previously published data shows that, during the first 24 hours of life, full-term neonates have reduced overall serum iron. Transferrin saturation decreases rapidly from 45% in cord blood to ~20% by six hours post-delivery. Methods: To study neonatal nutritional immunity and its role in neonatal susceptibility to infection, we will conduct an observational study on 300 full-term normal birth weight (FTB+NBW), 50 preterm normal birth weight (PTB+NBW), 50 preterm low birth weight (PTB+LBW) and 50 full-term low birth weight (FTB+LBW), vaginally-delivered neonates born at Kanifing General Hospital, The Gambia. We will characterize and quantify iron-related nutritional immunity during the early neonatal period and use ex vivo sentinel bacterial growth assays to assess how differences in serum iron affect bacterial growth. Blood samples will be collected from the umbilical cord (arterial and venous) and at serial time points from the neonates over the first week of life. Discussion: Currently, little is known about nutritional immunity in neonates. In this study, we will increase understanding of how nutritional immunity may protect neonates from infection during the first critical days of life by limiting the pathogenicity and virulence of neonatal sepsis causing organisms by reducing the availability of iron. Additionally, we will investigate the hypothesis that this protective mechanism may not be activated in preterm and low birth weight neonates, potentially putting these babies at an enhanced risk of neonatal infection. Trial registration: clinicaltrials.gov ( NCT03353051) 27/11/2017

Differential effects of frozen storage on the molecular detection of bacterial taxa that inhabit the nasopharynx

<p>Abstract</p> <p>Background</p> <p>Frozen storage often precedes metagenomic analysis of biological samples; however, the freezing process can have adverse effects on microbial composition. The effect of freezing on the detection of bacteria inhabiting the infant nasopharynx, a major reservoir of bacterial pathogens, was investigated.</p> <p>Methods</p> <p>16S ribosomal RNA (rRNA) gene-based terminal restriction fragment length polymorphism (T-RFLP) analysis of nasopharyngeal (NP) swabs from twelve Gambian infants was employed. NP swabs were analysed within hours of collection and then after 30 days of storage at -70°C.</p> <p>Results</p> <p>There was substantial heterogeneity among subjects with respect to the effect of freezing on the number of operational taxonomic units (OTUs) detected. Nevertheless, the mean number of OTUs decreased after frozen storage and the relative abundance for 72% of the OTUs changed by less than 0.5% after deep frozen storage. There were differences in the odds of detection and relative abundance of OTUs matched with <it>Moraxella sp</it>., <it>Haemophilus sp</it>./<it>Burkholderia sp.</it>, and <it>Pseudomonas sp</it>. A strong interaction between sex and the effect of freezing was found, whereby there was no significant change observed for males while the mean number of OTUs significantly declined among female infants following frozen storage.</p> <p>Conclusions</p> <p>Although frozen storage of biological samples is often necessary for archiving and logistic purposes, the potential effects on the number of taxa (composition) detected in microbial community studies are significant and should not be overlooked. Moreover, genetic factors such as sex may influence the integrity of nucleic acids during the freezing process.</p