Physical, Chemical, and Mineralogical Controls on Retardation of Anatoxin-a Migration by Sorption to Natural Soils with Implications for Groundwater Protection

Increasing prevalence of cyanotoxins in surface water bodies worldwide threatens groundwater quality when contaminated water recharges an aquifer through natural or artificial means. The subsurface fate of anatoxin-a (ATX) is not well studied. Laboratory batch experiments were performed to expand the current knowledge of ATX sorption affinities to geologic media, with a focus on natural soil (Vertisol, Ultisol, Alfisol, and Inceptisol) and physical, chemical, and mineralogical characteristics. For a range of aqueous ATX concentrations (0.3–14 μg/L), linear, Freundlich, and Langmuir isotherms fit observed data well (r2 = 0.92–1.00, RMSE = 0.4–6.3 μg/kg). Distribution coefficient (Kd) and retardation factor (Rf) values were computed for the linear isotherm, giving Kd of 22.3–77.1 L/kg and Rf of 62–256. Average percent removals were 85.0–92.2%. The strongest predictors of Kd were kaolinite and smectite group mineral abundances and for Rf were smectite group and silt and clay abundances. Results indicate that loamy, silty, or clayey soils—particularly Vertisols—tend to substantially slow migration of ATX through natural soil systems. Where implemented as a functionalized amendment in an engineered pollution control media, such soils may enhance natural ATX attenuation processes, thereby supporting the protection of in situ and extracted groundwater during irrigation, natural and managed aquifer recharge, or riverbank filtration

Health Literacy: Understanding Medication Labels

Introduction: According to the Institute of Medicine (IOM), over 90 million people in the U.S. have difficulty understanding and using health information including medication labels. Purpose: To determine how individuals interpret medication labels and the relationship between medication label interpretation and level of health literacy. Method: Participants were recruited from a student-run health fair and a University Relay for Life. After securing consent, participants completed demographic information and the Rapid Estimate of Adult Literacy in Medicine (REALM). Participants were asked to blindly choose three medication containers from a bag. The labels were prepared by a registered pharmacist and affixed to medication containers. In response to questions, participants relayed information perceived to be on the labels. Sample: There were a total of 21 participants. Ages ranged from 18-89 years. Education levels varied from 10th grade to master’s degree. Findings: Using content analysis, respondents were unable to correctly interpret dosing directions on four out five medication labels. Participants added incorrect information not on the labels. No relationship was found between REALM scores and the ability to correctly interpret medication labels. Conclusions: Findings support that nurses should ask clients to restate medication label information. This assessment of understanding may increase a client\u27s ability to adhere to the medication regimen

A Cross-Cultural Study of the Social Experience of Giftedness

The phenomenon of social coping among students with gifts and talents (SWGT) is not well understood. In interviews with elementary-, middle-, and high-school aged SWGT (N = 90; 50% female) from the United States, United Kingdom, South Korea, Ireland, and France, the universality of awareness of visibility of their exceptional abilities, high expectations and pressure to achieve from adults and peers, and peer jealousy and rejection, was confirmed. In all countries, SWGT were concerned about peers’ upward social comparison and the effects of their outperformance on peers’ feelings. SWGT attempted to hide their abilities or conform to peers’ behaviors. Prosocial helping behaviors were found among SWGT in nearly all age groups and a focus on the self was a useful coping strategy to students in all countries except France. Parallels are drawn between these findings and Goffman’s (1963) stigma theory

The Global Lake Ecological Observatory Network (GLEON): the evolution of grassroots network science

Nine years later, with over 380 members from 40 countries, and 50 publications to its credit, GLEON is growing at a rapid pace and pushing the boundaries of the practice of network science. GLEON is really three networks: a network of lakes, data, and peopl

The Effect of Processing and Seasonallity on the Iodine and Selenium Concentration of Cow's Milk Produced in Northern Ireland (NI): Implications for Population Dietary Intake

Cow’s milk is the most important dietary source of iodine in the UK and Ireland, and also contributes to dietary selenium intakes. The aim of this study was to investigate the effect of season, milk fat class (whole; semi-skimmed; skimmed) and pasteurisation on iodine and selenium concentrations in Northern Ireland (NI) milk, and to estimate the contribution of this milk to consumer iodine and selenium intakes. Milk samples (unpasteurised, whole, semi-skimmed and skimmed) were collected weekly from two large NI creameries between May 2013 and April 2014 and were analysed by inductively coupled plasma-mass spectrometry (ICP-MS). Using milk consumption data from the National Diet and Nutrition Survey (NDNS) Rolling Programme, the contribution of milk (at iodine and selenium concentrations measured in the present study) to UK dietary intakes was estimated. The mean ± standard deviation (SD) iodine concentration of milk was 475.9 ± 63.5 µg/kg and the mean selenium concentration of milk was 17.8 ± 2.7 µg/kg. Season had an important determining effect on the iodine, but not the selenium, content of cow’s milk, where iodine concentrations were highest in milk produced in spring compared to autumn months (534.3 ± 53.7 vs. 433.6 ± 57.8 µg/kg, respectively; p = 0.001). The measured iodine and selenium concentrations of NI milk were higher than those listed in current UK Food Composition Databases (Food Standards Agency (FSA) (2002); FSA (2015)). The dietary modelling analysis confirmed that milk makes an important contribution to iodine and selenium intakes. This contribution may be higher than previously estimated if iodine and selenium (+25.0 and +1.1 µg/day respectively) concentrations measured in the present study were replicable across the UK at the current level of milk consumption. Iodine intakes were theoretically shown to vary by season concurrent with the seasonal variation in NI milk iodine concentrations. Routine monitoring of milk iodine concentrations is required and efforts should be made to understand reasons for fluctuations in milk iodine concentrations, in order to realise the nutritional impact to consumers

Leaning in to Address Sleep Disturbances and Sleep Disorders in Department of Defense and Defense Health Agency

Letter to the Editor, Military Medicine, 187, 5/6:155, 202217 USC 105 interim-entered record; under review.The article of record as published may be found at http://dx.doi.org/10.1177/0018720820906050In their article entitled, “Engaging Stakeholders to Optimize Sleep Disorders Management in the U.S. Military: A Qualitative Analysis,” Abdelwadoud and colleagues conducted focus groups of service members, primary care managers (PCMs), and administrative stakeholders about their perceptions, experiences, roles in sleep management, stated education needs, and management of sleep disorders.1 The qualitative methods are rigorous, and the findings reinforce and nuance prior results, especially regarding key requirements from PCMs. We feel compelled, however, to further nuance the authors’ conclusion that “current military sleep management practices are neither satisfactory nor maximally effective” and offer specific examples of actions taken by the Department of Defense (DoD) and Defense Health Agency (DHA) in recognition of the significance of optimal sleep in combat readiness and overall health of service members. We offer here a succinct list of concrete efforts to support and implement substantial clinical, operational, research, or educational efforts by the DoD or DHA to improve sleep in service members and associated clinical challenges in this unique population.Identified in text as U.S. Government work

Habitual intake of flavonoid subclasses and risk of colorectal cancer in two large prospective cohorts

Background: Flavonoids inhibit the growth of colon cancer cells in vitro. In a secondary analysis of a randomized controlled trial, the Polyp Prevention Trial, a higher intake of one sub-class, flavonols, was significantly associated with reduced risk of recurrent advanced adenoma. Most previous prospective studies on colorectal cancer evaluated only a limited number of flavonoid sub-classes and intake ranges, yielding inconsistent results.  Objective: To examine whether higher habitual dietary intakes of flavonoid subclasses (flavonols, flavones, flavanones, flavan-3-ols and anthocyanins) are associated with lower risk of colorectal cancer.  Design: Using data from validated food frequency questionnaires administered every four years and an updated flavonoid food composition database flavonoid intakes were calculated for 42,478 male participants from the Health Professionals Follow-up Study and for 76,364 female participants from the Nurses’ Health Study.  Results: During up to 26 years of follow-up, 2,519 colorectal cancer cases (1,061 in men, 1,458 in women) were documented. Intakes of flavonoid subclasses were not associated with risk of colorectal cancer in either cohort. Pooled multivariable adjusted relative risks (95% confidence interval) comparing the highest with the lowest quintile were 1.04 (0.91, 1.18) for flavonols; 1.01 (0.89, 1.15) for flavones; 0.96 (0.84, 1.10) for flavanones; 1.07 (0.95, 1.21) for flavan-3-ols; and 0.98 (0.81, 1.19) for anthocyanins (all p-values for heterogeneity by sex >0.19). In subsite analyses, flavonoid intake was also not associated with colon or rectal cancer risk.  Conclusion: Our findings do not support the hypothesis that a higher habitual intake of any flavonoid sub-class decreases the risk of colorectal cancer

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

Improving access for community health and sub-acute outpatient services: protocol for a stepped wedge cluster randomised controlled trial

BACKGROUND: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional &quot;waitlist and triage&quot; model known as STAT (Specific Timely Appointments for Triage) may be successful in reducing waiting times without adversely affecting other aspects of patient care. This trial aims to test whether the model is cost effective in reducing waiting time across multiple services, and to measure the impact on service provision, health-related quality of life and patient satisfaction. METHODS/DESIGN: A stepped wedge cluster randomised controlled trial has been designed to evaluate the impact of the STAT model in 8 community health and outpatient services. The primary outcome will be waiting time from referral to first appointment. Secondary outcomes will be nature and quantity of service received (collected from all patients attending the service during the study period and health-related quality of life (AQOL-8D), patient satisfaction, health care utilisation and cost data (collected from a subgroup of patients at initial assessment and after 12&nbsp;weeks). Data will be analysed with a multiple multi-level random-effects regression model that allows for cluster effects. An economic evaluation will be undertaken alongside the clinical trial. DISCUSSION: This paper outlines the study protocol for a fully powered prospective stepped wedge cluster randomised controlled trial (SWCRCT) to establish whether the STAT model of access and triage can reduce waiting times applied across multiple settings, without increasing health service costs or adversely impacting on other aspects of patient care. If successful, it will provide evidence for the effectiveness of a practical model of access that can substantially reduce waiting time for outpatient and community services with subsequent benefits for both efficiency of health systems and patient care.<br /