Too hot to thrive: a qualitative inquiry of community perspectives on the effect of high ambient temperature on postpartum women and neonates in Kilifi, Kenya

Objective: To understand community perspectives on the effects of high ambient temperature on the health and wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi. Design: Qualitative study using key informant interviews, in-depth interviews and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16). Settings: We conducted our research in Kilifi County in Kenya’s Coast Province. The area is largely rural and during summer, air temperatures can reach 37˚C and rarely go below 23˚C. Data analysis: Data were analyzed in NVivo 12, using both inductive and deductive approaches. Results: High ambient temperature is perceived by community members to have direct and indirect health pathways in pregnancy and postpartum periods, including on the neonates. The direct impacts include injuries on the neonate’s skin and in the mouth, leading to discomfort and affecting breastfeeding and sleeping. Participants described babies as “having no peace”. Heat effects were perceived to be amplified by indoor air pollution and heat from indoor cooking fires. Community members believed that exclusive breastfeeding was not practical in conditions of extreme heat because it lowered breast milk production, which was, in turn, linked to a low scarcity of food and time spend by mothers away from their neonates performing household chores. Kangaroo Mother Care (KMC) was also negatively affected. Participants reported that postpartum women took longer to heal in the heat, were exhausted most of the time and tended not to attend postnatal care. Conclusions: High ambient temperatures affect postpartum women and their neonates through direct and indirect pathways. Discomfort makes it difficult for the mother to care for the baby. Multi-sectoral policies and programs are required to mitigate the negative impacts of high ambient temperatures on maternal and neonatal health in rural Kilifi and similar settings

Glatiramer acetate reduces the risk for experimental cerebral malaria: a pilot study

<p>Abstract</p> <p>Background</p> <p>Cerebral malaria (CM) is associated with high mortality and morbidity caused by a high rate of transient or persistent neurological sequelae. Studies on immunomodulatory and neuroprotective drugs as ancillary treatment in murine CM indicate promising potential. The current study was conducted to evaluate the efficacy of glatiramer acetate (GA), an immunomodulatory drug approved for the treatment of relapsing remitting multiple sclerosis, in preventing the death of C57Bl/6J mice infected with <it>Plasmodium berghei </it>ANKA.</p> <p>Methods and Results</p> <p>GA treatment led to a statistically significant lower risk for developing CM (57.7% versus 84.6%) in treated animals. The drug had no effect on the course of parasitaemia. The mechanism of action seems to be an immunomodulatory effect since lower IFN-gamma levels were observed in treated animals in the early course of the disease (day 4 post-infection) which also led to a lower number of brain sequestered leukocytes in treated animals. No direct neuro-protective effect such as an inhibition of apoptosis or reduction of micro-bleedings in the brain was found.</p> <p>Conclusion</p> <p>These findings support the important role of the host immune response in the pathophysiology of murine CM and might lead to the development of new adjunctive treatment strategies.</p

Fine-mapping the HOXB region detects common variants tagging a rare coding allele: evidence for synthetic association in prostate cancer.

The HOXB13 gene has been implicated in prostate cancer (PrCa) susceptibility. We performed a high resolution fine-mapping analysis to comprehensively evaluate the association between common genetic variation across the HOXB genetic locus at 17q21 and PrCa risk. This involved genotyping 700 SNPs using a custom Illumina iSelect array (iCOGS) followed by imputation of 3195 SNPs in 20,440 PrCa cases and 21,469 controls in The PRACTICAL consortium. We identified a cluster of highly correlated common variants situated within or closely upstream of HOXB13 that were significantly associated with PrCa risk, described by rs117576373 (OR 1.30, P = 2.62×10(-14)). Additional genotyping, conditional regression and haplotype analyses indicated that the newly identified common variants tag a rare, partially correlated coding variant in the HOXB13 gene (G84E, rs138213197), which has been identified recently as a moderate penetrance PrCa susceptibility allele. The potential for GWAS associations detected through common SNPs to be driven by rare causal variants with higher relative risks has long been proposed; however, to our knowledge this is the first experimental evidence for this phenomenon of synthetic association contributing to cancer susceptibility

Environment and Health Perspectives

Key messages Major environment-related health concerns in the pan-European region continue to be linked to poor air and water quality, hazardous chemicals, and noise. These are often interconnected through common driving forces or pressures. The burden of ill health attributable to environmental causes is much higher in EECCA and SEE than in WCE. One reason for this is the coexistence and combination of 'traditional' (e.g. unsafe water and sanitation) and 'modern' (e.g. urban air pollution, chemicals) hazards. Responses to environment-related health challenges in Europe at the international, regional and national level are improving. International action plans focus on children's health and reducing the burden of environment-related health problems in this vulnerable group. However, for many health hazards, actions lag well behind policies. The health toll of natural disasters such as violent storms, floods, heatwaves, landslides and droughts is being exacerbated by urbanisation, deforestation and climate change, and lack of preparedness. Although cause and effect relationships are hard to establish, there appear to be a number of associations between outdoor and indoor air pollution, water and soil contamination, hazardous chemicals and noise and respiratory and cardiovascular diseases, cancer, asthma, allergies, as well as disorders of reproductive and neuro-developmental systems. There is growing concern about adverse impacts of exposures to low levels of chemicals, often in complex mixtures. Several adult diseases are suggested to be linked to exposure in very early childhood or exposure of parents before conception. Persistent chemicals with long-term effects, and those used in long-life articles, may present risks even after their production has been phased out. Human health impacts of soil degradation across Europe are currently difficult to estimate. Efforts to achieve the sustainable use of soil will also have positive impacts on human health and quality of life.JRC.H.ADV01-Adviso

ECVAM Key Area Ecotoxicology: Summary of Activities and Future Perspectives

The European Centre for Validation of Alternative Methods (ECVAM) is part of the European Commission and is responsible for the development and validation of methods which would reduce, refine and replace (3Rs) the use of animals for the safety testing of chemicals and other products. ECVAM¿s activities in ecotoxicology started 2001 with a workshop on ¿The use of fish cells in ecotoxicology¿ (Castaño et al. (2003). ATLA 31, 317¿351) followed by the establishment of a ECVAM Taskforce Ecotoxicology composed by Commission and Non-commission experts giving scientific advice on 3Rs methods and testing strategies. The approaches focus on acute aquatic toxicity and bioaccumulation being the two endpoints in the regulatory framework (e.g. REACH, agrochemicals, pharmaceuticals), which use large numbers of fish. Thus, the threshold approach, a reduction strategy for acute aquatic toxicity testing recently approved by the ECVAM Scientific Advisory Committee (ESAC) has the potential to reduce the number of fish by 50%. Its implementation is discussed at European Union and OECD level. In partnership with regulatory bodies, industry and academia ECVAM is involved in various projects aiming at the complete replacement of the acute fish test using a testing strategy based on fish cells and fish embryos. ECVAM collaborates with ILSI HESI on reducing the number of fish in bioaccumulation testing and will launch a study evaluating the use of in vitro methods for this purpose. More information on ECVAM: [email protected]

Environment and Human Health in Europe

In 2010, the comprehensive European environment state and outlook report (EEA, 2010d) showed that environmental policies have delivered substantial progress in improving the state of the environment in Europe. However, it also stressed that major environmental challenges remain. Water and air pollution have declined but not enough to achieve good ecological quality in all water bodies or to ensure good air quality in all urban areas. Widespread exposure to multiple pollutants and chemicals and concerns about long-term damage to human health together imply the need for more integral and precautionary approaches. Given the complex links between environmental challenges, identification of environmental risks to human health and well-being should go beyond immediate and individual health impacts of a few well-known stressors. Multiple exposures, long-term impacts, inequalities and resource use patterns should also be addressed. It is in this context that this EEA-JRC reference report on Environment and Health has been produced. It tries to capture the most pertinent environmental problems and their policy implications, as identified and addressed in on-going work at the JRC and EEA.JRC.H-Institute for Environment and Sustainability (Ispra