Have health inequalities changed during childhood in the New Labour generation? Findings from the UK Millennium Cohort Study

Objectives: To examine how population-level socioeconomic health inequalities developed during childhood, for children born at the turn of the 21st century and who grew up with major initiatives to tackle health inequalities (under the New Labour Government). Setting The UK. Participants: Singleton children in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) years. Primary outcomes: Relative (prevalence ratios (PR)) and absolute health inequalities (prevalence differences (PD)) were estimated in longitudinal models by socioeconomic circumstances (SEC; using highest maternal academic attainment, ranging from ‘no academic qualifications’ to ‘degree’ (baseline)). Three health outcomes were examined: overweight (including obesity), limiting long-standing illness (LLSI), and socio-emotional difficulties (SED). Results: Relative and absolute inequalities in overweight, across the social gradient, emerged by age 5 and increased with age. By age 11, children with mothers who had no academic qualifications were considerably more likely to be overweight as compared with those with degree-educated mothers (PR=1.6 (95% CI 1.4 to 1.8), PD=12.9% (9.1% to 16.8%)). For LLSI, inequalities emerged by age 7 and remained at 11, but only for children whose mothers had no academic qualifications (PR=1.7 (1.3 to 2.3), PD=4.8% (2% to 7.5%)). Inequalities in SED (observed across the social gradient and at all ages) declined between 3 and 11, although remained large at 11 (eg, PR=2.4 (1.9 to 2.9), PD=13.4% (10.2% to 16.7%) comparing children whose mothers had no academic qualifications with those of degree-educated mothers). Conclusions: Although health inequalities have been well documented in cross-sectional and trend data in the UK, it is less clear how they develop during childhood. We found that relative and absolute health inequalities persisted, and in some cases widened, for a cohort of children born at the turn of the century. Further research examining and comparing the pathways through which SECs influence health may further our understanding of how inequalities could be prevented in future generations of children

Effects of child long-term illness on maternal employment: longitudinal findings from the UK Millennium Cohort Study

Background: Maternal employment has increased in European countries, but levels of employment are lower among mothers whose children have a limiting long-term illness or disability. However, we do not know whether having a child with a limiting illness prevents take-up or maintenance of paid employment or whether ‘common causes’, such as lack of qualifications or maternal disability lead to both maternal unemployment and childhood illness. Longitudinal data have the potential to distinguish between these. Methods: We analyzed four waves (3, 5, 7 and 11 years) of the Millennium Cohort Study (MCS) to examine the relationship between childhood limiting illness and maternal employment, unadjusted and adjusted for covariates. Multinomial regression models were used to test the association between child illness and trajectories of maternal employment. Fixed effects models assessed whether a new report of a child illness increased the odds of a mother exiting employment. Results: At every wave, maternal employment was more likely if the child did not have a limiting illness. After adjustment for covariates, childhood illness was associated with risks of continuous non-employment (adjusted Relative Risk Ratio = 1.46 [Confidence Interval: 1.21, 1.76]) or disrupted employment (aRRR = 1.26 [CI: 1.06, 1.49]), compared with entering or maintaining employment. If a child developed a limiting long-term illness, the likelihood of their mother exiting employment increased (adjusted Odds Ratio = 1.27 [CI: 1.05, 1.54]). Conclusions: ‘Common causes’ did not fully account for the association between child illness and maternal employment. Having a child with a limiting illness potentially reduces maternal employment opportunities

The 29 July 1994 Merritt Island, Fl Microburst: A Case Study Intercomparing Kennedy Space Center Three-Dimensional Lightning Data (LDAR) and WSR-88D Radar Data

Many researchers have shown that the development and evolution of electrical discharges within convective clouds is fundamentally related to the growth and dynamics of precipitation particles aloft. In the presence of strong updrafts above the freezing level collisions among mixed-phase particles (i.e., hail. ice, supercooled water) promote the necessary charge separation needed to initiate intra-cloud lightning. A precipitation core that descends below the freezing level is often accompanied by a change in the electrical structure of the cloud. Consequently, more Cloud-to-Ground (CG) than Intra-Cloud (IC) lightning flashes appear. Descending precipitation cores can also play a significant role in the evolution of mesoscale features at the surface (e.g., microbursts, downbursts) because of latent heat and mass loading effects of water and ice. For this reason, some believe that lightning and microbursts are fundamentally linked by the presence of ice particles in thunderstorms. Several radar and lightning studies of microburst thunderstorms from COHMEX in 1986 showed that the peak IC lightning systematically occurred ten minutes before the onset of a microburst. In contrast, most CG lightning occurred at the time of the microburst. Many of the preceding studies have been done using high-resolution research radars and experimental lightning detection systems in focused field projects. In addition, these studies could only determine the vertical origin or occurrence of IC lightning, and not a true three-dimensional representation. Currently, the WSR-88D radar system and a real-time, state-of-the-art lightning system (LDAR) at the Kennedy Space Center (KSC) in Florida provide an opportunity to extend these kinds of studies in a more meaningful operational setting

Temporal effects of maternal psychological distress on child mental health problems at ages 3, 5, 7 and 11: analysis from the UK Millennium Cohort Study

Background: Psychological distress is common among women of childbearing age, and limited longitudinal research suggests prolonged exposure to maternal distress is linked to child mental health problems. Estimating effects of maternal distress over time is difficult due to potential influences of child mental health problems on maternal distress and time-varying confounding by family circumstances. Methods: We analysed the UK Millennium Cohort Study, a nationally representative sample with data collected throughout childhood. Adopting a marginal structural modelling framework, we investigated effects of exposure to medium/high levels of maternal psychological distress (Kessler-6 score 8+) on child mental health problems (Strengths and Difficulties Questionnaire borderline/abnormal behaviour cut-off) using maternal and child mental health data at 3, 5, 7 and 11 years, accounting for the influence of child mental health on subsequent maternal distress, and baseline and time-varying confounding. Results: Prior and concurrent exposures to maternal distress were associated with higher levels of child mental health problems at ages 3, 5, 7 and 11 years. For example, elevated risks of child mental health problems at 11 years were associated with exposure to maternal distress from 3 years [risk ratio (RR) 1.27 (95% confidence interval (CI) 1.08–1.49)] to 11 years [RR 2.15 (95% CI 1.89–2.45)]. Prolonged exposure to maternal distress at ages 3, 5, 7 and 11 resulted in an almost fivefold increased risk of child mental health problems. Conclusions: Prior, concurrent and, particularly, prolonged exposure to maternal distress raises risks for child mental health problems. Greater support for mothers experiencing distress is likely to benefit the mental health of their children

Simulation of associative learning with the replaced elements model

Associative learning theories can be categorised according to whether they treat the representation of stimulus compounds in an elemental or configural manner. Since it is clear that a simple elemental approach to stimulus representation is inadequate there have been several attempts to produce more elaborate elemental models. One recent approach, the Replaced Elements Model (Wagner, 2003), reproduces many results that have until recently been uniquely predicted by Pearce’s Configural Theory (Pearce, 1994). Although it is possible to simulate the Replaced Elements Model using “standard” simulation programs the generation of the correct stimulus representation is complex. The current paper describes a method for simulation of the Replaced Elements Model and presents the results of two example simulations that show differential predictions of Replaced Elements and Pearce’s Configural Theor

Associations between mental health competence and indicators of physical health and cognitive development in eleven year olds: findings from the UK Millennium Cohort Study

Background: Positive mental health may support healthy development in childhood, although few studies have investigated this at a population level. We aimed to construct a measure of mental health competence (MHC), a skills-based assessment of positive mental health, using existing survey items in a representative sample of UK children, and to investigate its overlap with mental health difficulties (MHD), socio-demographic patterning, and relationships with physical health and cognitive development. Methods: We analysed the UK Millennium Cohort Study (MCS) when children were aged 11 years. Maternal (n = 12,082) and teacher (n = 6739) reports of prosocial behaviours (PS) and learning skills (LS) were entered into latent class models to create MHC measures. Using descriptive statistics, we examined relationships between MHC and MHD, and the socio-demographic patterning of MHC. Associations between MHC and physical health and cognitive development were examined with relative risk ratios [RRR] (from multinomial models): BMI status (healthy weight, overweight, obesity); unintentional injuries since age 7 (none, 1, 2+); asthma symptoms (none, 1, 2+); and tertiles of test scores for verbal ability, spatial working memory and risk-taking. Models were adjusted for potential confounding. Results: Four MHC classes were identified [percentages for maternal and teacher reports, respectively]: high MHC (high PS, high LS) [37%; 39%], high-moderate MHC (high PS, moderate LS) [36%; 26%]; moderate MHC (moderate PS, moderate LS) [19%; 19%]; low MHC (moderate PS, low LS) [8%; 16%]. Higher MHC was less common in socially disadvantaged children. While MHC and MHD were associated, there was sufficient separation to indicate that MHC captures more than the absence of MHD. Compared to children with high MHC, those in other MHC classes tended to have poorer physical health and cognitive development, particularly those with low MHC or high-moderate MHC. For example, children with maternal-report Low MHC were more likely to have experienced 2+ unintentional injuries (RRR: 1.5 [1.1–2.1]) and to have lower verbal ability scores (RRR: 2.5 [1.9–3.2]). Patterns of results were similar for maternal- and teacher-report MHC. Conclusion: MHC is not simply the inverse of MHD, and high MHC is associated with better physical health and cognitive development. Findings suggest that interventions to improve MHC may support healthy development, although they require replication

SISTEM PENGOLAHAN AIR ASAM TAMBANG DARI MATERIAL WASTE DAN APLIKASI MODEL ENKAPSULASI PADA BENDUNGAN TSF DI TAMBANG EMAS MARTABE

ABSTRAK Indonesia adalah negara yang kaya akan sumber daya alam, baik berupa sumber daya alam pulih maupun yang tidak pulih. Industri pertambangan adalah salah satu aktivitas yang bergerak dalam  mengolah sumber daya alam yang tidak pulih yang dapat memberikan dampak positif maupun negatif baik dari sisi sosial, ekonomi maupun lingkungan. Air asam tambang adalah salah satu dampak dari industri pertambangan yang harus ditangani secara serius yang terbentuk akibat reaksi mineral sulfida (pirit) dan logam berat yang terpapar ke media air dan udara yang berasal dari batuan yang terbuka pada saat  aktivitas penambangan berlangsung. Sejak tahun 2013, tambang emas Martabe telah menerapkan manajemen air asam tambang (AAT) dalam konstruksi bendungan TSF dengan enkapsulasi sederhana yang dirancang dengan dua kategori utama batuan PAF (Potential Acid Forming) dan NAF (Non Acid Forming) sebagai bagian dari material tanggul TSF konstruksi hilir dan juga mengembangkan basis data karakteristik geokimia material waste di lokasi tambang emas Martabe. NAPP (Net Acid Production Potential) adalah metode standar industri yang digunakan untuk menentukan potensi untuk mengoksidasi dan menghasilkan bahan limbah asam, yang nantinya akan ditempatkan di bendungan TSF dengan metode enkapsulasi. Metode ini bertujuan untuk membungkus material sulfida beresiko tinggi yang sedang di tambang di Martabe dengan lapisan penyegel (sealing layer) dengan mengambil keuntungan dari iklim (curah hujan yang tinggi) dan sifat material ROM (run of mine). Konstruksi lapisan penyegelan dan penjadwalan material waste dilakukan dengan pengembangan strategi operasional pengelolaan limbah yang terperinci dan terintegrasi. Monitoring rutin dengan instrument WRSF (Waste Rock Storage Facility) untuk pengukuran oksigen dan juga dari pengukuran kualitas air menunjukkan kalau enkapsulasi material waste pada embakment TSF berhasil mencegah pembentukan air asam tambang. Kata kunci: material waste, air asam tambang, naf, paf, bendungan tailing, model enkapsulasi  ABSTRACT Indonesia is a country that is rich in natural resources, both in renewable and non-renewable. The mining industry is one of the activities that is engaged in processing non-renewable natural resources that can have positive and negative impacts both in terms of social, economic and environmental aspects. Acid mine drainage is one of the impacts of the mining industry which must be dealt with seriously which is formed due to the reaction of sulfide minerals (pyrite) and heavy metals which is exposed with water and air from rocks during mining activities.Since 2013, the Martabe gold mine has implemented mine acid drainage management (AMD) in TSF dam construction with simple encapsulation designed, with two main categories of PAF (Potential Acid Forming) and NAF (Non Acid Forming) rocks as part of construction TSF embankment material downstream and also develop the geochemical characteristics database of waste material at the Martabe gold mine site. NAPP (Net Acid Production Potential) value is an industry standard method to determine the potential to oxidize and produce acid waste materials, which will be placed in the TSF dam by encapsulation model. This method aims to wrap the high risk sulfide material in a mine at Martabe sealing layer to take advantage of both the climate (high rai fall) and material properties of run of mine (ROM). The construction of sealing layer and scheduling of waste is made possible by the development a detailed and integrated operational waste management strategy. Routine monitoring with the WRSF (Waste Rock Storage Facility) instrument for measuring oxygen and also from measurements of water quality shows that the encapsulation of waste material in TSF embankments successfully prevents the formation of acid mine drainage.  Key words: waste materials, acid mine drainage, naf, paf, tailing storage facility, encapsulation model

Genetic risk of obesity as a modifier of associations between neighbourhood environment and body mass index: an observational study of 335 046 UK Biobank participants.

BackgroundThere is growing recognition that recent global increases in obesity are the product of a complex interplay between genetic and environmental factors. However, in gene-environment studies of obesity, 'environment' usually refers to individual behavioural factors that influence energy balance, whereas more upstream environmental factors are overlooked. We examined gene-environment interactions between genetic risk of obesity and two neighbourhood characteristics likely to be associated with obesity (proximity to takeaway/fast-food outlets and availability of physical activity facilities).MethodsWe used data from 335 046 adults aged 40-70 in the UK Biobank cohort to conduct a population-based cross-sectional study of interactions between neighbourhood characteristics and genetic risk of obesity, in relation to body mass index (BMI). Proximity to a fast-food outlet was defined as distance from home address to nearest takeaway/fast-food outlet, and availability of physical activity facilities as the number of formal physical activity facilities within 1 km of home address. Genetic risk of obesity was operationalised by weighted Genetic Risk Scores of 91 or 69 single nucleotide polymorphisms (SNP), and by six individual SNPs considered separately. Multivariable, mixed-effects models with product terms for the gene-environment interactions were estimated.ResultsAfter accounting for likely confounding, the association between proximity to takeaway/fast-food outlets and BMI was stronger among those at increased genetic risk of obesity, with evidence of an interaction with polygenic risk scores (p=0.018 and p=0.028 for 69-SNP and 91-SNP scores, respectively) and in particular with a SNP linked to MC4R (p=0.009), a gene known to regulate food intake. We found very little evidence of gene-environment interaction for the availability of physical activity facilities.ConclusionsIndividuals at an increased genetic risk of obesity may be more sensitive to exposure to the local fast-food environment. Ensuring that neighbourhood residential environments are designed to promote a healthy weight may be particularly important for those with greater genetic susceptibility to obesity

What if all children achieved WHO recommendations on physical activity? Estimating the impact on socioeconomic inequalities in childhood overweight in the UK Millennium Cohort Study

Background: The World Health organization (WHO) recommends that children engage in 60 min daily moderate-to-vigorous physical activity (dMVPA). Just half of children in the UK achieve these levels (with similarly low levels in other high-income countries). Thus, the dMVPA target is a focus of national obesity strategies. However, the potential impact of increased physical activity on prevalence and inequalities in childhood overweight is unknown. Using objective data from the Millennium Cohort Study (∼18 000 children born 2000–02) we simulated a series of hypothetical physical activity intervention scenarios: achievement of the target, and more realistic increases demonstrated in trials. Methods: Predicted probabilities of overweight and obesity (using measured heights and weights at age 11) were estimated in multinomial marginal structural models, adjusting for dMVPA (measured with accelerometers at age 7) and confounding. Inequalities were assessed according to household income quintiles [risk ratios (RRs) and risk differences (RDs)]. Intervention scenarios were simulated by re-estimating predicted probabilities of overweight/obesity after manipulating (increasing) dMVPA by varying amounts, for different eligibility criteria and with varying uptake. Analyses included 6493 children with accelerometer data. Survey weights and multiple imputation addressed sampling design, attrition and item missingness. Results: In all, 27% children were overweight/obese, with relative and absolute inequalities in the expected direction; 51% children were achieving 60 min dMVPA, with those from the lowest income quintile achieving, on average, 3 min more dMVPA than those from the highest income quintile. A simulation of universal achievement of the dMVPA target reduced the prevalence of overweight/obesity to 22%, but increased relative inequalities (absolute inequalities were unchanged). Smaller increases in dMVPA (informed by intervention evidence) did little to reduce prevalence or inequalities, even when targeting high-risk groups. Conclusions: Universal achievement of the WHO dMVPA target, if attainable, would reduce prevalence of childhood overweight and obesity but not inequalities. Scale-up of more realistic interventions would have limited impact

Does comorbidity explain the ethnic inequalities in cervical cancer survival in New Zealand? A retrospective cohort study

BACKGROUND: There are large ethnic differences in cervical cancer survival in New Zealand that are only partly explained by stage at diagnosis. We investigated the association of comorbidity with cervical cancer survival, and whether comorbidity accounted for the previously observed ethnic differences in survival. METHODS: The study involved 1,594 cervical cancer cases registered during 1994-2005. Comorbidity was measured using hospital events data and was classified using the Elixhauser instrument; effects on survival of individual comorbid conditions from the Elixhauser instrument were also assessed. Cox regression was used to estimate adjusted cervical cancer mortality hazard ratios (HRs). RESULTS: Comorbidity during the year before diagnosis was associated with cervical cancer-specific survival: those with an Elixhauser count of ≥3 (compared with a count of zero) had a HR of 2.17 (1.32-3.56). The HR per unit of Elixhauser count was 1.25 (1.11-1.40). However, adjustment for the Elixhauser instrument made no difference to the mortality HRs for Māori and Asian women (compared to 'Other' women), and made only a trivial difference to that for Pacific women. In contrast, concurrent adjustment for 12 individual comorbid conditions from the Elixhauser instrument reduced the Māori HR from 1.56 (1.19-2.05) to 1.44 (1.09-1.89), i.e. a reduction in the excess risk of 21%; and reduced the Pacific HR from 1.95 (1.21-3.13) to 1.62 (0.98-2.68), i.e. a reduction in the excess risk of 35%. CONCLUSIONS: Comorbidity is associated with cervical cancer-specific survival in New Zealand, but accounts for only a moderate proportion of the ethnic differences in survival