Devolution and the regional health divide: a longitudinal ecological study of 14 countries in Europe.

Greater regional devolution can reduce economic inequalities between regions; however, the impact on health inequalities is not clear. We investigated the association between changes over time in the level of devolution in European countries and regional economic and health inequalities. We used the proportion of government expenditure controlled by subnational levels of government as our measure of devolution in 14 European countries between 1995 and 2011. Fixed effects linear regression models were used to analyse trends in the level of devolution, trends in regional economic inequalities (Gini-coefficient) and trends in regional health inequalities (slope index) in life expectancy. Each additional percentage of government expenditure managed at subnational level reduced the Gini-coefficient of regional GDP by -0.17 points (95% CI: -0.33 to -0.01; P = 0.04). However, it increased the slope index of regional life expectancy by 23 days (95% CI: -2 to 48; P = 0.07). When trends in regional economic inequalities were controlled for, as a potential mediator-increased devolution-was significantly associated with an increase in health inequalities between regions (P = 0.01). Increased devolution does not appear to reduce regional health inequalities-even when it reduces regional economic inequalities-and it could be associated with increased health inequalities

Network modelling for road-based fecal sludge management

Improvements in the collection and treatment of sewage are critical to reduce health and environmental hazards in rapidly urbanising informal settlements. Where sewerage infrastructure is not available, road-based faecal sludge management options are often the only alternative. However, the costs of faecal sludge transportation are often a barrier to its implementation and operation and thus it is desirable to optimise travel time from source to treatment to reduce costs. This paper presents a novel technique, employing spatial network analysis, to optimise the spatiotopological configuration of a road-based faecal sludge transportation network on the basis of travel time. Using crowd-sourced spatial data for the Kibera settlement and the surrounding city, Nairobi, a proof-of-concept network model was created simulating the transport of waste from the 158 public toilets within Kibera. The toilets are serviced by vacuum pump trucks which move faecal sludge to a transfer station, and from there a tanker transports waste to a treatment plant. The model was used to evaluate the efficiency of different network configurations, based on transportation time. The results show that the location of the transfer station is a critical factor in network optimisation, demonstrating the utility of network analysis as part of the sanitation planning process

A Single Dose of Nicotine Enhances Reward Responsiveness in Nonsmokers: Implications for Development of Dependence

Background: Tobacco smoking, driven by the addictive properties of nicotine, is the most prevalent preventable cause of death in the Western world. Accumulated evidence suggests that nicotine may increase appetitive responding for nondrug incentives in the environment. Methods: To test this hypothesis, we conducted a randomized, double-blind, placebo-controlled, crossover study of the effect of a single dose of transdermal nicotine on reward responsiveness in 30 psychiatrically healthy nonsmokers. A novel signal detection task in which correct responses were differentially rewarded in a 3:1 ratio was used to assess the extent to which participants modulated their behavior as a function of reward. Results: Despite expected adverse effects such as nausea, nicotine significantly increased response bias toward the more frequently rewarded condition, at the expense of accuracy, independent of effects on attention or overall vigilance. Additionally, response bias on placebo was greater in participants who received nicotine in the first session, indicating that an effect of nicotine on reward responsiveness or reward-based learning persisted for at least 1 week. Conclusions: These findings suggest that a single dose of nicotine enhances response to non-drug-related rewards in the environment, with lasting effects. This effect may contribute to reinforcement of early smoking behavior and development of nicotine dependence.Psycholog

Physical health disparities and severe mental illness: A longitudinal comparative cohort study using hospital data in Northern Ireland

Abstract Background People with severe mental illness (SMI) die prematurely, mostly due to preventable causes. Objective To examine multimorbidity and mortality in people living with SMI using linked administrative datasets. Method Analysis of linked electronically captured routine hospital administrative data from Northern Ireland (2010–2021). We derived sex-specific age-standardised rates for seven chronic life-limiting physical conditions (chronic kidney disease, malignant neoplasms, diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, myocardial infarction, and stroke) and used logistic regression to examine the relationship between SMI, socio-demographic indicators, and comorbid conditions; survival models quantified the relationship between all-cause mortality and SMI. Results Analysis was based on 929,412 hospital patients aged 20 years and above, of whom 10,965 (1.3%) recorded a diagnosis of SMI. Higher likelihoods of an SMI diagnosis were associated with living in socially deprived circumstances, urbanicity. SMI patients were more likely to have more comorbid physical conditions than non-SMI patients, and younger at referral to hospital for each condition, than non-SMI patients. Finally, in fully adjusted models, SMI patients had a twofold excess all-cause mortality. Conclusion Multiple morbidities associated with SMI can drive excess mortality. While SMI patients are younger at referral to treatment for these life-limiting conditions, their relatively premature death suggests that these conditions are also quite advanced. There is a need for a more aggressive approach to improving the physical health of this population

Greenland tidewater glacier advanced rapidly during era of Norse Settlement

ACKNOWLEDGMENTS We thank the Greenland Institute of Natural Resources for providing logistical support in Nuuk. Martin Blicher, Thomas Juul-Pedersen, and Johanne Vad are thanked for their research and field assistance. We acknowledge the support of the National Museum of Greenland for permission to undertake excavations near Norse ruin sites (permit 2015/03). Project funding was provided by the Leverhulme Trust Research Project grant 2014-093, and J.M. Lea was supported by funding from the Quaternary Research Association, British Society for Geomorphology, and a UK Research and Innovation (UKRI) Future Leaders Fellowship (MR/S017232/1). We thank two anonymous reviewers and the editor for constructive comments, which helped to substantially improve this paper. D.M. Pearce would like to dedicate this paper to her father Richard M. Pearce.Peer reviewedPostprin

2018 GJMPP Monograph Series: Grace Jordan McFadden Professors Program

The Grace Jordan McFadden Professors Program (GJMPP), formerly the African American Professors Program (AAPP)/Carolina Diversity Professors Program (CDPP) at the University of South Carolina, is honored to publish its seventeenth edition of this annual monograph series. GJMPP recognizes the significance of offering its scholars a venue through which they have the opportunity to engage in research and to publish their refereed papers that continually contribute to their respective academic areas. Parallel with the publication of their manuscripts is a venue to gain visibility among colleagues throughout postsecondary institutions at national and international levels. Scholars who have contributed papers for this monograph are acknowledged for embracing the value of including this responsibility within their doctoral milieu. Writing across disciplines adds broadly to the intellectual diversity of these manuscripts. From neophytes to quite experienced individuals, the chapters have been researched and written with vigor. Founded in 1997 through the Department of Educational Leadership and Policies in the College of Education, AAPP was designed originally to address the under-representation of African American professors on college and university campuses. Its mission is to expand the pool of these professors in critical academic and research areas. Sponsored historically by the University of South Carolina, the W. K. Kellogg Foundation, and the South Carolina General Assembly, the program recruits doctoral students for disciplines in which African Americans and others are underrepresented among faculty in higher education. The continuation of this monograph series is seen as responding to a window of opportunity to be sensitive to an academic expectation of graduates as they pursue career placement and, at the same time, to allow for the dissemination of products of scholarship to a broader community. The importance of this series has been voiced by one of our 2002 AAPP graduates, Dr. Shundelle LaTjuan Dogan, formerly an Administrative Fellow at Harvard University, a Program Officer for the Southern Education Foundation, and a Program Officer for the Arthur M. Blank Foundation in Atlanta, Georgia. She recently completed an appointment as Corporate Citizenship and Corporate Affairs Manager for IBM International Business Machines in Atlanta and is currently a consultant with a focus on philanthropy and social impact. She is currently Assistant Vice President for Social Impact and Innovation at Emory University. Dr. Dogan has written an impressive Foreword for the 2014 monograph. In a personal letter, which is cited in an earlier monograph, Dr. Dogan penned: “One thing in particular that I want to thank you for is having the African American Professors Program scholars publish articles for the monograph. I have to admit that writing the articles seemed like extra work at the time. However, in my recent interview process, organizations have asked me for samples of my writing. Including an article from a published monograph helped to make my portfolio much more impressive. You were ‘right on target’ in having us do the monograph series” (AAPP 2003, Monograph, p. xi). The Grace Jordan McFadden Professors Program purports to advance the tradition of spearheading international scholarship in higher education as evidenced through inspiration from this group of interdisciplinary manuscripts. I hope that you will envision these published papers to serve as an invaluable contribution to your own professional and career enhancement. John McFadden, PhD The Benjamin Elijah Mays Distinguished Professor Emeritus Director, Grace Jordan McFadden Professors Program University of South Carolina Columbia, South Carolinahttps://scholarcommons.sc.edu/mcfadden_monographs/1010/thumbnail.jp

Network modelling for road-based Faecal Sludge Management

Improvements in the collection and treatment of sewage are critical to reduce health and environmental hazards in rapidly-urbanising informal settlements. Where sewerage infrastructure is not available, road-based Fecal Sludge Management options are often the only alternative. However, the costs of fecal sludge transportation are often a barrier to their implementation and operation and thus it is desirable to optimise travel time from source to treatment to reduce costs. This paper presents a novel technique, employing spatial network analysis, to optimise the spatio-topological configuration of a road-based fecal sludge transportation network on the basis of travel time. Using crowd-sourced spatial data for the Kibera settlement and the surrounding city, Nairobi, a proof-of-concept network model was created simulating the transport of waste from the 158 public toilets within Kibera. The toilets are serviced by vacuum pump trucks which move fecal sludge to a transfer station from where a tanker transports waste to a treatment plant. The model was used to evaluate the efficiency of different network configurations, based on transportation time. The results show that the location of the transfer station is a critical factor in network optimisation, demonstrating the utility of network analysis as part of the sanitation planning process

Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities

Minority ethnic groups have been disproportionately affected by the COVID-19 pandemic. While the exact reasons for this remain unclear, they are likely due to a complex interplay of factors rather than a single cause. Reducing these inequalities requires a greater understanding of the causes. Research to date, however, has been hampered by a lack of theoretical understanding of the meaning of “ethnicity” (or race) and the potential pathways leading to inequalities. In particular, quantitative analyses have often adjusted away the pathways through which inequalities actually arise (i.e. mediators for the effect of interest), leading to the effects of social processes, and particularly structural racism, becoming hidden. In this paper, we describe a framework for understanding the pathways that have generated ethnic (and racial) inequalities in COVID-19. We suggest that differences in health outcomes due to the pandemic could arise through six pathways: 1) differential exposure to the virus; 2) differential vulnerability to infection/disease; 3) differential health consequences of the disease; 4) differential social consequences of the disease; 5) differential effectiveness of pandemic control measures; and 6) differential adverse consequences of control measures. Current research provides only a partial understanding of some of these pathways. Future research and action will require a clearer understanding of the multiple dimensions of ethnicity and an appreciation of the complex interplay of social and biological pathways through which ethnic inequalities arise. Our framework highlights the gaps in the current evidence and pathways that need further investigation in research that aims to address these inequalities