Application of an indoor air pollution metamodel to a spatially-distributed housing stock

Estimates of population air pollution exposure typically rely on the outdoor component only, and rarely account for populations spending the majority of their time indoors. Housing is an important modifier of air pollution exposure due to outdoor pollution infiltrating indoors, and the removal of indoor-sourced pollution through active or passive ventilation. Here, we describe the application of an indoor air pollution modelling tool to a spatially distributed housing stock model for England and Wales, developed from Energy Performance Certificate (EPC) data and containing information for approximately 11.5 million dwellings. First, we estimate indoor/outdoor (I/O) ratios and total indoor concentrations of outdoor air pollution for PM2.5 and NO2 for all EPC dwellings in London. The potential to estimate concentration from both indoor and outdoor sources is then demonstrated by modelling indoor background CO levels for England and Wales pre- and post-energy efficient adaptation, including heating, cooking, and smoking as internal sources. In London, we predict a median I/O ratio of 0.60 (99% CIs; 0.53–0.73) for outdoor PM2.5 and 0.41 (99%CIs; 0.34–0.59) for outdoor NO2; Pearson correlation analysis indicates a greater spatial modification of PM2.5 exposure by housing (ρ = 0.81) than NO2 (ρ = 0.88). For the demonstrative CO model, concentrations ranged from 0.4–9.9 ppm (99%CIs)(median = 3.0 ppm) in kitchens and 0.3–25.6 ppm (median = 6.4 ppm) in living rooms. Clusters of elevated indoor concentration are found in urban areas due to higher outdoor concentrations and smaller dwellings with reduced ventilation potential, with an estimated 17.6% increase in the number of living rooms and 63% increase in the number of kitchens exceeding recommended exposure levels following retrofit without additional ventilation. The model has the potential to rapidly calculate indoor pollution exposure across large housing stocks and estimate changes to exposure under different pollution or housing policy scenarios

Neighborhood disparities in stroke and myocardial infarction mortality: a GIS and spatial scan statistics approach

<p>Abstract</p> <p>Background</p> <p>Stroke and myocardial infarction (MI) are serious public health burdens in the US. These burdens vary by geographic location with the highest mortality risks reported in the southeastern US. While these disparities have been investigated at state and county levels, little is known regarding disparities in risk at lower levels of geography, such as neighborhoods. Therefore, the objective of this study was to investigate spatial patterns of stroke and MI mortality risks in the East Tennessee Appalachian Region so as to identify neighborhoods with the highest risks.</p> <p>Methods</p> <p>Stroke and MI mortality data for the period 1999-2007, obtained free of charge upon request from the Tennessee Department of Health, were aggregated to the census tract (neighborhood) level. Mortality risks were age-standardized by the direct method. To adjust for spatial autocorrelation, population heterogeneity, and variance instability, standardized risks were smoothed using Spatial Empirical Bayesian technique. Spatial clusters of high risks were identified using spatial scan statistics, with a discrete Poisson model adjusted for age and using a 5% scanning window. Significance testing was performed using 999 Monte Carlo permutations. Logistic models were used to investigate neighborhood level socioeconomic and demographic predictors of the identified spatial clusters.</p> <p>Results</p> <p>There were 3,824 stroke deaths and 5,018 MI deaths. Neighborhoods with significantly high mortality risks were identified. Annual stroke mortality risks ranged from 0 to 182 per 100,000 population (median: 55.6), while annual MI mortality risks ranged from 0 to 243 per 100,000 population (median: 65.5). Stroke and MI mortality risks exceeded the state risks of 67.5 and 85.5 in 28% and 32% of the neighborhoods, respectively. Six and ten significant (p < 0.001) spatial clusters of high risk of stroke and MI mortality were identified, respectively. Neighborhoods belonging to high risk clusters of stroke and MI mortality tended to have high proportions of the population with low education attainment.</p> <p>Conclusions</p> <p>These methods for identifying disparities in mortality risks across neighborhoods are useful for identifying high risk communities and for guiding population health programs aimed at addressing health disparities and improving population health.</p

Effect of compost-, sand-, or gypsum-amended waste foundry sands on turfgrass yield and nutrient content

To prevent the 7 to 11 million metric tons of waste foundry sand (WFS) produced annually in the USA from entering landfi lls, current research is focused on the reuse of WFSs as soil amendments. Th e eff ects of diff erent WFS-containing amendments on turfgrass growth and nutrient content were tested by planting perennial ryegrass (Lolium perenne L.) and tall fescue (Schedonorus phoenix (Scop.) Holub) in diff erent blends containing WFS. Blends of WFS were created with compost or acid-washed sand (AWS) at varying percent by volume with WFS or by amendment with gypsum (9.6 g gypsum kg–1 WFS). Measurements of soil strength, shoot and root dry weight, plant surface coverage, and micronutrients (Al, Fe, Mn, Cu, Zn, B, Na) and macronutrients (N, P, K, S, Ca, Mg) were performed for each blend and compared with pure WFS and with a commercial potting media control. Results showed that strength was not a factor for any of the parameters studied, but the K/Na base saturation ratio of WFS:compost mixes was highly correlated with total shoot dry weight for perennial ryegrass (r = 0.995) and tall fescue (r = 0.94). Th is was further substantiated because total shoot dry weight was also correlated with shoot K/Na concentration of perennial ryegrass (r = 0.99) and tall fescue (r = 0.95). A compost blend containing 40% WFS was determined to be the optimal amendment for the reuse of WFS because it incorporated the greatest possible amount of WFS without major reduction in turfgrass growth

The PRO-AGE study: an international randomised controlled study of health risk appraisal for older persons based in general practice

BACKGROUND: This paper describes the study protocol, the recruitment, and base-line data for evaluating the success of randomisation of the PRO-AGE (PRevention in Older people – Assessment in GEneralists' practices) project. METHODS/DESIGN: A group of general practitioners (GPs) in London (U.K.), Hamburg (Germany) and Solothurn (Switzerland) were trained in risk identification, health promotion, and prevention in older people. Their non-disabled older patients were invited to participate in a randomised controlled study. Participants allocated to the intervention group were offered the Health Risk Appraisal for Older Persons (HRA-O) instrument with a site-specific method for reinforcement (London: physician reminders in electronic medical record; Hamburg: one group session or two preventive home visits; Solothurn: six-monthly preventive home visits over a two-year period). Participants allocated to the control group received usual care. At each site, an additional group of GPs did not receive the training, and their eligible patients were invited to participate in a concurrent comparison group. Primary outcomes are self-reported health behaviour and preventative care use at one-year follow-up. In Solothurn, an additional follow-up was conducted at two years. The number of older persons agreeing to participate (% of eligible persons) in the randomised controlled study was 2503 (66.0%) in London, 2580 (53.6%) in Hamburg, and 2284 (67.5%) in Solothurn. Base-line findings confirm that randomisation of participants was successful, with comparable characteristics between intervention and control groups. The number of persons (% of eligible) enrolled in the concurrent comparison group was 636 (48.8%) in London, 746 (35.7%) in Hamburg, and 1171 (63.0%) in Solothurn. DISCUSSION: PRO-AGE is the first large-scale randomised controlled trial of health risk appraisal for older people in Europe. Its results will inform about the effects of implementing HRA-O with different methods of reinforcement

Combinations of motor measures more strongly predict adverse health outcomes in old age: the rush memory and aging project, a community-based cohort study

<p>Abstract</p> <p>Objective</p> <p>Motor impairment in old age is a growing public-health concern, and several different constructs have been used to identify motor impairments in older people. We tested the hypothesis that combinations of motor constructs more strongly predict adverse health outcomes in older people.</p> <p>Methods</p> <p>In total, 949 people without dementia, history of stroke or Parkinson's disease, who were participating in the Rush Memory and Aging Project (a longitudinal community-based cohort study), underwent assessment at study entry. From this, three constructs were derived: 1) physical frailty based on grip strength, timed walk, body mass index and fatigue; 2) Parkinsonian Signs Score based on the modified motor section of the Unified Parkinson's Disease Rating Scale; and 3) a motor construct, based on nine strength measures and nine motor performances. Disability and cognitive status were assessed annually. A series of Cox proportional-hazards models, controlling for age, sex and education, were used to examine the association of each of these three constructs alone and in various combinations with death, disability and Alzheimer's disease (AD).</p> <p>Results</p> <p>All three constructs were related (mean <it>r </it>= 0.50, all <it>P </it>< 0.001), and when considered individually in separate proportional-hazards models, were associated with risk of death, incident disability and AD. However, when considered together, combinations of these constructs more strongly predicted adverse health outcomes.</p> <p>Conclusions</p> <p>Physical frailty, parkinsonian signs score and global motor score are related constructs that capture different aspects of motor function. Assessments using several motor constructs may more accurately identify people at the highest risk of adverse health consequences in old age.</p

A school-based resilience intervention to decrease tobacco, alcohol and marijuana use in high school students

<p>Abstract</p> <p>Background</p> <p>Despite schools theoretically being an ideal setting for accessing adolescents and preventing initiation of substance use, there is limited evidence of effective interventions in this setting. Resilience theory provides one approach to achieving such an outcome through improving adolescent mental well-being and resilience. A study was undertaken to examine the potential effectiveness of such an intervention approach in improving adolescent resilience and protective factor scores; and reducing the prevalence of adolescent tobacco, alcohol and marijuana use in three high schools.</p> <p>Methods</p> <p>A non-controlled before and after study was undertaken. Data regarding student resilience and protective factors, and measures of tobacco, alcohol and marijuana use were collected from grade 7 to 10 students at baseline (n = 1449) and one year following a three year intervention (n = 1205).</p> <p>Results</p> <p>Significantly higher resilience and protective factors scores, and significantly lower prevalence of substance use were evident at follow up.</p> <p>Conclusions</p> <p>The results suggest that the intervention has the potential to increase resilience and protective factors, and to decrease the use of tobacco, alcohol and marijuana by adolescents. Further more rigorous research is required to confirm this potential.</p

Ovicidal Activity of Organophosphate, Oxadiazine, Neonicotinoid and Insect Growth Regulator Chemistries on Northern Strain Plum Curculio, Conotrachelus nenuphar

An in vitro method was developed for assessing ovicidal effects of the organophosphate azinphos-methyl, the neonicotioids thiacloprid, thiamethoxam and clothianidin, the oxadiazine indoxacarb and the insect growth regulators novaluron and pyriproxifen on the plum curculio, Conotrachelus nenuphar (Herbst)(Coleoptera: Curculionidae). The baseline survivorship of this method was 88 percent. Plum curculio eggs were most sensitive to azinphos-methyl. Thiacloprid, clothianidin and the chitin synthesis inhibitor, novaluron, had LC50 values below 100 ppm. Thiamethoxam, indoxacarb and pyriproxifen were not ovicidal at 100 ppm. Octanol-water partitioning coefficients, log Kow, appeared to be an important indicator of ovicidal activity within the neonicotinoids. This new bioassay method eliminates the confounding of the insect-chemical and plant-chemical interactions and the results highlight the utility of a post-infestation curative approach to plum curculio management