EXPLORING THE POSSIBILITY FOR A PERVASIVE TECHNOLOGY SOLUTION TO FACILITATE EFFECTIVE DIABETES SELF-CARE FOR PATIENTS WITH GDM

Gestational diabetes(GDM) is increasing exponentially. To address this, we contend that a pervasive mobile solution that can facilitate self-care is a prudent strategy. To demonstrate proof of concept, user fidelity, usability and acceptability of such a solution a small pilot study of 10 patients was designed. A quasi-experimental approach employing a randomized control trial with a two period cross-over clinical trial strategy over 10 week duration at a private hospital in Melbourne, Australia was adopted. The main outcomes of interest were to establish proof of concept and the fidelity of the technology solution. Directional data gathered including patient and clinical interview data serve to demonstrate both proof of concept and fidelity. Without exception both patients and clinicians have preferred the pervasive mobile solution to the standard care approach. The study serves to highlight that pervasive mobile solutions can provide a useful adjunct in the effective monitoring and management of GDM.

Environmental Injustice in North Carolina's Hog Industry

Rapid growth and the concentration of hog production in North Carolina have raised concerns of a disproportionate impact of pollution and offensive odors on poor and nonwhite communities. We analyzed the location and characteristics of 2,514 intensive hog operations in relation to racial, economic, and water source characteristics of census block groups, neighborhoods with an average of approximately 500 households each. We used Poisson regression to evaluate the extent to which relationships between environmental justice variables and the number of hog operations persisted after consideration of population density. There are 18.9 times as many hog operations in the highest quintile of poverty as compared to the lowest; however, adjustment for population density reduces the excess to 7.2. Hog operations are approximately 5 times as common in the highest three quintiles of the percentage nonwhite population as compared to the lowest, adjusted for population density. The excess of hog operations is greatest in areas with both high poverty and high percentage nonwhites. Operations run by corporate integrators are more concentrated in poor and nonwhite areas than are operations run by independent growers. Most hog operations, which use waste pits that can contaminate groundwater, are located in areas with high dependence on well water for drinking. Disproportionate impacts of intensive hog production on people of color and on the poor may impede improvements in economic and environmental conditions that are needed to address public health in areas which have high disease rates and low access to medical care as compared to other areas of the state.ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure

Election commentaries

Introduction - Richard Crisp and Will Eadson. Crisis? What crisis? Housing policies from the main parties in England, Scotland and Wales for the 2015 general election - Ian Cole. Peering beyond the cliff-edge: what role for the voluntary sector in post-election United Kingdom? - Chris Dayson. Urban planning dilemmas: where next? - Karen Escott. Regional development: a casualty of the general election? - Steve Fothergill. The 2015 general election and the impending crisis in local public services - Tony Gore. Migration policy: stuck in a rut? David Robinso

Missing Doses in the Life Span Study of Japanese Atomic Bomb Survivors

The Life Span Study of atomic bomb survivors is an important source of risk estimates used to inform radiation protection and compensation. Interviews with survivors in the 1950s and 1960s provided information needed to estimate radiation doses for survivors proximal to ground zero. Because of a lack of interview or the complexity of shielding, doses are missing for 7,058 of the 68,119 proximal survivors. Recent analyses excluded people with missing doses, and despite the protracted collection of interview information necessary to estimate some survivors' doses, defined start of follow-up as October 1, 1950, for everyone. We describe the prevalence of missing doses and its association with mortality, distance from hypocenter, city, age, and sex. Missing doses were more common among Nagasaki residents than among Hiroshima residents (prevalence ratio = 2.05; 95% confidence interval: 1.96, 2.14), among people who were closer to ground zero than among those who were far from it, among people who were younger at enrollment than among those who were older, and among males than among females (prevalence ratio = 1.22; 95% confidence interval: 1.17, 1.28). Missing dose was associated with all-cancer and leukemia mortality, particularly during the first years of follow-up (all-cancer rate ratio = 2.16, 95% confidence interval: 1.51, 3.08; and leukemia rate ratio = 4.28, 95% confidence interval: 1.72, 10.67). Accounting for missing dose and late entry should reduce bias in estimated dose-mortality associations

Social regulation of gene expression in human leukocytes

Analysis of differentially expressed in circulating leukocytes from people who chronically experienced high versus low levels of subjective social isolation (loneliness) revealed over-expression of some anti-inflammatory genes and under-expression of some pro-inflammatory genes

Development of an operational, risk-based approach to surface water flood forecasting

Surface water flooding occurs regularly across England and Wales, especially during the summer months. It is widely acknowledged that surface water flooding presents a particular challenge to forecasters because of the difficulties inherent in forecasting intense localised rainfall and the highly complex runoff and drainage processes which operate at the surface, particularly in urban areas. The Flood Forecasting Centre (FFC) has a responsibility to provide guidance on the risk of surface water flooding to Category 1 and 2 responders across England and Wales. Consequently, there is the requirement for improved methods for forecasting surface water flood risk and the FFC is currently involved in developing and trialling a novel surface water flood forecasting system, the Surface Water Flooding Hazard Impact Model (SWF HIM). The SWF HIM offers significant advances over existing surface water flood forecasting methods used by the FFC, including provision of a risk-based approach. The SWF HIM links probabilistic runoff forecasts from the Centre for Ecology & Hydrology’s Grid-to-Grid model with a library of pre-calculated surface water impact information compiled by the Health and Safety Laboratory. These probabilistic runoff forecasts are combined with impact information to provide a forecast of surface water flood risk at a 1km2 resolution across England and Wales. This presentation outlines the methodology together with some initial results from the trial. The work has been undertaken as part of the UK’s Natural Hazards Partnership (NHP) and also benefits from the close working relationship between the Environment Agency and the Met Office through the FFC

Adversity in early life and pregnancy are immunologically distinct from total life adversity: macrophage-associated phenotypes in women exposed to interpersonal violence

Early childhood and pregnancy are two sensitive periods of heightened immune plasticity, when exposure to adversity may disproportionately increase health risks. However, we need deeper phenotyping to disentangle the impact of adversity during sensitive periods from that across the total lifespan. This study examined whether retrospective reports of adversity during childhood or pregnancy were associated with inflammatory imbalance, in an ethnically diverse cohort of 53 low-income women seeking family-based trauma treatment following exposure to interpersonal violence. Structured interviews assessed early life adversity (trauma exposure ≤ age 5), pregnancy adversity, and total lifetime adversity. Blood serum was assayed for pro-inflammatory (TNF-a, IL-1ß, IL-6, and CRP) and anti-inflammatory (IL-1RA, IL-4, and IL-10) cytokines. CD14+ monocytes were isolated in a subsample (n = 42) and gene expression assayed by RNA sequencing (Illumina HiSeq 4000; TruSeq cDNA library). The primary outcome was a macrophage-associated M1/M2 gene expression phenotype. To evaluate sensitivity and specificity, we contrasted M1/M2 gene expression with a second, clinically-validated macrophage-associated immunosuppressive phenotype (endotoxin tolerance) and with pro-inflammatory and anti-inflammatory cytokine levels. Adjusting for demographics, socioeconomic status, and psychopathology, higher adversity in early life (ß = .337, p = 0.029) and pregnancy (ß = .332, p = 0.032) were each associated with higher M1/M2 gene expression, whereas higher lifetime adversity (ß = −.341, p = 0.031) was associated with lower immunosuppressive gene expression. Adversity during sensitive periods was uniquely associated with M1/M2 imbalance, among low-income women with interpersonal violence exposure. Given that M1/M2 imbalance is found in sepsis, severe COVID-19 and myriad chronic diseases, these findings implicate novel immune mechanisms underlying the impact of adversity on health.publishedVersio