Urban green space and mental well-being of Aotearoa New Zealand adolescents : A path analysis

Background Growing evidence shows the positive influence of neighbourhood green space on mental well-being among adults through multiple health behaviours, but similar studies are lacking for adolescents. Methods Data were drawn from the 2019 wave of the Youth2000 survey series in Aotearoa, New Zealand with secondary school students (aged 10-19 years) from the city of Tamaki Makaurau, Auckland. Emotional well-being was measured with the World Health Organization-5 Well-being Index, and depressive symptoms were assessed using the Reynolds Adolescent Depression Scale-short form. Neighbourhood green space was assessed using three different measures: percentage of green space, Normalised Difference Vegetation Index (NDVI) and the distance to nearest green space from place of residence. Exposure areas of these measures were calculated using Euclidean buffers of 100m, 300m, 800m and 1600m around participants’ meshblock residential addresses. Three mediating (physical activity, social cohesion, sleep) and ten control variables (in adjusted models) were included in path analysis to test the direct and indirect relationships between green space and adolescent mental well-being. Results In unadjusted models, percentage of green space had a negative relationship with emotional well-being, and inconsistent effects of NDVI were detected in different buffers. Minor indirect effects of physical activity and sleep were also found. Depressive symptoms and emotional well-being were more strongly related to other individual and neighbourhood factors (e.g., neighbourhood deprivation). After adjusting for control variables, no significant associations of green space with adolescent depressive symptoms and emotional well-being were identified. Conclusions Urban neighbourhood green space does not appear to be a dominant factor contributing to adolescent mental well-being through physical activity, social cohesion and sleep. Appropriate individual and environmental control variables are needed to take into consideration in future studies that explore the green space-mental well-being relationships in adolescents

Dating of Bruises in Children: An Assessment of Physician Accuracy

Dating of Bruises in Methods. Children who presented to the emergency department of a children's hospital with accidental bruises of known age and origin had demographic data and information about their injury recorded. Historyblinded emergency pediatricians, other physicians, and trainees (fellows, residents, and medical students) independently examined the bruised area and recorded injury characteristics and age estimation and ranked characteristics that influenced their estimation. Results. Fifty children with accidental bruises were enrolled. Emergency pediatricians' accuracy of age estimation within 24 hours of actual age was 47.6%. Individual emergency pediatrician's accuracy ranged from 0% to 100%, and the interobserver reliability was poor ( ‫؍‬ ؊0.03). Accuracy within 24 hours of actual age was 29.4% for other physicians and 36.8% for trainees, which was similar to the emergency pediatricians. Observers reported using color primarily to estimate age, followed by tenderness and then swelling; however, none of these factors was significantly correlated with accuracy. Conclusions. Physician estimates of bruise age are highly inaccurate within 24 hours of the actual age of the injury. Large individual variability and poor interrater reliability also suggest that caution must be used when interpreting these estimates. This study supports earlier studies, urging extreme caution in estimating bruise age, even when such estimates are based on direct examination of the injured area. Pediatrics 2003;112:804 -807; children, bruising, abuse, emergency

Identifying Geographic Areas at Risk of Soil-transmitted Helminthes Infection Using Remote Sensing and Geographical Information Systems: Boaco, Nicaragua as a Case Study

Several types of intestinal nematodes, that can infect humans and specially school-age children living in poverty, develop part of their life cycle in soil. Presence and survival of these parasites in the soil depend on given environmental characteristics like temperature and moisture that can be inferred with remote sensing (RS) technology. Prevalence of diseases caused by these parasitic worms can be controlled and even eradicated with anthelmintic drug treatments and sanitation improvement. Reliable and updated identification of geographic areas at risk is required to implement effective public health programs; to calculate amount of drug required and to distribute funding for sanitation projects. RS technology and geographical information systems (GIS) will be used to analyze for associations between in situ prevalence and remotely sensed data in order to establish RS proxies of environmental parameters that indicate the presence of these parasits. In situ data on helminthisasis will be overlaid over an ecological map derived from RS data using ARC Map 9.3 (ESRI). Temperature, vegetation, and distance to bodies of water will be inferred using data from Moderate-Resolution Imaging Spectroradiometer (MODIS) and Landsat TM and ETM+. Elevation will be estimated with data from The Shuttle Radar Topography Mission (SRTM). Prevalence and intensity of infections are determined by parasitological survey (Kato Katz) of children enrolled in rural schools in Boaco, Nicaragua, in the communities of El Roblar, Cumaica Norte, Malacatoya 1, and Malacatoya 2). This study will demonstrate the importance of an integrated GIS/RS approach to define clusters and areas at risk. Such information will help to the implementation of time and cost efficient control programs and sanitation efforts

Thyroid storm associated with Graves' disease covered by diabetic ketoacidosis: A case report

<p>Abstract</p> <p>Background</p> <p>Thyroid storm is a condition in which multiple organ dysfunction results from failure of the compensatory mechanisms of the body owing to excessive thyroid hormone activity induced by some factors in patients with thyrotoxicosis. While diabetic ketoacidosis (DKA) is an important trigger for thyroid storm, simultaneous development of DKA and thyroid storm is rare.</p> <p>Case presentation</p> <p>A 59-year-old woman with no history of either diabetes mellitus or thyroid disease presented to our hospital because of developing nausea, vomiting and diarrhea for 2 days. Physical examination showed mild disturbance of consciousness, fever, and tachycardia. There were no other signs of thyrotoxicosis. Laboratory studies revealed elevation of random blood glucose and glycosylated hemoglobin, strongly positive of urine acetone, and metabolic acidosis. Since DKA was diagnosed, we initiated the patient on treatment with administration of insulin and adequate fluid replacement. Although the hyperglycemia and acidosis were immediately relieved, the disturbance of consciousness and tachycardia remained persistent. Levels of FT3 and FT4 were extremely high and TSH was below the detectable limit. TRAb was positive. The thyroid storm score of Burch & Wartofsky was 75/140, and the thyroid storm diagnostic criteria of the Japan Thyroid Association were satisfied. Oral administration of thiamazole, potassium iodide and propranolol resulted in immediate relief of the tachycardia.</p> <p>Discussion</p> <p>We encountered a case of thyroid storm associated with Graves' disease covered by DKA. Thyroid storm and DKA are both potentially fatal, and the prognosis varies depending on whether or not these conditions are detected and treated sufficiently early. The thyroid storm diagnostic criteria prepared in 2008 by the Japan Thyroid Association are very simple as compared to the Burch & Wartofsky scoring system for thyroid storm. The Japanese criteria may be useful in the diagnosis of this condition since they enable clinicians to identify a broad range of cases with thyroid storm. When dealing with cases of DKA or thyroid storm, it seems essential to bear in mind the possibility of the coexistence of these two diseases.</p

Unexpected behaviors in molecular transport through size-controlled nanochannels down to the ultra-nanoscale

Ionic transport through nanofluidic systems is a problem of fundamental interest in transport physics and has broad relevance in desalination, fuel cells, batteries, filtration, and drug delivery. When the dimension of the fluidic system approaches the size of molecules in solution, fluid properties are not homogeneous and a departure in behavior is observed with respect to continuum-based theories. Here we present a systematic study of the transport of charged and neutral small molecules in an ideal nanofluidic platform with precise channels from the sub-microscale to the ultra-nanoscale (<5 nm). Surprisingly, we find that diffusive transport of nano-confined neutral molecules matches that of charged molecules, as though the former carry an effective charge. Further, approaching the ultra-nanoscale molecular diffusivities suddenly drop by up to an order of magnitude for all molecules, irrespective of their electric charge. New theoretical investigations will be required to shed light onto these intriguing results