Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water

Background While previous research has suggested that there is an association between fluoride ingestion and the incidence of hypothyroidism, few population level studies have been undertaken. In England, approximately 10% of the population live in areas with community fluoridation schemes and hypothyroidism prevalence can be assessed from general practice data. This observational study examines the association between levels of fluoride in water supplies with practice level hypothyroidism prevalence. Methods We used a cross-sectional study design using secondary data to develop binary logistic regression models of predictive factors for hypothyroidism prevalence at practice level using 2012 data on fluoride levels in drinking water, 2012/2013 Quality and Outcomes Framework (QOF) diagnosed hypothyroidism prevalence data, 2013 General Practitioner registered patient numbers and 2012 practice level Index of Multiple Deprivation scores. Findings We found that higher levels of fluoride in drinking water provide a useful contribution for predicting prevalence of hypothyroidism. We found that practices located in the West Midlands (a wholly fluoridated area) are nearly twice as likely to report high hypothyroidism prevalence in comparison to Greater Manchester (non-fluoridated area). Interpretation In many areas of the world, hypothyroidism is a major health concern and in addition to other factors—such as iodine deficiency—fluoride exposure should be considered as a contributing factor. The findings of the study raise particular concerns about the validity of community fluoridation as a safe public health measure

Engagement in agriculture protects against food insecurity and malnutrition in peri-urban Nepal

BACKGROUND: Urbanization is occurring rapidly in many low- and middle-income countries, which may affect households’ livelihoods, diet, and food security and nutritional outcomes. OBJECTIVE: The main objective of our study was to explore whether agricultural activity amongst a peri-urban population in Nepal was associated with better or worse food household security, household and maternal dietary diversity, and nutritional outcomes for children and women. METHODS: A cross-sectional survey administered to 344 mother-child pairs in Bhaktapur district, Nepal, including data on household agricultural practices, livestock ownership, food security, dietary diversity and expenditures, anthropometric measurements of children (aged 5–6 years old), maternal body mass index (BMI), and maternal anemia. Multivariable adjusted and unadjusted odds ratios (AOR and OR respectively) were calculated using logistic regression. RESULTS: Our findings suggest that in this sample, cultivation of land was associated with a lower odds of child stunting (AOR 0.55, 95% CI 0.33,0.93) and household food insecurity (AOR 0.33, 95% CI 0.18, 0.63), but not low (or high) maternal BMI or anemia. Livestock ownership (mostly chickens) was associated with lower of food insecurity (AOR 0.34, 95% CI 0.16, 0.73) but not with nutrition outcomes. Women in farming households were significantly more likely to eat green leafy vegetables than women in non-farming households, and children living in households that grew vegetables had a lower odds of stunting than children in households that cultivated land but did not grow vegetables (AOR 0.49, 95% CI 0.25, 0.98). CONCLUSIONS: Our study suggests that households involved in cultivation of land in peri-urban Bhaktapur had lower odds of children's stunting and of food insecurity than non-cultivating households – and that vegetable consumption is higher among those households. Given Nepal's rapid urbanization rate, more attention is needed to the potential role of peri-urban agriculture in shaping diets and nutrition.Funding was provided by the USAID Feed the Future Security Innovation Lab for Nutrition - Asia [award number AIDOAA-l-10-00005] through a sub-contract to the Harvard T.H. Chan School of Public Health and the Johns Hopkins Bloomberg School of Public Health from the Friedman School of Nutrition Science and Policy, Tufts University; and by the GC Rieber Foundation.https://academic.oup.com/cdn/advance-article/doi/10.1093/cdn/nzy078/5154906Accepted manuscrip

Improving democratic governance through institutional design: civic participation and democratic ownership in Europe

In this article we provide a conceptual and argumentative framework for studying how institutional design can enhance civic participation and ultimately increase citizens’ sense of democratic ownership of governmental processes. First, we set out the socio-political context for enhancing the democratic governance of regulatory policies in Europe, and highlight the way in which civic participation and democratic ownership is given equal weight to economic competitiveness. We then discuss the potential for institutionalised participatory governance to develop and their prospects for improving effective and democratic governance in the multi-layered European polity. The article concludes by outlining a research agenda for the field and identifying the priorities for scholars working in interaction with civil society and governments

'Digital by Default' and the 'hard to reach': Exploring solutions to digital exclusion in remote rural areas

Williams, F., Philip, L., Fairhurst, G., & Farrington, J. (2016). ‘Digital by Default’ and ‘the hard to reach’: exploring solutions to digital exclusion in remote rural areas. Local Economy, 31(7), 757-777. DOI: 10.1177/0269094216670938. Copyright © 2016 SAGE. Reprinted by permission of SAGE Publications.In the UK, the geography of Information and Communication Technology (ICT) infrastructure required for Internet connectivity is such that high speed broadband and mobile phone networks are generally less available in rural areas compared with urban areas or, in other words, as remoteness and population sparsity increase so too does the likelihood of an area having no or very poor broadband connectivity. Against a policy backdrop of UK Government efforts to bring forward network infrastructure upgrades and to improve the accessibility of broadband services in locations where there is a weak commercial investment case, this paper considers the options for the ‘final few’ in the prevailing ‘Digital by Default’ public services context. The paper outlines the Rural Public Access WiFi Services project, a study focused upon enabling Internet connectivity for commercially ‘hard to reach’ rural areas in the UK. The Rural Public Access WiFi Services concept and the experiment are introduced before findings from a pilot deployment of a broadband service to households in a remote rural area, who may be classified as ‘digitally excluded’, are presented. The paper then reflects on our field experiment and the potential of the Rural Public Access WiFi Services model as a solution to overcoming some of the digital participation barriers manifest in the urban–rural divide. Early indications show that the Rural Public Access WiFi Services model has the potential to encourage participation in the Digital Economy and could aid the UK Government’s Digital by Default agenda, although adoption of the model is not without its challenges

Hen Harrier Circus cyaneus nest sites on the Isle of Mull are associated with habitat mosaics and constrained by topography

This is an Accepted Manuscript of an article published by Taylor & Francis in Bird Study on 07/02/2018, available online: http://www.tandfonline.com/doi/full/10.1080/00063657.2017.1421611Capsule: Hen Harrier on the Isle of Mull, UK, are associated with habitat mosaics consisting of moorland, scrub and forestry but avoid grazed land, suggesting that forested habitats could be managed sympathetically for Hen Harrier in the future should the current UK population increase. Aims: To use distribution modelling to investigate nesting habitat associations using a long term dataset for Hen Harrier on Mull. Methods: We develop area-interaction models using a LASSO penalty to explore the distribution of 102 Hen Harrier nest sites in relation to habitat and topography. Our model is then successfully validated in tests using data for 70 nest sites from subsequent years. Results: Our model is effective in predicting suitable areas for Hen Harrier nest sites and indicates that Hen Harriers on Mull are found in habitat mosaics below 200 m asl. Hen Harrier nest intensity is positively associated with increasing proportions of moorland and scrub, open canopy forestry and closed canopy forestry. Nest intensity is negatively associated with increasing proportions of grazed land. Conclusion: Hen Harrier avoid grazed areas but are relatively tolerant of other habitat combinations. These findings are supported by previous observations of Hen Harrier habitat use and have implications for the recovery of some Hen Harrier SPA populations and future forest management. Open canopy forest and forest mosaics could potentially be incorporated into landscape-scale conservation plans for Hen Harriers using the population in Mull as an example

Report to the president of Oregon State University

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Experiments on torrefied wood pellet: study by gasification and characterization for waste biomass to energy applications

Samples of torrefied wood pellet produced by low-temperature microwave pyrolysis were tested through a series of experiments relevant to present and near future waste to energy conversion technologies. Operational performance was assessed using a modern small-scale downdraft gasifier. Owing to the pellet's shape and surface hardness, excellent flow characteristics were observed. The torrefied pellet had a high energy density, and although a beneficial property, this highlighted the present inflexibility of downdraft gasifiers in respect of feedstock tolerance due to the inability to contain very high temperatures inside the reactor during operation. Analyses indicated that the torrefaction process had not significantly altered inherent kinetic properties to a great extent; however, both activation energy and pre-exponential factor were slightly higher than virgin biomass from which the pellet was derived. Thermogravimetric analysis-derived reaction kinetics (CO2 gasification), bomb calorimetry, proximate and ultimate analyses, and the Bond Work Index grindability test provided a more comprehensive characterization of the torrefied pellet's suitability as a fuel for gasification and also other combustion applications. It exhibited significant improvements in grindability energy demand and particle size control compared to other non-treated and thermally treated biomass pellets, along with a high calorific value, and excellent resistance to water

Penal reform in Africa: The case of prison chaplaincy

Penal reform is a challenge across the world. In Africa, those who are incarcerated are especially vulnerable and often deprived of basic human rights. Prison conditions are generally dire, resources are limited, and at times undue force is used to control inmates. The public attitude towards offenders is also not encouraging. Reform efforts include finding alternative ways of sentencing such as community service, making use of halfway houses and reducing sentences. These efforts have not yet yielded the desired results. The four principles of retribution, deterrence, incapacitation and rehabilitation guide penal practice in Africa. Retribution and rehabilitation stand in tension. Deterrence and incapacitation aim at forcing inmates to conform to the social order. The article argues that prison chaplaincy can make a valuable contribution to restoring the dignity and humanity of those who are incarcerated. Chaplaincy can contribute to improving attitudes and practices in the penal system and society. In addition to the social objective of rehabilitation, prison ministry can, on a spiritual level, also facilitate repentance, forgiveness and reconciliation. The aim is the holistic restoration of human beings

Service user engagement in healthcare education as a mechanism for value based recruitment: An evaluation study

Within the United Kingdom (UK) there is an increasing focus on Values Based Recruitment (VBR) of staff working in the National Health Service (NHS) in response to public inquiries criticising the lack of person-centred care. All NHS employees are recruited on the basis of a prescribed set of values. This is extended to the recruitment of student healthcare professionals, yet there is little research of how to implement this. Involving Service Users in healthcare educational practice is gaining momentum internationally, yet involvement of service users in VBR of ‘would be’ healthcare professionals remains at an embryonic phase. Adult nurses represent the largest healthcare workforce in the UK, yet involvement of service users in their recruitment has received scant attention. This paper is an evaluation of the inclusion of service users in a VBR of 640 adult student nurses