Review of Pesticide Urinary Biomarker Measurements from Selected US EPA Children’s Observational Exposure Studies

Children are exposed to a wide variety of pesticides originating from both outdoor and indoor sources. Several studies were conducted or funded by the EPA over the past decade to investigate children’s exposure to organophosphate and pyrethroid pesticides and the factors that impact their exposures. Urinary metabolite concentration measurements from these studies are consolidated here to identify trends, spatial and temporal patterns, and areas where further research is required. Namely, concentrations of the metabolites of chlorpyrifos (3,5,6-trichloro-2-pyridinol or TCPy), diazinon (2-isopropyl-6-methyl-4-pyrimidinol or IMP), and permethrin (3-phenoxybenzoic acid or 3-PBA) are presented. Information on the kinetic parameters describing absorption and elimination in humans is also presented to aid in interpretation. Metabolite concentrations varied more dramatically across studies for 3-PBA and IMP than for TCPy, with TCPy concentrations about an order of magnitude higher than the 3-PBA concentrations. Temporal variability was high for all metabolites with urinary 3-PBA concentrations slightly more consistent over time than the TCPy concentrations. Urinary biomarker levels provided only limited evidence of applications. The observed relationships between urinary metabolite levels and estimates of pesticide intake may be affected by differences in the contribution of each exposure route to total intake, which may vary with exposure intensity and across individuals

Diskrepans mellan vårdbehov och erhållen vård : Remitterade ambulansuppdrag mellan primärvård och akutsjukhus. En registerstudie.

Hälso- och sjukvårdens mål anger riktningen för god vård, att i varje vårdmöte bedöma och hänvisa patienten till ändamålsenlig vård på ett patientsäkert och effektivt sätt. Målet är att den vård som ges ska stödja hälsa och välbefinnande och ges på rätt vårdnivå. Tidigare forskning inom ambulanssjukvård har dock påvisat svårigheter med att svara an på patientens rätt till individuell och ändamålsenlig vård. Syftet i föreliggande studie är att undersöka patienters vårdbehov och erhållen vård för de patienter som av primärvårdsläkare remitterats till akutsjukvård och som transporteras med ambulans mellan primärvård och akutsjukhus. Studien genomfördes i en ambulansorganisation i Västsverige under 2018, som en retrospektiv journalgranskningsstudie med kvantitativ deskriptiv ansats. Journalerna valdes slumpmässigt. Resultatet påvisar att det finns en diskrepans mellan vårdbehovet och erhållen vård för patienter som av primärvårdsläkare remitterats till akutsjukvård och som transporteras med ambulans mellan primärvård och akutsjukhus. Det visade sig att ett fåtal patienter var i behov av ambulanssjukvårdens kompetens och resurser, medan majoriteten hade kunnat få en mer ändamålsenlig vård inom primärvård. Resurserna nyttjas inte på ett optimalt sätt för vård på rätt nivå, då patienter transporteras i ambulans utan vårdbehov. Nuvarande prioriteringar avseende vårdkedjan vårdcentral-larmcentral-ambulans-sjukhus är ett hot mot patientsäkerheten, samhällsekonomin och miljön. Studiens kliniska implikationer rekommenderar gemensam vårdutveckling för primärvård och akutsjukvård, till exempel transportordinationer, en vård med patientperspektiv och samsyn som motverkar stuprörsorganisationer

The translocation of rabbits in a sand dune habitat: survival, dispersal and predation in relation to food quality and the use of burrows

A decrease in a local rabbit (Oryctolagus cuniculus) population can be offset by translocation and restocking the area with rabbits from other areas. However, such translocation programmes tend to suffer from a low survival rate - possibly due to stress and lack of cover. As part of a project, that sought to evaluate the potential of translocating rabbits in Dutch coastal dune areas, we were able to compare the movements of resident rabbits with those of translocated rabbits. This was the first such experiment in the Netherlands. Mortality during the translocation process was minimised by reducing stress during the trapping, handling and transportation. However, following the rabbits’ release there was a high mortality from fox predation in the first week. We tested for other factors that could influence the outcome of the experiment such as the quality of food in the new habitat and immunity to RHD. Most of the translocated rabbits left the artificial burrows for unused natural burrows during the first night. They continued to use several burrows throughout the study. We conclude that this should not be interpreted as a lack of settling, but as a behaviour which is adapted to sandy dunes: rabbits will naturally use more than one burrow where sufficient burrows are available.

Commercial farmers’ strategies to control water resources in South Africa : an empirical view of reform

This article shows how large-scale commercial farmers, individually and collectively, are responding to land and water reform processes in the Thukela River basin, KwaZulu-Natal, South Africa. With a high degree of innovative agency, commercial farmers have effectively executed four strategies, enabling them to adapt and use their access to resources to neutralize multiple water reform efforts that once promised to be catalysts for inclusive change in the post-apartheid era. It is likely that policy alone will not facilitate the envisioned transformation, if local practices are not sufficiently understood and anticipated by the governmental officials charged with the implementation of water reform processes

Bilateral vessel-outlining carotid artery calcifications in panoramic radiographs : an independent risk marker for vascular events

BACKGROUND: In odontology, panoramic radiographs (PRs) are regularly performed. PRs depict the teeth and jaws as well as carotid artery calcifications (CACs). Patients with CACs on PRs have an increased risk of vascular events compared to healthy controls without CACs, but this association is often caused by more vascular events and risk factors at baseline. However, the risk of vascular events has only been analyzed based on the presence of CACs, and not their shape. Thus, this study determined if the shape of CACs in PRs affects the risk of future vascular events. METHODS: The study cohort included 117 consecutive patients with CACs in PRs and 121 age-matched controls without CACs. CAC shape in PRs was dichotomized into bilateral vessel-outlining CACs and other CAC shapes. Participants were followed prospectively for an endpoint of vascular events including myocardial infarction, stroke, and vascular death. RESULTS: Patients with bilateral vessel-outlining CACs had more previous vascular events than those with other CAC shapes and the healthy controls (p < 0.001, χ2). The mean follow-up duration was 9.5 years. The endpoint was reached in 83 people. Patients with bilateral vessel-outlining CACs had a higher annual risk of vascular events (7.0%) than those with other CAC shapes (4.4%) and the controls (2.6%) (p < 0.001). In multivariate analysis, bilateral vessel-outlining CACs (hazard ratio: 2.2, 95% confidence interval: 1.1-4.5) were independent risk markers for the endpoint. CONCLUSIONS: Findings of bilateral vessel-outlining CACs in PRs are independent risk markers for future vascular events

Increasing transfers-out from an antiretroviral treatment service in South Africa: patient characteristics and rates of virological non-suppression.

OBJECTIVES: To determine the proportion, characteristics and outcomes of patients who transfer-out from an antiretroviral therapy (ART) service in a South African township. METHODS: This retrospective cohort study included all patients aged ≥15 years who enrolled between September 2002 and December 2009. Follow-up data were censored in December 2010. Kaplan-Meier survival analysis was used to describe time to transfer-out and cox proportional hazard analysis was used to determine associated risk factors. RESULTS: 4511 patients (4003 ART-naïve and 508 non-naïve at baseline) received ART during the study period. Overall, 597 (13.2%) transferred out. The probability of transferring out by one year of ART steadily increased from 1.4% in 2002/2004 cohort to 8.9% for the 2009 cohort. Independent risk factors for transfer-out were more recent calendar year of enrolment, younger age (≤25 years) and being ART non-naïve at baseline (i.e., having previously transferred into this clinic from another facility). The proportions of patients transferred out who had a CD4 cell count 1000 copies/mL around the time of transfer, suggesting the need for careful adherence counseling and assessment of medication supplies among those planning transfer